WOMB, The, AND ITS DISEASES.
The womb or uterus is one of the generacisc organs of the female. In its cavity the im pregnated ovum is received, retained and sup ported during the development of the hems. and from this cavity the child is expelled at the time of parturition. In the virgin, the womb is pear-shaped, flattened from before backward. and is about three inches in length_ It is di vided into body and neck. The fundus or upper extremity of the body is broad and con vex, and is directed forward. From this por tion the body gradually narrows to the neck, the lower rounded and constricted portion of the womb, which is directed downward and backward in the line of the axis of the inlet of the pelvis and around its circumference is attached to the upper end of the vagina.
The womb is situated in the cavity of the pelvis, between the bladder and the rectum. and is retained in position by ligaments, which in a normal condition of the parts also allow free movements of the womb during respira tion, muscular exercise and change of The ligaments are the two lateral or braid ligaments which pass from the sides of the womb to the lateral walls of the pelsis; the two round ligaments which are attached at the upper angles of the womb, one on each side, and pass out through the internal abdominal rings to end in the labia majora; the two anterior ligaments or folds of peritonzum be tween the neck of the womb and the bladder; and the two posterior ligaments or folds be tween the won* and the rectum. The womb is a muscular organ, consisting of bundles of unstriped muscular fibres, arranged in layers intermixed with areolar tissue, blood-vessels. lymphatics, and nerves. A serous coat denied from the peritoneum covers the posterior sur face of the body of the womb and the upper three-fourths of its anterior surface. The cas ity of the womb is triangular and flattened from before backward, its base being toward the fundus, and is lined with mucous membrane, having ciliated epithelium at its upper portion This mucous coat contains the uterine glands, and is continuous with the mucous membrane lining the vagina, and connects with the pen tonzum through the orifices of the Fallopian tubes or oviducts, one orifice at each superior angle of the uterine cavity. The two Fallopta tubes (q.v.) are appendages of the uterus at tached to its superior angles and convey the ova from the ovaries (attached to the Woad ligaments) to the cavity of the womb. At the inferior angle of this cavity is a small con stricted opening, the internal orifice, which Scads into the cavity of the cervix. At the traictiod
extremity of the uterus is aperture the os uteri or external orifice.
The womb is subject to cancerous, fibroma fibrous and cystic tumors and polypi, to m flanunatory affections of the mucous lining and the parenchyma, such as endometritis and me tells of the neck or body of the uterus; to ulceration of the os and cervix uteri, and to displacement (prolapsusor falling of the womb), versions aanndd flexions. The CRUSES of endometritis are direct injuries (as from pes saries, chemical irritants, etc.), inflammation of the vagina, interference with the men strual flow etc.; of metritis, mechanical and other injuries, sudden suppression of the men strual flow, endometritis and morbid growths. Ukeration is usually a complication of endo metritis. Among the causes are uterine dis placements causing friction against the cervix, abuse of sexual intercourse, vaginal or uterine kucorrhora, the use of pessaries, and injuries in parturition. Displacements of the uterus are quite common ana among their causes are: 111 increase in weight of the uterus from irfLurimation or congestion, tumors, pregnancy, fluid retained in the cavity, etc.; (2) weaken ing of the uterine supports from rupture of the perineum, loss of tone of vaginal walls, laxity of uterine ligaments and degeneration of uterine tissue; (3) influences pressing the uterus out of place, such as tight clothing at the waist, the weight of heavy clothing on the abdomen, muscular efforts, such as lifting and straining, abdominal tumors, distended bladder, (4) traction on the uterus, from deposits of in pelvic areolar tissue, cicatrices in saginal walls, shortening of uterine ligaments, etc. Flexions of the uterus are bendings of it forward, backward, or to either side, known as auteversion, retroversion, etc. A prolapsus is a falling or descent of the uterus into the pelvic cavity, or the prolapsed organ may pro trude from the body at the vulvae orifice. The first form is known as incomplete prolapsus, the latter as complete prolapsus. The symp toms of uterine diseases include leueorrhaa, pan in the small of the back, dragging sen sations, a feeling of weight and heaviness, in terference with the functions of the bladder and rectum, dyspepsia and despondency. See Els It YOLOGY ; UENSTItU ATION ; OBSTETRICS ; Ovate; and consult Kelly and Noble, 'Gyne cology and Abdominal Surgery' (Philadelphia 191b).