DISEASE OF TILE GENERATIVE ORGANS.
—There is no doubt that many of the lighter and irritating affections of these organs, both in the male and female, in crease the nervous condition of the suf ferers, and, if they are not the direct exciting causes of attacks of hysteria, they increase the liability to them and exaggerate the symptoms when the dis ease is present. It seems true, also, that the depressing effects of prolonged at tacks of hysteria increase the tendency to the development of disease of the gen erative organs. Operative interference on the generative organs, especially in the hysterical female, should only be undertaken when the local condition jus tifies it. Ovaries should not be removed in the hope that the psychical effects of the operation will cure the hysteria.
There are grave causes of hysteria which arise from irritation of the ovary. In such difficult forms of ovarian his tology, where every plan of treatment is of no avail and threaten the existence of the patient, oophorectomy is indicated. Spannoechi (Deutsche med.-Zeit., Feb. 27, '90).
In both hysteria and Ilystero-epilepsy it is necessary to distinguish carefully those cases in which the symptoms are clearly referable to the reproductive or gans. These, and these alone, should be
operated upon, nor should o(iphorectonly be performed on these cases until every other means of relief has been exhausted_ Before operation physical examination may or may not disclose abnormal con ditions of the pelvic organs. The opera tion rests upon rational rather than physical signs.
Operation usually discloses ovaries in a more or less sclerotic condition, and often with cystic degeneration. Adhe sions are found in some cases, but not. in all. The uterus is sometimes smaller than normal, and sometimes, but not al ways, its position is not normal. Dudley P. Allen (Western Reserve 11.1ed. Jour., Dec., '95).
Hyperminia of the vulva and vagina found in seventeen cases of hysteria; it was commonly associated with hyperse cretion of the glanduhe Bartholini, and in some cases perhaps caused by mastur bation. Vedeler (Norsk Mag. f. Lxge vidensk., p. 317, '99).