In a similar manner, in other cases, the chronic ovaritis results in dilatations of the Graafian vesicles, forming cysts, – encysted ovarian dropsies. These forms of encysted dropsies of the ovaries are quite common; and there seems to be almost no limit to the size to which they may attain. And although thus separately mentioned, they are not always capable of being so definitely distinguished at the bedside of the patient. For while fluctuation may readily be detected in some instances, – in others, so great is the thickness and induration of the hypertrophied parietes, that it may be almost impossible to determine that any dropsical collection is actually present. An ovarian tumor, properly so called, may contain a single large or smaller cyst situated in its centre; or it may have numbers of such cysts scattered through its substance.
There are other forms of morbid growth in the ovaries, still to be mentioned in their appropriate places. But this general form of tumor or enlargement, whether principally solid, consisting mostly of dropsical accumulations, or composed of both solid and fluid elements combined, may be stated as constituting one of the most common results of chronic ovaritis.
The symptoms of chronic inflammation of the ovaries, except in those cases which follow the acute form, are not very strongly marked. The pain, which in acute ovaritis had been very severe, gives place to a sensation rather disagreeable than painful. There are a variety of sufferings within the pelvic regions, which, in default of any other cause, may be safely attributed to chronic ovaritis. Such are, “frequent need of urinating, painful constrictions of the vagina, uterine colics, a very painful tenesmus, together with the formation of haemorrhoidal tumors. The patient complains of an inconvenient weight in the diseased spot, which increases when touched, when walking, by remaining too long standing, by coitus, and especially at the menstrual period. Frequent we meet with various disorders in connection with the menstruation, without our being able always to comprehend why the courses are sometimes nearly or quite suppressed, while at other times they are much too abundant; as the disease very often affects one ovary alone, the courses are not necessarily accompanied every time by dysmenorrhoeal phenomena; we even see the catamenial flow occur two or three times without particularly painful sensations, which suggests the inference that the matured ovum at these periods belongs to the healthy ovary. At other times, each menstrual period is accompanied by a violent dysmenorrhoea, and then either both ovaries are diseased, or the ovulation affects in a high degree the diseased organ. – Scanzoni.
The pain which is either limited to the region of the ovaries or radiates from thence, which has continued for some time, and which is aggravated either before or during the menstrual period, will lead to the belief that there may be chronic inflammation of one or both ovaries. And this belief will be strengthened if we find the vaginal cul-de-sac painful to the touch, on the affected side.
Chronic ovaritis, whether it follow acute inflammation of the ovaries, or become imperceptibly developed from some external injury, constitutional dyscrasia, or even from excesses in sexual intercourse or abuse of the sexual organs, -as in females who lead vicious lives or indulge in secret vice, -is at the same time accompanied with enlargement and naturally tends to induration, softening or other structural degeneration. And in those cases in which constitutional miasms of a corresponding sort are present, there are developed tubercles, and calculi and even cancerous affections of the ovaries, from what at first may perhaps have appeared but simple forms of chronic inflammation. Thus we have tumors, dropsies, cancers and various other organic changes more or less common, -all of them gravely important in their nature. And all these forms of ovarian disorder must be studied with a careful examinations of all the attendant local and general symptoms, both sensational and functional, in order to secure the selection of the remedy which shall reach the seat of the disease in the interior of the system, and so prevent its fuller development and fatal termination.
IRRITATION; INFLAMMATION OF THE OVARIES.
Aconite. Will be indicated where the patient has been exposed to dry cold air, and has been so chilled through as to develop a real synochal fever. Or in case in which this inflammation has resulted from a fright.
Ambra g. Stitches in the ovarian region, when drawing in the abdomen, or pressing upon it. Discharge of bluish-white menses from the vagina. During urination there is burning, smarting itching and titillation of the vulva and urethra.
Anti. crud. Nausea and vomiting; white tongue; tenderness over the ovarian region.
Apis m. Stinging pains in the ovaries. Aggravation after sexual intercourse. Enlargement of the right ovary, and pain in the left pectoral region with cough. There is evidently a mutual sympathy between the ovaries and the lungs.
Arsen. a. Intense burning or tensive pain in the ovary, with great restlessness, -some relief being afforded by constantly moving the feet. Thirst, with drinking little and very often.
Aurum. Much depression of spirits. Her mind dwells constantly on suicide.
Belladonna. The right ovary is much enlarged. And with every menstrual period, the pressure downwards was so great, as if everything would be forced out of the vulva, that she was compelled to keep her bed for several days. This case was entirely cured in the course of a year with but three doses of Belladonna.
Bryonia. Stitching pains in the ovaries on taking a deep inspiration. The pains are made worse by motion. She can hardly bear the least touch on the affected parts.
Cantharis. Much tenderness and burning in the ovarian regions. Dysuria; cutting burning in passing only a drop or two, which is often bloody, or complete strangury. This remedy is very often indicated in this complaint.
China. In cases where profuse hemorrhages, or too frequent sexual intercourse, have produced the attack of inflammation. She can hardly bear the least touch upon the affected parts.
Colocynth. Intense boring or tensive pain in the ovary, causing her to draw up double, with great restlessness.
Conium. Induration and enlargement of the ovary, attended with nausea, vomiting, eructations of wind and expectoration of phlegm; lancinating pains; acrid, white and slimy leucorrhoea; labor-like contractions; pains in the iliac regions.
Graphites. The inflammation is aggravated by every cold she takes, or from getting the feet damp. Her menses delay. Morning sickness during the menses. Itching blotches on the skin, here and there, oozing a glutinous fluid.
Hepar. When suppuration is feared, and other remedies have failed, Hepar may prove to be the medicine, if no other is more strongly indicated.
Ignatia. In cases where the disease has seemed to be developed from disappointed affection. There is involuntary sighing, great despondency; and weak, empty feeling at the pit of the stomach.
Lachesis. If pus has already formed, Lachesis may be the most appropriate remedy to promote its escape externally.
Lycopodium. Cutting or shooting pain, extending from the right to left, across the ovary; worse after four P.M., better after eight or nine in the evening.
Nux vomica When the disease appears to have been occasioned by rich living, highly seasoned food, stimulating drinks, or by a too sedentary life.
Phosph. acid. When the disorder is caused by debilitating influences.
Platina. In cases where the sexual passion is altogether too strong, as an attendant condition. The pain in the region of the ovary is of a burning character, occurring in paroxysms, with stitches in the forehead. Hysterical condition strongly marked. Has proved curative after the pus has been discharged under Lachesis.
Ranun. bulb. In chronic cases where rough windy weather excites the symptoms.
Rhus tox. When the pain is relieved by motion.
Staphysagria. In many cases, particularly where the mind has been dwelling too much on sexual subjects, as an exciting cause.
Thuya oc. In cases where the left ovary is more particularly affected. The sufferings are much increased at every menstrual period, they even become almost intolerable. The pain extends all through the left iliac region, into the groin, and sometimes into the left leg; the pain is sometimes burning. Sometimes the pain is excited by walking or riding, and becomes so severe that she must lie down.
Zincum met. In chronic cases; boring pain in the left ovary, causing her to press on the part continually; but the pain is entirely relieved only during the flow of the menses; and it returns with the same violence at the expiration of the menstrual period.
OVARIAN TUMORS.
Ovarian Tumors. – Enlargements of the ovaries are by no means uncommon; and they may be divided into two general classes: 1. Those which are solid; 3. Those which have cavities more or less large in their interior, – dropsical tumors.
