A. B. Granville

“ Hunter and Professor Soemmering, in giving representations of the human embryo in many of its metamorphoses, such as Ruysch, Noortwyk, Albinus, Krapft, Wrisberg, Camper, Blumenbach, Denman, and others, I am ready to admit that both Hunter and Soemmering had given to the world delineations, such as are here referred to, which ought to satisfy the medical profession. The one in his splendid work on the “Gravid Uterus”, gigantic folio edition—the other in his no less valuable folio plates of the human embryo. ”

“ I support the affirmative by appealing to all those of the profession who have had occasion to be consulted in cases of abortion and the expulsion of those singular productions of the uterine cavity, which seem connected with menstruation or faulty conception. Let them say whether a work, in which the principal of the infinitely varied aborted human ova, and of the uterine productions alluded to, are faithfully represented, be not likely to be useful ”

“ The ideas which are now entertained respecting fecundation, after the successful congress of the two sexes, in the human species—respecting its seat—respecting the first origin, station, and rudimental creation of the embryo—respecting the journey of the latter into the womb, its sojourn in that cavity, and the various metamorphoses it undergoes therein, up to the period fixed for its projection into the WORLD, may be comprised within a small number of propositions. ”

“ There is another physiological fact which we have overlooked—it is this: That the uterine decidua is always pervious at the uterine orifices of the fallopian tubes, as well as over the internal orifice of the cervix uteri. The error thus signalized has arisen from not knowing that the ovulum comes from the ovarium with a cortical membrane over the shaggy chorion. It is curious to see how, even among some of the most skilful of the modern physiologists, their ignorance of the existence of a cortex ovi has misled them in their respective descriptions of the decidua or uterine lining. ”

“ Though the latter be formed in the uterus, even when the embryo is lodged, by aberration, in some other part of the abdomen, its presence must not be deemed, on that account, unessential to the embryo; for a vascular membrane, as nearly alike to it in texture as can be, has invariably been found to connect, by blood-vessels, the embryo to some vital part nearest to where that embryo has been casually deposited, that part having, at the same time, its circulation and vascularity greatly increased, and becoming, in fact, the parent of the connecting vascular membrane in question. ”

“ 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. ”

“ The tubercles are sub-amnionic, and the presence of these morbid accretions will settle the question of the vascularity of the inner, or as I call it, the secreting membrane (amnion) in the human Ovum. That the transparent membranes of the human Ovum are vascular, has been supposed from mere analogy to what we observe in other viviparous animals, particularly of the larger class of quadrupeds; but no proof has ever been adduced of the reality of such a fact, for no anatomist ever succeeded in injecting the supposed vessels of those involucra. ”

“ The drawings speak for themselves. They convey, with a precision which is one of the great merits of that artist, every minute feature of two preparations calculated to afford a fund of knowledge, on the subject of the formative process of the human Ovum, for which we should look elsewhere in vain.
The nutritive involucra are fleshy or coriaceous. Bunches of real hydatids hang pendulous from a part of their external surface—while internally they are lined with the secreting membrane in a morbid state, and that portion of the cord which is farthest from the fœtus appears to be dropsical. ”

“ This gentleman having observed an ovum still alive in the uterus of a ewe, which was a short time advanced in gestation, removed it and placed it upon a warm glass plate exposed to the rays of the sun, and attentively examined it with the microscope. The beatings of the heart became more lively. He noticed the blood arise to the surface of the chorion from the fœtus, there ramify plentifully, and by anastomosing vessels, return to two of the larger trunks which were the veins of the embryo. ”

“ The volume of the transparent involucra is disproportionate to the embryo itself: yet the placental covering, with its filiform vessels, bears a still larger proportion to them; so that the want of equilibrium between the external and internal apparatus of the Ovum has destroyed, first the growth, and next the life of the embryo. The preparation is in the museum of St. George’s Hospital, and like the preceding preparation (5) , has been flattened and pinned to a pasteboard—a mode which, for the steady display of the peculiarities of the Ovum in both cases, was, perhaps, the most judicious. ”

“ It is impossible, thoroughly and accurately, to comprehend the mode in which abortion takes place, without being previously acquainted with the origin, formation, progress, and metamorphoses of the fœtus, and its connection with the mother. ”

“ 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. ”

