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detached by moderate force. Having found, by the number and rapid growth of these bodies, that they would undoubtedly be reproduced, the next point was to prevent this danger, and it occurred to me that some substance capable of coagulating albumen promptly, without acting too energetically upon the animal tissues, would succeed. A strong solution of alum was chosen and injected, a compress being applied to retain it. This was followed by the discharge of much coagulated albumen, of which thick layers were every day removed from the indurated points of the walls, until they seemed natural. The injection of alum-water was continued for several days longer, simple warm water being also used for cleanliness. The discharge gradually diminished and ceased.

At the last examination, the vagina was contracted so as barely to admit the finger, and seemed perfectly natural. The os uteri, which had not been distinctly felt before, was perceived, in form of a small tubercle, the orifice just perceptible, showing the uterus to have been unaffected.

The urine required to be drawn for the first week, but since she has gradually re-acquired the power of discharging it; gradually improving in health and appearance until the present time, when she may be said to be quite well.

Some of the bodies removed in this case are the specimens sent, and you have only to suppose them larger, softer, and semi-translucent, and you will form an opinion of what they resembled when first discharged. They are only changed by the effect of alcohol. They were distinctly vesicular. The largest were an inch and a half in length, and an inch broad; the smallest not more than a fiftieth part as large.

At first I supposed them to be polypi, but soon perceived that such was not the case, since they had been discharged and removed to the number of several hundreds in all, and were evidently attached one upon the other in some points. So that I know not what they may be, unless it is an animal growth, allied to the acephalocyst, of which there are, I believe, several kinds, found sometimes in animals, and of which this may be a rare or unknown variety. Will you present the case, with my respects, to your father, and inform me, if convenient, of the opinion he may form of it? Very sincerely, your friend,

D. BRAINERD.

Dr. Brainerd sent several of these curious bodies. I found, on examining them with a good doublet, that they were not cysts, but solid bodies, more resembling a mere sarcode than anything else. They were without hooks or other apparent apparatus. I could not adopt Dr. B.'s supposition that they constitute a variety of the acephalocyst, and like Dr. B. I remained uncertain as to their nature; but rather inclined to believe that they consisted of a morbid production of the corpus mucosum of the vaginal membrane.

I sent them to Mr. Milne Edwards, the zoologist, at Paris, and hope to have his decision as to their character. Should Mr. Edwards ascertain and state their real nature, I hope to communicate his opinion to you.

There are a great many women, who when pregnant, are annoyed with a most distressing, and even intolerable pruritus of the vulva, affecting chiefly the inner face of the labia, mainly attacking the portions of them in a range with the nymphæ, and not irritating so severely the parts nearer the posterior commissure. The malady is not confined to the gravid female alone, but I should suppose that ninety per cent. of the instances I have met with, have been in women enceinte.

Dr. Dewees appears, at times, to have found the mucous surface affected with aphthous inflammation. I have not seen such a case, though I have met with some that were to the last degree distressing cases, in which the pruritus was so intolerable, that the person could not resist the provocation to scratch, and even wound the surface with her nails. In such a state I have found the mucous body of the membrane red, of a Modena color, very dry and hot, but I have not observed aphthæ. In certain other samples, the dryness and redness were wanting; nor was there any sensible increase of the heat.

Should you be invited by your patients to give counsel on such a complaint, I advise you to make careful inquiries as to the presence or absence of redness, dryness and heat; and where they exist in a subject not demanding or admitting the use of the lancet, to recommend the application of a few, say eight or twelve leeches, within the labial surfaces. If the signs be absent, it may not be worth while to trouble your patient with the leeching.

Some cooling laxative will be indicated in case of torpor of the bowels; and a conformable diet should be prescribed. In such a

patient, salted meats, gravies, spice, pepper, spirituous and vinous drinks, ought to be forbidden. The warm bath, or the hip bath, is a highly useful ordinance; and some proper lotion or application should be provided for the affected parts.

It seems obvious that this must be a case for the nitrate of silver to show its alterative powers; for if there be any sample of disease that would be likely to yield to it, this would seem to be, most probably, the very one. Yet, I am constrained to say, I have not found it to answer the purpose. Nor does vinegar, nor mucilage, nor cold, nor tepid water, nor laudanum and water, nor alum cure it; but this is true, viz., that very few cases fail to be either cured or kept within very moderate bounds, by the following recipe:

Take of biborate of soda, half an ounce; distilled rose-water, six ounces; sulphate of morphia, six grains. Mix, and direct the lotion to be applied to the part affected many times a day.

