Gynecology . ecial treatment. Furunculosis is a disease that may be the result of uncleanliness, but it some-times occurs periodically with menstruation. It may also appear as a specificdisease, usually near the time of the menopause, in which case it seems to be theresult of a local circulatory disturbance, possibly connected with deficiency of theovarian function. This latter type may be much benefited by the use of ovarianextract. Syphilis.—The primary syphilitic lesion of the vulva may have exactly thesame appearance as that seen in man, characterized as it is by a smooth, sharplydefined u
Gynecology . ecial treatment. Furunculosis is a disease that may be the result of uncleanliness, but it some-times occurs periodically with menstruation. It may also appear as a specificdisease, usually near the time of the menopause, in which case it seems to be theresult of a local circulatory disturbance, possibly connected with deficiency of theovarian function. This latter type may be much benefited by the use of ovarianextract. Syphilis.—The primary syphilitic lesion of the vulva may have exactly thesame appearance as that seen in man, characterized as it is by a smooth, sharplydefined ulcer, with hard indurated base, and a livid coloration of the surroundingtissue. In woman, however, there is a much greater tendency to the formation of 184 GYNECOLOGY multiple primary ulcers, due chiefly to the fact that the labia minora lie in closeproximity to each other, so that the infection is transmitted from one lip to theother. For this reason multiple syphilitic ulcers are often seen symmetrically. Fig. 44.—Condylomata Acuminata. In this case the excrescences are collected into discrete masses. Usually the condylomata are more widely scattered over the vulva and surrounding parts. located on both labia. The initial lesion may be situated on any part of theexternal genitals, but it is found most commonly near the frenulum, the clitoris,and the inner surfaces of the labia minora. The lesions are apt to be associated with hard edema of the surrounding parts GENERAL INFLAMMATORY PROCESSES 185 and extensive erosions. Indolent buboes are felt in both groins, while latersecondary efflorescent manifestations follow. Owing to the local edema, multiple ulcerations, and erosion of the primaryaffection syphilis may be confounded with elephantiasis, tuberculosis, andesthiomene. The diagnosis may be made absolute by finding the Spirochsetapallida and by a positive Wassermann reaction.
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