Volume 2

A system of gynecology / by American authors ; edited by Matthew D. Mann.

Date:
1887-1888
Catalogue details

Licence: Public Domain Mark

Credit: A system of gynecology / by American authors ; edited by Matthew D. Mann. Source: Wellcome Collection.

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    application with the lint tampon (jij to Oj) have seemed to me of more benefit than anything else. In puerperal cases the tampon is of course omitted. Granular or Follicular Vaginitis, which is chiefly due to the general venous stasis of the blood caused by the pressure of advancing pregnancy, is so rare as to be almost a medical curiosity. Deville first termed it vaginite granuleuse; and, as its name implies, its chief characteristic is the minute papillary or granular elevations which stud the surface of the vagina. In the few imperfectly developed cases I have seen (three in number, all in late pregnancy) these have been dusky red in color, attended with much itching and burning, and exud- ing a thin rnuco-purulent discharge. Dr. Thomas mentions a more striking case he once saw in consultation where the vaginal surface simulated malignant disease. The treatment is as for simple vaginitis. In pregnancy it rarely disappears completely until after confinement. Learned German authors make many other subdivisions of vaginitis, Buch as vesicular, emphysematous, exfoliative, septic, erysipelatous, and dysenteric vaginitis ;l but into these it is unnecessary to enter in a short practical treatise like the present. Malformations. Under this heading are generally included— a. Congenital absence of the vagina; b. Atresia, congenital or acquired ; c. Cicatricial bands; d. Double vagina. Complete absence of the vagina is, fortunately, extremely rare, and when it does occur it usually accompanies absence or rudimentary development of the uterus and ovaries. Such a condition is always an arrest of development, from failure of union or coalescence of the ducts of Miillcr. In the embryo these make their appearance on the front of the Wolffian bodies from the fourth to the sixth week. Supe- riorly, they remain separate as the Fallopian tubes; inferiorly, they unite to form the uterus and vagina. Imperfection of this union results, in accordance with its degree, in non-development or imper- fect development of these organs.2 1 Vide Chiari: Zeitschrift f. Heilh, 1885, vol. vi. p. 81; and Breisky, in Grandins Cyclop. Ob*t. and Gyn., x. 328, 1887, rearranged from his Krankheiten der Vagina, Stutt- gart, 1879, and his monograph in BMroth's Handbuch der Frauenkrankheiten, Band hi., 1886. 2 Leukart (Med. Zeitung, Munchen, 1852, vol. i. part 1, p. 1) and Thiersch (ibid,, vol. i. part 2, p. 69) originally demonstrated this development in the mammalian embryo, and all subsequent writers have accepted their conclusions as applied to the human foetus (vide Breisky: Cyclop. Obst. and Gyn., x. 211).