22 
assymetric, the mucosa very hyperemic and covered with an 
abundant often bloody, exudate, which often also contains 
pus flakes. The number of the uterine glands is decreased, 
and they are found singly or in bundles, separated through 
strong fibrous bands which transverse the mucosa in all di- 
rections. The glands proper are dilated, corkscrew shaped 
and have a ragged margin. The tissue between the glands 
is infiltrated with roundcells, which very often are so dense 
that they resemble an abcess. Endometritis without histo- 
logical lesions was found nine times, in five cases of which 
the uterus was enlarged, asymmetrical, its mucosa hyperemic 
and containing much mucous matter and pus flakes. The 
other four uteri were not asymmetrical, but contained exu- 
date and were hyperemic. In purulent endometritis with 
large accumulations of exudate, different changes in the 
mucosa are found by Kitt. In recent cases the mucosa is 
injected and infiltrated with roundcells, the surface epithe- 
lium and the epithelium of the uterine glands is largely 
necrotic. In other cases the mucosa shows a dirty grayish 
discoloration from old hemorrhages and, together with the 
whole uterus wall, becomes atrophic through the expansion 
of the uterus. Sometimes the walls are not much thicker 
than paper. In still other cases a thickening of the mucosa 
is found, together with necrosis. These thickened walls are 
of a grayish red or of a grayish white color. A few times 
cysts in the walls of the uterus were observed. 
The real chronic metritis does not seem to be very fre- 
quent. Tuff found it only four times among his sixty-four 
cases with lesions of the uterus, and Kitt says that a metri- 
tis which becomes chronic generally becomes catarrhal. 
In the four cases mentioned by Tuff the uterus was twice 
considerably enlarged and filled with a yellow, thick pus. In 
this pus streptococci were found in pure culture. In the two 
other cases the uterus was thicker but not longer than nor- 
mal; the uterine walls were thick and hard, forming a narrow 
tube and containing a yellow pus. The mucosa was much 
