ABNORNEAL ANATOmY OF THE UTERUS.
A. Defective development.— Imperfect or defective development of the uterus may oc cur under two circumstances. There may be either an original defect in its organisation, arising from a failure of growth or imperfect formation of those portions of the generative canal out of which the uterus is developed ; or else the organ, having been regularly formed during embryonic and fcetal life, may not have proceeded in its development, but may have retained the infantile character after the usual age of puberty has arrived and passed.
1st Class. Congenital defects. —Defects of this class may affect the uterus alone, or may be conjoined with corresponding imperfections of other organs. In order that their nature and origin, as well as the possibility of their occurrence, independently of any malforma tions of the other reproductive organsonay be clearly understood, it is necessary to remem ber the mode in which the uterus is originally constructed. Formed by the coalescence of the inferior extremities of the ducts of Mil ler*, the uterus will be materially modified in its construction according to the degree of perfection of those ducts, as well as by the amount of union which has taken place at their lower terminations.
Taking these particulars as atTording a basis for classification the malformations of the uterus which are dependent upon original vices of formation may be arranged in four groups, viz.:— Group The ducts of Mfiller being both imperfect or undeveloped, there results a more or less complete absence of the uterus. The examples of total absence of the uterus which have been recorded are probably cases in which the rudiments exist, but have been overlooked, on account of their slight deve lopment ; for generally there may be traced a more or less distinct fold of peritoneum ly-, ing behind the bladder and representing the broad ligament, within which are found some indications of a uterus. These rudiments consist of two uterine cornua, either conjoined at their lower extremities, or remaining sepa rate in their whole course. They usually oc
cur under the fortn of two hollow rounded cords or bands of uterine tissue, extending upwards towards the ovaries, and united per haps at the usual seat of the uterus by cellu lar tissue, with which some uterine fibres are intermixed. Sometimes one or two little masses of uterine tissue are found. These are either solid, or they contain a small cavity lined by mucous membrane. This constitutes the condition designated by Mayer the uterus bipartitzts. The concomitants of this condition may be a short vaginal cul-de-sac, together with rudimental Fallopian tubes, and perhaps well developed ovaries. In the latter case the external organs may be well formed, and there may be no deficiency of sexual caarac ter, or the vagina may be entirely- wanting.
The coexistence of this rudhnental uterus with ovaries well developed is easily ex plained. For the ovary is formed out of a separate portion of Mastema from that from which the Wolffian bodies and excretory duct of the generative apparatus are developed,fig. 4,00. and 416., so that the failure in growth of the one does not necessarily involve a cor responding defect in the other.
Group II. If one uterine cornu retains the imperfect condition last described, while the second undergoes development, the one horned uterus or uterus unieornis is produced. So that the organ here consists of a developed and an undeveloped half combined.
The developed uterine horn may be either the left or the right. It then consists of a cylindrical or fusiform canal or body, curved outwardly in the form of an arch which ex hibits various degrees of deflection from the meridian. To its upper extremity is usually attached a tube leading to the seat of a well formed ovary.
The second or undeveloped cornu, with its tube, is not always entirely deficient ; but there often exists a rudiment in connexion with the developed horn, nhich, according to the degree of malformation, is either solid or hollow, or is traversed by a canal opening into the cervix of the developed half.