Treatise on gynæcology : medical and surgical . ntegration at the centres oflarge tumors where the nutrition is impeded. There can be no gan-grene because of the absence of germs; it is then a necrobiosis, withthe formation of softNmasses, which later may fall into deliquescenceand fill the cavity with more or less dense fluid. Hemorrhages areoften added to dilute the contents of the cyst and increase their have been known to rupture into the uterus. In certain ofthese rare cases, the uterine orifice may be obliterated by the elonga- UTERINE FIBROMATA. 227 tion of the cervix, the
Treatise on gynæcology : medical and surgical . ntegration at the centres oflarge tumors where the nutrition is impeded. There can be no gan-grene because of the absence of germs; it is then a necrobiosis, withthe formation of softNmasses, which later may fall into deliquescenceand fill the cavity with more or less dense fluid. Hemorrhages areoften added to dilute the contents of the cyst and increase their have been known to rupture into the uterus. In certain ofthese rare cases, the uterine orifice may be obliterated by the elonga- UTERINE FIBROMATA. 227 tion of the cervix, the partial rotation of the organ, and a certain de-gree of inflammation, and thus is formed a peculiar form of hamia-tometra. W. A. Meredith lias reported a remarkable case of thiscondition which was cured by supra-vaginal hysterectomy; the mor-bid mass weighed fifteen pounds and contained five pounds of has punctured and drained, in a woman of sixty-five years,an hsematometra that simulated a fibro-cyst, due to obliteration of. Fig. 139.—Pediculated Fibroid with Abdominal Evolution (Schroeder). MS, Fibroid lobe: M C, Fibro-cystic lobe. the neck of the uterus containing a fibroma; this incomplete opera-tion was followed by death. Tillaux34 has published under the name cystic uterus an analogous case, which was cured by abdominalhysterectomy. These cases are usually found in aged patients, wherethe cervix has a tendency to become retracted and obliterated underthe influence of senile atrophy. It is evident, then, that from an anatomical point of view these 228 CLINICAL AND OPERATIVE GYNAECOLOGY. tumors do not form a natural group of myo- and fibro-cysts; for theymay take their origin from: 1st, closed spaces, resulting in dilatationof the lymphatics, or lym|3hangiectasis (Koeberle, Leopold); 2d, oede-matous (Oscar, Schroder) or myxomatous infiltrations (Virchow), intheir highest development; 3d, lacuna? (geodes) formed at the centreof myomatous or sarcomatous
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