“ In Ovum 19 there was nothing in the least analogous. Though the placenta is imperfectly formed; even in its filiform or mossy or primitive texture, it might serve and has served the purpose, of forwarding the nutrition and growth of the fœtus. The disease which destroyed the latter, being of an inflammatory nature, must have been more rapid in its effect. It put an end to life before there could have been time for growth to be much affected. ”

“ Hunter’s notion was gradually converted into an opinion, which most of his successors have repeated over and over again, out of respect for him, and without ever inquiring experimentally into the correctness of it. No one has advanced a single fact to prove it. There is no such a thing as a decidua reflexa. ”

“ But externally to this outer transparent membrane we have the cortex Ovi, which has contracted adhesion by means of branches of vessels, indistinctly made out in the preparation, owing to the dried clots of blood with which they are interspersed. These clots of blood are the remains of the accumulation of that fluid around the Ovum, which led to the laceration of the tube, and with it to the fatal hemorrhage that inundated the abdomen and produced death. ”

“ In a case of ventral aberrant fœtation, which had proceeded to the end of the sixth month, before it destroyed the patient, a vascular and tomentous membrane had been formed on the xviisurface of the peritoneum, to which adhered the regular placenta and chorion of the fœtiferous ovum. This membrane resembled in every respect the decidua, at six months—it was thicker, and more red and vascular where the placenta was adherent than any where else. ”

“ The cavity formed in the substance of the ovarium by the progressive advancement of the fecundated ovum, is here laid open, in order to exhibit how distinctly and perfectly the fœtus had, up to the time of the death of the mother, found station, nourishment and growth without the assistance of the cavity of the uterus, or of those membranes which physiologists are wont to look upon as essential to the development of the child in utero. ”

“ The Umbilical vessels unite the fœtus to the chorion before any regular placenta is formed outside of the membrane. Up to the tenth week the decidual vessels are as yet slender, straight, and insulated; while the umbilical vessels begin already to arrange themselves into minute cotyledons [21] . The reason of these arrangements is obvious. The embryo needs growth. This it gets through the maternal blood. But as its gossamer frame, for the space of two and three months, requires but little assistance from such a source for the promotion of growth ”

“ When the Ovum, after having lived and grown on its own life-principle, through its journey from the Ovarian nest into the cavity of the womb, has accomplished that connexion with the mother which before did not exist, the filiform vessels on the inner surface of the membrane in question, ought forthwith to begin to wither and be absorbed. ”

“ Blizard presented to the Royal College of Surgeons a very instructive specimen of a human Ovum having a sarcomatous and calculous placenta, which had been expelled at three months and a half, by a patient who had miscarried three times within the three previous months.
There is also in the same college a magnificent specimen of a solid Ovum, of the size of a hen’s egg and shape. A small portion of the shell of this Ovum having been cut off, the embryo is seen, of the size of a common fly, within the cavity, which may be just large enough to admit the top of a man’s thumb. ”

“ Immediately within the last-described envelope, and at the inferior part of the Ovum, we observe a thick cake, which was probably extravasated blood: it extends upwards on the right of the observer, getting less thick as it proceeds. The cake itself, on the side next to the fœtus, is lined, but loosely, by another bifoliated transparent involucrum, held fast to the involucrum just described by filiform vessels, which in some parts are distinctly visible even to the length of half an inch, with a space of the same dimension between the membrane and the cake before mentioned. ”

“ We there see a complete cast of the lining (caducous membrane) of the uterine cavity after fecundation, thrown off at a very early period, and with it the ovulum, (of the size of a Portugal grape,) exhibiting the cortex ovi, shelly and membranaceous, of a dense texture, yet flexible, which has burst like the pericardium of some seeds, and allows the shaggy chorion beneath it to be seen. ”

“ If the reader can procure a placenta which has been thrown off immediately after the birth of the child, without any effort, and cleaning it of all coagula from off the surface which lay next to the uterus, by careful maceration and washing, he will afterwards introduce a small quill or pointed tube into one of the arteries of the navel-string, and blow strongly into it, he will find that the air raises upon that surface, to various degrees of puffiness, a very delicate pellicular covering, through which none of the air can escape, unless through an accidental laceration. ”

