Salicylic acid 20 grains Oxide of zinc 2 drams Petrolatum enough for 1 ounce
Mix and make an ointment and apply daily.
If it is due to irritating discharges that cannot be checked, cleanse the parts thoroughly and use the Zinc ointment to protect.
ITCHING OF THE v.u.l.v.a.--v.u.l.v.ae or Pruritus.--This intense itching is the characteristic symptom. With the itching there is more or less swelling of the parts and extreme nervous irritability.
Causes.--This is doubtful; some think it is a purely nervous condition.
Parts irritable.--The upper angle of the l.a.b.i.a majora and the mons veneris are the usual locations. The skin is inflamed thickened, raw, from the continual scratching."
Symptoms.--The itching and burning are almost unbearable at times, beginning most often around the c.l.i.toris, coming in paroxysms and made worse by warmth and motion.
In chronic cases the skin is a little thickened and looks dull and dry and is covered with small cracks and scratches, the result of the patient"s efforts to stop the itching.
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Treatment.--Systematic, general tonic treatment. Diabetes, gout, irritating discharges from the v.a.g.i.n.a and r.e.c.t.u.m should be removed. Pin worms and highly acid urine sometimes cause it in children. Internally the bromides to quiet the nerves and a.r.s.enic to build up the system should be given.
Local.--Strong solutions of corrosive sublimate (1 to 1000), nitrate of silver, tincture of iodine, and cocaine ointment give temporary relief.
Sometimes an operation is necessary.
CYSTS OF THE v.u.l.v.a.--A cyst is a cavity containing fluid and surrounded by a covering (capsule). The duct (ca.n.a.l) of the gland of Bartholin, situated in the l.a.b.i.a majora, sometimes closes and the secretions of the gland are not cast out, thus forming the cyst.
Cause.--The closing is nearly always the result of gonorrhea.
Condition.--The cyst is formed in the duct, the gland itself being affected rarely. It contains a thin sticky mucus. If the cyst arises in the gland, the swelling is more deeply situated. These cysts may be attacked with an acute inflammation and finally pus is formed in them, and a very painful abscess is the result,
Symptoms.--There are no symptoms except from the size of the swelling unless an abscess occurs. Then there is an acute local pain, quite tender on pressure, and often high fever.
Treatment.--If the cyst is large it should be removed, especially if it causes annoyance. If it becomes inflamed, rest in bed and cold applications are indicated. If it goes on to an abscess, a free cut should be made, the abscess sc.r.a.ped and good drainage given. Sometimes it is best to use pure carbolic acid in the walls of the cyst.
INFLAMMATION OF THE v.a.g.i.n.a, (Vaginitis).--Vaginitis is an inflammation of the mucous membrane of the v.a.g.i.n.a.
Varieties.--l. Catarrhal or simple 2. granular; 3. gonorrheal; 4.
diphtheritic, and 5. senile.
1. Catarrhal or simple form.--This is the most usual form. There is a general redness of the membrane with swelling and increased secretion.
2. Granular.--This is an advanced stage of the simple type, and is due to long continued or repeated attacks.
3. Gonorrheal form.--Is due to infection by the gonococcus of Neisser (due to gonorrhea). This form is hardest to cure and may continue for years or life, The infection may extend to the womb, fallopian tubes and peritoneal cavity and produce inflammation of the womb (endometritis) pus in the tubes, (pyosalpinx) and peritoneal cavity. This is more common than even some physicians realize.
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4. Diphtheritic--Due to diphtheria, not frequent.
5. Senile type.--This comes only after the change of life.
Symptoms.--There is pain in the lower abdomen. Pa.s.sing of urine is frequent and is attended with smarting and burning pain. There is a feeling of heat and burning in the v.a.g.i.n.a, and a copious discharge of mucus and pus. In the gonorrheal variety the urinary disturbances are most marked.
In gonorrheal variety the symptoms date from a distinct onset, last longer, do not yield so rapidly to treatment, and complications, such as enlarged glands in the groin and in the v.u.l.v.a and v.a.g.i.n.a, inflammation of the lining of the womb and fallopian tubes, inflammation of the bladder, often make their appearance early.
Treatment (in acute cases).--Rest in bed and prolonged v.a.g.i.n.al 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 v.a.g.i.n.a, cervix and cervical ca.n.a.l 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 v.a.g.i.n.al 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.
The tear should be repaired after child-birth, if possible. If not then, and if it does not heal, it should be repaired later when the tear extends through the internal (opening) or in case of extensive raw surface on the cervix.
INFLAMMATION OF THE CERVIX.--This is an inflammation of the mucous membrane lining the ca.n.a.l of the cervix (cervical ca.n.a.l), known as Endocervicitis; it may be acute or chronic. The acute form is seen most often as a part of a general infection involving both womb and cervix, and will be described later. The chronic form is a very common condition and it is difficult to treat.
Cause.--Injury and tear of the cervix.
Symptoms.--Leucorrhea, profuse and frequent menstruation, pain in the back and loins. On examination a string of thick mucus is seen at the external opening (os) of the cervix; and of women who have borne children there are usually signs of tear and rawness of the cervix present; (Endometritis usually produces a thin watery discharge, while gonorrhea produces a thick, pus-like discharge).
Treatment.--Hot v.a.g.i.n.al douches, containing one dram of sulphate of zinc to one pint of water, used every night for ten minutes. Hot water with witch-hazel, about four drams to the pint, is also good. Tincture of iodine applied locally twice each month. White oakbark tea used as an injection once a day for this trouble; also good for vaginitis.