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 vulva.—­Vulvae 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 labia 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 clitoris, 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.

[496 Mothers’ remedies]

Treatment.—­Systematic, general tonic treatment.  Diabetes, gout, irritating discharges from the vagina and rectum should be removed.  Pin worms and highly acid urine sometimes cause it in children.  Internally the bromides to quiet the nerves and arsenic 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 vulva.—­A cyst is a cavity containing fluid and surrounded by a covering (capsule).  The duct (canal) of the gland of Bartholin, situated in the labia 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 scraped and good drainage given.  Sometimes it is best to use pure carbolic acid in the walls of the cyst.

Inflammation of the vagina, (Vaginitis).—­Vaginitis is an inflammation of the mucous membrane of the vagina.