SECT. LXX.—ON EXTIRPATION OF THE NYMPHA AND CAUDA PUDENDI.
In certain women the nympha (clitoris?) is excessively large and presents a shameful deformity, insomuch that, as has been related, some women have had erections of this part like men, and also venereal desires of a like kind. Wherefore, having placed the woman in a supine posture, and seizing the redundant portion of the nympha in a forceps we cut it out with a scalpel, taking care not to cut too deep lest we occasion the complaint called rhœas. The cauda is a fleshy excrescence arising from the mouth of the womb, and filling the female pudendum, sometimes even projecting externally like a tail; and it may be removed in the same manner as the nympha.
Commentary. That the nympha and clitoris were used anciently as synonymous terms is evident from Ruffus Ephesius (De Partibus Hominis); Soranus (c. 6); and Pollux (Onomasticon, ii.) Martial, in more than one place, makes allusion to unnatural practices connected with an enlarged clitoris. Aëtius says that it is a small muscular substance situated at the commissure of the alæ pudendi above the meatus urinarius. He adds, that when preternaturally enlarged it is to be amputated. Like our author, he directs us to take hold of the tumour with a forceps and cut off the protuberance, taking care not to carry the excision too far. He recommends us to apply a sponge squeezed out of an astringent wine or cold water, with suitable dressings. He gives the same account of the cauda as our author. (xvi, 103 and 104.) It was a tumour arising from the uterus itself. Albucasis merely transcribes our author’s account of these operations. (Chirurg. ii, 71.) Avicenna briefly recommends us to remove the enlarged nympha by medicines or the knife. (iii, 22; i, 24.) It would appear that this operation, like circumcision, is still often practised in the East.
The chapters of Soranus, in which these operations were treated of, are unfortunately wanting.
On extirpation of the enlarged clitoris see Heister’s Surgery (ii, 5, 147). The cauda pudendi was probably the cauliflower excrescence of the os uteri described by late authorities on midwifery.