Crsis and Abscesses of Gartner' s Ducts 649 



actually perforated. The infection then readily passes out 

 into the adjacent tissues. The invasion of the pelvic con- 

 nective tissues causes swelling of the vulva and anus, with 

 evidences of pain. Usually the patient moves carefully and 

 hesitatingly, the appetite is poor, and the rectal tempera- 

 ture may be elevated. Vaginal or rectal palpation discloses 

 more or less extensive swellings in the pelvis surrounding 

 the vagina. At some points collections of fluid (thin pus) 

 are recognizable, but there are no clearly defined limiting 

 walls. 



The course of such infection is usually rapid. As a rule 

 the patient succumbs, largely because the tissues fail to form 

 a barrier sufficient to prevent the highly virulent masses of 

 pus from invading the peritoneal cavity. If the infection 

 is not too virulent, abscessation may occur and the abscess 

 may open, or be surgically opened, into the vagina or rec- 

 tum. It then has the common significance of pyemia as 

 described under infections of the uterus. The invasion may 

 sometimes be anticipated if the parturient abrasions are 

 recognized early. The genital tract may then be cleansed 

 and iodoform with oil introduced into the uterine cavity. 

 This, flowing slowly over the abraded parts, may deter pu- 

 trefaction and bacterial invasion. Once established, the 

 phlegmon is difficult to control. Repeated warm vaginal 

 douches of saline solution may aid in checking the infection. 

 Internal remedies, such as quinine, may be tried, but they 

 offer little hope. 



D. Cysts and Abscesses of Gartner's Ducts. 

 Gartner's ducts, described on page 39, are frequently the 

 seat of retention cysts and abscesses. These occur along the 

 course of the ducts, as shown in Figs. 18-21. They vary in 

 form and extent, but are usually elongated, with a trans- 

 verse diameter of one-half inch or less. They may be very 

 large and spherical. They are of comparatively little impor- 

 tance except as reminders of the presence of infections 

 which, invading the duct, cause atresia of its opening, with 

 cystic or purulent distension. Rarely they may attain such 

 size as to interfere with coitus. When recognized, the cysts 



