قراءة كتاب Treatise on the Diseases of Women

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Treatise on the Diseases of Women

Treatise on the Diseases of Women

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دار النشر: Project Gutenberg
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parts contained in this framework.

The Female Pelvis
Fig. 2. The female pelvis. The flanging
sides form the hips. The union of the bones
in front forms the pubic arch which is felt
at the front of the lower part of the body.
The lower end of the spinal column, or
backbone, is seen at the back of the figure.

 

The Vagina.—The vagina is a membranous canal extending from the surface of the body to the uterus, or womb. Its posterior wall is about 3½ inches long, and its anterior about 3 inches. A careful study should be made of our illustration, in order that the relation of the vagina and uterus to the rectum behind and the bladder in front may be thoroughly understood; also the angle which is formed by the vagina and the uterus.

Notice should be taken, also, of the opening of the uterus into the upper part of the vagina; as inflammation of the uterus often causes a discharge which passes into the upper part of the vagina and finally out of the body. This gives rise to the belief that the only trouble is in the vagina itself, whereas the real seat of the disease may be high up in the uterus.

Contents of the Female Pelvis
Fig. 3. A lateral view of the contents of the female
pelvis. 1. the vagina; 2. uterus; 3. bladder; 4. lower
bowel; 5. bone forming the pubic arch; 6. the spinal
cord, with bone in front and back of it.

 

The Uterus.—The uterus, or womb, is a hollow organ formed of muscular tissue, and lined with a delicate mucous membrane. The bladder is in front, the rectum behind, and the vagina below.

Three Parts.—Physicians divide this important organ into three parts,—the fundus, body, and neck. The fundus is all the upper rounded portion; the body all that portion between the fundus and the neck; and the neck all the rounded lower part.

The Cavity of the Uterus.—This is divided into the cavity of the body and the cavity of the neck. By consulting our illustration it is seen that these cavities differ greatly in shape; that of the body being triangular, while that of the neck is barrel-shaped.

By referring again to Fig. 4 it will be seen that the cavity of the body has three openings, one on either side at the top going to the Fallopian tubes, and an opening at the bottom passing into the cavity of the neck. A constriction exists between these two cavities; but after childbirth this is largely done away with, and there is not that marked difference which existed formerly.

Glands in Uterus.—In the mucous membrane lining the uterus are vast numbers of minute glands which secrete mucus. It has been asserted that in the cavity of the neck alone there are from ten to twelve thousand of these glands. It is in this mucous membrane that such remarkable changes occur each month during menstruation, and still more wonderful changes during pregnancy.

The Ligaments of the Uterus.—By referring to Fig. 5 it will be seen that there are on each side of the uterus flat bands of tissue known as "broad ligaments." These ligaments are attached to the sides of the pelvic cavity, and aid greatly in holding the uterus firmly in place. There are also other ligaments concerned in this same work, although the broad ligaments are most important. The illustration also shows the walls of the vagina cut open, in order that the position of the mouth of the uterus may be easily seen.

The Cavaties in a Uterus   The Female Generative Organs
Fig. 4. This illustration shows the cavities
in a uterus which has been pregnant.
1, the vagina; 2, cavity of the neck of the uterus;
3, cavity of the body, above which is the fundus of the uterus;
4, Fallopian tubes, extending to the ovaries.
  Fig. 5. The female generative organs.
1, the vagina; 2, uterus;
3, broad ligament of left side; 4, a smaller ligament;
5, Fallopian tube; 6, ovary;
7, fringed end of Fallopian tube.

 

Blood-Vessels Surrounding Uterus.—The uterus is well supplied with blood-vessels, as Fig. 6 shows. Indeed, there is all over the walls of the uterus and through its tissue a vast network of these vessels. Whenever, for any reason, the circulation of the blood through the pelvis is disturbed, these blood-vessels are likely to become engorged, over-filled, producing congestion and inflammation.

The Blood-Vessels of the Right Side of the Uterus
Fig. 6. The blood-vessels of the right side
of the uterus. 1, blood vessels; 2, end
of the Fallopian tube; 3, ovary; 4, right
edge of uterus.

 

All Parts Closely Related.—The close relation of these blood-vessels to the blood-supply of the bowels, liver, etc., makes it possible for most serious disturbances to take place even from slight causes.

Study the Illustrations.—By studying these illustrations it can be readily seen how an over-distended rectum may produce such an impediment to the circulation that there will be congestion of all the neighboring parts. Or, the intestines themselves may become over-distended with fæcal matter, or gas, from dyspepsia, and the pressure induced thereby may be sufficient to interfere with the free circulation of these parts, and thus uterine congestion produced.

It is also seen how improper dress may compress the organs about these parts, and thus interfere with the circulation. Again, it is easily understood, simply from studying the illustrations alone, how any of these causes might produce dislocation of the uterus itself.

Object of Uterus.—The uterus is the source of the menstrual discharge, a place for the fœtus during its development, and the source of the nutritive supply of this fœtus. It is the uterus which contracts at full term and expels the child.

Uterus Not Rigidly Fixed.—In a perfectly normal condition there is considerable mobility to the uterus; in other words, it is not fixed firmly by the ligaments already mentioned. It is rather simply suspended, or hung in the pelvic cavity, by these broad flat bands

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