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Diseases of the Vaginal Passage

discharge, water, charge, health, chronic and injection

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Inflammation extending, that is, beyond the mere entrance, up into the canal, is called properly Vagi n itis.

Its cause may be very various—want of cleanliness, irritation of worms which have passed up the canal from the bowel, the pre sence of foreign bodies, such as a pessary intro duced for a displaced womb, &c. Simple ex posure to cold, especially at a monthly period, seems capable of producing it. It occurs, also, in the course of diseases like measles, small pox, scarlet fever, and is more apt to be found in persons of depressed general health. Irri tating injections may be its cause, and it may be the consequence of direct infection.

passage is hot and tender, there is a sense of burning and smarting, bear ina-down pain. freouent desire to make water.

and pain in passing it; aching and throbbing are felt in the passage, and walking is attended with difficulty. The external parts may also be swollen and inflamed. There is also die, charge, at first of clear and then of yellowish matter, which is often badly smelling. After a sharp attack the inflammation may pass off in a few days or weeks, or it may become chronic in persons whose vital powers are depressed.

Treatment.—In the period of acute inflam mation the person should be kept at rest in bed; brisk saline purgatives, seidlitz-powdera or effervescing citrate of magnesia, should be given, and mild food, milk, soups, &e. Stint* lants must not be given. Without skilled advice hot hip-baths may be given, or injections or douches of water as warm as can be comfor tably borne. The injection should be given with an enema syringe or douche. (See Plate XXXII.) The nozzle should be of caoutchoue„ or, still better, of glass, 5 or 6 inches long, and several openings should exist round the ev tremity of the nozzle, not one at the very point The person should lie on her back, with the hips raised. The water should be injected slowly, and care must be taken that it escapes quite easily. From a half to one gallon of water may be used at one time, and the injec tion may be repeated twice or thrice daily in sharp attacks. After the injection a medicated

pessary of 3 grains extract of belladonna should be pushed up into the passage and allowed to remain. It gives great relief. When the acute stage is past an injection of 30 grains sul phate of zinc to 1 pint of water is to be used. At the same time any bad state of general health requires treatment if the disease is to be got rid of.

Discharges from the Passage (Whites, Leucorrluta). —The lining membrane of the passage is studded with minute glands, which produce a clear thickish fluid for keeping the parts moist. Under a variety of circumstances it is so increased in amount as to appear ex ternally as a discharge. Just as when one has cold-in-the-head, or catarrh as it is properly called, the minute glands studding the lining membrane of the nostrils pour out their dis charge, which ordinarily is simply sufficient to keep the nostrils moist, and there is in conse quence a "running at the nose," so, as the result of exposure to cold or damp, the genital pas sage may be affected with catarrh and the dis charge appear. It may be thin and milky in annearance. or thick and sticky. or yellowish.

Commonly it is whitish, and has, therefore, been called "the whites." Besides being the result of cold, it may occur as a symptom of depressed health, in pale delicate girls for example, as an expression of defective nourish ment. It may also be a consequence of pro longed nursing. The discharge may originate, not in the passage, but in the womb itself, and may be the expression of some disorder there. In pale, weakly girls such a clear discharge may occur at the monthly periods without any discharge of blood. It will be the constant attendant of chronic inflammatory conditions of the passage.

The subject of such a chronic discharge usually complains of backache, discomfort in the lower part of the belly, and general weakness. This weakness may itself be the cause of the dis charge, but the occurrence of the discharge will make the weak state of health all the worse.

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