DROPSY OF THE OVARIA.

THERE is the same difficulty in distinguishing this disease from pregnancy, as in dropsy of the belly, consequently the same errors have occurred. Pregnancy, when it first alters the shape, produces an enlargement immediately over what is termed the pubes, or mount of Venus, the part which nature covers (as she does the head), at puberty; it ascends progressively until it reaches the navel, and then assumes an undefined boundary. In common dropsy of the belly the swelling is general and undefined from the commencement, whereas in ovarian dropsy it is first observed at one or both sides, according as one or both ovaria are diseased. Then (for it is of the utmost importance to attend to the patient's statement of the malady and progressive increase of the swelling) it is usually moveable, when the woman is placed on her back. Where there are several cysts or bags the tumour feels knotty or irregular; this disease commonly occurs in the meridian of life, in married females whose genital organs are irritable; though it has been known to make its attack in childhood, or just before puberty, but far more generally in the unimpregnated or barren; it sometimes happens in pregnant women,

and is also met with where the menstruation is regular as well as where it is defective, or has finally departed. The accumulation of fluid being often considerable. Morland states that he drew off from one patient, in ten months, the enormous quantity of four hundred and twenty-five pints; and in the space of twenty-five years, from the same patient, six thousand six hundred and thirty-one pints by eighty operations.

There is a monument near Dartford, in Kent, erected to the memory of Anne, daughter of John Munford, Esq. of Sutton Place, which informs us that her death was occasioned by a dropsy, for which, in the short space of three years, she was tapped one hundred and fifty times. She died on the 14th of May, in the twenty-third year of her age; doubtless this was a case of ovarian dropsy. The disease often continues for years without much derangement of the general health, yet it is insidious, the constitution after a time gives way, sinking beneath the suffering; and though recoveries have occasionally taken place, the instances are, unfortunately, rare. Internal remedies have seldom proved beneficial, and if exhibited, are such as would be indicated in other dropsies; tapping most certainly affords decided relief, is perfectly safe, and at all times a justifiable operation,

particularly when the patient suffers much from a large accumulation of fluid; so little, however, is the general health interfered with in this disease, that for the first year or two the female occasionally has become pregnant while the dropsy has continued to increase, and yet singular as the fact may appear to unprofessional readers, a safe delivery has been effected and of a living child. The fluid is very variable both in colour and consistence. It may be transparent, limpid, green, yellow, coffee-coloured, or black; in consistence, like boiled starch or arrow-root, gruel, honey, suet, lard, or plaster of Paris.*

Professor Richerand says, speaking of disease of the ovaria, "It has been clearly proved that the embryo may be enclosed within another, or, strange as it may appear, a boy may be with child of his brother, and a girl of her sister, though death generally takes place, in such instances, in early childhood, from the irritation and disorganization produced by the bones of the fœtus in the belly of the living subject." Claudius gives the following extraordinary account:-"A mil

* An operation for the removal of diseased ovaria has lately been introduced by some bold adventurers in surgery; though successful in a few instances, it can scarcely be considered justifiable.

ler's wife was delivered of a girl whose belly seemed of an unusual size. Eight days afterwards, this child was seized with violent pains and restlessness, which induced every one present to believe it could not outlive a few hours; the sick infant, in the meantime, actually brought forth a well-formed female child, about the size of the middle finger; the after-birth and other impurities were regularly discharged, but both died, and were buried early on the following day.

INFLAMMATION OF THE WOMB

Is characterized by fever, heat, tension and swelling in the region of the womb. In most cases it is attended with severe and troublesome vomiting. This affection has been known to arise in natural as well as difficult labours: it may also be induced by cold, taking the woman out of bed too early after delivery, thereby checking the secretion of milk, or the childbed evacuations; it is met with in full robust habits more frequently than in those who are delicate, particularly in such as have indulged freely in food of a rich stimulating nature, and the use of wine and spirits; it never prevails as an epidemic like child-bed fever, for which it has, in some instances, been mis

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taken by ignorant nurses, midwives, and unskilful practitioners. The disease shews itself generally about the third day after delivery, commencing with a feeling of pain about the lower part of the belly, which gradually increases in violence, without any kind of intermission; on examining externally, the womb is found considerably enlarged, hard to the touch, and on making the most gentle pressure, the woman experiences great tenderness and almost unbearable pain; in a short time there is an increase of heat over the entire system, pains in the head and back, extending to the groins, shiverings, thirst and as before remarked, nausea and vomiting; the tongue is white and dry, the secretion of milk diminished, the urine scanty and high-coloured, the pulse full and frequent. Such are the symptons in a mild case of this formidable disease, but in other cases they are so severe as to destroy life in a few hours, unless prompt and very efficient aid be at hand. Frequent shiverings, weakness of the pulse, great debility, delirium, and the sudden cessation of pain denote a fatal termination; on the contrary, a gentle diarrhea, the return of the child-bed discharge and secretion of milk, the womb becoming softer and less painful to the touch, with an