HO DISEASES OF THE OVAKIES. 



reabsorbed and the follicle atrophies ; in other cases it degenerates to 

 a serous cyst, and exceptionally ends in suppuration and formation of 

 an abscess. If the inflammation start from the stroma of the ovary, 

 the process is usually limited to a decided hyperaemia, an inflammatory 

 oedema, and a proliferation of the connective tissue, which subsequent- 

 ly leads to thickening and shrinking of the ovary. Suppuration and 

 formation of abscesses, or diffuse destruction of the ovary, rarely occurs 

 in these cases. In non-puerperal ovaritis, J&wisck has only twice 

 seen this rare termination. Inflammation of the peritoneal covering 

 is sometimes primary, sometimes secondary to that of the parenchyma. 

 In recent cases the ovary is usually covered by a scanty fibrinous ex- 

 udation, which unites it loosely to the neighboring parts, particularly 

 to the broad bands of the uterus and the Fallopian tubes, whose peri- 

 toneal covering usually participates in the inflammation. Subsequent- 

 ly firm adhesions, by means of fibrous bands and filaments, readily 

 form between these parts ; not unfrequently these closely envelop the 

 ovary and openings of the tubes. Exceptionally, peritoneal ovaritis 

 causes abundant exudation, and encapsulated foci are formed in the 

 pelvis. 



SYMPTOMS AND COURSE. The symptoms of a partial peritonitis 

 in the neighborhood of one of the ovaries are the only signs usually 

 furnished by ovaritis. If the peritoneal covering be not inflamed, 

 the disease almost always remains latent. The ovary lies so deep in 

 the pelvis, and is so completely covered by intestines, that pressure 

 downward from above the symphysis pubis does not affect the ovary, 

 unless the abdominal walls are very much relaxed and distensible. 

 Hence it is important to decide, by vaginal examination, whether 

 the ovary be really the origin of the pain. Occasionally the diseased 

 ovary may be reached through the rectum. The etiology, also, may 

 confirm the diagnosis. If we meet the above symptoms in a patient 

 who has caught cold, or received injury in some other way at the 

 menstrual period, and the menses have suddenly ceased, the presump- 

 tion that the partial peritonitis starts from the ovary is more tenable 

 than that it depends on disease of some other organ, covered by peri- 

 tonaeum. TRe symptoms may be modified by an extension of the in- 

 flammation to neighboring organs. Uterine blennorrhcea and bloody 

 or bloody serous discharge from the uterus, pain in passing water 01 

 faeces, neuralgic pains or numbness in the corresponding extremities 

 may accompany ovaritis, while in other cases they do not occur. 

 Oophoritis is only exceptionally accompanied by fever. The course ot 

 the disease varies greatly. In favorable cases the symptoms pass off 

 in a few days, without leaving a trace. Probably the combination of 

 symptoms called colica scortorum (colic of prostitutes) depends on 



