d secretion.

2. Granular.--This is an advanced stage of the simple type, and is due to
long continued or repeated attacks.

3. Gonorrheal form.--Is due to infection by the gonococcus of Neisser (due
to gonorrhea). This form is hardest to cure and may continue for years or
life, The infection may extend to the womb, fallopian tubes and peritoneal
cavity and produce inflammation of the womb (endometritis) pus in the
tubes, (pyosalpinx) and peritoneal cavity. This is more common than even
some physicians realize.

[WOMAN'S DEPARTMENT 497]

4. Diphtheritic--Due to diphtheria, not frequent.

5. Senile type.--This comes only after the change of life.

Symptoms.--There is pain in the lower abdomen. Passing of urine is
frequent and is attended with smarting and burning pain. There is a
feeling of heat and burning in the vagina, and a copious discharge of
mucus and pus. In the gonorrheal variety the urinary disturbances are most
marked.

In gonorrheal variety the symptoms date from a distinct onset, last
longer, do not yield so rapidly to treatment, and complications, such as
enlarged glands in the groin and in the vulva and vagina, inflammation of
the lining of the womb and fallopian tubes, inflammation of the bladder,
often make their appearance early.

Treatment (in acute cases).--Rest in bed and prolonged vaginal injections
of a solution of corrosive sublimate (1 to 4000 strength) three times a
day. If the gonorrheal poison is present in the pus, the walls of the
vagina, cervix and cervical canal should be dried and thoroughly painted
with a twenty per cent solution of nitrate of silver. The patient should
be in the knee-chest position for this treatment.

In chronic cases the gonorrhea poison (gonococcus) is found most
frequently just behind the posterior lip of the cervix and here the silver
solution should be applied very thoroughly.

VAGINISMUS.--This is a painful reflex muscular contraction of the vaginal
orifice, and is most often observed in patients of a nervous and sensitive
temperament. Treatment.--Any local cause of irritation should be removed.
If there is no local irritation, the opening should be dilated under an
anesthetic. Tonics, exercise, and a complete change of scene are
beneficial.

DISEASES OF THE CERVIX.

TEAR OF THE CERVIX (Laceration).--This is a tear in the lower part of the
cervix. There may be one or more. The left one-sided tear is the usual
form. Next comes the tear on