. The diagnosis and treatment of diseases of women. Fig. 50. Appearance of pus about the oiaening of the left vulvo-vaginal gland. Watery discharge. A portion of the discharge appears like water. This may beassociated with the normal muco-epithelial discharge or with a muco-purulentor purulent discharge. The most common cause of a watery discharge is the de-composition of a malignant tumor-mass in the vagina or uterus, giving the character-istic watery, foul-smelling discharge of advanced cancer or sloughing fibroid. ULCERS, SWELLINGS, NEW GROWTHS 37 INFLAMMATION ABOUT EXTERNAL GENITALS. GONOR
. The diagnosis and treatment of diseases of women. Fig. 50. Appearance of pus about the oiaening of the left vulvo-vaginal gland. Watery discharge. A portion of the discharge appears like water. This may beassociated with the normal muco-epithelial discharge or with a muco-purulentor purulent discharge. The most common cause of a watery discharge is the de-composition of a malignant tumor-mass in the vagina or uterus, giving the character-istic watery, foul-smelling discharge of advanced cancer or sloughing fibroid. ULCERS, SWELLINGS, NEW GROWTHS 37 INFLAMMATION ABOUT EXTERNAL GENITALS. GONORRHOEAL OR OTHERWISE. Inflammation is indicated by redness and tenderness, either diffused or in is usually accompanied by smarting or burning on urination. The smarting onurination and the increased frequency of urination, are most marked when theurethra is Fig. 51. Palpating the left vulvo-vaginal gland, to determineif there is thickening or tendeiness, or if pus can be pressed from it. ULCER ABOUT EXTERNAL GENITALS. SIMPLE, CHANCROIDAL, SYPHILITIC, TUBERCULAR, MALIGNANT. If an ulcer is found, determine its position, size, shape, consistency (edge andunderlying tissues), tenderness and mobility (whether fixed to underlying deepstructures or freely movable). Determine also the character of the discharge from it,and whether it bleeds readily on touching. Notice whether the base is made ofregular granulation tissue or has yellow dots scattered in it, or is filled with a also the edges—do they slope from within outward, as in an ordinary ulcerwhen healing, or are they sharp-cut and perpendicular, or undermined as in a rapidly 38 THE PHYSICAL ^EXAMINATION spreading chancroid? Is there a red acute-inflammatory zone about the uicer oris there a wide area of chronic infiltration (chronic inflammation, mahgnant)? Isthere only a
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