Mons pubis

“ The ova may be seen attached to the hair-shafts.
It infests adults chiefly, being in many instances probably contracted through sexual intercourse.
Is the pediculus pubis found upon any other part of the body?
Yes. Although its favorite habitat is the region of the pubes, it [Pg 276] may, in exceptional instances, also infest the axillæ, the sternal region of the male, the beard, eyebrows, and even the eyelashes.
State the diagnostic characters of pediculosis pubis. ”

“ If the husband is devoid of previous experience in sexual matters, maladroit attempts at intercourse are exceedingly likely to occur. The penis is thrust in the wrong direction, pressing against either the anterior or the posterior commissure of the vulva. Very often, moreover, the position of the vulva, which is subject to very striking individual variations, is concerned in the production of vaginismus. There are many women in whom the vulva lies in part in front of the symphysis pubis, so that the lower border of the symphysis lies below the urethral orifice. ”

“ In hairy individuals the malady is often persistent, due to the fact that ova have become attached to the hair and a new progeny soon hatched out. Continued treatment over a few weeks will usually suffice to rid the patient of their presence.
Pediculosis Pubis.
Describe the symptoms of pediculosis pubis.
Pediculosis pubis is a condition due to the presence of the pediculus pubis, or crab-louse. It is characterized by more or less itching about the genitalia, together with papules, excoriations, and other inflammatory lesions. The amount of irritation varies ”

“ Inflammation and also Calculus of the Bladder. Of cystitis, the symptoms are acute burning pain in the region of the bladder and perineum, and extending to the loins;{302} tumour, tension, and hardness of the abdomen from the distended bladder, which may be felt between the pubis and navel; and sometimes is turgid to an enormous magnitude; perpetual painful efforts to urine and stool, and the urine either suppressed, or in small quantity; a finger introduced into the anus, or into the female vagina, feels the vesical tumour ”

“ More or less completely septate bladder, atresia ani, or more rarely double anus, double urethra, increased breadth of the bony pelvis with defect of the symphysis pubis, and possibly duplication of the lower end of the spine, and hernia of some of the abdominal contents into a perineal pouch. Much more rarely, duplication of the heart, lungs, stomach, and kidneys has been noted, and the lower limbs may be shorter than normal. ”

“ This organ which generally acquires two-thirds of its size at puberty, remains as in infancy, and the voice preserves that shrillness which it has in young people, but becomes a little stronger because the chest enlarges. The different tissues are not only less developed, but some are not developed at all. Thus in eunuchs the beard and the hairs on the pubis are deficient; their skin remains as free from hairs as in early youth. The genital organs then have a powerful effect on nutrition, because when they are deficient, the growth is defective or ceases entirely. ”

“ In the female sex this association between the face, throat, nose, and pubis does not exist; whence no hair grows on their chins at the time of puberty, nor does their voices change, or their necks thicken. This happens probably from there being in them a more exquisite sensitive sympathy between the pubis and the breasts. Hence their breasts swell at the time of puberty, and secrete milk at the time of parturition. ”

“ In the male it may spread over the penis, involve the glans, scrotum, and upper part of the thighs. In either sex it may spread in the course of years to the pubes, over the perineum, and into the rectum, the recto-vaginal septum in the female ultimately breaking down. At times a profuse watery discharge exudes and even drips from the surface of the new growth, soiling the clothes, soddening the skin, and emitting a peculiarly offensive odour. ”

“ There being four varieties of it, according to Leonides; three of them occur in men and one in women. In men, sometimes about the perineum and sometimes about the middle of the scrotum, there is the appearance of a female pudendum with hair; and in addition to these there is a third variety, in which the discharge of urine takes place at the scrotum as from a female pudendum. In women there is often found above the pudendum and in the situation of the pubes the appearance of a man’s privy parts, there being three bodies projecting there, one like a penis, and two like testicles. ”

