Page:Clinical Lectures on the Diseases of Women.djvu/47

Rh quantity of pus. The walls of the uterus were flabby. The decidua serotina was easily seen. The right ovary was swollen, renitent, as big as a walnut, and when cut into was found to have its healthy tissue everywhere utterly destroyed and converted into a yellow, purulent, almost diffluent mass. There was no lymph in Douglas's space. Bladder and uterus normal; no general peritonitis. Of such ovaritis with suppuration examples are not rare, because puerperal pyæmia is not rare.

Leaving that subject, I come to say a few words on what may be regarded as prefatory to ovaritis—ovarian irritation, often called ovarian neuralgia; a very common affection. It is characterised by absence of every sign of disease, and of every regular symptom, except pain in the region of one or other ovary; curiously, more frequently in the left than in the right ovary. You know that when a disease is characterised by pain, and nothing else, it is called an irritation or a neuralgia; and so it is in the case of the ovary. Although that is the name given to it, you must not suppose that that is the final or true pathology of the disease. I am very doubtful of that. In accordance with the nature of this disease, characterised, as I have said, by a pain in one or other groin over the ovary, it is treated by anti-neuralgic medicines, and a combination of zinc and quinine has had great reputation in cases of this kind.

I go a step further, and now mention to you some cases which are not inflammatory, and yet which are certainly more than merely neuralgic. Of this kind of disease many examples occur. Either one or both ovaries may be felt, and they are slightly enlarged—they are tender, and you may well ask, "Why, then, do you not call that inflammation?" There are the following reasons for this:—That in many cases, as in one which I am just about to read to you, the women are in perfect health—not in all cases, for many practitioners would ascribe the nervous,