52Tr2

MARTIN'S ATLAS
OF

OBSTETRICS AND GYNJICOLOGY

EDITED BY
DOCENT

IN

MARTIN

A.

THE UNIVERSITY OF BERLIN

SECOND E...
17

PREFACE TO THE FIRST EDITION.
The numerous

works on Midwifery, deal, with few exceptions, besides illustrain the norm...
Preface.

vi
condition,

I

reduced their number

a minimum, retaining those only which seemed

to

I class as diagramhand...
Preface.

vii

view on page
I have begun with the anatomy of the pelvis
ff.
and female sexual organs; then follow the deve...
PREFACE TO THE SECOND EDITION.
The

first

already

edition of the Hand-atlas

commenced a new

the subject.

If I

editio...
Preface.
the Berlin clinic, wlnich

made

I

to

reproduce

Had

year 1872.

in the

should have been forced to reject

ix...
PREFACE TO THE ENGLISH EDITION.
When

asked

to the request

number

to

undertake the translation of Martin's Obstetric A...
CONTENTS OF PLATES.
PLATE
Fig.

I.

„

2.

Female

pelvis with

its

I.

lig-aments seen from above.
throug-h the pelvis t...
Contents of Plates.

xii

PLATE
Fig.

VIII.

Dissection of vagina, uterus, Fallopian tubes, uterine ligaments and ovaries....
Contents of Plates.

PLATE
Fig.

I.

xiii

XVI.

Female mammary glands.

,,

2.

,,

3.

Side view of female breast.
Lacti...
Contents of Plates.

xiv

PLATE
Fig.
,,

„
,,
,,

„

XXIII.

Internal org-ans of an embryo before birth.
FcEtal circulatio...
Contents of Plates.

XV

PLATE XXXI.
Fig.

„

I.
I

A.

Morbid enlargement of the clitoris.
Follicular polypus of the cerv...
Contents of Plates.

xvi

PLATE XXXVIII.
Fig.

Cleft uterus with double vagina, in a young woman ag-ed 30.
Uterus, divided...
Contents of Plates.

xvii

PLATE XLIV.
Fig.

I.

,,

2.

,,

3.

„

4.

,,

5.

Retroversion of the uterus.
Obtuse-angled ...
Contents of Plates.

xviii

PLATE
Fig.

I.

2.

L.

Vaginal portion of cervix with dilated os
polypus can be seen.

The

u...
Contents of Plates.

PLATE
Fig.

,,

,,

„

xix

LVI.

Diphtheritic endometritis in a woman who died fourteen days after d...
Contents of Plates.

XX

PLATE
Fig.

„

I.

2.

LXIII.

Ovarian cyst with gelatinous contents.
cyst as in fig. i, opened i...
Contents of Plates.

PLATE

xxi

LXXI.

Placenta of twins with compressed fcetus.

PLATE LXXn.
Fig.

I.

„

la.

,,

2.

,...
Contents of Plates.

xxii

PLATE LXXVIII.
1-4.

Fig.

The

different stages of

spontaneous expulsion.

Labour with the bo...
Contents of Plates.

xxiii

PLATE LXXXVIII.
Fic.

Pelvic
Pelvic
3. Pelvic
4. Pelvic
5. Pelvic
6. Pelvic
7. Pelvic
I.

2.

...
Contents of Plates.

xxiv

PLATE
Fig.

I.

2.
3.

4.
5.
6.
7.

XCIII.

Forceps after E. Martin.
Forceps after Nang'ele.
Br...
Tiif.

A'

.hirli,is ll„ii,l„ll<,^

II

.hin.r.l.Mailii,

cii'iv

s^diM.:i-.£,n. ^rjnoi. rBrviv
.

PLATE
FIGURE
Female Pelvis with
(

its

From KiwiscKs Atlas of Obstetrics,

lumbar vertebra.
B.B. Intcrarticular cartil...
.

Taf,

Fifi.l.

Fig. 4.

Fig.

Fig. 2.

f'v-/

...'-.•wi^

E

yjarlinn lliimhitla a

.

II

.hlfl

.

i>.

.1

.

M

(ii...
PLATE
FIGURE

II.

I.

Female Pelvis from below.
a.a.

Antero-posterior diameter of the pelvic outlet.

b.b.

Transverse d...
.

Taf.

Fj 2-

A'.

Marlin's llaiulalldH. IIAufl.

i:.

I.

Murlin

C^ee, S^ui-ltee.-.

^Wd.ciJMM

.

Ill

JB^,.ti„
PLATE
FIGURE

III.

1.

Second Aperture of the Female Pelvis, or the so called largest diameter(7.(7.

Transverse diameter...
Taf,

K

I

E.Mfir/iii.--

HiniihiUn.'i.

UAll/7,

v.

A. >Inr/.

zA^tb. S-cruu-te/t^ S^yUv. S'vu>t. D3,<4

I'i,
PLATE
FIGURE

IV.
I.

Pelvis with the soft parts.
( Drawn from Nature.)
a.

Psoas Muscles.

b.

Abdominal Aorta.

c.

Asce...
T;if.

Fi.U.

Fk- 4
Fiv.;i,

a^
FiO. 2.

d

A'

Miirtiiin Ihiiiilalltm. II .hill, r

.

I

Martin

!.{($.

ScCxnCxe.. £,-U...
PLATE
FIGURE

V.
I.

External Female Genital Organs.

Mons

a.

veneris.

Labia majora.
c.c. Labia minora.
(The letter t/w...
Tnf

PiE

A'

Marliiin

.

.

VI

1

llni„liilla.s.

II

.lull r.l. .Vlariin

Llff). Scl-mtfLS^.

^itd,

aJ-KiA-- iB^t-iiM
PLATE

VI.

FIGURE

I.

Section of the Abdominal Cavity of a middle-aged Multipara.

{Normal

position

of the parts after...
ViO

1

Vis. 2.

"^

F.

Marlu,„ Hiunlal/u..

1/ .lull.,.

.I..Ua,l,n
.

IfC

S^(vCU-;t.e,.

^U(i c0„M

„.
.

.'Rtr in

t
PLATE
FIGURE

VII.
I.

Perpendicular Section of the Viscera of the Female Pelvis.

(Half the Natural

Size).

{After O. Ko...
Tiif.M
Fi... I.

,.,^'

Fio. 7.

r'

,rfJiis*»»»r:K=S?

Pii
Fi').

./

().

A

F.

Marliiin

ll,i„(lall(is

II

Aiifl

,.
...
PLATE

VIII.

FIGURE

I.

Dissection of Vagina, Uterus, Fallopian Tubes, Uterine Ligaments,

and Ovaries.

(Two-thirds Lif...
PLATE YIU.—(Continued.)
FIGURE

V.

Well-developed Uterus of a young woman.
(Life-size).

6.

Fundus uteri.
Body of the ut...
Taf. IX

Fig. 2.

fA

Pi^.4.

t

Fie. 3.

K.yiiirUi.x IlinHladu.-.

II

.lull r .l-Mailiii

.'WS

.

S.cfi,at««,. JH,

1

...
PLATE

IX.

FIGURE

I.

Internal Sujface of Uterus soon after delivery at term.

(Two-thirds Life-size).
{A/ier Moreau, op...
Taf.

[',.

Marliirx llaiuladas.

ll.AuI'l. n.

.

I^

Marlin

.

aeg

.

S,sfi,u,Ue..

^U-R

.

c£Ii.i^,

^Sij-A&

X
PLATE
FIGURE

X.
1.

Peritoneal Tolds of the Serous Covering of the Uterus as shewing the direction and
expansion of the r...
<#^.
Tal.XI.

K. Mtirtiirs Hiniiiitdijs

IIAuH. V .I.Mai

tin

1C6.

Sifu^p^e. ^iHl .Du.A

.

,'Bivr Cii
—

PLATE

XI.

FIGURE

I.

Arteries of the Uterus.
(A/ler Hjril.^

Corrosion-Anatomy ami

nsulls,

ils

JVt «//<;,

Unilat...
r,if.

Pi£

.

ii.

1

•>/:'•

K Mnrlins

Ihuulathn:

II All 11 r.
.

.

I.

Martin..

eXf&. S^aiitee.,

£iM £I^^M

.'B^Ei...
PLATE
Cervical Ganglion, Sacral
(After Frankenhaiisen.

XII.

and Uterine Nerves of the

The Nerves of

the

left side

of...
Fii.i.

Tnr. ||[,

'i-r

'^n^*^-

He

mi'-u

Fig 3

f


*

/•'

Mnrt,„ Hnn.lallu^.

Il..h,n. f. A.

Martin

I

Fis.2.

aC6...
PLATE
FIGURE
Mucous Membrane
(Afler G. Leopold.

XIII.
I.

of the Uterus on the first day after Menstruation.

Sludics on ...
)

PLATE XllL—(Continued).
FIGURE

IV.

Fresh Corpus Luteum from 8 to 9 days old, 8 to 9 days after commencement of
HsBmor...
Taf.XIV

Fi£.l

y-r

Ph

#'^

4^^

'm

^-<
''m

Fig. 3.

£:^

E.yiurliiiH Ifainlatlas- II AtiH.

v.

A.

Martin

vM.

S^fU...
PLATE

XIV.

FIGURE

I.

Lymphatic Vessels of the Non-pregnant Normal Uterus.
The lymphatics of the normal unimpregnated

...
Taf. XV.

Ti^.l.

Fia.l'.

/

!:

yictrtiini lltiiij.illu^. II

AufLij.A.MarUr

(lu;.

.^sci'iui,-..

->',

n;

<rtM,rt.

...
PLATE XV.
FIGURE
Mucous Membrane

of the

Body

I.

of the Uterus at the fourth

{After G. Leopold, op.

month

of Pregnan...
.

Taf. Xl

Fi'i.2.

Fii.l.

['is,

1-

-^(B^

A'.

Murlin's llnndallus.

I/..

lull. u. .1.

AJui

tin.

Clf&. S*ft-u*it^...
PLATE

XVI.

FIGURE

I.

Female Mammary Glands.
(After Jules Cloquel,
a.

Mucous

c.

Analomy, &c., Obstetrical Demonstrat...
,

Tar.:s:vE
Fi^.

1.

Fi(5 g
dvcL

E. Marlins

Hn „,/,.!/,

,.-,-.

H A77/?

.

n A. Mnr/

I

fA

,?;,(',

A ^r f lU^, (3...
PLATE

XVII.

FIGURE

I.

Mucosa changed by the development
and Reflexa.

Surface of the Uterine

of the Deciduse Vera

(L...
PLATE

XVU.—(CoiitmuciI).

FIGURE

II.

Diagrammatic Transverse Section of a Pregnant Uterus, a few hours after the
Embryo...
PLATE

XVIII.

FIGURE

I.

Mucous Membrane developed into Decidua at the
6th week of Gestation.

