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VIII. — Histological Observations on the Muscular Fibre and Connective Tissue of 

 the Uterus during Pregnancy and the Puerperium. By T. Arthur Helme, 

 M.B. (With a Plate.) 



(Read 9th July 1888.) 



The study of a normal process in an organ so especially prone to disease as is the 

 human uterus, is beset with many difficulties ; so many foreign conditions are apt to be 

 present, giving a false impression as to what this process really is. That this is the case 

 to no small degree, when the character of the changes which occur in the normal involu- 

 tion of the uterus after child-birth is the subject of observation, is shown by the variety 

 of opinions held and stated by doubtlessly competent observers ; for while one holds that 

 the muscle undergoes a fatty degeneration, another holds that no such fatty change 

 occurs ; while one asserts that ODly a certain number of the fibres degenerate and 

 disappear, another states that so complete is the destruction, that not one single fibre 

 present in the uterus before birth survives the process ; while another goes to the extent 

 of saying, that the puerperal uterus can in no way be distinguished from a uterus that 

 has undergone an inflammatory process.* 



These differences of opinion are probably due to the facts that the organs studied 

 did not exhibit the normal process, this being masked by the presence of other foreign 

 conditions, and partly that the methods of research were not complete. For the follow- 

 ing various reasons then, have I thought it advisable to observe this process of normal 

 involution first in the rabbit. For owing to the fortunate rarity of maternal deaths, one 

 has little chance of obtaining uteri representing the various post-partum stages (and still 

 less those of pregnancy), and even when obtained, these uteri are not those of women 

 undergoing a normal puerperium ; on the contrary, the normal changes in the uterus are 

 materially interfered with by the presence of some important process (most frequently 

 some form of puerperal fever, septic or other) which causes the patient's death. 

 Further, human uteri are obtainable only after several hours have elapsed since the organ 

 ceased to live, and consequently many important features can in no way be recognised, 

 e.g., the proliferation of cells by the process known as karyokinesis. Again, the uteri 

 are generally those of multiparous women, the great majority of whom, owing to their 

 surroundings and work, are peculiarly subject to chronic uterine affections, the most 

 frequent of all being a chronic condition of " subinvolution." As a result, one is apt to 

 fall into many errors, and mistake the appearances due to earlier disease for those of a 

 normal involution. To avoid such sources of fallacy, I have taken the uteri of rabbits 

 which had been previously healthy, and were pregnant for the first time. They were 



* SCHRCEDER, SCHWANGERSCHAFT, GEBURT, and WOCHENBETT, 1867, S. 174. 



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