Evil Sequelæ of Vulvovaginitis. While, as stated, vulvovaginitis is a comparatively mild infection as far as its symptoms are concerned, it nevertheless has a very bad effect on the child who is unfortunate enough to become a victim of the disease. First of all, it is an extremely long drawn, persistent disease. It usually takes months, and these months may run into years, before a complete cure, is effected. Second, relapses are quite common. Third, the treatment is a disagreeable one for the child, and is occasionally painful. Fourth, it has a disastrous effect on the child's morale; most parents, though they may love the child most affectionately, look somewhat askance at it; and continuous vaginal treatment somehow or other has a humiliating effect on the child, which begins to consider itself as an outcast, as something apart from other children. Fifth, the child's education is very frequently seriously and permanently interfered with, because it must often be taken out of school, whether public or private, and private tutoring is of course feasible only for the few. Sixth, and this is a point not sufficiently appreciated by the profession and the laity, but it is an important point, nevertheless: vulvovaginitis in children has unfortunately a disastrous effect in hastening the sexual maturity of the child. Whether this is due to the congestion of the organs produced by the inflammation, or to the speculum examinations, paintings, douches, applications, tampons, suppositories, etc., the fact remains that girls who suffer from vulvovaginitis in childhood become sexually mature considerably earlier than normal girls of the same class, stratum and climate, and their demand for sexual satisfaction is much more insistent. Seventh, a mild vulvovaginitis may be the cause of permanent sterility.
It will therefore be seen that vulvovaginitis is a calamity, and everything possible should be done to guard female children from contracting it. All children should always sleep alone. Under no circumstances should a child sleep with anybody else, be it a sister, a mother, a friend, a governess, or a servant girl. People should be very careful in sending their children to spend a night or two with some friends. The friends may be all right, but still a friend of the friends or a relative of the friends may not be. I have known several cases where the origin of the vulvovaginitis could be traced to little girls spending a week at the house of some friends where a boarder or relative was infected with gonorrhea. That children should be kept away from associating or playing with adults or other children who are known to have gonorrheal infection goes without saying. The child's genitals should be frequently inspected by the mother, and scrupulous cleanliness by frequent bathing, sponging with warm solutions and powdering, should be maintained. The toilet seats in school should receive special attention. The wooden seat is a menace because it often harbors gonorrheal pus from either the female or male genitals, while the only proper seat is one of the so-called U-shaped style, that is, one in which the front is entirely open, like the letter U.
Chapter Twenty-five[ToC]
SYPHILIS
Syphilis Due to Germ—Syphilis a Constitutional Disease—Primary Lesion—Incubation Period—Roseola—Primary Stage—Secondary Stage—Mucous Patches—Tertiary Stage—Gumma—Hereditary Nature of Syphilis—Milder Course in Women Than in Men—Obscure Symptoms in Syphilis—Necessity for Examination by Physician—Locomotor Ataxia—Softening of the Brain—Chancroids.
Syphilis is a disease caused by a germ called spirocheta; the full name is spirocheta pallida—a pale, spiral-shaped germ. Though the disease has been ravaging Europe and America for centuries, the germ of it has been discovered only a few years ago, namely, in 1905, and, like the gonococcus, also by a German scientist, Fritz Schaudinn. Syphilis is a constitutional disease. In ten days to three weeks after a person has contracted syphilis, he (or she) develops a sore (at the spot where the germs got in). This sore is called chancre or primary lesion. But when this sore makes its appearance the spirochetæ and the poison which they elaborate are already circulating in the blood, all over the system. The disease is already systemic, or constitutional, and the chancre is the local expression of a constitutional disease. Cutting out the chancre will not cure the disease, because, as stated, the germs are already in the system. The time between the contraction of the disease (the infectious intercourse) and the appearance of the chancre is called the Incubation Period. The time between the appearance of the chancre and the appearance of the rash on the body (the rash looks like a measles rash and is called roseola, which means a rose-colored rash) is called the Primary Stage. It lasts about six weeks. With the appearance of the rash commences the Secondary Stage. This stage is characterized by all sorts of eruptions, mild and severe, by white little patches (called mucous patches) in the throat, mouth, tonsils, vagina, by falling out of the hair, etc. The length of this secondary stage depends a good deal upon the sort of treatment the patient gets. Improperly treated, or not treated at all, it may last two or three years or more. Properly treated, it may be cut short at once, in a few days, so that the patient may never again in his or her life get an eruption. The third or Tertiary Stage is characterized by ulcerations in various parts of the body and by swellings or tumors. The name of a syphilitic swelling or tumor is gumma (plural, gummata). The tertiary stage is the most terrible stage and it used to be the terror of syphilitic patients. But at the present time, under our modern methods of treatment, patients, if properly treated, never have a tertiary stage. We have seen many patients who considered syphilis a trifling disease, because all they knew of their disease was the chancre and the first eruption, i.e., the roseola, and perhaps a slight falling out of the hair. They then put themselves under energetic treatment, the activity of the disease was checked, and they never had another symptom afterwards, though a Wassermann test showed that the disease was not entirely eradicated. It was merely held in check—which is the second best thing.