Section of Pregnant Uteru...
<-rll„..-

Taf.XWll

Ha,,.l..tln.-._

nAiif/. u A. >Tnrl

fJltk. S-r^hCUv-t^ ^•iL.r-iM
1
PLATE

XVUl.^(Coniinned).

FIGURE

IV.

Placenta from the Internal Surface.

{A/Ur W. Hunter).
vascular branches to the in...
PLATE
FIGURE

XIX.
1.

Pregnant Uterus at the commencement of the 5th month from behind.
(One-third Life-size).
[ After

W...
T.-if.

XIX

fc>-

^S^-

^

^
A

/','

/-

71'''^

^"* 'f'

1

-l

'^-

1

^^O'

f^

Martins Handatlas.

//Jufl.z/-

A Mai...
i
Tnf X.
.

FiE.l.

A'

Marlins

//iJ,n/at/as.

H .hiH

.

r. .1

Muilin

CU&. SffUvfew.. Xuti.aXi,^.. tri^tin
PLATE XX.
Side view of Abdominal Cavity laid open after partial removal of the large
Omentum in a Woman far advanced in pr...
I

.

Fitf. 3.

Taf.XXt
FU>. 2.

Pi 6.

1.

3

Pio. 4.

E.M,n-Nn-.- Hni,,h.H,,.s.

UAuf/. a

A.

Mnrr„<

iJIM.

S-cPi

I'....
PLATE
FIGURE

Human Embryo

XXI.
I.

at the 9th

week,

(Life-size).

(After Sommering, Kiliatis Atlas of Obstetrics).

FI...
;if.

X.

""^

"->'

^



E.yhirtin« llninlatluH.

II

Jul'l r

A

.-J

uilui

.

t'tl6.

SilUitf.e. „fitfi

c^iii,

Xll.
PLATE
Human Embryo,

XXII.

Funis, and Placenta, with

its

Membranes,

lunar month of pregnancy.
(Life-size).

(After Som...
.

T;if.

Fi£

.

Fig.

<;

5.

will.

Fii.4

::p

Fis.l.

/

"^-^

w

A'

Marlin's /Irnidiillun

.

II

.lull n. .1
.

.
...
.

PLATE

XXIII.

FIGURE
Internal Organs of an
(After
a.

Funis.

b.

Embryo

Monau.

Umbilical arteries.

c.

d.

I.

e.
...
PLATE XXIIL— (Continued).
FIGURE

V.

Meconium seen imder the microscope.
(A/Ur

C. Ruge).

This drawing coloured by C. Ru...
PLATE XXIV.
Section of a normally formed Pregnant "Woman about 25 years old, after death from
hanging.
( W. Btaune, Alias ...
T;if..XI-.

Miirlin's llaiuliidus. II Alill.li. A.^tlaitin..

Cit^^ SdMf^.e^.

^M

GJ^Mt.lB/yi&if.
.

Taf. X-.

'^«--

A'.

.Martifi's Uaiidiillan

.

H .lull

.

i>.

.

/.

.Martin.

CTf&. ScKii-tx^c ^Itfi, tOuM^. Uoz-r...
PLATE XXV.
FIGURE
Uterus with Foetus in
{After W. Hunter

first

head presentation.

and H. Fr. Kilian).

FIGURE
Uterus wi...
Taf, XX-1

1m6

:!

o.t.-i

K Matiiu's Hinidalliin

II

.

lull

-

r. ./,

Marlin

I'Uf.. SiPuU.-.s-. i'iH;

.'iii-i

^"i...
PLATE XXVI.
FIGURE
Body

Section of the Frozen

of a

Woman
(After

in labour during the period of expulsion.

Bratine).
P...
if.

Fk.

XWI



(

^

I'ls-,:'

.j:

i:.M„rh,i llf,,„iall„s

II

'lull

,.

I.

Mai

In,

CW-^ &c)Mr.<^.±M- SuaX..^mZlvy.
PLATE XXVII.
FIGURE

I.

The engagement of the Pace descending
{A/ier Schroder.
u.

Urethra.

(The

Text hook of Midwifery...
'M.

XWI

i-ia.2.

Fig 4.

E

Marlin-x llaiulailus

//

.la/t

r.

A.Mariii

Fifi.l.

(.nil,

SctUltee-. J'U.fi,.r<M^l

I'...
PLATE XXVIII.
FIGURE

I.

Occipital presentation.
(After Olshausen.

On

the supplementary diagnosis

moulding of the skul...
'nf

f,

Marliit's [luiidatlus.

II Aul'l.

i'.A.

Merlin

cM.

S*fi.i.UA£.. ^i.'Hi.cCJvu.i

.

XXK.

.'ir'^tC-i
PLATE XXIX.
FIGURE

1.

Uterus with Twins in Cranial and Breech presentation.

(Two

Ova).

{A/ler Smellie).

FIGURE

II.
...
Tnf.

XX,

%

T

K Marlins

ilnn(/ul/ci s

11

Aul'l

.

f. .1

.

M

(iltui.

.

KJ

^Xtt,-

SAiaxc-.

1M',. cju^l:

•

^...
PLATE XXX.
FIGURE

I.

Inflammation of the Mucous and Sebaceous Glands of the Vulva.
{A/Ur P. C. Huguier.
Genital Organs o...
T;,f

.

XXXl.

I
^,*=.

...

V

^
-'?.-

-*°*A

.JW;,fe.-"....

^

/"^

Fse,i_

-'.w

K.Martins llaiulullas

II

Aiill.v
...
PLATE XXXI.
FIGURE

I.

Morbid enlargement of the
{AJ'lcr

Clitoris.

Atlas of Drawings of Theotetical and Practical Midmf...
T,if,

XXXII.

.^^!S^.

C ^^^^2^-'.

/•;

MartniS

Iliin.lalUi ^

.

II .lull.

! .I.Ahuliu

k

Hf..

SlIiuC.c.

.JS'iMi

...
.

PLATE XXXII.
FIGURE

I.

Lupus of the Vulva.
(From an Original Drawing).

(Half Life-size).

(By

the kindness

of Dr.
...
w
.

Tnf XXXIII

/>^

^

hi
k

1-12

4

^iW

W
¥

V^^

Fi£.5.

^..cpWf'Sr^-^'l^

J

K Marlins

lluudallas llJufl .i: A.

.i
...
PLATE XXXIII.
FIGURE

I.

Malformation and Occlusion of the External Female Genitals in a new-born chUd.
{After Aug. Fr. G...
.

[if

XXXIV.

^f:^.K-

^':^i

"»s..

J,

-A.

%

^

K.Marlin-a Hanclallus.

II

.Udl .u. AMarlin.

df^.

.'?-(:A,ilt-x^....
PLATE XXXIV.
FIGURE

I.

Occlusion of the Vaginal Oriflce (Atresia hymenea) with displacement forwards of
the Anal opening...
T,if.

Fie

XXXV

ViA.2

]

¥i6.4.

/','

Miirtiiis llaiu/allus

II

Aiifl

.

v.

.i

M

(iitiix

.

t-liffi

Sci'xiU7.c....
PLATE XXXV.
FIGURE

I.

Prolapse of the Posterior Vaginal Wall.
{After R. Frura'p, Surgery.
a.

Section throug'h the symph...
Td XX.WI

Fifi.l.

xr%^>r --^^

Fi'i.2.
/'

^3=*^:.

>

r^?;

f^x

,,;a.^«-

.^'

^.^_

.^

-Fin.

K

-'J-7tl.
*"&

Mclrli...
PLATE XXXVI.
FIGURE

I.

Vagina and Uterus divided by a Septum.
{A/ier Eistnmarin.

Tab. anal, uleri duplicis, ohserv., ra...
PLAT E XXXVI .—(Continued).
FIGURE

IV.

Pregnancy in the Left Rudimentary Uterine Horn, mistaken

at first for

Tubal

Ge...
PLATE XXXVII.
FIGURE
Rudimentary Horn united by a

solid

band with the

enlarged by pregnancy.
{After J.

Chr. Stan.

Czi...
.

I'iif,

1-1!;

'v:

:,

XXXI

1

/<rf^i
Fij.

(;

1^-.
^--

A'

Martins lliindattus

.

II

Autl.

o.

.-I.

Mai

ate.
...
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
Atlas of obstetrics and gynaecology
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Atlas of obstetrics and gynaecology

