Gynecological diagnosis . f healthhave been described in Chapter V., page 43. When pregnant or under conditions of disease the uterus is sub-ject to certain displacements as a whole, and its long axis may beturned or verted in one of several directions. Theoretically wehave to do with two distinct classes of displacements. The uterusmay be likened to a telescope upon a stand in a room. The tele-scope may be in the middle of the room (the pelvis), or it may beplaced against the wall (retro-position), or it may be raised (ascent),or lowered (prolapse). Also it may be tilted in one of many direc-
Gynecological diagnosis . f healthhave been described in Chapter V., page 43. When pregnant or under conditions of disease the uterus is sub-ject to certain displacements as a whole, and its long axis may beturned or verted in one of several directions. Theoretically wehave to do with two distinct classes of displacements. The uterusmay be likened to a telescope upon a stand in a room. The tele-scope may be in the middle of the room (the pelvis), or it may beplaced against the wall (retro-position), or it may be raised (ascent),or lowered (prolapse). Also it may be tilted in one of many direc- 215 216 MALPOSITIONS OF THE UTERUS tions (version) although its position as a whole with reference tothe walls, floor, and ceiling of the room has not been changed. Alteration of the position of the uterus generally but not neces-sarily implies change in its axis, and often in its form. For in-stance, retroversion generally means a certain degree of retro-position and often retroflexion; prolapse presupposes retroversion. Fig. 84.—Median Section of the Body of a Woman Who has Borne Empty. (Schultze.) Note Ante version of Uterus. in the early stages of the descent of the uterus; inversion is a formof prolapse. The lesion that is supposed to be the important one from apathological standpoint gives the name to the displacement, al-though—as before stated—several lesions are involved. Theclassification here used is a practical rather than a theoretical one. In describing the pelvic circulation, Chapter V., page 46, it hasbeen stated that the blood-vessels of the uterus and broad liga-ments are convoluted, valveless, and capable of great distention,depending for their normal tone on absence of constricting; influ- GENERAL CONSIDERATIONS 217 ences in the way of pressure from tumors or pelvic inflammatory masses, or stretching due to malposition of the uterus. We know how much a prolapsed uterus is reduced in size afterit has been replaced in a normal position
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