DISEASES OF WOMEN.

GENERAL DIVISION.

PART I.

DEVELOPMENT OF THE FEMALE GENITALS.

THE history of the development of the female genitals being an indispensable key to the understanding of their malformations, which are of frequent occurrence and often of great importance in regard to life and happiness, we give here a résumé of the same.*

THE WOLFFIAN DUCTS.

The first organs belonging to the genital sphere which appear in the male as well as the female embryo are the Wolffian ducts. There is one on either side of the body, situated between the proto

Transverse Section through the Median Part of the Body of the Embryo of a Rabbit of nine days and two hours (enlarged 158 times): dd, hypoblast: dr, intestinal groove: ch, notochord; ao, descending aorta; un, protovertebra: mr, medullary tube; ung, Wolffian duct; dfp, visceral division of the mesoblast; g, vessels in the deeper parts of the visceral mesoblast; hp, parietal mesoblast; h, epiblast; pp, pleuro-peritoneal cavity (Kölliker). vertebral column and the lateral plates (Fig. 1). Originally it is a *This is an abstract of the author's more elaborate article on the subject in A System of Gynecology by American Authors, edited by M. D. Mann, Philadelphia, 1887.

solid string, but it is later tunnelled, so as to form a tube. The upper end lies on a level with the fourth or fifth vertebra, and connects soon with the Wolffian body, forming its outlet. The lower end opens into that part of the allantois which is situated in the body of the embryo and communicates with the cloaca. After the separation between the urogenital canal and the intestine the Wolffian duct ends in the urogenital sinus (Fig. 2).

Sagittal Section through the Posterior Part of the Body of the Embryo of a Rabbit of eleven days and ten hours (enlarged 45 times): wg, Wolffian duct; n, ureter; n', beginning formation of the kidney; ug, urogenital sinus; cl, cloaca; hg, region in which, in the mesial plane, the hind-gut, opens into the cloaca; ed, post-anal gut; a, anus, or fissure of the cloaca; 8, tail; r, perineal fold (Kölliker).

In the male the Wolffian duct becomes, in the course of time, the tail of the epididymis and the vas deferens. In the female it disappears more or less completely. Still, in the cow and the sow it persists as Gartner's canal. In woman remnants of it are found in the broad ligaments.

THE WOLFFIAN BODIES.

Shortly after the Wolffian ducts appear the Wolffian bodies. These are two long prismatic bodies, one on either side of the median line (Fig. 3). The upper end is fastened to the diaphragm, the lower to the inguinal region by a ligament which in course of time becomes the round ligament of the uterus, or the gubernaculum testis in the male (Fig. 4). They fill the hollow of the posterior wall of the abdominal cavity, leaving a narrow fissure on either side. In the inner one of these is later developed the genital gland; in the outer lies the Wolffian duct, and later also the Müllerian duct.

These bodies originate from the endothelium of the peritoneum, and form at first a long row of pear-shaped solid bodies. Later,

Human Embryo of thirty-five days (front view): 3, left external nasal process: 4, superior maxillary process; z, tongue; b, aortic bulb; b', first permanent aortic arch; b", second aortic arch; b", third aortic arch, or ductus Botalli; y, the two filaments to the right and the left of this letter are the pulmonary arteries, which just begin to be developed; c, the trunk of the superior vena cava and right azygos vein; c', the common venous sinus of the heart; c", the common trunk of the left vena cava and left azygos vein; o, left auricle of the heart; v, right ventricle; v', left ventricle; ae, lungs; e, stomach; j. left omphalomesenteric vein; s, continuation of the same behind the pylorus, which afterward becomes the vena porta; z, vitello-intestinal duct; a, right omphalo-mesenteric artery; m, Wolffian body; , gut; n, umbilical artery; u, umbilical vein; 8, tail; 9, anterior limb; 9. posterior limb. The liver has been removed. The white band at the inner side of the Wolffian body is the genital gland, and the two white bands at its outer side are the Müllerian and the Wolffian ducts (Coste).

these are separated from the peritoneum and become hollow, forming a row of vesicles called the segmental vesicles, each of which soon connects with the Wolffian duct by the absorption of the tissue intervening between their cavities and the bore of the duct. The former

vesicles appear now as branches of the Wolffian duct (Fig. 5), which grow rapidly and connect at the other end with arterial tufts in the same way as the uriniferous ducts and the Malpighian tufts in the kidneys.

In the male the Wolffian body later is transformed into the epidididymis and the organ of Giraldez (Fig. 6); in the female into Rosen

The Genital and Urinary Organs of the Embryo of Cattle:

1, from a female embryo 11⁄2 inches long (double size): w, Wolffian body; wg, Wolffian and Müllerian ducts; i, inguinal ligament of Wolffian body; o, ovary with an upper and lower peritoneal fold: n, kidney; nn, suprarenal body; g, genital cord, composed of the united Wolffian and Müllerian ducts.

2, from a male embryo 21⁄2 inches long (nearly three times natural size): one of the testicles has been removed. Letters as in Fig. 1, and, besides, m, Müllerian duct; m', upper end of the same; h, testicle; h', lower ligament of testicle; h", upper ligament of testicle; d, diaphragmatic ligament of Wolffian body; a, umbilical artery; v, bladder.

3, from a female embryo (enlarged nearly three times). Letters as in Figs. 1 and 2, and, besides, t, opening of the upper end of Müller's duct; o', lower ovarian ligament; u, thickened part of Müllerian duct, which later becomes the uterine horn (Kölliker).

müller's organ, or the parovarium, and stray tubes found between the parovarium and the uterus (Fig. 7).

THE OVARIES.

In the beginning the sexual glands are identical in both sexes. At the end of the second month the ovary and the testicle begin to differ from one another, the testicle becoming broader and shorter, while the ovary stays long and narrow. The ovary has a much more developed columnar epithelium than the testicle.

The sexual glands are situated on the inner side of the Wolffian body (Fig. 4), to which they are fastened by a fold of the peritoneum

called the mesorchium in the male and the mesoarium in the female. At the upper end is a ligament which unites with the diaphragmatic ligament of the Wolffian body; at the lower end is another ligament, which is fastened to the Wolffian duct, opposite the starting-point of the inguinal ligament of the Wolffian body, and which later becomes the permanent ligament of the ovary.

The shape of the ovary undergoes great changes. At first it is a long flat body. Later it grows, especially at the edges, so that a transverse section has the shape of a bean or a mushroom (Fig. 8), and finally the transverse section becomes pear-shaped.

The ovary is subject to a descent just as the testicle. At the birth of the child the ovaries are yet situated above the ileo-pectineal line, and descend into the true pelvis during the first two or three months

Posterior End of the Embryo of a Dog, with budding alantoid. The mesoblast and the hypoblast, or the beginning of the intestine and the neighboring parts of the blastodermic vesicle, are thrown back in order to show the Wolffian bodies (enlarged 10 times). a, Wolffian bodies, with the duct and the single blind canals; b, protovertebræ; c, spinal marrow; d, entrance to the pelvic intestinal cavity (Bischoff).

of the child's life. This descent is partly apparent and partly real: it is chiefly due to the greater growth of the parts above the ovaries; but, besides that, a shrinking of the round ligament of the uterus takes place, by which the ovaries indirectly are pulled down. At the same time there is a change in position by which the upper end sinks considerably downward and outward, and the whole organ turns around its long axis until the inner edge becomes the lower, where the hilum is; the outer becomes the upper, free edge; the anterior surface becomes the inner, the posterior becomes the outer. The relations to the Fallopian tube are changed in such a way that the