Pathology and treatment of diseases of women.

  • Martin, August Eduard, 1847-1933.
Date:
1912
Catalogue details

Licence: In copyright

Credit: Pathology and treatment of diseases of women. Source: Wellcome Collection.

    21/500
    Although we may suppose that the anatomy and topography of the pelvic organs are entirely known to the physician, it seems to be well to present the most important aspects of the anatomy of this subject at the beginning of a treatise on the special pathology and treatment of the female pelvic organs, in view of the fact that it is quite difficult to obtain a conception of these relations in perspective. One must refer to the text- and handbooks on human anatomy for the minute details. The most comprehensive and latest is W. Waldeyer, “Das Becken” (the pelvis), Bonn, 1899, to which we call particular attention.1 The uterus in the pubescent woman is about the size and form of a middle-sized pear. It is 5 to 8 cm long in the nulliparous, and about 6 to 9 cm in the multiparous (Waldeyer). The uterus is divided into three parts: The cervix, projecting into the vaginal vault, from 2.5 to 3 cm long; the corpus, limited by the wedge-shaped and upward spreading cornu of the uterus; and the fundus, that part lying between the upper corners of the cornua. The corpus is 4 to 4.5 cm long. The anterior wall of the corpus is almost flat, while the posterior wall is convex back- ward. The thickness of the walls of the uterus is about 1 cm in the cer- vical portion and 1 to 1.5 cm in the corpus and fundus. They consist of irregulär bundles of smooth musculature interwoven with each other, enclosing connective tissue, vessels and nerves. The entire organ is bent at an obtuse angle over the anterior surface. The vertex of the angle is at about the junction of the cervix with the corpus: The normal anteflexio uteri. The cavity of the uterus has nearly a cylindrical form in the cervical canal, with a widening in the middle, a triangulär form with the base directed upward in the corpus. The cervical lips are continued into the anterior and posterior vaginal vaults which pass over to the anterior and posterior vaginal walls. The vagina is a canal surrounded by a muscular wall, and lined with mucous membrane with richly developed folds in the anterior and posterior walls, the columnae rugarum anterior et posterior. The walls lie directly one upon the other, so that an H-form arises (Fig. 1). A lumen proper, therefore, does not exist. The vagina is separated from the Vestibüle and the vulva by the hymen or its remains, the carun- culae myrtiformes. The latter are surrounded by the labia minora. At 1