The rational treatment of anterior and posterior displacements of the uterus / by Arthur V. Macan.

  • Macan, Arthur V. (Arthur Vernon)
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: The rational treatment of anterior and posterior displacements of the uterus / by Arthur V. Macan. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    the anterior wall of the uterus being nearly parallel to the anterior vaginal wall. The fundus lies supported on the empty bladder, while the cervix is suspended from the second bone of the sacrum by the folds of Douglas, which contain some unstriped muscular fibres, named by Luschka the musculi retractores uteri. As the bladder becomes filled, it gradually lifts the fundus upwards and backwards; and as it is emptied, the fundus follows it downwards and forwards—this being, in the upright position, in part due to the action of gravity, but chiefly to the intra-abdominal pressure, acting on the posterior surface of the uterus. Normally, therefore, the uterus is in a constant state of motion, the fundus rising and falling with the varying amount of urine in the bladder. Professor Schultzea has measured the angle through which the fundus moves during the emptying of a full bladder, and found it 48°. We cannot, therefore, speak of any one position of the uterus as the normal one. Indeed when the uterus, from any cause, becomes fixed and unable to follow the changing shape of bladder, this is a pathological condition. The most frequent cause for pathological anteflexion is, according to Schultze, a shortening of Douglas’s folds from inflammation, by which the cervix is drawn upwards towards the second bone of the sacrum. This inflamma- tion of Douglas’s folds is called by him parametritis posterior. Fig. ]. Normal Position of the Uterus (Graily Hewitt). “ Centralbl. f. Gynaek. 1878. P. 241.