. Pelvic inflammation in women. nd mucosa may bemoved freely over it. As-piration of the containedfluid will always make thediagnosis positive. In-clusion cysts of the lowervaginal wall are rare,usually solitary, and varyin size from that of a peato that of a mucous membraneof the vagina movesfreely over the surface ofthe tumor. If the cyst ison the posterior wall,rectovaginal touch willquickly reveal its limita-tions. Vulvar tumors are distinguished by their density and usuallyare devoid of inflammatory phenomena. Treatment.—It may be possible to dilate the Bartholin duct witha p
. Pelvic inflammation in women. nd mucosa may bemoved freely over it. As-piration of the containedfluid will always make thediagnosis positive. In-clusion cysts of the lowervaginal wall are rare,usually solitary, and varyin size from that of a peato that of a mucous membraneof the vagina movesfreely over the surface ofthe tumor. If the cyst ison the posterior wall,rectovaginal touch willquickly reveal its limita-tions. Vulvar tumors are distinguished by their density and usuallyare devoid of inflammatory phenomena. Treatment.—It may be possible to dilate the Bartholin duct witha probe and allow the contained purulent fluid to escape. A probe pointedhypodermic needle, attached to a syringe containing a dram of a 25per cent argyrol solution, may then be passed through the duct andinjected into the gland cavity. This treatment may be repeated daily,if the lumen of the duct will permit. Unfortunately it is painful andis neither as satisfactory nor as permanent as incision or excision ofthe abscess Fig. 2.—A. Infected Cyst of Bartholixs Gland,Extending Backward toward the Commissure. B. Incision Exposing Distended Gland. C. Gland Removed—Sutures in Place. INFECTIONS OF THE VULVA, VAGINA AND CERVIX s Incision.—After thoroughly preparing the vulva by cutting away thehair, cleansing the region of operation, and then painting it with tinctureof iodine three and one half per cent, the tissues about the tumor shouldbe infiltrated with a one half per cent solution of novocain. When theanesthesia is complete, the abscess may be emptied by a free incision overthe gland on its mucous surface, just within the labia, at the junction be-tween the skin and mucous membrane. While this allows the escapeof pus, extirpation or destruction of the gland membrane is necessary toprevent recurrence. This may be done with a sharp curet, or by the ap-plication of pure carbolic acid to the abscess cavity. After the capsule hasbeen removed or destroyed in this way, a
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