. The Principles and practice of gynecology : for students and practitioners. he same as in endometritis. The prognosis is much more favorable for puerperal than for non-puerperal myometritis—i. e., subinvolution, if non-infectious, is oftenonly temporary. The disease is apt to be obstinate and destructivein proportion as the infectious element predominates. 248 INFECTIONS, INFLAMMATIONS, AND ALLIED DISORDERS. 2. Pathology of Interstitial or Cirrhotic Metritis.—In thisform of metritis, sometimes called areolar hyperplasia, there are increaseof connective and loss of mnscular tissue. The muscul
. The Principles and practice of gynecology : for students and practitioners. he same as in endometritis. The prognosis is much more favorable for puerperal than for non-puerperal myometritis—i. e., subinvolution, if non-infectious, is oftenonly temporary. The disease is apt to be obstinate and destructivein proportion as the infectious element predominates. 248 INFECTIONS, INFLAMMATIONS, AND ALLIED DISORDERS. 2. Pathology of Interstitial or Cirrhotic Metritis.—In thisform of metritis, sometimes called areolar hyperplasia, there are increaseof connective and loss of mnscular tissue. The muscular wall is paleand indurated. The microscope will show hyperplasia of intermus-cular connective tissue, corresponding atrophy of muscle-fibres, andcontraction of blood-vessels as already stated. The chronic changesin these various parts may be the outcome of acute processes alreadydescribed under acute metritis; or there may have been no clearlymarked acute stage—i. e., the disease, at least apparently, may havebeen chronic or subacute from the beginning. Figure So-called hypertrophic elongation of the supravaginal portion of the cervix—rare exceptas a post-operative or post-mortem condition. The cervix often becomes elongated by tractionduring the removal of the uterus. Hyperplasia of connective tissue, whether puerperal or non-puerperal, may follow hypertrophy or may develop independently ofit. This form of the disease often results in a sort of pathologicalinvolution, with the following permanent changes : The lymph-vesselsand blood-vessels shrink and wither, the nutrition of the muscularelements is cut off, and they disappear as if crowded out by the in-creasing connective tissue; the uterus now becomes hard and ansemic ;it still may remain large from the superabundant connective tissue, butfinally this may contract and, cicatrix like, reduce the organ evenbelow its normal size. The result of these changes are great uterine CHRONIC METRITIS. 249 irritation and
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