The infantine condition of the uterus is here exhibited in every particular. The proportionately large size of the cervix, b, the small triangular uterine cavity, a, with a raphe extending into it, and the thin parietes, are precisely such as are usually found in the infantine organ.
In the last case, the ovaries exhibit also their ordinary infantine proportions ; but these may become developed, and the func tions of menstruation may proceed naturally, while the external characteristics also are those of a well-formed female, but the uterus remains small, the vagina is short, and instead of terminating in the usual fornix, with a pro jecting cervix, this canal ends in an aperture, which just admits a sound or probe, and is not furnished with the usual lips of the os tincm. These cases usually result in sterile marriage, and may be easily detected during life.
Anomalies of form. — Deviations from the ordinary form of the uterus which are ac quired during life, and do not proceed from original malformation, or imperfect develop ment, such as that last noticed, will be here considered.
The angular flexions of the uterus which take the definite forms of a forward or back ward curve, or of an inflexion towards either side, are distinguished as anti- and retro flexion and lateral inflexion.
a. Antillexion of the uterus is that condition of the or,,an in which, without any material change ofbposition in the cervix, the body is bent forwards, so that the fundus,lying more or less horizontally, is directed towards the sym physis pubis, while, according to the degree of inflexion, the anterior wall of the uterus is brought near to, or in contact with, the cervix in front, while the posterior wall looks up wards, corresponding more or less with the plane of the pelvic brim. The point of cur vature is always at the line of junction of the body with the cervix uteri, and here an angle more or less acute is forrned.
Fig. 466., giving a lateral view of the anti flexed uterus, exhibits the relative situation of its various parts when this deformity exists in the highest degree.
Now a slight amount of antiflexion of the body upon the cervix has been shown by fzgs. 426. and 433. to be natural to the uterus ; and it is not until one or two pregnancies have supervened, that this forward tendency, when excessive, is lost, and hardly even then, for the uterus may still retain that correspondence in form, with the curvature forwards of the pelvic cavity, which is so prominently ex pressed in the curve of the sacrum, and is in accordance with the normal form of the ute rine canal. In the fcetus (fig. 467.), and
during early infancy, antiflexion exists as a normal state, and it appears to me that this bias towards a forward inflexion of the uterus at the early periods of life is given by that remarkable bending forwards of' the lower ex tremity of the spine which is observable in the early embryo. The part containing the structures that are afterwards developed into the uterus exhibits then an abrupt curve, which at this early period will probably be impressed upon the organs within, and being abnormally retained by them after the pelvis has changed its form, may give rise to the malformation under consideration.* b. Retro!larion exhibits the converse pecu liarity, the body of the uterus being bent back wards upon the neck at such an angle that the fundus occupies a position mord or less deep between the cenix and rectum, filling and distending the pouch of Douglas. This condition of the uterus ought not to be con founded with retroversion or with those retro uterine tumours produced by inflammation, and effusion into the cellular tissue (fig. 433., G) at the back of the cervix, of which an account will be presently given. See p. 688.
c. Lateral itzflarion. — The uterine body ex hibits occasionally an inclination to lateral curvature, so that the fundus is directed to wards one or other side. A curvature out wards, in the form of an arch more or less deflected from the meridian, has been shown to be the usual condition of the uterus uni cornus. But where a tendency towards either side is shown in the otherwise normally formed organ, this appears to arise from some inequality in the development of the two uterine halves; or it may depend upon one half undergoing hypertrophy, so that in either case one uterine angle lies higher than the other, and a vertical line would divide the organ into two unequal parts. The cervix is here curved as well as the body, or the latter may remain perpendicular while the body is bent so as to form an angle with the cervix. The former variety has been designated the retort-shaped uterus.