FEMALE GENERATIVE SYSTEM 



1945 



Egyptian circumcision, entails in addition the removal of the upper 

 two-thirds of the labia majora. The result of these operations is 

 the formation of scartissue, and hence it is almost always necessary 

 to enlarge the vulvar orifice by means of a razor, not merely at the 

 time of marriage, but again at the birth of a child, when, otherwise, 

 it would be difficult for the head to emerge. The enlarged orifice 

 is again partially closed some little time after birth of the child, 

 and therefore incision has to be repeated at every succeeding 

 birth. 



In 1910 Wilson studied the peculiar elongation of the nymphse 

 found in Hottentot women, and came to the conclusion that it was 

 largely produced artificially. 



In 1917 Neve drew attention to the fact that rickets is rare in 

 Kashmir, but that osteomalacia was common in multiparous 

 women, in whom the first symptoms appear in pregnancy and cause 

 the characteristic deformity of the pelvis. 



We have discussed the question of the onset of puberty and the 

 climacteric in Chapter III., p. 77, to which reference may be made. 

 Displacements, inflammations, and tumours of the female generative 

 organs are quite common, especially uterine fibromata and ovarian 

 cysts. Cancer of the uterus is not rare. 



VULVO-VAGINITIS. 



Every type of vulvo-vaginitis met with in temperate zones is also found in the 

 tropics, and gonorrhoea! infections are very common. It is interesting to 

 note that we have found in the vaginal secretion practically all the organisms 

 we have mentioned under the heading Pseudo-Gonorrhoeal Urethritis, and 

 that there are forms of vulvo-vaginitis associated with flagellates, ciliates, 

 amoebae, spirochsetes, treponemata, and fungi, and hence it is quite possible 

 that a certain number of cases of protozoal and hyphomycetic urethritis in 

 man are contracted in reality by sexual intercourse. 



Vulvo-vaginitis associated with hyphomycetes is far from rare, and such 

 cases may be separated into two principal groups : — 



I. Associated with fungi of the genus Aspergillus, Sterigmatocystis, Peni- 

 cillium, Cladosporium, with discharge, which may be dark-brownish or black, 



II. Associated with fungi of the genus Monilia and the genus Oidium, with 

 white or yellow discharge. These cases may present two different clinical 

 appearances : some are characterized by the presence of thrush-like membranes 

 on the vaginal mucosa {vaginal thrush) ; others do not show any membrane on 

 the mucosa, but the discharge is purulent and very thick. In the tropics 

 Castellani has found fungi principally of the types Monilia pinoyi Castellani, 

 Monilia tropicalis Castellani. In temperate zones the same observer with 

 Taylor have found Monilia pinoyi Castellani, Monilia londinensis Castellani, 

 Monilia metalondinensis Castellani, and other species, 



VAGINAL PROTOZOA. 



The vagina of native women may be the habitat of numerous protozoa apart 

 from Treponema pallidum and spirochsetes. We record the presence of the 

 following : — 



Sarcodina : — 

 Loeschia histolytica {Schaudinn, I go 

 Loeschia coli'Loesch, iSy^. 



