Treatise on gynæcology : medical and surgical . vix alone. Treatment.—This is similar to that for retroflexion. II. Retroflexion. Pathology; to the forward deviations, retro-flexion seldom exists from childhood or puberty, although it mayfollow virginal metritis, habitual constipation, and masturbation(Fritsch). In the immense majority of cases the retroflexion succeedsto a metritis of puerperal origin; the subinvolution of the anterior 436 CLINICAL AND OPERATIVE GYNECOLOGY. face where the placenta is inserted plays here, according to E. Martin,a role similar to that which I
Treatise on gynæcology : medical and surgical . vix alone. Treatment.—This is similar to that for retroflexion. II. Retroflexion. Pathology; to the forward deviations, retro-flexion seldom exists from childhood or puberty, although it mayfollow virginal metritis, habitual constipation, and masturbation(Fritsch). In the immense majority of cases the retroflexion succeedsto a metritis of puerperal origin; the subinvolution of the anterior 436 CLINICAL AND OPERATIVE GYNECOLOGY. face where the placenta is inserted plays here, according to E. Martin,a role similar to that which I have indicated for anteflexion. Considerable importance must also be attributed to the weight of thecongested organ, and to relaxation of the broad and round ligaments,which cease to hold the uterus in place anteriorly, while the cervix re-mains fixed by the more resistant utero-sacral ligaments. The flaccid-ity of its own supports thus allows the uterus to bend backward at^he level of the isthmus, impelled by the weight and pressure of the. Fig. 226.—Retroflexion op the Uterus from Subinvolution of the Anterior Wall, on Which may beSeen the Site of Placental Insertion (E. Martin, Sr.). intestines. Retroflexion has been observed to follow simple retro-version and even anteversion; in the latter case this is possible whenthe seat of the flexion remains soft and movable like a hinge. Thecervix is directed downward and forward, ordinarily approaching thevulva, for it is usually a little lowered. The external os is somewhatpatent and its lips are swollen, owing to the disturbance of the venouscirculation which results from the curvature of the vessels. It mustnot be forgotten that the displacement almost always happens ina woman who has had at some time metritis of puerperal origin. DISPLACEMENTS OF THE UTERUS. 437
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