■J+* -V ■*3 S1 -Mr t ,-c_ r« JMRJ / > ♦"** *" /"" LH v Ys~ 'JC'L" O.' JOQ^i'&tX(Jl.^/cOlJ" r- -—% Surgeon General's Office XmBMt^-xXM ?%fe, and going directly from the Vagina to the Ovaria. The next hypothecs which I fhall no- tice is now taught in this city by Dr. Chap- man, in his lectures, and was fir ft advan- ced by Dr. Haighton, lecturer on Phyfiolo- gy at Guy's Hofpital in London. I fhall deliver it in Dr. Haighton's own words, " The femen firfl flimulates the Vagina, " os uteri, cavity of the uterus, or all of " them." ( i? ) tf By fympathy the ovarian veficles en- f large, project, and burfl." " By fympathy the tubes incline to the * Ovaria, and having embraced them, con- " vey the rudiments of the fcetus to the " uterus." " By fympathy the neceffary prepara- " tions are made for the formation and e growth of the fcetus. And—— " By fympathy the breafls furnifh milk u for its fupport after birth." After viewing this ocean of hypothefis, we pafs on to mention a few facts that ap- pear tolerably well fubflantiated. f« Ut rari nantes in gurgtfe vaflo." The femen is abforbed, carried into the cir- culation, and ultimately depofited on the ovaria. And that it is, I fhall infer from its indifpenfable agency in the ovaria, and fe- condly, from the improbability of its paffrng by any other route. C ( i8 ) That conception takes place in the ova- ria is abundantly proved by the cafes on record, of fcetuses being found in them— Mr. Maurice gives an account of one in the London Philofophical Tranfactions, (No. 150) of a woman in whofe abdomen, after death, he difcovered a fcetus, about as large as a man's thumb, perfectly difcon- nected from all the furrounding parts. The right ovarium was enlarged—its in- verting membrane ruptured, and in every way appearing as if the fcetus had jufl efcaped from its fubflance. In the fame work, (No. 257) we have an- other fimilar account by Dr. Fern. In the dead body of a woman who fuppofed her- felf to have been three months gone with child, he found the fkeleton of a fcetus, lodged in the ovarium. Thefe are not folitary cafes : they are but few of the many fads that have caufed a pretty general belief that this procefs of conception commences in thofe organs.__ And that the actual prefence of the male ( 19 ) feed is indifpenfably neceffary we infer from analogy. In frogs and fifhes this phenomenon is mofl apparent. The depofits made by the females of thefe claffes, unlefs effected in prefence of the male, foon grows putrid, like dead animal matter. But, if made under oppofite cir- cumflances, millions of new living beings foon make their appearance. In thefe fpe- cies there is no vagina, to receive the femen, nor any penis to inject it. The efficacy of the actual contact of the male femen and the ova is as evident as the noon-day's fun. But it may be faid that man is not a fifh nor a frog, and that analogy is falla- cious. But we would beg leave to reply, that the fallacy of this analogy is not great. The fame mufcular power that gives agility to this animal, gives graceful movements to the beautiful girl—the fame nerves give them fenfibility, the fame blood is neceffary to keep their veffels in motion, and the fame air is neceffary to oxygenate it—the bile, the urine, and fasces all bear the fame part in their economy. ( 20 ) Indeed, the experiments of Haightorfi even when taken by themfelves do not dif- prove the fact for which we contend. The marks of conception, which he conceived to have taken place, in confequence of im- preffions made on the vagina, are not infalli- ble. The obfervations of Blumenbach and Buffon certainly prove that the cor- pora lutea have been formed, when no fe- men has been applied to the vagina, tocaufe the local impreflion, to which he attribut- ed fuch wonderful powers—to which he attached fo important a chain of confe- quences. And indeed analogy would lead us to con- clude that corpora lutea are no marks of conception. In the hen, and all other oviparous animals the ovum will be detach- ed from the ovarium and expelled from the uterus without any irritation in the vagina. But it will be to all intents and purpofes dead matter. It will neither keep fweet, and yield a chick in an elevated tempera- ture, norrefifl the attack of cold in a reduc- ed one. ( 21 ) •Sensible indeed would he make the vagi- na, os uteri and cavity of the uterus. To the femen he would feem to attribute won- derful power of exciting peculiar action; fo that it will produce the Roman or aqui- line nofe of one father, the dwarfifh or gigantic limbs of a fecond, and the fair or footy complexion of a third. Having thus endeavoured to prove the neceffrty of actual contact between the ierncn and ova, I fhall attempt to prove that it is effected in no other way than •through the circulation. ill. The femen does not pafs to the ova- ria through the Fallopian tubes. That this is true I infer from the fituation of the uterus. This yifcus is fituated between the bladder and rectum, and of courfe liable to many changes of pofition. When the rectum is diflended, the body and fundus uteri will be preffed forward, and the os tincae will look towards the anus. When the bladder is dis- tended the uterus will be preffed towards the perineum, and the os tincae will be turn- ed toward the fymplryfis pubis.