120 DISEASES OF THE OVARIES. 



tact with the abdominal wall, percussion is absolutely dull. Since 

 the intestines are pushed upward and to the side by ovarian tumors, 

 the dulness becomes most decided at the prominent parts of ther 

 abdomen, where it is full in ordinary ascites ; at the most dependent 

 lateral portions, on the contrary, the tone is less dull and is tympa- 

 nitic. The uterus may be dislocated in various directions by large 

 ovarian cysts. Hence the result of vaginal examinations varies 

 greatly in different cases. The uterus may be pushed downward so 

 much as to constitute a prolapse ; it may be displaced forward, or 

 the vagina may be elongated, and the uterus elevated, so that the 

 os uteri cannot be reached by the finger. 



TREATMENT. The treatment of ovarian cysts belongs almost 

 exclusively to surgery. All absorbent remedies are useless, and, as 

 most of them are active, they are injurious. This is particularly 

 true of the preparations of iodine and mercury. Occasionally we 

 may retard the growth of the cyst by laxatives and derivatives ; 

 but, as we can only carry out this treatment for a short time, the 

 effect is only temporary, and it is no advantage to the patient to 

 have the tumor remain stationary for a few weeks, and then con- 

 tinue its growth. But we cannot hope by internal remedies to 

 cause a change in the inner wall of the cyst that shall deprive it of 

 its expansibility. In spite of the slight prospect of benefit from 

 medicinal treatment of ovarian cysts, humanity requires us to give 

 the patients a chance at the renowned baths and springs in Kreuz- 

 nach, Tolz, etc. [When the tumor threatens life, ovariotomy should 

 be performed. The success of certain specialists of late years is 

 remarkably good. Out of five hundred ovariotomies, Spencer Wells 

 has saved three hundred and seventy-two patients, and lost one hun- 

 dred and twenty-eight.] 



CHAPTER III. 



COMPLICATED NEOPLASIA AND SOLID TUMORS IN THE OVARY. 



FROM the excessive formation of new connective-tissue cells that 

 accompanies the development of cysts, we have cystosarcoma. This 

 forms tumors which rarely attain the size of those described in the 

 last chapter. 



Fibroid tumors, unaccompanied by the formation of cysts, rarely 

 develop alone in the ovary, but they have occasionally been observed 

 of very large size. For several years past I have been treating a 

 patient, aged fifty-five years, who has a very hard, nodular fibroid 



