SECTION III. 

 DISEASES OF THE VAGINA. 



IN this section we shall only treat of the inflammations of tho 

 vagina, leaving the congenital anomalies, tumors, and other diseases 

 of that organ, to the text-books on obstetrics and surgery. 



CHAPTER I. 



VIRULENT CATARRH OF THE VAGINA. 



ETIOLOGY. For the pathogeny and etiology of gonorrhceal catarrh 

 of the vagina, we may refer to what we have said of virulent catarrh 

 of the male urethra. Anatomically, it is not distinguishable from non- 

 virulent catarrh, but its course and origin are different. The disease 

 is not induced by sexual excess, or any other cause than infection with 

 gonorrhceal matter. 



ANATOMICAL APPEARANCES. In women the chief seat of virulent 

 catarrh is the mucous membrane of the vulva and vagina ; more rarely 

 it extends to that of the uterus. But in almost all cases the catarrh 

 extends to the urethra, and this is important in the diagnosis. The 

 affected mucous membrane at first shows the changes peculiar to the 

 most severe form of acute catarrh ; subsequently those of chronic ca- 

 tarrh. The secretion, which, in the beginning, is usually scanty, sub- 

 sequently becomes very copious, purulent, irritates the vulva and inner 

 surface of the thighs, but is only peculiar in that it is the bearer of the 

 contagion. 



SYMPTOMS AND COURSE. The first symptoms of gonorrhoea in the 

 female, a feeling of itching and warmth in the sexual organs, and a 

 scanty mucous discharge, are not very characteristic, and are often un- 

 noticed. A few days after the commencement of the disease, there are 

 severe burning pain in the genitals, swelling of the vulva, ardor urince ; 

 but these troubles rarely become so severe as to interfere greatly with 



