Atlas of Obstetrics and Gynaecology
Atlas of Obstetrics and Gynaecology
Atlas of Obstetrics and Gynaecology
MARTIN'S ATLAS
OF
EDITED BY
DOCENT
IN
A.
MARTIN
SECOND EDITION
FANCOURT BARNES,
M.D., M.R.C.P.
PHYSICIAN TO THE BRITISH LYING-IN HOSPITAL ASSISTANT PHYSICIAN TO THE ROYAL MATERNITY CHARITY OF LONDON, ETC.
17
and the female genital organs with the development of the ovum and the uterus
tions of the pelvis
foetus, the
works on Midwifery, deal, with few exceptions, besides illustrain the normal state, almost exclusively
during' pregnancy, the positions of the
in
obstetric
instruments,
and
the
Obstetrics.
and of the
obstetric operations
in
most
dummy
various positions in a
phantom or
pelvis,
Midwifery must
be considered
in its
and pathological changes which occur in the sexual Thus the scientific methods of study require it, and rebel more and more against the continued reign of the obstetric method. The practice which had long ago forced itself upon the obstetrician, also required a knowledge of the so-called diseases of women.
and
to
relation to gynoecology.
On
of the
sexual organs should be represented in the various phases of their functions, the
of the publishers for an atlas of obstetrics
often felt the
demand
I
me, especially as
had
want of an
my
annual course of
The
the lecture,
at a
is
useful
insufficient.
diagram during a
lectures.
my
hearers a collection
is
And
my
physician,
who does
an exact and
to his
faithful
dearly
has no time.
ful
mind than far-fetched deductions for the elaboration of which he frequently It moreover starts fresh ideas for future diagnosis and treatment of doubt-
individual cases.
The
and practitioners an
illus-
work
In the
first
place, the
number
On
this account,
G0a49?
vi
condition,
I
Preface.
reduced their number
to
I class as diagramhand. indispensable, and of which original drawings were not at the child in the pelvis matic illustrations the majority of illustrations of the positions of
are for the most during labour, which are given in various obstetric works, and which dummy in various positions in a phantom or pelvis. In part constructed by placing a which the child might present this way it is possible to imagine 96 or more positions in
and
still
On
memory
condemn
of the
student
his
judgment
prejudiced by
artificial theories.
My
whom
used frequently
to
these
fancy illustrations drawn with pedantic precision, and to place the unbiassed observation of nature above many a learned text-book. After this, I should have thought it hardly
possible at the present time, that
we
dominal
is
true,
may be demonstrated on a
to,
phantom, although
observation
in
the living
woman.
is
When
in addition to the
is
if
a question
if
the
some
cases,
the student,
who
trammelled by
he has learnt,
technicalities,
is
not to be condemned.
The
illustrations of operative
to
in
my
opinion, be-
narrow the
student's self-reliance.
be taught on the phantom, and where possible the reasons for which they are performed,
explained, because only he
who
them out
artificial
in
a competent manner.
at such illustrations
drawn from
reasoning operators,
who
by
the state.
all,
me
I
to limit the
number of
the illustrations
and
to
un-
In selecting
have endeavoured
with
my own
The
my
wishes;
some
cases,
to
my
desire,
concave mirror
the
stone,
so that
several
drawings do not
No
my
knowledge, from
this;
but
thought
it
it.
my
duty to mention
hypercritics
may
me
for
arrangement of the
to for
plates,
subjects which
have kept
years
in
my
lectures on gynoecology,
and which
is
fully
Preface.
set forth in the tabular
vii
view on page I have begun with the anatomy of the pelvis ff. and female sexual organs; then follow the development of the ovum, and the maternal genitals during pregnancy. These are succeeded by the pathological changes in the
l,
external genitals, the vagina, the uterus, the Fallopian tubes, the ovaries,
coats,
the ovarian,
to
the placenta,
the foetus
and
its
an obstruction
labour
and gynoecological instruments, which had, against my wish, to be confined almost exclusively to those used by myself. Here and there deviations have occurred from the general arrangement, caused by the imperaThey do not, however, interfere with the compretive and careful utilization of space.
obstetric
hope
this
compendium
may advance
medicine which, although so important and necessary to the lives and health of individuals, as well as for the happiness of families,
state,
and consequently
it
for the
good of the
was out
of print before
my
already
commenced a new
If I
I had knowledge on
the subject.
have only
it,
my
task,
it
is
not because
have allowed
In the
new
edition
endeavoured,
in
the
I
first
diagrammatic
was impossible
At
the
same time
it
was
to the
many
as possible of the
original stones should be retained, lest the expenses of publishing, which greater, should have been so raised as to render the
circle.
It is
were already
work
many
modern
have
I
originals exist.
were
essential to a proper
comprehension
suppressed the
first
without any regard for the occasional use of the old stones.
In addition to
new
illustrations,
my
father
had already
collected a
number of
original
drawings from preparations which he had obtained in the hospital clinic, or in private Besides these, I have been allowed the use of many old and recent drawings practice. by Carl Ruge in the clinic, and I wish here to thank Professor Schroder for the ready
assent he gave to
this.
I
also tender
my
best thanks to
my
himself for the friendly, and professional, and artistic advice, as well as for the assiduous
grew weary of rendering me in designing fresh drawings, and own collection, or from other sources. I have, of course, taken many drawings from many modern text-books, especially those of Spiegelberg and Schroder, from the "Archives of Gynaecology" and from the various periodicals. To
assistance which he never
selecting others from his
Herr Geheimrath Winckel of Dresden, and Herr Dr. G. Leopold of Leipzig, I am especially indebted for the great kindness with which they placed the valuable originals of their latest publications, some of them while still in the press, at my disposal. I have made extensive use of Braune's "Illustrations of Sections from Frozen Bodies," Hyrtl's
"Atlas on the Results of Corrosion-anatomy" Virchow's "Tumours" and others.
so
I
And
have, in the
new
edition,
the genitals in the various stages of their development, as well as the microscopical
illustrations of their physiological
The
plates illustratino-
the pelvic conditions have received an important addition in the collection of stereo-
scopico-photographic illustrations of
specimens
Preface.
the Berlin clinic, wlnich
I
ix
made
in the
year 1872.
Had
it
many
do
so,
reproduce
all
was
available.
Another
has induced
to a
difficult
question
should be illustrated.
me
to retain
complete armamentarium.
have therefore
and take this opportunity of saying that I by no means criticise by this selection any other instruments. As regards the obstetric instruments, the selection was simple enough, but the gynaecological instruments were not so easily chosen, because every
gynaecologist uses different instruments in his daily
practice,
I
is
very prevalent.
arranging old and new drawings together, sometimes on the same not always possible to place each in its right place. I must apologise for
was
on the
ground of insuperable
father,
difficulty.
As
a rule
have adhered
to the
to the
order adopted by
I
my
to
although
new
edition.
was induced
are not able to carry out such a combination as might appear, on account of the great advance and development in
In the place of the
we
schema, therefore,
have inserted
a detailed index.
cannot refrain from specially acknowledging the perseverance and great pains taken by the artist, Herr A. Schiiltze, in the difficult task of drawing the illustrations
Lastly,
I
in
giving effect to
my
wishes,
May
the
atlas
in
its
the
same favour
it
received on
its
first
appearance.
A.
Berlin, March, 1878.
MARTIN.
asked
to
to the request
made
me, because
number
of students
and practitioners
work would be welcome to a large who are unfamiliar with the German language, and
believed the
in
English.
have ventured
I
to
add several
illustrations
I
from
my
father's
work on
the Diseases
of
Women, which
commonly used
country.
FANCOURT BARNES.
London, ^Kw, iS8o.
CONTENTS OF PLATES.
PLATE
Fig.
I. I.
Female
pelvis with
its
,,
,,
2.
A perpendicular section
line of the pelvis.
lig-aments seen from above. throug-h the pelvis to shew the inclination
and median
3.
4.
View of the right sacro-iliac articulation from behind. The right sacro-iliac symphysis laid open from above.
PLATE
Fig.
,,
IL
,,
,,
pelvis from below. pelvis from above. 3. Transverse section through the symphysis pubis in 4. Transverse section through the symphysis pubis in
I.
2.
Female Female
PLATE
Fig.
I.
in.
,,
2.
3.
Second aperture of the female pelvis, or the so-called largest diameter. Third aperture, the so-called smallest aperture of the pelvis.
Anterior wall of the pelvis from within. Perpendicular section through the female pelvis.
Posterior wall of the pelvis.
,,
4.
PLATE
Fig. I. Pelvis with the soft parts. 2. Position of the viscera at the sixth
IV.
month of pregnancy.
V.
PLATE
Fig.
,,
I.
2.
3.
,,
External female genital organs. Outlet of the pelvis after removal of the integument. The vulva with the openings of the ducts of the glands.
glands.
4. Bartholini's
PLATE
Fig.
I.
VI.
2.
3.
Section of the abdominal cavity of a middle-aged multipara. Section of the pelvis with distended bladder and urethra. Section through the abdomen of a normally-formed woman, bladder empty, the rectum full.
aged
PLATE
Fig.
,,
VII.
I.
2.
Perpendicular section of the viscera of the female pelvis. View of the female pelvic viscera from above.
62
xii
Contents of Plates.
PLATE
Fig.
I.
VIII.
,,
Dissection of vagina, uterus, Fallopian tubes, uterine ligaments and ovaries. Well-developed uterus of a foetus at term. the uterus of a mature foetus. 3. Perpendicular transverse section of 4. Perpendicular transverse section of the uterus of a girl aged 7 years. 5. Well-developed uterus of a young woman. 6. Perpendicular transverse section of the uterus from the body of a young woman. ligaments from the body of a woman aged 79. 7. Uterus with broad
2.
PLATE
Fig.
,,
IX.
2.
,, ,,
Internal surface of uterus soon after delivery. Transverse section of uterus one year after delivery. 3. Antero-posterior section through uterus. 4. Broad ligament with Fallopian tubes, and Parovarium, 5. Section through an ovary.
I.
PLATE
Fig.
I.
X.
2.
Peritoneal folds of the serous covering of the uterus as shewing the direction and expansion of the retraction of the uterus. Leaf-like arrangement of the muscles of the pregnant uterus.
PLATE XL
Fig. I. Arteries of the uterus. 2. Injected arteries and veins of a pregnant uterus.
PLATE
Fig.
i.
XII.
left
PLATE
1.
XIII.
Mucous membrane of
2.
first
day
of menstruation. 3. Mucous membrane of the body of the uterus on the third day of menstruation. 4. Fresh corpus luteum from 8 to 9 days old, 8 to g days after commencement of
5. 6.
7.
last haemorrhage. Older corpus luteum (5 weeks). Corpus luteum three weeks old. Corpus luteum, seven weeks old.
8.
Almost
ripe follicle.
PLATE
1.
XIV.
2. 3.
Lymphatic vessels of the non-pregnant normal uterus. Uterus of a sow blood- and lymphatic- vessels. Blood-vessels and lymphatics from the uterus of a virgin aged
;
25.
PLATE XV.
Fig.
,, ,,
the bo^ly of the uterus at the fourth month of pregnancy. 2. Placenta and uterus at the middle of the fifth month of pregnancy. Transition of the placental 3. Uterine mucous membrane 7 days after delivery. site in the mucous membrane of the body of the uterus.
I.
Mucous membrane of
Contents of Plates.
xiii
PLATE
Fig.
,,
XVI.
I.
2.
3.
,,
,,
4.
5.
Two
Lobulus of
mammary
PLATE XVIL
Fig.
I
.
Surface of the uterine mucosa changed by the development of the deciduae Vera
,,
2.
,,
,,
3.
4.
and Reflexa. Diagrammatic transverse section of a pregnant uterus, a few hours after the embryo has become encapsuled, which apparently took place on the eighth day after impregnation. An ovum laid open at the twenty-first day. Ovum with embryo from the seventh to the eighth week,
PLATE
Fig.
I.
XVIII.
,,
2.
,,
3.
4.
5.
Section of pregnant uterus with mucous membrane developed into decidua at the sixth week of gestation. Section of uterus and placenta of a woman who died in the thirtieth week of gestation. Injected terminal loop of villus from a mature placenta. Placenta from the internal surface. External surface of placenta.
PLATE
Fig.
I.
XIX.
2.
3.
Pregnant uterus from behind at the commencement of the fifth month. Fundus uteri of a pregnant uterus at the eighth month. Internal surface of uterus far gone in pregnancy after removal of the mucosa developed into decidua, to shew the muscular fibres of the internal surface, and the developed folds of the arbor vitae.
PLATE XX.
Side view of abdominal cavity laid open after partial removal of the larger omentum in a woman far advanced in pregnancy.
PLATE XXL
Fig.
,,
I.
2. 3.
,,
4.
week. month. at the sixteenth week. ovum at the fifth month and a half.
at the ninth at the third
PLATE
Human
embryo,
funis,
XXII.
its
membranes,
month
of pregnancy.
xiv
Contents of Plates.
PLATE
Fig.
,,
XXIII.
,, ,,
Internal org-ans of an embryo before birth. FcEtal circulation. 3. Side view of cranium of a newly-born child. 4. Cranium of a newly-born child, seen from above. 5. Meconium seen under the microscope. 6. Vernix caseosa under the microscope.
I.
2.
PLATE XXIV.
Section of a normally-formed pregnant
woman
old, after
PLATE XXV.
Fig.
,,
I.
2.
in first in first
head presentation.
breech presentation.
PLATE XXVI.
Fig.
,, ,,
Section of the frozen body of a woman in labour, during the period of expulsion. Section through the parturient canal after removal of the child. 3. The engagement of the head. 4. Commencing expulsion of the head.
I.
2,
PLATE XXVII.
Fig.
,,
,,
I.
2.
3.
,,
,,
4. 5.
The engagement of the head descending Cranium of occipital presentation. Cranium of face presentation. Cranium of breech presentation.
first.
PLATE XXVIII.
Fig.
,,
I.
Occipital presentation.
2.
3.
Face presentation.
,,
,,
4.
PLATE XXIX.
Fig.
,,
I.
2.
3.
,,
Uterus with twins in cranial and breech presentation. placenta with twins. Triplet after birth with two embryos arrested in development.
One
PLATE XXX.
Fig.
,,
I.
2.
3.
Inflammation of the mucous and sebaceous glands of the vulva. Abscess of the right Bartholini's gland. Cyst formed by the dilatation of the occluded duct of the left Bartholini's gland.
Contents of Plates.
XV
PLATE XXXI.
Fig.
I.
I
,,
A.
Morbid enlargement of the clitoris. Follicular polypus of the cervix, extended from the vagina
stalk.
by elongation of the
2.
3.
orifice
and anus.
Fig.
,.
I.
2.
PLATE XXX n. Lupus of the vulva. Broad condylomata of the labia in a pregnant woman, removed Huginer without causing abortion.
Urethral excrescence.
in
two
sittings
by
,,
3.
I.
2.
,,
,,
3.
4.
Malformation and occlusion of the external female genitals in a new-born child. Malformation of the female genitals by growing together of the labia minora and unusual size of the clitoris. The internal organs of generation were normal. Occlusion of the vaginal orifice by malformation of the bands of the labia. Coalescence of the external genital parts as far as the meatus urinarius, in an old woman who had suffered from an intolerable pruritus but had not borne
children.
,,
5.
PLATE XXXIV.
Fig.
I.
,, ,,
2. 3.
Occlusion of the vaginal orifice (atresia hymenea) with displacement forwards of the anal opening in a girl aged 4 years. Narrowing of the vagina in a woman in labour by an ovarian tumour. Acquired partial occlusion of the vagina.
PLATE XXXV.
Fig.
,,
!.
2.
3.
,,
,,
4.
Prolapse of the posterior vaginal wall, (enterocele vaginalis). Prolapse of the posterior vaginal wall, (vaginal enterocele). Vesico-vaginal hernia, (cystocele vaginalis). Retro-vaginal hernia, (rectocele vaginalis).
PLATE XXXVI.
Fig.
,, ,,
I.
2.
3.
virgin aged 17. Left horn of uterus developed together with a rudimentary right horn in a sterile
Vagina and uterus divided by a septum. Two-horned uterus and divided vagina in a
married
woman aged
34.
first for
,,
4.
Pregnancy
in the left
tubal gestation.
PLATE XXXVII.
Fig.
1.
,,
2.
3.
Rudimentary horn united by a solid band with the fully developed uterine horn enlarged by pregnancy. Transverse section. One-horned uterus from a child. Drawn from behind. One-horned uterus from the body of a woman from six to seven days pregnant for
,,
the tenth time; the left kidney was also absent. of divided uterine body indicated by connective tissue and muscular fibrous tissue with simple cervix. 5. Apparently simple uterus with vaginal wall continuous with cervical cavity. 6. Dissected uterus with two horns and simple cervix.
4.
Schema
xvi
Contents of Plates.
PLATE XXXVIII.
Fig.
I.
2.
Cleft uterus with double vagina, in a young woman ag-ed 30. Uterus, divided from vagina, with double os uteri after termination of gestation in Drawn from behind. left half.
3.
in front.
PLATE XXXIX.
Fig.
I.
2.
3.
4.
5. 6.
Left obliquity of the uterus. The same uterus dissected shews a cicatrix in the neighbourhood of the internal OS uteri near the left border. Fundus uteri twisted to the right with inflection of the isthmus to the left and forwards. From a single woman over 30 years of age. Fundus uteri twisted to the left, and os uteri constricted, from a girl aged 15 years. Fundus uteri strongly developed to the right. In the neighbourhood of the isthmus
the uterus
is
atrophied.
Bulky vaginal portion of the above preparation from below, with obliquely
situated os uteri.
PLATE XL.
Fig.
,,
Anteflexion of the puerperal uterus; on the posterior wall at the placental site is attached a portion of placenta. 2. Puerperal retroflexion; placental polypus on the anterior uterine wall. 3. Retroflexion of the puerperal uterus; lengthening of the anterior uterine wall, on the internal surface of which is situated the uneven placental site.
