THE REPRODUCTIVE ORGANS OF THE FEMALE. 669 



hyperaeniia, haemorrhoids, acute hyperaemia, intra-iiteriue polypi and 

 other tumors, acute and chronic inflammation, typhus fever, scurvy, etc., 

 ulcerating carcinoma, abortions, and miscarriage. 



A peculiar form of haemorrhage results in the so-called polypoid hcema- 

 toma, or fibrinous polyp. It occurs after parturition and after abortions. 

 The portion of the uterine wall where the placenta was attached, with or 

 without a portion of retained placenta, forms the point of attachment of 

 the pedicle of the thrombus. A bloody mass is firmly attached by a 

 pedicle to the uterine wall ; the uterus enlarges with its formation, the 

 cervix is dilated, and the thrombus may project into and fill the vagina. 

 The formation of such a thrombus is accompanied by repeated haemor- 

 rhages. 



Haemorrhage in the substance of the uterus occurs in arterio- sclerosis. 

 The mucous membrane and uterine wall or the cervix are infiltrated with 

 blood, and there may be blood in the uterine cavity. 



Peri-uterine or Retro-uterine Hsematocele consists in an accumulation of 

 blood around the uterus or in Douglas' cul-de-sac. The haemorrhagic 

 mass may become encapsulated with fibrous tissue, or may soften or 

 suppurate and perforate into rectum or vagina, or may be absorbed. 

 A form of extraperitoneal haematocele is described in which the blood 

 lies between the folds of the broad ligament. The extravasation may 

 proceed from haemorrhage of any of the abdominal viscera or rupture of 

 aneurisms ; from vascular new-formed false membranes ; from rupture of 

 the varicose veins of the broad ligaments ; from rupture of haemorrhagic 

 cysts of the ovaries ; from the Fallopian tubes in tubal pregnancy or in 

 haematometra ; or from general causes, such as scurvy, purpura, etc. In 

 some cases the extravasation begins at a menstrual period, and increases 

 at the succeeding periods. 



Ante-uterine Haematocele is of occasional occurrence, either in connec- 

 tion with the retro-uterine form or when the posterior cul-de-sac is ob- 

 literated. 



ATROPHY, DEGENERATION, ETC. 



Atrophy of the uterus occurs as a physiological process in old age. 

 It may be associated with severe general or infectious diseases or follow 

 removal of the ovaries. It may follow pregnancy apparently as an ex- 

 cessive involution process. 



Fatty Degeneration. This may occur in connection with inflammatory 

 changes, in acute infectious diseases, and iu phosphorus poisoning. 



Amyloid Degeneration in the uterus is of rare occurrence. It may 

 affect the muscle fibres or the walls of the blood-vessels. 



Phagedenic or Corroding Ulcer. This rare and little understood form 

 of ulceration usually occurs in old age. It begins in the cervix and 

 gradually extends until it may destroy the greater part of the uterus or 

 even invade the bladder and rectum. The ulcer is of irregular form ; its 

 base is rough and blackish, its walls are indurated. It should not be 

 confounded with carciuomatous ulcer, which it considerably resembles. 



