OVARY (ABNORMAL ANATOMY). 



591 



cyst, or in which the tissues of the healthy 

 organ are entirely expanded and lost in the 

 walls of the sac. 



And lastly, the occurrence of these cystic 

 formations is limited to that period of life 

 when the Graafian follicle is in a state of 

 activity. They are not found as new for- 

 mations after the usual time at which the 

 follicles have ceased to be discoverable in 

 the ovaries as natural structures, nor do 

 they occur before the period of puberty has 

 arrived, except in cases much more rare than 

 those of an unusually early development of 

 these follicles, or of precocious puberty. 



These arguments apply more particularly 

 to cysts with fluid contents. How far they 

 may also serve to explain those which con- 

 tain more highly organised products is less 

 obvious. But it must still be remembered 

 that cystic formations of all kinds occur far 

 more frequently in the ovary than in any 

 other part, whilst there is nothing peculiar 

 in the stroma of the ovary, or that portion 

 which is external to the follicles, which would 

 rentier it more peculiarly liable to cystic for- 

 mations arising out of dilated areolar spaces, 

 than similar fibrous structures occurring in 

 other portions of the body where cysts occur. 



Solid Enlargements of the Ovan/. These 

 consist of formations of fibrous, and occa- 

 sionally of imperfect cartilaginous tissues, and 

 of osseous concretions, but more frequently 

 of cancerous growths, formed at the expense 

 of, or deposited within, the tissues of the 

 ovary. 



Of formations of fibrous tissue some ac- 

 count has been already given in the description 

 of the growth of cysts. The new formations 

 of fibrous tissue which take place in the 

 ovary occur chiefly in the cystic parietes, 

 where they are deposited for the purpose of 

 strengthening the walls and enabling them to 

 resist the increasing weight and pressure of 

 their growing contents. But as fibroid tu- 

 mours, or solid growths of the entire ovary, 

 such formations, except those of very small 

 size, are certainly rare, unless they are of a 

 cancerous or cancroid nature. 



It is probable, indeed, that, excepting the 

 cancerous and cancro'd cases, most, if not all, 

 of the specimens which have been described 

 or preserved in museums as examples of large 

 fibrous tumours of the ovary, have been 

 formed at the expense of the proper tissue 

 of the uterus, and have had nothing to do 

 originally with the ovary, although the latter 

 may be so involved in the mass that its proper 

 tissues can no longer be distinctly traced. 



Such I had no difficulty in determining to 

 be the case with a specimen preserved in 

 King's College Museum as an example of 

 fibrous tumour of both ovaries ; each sup- 

 posed ovary being of the size of an ostrich's 

 egg, and presenting all the characteristics of 

 the ordinary fibrous tumour of the uterus. 

 It was rendered evident, by dissecting the 

 parts and opening the uterus, which had not 

 been done previously, that these large tumours 

 which hung on either side of the uterine 



body had been formed at the expense of the 

 latter, for the natural tissues of the fundus 

 and corpus uteri were in great part absorbed 

 into and had evidently contributed to form 

 these masses ; and out of the apex of one of 

 these sprang the uterine end of the Fallopian 

 tube ; a clear proof that this was not an 

 ovary. 



In this way may be explained the remark 

 of Cruveilhier, that fibrous tumours of the 

 ovary are so perfectly identical with those 

 found in the uterus, that it is sometimes im- 

 possible to determine to which of the organs 

 they have originally belonged ; and also the 

 remark of Dr Baillie, that they resemble in 

 texture the tumours which grow from the 

 outside of the uterus. The absence of the 

 muscular element from the natural tissues of 

 the ovary, and the now well-known fact that 

 the uterine fibrous tumours contain, as one 

 of their characteristic constituents, more or 

 less abundantly the smooth or organic mus- 

 cular fibre of the uterus, forbid the belief 

 that tumours of similar composition to those 

 found in the uterus can be formed within or 

 at the expense of the proper tissues of the 

 ovary. 



Cartilaginous and Osseous Formations, espe- 

 cially the latter, are not rare in the ovary. 

 They are found chiefly in the parietes of cysts, 

 and also intermixed with cancerous deposits. 

 The process of deposition of earthy matter, 

 which should be termed calcification rather 

 than ossification, occurs here under three 

 principal forms. 



In fine sections of the more solid structures, 

 or in the thin walls of cysts which are slender 

 enough to be examined without cutting, may 

 be often seen, with a moderate amplifying 

 power, little aggregations of crystals in the 

 form of clavate spicula, clustered round a 

 centre, and forming groups scattered through 

 a fibrous basis. Such tissues are sensibly 

 rough to the finger, and grate under the knife. 



In the second form the same calcareous 

 materials, consisting of phosphate and carbo- 

 nate of lime, combined with a small proportion 

 of animal matter, occur as plates or laminae, 

 strengthening the walls of cysts ; or in the 

 shape of grains, or larger aggregations, or 

 layers intermixed with the tissues of more 

 solid tumours. 



In a third form the calcareous matter may 

 constitute an oval or solid mass contained 

 within a small cyst, and resulting apparently 

 from an entire calcification of the inner walls 

 of the cyst. 



The condition under \\hich true bony 

 structures are found in the ovary has been 

 already considered in another section. (See 

 Dermoid Cysts.) 



Cancer of /he Ovary occurs under the three 

 principal varieties of Colloid, Medullary, and 

 JScirrhous or hard cancer. Most of the large 

 tumours of the ovary,and such of the encysted 

 class as remain still to be described, belong 

 to the variety of 



Colloid or Alveolar Cancer, generally associated 

 with Cysts. These might have been classed, 



