Lectures on ectopic pregnancy and pelvic haematocele / by Lawson Tait, F.R.C.S., Edin., & Eng., LL.D.
- Lawson Tait
- Date:
- 1888
Licence: Public Domain Mark
Credit: Lectures on ectopic pregnancy and pelvic haematocele / by Lawson Tait, F.R.C.S., Edin., & Eng., LL.D. Source: Wellcome Collection.
Provider: This material has been provided by University of Bristol Library. The original may be consulted at University of Bristol Library.
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![consideration in the decision of any questions relating either to prognosis or to treatment. Here the views of the process following the primary tubal rupture which I have advocated explain all the difficulties of the situation. Dezeimeris was the first to discover the fact that there was such a thing as a pregnancy under the pelvic peritoneum, though he neither recognised its frequency nor discovered tlie ])rocess by which it was brought about. Rut there was no disputing Dezeimeris' facts, for almost as soon as they were published they were confirmed. As late as 1842 Campbell disputed them, and brought forward the familiar encystment theory as an alternative explanation. In the sous-pcritionco pclvienne, or second variety of Dezeimeris, Campbell says, it is difficult to comprehend how the ovulum can insinuate itself under the peritoneum which is reflected over the organs situated in the brim of the pelvis. Through time, certainly, the connexions of the original cyst with the adjacent parts become so numerous that when superficially considered the ovum may seem to be enveloped by the layers of the broad ligament; but how it can pass under this appendage it is impossible to conceive. But the explanation is now before us, and Dezeimeris' facts have been confirmed by every unprejudiced observer. As we have from this point to deal exclusively with cases in which the direction of rupture has been into the cavity of the broad ligament, I must ask to be excused further re-iteration of the fact, and it must at the same time be taken for granted that when I speak of effusion of blood in connection with these cases, I mean effusion into the broad ligament only—extra-peritoneal hajmatocele. The only exception to this will be when I speak of secondary rupture, by which I mean rupture of the broad ligament, distended as the result of the primary rupture and its resulting lijemorrhage, as in Nonat's case (p. 32), or in the case just alluded to, as so misunderstood by Matthews Duncan. This secondary rupture nnist, if it cause lia3morrhage at all, ]5our the blood into the peritoneal cavity, and thus produce intra-peritoneal ha3matocele. If, when the rupture takes place into the broad ligament, the blood effusion should be considerable, it is not difficult to understand that the ovum will frequently be killed at once, and be absorbed in time as the blood itself is. The whole thing will disappear, and the patient will get well, and I have no doubt that this is the origin of many of the inexjjlicable hieniatoceles of the broad ligament which we meet with. I have already given a case of the kind proved by abdominal section. I have as little doubt that in this way very many cases of ectopic gestation have a fortunate ending. But they do not all die in this way, and many of them go on developing in their new position, and their development may go](https://iiif.wellcomecollection.org/image/b21448048_0059.jp2/full/800%2C/0/default.jpg)
