cervix lengthens, so that a process of peritoneum may be
found under the vaginal reflection on the posterior surface
of the cervix. These facts require to be borne in mind in
amputation of the cervix, lest the bladder be injured. The
opening of the cttlom (peritoneal cavityj is less serious, and
is perhaps in most cases unavoidable.
A distinction is made by many Continental writers be-
tween hypertrophy of the supravaginal portion proper, and
the part which they describe as
the intermediate portion (Fig,
39). The former is said to cause
obliteration of both vaginal for-
nices (Fig. 37), whilst in the lat-
ter variety the po.sterior fornix is
preserved (Schroeder). In the
form which we are now about to
describe both forniccs remain.
Hypertrophy of the Vagi-
nal Portion of the Cervix. —
This i.s often spoken of as the
mfrm'aginal portion ; the above
term is more correct. A small
degree of hypertrophy often oc-
curs, as previously stated, in connection with chronic cer-
vical catarrh and erosion ; the enlargement is then more
strictly speaking due to inflammatory infiltration, with
thickening of the glandular tissues, and we need not dwell-
on it further.
Hypertrophy proper is a developmental or congenital
condition, but it is described here instead of in the chapter
on Malformations for convenience and for the sake of com-
parison with the previous condition. The growth takes
place principally at the time of puberty, and nothing is
known as to its causation. It is generally associated with
stenosis of the external os, which presents the "pinhole"
type. The elongation may be so great that the cervix




39. — Diognn af the thri
flhE iiteiini uctk (SthrDedci]



DISEASES OF THE UTERUS.