  1. 1. 52Tr2 MARTIN'S ATLAS OF OBSTETRICS AND GYNJICOLOGY EDITED BY DOCENT IN MARTIN A. THE UNIVERSITY OF BERLIN SECOND EDITION Translated and Edited with Additions 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. PHILADELPHIA PRESLEY BLAKISTON, 1012 WALNUT STREET 1880
  2. 2. 17 PREFACE TO THE FIRST EDITION. The numerous works on Midwifery, deal, with few exceptions, besides illustrain the normal state, almost exclusively illustrated and the female genital organs with the development of the ovum and the uterus tions of the pelvis foetus, the obstetric Not only are instruments, and the during' pregnancy, the positions of the operative manoeuvres required and of the the illustrations of the foetal positions, frequently diagrammatic, and obtained by placing the phantom or in its Obstetrics. most in various positions in a but the works themselves afford an insufficient insight into those pelvis, knowledge of the gynoecologist. conditions necessary to complete the be considered dummy in obstetric operations Midwifery must natural relation to the conditions of the other female sexual functions, 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 the various physiological organs, and consequently On in its relation to gynoecology. these grounds, then, that the pathological and physiological conditions sexual organs should be represented in the various phases of their functions, the of the publishers for an atlas of obstetrics often felt the want of an the lecture, at a is useful been anxious to place my lectures. physician, it is in my I had annual course of A mere passing glance so I had long of drawings to illustrate insufficient. lecture leaves behind no fixed impression. the hands of my hearers a collection But such a collection of illustrations who does me, especially as exhibition of enlarged illustrations or of preparations during and even indispensable, but diagram during a to illustrated description of these subjects in The lectures since 1S38. was very pleasing of the demand is And also of great value to the practising not see gynoecological cases every day, and who seldom has the One look opportunity to study the organic changes seen at post-mortem examinations. at an exact and dearly to his has no time. ful faithful drawing, presents the anatomical condition of the parts more 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- restricted to enable the work execution, of the undertaking, to present to students trated guide to obstetrics and gynoecology, was necessarily to be placed within the reach of a sufficiently large circle of readers. In the first place, the number of illustrations must not be too large. and because diagrammatic drawings only illustrate individual G0a49? On this account, views and not the actual
  3. 3. Preface. vi condition, I reduced their number a minimum, retaining those only which seemed 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 student My On not exhaust the infinite variety of nature. still burdened with diagrams, and is whom teacher, Fr. C. Naegele, judgment his the other hand, the prejudiced by is shall never forg-et, I memory of the artificial theories. used frequently to condemn 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 dominal we should set up so many, thoracic, shoulder, or abwhich, presentations with sub-classes, phantom, although observation in addition to the he has learnt, The may be demonstrated on a which hardly ever come under acrobatic tricks of this kind are resorted childbed, in some it a question is cases, if the student, if to, the who goes wrong when things do not correspond with the theory not to be condemned. illustrations of operative cause they tend true, not to be deplored, or, in is technicalities, is is compilation of fixed rules of action pedantry of the teachers trammelled by When woman. the living in it not without violent distortions, but to narrow the proceedings are equally injurious in my opinion, be- Such operative manoeuvres should student's self-reliance. be taught on the phantom, and where possible the reasons for which they are performed, explained, because only he them out artificial justly appreciates the reasons for The mere looking manoeuvres can carry at such illustrations the state. I who alone in the present condition of science should be tolerated have therefore omitted operative demonstrations, which, after all only represent individual ideas, and never obtain universal recognition. reason which caused me necessary drawings, I the various illustrations, my own The wishes; number of to limit the the illustrations I exclude would have made the work too expensive. have endeavoured to retain those all in some cases, however, he has, contrary concave mirror knowledge, from hypercritics un- In selecting which have best corresponded lithographer, Herr A. Schiiltze, has in general taken pains to carry out to the stone, exactly reproduce the position of the originals. my to observations on the living as well as the dead subject. illustrations with the to and all, For the same have limited the number of coloured plates and have copied existing plates, as original plates with drawn from demonstrations on a phantom, can at the best but produce rule-of-thumb, not reasoning operators, by who a competent manner. in may this; Lastly, as regards the subjects which I but I thought not wrongly blame have kept me for my it years in my so that No desire, my not transferred the several drawings do not important mistake has resulted, duty to mention it here, in order that it. arrangement of the to for to my plates, I have followed the same course of lectures on gynoecology, and which is fully
  4. 4. Preface. 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 set forth in the tabular l, external genitals, the vagina, the uterus, the Fallopian tubes, the ovaries, coats, the placenta, the foetus and its position, the pelvis as the ovarian, an obstruction to 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. and concluded by a short description of obstetric hension of the original plan by the intelligent reader. I hope this compendium of illustrated gynoecology will by students and physicians, and that it may advance meet with a kind reception the study of that department of 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 does not yet enjoy that general recognition which it for the good of the can and must claim. DR. ED. MARTIN. Berlin, August Sih, iS6i.
  5. 5. PREFACE TO THE SECOND EDITION. The first already edition of the Hand-atlas commenced a new the subject. If I edition have only personal matters to delay the fresh material which it, just was out of print before my completed my task, is it I had knowledge on father's death, but which should be abreast of the latest not because I have allowed but on account of the necessity of a thorough revision of had accumulated with the advance of our profession during the last few years. In the new edition I endeavoured, in the drawings by original ones when possible. of the diagrammatic drawings because At the same time it was it I first was impossible to procure trustworthy originals. many interest of the atlas that as to the diagrammatic instance, to replace the have, however, been obliged to retain some 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 modern have I for this reason that In addition to first new were already less accessible to a larger of the old drawings have been retained, of which Only where the originals exist. suppressed the many work latter were essential to a proper comprehension without any regard for the occasional use of the old stones. 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 honoured friend Carl Ruge 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 have, in the new edition, And increased and improved the topographical drawings of the genitals in the various stages of their development, as well as the microscopical illustrations of their physiological and pathological conditions. The plates illustratino- the pelvic conditions have received an important addition in the collection of stereo- scopico-photographic illustrations of selected specimens from the rich collection of
  6. 6. Preface. the Berlin clinic, wlnich made I to reproduce Had year 1872. in the should have been forced to reject ix many not been for the fact that it useful old drawing's to do so, I the pelvic illustrations, especially as in most cases their history all I should have liked was available. Another difficult should be illustrated. me has induced to a was whether or The experience that even not instruments generally, and which, question to retain them. complete armamentarium. It a limited selection was useful in practice was, of course, impossible to furnish even an approach This alone would require a larg-e only given those which have proved useful and trustworthy in atlas. I have therefore our hospital and private 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 practice, gynaecologist uses different instruments in his daily preference for certain instruments is practice, very prevalent. only to give those which appear to have been I and because individual have, therefore, endeavoured more generally adopted. arranging old and new drawings together, sometimes on the same not always possible to place each in its right place. I must apologise for In ground of insuperable father, although I difficulty. As suppress this by the conviction that naturally as it a rule I have not annexed his schema have adhered to the new to the plate, this it was on the my order adopted by edition. I was induced to we are not able to carry out such a combination as might appear, on account of the great advance and development in midwifery as well as gynaecology. In the place of the schema, therefore, I 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 and the willingness he displayed in giving effect to my wishes, and those of the pub- lishers. May the atlas in its new form enjoy the same favour it received on its first appearance. A. Berlin, March, 1878. MARTIN.
  7. 7. PREFACE TO THE ENGLISH EDITION. When asked to the request number to undertake the translation of Martin's Obstetric Atlas, made of students to me, because I and practitioners I have ventured Women, which I to add several work would be welcome to a large who are unfamiliar with the German language, and in English. illustrations thought might be useful. of the obstetric instruments most readily acceded believed the because no exactly similar work existed of I I from my father's work on the Diseases have also inserted illustrations of some commonly used in this country. FANCOURT BARNES. London, ^Kw, iS8o.
