Part 1

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GRAPHIC ILLUSTRATIONS

OF

ABORTION

AND

THE DISEASES OF MENSTRUATION.

CONSISTING OF

TWELVE PLATES FROM DRAWINGS ENGRAVED ON STONE,

AND COLOURED BY MR. J. PERRY,

AND

TWO COPPER-PLATES

FROM THE PHILOSOPHICAL TRANSACTIONS,

COLOURED BY THE SAME ARTIST.

THE WHOLE

REPRESENTING FORTY-FIVE SPECIMENS OF ABORTED OVA AND ADVENTITIOUS PRODUCTIONS OF THE UTERUS,

WITH

PRELIMINARY OBSERVATIONS, EXPLANATIONS OF THE FIGURES

AND

REMARKS,

ANATOMICAL AND PHYSIOLOGICAL.

BY

A. B. GRANVILLE, M.D., F.R.S., F.L.S., F.G.S., F.R.A.S., ETC. ETC. ETC. FOR FIFTEEN YEARS PHYSICIAN-ACCOUCHEUR TO THE WESTMINSTER GENERAL DISPENSARY, AND DURING TEN YEARS PHYSICIAN TO THE BENEVOLENT LYING-IN INSTITUTION.

LONDON: PRINTED FOR JOHN CHURCHILL, Medical Bookseller and Publisher, 16, PRINCES STREET, SOHO.

MDCCCXXXIV.

G. WOODFALL, ANGEL COURT, SKINNER STREET, LONDON.

HENRICO HALFORD,

BARONETO,

EX GUELPHORUM EQUITUM PRIMÂ COHORTE; BRITANNIARUM REGIS ARCHIATRO; COLLEGII REGALIS MEDICINÆ LONDINENSIS PRÆSIDI;

MEDICO DOCTO, PERITO, FELICI,

IN OMNI DOCTRINÆ GENERE ILLUSTRI,

OBSERVANTIÆ ET AMICITIÆ ERGO

GRAPHICA HÆC LINEAMENTA

D.D.D.

AUCTOR.

CONTENTS.

DEDICATION.

Advertisement, XI.

PROLEGOMENA, p. i.–xxi.

Perfect (Normal) Animal Reproduction, prop. 1–3.

Imperfect (Anormal) Animal Reproduction (Abortion) prop. 4–7.

Study of Abortion, prop. 8–12.

CONCEPTION, prop. 13.

Ovulum (Description of before Fecundation), prop. 14–17.

FECUNDATION, prop. 18.

Ovulum (Description of after Fecundation), prop. 19–22.

CORTICAL MEMBRANE of the Ovulum, prop. 23–26.

Deciduous Membrane of the Uterus, prop. 27–31.

Corpora Lutea, prop. 34–37.

Transit, Volume, and First Development of the Ovulum, prop. 38–42.

THE CHORION, prop. 43–44.

Structure, Function and Vascularity of the Chorion, prop. 45–51.

Fluid of the Chorion, prop. 55.

THE AMNION, prop. 54.

Structure, Function and Vascularity of the Amnion, prop. 52–54.

Fluid of the Amnion, prop. 53.

Progressive Increase of the Ovulum, prop. 56.

Independent Life of the Ovulum, prop. 57–59.

Earliest or Mechanical Connection of the Ovulum with the Uterus, prop. 60.

Metamorphoses of the newly engendered Being, prop. 61.

Growth and Progress of the Embryo and Fœtus, prop. 62–66.

Priority of the Vascular over the Nervous System in the Fœtus, prop. 67.

Formation of the Blood in the Fœtus, prop. 68.

Formation of the Nerves in the Fœtus, prop. 69.

Apparatus for Digestion, prop. 70.

VESICULA UMBILICALIS, prop. 71.

THE ALLANTOID, prop. 72.

THE UMBILICAL CORD, prop. 73–75.

Omphalo-mesenteric Vessels, prop. 76.

More advanced, or Vascular Connection of the Ovum with the Uterus, prop. 77,

FIRST FORMATION OF THE PLACENTA, prop. 77.

Cotyledons of the Placenta, prop. 78–80,

Deciduous Vessels of the Placenta, prop. 81–83,

Membrana Propria of the Placenta, prop. 84.

Proofs of the Existence of Deciduous Vessels in the Placenta, prop. 85.

