FEMALE ORGANS OF GENERATION. 118 
may be decreased in size by strictures which have followed some pre- 
ceding inflammation or ulceration. Or the decrease in size of the 
urethra may be due to constriction caused by a fibrous induration of 
the corpus spongiosum. 
What are the changes in, and causes of, catarrhal urethritis ? 
The mucous membrane is congested and swollen and covered with 
muco-pus. This form of inflammation is due to the action of 
chemical irritants, to extension of an inflammatory process from other 
parts, to unknown causes and to the action of gonorrheeal poison. The 
most common cause is the latter. In the exudation of gonorrheal 
inflammation there is always present a form of coccus called the gono- 
coccus. The constant presence of this particular form of coccus seems 
to render it fairly certain that it is the cause of this form of inflamma- 
tion. This fact has not been definitely settled, however. (Peculiari- 
ties of this coccus will be noted in the section on bacteriology.) 
What other forms of inflammation have been observed in the 
urethra ? 
Croupous inflammation with the formation of fibrinous casts of the 
urethra have been seen in children. 
Syphilitic ulcers may occur at the meatus and as far back as the 
fossa navicularis. Tubercular inflammation rarely occurs. 
What tumors may occur in the urethra ? 
There may be polypoid growths from the mucous membrane, or 
there may be circumscribed masses of dilated veins. Carcinomata 
may extend to the urethra from adjacent organs, 
THE FEMALE ORGANS OF GENERATION. 
VULVA AND VAGINA. 
What disorders of circulation may occur in the vulva? 
There may be hemorrhage from ulceration or injury, or there may 
be an extravasation of blood into the connective tissue of the vulva. 
This blood may be abSorbed or may decompose with suppuration - or 
gangrene of the surrounding tissue. Varicose veins may occur in the 
vulva, or the part may become cedematous especially in pregnant 
women. 
What inflammatory conditions are common to the vulva ? 
Acute and chronic catarrhal inflammation, syphilitic inflammation, 
erysipelatous inflammation, suppurative inflammation and croupous 
8—H.P.B. 
