Volume 1

Diseases of women : a clinical guide to their diagnosis and treatment / by George Ernest Herman.

  • Herman G. Ernest (George Ernest), 1849-1914.
Date:
1902
Catalogue details

Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: Diseases of women : a clinical guide to their diagnosis and treatment / by George Ernest Herman. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    rare, and as some of the observations were made very long ago, it is possible that there may be error. Symptoms.—Hernial ovaries often give no trouble. In congenital hernise symptoms may begin at puberty. There may be pain, radiating from the hernia, increased by lying on the opposite side, increased also by biraanually pressing the uterus away from the hernia, so that the ovarian ligament is dragged on. In some cases the ovary has been observed to swell and become more painful and more tender during menstruation; but in others there has been no change. In the latter case, it is probable that the hernial ovary, like an undescended testis, is imperfectly developed. If an inguinal swelling is stated to become larger during menstruation, this does not prove it to be an ovary, for this statement has been made by women whose hernise only contained bowel. When ovarian hernia is bilateral, sterility is the rule ; but not all patients with ovarian hernia are sterile. A hernial ovary may become incarcerated, like a hernia of bowel. It may become the subject of cystic disease or of cancer. The hernial sac may contain the ovary and nothing else, or it may contain also bowel or omentum, or both. The ovary may be adherent to bowel or omentum ; in which case, if the hernia be an acquired one, it is reasonable to think that the adhesion has pulled the ovary down into the hernia. Generally the uterus is pulled into an oblique position in the pelvis, and in rare cases one corner of the uterus has been contained in the hernia. Diagnosis.—An ovarian hernia differs from one con- taining bowel in being more solid and firm, and not gurgling. It differs from an enlargement of inguinal glands in having a neck passing up the inguinal canal; by passive movement of the uterus it may be possible to demonstrate that this neck is connected with the uterus. I know not how to distinguish between an ovary in a hernial sac and a piece of omentum of about the same size and shape, unless the ovary should plainly swell and become tender with each menstruation. Cases have been recorded * in which an inguinal swelling, thought to be an ovary, turned out, on * See Chambers, “ Obst. Trans.,’’ vol. xxi.