Cervicitis 621 



der parturition impossible without surgical interference, but 

 in no case hermetically sealed the canal. I have seen com- 

 plete atresia of the cervical canal only in uterine abscess un- 

 less the arrest in development of the cervix in the embryo, 

 in which the canal fails to become excavated, may be called 

 atresia. 



The bacteriology of cervicitis, in any reliable measure, is 

 yet to be learned. Thus far the chief invader recognized is 

 the streptococcus viridans. There is doubtless a wide varia- 

 tion in bacteria. In purulent cervicitis the streptococcus 

 viridans is probably not the real offender. In histologic 

 section of the inflamed mucosa, bacteria are abundant, 

 especially within the mucous glands, where they mingle with 

 the epithelial debris. 



The prognosis of cervicitis is dependent upon its in- 

 tensity, type and duration. In itself, cervicitis is gen- 

 erally remediable, but, if intense and neglected, the in- 

 fection tends to invade the oviducts and pass beyond surgi- 

 cal control. Many cases recover spontaneously or are of so 

 mild a type that the disease does not prevent conception. As 

 a rule, cervicitis of moderate or great intensity either de- 

 lays or prevents conception. The exact method by which it 

 interferes with conception has not been fully determined. 

 In certain extreme cases the profuse secretion of tenacious 

 mucus apparently entangles the spermatozoa and inhibits 

 their migration to the oviduct. In some cases the bacterial 

 toxins present probably disable and eventually destroy the 

 spermatozoa, but in a very large measure the copious secre- 

 tion of mucus during estrum floods the cervical canal and 

 vagina, washes away or submerges the bacteria, and serves 

 as a protective bridge over the infected mucosa, in which 

 the spermatozoa may move freely and safely. 



The greatest danger from cervicitis apparently arises 

 after fertilization. Then the infection tends to inhibit the 

 prompt physiologic sealing of the canal and is free to attack 

 the embryo immediately it arrives in the uterine cavity. 

 Cervicitis is the fundamental lesion in abortion and re- 

 tained fetal membranes. In all recorded cases of autopsy 



