THE nervous centre of the female organization has been described as residing in the sexual system; of which the ovaries constitute the ultimate foci. Hence it might be expected that these organs would be subject to disorders both nervous and inflammatory, similar to those which affect the uterus. And such in fact proves to be the case, notwithstanding their great dissimilarity of structure. Thus as the uterus is found subject to nervous irritability, neuralgia, acute and chronic inflammation, displacements, ulcerations both benign and malignant, dropsy, tumors and other forms of structural disorganization, – so the ovaries are in like manner liable to nervous irritation, ovaralgia, inflammations, displacements, tumors, dropsies, and a great variety of organic degenerations.
These disorders of the ovaries, even while presenting no apparent change of structure, exert a controlling influence upon the other portions of the sexual system, and so upon the entire constitution. some of the most important of these disorders, being comparatively obscure, are liable to be overlooked in the consideration of more obvious derangements of which they are still the efficient causes. By reason of their situation, the ovaries are less exposed than the uterus, to external injury. But from being as it were the head centres of the entire sexual system, these structures are liable to have concentrated in them all the morbid influences arising from functional obstruction in the dependent organs. And the fact that the ovaries are thus exposed to disorders reflected from other parts of the generative apparatus, in addition to those which may arise from their own functional derangement and structural disorganization, shows the primary importance of a careful study of all ovarian disorders, not only by themselves, but still more especially in their connection with morbid conditions of other organs. In the ovaries are implanted then the seeds of life, -and of death! And these latter may destroy the impregnated ova while yet contained in the Graafian vesicles; cause the product of conception to be blighted in the womb, resulting in a molar instead of a true pregnancy; produce abortion at three months, – a still born child at full term; or finally destroy life at any period short of the normal three score years and ten.
Some of the forms of ovarian disorder are very common and important, although not necessarily very obvious; these will be fully described. Others, which are rare, will be briefly mentioned, so that they may be recognized when they do appear. In either case a careful study of all the attendant symptoms will be equally essential in order to make a proper prescription. Nor in many cases will the pathological details or diagnosis greatly aid in making such a prescription. But the Homoeopathic physician needs to become familiar with the possible forms and terminations of such disorders, in order to know how to examine such cases and to anticipate their natural course. And nowhere is the superior advantage of the Homoeopathic practice more obvious than in the anticipative treatment of forms of disease so obscure, so deep-seated, and so formidable as are many of those to which the ovaries are liable. The single fact that ovarian tumors seldom or never appear in persons who have been brought up under Homoeopathic treatment, at once illustrates and confirms this statement.
The Fallopian tubes no doubt very strongly sympathize with the uterus and the ovaries in their disordered conditions. But we have not deemed it necessary to make any particular mention of the various morbid conditions to which these organs are liable, partly from the difficulty of distinguishing any separate affections of these tubes; partly from the fact that those disorders which attack them from sympathetic connection with other organs will be most readily removed by treatment directed (in general) to the primary seat of disorder; and partly from the fact that all the symptoms must in any event be considered in prescribing for these disorders. And this totality of the symptoms may be just as truly and completely arrived at in these cases, whether we pay special attention to the Fallopian tubes, or not.
OVARIAN IRRITATION.
OVARIAN IRRITATION is the analogue of irritability of the uterus. By some authors this affection has been termed sub-acute from the description, the symptoms are not inflammatory; but purely nervous. And as already intimated, ovarian irritation may be either the cause, the primary indication, or the consequence of severe disorder of some other organ of the sexual system. It may appear in women of all ages between the commencement and cessation of menstruation. Principally an affection of the unimpregnated female, – it is most frequent in those of a delicate nervous temperament, although by no means confined to them.
