Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: DIAGNOSIS We are able to arrive at a clinical diagnosis of gonorrhoeal infection in a large number of cases by a consideration of the history without a physical examination. Such a diagnosis is at best imperfect, in that it no more than establishes to a high degree of probability the existence of gonorrhoea in the genitourinary tract, without any exact knowledge of the extent of the infection. For example, a child nursed by a mother or maid who is known to have a gonorrhoeal discharge acquires a leucorrhoea with signs of inflammation about the vulva; a recently married woman experiences a leucor- rhoea with burning pain on urinating, and it is learned that her husband at one time had a gonorrhoeal infection, though there has possibly been no evidence of it for months and years; a woman who w/is previously free of all complaint submits to illicit intercourse and in a few days suffers from painful urination and leucorrhoea; such histories lead almost certainly to the diagnosis of gonorrhoea. Grave mistakes have been made in diagnosis by assuming that no infection exists because the usual complaints of an acute infection do not appear in the history. It is to be remembered that a woman may acquire a gonorrhoeal infection without her knowledge, and in the absence of all local or general symptoms. Such an affection is confined to the lower genital tract and either disappears spontaneously within a variable period of time, or is subsequently caused to extend higher in the genital tract, where with each advance from the cervix to the corpus, from the corpus to the tubes, and from the tubes to the ovaries and peritoneum, the general and local disturbances are exaggerated. The diagnosis of gonorrhoea in the female is much more difficult than in the male for the reason that the chi...