544 GENITAL APPARATUS. 



circumstances. From the clinical standpoint three varieties are dis- 

 tinguished : simple or contagious acute vaginitis ; croupal vaginitis ; 

 and chronic vaginitis. 



ACUTE VAGINITIS. 



Causation. Deep-seated genital injuries leading to metritis, exces- 

 sive and prolonged strains due to painful labours, accidental injuries 

 caused l)y obstetrical operations, etc., are followed by more or less 

 acute vaginitis. 



Suppurative inflammation of Gartner's canals, irritant and caustic 

 injections, and foreign bodies likewise cause local irritation, which may 

 become complicated by infection and eventually produce vaginitis. The 

 infective organisms may be numerous and varied. 



Symptoms. The vagina being closed to external inspection, the 

 symptoms are not very apparent. At first, acute vaginitis is sug- 

 gested l)y swelling of the vulva, pruritus, and dysuria. The lips 

 of the vulva are tudematous, injected, sensitive and of a brownish- 

 red or violet-red colour on the internal surface. Sometimes they 

 are excoriated and torn. 



The period of full development is accompanied by the escape from 

 the vulva of a serous, mucous, muco-purulent or purulent discharge 

 of varying odour. Urination is painful and defecation difficult. Ex- 

 amination of the vagina by means of a speculum shows the mucous 

 membrane to be excoriated, ultra-sensitive, ulcerating or suppurating at 

 certain points. The parts are hot. 



The general symptoms are little marked, and without importance. 

 The usual termination consists either in recovery, which may be spon- 

 taneous, or in passage to the chronic form. 



The diagnosis is easy, and the prognosis favourable, provided the 

 vaginitis has not been caused by severe mechanical injuries, cajpable 

 of setting up cellulitis or the formation of deep abscesses of the pelvis. 



Treatment. One of the principal reasons why vaginitis j)ersists is 

 the retention of morbid products in the vaginal culs-de-sae. Treat- 

 ment ought therefore to aim chiefly at removing these by soothing, 

 astringent, and antiseptic injections. Soothing injections should first 

 be tried. They consist of lukewarm water at body temperature, 

 decoctions of black-cherry bark, poppy-heads, linseed, etc. After a 

 few days, when the excessive sensibility has disappeared, antiseptic 

 and astringent solutions may be used, such as crystallised alum, 150 

 grains to the pint ; sulphate of zinc, 75 grains to the pint ; carbolic 

 acid, lysol, cresyl, etc., 150 grains to the pint. 



Injections of permanganate of potash of the strength of 150 grains 

 to the pint and of solutions of iodine at a strength of 1 in 2,000 are 



