Vulmea

“ It may be caused by the irritation from the discharges of a vesico-vaginal or recto-vaginal fistula, from a cancer of the cervix or in some forms of endometritis. Girls and 37 women who are unclean may be attacked by vulvitis as a result of irritation from decomposed smegma, sweat, urine, etc. The oxyuris, or thread-worm, may enter the vulva from the rectum and cause, in unclean children, sufficient irritation to produce inflammation. Vulvitis from uncleanliness is most likely to occur in hot weather after prolonged exercise. ”

“ A venereal bubo, or scrofulous enlargement of glands, or enlargement of femoral or inguinal gland due to traumatic or other causes which may be attended with fever should not be mistaken for a plague symptom. A medical man who has, however, carefully observed the facies of a few cases of true plague, and who carefully takes into consideration all other probable conditions which may be mistaken for plague, may not commit a mistake, but its probabilities are to be borne in mind. ”

“ The inflammation subsides, but some of the swelling remains in dependent members of the body, arms, legs, breasts, vulva and scrotum. These swellings may be caused by dead filaria worms, which block the glands whose function it is to drain a dependent area; thus the dead worms might impede the return flow of lymph and cause an overgrowth of skin and subcutaneous tissue, slowly piling up to a huge size. The skin grows rough like an elephant’s hide, and the monstrous limbs add to the elephantine look. ”

“ When I touched the glands in the groin, they felt like walnuts under the skin, and it is, as I said, the presence of this obvious symptom which gives the plague its characteristic name of “bubonic,” from the Greek word for groin. After incision, the patient’s temperature often goes down rapidly, but, in any case, the pain from the glands is usually very great; indeed, I think it is the chief cause of such pain as the plague gives.
Next to heart failure, the commonest cause of death is lung complication after the crisis of fever is passed. ”

“ I have seen this Suppression in strong Habits quickly followed with an Inflammation about the Seat of the Vomica, which has obliged me to bleed, after which the Expectoration immediately returned.
§ 82. It happens sometimes, that the Vomica is entirely cleansed; the Expectoration is entirely finished, or drained off, the Patient seems well, and thinks himself compleatly cured: but soon after, the Uneasiness, Oppression, Cough and Fever are renewed, because the Membrane or Bag of the Vomica fills again: again it empties itself, the Patient expectorates for some Days, and seems to recover. ”

“ Former Causes of Vulvovaginitis in Little Girls—Discharge Chief Symptom—Evil Results of Vulvovaginitis—Psychic Results of Treatment—Effects in Hastening Sexual Maturity—Vulvovaginitis a Cause of Permanent Sterility—Measures to Prevent the Disease—Toilet Seats and Vulvovaginitis.
The mucous membrane, or the lining of the vulva and vagina, in little girls is very tender, and therefore very readily subject to infection. An infection of the vulva and vagina due to the gonococcus or to some other germ is very common in little girls. ”

“ The infected child should sleep by herself, and utmost care must be exercised in preventing her fingers from first touching the itching vulva and then placing them to the eyes or to the mother's eyes. A vulva pad must be worn as long as the disease lasts. The physician will give you the proper medicines to be used in these cases, and if no physician is within reach, you are perfectly safe in dropping into the spread apart vulva a few drops of twenty-per-cent argyrol and then applying the vulva pad. After each treatment the hands of the mother or nurse must be most rigidly cleansed. ”

“ The affected glands actually contain the germs which have made their way to them through lymph channels under the skin. When the glands begin to swell, the critical period of limitation of the disease to the starting-point will soon be over and the last chances for a quick cure will soon be gone. At any moment they may gain entrance to the blood stream in large numbers. While the swelling of these glands occurs in other conditions, there are peculiarities about their enlargement which the physician looking for signs of the disease may recognize. ”

