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cases of vaginismus no local disease can be found, because genuine
vaginismus is of nervous origin.
_Dyspareunia_ means painful or difficult intercourse, from whatever
cause. It differs from vaginismus in that the cause is generally a
local one, that is, it may be inflammation, laceration as after a
confinement, small size or atresia of the vagina, etc. When vaginismus
is present, it is present in reference to all men, in fact the mere
touch of the finger or an instrument may call forth a painful spasm;
while dyspareunia may show itself with one man and be absent with
another. The origin of the word dyspareunia shows that this may be
the case, for _dyspareunos_ in Greek means badly mated.
Dyspareunia must not be confused with true vaginismus. In dyspareunia
the sexual act can be freely indulged in, only the act is painful or
disagreeable. In vaginismus intercourse is _impossible_. In
exceptional cases where the husband attempts to use brute force, the
wife may faint away, she may get a convulsion or become wildly
hysterical. If the husband insists in attempting relations, the wife
may run away, or in exceptional cases even attempt suicide.
ADHERENT CLITORIS OR PHIMOSIS
The word phimosis means "muzzling," and it is a term applied to a
constriction or narrowing of the foreskin, so that the glands of the
clitoris cannot be freely uncovered. This condition may give rise to
an accumulation of smegma or secretion which may cause inflammation,
itching, and nervous irritation. This in its turn may be the cause of
masturbation. It is claimed by some that an adherent clitoris may even
be the cause of convulsions resembling epilepsy. In some cases it
leads to an irritable bladder, inability to retain the urine, and
In all girls, big or little, that show a tendency to masturbate or
simply to handle the genitals, or that complain of itching, the
clitoris should be examined and if adhesions are found they should be
separated. This can easily be done under a local anesthetic.
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