. Diseases of women. A clinical guide to their diagnosis and treatment. ry pass through it, and thenending like a gable below the Fallopian tube. (Fig. 85.)A horizontal section through the pelvis at about the levelof the internal os shows a star-shaped thickening of thecellular tube. It is dense all round the uterus ; and fromthis circle two limbs run back, one on each side of therectum, embracing and supporting it; one on each side of thebase of the bladder; and a broad one runs out on each sidesupporting the vessels, nerves, and lymphatics which go to theuterus. (Fig. 86.) The pelvic cellula
. Diseases of women. A clinical guide to their diagnosis and treatment. ry pass through it, and thenending like a gable below the Fallopian tube. (Fig. 85.)A horizontal section through the pelvis at about the levelof the internal os shows a star-shaped thickening of thecellular tube. It is dense all round the uterus ; and fromthis circle two limbs run back, one on each side of therectum, embracing and supporting it; one on each side of thebase of the bladder; and a broad one runs out on each sidesupporting the vessels, nerves, and lymphatics which go to theuterus. (Fig. 86.) The pelvic cellular tissue thus forms acontinuous mesh of fibrous tissue extending from the endo- PARAMETRITIS. 257 metrium to the periosteum of the pelvic wall. The spreadot parametritis depends upon the continuity of the cellulartissue. Difference between the pregnant and the non-pregnantstate.*—During pregnancy the cellular tissue in and near thebroad ligaments is increased. At the sides the peritoneum islilted up, so that at the end of pregnancy it leaves the uterus Cervix uteri. Pouch ofDouglas Rectum Fig. 86.—Horizontal section of pelvis at level of internal os, showing arrangementof cellular tissue. (After Freund.) about an inch and a half above the pelvic brim. Hence atthis time the base of the broad ligament might be describedas being at the brim ot the pelvis, stretching from theilio-pectineal eminence to immediately in front of the sacro-iliac joint. There is a large triangular area at the sidesof the uterus uncovered by peritoneum. The bottom of thevesico-uterine pouch, instead of dipping below the pelvicbrim, is about on a level with it. Hence behind Poupartsligament there is much loose cellular tissue which is notthere in the unimpregnated state, and which is continuouswith the cellular tissue at the sides of the uterus. (Fig. 87.)Upon this alteration in the anatomy of the cellular tissueduring pregnancy depends a difference between the courseof parametritis occurring after del
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