The diseases of women : a handbook for students and practitioners . aceration issometimes produced by operations on the cervix, but in thevast majority of cases it occurs in childbirth. The imme-diate causes are precipitate labor, a large or well-ossifiedfoetal head, and the application of forceps before dilatationof the cervix is complete. A natural labor may result inlaceration when the distensibility and elasticity of the cervixare impaired by disease, such as carcinoma and chronicinflammation. Results of Laceration.—When a cervix is torn (as duringlabor) the raw edges become healed over by
The diseases of women : a handbook for students and practitioners . aceration issometimes produced by operations on the cervix, but in thevast majority of cases it occurs in childbirth. The imme-diate causes are precipitate labor, a large or well-ossifiedfoetal head, and the application of forceps before dilatationof the cervix is complete. A natural labor may result inlaceration when the distensibility and elasticity of the cervixare impaired by disease, such as carcinoma and chronicinflammation. Results of Laceration.—When a cervix is torn (as duringlabor) the raw edges become healed over by granulation and cicatrization, but as a rulewithout uniting. The resultingfissure does not necessarily giverise to symptoms, even if deepor bilateral. For the cervicalmucous membrane may grad-ually acquire the characters ofthe vaginal epithelium; the ex-ternal os retreats, as it were,toward the internal, while theanterior and posterior lips ofthe cervix become in realitylips or lappets, which can bereadily separated to a greater or less extent (Fig. 49). A 160. Fig. 49 —Bilateral laceration of thecervix (A. E. G.)- DISEASES OF THE UTERUS. IOI cervix in this condition is not uncommonly discoveredwhen a vaginal examination is made on account of othersymptoms. But the lesion may take a less favorable course. Theexposed cervical mucous membrane may become unhealthy,either alone or as part of a general endometritis; it thenbecomes congested, and, in consequence, the lips becomeseparated. The tendency to separation is exaggerated ifthere be a marked coincident flexion of the uterus. Theeverted mucous membrane is then bathed in the unhealthysecretions (arising partly from the uterus) found in thevagina; and it is but a short step from this condition tothat of erosion, with the formation of the cysts known asNabothian follicles. The congestion and oedema of the cer-vix commonly spread to the body of the uterus, whichbecomes heavy and enlarged, resembling the conditionfound in subi
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