. The Principles and practice of gynecology : for students and practitioners. hereby decrease the elasticity and increase the liabilityto rupture. The condition is an approach to ])ressure-necrosis. 1 Surgery of the Cervix Uteri. American Journal of Obstetrics, February, 1S69. Lacera-tion of the Cervix Uteri as a Frequent and Unrecognized Cause of Disease. Ibid., Novem-ber, 1874. The Proper Treatment of Lacerations of the Cervix Uteri. American Practitioner,January, 1877. - The Causes and Treatment of Sterilitv. Gardener, 1856. Cicatricial Ectropion of theCervix. W. Roser. Archiv fiir Heilkund
. The Principles and practice of gynecology : for students and practitioners. hereby decrease the elasticity and increase the liabilityto rupture. The condition is an approach to ])ressure-necrosis. 1 Surgery of the Cervix Uteri. American Journal of Obstetrics, February, 1S69. Lacera-tion of the Cervix Uteri as a Frequent and Unrecognized Cause of Disease. Ibid., Novem-ber, 1874. The Proper Treatment of Lacerations of the Cervix Uteri. American Practitioner,January, 1877. - The Causes and Treatment of Sterilitv. Gardener, 1856. Cicatricial Ectropion of theCervix. W. Roser. Archiv fiir Heilkunde, li. S. 97,1861. 651 552 TRAUMATISMS. Pathological Anatomy and Results of Laceration of theCervix Uteri. At the outset, let the important fact be kept clearly iu mind thatthe injury is usually more extensive in the surrounding vaginal struct-ures than in the cervix proper. This is, perhaps, contrary to the usualnotion ; but will be apparent on examination of later paragraphsin this chapter which treat of the state of the cervix before, during,and after labor. Figure Vesico-uterine fistula at angle of laceration. The fistulous tract has been left after partialhealing of an anterior laceration. The diameter of the cervical canal iu the non-pregnant uterus isabout one-fifth of an inch. This must be increased at delivery tocorrespond to the diameter of the childs head ; it is, therefore, notsurprising that some degree of laceration occurs in the majority oflabors. The lesion, however, is generally slight, and heals so readilyand rapidly as to cause little or no pathological result. The Directions and Extent of cervical laceration vary within thewidest limits—i. e., the cervix may tear in any direction and to anyextent. The usual directions are : anterior, posterior, and lateral. PUERPERAL LACERATION OF THE CERVIX UTERI 553 Anterior and posterior lacerations, especially the former, usuallyheal spontaneously, and, therefore, seldom are observed, Tiiis heal-ing; is explained
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