ligaments, running from without inwards, towards the superior margin of the uterus, the ovaries being situated behind and somewhat above them. They are somewhat contorted, and are considerably more dilated at their abdominal extremity where they are unattached, than where they are connected to the uterus, being as much as from three to four lines at the former point; whereas, at the latter, they are not more than half a line.

Their abdominal extremity, which is like the mouth of a funnel, has its edge strongly finbriated, and has hence been called the morsus diaboli. Their other extremity opens into the cavity of the uterus at the angle which the fundus forms with its sides, and the whole of the tube is about five inches.

The Fallopian tubes receive their external covering from the peritoneum, which becomes connected at their open extremity with the membrane which lines them. Between the external and internal membrane is the proper tissue of the tubes, and which, except in very muscular subjects, seldom display the fibrous structure; still, nevertheless, two layers of fibres have been observed-an outer or longitudinal, and an inner or circular layer. The Fallopian tubes are lined with mucous membrane, forming numerous longitudinal ruga. The canal is not pervious during the early months of foetal life, the abdominal extremity being closed and rounded; this appears to open about the fourth month. The canal is relatively larger, the younger the embryo is, and may, therefore, be easily demonstrated at this time..

At the period of impregnation, the Fallopian tubes implant themselves by means of their fimbriated extremity upon that part of the ovary where the Graafian vesicle is about to burst; they become remarkably engorged with blood, assuming a deep purple colour, and are now much thicker; the canal enlarges, so that a tolerably-sized probe can be introduced, whereas, at other periods, it will scarcely admit a large bristle. The uterine extremity of the tube is closed by a continuation of that pulpy coagulable lymph-like secretion which now lines the cavity of the uterus, forming the membrana decidua of Hunter, and which, especially on the side where the corpus luteum is found, extends into the tube to nearly the distance of an inch. The tubes are now observed to be in a state of distinct peristaltic motion, "like writhing worms," as Mr. Cruickshank has well expressed it; "the fimbriae were also black, and embraced the ovaria (like fingers laying hold of an object) so close and so firmly, as to require some force and even slight laceration to disengage them."* From the great degree of vascularity which is observed in the Fallopian tubes at this period, some anatomists have been induced to conser that their proper tissue was vascular, analogous to the corpora caversa penis. Besides the peristaltic motion already mentioned, other moverents called ciliary have been observed in the Fallopian tubes at this period, consisting of minute portions of mucous membrane moving briskly and whirling round their axis, apparently for the purpose of propelling the ovum.†

As pregnancy advances, the Fallopian tubes undergo other changes as respects their situation, which are worthy of notice. The broad ligaments, in the upper parts of which the Fallopian tubes take their course,

* Phil. Trans. 1797.

† Purkinje and Valentin, de Phænomeno generali Motus vibratorii. Wratisl. 1825.

are well known to be merely expansions of peritoneum from each side of the uterus, and therefore become gradually unfolded and shorter as the uterus increases in size. "In proportion as the fundus uteri rises upwards and increases in size, the upper part of the broad ligament is so stretched that it clings close to the side of the uterus, so that in reality the broad ligament disappears, no more of it remaining than its very root, viz. its upper and outer corner, where the group of spermatic vessels pass over the iliacs immediately to the side of the uterus. In this state, though the small end of the tube opens in the same part of the uterus as before impregnation, yet the tube has a very different direction. Instead of running outwards in the horizontal direction, it runs downwards, clinging to the side of the uterus. And behind the fimbriæ lies the ovarium, for the same reason clinging close to the side of the uterus."*

Uterus. The uterus is a hollow fibrous viscus situated in the hypogastric region between the bladder and the rectum, below the intestinum ileum and above the vagina, and is by far the largest of the generative organs. It is of a pyriform figure: its upper portion which is largest is triangular, becoming gradually smaller inferiorly; that portion of it which is above the spot where the Fallopian tubes enter is called the fundus uteri; the lower and cylindrical portion receives the name of cervix; that between the cervix and fundus is called the body of the uterus.

The parietes of the adult uterus are nearly half an inch in their greatest thickness, which is about the middle of the body, the body being slightly thicker than the cervix, which is of a somewhat harder structure. Near the point at which the Fallopian tubes enter the uterus the parietes become thinner, gradually diminishing from four or five to only one line in thickness.

The cavity of the uterus is triangular, its base being directed upwards, the superior angles corresponding to the points where the Fallopian tubes enter it. The cavity of the uterus is so small, owing to the thickness of its parietes, that they are nearly in contact: it is only four lines in breadth; the fundus, which forms the base of the triangle, is convex both internally and externally; whereas, the sides which form the body are convex internally, but somewhat concave externally.

