A practical treatise on the diseases of the uterus, ovaries and fallopian tubes / by A. Courty ; translated from the third edition by Agnes M'Laren, with a preface by J. Matthews Duncan.

  • Courty, Amédée.
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on the diseases of the uterus, ovaries and fallopian tubes / by A. Courty ; translated from the third edition by Agnes M'Laren, with a preface by J. Matthews Duncan. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    bladder, the posterior with the rectum; it is at right angles from the latter that the two folds of Douglas arise, which cover the utero-sacral ligaments. There are four borders—superior, inferior, internal, and ex- ternal. The superior is subdivided into three small folds. Tine inferior is in relation with the subperitoneal cellular tissue of the pelvis and M.U Fig. 22.—Section of the uterus aud broad ligaments perpendicular to the large axis of the womb at 2 centimetres from its base (after Tillaux). B, pelvic wall ; cu, uterine cavity; ll, broad ligament; MU, uterine mucous membrane ; P, P, peritoneum ; TU, uterine tissue; vu, utero- ovarian veins. with the superior perineal aponeurosis. The internal is very wide (Fig. 22), the two folds being separated from each other by the thicic- ness of the uterus; it is in relation with the uterine artery and the utero-ovarian plexuses, venous and lymphatic ; it is continuous with the inferior border on the lateral portions of the vagina (Fig. 28, l s p), having the same relations with the veins and lymphatics, and allowing of the recognition by vaginal touch of phlebitis, lymphangitis, tumours and purulent collections formed in this ligament. The external is in relation with the walls of the cavity; it is very thin, the two folds of peritoneum being in close proximity ; a horizontal section of the broad ligaments and of the uterus at about an inch from its base shows very clearly the difference in thickness of the two borders (Fig. 22). The cellular tissue with which this vast peritoneal fold is lined is loose and abundant, especially below where it is continuous with the cellular tissue covering the upper perineal aponeuroses and levator ani (Fig. 23) and with that which covers the lateral surfaces of the bladder, the peritoneal lining of the abdominal wall at the hypogas- trium and of the internal iliac fossa. Consequently an inflammation of the broad ligament may be propagated in any of these various regions, or an abscess of this ligament may open into the vagina, bladder, rectum, into the ischio-rectal fossa, at the top of the sacro- sciatic groove, or may appear at the hip with the sacral plexus and the sciatic nerve or may reach the abdominal wall on a level with the Fallo- pian ligament, above or below the crural arch or even at the obturator foramen. Pelvi-peritonitis is most frequently posterior (retro-uterine cavity); it may be anterior or it may surround the uterus on all sides