Ovarian Cysts. 291 



Symptoms. Small, tardily growing cysts may cause no ap- 

 preciable symptoms. The larger ones or those that increase 

 rapidly are liable to cause disorders of circulation, innervation 

 and digestion. The mere pressure of a considerable cystic ovary 

 may interfere with portal circulation so as to entail muco-enteri- 

 tis, rectal congestion, piles, or intestinal torpor or impaction. 

 Adhesions of the diseased ovary to adjacent intestinal viscera, 

 tend to produce constrictions, obstructions and local congestions 

 or inflammation. In adhesions to the womb or bladder, ureter 

 or kidney, the symptoms will indicate disorder of these respective 

 parts. The weight of the enlarged ovary causing extension of 

 its ligamentous connections will allow of its winding around a 

 loop of intestine and producing strangulation. In those unusual 

 cases in which pregnancy occurs it may interfere with its com- 

 pletion, causing abortion or, failing in this, with parturition, 

 by becoming imbedded in the pelvis. In the line of innervation, 

 disorder is especially common in the digestive organs, anorexia, 

 nausea, impaired rumination, and colicy pains resulting. Again, 

 in many subjects the genesic instinct is stimulated, the patient is 

 more or less constantly in heat, cows become bullers, and mares 

 switchers, they cannot be impregnated, and under the continuous 

 excitement undergo rapid emaciation. There is often urinary 

 disturbance, frequent straining with the passage of a small quan- 

 tity only of turbid or glairy liquid, colored, it may be, by blood, 

 or foetid. The coUcs are liable to be dull and sUght, the patient 

 moving uneasily, switching the tail, moving the weight from one 

 hind foot to the other, pawing, looking at the flank, but sel- 

 dom lying down or rolling. In other cases, with adhesions, 

 impactions, obstructions, and congestions, all the violent motions 

 of the most intense spasmodic colic may be shown. Where there 

 has been rupture of the obstructed bowel, these symptoms may 

 merge into those of peritonitis, septic infection, or collapse. When 

 with these symptoms of intestinal disorder, there are tender loins 

 and flank, abdominal plenitude and tension, genital excitement, 

 frequent straining to pass urine, the discharge of a glairy or foetid 

 liquid, and when all these symptoms have increased slowly for 

 weeks or months in a female, the ovaries may be suspected and a 

 rectal examination should be made. Usually the outline of the 

 womb can be made out with the enlarged and irregularly shaped 