I.
PLATE
Fig.
,,
,,
XLI.
i.
2. 3.
,,
4.
5. 6.
,,
Marked anteflexion of the uterus. Anteflexion of the uterus soon after delivery. Retroversion of the gravid uterus at the fourth month. Retroversion of the gravid uterus at the commencement of the fifth month, with considerable distension of the bladder by retained urine. Distension of the bladder by retained urine, consecjuent on retroversion of the womb. Retroflexed uterus bound down to the rectum by exudation membrane.
PLATE XLI I.
Fig.
Vertical section of uterus. Vertical section of uterus. 3. Vertical section of senile uterus. Hypertrophy of the neck of the uterus. 4. Partial prolapsus uteri. 5. Myoma of the uterus. 6. Carcinoma of the uterine neck.
i
.
2.
2.
3.
4.
5. 6.
7.
Obtuse-angled anteflexion. Obtuse-angled anteflexion. Obtuse-angled anteflexion. Right-angled anteflexion. Right-angled anteflexion. Acute-angled anteflexion.
Contents of Plates.
xvii
PLATE XLIV.
Fig.
,,
I.
2. 3.
,,
,,
4.
5.
Retroversion of the uterus. Obtuse-angled retroflexion of tlie uterus. Retroversion of the uterus. Retroflexion with adhesions to the rectum. Retroflexion with adhesions to the rectum.
PLATE XLV.
Fig.
I.
woman
30,
who
2.
3.
Partial inversion of the uterus. Partial inversion of the uterus five years after the occurrence of the inversion,
with prolapse.
PLATE XLVL
Fig.
1.
,,
,,
2.
3.
4.
Inversion of the uterus with prolapse, resulting- from injudicious traction on the placenta. Prolapse of hypertrophied polypoid growth of anterior lip of the os uteri. Polypoid growth of posterior lip of os uteri to a weight of 14 pounds. Elongation of the vaginal portion.
PL.\TE XLVII.
Fig.
I.
Complete prolapse of the uterus with elongation and hypertrophy of the cervix
uteri.
,,
,,
,,
,,
Pelvic viscera in prolapse of the uterus drawn from within. 3. Complete prolapse of the uterus following elongation of the cervix. 4. Complete prolapse of the uterus without cystocele, following- prolapse of the posterior wall of the vagina with enterocele and prolapse of the rectum. 5. Complete prolapse of the uterus advanced in gestation, with partial foot presentation of the foetus in multipara, ag-ed 38 years.
2.
PLATE XLVII
Fig.
,,
,,
I.
I.
2.
3.
,,
,,
4. 5.
posterior wall of the vagina, with sinking of the uterus. uterus with marked enterocele. uterus from marked elongation of the uterus with cystocele. uterus following- prolapse of anterior and posterior vag-inal walls. anterior wall of the vagina with elongation of the uterus.
PLATE
P'iG.
I.
XLIX.
of the uterus,
,,
,,
Elong-ation of the cervix with prolapse; fibroid growths in walls and cyst at the fundus. 2. Elongation of the uterus which prolapsed into a crural hernia. 3. Perforation of the posterior wall of the cervix with preservation of covering- in a patient who died from peritonitis six weeks after 4. The same cicatrised rupture as in fig. 3, drawn from within. 5. Bladder-polypus or cysto-sarcoma of the mucous membrane of the caused by degenerations of the utricular glands.
xviii
Contents of Plates.
PLATE
Fig.
I.
L.
uteri,
2.
The
seen growing
,,
,,
in fig. 2, which has grown from the uterine wall. 4. Fibroid tumour of uterine wall, and follicular polypus of the cervical canal. 5. Fibroid tumour in the anterior wall of the uterus, which has grown to the size of a uterus far advanced in pregnancy.
3.
PLATE LL
Fig.
,, ,,
I.
2. 3.
4.
Polypus of the mucous membrane and underlying uterine tissue which has grown into the uterine cavity from the internal os. Numerous mucous growths in the uterine cavity. Mucous polypus at fundus, growths of mucosa and its utricular glands. Interstitial submucous fibroids the submucous fibroid has grown into the uterine
;
cavity.
,,
,,
fibroids, partly under the peritoneal covering, partly under the uterine mucosa. 6. Fibroid tumour in the wall of the fundus uteri soon after labour.
S-
Numerous round
PLATE LIL
Fig.
,,
.,
I.
2. 3. 4.
the posterior wall of the cervix and body of the uterus. in fig. cut through. Interstitial fibroid in the anterior wall of much enlarged uterine body. Section of fibroid seen in fig. 3.
Fibroid
in
The tumour
PLATE
Fig.
I.
LIII.
,,
,,
uterus, with cancer of the anterior wall of the vagina, and the posterior portion of the vaginal cul de sac. 2. Ulcerated uterine cancer. 3. Cancerous destruction of the vaginal portion of the uterus and the vaginal wall between the vagina and bladder. 4. The uterus seen in fig. 3 infiltrated with cancer, together with the Fallopian tubes.
Cancer of the
PLATE
Fig.
,,
LIV.
I.
Adenoma
uteri.
uteri.
2.
Carcinoma
PLATE
Fig.
,,
LV.
I.
2. 3.
,, ,,
4.
Polypoid adenoma of the uterus. Adenoma. Vertical section from the surface. Adenoma. Section from the neighbourhood of Adenoma. Longitudinal section from surface.
the pedicle.
Contents of Plates.
xix
PLATE
Fig.
1.
LVI.
,,
,,
Diphtheritic endometritis in a woman who died fourteen days after delivery of a dead child, from uterine phlebitis. Retention of a portion of placenta. 2. Thrombosis of the veins in the uterus, and broad ligaments of the preparation drawn in fig. i from within. 3. Inflammation of the lymphatics of the uterus of a puerperal woman. Collum tapyroides 4. Chronic inflammation with thickening- of the cervical mucosa. ectropion of the lips of the os uteri.
PLATE LVIL
Fig.
,,
,,
,,
Posterior surface of a puerperal uterus with inflammation of the lymphatics, Fallopian tubes, and ovaries. 2. Section of an ovary from fig. I. 3. Section of a serous infiltrated ovary, as it is frequently seen in metro-lymphangitis. 4. Softened ovary in puerperal metro-lymphangitis. 5. Lymphangitis and thrombosis of the veins of the uterus in a woman who died
I.
fifteen
PLATE LVIIL
Fig.
,,
I.
2. 3.
,, ,, ,,
4.
Ulceration of the vaginal portion of the cervix and posterior vaginal cul de sac. 5. Non-scirrhous vaginal portion.
PLATE
Fig.
,, ,,
I
LIX.
2.
3.
Ectropion of the cervical mucous membrane. Microscopic section of a papillary erosion. Clinically a suspicious, microscopically a non-malignant vaginal portion of the
cervix.
,,
4, 5, 6. 7.
Commencing cancer in a prolapsed portio vaginalis. Microscopic appearance of figure 3, plate Iviii.
PLATE
Fig.
,,
LX.
I.
2.
Circular rupture of the cervix and expulsion of the portio vaginalis: Vie*v of the above preparation from below.
PLATE
Fig.
,,
LXI.
I.
2.
Transverse rupture of the upper portion of the anterior cervical wall. Longitudinal rent of the cervix.
PLATE LXIL
Fig.
,,
Dropsy of the Fallopian tubes. Tuberculosis of the Fallopian tubes. 2B. Right Fallopian tube of fig. 2, slit open longitudinally. ,, 3. Pregnancy in right ovary.
I.
2.
C2
XX
Contents of Plates.
PLATE
Fig.
I.
LXIII.
2.
The same
Ovarian cyst with gelatinous contents. cyst as in fig. i, opened in several places.
PLATE LXIV.
Fig.
I.
Dermoid
cyst.
,,
lA. 2.
3.
The chalky
plate, shaped like maxilla bearing two teeth. Hair- and fat-cyst of the right ovary. Adenoid tumour of the breast.
PLATE LXV.
Fig.
I.
,,
2.
3.
Cancer of the breast with cancer tubercles in, and under, the skin of an old woman aged 83. Carcinoma of the breast with retraction of the nipple.
,,
,,
4.
5.
,,
Compound mammary haematocyst. Compound proliferating cystoid of female breast with serous contents. Diffused arborescent intracanalicular myxoma of the mamma.
PLATE
Fig.
,,
,,
LXVI.
I.
2.
3.
Bladder-mole expelled at the fifth month of pregnancy. Bladder-mole from a woman aged 28.
Internal surface of the cavity of the
cysts.
ovum
,, ,,
4.
S-
Hypertrophied oedematous chorion villi from a bladder-mole. Hypertrophied oedematous terminal ramifications of the chorion-villi from an ovum the size of a hazel nut.
PLATE LXVn.
Fig.
,,
,,
,,
,,
Microscopical section of a mammary cancer. Arborescent cysto-sarcoma of the mamma. 3. Placental villi. 4. External surface of placenta with multiple blood effusions. 5. External surface of a placenta, with the impressions of old and recent extravasaI.
2.
tions.
PLATE LXVin.
Fig.
,,
i.
2.
PLATE
Fig.
,,
LXIX.
I.
2.
3.
,,
,,
4.
funis into the membranes at a distance from the placenta. Strangulation of the funis by unusual twisting of the umbilical arteries. Twisting and strangulation of the umbilical cords in twins.
PLATE LXX.
Fig.
,, ,,
I.
2. 3.
Twisting of the umbilical cord. Twisting of the cord. Twisting and knotting of the cord.
Contents of Plates.
xxi
PLATE
LXXI.
PLATE LXXn.
Fig.
I.
,,
la.
2.
,,
3.
Abdominal cavity of a woman who had carried a lithopoedion 22 years. The lithoijoedion in fig;, i, removed from the abdominal cavity. Embryo which died from haemorrhage during the fourth month of pregnancy in an uninjured ovum. A lithopoedion which was carried in the abdomen by a peasant woman during 40 years, although two normal pregnancies occurred.
PLATE LXXIIL
Fig.
,, ,, ,,
I.
2.
3.
4.
Hydrocephalus with spina bifida. head with hernia cerebri. Absence of head and upper extremities in a fatty twin foetus 24 centimeters lono-. Complete ectopia of the thoracic and abdominal viscera in a female foetus with
Foetal
cloacal formation.
5.
Monopodia.
PLATE LXXIV.
Fig.
I
.
Ruptured congenital umbilical hernia, acrania, cyclopia with proboscis and absence of the superior maxilla. foetus born in foot presentation with hydrocephalus. An encephalous foetus with distended backward cranial cleft. Eyes situated above, ears below. new-born female foetus with coccygeal tumour which should contain another
,,
,,
2.
3.
Male
4.
foetus.
PLATE LXXV.
Fig.
I.
2.
3. 4.
Sympodia.
Growing together of the cranial integument and the placenta. Monstrum sireniforme. Growing together of both lower extremities. Cyclopia with proboscis and hydrocephalus in a twin child.
Incomplete development of the finger, so-called self-amputation. One-headed double monster. Janiceps.
(Hernia cerebri).
5.
6.
PLATE LXXVL
Fig.
,,
I.
Double monster.
Skeleton
fig. I.
2.
,,
3.
membranes.
Amputatio spontanea.
PLATE LXXVIL
Fig.
I.
,,
2.
Transverse presentation in the uterus laid open during the seventh month of pregnancy. Transverse presentation with prolapsed arm, head to the right, feet to the left, and backwards.
xxii
Contents of Plates.
PLATE LXXVIII.
Fig.
1-4.
5.
The
different stages of
spontaneous expulsion.
PLATE LXXIX.
Fig.
I.
2.
PLATE LXXX.
Fig.
I.
2.
Flattened pelvis from rachitis. Antero-posterior contraction of the pelvis from rickets.
PLATE LXXXI.
Fig.
I.
2.
PLATE LXXXIL
Fig.
I.
2.
pelvis.
PLATE LXXXI IL
Fig.
,,
I.
2.
3.
,,
The same pelvis seen from above. The same pelvis seen from beneath.
PLATE LXXXIV.
Fig.
I.
,,
2.
Transverse contraction of the pelvis from early-acquired anchylosis of both sacro-iliac synchondroses. Contraction of pelvic cavity by exostosis of the sacrum.
PLATE LXXXV.
Fig.
I.,
left
sacro-iliac synchondrosis
2.
left
sacro-iliac synchondrosis
PLATE LXXXVI.
Fig.
,,
I.
Pelvis spinosa.
2.
PLATE LXXXVII.
Fig.
,,
i.
2,
3.
,,
4.
Lumbo-sacral kyphotic pelvis. Funnel-shaped pelvis. Cleft pelvis seen from the front. Cleft pelvis seen from behind.
Contents of Plates.
xxiii
PLATE LXXXVIII.
Fic.
inlet of inlet of
2.
inlet
inlet
inlet
inlet
inlet
a normal female pelvis. a universally-contracted pelvis. of a flattened rickety pelvis. of an obliquely-contracted pelvis with unilateral ilio-sacral anchylosis. of an obliquely-contracted pelvis with lumbo-sacral kypho-scoliosis. of a transversely-contracted osteomalacic pelvis. of a pelvis spinosa.
PLATE LXXXIX.
Fig.
I.
,,
,,
2.
3.
Front view of a kyphoscoliotic girl complete prolapse of the uterus. Side view of same. Back view of same.
menstruated, and
who had
PLATE
Fig.
,,
XC.
I.
The impressions
2.
3.
4.
5.
6.
Microscopic section of the above. Cranial impression. Spoon-shaped impression of the cranium. Cranial depression. View of the point of depression in the left side of the foetal head
in
fig-.
5.
PLATE XCL
Fig.
1.
2.
2A.
3.
3A.
4.
4A.
Chamberlain's forceps. Palfyn's forceps. Single blade of Palfyn's forceps. short straight English forceps with leather covering. Single blade of Orme's forceps. Leveret's forceps with head and pelvic curves. Right female blade of Leveret's forceps.
PLATE
Fig.
,,
,,
XCII.
1.
2.
3.
4.
5.
.,,
6.
7.
8.
,,
9.
10.
II.
,,
Pelvimeter after E. Martin. Pelvimeter after Collin. Colpeurynter after C. Braun. Fiddle-shaped india-rubber dilators after R. Barnes. Balloon for artificial induction of labour after Tarnier. Shapes of laminaria tents and compressed sponges in various Funis repositor after E. Martin. Funis repositor after Robert. Blunt hook. Key-hook after C. Braun. Smellie's perforating scissors,
sizes.
,,
,,
15.
,,
i6.
Bone forceps
after Mesnard-Stein.
xxiv
Contents of Plates.
PLATE
Fig.
I.
XCIII.
2.
3.
4.
5. 6.
7.
Forceps after E. Martin. Forceps after Nang'ele. Brush forceps after Ideler. Cephalotribe after E. Martin. Cephalotribe after Braxton Hicks. Cranioclast after C. Braun. Combination of perforator and cranioclast after
J. Veit.
PLATE XCIV.
Fig.
I.
2.
3.
One-bladed speculum
after Kristeller.
4.
5.
6.
7.
8.
Curved
scissors.
9.
Mayer.
Sharp curette
13.
14.
15.
16.
17.
18.
19.
23. 24.
PLATE XCV.
Fig.
I.
2.
uteri.
PLATE XCVI.
Fig.
I.
2.
PLATE
Fig.
,,
XCVII.
I.
2.
3.
Extreme
PLATE XCVI 1
Fig.
,,
1.
,,
Dr. Grigg's uterine dilator. forceps after R. Barnes. 3. Craniotomy forceps after R. Barnes. 4. Crescent speculum after R. Barnes. 5. Pessary for anteflexion of the uterus after Fancourt Barnes.
I.
2.
Long
Tiif.
A'
.\hirli,is llii,lll<,^
II
.hin.r.l.Mailii,
cii'iv
PLATE
FIGURE
Female Pelvis with
(
I.
I.
its
S5
lumbar vertebra. B.B. Intcrarticular cartilage between the fifth lumbar vertebra and the sacrum. C.C. Sacrum. D.D. Coccyx. E.E. Ilium. F.F. Descending' rami of the pubes. G.G. Ischia. H.H. Femora.
A. A. Fourth
a.
Lumbo-iliac lig-aments.
Sacro-iliac lig-aments, under which
lie
d.d.
e.e.
/. Sacro-coccygeal articulation.
g.g. Sacro-spinous ligaments.
Anterior
common
ligament.
Anterior pubic ligament. Sub-pubic ligament. k.k. Obturator membrane. /./. Capsular ligaments.
h.
i.
b.li.
FIGURE
II.
Perpendicular Section through the Pelvis to shew the Inclination and Median Line of the Pelvis.
{^From a Preparation in the Obstetiic Clinic at Berlin).
A.B. Horizontal
a.a.a.
/'.
lines.
h.g.
The
last three
lumbar vertebras.
f.
Promontory
of the sacrum.
i.k.l.m.
c.
Sacro-coccygeal articulation.
h.e.
Tip of the coccyx. Conjugate diameter of the pelvis. d.f. Antero-posterior diameter of the pelvic
d.
The curve of the true pelvis. This point is wrongly placed in the drawit should ing on the horizontal line properly stand on the lower margin of The lines runthe symphysis pubis.
;
outlet.
f)./.
to the
lower
FIGURE
View
a.a.
III.
sawn
|
b.
I
through.
FIGURE
The Right
';.
IV.
laid
Sacro-iliac
Symphysis
a.c.
Right ala
tebra.
Sacro-iliac articulation.
d.
b.b.
Ilium
sawn through.
Taf,
II
Fifi.l.
Fig. 4.
Fig.
Fig. 2.
f'v-/
...'-.wi^
^^^rffSfej,,
yjarlinn lliimhitla a
II
.hlfl
i>.
.1
(ii
tin
PLATE
FIGURE
I.
II.
outlet.
outlet.
d.d.
