OTHER CAUSES OF MATERNAL DYSTOKIA. 371 



When the dystokia is due to disease or a traumatic cause, birth is 

 more ditVicult ; and this difliculty is increased as the pathological altera- 

 tion is extensive. 



Treatment. 



Tlie treatment of stenosis of the vulva and vagina must be, of course, 

 surgical, and will vary according to the cause producing the constric- 

 tion. But it will chiefly consist in incisions carried to a depth and 

 extent commensurate with the exigencies of each case, and modified 

 according to the anatomy of the part which forms the seat of stricture. 

 It will be found that lateral incisions are, when they can possibly be 

 practised, preferable to those made either superiorly or inferiorly, as 

 they are less lil<ely to be followed by inconvenient alterations and un- 

 favourable consequences ; while, with regard to the vulva, the textures 

 at the sides of that orifice have more vitality, and therefore cicatrise 

 more rapidly than at the superior commissure. 



