File:Tri-State medical journal and practitioner (1897) (14591828438).jpg

Identifier: tristatemedicalj4189unse (find matches)
Title: Tri-State medical journal and practitioner
Year: 1897 (1890s)
Authors:
Subjects: Medicine
Publisher: St. Louis : (s.n.)
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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e is pre-sented by the external genitalia. It is not unusual for the labia minoraand clitoris to be destroyed, the labia majora also suffering severely. InFigure 3 may be seen a picture of a case in which both labia minora, theright labium niajus and the clitoris were destroyed. The encroachmentof the process on the right buttock is also plainly seen, as well as the iso-lated patches of destruction separated from the main phagedena. It is notat all unusual for the phagedenic process to encroach upon the vagina, andsubsequently lead to a greater or less atresia or stricture, caused by repar-ative cicatrization. In the case shown in Figure 3 there existed a foul, 502 Original Articles. sanious secretion of ill-smelling pus, considerable in quantity and of ahighly corrosive character. Throughout the pus shreds of disintegratedtissue could be observed. The treatment of phagedenic chancroid is one which needs more thanordinary care and attention, as has already been said above. The first 1
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Fig. 3. Extensive Phagedenic Chancroid of Vulva. thing to do is to give the ulcerated surface a thorough cleansing by meansof a warm solution of some antiseptic. The strength need not be particu-larly marked, as the object is to obtain, as far as is possible, a comparativelyclean field to work on. If the surface be extensive and offer a compara-tively large area, as in the cases shown in Figures 2 and 3, the patientshould be anesthetized, as the pain of the subsequent operation is such as to Phagedenic Chancroid—Ohmann-Dumesnil. 503 be unbearable without recourse to general anesthesia. Cocaine is impotentin such an instance, as it does not penetrate to a sufficient depth; and theinfiltration method is more tedious than administering an anesthetic. Theoperation consists in curetting the ulcerated surface, in order to remove allthe destroyed and partially-destroyed tissues. Of course, it is not neces-sary to resort to this measure in every case, as some can be very welltreated, when t

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