GENERATION. 



pari, into two lateral cavities, fo as to bear fonu' analogy to benumbed, and more liable to cramps, and ocdematous fwell- 

 the two horns of the uterus in a quadruped. This peculiar ings 



conformation may explain the unequal extenfion of the two 

 fides in fonie cafes of pregnancy ; and may elucidate the 

 above-mentioned cafe of Dr. Mackenzie. 



The fmall or lower end of the organ is placed in the ca- 

 vity of the pelvis. This generally contains the greater 

 part of the child's head, and fills tip the cavity fo com- 

 pletely, as to prefs the bladder againfl the pubes, and the in the fame manner as the analogous membi 

 refturii ao-ainft the facrum. The os uteri is directed againil tinal tube makes the mefentery. When tl 

 the coccyx, or the lower part of the facrum. The body and 

 fundus, which contain the reft of the child and the placenta, 

 are fo placed in the front of the abdomen, from the brim 

 of the pelvis upwards to the epigaftric region, as to be un- 

 der and before all the other bowels, and in immediate con- 



Of the Ligivnetils, Tubes, and Ovar'ui of the Pregnant 

 Uterus. — It has been commonly obferved that the liganients 

 and tubes of the pregnant uterus are attached lower upon 

 the fide of the organ than they were in the unimpregnated 

 ftpte ; and the reafon is very obvious. The peritoneal coat 

 of the uterus makes the broad ligament on each llde, much 

 analogous membrane of the intef- 

 le woman is not 



pregnant, the ligament is of confiderable bread'.h, the fper- 

 matic velfels pals between its two laminx, the round ligament 

 runs downwards and outwards, on its anterior furface, and 

 the tube runs in loofe ferpentine turns on its upper edge. 

 But in proportion as the circumference of the uterus grows 

 tact with the parietes abdominis, and to occupy the whole larger, the broad ligaments become narrower, their polierior 

 fpace from one hip-bone to the other, and a proportional lamella covering the pofterior furface, and their anterior la 



extent from thefe bones upwards. As it rifes up from tl 

 cavity of the pelvis into the hypogaflric and umbilical re- 

 gions of the abdomen, the loofe connections of the inteftines 

 and omentum ealily account for thefe parts being pulhed up 

 before it. 



The axis of the uterus is oblique, its lower end being 

 turned backwards, and the upper proportionally forwards. 

 This obliquity is changed by the attitude of the body, 



mella the anterior furface of the uterus itfelf. We obferve 

 now, that the round ligsments do not run down on the fore- 

 part of the broad ligaments, but upon the forepart of the 

 body of the uterus itfelf. In proportion as the fundus rifes 

 upwards, and increafes in fi/e, the ujiper part of the broad 

 ligament is fo llretched, that it clings clofe to the fide of the 

 uterus, £b that in reality the broad ligament dlfappcars, no 

 more of it remaining than its very root ; namely, its ujjper 



and by maiiy other caufes. In the ereft pofture, the weight and outer corner, where the group of fpermatlc velfels 

 of the uterus prefles the forepart of the organ into a greater pafTes over the lilacs, to the fide of the uterus. In this 

 rotundkv, and its axis then approaches the neai-eil to a ilate, altlunigh the fmall end of the tube opens into the fame 

 tranfverfe or horizontal line. In the recumbent pofture, part of the uterus,' as before impregnation, yet the tube has 

 the contrary fituation is exhibited. In a firft pregnancy, a very different direftion ; inftcad of running horizontally 

 the uterus ftretches itfelf higher up in the epigallric region, 

 and its axis comes nearer to the longitudinal or vertical di- 

 redtion, becaufe the parietes of the abdomen do not eaiily 

 give way : but in a w-oman who has had many children, 



outwards, it palTes downwards, clofely attached to the fide 

 of the uterus. Behind the timbrix lies the ovarium, alfo 

 connefted to the uterus. The fimbrias and -ovarium are 

 commonly placed upon the iliac veftels, or flefhy brira of the 



the abdomen, by repeated diftention, is rendered more loofe pelvis, behind the group of fpermatlc veffels. 