The cavity of the uterus is most contracted at the point where the cervix is united to the body, which here forms the os uteri internum: from this point the cervix gradually dilates as far as its middle portion, when it again contracts; its lower extremity terminates in the upper part of the vagina by an anterior and posterior cushion-like projection, of which the posterior is usually the longest, although from the direction of the uterine axis the anterior is commonly felt lowest in the pelvis. Between these there is a transverse fissure known by the name of os tinca or os uteri externum, the lips or labia of which are formed by the two above-mentioned prominences. The internal surface of the body of the uterus is month whereas that of the cervix is uneven, forming upon its anterior a number of delicate rugæ diverging obliquely in an ard hence called the arbor vitæ. The lips of the os uteri when slight lacerations have taken place during labour.

tomical Description of the Human Gravid Uterus, &c., p. 13.

In the virgin state the uterus is about two inches long, of which the cervix occupies the smaller half: the greatest breadth of the body is sixteen lines; that of the cervix from nine to ten. The uterus which has been impregnated, especially when this has been frequently the case, scarcely ever regains its original dimensions, and the fissure which the os tincæ forms becomes broader from before backwards. The weight of an adult virgin uterus is from seven to eight drachms, but the uterus which has been once impregnated is seldom less than an ounce and a half. It lies between the bladder and rectum, its upper half being covered by peritoneum, which closely adheres to it. In the adult state it is situated entirely in the cavity of the pelvis; the fundus, which is below the upper edge of the symphysis pubis, is turned forwards and upwards, while its mouth is directed downwards and backwards, so that its long axis is nearly parallel to the axis of the superior aperture of the pelvis.

The uterus is connected to the neighbouring parts by several duplicatures of peritoneum, which are continuous with that portion of it which covers the fundus. The most considerable are the broad or lateral ligaments; these arise from the sides of the uterus, which is enclosed between their anterior and posterior layers or lamine; they proceed transversely outwards towards the sides of the pelvic cavity, which is thus divided into two portions, and are then continued into that portion of the peritoneum which lines the cavity.

The round ligaments arise from the sides of the uterus close beneath and a little anterior to the uterine extremity of the Fallopian tubes. They pass between the two layers of the broad ligaments, behind the umbilical arteries, and before the iliac vessels, in a direction upwards and outwards to the external opening of the inguinal canal; they then make a turn round the epigastric artery downwards, inwards, and forwards, and pass through the abdominal ring, and dividing into numerous fasciculi and fibres are gradually lost in the cellular substance of the mons Veneris and upper portion of the labia. Besides consisting of cellular substance and blood-vessels, the round ligaments contain some very distinct bundles of muscular fibres, of which the upper arise from the external layer of uterine fibres, and the lower from the inferior edge of the internal oblique muscle, and pass upwards.

Upon a superficial examination, the structure of the uterus would almost seem to be homogeneous; nevertheless a number of reddish-yellow strata interspersed with whitish streaks running from behind forwards, may be perceived even in the unimpregnated state; between these strata the vessels of the uterus take their course, forming numerous anastomoses. There is much difference of opinion among anatomists as to the fibroust structure of the uterus. The majority however agree as to the presence of muscular fibres, some considering that they always exist, while others, and by far the greater number, consider them as appearances peculiar to pregnancy they are, it is true, extremely indistinct in the unimpregnated state, but they are far from being peculiar to pregnancy, as they are frequently developed by any circumstances by which the formative powers

Vesalius, Malpighi, Morgagni, Diemerbroeck, Vieussens, Ruysch, Monro, Hiester. Haller, Ræderer, Meckel, Hunter, Wrisberg, Lobstein, C. Bell. (Meckel's Anat. vol. iv.)

of the uterus are excited. Thus in cases where the uterus has been much distended by some abnormal growth, its fibres become much developed and distinctly fasciculated. Lobstein observed them very distinctly in a uterus which had been distended to the size of a seven-months' pregnancy by a fatty tumour.

