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Ovarian Tumors.These tumors, since they do not grow beyond a certain size, do not threaten the existence of the patient's life directly ; yet, on the other hand, they are especially liable to excite inflammation of the surrounding tissues, which may result fatally. So long as they remain of their usual small size, they require no treatment; indeed it is not unusual to find after death such a tumor, whose existence was never suspected during life. The majority of ovarian tumors are the so-called cysts which seem to result from the imperfect performance of menstruation. It will be remembered that the egg is contained in a minute sac, which lies in the substance of the ovary ; and that at the menstrual periods this sac swells, bursts and permits the escape of the egg. Now if this minute sac fails to burst, but continue increasing in size by the addition of a watery liquid, the result is a so-called cyst, that is a membranous sac full of fluid ; such seems to be the origin of ovarian tumors. It is not infrequent to find that the cyst is subdivided into compartments by partitions running through it, that it is indeed a collection of cysts, and not a single sac. The size which these cysts may attain seems to be limited only by the strength and endurance of the patient, since instances are on record in which the sacs have contained over ioo pounds of liquid. The contents are usually clear fluid, containing more or less albuminous material, and sometimes a jelly-like matter. The right ovary is more frequently affected than the left. Causes.-We have no definite information as to the causes of ovarian cysts, that is why these little sacs should fail to rupture, and continue their growth. Certainly it occurs only during a period of ovarian activity, as a rule, since the formation of an ovarian cyst before puberty is a rare occurrence. It is, however, possible even for a child to have a true ovarian cyst. These tumors have been discovered and removed from girls six years of age. These cysts may last a considerable time without causing noticeable symptoms, and even after their presence has been discovered they may grow so slowly as to occasion no serious difficulty for five, ten or even twenty years. Sometimes, indeed, nature effects a spontaneous cure, the fluid is absorbed, and the tumor disappears as quietly as it came. These are, however, the exceptional cases. It may not be expected that such a favorable issue will occur. The usual course is a gradual but uninterrupted increase in size, until the pressure upon surrounding organs occasions serious interference with the functions of life. Sometimes an even less favorable course occurs. The cyst may rupture, discharge its contents into the abdominal cavity, and occasion a serious, even fatal inflammation ; or the wall of the cyst may undergo spontaneous inflammation, resulting in high fever and, perhaps, blood-poisoning. If none of these accidents happen, and if the growth of the tumor is not so rapid as to impair the performance of other functions, no operative interference will be necessary until the usual complications occur. These consist of derangements of the bowels and bladder, dropsy, interference with digestion. Relief from the immediate symptoms can be obtained by tapping the cyst, since the patient obtains a temporary respite by the withdrawal of the fluid. Symptoms.-During the earlier development of the tumor but few symptoms are ordinarily manifested, and even after it has attained the size sufficient to attract attention it becomes difficult to decide definitely upon the nature of the growth. This is especially the case if, as sometimes happens, the menses are suppressed, for if the woman be a wife she naturally suspects pregnancy. Later there may occur some of the ordinary symptoms of pregnancy, due to the pressure upon different organs by the increasing tumor; nausea and vomiting and even unusual sensations in the breasts have been known to accompany the growth of ovarian cysts. So, too, the tumor may occasion the same derangements of the bowels and bladder which result from the presence of the pregnant uterus. On the other hand there are various affections-fibroid tumors of the womb especially--which can be with difficulty distinguished from ovarian tumors even by the physician. It is not our purpose to discuss the various means for distinguishing a tumor of the ovary from the various other enlargements which the abdomen may present ; the matter must be entrusted to the medical adviser in each case. Treatment.-Medicines are utterly unable to effect a cure of this complaint; they may of course be useful in supporting the strength of the patient, and thus enabling her to bear the different surgical measures necessary for her relief. The first and less formidable of these consists in tapping, whereby the greater part of the fluid can be withdrawn ; although this measure is not entirely devoid of danger, it is far safer than the attempt at radical cure by operation. In some cases, too, repeated tappings, as they became necessary after intervals of several months, have been followed by complete relief, the tumor having failed to reappear after the last tapping. This, however, cannot be regularly nor even usually expected ; in the majority of instances tappings accomplish merely temporary relief and the postponement of the operation for cure. In the last decade this operation - technically called ovariotomy - has become so devoid of danger that surgeons now strongly advise against tapping, since the final operation is thereby rendered more complicated and less certain of a good result. As for the operation itself-the removal of the ovaries with the tumor in question - it is unnecessary to say anything except that nowhere has a greater advance in surgical procedures been manifest than in this very operation. By improvements in methods the mortality following the operation has been so reduced that ovariotomy has lost much of the terror that the word formerly inspired. In the latter years the death rate after this operation has been reduced to one case in ten, fifteen or even twenty. But first, if you want to come back to this web site again, just add it to your bookmarks or favorites now! Then you'll find it easy! Also, please consider sharing our helpful website with your online friends.
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