Outlines of the diseases of women / by John Phillips.

  • Phillips, John.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Outlines of the diseases of women / by John Phillips. Source: Wellcome Collection.

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    becoming cystic; lastly, the glands of Bartholin may become cystic and project upwards. They contain a clear serous fluid, which may undergo purulent change, one form of vaginal abscess being produced in this way. The cavity is lined by a single layer of cylindrical epithelium. They rarely give rise to symptoms, unless they suppurate or form an obstruction to coitus. Treatment consists in making a free incision, swabbing the interior over with tincture of iodine, and keeping the orifice patent; healing must take place from the bottom of the cavity. (/3) Carcinoma and Sarcoma as primary growths are extremely rare; they occur more commonly as secondary growths, spread- ing downwards from the uterus. Pain, haemorrhage, and fetid discharge are the chief characteristics of them both. The in- guinal glands are enlarged if the lower third of the vagina is affected. Treatment is useless in the secondary form; in the primary disease free excision should be resorted to, but recurrence is frequent. 4. Lacerations after the use of instruments, prolonged labour with consequent sloughing, and violent coitus, may open a passage into the surrounding organs, producing so-called fistulce ; the peritoneal cavity has been opened in rare cases. Vaginismus. By this term is meant a painful reflex spasm of the muscles situated around the vaginal orifice, rendering coition difficult or impossible; the levatores ani and the bulbo-cavernosus muscles (p. 6) seem to be chiefly concerned. The spasm is set up by the slightest attempt at sexual intercourse or digital examination; sometimes even the friction of walking wiU produce it. The spasmodic condition may be limited to the vaginal orifice, or it may extend in bad cases to the whole body. There are two distinct classes of cases in which it occurs: 1. Those in which no local cause can be found, and which are purely neurotic in origin: in these cases the spasm may come on before any contact has occurred, simply owing to the dread of pain, which amounts in some to a monomania. Allied to this condition are cases of painful micturition and defeca- tion without local cause, occurring in nervous and hysterical girls. J2. Those where some painful local condition is found on examination.