FIGURE
II.
inlet. inlet.
inlet.
d.d.
e.e.
f.f.
(The
f which
omitted
in the
drawing).
c.g.g.
Right and
left
sacro-cotyloid diameters.
FIGURE
III.
FIGURE
IV.
state.
Fj 2-
Taf.
Ill
A'.
i:.
I.
Murlin
C^ee, S^ui-ltee.-.
^Wd.ciJMM
JB^,.ti
PLATE
FIGURE
III.
1.
h.l.
pelvic cavity.
FIGURE
II.
FIGURE
III.
FIGURE
IV.
Height of the posterior pelvic wall from the promontory of the sacrum
the coccyx.
the tip f
b.b.
at the side.
Taf,
E.Mfir/iii.--
HiniihiUn.'i.
UAll/7,
v.
A. >Inr/.
I'i,
PLATE
FIGURE
I.
IV.
Psoas Muscles.
Abdominal Aorta.
Ascending-
Vena Cava.
d.
Iliac Muscles.
FIGURE
II.
month of pregnancy.
Uterus.
Urinary Bladder.
(.
Stomach.
Transverse Colon,
Liver.
(i.
e.
T;if.
\-
Fi.U.
Fk- 4
Fiv.;i,
a^
FiO. 2.
f/
A'
Martin
!.{($.
ScCxnCxe.. ,-U\
Snot
,'B,:,Cn,
PLATE
FIGURE
I.
V.
Mons
veneris.
Labia majora. c.c. Labia minora. (The letter t/with d. Clitoris. Prepuce of the clitoris.
c'.
its
indicating line
is
/. Urethral meatus.
"-.
Vestibulum.
//.
/.
Hymen.
Frenulum. Anus.
Perinaeum.
X'.
/.
FIGURE
II.
G. L. Kohdt.
orga?is,
Anus.
Sphincter ani.
b.b.
e.e.
d.
c.
Glans
/./.
Ischio-cavernous muscles.
g.
The
left
in the
wall of the
vagina.
h.h.
i.i.
Transversales perinaei.
Levator
Glutei.
ani.
k.k.
FIGURE
Labia minora. Meatus urinarius.
in.
Numerous small
d.d.
follicular openings round the meatus. Openings of the ducts of Bartholini's glands.
FIGURE
On
IV.
Bartholini's Glands.
{A/icr Fr. Tiedemann.
a.
b. c.
Tnf
VI
PiE
A'
Marliiin
llniliilla.s.
II
Llff). Scl-mtfLS^.
^itd,
aJ-KiA-- iB^t-iiM
PLATE
FIGURE
VI.
I.
{Normal
position
of the parts after Pirogoff, III. A. 22. Figure i). {Accompanying W. Braune. Atlas 0/ Topogiaphical Anatomy, Leipzig, 1868).
r.
text ly
U. Uterus.
V.
Rectum.
Bladder.
m.
/'.
Mens
veneris.
Intestines.
and appendages were normal and lay between the distended bladder and There were no small intestines behind the uterus. From this it is seen that the uterus always lies between the rectum and bladder even in their most varied degrees of distension and that its position is considerably altered by their variations. The uterus The conitself in this representation lies considerably deeper than in the following. jugate measures 105 millimeters.
The
uterus
rectum.
FIGURE
II.
Fig. 20).
c.
{Text of W. Braune).
Bladder.
Tip of the coccyx. (The line in the drawing is drawn beyond the exact tip of
the coccyx).
t.
m.
Mons
veneris.
The greatly distended bladder has drawn the peritoneum away from the symphysis a distance of 35 millimeters, and the uterus is drawn backwards and upwards by the stretching of the anterior wall of the vagina. The conjugate measures 102 millimeters. The rectum is empty and contracted. In this case again there are no small intestines to
to
FIGURE
Section through the
III.
Abdomen
of a normally formed woman, aged 35, with the Bladder empty, the Rectum fxiU.
{Braune,
op. cit.)
Bladder.
m.
Mons
veneris.
Symphysis pubis.
The
line
of the skeleton,
divided the urethra and anus, but only the uterus. The angle with the vagina but is not anteflected. No small intestines and rectum. The conjugate measures 1 10 millimeters.
ViO
Vis. 2.
"^
F.
Marlu, Hiunlal/u..
1/ .lull.,.
.I..Ua,l,n
.
IfC
S^(vCU-;t.e,.
^U(i c0M
.
.
.'Rtr in
PLATE
FIGURE
VII.
I.
Size).
{After O. Kolratich, on the Analomy and Physiology of the Pelvic Organs, Leipzig, 1854, aw/
Berlin Anatomy).
Sacrum.
laid
open
in its
lower part,
The longer anterior lip. The shorter posterior lip. f The bladder. g. The symphysis pubis. h. The vag-ina. /. The urethra. k. The clitoris. /. The septum. m. The anus. n.n.n. The peritoneal covering'
d.
e.
(On
the fundus
is
written instead
of).
0.0.
Pelvic fascia.
/. Fascia transversalis.
FIGURE
View
of the
II.
Atlas).
The
bladder.
uteri.
The fundus
d.d.
e.
The rectum.
f
g.
The abdominal aorta. The ascending vena cava. The round ligaments.
h.h.
Tiif.M
Fi... I.
,.,^'
r'
Fio. 7.
,rfJiis*r:K=S?
Pii
Fi').
().
./
F.
Marliiin
ll,i(lall(is
II
Aiifl
,.
;,
Mui
liii.
Cltg. ScflCUsc
^i + K </M
SMfii,
PLATE
FIGURE
VIII.
I.
and Ovaries.
(Two-thirds Life-size).
a.
b.
c.
Fundus
uteri.
h.h. Vag-ina,
i.{.
Body
of the uterus.
Round
ligaments.
Cervix.
k.k.
/./.
Broad ligaments.
Fallopian tubes.
J.
e.
Vaginal portion.
External os uteri.
m.7n.
0.0.
Fimbriated extremities.
Ovaries.
Anterior
lip of
the os uteri.
FIGURE
II.
at term.
a.
b.
f.
uterus.
d.d.
e.e.
Fallopian tubes.
uterus.
Round
ligaments.
Cervical portion.
FIGURE
III.
d.
e.
FIGURE
IV.
On
Uterus,
Wurzburg, 1859).
a.
b.
Os
uteri.
c.
Cervical canal.
d.
e.
PLATE YIU.(Continued.)
FIGURE
V.
d.
e.
Cervix.
External os uteri.
Fallopian tubes.
c.
/]/.
g.g.
Round
ligaments.
FIGURE
VI.
Perpendicular Transverse Section of the Uterus from the body of a young woman.
a.
c.
Fundus
uteri.
d.
vitai
inwards.
c.
e.e.
Vaginal portion.
FIGURE
VII.
woman aged
79.
c.
Cervix.
d.
External os
uteri.
Taf. IX
Fig. 2.
Pi^.4.
fA
Fie. 3.
K.yiiirUi.x IlinHladu.-.
II
.lull r .l-Mailiii
.'WS
S.cfi,at,. JH,
1;
cH,,
,.,t
.'Re-, r.n
PLATE
FIGURE
I.
IX.
(Two-thirds Life-size).
{A/ier Moreau, op.
a.aa. Cervix Uteri.
h.b.b.
c.c.
citi)
d.d.d.
Divided wall of body of uterus. Internal surface of lower portion of uterine cavity. Placental site with g'aping- lacerated veins.
FIGURE
(From
a.
//.
II.
who
died of typhus).
e.
uterus.
c.
vitae.
d.d.
FIGURE
<7.
III.
Fundus
uteri.
e.
External os
uteri.
b. c.
d.
Vasfinal vault.
FIGURE
IV.
op. cit.)
Ovary. Parovarium.
d.
e.e.
The The
f.f.
Fimbriated extremity.
FIGURE
V.
woman.
The
inner
membrane
some time
Taf.
[',.
Marliirx llaiuladas.
ll.AuI'l. n.
I^
Marlin
aeg
S,sfi,u,Ue..
^U-R
cIi.i^,
^Sij-A&
PLATE
FIGURE
1.
X.
Peritoneal Tolds of the Serous Covering of the Uterus as shewing the direction and expansion of the retraction of the Uterus.
(After Matthews Duncan.
especially at the time
On
retraction
of
the
uterus,
of complete evacuation of
band
vi. s.
a.
b.
c.
Fundus.
Opposite the ostium internum.
Bladder.
d.
e.
Body
of uterus.
Fallopian tubes.
FIGURE
II.
Zeitschrifl
fiir Geburtshiilfe
und Frauenkrankheiten,
876,
s.
448^.
P.
Peritoneal covering-, from which the muscular leaves arise and from which they overlap each other.
/. //. etc.
l.r.
Round
ligament.
under which
or decidual layer.
<#^.
Tal.XI.
K. Mtirtiirs Hiniiiitdijs
IIAuH. V .I.Mai
tin
1C6.
,'Bivr Cii
PLATE
FIGURE
XI.
I.
Corrosion-Anatomy ami
ils
nsulls,
JVt //<;,
1873.
of
/"/.
XIII.)
Organs
a Puerperal
Woman.
Posterior View.
a.
b.
c.cb'.
Branch
to Fallopian tube.
to
c .c
Branches
.a
to the
abdominal
The
anastomose on the
FIGURE
II.
Anterior View.
{After Hyttl, op.
cit.
Plate
XV.)
the
The
The
which at
venous
plaits.
Uterine Artery.
artery,
c.c.
of which
is
untwisted as
is
'
The
5
so-called Corrosion-Anatomy consists in injecting the vessels with a solution of equal parts of
The organ
is
placed
in
a solution of from
hydrochloric acid and water, and the soft parts allowed to corrode away. remain, etched out as it were. F. B.
to
The
r,if.
\ii.
Pi
>/:'
K Mnrlins
Ihuulathn:
II All 11 r.
.
I.
Martin..
eXf&. S^aiitee.,
iM\ I^^M
.'B^Eiif.
PLATE
Cervical Ganglion, Sacral
(After Frankenhaiisen.
XII.
left side
of a Pregnant Uterus.
smooth
The Nerves of
muscular
/.
//. Rig-ht
///.
IV.
V.
VI.
VII.
VIII.
1.
Right round ligament. Uniting branch of the ovarian and uterine veins. Ovarian vein. Venous ple.xus going to the base of the ovary. Posterior fold of the broad ligament. Peritoneum dissected off and turned up.
2.
3.
Hsemorrhoidal nerve. Largest nerve from the fourth sacral foramen going to join the cervical ganglion. Nerve from the third sacral foramen going to the vagina and bladder across the
cervical ganglion.
4.
5.
6.
7.
8.
Branch from the second sacral nerve to the cervical ganglion. (Sometimes absent). The largest branch to the cervical ganglion, from the third sacral nerve. Small nerve ganglion, attached to the cervical ganglion, from which proceed branches to the hsemorrhoidal plexus. Nerves communicating with each other between the vagina and rectum. Small ganglion, lying on the cervical ganglion, from which branches go to the
bladder.
9.
10.
11.
Vaginal nerves. The most external branch of the hypogastric plexus entering the cervical ganglion. The artery and vein perforating the middle of the cervical ganglion, frequently giving rise to a large opening of a ring-shaped appearance.
Cervical ganglion.
12. 13.
14.
15, 17.
16.
18, 19.
Branches running between the vagina and bladder. Nerve from the first sacral ganglion of the sympathetic to the ureter. Communicating branches with the vesical ganglion. Nerves passing into the deep structure of the neck of the womb. Communicating branches between the cervical ganglion and the innermost branch
of the hypogastric plexus.
(21).
23, 24.
25, 26,
Branches of the same, some going to the deep tissues of the uterus, others communicating with the innermost branch of the hypogastric plexus. Nerves from the hypogastric plexus to the ureter. hypogastric plexus and cervical 27, 28. Superficial network of the nerves from the
ganglion
to the uterus.
29.
30.
31, 32.
Branch connecting the cervical and uterine nerves. Entrance of the ovarian nerves from the posterior surface. ganglionic swellJunction of the ovarian and uterine nerves, frequently presenting runs to the round ligament, the other (35) to the ings, whence one branch (34)
fundus of the uterus.
33.
The nerves
to the
Fii.i.
Tnr. \||[,
'i-r
'^n^*^-
He
mi'-u
Fig 3
f
\
I
Fis.2.
/'
Mnrt,\ Hnn.lallu^.
Il..h,n. f. A.
Martin
aC6. SifvM^.c.
^a-f'i
^u^
:',,.
PLATE
FIGURE
Mucous Membrane
(Afler G. Leopold.
XIII.
I.
and
childbed.
Archivfiir Gyncecologie,
band
xi
und
xii.
1877).
Mc. Mucous membrane. Ms. Muscular tissue. E. Epithelium of the free surface, still preserved and attached in some parts in others, wanting- or raised up by bleeding from the surface, but still recognisable amidst the sanguineous difbris. Glands, twisted like corkscrews, with dilatation of the lumen, most numerous in the D. middle layer; their openings are narrowed and turned inwards. The cylindrical
;
G. Vessels,
epithelium well preserved, in parts swelled with large nuclei. in part insufficiently injected.
B. Bundle of muscular fibres divided transversely. Z. Conical depressions of the mucous tissue in the funnel-shaped cavities between the limiting muscular bundles.
FIGURE
II.
Transverse Section of the Left Fallopian Tube (middle portion) on the Menstruation.
(^A/ter Leopold, op.
cit.")
first
day of
Z.
tufts
The epithelium
tufts and mi.xed with blood corpuscles. R. Circular muscle, this like the tufts is interspersed with numberless red and white blood corpuscles, which are principally arranged round the dilated blood-vessels.
G. Vessels.
FIGURE
III.
Muco\is Membrane of the Body of the Uterus on the third day of Menstruation.
{After G. Leopold, op.
C. Exuberant, here
cit.)
E. The mucous surface in the first stage of desquamation. D. Glands more spiral and broader than in Fig. I. A. The arteries in the deeper layers of the mucous membrane. Z. Depressions of the mucous membrane in the muscular layer.
B. Muscular bundles.
PLATE XllL(Continued).
FIGURE
IV.
last
Fresh Corpus Luteum from 8 to 9 days old, 8 to 9 days after commencement of HsBmorrhage.
{A/ier Leopold,
C.
op. at.)
Corpus luteum.
Cicatrix, through
N.
glistens.
FIGURE
V.
FIGURE
VI.
old.
is
mem-
brane, in the most external borders of which are seen numerous minute extravasations.
FIGURE
VII.
old.
The coat of the follicle half a millimeter in diameter, encloses a yellowish-grey nucleus containing a small cyst.
FIGURE
Almost Ripe
VIII.
Follicle.
cit.)
A
lilie
follicle
of the size of a small bean, with nucleus projects into outer wall of ovary
Taf.XIV
Fi.l
y-r
Ph
#'^
4^^
'm
^-<
''m
Fig. 3.
\:^
v.
A.
Martin
vM.
S^fUitxe,.
XiAK.&Mi..
SmUk.
PLATE
FIGURE
XIV.
I.
uteius.
Archivfur Gymkohgie,
band
vi.)
Uterus of a
T. Fallopian tubes.
0. Left ovary.
a.
b.
Woman
aged 30 years.
Anterior View.
FIGURE
II.
H.
Left horn.
T. Fallopian tube.
d.d.
e.
Subserous network of lymphatics of uterus. Branch from the same to the Fallopian tube. Subserous network of the lymphatics of the Fallopian tube. Lymphatic ducts between the two layers of muscle. Duct in broad ligament. Ducts of the lymphatics of the Fallopian tube in the broad ligament.
FIGURE
III.
A. Arteries.
V.
a.
Veins.
and
c.
d.
e.e.
Lymphatic vessels with raised endothelial membrane, resting on the margin and on the surface at b. Larger lymphatics, adjoining the blood-vessels. Branch from the lymphatic vessels into the lymphatic loculus. Lymphatic loculi with boundary of the nucleus of the same.
b.
at
a,
Ti^.l.
Taf. XV.
Fia.l'.
!:
yictrtiini lltiiij.illu^. II
AufLij.A.MarUr
(lu;.
.^sci'iui,-..
->',
n;
<rtM,rt.
fiS,-/:!',
PLATE XV.
FIGURE
Mucous Membrane
of the
I.
Body
month
of Pregnancy.
The decidua has become more like a network of cavities than a mucous membrane The tubular glands, as far as the under surface of the membrane, have changed into broad cavities, they are almost entirely denuded of epithelium with the exception of a thin basement membrane. The decidual membrane has become
with tubular glands.
spongy in consistence. Thick masses of interstial tissue lie at irregular distances between the enlarged gland-spaces, and generally contain the larger arteries. The boundary between the mucous membrane and the muscular layer is sharply defined.
Mc. Mucous membrane. Ms. Muscle.
FIGURE
II.
fifth
month
of Pregnancy.
cit.)
A. Amnion.
C. Chorion.,
J?.
Serotina reflexa.
Jis.
5".
-f-
Marginal
sinus.
B. Serotina with glandular layer. T. Line of demarcation between the uterus and the ovum.
M. Muscle.
Z. Chorion
villi.
FIGURE
Uterine
III.
Mucous Membrane 7 days after delivery. Transition of the in the Mucous Membrane of the body of the Uterus.
{After G. Leopold,
op. cit.)
Placental Site
Mc. Mucous membrane with gland-spaces. Ms. Muscles with commencing thrombosis.
Taf. X\l
Fii.l.
Fi'i.2.
['is,
1-
-^(B^
A'.
Murlin's llnndallus.
I/..
lull. u. .1.
AJui
tin.
Clf&. S*ft-u*it^.
^L-bfi..
gJmM-
.'Sj>1/I
PLATE
FIGURE
XVI.
I.
Human
xi.
1S32J.
Nipple.
Mucous
Areola.
follicles
FIGURE
II.
FIGURE
III.
Paris, 1849.)
is
b.b.
Anastomoses of the
lactiferous ducts.
fat.
d.d.d.