  8. 8. CONTENTS OF PLATES. PLATE Fig. I. „ 2. Female pelvis with its I. lig-aments seen from above. throug-h the pelvis to shew the inclination A perpendicular section and median line of the pelvis. ,, 3. ,, 4. View of the right sacro-iliac articulation from behind. The right sacro-iliac symphysis laid open from above. PLATE Fig. ,, ,, ,, 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. „ 2. ,, 3. ,, 4. I. ,, 2. „ 3. ,, 4. Bartholini's „ 3. I. 2. VI. 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. PLATE ,, V. glands. PLATE I. IV. External female genital organs. Outlet of the pelvis after removal of the integument. The vulva with the openings of the ducts of the glands. Fig. 2. Posterior wall of the pelvis. month of pregnancy. PLATE „ in. Anterior wall of the pelvis from within. Perpendicular section through the female pelvis. PLATE Fig. advanced pregnancy. advanced pregnancy. Second aperture of the female pelvis, or the so-called largest diameter. Third aperture, the so-called smallest aperture of the pelvis. Fig. I. Pelvis with the soft parts. „ 2. Position of the viscera at the sixth Fig. IL aged 35, with the VII. Perpendicular section of the viscera of the female pelvis. View of the female pelvic viscera from above. 62
  9. 9. Contents of Plates. xii PLATE Fig. 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 I. 2. ,, PLATE Fig. ,, ,, ,, „ IX. 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. 2. PLATE Fig. I. „ 2. X. 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. Cervical ganglion, sacral and uterine nerves of the PLATE 1. Mucous membrane of 2. Transverse section of the left side of a pregnant uterus. XIII. first day after menstruation. Fallopian tube (middle portion) on the the uterus on the left 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 7. last haemorrhage. Older corpus luteum (5 weeks). Corpus luteum three weeks old. Corpus luteum, seven weeks old. 8. Almost 5. 6. ripe follicle. PLATE 1. 2. 3. XIV. 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. ,, ,, Mucous membrane of 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.
  10. 10. Contents of Plates. PLATE Fig. I. xiii XVI. Female mammary glands. ,, 2. ,, 3. Side view of female breast. Lactiferous ducts and lobuli of the milk g-lands during lactation. „ 4. Two ,, 5. Lobulus of prepared and injected. gland during- lactation (enlarged). lactiferous ducts during' lactation mammary PLATE XVIL Fig. ,, I . 2. ,, 3. ,, 4. Surface of the uterine mucosa changed by the development of the deciduae Vera 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. 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. „ 2. „ 3. XVIII. XIX. 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. Human Human Human Human embryo embryo embryo week. month. at the sixteenth week. ovum at the fifth month and a half. at the ninth at the third PLATE Human embryo, funis, of pregnancy. XXII. and placenta with its membranes, at the sixth lunar month
  11. 11. Contents of Plates. xiv 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 about twenty-five years old, after death from hanging. PLATE XXV. Fig. ,, I. 2. Uterus with foetus Uterus with foetus in first head presentation. in first 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. ,, 3. ,, 4. The engagement of the head descending Cranium of occipital presentation. Cranium of face presentation. Cranium of breech presentation. ,, 5. Lateral curve of the trunk during labour in breech presentation. Fig. ,, I. 2. first. PLATE XXVIII. Fig. ,, I. 2. ,, 3. ,, 4. Occipital presentation. Face presentation. Brow presentation. Antero-frontal presentation. 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.
  12. 12. Contents of Plates. XV PLATE XXXI. Fig. „ I. I A. Morbid enlargement of the clitoris. Follicular polypus of the cervix, extended from the vagina by elongation of the stalk. ,, 2. „ 3. Fig. I. ,. 2. ,, 3. Lupus of the labia, the vaginal Lupus of the vulva. orifice and anus. PLATE XXX n. Lupus of the vulva. Broad condylomata of the labia in a pregnant woman, removed Huginer without causing abortion. in two sittings by Urethral excrescence. PLATE XXX in. Fig. ,, I. 2. ,, 3. ,, 4. ,, 5. 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. Hypertrophic degeneration or elephantiasis of the labia minora and prepuce of clitoris. 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. Vagina and uterus divided by a septum. Two-horned uterus and divided vagina in a ,, 2. ,, 3. virgin aged 17. Left horn of uterus developed together with a rudimentary right horn in a sterile ,, 4. Pregnancy married woman aged in the left 34. rudimentary uterine horn, mistaken at first for 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
  13. 13. Contents of Plates. xvi PLATE XXXVIII. Fig. 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. I. 2. The same preparation opened 3. in front. PLATE XXXIX. 5. 6. Fig. 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 Bulky vaginal portion of the above preparation from below, with obliquely I. 2. 3. 4. the uterus is atrophied. 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. i. ,, 2. ,, 3. ,, 4. „ ,, 5. 6. XLI. 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. PLATE XLI II. Fig. I. Retroflexion of the uterus in a new-born female. 2. Obtuse-angled anteflexion. Obtuse-angled anteflexion. Obtuse-angled anteflexion. Right-angled anteflexion. Right-angled anteflexion. Acute-angled anteflexion. 3. 4. 5. 6. 7.
  14. 14. 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. Partial inversion of the uterus in a woman 30, who died three hours after delivery; viewed from above. ,, 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. ,, 2. ,, 3. ,, 4. ,, 5. Prolapse Prolapse Prolapse Prolapse Prolapse of the of the of the of the of the 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. 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. I. of the uterus, the peritoneal labour. uterine cavity C
  15. 15. Contents of Plates. xviii PLATE Fig. I. 2. L. Vaginal portion of cervix with dilated os polypus can be seen. The uteri, through which an intra-uterine polypus, after division of the anterior wall of the uterus, is seen growing from the fundus. ,, ,, ,, 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. Perpendicular section of the polypus, seen 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. ,, ,, Numerous round 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- 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 i PLATE I. Cancer of the Fig. I. Adenoma ,, 2. LIII. Fig. ,, „ ,, 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. PLATE LIV. uteri. Carcinoma uteri. / PLATE Fig. I. ,, 2. ,, 3. ,, 4. LV. Polypoid adenoma of the uterus. Adenoma. Vertical section from the surface. Adenoma. Section from the neighbourhood of Adenoma. Longitudinal section from surface. the pedicle.
  16. 16. Contents of Plates. PLATE Fig. ,, ,, „ xix 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. 1. 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 days after delivery. PLATE LVIIL 2. Simple erosion. Microscopic appearance of foregoing figure. ,, 3. Follicular erosion. ,, 4. Fig. I. ,, ,, Ulceration of the vaginal portion of the cervix and posterior vaginal cul de sac. 5. Non-scirrhous vaginal portion. PLATE LIX. Ectropion of the cervical mucous membrane. Microscopic section of a papillary erosion. Clinically a suspicious, microscopically a non-malignant vaginal portion of the Fig. I ,, 2. ,, 3. ,, 4, 5, 6. „ 7. Fig. I. cervix. Commencing cancer in a prolapsed portio vaginalis. Microscopic appearance of figure 3, plate Iviii. PLATE ,, 2. PLATE Fig. I. ,, 2. LX. Circular rupture of the cervix and expulsion of the portio vaginalis: Vie*v of the above preparation from below. LXI. Transverse rupture of the upper portion of the anterior cervical wall. Longitudinal rent of the cervix. PLATE LXIL 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. „ Fig. I. ,, 2. C2
  17. 17. Contents of Plates. XX PLATE Fig. „ I. 2. LXIII. Ovarian cyst with gelatinous contents. cyst as in fig. i, opened in several places. The same PLATE LXIV. Fig. „ „ ,, I. lA. 2. 3. Dermoid cyst. plate, shaped like maxilla bearing two teeth. Hair- and fat-cyst of the right ovary. Adenoid tumour of the breast. The chalky PLATE LXV. Fig. ,, I. 2. ,, 3. ,, 4. ,, 5. 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. Compound mammary haematocyst. Compound proliferating cystoid of female breast with serous contents. Diffused arborescent intracanalicular myxoma of the mamma. PLATE LXVI. Fig. I. ,, 2. Bladder-mole expelled at the fifth month of pregnancy. Bladder-mole from a woman aged 28. ,, 3. Internal surface of the cavity of the ovum with the chorion-villi degenerated into cysts. ,, 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. Seat of the placenta at the os uteri. Placenta praevia centralis. PLATE Fig. I. ,, 2. ,, 3. ,, 4. LXIX. Double placenta. Forked insertion of the 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.
  18. 18. Contents of Plates. PLATE xxi LXXI. Placenta of twins with compressed fcetus. 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 ,, 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 „ 5. Absence of one of the lower extremities. Fig. I. ,, 2. Foetal cloacal formation. Monopodia. PLATE LXXIV. Fig. I ,, 2. ,, 3. „ . 4. 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 Male A foetus. PLATE LXXV. Fig. I. 2. 3. 4. 5. 6. 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. (Hernia cerebri). Sympodia. Incomplete development of the finger, so-called self-amputation. One-headed double monster. Janiceps. PLATE LXXVL Fig. I. Double monster. ,, 2. Skeleton ,, 3. Division of joints by exudation fig. I. 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.
  19. 19. Contents of Plates. xxii PLATE LXXVIII. 1-4. Fig. The different stages of spontaneous expulsion. Labour with the body bent double. 5. PLATE LXXIX. Fig. „ Universally-contracted pelvis. Universally-contracted pelvis. I. 2. PLATE LXXX. Fig. Flattened pelvis from rachitis. Antero-posterior contraction of the pelvis from rickets. I. 2. PLATE LXXXI. Fig. Antero-posterior contraction of the pelvis. Section through a spondylolisthetic pelvis. I. 2. PLATE LXXXIL Fig. Transversely-contracted osteomalacic pelvis. I. „ 2. Transverse contraction of the pelvis. PLATE LXXXI IL Fig. Transverse contraction of the pelvis with bilateral sacral anchylosis. 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., Obliquely contracted pelvis from anchylosis of the 2. early childhood. Obliquely contracted pelvis from anchylosis of the shewn from behind. left sacro-iliac synchondrosis in „ PLATE LXXXVI. Fig. I. Pelvis spinosa. ,, 2. Contraction of the pelvic cavity by bony cancer. 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. left sacro-iliac synchondrosis
