The Hahnemannian monthly . Posterior Surface of the Left Ovary. condition is not fully understood. As the result ot septic orgonorrhceal infection it is perhaps plainer. But if having thestarting-point as I have indicated, it is comprehensible thatthe advent of puberty and the increased congestion and the as-sociated discharges from the uterus and cervical canal formeda means whereby was furnished a column along which infec-tion could have reached these glands and the endometrium. There existed pronounced endometritis. This may havefor years been the cause of the pain. The soft and readily in-
The Hahnemannian monthly . Posterior Surface of the Left Ovary. condition is not fully understood. As the result ot septic orgonorrhceal infection it is perhaps plainer. But if having thestarting-point as I have indicated, it is comprehensible thatthe advent of puberty and the increased congestion and the as-sociated discharges from the uterus and cervical canal formeda means whereby was furnished a column along which infec-tion could have reached these glands and the endometrium. There existed pronounced endometritis. This may havefor years been the cause of the pain. The soft and readily in- 1900.] A Case of Dysmenorrh<i. 371 filtrated tissues at the internal os may have been the immediatecause. The imperfectly performed function of the uterus doubt-less affected the Fallopian tubes and the ovaries. In the Fallo-pian tubes some form of infection took place, no doubt fromthe endometrium, for, as above stated, the fimbriated extremitiesof both tubes were found occluded, and the tubes themselves. Section Through Long Axis of Left Ovary. in a condition of hydro-salpinx and chronic endo-salpingitis,the tissue changes of which have been referred to. The hydro-salpinx I regard as not very ancient, since the fimbriated ex-tremities were not very securely closed. By some of the various means by which inflammation isstarted in the ovary, it existed there. The evidences of chronic 372 The Hahnemannian Monthly. [June, oophoritis are everywhere present. They show in the thick-ened tunica albuginea, in the inflammatory infiltration of thecortex, in the destruction of the graafian follicles, and in thecystic degeneration of about four which remain, as is seen inthe cut surface of the left ovary in the photograph. In addi-tion to these, there yet existed the corpus luteum cysts or endo-theliomata which form such a prominent feature of the surfaceof the larger ovary. Throughout the ovaries, both in theparenchyma and in the medullary zone, are found endarteritisobliterans and ar
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