CHAPTER X. 



THE REPRODUCTIVE ORGANS OF THE FEMALE. 

 The Vulva. 



Malformations. 



THE external genitals may be entirely absent or imperfectly developed. The 

 fissure between the labiamay be unformed, or the labia may grow together, with or 

 without obstruction of the urethra. The clitoris and nymphae may be abnormally 

 large, or the nymphse may be increased in number. The clitoris may be abnormally 

 long; at the same time the vagina is narrow, the uterus small and undeveloped or 

 malformed; the ovaries are small, sometimes situated in the labia ; the mammse small, and 

 the body is of a masculine character. Such cases are sometimes called pseudo-hermaph- 

 rodites. The clitoris may be perforated by the urethra or may be cleft and appar- 

 ently double. 



The hymen is subject to various anomalies. It may be entirely absent. The open- 

 ing may be very large or in unusual places; there may be several openings; the free 

 edge may be beset with papillary projections; there may be no opening at all. 



HEMORRHAGE, HYPER2EMIA, ETC. 



Haemorrhage may take place from wounds or ulcers of the vulva, but 

 the most important form of haemorrhage is that which occurs in the con- 

 nective tissue of the labia majora. This may occur during labor or re- 

 sult from external injury. One of the labia may be much swollen and 

 distended by the extravasated blood. The blood may be gradually ab- 

 sorbed, or it may decompose with suppuration or gangrene of the sur- 

 rounding tissue. 



Varicose Veins in the labia are not infrequent. (Edema of the labia 

 majora may occur in pregnancy or in labor. It frequently accompanies 

 disturbances of the venous circulation, as in certain heart and lung dis- 

 eases ; or it may occur in chronic diffuse nephritis or other wasting dis- 

 eases ; or as a result of thrombosis or other disturbances of circulation in 

 the uterine or perivaginal venous plexuses. The latter may be excessive, 

 leading to the transudation of fluid through the skin, to the formation of 

 vesicles, or superficial erosion, or even of gangrene. 



* 

 INFLAMMATION. (Vulvitis.) 



The skin, mucous membrane, connective tissue, and glands of the 

 vulva may be the seat of inflammation. 



Acute Catarrhal Inflammation of the mucous membrane may be in- 

 duced by a variety of substances, but is most frequently due to gonor- 

 rhosal infection. The mucous membrane is swollen and red and covered 



