Kraurosis vulvæ : a disease of chronic inflammatory nature and characterized by cutaneous atrophy, with marked shrinking and contraction of the vaginal orifice / by J.M. Baldy and H.L. Williams.

  • Baldy, J. M. (John Montgomery), 1860-1934.
Date:
[1899]
Catalogue details

Licence: Public Domain Mark

Credit: Kraurosis vulvæ : a disease of chronic inflammatory nature and characterized by cutaneous atrophy, with marked shrinking and contraction of the vaginal orifice / by J.M. Baldy and H.L. Williams. Source: Wellcome Collection.

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    who were pregnant, and Hallowell9 describes one in a woman of thirty- three, whom he watched all through her pregnancy, and delivered at term without rapturing the perineum, although the skin surface of the vulva was extensively cracked and seamed. Johnstone20 describes kraurosis as trachoma of the urogenital canal. Peters,16 after careful microscopical examination, described the dis¬ ease as a chronic hyperplasia of the subcutaneous tissue and corium, with a tendency to scar-like shrinking of the vulva. Attendant with and as a result of the subcutaneous atrophy, sclerosis and degeneration of the elastic tissue, the whole skin becomes involved with inflammatory oedema and atrophic lesions of the epidermis. But on the primary cause of the disease he throws no light. Peed,15 who re-introduced the subject of kraurosis five years ago, and presented a most complete description of six cases, together with the result of microscopical examination, suggested the term “ progressive cutaneous atrophy of the vulva,” on the supposition that the patholog¬ ical lesions were confined to the skin. As a result of the study of his own cases and the reports of others, he inclined to the theory that the disease of peripheral trophic nerve- filaments, or else the ganglia whence they originate, was the primary etiological factor. This, however, is a matter of theory and has no supporting evidence. Longyear,26 while advancing no positive opinion as to the etiology of kraurosis, nevertheless states that he does not believe the disease to be due to any local or constitutional disturbance outside the nervous sys¬ tem, and that the morbid process is due to defective nerve-action, prob¬ ably reflex in origin. Some writers have attempted to explain the origin of kraurosis in a previously existing specific lesion, but the large number of cases in which no syphilitic history can be traced, and in which venereal affec¬ tions can be almost positively set aside, renders any serious considera¬ tion unnecessary. The testimony of Lewin,22 too, who stated that he had treated between 70,000 and 80,000 women in his clinic at the Charite without ever seeing a case of kraurosis vulvse, confirms the belief that this peculiar disease of the vulvse is not of syphilitic origin. Veit,33 although himself having had but one case, reviews the whole subject in a scholarly article, and while exceedingly conservative in his statements as to what may be definitely proven in regard to the causa¬ tion of the disease, nevertheless advances theories of etiology that are rational and deserving of careful consideration. In his opinion a close relationship exists between pruritus and kraurosis. Recognizing in pruritus only a symptom, which by scratching is also able to produce an alteration of the skin of the vulva, in kraurosis he