LLEMORRHAGES FROM THE GENITALS Schulkowski observed in 10,000 nen-born children (girls), 35 cases of ha,morrhage front the genitals. The inetrorrhcra, usually extremely scanty, and seldom abundant, never appeared before the fifth and gen erally at the sixth day. Sehulkowski refutes the contention that in these cases the hmmorrhage was a precocious menstruation, as some writers believe. Neither does he believe the Muniorrhage can be ascribed to asphyxia, breech presentation, or instrumental delivery. Ile sees the cause as a physiological hyperiemia of all the abdominal organs which is present after birth. Zappert believes, as a result of histological examinations, that the cause of the hmmorrhages is a physiological irritation of the uterine mucous membrane. Henoeh connects the vaginal MemoiThage with the shedding of epithelium that appears after birth, and designates as further causes papilloma of the vulva and vagina. He calls our attention to the fact that vaginal Inemorrhage may be imitated by bleeding from the polypoid prolapse of the urethral mucous membrane, which in cases of great severity may be represented as a (lark red protrusion between the walls of the genital fissure.
Precocious menstruation, is in any case, extremely rare as a cause of hremorrhage. It is accompanied by other evidences of general maturity. In older girls lnemorrhages are described which may be due to hyper trophy of the cervix, fungous endometritis, salpingo-oophoritis, metritis (of gonorrhceal origin), cystic degeneration of the ovaries, or to causes belonging to diseases outside the genital apparatus entirely.
It seems useless to treat the hminorrhages of the newborn which are due to physiological irritation, since they cease in a short time of their OWR accord. The treatment of the other forms is based upon the etiology.