FIGURE Two
IV.
a.a.a.a.
b. c.
Lobuli of
mammary
of
glands.
Commencement
d.
FIGURE
Lobulus of
V.
Mammary Gland
{After P. Dubois,
a.a.a.a.
b.
Single acini.
Lactiferous duct.
Tar.:s:vE
Fi^.
1.
Fi(5 g
dvcL
E. Marlins
Hn ,/,.!/,
,.-,-.
H A77/?
n A. Mnr/
fA
,?;,(',
A ^r f lU^, (3^^^
.
03^.,,<',
PLATE
XVII.
FIGURE
Surface of the Uterine
I.
{After Reichert.
Description
in
The
side
anterior wall of the uterus has been divided through the fundus from the
left
left
and the
The
in
vera, triangular
lies
encap-
u.
u^.
7/.
u.c.
v.g.
o.v.
/.
/'.
l.r.
Infundibulum of the Fallopian tube with the fimbriae. Round ligament of the uterus.
Posterior wall of the uterus.
u.p.
ti.a.
u.c^. u.l^.
Os
uteri.
q^.
d.v.
palmatae on the surface of the mucosa of the cervix uteri. Transverse folds of the mucous membrane of the vagina. Decidua vera, chiefly that portion, not concerned in the development of the raised plateau, on each side of the body with an almost even triangular summit pointing towards the cervix uteri and passing into the marginal furrow. The dark points indicate the orifices of the utricular glands which can still be seen at this period. In the drawing at d.r. the indicating line to the margin of the raised plateau is wantPlicae
ing at the
d.v^.
d.v.a.
left
;.
.'
Right marginal furrow. The raised plateau of decidua vera pointed and triangular, developed into cotyledons and papillae. The cotyledons in the raised plateau of the anterior uterine wall have become unrecognisable through pressure. Groups of cotyledons of the raised plateau of decidua. The island at the base of the raised plateau in the lower portion of which the embryo lies embedded. The decidua reflexa (embryonic capsule) can just be seen above
the level of the raised plateau.
islands.
PLATE
XVU.(CoiitmuciI).
FIGURE
II.
Diagrammatic Transverse Section of a Pregnant Uterus, a few hours after the Embryo became encapsuled, which apparently took place on the 8th day after
impregnation.
{^After Reichert, op. cil.)
u.'
;/.' /.
i.^ SI.
dva. dv.
a.s.p.^
Dendritic and netlike furrows running- between the primary cotyledons. /.v. Vesicular shaped embryo.
Marginal zone of the embryo; villi partly in process of ramification. Free wall of the embryo. M. Layer of mucous membrane of uterine wall, especially the portion not connected with the decidual structure which receives the blind endings of the mucous glands. p.^up."^ Primary and secondary papillae in the cotyledons of the raised plateau of decidua
/.v.^
/.v.^
vera.
d.r.
X.
e.m.
vt.e.
Region of decidua reflexa with the basilar wall mostly free from villi. Near the cicatricula of the ovum at its free wall, where the lips of the marginal zone grow together over the ovum. Embryonic lemma (investing membrane). Coste's embryonic macula.
FIGURE
III.
An Ovum
(After
a.
b.
c.
laid
open
R. Wagner, Icones
Physiologict.
villi.
839).
d.
FIGURE
IV.
Ovum
R. Wagner,
op. cit.)
a.a.
h.b.
The deciduous membrane, and that part which adheres to the wall of the uterus (membrana decidua adnexa). That portion of the decidual membrane which directly surrounds the ovum, the socalled
membrana decidua
reflexa.
villi.
c.
d.
e.
f.
The cerium, chorion, dotted with The amnion opened. The vesicula umbilicalis. The embryo.
PLATE
XVIII.
FIGURE
Section of Pregnant Uterus with
I.
{A/ier Coste.
a.a.
b.
Muscular and vascular layer of the uterus. Internal surface of the mucosa developed into decidua, which by the removal of the muscular layer allows the utricular glands to be plainly seen.
FIGURE
Section of Uterus and Placenta of a
II.
Woman who
a.
b.
c.
Root of umbilical
Chorion.
cord,
and
its
funis.
d.d.
e.e.
Uterine wall.
ff. Villous branches, forming the stroma of the placenta. g.g. Decidual membrane. h.h. Prolongations of decidua into the placenta. i.i.i. Spiral- or corkscrew-shaped uterine arteries.
i.p.
k.k.k.k.
veins.
FIGURE
III.
cii.)
c.
which has been removed from the chief portion of the villus. Prolongation of epithelial covering stretched through the vascular spaces of the placenta as continued into the denudations of the same. Arterial branch.
Epithelial covering,
d.d.
e.
Taf.XWll
<-rll..-
Ha,,.l..tln.-._
nAiif/. u A. >Tnrl
PLATE
XVUl.^(Coniinned).
FIGURE
IV.
{A/Ur W. Hunter).
a.
h.
Funis with
its
ex.
d.
Membrana
Border of placenta.
FIGURE
V.
c.e.
d.
e.
PLATE
FIGURE
XIX.
1.
W. Hunter).
a.
h.
c.
Body
External os
uteri,
d.d.d.
Vagina.
FIGURE
II.
at the
8th month,
(One-third Life-size).
{After W. Hunter).
a.
b.b.
FIGURE
III.
Internal surface of Uterus far gone in Pregnancy after removal of the Mucosa developed into Decidua, to shew the muscular fibres of the internal surface and
Vitse.
(One-third Life-size).
{After W. Hunter).
T.-if.
XIX
fc>-
^S^-
/','
^ A
/-
71'''^
^"* 'f'
-l
'^-
^^O'
f^
Martins Handatlas.
//Jufl.z/-
A Maitai
Caffc.
S^iU^^.
i.tfi..
cSm^
."B/Tfi.,
Tnf \X.
.
FiE.l.
A'
Marlins
//iJ,n/at/as.
H .hiH
r. .1
Muilin
PLATE XX.
Side view of Abdominal Cavity laid open after partial removal of the large Omentum in a Woman far advanced in pregnancy,
The The
li.
c.
d.
e.
The right Fallopian tube. The fimbriae of the right tube pushed forwards. The ascending colon.
Coils of intestine.
/.y.f.
g.
h.
I.
Remains
of large intestine.
liver.
k.
/.
Round ligament of the liver cut through. The diaphragm covered with the pleura.
Fitf. 3.
Taf.XXt
FU>. 2.
Pi 6.
3
1.
Pio. 4.
E.M,n-Nn\-.- Hni,,h.H,,.s.
UAuf/. a
A.
Mnrr<
iJIM.
S-cPi
I'.i
PLATE
FIGURE
XXI.
I.
Human Embryo
at the 9th
week,
(Life-size).
FIGURE
II.
Human Embryo
at the
3rd month.
(Life-size).
FIGURE
III.
Human Embryo
at the 16th
week.
(Life-size).
FIGURE
IV.
Human Ovum
at the 5th
month and a
half.
(Life-size).
;if.
X\ll.
X.
""^
"->'
E.yhirtin llninlatluH.
II
Jul'l r
.\-J
uilui
t'tl6.
SilUitf.e. fitfi
c^iii,
PLATE
Human Embryo,
XXII.
its
Membranes,
at the
6th
Macerated
villi
of the placenta.
d.e.
Amnion
in folds.
f. Funis.
T;if.
will.
Fi
<;
Fig.
5.
Fii.4
::p
Fis.l.
"^-^
A'
Marlin's /Irnidiillun
II
.lull n. .1
.
.Mai Un,
JlCfi.
SiivM^e.
_iiMi-. (iitwl
Sii
fall
PLATE
Internal Organs of an
(After
a.
b. c.
XXIII.
I.
FIGURE
Embryo
before birth.
Monau.
e.
Atlas).
Funis.
Umbilical arteries.
d.
f.
f'.
FIGURE
II.
Festal circulation.
(After Hasse, by
H.
Strasser.
877)
The
vessels
V.
This drawing coloured by C. Rug-e could not, for technical reasons, be reproduced
in
the
same way.
wooly hair (lanugo)
fat globules,
lies
A
lial
scales,
across between the crystals of cholestearin, fatty epithedetritus, which are coloured greenish-
yellow.
FIGURE
VI.
Wooly
PLATE XXIV.
Section of a normally formed Pregnant "Woman about 25 years old, after death from hanging.
( W. Btaune, Alias of Topographical Anatomy^ l868.
C. U.
O.u.i.
Body
ovum
at the
Internal os uteri.
Bladder.
d. Clitoris.
A. Aorta.
V.i.
Right
common
iliac vein.
and broad, with a conjugate diameter of 120 millimeters. than that of the male which is 60. The characteristic of the female vertebral column is the diminished prominence of the promontory compared with that in the male, as well as the marked depth and declivity of the pulvic symphysis. The position of the intestines normal there are none between the rectum and uterus nor between the latter and the bladder. The position of the os uteri low down in the pelvis, as well as the mucous plug emerging from it, correspond with the early period of
The
The
pelvic inclination
58, less
the pregnancy.
The decidua
vera,
is
The gland tubes present punctiform of mucous glands, connective tissue and vessels. openings on the internal surface and can be seen with the naked eye. From above from
the anterior wall of the uterus the decidua
nal surface of the uterus, until
it
is
markedly
gradually increases
in thickness
developed in the neighbourhood of the internal os uteri. At the superior thinnest point, corresponding with the middle of the fundus uteri, a fold is formed, the decidua reflexa, which extends downwards as a small membranous envelope of the ovum as far as the triangular extravasation of blood, which is drawn shaded. In the
and becomes
fully
above membrane which forms the external membrane of the ovum and is composed of chorion Iseve and decidua reflexa, only epithelial remains, connective tissue and rudimentary villi are to be found. An undulating delicate boundary line runs up backwards and forwards from the site of the extravasation and divides the chorion frondosum from The chorion portion, plainly distinguished by the drawing and cothe decidua vera. louring, only contains villi and vessels, and indicates the future site of placental
formation.
To
is
down over
attached a thin layer of fascia with undulating cell-tissue, which allows the separation similar of the rectum and vagina to take place during the dilatation of this organ.
condition obtains between the bladder and cervix uteri, so that the bladder
may be
cap-
relations of the
XXIV.
T;if..\XI\-.
Cit^^ SdMf^.e^.
^M\
GJ^Mt.lB/yi&if.
Taf. \X\-.
'^-\-
A'.
.Martifi's Uaiidiillan
H .lull
i>.
/.
.Martin.
PLATE XXV.
FIGURE
Uterus with Foetus in
{After W. Hunter
first
I.
head presentation.
FIGURE
Uterus with Pcetus in
first
II.
breech presentation.
(After W. Hunter).
Taf, XX\-1
1m6
:!
o.t.-\i
K Matiiu's Hinidalliin
II
lull
r. ./,
Marlin
.'iii-i
^"i^'-ii
PLATE XXVI.
FIGURE
Section of the Frozen
I.
Body
of a
Woman
(After
Bratine).
PL
d. a.
F. Bag- of waters,
u.
r.
Placenta.
Urethra.
Duodenum.
Aorta.
Rectum.
uteri.
o.e.o.e.
External os H. Bladder.
Pa. Pancreas.
v.p.
Vena
portae.
o.i.o.i.
Af.
Stomach.
v.i.s.
L. Liver.
FIGURE
II.
op. cit.)
Vagina.
External os
uteri.
o.i.o.i. o.t.
Internal os uteri.
Opening
of Fallopian tube.
C. Cervix.
PI. Placenta.
FIGURE
The engagement
(Diagrammatic after Schroder.
f. Frenulum.
u. a.
III.
of the Head.
5th edit. p. 162).
Text-book of Midwifery.
Urethra.
Anus.
Rectum.
FIGURE
IV.
Commencing Expulsion
of the Head.
p. 163).
2,K.
Urethra.
a.
Anus.
if.
XWI
Fk.
I'ls-,:'
.j:
i:.Mrh,i\ llf,,ialls
II
'lull
,.
I.
Mai
In,
PLATE XXVII.
FIGURE
I.
first.
5 th edit. p. 178).
Urethra.
(The
indicating- line
to the
under-
lying urethra).
2.S'.
f
a.
FIGURE
II.
FIGURE
III.
FIGURE
Cranium of breech
IV.
presentation.
(After Hecker).
FIGURE
Lateral Curve of the
V.
in breech presentation.
174).
cit. s.
'M.
XWI
i-ia.2.
Fig 4.
Fifi.l.
Marlin-x llaiulailus
//
.la/t
r.
A.Mariii
(.nil,
SctUltee-. J'U.fi,.r<M^l
I'SxT^ia
PLATE XXVIII.
FIGURE
I.
Occipital presentation.
(After Olshausen.
On
of the
Series
FIGURE
II.
Pace presentation.
FIGURE
Brow
III.
presentation.
FIGURE
IV.
Antero-f^outal presentation.
'nf
XXK.
f,
Marliit's [luiidatlus.
II Aul'l.
i'.A.
Merlin
cM.
S*fi.i.UA.. ^i.'Hi.cCJvu.i
.'ir'^tC-i
PLATE XXIX.
FIGURE
1.
(Two
Ova).
FIGURE
II.
titer.
a.a.
b.b.
Anastomising vessels of the two embryos on the internal surface of the placenta.
Junction of the
FIGURE
Triplet afterbirth with
{After
a. b.b. V.
III.
in development.
D' Outreponl.
Obstetric Demonstrations).
Tnf.
XX\,
KJ
K Marlins
ilnn(/ul/ci s
11
Aul'l
f. .1
(iltui.
^Xtt,-
SAiaxc-.
1M'\,. cju^l:
^eit
PLATE XXX.
FIGURE
I.
Memoir
o?i
the Diseases
the
External
vol. xv.
Woman ;
in the
FIGURE
II.
(Vulvo-vaginal Gland).
cit.)
FIGURE
Cyst formed
III.
by the
Duct of the
cit.)
left Bartholini's
Gland.
A. Cystic tumour.
B. Introitus vaginae.
C.
(The
line is
orifice).
orifice.
T;,f
XXXl.
I
^,*=.
...
V
^
-'?.-
-**A
.JW;,fe.-"....
/"^
Fse,i_
-'.w
K.Martins llaiulullas
II
Aiill.v
.iMuihn
rtffe. S-cfvLitxc
^i-tfl
c3vwt.
ffl/xiEtii
iJ
PLATE XXXI.
FIGURE
I.
Clitoris.
D. W. H. Busch.
FIGURE
Follicular Polypus of the Cervix,
Ia.
which has become extruded from the Vagina by gradual elongation of the Stalk.
and Boivin and Dughs, plate
xvii).
This figure
is
among a number
FIGURE
II.
Orifice
and Anus.
plate 3,
fig. ii.)
A. Hypertrophied
left
labium majus.
D. Meatus urinarius. E. Opposite ulcerating point in fraenum labii. F.F.F. Seat of ulceration with separation of the posterior and vagina.
G. Internal margin of the ulcer.
left lateral
wall of the
H. Entrance of vagina. (The indicating line has fallen out of the type, its indicating end should lie over (J). /. Extension of the ulceration to the point of union of the right large and small labia. JJJ. Growth on perinaeum and anus.
K. Swelling of
left
inguinal glands.
FIGURE
III.
Memoir
Region.
A. A. Enlarged and infiltrated labia majora. B.B. Degenerated labia minora. C. Puckered portion from previous ulceration. D. Growth of perinseal raphe and folds of anus. E.F. Opposite the meatus urinarius and vestibulum. G.G.G. Growths at orifice of vagina.
T,if,
XXXII.
.^^!S^.
C ^^^^2^-'.
/;
MartniS
Iliin.lalUi ^
II .lull.
! .I.Ahuliu
Hf..
SlIiuC.c.
.JS'iMi
,ri,,,.i
.'i!.-vlu,
PLATE XXXII.
FIGURE
I.
(Half Life-size).
(By
the kindness
of Dr.
Loretit, Director
The history and description of the case are in the " Monatschrift fiir Geburtskunde und Frauenkrankheiten," edited by Cred^ Martin, von Ritzen, von Siebold, band xiii.
FIGURE
II.
Broad Condylomata of the Labia in a Pregnant Woman, removed in two Huguier without causing abortion.
(One-third Life-size).
(After
sittings
by
H.
Lehert.
Treatise
large labia.
The growths on the prepuce of the clitoris are easily distinguished from those on the The growths round the anus are continuous with those of the vulva, so that
is
surrounded by them.
FIGURE
III.
Urethral Excrescence.
(Half Life-size).
(After Boivin and
Dugh)
orifice
A spongy growth
w\
Tnf XXXIII
/>^\
hi
k
1-12
^iW
W
V^^
Fi.5.
^..cpWf'Sr^-^'l^
7;>^))./
K Marlins
.\i
,..
,.
PLATE XXXIII.
FIGURE
I.
into the
bladder.
h.b.
c.
Body of uterus
(cervix uteri
?).
d.d.
e.e.
?).
f.f.
FIGURE
II.
Malformation of the Female Genitals by growing together of the Labia Minora and vmusual size of the Clitoris. The Internal Organs of Generation were normal.
{Ajlcr
a.a.
b.b.
c.
Gtiil.
H. M.
Becker.
The large abnormally developed labia joining together underneath. The labia minora grown together in their lower half. The clitoris measuring 2, 3 centimeters in length with a semi-canal underneath
ing to the meatus urinarius.
lead-
d.
FIGURE
III.
H.
Busch, Atlas).
FIGURE
IV.
Coalescence of the External Genital parts as far as the Meatus Urinarius in an old woman, who had suffered from an intolerable Pruritus but had not borne children.
{After Boivin and
Dugh.
Uterus, Paris,
1833.
Atlas,
plate 40).
FIGURE
V.
{After
H. Herzog,
[if
XXXIV.
^f:^.K-
^'\:^i\
"s..
J,
-A.
K.Marlin-a Hanclallus.
II
df^.