Deciduous Vessels, form the connecting Vascular Link between the Uterus and Placenta, prop. 86.

Proofs of it from Anormal Anatomy, prop. 87.

CIRCULATION, Utero-fœtal, prop. 88 and 90.

Recent Fallacies respecting the Structure of the Placenta, prop. 89.

FUNCTIONS OF THE PLACENTA, prop. 91.

Physiological Proofs of the Deciduous and Fœtal Structure of the Placenta, prop. 92.

NUTRITION of the Fœtus through the Placenta, prop. 93.

Lymphatics and Lymphatic Absorption in the Placenta, prop. 94.

Pretended Nutrition by the Amnionic Fluid, prop. 95–96.

RESPIRATION of the Fœtus in Utero, prop. 97.

Nature of the Changes in the Fœtal Blood, prop. 98.

Bile secreted by the Placenta, prop. 99.

Distinction between Life and Nutrition in the Fœtus, prop. 100–102.

EXPLANATIONS OF PLATES, AND REMARKS.

PLATE I. page 1–6.

SPECIMENS OF VERY EARLY MISCARRIAGES.

Remarks on Fig. 1 and 2. page 2. Remarks on Fig. 5, 6, 7, 8, 9. p. 5.

PLATE II. p. 7–8.

MISCARRIAGE BETWEEN TWO AND THREE MONTHS.

Remarks on Fig. 10, 11, 12. p. 8.

PLATE III. p. 9–12.

MISCARRIAGE BETWEEN TWO AND THREE MONTHS.

Remarks on Fig. 13, 14, 15. p. 11.

PLATE IV. p. 13–16.

MISCARRIAGE DURING THE THIRD AND BEFORE THE COMPLETION OF THE FOURTH MONTH.

Remarks on Fig. 16. p. 14. Remarks on Fig. 17. p. 15.

PLATE V. p. 17, 18.

MISCARRIAGE BETWEEN THE THIRD AND FOURTH MONTH.

Remarks on Fig. 18. p. 17. Remarks on Fig. 19. p. 18.

PLATE VI. p. 19–24.

MISCARRIAGE BETWEEN FOUR AND FIVE MONTHS.

Remarks on Fig. 20. p. 20. Remarks on Fig. 21. p. 22. Remarks on Fig. 22. p. 23.

PLATE VII. p. 25–26.

MISCARRIAGE AT FIVE MONTHS.

Remarks on Fig 1. p. 26.

PLATE VIII. p. 27.

FIRST SPECIMEN OF ABERRANT GESTATION.

Remarks on Fig. 1. p. 28.

PLATE IX. p. 29.

SECOND SPECIMEN OF ABERRANT GESTATION.

Remarks on Fig. 1. p. 30.

PLATE X. p. 33–36.

THIRD SPECIMEN OF ABERRANT GESTATION.

Remarks on Fig. 1. p. 33. Remarks on Fig. 2. p. 35.

Classification of Erratic (Extra-uterine) Gestation. p. 35.

PLATE X. (A.) p. 37–38.

FOURTH SPECIMEN OF ABERRANT GESTATION.

References to Do. p. 37.

PLATE X. (B.) p. 39–40.

CONTINUATION OF ABERRANT GESTATION.

Remarks on Do. p. 39.

PLATE XI. p. 41–44.

DYSMENORRHOIC ORGANIZATIONS.

PLATE XII. p. 45–51.

POLYMENORRHOIC STRATIFICATIONS.

Remarks on Figs. 1, 2, 3, 4, 5. p. 48.

Classification of the Adventitious Productions of the Uterus. p. 48. Classification of the Diseases incidental to Menstruation. p. 48–49.

Synopsis of a Work on Abortion. p. 51–52.

LIST OF THE FORTY-FIVE COLOURED FIGURES OF HUMAN OVA, AND ADVENTITIOUS PRODUCTIONS OF THE UTERUS REPRESENTED IN THE PLATES.

1. Ovulum bigeminum lanuginosum.

2. Ovulum semi-lanuginosum.

3. Ovulum lanuginosum.

4. Ovulum semi-lanuginosum.

5 and 6. Ovula of the same species.

7. Ovum denudatum, or diaphanous Ovum.

8 and 9. Ova of the same species.

10. Ovum piriforme externè opacum.

11. The same laid open.

12. Ovum opacum plethoricum.

13 and 14. Ova semi-coriacea.

