. Clinical gyncology, medical and surgical. OPLASMS OF THE VULVA AND VAGINA. In the hard tumors, delicate fibrillated connective tissue predominatesand muscle tissue is scanty, whereas the latter is abundant in the myxo-matous variety. The lymphatics, although dilated, are not increased, butthe blood-vessels are numerous, especially the arterioles. The capillariesare not dilated; numerous nests of inflammatory corpuscles are conspicu-ous, especially around the arterioles. There exist combinations of inflammatory changes with new formations occur first in the super-ficial layers pr
. Clinical gyncology, medical and surgical. OPLASMS OF THE VULVA AND VAGINA. In the hard tumors, delicate fibrillated connective tissue predominatesand muscle tissue is scanty, whereas the latter is abundant in the myxo-matous variety. The lymphatics, although dilated, are not increased, butthe blood-vessels are numerous, especially the arterioles. The capillariesare not dilated; numerous nests of inflammatory corpuscles are conspicu-ous, especially around the arterioles. There exist combinations of inflammatory changes with new formations occur first in the super-ficial layers predominating in the papilla?, that form of tumor is producedwhich strongly resembles the large coalescing condylomata sometimes foundin pregnant women. The large tumors are liable to extensive ulceration from local irri-tation, so that they may occasionally give rise to difficulty in warty form, besides being a source of great annoyance from the accu-mulation of repulsive secretions, may undergo malignant degeneration. Fio. Elephantiasis of vulva, before operation. (Schroeder.) Etiology.—The causative factors are quite numerous, but all hinge onthe same principle,—a local irritation. Thus, syphilis, traumatism, localinflammation, as pruritus, eczema, or recurrent attacks of dermatitis, maybe enumerated ; but any of these conditions must produce an inflammationand obstruction of the lymphatics in order to give rise to direct cause is considered to be the presence of a parasite, the filariasanguinis hominis, in the blood and lymphatics of the parts affected. Symptoms.—The invasion of the disease is marked by local inflam-mation, which ceases later, when the tumor has attained a moderate size. NEOPLASMS OF THE VULVA AND VAGINA. 533 The growth does not annoy the patient until it has reached a size sufficientto produce inconvenience and pain by reason of its weight. Tumors whichreach to the base of the urethra usually produce incontinence of
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