ELONGATED NYMPHO, 
A 
Sign of Sterility. 
Reprint from transactions of Texas State Medical 
Association, 1886, 
By Chas. L. Gwyn, M. D., Galveston, Texas. 
With Compliments of the 
GALVESTON, TEXAS: 
CLIFFORD P. MARYE, PRINTER, 
1887. ELONGATED NYMPHJ3, A SIGN OF STERILITY. 
Chas. L. Gwyn, M. D., Galveston, Texas. 
Twelve months ago, in a paper before your honorable 
body, I suggested that there had been, in my practice, ster- 
ility almost invariably in cases of elongated, enlarged or 
hypertrophied nymphae. Being in doubt whether this con- 
dition was accidental—a mere coincidence—or not, I have 
kept notes of twenty-three cases of enlarged labia minora 
in which the patients were sterile, some originally so, some 
acquired. 
I think, when we come to study the anatomy of the re- 
productive organs of the female, especially in regard to 
their nerve and blood supply, that we will have but little 
difficulty in arriving at rational conclusions why, under 
exciting causes, these pathological conditions should exist. 
The vascular system being under the control of the 
nervous, which, to these organs, is large, it is patent that 
any element that disturbs the one must disturb the other. 
“ Ubi irritatio, vbi flexus ” is an old but true saying, and is 
as equally true in these organs as in the rest of the econo- 
my. Our attention is often attracted to, and we are fre- 
quently able to diagnose, stone in the bladder, or cystic 
disease in boys, by their habit of pulling at their prepuce, 
which becomes elongated. The symptom of picking at the 
nose, or itching at the anus, is pathognomonic of intestinal 
irritation or parasites, from the fact that irritation along 
the course of a nerve is felt at its terminal branches. The 
same that holds good for the urethra and for the intestines, 
will hold good for the vagina and its appendages. 4 
At the external orifice of the vaginal canal are placed 
the nymphoe, which, while they contain erectile, contain no 
retractile tissue. Irritation set up, from any cause, in the 
vagina, or uterus, is referred to the nymphse. Handling or 
pulling at them permanently elongates them, and they do 
not retract, but the erectile tissue which they contain be- 
comes engorged, and through nervous excitation we have a 
flow of blood to the genitals. 
In illustration of this fact, I shall copy a case from my 
note book: 
Mrs. K , a German, aged 43 years, married, elongated 
labia minora, excessive hemorrhage. 1 was called to this 
case, a stormy night, by her husband, who stated that his 
wife was bleeding to death, and, at each monthly period, 
that she lost large quantities of blood, and had done so for 
the past three or four years. Digital examination revealed 
a tumor about the size of an English walnut just within the 
os tincae. The use of ergot internally, and the salts of iron 
locally, soon checked the flow. 
Two days afterwards the hemorrhage was renewed. 
Being called from my office, I carried my gynaecological 
bag, and was enabled to make a speculum examination, 
and found a hard, smooth, fibroid polipus attached by a 
broad base to the right lip of the cervix, dilating the os 
internum to the size of a silver half-dollar. 
I excluded cancer from my diagnosis, from the facts (1) 
that Tie woman was barren, and cancer is a disease that 
follows in the wake of child-bearing; (2) that cancer is a 
disease of the fundus, not of the cervix, epithelioma ex- 
cepted; (8) that, had it>been cancer, the patient would have 
succumbed before this time, as cancer, untreated, usually 
proves 4atal in from eight months to two years. 
Undfi* the internal use of ergot, the tumor necrosed 
and came away, the patient doing well, justifying my diag- 
nosis. 
I mention this case to show how an irritant in the womb, 5 
or at its neck, might produce its effect on the nymphae, 
which were, in this case, from repeated handling, protrud- 
ing about three inches. 
In nearly all of these cases, we have swelling of the 
mucosa, and frequently inflammation of the sub-mucous 
tissue. The mucosa swelling concentrically, practically 
occludes the os tincae. 
Excessive and masturbation are the most potent 
causes of engorgement of the mucosa, vaginitis, and of 
hypertrophy of the nymphaa. 
Prostitutes rarely breed, because of continual sexual ex- 
citation and the excessive use of their genitals, and we are 
apt to find both a hypertrophy of their nymphae and a tur- 
gescence of their vaginal walls. 
The young married woman, who is twiitedby her friends 
for the absence of the cradle from her bedside, exhausts 
her own and her husband’s nervous strength in the effort 
to carry out Nature’s law, “ Grecendo et multiplicando 
In her you will find the same symptoms as in her “ frail 
sister.” 
In all of the twenty-three cases which I have kept rec- 
ord of, none applied for treatment for this abnormality, 
but for troubles dependent upon a hypermmic condition of 
the pelvic organs, and were all sterile; and I am not 
certain that the case of polypoid tumor related was not de- 
pendent upon a hyperaemic condition acquired in early 
married life.