Treatment (in acute cases).—Rest in bed and prolonged vaginal injections of a solution of corrosive sublimate (1 to 4000 strength) three times a day. If the gonorrheal poison is present in the pus, the walls of the vagina, cervix and cervical canal should be dried and thoroughly painted with a twenty per cent solution of nitrate of silver. The patient should be in the knee-chest position for this treatment.
In chronic cases the gonorrhea poison (gonococcus) is found most frequently just behind the posterior lip of the cervix and here the silver solution should be applied very thoroughly.
VAGINISMUS.—This is a painful reflex muscular contraction of the vaginal orifice, and is most often observed in patients of a nervous and sensitive temperament. Treatment.—Any local cause of irritation should be removed. If there is no local irritation, the opening should be dilated under an anesthetic. Tonics, exercise, and a complete change of scene are beneficial.
DISEASES OF THE CERVIX.
TEAR OF THE CERVIX (Laceration).—This is a tear in the lower part of the cervix. There may be one or more. The left one-sided tear is the usual form. Next comes the tear on both sides (bilateral). Tears on front and behind are not frequent. Tears are found in about thirty per cent of women who have had children.
Causes.—The majority of cases are caused by labor, and is due to a cervix that is not perfectly dilated. Very hurried, quick labors cause it sometimes, but the greatest injuries are due to the various operations for delivering the child through a cervix that is not fully dilated.
Symptoms. Immediate and remote.—On the immediate, when the tear is severe, there is bleeding; later, sub-involution, that is, the womb does not return to its normal size and weight.
Remote symptoms.—Leucorrhea, thick and mucus in character; profuse menstruation and inability to become pregnant. When the tear has extended through the internal opening the woman win not be able to carry the child to full term, even if she becomes pregnant.
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Treatment.—Tampons of ichthyol (ten per cent), mixed with glycerin, introduced twice a week against the cervix and permitted to remain forty-eight hours will often afford relief.