Symptoms. A certain sense of uneasiness, which may become a very severe pain, in one or both iliac or inguinal regions, but most frequently in the left, forms one of the chief characteristics of this disorder. This pain may be either a dull aching, or a more acute sensation; it may appear in paroxysms, especially after fatigue or over-exertion; it may be aggravated by gentle pressure, but is sometimes capable of being relieved by severe pressure; and may entirely disappear in a state of rest, leaving no evidence of its previous existence. “The pain is much more severe than in chronic inflammation of the ovarian tissues. It is, indeed, often intense; comes on in paroxysms; is seldom aggravated, but is often moderated, by firm pressure from a hand, a bandage, or a abdominal supporters constantly worm. It extends to the groin, to the front and inside of the thigh, and sometimes is evidently connected with pain in the back. It is unaccompanied by any enlargement which can be discovered by an external or internal examination. The patient has no fever (inflammatory or hectic) is often not emaciated or anaemic, and frequently as regards her organic life is perfectly well, with plenty of rich blood, strength and physical development. The pain may be very persistent for days, months and years, without any local or general change ensuing. In many patients, brought to my care, the antiphlogistic treatment had been perseveringly and repeatedly resorted to, in all its modifications, by rest, leeches, fomentations, by blisters and other revulsives, and had entirely failed to afford any permanent relief; but had rather aggravated the sufferings, by debilitating the patient, and thus rendering her nerves more sensitive, and her suffering greater. – Hodge. “When the irritation is great, it may be extended to the bladder, giving rise to a desire to evacuate its contents frequently, and causing great pain in doing so. Hysterical paroxysms are by no means unfrequent. In two of the most violent case of hysteria that I have seen for some time, there was extreme tenderness of the region of the left ovary, and pressure there aggravated the hysterical paroxysms. – Churchill.
These sufferings from ovarian irritation are unaccompanied by any sympathetic pain in the breast, or fever, – as is the case in actual inflammation of the ovaries. “Should the skin on being lifted give great pain, it cannot depend on a deep-seated lesion; irregular variations and the complete subsidence of pain, point to neuralgia. (Ovaralgia.) – Tilt. We have given these frequently descriptions of this affection from different authors, in order to distinguish it from ovaritis, (even sub-acute,) and as containing pretty nearly all the symptoms by which it is characterized.
Various forms of disorder of the female organism appear in connection with ovarian irritation; either as its causes or as its consequences. These we will indicate, without attempting to distinguish the former from the latter. Nor indeed would it be essential to make this distinction, even if it were always practicable; – since we must always prescribe for the totality of the symptoms present.
CAUSES AND CONNECTIONS. Ovarian Irritation scarcely ever appears entirely alone; usually it is accompanied by a corresponding irritability of the uterus, or by some other morbid condition to which it either gives rise or by which it is itself caused. In many cases it is impossible to determine what are the exact relations, as primary or secondary, which these various and concomitant affections bear to each other. No indeed it is essential; for on the one hand they are all alike caused no doubt by some profound constitutional dyscrasia, (psoric miasm,) and on the other hand they are all alike to be taken into considerations in our prescriptions. And in either case the symptoms present, as in displacements of the ovaries – and the conditions of aggravation, as, worse from motion, will sufficiently indicate the requisite hygienic directions.
A certain amount of ovarian irritation is frequently found in connection with amenorrhoea. The absence of the menses may be due to the same morbid condition of the ovaries that constitutes the irritability itself; or the irritation may be the result of a sudden suppression of the menstrual discharge and an irritable state of the ovaries and other sexual organs. The sudden suppression of the menses, as from cold, will almost necessarily result either in irritation or in acute inflammation of the ovaries. This condition is not very different from that in which there is a deficiency of action from some latent dyscrasia or organic imperfection in the ovaries. Here the ovarian nisus is incapable of effecting its normal development; but only produces an irritable condition of the ovaries themselves. For it must always be borne in mind, that as organic inflammation is the result of congestions or obstructions of the arterial or venous blood-vessels, so nervous irritation is the result of suppressed, imperfect, or excessive functional action. In dysmenorrhoea there is always more or less irritation of the ovaries; and this general irritability will be found to be greatly aggravated at the period of the menstrual nisus. The importance of carefully observing the morbid conditions of (irritation, “congestion”) the ovaries even in their incipient stage, on account of their strong disposition to lead to serious disorder, is well expressed by Dr. Duncan.(*Tilt, “Uterine and Ovarian Inflammation, p.339.) “The propriety of attending seriously to the symptoms of congestion (irritation) of one or of both ovaries, as rendered evident by thrilling pain a little above the centre of Poupart’s ligament, accompanied by tenderness on pressure, and increased by the erect posture, ought to be strongly insisted upon. Whether the pain be constant or intermittent, returning at, or exacerbated during the monthly crisis, accompanied by menorrhagia, or co-existing with amenorrhoea and chlorosis, it should receive our urgent consideration; for when an organ has been congested for any length of time, such a state is difficult of eradication-morbid changes rapidly occur and irremediable mischiefs result.