  20. 20. Contents of Plates. xxiii PLATE LXXXVIII. Fic. Pelvic Pelvic 3. Pelvic 4. Pelvic 5. Pelvic 6. Pelvic 7. Pelvic I. 2. 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. inlet of inlet of inlet inlet inlet inlet inlet 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. who had never PLATE Fig. I. ,, 2. „ 3. „ 4. „ 5. „ 6. The impressions menstruated, and XC. of the foetal head in new-born children. 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 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. A PLATE Fig. ,, 1. 2. ,, 3. „ 4. „ 5. .,, 6. „ „ 7. 8. „ 9. ,, 10. ,, II. XCII. 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, Blot's perforator. „ 13. Naegele's perforator. „ 12. ,, 14. ,, 15. Trepan-shaped perforator with bayonet socket. 1 repan-shaped perforator after C. Braun. ,, i6. Bone forceps after Mesnard-Stein. sizes. fig-. 5. who had
  21. 21. Contents of Plates. xxiv PLATE Fig. I. 2. 3. 4. 5. 6. 7. XCIII. 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. 2. C. Mayer's glass speculum. Sims' speculum. 3. Fig. One-bladed speculum I. after Kristeller. 6. Simons' speculum. Uterine sound. Bullet forceps with clutch hook. 7. Spring- dressing- forceps. 4. 5. 8. Curved 9. 1 Schroder's scissors for incising os uteri. scissors. 10. Scarificator after C. Mayer. 11. Squirt from intra-uterine injections after C. Braun. 12. Sharp curette 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. after Simon. Recamier's curette. Uterine medicator after E. Martin. Bath speculum. Speculum for irrigating the vagina after von Preuschen. Dilator after Greenhalgh. Instrument to introduce sponge tents after R. Barnes. Double knife for the incision of the os uteri after E. Martin. Double knife after Greenhalgh. Knife for incision after Sir James Simpson. Hodges' vaginal pessary. Intra-uterine stem with holder. Spring- stem pessary after E. Martin. PLATE XCV. Complete procidentia Fibroma uteri. Fig. I. „ 2. Fig. I. „ 2. Fig. I. ,, 2. Atresia of vagina. Retro-uterine haematocele. „ 3. Extreme uteri. PLATE XCVI. Occlusion of the vulva. Atresia vagina. PLATE XCVII. retroflexion of the uterus. 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 i
  22. 22. Tiif. A' .hirli,is ll„ii,l„ll<,^ II .hin.r.l.Mailii, cii'iv s^diM.:i-.£,n. ^rjnoi. rBrviv
  23. 23. . PLATE FIGURE Female Pelvis with ( its From KiwiscKs Atlas of Obstetrics, 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. Anterior b.li. common C.C. e.e. Erlaiti^cn, I S5 I ) Lumbo-iliac lig-aments. Sacro-iliac lig-aments, under which d.d. lie the sacro-iliac synchondroses. Sacro-coccygeal ligaments. /. Sacro-coccygeal articulation. g.g. Sacro-spinous ligaments. Anterior pubic ligament. Sub-pubic ligament. k.k. Obturator membrane. /./. Capsular ligaments. h. i. ligament. Promontory of the sacrum. FIGURE A I. Ligaments seen from above. A. A. Fourth a. I. 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. The lines. last three h.g. lumbar vertebras. /'. Promontory c. Sacro-coccygeal articulation. of the sacrum. 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. i.k.l.m. f. Tip of the coccyx. Conjugate diameter of the pelvis. d.f. Antero-posterior diameter of the pelvic d. ; h.e. ning to 7^ are to be drawn edge of the symphysis. outlet. f)./. Diagonal conjugate diameter. FIGURE View a.a. Antero-posterior diameter of the cavity of the pelvis. to the lower III. of the Right Sacro-iliac Articulation from behind. sawn Posterior part of the right ilium b. Sacro-iliac joint laid open, | through. I FIGURE The Right ';. Right ala Ilium Symphysis lateralis of the first sacral ver- tebra. b.b. Sacro-iliac sawn through. IV. a.c. d. laid open from above. Sacro-iliac articulation. Right posterior sacro-iliac ligament.
  24. 24. . Taf, Fifi.l. Fig. 4. Fig. Fig. 2. f'v-/ ...'-.•wi^ E yjarlinn lliimhitla a . II .hlfl . i>. .1 . M (ii tin , r ^^^rffSfej,, II
  25. 25. PLATE FIGURE II. I. Female Pelvis from below. a.a. Antero-posterior diameter of the pelvic outlet. b.b. Transverse diameter of the pelvic c.c. Right oblique diameter of the pelvic d.d. outlet. outlet. Left oblique diameter of the pelvic outlet. FIGURE II. Female Pelvis from above. a.a. Posterior transverse diameter of the false pelvis. h.b. Anterior transverse diameter of the false pelvis. c.c. Conjugate diameter of the pelvic d.d. inlet. Transverse diameter of the pelvic inlet. e.e. Right oblique diameter of the pelvic f.f. Left oblique diameter of the pelvic inlet. sacro-iliac synchondrosis c.g.g. Right and left is inlet. omitted (The in the f which should be on the Kft drawing). sacro-cotyloid diameters. FIGURE III. Transverse Section through the Symphysis Pubis in advanced pregnancy. FIGURE IV. Transverse Section through the Symphysis Pubis in the non-pregnant state.
  26. 26. . Taf. Fj 2- A'. Marlin's llaiulalldH. IIAufl. i:. I. Murlin C^ee, S^ui-ltee.-. ^Wd.ciJMM . Ill JB^,.ti„
  27. 27. PLATE FIGURE III. 1. Second Aperture of the Female Pelvis, or the so called largest diameter(7.(7. Transverse diameter of the pelvic cavity. h.l. Antero-posterior diameter of thie pelvic cavity. FIGURE II. Third Aperture, the so-called smallest diameter of the Pelvis. a.a. b.h. Transverse diameter of the third aperture. Antero-posterior diameter of the third aperture. FIGURE III. Anterior Wall of the Pelvis from within. a.a. b.h. Height of the symphysis pubis. Total heights of the pelvis. FIGURE IV. Perpendicular Section through the Female Pelvis. a.a. Height of the posterior pelvic wall from the promontory of the sacrum the coccyx. b.b. Posterior wall of the Pelvis. Height of the true pelvis at the side. to the tip «f
  28. 28. Taf, K I E.Mfir/iii.-- HiniihiUn.'i. UAll/7, v. A. >Inr/. zA^tb. S-cruu-te/t^ S^yUv. S'vu>t. D3,<4 I'i,
  29. 29. PLATE FIGURE IV. I. Pelvis with the soft parts. ( Drawn from Nature.) a. Psoas Muscles. b. Abdominal Aorta. c. Ascending- d. Vena Cava. Iliac Muscles. FIGURE II. Position of the Viscera at the sixth month of pregnancy. iyDrawn from Nature.) a. Uterus. 1^. Urinary Bladder. (. Stomach. (i. e. Transverse Colon, Liver.
  30. 30. T;if. Fi.U. Fk- 4 Fiv.;i, a^ FiO. 2. d A' Miirtiiin Ihiiiilalltm. II .hill, r . I Martin !.{($. ScCxnCxe.. £,-U f/ Snot . ,'B,:,Cn, -
  31. 31. PLATE FIGURE V. I. External Female Genital Organs. Mons a. veneris. Labia majora. c.c. Labia minora. (The letter t/with d. Clitoris. Prepuce of the clitoris. 6.d. its indicating line is not printed on the plate). c'. /. Urethral meatus. "-. Vestibulum. //. Hymen. X'. Frenulum. Anus. /. Perinaeum. /. FIGURE II. Outlet of the Pelvis after removal of the Integument. ( AfUr G. L. Kohdt. The male andfemale sexual orga?is, Freiburg, 1844, and Kiwisch, Atlas). Anus. a. b.b. Sphincter ani. e.e. Closing muscle of the vagina, or constrictor ani. d. Clitoris. c. Glans g. clitoridis. Ischio-cavernous muscles. /./. The left bulbus vestibuli injected, by the side of the plexus of veins in the wall of the vagina. h.h. Transversales perinaei. Levator i.i. k.k. ani. • Glutei. FIGURE in. The Vulva with the openings of the Ducts of the Glands. b. Labia minora. Meatus urinarius. c. Numerous small a.a. d.d. follicular openings round the meatus. Openings of the ducts of Bartholini's glands. FIGURE IV. Bartholini's Glands. {A/icr Fr. Tiedemann. On Duverncy's and other glands in woman, Heidelberg). a. Right labium majus. b. Bartholini's (or Duverney's or Cowper's) glands. c. Excretory ducts of the same.
  32. 32. Tnf PiE A' Marliiin . . VI 1 llni„liilla.s. II .lull r.l. .Vlariin Llff). Scl-mtfLS^. ^itd, aJ-KiA-- iB^t-iiM
  33. 33. PLATE VI. FIGURE I. Section of the Abdominal Cavity of a middle-aged Multipara. {Normal position of the parts after Pirogoff, III. A. 22. Figure i). {Accompanying W. Braune. Atlas 0/ Topogiaphical Anatomy, Leipzig, 1868). U. Uterus. V. Rectum. r. m. Bladder. Symphysis pubis. P. Promontory of the Sacrum. ^. text ly 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. Section of the Pelvis with Distended Bladder and Urethra. {After Pirogoff, II. A. 32. U. Uterus. V. Fig. 20). Tip of the coccyx. (The line in the drawing is drawn beyond the exact tip of c. Bladder. P. Promontory of the sacrum. .S". t. Symphysis pubis. Rectum. {Text of W. Braune). the coccyx). 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 be seen behind the uterus. FIGURE Section through the III. of a normally formed woman, aged 35, with the Bladder empty, the Rectum fxiU. Abdomen {After Pirogoff, III. A. 21. Fig. li). U. Uterus. r. r. Bladder. c. P. Promontory of the sacrum. .S. m. {Braune, op. cit.) Rectum. (Marked Fin the drawing). Tip of the coccyx. Mons veneris. Symphysis pubis. The section has not gone through the median line of the skeleton, and has not uterus forms here an obtuse 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. lie between the uterus
  34. 34. ViO 1 Vis. 2. "^ F. Marlu,„ Hiunlal/u.. 1/ .lull.,. .I..Ua,l,n . IfC S^(vCU-;t.e,. ^U(i c0„M „. . .'Rtr in t
  35. 35. PLATE FIGURE VII. I. Perpendicular Section of the Viscera of the Female Pelvis. (Half the Natural Size). {After O. Kolratich, on the Analomy and Physiology of the Pelvic Organs, Leipzig, 1854, aw/ from a preparation of the a. Berlin Anatomy). Sacrum. b. The rectum c. The laid open in its lower part, uterus. 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. of the pelvic organs. (On the fundus R is written instead of«). Pelvic fascia. 0.0. /. Fascia transversalis. FIGURE View of the II. Female Pelvic Viscera from above. (One-third Life-size). {After Moreau, Practical Treatise of Obstetrics, Paris, 1857. a. The b. The fundus c.c. d.d. e. f g. bladder. uteri. The Fallopian Tubes. The ovaries. The rectum. The abdominal aorta. The ascending vena cava. h.h. The round ligaments. Atlas).
  36. 36. Tiif.M Fi... I. ,.,^' Fio. 7. r' ,rfJiis*»»»r:K=S? Pii Fi'). ./ (). A F. Marliiin ll,i„(lall(is II Aiifl ,. . ;, Mui liii. Cltg. ScflCUsc , ^i + K <£/«M . SMfii, ,
  37. 37. PLATE VIII. FIGURE I. Dissection of Vagina, Uterus, Fallopian Tubes, Uterine Ligaments, and Ovaries. (Two-thirds Life-size). a. Fundus b. Body c. Cervix. k.k. J. Vaginal portion. /./. e. External os uteri. / h.h. Vag-ina, uteri. of the uterus. Anterior lip of Round i.{. Broad ligaments. Fallopian tubes. Fimbriated extremities. m.7n. the os uteri. with posterior rugae. ligaments. Ovaries. 0.0. g. Posterior lip of the os uteri. FIGURE II. Well developed Uterus of a FcBtus at term. (Life-size). b. Body of the Neck of the f. Cervical portion. a. uterus. d.d. uterus. e.e. FIGURE Fallopian tubes. Round ligaments. III. Perpendiciilar Transverse Section of the Uterus of a Matvire Foetus. Life-size). a. b. c. Fundus of the uterus. Body of the uterus. Neck of the uterus. d. e. FIGURE Vaginal portion. Vagina. IV. Perpendicular Transverse Section of the Uterus of a girl aged 7 years. (A/tet A, Kussmaul. On the Absence, Arrested Development, and Double Development 0/ the Wurzburg, 1859). a. Os b. Uterine cavity, shews only a trace of the posterior uterine fold. uteri. c. d. e. Cervical canal. Puckered vaginal portion. Vagina. Uterus,
