THE PAROVAR1UM (NORMAL ANATOMY). 



bedded in the jelly-like substance may be 

 found opaque white masses resembling blanc- 

 mange or thick cream. Intermixed with 

 these contents, in varying proportions, are 

 found nucleated epithelial cells, oval corpus- 

 cles, oil granules and molecules, and delicate 

 filaments. 



Besides these contents of the alveoli, there 

 may be often observed hanging into their in- 



4 



tenor, and sprouting from their walls, clusters 

 of leaf-like clavate or villous processes, such 

 as are observed in that variety which has 

 more particularly received the name of villous 

 cancer. 



But it frequently happens that the alveolar 

 type of structure is not generally diffused 

 through the mass. This may form only a 

 small portion of the diseased ovary, whilst the 

 greater part is composed of one or more large 

 cysts, with contents similar to those just 

 described. 



Within such cysts, or growing from the 

 walls of those which present no other type of 

 malignant structure, may be observed round 

 or oval bosses, bearing no inapt resemblance 

 to the uterine cotyledons of the cow, and ex- 

 hibiting in section the compact areolar tex- 

 ture characteristic of the closer forms of 

 alveolar cancer. 



Colloid or alveolar cancer is occasionally 

 found associated with medullary disease in 

 the same ovary, whilst its presence there may 

 be accompanied by other varieties of carci- 

 noma in other organs, and attended by a well- 

 marked constitutional cachexia. 



Medullary Cancer of the ovary is of less 

 frequent occurrence than the preceding variety, 

 but like it is also occasionally associated with 

 the formation of cysts. 



Medullary cancer may occur either in the 

 form of a general infiltration of the entire 

 ovary with encephaloid matter, or in that of 

 distinct tumours, bounded by a fibrous enve- 

 lope, and having the carcinomatous matter 

 distributed through an interior cellular sub- 

 stance, or confined there by cellular septa. 

 These tumours may attain the size of an orange 

 or more. Their growth appears to be in the 

 first instance repressed by their fibrous sheaths, 

 but these occasionally burst and allow of the 

 diffusion of their contents. This form of can- 

 cer often affects both ovaries together, and is 

 found associated with cancer in other and 

 especially adjacent parts. Notwithstanding 

 the number and variety of the contiguous 

 structures which may be thus involved, the 

 ovary may sometimes be traced as the centre 

 or focus from which the cancerous deposit 

 has spread. This was remarkably the case in 

 an example of medullary cancer, which was 

 for some months under my notice, where the 

 disease commenced apparently in the left 

 ovary, and was found to have spread from 

 this point upwards along the chain of ab- 

 sorbent glands on the corresponding side, as 

 far as the pancreas, and outwardly through the 

 ischiatic notch to the gluta3i, and all the ad- 

 jacent muscles, including in its destructive 

 march the os innominatum, which could be 

 Supp. 



593 



cut with a knife like cartilage. A medullary 

 tumour the size of a walnut was found in the 

 fuiulus of the uterus, but the rest of that 

 organ, as well as the opposite ovary, had es- 

 caped the general destruction. 



The melanmd variety of medullary cancer 

 is occasionally observed in the ovary. (Roy. 

 Coll. of Surg., No. 2642. and A.) 'it differs 

 only from the foregoing in having pigment 

 cells, of a black or brown colour, scattered 

 through the carcinomatous matter. 



Scirrhous or Hard Cancer and Cancroid are 

 by no means so common as the two former 

 varieties. Yet it is not rarely that one meets 

 with the ovary, of one or both sides, in a hard 

 white nodulated condition, resembling some- 

 what the human kidney, both in size and shape, 

 and having its entire tissue converted into a 

 form of cancroid, characterised by the de- 

 velopment of a peculiar kind of stiff close-set 

 fibres, containing between their meshes nu- 

 merous nuclei (Fibro-nucleated cancroid). 

 Such a condition of the ovary is sometimes 

 found associated with hard cancer in other 

 parts of the body. * 



Of Scrofulous Tubercle in the ovary I can 

 give no account. Most authors who refer to 

 the subject mention it as rare, but give no 

 decisive instances. Boivin and Duges, how- 

 ever, have figured an example (fig. 16. Atlas) 

 occurring in a girl of 16, associated with 

 tuberculous disease of the mucous membrane 

 of the uterus. In cases of my own, which 

 I had regarded as examples of scrofulous 

 ovary, until submitted to the microscope, I 

 could find no trace of tuberculous matter. 

 By Rokitansky the existence of tubercle in 

 the ovary is altogether denied. 



THE PAROVARIUM. 



Syn. Corpus Conicum. Neben-Eierstock. 

 Organ of Roseinndller. 



These names have been applied at various 

 times to an organ which has hitherto received 

 little attention, but which is nevertheless in- 

 variably present in close proximity to the 

 ovary. The first discovery of this body is 

 due to Rosenmullerf , who termed it the 

 corpus conicum. It has since come under the 

 notice of many observers, and particularly of 

 J. Miiller. And it has recently been re- 

 examined, and very accurately described by 

 Kobelt , in an essay devoted to this subject, 

 in which the author expresses his surprise 

 that a structure so easily distinguished both 

 by sight and touch, should have attracted 

 comparatively so little attention up to the pre- 

 sent time. 



The Parovarium is most readily found by 

 holding up the broad ligament between the 

 observer and the light. Within the folds 

 of this membrane, at the part where the layer 



* For an example see Roy. Coll. of Surg. prep. 

 2636. 



f Quajdam de Ovariis Embryonum et Fostuum 

 humauorum. Leipsise, 1802. 



J Der Neben-Eierstock des Weibes. Heidel- 

 berg. 1847. 



a 



