File:Gynaecology for students and practitioners (1916) (14781000142).jpg

Identifier: gynaecologyforst00eden (find matches)
Title: Gynaecology for students and practitioners
Year: 1916 (1910s)
Authors: Eden, Thomas Watts, 1864-
Subjects: Gynecology Gynecology
Publisher: New York : Macmillan
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons

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ghing. The structure of the membranecan be determined by taking a portion for microscopic examinationand cutting sections at right angles to its surface. The nature ofthe epithelial covering is the point to which attention should bedirected. The external surface is in all cases covered with stratifiedsquamous cells of the same type as the vagina ; the internal surfacemay show traces of columnar epithelium ; and, according to BlairBell, it does so in over 50 per cent, of cases. In some instances thisepithelium forms a well-developed layer with small glands. Accordingto the same authority such cells indicate that the membrane has been ^ See footnote on page 84. 174 GYNAECOLOGY formed from the Miillerian duct, at any rate in part, for the hymenitself never contains columnar cells. If the membrane is coveredwith squamous cells on both surfaces it is a true imperforate hymen ;if columnar cells are found on the inner surface, the Miillerian ducthas not been canalized at its lower extremity.
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Fig. 96. H.^matocolpos (showii diagrammaticalh^), after CuUingworth. The cervical canal is also dilated up to the level of the internal os. Note the elongation of the urethra and the elevation of uterus and bladder. Occasionally occlusion of the ostium vaginae results from vaginitisin infancy, leading to adhesion of the apposed surfaces ; this formof occlusion is usually incomplete and does not lead to concealmentof menstruation (see Fig. 93). Sometimes occlusion of the vagina orcervix may be acquired in adult life as the result of sloughing andsubsequent cicatricial contraction ; but this again seldom leads tothe occurrence of cryptomenorrhoea. The accumulated menstrual blood distends the whole vagina PRIMARY AMENORRHCEA 175 (hsematocolpos), which may become gradually dilated until it containsfrom two to three pints of fluid. A large hsematocolpos forms adome-shaped swelling, palpable per abdomen, which may reach ashigh as the umbilicus, may fill the entire pelvic cavity compressingt

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