File:Clinical gyncology, medical and surgical (1895) (14598109209).jpg

Identifier: clinicalgyncolog00keat (find matches)
Title: Clinical gyncology, medical and surgical
Year: 1895 (1890s)
Authors: Keating, John M. (John Marie), 1852-1893 Coe, Henry Clark, 1856-
Subjects: Women Gynecology
Publisher: Philadelphia, Lippincott
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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ble pelvic organs, all we have to do is tolook at the accompanying diagram of a woman in the erect position. Theline drawn from her vertex to the upper border of her symphysis pubisstrikes just in front of the fundus uteri. Now let the small intestineswhich normally lie in front of the fundus uteri and against the anteriorabdominal wall be forced still farther down and forward by compressionaround the waist, room is given for the fundus uteri to tip forward ; thesuperincumbent intestines then press the body of the uterus still fartherdown until it occupies the position believed by some to be the normal one,—namely, at an angle of 35° with the vagina. It only requires time anda continuance of this abnormal pressure to increase the angle of flexion atthe internal os and produce a truly pathological condition. Constipation is undoubtedly also a fruitful factor of displacement for^ward, backward, and downward. The full bowel resting upon the body DISPLACEMENTS OF THE UTERUS.Fig. 9. 471
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Longitudinal sagittal section of woman in erect position, showing the various axes of the uterine andvaginal canals and pelvic brim and vaginal roof. 472 DISPLACEMENTS OF THE UTERUS. of the uterus will tend to displace it in the position to which it naturallyinclines, and the straining of a constipated stool will, of course, help toforce the uterus down and relax its ligaments. The habit of allowing; thebladder to fill to over-distention may also be held responsible for a certainnumber of backward displacements. Apart from the causes already men-tioned, which hold good in unmarried, married, and parous women, child-birth is, in my opinion, by far the most frequent factor in the causation ofuterine displacements. Relaxation of the uterine ligaments and supports,injury—that is, laceration—of the perineum and its component muscles,laceration of the cervix uteri with subinvolution and consequent increasein weight of the uterus, prolapse of the vaginal walls with bladder andrectum, inf

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