Syphilis and local contagious disorders / by Berkeley Hill.

  • Hill, Berkeley, 1834-1892.
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Syphilis and local contagious disorders / by Berkeley Hill. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    dotted with little granular elevations of a darker hue than the surface they spring from. The discharge in the chronic stages is generally whitish, milky, even creamy; it consists of pavement epithelium, pus, and mucus cor- puscles, and very often infusoria are present; one of these, the trichonomas, was at one time supposed to distinguish gonorrhoeal from simple vaginitis, but Scanzoni and others have detected it in ever}'- form of abnormal vaginal discharge though not in healthy mucus. The diagnosis of vaginitis from other disorders is seldom a difficult matter. The bright red mucous membrane which secretes serous pus, or thick matter, and is tender and bleeds if chafed, distinguishes acute vaginitis. The mere presence of pus in the vagina is not sufficient to diagnose vaginitis, as the matter may come from an abscess in the wall of the vagina, or from the uterus; but the speculum shows at once if the discharge come from such a source. It may be impossible to say, when the vaginitis has no complication, whether it arises from contagion or from other causes; nor is the infectious nature of the secretion peculiar to gonorrhoeal vaginitis, for it is tolerabl}^ certain that the purulent discharge of any acute vaginal inflammation is more or less contagious. The co-existence of urethritis with vaginitis is strongly suggestive of gonorrhoeal origin, for this complication rarely follows any vaginal inflammation except that produced by contagion. Another question to be decided is, the power of a particular discharge to communicate urethritis to the male. This is often extremely difficult to settle; sometimes the discharge becomes apparently mere mucus, yet retains the infectious qualitj^ very strongl3^ Again, the greater part of the vagina may have recovered its natural condition, while a certain small area—the cul de sac behind the neck of the uterus, for instance—still secretes a contagious dis- charge. Guerin beheves that the urethra, and some of the ducts of the glands in the vulva, may continue inflamed long after gonor- rhoea, and that if the genital organs are irritated or unusually excited, these small foci may secrete matter in sufficient quantity to pro- pagate the disease afresh. Gonorrhoeal vaginitis is characterised by the acuteness and severity of its symptoms; the pus is earl}^ and copious in formation, and the vulva rarely escapes. The inguinal glands are likely to suffer, and extension to the uterus and ovary is more common in gonorrhoeal than in other forms of vaginitis. The diagnosis between gonorrhoeal and simple vaginitis depends on the presence or absence of some of these comiDlications, and cannot in all cases, even with this assistance, be made certain ; but the greater the number