Femina, A Work for Every Woman

by John A. Miller

INFLAMMATION OF THE OVARIES, OR ACUTE OVARITIS.

What inflammation is elsewhere, it is again here in these glandular structures.

I endeavored to point out in the beginning of these articles, that the difference of inflammatory diseases was not due to any difference in the inflammatory processes, these are identical, but the modification of the processes are due to the nature of the structure of the tissues that are involved.

If the intelligent reader will bear this in mind, she will form a clear idea of all the inflammatory diseases that come under consideration.

Pathological microscopists have recognized two forms of ovaritis, the follicular or parenchymatous, in which the Graafian follicles or ovisacs are the seat of the inflammatory process, and the interstitial, in which the intervening or interstitial connective tissue, the stroma, between the follicles is inflamed. This distinction has only a scientific interest because it is impossible to distinguish one variety from the other in the living subject; this can only be done with the aid of a powerful microscope after the suspected ovary is removed from the body. Whether the inflammation is follicular or interstitial or both combined, it is liable to destroy all the follicles or ovisacs which contain the ova, that are essential to procreation, and the consequence will be sterility.

The great functional activity to which the ovaries are subjected at each menstrual period, make them extremely liable to an inflammatory process, so that women cannot be too careful of themselves at this precarious period. It is during menstruation that the ovaries become periodically congested, and this alone offers an excellent predisposition for inflammation. As a complication of other inflammatory diseases, ovaritis is very common; it seems hardly probable that there can be an inflammation of a pelvic peritoneal fold or of the pelvic cellular tissue in close proximity to or surrounded by it, without involving the corresponding ovary. There cannot be a serious inflammation of the womb or of the Fallopian tubes without being communicated to the ovaries, and this is always true of the infectious catarrhs, especially the gonorrhœal form.

There is a great tendency in inflammation of the ovaries to suppurate and change the entire tissue of the ovary into an abscess. Ovarian abscesses are not much different in their behavior from abscesses in the Fallopian tubes or cellular tissue. It is claimed that they have a greater tendency to break into the bladder than other pelvic abscesses; this may be due to a displacement of the ovary, which locates the gland near or between the bladder and uterus, before the advent of the inflammation. There are no infallible signs that point to the existence of acute inflammation of the ovaries, owing to the complication of other inflammatory processes in the majority of cases. The characteristic pain of an inflamed ovary is of a throbbing or pulsating nature.

I cannot imagine an ovaritis without at least a circumscribed peritonitis, and one can hardly suppose a pelvic peritonitis to exist without in a certain degree compromising the ovary.