Fig. 13. Ovum semi-coriaceum.

(Nine weeks after menstruation?)

The external covering has been laid open. It is thick and fleshy. A second or inner covering is observed equally dense in texture and opaque; and a third involucrum, lying over the secreting membranes, (which are seen through a wide slit, bearing at their upper portion the filiform vessels,) is not only thick, like the second involucrum, but is actually seen passing from the transparent into the dense and opaque texture. The artist has portrayed this circumstance most accurately in his engraving. The placental cotyledons are at the posterior part of the figure, mossy, in groups, and some of them covered with their membrana propria. The embryo of this, and of Ovum 15, are not visible.

There can be little doubt but that intro-uterine inflammation, extended to the involucra of the Ovum, has produced, first, its morbid change of structure, and lastly, its early expulsion from the womb.

Fig. 14. Ovum semi-coriaceum.

(Ten weeks after menstruation?)

This is somewhat larger than the preceding Ovum, although of the same tissue and structure. The withered fœtus is visible through the opening made in the secreting membranes, and the cicatricula may also be perceived on one part of the inner layer of the middle membrane, or involucrum, which lies immediately over the amnion.

I attribute both the structural condition, and the untimely expulsion of the Ovum, to the same causes.

Fig. 15. Ovum omnino opacum, rotundum.

(After the lapse of three menstrual periods?)

The external covering, or cortex, is one twelfth of an inch thick, with an uneven surface, having vascular orifices upon it to the extent of about three fourths of that surface. The rest is smooth, shewing that in that part, the Ovum had not contracted any adhesion, by vascular connexion, to the inner cavity of the womb. That connexion was accomplished by means of the placenta, which is seen at the posterior part of the preparation, and appears quite compact, and one twentieth of an inch thick, judging by the portion which has been purposely laid open. It is through this aperture that the cortex Ovi is seen, as described above. On removing a good portion of this thick cortex, a large cotyledon, or group of vessels belonging to the middle membrane, is exposed to view. The middle membrane itself is seen perfectly transparent, and upon it the cicatricula.

I have been the more particular in designating this Ovum as globular, because the fact of its having such a configuration assists (with other circumstances) in proving that these solid and thick general envelopes, found over human Ova expelled from the sixth to the twelfth, and even fourteenth week, cannot (as pretended by some) be the so called caducous membrane of the womb. We have here a thick and solid shell, perfectly round, closely embracing in every part the lanuginous surface of the Ovum; whereas the cavity of the womb is never otherwise than triangular in its shape, or like unto a congeries of triangular vertical planes, however much the organ itself may be developed. Nor could any membrane (lining such a cavity) in detaching itself from its walls, or falling off during abortion, surround in a globular form, and in so compact a manner, the Ovum, as we see in the present instance. Here again, slow, insidious, persisting inflammatory action, must have done the mischief.

REMARKS.

The three preparations here represented of morbid human Ova, or abortions, are in the museum of St. George’s Hospital, and belong to Sir Charles Clarke’s collection. They admirably illustrate the morbid development of the external involucra. Although the specimens retain scarcely any colour, (as is the case with most of the morbid preparations not injected,) the artist was directed in the choice of the colours applied to his drawings, by recent specimens of analogous abortions, which offered themselves to my attention in the exercise of my profession, during the six years that he was engaged in the present work. I regret that I can procure no data respecting the three abortions delineated in this Plate, nor have I any positive knowledge of their age—but judging of the latter by their appearance and from analogy, I affixed that age to them which seemed to me the most probable.

There are many similar specimens in the museum of the Royal College of Surgeons, and I have seen some in that of Professor Meckel at Halle, and of the late venerable Professor Sœmmering, both of whom honoured me with their friendship. In the first of these three establishments there is a preparation which in many respects resembles Ovum 14. It is marked 3447 and was presented by Mr. Lawrence. Viewed externally, the Ovum in the latter case looks almost sarcomatous. It has a triangular outline with two short prolongations at each of the two upper angles corresponding with the situation of the uterine orifices of the fallopian tubes. The inner or transparent involucra of the Ovum (which is bigeminum) are covered by the cotyledonous prolongations weaved into a general placenta with its membrana propria, and a coriaceous envelope over all. The internal cavity is laid open so as to exhibit an embryo in each half of the Ovum, the one being double the size of the other. The smaller embryo is about as large as a good-sized house-fly. The cord of the largest embryo is nearly an inch and a half long, sacculent, and expanding towards the abdomen so as to form the only covering of that cavity. The cord of the smaller embryo is half an inch in length and filiform.

I have before me two other specimens of the semi-coriaceous Ovum obtained in cases of abortion which occurred in the course of my practice last year: the one in June, the other in December. In the first case the lady had had several live children, and had also miscarried often before. In the second case the lady was primiparous. Both suffered dreadfully—and it is to be remarked, that the pains experienced by the patient during the process of this species of miscarriage is always excessive, and the escape of the Ovum generally followed by violent hemorrhage. Many years ago I succeeded in saving the life of a patient of high rank, then in the country, who was sinking under an almost total loss of blood, consequent on a miscarriage of this kind, in which a large portion of the semi-coriaceous envelopes had remained behind adhering partly to the inner orifice of the womb, thereby producing and keeping up the hemorrhage. In all these cases, the Ovum could not have been in existence more than three months, reckoning from the cessation of the menses. They were all nearly of the same volume, but the size of the fœtus varied in proportion to the greater or less thickness of the envelopes.

On examining that part of the anatomical collection of the Royal College of Physicians, in London, which relates to these subjects, I found a very interesting specimen of the globular and wholly opaque Ovum, marked 7. G. No. 19. All the involucra, without any distinction, adhere together most compactly, so as to form a species of egg-shell of an equal thickness throughout; that thickness being no less than one third of an inch. The Ovum resembles in size a large duck’s egg, though more spherical than the latter.

The inscription on the label is, “A Miscarriage at Six Weeks”, but the embryo appears of no more than four weeks’ growth.