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Tests for cure of gonorrhea in women
308 Blaschko
THE
AMERICAN
and Gross:
Medizinische
JOIJRNAI,
OF
To Determine
Wochenschriftt
ORSTETRICS
Cure After
l!~?l~
xlrii.
4ND
Gonorrhea
GYNECOLOG-i?
in Women.
Dcutscht:
1202.
Every gynecologist knows how difficult it is )to determine whrn a given case of gonorrhea1 infection in woman may be regarded as cured. Even when after re peatcd examinations no gonococci can be demonstrated in the secretions, the woman frequently infect8 her partner. FaCous aids have been proposed to determine :L (‘UI’C. Among these the injection of gonococcus vaccine or r~cn elf a nonspecifi~~ foreign protcid hold first iplace as they frequently cause a latent gonorrhea to light up, thus making the diagnosis relatively easy. Unfortunately these measures often I’ail. With the same object in view, Blaschko and Gross apply a 2U per cent Lugol’s wlution locallv 0. The solution is applied to the cervix by means of a cotton lswah which is kept in place for fifteen to thirty seconds. To the urethra it is applictl by means of a syringe and ret&nod for from one-half to one minu,te, the bladder being full. This method. may 1~3 used aloncl or in conjunction with the oacrinc injection.
‘
After this procedure, the secretions should be examined on several succwsirc flays. If no gonococci arc found, the authors belicae, a latent infection may lr~ cxcludetl with a considerable degrc,c of certainty. They warn against using any provocative measure in t,he presence of old tubal infections ,or within tllree wcleks after at least two rxaminations have been negative, these examinations to be prefcl,ahly made immediately after t,wo menstrual periods. R. E. m’OB7TS.
Abraham:
Tests for Cure of Gonorrhea
in Women,
The
Lanret,
1924,
ccvi,
429.
The author believes that gonorrhea in women may be considered cured when certain clinical and bacteriologic requirements are fulfilled. Thus all &&al signs ot’ the disease must have disappeared and must romain so on repeated examinations. All bacteriologic signs of the disease must be absent. This must include negat.ive bacteriologic evidence obtained not only from the urethra and cervix but also from the anal canal. These examinations must be repeatedly negative. In so far as the complement-fixation test is concerned the author believes the test not sufficiently powerful to diagnose the disease in the early stages. In the middle stage it will differentiate between gonococcal and nongonococcal disease and during the conyalcsccnt stage he feels that it is too delicate for use as a practical sign of’ curt. If at the end of six mont,hs, without treatment, the patient shows no return of clinical or bacteriologic evidence it maJ- be assumed that the patient is cured. If a repetition of the tests a year later still prove negative, the patient may safely ??ORhf Ah’ F. &fIX,I>GEL resume marital life.
Lees: Some Observations Ovaries. Transactions 1922.1923,
on Go&mcoccal Infections of
the
Edinburgh
Obstetrical
of the Fallopian Society.
Tubes and
Session
Ixxsii,
p. 37.
The cervix and urethra are attacked simultaneously in fifty per cent of acute gonorrhea1 infections. Uret,hral infections are more frequently secondary to cervical involvement than the reverse. Gonorrhea1 vaginitis is seldom seen in the adult except during pregnancy and the puerperium. When secondarily infected, smears from the vaginal wall seldom reveal the organism. Tubal involvement, though usually due to extension along mucous surfaces, may result from lymphatic or blood-stream exThe usual exciting causes of tubal complications tension from the lower pelvis. are menstruation, coitus, careless manipulation during examination, exercise, alcoholic excesses and factors lowering resistance.
THE
AMERICAN
and Gross:
Medizinische
JOIJRNAI,
OF
To Determine
Wochenschriftt
ORSTETRICS
Cure After
l!~?l~
xlrii.
4ND
Gonorrhea
GYNECOLOG-i?
in Women.
Dcutscht:
1202.
Every gynecologist knows how difficult it is )to determine whrn a given case of gonorrhea1 infection in woman may be regarded as cured. Even when after re peatcd examinations no gonococci can be demonstrated in the secretions, the woman frequently infect8 her partner. FaCous aids have been proposed to determine :L (‘UI’C. Among these the injection of gonococcus vaccine or r~cn elf a nonspecifi~~ foreign protcid hold first iplace as they frequently cause a latent gonorrhea to light up, thus making the diagnosis relatively easy. Unfortunately these measures often I’ail. With the same object in view, Blaschko and Gross apply a 2U per cent Lugol’s wlution locallv 0. The solution is applied to the cervix by means of a cotton lswah which is kept in place for fifteen to thirty seconds. To the urethra it is applictl by means of a syringe and ret&nod for from one-half to one minu,te, the bladder being full. This method. may 1~3 used aloncl or in conjunction with the oacrinc injection.
‘
After this procedure, the secretions should be examined on several succwsirc flays. If no gonococci arc found, the authors belicae, a latent infection may lr~ cxcludetl with a considerable degrc,c of certainty. They warn against using any provocative measure in t,he presence of old tubal infections ,or within tllree wcleks after at least two rxaminations have been negative, these examinations to be prefcl,ahly made immediately after t,wo menstrual periods. R. E. m’OB7TS.
Abraham:
Tests for Cure of Gonorrhea
in Women,
The
Lanret,
1924,
ccvi,
429.
The author believes that gonorrhea in women may be considered cured when certain clinical and bacteriologic requirements are fulfilled. Thus all &&al signs ot’ the disease must have disappeared and must romain so on repeated examinations. All bacteriologic signs of the disease must be absent. This must include negat.ive bacteriologic evidence obtained not only from the urethra and cervix but also from the anal canal. These examinations must be repeatedly negative. In so far as the complement-fixation test is concerned the author believes the test not sufficiently powerful to diagnose the disease in the early stages. In the middle stage it will differentiate between gonococcal and nongonococcal disease and during the conyalcsccnt stage he feels that it is too delicate for use as a practical sign of’ curt. If at the end of six mont,hs, without treatment, the patient shows no return of clinical or bacteriologic evidence it maJ- be assumed that the patient is cured. If a repetition of the tests a year later still prove negative, the patient may safely ??ORhf Ah’ F. &fIX,I>GEL resume marital life.
Lees: Some Observations Ovaries. Transactions 1922.1923,
on Go&mcoccal Infections of
the
Edinburgh
Obstetrical
of the Fallopian Society.
Tubes and
Session
Ixxsii,
p. 37.
The cervix and urethra are attacked simultaneously in fifty per cent of acute gonorrhea1 infections. Uret,hral infections are more frequently secondary to cervical involvement than the reverse. Gonorrhea1 vaginitis is seldom seen in the adult except during pregnancy and the puerperium. When secondarily infected, smears from the vaginal wall seldom reveal the organism. Tubal involvement, though usually due to extension along mucous surfaces, may result from lymphatic or blood-stream exThe usual exciting causes of tubal complications tension from the lower pelvis. are menstruation, coitus, careless manipulation during examination, exercise, alcoholic excesses and factors lowering resistance.