CLITORITIS. Latin, from Greek, 0.Erropi;Etv, to titillate; and itis, in flammation.
Definition.—The question as to the frequency of this condition is one which involves great difference of opinion, and depends not a little upon the definition which one gives to it. If it is considered as an inflammation which involves the structures, as a whole, of which the organ is composed, it is, indeed, of rare occur rence; but if we include that adventi tious form of inflammation, often of slight intensity, indicated by fibrous structures which are attached to and bind down its terminal portion, it is of great frequency. If all female children were carefully examined to determine its presence or absence it would doubt less be recognized much more frequently than it is. It would probably be found as often as the analogous condition which affects the penis of male children.
Symptoms.—The venereal variety of clitoritis may be associated with either of the forms of venereal infection; that is, with chancre, chancroid, or gonor rheea. True chancre of the clitoris is of rare occurrence. In a dispensary experi ence of many years among women with every shade of venereal disease I do not recall a single instance.
Dr. R. IV. Taylor has informed me that he has seen it several times, and that it was characterized by great pain, swell ing, and induration, and reported a typ ical case in a woman, 21 years of age, who contracted syphilis from her husband. The clitoris and prepuce were indurated, enlarged, and very painful, and there was an ulcer at the tip of the glans. Local treatment with solution of caustic potash and lead-and-opium lotion pro duced relief. Other cases have been re ported by Mauriac.
Chancroid of the clitoris I have seen several times, though Taylor thinks it is of rare occurrence. Its phenomena are those of chancroid on other portions of the female genitalia, viz.: local sore with out great attendant hyperaamia in the structures of the clitoris, and usually en largement of the neighboring inguinal glands.
Gonorrhcea involving the clitoris is not of infrequent occurrence. The phenom ena are redness and swelling of the pre puce and to a greater or less degree of the organ itself; the accompanying pain may be considerable. Traumatic clito
ritis is relatively of rare occurrence. It is the result of direct injury from violent coitus, from a blow, a thrust, or a fall, the clitoris sharing injury with the sur rounding structures. The inflammation follows the course of inflammations of a traumatic character in similar vascular tissues, pain and swelling being the most prominent features.
Etiology and Pathology.—It is some what surprising that inflammatory phe nomena of a decided character are not more frequently connected with the clit oris when we remember its exquisite sensitiveness, its abundant blood-supply, and its constant exposure to irritation during the entire period of life in which the tissues of the genital organs are in an active functional condition. During childhood its conspicuous position in vites the injuries to which childhood is unusually susceptible, and it is also in danger from uncleanliness, from para sites, and from masturbation. After the external genitals have acquired coraplete development and the mature condition which follows puberty has placed the organ in a less exposed situation there is still danger from traumatism, though not to a great degree; from uncleanli ness, from masturbation, from violence in coitus, and from the poisonous influ ence of venereal disease. It would seem that the susceptibility to injury increased with the size of the organ, a large organ being an anomaly and requiring constant care and precaution. This fact empha sizes the necessity that the family physi cian be acquainted with the peculiarities of his patients in order to safeguard them from evils which may be avoided.
The clitoris may be the seat of cystic disease from hwmorrhage or other cause (Peckham), of syphilitic new growth (Kelley), of carcinoma, and less fre quently of sarcoma (Robb), of hyper trophy, in addition to various congenital deformities and defects. Its appearance in spurious hermaphrodism is a very good illustration both of hypertrophy and of congenital deformity. These statements are made incidentally, since a true inflammation may be associated with either of these conditions, a true clitoritis being then present.