The Bacterial Flora of the Human Vagina *

An understanding of the bacteriology of the vagina in the healthy individual is of importance not only to the bacteriologist but also to the clinician, who would have a better comprehension of the various factors involved in disease of the female genitalia. Before a clear picture of the changes brought about by the presence of pathogenic bacteria can be presented, it is necessary to know the organisms which are normally present, so that their relationship as secondary invaders to the primary infection can be better understood. Knowledge concerning the normal bacterial flora is also important in those diseases of the female genitalia endogenous in origin. Although, prior to 1892, many sporadic attempts were made to obtain information concerning the bacterial flora, it was not until then that a comprehensive monograph by D6derlein2 furnished the first truly scientific information concerning the types of organism normally present in the vaginae of pregnant and non-pregnant individuals. Previous to this work, most investigators had concerned themselves only with the organisms which cause disease and had little knowledge of those bacteria which are present -under apparently normal conditions. Doderlein's work was the incentive for a series of publications dealing with various phases of the bacterial population of the normal vagina. Much of the published material is open to question, however, because of the methods used in the studies. Many investigators arrived at their conclusions merely by microscopic slide examination. Others used culture media. which, in the light of our present knowledge, were obviously inadequate for some of the organisms studied. No attempt will be made here to review the literature on the normal vaginal flora. It was our purpose in the work reported here to examine bacteriologically the secretions of ill and healthy pregnant and non-pregnant women, to determine what types of organism were present, and to ascertain whether or not a definite bacterial picture could be correlated with other data, such as age, medical history, etc., obtained from the patients. Materials and Methods