256 THE AMERICAN MONTHLY [November, 



It is probable tbat all catarrhal diseases, such as Bronchitis, Conjunc- 

 tivitis, Diarrhoea, etc., are of bacterial origin, and that various bacteria 

 are engaged as causative factors in different varieties of these several 

 diseases. These have been isolated with varying degrees of certainty. 



With regard to Diphtheria, it is probable that two or more diseases 

 are included under this name, and that more than one bacterium is ca- 

 pable of inducing the formation of pseudo-membrane. 



o 



A Hitherto Undescribed Disease of the Ovary. — The leading 

 article in the New York Medical Journal for September 28, 1889, is 

 from the pen of Dr. Mary A. Dixon Jones, of Brooklyn. Therein she 

 describes a disease of the ovary, thus far unrecognized by morbid his- 

 tologists. This disease, or tumour, can hardly be said to have an 

 established name. In the title of the paper it is spoken of as " En- 

 dothelioma, changing to Angeioma and Hematoma." 



The name Kirsoma has been proposed on account of the peculiar 

 convolutions that are manifested. She gives the clinical history of 

 twelve cases in which she removed the ovaries on account of this dis- 

 ease, the diagnosis having been confirmed by subsequent microscopic 

 examination. These cases all were operated upon, mainly at the 

 Woman's Hospital, in Brooklyn, during 1S87 and 1888. It would 

 seem, therefore, that the disease is not unfrequent ; but has hitherto 

 been called by other names — alveolar sarcoma, for example. 



The symptoms of the disease are : — a special and characteristic pain in 

 the region of the ovaries, at times severe, sharp, and lancinating ; a 

 peculiar pale or cachectic look, like the pallor of the consumptive ; and 

 marked emaciation. The symptoms are so marked that a diagnosis 

 can usually be made with confidence. 



Sterility is an almost invariable l-esult, from the fact that the neoplasm 

 usually encroaches upon and destroys the ova, and, indeed, in time the 

 whole normal structure of the ovary. 



The cachexia developed is compared to that of carcinoma, and the 

 author suggests that the growth may be malignant. 



Microscopical sections of an ovary affected with this disease, sub- 

 mitted to Prudden, of New York, and to Waldeyer, of Berlin, were 

 pronounced carcinoma. 



But the author asserts that the growth is " a new formation of blood- 

 vessels and blood-corpuscles ." 



If we understand rightly her theory of the morbid change, it is as 

 follows : — beginning in the walls of menstrual follicles, there is a retro- 

 grade metamorphosis of connective tissue elements whereby they take on 

 their embryonal condition, causing the reappearance of medullary 

 corpuscles — the bodies described by Theodore Schwann, in 1S39, as 

 blood cells, and by C. Heitzman, in 1S72, as haamatoblasts. These 

 corpuscles rapidly proliferate, and may destroy and occupy the place 

 of all the normal structures of the ovary, the medullary corpuscles be- 

 coming blood-corpuscles, and these, by fusion of their hamiatoblastic 

 substance, forming the walls of new blood-vessels. 



There is no apparent augmentation of the volume of the diseased 

 ovaiy. Sometimes it is really diminished in size. 



The paper is illustrated by ten well-drawn cuts showing sections of 

 " endotheliomata " at various stages, magnified X 25, 100, 300, and 

 600. 



