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On separating the nymphae, a gray, partially adherent, partially desquamating membranous layer was seen, which began above the urethra, and spread over the anterior vaginal wall, along the inner surface the nymphse, down the posterior commissure and thence over the entire vagina. Externally it terminated sharply at the frenulum, and above at the vaginal vault on one occasion alone, a portion the size a pea was found adherent the posterior lip the cervix. The external was entirely smooth there was no cervical discharge.

The membranous layer, a number lines writing services canada thick, could removed with the forceps, and the mucous membrane beneath was pale red.

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The insertion the finger and the speculum was difficult and painful, although there was no hemorrhage.

The condition had lasted for about three months. A year previously she had been treated for the leucorrhcea and for pain in the back and abdomen. The reaction the secretion was highly acid.

On microscopic examination the layer was found consist in numerous fat corpuscles, like cells, partially containing crystals in the shape needles these bodies dissolved in ether.

There existed also a thick layer partially cornified Birch-Hirschfeld examined a portion excised from the neighborhood the introitus and reported that the epithelium was markedly thickened, the upper layers being partially converted into membranous lamellae the rete malpighi contained large cells, and was much thickened the papillae were hypertrophied, the sub-mucosa greatly thickened and filled with many thick walled vessels the tissue was infiltrated with round and spindleform cells, that the appearance was similar that obtained from fresh Winckel watched the patient for four and a half weeks. Within two three days, the parts whence large pieces membrane had been removed, nodules the size a pin's head formed anew, grayish in color, which quickly coalesced into membrane. For two days she lost a slight amount blood menses, and the third day Winckel found service essays the entire vagina filled with a boggy, black mass which was shed, and then the previous membranous formation recurred. It interesting note that the case was complicated with a chronic affection the left eye, which had existed since her nineteenth year, and had been repeatedly treated. At the time Winckel examined her, the conjunctiva was covered a layer very similar that in the vagina, the cornea being partially cloudy and the pupils prominent. In addition the patient had had an eruption the face and arms, which had yielded inunction with some ointment. She did not cohabit till afterwards.

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Examination revealed no sign syphilis, and the affection was neither cured nor bettered protracted use antrsyphilitic remedies. Far more infrequent than the catarrhal are the exudative inflammations the vagina.

Vaginitis Diphtheritica. Croupous and diphtheritic changes in the vaginal mucous membrane have been frequently academic essay help noticed since Rokitausky called attention them, although the identity the process with that in the pharynx and the larynx, has only been settled in the minority of Klebs, who admits the occurrence true croup in intense inflammations the vaginal mucous membrane, describes further, as diphtheritic, the changes which are seen in lacerations at the introitus in puer perse the dirty yellow, adherent layer, which frequently remains unchanged for some time, and again said give way purulent and granulation changes, or else becomes the seat suppuration. In secondary diphtheria, which developes in the course acute infectious diseases, cholera, variola, scarlatina, measles, the vaginal mucous membrane, according to Klebs, reddened, ecchymosed, and its surface there are generally, in groups, small elevations, grayish yellow in color the superficial layer necroses, and shed in patches, or later in large pieces, and then usually described as croup. Schroeder calls attention the fact, that in addition term paper writer the extensive croupous and diphtheritic processes seen in puerperal women, and also after gonorrhoea and in the course acute infectious diseases, often find whitish, more or less adherent layers as the result some local traumatism irritation purulent secretion, fistula?, etc. In case the general diphtheria accompanying acute infectious diseases, the swelling in the vagina attains the highest grade, so that, as in a case seen Schroeder, the legitimate essay writing services recto-vaginal septum may form a thick tumor, and the vaginal folds and the cervix may swollen that the finger cannot reach beyond the cervix. On the mucous membrane are found white and green diphtheritic membranes, and there exists a foul, purulent discharge. Occasionally the cervix implicated, extension taking place the cervical mucous membrane which greatly swollen.

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