A Text-book of Diseases of WomenPenrose, Charles B. (Charles Bingham)
Science
A Text-book of Diseases of Women
Penrose, Charles B. (Charles Bingham)
Women -- Diseases
The reflex disturbances caused by chronic oöphoritis form a very
important part of the woman’s suffering. Loss of appetite, digestive
disturbances, nausea, and vomiting occur. Hysteria, profound mental
depression, and various cerebral derangements take place. Sterility
may be caused by chronic oöphoritis if the ovarian capsule becomes so
thickened that rupture of ovarian follicles cannot take place.
Bimanual examination should be performed with great gentleness. The
condition of the ovary may be most satisfactorily determined in those
cases in which the ovarian lesion is the chief trouble and in which the
tubes and other pelvic structures are not coincidently inflamed. If the
ovary is felt, it is found to be very tender and usually enlarged. In
cases of long-standing interstitial inflammation the ovary may be below
the usual size. Palpation is very easy if the ovary is prolapsed in
Douglas’s pouch.
Chronic oöphoritis rarely recovers spontaneously. The woman may
have periods of relief, but the symptoms may all recur after some
indiscretion or unusual exercise. Suffering usually diminishes, and
may in time cease, after the menopause, when atrophy takes place and
menstrual congestions have stopped.
_Treatment._--Chronic oöphoritis usually requires operative treatment
(salpingo-oöphorectomy), because it is associated with disease of
the tubes. In other cases a great deal may be accomplished without
operation, and the woman may be tided over the period of menstrual life
until permanent relief is secured at the menopause.
This palliative treatment is usually applicable, however, only to those
women who are not dependent for a living upon their own labor. It is
best to begin the treatment by putting the woman to bed for one or two
months; to administer daily massage; to maintain mild purgation with
saline purgatives; to make, once a week, applications of Churchill’s
tincture of iodine to the vaginal vault, followed by the glycerin
tampon; and to give hot-water vaginal injections twice a day.
If there is any disease of the uterus, such as laceration of the cervix
or endometritis, this should be treated first.
After the woman leaves her bed the douches, saline laxatives, and
vaginal applications should be continued. Absolute rest in the
recumbent posture should be prescribed at the menstrual periods, and
at other times if the ovarian pain becomes severe. Coitus should be
forbidden during the treatment. If the woman is unable to begin the
treatment by prolonged rest, the subsequent part of the treatment
advised here may be followed.
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