Text Appearing Before Image: va. The stroma of the papilla contains several dilated blood-vessels and is infiltrated with leuko-cytes. The growth of the papillae is entirely superficial, there being no tendency togrow down into the subcutaneous tissue. For this reason the treatment isvery simple. It consists merely in scraping off the papillary growths with asharp curet. The superficial excoriation of the skin may be painted withiodin and the healing process is very rapid. If the condylomata extend to thesofter parts of the vestibule and vaginal orifice their removal may be attended by GENERAL INFLAMMATORY PROCESSES 229 troublesome bleeding, especially if the patient happens to be pregnant. If thecondylomata are at all extensive it is best to remove them under general anes-thesia. ESTHIOMENE This is a disease about which we have very little definite knowledge. Thename is adapted from the Greek word meaning to gnaw out, so that it corre-sponds practically to the term rodent ulcer. The disease consists of an exten- Text Appearing After Image: FlG. 49. ESTHIOMENE. The labia are hypertrophied, resembling somewhat elephantiasis. There is extensive ulceration ofall the parts. The ulcerated areas have a tendency to be symmetric on the two sides. sive inflammation and ulceration of the vulva. The parts are greatly swollenand covered with superficial sloughing areas. These areas are apt to be at thepoints of contact of the swollen labia, so that there is a certain symmetry in theulcerations. The parts are bathed with a foul purulent discharge. The origin of this disease is obscure. It is seen mostly in prostitutes, and,though it is thought to have some possible relationship to syphilis, it does notyield at all to syphilitic treatment. It is regarded by some to be the result of a 230 GYNECOLOGY lymph-stasis in the external genitals, as it sometimes follows the excision ofinguinal buboes. It is often associated with stricture of the rectum. Esthiomene simulates in its appearance cancer and lupus, from which itshould always be disti
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