Every man becomes probably more or less a routinist in his methods. It is with me a routine to order the above compound lotion; and I aver to you, that I believe, if you order it for your patients, you will have very little trouble in curing them. I am speaking here of the general run of cases. Should you use this compound, and find yourselves disappointed as to its curative powers, you ought to request an opportunity to examine, by inspection, the peculiarities of the malady, in order to enable you to judge whether blood-letting, purging, emollients, nitrate of silver, or astringents and tonics should be preferred.

Ancient injuries, by laceration, by ulcers, and by fevers, may have contracted the external parts so much as greatly to interfere with the dilatations required for the transmission of the child in labor. Patience can, perhaps, overcome even the contractions of old cicatrices; but when you are called on to give your opinion in such cases, you would do well to have at the call of your memory the views of Dr. Dewees, who taught us that the most resolute cicatrix may be rendered dilatable under the influence of bleeding, ad deliquium animi. I have met with no such cases myself.

The labia are frequently the seats of a phlegmonous inflammation. The texture of the organ being very lax and distensible, the abscess formed within it generally points early, and always points on the mucous surface: I never yet met with one that did

not end in suppuration; not because suppuration could not be prevented, but because the woman will never call for counsel until it is too late to expect any other termination. It is a simple matter, though a very vexatious and painful one.

You should open the abscess as soon as the fluctuation of the pus can be made out. The pain disappears with the cessation of the tension upon the escape of the pus. It is very common for a woman, who has had one labial abscess, to be troubled with several consecutive attacks of the same kind.

With these remarks, which appear to me sufficient to set the matters in question in a clear light, I have to conclude this letter with the assurance of my respectful consideration.

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GENTLEMEN:-There is another part of the system of organs contained within the pudenda, which deserves your professional attention, I mean the labia minora, or, as they are more generally denominated, the nymphæ; quasi custodes castitatis.

They are composed of an external or mucous membrane, within which there is an erectile spongy texture, which gives to them in the young, a certain degree of firmness, or hardness, that is not to be observed in individuals reduced by disease, or those who are advanced in age.

In the young and healthy female, the labia minora are of a rosaceous hue, which for such as have borne children, gives place to a dark, or even brownish tint. They are also much changed by the repeated excitement of the sexual passions, and are often after labor, discovered to be permanently enlarged, or torn and ragged or jagged on their edges or sides, by the violence done to them during the extremest extension of the parts, by the outpassing child, or by the edges of instruments employed in its delivery.

In a young child newly born, it is usual to find the nymphæ

jutting out beyond the genital rima—but very early-say by the end of the 14th or 20th day, the development of the labia majora, which proceeds rapidly as soon as the fœtal circulation is cut off, comes to cover up and wholly conceal the nymphæ; which, in the virgin, are not found to jut beyond the rima; whereas, the woman who has borne children, and who has suffered lesion of this organ in parturition, generally protrudes one, or both of them above or beyond the rima.

The physiological uses of the nymphæ are not agreed upon; but it is strange to find that such a writer as Dr. Campbell, in his Introduction to the Study and Practice of Midwifery, p.31, should say that "they are supposed to direct the urine from the urethra, and prevent its flowing over the external parts, and they contribute to enlarge the vagina during the exit of the fœtus; for at this time they are quite obliterated."

Pray observe that, should the stream of urine touch the lower end of the nymphæ, it would be sure to flow over and bathe the whole perineum; and you will not forget my assurances in the lecture-room, that I had very repeatedly found during the extremest distension of the external genitalia, the nymphæ hard and well marked along each side of the distending head of the child. You will find that Dr. Murat, in the article Nymphes of the Dict. des Sci. Med., avers that they do serve to the amplification of the vaginal orifice. It is incorrect to say so, since they belong not to the vagina but are a sort of valvulæ conniventes of the labia majora, to whose enlargement in labors they contribute not, or if I am incorrect in saying not at all, at least I am surely correct to say very little.

Fabricius ab Aquapendente, relates a case in which there was atresia of the vagina from imperforate hymen. The external part was protruded by the collection of the menstrua within. This distension had so effaced the nymphæ as to lead to the belief that the girl had none at all; but when the collection had been discharged and the external organs recovered their situs, the nymphæ were found to be perfect. This example is relied on by Dr. Murat in support of his view. But I ask you to consider whether the slow protrusion and development caused by a gradual collection of blood within the womb and vagina, might not introduce changes in the character of the formation within the sinus pudoris, which

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