Diseases of women and abdominal surgery . r where secondary rupturgi^j/c^/- ^of~a broad Tigaineiit cyst has converted an extra-peritoneal ^r*>^/>*^-^ectopic gestation into one within tlie peritoneal cavity. That A.*-i/A*^the first of these processes is by far the most common condition »-*^has been proved to me beyond doubt in my (jperations, ror I r) t^?Thave seen tlie ruptuied tube within a few days of the catastrophecontaining the great Itulk of the placenta, wlulst the villi of theextruded portion has been engaged in making epiphytic inroadson intestine, bladder, tlie back of th
Diseases of women and abdominal surgery . r where secondary rupturgi^j/c^/- ^of~a broad Tigaineiit cyst has converted an extra-peritoneal ^r*>^/>*^-^ectopic gestation into one within tlie peritoneal cavity. That A.*-i/A*^the first of these processes is by far the most common condition »-*^has been proved to me beyond doubt in my (jperations, ror I r) t^?Thave seen tlie ruptuied tube within a few days of the catastrophecontaining the great Itulk of the placenta, wlulst the villi of theextruded portion has been engaged in making epiphytic inroadson intestine, bladder, tlie back of the uterus and the folds of theomentum. I have pulled these villi out of the living crypts theyhave made, much as one pulls a barnacle out of its bed, leavingbleeding holes behind them. But Berry Hart has proved thisbeyond dispute, for he has been able to inject the placenta whichhad come out of its ruptured tube and accj^uired tliese strangeand unusual associations, and I here give a drawing of one ofthe preparations showing the Fig. 58.—Actual view of placental villi (c) encroaching upon and causing thinning of themuscular wall (a) of the Fallopian tube ; 6, maternal blooii sinuses. Uiawn by E Teichelmannfrom section made by Beny Hart. From the relations of the outer extremity of the tube I shouldsuppose that a tubo-ovarian pregnancy, or one in tlie pa^dlion,must of necessity always end by rupture into the peritonealcavity, and I think it would do so within the period whichlimits the existence of the purely tubal ectopic gestations—thatis, thirteen or fourteen weeks Clinically, therefore, there wouldbe no advantage in multiplying by further sub-divisions thevarieties of tubal gestations. Whatever difference of opinion onthese matters there may be, there can be but a uniform consensus29 450 STATISTICS. of belief to this effect: that by far the greater number of casesof ectopic gestations are tubal. I believe that they are reallyall tubal, and in this consists the
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