DISEASES OF THE ORGANS OF REPRODUCTION IN THE FEMALE 91 



from the uterus (metro-peritonitis) there is serous effusion into the cavity 

 of the abdomen, with more or less enlargement and increased roundness, 

 the presence of abnormal fluid being ascertained by percussion of the flanks 

 and the absence of resonance in the lower portion of the belly. A few 

 days, rarely exceeding five, will see a termination in death, unless a 

 healthy reaction is rapidly followed by recovery. 



In a few instances the disease passes into the chronic form, there is 

 a considerable abatement of the symptoms, less pain, increased appetite, 

 the enlargement of the vulva is not so noticeable, but the discharge persists 

 and the milk does not return. There is continued debility and probable 

 wasting of the body generally, while a false oestrum occurs at irregular 

 intervals. 



Treatment consists in irrigating the uterus with antiseptics, emol- 

 lients, and anodynes, while sustaining the patient's strength with nutritive 

 and easily-digested foods of a laxative character, and otherwise guarding 

 against constipation and keeping down febrile symptoms by the adminis- 

 tration of salines, salicylates, and other agents which are more particularly 

 described under the heading " Parturient Fever ". 



VAGINITIS 



By this term is understood an inflammatory condition of the passage 

 through which the foetus has to pass after leaving the uterus. While 

 commonly associated with metritis, or inflammation of the womb, it may 

 arise independently, as from mechanical difficulties in delivery and the 

 use of obstetric in.struments, exerting undue pressure, or actual wounding; 

 from protracted labours or abnormally large offspring. It may be simple 

 and remediable, or associated with lacerated wounds, ulcers, gangrene, and 

 mortification. 



The symptoms consist of tumefaction of the lips of the vagina, bulging 

 of the region immediately below, swelling of the mucous membrane lining 

 the canal, with discoloration varying from bright red to purple or almost 

 black, with wounds and abrasions, commonly the latter, and of a super- 

 ficial character, but not rarely of a serious description, where undue force 

 has been employed in the extraction of the foetus. The membrane is dry, 

 of a florid red hue, adhesive, and hot. A difliculty is experienced in pass- 

 ing urine, there is often much itching of the labia, a general febrile con- 

 dition and constipation, which latter would seem to have its origin, at least 

 in part, in deferred defecation arising out of the pain induced by the act. 



On the second or third day the congested, dry condition of the mem- 

 brane gives place to a somewhat profuse secretion, which is at first serous, 



