ophy and destruction of the
testis, ligature of the Fallopian tube, which is only a uterine
appendage and not a secretory duct of the ovary, has absolutely no
effect whatever on that organ.
A simple ligature of each Fallopian tube would effectually and
permanently sterilise, without in any way whatever altering or changing
the organs concerned, or the emotions, habits, disposition, or life of
the person operated on.
The Fallopian tubes are two in number, attached to the upper angles of
the uterus, and communicating therewith. Each is about five inches in
length, and trumpet-shaped at its extremity, which floats free in the
pelvic cavity.
Attached to the margin of this trumpet-shaped extremity, is a number of
tentacle-like fringes, the function of which is to embrace the portion
of the ovary, where an ovum has matured during or immediately after
menstruation.
At all other times these tubes are practically unattached to the
ovaries. Ova may and do mature on the surface of the ovaries, but do not
always pass into the Fallopian tubes; being almost microscopic, they are
disintegrated and reabsorbed. If they do pass into a tube they are lost
or fertilized as the case may be.
It can be seen that the function and vitality of the ovaries are in no
way affected by the tubes. The ovarian function goes on, whether the
tubes perform their function of conveyance or not, and if this function
can be destroyed, life-long sterility is assured. There is no abdominal
operation more simple, rapid and safe, than simple ligature of the
Fallopian tubes. It may be performed by way of the natural passage, or
by the abdominal route, the choice depending on various circumstances.
If the former route be taken, there may be nothing to indicate, in some
cases not even to a medical man, that such an operation has been
performed.
The Fallopian tubes have been ligatured by Kossman, Ruhl and Neuman for
the sterilization of women with pelvic deformities; but all testify to
the danger of subsequent abnormal or ectopic pregnancy, and several
instances are given. Mr. Bland Sutton relates a case in an article on
Conservative Hysterectomy in the British Medical Journal.
After numerous experiments on healthy tubes, I have found that simple
ligature with even a moderate amount of force in tying will cut the tube
through in almost any part of its length. The mucous lining is so thrown
into folds that its thickness in relation to the peritoneal lay
|