THE FEMALE GENITAL TEACT. 837 



latter show only flat epithelia. He believes membranous dysmenorrhcea 

 depends upon a diseased condition of the uterus, such as chronic metritis, 

 fibrous tumors, or displacements. He says the tissue between the tubular 

 glands consists of small, polyhedral or globular cells whose nuclei almost fill 

 the bodies. Between these cells he found clusters of small, globular lymph- 

 corpuscles. Evidently, he does not consider these cells to be decidual forma- 

 tions. He also found a few waving arteries in the midst of the membrane, 

 and a great many capillaries close beneath the surface epithelia, where the 

 hemorrhagic clots are situated. He agrees with Beigel in terming this condi- 

 tion chronic endometritis and endocolpitis exfoliativa. 



J. Hoggan and F. E. Hoggan * draw attention to the difference between 

 membranes cast off from the uterus and those from the vagina. In the for- 

 mer, utricular glands were present, and around them, in a transparent matrix 

 or intercellular substance, embryonal cells in different stages of development 

 were noticed. These writers also call attention to the presence of embryonal 

 tissue below the epithelia of the normal uterus, which they consider to be 

 morphologically identical with that of true decidua, as well as that of the dys- 

 menorrhoeic membrane. 



Wydert asserts that, in menstruation, the superficial layers of the mucosa 

 are cast off, whereas the deep layers remain intact. A distinguishing feature 

 between decidua vera and menstrualis is that, in the latter, the inter-glandular 

 cells are small, round cells, almost completely filled by the nucleus, while in 

 the former, the nucleus, in comparison with the protoplasm, remains small. 

 He considers dysmenorrhoea membranacea (1) as a fibrous coagulum, (2) as a 

 mucosa altered by endometritis, and (3) as a decidua of pregnancy. 



The results of my studies of the structure of decidual formations are the 

 following : 



1. Decidua menstrualis is formed by medullary or embryonal corpuscles, exhib- 

 iting a gradual development from a shining, globular, homogeneous mass of living 

 matter into nucleated plastids. 



2. Basis-substance, in decidua menstrualis, is always scanty. It may appear 

 either in the myxomatous or fibrous varieties. In the former, it is slightly granu- 

 lar and apparently structureless ; in the latter, it is either reticular or arranged in 

 fibrous bundles. Both kinds of basis-substance are formations springing from the 

 original medullary corpuscles. 



3. Decidua catamenialis is traversed by a large number of blood-vessels, mostly 

 capillaries. In some cases there is also a distinct new growth of arteries in such 

 quantities as to greatly exceed the capillaries. Frequently, also, the formation of 

 veins occurs. 



4. Decidua catamenialis always contains glands of the tubular variety, lined 

 by columnar ciliated epithelia. Very probably, these glands are not new forma- 

 tions, but simply the remains of the original utricular glands. 



5. Decidua refiexa is composed of large medullary corpuscles, mostly of oval 

 shape. The formation of a myxomatous and fibrous basis-substance is much 

 further advanced, and the amount of venous blood-vessels much greater than in 

 decidua catamenialis. 



6. Decidua vera is made up of a freely vascular ized and fully developed myxo- 



*" Pathology and Therapy of Dysmenorrhcea Meinbranacea." Archiv fur Gynakologie, 

 1876. 



f'Beitrage zur normalen nnd patholog. Auatomie der menschl. Uterus-Schleimhaut. 

 Archiv. 1. Gynakologif, Bd. xiii. 



