The PATHOLOGICAL ANATOMY may involve all the displaced organs. The circulation throughout the pelvis is impeded by traction upon the vessels, and the entire pelvic contents therefore become the subject of venous congestion, with consequences disastrous to local innervation and nutrition. The ovaries may suffer concurrent displacement, with resulting inflammatory and cystic enlargement. The peritoneum which enters into the formation of the uterine ligaments and of the pelvic floor is dragged along with the uterus. The vagina is hypertrophied and swollen. Its mucous membrane becomes the seat of acute vaginitis and chronic catarrh. In the third degree of descent the exposed vagina, no longer lubricated by the normal secretions of the uterus, becomes dry, parchment-like, oedematous, eroded, and ulcerated. Sometimes the cul-de-sac of Douglas is distended by downward pressure of the intestines, by a small tumor, or by ascitic fluid, and a consequent hernial sac may protrude into the vagina through some portion of the posterior vaginal fornix. The anterior fornix is subject to a similar accident. These conditions are designated enterocele vaginalis, anterior and posterior. The rectum and bladder are subject to inflammation and chronic catarrh, and the bladder especially to concurrent descent. The uterus may be enlarged from any one or all of a variety of causes--congestion, subinvolution, hypertrophy, and hyperplasia. Its cervix is often the seat of extreme erosion or so-called ulceration. The endometrium, in order to relieve the organ of its surplus blood, gives forth an excessive secretion of mucus, which upon being increased in quantity becomes vitiated in quality. This is termed uterine catarrh. The enlargement of the uterus often pertains more to the cervix than to the body, especially in prolapse of the second and third degrees. An explanation of this may be found in Figs. 5 and 6. [Illustration: FIG. 5. Descent of the Virgin Uterus into the Vaginal Canal, showing the Reduplicated Vaginal Walls. The utero-vaginal attachment, points _X_ and _Z_, appears to be at _X'_ and _Z'_. The apparent increase of length in the vaginal portion of the cervix due to the reduplication is measured by the distance from _X_ and _Z_ to _X'_ and _Z'_.] [Illustration: FIG. 6. Descent of the Uterus, showing Excessive Circular Enlargement of the Lacerated Cervix, consequent upon Reduplication of the Vaginal Walls and Out-rolling of Intracervical Tissues. The divided fragments of the os externum are at _a_ and _b_. The curved lines forming the angles 1, 2, 3, 4, and 5 indicate the gradual process of the eversion. The angle of the laceration at point 1 has been forced by the swelling and out-rolling of the mucous and submucous tissues of the cervix to point 5. The apparent os externum is at point 5. The utero-vaginal attachment _X_ and _Z_ seems to be at _X'_ and _Z'_. The vaginal portion of the cervix therefore appears much larger and longer than it actually is.]