The diseases of women : a handbook for students and practitioners . stinct cavi-ties. The septum may extend to the vulva, producing avagina with the appearance of a double-barrelled gun; orit may involve the uterus alone, the vagina being single; orit may fail to reach the external os, in which case the cer-vix looks normal when seen through a speculum. This isthe uterus subscptus. 2. In the uterus bicornis external union has occurredin the lower part of the uterine body, but is wanting in theupper part; so that when such a case is bimanually ex-amined, the depression between the two halves of
The diseases of women : a handbook for students and practitioners . stinct cavi-ties. The septum may extend to the vulva, producing avagina with the appearance of a double-barrelled gun; orit may involve the uterus alone, the vagina being single; orit may fail to reach the external os, in which case the cer-vix looks normal when seen through a speculum. This isthe uterus subscptus. 2. In the uterus bicornis external union has occurredin the lower part of the uterine body, but is wanting in theupper part; so that when such a case is bimanually ex-amined, the depression between the two halves of thefundus is plainly felt (Fig. 22). Here also the extent ofthe septum varies, reaching to the vulva, to the os exter- 64 DISEASES OF WOMEN. num, or to the os internum only. The last kind gives thevariety known as uterus bicornis unicollis. 3. In Uterus didelphys (Fig. 23) the two halves of theuterus have remained externally distinct, and can be movedindependently of one another. The vaginae are invariablyseparate, though united by connective tissue, and a loose. Fig. 22.—Uterus bicornis (Schroeder). bridge of connective tissue and peritoneum stretches be-tween the cervices. A well-marked fold of peritoneumusually stretches directly between the bladder and rectum,passing between the two halves of the uterus. Each uterus has its own Fallopian tube, whose point ofjunction with the uterine body is indicated by the origin ofthe round ligament; it has also its own ovary. The two halves are often unequally developed, and onevagina may end blindly above the vulva, so that the corre-sponding uterus is quite shut off from the outside. Diagnosis.—The presence of two vaginal canals is a cer-tain indication that the uterus is double. Where the vaginais single, the malformation of the uterus may be discoveredin one of several ways. Thus, when the division involvesthe cervix, two ora externa may be seen through the specu-lum ; on bimanual examination two separate uterine cornua MALFORMA
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