A Text-book of Diseases of WomenPenrose, Charles B. (Charles Bingham)
Science
A Text-book of Diseases of Women
Penrose, Charles B. (Charles Bingham)
Women -- Diseases
In describing the lesions of laceration of the cervix and cervical
catarrh, frequent mention has been made of the cervical erosion or
the catarrhal patch. The erosion, or red granular area, surrounding
the external os seems to be caused by various factors. In laceration
it is due to the eversion and exposure of the normal cervical mucous
membrane, and perhaps to slight proliferation of the cylindrical cells
of this mucous membrane on to the mucous membrane of the vaginal
aspect of the cervix. In cervical catarrh it is caused by swelling and
prolapse of the mucous membrane of the cervical canal, and extension
of the inflammatory process beyond the limits of the external os, with
partial desquamation of the squamous cells.
There are other cases, however, in which the erosion appears to be
congenital. Such erosions have been observed by Fischel and other
investigators surrounding the external os in new-born infants. Erosion
of this character has been found, in a more or less marked degree,
in 36 per cent. of new-born infants. Microscopically, these erosions
appear to be a direct continuation of the mucous membrane of the
cervical canal. They are covered with a single layer of cylindrical
epithelium, and they possess mucous glands, resembling in these
features the cervical mucous membrane, and not the mucous membrane
of the vaginal aspect of the cervix, which, it will be remembered,
is covered with squamous epithelium and contains no glands. This
congenital erosion usually is of very limited extent, but in some
cases it covers the greater part of the vaginal aspect of the cervix,
and may then give rise to decided symptoms. The condition is due to
imperfect development of the external os. In the well-formed woman
there is, at the external os, a sharp line of demarcation between
the squamous epithelium of the vaginal aspect and the cylindrical
epithelium of the cervical canal. In the congenital erosion the
epithelium of the canal extends beyond the limits of the external os,
and meets the squamous epithelium at a lower level than normal.
Such congenital erosions usually give rise to no trouble, though
perhaps they predispose the woman to cervical catarrh as a result
of exposure of the mucous membrane. In extreme cases, however, in
which the cylindrical epithelium of the cervical canal persists over
the greater part of the vaginal cervix, and in which the glandular
elements of the canal are found on the vaginal aspect, a distinct
pathological condition arises. The symptoms of this condition resemble
closely those of laceration of the cervix with ectropion. There is
backache, a feeling of weight in the pelvis, and perhaps some ovarian
pain. In addition, the woman complains of a leucorrhea presenting the
characteristics of the cervical mucus. Decided nervous and digestive
disturbances may be present.
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