DISEASES OF THE VAGINA. 



contained more epithelial cells, and, after the cessation of the menses, 

 as long as it retained its red color, there were more or less blood-cor- 

 puscles in it. In catarrhal affections they found the secretion either 

 milky and thin, or more yellowish and thicker. The more opaque, 

 white, or yellow, the secretion appeared, the more numerous were its 

 pavement epithelium and young cells (mucous and pus-corpuscles), 

 often also the infusoria discovered by Donne (trichomonas vaginalis), 

 and some few fungous filaments and vibriones. Hence we see that 

 these observers rarely found a perfectly normal secretion, and that 

 catarrh of the vagina is ( one of the most common of female diseases. 

 Irritation of the vagina, by sexual excess, is the chief cause of catarrh 

 of that part, it is true ; but it is often induced by other causes, which 

 were mentioned when speaking of uterine catarrh. It is particularly 

 to be borne in mind that catarrh of the vagina, like that of the uterus, 

 depends as often on constitutional as on local causes. A consideration 

 of the exciting causes shows that ,this disease must be rare during 

 childhood ; and this is true, except in the cases where oxyuris have 

 passed over the perinaeum from the anus to the vagina, and have there 

 caused great irritation. 



ANATOMICAL APPEARANCES. In acute catarrh we find the mucous 

 membrane bright red, swollen and relaxed ; in many cases we see 

 small prominences on it, which give the membrane a granular appear- 

 ance, and which are not, as was formerly supposed, due to distention 

 of the follicles, but to swelling of the mucous papillae. Sometimes 

 these changes affect the entire vagina, at others only parts of it. At 

 first the secretion is scanty, but, after the disease has lasted a very 

 short time, it becomes more copious and more or less opaque. 



[The inflammation usually spreads all over the vagina, and over 

 the vulva as well. Sometimes, however, a portion only of the va- 

 gina is involved. For instance, at the beginning of a vaginal gon- 

 orrhoea the lower part only will be attacked, while a catarrh caused 

 by disease of the cervix or uterus will be confined chiefly to the up- 

 per part of the canal. 



Hildebrand describes a peculiar ulcerous form of inflammation 

 of the upper vagina, caused by loss of the epithelium and slight 

 hypertrophy of the papillae, and finally adhesion of the vaginal por- 

 tion to the vaginal walls, so that the fornix vaginae is obliterated, 

 and the os uteri is to be felt at the top of a funnel-shaped tube. 

 Schroeder has also seen this disease, which in one case resulted in 

 complete atresia, in another in partial closure of the vagina below 

 the vaginal portion, and in a third case in complete contraction 

 (stenosis) of the entire upper vaginal region.] 



In chronic catarrh the walls of the vagina appear distensible and 