“ The most frequent alteration, however, of the genital organs of the female, which may be thus produced, is an inflammation of the membrane which lines the vulva and vagina. This inflammation is constantly indicated by a more or less abundant leucorrhœal discharge, and often by swelling, redness, and pain. When this discharge continues, which is often the case, it occasions in young females symptoms analogous to those of diurnal pollution. The complexion loses its color, and becomes yellowish; the eyes are constantly suffused, and the countenance is sad; the patients are feeble and careless ”

“ In some cases the first symptom noticed is a swollen and painful gland, but fever soon manifests itself. The glandular enlargement may antedate, coincide with, or follow the rise in temperature. Sometimes only pain in the gland is complained of, but no swelling is observed. ”

“ The lymph passes on to the deep inguinal and external iliac glands. The superficial glands through their relations to the genitals are frequently the subject of venereal infection, and also of epithelioma when this disease affects the genitals or anus; they are rarely the seat of tuberculosis. _The deep inguinal glands_ lie on the medial side of the femoral vein, and sometimes within the femoral canal. They receive lymph from the deep lymphatics of the lower limb, and some of the efferent vessels from the femoral and superficial inguinal glands. ”

“ Notwithstanding I have supposed dropsies to be connected with a peculiar state of force in the blood-vessels, yet I have not ventured to assert, that dropsies may not exist from an exclusive affection of the exhaling and absorbing vessels. I conceive this to be as possible, as for a fever to [188] exist from an exclusive affection of the arteries, or a hysteria from an exclusive affection of the nervous system. Nothing, however, can be said upon this subject, until physiology and pathology have taught us more of the structure and diseases of the lymphatic vessels. ”

“ It rarely extends to the lymph glands, and of all tuberculous lesions is the least dangerous to life. The commonest form of lupus—lupus vulgaris—usually commences in childhood or youth, and is most often met with on the nose or cheek. The early and typical appearance is that of brownish-yellow or pink nodules in the skin, about the size of hemp seed. Healing frequently occurs in the centre of the affected area while the disease continues to extend at the margin. ”

“ Swelling of the glands has at all times been a characteristic phenomenon of scrofula. A swelling is merely the result of diseases of the mucous membrane of the throat or nose, of herpes of the scalp or face, of inflammations of the ears, eyes, periosteum, bones, etc. In the beginning the swelling of the glands is painless and results in flat swellings of about the size of filberts, which may be moved back and forth ”

“ The mucous membrane of the mouth may also be invaded. The lesions may remain discrete or may coalesce, forming small blebs.
When the affection shows itself upon the genitalia, it is termed herpes progenitalis; and when on the prepuce, a common site, herpes præputialis. In the female, in whom it occurs here much less frequently, the labia majora and labia minora, as well as the skin about the vulva, are the parts usually invaded. It is seen most commonly in the young and middle-aged. Burning, slight itching, sometimes darting pain, and more or less oedema, may be present. ”

“ Tumescence must thus be obtained before desire can become acute, and courtship runs pari passu with physiological processes. "Normal estrus," Heape states, "occurs in conjunction with certain changes in the uterine tissue, and this is accompanied by congestion and stimulation or irritation of the copulatory organs. ... Congestion is invariably present and is an essential condition. ... The first sign of pro-estrum noticed in the lower mammals is a swollen and congested vulva and a general restlessness, excitement, or uneasiness. ”

“ There can be no doubt whatever that the mucus which is so profusely poured out over the external sexual organs in woman during the excitement of sexual desire has for its end the lubrication of the parts and the facilitation of the passage of the intromittent organ. The most casual inspection of the cold, contracted, dry vulva in its usual aspect and the same when distended, hot, and moist suffices to show which condition is and which is not that ready for intercourse, and until the proper condition is reached it is certain that coitus should not be attempted. ”

“ When the external skin is the seat of inflammation, and produces sensitive irritated fever, no collection of matter is formed, as when a phlegmon is situated in the cellular membrane beneath the skin; but the cuticle rises as beneath a blister-plaster, and becomes ruptured; and a yellow material oozes out, and becomes inspissated, and lies upon its surface; as is seen in this kind of erysipelas, and in the confluent small-pox; or if the new vessels are reabsorbed the cuticle peels off in scales. ”

