Hyperemia of the uterus, and especially of its mucous membrane, with effusion of blood in various states of coagulation and discoloration, is often observed in the dead subject as menstrual congestion and hemorrhage. It also occurs in combination with tumefaction (congestive intumescence) of the uterus and its appendages, with relaxation of its parenchyma and the mucous membrane, dark color, copious sanguineous contents, and hemorrhage into the uterine cavity, representing active or passive congestion or mechanical stasis, consequent upon excessive or anomalous menstrual discharge, or other injurious influences.

Advanced degrees of hyperaemia give rise to uterine apoplexy, i. e. to effusion of blood into the uterine parenchyma, with or without concurrent hemorrhage into the cavity of the organ. It is observed in two distinct forms.

One occurs at the period of decrepitude, and is chiefly caused by the marcidity of the uterine tissue above alluded to, and by the rigidity of its vessels; its main seat is the fundus uteri, to which it may be entirely limited, or at which, if more extensively diffused, it has taken its origin, and is most prominently developed. The fragile and softened uterine tissue presents a dark red or black discoloration, extending to a greater or less distance from within outwards; the accumulation of blood may be so considerable as to destroy all traces of structure; it oozes from the cut or broken surfaces, in greater or smaller quantities, according as it is more or less coagulated. The mucous membrane presents a similar condition, and the uterine cavity very often contains more or less slightly coagulated or fluid blood. The posterior wall of the uterus is but rarely affected, and if so, but to a slight extent.

This form of apoplexy undoubtedly constitutes many of the metror-rhagic cases that occur in advanced age; the lower degrees may be cured, the tissues subsequently presenting a loose, retiform, contused, and porous appearance, of a rusty or yellowish color.

The second form results from tedious and slow labors; it occupies the lower segment and the cervix of the uterus. The affected portion appears dark rek, and full of blood; the part is dilated, relaxed, pendulous and paralyzed, and there may be contusion and laceration also.

Anaemia accompanies an arrest of development, marasmus, induration of the uterus, and general anaemia.