  38. 38. PLATE YIU.—(Continued.) FIGURE V. Well-developed Uterus of a young woman. (Life-size). 6. Fundus uteri. Body of the uterus. c. Opposite the internal os uteri (Isthmus a. d. Cervix. e. External os uteri. Fallopian tubes. /]/. uteri.) g.g. FIGURE Round ligaments. VI. Perpendicular Transverse Section of the Uterus from the body of a young woman. a. Fundus c. Uterine cavity with the convex margins c. Internal os uteri. (The line should point to uteri. d. inwards. Small folds of the cervix (Arbor uterinus.) Vaginal portion. e.e. g.g. Fallopian tubes. the upper border of the cervical cavity.) FIGURE VII. Uterus with Broad Ligaments from the body of a a. 6. Fundus uteri. Body of the uterus. c. d. woman aged Cervix. External os uteri. 79. vitai
  39. 39. Taf. IX Fig. 2. fA Pi^.4. t Fie. 3. K.yiiirUi.x IlinHladu.-. II .lull r .l-Mailiii .'WS . S.cfi,at««,. JH, 1 1; cH,, ,.,t . .'Re-, r.n
  40. 40. PLATE IX. FIGURE I. Internal Sujface of Uterus soon after delivery at term. (Two-thirds Life-size). {A/ier Moreau, op. citi) a.aa. Cervix Uteri. h.b.b. c.c. 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 II. Transverse Section of Uterus One Year after delivery. (From a. //. c. the body of a patient Fundus uteri. Walls of the body of the in (After a drawing by Dr. B/inkmann). died of typhus). Internal os uteri. e. /. Posterior lip of os uteri. uterus. Posterior wall of the uterine cavity. Fallopian tubes d.d. who r.p-. Folds of the arbor vitae. the uterine walls. FIGURE III. Antero-posterior Section through Uterus. Fundus <7. uteri. e. b. c. Flattened anterior wall of uterus. d. External os uteri. f. Elongated anterior lip. g. Shortened posterior lip. Posterior uterine wall. Internal os uteri. Vasfinal vault. h. FIGURE IV. Broad Ligament with rallopian Tube, Ovary, and Parovarium. (After Kobelt arid Kiwisch, a. b.b. c. Ovary. Parovarium. d. e.e. Rudiment of obliterated duct of Wolffian f.f. op. cit.) The The cystiform bulbous end of the same. cut Fallopian tube. Fimbriated extremity. body. FIGURE V. Section through an Ovary. (After Kiwisch, op. a.a. cit.) Section through recently ruptured Graafian follicle in a young inner membrane coated with blood. b.b.b.b. c.c.c.c.c. woman. The of the hypertrophied follicle appeared unevenly puckered, and Sections of two follicles some time after rupture (corpora lutea). Follicles in process of development.
  41. 41. Taf. [',. Marliirx llaiuladas. ll.AuI'l. n. . I^ Marlin . aeg . S,sfi,u,Ue.. ^U-R . c£Ii.i^, ^Sij-A& X
  42. 42. PLATE FIGURE X. 1. 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 band vi. s. On and expansion of the the chief direction of complete evacuation of the pregnant organ. retraction of the uterus, Archiv fiir Gyncekologie, 424, and a photograph of a preparation by the same author). a. Fundus. b. Opposite the ostium internum. c. Bladder. d. Body e. of uterus. Fallopian tubes. FIGURE II. Leaf-like arrangement of the Muscles of the Pregnant Uterus. (After G. von Hoffmann. Morphological researches on the muscles of the uterine body. fiir Geburtshiilfe P. und Frauenkrankheiten, 1 876, s. 448^. Peritoneal covering-, from which the muscular leaves arise and from which they overlap each other. /. //. etc. l.r. Zeitschrifl First, second, etc., Round muscular leaf of anterior wall. ligament. D. Posterior surface of uterus. G. Vascular, or middle layer PI. Placenta. ; under which lies the internal or decidual layer.
  43. 43. <#^.
  44. 44. Tal.XI. K. Mtirtiirs Hiniiiitdijs IIAuH. V .I.Mai tin 1C6. Sifu^p^e. ^iHl .Du.A . ,'Bivr Cii
  45. 45. — PLATE XI. FIGURE I. Arteries of the Uterus. (A/ler Hjril.^ Corrosion-Anatomy ami nsulls, ils JVt «//<;, Unilateral Injection of the Arteries of the Internal Genital 1873. Organs of /"/. XIII.) a Puerperal Woman. Posterior View. a. b. Internal spermatic artery. Inferior branch of the same. c.cb'. Branch c .c Branches . to Fallopian tube. the ovaries, from which large branches run at a to .a . to the abdominal end of the Fallopian tube. The d. inferior division of the internal spermatic, uterus with the superior branch g.g. e, anastomising on the side of the of the uterine artery. Branches of the uterine artery whose ascending branches anastomose on the h.h. side of the uterus with the internal spermatic artery. FIGURE II. Injected Arteries and Veins of a Pregnant Uterus. Anterior View. {After Hyttl, op. The cit. twisted arteries on the outer surface, few in veins. The Plate XV.) number and volume compared with veins converge on both sides into two chief branches once unite into one larger branch of a knotty form. of the entire veins dition of the venous Uterine Artery. b.b. artery, The ' is 5 Varicose con- plaits. of which is untwisted as is that of the vaginal c.c. so-called Corrosion-Anatomy consists in injecting the vessels with a solution of equal parts of The organ after being injected with the above, is hydrochloric acid and water, and the soft parts allowed to corrode away. remain, etched out as it were. F. B. to which at The interwoven arrangement seen to obtain also in the broad ligament. The main branch wax, turpentine, and copaiba. !, {a.a.) the placed The in a solution of from injected portions then
  46. 46. r,if. Pi£ . ii. 1 •>/:'• K Mnrlins Ihuulathn: II All 11 r. . . I. Martin.. eXf&. S^aiitee., £iM £I^^M .'B^Eiif.
  47. 47. PLATE Cervical Ganglion, Sacral (After Frankenhaiisen. XII. and Uterine Nerves of the The Nerves of the left side of a Pregnant Uterus. Uterus and their terminations in smooth muscular filaments, Jena, 1867^. /. Right Fallopian tube. //. Rig-ht ///. IV. V. VI. VII. VIII. 1. 2. 3. ovary. 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. 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. 12. 13. 14. 15, 17. 16. 18, 19. 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. 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). 20. Vesical ganglion. 22. 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 29. 30. 31, 32. to the uterus. 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 Fallopian tubes, drawn somewhat too large.
  48. 48. Fii.i. Tnr. ||[, 'i-r '^n^*^- He mi'-u Fig 3 f * /•' Mnrt,„ Hnn.lallu^. Il..h,n. f. A. Martin I Fis.2. aC6. SifvM^.c. ^a-f'i . ^u^ . ,«« :',,. I
  49. 49. PLATE FIGURE Mucous Membrane (Afler G. Leopold. XIII. I. of the Uterus on the first day after Menstruation. Sludics on the uterine mucosa during menstniation, pregnancy, Archivfiir Gyncecologie, band xi und xii. and childbed. 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 ; epithelium well preserved, in parts swelled with large nuclei. in part insufficiently injected. G. Vessels, 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. Z. Thickened bulbous ends of the capillaries. tufts The epithelium first day of cit.") of the swollen mucous membrane, with exuberant partly preserved, partly pushed off the ends of the 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. Mucois Membrane of the Body of the Uterus on the third day of Menstruation. {After G. Leopold, op. C. Exuberant, here cit.) and there denuded capillary networks, between which are occasional depressions, the openings of glands. 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.
  50. 50. ) PLATE XllL—(Continued). FIGURE IV. Fresh Corpus Luteum from 8 to 9 days old, 8 to 9 days after commencement of HsBmorrhage. {A/ier Leopold, C. last op. at.) Corpus luteum. F. Follicle, the size of half a split pea. N. Cicatrix, through which the blood-mass glistens. FIGURE V. Older Corpus Luteum (5 weeks). (After G. Leopold, FIGURE op. cit. VI. Corpus Luteum, three weeks old. {After G. Leopold, op. cit.) The reddish-brown tough coagulum is closed in by a strong yellow jagged mem- brane, in the most external borders of which are seen numerous minute extravasations. FIGURE VII. Corpus Luteum., seven weeks {After G. Leopold, op. old. cit.) The coat of the follicle half a millimeter in diameter, encloses a yellowish-grey nucleus containing a small cyst. FIGURE Almost Ripe VIII. Follicle. {After G. Leopold, op. A lilie follicle cit.) of the size of a small bean, with nucleus projects into outer wall of ovary a cyst and has a thin wall.
  51. 51. Taf.XIV Fi£.l y-r Ph #'^ 4^^ 'm ^-< ''m Fig. 3. £:^ E.yiurliiiH Ifainlatlas- II AtiH. v. A. Martin vM. S^fUitxe,. XiAK.&Mi.. SmUk.
  52. 52. PLATE XIV. FIGURE I. Lymphatic Vessels of the Non-pregnant Normal Uterus. The lymphatics of the normal unimpregnated (After G. Leopold. band Uterus of a Woman uteius. Archivfur Gymkohgie, vi.) aged 30 years. Anterior View. T. Fallopian tubes. 0. Left ovary. Subserous network of lymphatics. Branches to the Fallopian tubes. a. b. FIGURE II. Uterus of a Sow, Blood- and Lymphatic-vessels. {After Leopold, op. H. cit.) Left horn. T. Fallopian tube. L.L. Broad ligament. a. b. c. d.d. e. f 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. Blood-vessels and Lymphatics from the Uterus of a Virgin aged 25. {Aftet G. Leopold, op. cit.) A. Arteries. V. Veins. 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. and a. b. a, c. d. e.e. at
  53. 53. Taf. XV. Ti^.l. Fia.l'. / !: yictrtiini lltiiij.illu^. II AufLij.A.MarUr (lu;. .^sci'iui,-.. ->', n; <rtM,rt. fiS,-/:!',
  54. 54. PLATE XV. FIGURE Mucous Membrane of the Body I. of the Uterus at the fourth {After G. Leopold, op. month of Pregnancy. a'l.) 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. D. Gland spaces. B. Muscular fasciculus. G. Vessels. FIGURE II. Placenta and Uterus at the middle of the fifth month {Partly diagrammatic after G. Leopold, op. of Pregnancy. cit.) A. Amnion. C. Chorion., J?. Jis. 5". -f- Serotina reflexa. 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, Mc. Mucous membrane with gland-spaces. Ms. Muscles with commencing thrombosis. op. cit.) Placental Site
  55. 55. . Taf. Xl Fi'i.2. Fii.l. ['is, 1- -^(B^ A'. Murlin's llnndallus. I/.. lull. u. .1. AJui tin. Clf&. S*ft-u*it^. ^L-bfi.. gJmM- . .'Sj>1/I
  56. 56. PLATE XVI. FIGURE I. Female Mammary Glands. (After Jules Cloquel, a. Mucous c. Analomy, &c., Obstetrical Demonstrations, Weiviar, part xi. 1S32J. Nipple. b.b. Human Areola. follicles or the so-called glands of Montgomery. FIGURE II. Side view of Female Breast. (After J. Cloquet, FIGURE op. cit.) III. Lactiferous Duets and Lobuli of the Milk Glands during Lactation. {After P. Dubois, Complete Treatise of the Art of Midwifery, vol. Lactiferous ducts and their dilatations (the indicating line a.a. is i. Paris, 1849.) not attached to one of the letters a.) Anastomoses of the b.b. d.d.d. lactiferous ducts. Connective tissue containing fat. FIGURE Two IV. Lactiferous Ducts diiring Lactation prepared and injected. (After f. Cloquet, Atlas of Anatomy, Paris). a.a.a.a. b. c. d. Lobuli of mammary Commencement glands. a lactiferous duct. Sinus-like dilatation of a duct. Section through the mamma. of FIGURE Lobulus of Mammary Gland V. during Lactation (enlarged). {After P. Dubois, a.a.a.a. b. Single acini. Lactiferous duct. op. cit.)
  57. 57. , Tar.:s:vE Fi^. 1. Fi(5 g dvcL E. Marlins Hn „,/,.!/, ,.-,-. H A77/? . n A. Mnr/ I fA ,?;,(', A ^r f lU^, (3^^^ . . 03^.,,<', ,