JUwo^-. ^xitCivi
PLATE XXXIV.
FIGURE
I.
Occlusion of the Vaginal Oriflce (Atresia hymenea) with displacement forwards of the Anal opening in a girl aged 4 years.
(Half Life-size).
{A/kr
Gtisl.
Aug. Lolze.
am
ct
atresia
a.
b.
Clitoris.
Small labia.
Urinary meatus.
Larsre labia.
Occluded vaginal
orifice.
c.c.
f.
Anal aperture.
FIGURE
Narrowing of the Vagina
{After S. Merriman.
II.
in a
woman
in labour
by an Ovarian Tumour.
London, 182
a.
b.
c.c.
).
d.
e.e.
/./.
The vaginal
wall.
FIGURE
III.
c.
tab.
The The
uterus cut
off.
off.
c.c.
The broad
ligaments.
d.d.d.d.
e.e.
Exudation membranes.
portion of vagina dilated into a pouch. portion of vagina with rugae.
to
Sound
to
Neck
of the bladder.
k.k.
External genitals.
T,if.
XXXV
Fie
ViA.2
i6.4.
/','
Miirtiiis llaiu/allus
II
Aiifl
v.
.i
(iitiix
t-liffi
Sci'xiU7.c.
SuK
SHyi..Sij>r(i,'
PLATE XXXV.
FIGURE
I.
(Enterocele Vaginalis).
Vagfinal orifice.
Uterus.
Bladder.
d.
Vagina.
FIGURE
II.
(Vaginal Enterocele).
cit.)
d.
e.
Bladder. Divided vagina. Section through the prolapsed posterior vaginal wall.
Divided uterus. / Entrance to the Hernia rectalis. g. Section through the rectum. h. Sacrum.
FIGURE
Vesico-vaginal Hernia.
III.
(Cystocele Vaginalis).
cit.)
e.
between
and rectum.
f.
Rectum.
d.
FIGURE
Recto-vaginal Hernia.
IV.
(Rectocele vaginalis).
cit.)
Divided symphysis.
Section through vagina. Uterus.
e.
f.
g.
Rectum.
Stretching of the utero-rectal folds.
d.
Td\ XX.WI
Fifi.l.
xr%^>r --^^
Fi'i.2.
/'
^3=*^:.
>
r^?;
.^'
,,;a.^-
f^x
-'J-7tl. *"&
^.^_
.^
-Fin.
-I
Mclrlins HinllluH
II
lull r
A MuiUn
I.
UT-
ScCviu.'.fc, Jj, Hi
,n,i,.t
.'S.-rfi,
PLATE XXXVI.
FIGURE
I.
sistentes.
Argentor, 1752).
a.a.
b.
c.
/./.
g.g.
h.h.
i.i.
Round
ligaments.
d.d.
e.e.
Fallopian tubes.
k.k.
Ovaries.
FIGURE
II.
in a virgin
aged
17.
Berol. 1841).
a.a.
b.
c.
The vagina cut away. The OS uteri of left side. The external surface of
stands instead off
by one septum.
(The
letter
in several plates).
d.d.
e.e.
f.f.
g.g.
The two horns of the The round ligaments. The Fallopian tubes. The ovaries.
uterus.
FIGURE
Left
III.
Horn
Horn
in a
married
woman aged
34.
vol.
ii.
{After Rokitansky.
1842,
s.
514, and
On
Oesterreich, Staates,
a.
b.
Hollow cavity of right rudimentary horn, which is connected with the left developed portion by a solid flat band of uterine tissue about 3 centimeters above the external
OS uteri.
c.
Tubal
{A/hr Hcyfelder
a7id
Ad. Kussmaul.
On
and doubling up of
the
Uterus,
Wiirzburg, 1S59).
a.
b.
c.
Vagina. e. Right Fallopian tube. f. Right ovary. h. Incompletely developed left uterine horn. Uniting portion in which for a short distance a small canal can be followed from /.
the right horn.
k.
/.
Muscular
fibres
left
round ligament
into
the
body of the
right horn.
q. d.
Umbilicus.
g.
r.
Membrana
ovi.
1
Female embyro
2-5
centimeters long.
PLATE XXXVII.
FIGURE
Rudimentary Horn united by a
{After J.
Chr. Stan.
Czihak.
I.
solid
enlarged by pregnancy.
824,
and Ad.
Kussmaul,
a.
b.
Cavity of
left
uterine horn.
Cervical canal.
c.c.
Vaginal
cavity.
d.
e.
f.
g. Cavity of tlie
h.h.
i.i.
vessels.
k.
in.
n.
Funis to which was attached a male embryo at the 6th month of gestation. Right Fallopian tube.
FIGURE
One-horned Uterus from a
II.
child.
Drawn from
behind.
op. cit. s. 22).
and Kussmaul,
d.
e.
Bladder.
f.
g.
Vagina with os
uteri
into
it.
FIGURE
Onc-hornod Uterus from the body of a
tenth time
;
III.
woman from
was
{After Chaussier, Bulletin of the Faculty of Medicine of Paris, 1 81 7, and Granville, Philosophical Accompanying text of Kussmaul, op. cit. s. 122). Transactions, for the year 1818.
a.
b.
c.
d.
Posterior wall of pregnant uterine horn. Right Fallopian tube. Right ovary. Right broad ligament.
e.
f.
g.
Undeveloped Fallopian tube ovary, and broad ligament of the left side. Vaginal portion, Vagina.
I'iif,
XXX\I
1-1!;
\'v:
:,
/<rf^i
Fij.
(;
1^-.
^--
A'
Martins lliindattus
II
Autl.
o.
.-I.
Mai
ate.
S*ft.iU^.'. -Sl-td
eJ"->t.iB'>
IV.
Body indicated by Connective Tissue and Muscular Fibrous Tissue with simple Cervix.
{After Kussmaul, op. at.)
a.
b.b.
c.c.
Indication of cervix.
Indication of uterine horns.
e.e.
Ovarian ligaments.
/./.
gf.
Round
ligaments,
Fallopian tubes.
Ovaries.
d.d.
FIGURE
V.
Apparently simple Uterus with Vaginal Wall continuous with Cervical Cavity.
{After a preparation in the Heidelberg Anatomical
a.
b.
Museum.
Kussmaul,
d.d.
e.e.
Fallopian tubes.
Ovaries.
c.c.
Horns
f.f.
Round
ligaments.
FIGURE
VI.
De
Accompanying
text,
Kussmaul,
a.
b.
op. cit.)
Vagina. Simple lower portion of cervical canal. c.c. Vaginal wall, thicker above, thinner below. d.d. Right and left halves of uterine cavities. e.e. Two protruberances in the neighbourhood of the internal os f. Fundus uteri.
g.g. Fallopian tubes.
h.h.
uteri.
Round ligaments.
PLATE XXXVIII.
FIGURE
I.
a.
b.
Right round ligament raised up after dividing the layers of the broad ligament.
Ovaries.
c.c.
d.d.
c.
in
and rectum.
FIGURE
II.
Uterus, divided from Vagina, with double Os Uteri after termination of Gestation
in left half,
(After Cruveilhicr)
a. a.
of the uterus.
FIGURE
III.
in front.
Tiir.wwiii
-y
MartiitS Uanclallus
II
Aullc. .iMartin
an,
s^aiu,-_e,.
ivd
<0t4M,. 8^^ei
Taf.WXIX.
FlSl,
^1
'
I'*
Fie
Vie.
f
Fi^.4-.
rTi'BRfr'J'Pi'^
.-I'iVi'i^
Fie. 5.
FiE
(,
!:
Miirliii's /hiiii/allus-
II .lull.
I-
.IMarlin
tite
s.-riut--.c.
i"Hi cri,,^.ss^&.
PLATE XXXIX.
FIGURE
1.
Unusually developed
left fold
of Douglas.
FIGURE
The same Uterus dissected shews a Cicatrix Os Uteri near the
II.
border.
FIGURE
Fundus Uteri twisted
forwards.
{After Tiedemami.
III.
and
From
a single
woman
On Duvemey's Glands
in the
and
positions
of the
Uterus, Heidelberg,
840).
a.
and forwards.
FIGURE
Fundus Uteri twisted
to the left
IV. constricted.
cit).
and Os Uteri
From
FIGURE
Fundus Uteri strongly developed
Isthmus the Uterus
V.
to the right.
is
atrophied.
cit.)
FIGURE
VI.
Bulky vaginal portion of the above preparation from below with obliquely situated Os Uteri.
Tnf.XI.,
*-.
^M"^
^:
PLATE XL.
FIGURE
Anteflexion of the Puerperal Uterus;
I.
site is
The patient was delivered by forceps on account of The placenta was expressed, apparently completely.
septic peritonitis, together with
haemorrhage and
on the 14th
FIGURE
Puerperal Retroflexion
;
II.
Death took place suddenly on the 29th day after labour from pulmonary embolism.
FIGURE
Retroflexion of the Puerperal Uterus
;
III.
is
lengthening of the Anterior Uterine Wall on situated the tineven placental site.
cit.)
The
day
after labour
uteri.
is
The
open.
anterior wall
is
27
laid
Tnf.Xl.l.
Pifi.l
FiS 2
.
Fi4.;i-
FiS
/I^Sr.
'
4s..^
Fia.5.
^'^iXa '*: W
-fel
n
Fig. 6.
ii)
K
/;
Marhns
J/.,.!a,/ ^
II
Allll ?..
Martin
aee.
PLATE
FIGURE
Marked Anteflexion
XLI.
I.
of the Uterus.
Symphysis.
Bladder.
Uterus.
d.
e.
b. c.
Rectum. Sacrum.
FIGURE
II.
[A/kr Li Gaidn,
a.
b.
c.
op. cil.)
Symphysis.
Bladder.
Uterus.
d.
e.
Rectum. Sacrum.
FIGURE
III.
FIGURE
IV.
Retroversion of the Gravid Uterus at the commencement of the fifth month with considerable distension of the Bladder by retained Urine.
(Diagrammatic).
FIGURE
Womb.
{A/ier W. Hunter.
a. a.
V.
Bladder
full
of urine.
Intestines.
FIGURE
Retroflexed Uterus bound
VI.
down
to the
Dugh.
Symphysis
Bladder.
Uterus.
T,ii. xi,ir.
l\.M,irhns //./al/us
11
.lull ,:.l
.Wa/Un
Hr}
^jCT\/i.\,i,
..:.&,
PLATE
XLII.
I.
FIGURE
{A/ttr F.
WiiickcL
/rem
The
uterine cavity
almost
in
a straight
{o.i.
line,
is
directed forwards.
the cervical cavity is more .sliyhily backwards at first, at the middle of the Are placed too low down in the drawin.i,'-,
FIGURE
II.
FIGURE
III.
FIGURE
Partial Prolapsus Uteri.
{After Winckel,
IV.
B. Bladder.
]
v.
Anterior
lip.
R. Rectum.
h.
A. Cystocele.
lip
Posterior
of OS uteri.
|
V.
Uterus.
cit.)
myoma
g^rowing outwards
in
of the uterus.
FIGURE
VI.
R. Rectum.
o.i.
Internal os uteri.
The
uterus.
cervix
The
involved as far as the internal os uteri and on the posterior wall of the Douglas' pouch is unimplicated.
is
fmUfJ
II
vvr^
T.-if.
XLin
xVi
--
E,Mrli-sna,h,>l.'-^l/
Ml
"-^ ^''""-"
PLATE
XLIII.
I.
FIGURE
{Ajlei C. Ruge, Clinical Conlrihulions.
hand
ii.
24, 1877).
o.i.
D. Bladder.
R. Rectum.
|
Internal os uteri.
FIGURE
{A/tei
o.i.
II.
Obtuse-angled Anteflexion.
Winckd,
op. cil.)
Internal os uteri.
T.
Thrombi
in
The anterior
wall
is
the posterior.
FIGURE
III.
Obtuse-angled Anteflexion.
{After Winckel, op.
cil.)
FIGURE
IV.
Obtuse-angled Anteflexion.
{A/ler Winckel, op.
cil.)
The
point of curvature
is,
in Figs. 3
and
4,
uteri,
o.i.
FIGURE V.
Right-angled Anteflexion.
{A//e/
Winckel, op.
cil.)
FIGURE
VI.
Right-angled Anteflexion.
{A/ler Winckel, op.
V.
o.e.
cil.)
Vagina.
External os
uteri.
o.i.
FIGURE
VII.
Acute-angled Anteflexion.
{After Winckel, op.
cil.)
its
o.i.
Internal os uteri,
T.
Thrombi.
Taf. \l.i\'.
FiA
:.
!:
Mnrl(->r
Jlr/,il/:j.i. II .hifl i:
.
A.
.''^arlii
CtC&. S^f'uLvt^^e.
PLATE XLIV.
FIGURE
Retroversion of
I.
thie
Uterus.
{Afhr Winckd,
V.
op. cit.)
Vagina.
its
JR.
Rectum.
External os
uteri.
B. Bladder;
is
o.e.
0.2.
disturbed.
Internal os uteri.
FIGURE
II.
o.c.
o.i.
External os
uteri.
Internal os uteri.
B. Bladder.
FIGURE
III.
R. Rectum. v. Vagina.
o.c.
o.i.
External uterine
orifice.
Near
The
cervical canal
is
markedly .S-shaped, the mucous membrane of the cervix and body of the uterus are degenerated.
FIGURE
IV.
Posterior
lip
lengthened, anterior
lij)
has
become
li.
obliterated.
Rectum.
Vagina.
External os
uteri.
CD.
Internal os uteri.
FIGURE
V.
o.i.
Internal os uteri.
a.a.
V.
o.e.
Vag-ina.
CD.
uteri.
External os
The
is
is bound down to the rectum by two The mucous membrane of the cervi.\
adhesions, and
is
liyperplastic
with cystoid
PLATE XLV.
FIGURE
Partial inversion of the Uterus in a
I.
delivery
woman aged 30, who died three hours viewed from above.
vol.
ii.
after
{From
the
Pathological Repertory oj
Paris, 1826.
Obstetric
Bladder.
Projection of anterior uterine wall.
d.d.
e.e.
Fallopian tubes
Ovaries.
/.
Rectum.
FIGURE
II.
Series
0/ Engravings, 2nd
edit. London,
Si 2.
Surgical Copperplates,
Weimar,
The
show
d.
FIGURE
III.
Partial inversion of the Uterus, five years after the occurrence of the inversion,
with prolapse.
(Life-size).
D ugh,
op. cit.
plate 12).
Firmly contracted
ring-
of cervic neck.
T^if,
Xl,\,
E.
II
lull. v.. 4.
Martin
.Hi. ^rti^.SJxvfin
Taf.XlAl
-tOU ;_.;-,/
K.MaHin's ll.uulalla,
II
.lull r
.LMarl,n
tU&. S^Wt*.;..t'.tr,
^lu..t
;b
fin
PLATE XL VI.
FIGURE
I.
Inversion of the Uterus with prolapse, resulting from injudicious traction on tho Placenta.
{A/ier Boivin and
Dug}s,
op. cit.,
plate 12).
a.
b.
The
FIGURE
II.
lip of the
Os Uteri.
Half
{After W.
Life-sizej.
H.
band
i.
a.
(Removed
by
ligature).
FIGURE
Polypoid growth of posterior
{From a
a.
b.
c.
III.
lip of
Os Uteri
who
to a weight of 14 pounds.
case by
Afi,
diedfrom hcemorrhage.
Diagrammatic).
Fundus
uteri to
lip
be
felt
Anterior
Hypertrophied posterior
FIGURE
IV.
(Half Life-size).
(After Boivin
and Dugh,
op. cit.)
a.
3.
c.
uteri.
Anterior
lip
of os uteri.
clitoridis.
d.
;il-
XLMI.
Fi,l.
t'iE.i.
//
,
""^^y
gt:-.
)
tr
S'^^
,..4^
,t^iWfefci^
Vii.2.
e-f
i-'ia.
V'Nii
Fifi.J.
i-
i/C
A' .V/a/-/i/;s
lla,ulatlu.s^ II Attfl.
u.
A.
Mart
(.%((.
StPiu-tec. ^irft
<3,,,^
.'B/nfiu
PLATE XL VII.
FIGURE
1.
Copperplates,
e.e
Fallopian tubes.
/. Bladder.
g.g. Fimbriae of the Fallopian tubes.
c.
Labia minora.
d.d.
Round ligaments.
FIGURE
II.
drawn from
within.
Accompanying Fig.
I.
Bladder.
d.d.
e.e.
Rectum.
Ovaries.
Round ligaments.
Ureters,
c.c.
/./.
FIGURE
III.
Matthew
Baillie.
Series
of Engravings, 2nd
c.
edit.,
London, 1812).
a.
b.
Meatus
urinarius.
Os
uteri.
d.
Vaginal portion.
FIGURE
IV.
Complete prolapse of the Uterus without Cystocele following prolapse of the posterior wall of the Vagina with Enterocele and prolapse of the Hectum.
{After R. Froriep, Surgical Copperplates, plate 388.
a.
b.
c.
fig. 2).
Meatus urinarius.
Prolapsus uteri with inversion of the vagina.
Prolapse of the rectum.
Complete prolapse of the Uterus advanced in Gestation with partial foot presentation of the Foetus in Multipara, aged 38 years.
{A/ler Wagner in El.
v.
.Sicbold' s JotirnaJ
of Midwifery.
v.
Diseases of
Women and
Childten.
1816, p. 615).
Meatus urinarius.
Prolapsed uterus with the fcetus in the inverted vagina. Os uteri, from which the right foot of the fcetus is extruded.
PLATE XL VIII.
FIGURE
I.
Prolapse of the posterior wall of the Vagina with sinking of the Uterus.
{Aficr Robert Froriep, Surgical Copperplates).
a.
b.
Rectum.
Dilated Douglas' pouch with prolapse of the posterior vaginal wall.
(Enterocele
cum
Uterus.
d.
e.
Bladder.
Symphysis.
FIGURE
II.
