Femina, A Work for Every Woman

by John A. Miller

For convenience of description and corresponding with the anatomical changes and the sources of their origin, inflammation of the mucous membrane of the vagina may be acute or chronic, simple or specific.

Acute inflammation in this instance is no different in its characteristic symptoms from inflammations elsewhere; it develops suddenly, and there is congestive swelling and pain. There is considerable heat in the parts, increased redness, and the canal is very sensitive. In the beginning the mucous membrane is dry and contracted, but after a few hours or a day, relaxation and moisture supersede. The secretion is very scant at first, but becomes more abundant as the disease progresses, its character also changes from a white, glairy mucus to a creamy, muco-purulent or yellowish discharge. The urethra may also become involved, and then the symptoms that were detailed in connection with urethritis are also present.

Acute vaginitis may arise from a great variety of causes, but the worst case that ever came under my notice was the scalding effect of a hot-water injection, given under the advice of a physician who had ordered the patient to use the water “as hot as she could stand it,” and also told her “the hotter the better.” This profoundly wise suggestion was carried out by the patient with a vengeance, for she used nearly boiling hot water, which she had tested by putting in her finger and quickly withdrawing it. The steaming fluid so scalded the vagina that a most pronounced acute inflammation of the vagina was the immediate result. I have had other cases of the chronic form come under my notice that were aggravated by similar advice, so that a word of warning against the thoughtless and indiscriminate use of hot-water injections will not be without value.

The vaginal irrigations of hot water, as a general stimulant to the mucous surfaces, or as an alterative to stimulate the absorbents to increased activity in removing old pelvic exudations, deserve a recognized place as a useful therapeutic measure, often of the greatest value, but too hot or “as hot as the patient can bear it,” is superlative nonsense and absolutely injurious.

No water injections into the vagina that are kept up any length of time should be warmer than 110 degrees Fahr. and never should vaginal injections be employed without using a thermometer to gauge the heat. When the solution is medicated, 103 degrees should be the average temperature, but it should never exceed 107 degrees Fahr. Exposure to cold and moisture especially during the menses is prominent among the causes of acute vaginitis; injury from pessaries or coition, retained putrefying secretions in the vagina, or the application of chemical preparations, or injury during confinement, will all induce this disease. Prolonged nursing causes anæmia, which predisposes the system to catarrhs. During the child-bearing period catarrhs of the vagina are quite common, and excessive coition excites a very painful inflammation of the vaginal mucous membrane.

Gonorrhœal infection arising from a specific contagion gives rise to a very painful and dangerous vaginitis. The character and nature of the specific virus admits of no particular description, because its infectious quality of a specific nature does not at all depend upon the physical appearance of the infectious discharge from the male. Whether it is yellow or greenish, muco-purulent or a glairy mucous discharge, establishes no criterion, but the presence of microbes, the gonococcus of Neisser; this, of course, a careful microscopic examination can alone establish. This much is true, that careful researches in Europe, by competent and reliable authorities, have established the fact, from carefully-prepared statistics, that this is a far more fruitful source of uterine diseases than was formerly dreamed of.

A specific vaginitis has a greater tendency to spread itself along the mucous tract of the genital organs of the female than a simple non-specific catarrh. In the former the womb and Fallopian tubes become successively affected, as we shall learn more definitely when we have occasion to inquire into the diseases peculiar to these organs.

Acute inflammation of the vagina has pronounced symptoms, and when any one of them is felt by the patient, she should lose no time in resorting to treatment.