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.

    13/18 (page 539)
    reached it is readily seen that the only treatment that can be of any avail is the total removal of all scar tissue and an approximation of the edges of the healthy skin and mucous membrane. The treatment of this condition has been divided into palliative and curative. The former is simply to relieve the subjective symptoms, which at times are excruciating. Carbolic acid and cocaine afford tem¬ porary relief, but the symptoms return soon after with renewed severity. Tait mentions the soothing effect of a solution of neutral acetate of lead in glycerin, placed on cotton between the nymphse. Johnstone advises a salve of yellow oxide of mercury in the early stages. Pure nitrate of silver applied repeatedly lessens the suffering, but has no effect upon the progress of the disease. Hot water often affords con¬ siderable temporary relief. Heitzmann has practised curetteinent and scraping of the diseased tissue, but the result has been entirely unsatis¬ factory and the process a long and painful one, requiring very many repetitions. Martin17 was the first to suggest complete excision of the diseased tissue as a curative measure, and applied the method in five cases, four of which were permanently cured, and one experienced a recurrence. Others have since followed the same method, the results obtained by Reed, and published in the article above referred to, being particularly gratifying. To be completely successful total excision of the diseased tissue should be accomplished. If this is done the prognosis is most favorable. Recurrence has occurred in some cases when this was not obtained and when the operation was performed before the process of atrophy had been entirely accomplished. The history of the following typical case is herewith presented : The patient, aged forty-three years, married nineteen years, is the mother of one child, which is fourteen years old. Her labor was entirely normal, no instrument being used and no febrile reaction fol¬ lowing. She never had a miscarriage. Until the last four years she has been a well woman, although always somewhat neurotic. Four years ago she began to suffer from an obstinate itching about the vulva, which nothing could relieve permanently. Bathing with warm water gave as much temporary relief as anything, although all manner of washes and douches were tried by her physician. At times she suffered from a sensation of drawing and puckering about the vulva, which, however, lasted only a few hours, and then disappeared for a period of months. Her menstrual periods recur every four weeks, remaining for four or five days. The flow was free and accompanied by bearing-down pains which continued half a day. Some years ago she had a slight amount of leucorrhcea, but has had none whatever of late years. At the present time she sleeps well and has a good appetite. She suffers somewhat from indigestion, resulting in gastric distress and ab¬ dominal distention after eating. Her bowels are regular in their action.