The diagnosis, pathology, and treatment of diseases of womem : including the diagnosis of pregnancy / by Graily Hewitt.

  • Hewitt, Graily, 1828-1893.
Date:
1872
Catalogue details

Licence: Public Domain Mark

Credit: The diagnosis, pathology, and treatment of diseases of womem : including the diagnosis of pregnancy / by Graily Hewitt. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    703/760 (page 677)
    Illation,' the rectum, the vagiiical canal, and the urethra opening into one common external orifice. And irregularities of other kinds may bo observed, giving rise to conditions which have been described as due to hermaphroditism. A full consideration of these various kinds of defective formation of the external gene- rative organs cannot be entered upon in this work. Particulars concerning these rare cases will be found in several systematic treatises.* The defects which are the most practically interesting are those which relate to the condition of the orifice of the vagina, and the canal of the vagina itself. These have been already described in the previous remarks on the diagnosis. STRICTURE OF THE VAGINA. There are two classes of cases coming under this denomination. First, we have those congenital instances in which the vagina is normal below, the hymen in its usual position, but a short dis- tance above the hymen the finger meets with an obstruction—the canal of the vagina, in fact, appears far too short. Here the apparent shortness may prove to be due to presence of a fibrous or membraneous septum dividing the vagina above the hymen into two parts. The usual seat of this septum is the junction of the upper with the middle third of the vagina. In the second place we have cases of real stricture of the vagina, due to ad- hesions of the opposite walls, following after lacerations or wounds of the vagina, the primary cause of such lacerations being accidents connected with the process of parturition, lace- rations of the vaginal walls with subsequent cicatrisation and contraction. Regarding the congenital class of cases, we may have complete absence of an opening in the septum, there being then usually found to be present an accumulation of menstrual blood above the obstructing membrane or partition ; or, on the other hand, there may be an opening sufl&cient to allow of the escape of menstrual blood. It is obvious that in the former case there is no possibility of menstruation occurring, and impregnation is equally impos- sible. Such instances are not common. Complete congenital closure of the vagina might be confounded with imperfect hymen, * A good account of the subject will bo found in Kiwisch's Klinische Vortrdge, Band ii. (third edition, by Scanzoni. Prague : 1857). On the subject of hermaphro^ ditism, the reader is referred to the admirable essay by Sir J. Y. Simpson, published