The hymen : anatomically, medico-legally and historically considered / by E.S. M'Kee.

  • McKee, Edward S.
Date:
1908
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Licence: In copyright

Credit: The hymen : anatomically, medico-legally and historically considered / by E.S. M'Kee. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    slightly fringed which can be readily de- pressed backwards. A hymen bipartus, or septus, or bridge-shaped hymen, is an orifice divided into equal parts by a narrow band of mucous membrane running from above downward. Congenital hyperplasia is, ac- cording to Luschka, the cause of the hymen fibrinatus. There are two forms of hymen which allow the penetration of large bodies 1 2 J. Aiuitomy of the hymen ami surrounding tissues. 2. The hymen semilunaris, crescentic, or normal hymen. without rupture—congenital slits and elas- tic membrane. ANATOMY OF THI- HYMKN. This is a membrane situated at the junc- ture of the vulva and the vagina, partially closing the entrance to the latter. Authori- ties give the hymen as occurring in the ape, bitch, bear, donkey, hyena, giraffe, horse, cow and pig, besides the human female. iMacroscopically the hymen appears as a semilunar fold. Next most frequent to the crescentic form is the annular variety, in which the hymeneal opening is circular in shape. The thickness and consistence of the hymen vary widely; in one the structure is as delicate as a spider’s web, in the other a dense ligamentous membrane. 1 he hymen is composed of dense con- nective tissue covered on either side by epi- thelium. The epithelium is the usual multi- layered pavement type. The connective tissue in the hymen of the fetus, new-born and adult is dense, with numerous nuclei. In the amount of nuclei, as well as' in the density of fibres, the hymen is readily dis- tinguished from the vulva. The blood sup- ply is rather rich, A gradual increase of lyjth the number and thickness of the elastic fibres takes placg throughout the existence of the membrane. Smooth muscular fibres have been repeatedly found in the normal hymen, though their presence is not the rule. In atresia, congenital or acquired, smooth mus- cular fibres are found with great uniformity. It has always been found very difficult to demonstrate the nerve supply of the hymen, and most authorities have failed in this, though some few report having done so. Experiments have shown that if the patient’s attention is diverted the hymen can be pierced or pinched without pain, and that it is not sensitive to heat and cold. The pain in defloration is probably not due to the lac- eration of the hymen in most cases, but rather to the forcible dilatation of the en- trance to the vagina. I'he elasticity of the hymen is in some instances so great that in- tercourse, or even parturition, may occur without rupturing it. As a rule, however, it is ruptured by the first coition. Healing is accompanied by a considerable formation of elastic and connective tissue. ANOMAUFS OF FHK HYMEN. Hymen Daiticulatus.—A frequent form, consisting of a number of tooth-shaped in- dentations, which are frequently limited to the smooth inner border, especially the an- terior surface. Frequently mistaken for rup- tured hymen. To differentiate, note the uniform softness of the borders and the ab- sence of cicatrization. Hymen I'ibrinatus.—The border of the hymen is fringed as shown by the microscope 3 4 3. The hymen circularis, or annulur, with small cen- tral opening. 4. The hymen cribriformis, sieve-like, containing many holes like a water pot, to be due to a development of the papillae. The fimbria; are not limited to the border of the hymen, but are spread «)ver its surface, and at times oyer the labi;i minora. This is