Observations on some forms of inflammation and irritation of the bladder and vagina / by Lombe Atthill.

  • Atthill, Lombe, 1827-1910.
Date:
1866
Catalogue details

Licence: Public Domain Mark

Credit: Observations on some forms of inflammation and irritation of the bladder and vagina / by Lombe Atthill. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Churchill “reflex irritation of the bladder”—I mean, inflammation of the vagina itself. We have all seen instances in which cancer of the uterus, or even simple ulceration of the cervix, gives rise to irritation of the bladder, but after all they are (at least so far as my own observations go) rare in comparison with the cases in which vaginitis, simple and uncomplicated, is the sole cause. The existence of vaginitis itself is often overlooked, and instances have occurred to me in which the patient was assured that there was nothing wrong with her, because the os uteri alone was looked at, and the vagina itself, though intensely inflamed, entirely forgotten. I do not now allude to acute inflammation of the vagina, which occasionally follows parturition, nor to the acute attacks which sometimes come on after injuries or excessive sexual intercourse, but to the chronic varieties, which are met with frequently in practice. They are, I think, more commonly seen in the weakly and delicate than in the robust female. Frequent desire to make water, and, in severe cases, constant straining to do so, pruritus, sometimes smarting under micturition, and, not unfrequently, pain above the pubes, are the most common symptoms. In married women the act of coition often gives pain, and when this is the case the inflammation will be found to have extended almost to the vulva. This last symptom will aid in distinguishing vaginitis from ulceration of the os or cervix uteri, in which it is seldom observed, especially if it be of a cancerous nature. I lately saw a patient in whom nearly the entire of the cervix had been destroyed by cancerous ulceration, yet she did not suffer from irritation of the bladder, and sexual intercourse was painless. An examination of the vagina with the speculum, in patients suffering from vaginitis, generally gives pain; but a speculum must be used, for it is essential not only to see the condition of the mucous membrane of the vagina, but to apply our remedies through it. There is no occasion, however, to use a large instrument; a small speculum will answer equally well, and give much less distress to the patient. The vagina, on examination, will be found to present either an uniform deep red tint, or else to be covered with white aphthous looking patches, or even sometimes with a herpetic eruption. In either case a cure of the local disease will be generally affected by the application of a solution of nitrate of silver, joined to the use of a cold or tepid douche twice a day, and a tonic treatment; purgatives, except in cases of plethoric women, are to be avoided. Some patients will bear the application of a thirty or forty grain solution of nitrate of silver without its causing pain, but sometimes even a weak solution produces much suffering, and in one instance, that of a delicate married woman, I was obliged to discontinue its use altogether. This fact suggested to my mind the idea of applying, in similar instances, the caustic solution in the shape of spray, by means of one of “Maunders’ spray producers,’’ and though I have only used it in a couple of cases, I think it well worth a trial. You can apply the