. Clinical gyncology, medical and surgical. d 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 of pathological hypertrophy of the supra-vaginal portion ofthe cervix, a uterus prolapsed in the third degree is almost always elongated,so that instead of measuring two and a half inches in depth it often attainsa length of from four to seven inches. A curious feature of this elonga-t
. Clinical gyncology, medical and surgical. d 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 of pathological hypertrophy of the supra-vaginal portion ofthe cervix, a uterus prolapsed in the third degree is almost always elongated,so that instead of measuring two and a half inches in depth it often attainsa length of from four to seven inches. A curious feature of this elonga-tion of the uterus is that when the uterus is replaced, together with theprolapsed vagina, its length diminishes, and the sound, which before enteredsix inches, we will say, now reaches the fundus at a depth of only threeinches. This peculiar phenomenon has been explained by Emmet on theprinciple of the drawing out of a cone of putty and its shortening when itis pushed together. A truly hypertrophied uterus could not, of course, be Fig. Section of prolapsus uteri et vagina; with hypertrophic elongation of supra-vaginal portion of cervix. reduced in length by being replaced. AVe must, therefore, assume that thedownward traction of the attached prolapsed vagina draws out the uterinetissue, and on reposition the same tissue shrinks. There are a few instanceson record in which an antefiexed or retroflexed uterus of perfectly normalsize was found prolapsed outside of the vaginal orifice, surrounded by thecompletely prolapsed vaginal walls with bladder and rectum. These lattercases are very rare, and can only be explained on the principle that a verysmall uterus, either antefiexed or retroflexed, was gradually or forciblydrawn down by the prolapsing vaginal walls. This, however, is by nomeans the usual mode of formation of prolapse of the uterus and should be stated that these rare forms of prolapse of the normal retro-flexed or antefiexed uterus occurred in virgins of
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