 and pendulous, and the uterus extends forwards rather than The round ligaments run ahnoft perpendicularly down- 

 upwards. This pofition is more remarkable in very fliort wards from the fundus uteri to their paffage through the 

 fubjefts ; becaufe in them the cheft is fo near the pelvis, mufcles ; they are confiderably enlarged in thlcknefs, and 

 that the uterus is ftopped in afcent. The fame circumftance are fo vafcular, that u'hen injetted they feem to be little more 



happens, and for a fimllar reafon, when the pelvis is very 

 narrow : as no part of the organ, in fuch a cafe, can be 

 lodged in the pelvis, it muft be placed proportionally higher. 

 In a very (hort and crooked woman, on whom the cs- 

 farean feftiou was performed, the fundus uteri was not only 

 turned forwards, but even a little downwards. As fhe lay 



than a bundle of arteries and veins. Their arteries are all 

 convoluted. Both their arteries and veins proceed princi- 

 pally from the fpermatics, and anailomofe evidently with the 

 external vefi'els in the groin or upper part of the labia. 

 Even in this enlarged ftale of the round ligaments, it is very 

 dlfHeult to lay how they terminate in the groin ; they appear 



upon the table, the navel could not be fcen, as it was placeci to be infenfibly loft. The tubes are more flelliy, vafcuL' 

 on the pofterior and inferior part of the abdominal tumour. 

 lu order to expofe that part of the abdomen to the furgeon, 

 it was necelTary to lift up the fundus uteri, without which 

 Llie hypogaftricreglon would havebeen inacceflible. Thedevia- 

 tion of the organ towards the right or left llde cannot, in ge- 

 neral, be very confiderable ; as it poffeffes nearly the whole markable change. The latter body can be diftinguiflied by 



and foft in their fubftance, and are lefs convoluted than in 

 the unimpregnated ftate. The fimbria: and internal rugfe 

 are larger and much inore beautiful, efpeclally when their 

 vefl'els are well injetled. The ovaria, excepting that which 

 contains the corpus luteum, feem to have undergone no re- 



fpace between the hip-bone, and its lower extremity is fixed 

 to the pelvis. A fmall lateral obliquity is very common ; 

 and we can eafily fuppofe, that in a reclined pofture, the pro- 

 jeftion of the lumbar vertebra: will throw rather more 

 than one-half of the uterus into the lateral cavity between 

 the fpine and one hip-bone. We know, indeed, that in all 

 the laft months, the abdomen is often more full on one fide 

 than on the other. Women fay in fuch a cafe, that the 

 child lies on one fide, and they judge rightly. Where the 

 child lies the bulk mull be both more confiderable and 



a rounded fullnefs, and frequently a confiderable promi- 

 nence, fenfible both to the fight and touch, upon the mid- 

 dle of which there is a fmall pointed cavity or indentation, 

 like a cicatrix. Upon flitting the ovarium at this part, the 

 corpus luteum appears a round body, of a very dlftinft 

 nature from the reft of the ovarium. Sometimes it is oblong 

 or oval, but more generally round. Its centre is white, 

 with fome degi-ee of tranfparency ; the reft of its fubftance 

 has a yellowifli caft, is very vafcular, tender and friable, 

 like glandular flefh. The larger veffels appear round its 



more permanent, but where there is only uterus, placenta, circumference, and fend fmaller branches inwards. A fev 



and water, the fweUing will be fofter, and projedf lefs. of the larger veffels are fituated at the cicatrix or indentation 



TheprcfTure of the child, when it lies more in one fide than on the outer furface of the ovarium ; and are there fo little 



ill the other, makes the limb of that fide weakerj more covered, as to give that part the appearance of being bloody, 

 4 wh«n 



