. Maladies des femmes. Un guide clinique de leur diagnostic et de leur traitement. glas conteneug sérum Fold of cervicalcaual VeinSymphysis pubis. Urètre tissu cellulaire eVagina anus (partie supérieure) Fig. 94.—Section à travers le bassin de la femme puerpérale dans le plan sagittal, le tissu showingcellulaire entre l'utérus et la vessie. {après Barbour.) —dans certains cas de paramètrite puerpérale, l'inflammation ne monte pas au-dessus du bord pelvien, mais s'étend dans le samemanner comme dans la forme non puerpérale, vers le bas jusqu'à la sortie pelvienne et vers l'arrière autour du rectum. Les Thesecases ressemblent à une paramétite non puerpérale dans leur cour

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. Diseases of women. A clinical guide to their diagnosis and treatment. glas containiug serum Fold of cervicalcaual VeinSymphysis pubis. Urethra Cellular tissueVagina Anus (upper part) Fig. 94.—Section through pelvis of puerperal woman in sagittal plane, showingcellular tissue between uterus and bladder. {After Barbour.) —In some cases of puerperal parametritis the inflammationdoes not rise above the pelvic brim, but extends in the samemanner as in the non-puerperal form, downwards to thepelvic outlet and backwards around the rectum. Thesecases resemble non-puerperal parametritis in their course andeffects. The unusual course of the inflammation doubtlessdepends upon some peculiarity in the time or manner ofits causation, but I know not what. Anterior parametritis.—Sometimes parametritis begins 278 DISEASES OF WOMEN. in the vesicouterine cellular tissue. (Fig. 94.) This is notcommon. It may suppurate and burst into the vagina or intothe bladder, or extend into the inguinal region. (Fig. 95.)The cases I have seen have been mostly non-puerperal; but I. have not seen enough to make me sure that this is the rule.One of my patients was a virgin; another was sterile, andattributed the inflammation to excessive sexual intercourse, but whether this was cause or coincidence I know not. Pubo-vesical cellulitis.—I have twice seen inflammation of PARAMETRITIS. 279 the cellular tissue between the bladder and pubic symphysis.One case ended in recovery by absorption of the exudationwhile the patient was attending as an out-patient. The othersuppurated; the patient was admitted into hospital, and theabscess opened. I explored the cavity with the finger, butcould find no sign of bone disease, nor anything to account forthe inflammation. The cavity quickly closed. The illness ineach case was over in less than a month. Non-puerperal inguinal parametritis.—Sometimes, butvery seldom, in parametritis independent of pregnancy, theinflammation extends upwards into the groin. I hav

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