Page:Clinical Lectures on the Diseases of Women.djvu/43

Rh introduced; quite soft, and partially denuded of epithelium, and secreting a viscid yellow muco-pus.

We will now proceed to the treatment of the disease, and this varies according to its severity.

In many slight cases a lotion may be used, partly to keep the vagina clean, and also to wash the accessible part of the diseased surface. The lotion may be applied by the patient herself with an ordinary Higginson's syringe, which throws the lotion against the cervix.

The lotion is used daily while the monthly period is absent, and often nothing more is required in the way of treatment.

It is a great mistake to use strong astringent lotions of alum or of decoction of oak-bark, for these have only temporary and only apparent good effects. They are injurious by the irritation of the vagina which they produce. A soothing, healing, cleansing application is what you want. Eight ounces of tepid water, holding in solution half a drachm of sugar of lead, is a good lotion; or the same water with half a drachm of alum, and also of sulphate of zinc.

The ordinary treatment is the cauterisation, by nitrate of silver, of the diseased surfaces. The stick is to be passed into the cervix and turned round. This may be repeated every third or fourth day for several times. It is not the most successful treatment. Many cases do not yield to it; and frequently the practitioner perseveres with its use, not only long after it has ceased to be useful, but when it has become positively injurious. I have known this kind of treatment continued for years. Long before such a period has elapsed, indeed after several—say about ten—applications at most, in ordinary circumstances, the practitioner should have the case cured, or give it up as not amenable to the method.

In the severer cases, such as that which is the subject