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To the Editor:—
Having conducted a vaginitis clinic for many years, I wish to congratulate Dr. Lang on his excellent paper in The Journal, Dec. 3, 1960.It is well known that cancer must be ruled out in all leucorrhea cases. We no longer suggest that a physician collect only 1 or 2 drops of secretion, but rather as much as possible to facilitate pathogen identification. The secretion is placed in a test tube containing 1/2 to 1 cc. of normal saline solution. For fresh smear studies for Trichomonas, Candida, Hemophilus, types of epithelial cells present, etc., special cultures are made if necessary. Contrary to Dr. Lang's findings, we find that the pH determinations are important. About 85 per cent of the trichomonal or hemophilic or nonspecific vaginal infections produce a pH concentration of 4.9 to 5.9. Candida albicans produces a pH level near 4.5, and all acute vaginitis begins
Karnaky KJ. Experiences in a Vaginitis Clinic. JAMA. 1961;176(4):389. doi:10.1001/jama.1961.03040170135028
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