86 THE PHYSIOLOGY OF REPRODUCTION 



Minot, 1 and Martin, 2 agree in supposing that the superficial 

 layers of the mucosa degenerate after the blood has passed out, 

 so that the bleeding is in no sense the consequence of the 

 destruction. According to Martin, fatty degeneration plays a 

 distinct part in causing the destruction. 



Lipes has shown that the amount of destruction is related to 

 the character of the haemorrhage. If the congestion is rapid 

 and the amount of extravasated blood large, the denudation 



FIG. 9 Section through mucosa of human uterus showing sub-epithelial 

 haematomata *. (From Sellheim.) 



is comparatively extensive ; but if the hemorrhage is slight, and 

 takes place chiefly by diapedesis, then the loss of tissue is 

 practically nil. Lipes adds that in none of the cases examined 

 by him were there enough epithelial cells in the discharge to 

 suggest a complete loss of epithelium. 



Galabin states that in addition to uterine and vaginal epithelial 

 cells being found in the discharge, shreds of tissue can frequently 

 be detected showing the structure of uterine stroma. Heape 3 



1 Minot, loc. cit. 



2 Martin, " The Physiology of Ovulation, Menstruation, and Fertilisation," 

 Hirst's Obstetrics, vol. i. 1888. 



3 Heape, " The Menstruation and Ovulation of Monkeys and the Human 

 Female," Trans. Obstet. Soc., vol. xl., 1899. 



