File:A textbook of obstetrics (1898) (14757794946).jpg

Identifier: textbobstet00hirs (find matches)
Title: A textbook of obstetrics
Year: 1898 (1890s)
Authors: Hirst, Barton Cooke, 1861-1935
Subjects: Obstetrics
Publisher: Philadelphia : Saunders
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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und on the polypoid elevations.The whole membrane is greatly thickened, which, as a micro-scopic examination shows, is due to the great hypertrophy of theconnective-tissue elements and to a great increase in the decidual 1 D. I., Marburg, 1869: 2 Op. cit., p. 402. 3 Die Krankh. Geschw. Ueber Hyperplasie der Decidua.Bd. ii, S. 478. THE DECIDUvE. 147 cells, which contain nuclei of enormous size. The connectivetissue forms fibrous bands constricting the openings of the uterineglands, as well as the blood-vessels in the diseased membrane ;and yet the whole decidua is exceedingly vascular. In Virchowscase there was a syphilitic history, and, therefore, he ascribesthe disease to syphilis ; in other instances no cause whatevercould be discovered, but often this disease, as well as otheraffections of the decidual endometrium, depends upon a pre-existing chronic endometritis. It is a disease of young ova, andfrequently the chorion villi implanted in the diseased mucous Tuberous projec- -tions.
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:<■ Uterine wall. „* Decidua. Fig. 115.—Tuberous subchorial hematomata of the decidua (Walther). membrane are in a condition of myxomatous degeneration.1 Inall the cases hitherto described the ovum has been expelled atthe end of the second to the fourth month of pregnancy (Schroe-der). Polypoid endometritis is closely simulated by bloodextravasations between the decidua and the chorion, as shown infigure 114.2 Catarrhal Endometritis.—A chronic inflammation of the de-cidual endometrium will occasionally affect chiefly the glandular 1 Midler, Bau der Molen, 1867. 2 Walther, Centralbl. f. Gyn., ii )2, p. 707. 48 PREGNANCY. elements of the membrane, with the result of a hypersecretionof a thin, watery mucus, which, collecting between the chorionand deciduae, may be suddenly expelled, after a rupture of theovular decidua, in the later months of pregnancy. This oc-currence gives rise to sudden gushes of fluid from the vagina,which may reach a pint in quantity. Afterward the fluid

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