550 THE PHYSIOLOGY OF REPRODUCTION 



FlG. 133. Virginal exter- 

 nal os (human). (From 

 Williams' Obstetrics, 

 Appleton & Co. ) 



After a first delivery its outlet remains permanently wider than 

 before. The rugse reappear about the third week. The place 

 of the hymen is taken by numerous small tags of tissue which 

 become transformed into the carunculae myrtiformes. The 

 condition of the labia majora and 

 labia minora is generally flabby and 

 atrophic as contrasted with that exist- 

 ing in virgin women. 



The characteristic changes which 

 occur in the breasts in connection 

 with the secretion of milk are described 

 in the next chapter. 



The quantity of urine passed during 

 the first two days of the puerperium is 

 generally above the average. The urine 

 frequently contains sugar, which may be either glucose or lactose. 

 In the latter case it is generally believed that the sugar has been 

 absorbed into the circulation from the changed mammary glands. 

 When glycosuria occurs, it is probably comparable to post-opera- 

 tive glycosuria (see p. 510 and pp. 571573). Albumen may 

 also be present in the urine in the first 

 days of the puerperium. It is stated 

 further that there is an increase in the 

 amount of acetone 1 (see also p. 507). 

 As mentioned above, a marked leuco- 

 cytosis occurs during labour. According 

 to Hofbauer, 2 this becomes still more 

 pronounced during the first twelve 

 hours of the puerperium, after which 

 the number of leucocytes in the blood 

 falls again and in a short time becomes 

 normal. Henderson 3 states that on the 

 fifth day the average number of leucocytes per cubic millimetre is 

 12,000, whereas immediately after parturition it is 21,000, as 



1 Scholten, " Ueber Puerperale Acetonurie," Hegar's Beitrdge zur Oeb. 

 und Gyncik., vol. Hi., 1900. 



2 Hofbauer, "Zur Physiologic des Puerperiums," Monatsschr. f. Geburt. 

 und Gynak., vol. v., 1897. 



3 Henderson, " Observations on the Maternal Blood at Term and during 

 the Puerperium," Jour, of Obstet. and Gyncec., vol. i., 1902. 



i 





FlG. 134. Parous exter- 

 nal os (human). (From 

 Williams' Obstetrics, 

 Appleton & Co.) 



