Inflammatory disease of the clitoris may, therefore, be prenatal or postnatal in its origin, congenital or acquired. In the great majority of cases it is prenatal; that is, it originates during fcetal life. Why such a condition should arise so frequently during this period is not known; but the fact remains that many female children come into the world with the glans clitoridis surrounded by more or fewer bands of adhesion, binding it down, interfering with its circulation and development, and furnishing cause for more or less subsequent irritation and disturbance.
Of the postnatal, or acquired, form of the disease, while there are occasional instances in which it is caused by un cleanly habits, by parasites, and by the extension of dermatitis affecting the con tiguous tissue, in the greater number of cases it will be due to venereal infec tion or to traumatism.
With reference to its etiology, there fore, the disease may be classified as (1) congenital, (2) venereal, and (3) trau matic.
Of the causes of the congenital variety we are ignorant, as has already been re marked.
The bands and strands of fibrous tis sue of greater or less density and firm ness, which are its visible consequence, attach its glans to its prepuce, or hood, which is formed by the coalescence of the nymphm, and to the surface which lies immediately around it. The contrac tion of this tissue, according to its abun
It is conceivable, as Baker Brown in sisted, that certain forms of nervous dis ease might result in consequence of such conditions, but the number of cases in which such a relationship has been care fully observed must be quite small. In the great majority of cases it is believed that the resulting disturbance has been too slight to require attention and treat ment from the gynmcologist.
Treatment.—There is little to be said concerning the treatment of clitoritis of whatever variety.
Rest in bed is essential; local cleanli ness equally so. In the congenital va riety the adhesions must be removed, and this can usually be done by retracting the prepuce with the thumb and fore finger of one hand while the forefinger of the other is rubbed over tbe glans with sufficient firmness to remove all obstruc tions. The bruised surface may then be dusted with iodoform, aristol, or no sophen, and this process repeated daily as long as the surface remains broken. For the venereal variety a 10- or 20-per cent. solution of nitrate of silver should be applied daily upon absorbent cotton until pain and swelling have subsided and the ulcerated surface has healed. For the traumatic variety only soothing lotions will be required. Lead-and-opium wash, frequently applied upon absorbent cotton, will serve the purpose sufficiently well.