. Operative gynecology. is impossible to make absolute statements as to the frequency of this con-dition until seiial sections of the entire tube have been cut in a large number ofcases, which has not yet been done; but it probably occurs frequently; has been able to demonstrate this mode of development in four andpossibly five cases out of thirty specimens which he has examined. Accessory Ostia.—The accessory tubal ostia (Kossmann, Zeit. f. ,. Oyn., Bd. xxvii, p. 266) act very much as diverticula by breaking the conti-nuity of the walls of the tube, and thus interfei-ing with
. Operative gynecology. is impossible to make absolute statements as to the frequency of this con-dition until seiial sections of the entire tube have been cut in a large number ofcases, which has not yet been done; but it probably occurs frequently; has been able to demonstrate this mode of development in four andpossibly five cases out of thirty specimens which he has examined. Accessory Ostia.—The accessory tubal ostia (Kossmann, Zeit. f. ,. Oyn., Bd. xxvii, p. 266) act very much as diverticula by breaking the conti-nuity of the walls of the tube, and thus interfei-ing with the normal passage ofthe ovum toward the uterus. This condition explains only the extra-uterinepregnancies, which occur in the ampullar portion of the tube, where accessoryostia are usually found. Inflammatory Affections.—Orthmann and Tait believe that in-flammatory affections of the tube play a most important part in the causation ofextra-uterine pregnancy. Tait thinks that catarrhal salpingitis leads to the pro-. FiQ. 520,—Triple Tubal Ostia. March 8, 1894. No. 202. Natural Size. duction of an extra-iiterine pregnancy by the destruction of the ciliated epithe-lium ; this interferes with the normal downward current of the tubal secretionand allows the entrance of spermatozoa, which then fertilize the ovum vrithinthe tube, where it undergoes its further development. The fallacy of this conception has been demonstrated by A. Martin, and it isgenerally admitted that spermatozoa readily make their way up the tube, inspite of the downward current produced by the cilia, and that fertilizationnearly always occurs in the tube; indeed, the careful examination of inflamedtubes shows that the cilia are rarely destroyed, even in well-marked cases ofpyosalpinx, and are perfectly preserved in cases of catarrhal salpingitis. Whenwe add to this the fact that cilia are readily demonstrated in nearly every caseof tubal pregnancy which has been examined by Dr. Williams or my assistants,it
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectgenitaldiseasesfemal
