A treatise on the diseases and special hygiène of females / By Colombat de l'Isère. Translated from the French, with additions, by Charles D. Meigs.
- Marc Colombat de L'Isère
- Date:
- 1850
Licence: Public Domain Mark
Credit: A treatise on the diseases and special hygiène of females / By Colombat de l'Isère. Translated from the French, with additions, by Charles D. Meigs. Source: Wellcome Collection.
Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.
59/764 (page 53)
![s NECK OF THE WOMB. 53 inclined forwards, it nevertheless is almost always inclined backwards, especially in married women, because, during the copulative act, it is forced backwards in that direction. Without being at all diseased it is found to be softer and larger some days before and during the whole period of the catamenial discharge: it is then of about the same size, consistence and sensation as is found in *it at the second month of gestation. [The whole organ becomes enlarged and engorged as the mensual period approaches, and it is probable that the womb is much increased in weight by the menstrual excitement or polygsemia.—M.] Our own anatomical researches have led us to conclude, that the distance from the os tincae to the peritoneum is really but nine lines in front, and not more than seven or eight behind, for on that side the serous membrane descends quite low down upon the vagina, to make the recto-genital excavation. These measurements, which, by some surgeons are estimated to be greater, are not so large as they really are in women advanced in years, because both the body and neck of the womb may, in such persons, be said to become atrophied, which is doubtless the real cause of that obliteration of the os tincse, long known to the medical authorities, among whom we may mention the names of Mayer of Bonn, Lisfranc, and Velpeau, and which, in accordance with M. Breschet's opinions, we look upon as a real physi- ological law. According to Messrs. Velpeau and Civatte de Sisteron, the dimen- sions we have laid down would be found too large, particularly on the posterior part of the vagina. The last named author asserts in his thesis, that the antero-superior part of the cervix touches the bas- fond of the bladder, and adheres to it by means of a loose layer of cellular tissue, which corresponds precisely to the middle of a line drawn from the orifice of one ureter to the other. He states, that if a horizontal section of the womb should be made, at the distance of four lines above the extremity of the anterior lip of the os tines, it would just lay open the cellular tissue that unites the bas-fond of the bladder to the neck of the womb. If, instead of making the incision at this point, it should be effected five lines above, it would inevitably open the peritoneum. M. Civatte says, further, that in making an incision at the distance of five lines, if the edge of the bistoury were directed forwards and upwards, it must wound the bladder, particularly if distended with urine. Posteriorly there is a greater space between the extremity of the lip and the terminus of the surgical neck, but in this situation there is no cellular space like that which is found in front, and a sec- tion, even a horizontal one effected higher up than the limits proposed by M. Mury, would hazard a wound of the peritoneum. Here the rectum is united to the cervix by means of the upper part of the vagina, and by about one line in width of cellular tissue. The upper part of the vagina is inserted into and confounded with the neck, anteriorly, four lines above the end of the lip, and posteriorly, five lines higher up than the top of the posterior lip : the longitudinal and](https://iiif.wellcomecollection.org/image/b21029313_0059.jp2/full/800%2C/0/default.jpg)
