A treatise on the science and practice of midwifery / By W. S. Playfair.
- William Smoult Playfair
- Date:
- 1885
Licence: Public Domain Mark
Credit: A treatise on the science and practice of midwifery / By W. S. Playfair. Source: Wellcome Collection.
Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.
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![rule, it is attached to some point near the opening of a Fallopian tube, the swollen folds of mucous membrane preventing its descent to the lower part of the uterus; in exceptional circumstances, however—as in' women who have borne many children and have a more than usually dilated uterine cavity—it may fix itself at a point much nearer the internal os uteri. According to the now generally accepted opinion of Coste, the mucous membrane at the base of the ovum soon begins to sprout around it, and gradually extends until it eventually covers the ovum (Figs. 50—52) and forms the decidua reflexa. Coste describes, under the name of the umbilious, a small depression at the most prominent part of the ovum, which he considers to be the indication of the point where the closure of the decidua reflexa is eifectecl. There are some objections to this theory, for no one has seen the decidua reflexa incomplete and in the process of formation, and on examining its external surface—that is, the one farthest from the ovum—its microscopical appearance is identi- FiG. 53. An Ovum removed from Uterus, and part of the Decidua Vera cut away. (After Coste.) a. Decidua vera, showing the follicles opening ou its inner surface, b. Inner extremity of Fallopian tube. c. Flap of decidua reflexa. d. Ovum. cal with that of the inner surface of the decidua vera. To meet these difliculties, Weber and Goodsir, whose views have been adopted by Priestley, contended that the decidua reflexa is the primary lamina of the mucous membrane, which, when the ovum enters the uterus, sepa- rates in two-thirds of its extent from the layers beneath it, to adhere to the ovum ; the remaining third remains attached, and forms a centre of nutrition. According to this view, the decidua vera would be a sub- sefjuent growth over the separated jx^rtion, and the decidua scrotina the portion of the primary lamina which remained attached. In tliis way the fiict of the op])os(!(l surfaces of the decidua vera and reflexa being identical in structure would be accounted for. *The difficulty which this ther)^'\^ is thus intended to meet does n(jt seem so great as is supposed; for if, as is likely, it is only the epithelial or internal surface of the mucous membrane which sprouts over the ovum, and not its deeper layers,, the fiu^ts of the case would be suffi(.'iently met by Coste's view.](https://iiif.wellcomecollection.org/image/b2121072x_0113.jp2/full/800%2C/0/default.jpg)
