Page:Clinical Lectures on the Diseases of Women.djvu/46



diseases to which I am to devote most of this lecture are very difficult of precise investigation. They are seldom fatal, and consequently seldom illustrated in the post-mortem theatre. For these reasons progress in this department of gynæcology has been very slow.

Ovaritis, like several of the diseases that I have been lecturing on in this room, occurs as a complication of pyaemia; and such ovaritis I do not consider now at all. A case of this sort occurred in "Martha," and I just mention it to give you an example of kinds of ovaritis that I am not considering at present. A woman was delivered with great difficulty on account of placenta prævia, complicated with slight contraction of the pelvic brim. After delivery she suffered from putrid intoxication or sapræmia. She was in this condition brought to the hospital. The putrefaction was arrested by intra-uterine lotion. She then showed symptoms of pyæmia, and died. Two pelvic collections of pus were found—one (perimetric) in a cavity bounded by the left ovary, the uterus, and above by a piece of omentum: this contained half an ounce of pus; the surface of the ovary was ulcerated where it formed the wall of the pus-sac; the ovary itself was enlarged, and corpora lutea in it contained pus. The other collection of pus was in the cellular tissue (parametric), to the right of and a little behind the cervix uteri, and contained the same