CHANGES IN NON-PREGNANT UTERUS 



81 



character of the haemorrhage. If the congestion is rapid and the 

 amount of extravasated blood large, the denudation is comparatively 

 extensive ; but if the haemorrhage is slight, and takes place chiefly 

 by diapedesis, then the loss of tissue is practically nil. Lipes adds 

 that in none of the cases examined by him were there enough 

 epithelial cells in the discharge to suggest a complete loss of 

 epithelium. 



Galabin states that in addition to uterine and vaginal epithelial 

 cells being found in the discharge, shreds of tissue can frequently be 

 detected showing the structure of uterine stroma. Heape x also has 



FIG. 10. Section through mucosa of human uterus, showing sub-epithelial 

 hsematomata *. (From Sellheim.) 



detected stroma tissue in the menstrual discharge of the human 

 female. This clearly shows that destruction is not always confined 

 to the epithelial layer. 



The blood poured out into the uterine cavity, and thence to the 

 exterior, does not usually clot, unless the amount be excessive. This 

 is probably due to the absence of fibrin ferment, and perhaps also 

 to the fact that the blood is considerably diluted with mucus derived 

 from the uterine glands. The glandular activity is accompanied by 

 an emigration of leucocytes which, according to Blair Bell, 2 are 

 engaged in excreting calcium compounds (see p. 63). The relative 



1 Heape, "The Menstruation and Ovulation of Monkeys and the Human 

 Female," Tram. Obstet. Soc., vol. xl., 1899. 



2 Blair Bell, " Menstruation and its Relation to the Calcium Metabolism," 

 Proc. Rot/. Soc. Med., July 1908. 



