CHAPTER XI. 

 OVARIAN PREGNANCY. 



Although the Carnegie Collection contains almost 3,000 specimens of abor- 

 tuses and others from operations upon the tubes and uteri, it includes only 2 

 cases of ovarian pregnancy. The first of these (No. 550) was described by Mall 

 and Cullen (1913) and the second (No. 1522) by Meyer and Wynne (1919). This 

 is an incidence of only 1 in 1,500 miscellaneous accessions composed mainly of 

 abortuses, but it is not at all unlikely that the near future will experience an in- 

 creased frequency, if not among the accessions to the Carnegie Collection, at 

 least in the cases reported. For, although the first case of ovarian pregnancy 

 under that heading in the Index Medicus is that of Kouwer (1897 [van Tussen- 

 broek, 1899]), careful scrutiny of the titles listed for the last decade reveals the 

 fact that 5 cases of ovarian pregnancy were reported in 1908, 4 each in 1909 and 

 1910, 7 in 1911, 13 in 1912, 9 in 1913, 7 in 1914, 3 in 1915, 1 in 1916, and 5 in 1917. 

 This makes a total of 58 apparent cases reported within this decade. Since the 

 reports on some of the cases were published in three different journals, these were, 

 of course, counted merely as one, and although the authenticity of 4 of the cases 

 must be questioned on the basis of the titles alone, the series, nevertheless, is a 

 large one in spite of these facts and of a marked decline in the number reported 

 during the war. Since Norris (1909) stated that only 19 certain cases, approxi- 

 mately only one-third as many as all cases listed in the last decade, were reported 

 in the decade between 1899 and 1909, it would seem that ovarian pregnancy is not 

 only receiving increasing attention, but that a change in attitude as to what 

 constitutes ovarian pregnancy is probably in progress. This conclusion would 

 seem to be justified, even though a careful examination of the descriptions of 

 the cases reported in the decade between 1908 and 1917 would reduce somewhat 

 the number listed. 



Lockyer (1917) accepted as authentic only 22 cases of those reported between 

 1910 and 1917, but his review is only a partial one. Even so, it shows that there 

 is a decided increase in the number of cases which have been regarded as genuine 

 from decade to decade. The marked increase in the number of genuine cases 

 reported in recent decades becomes still more evident if one recalls that Williams 

 (1910) found only 13 positive cases up to 1906, whereas Norris found 19 positive 

 cases in the single decade between 1899 and 1909. That is, Norris found more 

 positive cases reported in that decade than had been reported in all previous medi- 

 cal history up to 1906. This surely is striking. 



The opinion that many, even if not all, cases of so-called hematocele, hema- 

 toma, apoplexy, blood-cysts, and rupture of the ovaries are probably nothing but 

 cases of ovarian pregnancy in disguise has been held by various investigators for 

 some time. Hence, if hematocele of the ovaries repeats the history of hematosal- 

 pinx, it is not unlikely that the near future will see a marked increase in the reported 

 frequency of "a fact so curious and important in itself," as Granville aptly put it 



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