—Again, in ( 22 j women who have borne many children, the os tincae projects outwards almofl to the la- bia externa. By thefe impediments the urethra is prevented from coming into di- rect appofition with thf orifice of the uterus. But a late writer* has afferted that the uterus has, by the affiflance of its appen- dages, the power of adapting itfelf to the urethra. If the gentleman would demon- flrate by diffection, that thefe parts have a flructure, capable of exerting fuch energy, we fhould feel more fatisfied than we now are. Under this head might likewife be mentioned the effects that are brought about by penises that are vitiated in their flruc- ture. Morgagni mentions an inflance of a man whofe urethra came out on the dorfum penis fomeways behind the glans: and this man was a father. * Dr. P. Harrison. Vid. Med. Museum. C 23 J I infer it, fecondly, from the un* fuccefsful efforts of anatomifls to difcov- er femen in the uterus poft coitum. Har- yey diffected a confiderable number of does, bitches, and rabbits, with the exprefs view of fettling this point. De Graaf like- wife made a confiderable number of diffec- tions, with rabbits, for the fame purpofe; but neither of them were able to detect any femen in the uterus or Fallopian tubes. Saumarez, likewife diffected for the fame purpofe, but never fufpected that he faw any, except in one inflance, and there he was not pofitive. He profecuted his dif- fections under the influence of a theory that would have led him to notice every appearance of inaccuracy in the flatements of thofe who publifhed fimilar accounts be- fore him. I infer it, thirdly, from the occur- rence of pregnancy during the exiflence of imperforate hymens, anomalous mem- branes, and adhefions confequent on infla- mations seated in the vagina. Mauriceau has related a cafe of a woman who was de- ( H ) livered of a child, although her hymen had not been broken in coition. Ruyfeh, though no advocate for the abforption of femen, relates, that he was called to a wo* man in labor, whofe hymen was imperforate. In addition to this, he difcovered in the fame woman an anomalous membrane that com- pletely obftructed the canal of the vagina. This is one of the befl cafes of the kind on record. That the femen does not pafs to the ova- ria through the Fallopian tubes, I infer, fourthly, from the occurrence of fuperfceta- tion. But left I fhould feem endeavouring to eftablifh contefted principles by doubtful fafts, I beg leave to cite fome well attefted cafes........ In Smellie's Midwifery, there is an ac- count, tolerably fatisfaftory. A woman, five days after delivery of a full grown child, mifcarried of a fcetus that appeared to be about four or five months old. There was no putrefaction, although it was flill ( 25 ) born. It had no hair, nor any other mark that indicated a more advanced age. In the London Medical and Phyfical Journal, No. 52, we find a well attefted cafe, by Mr. Hope—In April 1800, he was cal- led to a woman attacked with fevere labor- pains, and as fhe fuppofed, in her feventb month of pregnancy. The pains gradually ceafed; but, immediately afterwards fhe began to complain of a large painful tu- mor in the right hypogaftrium. This fhe could never get removed. In November following, fhe difcovered figns of recent impregnation, and was delivered of a living child, eight months afterwards. The child was of rather an unhealthy afpeft, but the author believed it to be living at the time of publifhing the account. Every thing went on well with the mother for a fortnight. She was then feized with a flercoraceous vomiting, and died.—On opening the ab- domen he difcovered the uterus about as large as an inflated calf's bladder. With- in the cavity of the uterus he found a pu- trid fcetus, apparently of the fixth or fev- cnth month. The placenta was attached D ( 26 ) to the fundus. The writer was particular- ly careful to afcertain that the fcetus was not extra-uterine, as the tumor appeared to indicate. Doctor Dewees, in his effay on fuper- fcetation, publifhes a cafe or two that fell un- der his own obfervation. In 1 jgg, he deli- vered a lady of a full grown boy. A few hours afterwards the lady was delivered of a fmall fcetus, which was evidently of a more tender age than the full grown child. To the firft and lafl of thefe cafes it may be objected that the fmall foetuses were con- ceived at the fame time with the full grown children; and that their growth had been prevented by fome unknown caufe. But are there not certain marks of age difcoverable in foetuses as well as in chil- dren ? Are not their extremities gradually made more proportionate to their heads ; and do not hairs fhoot from the heads of thofe that have been borne their full time ? Thefe marks certainly are fufficient to dif- tinguifhthe puny, but full grown child, from the Iufty, thriving fcetus, fuddenly deprived of life. But to the fecond cafe that I have cited., ( 27 J no fuch objections can be raifed. The child ■ born alive was evidently conceived after the other had attained its greateft magnitude. Of courfe, the femen could not in that inflance have had a route through the uterus. That the femen fhould be carried to the ovaria by the Fallopian tubes, and be by them returned to the uterus is imputing to them an economy not analogous to any other in the human fyftem. It is true that there is fometimes a double action in the cefophagus, flomach, and other parts of the alimentary canal; and perhaps in the lafteals, duftus communis choledochus, and urethra. But thefe inverted motions are performed only in difeafe. The femen is not tranfmitted directly from the vagina, to the ovaria, by an appropriate fet of veffels. To thofe who believe in the exiflence of fuch veffels, we beg leave to remark, that none fuch have ever been demonftrated. It it is unphilofophical to multiply the