660 THE REPRODUCTIVE ORGANS OF THE FEMALE. 



with a muco-puruleut exudate. The labia may be swollen, the glands 

 of Bartholiu are liable to be involved, and abscesses of the labia may be 

 developed. 



Chronic Catarrhal Inflammation may lead to superficial or deep ulcera- 

 tion of the mucous membrane, or to papillary outgrowths, or to thicken- 

 ing of the labia. Suppurative inflammation of the tissue of the labia 

 may occur with a similar process in neighboring parts. Erysipelatous 

 Inflammation of the skin of the vulva is frequent in young children. In 

 adults it is less common. Inflammation of the vulvo-vaginal glands 

 may be acute and lead to abscesses, or chronic and produce induration 

 of the gland. 



Gangrene may follow erysipelatous inflammation, or occur after par- 

 turition ; it may accompany severe exhausting and infectious diseases. 

 It may follow bruises or other injuries. In some forms, such as those 

 known as noma and hospital gangrene, the destruction of tissue proceeds 

 with extreme rapidity. 1 



Croupous Inflammation may occur, with or without diphtheria and a 

 similar lesion of the fauces or elsewhere, and is frequently associated 

 with gangrene. 



Tuberculous Inflammation, usually with ulceration, occasionally occurs 

 in the vulva. . 



Syphilitic Inflammation and ulceration are of frequent occurrence on 

 the vulva, particularly on the mucous surfaces, and may lead to consid- 

 erable destruction of tissue and cicatricial contractions. 



In one form, the so-called mucous patch, there is an infiltration of the 

 papillary layers of the skin or mucous membrane with variously shaped 

 cells and fluid, so that the tissue has a gelatinous appearance. In other 

 cases there is an hypertrophy of the papillae, so that larger and smaller 

 wart-like excrescences are formed. This is called the pointed condyloma. 



TUMORS. 



Fibroma, Circumscribed fibrous tumors are found in the connective 

 tissue of the labia, mons veneris, perineum, clitoris, and entrance to the 

 vagina. They may attain a large size, and, attached only by a pedicle, 

 may hang far down between the legs. The skin is usually movable over 

 the surface of these tumors. 



Fibroma diffusum (elephantiasis). This usually involves the clitoris 

 or the labia, or both, and may extend to surrounding parts of the skin. 

 It consists essentially of a diffuse hypertrophy of the skin and subcuta- 

 neous tissue, with or without involvement of the papillae and epidermis. 

 The surface may be smooth or rough. When the papilla and epidermis 

 are much involved, larger and smaller cauliflower-like excrescences may 

 cover the hypertrophied parts and the surface be very rough and scaly. 



Papillomata. These growths consist of hypertrophied papillae covered 

 with thick layers of epithelium. They vary in size from that of a pea to 



1 For a study of noma with bibl. see Blumer and MacFnrlane, Am. Jour. Med. Sci., 

 vol. cxxii., 1901, p. 527. 



