VAGINA. 



VAGINA, a Latin term, literally fignifying a fheath, or 

 fcabbard ; ufed on divers occafions. As, 



Vagina, in ^rchiuaure, is ufed for the lower part of a 

 terminus ; becaufe refembling a fheath, out of which the 

 ftatue feems to iffue. See Terms. 



The vagina is that long part between the bafe and the 

 capital ; and is formed in divers manners, and with divers 

 ornaments. 



Vagina, in Anatomy, the membranous canal leading from 

 the external organs of generation to the neck of the uterus, 

 and receiving the male organ in coitu. See Generation. 



The vagina is liable to an inflammation after delivery, 

 occafioned by the head of the child being long retained in 

 the pelvis. If the fwelling and inflammation are not very 

 great, they are generally removed by the difcharge of the 

 lochia ; but if the internal membrane of the vagina be in- 

 flamed, emollient injections muft: be occafionally ufed, and 

 apiece of prepared fponge fhould be introduced, to prevent 

 its coalefcing. The fponge may be thus prepared : Take 

 a piece of a proper fize for keeping the vagina open, when 

 it is expanded ; foak it in warm water ; then roll it tight 

 from end to end with a ftring ; cut off any hard lumps, and 

 lay it to dry ; then take off the ftring, anoint it with lard, 

 and introduce it into the vagina, the moilture of which will 

 expand it. If the preffure on this part was fo long con- 

 t.nued, as to obfl:ruft the circulation in it, a mortification 

 will enfue, which may be either total or partial : if it be 

 total, the patient will die ; if partial only, the mortified 

 parts will flough off. This may be known by great pain 

 after delivery ; a fetid fmell, and a difcharge of fliarp 

 ichor at firft from the vagina, then pus and matter. When 

 this is the cafe, emollient fomentations may be thrown up 

 from time to time ; doffds of lint may be dipped in fome 

 proper balfam, and applied to the parts in order to deterge 

 and heal them ; and when the floughs are all caft off, great 

 care fhould be taken to prevent the vagina from growing 

 together, either by introducing doffils of lint, or pieces of 

 fponge into it. 



Vagina, Imperforate. The vulva is liable to two dif- 

 ferent kinds of imperforation, which ought to be difcri- 

 minated. Firil, the labia and nymphje may be every 

 where united and blended together, the orifice of the 

 meatus urinarius being totally covered by them, fo that no 

 urine can be voided. Secondly, the hymen may form a 

 complete feptum, or elfe fome part of the vagina may be 

 clofed with a membrane of fimilar flrufture ; in which cir- 

 cumftances, although the vagina be imperforate, there is 

 no impediment to the free iffue of the urine. 



The firft cafe conftitutes a fpecies of malformation, at- 

 tended with the greateft urgency, and which indeed admits 

 of no delay of that operation by which the conjoined parts 

 are to be feparated. The kind of raphe, fituated where the 

 natural opening ought to be, ibould be immediately fought 

 for, and here the requifite divifion of the parts is to be 

 made, the incifions being carried to the neceffary depth, 

 yet always with a cautious hand, left an opening be made 

 into the bladder, or reftum. Concretions of the labia and 

 nymphs together may be the confequence of ulcerations of 

 thefe parts ; but the clofure of the vulva is then never com- 

 plete. The frequent evacuation of the urine feparates the 

 parts ; and, if not capable of preventing their union entirely, 

 it is at leaft fufBcient to maintain an aperture oppofite the 

 meatus urinarius. The narrownefs of the external opening, 

 however, may obftruft the free difcharge of the urine ; and 

 urinary calculi may even form more or lefs deeply in the 

 vagina. Now, without taking mto the account other 

 fundions of the fexual organs, the motives already explained 



are quite prefTing enougii to make the removal of the dc. 

 formity right and advifeable. 



Before the age of puberty, no inconvenience can arlfo 

 from the vagina being completely fhut up by the hymen, 

 or fome other analogous membrane. But, at this period, 

 the menftrual blood colleas firft in the vagina, and then in 

 the uterus. Severe periodical colic pains, a gradual dif- 

 tenfion of the uterus, the abfence of the menfes, impairment 

 of the health, a variety of nervous complaints, and fome- 

 tiraes even inflammatory fymptoms, which recur, or are 

 exacerbated periodically, afford ftrong prefumptive grounds 

 for fufpefting an imperforation of the vagina. More in- 

 formation may be acquired from a careful examination of 

 the parts. In the greater number of inftances, the mem- 

 branous feptum is diftended with the menftrual blood, and 

 even foraetimes protrudes from the vulva, in the form of a 

 browifli, elaftic, fluAuating tumour. Almoft an immediate 

 ftop has been often put to alarming fymptoms of long 

 duration, by making an incifion through the membrane 

 caufing the obftruftion. A crucial wound will be fufficient, 

 without cutting any of the membrane away ; but we are 

 recommended not to negledt to keep the newly divided 

 parts afunder for a few days, by means of a tent, or a doffil 

 of hnt. 



Labours are fometimes fo difficult, and attended with 

 fuch injury, that inflammation, and even ulceration of the 

 vagina, may be thus produced. Thefe effects may be fol- 

 lowed by confiderable contractions of tins canal, ariiing 

 from the fhrinking of the cicatrices. However, fuch a cafe 

 is not what we have now to confider, our remarks benig at 

 prefent reftrifted to examples in which the vagina is ^to- 

 gether impervious. 



The OS tincEe may be entirely obliterated by congenital 

 malformation, the effefts of difficult labours, or any other 

 circumftances producing inflammation in the part. In all 

 thefe cafes, menftruation and conception are rendered im- 

 poffible, and a train of phenomena is obferved, refembling 

 thofe of the congenital imperforation of the vulva_ and 

 vagina. But the os tincae may become clofed, from fome 

 accidental caufe, fubfequently to conception, and then the 

 defeft cannot be known until the period of delivery. In 

 this laft cafe, it is highly important to afcertain correftly 

 whether the orifice of the womb is really obhterated ; or 

 whether an obhquity of that organ, or fome other derange- 

 ment of it, may not impofe upon us ? 



The re-eftablifhment of the natural opening is always in- 

 difpenfable, and it is materially facilitated by the diftended 

 ftate of the uterus. The operation can be moft conveniently 

 done, either with the inftrument called a pharyngotomus, or 

 a curved biftoury, which has a cutting edge that extends 

 only a ftiort diftance from the point. See Delpech, Precis 

 Elementaire des Maladies reputees Chirurgicales, torn. i. 

 p. 497, &c. 



Vagina, Prolapfus of, denotes, in Surgery, a fpecies of 

 bearing down, arifing from a protrufion or defcent of the 

 vagina. The vagina is liable to two kinds of prolapfus. 

 In one cafe, all its tunics are included in the protrufion, 

 and at the fame time that the part falls downwards, it be- 

 comes inverted. In the other example, it is only the relaxed 

 lining of the vagina which defcends and makes a protrufion. 



The firft fpecies of prolapfus vaginas is fubjed to varieties. 

 For inftance, fometimes the whole circumference of the 

 part falls down; fometimes only a portion of one of its 

 fides. In the firft event, the prolapfus forms a cylmdrical 

 tumour, which confifts of all the coats of the v.ngina, pre- 

 fenting an opening at its lower termination, and having an 

 external covering, which is compofed of the internal Lnmg 

 -y 2 of 