“ The facts are singular, yet authentic in all their particulars. It is, therefore, impossible to deny the existence of another distinct species of pregnancy, extra muros uteri, in which the fœtus is lodged among the interstitial elements of that viscus, and has no communication whatever either with the cavity of it on the one side, or the cavity of the abdomen on the other; unless ulceration or laceration take place. ”

“ While the process or metamorphosis of the ovulum noticed by Boer takes place in the ovarium, in consequence of fecundation, the cavity of the womb does not remain idle, but forthwith sets about weaving for itself a general lining—a sort of pseudo-textile membrane—which extends all over the cavity, descends partly into the cervix, and is often, (not necessarily always,) projected even into a great portion of the fallopian tubes. ”

“ The secreting or inner involucrum (amnion) of that Ovum, when laid open, was found tinged with blood and the cord distended by the same fluid which pervaded also the liquor amnii, as well as the fœtus itself. The morbid adhesions, contracted by the middle membrane with the chorion in consequence of plethora, are well marked in one part of the drawing by the artist to whom I carefully dissected the preparation. The chorion itself is in a morbid state.
Fig. 12. Ovum opacum plethoricum. (Eleven weeks after menstruation.) ”

“ They prove that the embryo, called into existence by the mysterious act of fecondation (the only point that is mysterious about the process of generation according to Cuvier) may, and will, and does live independently of the mother,—with a life wholly its own, and that it derives from its parent growth only, or accretion of substance, as I stated in my preliminary observations. The museum of the Royal College of Surgeons supplies a most striking illustration, and I may add, corroboration of this opinion. ”

“ Hunter supposes, by pushing the said lamina forward, and following it close, so at last to make good an entrance into the womb, surrounded by this inner lamina of the decidua, which the ovulum compels to enlarge with its own gradual enlargement, until both fill the entire cavity of the uterus, and the inner lamina of the decidua comes in contact with itself. It is impossible to conceive a more improbable operation, or one more contrary to facts. Yet such is the notion formed by Hunter of an imaginary membrane, to which he has given the name of reflected decidua ”

“ It has been so considered by Ruysch, who calls the villous side of the Chorion, “succosa nutritioni fœtus inserviens.”
45. The fibrils of the Chorion have generally been considered as filiform vessels. When examined with the microscope, they appear diaphanous and ramiform; some of them terminate into little bulbs like the ampullæ of the villosities of the intestines. These bulbs adhere so firmly to the cortex ovi, that when an attempt is made to detach them, many are lacerated. (Carus.) It is only when the cortex bursts of its own accord that they are set at liberty. ”

“ Some have indiscriminately called by this name the polypi of the uterus; hardened, soft or spungy coagula of blood; carneous masses expelled by the uterus; diseased or deformed ova; and in fact almost any thing in the shape of a mass that has come away from the genital passages of a female after supposed conception, or subsequently to parturition. To embrace so many different substances under one general denomination, is surely wrong, (as Denman said,) and accordingly we find such a practice condemned by many. ”

“ The whole of the English physiologists, writers on midwifery, and lecturers, whether ancient or modern, are entirely silent on this important stage of embryonic life. They have talked rather loosely on the subject without the species of life which he must suppose the embryo to enjoy. He tells us, that even at the end of three weeks the Ovum is not found in the uterus, but how it exists during that period, wherever it may be, he has not even alluded to a single reference to facts or anatomical remarks of their own. Burns, in his work on abortion, never once alludes to ”

“ But as the object of the present work is to illustrate abortion, and not the complete life-circle of the fœtus, I shall stop the number of my propositions at the fifth iiimonth of its intro-uterine existence. After that period, the various phenomena of fœtal gestation are so uniform, that they afford less matter of interest to the philosopher.
13. Conception, or that result which follows sexual congress, in virtue of which one, or more individuals, of the same species is called into being, takes place in the ovarium of women. ”

“ The latter succeeds immediately to the former; beginning at the moment when the new being is grafted on the maternal womb, and continuing until its expulsion from thence at the full period of gestation. It follows, therefore, that the Embryonic or former state is that in which the new being is as yet, without any direct or indirect communication with the mother, and still less so with external objects. This state persists for about two weeks after fecundation, during which the Embryo continues to derive its nourishment from the cortical membrane of the Ovum. (Boer, Soemmering, Plagge, myself.) ”