15. Ovum omnino opacum rotundum.

16. Ovum pseudo-membranosum.

17. Ovum uviforme.

18. Ovum coriaceum, cum hydrope funis et placentâ hydaticâ.

19. Ovum cum placentâ, nec vasculare nec plene cotyledonica, sed filiforme. Amnion morbosum.

20. Ovum tuberculosum.

21. Ovum pane solidum. Placenta sarcomatosa cum tuberculis. Involucra fœtüs solidificata.

22. Ovum cum involucris internis ab amnio-chorionitide condensatis.

23. Ovum fœtiferum optimè conditum, subitò, ab amnio-chorionitide interfectum.

24. Ovum fœcundum in receptaculo Ovarico.

25 and 26. Ovum fœcundum in receptaculo Tubico.

27 and 28. Ovum fœcundum in receptaculo Interstitiale.

29. Ovum fœcundum in receptaculo Ovarico.

30. The sac of the preceding Ovum laid open.

31. Membrana pseudo-textilis intro-uterina bi-tubulata.

32. Membrana pseudo-textilis intro-uterina sine tubulis.

33. Coagulum intro-uterinum hæmatosum pseudo-membranaceum incavum.

34. Coagulum intro-uterinum hæmatosum laminare cavum.

35. Coagulum intro-uterinum spongiosum cavum, interne velatum.

36 and 37. Coagulum intro-uterinum, interne solidum, externe membranaceum.

38. Mola avellana tunicata.

39. The same laid open.

40. Mola avellana nuda.

41. The same laid open.

42. Mola conchula.

43. The same laid open.

44. Mola Mytilus.

45. The same laid open.

N. B. In the last Plate, the figures 2 and 3 should be reversed, in order to correspond with the text or printed explanations.

ADVERTISEMENT.

I submit to my professional friends and acquaintances, as well as to all those medical brethren who take an interest in the progressive advancement of the sciences they cultivate, a series of beautifully executed Drawings of anatomical preparations, intended to explain and illustrate the important subjects of “Abortion”, and “The Diseases incidental to Menstruation”; subjects in which all classes of the medical profession, whether specifically devoted or not to obstetrical practice, are equally interested. The drawings speak for themselves. The Artist, under my immediate and constant superintendence, and with the anatomical preparations in every case before him, explained and demonstrated to him, has, in the course of six years, been able to produce twelve plates, containing upwards of forty anatomical figures, lithographed and coloured by himself, which reflect no small honour on the arts of this country, and are highly creditable to his abilities. These plates, I will venture to say, leave nothing to be desired in such a mode of representing anatomical subjects, (a mode which appears from the present endeavours to be the best calculated of any for that purpose,) whilst they remove every cause of regret, hitherto entertained, that the most successful efforts of anatomical lithographic representation, of which foreign countries can boast, had never yet been equalled in England. It may now be asserted that those efforts have been triumphantly rivalled by Mr. Joseph Perry on the present occasion; and, in some of the plates, unquestionably surpassed.

Having said thus much in favour of the Artist, I hope I shall be excused if I add, for myself, that I have selected such specimens only as I considered likely to illustrate some of the most interesting points of the physiology of human generation, and which might assist in unravelling the various practical difficulties which beset that mysterious question;—that I have chosen those which, I believe, (with the exception of one or two preparations,) have never been published before either in this or any other country, and many of which are to be found only in some private anatomical collection;—that I have explained them in such a way as to render their meaning and usefulness evident to all my brethren;—and that, under such circumstances, I venture to believe that the plates so explained will prove of no inconsiderable service to every medical practitioner as a work of reference, where either a private or a public museum is not at hand to solve cases of doubt.

I am aware that I might have extended this series of representations to more than double the present number of analogous preparations; but I purposely limited it to what it is, from a consciousness that any unnecessary increase in the number of plates, which the peculiarity of the subject did not absolutely require, would only tend to increase the bulk, and with it the expense of the “Graphic Illustrations”, without any adequate or corresponding advantage.

It may, after all, be asked: were these delineations wanted? Were there not already in existence works of a similar, or at least analogous character, executed in an equally masterly style, to which the medical reader and the physiologist could refer for information and in cases of doubt? I reply, yes, to the first—and negatively, to the second question.

