Nymphom,a7iia 189 



garded as cysts, since, in these, according to Rubeli, (vid. pages 

 163 and 164) no ova are ever found. 



They are located either comparatively peripherally or centrally 

 and lead, in both instances, to atrophy of the ovarial paren- 

 chyma, which, under the pressure of the cysts, may completely 

 disappear. By rectal palpation, the peripheral, solitary cysts, 

 which are frequently thin walled, may be diagnosed by the en- 

 largement of the ovary, upon which they appear as elastic, tense, 

 smooth, fluctuating eminences. In thick walled peripheral cysts 

 the gland feels more firm and elastic. 



More difficult than the diagnosis of solitary peripheral cysts is 

 the recognition of the solitarj^ central cysts, which are common 

 and lead to every grade of nymphomania. One or two of these 

 may be located in the center of the gland, never project above 

 its surface and are surrounded by a layer of ovarian tissue as 

 much as 8 mm. thick. Here, the diagnosis is to be based upon 

 the size of the ovary, the increased tension, the less readily com- 

 pressed, elastic surface and the non-crusha])le character of the 

 gland /<fr rectum and especially per vaginam. 



It is an interesting observation that, in a cysto-fibrous de- 

 generated ovary, there is now and then found one, rarelj' two 

 large solitarj' cysts, after the crushing of which there still re- 

 mains an abnormally large, firm, solid ovary. We have also 

 found that after vigorous crushing of a cysto-fibrous degenerated 

 ovary in exceptional cases there develop, after the lapse of a few 

 weeks, cysts from the size of a hickorynut to that of a small 

 hen's egg and that, by periodic compression and massage, the de- 

 velopment of small central cysts may be accelerated, as a con- 

 sequence of which they may then approach the periphery. 



Another finding, to which we have already referred and which 

 admittedly occurs rarely in nymphomaniac cows, consists in the 

 formation of multiple cysts by which several ovisacs in various 

 parts of the ovary hypertrophy and acquire the dimensions of 

 large peas, owing to which those most peripherally located pro- 

 ject slightly beyond the surrounding surface of the ovary. The 

 disseminated arrangement of the numerous follicles of approxi- 

 mately uniform size, as well as the general, though not constant, 

 absence of corpora liitea, indicates multiple cyst formation and 

 that they are not normal, ripe ovisacs. 



2. A quite frequent cause of nymphomania consists of the 



