Child birth.—­Pelvic diseases frequently come from injuries received during labor.

Venereal diseases.—­Dr. Child says, “Syphilis exerts its usual baneful influence, but gonorrhoea is responsible for more pathological (diseased) lesions (conditions) in the female pelvis than any other one factor.  Its attack, if not resulting in ultimate loss of life, always leaves the tissue in an impaired condition, from which resolution (returning to natural condition) is rare.  It is doubtful if a woman once infected with gonorrhoea ever recovers from its ravages.  As a cause of sterility its power is beyond estimation.”

Inflammation of the vulva.—­(Vulvitis).—­An acute or chronic inflammation of the vulva (external genitals) either from a specific, like gonorrhoea, or non-specific cause.

Causes.—­Veit says, “Seventy-five per cent of the cases are caused by gonorrhoea.”

Other Causes.—­Accumulation and decomposition of discharges from the womb and vagina, inflammation of the inner lining of the womb and of the vagina.  Foul, putrid discharges from neglected supports (pessaries) and tampons in the vagina; sloughings from cancer may act as exciting causes.  Contact with ammoniacal and sugar urines has a similar effect.

[Woman’s department 495]

In Infants.—­It is usually due to want of cleanliness in failing to remove decomposing urine and feces.  Mothers often allow soiled, foul smelling diapers to remain for a long time on the baby.

Symptoms and Condition of the Parts.—­In the acute stage the mucous membrane around the opening of the vagina is red, swollen, painful and bathed in pus.  The glands in the groin and glands of Bartholin are usually enlarged and tender.  The glands of Bartholin and those around the urethra may become infected and fill with pus.  The fatty glands of the labia majora are also sometimes affected and then appears the disease called Follicular Vulvitis (in the chronic stage secretion is abundant).  The parts feel hot and there is more or less burning and itching.  Walking makes the trouble worse, due to rubbing of the parts.  Passing of urine increases the distress.

When the disease is caused by gonorrhoea it is more extensive and involves the vagina, urethra, the glands around the urethra and glands of Bartholin.  This gland infection frequently results in an abscess.

Treatment.—­In the acute form the patient should go to bed and remain there for some time.  The parts should be kept constantly moist with a wet antiseptic dressing, listerine, hot water, etc., applied to the vulva and kept there.

1.  If there is much pain the following solution may be used: 

Acetate of lead      1 dram
Laudanum           1/2 ounce

Water enough for six ounces.

Mix and apply constantly with sterile cloths.

2.  For chronic form Dr. Child says, “The vulva should be shaved, thoroughly cleansed and a mild ointment applied daily thereafter,” such as: