Traité sur gynæcology : médical et chirurgical . forme iale, propre à la membrane thémateuse où ils sont développés. À un stade avancé de l'évolution, le cancer du corps de l'uterusmai ulcerate, ou, comme le Cornil l'a trouvé, la muqueuse peut être préservé et simplement élevé par les lobules épithéliaux. La muqueuse du corps de l'utérus est habituellement easilyreconnue, car ses cellules épithéliales sont préservées bien que couvertes par certaines cellules errant, mais ses glandes sont atrophiées et leurs cellules cylin-droicales sont très petites, le tissu conjonctif étant mince et com- 402 CLINIQUE ET OPEKA

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Treatise on gynæcology : medical and surgical . ial form, peculiar to themucous membrane where they are developed. At an advanced stage of evolution, cancer of the body of the uterusmay ulcerate, or, as Cornil has found, the mucous membrane may bepreserved and merely elevated by the epithelial lobules. The mucous membrane of the body of the uterus is usually easilyrecognized, for its epithelial cells are preserved although covered bycertain wandering cells, but its glands are atrophied and their cylin-drical cells are very small, the connective tissue being thin and com- 402 CLINICAL AND OPEKATIVE GYNAECOLOGY. pressed. In other 23laces the mucous membrane is reduced to a verythin layer of connective tissue lined by one simple layer of cylindri-cal cells (Fig. 204). At a later period the muscular layers are infiltrated by the neo-plasm, and there may also be extension to the tubes and ovaries. I have described as a unique anatomical curiosity a case of pri-mary pavement epithelioma of the body of the uterus, observed byO. Piering.12. Fig. 201.—Epithelioma of the Uterus. X 120. 6, 6, Lobules of the epithelioma; m, lobules showingempty spaces, which are either transverse sections of vessels or cavities filled with cells in mucous degen-eration; n, smaller alveoli of the epithelioma. Nearly all of these epithelial cells have a tendency towardisolation by the walls of the spaces that enclose them. Symptoms.—Hemorrhage is the primary symptom, and, as in can-cer of the cervix, it is usually accompanied by a serous discharge13 ofa reddish color and a stale, disagreeable odor; with this there is oftena discharge of small shreds of tissue from the broken fungosities. The pains and the other functional and reflex symptoms are, fora long time, those which I have described under the head of the uter-ine syndroma (vide metritis); but according as the disease becomesmore advanced the pain takes on a paroxysmal character which is re-markable and almost pathognomonic. These cris

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