In this case, the "cause" is the explanans for the explanandum, and failure to recognize that different kinds of "cause" are being considered can lead to futile debate. Of Aristotles four explanatory modes, the one nearest to the concerns of the present article is the "efficient" one. David Hume, as part of his opposition to rationalism, argued that pure reason alone cannot prove the reality of efficient causality; instead, he appealed to custom and mental habit, observing that all human knowledge derives solely from experience. The topic of causality remains a staple in contemporary philosophy. Concept
Metaphysics
The nature of cause and effect is a concern of the subject known as metaphysics. Kant thought that time and space were notions prior to human understanding of the progress or evolution of the world, and he also recognized the priority of causality. But he did not have the understanding that came with knowledge of Minkowski geometry and the special theory of relativity, that the notion of causality can be used as a prior foundation from which to construct notions of time and space. Ontology
A general metaphysical question about cause and effect is what kind of entity can be a cause, and what kind of entity can be an effect. One viewpoint on this question is that cause and effect are of one and the same kind of entity, with causality an asymmetric relation between them.
In patients with labial fusion, a flat plane of tissue with a dense central line of tissue is usually seen when the labia majora are retracted, while an anterior opening is usually present below the clitoris. Treatment
Treatment is not usually necessary in asymptomatic cases, since most fusions will separate naturally over time, but may be required when symptoms are present. The standard method of treatment for labial fusion is the application of topical estrogen cream onto the areas of adhesion, which is effective in 90% of patients. In severe cases where the labia minora are entirely fused, causing urinary outflow obstruction or vaginal obstruction, the labia should be separated surgically. Recurrence after treatment is common but is thought to be prevented by good hygiene practices. One study has shown that betamethasone may be more effective than estrogen cream in preventing recurrence, with fewer side effects. Epidemiology
Labial fusion is not uncommon in infants and young girls. It is most common in infants between the ages of 13 and 23 months, and has an incidence of 3.3% in this age group. It is estimated that labial fusion occurs in 1.8% of all prepubertal girls. It is rare in adult women, particularly in reproductive age, but is occasionally found in postpartum and postmenopausal women. References
External links
Labial adhesions at Medscape