After the discharge of the ovule consequent on the rupture of the Graafian vesicle, the walls of the vesicle contract on the matter that is effused within it, and form a compact mass, which after a time has an orange yellow color—this is called the corpus luteum.
Ordinarily, in the human female in the normal condition, a new Graafian vesicle increases in size every month, becomes excessively developed, and finally bursts and discharges its ovule, to become, through successive transformations, the corpus luteum. What is called the “monthly sickness,” “monthlies,” “courses,” etc., never occurs without having been preceded and accompanied by the development of a Graafian vesicle.
CHAPTER IV.
OF DISPLACEMENTS OF THE UTERUS.
In order to compress as much as possible what I say upon these topics, I shall consider here displacements of the uterus, both of those which occur in the pregnant and non-pregnant women.
By the inflection of the peritoneum the uterus is permitted to expand freely during pregnancy, and to rise without inconvenience into the cavity of the abdomen; this it could not do if it was confined to its place by short ligaments, or by adhesions. But from the same cause, women become liable to various diseases; to the retroversion of the uterus, and other displacements; to dropsy of the peritoneum, and to that species of hernia which is occasioned by the descent of the intestines between the vagina and rectum.
By PROLAPSIS is meant that condition in which the uterus falls below its natural level in the pelvic cavity. Procidentia is a term used to signify the protrusion of the uterus beyond the vulva. Women are liable, even when young, to a falling of the womb, but it occurs most commonly after the age of thirty-five, in such as lead a laborious life. Amongst other causes may be enumerated violent bearing down efforts, such as are made in straining to pass hardened feces, or in urging an evacuation through a stricture in the rectum, in coughing, lifting heavy weights, etc.
The immediate causes of the displacements are the pressure on the uterus by the viscera above it, and a diminution in tone of the uterine supports.
Displacements of the womb are more common among women who have hollow and capacious pelves; in sufferers from dropsy, and in delicate, flabby subjects, where the broad and round ligaments are affected and elongated.
There may be prolapsis during the early months of pregnancy, and in cases where the pelvis is large and the ligaments are relaxed, the womb may rest on the perineum; or the neck, and even the body may become visible externally; but it subsequently rises out of the pelvic cavity, assuming a normal position.
When a woman has prolapsis uteri she often complains of a sense of weight about the pelvis, of dragging pains, of a wearisome backache, and of a leucorrhocal discharge. Menstruation is seldom interfered with, and as the uterus goes back of itself, or is easily pushed up when the patient is in bed, conception may take place, and the general health may not be directly affected.