  58. 58. PLATE XVII. FIGURE I. Mucosa changed by the development and Reflexa. Surface of the Uterine of the Deciduse Vera (Life-size). {After Reichert. Description of a premature human ovum in a state of vesicular development. Berlin, 1873). The side anterior wall of the uterus has been divided through the fundus from the and the left vera, triangular border separated and turned back. by the development of the cotyledons, suled, stands plainly out u. u^. 7/. u.c. v.g. o.v. /. /'. l.r. The in left raised surface of the decidua which the embryo lies encap- on the posterior wall. Body of the uterus. Fundus uteri. Margin of the uterus. Cervix uteri. Cut portion of the vagina. Ovary. Fallopian tubes. Infundibulum of the Fallopian tube with the fimbriae. Round ligament of the uterus. u.p. Posterior wall of the uterus. ti.a. Anterior wall of the uterus. u.c^. Os u.l^. q^. d.v. uteri. 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 side ot the posterior cut surface. 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. i} Papilliform island jutting out at the s.i. Furrows between the islands. apex of the raised plateau.
  59. 59. 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. dv} ua. up. as above. Dendritic and netlike furrows running- between the primary cotyledons. /.v. Vesicular shaped embryo. a.s.p.^ 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 An Ovum (After laid open R. Wagner, Icones III. at the 21st day. Physiologict. a. The chorion completely surrounded with b. Leipzig, 1 839). Amnion. c. d. villi. The vesicular umbilicalis. The embryo with the allantois. FIGURE Ovum with Embryo from the 7th to the 8th week. {_After a.a. h.b. d. e. f. R. Wagner, op. cit.) 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 c. IV. membrana decidua reflexa. The cerium, chorion, dotted with The amnion opened. The vesicula umbilicalis. The embryo. villi.
  60. 60. PLATE XVIII. FIGURE I. Mucous Membrane developed into Decidua at the 6th week of Gestation. Section of Pregnant Uterus with {A/ier Coste. a.a. b. General and Special History of the Development, 6^c., of the Human Species). 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 died in the 30th week of Gestation. {After Al. Ecker, Icones Physiologicce. a. Root of umbilical b. Amniotic layer of the c. Leipzig^ 185 i). Chorion. cord, and its insertion into the placenta. funis. d.d. Foetal portion of the placenta. 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. Artery, entering the placenta. k.k.k.k. Extremely dilated uterine veins. FIGURE III. Injected Terminal Loop of Villus from a Mature Placenta. (Magnified 350 times). {After Ecker, op. a. b. c. d.d. e. cii.) 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, Terminal loop returning as a vein. Fine capillary network.
  61. 61. <-rll„..- Taf.XWll Ha,,.l..tln.-._ nAiif/. u A. >Tnrl fJltk. S-r^hCUv-t^ ^•iL.r-iM
  62. 62. 1
  63. 63. PLATE XVUl.^(Coniinned). FIGURE IV. Placenta from the Internal Surface. {A/Ur W. Hunter). vascular branches to the internal surface of the placenta. a. Funis with h. Internal surface of placenta covered with the ex. d. Membrana its amnion and chorion. ovi raised up. Border of placenta. FIGURE V. External Surface of Placenta. a.a. h. c.e. Single lobules of placenta (cotyledons). Funis. Opening's of the so-called marginal sinus of the placenta. d. Marginal sinus opened. e. External surface of chorion spotted with decidual remains.
  64. 64. PLATE FIGURE XIX. 1. Pregnant Uterus at the commencement of the 5th month from behind. (One-third Life-size). [ After W. Hunter). a. Body h. Cervix, hanging to the uterus like a cone. c. External os d.d.d. of uterus widened into a spheroid. uteri, studded with small swollen mucous glands. Vagina. FIGURE II. Fundus Uteri of a Pregnant Uterus at the 8th month, (One-third Life-size). {After W. Hunter). a. b.b. Anterior smooth wall denuded of peritoneum. Posterior wall arched prominently upwards, denuded of peritoneal covering, to shew the enlarged vessels, especially the veins. 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 developed folds of the Arbor Vitse. (One-third Life-size). {After W. Hunter).
  65. 65. T.-if. XIX fc>- ^S^- ^ ^ A /',' /- 71'''^ ^"* 'f' 1 -l '^- 1 ^^O' f^ Martins Handatlas. //Jufl.z/- A Maitai Caffc. S^iU^^. £i.tfi.. cSm^ ."B/Tfi.,
  66. 66. i
  67. 67. Tnf X. . FiE.l. A' Marlins //iJ,n/at/as. H .hiH . r. .1 Muilin CU&. SffUvfew.. Xuti.aXi,^.. tri^tin
  68. 68. PLATE XX. Side view of Abdominal Cavity laid open after partial removal of the large Omentum in a Woman far advanced in pregnancy, (One-third Life-size). {A/hr W. Hunter). (.1. li. c. d. e. /.y.f. The uterus advanced in gestation. The right round ligament. The right Fallopian tube. The fimbriae of the right tube pushed forwards. The ascending colon. Coils of intestine. g. Remains h. Right lobe of the I. k. /. of large intestine. liver. Left lobe of the liver. Round ligament of the liver cut through. The diaphragm covered with the pleura.
  69. 69. I . Fitf. 3. Taf.XXt FU>. 2. Pi 6. 1. 3 Pio. 4. E.M,n-Nn-.- Hni,,h.H,,.s. UAuf/. a A. Mnrr„< iJIM. S-cPi I'.i
  70. 70. PLATE FIGURE Human Embryo XXI. I. at the 9th week, (Life-size). (After Sommering, Kiliatis Atlas of Obstetrics). FIGURE Human Embryo II. at the 3rd month. (Life-size). FIGURE Human Embryo III. at the 16th week. (Life-size). FIGURE Human Ovum at the 5th IV. month and a (Life-size). half.
  71. 71. ;if. X. ""^ "->' ^ E.yhirtin« llninlatluH. II Jul'l r A .-J uilui . t'tl6. SilUitf.e. „fitfi c^iii, Xll.
  72. 72. PLATE Human Embryo, XXII. Funis, and Placenta, with its Membranes, lunar month of pregnancy. (Life-size). (After Sommering, accompanying Kilian's Atlas). a. Internal surface of the placenta. b. External surface of the placenta. c. Macerated d.e. Amnion f. Funis. villi of the placenta. in folds. at the 6th
  73. 73. . T;if. Fi£ . Fig. <; 5. will. Fii.4 ::p Fis.l. / "^-^ w A' Marlin's /Irnidiillun . II .lull n. .1 . . .Mai Un, JlCfi. SiivM^e. , _iiMi-. (iitwl Sii fall
  74. 74. . PLATE XXIII. FIGURE Internal Organs of an (After a. Funis. b. Embryo Monau. Umbilical arteries. c. d. I. e. before birth. Atlas). Junction of the umbilical vein with the portal vein. Urinary bladder with urachus. Umbilical vein. f. f'. FIGURE Liver, raised up. Ductus venosus Arantii. II. Festal circulation. (After Hasse, by The vessels Strasser. drawn white contain dark contain venous blood. A. H. Spiegelberg System of Alidivifery, arterial blood, those shaded 1 877) mixed blood, and those
  75. 75. PLATE XXIIL— (Continued). FIGURE V. Meconium seen imder the microscope. (A/Ur C. Ruge). This drawing coloured by C. Rug-e could not, for technical reasons, be reproduced in the same way. A lial wooly hair (lanugo) scales, fat globules, lies across between the crystals of cholestearin, fatty epithedetritus, which are coloured greenish- mucous globules and yellow. FIGURE VI. Vernix Caseosa under the microscope. (A/ier C. Ruge). Wooly hair (lanugo) epithelial scales in fatty degeneration, fat globules.
  76. 76. 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. Body O.u.i. ovum Plate II. A.B.) end of 8th week. Internal os uteri. of the uterus containing at the C.u. Cervix uteri. Bladder. V. d. Clitoris. R. Rectum. V. Entrance to the vagina. c.t. Transverse colon. F.i. Iliac flexure. 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 pelvis well developed pelvic inclination is 58°, less : the pregnancy. The decidua vera, is plainly seen inside the muscular layer of the uterus, consisting 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 thin but continuous with the inter- in thickness towards the posterior wall 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 the peritoneum which stretches farther down over the uterus behind than in front, 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. is A condition obtains between the bladder and cervix uteri, so that the bladder may be cap- able of considerable distension. The more minute relations of the not recapitulated at Plate XXIV. ovum, which correspond with the eighth week are
  77. 77. T;if..XI-. Miirlin's llaiuliidus. II Alill.li. A.^tlaitin.. Cit^^ SdMf^.e^. ^M GJ^Mt.lB/yi&if.
  78. 78. . Taf. X-. '^«-- A'. .Martifi's Uaiidiillan . H .lull . i>. . /. .Martin. CTf&. ScKii-tx^c ^Itfi, tOuM^. Uoz-r^u
  79. 79. PLATE XXV. FIGURE Uterus with Foetus in {After W. Hunter first head presentation. and H. Fr. Kilian). FIGURE Uterus with Pcetus in I. first II. breech presentation. (After W. Hunter).
  80. 80. Taf, XX-1 1m6 :! o.t.-i K Matiiu's Hinidalliin II . lull - r. ./, Marlin I'Uf.. SiPuU.-.s-. i'iH; .'iii-i ^"i^'-ii
  81. 81. PLATE XXVI. FIGURE Body Section of the Frozen of a Woman (After in labour during the period of expulsion. Bratine). PL F. Bag- of waters, u. v.p. Af. Left iliac vein. v.i.s. Aorta. Pa. Pancreas. uteri. Internal os uteri. o.i.o.i. Duodenum. a. Rectum. External os H. Bladder. o.e.o.e. Placenta. d. Urethra. r. I. Vena portae. Stomach. L. Liver. FIGURE II. Section through the parturient canal after removal of the child. (After Braune, V. o.e.o.e. Vagina. External os op. cit.) o.i.o.i. uteri. o.t. FIGURE The engagement (Diagrammatic after Schroder. u. Urethra. a. III. of the Head. Text-book of Midwifery. r. FIGURE Rectum. IV. Commencing Expulsion of the Head. (Diagrammatic after Schroder, u. Urethra. a. Anus. 5th edit. p. 162). H. Bladder. iK. Second sacral vertebra. Anus. F. Frenulum. of Fallopian tube. PI. Placenta. C. Cervix. f. Frenulum. Internal os uteri. Opening p. 163). Second sacral vertebra. H. Bladder. r. Rectum. 2,K.
  82. 82. if. Fk. XWI ( ^ I'ls-,:' .j: i:.M„rh,i llf,,„iall„s II 'lull ,. I. Mai In, CW-^ &c)Mr.<^.±M- SuaX..^mZlvy.
  83. 83. PLATE XXVII. FIGURE I. The engagement of the Pace descending {A/ier Schroder. u. Urethra. (The Text hook of Midwifery, indicating- line first. 5 th edit. p. 178). has been drawn to the pubes instead of to the lying urethra). 2.S'. f a. Second sacral vertebra. Frenulum. Anus. FIGURE II. Cranium of Occipital presentation. (After Hecker). FIGURE III. Cranivim of Face presentation. (After Hecker). FIGURE Cranium of breech • presentation. (After Hecker). FIGURE Lateral Curve of the IV. V. Trunk during labour {After Hodge in Spiegelberg, op. in breech presentation. cit. s. 174). under-
  84. 84. 'M. XWI i-ia.2. Fig 4. E Marlin-x llaiulailus // .la/t r. A.Mariii Fifi.l. (.nil, SctUltee-. J'U.fi,.r<M^l I'SxT^ia
  85. 85. PLATE XXVIII. FIGURE I. Occipital presentation. (After Olshausen. On the supplementary diagnosis moulding of the skull of the new-born child. FIGURE course of labour by means of the of Clinical Lectures, No. S). of the Series II. Pace presentation. FIGURE Brow III. presentation. FIGURE IV. Antero-f^outal presentation.
  86. 86. 'nf f, Marliit's [luiidatlus. II Aul'l. i'.A. Merlin cM. S*fi.i.UA£.. ^i.'Hi.cCJvu.i . XXK. .'ir'^tC-i
