Acute vaginitis may arise from a great variety of causes, but the
worst case that ever came under my notice was the scalding effect of
a hot-water injection, given under the advice of a physician who had
ordered the patient to use the water “as hot as she could stand it,”
and also told her “the hotter the better.” This _profoundly wise_
suggestion was carried out by the patient with a vengeance, for she
used nearly boiling hot water, which she had tested by putting in her
finger and quickly withdrawing it. The steaming fluid so scalded the
vagina that a most pronounced acute inflammation of the vagina was
the immediate result. I have had other cases of the chronic form come
under my notice that were aggravated by similar advice, so that a word
of warning against the thoughtless and indiscriminate use of hot-water
injections will not be without value.
The vaginal irrigations of hot water, as a general stimulant to the
mucous surfaces, or as an alterative to stimulate the absorbents
to increased activity in removing old pelvic exudations, deserve
a recognized place as a useful therapeutic measure, often of the
greatest value, but too hot or “as hot as the patient can bear it,” is
superlative nonsense and absolutely injurious.
No water injections into the vagina that are kept up any length of
time should be warmer than 110 degrees Fahr. and never should vaginal
injections be employed without using a thermometer to gauge the heat.
When the solution is medicated, 103 degrees should be the average
temperature, but it should never exceed 107 degrees Fahr. Exposure to
cold and moisture especially during the menses is prominent among the
causes of acute vaginitis; injury from pessaries or coition, retained
putrefying secretions in the vagina, or the application of chemical
preparations, or injury during confinement, will all induce this
disease. Prolonged nursing causes anæmia, which predisposes the system
to catarrhs. During the child-bearing period catarrhs of the vagina are
quite common, and excessive coition excites a very painful inflammation
of the vaginal mucous membrane.
Gonorrhœal infection arising from a specific contagion gives rise to
a very painful and dangerous vaginitis. The character and nature of
the specific virus admits of no particular description, because its
infectious quality of a specific nature does not at all depend upon
the physical appearance of the infectious discharge from the male.
Whether it is yellow or greenish, muco-purulent or a glairy mucous
discharge, establishes no criterion, but the presence of microbes,
the _gonococcus_ of Neisser; this, of course, a careful microscopic
examination can alone establish. This much is true, that careful
researches in Europe, by competent and reliable authorities, have
established the fact, from carefully-prepared statistics, that this
is a far more fruitful source of uterine diseases than was formerly
dreamed of.