THE REPRODUCTIVE ORGANS OF THE FEMALE. 689 



In adult life the ovaries may pass as herniae into the inguinal or crural canal, the 

 foramen ovale, or the umbilicus. Their position in the abdomen may be changed by 

 the pressure of tumors, the traction of false membranes, etc. This may occur in en- 

 larged ovaries or in those of normal size, and by the compression of the veins may lead 

 to congestion and chronic inflammation of the organs. 



HYPER2EMIA AND HAEMORRHAGE. 



Aside from the normal hypersemia of the ovaries during menstrua- 

 tion, the vessels may be congested in inflammation, in displacements with 

 interference with the venous circulation, in certain diseases of the heart, 

 etc., and may then be followed by chronic inflammation. 



The menstrual periods are accompanied by the effusion of blood into 

 a Graafiau follicle, formally the amount of blood is small, becomes 

 solid, is decolorized, and then gradually absorbed. Sometimes the effu- 

 sion of blood is much greater ; the follicle filled with blood is as large as 

 a pigeon's egg. The blood may remain in the follicle and be absorbed, 

 and replaced by a serous fluid, or through rupture it may escape into the 

 peritoneal cavity. Death may ensue from the hemorrhage, or the blood 

 may collect in Douglas' cul-de-sac and become encapsulated. Haemor- 

 rhages also occur in follicles which have become cystic. Interstitial 

 haemorrhage in the ovary sometimes occurs without known cause. 



INFLAMMATION. (Oophoritis.) 



Acute Exudative Inflammation of the ovaries occurs most frequently in 

 the puerperal condition, either as part of a general peritonitis or as a 

 primary affection. 



With puerperal peritonitis both ovaries are usually inflamed ; they 

 are swollen, congested, soft, infiltrated with serum or pus, or gangren- 

 ous. The lesion may involve principally the capsule, the stroma, or the 

 follicles. Inflammation of the capsule results in adhesions and collec- 

 tions of pus, shut in by false membranes ; of the stroma, in abscesses and 

 fibrous induration; of the follicles, in their dilatation with purulent 

 serum. 



If the inflammation of the ovary be the primary lesion it is usually 

 confined to one organ. The stroma of the ovary is infiltrated with serum 

 and pus, and may contain abscesses of large size. In other cases the 

 ovary itself is but little changed, but is surrounded by a mass of fibrin- 

 ous and purulent exudation. Such independent forms of ovarian inflam- 

 mation may terminate in recovery ; or the abscesses may perforate into 

 the rectum and vagina ; or the ovary is left indurated and bound down 

 by adhesions ; or the patient may die. 



Acute exudative inflammation of the ovaries unconnected with the 

 puerperal condition is not common, but it may occur in connection with 

 acute or chronic peritonitis or perimetritis, with various infectious dis- 

 eases, pyaemia, etc. It is usually confined to one ovary. 



Chronic Interstitial Oophoritis is not infrequently preceded by an acute 

 inflammation, or it may gradually develop as an independent condition, 

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