File:The diagnosis of diseases of women (1905) (14576874747).jpg

Identifier: diagnosisofdise00find (find matches)
Title: The diagnosis of diseases of women
Year: 1905 (1900s)
Authors: Findley Palmer. (from old catalog)
Subjects:
Publisher: Philadelphia and New York, Lea brothers & co.
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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of the vaginal secretion. The tubercle bacillus has beendemonstrated in the secretions of the vulva by Menge, Chiari,Dechamps, and Demure. Diphtheritic vulvitis has been identifiedmany times by the finding of the specific organism. It has been estimated that 75 per cent, of the cases of vulvitisare caused by gonorrhoea. The leptothrix and oidium have beendemonstrated by Wenkel. DIAGNOSIS OF DISEASES OF THE VULVA 251 In addition to the above-named essential factors may be men-tioned certain exciting causes, such as excessive sexual intercourse,masturbation, uncleanly habits, irritating urine, and vaginal secre-tions. The following varieties are recognized: Vulvitis furunculosa, in which multiple small abscesses are foundupon the labia majora, less frequently upon other portions of thevulva. These abscesses are usually found in the sebaceous andsweat-glands. Of all the glands of the vulva, the Bartholineanglands are most commonly infected, and gonorrhoea is the cause in Fig. 90 Fig. 91
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Enlargement of the vulvovaginal gland bycyst or abscess. (Schaffer.) Right inguinal hernia simulating vulvo-vaginal cyst or abscess. Eversion of anteriorand posterior vaginal walls. (Schaffer.) a great majority of the cases. As a rule, the glands are not exten-sively involved. The mouths alone of the glands may be involved,giving rise to the so-called *maculae gonorrhoeica of Sanger.Gebhard affirms that when suppuration occurs in the gland thereis always a mixed infection of the gonococcus and staphylococcus.It is very unusual to observe Bartholinitis in infants. The sizewhich these infected glands may attain is from that of a split peato a mans fist. The infected Bartholinean gland is located in the labia majora;is round or oval, firm or fluctuating, and may or may not be tender. 252 SPECIAL DIAGNOSIS It is to be differentiated from hernia into the labium (Figs.90 and 91). The latter is not tender, is elongated, tympanitic onpercussion, and may be made to disappear by taxis. When red

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