682 



UTERUS AND ITS APPENDAGES. 



characterise it in infancy or childhood. Such 

 may be the condition of the entire internal 

 organs, as in the accompanying example (fig. 

 465.) of the undeveloped uterus from a 

 female aged 19, who had never menstruated. 

 In these cases, the body generally exhibits a 

 corresponding feebleness of growth, and the 

 sexual attributes are little, if at all, dis- 

 played. 



The infantine condition of the uterus is 

 here exhibited in every particular. The 

 proportionately large size of the cervix, b, 

 the small triangular uterine cavity, a, with a 

 raphe extending into it, and the thin parietes, 

 are precisely such as are usually found in the 

 infantine organ. 



In the last case, the ovaries exhibit also 

 their ordinary infantine proportions ; but 

 these may become developed, and the func- 

 tions of menstruation may proceed naturally, 

 while the external characteristics also are 

 those of a well-formed female, but the uterus 

 remains small, the vagina is short, and instead 

 of terminating in the usual fornix, with a pro- 

 jecting cervix, this canal ends in an aperture, 

 which just admits a sound or probe, and is 

 not furnished with the usual lips of the os 

 tincae. These cases usually result in sterile 

 marriage, and may be easily detected during 

 life. 



Anomalies of form. Deviations from the 

 ordinary form of the uterus which are ac- 

 quired during life, and do not proceed from 

 original maltbrmation, or imperfect develop- 

 ment, such as that last noticed, will be here 

 considered. 



The angular flexions of the uterus which 

 take the definite forms of a forward or back- 

 ward curve, or of an inflexion towards either 

 side, are distinguished as anti- and retro- 

 flexion and lateral inflexion. 



a. Antiflexlon of the uterus is that condition 

 of the organ in which, without any material 

 change of position in the cervix, the body is 

 bent forwards, so that the fundus, lying more or 



Fiy. 4-66. 



less horizontally, is directed towards the sym- 

 physis pubis, while, according to the degree 

 of inflexion, the anterior wall of the uterus is 

 brought near to, or in contact with, the cervix 

 in front, while the posterior wall looks up- 

 wards, corresponding more or less with the 

 plane of the pelvic brim. The point of cur- 

 vature is always at the line of junction of the 

 body with the cervix uteri, and here an angle 

 more or less acute is formed. 



Fig. 466., giving a lateral view of the anti- 

 flexed uterus, exhibits the relative situation of 

 its various parts when this deformity exists in 

 the highest degree. 



Now a slight amount of antiflexion of the 

 body upon the cervix has been shown by figs. 

 426. and 433. to be natural to the uterus ; 

 and it is not until one or two pregnancies have 

 supervened, that this forward tendency, when 

 excessive, is lost, and hardly even then, for 

 the uterus may still retain that correspondence 

 in form, with the curvature forwards of the 

 pelvic cavity, which is so prominently ex- 

 pressed in the curve of the sacrum, and is in 

 accordance with the normal form of the ute- 

 rine canal. In the foetus (fig. 467.), and 

 during early infancy, antiflexion exists as a 



Fig. 467. 



Antiflexion of the uterus. (After Boivin and 

 Duges.} 



The point of flexure is at tlie junction of the boily 

 with the cervix. Both canals are laid open. (The 

 tigure is viewed from the right side.) 



Natural state of antiflexion of the uterus in ftetal 

 and infantine life. (After Bourgery.) 



a, body, and b, fundus of the uterus; c, point of 

 junction'of body and cervix ; d, cervix ; e, os tineas ; 

 ./; vagina ; g, hymen ; j, bladder ; k, rectum ; I, Fal- 

 lopian tube ; n, symphysis pubis ; m, labiutn. 



normal state, and it appears to me that this 

 bias towards a forward inflexion of the uterus 

 at the early periods of life is given by that 

 remarkable bending forwards of the lower ex- 

 tremity of the spine which is observable in 

 the early embryo. The part containing the 

 structures that are afterwards developed into 

 the uterus exhibits then an abrupt curve, which 

 at this early period will probably be impressed 

 upon the organs within, and being abnormally 



