OVARIES, DISEASES OF.—Inflammation of these organs usually results from an extension of a similar process in the uterus or in the tubes. If the inflammation he very severe, one or both ovaries may suppurate, and death follow. Where the course of the inflammation is more chronic in character, a painful swelling of the ovaries is produced, which gives rise to symptoms similar to those of an inflammation of the tubes. The pains become especially marked if adhesion takes place between the inflamed ovary and the uterus or the rectum, for whenever the bowels are emptied the force of the act is transmitted to the tender organ. Just as the normal ovary influences the appearance of menstruation, so may the diseased organ bring on uncontrollable and exhausting uterine hemorrhages. The disease exerts a very deleterious influence on the entire nervous system, and women thus afflicted are often accused of being hysterical.
The commonly accepted methods of treatment consist of hot douches, the introduction into the vagina of tampons saturated with various medica ments, baths of different kinds, and attention to the general health.
after thorough trial, these methods prove unsuccessful, operative treatment must he considered. Thanks to the advances in modern gynecology, this need no longer include the total extirpation of both ovaries, but merely the removal of the diseased portions. In this vox the woman retains her sexual characteristics, her menstrual functions, and the ability to conceive. The operation may usually be performed through a vaginal incision.
Ovarian tumours may become very large, and cause death within a period of three years. They may be of a malignant nature from the very beginning.
especially in old persons ; or they may become converted into malignant tumours during some period of their growth. The symptoms caused by their presence may be slight or very indefinite in character. The patients lose their appetite, complain of abdominal pain, are constipated, and become emaciated. These symptoms always demand a careful gynzecological examination. The tumour itself may have attained the dimensions of a man's head, and extend upwards as far as the navel before the patient becomes aware of any distension of the abdomen. Its presence is more apt to be observed by others, and, if the patient is unmarried, an unjust accusation of pregnancy may be made. Later on the effects of the pressure exerted on the other abdominal organs by the gradually growing tumour become mani fest, the emaciation progresses steadily, and the abdomen becomes unduly distended. The patient finally dies from exhaustion, unless suppuration meanwhile occurs in the growth, or a peritonitis hastens the fatal issue.
Treatment consists in the complete removal of the tumour as soon as a diagnosis has been made. If the other ovary is found to be normal, it may be left together with the uterus. The earlier the operation is performed, the less dangerous it is. The opportunity to conduct it through a vaginal incision is also much better, and the result more certain of being favourable.