The gonococcus, in the vulvovaginitis of little girls, infects not only the vulva, but the vaginal mucosa, the cervix, the external os, and not infrequently the urethra. Perrin1 believes that the gonococcus always infects the cervical canal. He describes the technic which he has used in the examination of about a hundred cases, and says that after wiping the vaginal surface of the cervix free of mucus, one can obtain pus containing the organism from within the cervical canal.
Although some observers have not found the cervical canal involved, all agree that the infection extends well into the vagina. Applications to the vulva alone cannot be expected to cure, since they do not reach the places where the gonococci are. It is on this basic principle that the method of treatment used in the Women's Room of the Genito-Urinary Department of the Massachusetts General Hospital has been developed.
SMITH GG. THE TREATMENT OF GONOCOCCUS VULVOVAGINITIS, WITH FURTHER OBSERVATIONS ON THE VALUE OF THE COMPLEMENT FIXATION TEST IN THE MANAGEMENT OF THIS DISEASE. Am J Dis Child. 1914;VII(3):230-237. doi:10.1001/archpedi.1914.04100390063004