  87. 87. PLATE XXIX. FIGURE 1. Uterus with Twins in Cranial and Breech presentation. (Two Ova). {A/ler Smellie). FIGURE II. One Placenta with Twins. {After C. Chr. H titer. The Simple Placenta, Marburg, 1842). a.a. Anastomising vessels of the two embryos on the internal surface of the placenta. b.b. Junction of the two amnions with each other. FIGURE Triplet afterbirth with {After a. b.b. V. III. two Embryos arrested D' Outreponl. in development. Obstetric Demonstrations). Placenta which belonged to fully matured foetus. Prematurely dead embryos and their placenta.
  88. 88. Tnf. XX, % T K Marlins ilnn(/ul/ci s 11 Aul'l . f. .1 . M (iltui. . KJ ^Xtt,- SAiaxc-. 1M',. cju^l: • ^eit
  89. 89. PLATE XXX. FIGURE I. Inflammation of the Mucous and Sebaceous Glands of the Vulva. {A/Ur P. C. Huguier. Genital Organs of Memoir Woman ; o?i the Diseases in the of the Secretory Apparatus of the Memoirs of the National Academy of Medicine, External vol. xv. Paris, 1S50, 4, plate i). FIGURE II. Abscess of the right Bartholini's Gland. {After Huguier, op. FIGURE Cyst formed by the (Vulvo-vaginal Gland). cit.) III. Dilatation of the Occluded {After Htiguier, op. Duct of the left Bartholini's cit.) A. Cystic tumour. B. Introitus vaginae. C. A (The line is protuberance formed by the continued beyond the left orifice). border of the vaginal orifice. Gland.
  90. 90. 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
  91. 91. PLATE XXXI. FIGURE I. Morbid enlargement of the {AJ'lcr Clitoris. Atlas of Drawings of Theotetical and Practical Midmfery, 1838). D. W. H. Busch. FIGURE Ia. which has become extruded from the Vagina by gradual elongation of the Stalk. Follicular Polypus of the Cervix, (^After original observation This figure is among a number and Boivin and Dughs, plate of impressions without special reference to them. FIGURE II. Lupus of the Labia, the Vaginal {After Hugtiier, op. A. Hypertrophied left xvii). cit. Orifice plate 3, and Anus. fig. ii.) labium majus. B. Left labium minus destroyed at the base. C. Cicatrised point of arrest of ulceration. D. Meatus urinarius. E. Opposite ulcerating point in fraenum labii. F.F.F. Seat of ulceration with separation of the posterior and vagina. left lateral wall of the G. Internal margin of the ulcer. 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. Lupus of the Vulva. {Perforating and Hypertrophic Ulcer after Huguier. Region. National Academy of Music. Memoir on Rodent Ulcer of the Vulvo-anal Vol. xiv. Paris, 1849, plate 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. 2, fig. i.)
  92. 92. T,if, XXXII. .^^!S^. C ^^^^2^-'. /•; MartniS Iliin.lalUi ^ . II .lull. ! .I.Ahuliu k Hf.. SlIiuC.c. .JS'iMi ,ri,,,.i .'i!.-vlu,
  93. 93. . PLATE XXXII. FIGURE I. Lupus of the Vulva. (From an Original Drawing). (Half Life-size). (By the kindness of Dr. Loretit, Director of the Geneial Hospital of Bremen). 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. sittings by (One-third Life-size). (After H. Lehert. Treatise of Pathological Anatomy, Paris, iSjg). 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 large labia. the entrance of the vulva is surrounded by them. FIGURE III. Urethral Excrescence. (Half Life-size). (After Boivin and A spongy growth projects from the meatus Dugh) and displaces the orifice from the right.
  94. 94. w
  95. 95. . Tnf XXXIII />^ ^ hi k 1-12 4 ^iW W ¥ V^^ Fi£.5. ^..cpWf'Sr^-^'l^ J K Marlins lluudallas llJufl .i: A. .i ,.. ,. 5 7;>^))./ r ClC6. S.-riut!ifc. JiiHl ^0M..t.S3«l'iii.
  96. 96. PLATE XXXIII. FIGURE I. Malformation and Occlusion of the External Female Genitals in a new-born chUd. {After Aug. Fr. Giiniher. a. Penis-like clitoris with prepuce Commentaries on Hermaphroditism, Lips. 1846;. and opening, which, however, does not lead into the bladder. h.b. c. Swelling resembling the labia. Body of uterus (cervix uteri ?). d.d. Globular enlargement of the Fallopian tubes. e.e. Fallopian tubes with fimbriated extremities. f.f. (Divided body of uterus ?). Ovaries. 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. Dissertation on Hermaphroditism, Jena, 1842). 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 lead- ing to the meatus urinarius. d. The hypcrtrophied prepuce of the glans clitoridis. FIGURE III. Occlusion of the Vaginal Orifice by Malformation of the Bands of the Labia. {After D. W. 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. Practical Treatise of Diseases of the Uterus, Paris, 1833. Atlas, plate 40). FIGURE V. Hypertrophic Degeneration or Elephantiasis of the Labia Minora and Prepuce of Clitoris. {After H. Herzog, on the Hypertrophies of I hi External Female Genital Organs, Erlangen, 1842).
  97. 97. . [if XXXIV. ^f:^.K- ^':^i "»s.. J, -A. % ^ K.Marlin-a Hanclallus. II .Udl .u. AMarlin. df^. .'?-(:A,ilt-x^. J?i ^^l- JUwo^-. ^xitCivi
  98. 98. 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. Dissettaiio in sistens singularem Aug. Lolze. vagincB. Clitoris. b. Urinary meatus. c.c. Larsre labia. A {After S. Merriman. c.c. atresia in a woman orifice. II. in labour by an Ovarian Tumour. Synopsis 0/ the various kinds 0/ Difficult Parturition with plates, London, 182 b. ct Anal aperture. f. FIGURE a. Occluded vaginal e. Narrowing of the Vagina prater naturam coUocati Small labia. d.d. a. am JencE, 1S27, 4c. tab.) The symphysis divided. The sacrum. The urethra and bladder. 1 ). d. e.e. /./. FIGURE The ovarian tumour. The rectum. The vaginal wall. III. Acquired Partial Occlusion of the Vagina. {After Aug. Ae. fans on. a.a.a. h. c.c. d.d.d.d. The The uterus cut i. k.k. tab. Francof. a.M. 1845-8). off. ligaments. Exudation membranes. Upper Lower f.f h.h. c. off. right Fallopian tube cut The broad e.e. g.g. Diss, in'de atresia vagincB acquisita, portion of vagina dilated into a pouch. portion of vagina with rugae. Sound with cross-bar Sound Neck to to expand the upper part of the vaginal pouch. expand the lower portion of the vagina. of the bladder. External genitals.
  99. 99. T,if. Fie XXXV ViA.2 ] ¥i6.4. /',' Miirtiiis llaiu/allus II Aiifl . v. .i M (iitiix . t-liffi Sci'xiU7.c. SuK SHyi..Sij>r(i,'
  100. 100. PLATE XXXV. FIGURE I. Prolapse of the Posterior Vaginal Wall. {After R. Frura'p, Surgery. a. Section throug'h the symphysis. c. Bladder. d. Copperplates, Heft. 86, 1841, Taf. 435). Vagfinal orifice. h. (Enterocele Vaginalis). Vagina. Uterus. e. Entrance to the vaginal enterocele. g.g. Rectum. h. Sacrum. f. FIGURE II. Prolapse of the Posterior Vaginal Wall. {After Froreip, op. (Vaginal Enterocele). cit.) Section through symphysis. a. Bladder. Divided vagina. Section through the prolapsed posterior vaginal wall. b. c. d. (Hernia vaginalis postica). Divided uterus. / Entrance to the Hernia rectalis. g. Section through the rectum. h. Sacrum. e. FIGURE Vesico-vaginal Hernia. III. (Cystocele Vaginalis). {After Froreip, op. c. Divided symphysis. Vesico-vaginal hernia. Section through vagina. d. cit.) Stretching of peritoneal folds between Uterus. a. b. e. uterus f. FIGURE Recto-vaginal Hernia. Rectum. IV. (Rectocele vaginalis). {After Froteip, op. a. Divided symphysis. b. Section through vagina. c. Uterus. d. Recto-vaginal hernia with prolapse of the posterior vaginal wall. and rectum. e. cit.) Perinaeum diminished by the pressure of the rectocele. f. g. Rectum. Stretching of the utero-rectal folds.
  101. 101. Td XX.WI Fifi.l. xr%^>r --^^ Fi'i.2. /' ^3=*^:. > r^?; f^x ,,;a.^«- .^' ^.^_ .^ -Fin. K -'J-7tl. *"& Mclrlins H„inl„lluH II . lull r -I A MuiUn I. UT- •ScCviu.'.fc, Jj, Hi ,n,i,.t .'S.-rfi,
  102. 102. PLATE XXXVI. FIGURE I. Vagina and Uterus divided by a Septum. {A/ier Eistnmarin. Tab. anal, uleri duplicis, ohserv., rarior Argentor, 1752). sistentes. b. Double orifice of vagina. Meatus urinarius. g.g. Double cervix uteri. Double body of uterus. c. Urethra. h.h. Round a.a. d.d. e.e. /./. Double vagina. Double os uteri. i.i. k.k. FIGURE Ovaries. II. Two-horned Uterus and divided Vagina b. c. The vagina cut away. The OS uteri of left side. The external surface of e.e. f.f. g.g. of Uterus developed together with a rudimentary Right Horn {After Rokitansky. married e.e. in a 34. vol. ii. 1842, Oesterreich, Staates, s. 514, and On 1838, vol. 26). Left uterine horn. 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 Projecting funnel-shaped vagina. Ovaries. Fallopian tubes. ligament. f. Right broad g.g. Round ligaments. d.d. woman aged Medical Ycar-ho;k. OS uteri. c. III. Handbook of Special Pathological Anatomy, the so-called duplicated uterus in the a. letter uterus. Sterile b. Berol. 1841). (The the cervi.x apparently divided FIGURE Horn 17. in several plates). The two horns of the The round ligaments. The Fallopian tubes. The ovaries. Left aged by one septum. stands instead off d.d. in a virgin Diss, de uleri ac vagina sic die/is duplicitatibus. (After Fr. Schroder. a.a. ligaments. Fallopian tubes.
  103. 103. PLAT E XXXVI .—(Continued). FIGURE IV. Pregnancy in the Left Rudimentary Uterine Horn, mistaken at first for Tubal Gestation. {A/hr Hcyfelder a7id Ad. Kussmaul. On Uterus, a. Cervix and doubling up of the Right half of body of uterus. b. the Absence, Mal/otmalion, Wiirzburg, 1S59). uteri. 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 /. c. the right horn. k. /. Left round ligament. Muscular fibres which diverge from the right horn. m.m. Borders of peritoneum dissected off. n. Left Fallopian tube. 0. Left ovary with a large corpus luteum. />. Point of rupture with everted borders. q. Placenta. d. Umbilicus. g. Membrana r. ovi. Female embyro 1 2-5 centimeters long. left round ligament into the body of the
  104. 104. PLATE XXXVII. FIGURE Rudimentary Horn united by a solid band with the enlarged by pregnancy. {After J. Chr. Stan. Czihak. Cavity of b. fully developed Uterine Horn Transverse Section. Diss, in de gravidiiate extra nterina, Kussmaul, a. I. Heidelb. 1 824, and Ad. op, cit. s. 124). Cervical canal. Vaginal c.c. d. e. f. left uterine horn. cavity. Decidual membrane. Opening- of tlie left Fallopian tube. Muscular band of union. rig^lit pregnant horn. g. Cavity of tlie h.h. i.i. k. in. n. Peritoneal covering. Muscular layer with numerous divided vessels. Placenta. Funis to which was attached a male embryo at the 6th month of gestation. Right Fallopian tube. FIGURE One-horned Uterus from a II. Drawn from child. (After Pole, Metnoirs of the Medical Society of London, 1794, I. Right horn of uterus alone developed. Right Fallopian tube. c. behind. and Kussmaul, op. cit. s. 22). (Uterus unicornis dexter). Left Fallopian tube. a. d. Left ovary. e. Bladder. f. Vagina with os g. Right ovarian ligament. uteri and vaginal portion projecting FIGURE Onc-hornod Uterus from the body of a tenth time ; into it. III. woman from the left Kidney was 6 to 7 days pregnant for the also absent. {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. •!
  105. 105. . I'iif, 1-1!; 'v: :, XXXI 1 /<rf^i Fij. (; 1^-. ^-- A' Martins lliindattus . II Autl. o. .-I. Mai ate. S*ft.iU^.«'. -Sl-td eJ"->t.iB'>

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