File:Diseases of women. A clinical guide to their diagnosis and treatment (1899) (14581494240).jpg

Identifier: diseasesofwomenc00herm (find matches)
Title: Diseases of women. A clinical guide to their diagnosis and treatment
Year: 1899 (1890s)
Authors: Herman, G. Ernest (George Ernest), 1849-1914
Subjects: Women
Publisher: New York, W. Wood & Co.
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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:— 1. Without symptoms. 2. With symptoms of descent. 3. With congestion. 4 Suddenly produced.5. With adhesions. When not important.—(1) Retroflexion is often presentin the healthy without symptoms. In such it neitherbrings with it liability to ill-health, nor interferes withfertility. We know not how numerous such cases may be,because they come not for examination. (2) Retroflexion is usually present with prolapse. If theonly symptoms are those of prolapse, and the body of theuterus is not tender, the combination of retroflexion withprolapse is not a factor of moment in the case. 146 DISEASES OF WOMEN. When important.—(3) Retroflexion sometimes producesvenous congestion ot the body of the uterus. * Behind theuterus is the pouch of Douglas, bounded on each side by aperitoneal fold running from the uterus back to the sacrum.These folds in different subjects vary much in positionand sharpness. Sometimes they are gently convex undu-lations. If so, the uterus may be bent back without
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Fig. 55.—Showing blood supply of uterus. (After Hyrtl.) effect upon its circulation. Sometimes they are sharp bandsrunning backwards nearly parallel to one another. Theblood returns from the uterus by veins that run outwards inthe broad ligament (Fig. 55). * If the body of the uterus sinksbetween sharp and firm utero-sacral ligaments, the veinsin the broad ligaments are pressed against the sharp lateralboundaries of Douglass pouch, the return of blood throughthem is hindered, and congestion of the body of the uterus is * See Sir J. Williams on the circulation in the uterus, Obst. Trans.,vol. xxvii. UTERINE DISPLACEMENTS: RETROFLEXION. 147 the result. It in consequence becomes tender and sometimesa little swollen. It is difficult rightly to estimate the frequency of thesecases as compared with those in which retroflexion producesno effect, because healthy women are not examined, andobstetric physicians only have limited opportunities of post-mortem examination. Judging as nearly as I

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