THE REPRODUCTIVE ORGANS OF THE FEMALE. 665 



small in proportion to the cervix. At puberty the shape changes and the body be 

 conies larger. 



At every menstruation the uterus is somewhat swollen and congested. After preg- 

 nancy it does not return to its virgin size, but remains somewhat larger. In old age it 

 gradually becomes smaller; its walls are harder and more fibrous. 



ABNORMAL, SMALLNESS of the uterus is sometimes found as an arrest of develop- 

 ment. It may result, however, from chronic endometritis, from repeated pregnancies, 

 from old age, or from chronic exhausting diseases. Its cavity may be smaller than 

 normal, or distended with mucus. Large myomata sometimes induce atrophy of the 

 uterine wall. Atrophy of the vaginal portion of the uterus is sometimes observed after 

 repeated pregnancies. Narrowing and obliteration of the cavity of the uterus and of 

 the cervix are usually produced by chronic inflammation. 



ENLARGEMENT OP THE UTERUS may be due to too early development. It is ac- 

 companied by abnormally early development of all the sexual organs and functions. 

 The uterus may be enlarged in connection with heart disease, prolapse and abnormal 

 flexions and versions, chronic inflammations, repeated pregnancies, myomata, and ac- 



FIG. 430. HOUR-GLASS UTERUS. 



Showing a small uterus with distention of the cavities of the body and cervix from flbrous-tissue contraction 

 at the os externum and the os internum. 



cumulations of blood or mucus in the uterine cavity. Enlargement of the vaginal .por- 

 tion alone may occur. One or both lips of the cervix may be uniformly increased 

 in size, or they may be lobulated. 



Dilatation of the uterus is produced by accumulations of blood, mucus, or pus in 

 consequence of narrowing or obliteration of the cervix or vagina. The uterine walls 

 may retain their normal thickness, be thickened or thinned. The most frequent posi- 

 tion of the stenosis is the os internum. The retained contents after a time change in 

 character, forming a thin, serous fluid hydrometra or they may be mixed with blood. 

 The dilated uterus may be of enormous size. If both os internum and os externum are 

 closed the cervical cavity may be also dilated and the uterus have an hour-glass shape 

 (Fig. 420) ; or the dilatation may be limited to the cervix. If the obstruction is not 

 complete, the retained fluid may escape into the vagina and be followed by a fresh ac- 

 cumulation. If the obstruction be in the vagina, the uterus and vagina may form 

 a large, flask-shaped body, and the line of demarcation between cervix and vagina 

 be lost. 



