File:Pathology and treatment of diseases of women (1912) (14594934439).jpg

Identifier: pathologytreatme00mart (find matches)
Title: Pathology and treatment of diseases of women
Year: 1912 (1910s)
Authors: Martin, August Eduard, 1847- Jung, Ph. (Philipp Jacob), 1870-1918
Subjects: Gynecology Gynecology
Publisher: New York : Rebman company
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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inued pressure in deeply inverting the vagina. Not rarelythe whole mass of the hypertrophied cervix with the vaginal walls stillpreserved as a sulcus, emerges gradually and slowly. Behind this ante-rior vaginal wall lies the bladder which in its empty state is situated inits entire extent external to the rima, so that the sound can be introducedin a normal direction only as far as the urethra is connected with the 112 DISEASES OF WOMEN ligamenium arcuatum. Then the point must be conducted downwardalong the cervix uteri. On introducing the finger into the anus it passesjust above the more or less strongly closed sphincters into the roomydiverticulum of the anterior rectal wall and enters without effort abovethe posterior commissure of the introitus into the pouch of the posteriorvaginal wall. The body of the uterus lies above these in a retroflexedposition. The cervix shows a considerable elongation of its supravaginalportion. The sound can enter only in a posterior and downward direc-
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FlG. 65. — Prolapsus Vaginae AnteriorisSuperioris et Enterocele VaginalisAnterior. (Schematic.) Fig. 66. — Prolapsus Vaginas Posterioriscum Rectocele. (Schematic.) tion. The cervix measures 6 to 11 cm, the body 4 to 8 cm. Its walls aremostly thickened. However, they may be highly atrophied in olderpersons, so that the thickened corpus seems to hang on a slender stem.The different forms of prolapsus develop from this initial stage. 1. A descent of the lower half of the anterior vaginal wall intothe lumen of the vagina is the most frequent. (Prolapsus vaginaeanterioris.) 2. The upper third of the anterior vaginal wall (Fig. 65) alone israrely pressed down by intestinal loops between the uterus and thevagina. Such a prolapsus vaginae anterioris superioris with entero-cele vaginalis anterior, I have seen in a Policlinic patient similar to theone proven by post-mortem examination by E. Martin.8i The possibilitymust be admitted a priori, as the connection between the cervix uteri and PA

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