Treatment of trichomonas vaginalis

Abstract

TEUCORRHEA is one of the commonL est complaints among gynecoIogica1 and obstetrica patients. From the symptomatic standpoiht, it is usuaIIy the first to arise and the Iast to disappear. Davis,l in examining IOOO femaIe patients, found that 33 per cent had some type of discharge. This is about the percentage in my practice and in the gynecoIogica1 cIinic of the Jefferson Davis HospitaI, Houston, Texas. Trichomonas vaginaIis is one of the most common causes of Ieucorrhea, but had been overIooked unti1 our research at the University of Texas SchooI of Medicine. The first case of trichomonas vaginaIis reported in the United States was by George Dock2 in GaIveston, Texas, where most of this research was carried out. The first papers on trichomonas vaginaIis were reported by Donne3 in 1837 and Iater ones by KunstIer4 in 1893 and 1894, by Benson in Igr 2, DeLee5 in 1920, ReuIing6 in 1 g2 I, Hegner7 in 1925, BIand and RakofP in 1932. Since that time many American authors, such as HesseItine,g Drabkin,lO Buxton and SheIanski,ll and the author12 have added to the Iiterature. Incidence of Trichomonas Vaginalis. In 1932 at the John SeaIy HospitaI, GaIveston, 500 consecutive women coming to the outpatient cIinics of the hospita1 were examined. There were 187 positive cases of trichomonas vaginaIis, a percentage of 37.4. There were 300 negro and 200 white femaIes; 46.3 per cent of the negro femaIes, and 24.0 per cent of the white femaIes harbored the organism. These patients ranged from I I to 52 years of age. The Iargest percentage of positive cases of trichomonas vaginaIis Iay between the ages of Ig and 33 years with the Iargest singIe group at 23. According to the author’s statistics, based upon the examination of over 10,000 women, trichomoniasis was present in 37.5 per cent of the gynecoIogica1 and obstetrica patients in GaIveston, Texas, a seaport, and in onIy 27 per cent of the same class of patients in Houston, Texas, 52 miIes inIand. The author has examined more than 25,000 femaIe patients for trichomonas vaginaIis during the past eight years and the percentage of patients found positive was 25.5 per cent. Urinary Infections. FIashkamp14 found trichomonas vaginaIis in the urine in one out of 250 patients examined, and Saye+ in 27 per cent of 2 12 patients examined. Sayer beIieves the bIadder to be the norma habitat for trichomonas vaginaIis. In our resistant and obstinate cases, we find trichomonas vaginaIis more often in the bIadder. Whenever one fails to cure trichomonas vaginaIis by the routine method, such as fforaquin and vinegar douches, then at the same time as the vagina is treated, the bIadder is irrigated with boric acid foIIowed by the instiIIation of argyro1. Signs and Symptoms. The patient usuaIIy compIains of a discharge or “whites” with an itching and burning, or chafing, of the externa1 genitalia and inner aspect of the thighs. No other discharge produced by the vagina1 mucosa and no other microorganisms besides the trichomonas vaginaIis causes a scaIding sensation of the vagina, vuIva and perineum. The discharge is usuaIIy thin and creamy in coIor, but it may be thick and yeIIowish. At times it is diffIcuIt to distinguish trichomonas infection from gonorrhea1 infection. The discharge of trichomonas vaginalis usuaIIy resists a11 types of treatment, but it may sometimes be checked by