It was supposed until quite recently that when the body of the womb
was inclined horizontally forwards, this was unnatural or a sign of
disease, until Prof. B. S. Schultze, director of the gynecological
clinic of Jana, successfully controverted this doctrine. In his work
“_Die Pathologie und Therapie der Lageverænderungen der Gebærmutter_,”
which is the most classical work extant on displacements of the
uterus, says: “From the _post-mortem_ findings it was inferred that
the uterus occupied in the _living_ woman the same position as in the
cadaver; such an assumption did not take into account the actions of
the muscles on the position of the uterus in the living subject nor
the intra-abdominal pressure which is entirely absent after death, so
that the dead organ naturally gravitated backward after the remains had
lain for several days on the back.” Another observer, Dr. Hach, found
in a number of cases that he had examined during life, the uteri bent
forward or antiflexed; twenty-four hours after death he discovered the
same uteri in an opposite direction or retroflexed.
This and similar subsequent researches have demonstrated the fact that
when the body of the womb rests on the bladder it is not in an abnormal
position as formerly supposed and called _anteversion_ or anteflexion,
but that it is natural for it to be so, and when the body is elevated
and its axis forms an obtuse angle with the horizon, the inclination is
a _post-mortem_ condition.
With these precursory remarks I am now able to answer the first clause
of our query, and would say that the uterus is in its normal position
when its long axis is nearly parallel to the horizon or at right angles
with the perpendicular or long axis of the body. The normal position of
the uterus is modified when the bladder is full or distended, for this
lifts the body of the uterus upwards, thus temporarily making an acute
angle with the vertical axis of the body, which was formerly considered
to be the permanent and natural pose of the organ.
In referring to the bony pelvis, Plate I, it will be observed that the
same is in the nature of a canal, for the passage of the child into
the world. At other times than during the child-bearing process, this
canal must be effectually closed to perfectly retain its contents. To
accomplish this purpose it is provided with a bottom or floor, which is
to give this necessary support, not only to the organs that the pelvic
cavity contains but also to the abdominal viscera that are superimposed
upon them. In order to accomplish this, its outlet must be as
effectually closed as the bottom of a box or barrel in which material
things are stored for the purpose of carrying them from place to place.
In the human subject this bottom is called the pelvic floor, because it
serves the purpose of a bottom or floor to the pelvic canal.