Prolapse of the Uterus with marked Enterocele and prolapse of the Uterus.
(After R. Froriep, Surgical
a.
h. c.
Accompanying
d.d.
e.e.
Extremely elongated and thickened cervix. Peritoneal fold between the uterus and rectum.
/. Bladder.
g.
h.
i.
k.
FIGURE
III.
Prolapse of the Uterus from marked elongation of the Uterus with Cystocele.
[After
Rabat
a.
1^.
c.
d.d.
e.e.
/
g.
//.
/.
Bladder.
Symphysis pubis.
Slightly prolapsed
uterus.
Perinaeum.
k.
XIAIII
'\2
I
Pi'i,
!'
Marlins
H:in,/al/(i.s
II. lull
r.
Mailin
(ff.
Sffiui-.-
'.t;
PLATE XLWUL(Continued).
FIGURE
IV.
Prolapse of the Uterus following prolapse of anterior and posterior Vaginal Walls.
(^After Robert Ftoriep, Surgical Copperplates, plate 416).
a.
I.
c.
d.
e.e.
side,
with occluded os
uteri.
f.f.
g.
h.
i.i.
\.
/.
Bladder divided into two compartments by the cystocele. Symphysis pubis. Urethra running downwards. Ovary and Fallopian tube. Ureter much dilated by continuous distention from below. Peritoneal fold between uterus and bladder.
Rectum.
FIGURE
V.
Prolapse of the anterior wall of the Vagina with elongation of the Uterus. {From a preparation
in the GyncBcological Clinic at Berlin)
The uterine walls are considerably atrophied at the fundus there is an intraparietal myoma. An ovulum Nabothi is situated in the cervical canal. The connection between
;
the bladder
and uterus
is
PLATE XLIX.
FIGURE
Elongation of the Cervix with prolapse
;
I.
and
(One-third Life-size).
a.
b.
c.
Inverted vag-inal wall with thickened epithelial-like epidermis. Lips of OS uteri. Cervical canal much elongated.
Uterine cavity. Fibroid tumours in uterine wall. /././. Large cyst, with serous contents, above the larger fibroid.
d.
e.e.e.
FIGURE
II.
(One-third Life-size).
FIGURE
III.
Perforation of the posterior wall of the Cervix with preservation of the peritoneal covering in a patient who died from Peritonitis six weeks after labour.
(After Cruveilhier,
a.
op. cit.)
FIGURE
The same
IV.
drawn from
within.
op. cit.)
(One-third Life-size).
FIGURE
V.
Bladder-polypus or Cysto-sarcoma of the Mucous Membrane of the Uterine Cavity, caused by degenerations of the Utricular Glands.
{After f. Hope, Principles
and
Illustrations
The
similar tumour in 1849, from the anterior wall of the uterus. cystic tumour, larger than a foetal head, was removed by the ligature passed into the uterine cavity. The recovery of the patient, aged 39, was permanent. Before the operation .she had suffered for years from severe uterine hasmorrhage which had rendered her ex-
tremely anaemic.
a.a.a.a.
b.h.h.b.
c.c.
Uterine walls. Utricular glands degenerated into bladders as large as cherries. Incision into the cysto-sarcoma.
Tnl.MJX
..^
>'
^.\fnrt,s Jt,ulullu<.
II
AurLi-AMaiUn
cm,.
S*ft,a{s.e..
^,
Fia.:'.
PiA,
1.
/---^
l(i
Via A.
ri2..-i.
Fi ^
!:
Marlius Ihuulallus.
II
lull
v.
a, Mr
eu6.' s^fviitj^.
.fim
cr(ii..i
.'R,.,c,
PLATE
FIGURE
I.
L.
Vaginal portion of Cervix with dilated Os Uteri, through which an Intra-uterine Polypus can be seen.
(^After Cruveilhier, Palhologi'cal Attalomy,
book
a.a.a.a.
b.
Dissected vagina.
c.c.
Hypertrophied
follicle.
Vaginal portion.
d.
Lower extremity
of polypus.
FIGURE
The Polypus,
II.
after division of the anterior wall of the Uterus, is seen the Fundus. (Same preparation as in Pig. 1).
growing from
(One-third Life-size).
{^Afler Cruveilhier, op. cii.)
a.a.a.
b.b.
c.
Lips of os uteri which projected vy centimeters below the polypus. Thickened wall of the uterus" with development of vessels. Fibrous polypus which has caused some inversion of the fundus.
FIGURE
III.
2,
sarcoma.
FIGURE
Fibroid
IV.
Tumour
of Uterine Wall,
(One-third Life-size).
{After Cruveilhier, op.
a.a.
n't.
book
The
d.d.d.
e.
Other
Subperitoneal fibroid.
PLATE
L.
(Continued).
FIGURE
Fibroid
V.
Tumour
in the anterior wall of the Uterus, which has a Uterus far advanced in pregnancy.
grown
to the size of
(One-third Life-size).
{After Criiveilhier, op.
a.a.a.
b.b.
c.c.
cit.)
e.e.e.
with thrombi.
PLATE
FIGURE
LI.
I.
Polypus of the Mucous Membrane and underlying Uterine Tissue which has grown into the Uterine Cavity from the Internal Os.
(One-half Life-size).
{After
a.
h.
R.
Weimar, 1839).
and
removal.
FIGURE
Numerous Mucous growths
II.
(Half Life-Size.)
(After R. Froriep,
a.a.a.a.
b.
op.
at.)
The mucous
FIGURE
Mucous Polypus
at
{After
III.
its
Utricular Glands.
FIGURE
Interstitial
IV.
Submucous Fibroids
(Half Life-size).
{After
R.
FIGURE
Numerous round
V.
Uterine Mucosa.
(Half Life-size).
{After R. Froriep, op.
cit.)
FIGURE
Fibroid
VI.
after labour.
Tumour
(One-third Life-size).
{After Cruveilhier, Pathological Anatomy,
a.a.a.a.a.
book
site.
xi.)
Through
b.
Placental
c.c.
T;if. L,l.
Fi-,
1.
Vii
Kig.
i
Fis5.2.
Fi^.5.
A'.
A/ort,n-.v
Haiuhitlas. ILAufl
v.
I.
Marti,
am.
S^fxut-.c SAtfl
.TT,,..,
fR,.-:?.
Tai.
LU.,
Fii.3.
FiA.4/
,-....:!r;i :
.
A'
v.
A. Martin..
CU6. S*^iW*..
-2i.t(l
S^MA.. iB^fiil.
PLATE
FIGURE
LII.
I.
Body
of the Uterus.
pi. 7).
ing head.
d.
"figure
The Tumour
{After C.
a.a.a.a.
b.b.b.b.
c.c.
II.
8.)
d.
<?.
FIGURE
Interstitial
III.
much
(One-third Life-size).
{After C. Wenzel, op.
a.a.
b.b.b.
c.c.
cit). pi.
lO.
membrane
The
d.d.
Fibroid in posterior
os uteri.
FIGURE
IV.
3.
pi. ll).
d.
r,ii
LiJi.
Fig. 3.
Fis.I.
Fig. 2.
Fig.+
i-f"
A' .V/r/,/,\
//,/l/a:i
II
lull ir.l.
Mai
lin
PLATE
FIGURE
LIII.
I.
Cancel- of tho Uterus, with Cancer of the anterior wall of the Vagina posterior portion of the Vaginal cul do sac.
(Hali' Life-size).
and the
cit.
book
24).
The indurated bladder. The body of the uterus apparently free from cancerous infiltration. Cancer, in the anterior and posterior vaginal walls, commencing- to break down
front.
in
(/.
Lower
FIGURE
(^After C.
a.a.
b.b.b.
c.c.
II.
Uterus laid open from behind. Cancerous tumour of the cervi.x. Thickened Fallopian tubes with adherent Fimbriae.
Ovaries.
d.d.
e.e.
Rectum
cut through.
FIGURE
III.
Cancerous destruction of the vaginal portion of the Uterus and the vaginal wall between the Vagina and Bladder.
(Half Life-size).
{After C. We?izel, op.
a.a.
b.b.
c.c.c.
cit).
Body
Fallopian tubes.
d.d.d.
e.e.e.e.
Border of vesico-vaginal fistula infiltrated with cancer. Indurated bladder and urethra laid open from the front.
FIGURE
The Uterus, seen
{After C.
a.a.
b.
IV.
uterus.
by adhesions,
terminating
d.
e.
in
Taf.
I,
IV.
'S^
,\
^^-
V\il.2-
<i:
K Mniiin's
Hiini/iilliis. II Aul'l n.
.
altin.
C%&. Scl'uilAC,
Jt'itll,
aJviof
.'Beii
PLATE
FIGURE
LIY.
II.
Careinoma Uteri.
Original drawing
torn,
8 70).
The whole
cancer.
uterus, especially
is
orifice
invaded with
The
The
cervical canal
mucus.
FIGURE
Adenoma
{After Schrodei;
I.
Uteri.
Adenoma of
the Uterus.
band
i.
189).
in
Taf L\.
Vik.3.
'tM
MfSi^vd
' '
'
Mid/ :*/Sf,^
'
.Pi*.
f.
'
'
^^^i'i^i','"
...'7;
f^-^'isss
Pifi.l.
-;^5^
E.Martin's UniulatUie.
H AiiFJ- v. A Martin
C.%6. S-c-fiii.tAe.
Siifv. <?mM
(^e^.tw'
PLATE
FIGURE
Polypoid
LV.
I.
Adenoma
of the Uterus.
cti).
(Life-size).
Pedicle.
The
(/.
The dark parts pedicle ramifying inwards, displaying the stroma of the tumour. between the ramifications of the stroma are clearly seen on the cut surface, some small some larger, and are cysts of the size of peas. The lighter and more clearly striped part appears microscopically to be composed of solid connective-tissue and to be free from cysts, but small cysts of the same structure are to be seen by the microscope. The tissue itself has a myomatous character.
This portion as far as the next notch towards the
left, is
lium.
The remaining
surface
is
FIGURE
II.
surface.
FIGURE
III.
of the Pedicle.
At the
scence
is
The
the wall of a large cyst lined with cylindrical epithelium and an excreseen projecting into it, which is also clothed with cylindrical epithelium. neighbourhood of this and the other cysts is surrounded by connective-tissue.
left is
is
To
the
nuclei.
FIGURE
Adenoma. Longitudinal
IV.
section from surface.
Gland
shape,
Also glands
some of which are seen to have a small lumen. with their lumens occluded by pale glistening fatty particles of irregular
(Altered epithelium).
Taf.
L\l
EMarliii's llriiidallus
II
Aal'Lu A-MalUi\.
<n..jt. .SiiTPw
PLATE
MGURE
Diphtheritic Endometritis in a
LVI.
I.
woman who died, 14 days after delivery of a dead chUd, from Uterine Phlebitis. Retention of a portion of Placenta.
(One-third Life-size).
{After Crtwcilhicr,
op. cit.,
book
iv. p.
6).
a.a.a.
b.h.h.
c.c.c.c.c.
d.d.
Tumefied inner surface of the uterine cavity covered with exudation. Raised placental site. Veins filled with thrombi and detritus. Infiltration of blood round diseased veins.
FIGURE
Thrombosis of the Veins
in the
II.
drawn
Round ligaments.
Blood clots in the opened veins. Veins filled with ichorous thrombi.
FIGURE
III.
bk.
xiii.)
a.
b.
c.
Kidneys.
Inferior
vena cava.
Aorta.
Ureters.
d.d.
e.
Rectum.
drawn
out.
filled
g.g.g.
h.h.h.h.
i.i.i.
Lymph
cavities
and vessels
laid open.
k.k.
/./.
Exudation masses on the swollen ovaries. Distended lymphatics, in the course of the vasa spermatica,
Lyirlphatic glands.
filled
with
juis.
FIGURE
IV.
Chronic Inflammation with thickening of the Cervical Mucosa. Ectropion of the lips of the Os Uteri.
{After Boivin
CoUum
Tapyroides.
and Dugcs,
op. cit.)
Taf.LW
v.
A.A/arliii
CXll>- SifilU-Ke,.
^U/vd7i.iM S3tU.
,
PLATE
LVII.
I.
FIGURE
Posterior surface of a Puerperal Uterus with Inflammation of the Lymphatios, Fallopian Tubes and Ovaries.
(One-third Life-size).
{A/ler Cruvcilhicr, op. at.
a.a.a.
h.h.b.
c.c.c.
book
xiii.)
cavities laid
vessels distended with pus, seen through the peritoneal covering. open after removal of the peritoneum.
d.
e.e.
Divided lymphatic vessels distended with lymph thrombi. Unimplicated vein cut through. Inflamed Fallopian tube.
f. Section of the left Fallopian tube thickened, and shewing its purulent contents. g.g. Ovaries enlarged by infiltration and covered with purulent exudation.
FIGURE
II.
1.
FIGURE
Section of a serous infiltrated Ovary, as
it is
III.
{After Cruveilhier,
FIGURE
IV.
FIGURE
V.
Lymphangitis and Thrombosis of the Veins of the Uterus in a 15 days after delivery.
{After Cruveilhier,
woman who
died
book
xiii.)
(Half Life-size).
a.a.a.
b.b.h.b.
c.c.
filled
d.
e.e.
Thrombi
Ureters.
site.
f
h.h.
g. Kidneys.
Fallopian tubes.
TA
l.\'ll!
.)K,
Fiii.5.
A'
ace. s,ciiat,xe.^itf;.
.:3u.i
Si'ii';,;
PLATE
LVIII.
I.
FIGURE
{After C. Ritge
Simple Erosion.
and y.
Veil,
The Pathology 0/ the Vaginal Portion. und Gyncekologie, band ii. 1S78, s. (I.15).
is
The eroded
which
rests
surface
The
all
external appearance
is
that of
evenly covered with cylindrical size of the papillary protruberances much exceeds that of the normal
itself
its
position on
the
deli-
protruberances.
it
becomes more
and the nuclei are nearer the bases of the cells. The stroma of the papillary projections was apparently full of nuclei and vessels. The border between cylinder- and pavement-epithelium is well defined. The basement cylindrical layer of the Rete Malpighi becomes larger and clearer, and furnishes the epithelium which covers the new growth.
cate and longer in the depressions,
FIGURE
II.
Microscopic appearance of foregoing Figure. To the right, the pavement epithelium remains intact; to the left, it is beginning to shew glandular depressions.
Through
the deeper
growth of the
epithelial
at their
terminations and present on their inner surfaces secondary fine papillary projections
covered with a
structure,
FIGURE
{After C.
III.
rollicular Erosion.
Ruge and J
The
disease.
anterior
lip
follicles,
xix. Fig. 7.
FIGURE
Ruge and f.
IV.
TTlceration of the vaginal portion of the Cervix and. posterior vaginal Cul de sac.
{After C.
Veit, op. cit.).
The
tration.
infil-
The pavement-epithelium of
looked as
if it
the vagina
blister, at
is
still
intact here
it
and there
at
part
it
were raised by a
another
had disappeared.
one Glands
PLATE
LyiU.(Cotitmued).
FIGURE
V.
6.
from transverse
sections).
Ruge and J.
The
The epithelium was appeared interspersed with newly-formed glands. pavement-epithelium which sent out irregular thickened conical prolongations into the connective-tissue which was arranged in stripes.
PLATE
FIGURE
LIX.
I.
Ruge and J.
Glandular depressions are present beneath the surface which is covered with cylinThey have small follicular formations. The tissue is full of nuclei and appears limited between the large masses of glands.
drical epithelium.
FIGURE
II.
Ruge ami J.
The
by the depth
FIGURE
III.
Rage ami J
The vaginal portion was irregularly conical with apparently a double posterior lip, from which protruded, like a tumour, through the open cervical canal, a mass as large as a hazel nut. The mucous membrane presented cock's-comb-lilvc folds. The external surface was covered with cylindrical epithelium. Numerous depressions of the epithelium in process of development. The connective-tissue abundantly nucleated. In and around
the vessels
nuclear proliferations.
which pass undivided close under the epithelium are scattered well developed The connective-tissue is traversed by large, long gland tubules.
FIGURES
Commencing Cancer
{After C.
IV.,
v.,
VI.
Ruge and f.
in figs.
4 and
5,
of which the
first
has been
The
erosion
is
FIGURE
VII.
3,
Plate
Ivili.
therefrom.
tissue.
Tnl'.
LIX.
Fi2.:.
/SS*^:
^,,;aS!^
;>!
;\:
If^
Fii.!.
Pie
ii
I-'i^.4.
;.-''*'.{'
l-i^,7
/^
If, /
/y
^ 1
W^
\'
IL<2^
M^h
K MdHiirs
Iflin.lallun. II lull. r.
.
I.
Men
til)
CfK
5:f.r.iU?.<:.
^itft <0Mi^..S.e;i.
Fal"
LX.
Fis.i.
/,'
r.
I.
Martin,.
t'lE6.
SiPiutAe.. SiA'^.iBuM,.
ft!.
PLATE LX.
FIGURE
Circular rupture of the Cervix
{A/let C. Siattdf,
I.
and expulsion
Case of Circular Rupture of the Cervix with expulsion of the Portio Vaginalis
Beitrdge zur GeburtshiUfe und Gynacologie der Gesellschaft fiir Geburtshiilfe
i.
during Labour.
zu Berlin,
band
1872,
s.
144.)
of the OS uteri.
The cervical rupture healed without any complications. The annular flat surface of the preparation has a transverse diameter
its
is
of
centiin
and
the
centre
the round
smooth-margined os
The
inner
uteri.
FIGURE
View
The
II.
external surface
Taf.LXr
^'
E.Martin's Hiuiilailuf;.
II Aiifl. v.
A.Martin.
SS-ct-fcii
PLATE
FIGURE
LXI.
I.
s.
605).
The
had drained
off.
abdominal
cavity.
The
rent passes close under the internal uterine orifice through the whole thickness
of the anterior wall of the neck and part of the posterior and right side.
