File:The diagnosis of diseases of women (1905) (14740245356).jpg

Identifier: diagnosisofdise00find (find matches)
Title: The diagnosis of diseases of women
Year: 1905 (1900s)
Authors: Findley Palmer. (from old catalog)
Subjects:
Publisher: Philadelphia and New York, Lea brothers & co.
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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ancy. Tuber-culous and puerperal infections of the tube play a less importantbut by no means insignificant role. Erich Opitz detected signs ofinflammation in all of his 23 cases. ^ The author acknowledges his indebtedness to J. Clarence Webster, from whose mono-graph on Ectopic Pregnancy much of the material in this chapter has been taken. (147) 148 SPECIAL DIAGNOSIS II. Essential Cause. While the above conditions are frequentlypresent, it is a matter of common observation that tubal pregnancymay occur in an apparently normal tube. Webster affirms that in ectopic pregnancy there is a geneticreaction in the tube which is essential to the implantation anddevelopment of the ovum in the tube as truly as is a similar geneticreaction in the uterus essential to uterine gestation. This geneticreaction consists in the formation of decidual tissue. It is claimedby Webster that a decidua, however limited, is always to be foundin the pregnant tube. Without a decidua the ovum would find no Fig. 41
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Ectopic gestation in blind accessory fimbriated extremity of the right tube. (Jewett.) abiding place in the tube, even in the presence of the above-namedpredisposing causes. In the event of a decidual formation in thetube these predisposing causes will serve to obstruct the passage ofthe ovum, making possible the implantation of the ovum in thetube rather than in the uterus. Ectopic pregnancy may occur at any time during the period ofsexual maturity, but with the greatest frequency between the ages ofthirty and forty. It is stated that a long period of sterility pre-disposes to ectopic pregnancy, probably because of the existence ofone or more of the above-named predisposing causes. Tubal gesta-tion occurs five times as frequently in multiparae as in primiparse—■ THE DIAGNOSIS OF ECTOPIC PREGNANCY 149 a fact which may again be explained on the ground of the develop-ment of the above predisposing causes. We occasionally seereports of cases in which a second, third, and even fourth

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