And first, of the second question. Not to speak of the many authors on matters of this description, who preceded Dr. 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. But, unfortunately, neither of those works can be considered as accessible to the generality of professional readers, on account of their high price and rarity; and even if either were accessible, the subjects therein treated are viewed differently from those collected in the present work. Those works, moreover, present no coloured specimen of delineations of parts, most of which, if not all, from that simple circumstance, lose their principal value;—and as productions of art they are not equal to what Mr. Perry has enabled me to offer to the public. Soemmering himself, in his “_Icones Embryonum Humanorum_”, admits, that although those who had gone before him in the same channel of inquiry, had produced valuable works and splendid plates, particularly Dr. Hunter and Dr. Denman; there was yet room for a more complete, and, above all, for a more minute representation of the metamorphoses of the human embryo. “_Elegans profecto et utilis admodum speculatio!_” exclaims the veteran physiologist; and forthwith he proceeds to compare what he had been able to give to the public on the subject of embryology with that which his predecessors had done. This leads him to the conclusion that, from having paid greater attention to minuteness, from being more strictly accurate, from the advantage of having a better collection of specimens than fall to the lot of most anatomists, and from the circumstance of both his delineator and engraver being much superior to those of former times—he had been able to complete a work of art on the progressive development of the human fœtus which left those of his predecessors far behind.

With one or two exceptions, the representations in Soemmering’s work are simply those of the fœtus in its progressive advancement from the third week after fecundation, to the fifth or sixth month of gestation. Those representations have no reference to the whole ovum at those several periods of fecundation: and they are not coloured. Still they are, as he has stated, superior as a work of art to any that had appeared before. Soemmering tells us that he selected for his plates the best specimens of the human embryo, the best draughtsman, and the most skilful engraver; and that when he compared those plates with those of Trioenius, Albinus, Wrisberg, Hunter, and Denman, in order that he might better understand, explain, and perhaps correct his own: “_magnopere delectabatur_”, to find, on such a comparison, that the superiority of his plates was not inconsiderable. Well, then, let the reader who has the means of doing so, turn to the two folio plates of Soemmering, and then direct his attention to the fourteen plates contained in the present volume, and I will abide by their decision whether or no, in all such delineations as relate to either parallel or identical subjects in the two publications, the palm of superiority (in every circumstance of design, precision, and execution,) which Soemmering claimed for _his_ publication, ought not to be yielded by him to _another_ sent forth under the advantage of recent improvements in drawing, and a newly invented art admirably adapted for such imitations of nature. Independently of which advantages there is to be added the charm of colour—a circumstance which so greatly embellishes, without disfiguring, truth.

With such impressions, I can feel no hesitation in giving publicity to my collection; and if in selecting, denominating, and appropriating to particular views of my own the several specimens I now publish, there should be found neither taste nor judgment, novelty nor utility, the blame must rest on me—but the merit of superiority will still remain to it as a work of art, which, in the department of morbid embryology, has at present no equal either in England or on the Continent.

Now to the first question—whether these delineations were wanted? 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; whether, in fact, it be not wanted—or whether it exist already anywhere. If the want of such a work be made manifest, its importance must be self-evident. But that importance is not a little enhanced when we find Denman—a plain unsophisticated practitioner—with quite enough of science to constitute him an authority in physiological questions concerning human generation,—recommending the inquiry, in his own work on an analogous subject, entitled “Engravings representing the Generation of some Animals”, in which he has given three drawings of aborted ova. “It must be allowed”, observes the Doctor, “that the generality of these things (the aborted ova) are preserved for their beauty, or as matter of curiosity, rather than of use. I suspect, nevertheless, that there are some appearances besides the _vesicula umbilicalis_ not yet perfectly understood, and therefore recommend the whole subject as worthy of being reviewed”: and, in a subsequent part, he says, that “in every collection there must be some example, which may enable us to distinguish the different parts of which an ovum is composed, the proportion which they bear to each other at different periods of pregnancy, and sometimes the process of utero gestation which failed”. What greater encouragement, therefore, needed I than this opinion and advice of one of the best obstetricians England can boast of, to select, prepare, and point out the importance of this species of anatomical and physiological delineations?

