CHANGES IN THE NON-PREGNANT UTERUS 85 



the epithelial cells, or that a larger exit is provided by certain 

 of the cells being carried bodily away. Gebhard also believes 

 that bleeding may take place into the lumina of the glands. 

 Christ 1 states that when the menstrual flow is very profuse 

 there is a considerable loss of surface epithelium, but that in 

 other cases the removal of epithelium is slight. This author 

 has also described bleeding into the glands. (Fig. 9.) 



Very contradictory statements have been made regarding 

 the extent to which denudation takes place during menstruation. 

 Williams (Sir J.), von Kahlden, 2 and others among the older 

 writers, expressed the belief that a large part, if not the whole, of 

 the uterine mucous membrane was destroyed. This view, as 

 will be seen later, has been partially confirmed for monkeys by 

 Heape. It has been pointed out, however, by Whitridge 

 Williams, 3 that the older writers made their observations upon 

 uteri which had undergone post-mortem changes. The pre- 

 ponderance of recent opinion appears to be that destruction of 

 the mucous membrane is, as a rule, confined to the epithelium, 

 and that this is only partially removed. Among those 

 who have accumulated evidence in support of this conclusion 

 are Gebhard, Strassmann, 4 Westphalen, Findley, Whitridge 

 Williams, and Lipes. De Sinety, 5 Moricke, and Oliver appear 

 to uphold the opinion that even the superficial epithelium 

 remains practically intact. Mandl, 6 Maerdervort, 7 and also 

 Champneys 8 have made the exceedingly likely suggestion that 

 the extent to which the mucosa is destroyed varies within wide 

 limits in different individuals or even in the same individuals 

 at different periods of life. 



1 Christ, " Das Verhalten der Uterusschleimhaut wahrend der Menstrua- 

 tion/' Inorg. Dissert., Giessen, 1892. 



2 Von Kahlden, " Ueber das Verhalten der Uterusschleimhaut wahrend 

 und nach der Menstruation," Hegar's Festschrift, Stuttgart, 1889. 



3 Whitridge Williams, Obstetrics, London and New York, 1904. 



4 Strassmann, "Beitriige zur Lehre von der Ovulation, Menstruation, und 

 Conception," Arch. f. Gynak., vol. lii., 1896. 



5 De Sinety, " Kecherches sur la muqueuse uterine pendant la menstrua- 

 tion," Annalcs de Gyncec., 1881. 



6 Mandl, " Beitrag zur Frage des Verhaltens der Uterusmucosa wahrend 

 der Menstruation," Arch. f. Gynak., vol. lii., 1896. 



7 Maerdervort, " Die normale und menstruirende Gebarmutterschleimhaut," 

 Inorg. Dissert., Freiburg, 1895. 



8 Champneys, " On Painful Menstruation," Harveian Lectures, 1890. 



