UTERUS (ABNORMAL ANATOMY). 



the menstrual molimen may not be thereby 

 hindered, but the escape of blood can only 

 take place, if at all, from some unsuitable 

 situation producing the so-called menses devii, 

 or vicarious menstruation. 



Regarding the influence of these malforma- 

 tions upon insemination and a resulting im- 

 pregnation, much of necessity depends upon 

 the condition of the vagina ; for this canal may 

 be in so rudimental a state as not to admit 

 of intromission. The canal leading to the 

 ovary also may be either open or closed. In 

 the case of the rudimental tube attached to 

 one side of a single developed cornu, the 

 passage may open into the cervix of the de- 

 veloped half, and thus a channel for the se- 

 minal fluid will be established in connexion 

 with an ovary that may be normally formed, 

 and thus impregnation and gestation, even in 

 an undeveloped cornu, is possible.* 



Greater difficulties and considerable danger 

 indeed to life arise, during the progress of 

 gestation, in the higher deformities of this 

 class. Pregnancy in a rudimental horn would 

 probably be attended by rupture and fatal 

 haemorrhage at an early period, as happened 

 in Rokitansky's case quoted in the last note, 

 and as usually occur also in the not dissimilar 

 example of ordinary tubal gestation. But 

 even in the case of pregnancy occurring in 

 the developed horn of a uterus unicornis, the 

 undeveloped half will exercise a marked in- 

 fluence upon the progress of gestation, by 

 impeding the due expansion of the developed 

 side; while the supply of blood usually fur- 

 nished in pregnancy being here provided by 

 only one set of vessels, the course of the 

 pregnancy will probably suffer in a corre- 

 sponding degree. 



681 



In the cases of the uterus bicornis and 

 bilocularis, either horn, or either uterine half, 

 may become separately or alternately the seat 

 of gestation, or pregnancy may proceed simul- 

 taneously in both. There is even reason to 

 suppose that twins have been developed in 

 one half, and also that superfuetation has 

 obtained in such a condition of parts. 



In those cases where the vagina is parti- 

 tioned into two canals impregnation may take 

 place more frequently or even exclusively on 

 one side, in consequence of the one channel 

 or half being more favourably formed for in- 

 tromission than the other. 



Regarding the influence which these ano- 

 malies may have over the last office of the 

 uterus, viz. parturition, it is only necessary to 

 observe that in both the uterus" bicornis and 

 bilocularis the organ will be deprived of the 

 advantageous use of the fundus, which so ma- 

 terially aids expulsion in a normally formed 

 uterus, while in the case of the uterus uni- 

 cornis and bicornis, where the impregnated 

 half usually forms an acute, or even nearly a 

 ri^ht angle with the axis of the body, the 

 effect, as Rokitansky has shown *, will be, 

 that during the act of parturition the axis of 

 the impregnated half meeting with the vaginal 

 axis in an obtuse angle, the direction of the 

 uterine force and of the expulsion of the 

 foetus will cross the axis of the pelvis, and 

 fall upon the pelvic parietes that lie opposite 

 to the vertex of the pregnant half of the 

 womb v and thus the act of parturition will be 

 rendered correspondingly difficult in such 

 cases. 



2nd Class. Defective development after 

 birth. The pre-pubertal uterus. The or- 

 dinary age of puberty may have arrived and 



Fig. 465. 



The uterus undeveloped after the ordinary period of puberty has arrived. The cavities of the body and cervix 



are laid open. (Ad Nat.) 



o, cavity of the body retaining the triangular form and the lines or rugae characteristic of infancy ; b, the 

 cervix, the extent of which is indicated by the penniform rugae ; c, anterior lip of the cervix ; d, ovaries ; 

 <?, Fallopian tubes. From a female aged 19, who had never menstruated. (Compare with/0. 442., repre- 

 senting the uterus of an infant. Both these figures are of the natural size.) 



passed, and yet no corresponding enlargement 

 or growth of the uterus may have taken place; 



* See a remarkable case of pregnancy in the 

 rudimentary half of a uterus unicornis, ending in 

 rupture of the sac and death in the third month, by 



the organ retaining the form and size which 



Rokitansky. (Pathol. Anat. Syd. Soc. vol. ii 

 p. 277.) The preparation is preserved in the Vien- 

 nese Museum. 

 * Loc. cit. 



