In the first, the mucous membrane seems intact, but its folds, which have been rumpled during labor, are already beginning to reform. It is covered by an almost intact cylindrical epithelium, which differentiates it from the membrane of the body. At the second week it has resumed its normal appearance.
The second zone includes all of the internal surface of the uterus, except the placental site. The line of separation is in the spongy layer of the decidua vera and the serotina, always above the muscular coat, and this spongy layer is made up of the glandular layer, the ampullary of Friedliinder and of Langhaus.
The third zone has an appearance peculiar to itself. The decidua serotina, sending branches into the inter-cotyledonary spaces, as soon as the placental site sinks, projects, and forms a series of depressions and elevations, covered by a remnant of the serotina, from M to inches in thickness, but this serotina is not continuous, because its continuity is interrupted by the large sinuses which are uncovered, and filled with blood. The demarcation between the placenta and the serotina, occurs here in the deeper layers, but the glands, thus torn, still open at the sur face; there remains, therefore, of this mucous membrane, only the ex ternal half, that is to say, the one which, is made up of numerous torn glandular spaces, deprived of epithelium, of inter•glandular rifts, of lymph spaces and of blood vessels. The glandular pouches alone retain their epithelium, and they are the ones which are going to assist in the re generation of the mucous membrane.
Seven days after labor (Fig.257) the uterus is 4.6 to 4.8 inches in height; its cavity is 3.9 inches; its internal surface is covered with a reddish-brown coat, showing a number of little blood spots and very hyperemic vessels. The mucous membrane of the cervix is ruffled, and is composed of numerous blood vessels and scattered cells; it is clotted with cylindrical epithelium and with large nuclei. Beginning at the internal os,the internal surface of the uterus, to the level of the placental site, is covered by a soft membrane, reticular, and with studded surface. This membrane, of the thickness of from .039 to .058 inches. is a little thicker at the border of the placental zone, and is higher above its level. Under the microscope it is seen that the irregular folds, which existed on its surface, have been destroyed by fatty degeneration of the cells, and that the internal surface has become smooth, the glands vertical and widely open, and that the epi thelium has proliferated from the bottom to the surface, above the glan dular walls, up to the most superficial surface. Between these young
glands, the epithelium extends cell by cell, and it is traversed by so many capillary vessels, by so many blood and lymph corpuscles, that it is not as yet a question of definite structure.
The third zone, the placental, is 1.9 to 2.3 inches wide, and it projects 1.9 to 2.3 inches, covered by a layer about .019 inches thick, reddish brown, friable, composed of detritus made up of decidual cells which have undergone fatty &general:ion, of blood and lymph corpuscles, of glandular epithelium, and of debris of fibrin. At the border is found the destroyed remnant of the glandular layer; the most superficial of these are traversed by fatty molecules and blood corpuscles, surrounding the vessels and almost obscuring the cells of the decidua. In the front rows these glandular spaces look rather like gutters, containing here and there epithelium and blood corpuscles, than true glands. At the centre of the placental zone the projections have been levelled off; they are made up of the large cells of the scrotina, which have accumulated in the furrows left by the projections. Frequently, there are found glandular rows furnished with epithelium, and well preserved. The blood-vessels are filled with large thrombi, old and recent, the first of which go back to pregnancy; the vessels are small in size, and their walls are thickened.
...Vine Days after Delivery (Fig. 258).—The limit of the mucous mem brane of the cervix and of the body, at the internal os, is well marked. The mucous membrane of the body, .039 to .078 inches thick, is made up of a number of vacuoles, forming, in their depth, large spaces, opening at the surface, and these are new glands; they are lined with epithelium, with large nuclei, which multiply and form epithelial islets, which, here and there, cover the surface. Between the glands are found vessels, small and large, here and there without walls, also round cells, blood cor puscles, fat nuclei; cells fattily degenerated, and a tissue in the stage of new formation, which seems granular.