The uterine fibres have been usually considered as fleshy, but they differ from the red fibres of voluntary muscles, in being of a paler colour, flatter, and remarkably interwoven with each other; nevertheless they appear to be really muscular fibres from the powerful contraction with which they expel the foetus and placenta, and nearly obliterate the cavity of the uterus. In the unimpregnated state they resemble the fibrous coat of an artery, whereas, those of the gravid uterus are more like the fibres of muscles. Most anatomists agree in describing two sets of fibres, viz. longitudinal and transverse. The external layer of fibres appears to form the round ligaments, which seem to have the same relation with them as tendon and muscle. "The fibres arise from the round ligaments, and regularly diverging spread over the fundus until they unite and form the outmost stratum of the muscular substance of the uterus. The round ligaments of the womb have been considered as useful in directing the ascent of the uterus during gestation, so as to throw it before the floating viscera of the abdomen: but in truth it could not ascend differently; and on looking to the connexion of this cord with the fibres of the uterus, we may be led to consider it as performing rather the office of a tendon than that of a ligament."* "On the outer surface and lateral part of the womb, the muscular fibres run with an appearance of irregularity among the larger blood-vessels, but they are well calculated to constringe the vessels, whenever they are excited to contraction. The substance of the gravid uterus is powerfully and distinctly muscular, but the course of the fibres is less easily described than might be imagined: this is owing to the intricate interweaving of the fibres with each other-an intermixture, however, which greatly increases the extent of their power in diminishing the cavity of the uterus. After making sections of the substance of the womb in different directions, we have no hesitation in stating that towards the fundus the circular fibres prevail, that towards the orifice the longitudinal fibres are most apparent, and that on the whole, the most general course of the fibres is from the fundus towards the orifice.

"This prevalence of longitudinal fibres is undoubtedly a provision for diminishing the length of the organ, or for drawing the fundus towards the orifice. At the same time these longitudinal fibres must dilate the orifice and draw the lower part of the uterus over the head of the child.

"In making sections of the uterus while it retained its natural muscular contraction, I have been much struck in observing how entirely the blood-vessels were closed and invisible, and how open and distinct the mouths of the cut blood-vessels became when the same portions of the uterus were distended or relaxed. This fact of the natural contraction of the substance of the uterus closing the smallest pore of the vessels, so that no vessels are to be seen, where we nevertheless know that they are large and numerous, demonstrates that a very principal effect of the mus

* C. Bell, On the Muscularity of the Uterus. (Med. Chir. Trans., vol. iv.)

cular action of the womb is the constringing of the numerous vessels which supply the placenta, and which must be ruptured when the placenta is separated from the womb."

"Upon inverting the uterus, and brushing off the decidua, the muscular structure is very distinctly seen: the inner surface of the fundus consists of two sets of fibres, running in concentric circles round the orifices of the Fallopian tubes; these circles at their circumference unite and mingle, making an intricate tissue. Ruysch, I am inclined to believe, saw the circular fibres of one side only; and not adverting to the circumstance of the Fallopian tube opening in the centre of these fibres, which would have proved their lateral position, he described the muscle as seated in the centre of the fundus uteri. This structure of the inner surface of the fundus of the uterus is still adapted to the explanation of Ruysch, which was that they produced contraction and corrugation of the surface of the uterus, which the placenta not partaking of, the cohesion of the surface was necessarily broken. Farther, I have observed a set of fibres on the inner surface of the uterus, which are not described: they commence at the centre of the last described muscle, and having a course in some degree vortiginous, they descend in a broad irregular band towards the orifice of the uterus: these fibres co-operating with the external muscle of the uterus, and with the general mass of fibres in the substance of it, must tend to draw down the fundus in the expulsion of the fœtus, and to draw the orifice and lower segment of the uterus over the child's head." (C. Bell, op. cit.)

There are other circumstances which prove the muscularity of the uterus, beyond the mere evidence of its fibres, as seen during pregnancy. "In the quadruped," as Dr. Hunter observes, "the cat particularly and the rabbit, the muscular action or peristaltic motion of the uterus is as evidently seen as that of the intestines, when the animal is opened immediately after death." It is also proved by the powerful contraction which it exerts during labour, and "by the thickness of the fibres corresponding with their degree of contraction." (Ibid.)

The inner surface of the uterus is lined by a smooth or somewhat flocculent membrane of a reddish colour, which is continued superiorly into the Fallopian tubes; inferiorly it becomes the lining membrane of the vagina.

Mucous follicles are only found in the cervix, especially at its lower part: when by chance these become inflamed, the orifice closes, and the follicle becomes more or less distended by a collection of thin fluid. The mucous casts of these follicles have been known by the name of ovula Nabothi, having been mistaken by an old anatomist for Graafian vesicles, which had been detached from the ovary, and conveyed into the cavity of the uterus.

The mucous membrane which lines the cervix uteri is corrugated into a number of rugæ, between which the mucous follicles are chiefly found. Before quitting this subject, it will be necessary to point out the changes which the uterus presents at different periods of fœtal life, and the great resemblance it has at these periods to the uterus, as it appears in the lower classes of the mammalia. We may, however, observe, in the first place, that the uterus is not found to exist as a separate organ until