A demonstration of specimens illustrating cysts of the female appendages / by Arthur Keith ; with notes, by Alban Doran.

  • Keith, Arthur, Sir, 1866-1955.
Date:
1910
Catalogue details

Licence: In copyright

Credit: A demonstration of specimens illustrating cysts of the female appendages / by Arthur Keith ; with notes, by Alban Doran. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Vaginal cysts are not rare, but as a rule, for instance, in Mr. Doran’s case, preserved in the Museum, they appear to arise from Skene’s tubules which are the homologues of the prostatic tubules, since they are always developed near the urethra. We cannot, however, be too careful lest we should fall into error about homologies, because great proliferation of epithelium occurs in foetal life, clogging the vagina. Hence the cyst above mentioned, and some other vaginal cysts preserved or reported, may have been developed out of epithelial invaginations. Thus there is much doubt about the relations of vaginal and urethral cysts to the opening of the Wolffian duct. Thei'e is, on the other hand, no uncertainty whatever about cysts whicli develop higher up in the vagina; some of them undoubtedly arise from the paravaginal portion of the Wolffian duct, “ Gartner’s duct,” ^ as it is generally called in human anatomy. In order to perfect, if possible, our knowledge of the origin of these cystic structures, it is important to study the Woffian bod}' and its duct in the human female independently of cysts and anomalies. The parovarium, as we usually call it, is not very small. Dr. Keith found that it can be most clearly defined in the new-born subject, although Percival Cole ^ recently reported that in the foetus the parovarium can with difficulty be distinguished by the naked eye, and that at the age of twelve, although the uterus and broad ligament and all the sexual apparatus have considerably increased, the parovarium is still a structure which might easily escape notice. Keith, on the other hand, finds, as Cole did, that the Wolffian body or parovarium reaches its highest development quite late in adult sexual life, about the 35th year. Cole, indeed, noted the most evident examples in women from 40 to 43. There are some fine dissections recently prepared for the College Museum demonstrating the Wolffian body in the human infant and adult, and its relations to the Kallopian tube and ovary. In one specimen a minute cyst is seen on the ovarian fimbria, and another on one of the vertical tubes of the Wolffian body or parovarium. As already shown, cysts of the latter type have never been traced upwards to the common broad ligament cystic tumour; there is little difficulty in demonstrating the development of the fimhrial cyst into the cystic tumour, a series of preparations at the College displaying that development. The development of Muller’s duct is not so intricate, but the 1. See Unterberger, “ Durch Laparotomie gewonnene Gartnersche Cysten,” Monatsschr. f. Geb. ii. Gyn., Vol. xxix, 1909, p. 587; an important paper, with references. An abstract appeared in the Journal, Vol. xvi, p. 123 (August 1909). 2. “The Relation of the Parovarium to Cyst Formation.” British Med. Jovrn., Vol. i, 1910 (March 24), p. 748.