372 SURGICAL APPLIED ANATOMY. [Chap. xvm. 



The female generative organs require but 

 little notice in the present volume. The labia majora 

 have the same pathological tendencies as has the 

 scrotum, to which, indeed, they anatomically correspond. 

 They are liable to present large extravasations of 

 blood, are greatly swollen when cedematous, are prone 

 to slough when acutely inflamed, and are the usual seats 

 of elephantiasis in the female. A hernia may present 

 in one or other labium (pudendal hernia), the neck of 

 the sac being between the vagina and the pubic ramus. 



The vagina is lodged between the bladder and 

 rectum, while the upper fourth of its posterior surface 

 is covered with peritoneum, and is therefore in relation 

 to the abdominal cavity. Thus it happens that the 

 bladder, the rectum, or the small intestines, may pro- 

 trude into the vagina by a yielding of some parts of 

 its walls and thus produce a vaginal cystocele, recto- 

 cele, or enterocele. 



The abdominal cavity may be opened through a 

 wound of the vagina. In one or two instances of such 

 injuries several feet of intestine have protruded 

 through the vulva. In one reported case an old 

 woman, the subject of a brutal rape, walked nearly a 

 mile with several coils of the small bowel hanging 

 from her genitals. 



From the comparative thinness of the walls that 

 separate the vagina from the bladder and rectum, it 

 happens that vesico-vaginal and recto-vaginal fistulae 

 are of frequent occurrence. The vagina is very 

 vascular, and wounds of its walls have led to fatal 

 haemorrhage. . It is very dilatable, as can be shown 

 when the canal is plugged to arrest haemorrhage from 

 the uterus. 



The unimpregnated uterus is very rarely wounded, 

 owing its immunity to the denseness of its walls, to 

 its small size, to its great mobility, and to its position 

 within the bony pelvis. 



