By dropsy of the uterus we understand an accumulation of serous or mucous fluid within its cavity. It is generally the immediate consequence of stricture or atresia of the orifices, and occurs in its true form only after the cessation of menstru- ation.
If tlie efflux of uterine mucus secreted in considerable quan- tity, be impeded by the above-mentioned causes, it accumulates in the cavity of the body of the uterus when the impediment is situated at the internal orifice, and in the cavity of the cervix, when it exists at the external orifice. In rare cases also of stricture of both orifices, accumulation of fluid takes place in the cavity of the body as well as in that of the cervix. In stricture of the internal orifice the cavity of the body of the uterus dilates in such a manner as to become globe shaped ; its walls are uniformly distended, and in general are found in a state of eccentric hypertrophy. If the distention attains a higher degree the uterus is finally transformed into a thin- walled sac with inelastic walls. Investigations, especially of cases of considerable hydrometra in aged females, show that the elements of connective tissue predominate considerably over those of muscular tissue and we must assume that the latter are chiefiy destroyed by the distension, and that the hyperplasia accompanying nearly every case of hydrometra, chiefly aflfects the connective tissue. When the cavity of the body of the uterus is considerably distended, its mucous membrane becomes thin and degener- ates, and its external soft velvet-like appearance is lost, its sur- face assuming the smooth, glossy appearance of serous mem- branes. If the uterus be further distended it becomes net- like in appearance, and is Anally changed into a soft layer of connective tissue covered with a single layer of frequently degenerated cyhndrical epithelial cells. The latter generally, and in the higher degrees of hydrometra, always loose their cihas, and appear shorter and thicker, resembling the so- called transitory epithelium. I have been unable, even in the highest degree of hydrometra, to discover the pavement epithe- lial cell, which is found in analogous conditions of the gaU bladder. The glands of the uterine mucous membrane in the commencement of hydrometra, are generally affected with a fatty degeneration of their epithelium, and are finally destroyed, leaving indurations in the mucous membrane. Sometimes also tlie utricular glands degenerate into small cysts. The fluids contained in the cavity of the uterus are at first a viscid mucus, sometimes clear or serous, sometimes slightly turbid and yellowish or brown in color. In many cases of atresia after menstruation has made its appearance for a short time only, or several times and then ceased, a hsematometra formed at first, may turn into hydrometra, and the hsematine being changed into brown pigment, may give a peculiar color to the fluid. Upon closer investigation we find varying quan- tities of cast-off epithehum and colloid bodies suspended in a mucus fluid. After a longer continuance of hydrometra how- ever, we generally find the contents strongly alkaline, very fluid and nearly or perfectly clear. The mucous substance contained in the secreted fluid may have been dissolved by its alkalescence.* In stricture of the external orifice the cervical canal is dis- tended Hke a pouch, and we may mention that the cavity of the uterus participates only slightly in the enlargement. Fre- quently enough I have observed pouch-hke distention of the cervical canal without dilatation of the uterine cavity. In every such case there was stricture only at the external orifice. Ob- struction of the cervical canal being the chief cause of disten- tion of the cavity of the uterus, we are led to assume that in such cases there is no hypersecretion of the uterine mucous membrane, consequently that the cervical mucous membrane alone is diseased, or, which seems possible, that although the cervical catarrh may be most severe, a slight catarrh of the uterine mucous membrane may co-exist, but that a temporary emptying of the cervical canal occm's from time to time and the uterus distended by accumulated fluid, contracts and tem- porarily assumes its former size, whilst the less muscular cervix is distended to its utmost at an earlier period and remains