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.
This treatment always does good for a time. Unfortunately, its results are not often permanent. The old pain and suffering return as soon as the woman ceases to be under medical care. If the inflammatory changes have become well established, no permanent good results from any medical treatment. This is especially true in those cases in which the original causative state of things continues after treatment is given up. If the cirrhotic ovaries are the result of celibacy, medicine can be but palliative.
Working-women are unable to obtain the proper medical treatment, especially when the prospect of cure is doubtful, and therefore, if their suffering incapacitates them, must be subjected to the operation of oöphorectomy.
In any case oöphorectomy should be advised if the suffering persists after carefully tried medical treatment.
Hemorrhage may take place either into an ovarian follicle, in which case it is called follicular hemorrhage; or it may take place into the ovarian stroma; to this condition the term ovarian apoplexy is applied.
Hemorrhage into the follicles is usually small in amount, the distended follicle rarely exceeding the size of a hickory-nut. In case of cystic degeneration of the ovary small blood-filled cysts may be present, formed by the fusion of several follicular cysts. Occasionally the amount of blood in the follicle is enough to cause its rupture. If the follicle should rupture into the peritoneum, a small hematocele would result. If the follicle ruptures into the ovarian stroma, ovarian apoplexy occurs.