Observations on the structure of the corpus luteum : and its value as a test of early pregnancy / by Robert Lee.

  • Robert Lee
Date:
1844
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the structure of the corpus luteum : and its value as a test of early pregnancy / by Robert Lee. Source: Wellcome Collection.

    7/14 (page 7)
    moval of the “incubus” on Dr. Pater¬ son’s “ character as an observer” that any of these facts should be revealed. Monkwearmouth, May 9, 1844. Dear sir,—I venture to encroach on your valuable time, to ask your opinion of the accompanying preparation illustrative of a point to which the medical world knows you to have paid much attention. Is the corpus luteum in this case a true or false one ? It was taken from the body of a female upwards of thirty years of age. She died suddenly, and no accurate information could be gained regarding her last menstrual periods. Several medical gentlemen have examined the corpus luteum, and are so much divided in opinion about it, that they would feel deeply indebted to you to examine it, and favour us with your decision upon the question. I hope you will have the goodness to ex¬ cuse the great liberty a stranger thus ven¬ tures to take; but knowing your kindness, and having every confidence in your opinion, I have the honour to remain, your obedient servant, Henry O. Bowman, M.D. Dr. Lee. P.S.—As the preparation belongs to a medical friend, who was so kind as to allow me to examine it, I shall feel obliged by your returning it with your decision. If it were mine you would be heartily welcome to it; indeed I should have considered it my duty to have presented it to you.—H. O. B. The following was the condition of the uterus and its appendages when they came to me :— The uterus was not enlarged in the slightest degree beyond the ordinary size at the middle period of life in women who have never been pregnant. Its walls were compact, and the strata of muscular fibres could not be sepa¬ rated from one another as they always can be after recent impregnation. The lining membrane of the uterus w'as unusually thickened, but no part of it was covered wdth deciduous membrane. Under alcohol and water, with the naked eye and with the magnifier, I could not detect the slightest portion of this membrane adhering to the inner surface of the uterus, nor did the lining membrane of the organ present the ap¬ pearance which it usually does when the recent decidua has been removed with the utmost care. The glands of the orifice and cervix uteri w'ere not developed, and there w’as no change in the walls, cavity, cervix, or orifice of the uterus, to.indicate that recent im¬ pregnation had taken place. If, there¬ fore, as Dr. Paterson states, “ the uterus of this case was a little enlarged, and contained an extremely thin and soft decidual membrane” when first opened, the enlargement had entirely disap¬ peared, and the thin and soft decidual membrane completely vanished, when the uterus came into my possession. Why “ no ovum could be detected, though minutely and carefully ex¬ amined, was now fully explained.” The fimbriated extremity of the right fallopian tube had adhered throughout nearly its whole extent by old, dense, false membranes, so as to fix the tube immoveably in its unnatural position, and render it incapable of performing its functions. Neither spermatic fluid could have passed from the uterus to the ovarium, nor could an ovum have been transmitted from the ovarium to the uterus. These firm false mem¬ branes had been extensively divided artificially, but by placing the cut ends in apposition, it was obvious that the corpus fimbriatumhad been extensively, if not completely, adherent to the ovary, and that the tube must have been im¬ pervious. The condition of the tube and ovarium, therefore, fully confirmed the accuracy of Dr. P. w’hen he stated, “ that from the puckered and contracted appearance of the fimbriated extremity of the fallopian tube, which could hardly admit of a small probe to enter, that no ovum could have passed into the uterus.” But, though “ no ovum could have passed into the uterus,” he nevertheless maintained “ that this person had conceived.” A section had been made, as Mr. Wharton Jones describes, dividing the ovary and the body it contained into tw'o similar halves. The appearance w^hich this section of the body pre¬ sented w^as like that of a firm dark clot of blood, having in its centre an elon¬ gated membraniform shred, one end directed towards the interior of the ovary, the other towards the exterior. From this shred, which was smooth on its free surface, processes extended here and there in a radiating manner into the substance of the clot-like body. The body in question was of a lenticular form, about six-tenths of an inch in diameter, and about four-tenths thick,