The diseases of women : a handbook for students and practitioners . Fig. 46.—The inverted uterus represented in preceding figure, opened from behind. presence of the tumor distends the cavity of the uterus andthe polypus is pushed into the cervical canal by the muscu-lar efforts of the uterus ; this traction under favorablemechanical conditions produces inversion of the fundus, andfinally the polypus with the inverted fundus makes its ap-pearance in the vagina or even protrudes beyond the vulva. 156 DISEASES OF WOMEN. When the inversion takes place gradually it is termedchronic. Acute inversio
The diseases of women : a handbook for students and practitioners . Fig. 46.—The inverted uterus represented in preceding figure, opened from behind. presence of the tumor distends the cavity of the uterus andthe polypus is pushed into the cervical canal by the muscu-lar efforts of the uterus ; this traction under favorablemechanical conditions produces inversion of the fundus, andfinally the polypus with the inverted fundus makes its ap-pearance in the vagina or even protrudes beyond the vulva. 156 DISEASES OF WOMEN. When the inversion takes place gradually it is termedchronic. Acute inversion of the uterus is always a grave accident;many patients die in a few hours from shock or loss ofblood. In years gone by the inverted mass has been cutaway by practitioners in ignorance of the nature of theaccident. When the patient escapes the immediate dangers,. Fig. 47.—Partial inversion of a uterus due to a polypus. ulceration, sloughing, bleeding, and exhaustion destroy herin a few weeks or months. Chronic inversion of the uterus has a different patient suffers from menorrhagia or metrorrhagia, leu-corrhcea, and vesical troubles, which lead to an examination,and the tumor-like mass is detected in the vagina. Inmany cases its nature is recognized, but this is not always asimple matter. Care must be exercised— DISEASES OF THE UTERUS. 157 1. To distinguish between an inverted uterine fundus anda uterine polypus. 2. To recognize a case iri which a polypus is responsiblefor the inversion of the uterus. A submucous myoma protruding through the os uterioften strikingly resembles a partially inverted fundus. In cases of acute inversion there should be no difficultyin diagnosis, but when the inversion is of long standing theexposed surface becomes grayish-white like skin. In partial inversion great caution in diagnosis is neces-sary
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