Sulfathiazole in the Treatment of Gonorrhea in Women

Abstract

tion. For example, his group of so-called untreated patients were handled quite differently from an "untreated group" in the usual sense. These patients were hospitalized under hygienic surroundings and were examined, cleansed and cultured fre¬ quently. I have always stressed the value of simple vaginal invasion with distention of crypts in the interest of drainage, incidental to the use of estrogenic suppositories and medicated ointment. There is a mechanical factor of importance here; therefore these children in ideal surroundings, treated weekly or semiweekly by vaginal manipulation, are not typical of a group left entirely alone, and we must not allow any one to suppose that we must not use the strictest precautions in relation to cross infection. In relation to infection from toilet seats, I have this to say: Six children with gonococcic infections, doubtless ordinarily cleansed, were passed on and off a toilet seat; then cultures of the toilet seat were carefully taken, and in only one instance were isolated colonies of Neisseria found. Uninfected children were not infected by the use of these seats.I think it has been proved that the culture material available to date is unsatisfactory. It seems likely, then, that culture may be at fault here. Also whereas six children might be exposed safely to such tests, the seventh or the seventieth might be the unfortunate victim. In any event, I don't believe we can dispense with all these precautions. I don't agree that institutionalization is not dangerous from several angles. I am certain that there is a danger in foundling home care. As for hos¬ pitalization in general, I admit that, save in exceptional cir¬ cumstances, it is unsatisfactory from both a practical and a psychologic point of view.Dr. Haven Emerson, New York: Twenty-six years ago Dr. William H. Park made a study of the bacteriology of toilet seats in schools in which children with gonococcic vaginitis had been found, and he never found any such organism on the toilet seats. That was done in numerous schools in Brooklyn and Manhattan with the thoroughness and controls characteristic of the work of Dr. Park. We must recognize that one of the most valuable results of specific chemotherapy is the abbrevia¬ tion of the period of communicability. If a child's period of communicability can be reduced from twenty-six or twenty-eight weeks to one week, a great gain has been accomplished in con¬ trol of the disease. The risk of careless handling in an insti¬ tution for children or orphan home is of a different order from what is found in a hospital. The hospital is operated on the basis of a medical aseptic technic. I should be inclined to suggest that we do not change the sanitary code of the city of New York with regard to the exclusion of children with purulent vaginal discharges from any nurseries, not because we believe the association of those children in a hospital would lead to infection but because of obvious risks of infection where less exact and careful measures for bacterial cleanliness are observ...