DISEASES OF THE GENERATIVE SYSTEM 



to fungi of the genus Aspergillus Micheli and Cladosporium Link. One of us 

 has described some of these cases in Ceylon. 



2. Discharge whitish or yellowish. Generally fungi of the genus Monilia 

 and of the genus Oiddwrn are found. 



3. Red discharge. Generally due to a red pigment-producing monilia or 

 cryptococcus, or to a non-pigmented monilia, and associated with red pigment- 

 producing bacilli or cocci. 



C. Urethritis associated with Animal Parasites : I. With Protozoa ; II. With 

 Animal Parasites Higher than Protozoa. 



I. Urethritis of Protozoal Origin. — The following varieties may be dis- 

 tinguished : — 



(1) Urethritis associated with Flagellates. — The flagellates found belong to 

 the genera Trichomonas Donn6, Cercomonas 'Dui3i.r^in,Prowazekia Hartmann 

 and Chagas. In one of our cases a flagellate with four flagelli was observed. 

 It is doubtful, however, whether the flagellates found are the true aetiological 

 agents of the discharge. 



(2) Urethritis associated with Ciliates, — In a case of urethral discharge in a 

 native man we observed the same ciliate we have fairly often noticed in Ceylon 

 in the vaginal secretion of native women. 



(3) Urethritis associated with AmcebcB. — We have seen several such cases. 

 The amoebae were of difEerent t3rpe; in one case it closely resembled Loeschia 

 histolytica. 



(4) Spirochcstic Urethritis. — This tjrpe of urethritis due to 5. urethralis 

 Macfie is occasionally met with. The discharge may be abundant and frankly 

 purulent, and contains an enormous number of spirochaetes. It must be noted, 

 however, that spirochaetes are not rarely found in the normal urethra, as 

 shown by many observers and in the tropics by Mendelson. 



(5) Treponema urethritis. — The discharge is muco-purulent and contains a 

 large number of treponemas {Treponema urethrale Castellani). The organism 

 is very delicate, stains purplish or pinkish, has numerous small spirals, all 

 practically of the same size ; length of the parasite 6 to 1 2 microns , The patient 

 has no sign of syphilis, and Wassermann is negative. Urethral irrigation of a 

 I in 20.000 solution of hyd. perchlor, cures the condition. 



II. Urethritis associated with Animal Parasites Higher than Protozoa. 

 — These are generally due to larvae of flies and chance parasites setting up an 

 inflammation of the urethra. 



Balanoposthomycosis. — In 1881 Simon of Breslau first described a balano- 

 posthitis due to fungi, and occurring in persons suffering from diabetes. It 

 is probably the same disease as that referred to by RoUo in 1 798, by Bardsley 

 of Manchester in 1807, by Friedreich in Hanover in 1864, by Hassal in 1833, 

 and by de Beauvais in 1874. The symptoms consist of slight itching and 

 burning on the glans penis and on the inner aspect of the prepuce, and is asso- 

 ciated with erythema, followed by superficial ulceration and a yellow purulent 

 discharge, while the margin of the prepuce may become irritated and phimosis 

 set in. On examining the discharge fungal hyphae of a moniliform character 

 may be seen. Castellani has described several such cases due to fungi of the 

 genus Monilia. 



FEMALE GENERATIVE SYSTEM. 



Circumcision is exceedingly common among native races — e.g., 

 among the semi-civilized Arabs and the Sudanese of Kordofan and 

 other parts of the Sudan every young girl when aged five or six 

 years undergoes one of two varieties of this operation. The milder 

 operation, called ' sunna tahuret/ or circumcision according to 

 religious law, consists of the removal of the clitoris and labia minora, 

 while the more severe cutting, called ' Pharaoh's tahuret,' or the old 



