. Clinical gyncology, medical and surgical. thefloor of the pelvis, the fundus uteri is proportionately below its normal 510 DISPLACEMENTS OF THE UTERUS. level, and the uterine axis inclines slightly backward. The suspensory-ligaments of the uterus, chiefly the broad ligaments, are more or less re-laxed, otherwise this sinking of the organ could not take place. Neitherthe bladder, the rectum, nor the vagina is necessarily involved in this firstdegree of prolapsus. In the second degree the external os approaches thevaginal orifice, the body of the uterus is retroverted and lies in the sacralexc
. Clinical gyncology, medical and surgical. thefloor of the pelvis, the fundus uteri is proportionately below its normal 510 DISPLACEMENTS OF THE UTERUS. level, and the uterine axis inclines slightly backward. The suspensory-ligaments of the uterus, chiefly the broad ligaments, are more or less re-laxed, otherwise this sinking of the organ could not take place. Neitherthe bladder, the rectum, nor the vagina is necessarily involved in this firstdegree of prolapsus. In the second degree the external os approaches thevaginal orifice, the body of the uterus is retroverted and lies in the sacralexcavation, the suspensory ligaments are proportionately relaxed and drawndown, and usually the anterior vaginal wall and the posterior wall of the1 (ladder accompany, if they do not precede, the prolapse of the posterior vaginal wall and the rectum are as yet usually in their nor-mal position. In the third degree the cervix protrudes from the vulvamore or less, even to the extent of the entire extrusion of the uterus. The Fig. Section of complete prolapse of uterus and vagina. anterior vaginal wall, and the posterior wall of the bladder down to themeatus urinarius, protrude from the pelvic cavity, and in a very largeproportion of eases the posterior vaginal wall and the anterior wall ofthe rectum are prolapsed to the same extent. The sound passed into thebladder through the urethra and the finger introduced into the rectumwill at their lowest points be on a level with the external os, showing acomplete prolapsus of the anterior and posterior vaginal walls with the cor-responding walls of the bladder and the rectum. Almost invariably inprolapsus uteri of the second and third degrees the organ is found retro-verted or rctroflexed. This is due to the tendency of the uterus to dropbackward when its fundus falls below the excavation of the sacrum. In DISPLACEMENTS OF THE UTERUS. 511 consequence of the downward traction of the adherent vaginal walls and acertain amount
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