-JAHR Georg Heinrich Gottlieb

 As has already been stated, gonorrhoea in females may be seated in the vulva, vagina, and at the neck of the uterus as well as in the urethra. If the vulva is the seat of the disease, the inflammation may be confined to single parts such as the papillæ, labia, clitoris and its prepuce, etc.; in most cases the whole of the vulva is involved. In such a case we notice very often an erythematous redness without any perceptible alteration of the secretion; such an alteration always takes place if the inflammation becomes more deep seated, in which case it may assume a phlegmonous character. In some cases this affection, which is very much like the balanorrhoea of the male, seems more particularly confined to the mucous and sebaceous follicles. In such a case the itching is generally very violent; oedema or an inflammatory swelling of the affected parts, and even abscesses frequently supervene; in some cases the phlegmonous swelling may become so extensive that it may close up the entrance of the vagina and may render the emission of urine difficult and painful. The inflammation may even extend to the external pudendum and the surrounding integuments, in which case they become oedematous, the epidermis softens, and the parts assume the appearance of a suppurating blister. In all these forms of gonorrhoea of the pudendum the secretions always have a fetid odor.



Gonorrhoea in female



In most cases gonorrhoea remains confined to the pudendum; but frequently it gradually progresses through the vagina as far as the uterus, more particularly if it lasts a long time; after having disappeared in every other part, it may localize itself in the uterus, and, without causing any other ailments, may occasion those uterine catarrhs which are often of such an equivocal nature, and which without betraying their true character by any external signs, are nevertheless capable of transmitting the venereal infection by coit.
In the female gonorrhoea, the inflammation may extend to the ovaries, as in the male to the testicles; who knows whether a number of ovarian affections in old prostitutes do not owe their existence to such a cause?
Another complication, which can only take place in females, is the spreading of the inflammation to the anus and the lower border of the rectum; these organs being so situated that, when the female is lying on her back, the discharge from the vagina most necessarily gravitate towards them, and must corrode them to a greater or less extent. Such an invasion of the back parts by the gonorrhoeal disease frequently developes a true anal gonorrhoea (as I know from personal observation), with extensive soreness of the surrounding parts, profuse secretion, frequent tenesmus, and very frequently such violent pains during an evacuation that they cause the patient to scream and tremble.
We hardly need allude to the fact that the metastases of which mention was made when treating of the gonorrhoea of males, such as ophthalmia, articular rheumatism, may likewise occur among females. Among the latter, however, they seem to be less frequent than among the former.

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