Identifier: operativegynecol001kell (find matches)
Title: Operative gynecology :
Year: 1906 (1900s)
Authors: Kelly, Howard A. (Howard Atwood), 1858-1943
Subjects: Gynecology Gynecology Gynecologic Surgical Procedures
Publisher: New York and London : D. Appleton and company
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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lity tosit down without increasing the pain, together with a sense of pressure in therectum. The gait is slow and straddling and the body bent forward. Thereare often chills and fever. The general condition of the patient is one of extreme malaise. Often-times there is a history of leucorrhea, offensive or irritating, with painfulmicturition. One of my cases had an ulcer 1 cm. in diameter at the fourchette andanother in the inferior wall of the urethra, near its internal orifice, 6 mm. by ABSCESS OF BARTHOLIN S GLANDS. 255 10 mm. in size. In tins case the pus removed from the left vulvovaginal glandcontained numerous typical colonies of gonococci within the cells. In mostcases, however, the microscopic examination of cover slips has proved entirelynegative. The affection usually reaches its height in a few days; it may, however, beseveral weeks in developing; it tends toward spontaneous recovery by ruptureon the mucous surface of the labium, discharging from 15 to 100 c.c. (•£ to 3
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Fig. 138.—Abscess of Left Vulvo-vaginal Gland. The distention is in the direction of least resistance, out from the left pubic ramus, partly coveringthe vaginal outlet. ounces) of blood, grumous pus, or pure yellow pus. The exit may be by oneor several small openings, which tend to close rapidly. But the disease is proneto relapse (relapsing abscess) in such cases. I have had a patient whopresented a history of repeated suppurations extending over many months.Other rare cases give a history of alternation (alternating abscesses) of theaffection from one side to the other. Abscesses of the vulvo-vaginal gland areespecially liable to recur, because the ultimate ducts become infected, and sothe suppurative process may go on indefinitely, until the entire gland is eitherdestroyed or removed by operation. Occasionally there is no enlargement of the gland visible on inspection. In 256 DISEASES OF THE EXTERNAL GENITALS. spite of the fact that there is no evident tumor, there may be a more

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