FUNGOUS GROWTHS AND PARASITES OF THE VULVA.
The most common parasite is the oxyuris vermicularis. There is certainly no obstacle in the way of the wanderings of this ascaris from the rectum into the vagina, since it may progress along the perineum. They are found most frequently in little girls. In addition to the ascarides the eggs of the tienia solium and the ascaris lumbricoides have been found in the vulva, the result of uncleanly habits in wiping the anus after defecation. We are not in a position to state whether the eggs of these parasites may be retained in the vulva and the vagina and eventually there be developed. In case of the ascarides this is claimed by Via.
The pediculus pubis is only found in the hair of the pudenda and of the mons veneris, and causes itching and scratching. During coition the acarus scabiei may be carried into the vagina. Haussmann in one instance found the mites of this species in the vaginal mucous, although they were dead.
The vegetable parasites are scarcely of less importance. We will not refer here to vibrios and bacteria. These are so frequent, especially dur ing the puerperium, that it is no matter for surprise that they are found constantly. Of the vegetable parasites only a few are noted: the leptothrix vaginalis, the oidium albicans of Robin. Leptothrix was first found by Leuwenhceck, but this had been forgotten until Donne again called attention to it, and KbHiker and Scanzoni as well. In addition, C. Mayer, E. Martin, Frankenhafiser, and Winckel detected this fungus in the female genital organs.
These fungi are harmless. With the exception of transient burning in the genitals they cause neither symptoms nor disease. The burning appears ten days after deposition of the fungus, and in a further similar period disappears.
The oidium albicans, according to Haussmann, causes a little extra burning, and there is also elevation of temperature. In one case it was found in a gravida; pregnancy indeed would seem to predispose to this fungous growth. Diabetes has a marked influence. According to Friedreich
the cause of the pruritus which accompanies diabetes is the presence of this fungus. We saw one instance where, in the presence of grape sugar, the oidium developed into threads. Further still, I have seen the develop ment of this fungus in a woman not gravid, and in the absence of diabetes; and here I would refer to certain experiments which I made in 1877 with Dr. Rees, the professor of botany.
Thrush deposit from the mouth of a child was placed in cherry-juice, and there developed germs similar to that of the yeast plant. Control experiments proved that the yeast germs from the mouth also developed into threads, and so the two forms were similar except in their develop went sites. In both instances we were likely enough dealing with spores. The thrush was further afterwards subjected to the customary treatment with borax and honey. The control experiments in the mouths of adults, and in particular of dogs, were negative except when the salivary glands had been removed from the dogs. Usually also attempts at implantation on the vulvar mucous membrane were negative. Only once did a slight layer of the fungus appear, and this vanished spontaneously in a short time.
The treatment of this parasite is simple. Injections of weak metallic solutions, cupric sulphate, sulphate of zinc, will cause its speedy disap pearance. Latterly two per cent, solutions of carbolic have been recom mended by Conrad and Haussmann, aril solutions of borax or hyper manganate of potass by Mettenheimer.
Finally, we must mention that harmless parasite the trichomonas vaginalis. This is a mass of protoplasm with one or two vibratile cilia. It is of no pathological importance, and will disappear on attention to cleanliness and on the use of injections.