THE REPRODUCTIVE ORGANS OF THE FEMALE. 



675 



without them, there may be thrombosis of the uterine sinuses, purulent 

 inflammation of the veins, suppuration and abscess in the uterine wall, 

 suppurative inflammation of the ovaries and tubes, and, owing to the 

 generalization of the infectious material, metastatic abscesses in the lungs, 

 spleen, kidneys, etc. Or acute pleurisy, ulcerative endocarditis, ery- 

 sipelas, purulent inflammation of the joints, hyperplastic swelling of the 

 spleen and lymph-nodes, thrombosis or thrombo- phlebitis of the saphen- 

 ous veins, etc. , may follow. In some cases which rapidly pass to a fatal 

 termination the local lesions may be but slightly marked, and general al- 

 terations characteristic of pyaemia, such as metastatic abscesses, etc., be 



'&"S.'-- : J--:" 7 - >* : "/;-' <^ ;-'. ;> ""&;;'-''./.*;.'" ''':' : "/'.. '^x..'^-'^''-'^-.-': > 





FIG. 437. UTERINE PHLEBITIS FOLLOWING DELIVERY; WITH RETAINED PLACENTA. 

 Death nine days after delivery. Micrococci in the walls of the inflamed veins stained violet. 



entirely wanting. Death is in such cases apparently due to toxaemia or 

 septicaemia. 



Bacteria are usually present in the exudate, in the lymph-vessels, 

 veins, and inflamed tissue of the uterus (see Fig. 427) ; often in enormous 

 quantities in the peritoneal exudation and in the metastatic inflammatory 

 foci. Streptococcus pyogenes, the gonococcus, B. aerogenes capsulatus, 

 and the colon bacillus are the most frequent excitants of the lesion. ' 



TUMORS. 



Fibromata. Dense nodular fibromata of the uterus are rare, the so- 

 called fibromata being in most cases myomata or fibro-myomata. Fibroma 

 papillare, on the other hand, is a common form of growth from the mu- 



1 Consult Wadsworth, "On Puerperal Infection," Am. Jour, of Obstetrics, vol. xliii., 

 1901. 