“ With those however is love’s pleasure most exquisite, whose testicles, when they are lusty and fully matured, are delivered to the surgeons, the pubis being already black with hair. The organs are spared till they are full and ready ”

“ Motion, particularly jolting as in rough riding, causes pain. This pain is referred to the lower part of the belly, to the perineum, to the end of the penis, the urethra, the anus. The straining after urination may be absent or of the most intense character, leading to prolapse of the rectum and causing excruciating torture. The urine always contains pus scattered through it, and generally also more or less pus in that semi-solid condition known as stringy mucus. Stringy mucus is pus gelatinized by the ammonia of the decomposing urine. ”

“ And if the penis is pressed between the finger and thumb, matter or pus exudes. As the inflammatory stage commences, the formation of pus is increased, which changes from a thin to a thick yellow color, accompanied by a severe scalding on making water. The inflammation increases up to the fifth day, often causing such pain, on urinating, that the patient is tortured severely. When the disease reaches its height, the erections become somewhat painful, when the discharge may be streaked with blood. ”

“ In most cases it is a local disorder, the common regions being the genitalia and anus. The trunk, especially in elderly persons, is also not infrequently invaded. Occurring about the female genital organs, it constitutes the pruritus vulvæ of writers, having its seat in the labia or in the vagina. It is a very distressing form of disease, and is met with, as a rule, in middle life and old age. In the male the anus and the scrotum are the regions generally attacked, the perineum sometimes also being involved simultaneously. ”

“ The penis can then be shelled out, the prepuce being first cut through around the corona glandis. If lateral flaps can be formed of sound skin they are then dissected up. The perineal and pubic incisions are now deepened and, assistants holding the testes and penis well out of the way, the neck of the tumour is cut through close to the perineum and pubes. Gaping vessels are all carefully ligatured, redundant tunica vaginalis—if hydroceles be present—being excised. ”

“ In consequence of prostatic enlargement, pain is felt in the perineum, with occasional throbbing, and a sense of weight; there is frequent desire to make water, the bladder is irritable, and discharges ropy mucus. There is more or less irritation of the lower bowels; there is an almost constant desire to empty the rectum, from a feeling of fulness there, and pain, often severe, is felt on going to stool; when the enlargement is great, the bowel is considerably compressed, and the feces, when solid, are passed flattened like portions of tape. ”

“ On the day previous to the operation the perinaeum, sacral region and pubis should be shaved, dressed with a soap poultice for two hours, then washed and dressed with bichloride XXVdressing, which should be retained until patient is anesthetized. Notwithstanding all of these preparations, it is impossible to obtain absolute asepsis of the affected area, and so many fatalities occur from infection that it is deemed wise by many surgeons to make an artificial inguinal anus as a preliminary procedure in all extirpations of the rectum. ”

“ Of a violent inflammation of the penis, which had originated in unclean intercourse with a beast, with a coruncle, or knot, constricting the urethra, cured in a manner to the last degree empirical and cruel. The penis being laid on a rough stone, the Physician suddenly when the patient was not expecting it, struck it as heavily as ever he could with his doubled fist, so that the stoppage and ulcer might burst. This case has a smack of the Venereal disease about it; and might serve as an argument for those who hold that this disease was known to the Ancients as well. ”

“ Immediately behind the prostate, the vesiculæ seminales may be distinguished as two softish masses situated one on either side of the middle line. Internal to them, the whipcord-like feel of the vasa deferentia can be readily traced over the bladder to the sides of the pelvis.
‘The bladder is easily recognised, when moderately distended, as a soft fluctuating tumour behind the prostate; when empty it cannot be distinguished from the intestines, which then descend between the rectum and the pubes. The arch of the pubes can well be defined when the bladder is empty. ”

“ That economical adaptation of a portion of a vesicular organ, originally formed for purposes of communication between the embryo and the mother, appears to entail sometimes a defect in the wall of the abdomen just above the pubes, and a defect in the anterior wall of the bladder itself. This is the distressing congenital condition of fissure of the urinary bladder, in which its interior is exposed through an opening in the skin; the pubic bones are separated by an interval, and the reproductive organs are ill-formed ”

