I endeavored to point out in the beginning of these articles, that the
difference of inflammatory diseases was not due to any difference in
the inflammatory processes, these are identical, but the modification
of the processes are due to the nature of the structure of the tissues
that are involved.
If the intelligent reader will bear this in mind, she will form a clear
idea of all the inflammatory diseases that come under consideration.
Pathological microscopists have recognized two forms of _ovaritis_,
the follicular or parenchymatous, in which the Graafian follicles
or ovisacs are the seat of the inflammatory process, and the
_interstitial_, in which the intervening or interstitial connective
tissue, the _stroma_, between the follicles is inflamed. This
distinction has only a scientific interest because it is impossible to
distinguish one variety from the other in the living subject; this can
only be done with the aid of a powerful microscope after the suspected
ovary is removed from the body. Whether the inflammation is follicular
or interstitial or both combined, it is liable to destroy all the
follicles or ovisacs which contain the ova, that are essential to
procreation, and the consequence will be sterility.
The great functional activity to which the ovaries are subjected at
each menstrual period, make them extremely liable to an inflammatory
process, so that women cannot be too careful of themselves at this
precarious period. It is during menstruation that the ovaries
become periodically congested, and this alone offers an excellent
predisposition for inflammation. As a complication of other
inflammatory diseases, ovaritis is very common; it seems hardly
probable that there can be an inflammation of a pelvic peritoneal fold
or of the pelvic cellular tissue in close proximity to or surrounded
by it, without involving the corresponding ovary. There cannot be a
serious inflammation of the womb or of the Fallopian tubes without
being communicated to the ovaries, and this is always true of the
infectious catarrhs, especially the gonorrhœal form.
There is a great tendency in inflammation of the ovaries to suppurate
and change the entire tissue of the ovary into an abscess. Ovarian
abscesses are not much different in their behavior from abscesses
in the Fallopian tubes or cellular tissue. It is claimed that they
have a greater tendency to break into the bladder than other pelvic
abscesses; this may be due to a displacement of the ovary, which
locates the gland near or between the bladder and uterus, before the
advent of the inflammation. There are no infallible signs that point
to the existence of acute inflammation of the ovaries, owing to the
complication of other inflammatory processes in the majority of cases.
The characteristic pain of an inflamed ovary is of a throbbing or
pulsating nature.