_Examination of the uterus and its appendages._—In the case of a female the organs of generation should always be inspected; very important conclusions may be deduced from the discovery of an unimpregnated uterus. In the case of _Miss Burns_, to which we have so frequently alluded in the progress of our work, this part of the dissection was so incomplete as to occasion considerable dissatisfaction. The uterus and its appendages having been carefully removed from the body, we should proceed to expose the cavity of the former by an incision, from near the _os tincæ_ to the _fundus_, and by a transverse section at the _fundus_, between the inner ends of the _fallopian tubes_. This organ is liable, amongst other diseases, to inflammation, ulceration, schirrus, tubercles, polypus, dropsy, and organised masses, or _moles_; upon which we shall offer such observations as appear to connect the dissection with questions of forensic interest. In an adult and unimpregnated female its length is about 2½ inches; its thickness, 1 inch; its breadth at the fundus 1½ or 2 inches, and at the cervix about 10 lines. Although it returns after parturition to its original size, it never becomes again so small as it was in the virgin. In women who have borne many children, the neck of the uterus is generally thicker, and more rounded; its orifice, or _os tincæ_, is always very gaping, and the lips more or less irregular, presenting generally one or more grooves, or chops, separated by what appear like tubercles. The _os uteri_ may, however, be as regular in its figure in women who have borne children, as in others; and on the contrary, it may present in the latter, those irregularities which are more usual in the former; hence the inferences drawn from the state of this part, in cases where infanticide is suspected, or where parturition is supposed to have been concealed, cannot be received as being unexceptionable, although they will add to the weight of evidence, and assist us, in conjunction with other evidence, in attaining that high degree of probability, which practically amounts to certainty. The cavity of the _cervix uteri_ undergoes also a change in form and appearance, which it is necessary to notice, although we are not disposed to assign very great importance to its indications. In women who have never borne children, the figure of the cavity may be said to resemble that of two cones joined bases to base, more capacious in the middle than at the two extremities; but, from the time of conception, that extremity of the canal, which opens into the vagina, is dilated; and, after parturition has once occurred, it is always found much wider than before, when it represents a cone with the basis towards the _vagina_, and the apex towards the _fundus uteri_. By a schirrous enlargement, the uterus may arrive at a very considerable size. _Dr. Baillie_ has seen it as large as the gravid uterus at the sixth month; the cavity may also enlarge and contain a _polypus_, which is a very common disease at middle or advanced age; it has been defined “a diseased mass, which adheres to some part of the cavity of the uterus, by a kind of neck, or narrower portion.” An attempt was made on the trial of _Charles Angus_ to explain the appearance presented by the uterus of _Miss Burns_, upon the supposition of an _hydatid_ having been recently ejected from it, (_see vol._ i, _p._ 254.) Water has been known to have accumulated in very considerable quantities in the cavity of the uterus,[38] in some cases to the amount of fifty, sixty, or even a hundred pints.
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Medical Jurisprudence, Volume 3 (of 3) — Part 30
2026-11-15 11:34:36 · Cedar Herald Index
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