A handbook of diseases of women : including diseases of the bladder and urethra / by F. Winckel ; authorised translation edited by Theophilus Parvin.

  • Winckel, F. (Franz), 1837-1912.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: A handbook of diseases of women : including diseases of the bladder and urethra / by F. Winckel ; authorised translation edited by Theophilus Parvin. Source: Wellcome Collection.

    32/784 (page 20)
    DISEASES OF WOMEN. the urethra continues short and occupies an abnormally high position. This condition is to be considered as the beginning of hypospadia femintc, a true hypospadias occurring when the blad- der opens without the vagina into the vestibule. A case of this kind has been described by Heppner. IV. If the formation of the urethra and the closure of the anterior parts of the vulva be prevented by a delayed commu- nication of the allantois with the external surface, or if there be a defect in the anterior wall of the bladder with a cleft of the pubic symphysis, the condition is known as epispadias. Here the clitoris and nymphse are cleft, and the anterior wall of the urethra is absent; cases of this kind have been described by Eoeser, Gosselin, Testelin, and others. The causes of all such arrests in development lie in part in the relations of the respective organs themselves, e. g., a closure of ducts may interfere with the passage of the contents, and the consequent distention may prevent normal union, producing new separation. Again, they may be caused by neighboring organs, e.g., by the omphalo-mesaraic duct, by the intestines, or from abnormalities in the larger abdominal organs, such as the liver, which, owing to its great size or unusual connections, may per- manently dislocate the organs beneath it. It is certainly incorrect to speak of a congenital vulvar atresia where there is an orifice beneath the hypertrophied clitoris lead- ing to the uro-genital sinus, through which the urinary and genital secretions pass out, for here there is no complete closure and the vulva is not imperforate. The condition which Hilde- brandt represents in his work, p. 5. Fig. 3, does not, therefore, show an atresia of the vulva, but hyperplasia of the clitoris, per- sistence of the uro-genital sinus, and an abnormal shortening of the recto-vaginal septum. V. A peculiar malformation of the external genitals is that which has been designated hermaphroditism. Here some parts of the vulva, especially the clitoris and labia majora, are developed to an unusual degree. The labia, uniting at a higher level, present a sort of raphe and not infrequently contain the ovaries, increasing the resemblance to the scrotum. Other parts, on the contrary, especially the nymphre, have been arrested in