§ 238. Oophoritis, Ophorites, inflammation of the ovary.

We distinguish acute and chronic oophoritis.

Acute oophoritis is characterized by the following symptoms: The patient complains of a dull, more or less intense, sometimes rather burning, but more frequently stinging, pain in the groin. If the patient be examined on her back, with the limbs drawn up, a deep-seated swelling, of variable size, is felt through the abdominal wall, directly over the horizontal ramus of the pubes, on one side of the median line of the abdomen. The pain sometimes extends to the adjoining parts, even to the thigh of the affected side, which feels numb and rigid; it is aggravated by the patient suddenly raising herself, and by straining at stool. The swelling is sometimes more distinctly felt by means of an examination per anum. If the swelling be large, the uterus is pushed to one side. There is generally a discharge of serum from the vagina, particularly during the fever paroxysm. The fever is either erethic or synochal, and is accompanied by a variety of nervous symptoms, such as, hysteric symptoms, spreading of the pain towards the stomach, nausea, spitting of water, vomiting, hysteric megrim, claims, which is sometimes attended with convulsions, delirium, which generally bears the character of nymphomania, etc.

Chronic oophoritis is easily confounded with hysteria. The pain is duller, and is only felt at the time of the menses, during an embrace, and after bodily exertions. There is a bearing-down sensation in the pubic region and perineum; at times, metrorrhagia; at others, suppression of the menses, leucorrhea. The swelling is not distinctly perceived at first.

§ 239. Oophoritis rarely occurs on both sides at the same time; generally only on one side, and most frequently on the left. The disease occurs between the age of pubescence and the critical age. It may be occasioned by mechanical causes, rough handling during delivery or an embrace, abortion, onanism, suppression of the menses; or the inflammation may spread to the ovaries from adjoining parts.

Terminations: (1.) Dispersion, after eight days or a fortnight, with abatement of the painful sensations, and restoration of the menses or lochia. (2.) Suppuration, with increase of the throbbing pains, swelling, numbness in the thigh, with frequent recurrence of the chills, and suppurative fever. (3.) Hypertrophy, induration, or some other degeneration. (4.) Death, by extension of the inflammation to the peritoneum, by exudation, etc.

The prognosis depends upon the extent and character of the inflammation, and upon the diseases with which the inflammation happens to be complicated. According to Schoenlein, the prognosis is unfavourable, because the disease generally arises from moral causes which it is difficult for a physician to remove.

§ 240. For the synochal fever a few doses of Aconite are required in the first place, after which the proper specific remedy should be exhibited.

If the disease had been caused by a sedentary life, or the abuse of spirituous drinks, Nux vom. will be found efficacious.

If excessive venery or onanism was the cause of the inflammation, China is the best remedy; those practices should, of course, be discontinued. Other remedies, such as Acidum phosphor, and Staphysagria ought not to be overlooked.

If the pain should get worse during motion, Bryonia will prove most suitable; and if during rest, Rhus tox.

Arsenic is indicated when the pain is relieved by constantly moving the feet. Colocynthis may likewise prove serviceable for this symptom, particularly when the patient complains of boring, tensive pains in the region of the ovary.

If the disease should have been caused by disappointed love, and constant dwelling of the fancy on sexual things, the alternate use of Ignatia, Staphys., and Acidum phosphor., will accomplish a good deal. The best course in regard to the use of those remedies is, to select each according to the symptoms.

Platina is indicated by the following symptoms: Constant titillation in the internal sexual organs, obliging the patient to rub herself, and attended with complete nymphomania; when the characteristic pain in the region of the ovaries is, by pressure, changed to a contusive or bruised pain; when anxiety and oppression, palpitation of the heart, stitches in the fore part of the head, alternate sadness and excessive mirthfulness are present.

Belladonna is related to Platina, except that the nymphomania and the above-mentioned itching are not present.

Ambra, Mercurius, Cantharides, Ignatia, Pulsatilla, and Antim. cr., will likewise be found useful.

If the disease should be complicated with psora, the anti-psorics will have to be resorted to.