Femina, A Work for Every Woman

by John A. Miller

Ovarian cysts or tumors cannot be considered in a work for home treatment, but a desire must be awakened in the minds of thoughtful readers, to learn the origin of these growths, and it seems to me quite appropriate at this juncture of the subject, to state that Professor Waldeyer, of Berlin, has discovered that ovarian tumors are developed from the remnants of the little tubules from which the Graafian follicles originate, so that the cause or source of these tumors is already laid before the patient is born; hence cannot be attributed to any fault on the part of the afflicted person. From the earliest period of intra-uterine development up to the age of puberty, the growth of the ovaries is entirely passive, but after that a continuous change takes place in the substance of the ovaries; the contents of the ovaries become active from the period of puberty, from which dates the commencing aptitude for procreation, until the menopause, or final cessation of the menses, which, in popular language, is termed “change of life,” when the aptitude for conception ceases with the proliferation of the ova.

The period of fruitfulness is characterized by the persistence of the menses, and this terminates, on the average, in the forty-fifth year; during all of this time the little ova, or eggs, continually ripen, and at their maturity the ovisacs, or Graafian vesicles, rupture from an increased secretion into their cavities. This ripening of an egg and rupture of a follicle corresponds with the monthly flow. The human ovum is very small; the largest does not measure above 1-120th of an inch in diameter, and very often it measures only half that size.

The situation of the ovary is not fixed in the pelvic cavity with any absolute degree of certainty, but it enjoys a degree of mobility that is even greater than that of the womb itself, to which it is attached by means of the ovarian ligament. Its usual place is about an inch from the uterus and a little backwards. It is partly surrounded by folds of peritoneum, and partly by the tissue that pads out the interspaces between the pelvic organs. If we remember the physiological fact, that at every monthly discharge of blood from the uterus, which is called menstruation, an ovum or egg ripens and an ovisac bursts, we cannot fail to appreciate the importance of the intimate relations that these functions must have, to the health of the individual and the perpetuation of the species.

This process of ovulation has the peculiarity of the first stages of an inflammatory action, because the ovaries become congested whenever an ovisac ruptures.

Through the nervous sympathy existing between the ovaries and uterus, this too becomes congested, so that the network of uterine vessels becomes so engorged that the capillary blood vessels of the mucous membrane of the womb rupture, and the hemorrhage that is the result constitutes the menstrual flow.

There are three physiological processes concerned in the menstrual phenomena: first, irritation and congestion of the ovary, rupturing the ovisac; second, congestion of the Fallopian tubes and uterus; third, consequent rupture of the blood vessels of the mucous membrane of the uterus and probably of the Fallopian tubes.

There may be one or more supernumerary ovaries without disturbing the normal functions; one or both ovaries may be congenitally absent. The entire absence of both ovaries is generally accompanied by deformities of so serious a nature that the newly-born infant is incapable of living.

If the defect is principally limited to congenital absence of the ovaries, then there is an absence of the changes in which puberty is recognized; the mammary glands remain flat; there is not the roundness and fullness of the girl’s figure that signalizes budding maidenhood. The apparently undeveloped form and girlish characteristics are prolonged into the years of adult age, and she remains weakly and small.

In an incomplete or rudimentary development, from an arrested or imperfect evolution of the ovaries, there is often a condition that resembles the above very much; neither are these cases nearly so infrequent as those whose organs are entirely absent. The ovaries may persist in their fetal state, or their growth may be arrested at any time before the expected period of puberty. The diagnosis of this pathological condition must be inferred from the undeveloped state of the different organs and from the absence of those signs which the approach of the menses communicate.

Displacements of the ovaries are often the cause of suffering and disease, that may excite symptoms quite remote from the seat of trouble. I remember the case of a young woman, who had suffered from obstinate dyspepsia, which subsided at once after the removal of the prolapsed ovary. It has been already alluded to, that these glands are naturally very movable. Anything which increases their weight, whether inflammatory enlargement or a dragging in connection with some inflammatory adhesion to a neighboring organ, may cause their displacement in various directions. It happens that the ovary may form the contents of a hernia or rupture. A prolapse or descent is the most common form of an ovarian displacement. We often find one or the other ovary resting in the pouch between the uterus and rectum, and if the patient should be troubled with constipation, the hardened feces may give rise to painful symptoms in the ovaries, and pain in the rectum, while it also is one of the causes of painful sexual relations. The irritation to which the dislocated ovary is exposed gives rise to inflammatory affections, that may be the cause of continual suffering.