Femina, A Work for Every Woman

by John A. Miller

If the ovary has once become inflamed, whether alone or as a complication of other diseases, then the most important question to decide is the existence of an abscess. This can only be recognized by an experienced and careful specialist, who has trained his sense of touch, so that he can feel the abscess between the fingers of one hand in the vagina, and the other making counter pressure on the abdomen. The history of each case must in a measure decide the nature of the fluctuating tumor, whether it may not be an ovarian cyst instead of an abscess, although an abscess may have been a small cyst.

The development and course of different cases, present various aspects for consideration. The enlargement may become obstinate to the ordinary methods of treatment and assume the chronic form of subacute inflammation. The inflammation may spread from the ovary to the peritoneal membrane that partly covers it; these are the broad ligaments of the uterus. This may be the means through which the organ may grow to the surrounding tissue and adjacent organs, so that it becomes utterly impossible to move it or even successfully extirpate it from its intimate attachments.

In other cases the ovary remains entirely free from attachments or complications, and while it can be generally felt lower down pressing perhaps on the rectum, it is readily movable or replaced. In the majority of cases only one ovary is involved, but in these cases there is a predisposition which in a large proportion sooner or later compromises also the other ovary in a similar diseased process.

TREATMENT.

The treatment of this affection is greatly modified or influenced by a knowledge of the causation of the inflammation. In every case, however, the patient should take to her bed. If there is a profuse vaginal secretion it should be ascertained if the disease is of infectious origin, and where this is suspected, the vaginal canal should be thoroughly rinsed with an antiseptic solution of corrosive chloride of mercury in the proportion of one grain of the sublimate to two thousand grains or parts of water, or about fifteen grains to the half gallon of water. There are tablets to be had at the drug stores which contain the requisite amount of corrosive when added to a given quantity of water; these are preferable and more convenient than the crude drug, and as they are a deadly poison they should be kept under lock and key. There is nothing to equal the corrosive for an offensive vaginal discharge, for it is the most reliable disinfectant there is in the entire pharmacopœa. Half a gallon of this solution should be used at a time, and after the vaginal canal has been thoroughly disinfected, about a pint of the same solution must be passed through the uterine cavity by means of a double catheter, that has a reverse flow and is especially made for the purpose. To insure against mercurial poisoning I am in the habit of following mercurial irrigations with warm water, that was previously sterilized by boiling. One pint of the simple water is generally sufficient to displace all the mercurial water that might have remained in the uterine or vaginal cavities. These medicated irrigations should have an average temperature of 105 degrees Fahr. and be repeated daily for about a week.

If the vaginal secretion is not of a specific nature, then the Femina antiseptic uterine lotion is a safer remedy.

Ice bags applied over the regions of the painful ovaries check the acute inflammation from going into suppuration and forming an abscess. Should the latter be found to exist, it should be opened by means of a trocar or aspirator. The bowels should be kept free by taking a daily dose of Femina laxative tablets.

CHRONIC OVARITIS.

If an acute inflammation does not terminate in prompt recovery or an abscess it may lose its fiery nature and tone down into a low grade of prolonged congestion which does not go on to the production of suppuration. This would constitute the chronic form of inflammation.

It does not follow that all chronic inflammations are preceded by the acute form, for there are inflammations that are subacute from the beginning, that is, that there is not the heat nor feverishness in the tissues which is one of the principal features of the acute process.