UTERUS (NORMAL ANATOMY). 



of either lip. Within the cervical canal the 

 epithelium changes its form. It has been 

 described here as constantly cylindrical or 

 dentate; but upon all the finer structures 

 here found, such as the filiform papillae, this 

 so-called epithelial covering consists, as 

 Reichert has well described, and Kilian ac- 

 curately represented it, of elementary cells, 

 whose cell membranes are closely united to- 

 gether, having a polyhedral outline, and \\ ith- 

 out undergoing such an amount of flattening 

 as to lo.se their spherical form. They contain 

 a slightly flattened nucleus with several nu- 

 cleoli, surrounded by a clear somewhat thick 

 fluid intermixed with molecular bodies, and 

 sometimes oil globules. 



Some difference of opinion exists as to the 

 part of the cervical canal in which the epithe- 

 lium first becomes ciliated. Drs. Tyler Smith, 

 and Hassall, who have examined numerous 

 uteri at an early period after death, with a 

 view to anticipate post-mortem changes, state 

 that the ciliation of the epithelium commences 

 in the rugose portion of the canal, and ex- 

 tends up to the fundus, while the epithelium 

 just within the os, though also cylindrical, is 

 not ciliated.* It should be observed, however, 

 that there is no particular portion of the cer- 

 vical canal in which the membrane constantly 

 becomes rugose, but that the rugosities often 

 extend quite down to the margin of the os. 

 According to Henle f, the cervix is provided 

 with ciliated epithelium from the middle up- 

 wards, and with pavement epithelium from 

 that point downwards. 



One peculiarity or variety in the arrange- 

 ment of the epithelium upon the vaginal por- 

 tion of the cervix requires special notice here 

 on account of the singular degree of import- 

 ance which has of late years been attached to 

 it, and still more from the remarkable pa- 

 thological speculations to which it has given 

 rise. 



It occasionally happens that the tessellated 

 epithelium of this part, instead of extending 

 as far as the os, abruptly ceases at a distance 

 of one or two lines from the inner margin of 

 either or both lips, leaving a single or double 

 crescentic patch where the ordinary pave- 

 ment epithelium is replaced by a crop of close- 

 set filiform papillae, projecting very slightly, 

 if at all, above the general surface, and pre- 

 senting to the touch that velvety feel, and to 

 the eye, on account of their great vascularity, 

 that florid aspect, which has often led to the 

 supposition that this mere morphological va- 

 riety of structure is the result of a pathologi- 

 cal change, and that it constitutes a form of 

 ulcer peculiar to the os uteri. 



Beneath the epithelium is a basement mem- 

 brane, which, upon the outer portion of the 

 cervix, extends in a smooth lamina over the 

 papillae that everywhere crowd this part, but 



* Memoir on the Pathology and Treatment of 

 Leucorrhoea, based upon the microscopical anatomy 

 of the os and cervix uteri Med. Chir. Trans., vol. 

 xxxv. 1852. 



t Allege m. Anatom., p. 246. 



639 



within the cervical canal it dips into the 

 furrows and follicles, or covers its numerous 

 rugosities and projections. 



An unequal layer of fibrous tissue, traversed 

 by vessels, and supporting and containing the 

 numerous papilla? and mucous crypts of vari- 

 ous forms and sizes which characterise the 

 cervical mucous membrane, completes this 

 structure. Tough and coriaceous upon the 

 outer portion, and thinner and more delicate 

 within the canal of the cervix, it forms the 

 chief substance of the mucous membrane, and 

 lies immediately upon the muscular coat, the 

 fibres of which become intermingled with it. 



The papilltB, or villi, as they are sometimes 

 termed, of the cervix, exhibit considerable 

 varieties of size and figure, being conical, 

 verrucose, or tuberculated, dentate, clavate, 

 and filiform. The clavate papillae are usually 

 found fringing the surface and margins of the 

 thinner plicae. The dentate usually form a 

 border to those which are a little more fleshy, 

 and are commonly seen at the margins of the 

 lateral and upper mucous folds. The verru- 

 cose papillae are seen in various situations, 

 but are most constantly observed in the sharp 

 lateral furrows which constitute the lines of 

 demarcation between the two cervical walls. 

 The filiform papillae are the finest of all. 

 They are more slender and pointed than the 

 clavate. They occur under two forms, and in 

 two situations. 



One of these forms is invariably present on 

 the outer or vaginal part of the cervix. The 

 whole of this portion, from the margins of the 

 os outwardly, is covered by numerous short 

 close-set thread-like papillae, invisible to the 

 naked eye, but with the help of a sufficient 

 amplifying power easily distinguished by their 

 white colour, through the somewhat dense 

 layer of pavement epithelium and basement 

 membrane that closely covers and binds them 

 down. Similar papillae clothe the inner sur- 

 face of the vagina, and form, with those just 

 described, a continuous layer. 



The filiform papillae constituting the second 

 variety are larger and longer than these, so that 

 they may be discerned by the naked eye. They 

 occur usually at the margins of the os, and 

 may be traced to a variable distance within the 

 canal. But their presence here is uncertain, 

 while that of the former variety is constant 

 in the situations indicated. These larger fili- 

 form papillae may be sometimes seen to form 

 the terminations of the longitudinal cervical 

 plicae in those cases where parallel folds run 

 down to the very margins of the os uteri. 

 Here the folds, each ending in a little tuft or 

 tassel, form by their junction a close-set crop 

 of villi, which may merely border one or both 

 lips with a narrow fringe, or form a velvetty 

 patch extending outwardly upon the lips of 

 the cervix, and being here uncovered by the 

 ordinary dense epithelial layer of this region, 

 which, as just stated, sometimes, terminates at 

 this spot with an abrupt margin, they may 

 present the appearance already described as 

 simulating an ulcer. 



Regarding the minuje structure and compost- 



