Gonorrhea in women is a much more frequent and serious disease than was formerly supposed. The general impression among the laity is that gonorrhea in women is limited to the prostitute and vicious classes who indulge in licentious relations. Unfortunately, this is not the case. There is perhaps more gonorrhea, in the aggregate, among virtuous and respectable wives than among professional prostitutes, and the explanation is the following: A large proportion of men contract the disease at or before the marrying age. The great majority are not cured, and the disease simply lapses into a latent form. Many of them marry, believing themselves cured, and ignorant of the fact that they are bearers of contagion. They transmit the disease to the women they marry, many of whom, from motives of modesty and an unwillingness to undergo an examination do not consult a physician, and they remain ignorant of the existence of the disease until the health is seriously involved. In women, gonorrhea is not usually so acute and painful as in men, unless it involves the urethra. It usually begins with smarting and painful urination, with frequent desire to urinate and with a more or less abundant discharge from the front passage. In the majority of cases the infection takes place in the deeper parts, that is, in the neck or body of the womb. In this location it may not give rise at first to painful symptoms, and the patient often attributes the increased discharge to an aggravation of leucorrhea from which she may have suffered. The special danger to women from gonorrhea is that the inflammation is apt to be aggravated during the menstrual period and the germs of the disease ascend to the cavity of the womb, the tubes, and ovaries, and invade the peritoneal covering, causing peritonitis. Pregnancy and childbirth afford favorable opportunities for the upward ascension of the germs to the peritoneal cavity. The changes caused by gonorrheal inflammation in the maternal organs are the most common cause of sterility in women. It is estimated that about fifty per cent of all sterility in women proceeds from this cause. In addition to its effects upon the child bearing function, the danger to the health of such women is always serious. In the large proportion of cases they are made permanent invalids, no longer able to walk freely, but compelled to pass their lives in a reclining position until worn out by suffering, which can only be relieved by the surgical removal of their maternal organs. It is estimated that from fifty to sixty per cent of all operations performed on the maternal organs of women are due to disease caused by gonorrheal inflammation.
Treatment. Rest in bed, the use of injections of hot water, medicated with various astringents, by means of a fountain syringe in the front passage three times daily, and the same remedies and bath recommended above, with hot sitz baths, will usually relieve the distress. In view of the serious character of this affection in women and its unfortunate results when not properly treated, it is important that they should have the benefit of prompt and skillful treatment by a physician. Otherwise, the health and life of the patient may be seriously compromised.
The social danger of gonorrhea introduced after marriage is not limited to the risks to the health of the woman. When a woman thus infected bears a child the contagion of the disease may be conveyed to the eyes of the child in the process of birth. Gonorrheal pus is the most virulent of all poisons. A single drop of the pus transferred to the eye may destroy this organ in from twenty four to forty eight hours. It is estimated that from seventy five to eighty per cent of all babies blinded at birth have suffered from this cause, while from twenty to thirty per cent of blindness from all causes is due to gonorrhea. While the horrors of this disease in the newborn have been mitigated by what is called the Crédé method (instillation of nitrate of silver solution in the eye immediately after birth), it still remains one of the most common factors in the causation of blindness. Another social danger is caused by the pus being conveyed to the genital parts of female children, either at birth or by some object upon which it has been accidentally deposited, such as clothes, sponges, diapers, etc. These cases are very common in babies’ hospitals and institutions for the care of children. Quite a number of epidemics have been traced to this cause. The disease occurring in children is exceedingly difficult of cure and is often followed by impairment in the development of their maternal organs. Much of the ill health of young girls from disordered menstruation and other uterine diseases may be traced to this cause. Another serious infection in babies and young children is gonorrheal inflammation of the joints, with more or less permanent crippling.