“ In grave and progressive cases the lesions of the generative organs become very marked. The lips of the vulva become rigid and distorted so that it remains constantly open and the erect clitoris continually exposed. The skin of the vulva is tense, dry and shining. Lameness is shown in one or both hind limbs, knuckling over at the fetlock, shortening of the step, planting the toe first and the heel later with a jerk, lack of balance, paresis and even inability to rise. ”

“ Surgeons apply the word bubo to inflamed glands from syphilis, wherever they happen to be. The body abounds with absorbents, which are small delicate vessels that form a net-work over the entire surface, and exist also in every structure. Their purpose is to convey the nutriment to the circulation. They form stations, as it were, or points of assemblage; and these are generally situated in the angles of the body—the groin, the armpits, hams, neck, &c.—parts [94] most protected from injury. When skin inflammation is present, to familiarize the meaning, the nearest glands sympathize and swell ”

“ In the Spring began inflammatory fevers and erysipelas, and190 “in many cases aphthae and ulcerations formed in the mouth, many rheums occurred in the genitals taking the form of ulcers and abscesses on the external and internal surface of the sexual parts; also eye troubles, with discharge, obstinate, persistent and painful; also growths, which are called σῦκα (figs) on the inner and outer surface of the eye-lids, causing many to lose their sight; besides they frequently occurred on other parts liable to ulceration and particularly on the genital organs.” ”

“ Head subglobular, covered with simple spines. Two spicules. Vulva behind middle of body, parasitic in vertebrates, especially mammals (e.g., Gnathostoma, Tanqua, Rictularia) .
Family. Dracunculidæ, Leiper, 1912.
Males very small in proportion to females. Anus absent. Vulva absent (?) . Genera: Dracunculus, Icthyonema (in body cavity of eel and other fish) .
Family. Filariidæ, Claus, 1885.
Long thread-like Nematodes. Anus present. Œsophagus without bulb. Vulva usually in anterior half of body. Two ovaries. Generally ovoviviparous. Development often requires an intermediate host. ”

“ He said that the patient was suffering from the visits of a vampire! The punctures which she described as having occurred near the throat, were, he insisted, the insertion of those two long, thin, and sharp teeth which, it is well known, are peculiar to vampires; and there could be no doubt, he added, as to the well-defined presence of the small livid mark which all concurred in describing as that induced by the demon’s lips, and every symptom described by the sufferer was in exact conformity with those recorded in every case of a similar visitation. ”

“ The vampire rises in the air by means of a wide flattened membrane connecting the whole of the limbs and tail, the thumb of the fore-paws and the hind-feet alone being left free. This membrane, though wonderfully delicate, is furnished with minute blood-vessels. It also possesses a system of nerves of the most exquisite power of sensation, which enables it to fly rapidly among the boughs and foliage, avoiding all impediments even in the darkest hours of night. The vampire can run along the ground and climb trees by means of the sharp hooks on the fore-paws. ”

“ The swelling of the glands is seldom the first symptom. Patients are every day seen who, being supposed ill of another disorder, in two, three or more days show glandular swellings, or carbuncles, by which the plague is manifested. On the contrary, many, who from the usual signs are supposed to have the plague, become well in a day or two, without any external swelling. The first symptoms are, horripilation, or actual shivering, nausea or vomiting, loss of strength, and fever. ”

“ Pathogenesis.— 0. volvulus is found in peculiar subcutaneous fibrous tumours, the size of a pea to that of a pigeon's egg. The same patient may present one or several of these tumours. The regions of the body most frequently affected are those in which the peripheral lymphatics converge. Thus the tumours are usually found in the axilla, in the popliteal space, about the elbow, in the suboccipital region, and in the intercostal spaces. They are never adherent to the surrounding structures and can be easily enucleated. ”