The Nodular Venereal Disease 285 



terest in the subject. It has never received, and is not re- 

 ceiving serious study at the hands of pathologists and bac- 

 teriologists. The disease is accordingly a difficult subject 

 with which to deal. It may be said to be a lesion without a 

 known cause and regarding the effect of which there is very 

 scant knowledge. I feel that the disease should be recog- 

 nized as holding a definite place amongst the genital infec- 

 tions, but do not believe that at present it should have as- 

 cribed to it that importance with which Isepponi and his 

 followers clothed it nor that it should be so utterly ignored 

 as it has been recently. 



The nod ular jvenergal disease may be described as a vir- 

 tually universal, chronic infection affecting the mucosa of 

 the copulatory area of the genitalia. It involves both sexes 

 and all ages of ruminants and swine. It expresses itself 

 clinically in the form of granular or nodular elevations in 

 the mucosa of those parts participating in coitus (vulva, 

 vagina, sheath, prepuce, and glans penis) . 



The essential clinical symptom is the appearance in the 

 genital mucosa, protruding above the surface, of nodular, 

 conical, or spheroidal elevations, usually 1 to 2 mm. in di- 

 ameter. (See Figs. 79, 80.) In the female they are best 

 observed clinically by holding the vulvar lips apart and 

 causing a strong light to enter obliquely. The examina- 

 tion may be conducted advantageously in a well-lighted 

 stable, by having the animal placed with her posterior parts 

 presenting toward a window somewhat above the level of 

 her back. The examiner grasps each vulvar lip between 

 the thumb and fingers and, drawing the lips backward and 

 outward, exposes the interior of the vulva to vision. The 

 light, falling obliquely into the vulvar cavity, by refraction 

 brings the nodules clearly into view. In order to examine 

 every part, the examiner should shift his position again 

 and again, that he may view each area at the proper angle. 

 In order to examine satisfactorily the roof of the vulva, the 

 eye of the examiner should be on an approximately hori- 

 zontal line with the mucosa. Highly satisfactory examina- 

 tions may be made in dark stables or at night with the aid 

 of a good reflecting lamp or an electric flash light. 



