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.

    88/500 (page 68)
    tus up to both cervices and sutured the cut surface with catgut. Union was good. The patient married, but so far has remained sterile. It is clear that such cases may run through all the Physiologie phases of development without any pathologic disturbances, while on the other hand irregularity in the development of one side or a pregnancy in both halves may result in various difficulties. In coalescence of both cervices, uterus bicornis unicollis, both Cor- pora diverge in a remarkable way, so that the more they separate from each other the more obtuse becomes the angle between them. In some cases a fold of peritoneum is found running from the rectum to the bladder. I found such a fold strikingly developed in a case of forma- tion of an intramural myoma, the size of an orange, in the left uterine cornu. A uterus otherwise normally developed externally, may be divided completely by a septum extending from the fundus, either down to the orificium internum or through a small portion of the cavity, a uterus septus or subseptus. The vagina may also be divided in a similar way or remain single.24 (d) Incomplete Development with Incomplete Communication of the Gen- ital Canal with the External Surface of the Body Cases in which Müller’s ducts during their development coalesce with each other, but do not reach in a normal way a communication with the sinus urogenitalis are of a much greater importance than the foregoing conditions. These cases of atresia must be differentiated according as they are situated at the hymen, atresia hymenalis, or higher up in the vagina, atresia vaginalis, or in the uterus, atresia uteri. The atresia uteri is again differentiated into an atresia of the external os, the cervi- cal canal or the internal os. To these cases must be added those in which the lumen of the uterine horn is imperforate or not, cases of so-called congenital atresia of the uterine tubes, Müller’s ducts having otherwise well coalesced. These cases of congenital atresia resemble in their effect the cases of acquired atresia, which may also be situated at the entrance of the genital canal or in its course. The origin of these atresias is doubtful; even “congenital” atresia may develop through inflammatory processes in intrauterine as well as in early life.25 Congenital atresia does not make itself feit before the development of puberty. As soon as puberty sets in a retention of the menstrual fluid and other secretions takes place, if the genitalia are fit for the develop- ment of menstruation. Another consequence is the prevention of con- ception corresponding to the location of the atresia. Occasionally several atresias occur in the same genital apparatus. In this case several reten- tion cavities may develop during menstruation, which may lie above one another, and need not communicate with each other.