604 JAMES E. GOODALL 



phatic extension or by invasion from the peritoneal cavity. In the early 

 stages the interstitial tissues of the ovaries become much enlarged by edema 

 and infiltration of their tissues. The Graafian follicles shed their mem- 

 brana granulosa, the follicular fluid becomes turbid and the ova die. The 

 corpora lutea become cystic and, if the condition should last a consider- 

 able period of time, and be sufficiently acute, and finally resolve, destruc- 

 tion of all specialized tissues may result and atrophy follow. In other 

 cases pus formation takes place either in a recent corpus luteum or in the 

 interstitial tissue, and the whole ovary becomes converted into a large pus 

 sac or isolated small pus collections. 



Infection Complicating the Acute Fevers 



First to be noted among these is acute double oophoritis complicat- 

 ing mumps. This complication is fortunately rare. The condition bears 

 all the clinical signs of a diffuse, usually double, oophoritis in which all 

 the tissues are involved. The ovaries may enlarge to the size of a grape 

 fruit and be followed by atrophy of the parenchyma and loss of function. 

 When removed years afterwards these ovaries are small and of almost 

 cartilaginous hardness, and show not a vestige of the normal functioning 

 structures of the normal organ. 



A similar condition may follow scarlet fever. I saw such a case some 

 years ago complicating scarlet fever. The subject was a girl of eighteen 

 and she never menstruated after this affection, though for four years 

 previous she had been quite normal as to pelvic function. Upon opening 

 the abdomen five years after for another condition, the ovaries were found 

 atrophic, hard, and measured, roughly, 1.5 centimeters from pole to pole. 

 Pelvic function was never re-established and she is sterile though now 

 married many years. 



This condition may also follow the other infectious fevers. 



Morphological Changes Due to Abnormal or Arrested 

 Development of the Ovaries 



1. Total or partial congenital absence of the ovaries, though rarely 

 seen, is occasionally met. From a morphological viewpoint these cases are 

 of no interest. 



2. Hermaphroditism. True hermaphroditism is the existence in the 

 one individual of both ovary and test is and is among the very rarest of 

 anomalies. Furthermore one or both of the organs are sexually immature. 

 Pick was able to collect only four authentic cases in the literature. Three 

 forms are recognized : 



