Le diagnostic et la pathologie gynécologique . avec un singlelayer d'épithélium cylindrique (fig. 74). Cet épithélium est réglé sur une certaine pathologie gynécologique 80 membrane de sous-sol ; les cellules ont un nucleusand ciliées sont placé au centre vers la surface libre de la muqueuse. Il producethe la sécrétion alcaline aqueuse de la muqueuse utérine. Changements menstruels dans les muqueuses.-c'est seulement d'lateyears, comme le résultat de l'examen de frottis utérin et d'uteriremoved pendant les règles, que nous avons appris la nature de thechanges qui se produisent en ce moment. Pendant plusieurs jours

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Gynecological diagnosis and pathology . with a singlelayer of columnar epithelium (fig. 74). This epithelium is set on a 80 GYNECOLOGICAL PATHOLOGY definite basement membrane ; the cells have a centrally placed nucleusand are ciliated towards the free surface of the mucosa. They producethe watery alkaline secretion of the uterine mucous membrane. Menstrual Changes in the Mucous Membrane.—It is only of lateyears, as the result of the examination of uterine scrapings and of uteriremoved during menstruation, that we have learned the nature of thechanges which occur at this time. For several days before the onset ofmenstruation the mucous membrane of the body is becoming morevascular. The capillary vessels dilate and a transudation of serumtakes place through their walls, resulting in an oedema of the stroma.The stroma cells proliferate and enlarge (fig. 75). The uterine glandsbecome tortuous and the epithelium proliferates, so that an appearancelike that described as glandular endometritis may be produced. These **&»». Fig. 75.—Mucous Membbaue of Uteilus just BEFORE Menstruation. Note the looseness and oedema of the stroma and the dilatation of the vessels. changes result in a considerable thickening and softening of themucous membrane, affecting also the wall of the uterus. Asthe day of menstruation approaches, the capillaries become moredilated and a diapedesis first of white and then of red cells takes placethrough their walls. Finally the walls give way in places and thecontained blood is estravasated into the stroma, which has beenpreviously opened up and loosened by oedema. The extravasated bloodfinds its way to the surface and escapes into the cavity of the uterusthrough a series of minute breaches in the surface epithelium (figs. 7G, 77). There is no casting-off of the surface epithelium as a whole as wasat one time thought, except under pathological conditions such asmembranous dysmenorrhrea, where the greater part of the mucosa maybe detached and come aw

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