On
in at a.
FIGURE
II.
s.
232).
The
uterus of a
During labour
(turning, forceps,
in
and
and
the
left
tumour.
The
folds of the
nif.i^xii
Fiii.;!
4)
vCV
Vi'j..2.
H
:\
W'il.ZM
I.
Marl,
IIT'
SAiUp.i..
Jli Hi
JDu^t
S:ii^eiH
PLATE
FIGURE
LXII.
I.
tubes.
R.
Weimar, 1836,
pi. iv.)
c.c.
d.
e.e.e.e.
Round litfaments. The left ovary, occluded inwards, laid open. The cavernous dilatations of the left ovary, laid open.
FIGURE
II.
Tuberculosis of the Fallopian tubes and the mucous membrane of the uterine cavity, in a young girl who died of Pulmonary Tuberculosis. The peritoneum appeared free from tubercles. In another part, the original presents a haemorrhage (from a phagedcenie ulcer?) at the disintegrated vaginal portion.
(Half Life-size).
(After Cruveilhier, op.
a.
cit.
book
39).
h.
c.c.
tube, dilated in its outer half, and filled with a white cheesy mass. e.xtremity was occluded. both ends patent. Fallopian tube more distended than the left
;
d.
Ovaries. Uterine cavity laid open with the mucosa infiltrated with tubercles.
FIGURE
Bight Fallopian tube of Fig.
IIb.
2, slit
open longitudinally.
Unusually developed longitudinal folds of mucous membrane, with tuberculous masses scattered over it.
FIGURE
Pregnancy
III.
in right Ovary.
Life-size).
band
old.
3, s. 85).
The ovum
a.a.
b.b.
c.
is
d.d.
e.
f
g.
h.
i.i.i.
The anterior uterine wall eight centimeters long. The wall of the uterus 2'6 centimeters thick. The mucous membrane developed into a finely-tufted decidua. The round ligaments. The rigHt ovary protruded through the anterior layer of the broad ligament. The occluded right ovary. The left Fallopian tube. The fimbriated free end of the left Fallopian tube. The sac of the ovum, 7 centimeters long, situated in the enlarged ovary, covered
with the folds of the
left
broad ligament.
'ill
LXIII.
Fi^.l.
A'
Marlins Hdiulullus.
II .lull. r.
I.
.V/ai tin
L^f6.
SiKuUe.. iAil..lu^
ffScrCu
PLATE
LXIII.
FIGURE
I.
(Half Life-size).
{After Cruvcilhiet,
op. eft.)
a.
b.b.
c.
Uterus,
drawn
to the left.
Round
lig^aments.
d.
e.
Fallopian tube.
Ovarian
cyst.
cyst.
Prominent transparent
k.
FIGURE
The same Cyst
as in Fig.
1,
II.
A. Uterus.
h.h.b.b.
c.c.c.
Patches of blood
d.
e.e.e.
Venous networks on
Taf,
IjXI;'
Ji&
/,
n-
Fig. 2
/ %
,/
/
''
_^-
'^'Spi^^''
'
Fie
Fia.3.
^.MKms-i
'
f
,1
y^\
-':
'
-v-'p
'llSl
\
'"""ofttesvj
~
^"^
E.
Martin's Huiiilatlus
II Aiifl r.
.
Marlii
J
C(.U>. ..).>ruU?.e..
^iKi lO.wi
.'ijitt'lu
PLATE LXIY
FIGURE
Dermoid
Cyst.
I.
{Afkr
a.
h.b.
Cruveilhier, Pathological
Anatomy, book
c.c.c.
d.d.d.
e.
Single hair-bulbs and Abundant chalky deposits are present. A larger chalk mass with alveolar margin and two
teeth.
FIGURE
The Chalky-plate, shaped
Ia.
Taken from
the Fat-
cit.)
like maxilla.
FIGURE
II.
Hair- and Fat-cyst of the right Ovary, as large as a fcetal head, with small colloid The Tumour had caused an incarceration of the Pelvic Viscera. cysts.
(One-third Life-size).
{After Cruveilhier, op.
a.
t/.
cit. pi.
5).
c.c.c.
d.d.
e.
hair of some length, set free from fat by alcohol. Hair bulbs in the cuticular tissue, which Was developed at three prominences in the cyst wall. Two horny excrescences from one of the cuticular spots. Areolar colloid cyst with fat- and hair-cysts.
Mass of tangled
f.
Sound,
to raise
up bridge of cuticular
tissue.
FIGURE
III.
Firm
fibrous tegument.
;
filled
with
Taf.LKV:
Pie.:'.
^iei^r^--
J^J^
Fig, 3.
Fi2.4.
y^.
Fi.l.
J^
:^
E Martin
llrni.latlus. II .lull, v-
A MaitL
I
W.
ScduUi..
^W.fi.,
^M
Si^
!i
PLATE LXV.
FIGURE
I.
Cancer of the Breast with cancer-tubercles in, and under, the skin of an old aged 83.
[A/kr
a.
b.
woman
book
27).
Right
mammary
gland degenerated.
in the skin
in the
c.c.c.
d.d.
varying
in size
FIGURE
II.
FIGURE
Compound mammary
hsematocyst.
III.
(Removed
band
i.
from, an old
1S63, fig. 50).
woman).
Nipple.
Fibrous indurated and shrivelled portion of the gland. Glandular tissue still remaining, but chiefly seen with dilated vesicles, round which, and in which, the cystoid cavities are present, partly as large round open sacs, partly as The contents consisted of a brownish fluid, from which fine longitudinal fissures. numerous rusty concretions had become universally attached to the wall. Also by
microscopical examination, numerous granular brown pigment infiltrations into the
partly sclerosed cartilaginous cyst wall of the larger sac.
FIGURE
IV.
have merged by Other shelf-like prominences are seen on the and are remains of septa which previously subdivided them
Remains of original glands, compressed and indurated. At g the remains of the glandular parenchyma are more clearly seen, which partly extend into the neighbouring cyst and penetrates it as far as c.c.
FIGURE V.
Diffused arborescent intracanalicular
(A//er Virchow, op.
cit.
myxoma
fig.
of the
Mamma.
86).
The lower
portion seems to be quite solid and thick, but certain lobulated structures
are recognisable, which in the section correspond with the masses which have
grown
to-
Above, larger gaps are seen between the walls of the lactiferous dilatations and the intra-canalicular excrescences, which last are easily recognised as such, and stand out clearly in their relation with the tissue of the At the upper part is a larger ectasia laid open. The warty excrescences at cyst wall. its termination appear more isolated.
gether and completely
fill
PLATE LXVI.
FIGURE
I.
Bladder-mole, from a secundipara aged 39, at the fifth month of pregnancy. expelled with great difllculty, haemorrhage, &c.
It
was
No ovum was
found
in
was
filled
with brownish
fluid.
(Half Life-size).
{Original dtaiving).
a.a.a.
b.b.b.
Decidual covering-.
Cysts on the surface protruding- through the decidual membrane.
FIGURE
II.
Bladder-mole from a woman, aged 28, delivered four times at the eighth month, opened, so that the grape-like bladders protrude.
(One-third Life-size).
{After Boivin,
New
Researches on the
Origin of the
Ohslelric
Demonstrations,
FIGURE
in.
Internal surface of the ca-vity of the Ovum -with the Chorion--vllli degenerated into cysts, after opening of the bladder-mole, expelled by a wom.an aged 24 years, primipara, at the seventh month of the pregnancy.
(One-third Life-size).
{After Cruveilhier, Pathological Anatomy,
a.
b.
book
i.)
to
a thin thread.
FIGURE
{After
IV.
H.
ii.
jahrgang, 1847,
FIGURE
the size of a hazel-nut.
V.
Ovum
(Two-thirds Life-size).
{After Gierse, Verhandlungen der Gesellschaft fiir Geburtshiilfe in Berlin,
taf. 3, fig- 13).
a.
b.
ii.
Jahrg. 1847,
s-
133,
c.c.
Network spaces
Nuclei of the
filled
with serum.
Connective-tissue.
d.
cells.
rar.i.wi
Vi&A.
i'^$i^:'\.
'^^^
^CJ^^iT '<>*
E.Marlins Hn,li!us
II .-lull
.1
Martiiv
./i.i.rt
.'KCT-ftii
Vi'lA.
Fia.J.
Taf.
LXMl.
MarlNi-s
llnilall<,>i. II
Ann
.1
Mailin
act;. Sc(i.iU.-.c,i;iHl
e3.n..1
ffi,.fii
PLATE LXVII.
FIGURE
Microscopic section of a
{Carcinoma smiplex, Waldiycr).
a.a.a.
b.b.b.
b.
I.
Mammary
Cancer.
(After
H. Bagel,
Connective-tissue stroma.
Cancer stroma. Cancer bodies with cancer cells. Cancer body with almost normal gland acinus near
pears
to
to
it,
it
ap-
proceed.
c.c.
/'.
Separate normal acini with small lumens. Lactiferous duct, shewing irregular proliferation and raising up of its epithelial cells with irregular branches. In the cancer bodies and proliferating glandular portions is seen an increased small celled infiltration of the stroma.
FIGURE
II.
Mamma.
166).
To the right is seen a portion of the dilated gland-duct perforated with cavities and ducts (beneath the nipple), in which scattered broad masses of sarcoma are developing
from the rounding
which externally merge, almost imperceptibly, into the surthe left is the deeper portion full of cavities and ducts, which are filled with large polypoid, often dendritic ramifying excrescences, which in the drawing are partly laid outside. To the left and above, is a large thick knot of lobulated structure, which presents towards the right some scattered foramina (divided ducts). Towards the left it is completely solid. This portion does not belong to the gland but spreads into its fatty capsule and the skin outside, which is in some places almost cominterstitial
tissue
fatty tissue.
To
pletely destroyed.
FIGURE
Placental
{After E.
Ftci^ikel,
III.
villi.
On
Calcification
of the Placenta.
figs. 2
band
ii. s.
373).
(Continued from
a.
h.
and 4 of plate
Villous terminations with complete calcification of the capillary branches. Xon-calcified branch of villus with bulbar thickened termination, with abundant
tration of round and spindle-shaped granulation
cells.
infil-
The
in
a solution of
b.
salt.
The drawing
in
con-
PLATE LXYU.(Continued).
FIGURE
IV.
Placental apoplexy.
book
i6, p. i).
a.a.
in the
FIGURE
V.
External surface of a Placenta with the impressions of old and recent extravasations.
(Original Drawing).
a.a.
b.b.
c.c.
Old extravasations with umbilicated depressions of the atrophied placental tissue. Openings of old blood effusions in the cotyledons lying deeper under the surface. Recent superficial coagula infiltrating the internal surface of the cotyledon.
(
PLATE
LXVIII.
I.
FIGURE
Seat of the Placenta at the Os Uteri, rrom the autopsy in a woman who died after 14 days' haemorrhage with convulsions in the eighth month of pregnancy. Pla-
(Half Life-size).
{After Jewel' s
Obstetric Plate,
'
no
I.
Accompanying
182S).
Obstetric Demonstrations.
Weimar, part
<j.
a.
b. c.c.
Vaginal cul de
External os
sac.
I
uteri.
Blood coagulum.
d.
e.
Bag
FIGURE
II.
Seat of the Placenta over the Os Uteri, from the body of a woman who died from uterine haemorrhage in the ninth month of pregnancy. Placenta praevia centralis.
xii.)
c.c.
d.
The vagina. The divided os uteri. The placenta lying in The membranes.
Till'
I,.\VII1
If.
E.Martin's Hundat/as
II
Jafl
ik .1
M, i,
Cll'6
.'?<^fi.iU.^^,,
lltfx.
Su^
.--
.''i-
'.If
l,\l\
Fi^.2.
Fis.L
.Marlins llninlullas
//
AuFL
p..
Murlh,
flfj;
SifixUxe^.Ji'iiti .nii^f
,8rifi
PLATE LXIX.
FIGURE
I.
Double Placenta.
{A/ier Fr. Mauer, Diss.
in.
Cur uno
c.
tab.)
a.a.
b.h.
c.c.c.
of the placenta.
membranes.
d.
FIGURE
II.
at a distance
Funis.
Umbilical vessels passing along the membranes separated from each other.
Rent
in the
d.d.
e,e.
FIGURE
III.
Strangulation of the Funis occurring in prolapse of the Funis by unusual twisting of the umbilical arteries.
FIGURE
IV.
H.
i.
%1.
Taf.
LXX.
@J&.
SAiA^, U^,
cSwi. &bat<M-
PLATE LXX.
FIGURE
I.
D. Marburg,
(Life-size).
The preparation is from a male embryo at the third month ot g-estation, and is mumThe whole of the abdomen is swelled up as in a foetus sanguinolentus. The long diameter of the body measures io"4 centimeters. The funis measures 19-7 centimeters. The funis is twisted throughout with the exception of a portion centimeters in length at the fcEtal end. The twisting-s are so numerous through their whole extent that it is
mified.
1 1
twists.
FIGURE
{After F. Hille, op.
II.
Obs. ix.)
plainly
Male embryo at fifth month. Long' diameter 16-2 centimeters. The fontanelles are felt. The cranial bones very soft and easily squeezed together. The left foot is clubbed. The funis is twisted to the right and measures 247 centimeters. The placental end of the cord is much distended. There are three places at which twisting has occurred. The first is at the fcetal extremity of the cord. It is 2-3 centimeters long, 0'2 wide, and presents 5 turns. A second torsion is found at the lower third of the cord, 2-i centimeters in length, 0^25 centimeters in breadth, with 5 turns. At this point it is continuous with a large ribbon-like untwisted portion of cord. At a distance of 1'9 centimeters from the placental end is a third twisted portion, the smallest, which only presents one turn. This only comes into view when slight traction is made on both ends of the
cord.
FIGURE
in.
(Life-size).
three months male embryo. After passing along in front of the thoracic wall the cord suddenly makes a bend down to the left, and forwards, to pass round the right side of the neck from the original twist to the left. At this point there is a bag-shaped dilated swelling, compared with the ordinary diameter of the cord. The point where the turn occurs, which lies underneath the first complete coil round the neck, is characteristic by its distinct colour and tenuity in its thickness and breadth. From this point, however, the cord is twisted 4^ times round the neck of the embryo, and on closer inspection is
markedly atrophied. It is to be noticed that in the relatively short extent of the third twist coil round the neck are six twists running from right to left, whilst in the whole remaining portion of the cord only one twist is seen and this does not belong to the coils round the neck.
Taf.
hXXl
yiarlln's lliliulatlu s
II
Autl. r
/.
Mm
tin
Offe. S^daixfc.
Sufv C0UM
.
?S/T
f,,
PLATE LXXI.
Placenta of twins with compressed Foetus.
{Ftom a
a.
b.
at
The
foetus,
born alive
at term.
c.
d.
The membranes
of the dead
originally in the
the
surviving foetus.
Taf.LXXII.
./
^g^^^f^-:
,!y
F.
Miulm's
lliulnlt.H
//.//(//.
/',
Marlin
C\(i>.
S-cdiiUt. Siik.
<0wM
Sic-
r.
PLATE LXXII.
Abdominal cavity of a
I.
(One-third Life-size).
{After
y. G.
Walter, Account
in
the Abdomen,
a.
h.
c.
h.
of the liver.
i.
the
back
d.
e.
Stomach.
k.
f
g.
/.
the lithopcedion.
FIGURE
The
Lithopoedion in Fig.
1,
Ia.
cavity.
(One-third Life-size).
(After f. G. Walter,
a.a.a.
b. c.
op. cit.).
The The
incrusted integument
breast.
drawn back
d.
e.
Right eye.
FIGURE
II.
Embryo which died from hasmorrhage during the fourth month of pregnancy in an uninjured Ovum. It became encrusted in the Ovum which was not expelled
until the eth month.
(After Fr. Aem. Knopff.
Diss.
in.
exhibens
novum
lithopcedii
exemplum,
fence,
845).
FIGURE
in.
Lithopoedion which was carried in the Abdomen by a peasant woman during 40 years, although two normal pregnancies occurred.
(Half Life-size).
(After W. Kicser, Lithopadion of Leinscll, Stuttgart, 1854).
a.a.a.a.
b.b.
External surface of the chalky covering with prominences And shrunken membranes, e.e.e.
Inner surface of the shell.
i.
Tumour
of the shrunken
lips.
k.
d.
e.
/.
Epithelium of the tongue hardened by layers of chalk salt. Right upper extremity.
through.
The
f
h.
n.
amalgamated with
the
g. Flattened cheek.
chalky covering.
0.
Nose pressed
flat.
Left knee.
Tcif
LXXin
Fi^.l.
ri.
5.
n&. 4.
^.f
E. Martin's Haiidiillait.
IIAuH.
p. .1.
.\Iartiii
Clf6
Sif^UUe.. litJ^
Sfn^
.'B^tfi.
PLATE
Hydrocephalus with spina
LXXIII.
I.
FIGURE
summer
of 1860,
FIGURE
Foetal
II.
cerebri.
(One-third Life-size).
{After W. Vrolik.
TabulcE
el
mammalium.
Amstelodami,
Plate 43).
FIGURE
III.
fatty
(Half Life-size).
(After Sandiforl in W.
a.a.
Plate 49).
The neighbourhood
nipple.
of the breasts
is
b.
c.
small longitudinal fissure, which leads to a cul de sac in a fissure of the sternum. Umbilical hernia covered with a delicate skin into which the thin funis is inserted.
d.
e.
Male
genitals with
empty scrotum.
toes.
and commencing
nails.
Heart, stomach,
liver, spleen,
in the
thorax which
Traces of the
The
vertebral
10 dorsal
column presents a small moveable bone above the single vertebrae, and 5 lumbar vertebrae.
vertebra-
FIGURE
IV.
foetus with
(One-third Life-size).
{After Vrolik, op.
a.a.
b.b.
c.c.
cit.
