Treatise on gynæcology : medical and surgical . ntiawill be in front only, and the posterior cavity of the vagina will stillremain; a finger introduced into the posterior cul-de-sac (Figs. 258and 259) will be able to appreciate the fact that the posterior portionof the cervix is hypertrophied. This somewhat singular condition of things is quite accounted forby the preceding considerations, although Schroder gives a more elab-orate explanation. He thinks it due to the fact that the hypertrophy PROLAPSE OF TIIL GENITAL ORGANS. 485 begins in the middle portion of the cervix, intra-vaginal posteri
Treatise on gynæcology : medical and surgical . ntiawill be in front only, and the posterior cavity of the vagina will stillremain; a finger introduced into the posterior cul-de-sac (Figs. 258and 259) will be able to appreciate the fact that the posterior portionof the cervix is hypertrophied. This somewhat singular condition of things is quite accounted forby the preceding considerations, although Schroder gives a more elab-orate explanation. He thinks it due to the fact that the hypertrophy PROLAPSE OF TIIL GENITAL ORGANS. 485 begins in the middle portion of the cervix, intra-vaginal posteriorly,supra-vaginal anteriorly (Fig. 264, b, b). 3. Prolapse of Vagina and Uterus Resulting from a Primary Hy-pertro%)hic Elongation of the Supra- Vaginal Port ion of the Cervix.—This condition was for a long time unrecognized, and is still dis-puted by some authorities (Virchow); it nevertheless exists, althoughit is of less frequent occurrence than Huguier supposed. In somevirgins with firm vagina and perineum and no prolapse of the uterus,. Fig. 263.—Prolapse of the Uterus. Hypertrophic elongation of the cervix ; rectocele. an inversion of the upper part of the vagina may be observed, coex-istent with a supra-vaginal hypertrophy of the I operatedupon such a case when with my lamented preceptor G-allard. We areforced to admit that the initial elongation of the cervix drags uponthe vaginal attachments, yet, although the starting-point of the processis always the cervical hypertrophy, later the roles may be reversed, andthe vaginal procidentia become of chief importance, in its turn causingelongation of the cervix. The position of the intra-vaginal cervix willaid in determining whether this condition of things exists; it is sooften lengthened by hypertrophy that if we find it in normal positionwe may be quite sure that the vaginal attachments are not draggingupon it. This influence exerted upon prolapse of the genitalia by 486 CLINICAL AND OPERATIVE GYNAECOLOGY hy
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