“ With paralysis of the bladder the penis may be pendent out of the sheath, or being retained within it, the urine may dribble constantly into and from that cavity, and the vulva may be soft and flaccid. When the anus is involved, the adjacent part of the rectum usually participates becoming overloaded, the sphincter is soft and lax and allows a constant oozing, and the exposure of the mucosa. The paralytic tail hangs between the thighs, limp and flaccid, and becomes saturated with manure and in females with urine. ”

“ The strain required to induce a prolapsus of the bowel or a rupture into the inguinal canal is exerted as much on the bladder, ureter, and kidney as on the other localities. Physicians who have taken the pains to observe must have noticed, more than once, how the child afflicted with a phimosis has not only at times to wait for the stream of urine to appear, there seemingly being some obstruction to its starting, but how often such a case is afflicted with a stammering, halting urination. ”

“ Autopsy: In the bladder, a sulphur-yellow stone, as large as a hen’s egg, completely filling the organ; similar calculi, from the size of a pea to that of a bean, in the pelvis of the left kidney; right kidney normal.”
In the above case, the œdema of the penis, scrotum, and perineum was as much a result of the distension of the bladder by the retained urine interfering with the return circulation from the œdematous parts as the different appearances of diseased conditions were a result of the primary phimosis ”

“ This occurrence is always attended with most imminent risk; and is generally the result of retention from stricture. The urine escapes into the bulb, or anterior to it. Alarming constitutional symptoms quickly supervene; rapid sinking is threatened. The whole penis, scrotum, and perineum are swollen, but the swelling is hard, and most marked in the glans and along the course of the urethra. The glans blackens, unhealthy abscesses form in the spongy body, and before these give way, or at least before the sloughs begin to separate, the patient usually perishes. ”

“ The sphincter ani, or the muscles of the anus, are relaxed, from the excessive action of the abdominal muscles; and the fæces pass in small quantities involuntarily. There is a protrusion of the bowel, which adds to the distress, and, by its irritation, brings on a looseness or diarrhœa.
The prostate gland, which is seated near the neck of the bladder, suffers inflammation and enlarges, beginning at the orifice of the ducts, which open into the urethra.
The emission of semen, which often happens involuntarily, is attended with agonizing pain, producing cold shiverings, followed by heat ”

“ The surface of the mucosa is discolored, mottled and variegated, slaty blue, brown, red, purple, or even black, with ulcers, encrustations of triple phosphate, and fungoid elevations. In dogs especially, the prostate is often enlarged.
Symptoms. Frequent urination accomplished with pain, groaning, or whining and it may be with sudden arrest. There may be incontinence, the urine dribbling almost continuously from the penis or vulva and in the latter case trickling down the thighs. The presence of pus and mucus tends to mat the hairs, and a strong urinous and ammoniacal odor is emitted. ”

“ Temporary relief is experienced when the urethra gives way by ulceration, and the urine becomes extravasated into the cellular texture; the patient gets up, and, if in the dark, thinks that the stricture has yielded, and that he is passing urine naturally. But soon he feels a glowing heat in the perineum; the parts swell and become livid; violent constitutional symptoms come on, the discoloration advances, the integuments slough, ill formed matter is discharged, and disorganised cellular tissue mixed with putrid sanies is exposed. ”

“ The patient often experiences an insupportable inclination to urinate, with a sensation as though the bladder were ready to burst—whereas there may be little or no urine in it. There is much pain at the root of the penis, and it extends along the perinœum to the rectum, which latter is assailed with almost constant spasms resembling straining. There is considerable thirst, fever, and anxiety; the pulse is full and quick, the tongue furred, and all those symptoms are present that prevail during severe constitutional excitement. The treatment consists of bleeding, leeching, or cupping ”