I shall conclude, by remarking, that the plates are intended to illustrate a work “On Abortion and the Diseases incidental to Menstruation”, which I have been preparing for several years, and a prospectus of the contents of which will be found at the end of the present volume. That work will appear, DEO favente, in the course of the present year; but for the convenience of such persons as may not feel inclined to purchase it, the collection of plates has been purposely so arranged, as to be published, with a corresponding text, in a separate form, and independently of the forthcoming volume.

_Grafton-street, Berkeley-square, 30th March, 1833._

PROLEGOMENA

OF

THE DEVELOPMENT AND METAMORPHOSES

OF

THE HUMAN OVUM.

PROLEGOMENA.

1. The ultimate purpose of nature, in associating the two sexes in the human species, is to bring to maturity and produce, in a fit state to live and procreate, a constant succession of individuals, that shall perpetuate the species to the end of time.

2. This object is invariably accomplished by one uniform series of laws and phenomena, which have been studiously inquired into, accounted for, and, in most instances, explained in a satisfactory manner, amounting almost to demonstration.

3. The study of the function of reproduction, in all the other classes of animals, affords no other nor any dissimilar evidence. On the contrary, both by comparison and analogy, the study in question serves to confirm us in the notion, that Man differs in nought, in this respect, from the animated beings placed below him in the scale of creation. One same primary intention is manifest in their sexual distinctions; the means to ensure the ultimate purpose—their perpetuation—are the same; the same laws and the same phenomena mark the appearance, the development, and the final production of successive generations of individuals.

4. Any deviation from those laws—any violent change in those phenomena—and, still more so, any impediment to the accomplishment of the _ultimate purpose_ of Nature, is a defeat of her intention.

5. Such a deviation, change, or impediment may occur at any time previously to the period established for the appearance of a new and perfect being. If it occur at such a time as shall be incompatible with the maturation, and consequently with the life of the new creature, or even with its maturation alone, (although tokens of life be observed at the time in question,) a MISCARRIAGE is said, in common parlance, to have taken place; for Nature has _miscarried_ in her undertaking: she has been foiled in her expectations.

6. In the reproduction of the human species, such an event might justly be considered to have occurred, if, at any time before the completion of the natural period of gestation, the fœtus be expelled, whether dead or alive. But as in many instances, notwithstanding its premature expulsion, the fœtus has grown and has continued to live its extra-uterine life, in spite of the want of maturity, (a case known to have occurred even so early as between the sixth and the seventh month,) the expression, before mentioned, (5) is not applied to any untimely expulsion of the fœtus that may take place later than that period—at which, and after which, and till the completion of the ninth month of gestation, such an expulsion would be called a _premature_ labour. The distinction, however, is more specious than useful: it is an offering to social etiquette, rather than to science.

7. The premature expulsion of the produce of conception before the seventh month, has also received the name of ABORTION. This denomination has been generally adopted, and is used by the writers of every civilized nation, ancient or modern, according to their respective languages. It is that which has been employed in the following explanations of figures taken from nature, which are intended to exhibit several examples of abortion in the human species.

8. The study of abortion, in this point of view, (7) is an infinite source of interest, whether considered in reference to science and the important question of generation, or simply in reference to medical practice. On the continent of Europe, and even in the States of America, but more particularly in Germany, the subject, under its two-fold aspect, has engaged the serious attention of some of the most learned philosophers and most skilful practitioners. I know of no other professed writer on the same subject, besides Burns, in this country. His work on abortion is brief, and more valuable for the practical suggestions it contains, than for any luminous or accurate view of the various scientific points connected with that subject. But like every thing which proceeds from the hands of that able practitioner, the performance is respectable.

9. 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. On all these points, we have, until lately, been in the habit of professing the same articles of belief as our predecessors: we have repeated what we heard them say, or what we read in their writings; and many, both here and elsewhere, repeat still the antiquated theories respecting conception and the structure of the human ovum, which they have learned on the obstetrical benches.

10. The great advancement—the great and forward strides which physiology has made in France, as well as in Germany, have contributed to explode those antiquated theories. Acute and indefatigable anatomists have been busy watching Nature in all her movements, from the first moment of her calling the rudiments of a human embryo into existence, until her magnificent work has been completed by the production of a new, life-gifted, individual of the species. They have called to their aid the much improved art of microscopical observation, and have thereby succeeded in almost tracing the very earliest instant of embryonic existence. The register of their observations constitutes the biography of the human fœtus.