Plate 22).
is
The internal membrane of the enclosing The amnion united the chorion covering
Placenta.
sac
the peritoneum.
of the placenta.
d.d.
e.e.
Umbilical arteries going to the short, almost undeveloped Openings of the ureters. f. Anus surrounded by the sphincter ani. g. Vagina. h. Blind opening representing anus.
funis.
i.i.
Two
The
vertebral column
is
so bent
backwards
FIGURE
V.
Monopodia.
Vrolik, op.
cit.
Plate 63).
Funis half an inch long, torn by the delivery of child by forceps. Large umbilical hernia with very thin walls through which are seen the
intestines,
liver
and
c.
d.
Cleft in the skin, into which a sound can be pushed some Three toes seen on the single left lower extremity.
distance.
PLATE LXXIV
FIGURE
I.
Ruptured congenital umbilical hernia, Acrania, cyclopia with proboscis and absence
of the superior Maxilla.
(One-third Life-size).
{After Vrolik, op.
cit.
Plate 26).
a.
/'.
Absence of cranial
Proboscis.
vault.
.1
c.
(/.
Monoculus.
The
ears
grown
togfether
c.t-.
The
FIGURE
Male
foetus
II.
Plate 35).
fluid
The
was contained
in
it.
FIGURE
III.
cleft.
Plate 41).
FIGURE
IV.
new-born female
foetus
(Foetus in foetu).
(One-third Life-size).
{After Vrolik, op.
cit.
Plate 100).
Taf.LWIV
Fia
Fi^ 2.
Fi^.l
Fii.
Martin's Handatlus
II .lufl
, .1 .Varlir
S^fc,.
Taf-
l.X.W.
Fig. 4.
Flii
Jl
i'i!;.;;.
m
N
Fie
1'
Fie.
i:
Martin' llnndnltas
U luP
Marlln
Iffi
SvAutxc.
i^Utft-.
gJmM.- SiiyUiu
PLATE LXXV.
FIGURE
I.
Growing together of the cranial integument and the Placenta, Hernia cerebri. Double hare-lip and fissured palate, and ectropion of the Heart in a male foetus
at term.
(One-third Life-size).
{After VroUk, op.
a.
cit.
Plate 27).
ring-lilce constriction,
On
the index fing-er of the right the right middle finger there
hand was a
and
at the tip of
was a
thread-lilie
appendage.
FIGURE
Sympodia.
II.
Monstrum
sireniforme.
(One-third Life-size).
{After Vrolik, op.
cit.
Plate 65).
a.
b.
Remains of
is
and anus, as
is
usual in
FIGURE
in.
extremities.
Cruveilhier, Pathological
Plate 6).
a.
b.b.
Club hand. Both legs are completely developed, but are enclosed
as the insteps.
in
common
integument as far
The
feet
have
c.
FIGURE
rV.
fig. 3).
FIGURE
V.
Plate 76).
FIGURE
VI.
Plate 96).
On
the posterior surface of the head are two other external ears which have
grown
together.
PLATE LXXVI.
FIGURE
I.
Double monster with two heads, four arms, and three legs, which was born immediately after the delivery of a male child at term. The mother, a strong peasant woman, aged 35 (mother of five sons, of which two were twins, and three daughters), was delivered by two midwives.
(One-third Life-size).
{^AflerJ. G.
Waller, Anatomical Observations, Berlin, 1782).
}
a.
b.
c.
Scrotum without
Occluded anus.
testicles.
Common
tive-tissue).
d.d.
The common
umbilicus, which
was about
3 ells long.
FIGURE
Skeleton of figure
1.
II.
Pelvis.
(One-third Life-size).
(After J. G. Walter, op. at.)
FIGURE
Division of joints
in.
German
Tiif.LXWI
K.Mnrliit's HainLallus.
II .lull
A Marlin
ifl&-
S^PiUt:^^.
^U^.
oJ-vuyt. ^.M-ft-w
Taf^ L'XXMI.
=.^1
A'
MiirlniH linn<liilUis-
I! .hill,
.IMurtin
CM.
SxTEi.,
PLATE LXXVII.
FIGURE
I.
Transverse presentation in the Uterus laid open during the seventh month of pregnancy.
{Afler
a.
b.
H. Fr.
Decidua.
Chorion.
c.
d.
Amnion.
h.
Vagina
laid open.
The
letters
do not correspond
to the
drawing.
FIGURE
II.
Transverse presentation with prolapsed arm, head to the right, feet to the backwards.
(Diagrammatic).
left
and
Taf.
LXXVIH.
Pii2.
li^.3.
Fig.
.5.
P^.
Murtrn','; JJaitr/afhus.
KA^itl I'.AMarrin.
PLATE LXXVIII.
FIGURES I IV.
The
diflFerent stages of
spontaneous expulsion.
1878, p. 540.)
{After Spt'egelberg,
Manual of Midwifery,
FIGURE
V.
Archivfiir Gyndkologie,
Band
ii., s.
in.)
Taf. [,XX[X.
V\f>
1
.^^-
%. *?>
"^
;
'*^.,.^'-'
Fig -2.
A' .V/i)/7//r.i
llt}}itliiliti.i
// .liifl.D..
I.Mai
lin-
iXK. SAiUt^.
^ud. oJiiit
fSjj^Cin
PLATE LXXIX.
FIGURE
I.
FIGURE
II.
T:if
I.
XXX.
Fis
Fi^.2.
K. Marlins Haiulnllui:
II .lufl. v.
I.
Martui
PLATE LXXX.
FIGURE
I.
cavity.
b&.
FIGURE
II.
Antero-posterior contraction of the Pelvis from rickets, with unequal sides of the pelvis from scoliosis of the lumbar and sacral vertebrae with projection inwards of the left acetabulum.
nil
i.x.wi.
Fi.I,
Fifi.2.
A'
Martm's llnndnllu
Il..lfl. ,..[.
.)/,.
PLATE LXXXI.
FIGURE
I.
Antero-posterior contraction of the pelvis with sinking of the promontory and projection inwards of the acetabula from old-standing rickets.
(Pseudo-osteo-malacic pelvis).
FIGURE
II.
by
spondylolisthesis.
PI. 2.)
H. F.
Kilian,
Mannheim, 1854,
Taf.LXXXIl.
Pifi.l.
Vi. 2
E.Murhn's Hundallui:.
//..-Iiif/r.
A.
Martin.
PLATE LXXXII.
FIGURE
I.
FIGURE
II.
Taf IJOCXni
Fifi.l.
Fig. 2.
Fii.3
K.
Martin's llnmlulla.i
II At: fI
A. Martin.
(.%((,-
^ni
PLATE LXXXIII.
FIGURE
I.
ing labour.
Berlin, 1870.)
FIGURE
The same
II.
pelvis seen
from above.
FIGURE
The same
III.
Taf. LX\.\1\
Fii.l.
Fig. 2.
v..
Muriiir^ lltluilus.
II
.Uin r
,1
Mul
I, II
tlfft. S.iiuitj,*.
M\\\
.0-.I..-I
.'I?"
PLATE LXXXIV.
FIGURE
iliac
I.
Transverse contraction of the pelvis from early acquired anchylosis of both sacrosynchondroses.
Pragel Vierte^ahrschri/t.
lSS4,
II
Band.)
FIGURE
II.
( After Eli de Haber prces. Fr. C. Naegele, Diss, exhibens casum rarissimum partus, qui propter exestosin in pelvi absolvi
non potuit.
Heidelberg
830. j
1!
Taf.
LXXXV,
Fig. 2.
A'
Martin
Nrinchtlui;
// Jiifl. p. .1
Martin
PLATE LXXXV.
FIGURE
I.
left
sacro-iUac synchondrosis in
of the
FIGURE
II.
left
sacro-Uiac synchondrosis,
Mainz 1839.
Plate 5).
I:
Fii.l.
Tiif^
L.WXM
Fig. 2.
Martin'
>:
A Mailni
PLATE LXXXVI.
FIGURE
I.
the bony-
anatomical
.
museum
at
Bonn.
Plate 4).
H. Fr.
Kilian.
Drawings of nnv
pelvic forms
Mannheim 1854.
FIGURE
Contraction of the pelvic cavity
II.
by bony cancer
in a
delivered for
(The pelvis
I,
is in
Forster.
Accompanying text of E. Martin, on cancer of the pelvic bones 1 85 I. Bd. Ill Heft 4).
Taf
LXXXVU
"1.
''k
":
\i
.:-'
/i'
Marliir.s ItaiuliilluK.
II
, lull.
:i.
A. M'ai
lin.
PLATE LXXXVII.
FIGURE
I.
Lumbo-sacral kyphotic
(After Hoening, Contribution
to the study
pelvis.
Bonn 1870^.
FIGURE
Funnel shaped
II.
pelvis.
BandY.
1877^.
FIGURE
Cleft pelvis seen
III.
from the
front.
Ed. 4 1872/
FIGURE
Cleft pelvis seen
IV.
from behind.
cit.)
Taf.LXXXVUI.
Fi*.l.
Fi.5.
Fig-
i'i.6.
Fii
\-\t. I-
E.ylarlin'H llnmlallus.
//
.hlH
7'.
.1
.Mai
lin
Clfft.
S^rviUie,. ^Ufi,.cDu.'t
Sit^CiA
PLATE LXXXVIII.
FIGURE
I.
(From a photographic
stereoscopic illustration
of a preparation
)
in the collection
of pelves
in the Berlin
obstetric clinic
FIGURE
II.
FIGURE
III.
FIGURE
IV.
FIGURE
V.
FIGURE
VI.
FIGURE
VII.
Tafl.XKXK.
'^-....i^^'
PLATE LXXXIX.
FIGURE
Front- (Figure
girl
1),
I.
Side- (Figiire
2),
3) of a
Kyphoscoliotic
menstruated, and
(4//eT
Vdt,
Clinical Contribution.
und
GjmcBCologie,
bd.
ii.
1877,
s.
118).
The
girl
aged 14^ years had noticed the prolapse " some time."
The
anterior
The broad
os uteri
was
ulcerated.
The whole
both
was
6 centimeters
long, on
felt.
with a
The
The Diagonal
20,
S,
centimeters.
Pelvis
remarkably
slightly distorted.
Spinae
o centimeters, Cr.
TafXC,
PiE.l.
Fig. 2.
d
{/
--vt
M:
.'
:^^---
A'
Martin's lltinilullus.
II .hifl. r. .1.
Marin
C1C6. Sf<'iu^^.
^u(l. c0hm.
.'Si^-On
PLATE
FIGURE
(After Kehrer.
XC.
I.
On
ihe impressions
in
new-lont children.
14 Jahreshetichl
da
mid Heilkundc).
of a kitten 4 days
old.
Kehrer made a trough-shaped impression in the left parietal bone After eight days as it appeared to have healed, he killed it.
a.
b.
e.
External surface.
Internal surface.
Point of rupture.
FIGURE
II.
At
and open-
Parallel
and
fine fibrous
vascular,
d.
e.
cells
Network
of bone substance,
of fracture.
FIGURE
III.
Cranial impression.
{After Dohrn,
On
the
way
in
Archiv fiir
82).
in
The
week of pregnancy in a primipara with a was born in the first position at the end of \%
The whole
of the
left
surface. of the
denuded and pushed forwards. The parietal bone is under the frontal bone. On the left parietal bone is a furrow 6>, 5 to I, o centimeters broad, beginning near the It takes an almost rightanterior fontanelle and ending beyond the parietal eminence. angled curve forwards and ends between the squamous and coronal sutures. The left parietal bone had been indented by the promontory of the sacrum, this was not caused by projection of the promontory but by sinking of the occiput, so that the parietal prominence impinged on the sacral promontory as it entered the pelvis.
cranium
is
PLATE
XC (Continued)
IV.
FIGURE
made
The head which was delivered in the first position through a flat pelvis presents a deep furrow in the left parietal bone beneath the frontal bone. The left parietal bone is indented and displays a deep depression involving the parietal eminence slanting from above and behind and running forwards. The depression is about i centimeter in depth with fissures diverging from it over the upper half of the parietal bone. The child was living and was discharged from the hospital with its mother apparently
in
good
health.
FIGURE
V.
Cranial depression.
After A. Martin,
On
of the antero-conjugate
s.
diameter.
30).
in the second position and expelled by very powerful pains. The weighed 3,400 grammes, and was well developed. Cranial bones firm. Sutures narrow. Two centimeters below the right parietal eminence is a dark red depression i, 2 centimeters broad and o, 8 centimeters long with a wide red areola. From this depression a bright red colouration extended forwards towards the coronal suture from which spot it turned downwards as far as the right zygoma.
child
In
narrow conjugate (through which the broad posterior half of the cranium could not have passed), and allowed of the passage of the foetal head through
the pelvis.
FIGURE
View
VI.
of the point of depression in the left side of the foetal head in figiire 5.
left
On
the
is
pushed underneath the right, is a pale depression eminence in the semicircular line.
PLATE
FIGURE
XCI.
I.
Chamberlain's Forceps.
FIGURE
II.
Palfyn's Forceps.
FIGURE
IIa.
FIGURE
III.
FIGURE
IIa.
English lock.
FIGURE
IV.
FIGURE
IVa.
'I'nf.
xr(.
Fio
1 a
^^UA/^I
Taf. XCII.
/A
I^lc43-Un's lidtid-aHu'S
JI.AilFL.
u.A.Martin.
&.
h<^'^''f'-i
--t^ii^. cSAA^jb,
c?3m-&a
PLATE
XCII.
I.
FIGURE
FIGURE
II.
FIGURE
III.
FIGURE
IV.
FIGURE
Balloon for
artificial
V.
FIGURE
VI.
sizes.
FIGURE
VII.
FIGURE
VIII.
FIGURE
IX.
Blunt Hook.
FIGURE
Key-hook
X.
after C. Braun.
FIGURE
XI.
Blot's Perforator.
FIGURE
XIII.
Naegele's Perforator.
FIGURE XIV.
Trepan-shaped Perforator with bayonet socket of the crown after E. Martin.
FIGURE XV.
Trepan-shaped Perforator after C. Braun.
FIGURE XVI.
Bone Forceps
after Mesnard-Steln.
PLATE
XCIII.
FIGURE
I.
FIGURE
II.
FIGURE
III.
Ideler.
FIGURE
IV.
FIGURE
V.
FIGURE
VI.
FIGURE
VII.
after J. Veit.
Taf. XCIII.
Fii
1.
Fi
3.
CM. SAOA^,
gUK,. c5Ajt.
c^c^v
raf XC'IV.
K.Hardn:,-: HunduHiu-^
If.Au.n.
j>.
A MaHin.
Si/cfiMja^,
S^.
dtAik. &civ(lcu
PLATE XCIV.
FIGURE
C.
I.
FIGURE
II.
Sims' Speculum.
FIGURE
III.
FIGURE
IV.
flgs.
4a and 4b.
FIGURE
V.
Uterine Sound.
FIGURE
VI.
FIGURE
VII.
FIGURE
Curved
VIII.
Scissors.
FIGURE
Scissors for incision of
IX.
at the handle after Schroder.
Os Uteri curved
FIGURE
X.
FIGURE
XI.
FIGURE
Sharp Curette
XII.
after
Simon.
Recamier's Ciirette.
FIGURE XIV.
Uterine Medicator after E. Martin.
FIGURE XV.
Bath Speculum.
FIGURE XVI.
Speculum
for irrigating the
Vagina
after
von Preuschen.
FIGURE XVII.
Dilator after Greenhalgh.
FIGURE
XVIII.
FIGURE XIX.
Double Knife
for incision of the
Os Uteri
after E. Martin.
FIGURE XX.
Double Knife
after Greenhalgh.
FIGURE XXI.
Knife for incision after Sir James Simpson.
FIGURE
XXII.
FIGURE
Intra-uterine
XXIII.
FIGURE XXIV.
Spring Stem Pessary after E. Martin.
PLATE XCV.
FIGURE
I.
Clinical History
edition.
P. Symphysis pubis.
B. Bladder.
U. Urethra,
drawn almost
vertically
downwards
to
open
in front
A.
FIGURE
Fibroma
{After
II.
TJteri.
R. Barnes,
op. cit.)
Large
uterus.
fibroid tumours,
one
in
The
uterus
in
the
PL. XCY,
Fig. 1.
PL. XCVI.
Fig. 1.
Fig. 2.
PLATE XCVI.
FIGURE
I.
R. Barnes,
op. cit.)
(One-third Life-size).
(From a specimen
V.
in the RadcliflFe
Museum, Oxford.
OM.
Os
uteri,
it
also distended.
FIGURE
II.
Atresia Vagiaae.
(After
R.
Barnes,
in St.
op. at.)
From a preparation
George's Museum.
(Half Life-size).
U. Dilated uterus.
V.
The Fallopian
PL. XCVII.
Fig. 1.
Fi?. 2.
Fig. 3.
PLATE
XCVII.
I.
FIGURE
Atresia of Vagina.
{After R. Barnes^ op.
cii.)
R. Rectum.
B. Bladder.
U.
V.
Uterus.
Cul-de-sac at vulva.
and
FIGURE
II.
Retro-uterine Hsematocele.
{A/ier R. Barnes,
U.
op. cit.)
The
A.
The haematocele
and the small
bounded above by
plastic
effusions
intestines.
FIGURE
Extreme
III.
(After
R. Barnes,
op. cit.)
(From Nature\
section
is
made through
the centre,
showing atresia
in
PL. XCVIII.
Fi?. 1.
Fig. 3. Fig. 2.
Fig. 4.
Fi-. 5.
PLATE
XCVIII.
I.
FIGURE
FIGURE
Long Forceps
after
II.
Robert Barnes.
FIGURE
Craniotomy Forceps
III.
after
Robert Barnes.
FIGURE
IV.
FIGURE
V.
OMEi)
FEB
1 8 198^.
BIOMED
BIOMED UB.
FEB
IpM
JUL 2 9
1987
APR
1 1988
AUG
1 8 1988
Form L9-52M-7,'61(01437s4)4-Ji