inftru- nients by which natural proceffes are per- formed. " Nee deus interfit nifi dignum vin- dice nodi." The propriety of inferring the ( 28 ) exiflence of organs from the apparent ne- ceffity of their agency, will not juftify any fuch inference in this cafe* That fuch veffels would be fuperfluous, I fhall attempt to prove, in confidering the facility with which the femen is taken into the circulation, and conveyed to the ovaria, unchanged. The thin cuticle with which the vagina is lined, feems very well calculated to favour this procefs. In this part of its flructure, it bears a great refemblance to the lips and noflrils. The firft of thefe readily abforbs the virus of lues, and the latter is readily in- fected by the matter of fmall pox. The rugae which lie in that canal appear to favour the idea of abforption. They en- large the furface on which the femen is de- pofited, and on which the lymphatics are fpread. And by offering fuch a furface are evidently calculated to anfwer the fame pur- pofe as the valvulae eonniventes in the intef- tines. The flight degree of inflammation which Bell remarks as favouring the abforption of venereal virus, and mercury, exifts in the ( 29 ) venereal orgafm. Perhaps I go too far in calling it an actual inflammation. But the term would not begrofsly mifapplied. Cruik- fliank thus defcribes it. " I obtained a rab- bit, (in heat) and after killing her fuddenly, by running a knife through her fpinal mar- row, proceeded to examine the organs of generation. They were turgid with blood, and black as ink."—And this flate continues fome days after coition, according to the ob- fervations of Haighton. The femen when ejected from the urethra, foon liquefies, and by that means is readily prefented to the patulous mouths of all the veffels that are fpread in the vagina. The femen is a mild, bland, fluid, in eve- ry way fuch an one, as we fhould fuppofe calculated to pafs through the fyftem, with- out occafioning much inconvenience. The ficknefs at flomach and vomiting, are fuch as we fhould expect, by reafoning a priori. Thefe fymptoms are much the fame as are frequently occafioned by the injection of extraneous matter into the veins. The ftrong digeftive powers of the lym- phatics, has frequently been urged as an ( 3o ) objection to this hypothefis. The fmell of garlick in the breath, of fpirits of turpen- tine in the urine of perfons who have taken thefe medicines, and the fmell of urine in the breath of patients afflicted with long continued ftrangury, are frequent occur- rences. They certainly fhew that the diges- tive powers of the abforbents are not equal to the talk of affimilating all the matters which they take up.* The flomach, like the lymphatics, poffeffes wonderful powers of affimilation. But the experiments of Spallanzani afford ample proof that it does not poffefs the power of operating on living animals. Hence we may with fome degree of certainty infer, by analogy, that the lymphatics have not the * It has been frequently contested whether mercury- be ever carried into the circulation. One well attested case may perhaps tend to satisfy those who are unset- tled in their opinions on this head. Mr. Edward John- son of Virginia, in prosecuting a dissection in this city since the close of this last course of le&ures, dis- covered pure quick silver in various parts of the body. The globules were very evident, and amalgamated the gold coin that was presented to it. ( 3i ) power of altering living fluids, fuch as the femen is known to be. The experiments of Spallanzani on the femen of the frog, evince that after extreme dilution it flill retains its power. The di- luting liquor which he ufed was water. We have endeavoured to prove that the blood produces as little change of the hu- man femen, as water did in his experiments. The femen, thus mixed with the blood, part of it paffes through the hypogaftric arteries, to be depofited on the ova. The exhalant extremities of the branches fpread in the ovarium, appear well calculated for this purpofe. The frequent occurrence of hydatids in thefe organs fhow that thefe ex- halants can readily be excited to uncom- mon action. But how the femen afts when it is has thus reached its place of deftination is yet un- known. On this point we are not fatished ourfelves ; much lefs are we prepared to fa- tisfy others. To fuppofe, with Spallanzani, that the femen of an afs fhould fo flimulate the ova of a mare, as to caufe the long ear to fhoot ( 32 ) from the head of the mule, and that the fe- men of a white man fhould fo ftirnulate the ovum of a negro wench as to give a yellow hue to the fkin of the child—is no lefs diffi- cult, than to fuppofe, with Buffon, that all thefe effects are produced by the union of organic molecules. The ovum after fecundation is feized by the fimbriated extremities of the Fallopian tubes, carried into the uterus, and there retained and nourifhed till the time of par-* turition. " Tempus quod cogit, defendit." The indifpenfible neceffity of completing this ef- fay in a prefcribed time, muft be my juftifi- cation for obtruding it on the public in this imperfect ftate. To the profeffors of medicine in this Uni- verfity, I return my fincere thanks for the inflruftion I have received from their lec- tures.—Drs. Dewees and Chapman will alfo pleafe to accept my acknowledgments for the affiftance which they have afforded n * in their department. Me.«L. H.st. WZ M537u Igofo c-\ T^S^ •■ , A ' :i. * £K" ■* *JFK ***> '\u 3*- ^ * * '^T *i |OT^ T *-J T**4,' 1 I 1 *y 4 » t . a.' ! ^; *-*• - • ' >.-<*% ■*** " , *4 I ,.4 _ L- f