648 Diseases of the Genital Orgaiis 



The symptoms consist chiefly of vulvar swellings, profuse 

 genital discharge, straining and general evidences of pain. 

 The discharge is often fetid. Manual examination causes 

 intense pain. The vaginal walls are greatly swollen, render- 

 ing the introduction of the hand difficult. Portions of the 

 mucosa are partly detached or are very fragile. By spread- 

 ing apart the vulvar lips, dark, necrotic areas may be ob- 

 served. 



Nothing of special value has been learned regarding the 

 bacteriology of the disease. As in other types of genital in- 

 fections, it appears that in certain herds at a given time 

 some one form of bacterium acquires special intensity and 

 induces a prevalent type of lesions. 



The handling of gangrenous vaginitis calls first of all for 

 the control of uterine and cervical infections. I have ob- 

 served very energetic efforts to control gangrenous vaginitis, 

 while imprisoned, decomposing fetal membranes which were 

 the basic cause were overlooked. The vagina itself should 

 be cleansed by the gentlest available measures, essentially 

 those mentioned above for vaginitis. 



C. Perivaginal Phlegmon. 



Parturient contusions and abrasions open the way for 

 the invasion of infection from the genital tube into the pel- 

 vic connective tissues. Once the infection passes the barrier 

 of the vaginal walls and gains the very loose, open areolar 

 tissue of the pelvis, it tends to spread with great rapidity. 

 The progress of the infection is often so rapid that the tis- 

 sues are unable to erect any efficient barrier and suppura- 

 tion or gangrene advances rapidly. Sometimes imperfect 

 abscess walls are formed which offer no important degree of 

 resistance. 



The contusions and abrasions are much the same as those 

 producing vaginitis, but act more upon the deeper tissues. 

 In some cases the prominent, conical, bony projection at the 

 anterior end of the pubic symphysis plays an essential part 

 in causing the original contusion. The vaginal floor becomes 

 impinged between the summit of the cone and some hard 

 portion of the fetus ; in some instances the vagina becomes 



