three days,
then the iodine injection is resumed, then again the lactic acid, and
so on. I know of many cases that were cured by this treatment alone.
And I might mention that these injections are generally also very
efficient in leucorrhea, as stated in the chapter on Leucorrhea.

CHAPTER TWENTY-FOUR

VULVOVAGINITIS IN LITTLE GIRLS

Former Causes of Vulvovaginitis in Little Girls--Discharge Chief
Symptom--Evil Results of Vulvovaginitis--Psychic Results of
Treatment--Effects in Hastening Sexual Maturity--Vulvovaginitis a
Cause of Permanent Sterility--Measures to Prevent the
Disease--Toilet Seats and Vulvovaginitis.

The mucous membrane, or the lining of the vulva and vagina, in little
girls is very tender, and therefore very readily subject to infection.
An infection of the vulva and vagina due to the gonococcus or to some
other germ is very common in little girls. At least it used to be,
particularly among children of the poor, in institutions and
hospitals. The very dangerous infective character of vulvovaginitis
was not known, and the infection was therefore easily transferred by
towels, linen, toilet seats, bedpans, syringe nozzles, thermometers,
the nurses' hands, and in various other ways. Now great care is being
taken and in most hospitals no children are admitted in the general
wards unless it is determined that they are free from vulvovaginitis.

Generally speaking, vulvovaginitis in children is a mild infection. A
child may have it for several weeks or months without being aware of
it, without saying anything about it, the diagnosis often being made
by the mother, who begins to notice the creamy discharge on the girl's
linen or underwear. And this is the principal symptom in little girls
thus afflicted--the discharge. This discharge may be very profuse,
covering the vulva, vagina, and cervix.

In severe cases, there is also an infection of the urethra, and the
child may complain of burning at urination, itching and pain around
the vulva and anus, and slight pain in the abdomen. There may be a
moderate rise in temperature, up to 101 deg. F., and in some instances
the attack is sufficiently acute to give rise to a chill and fever. A
mild inflammation of the joints may set in within the first weeks of
the infection, although as a usual thing it comes later on.

=Evil Sequelae of Vulvovaginitis.= While, as stated, vulvovaginitis is
a comparatively mild infection as far as its symptoms are