ABOUT RUDIMENTARY UTERUS

From the description of cases of absence of the uterus we next come to the description of those in which the uterus is indicated by the presence of muscular or fibrous structure. Such I will term cases of rudimentary utenis. Most of the imperfect observations and reports of absence of the uterus undoubtedly belong to this class. At the point of junction between the round ligaments and the inner extremities of the Fallopian tubes, a thin membranous or fibrous septum is seen descending, and either merging into the posterior walls of the rectum, or tapering up from a cloaca or sinus urogenitalis in the direction of a rudimentary vagina, and ending in a bhnd sac.

CAN RUDIMENTARY UTERUS BE POSSIBLE IN MALE ALSO?

This form I would term memhranous iiterine rudiment, and classify with it the case of Lucas in which the vagina ended in a blind sac two and half inches from its orifice, and in place of the uterus, a membranous tissue, one inch in width, extended from the blind sac of the vagina to the position the uterus should have occupied ; the round ligaments occupied the usual position, and were at the exterior limits of this membranous mass, with the inner extremities of the Fallopian tubes.

As a second form of rudimentary uterus, I consider the bulky , densely fibrous and wvpeyfiorate rudiment of Kussmaul. in this form is represented by a round, fibrous, solid body, botli sides of which elongate into two cord-like horns. The case of Khnkosch (Hill) in which a fixed cylindrical body tlu-ee inches long was found in place of a uterus. Fallopian tubes and ovaries, belongs to this class.

Kussmaul further mentions the cases of Dupuytren and Macfarlane as likewise belonging to the above. As a third form of rudimentary uterus we describe the bow- shaped rudiment of Kussmaul. This is represented by a flattened, solid, muscular ligament, extending across the pelvic cavity hke a bow arched upwards, and merging on both sides into the round ligaments. The neck of the uterus is entirely absent, the horns and fundus being only outlined, and not forming a uterine cavity. Kussmaul mentions the cases of Nega and Krocker as illustrating this form. The form next to be considered is that of an imperforate body with round stalk-shaped horns resembling a continuation of the round ligaments. Forster at the request of Kussmaul gave a description of the specimen in the Gottingen Museum, formerly described by Langenbeck as one of absence of the uterus, and he considers it as belonging to the form just men- tioned. The condition of the other organs of the generative appara- tus and the body in general, in cases of rudimentary uterus, i& similar to those in which the organ is completely absent. The last mentioned form of rudimentary uterus is closely allied to that arrest of development which Mayer (of Bonn) calls uterus bipartitus, and others uterus bifidus. In this form neither the body or cervix have been fully devel- oped, the horns only being formed as round bodies either hollow throughout, or having a small cavity in them, which bodies can- not be easily confounded with other parts.