Inflammation occurring in the ovary, independently of the puerperal state, is limited to the follicles. The coats of a follicle are occasionally found injected, reddened and softened, and friable; the contents are opaque, flocculent, reddened by an admixture of blood, and not unfrequently purulent. Each of these processes, even in its slightest form, is followed by a destruction of the germ by means of the exudation; obliteration of the follicle soon ensues, and the first impulse is thus given to its conversion into a common serous cyst, which in its turn may grow into ovarian dropsy.

On the other hand, inflammation resulting from childbirth, puerperal inflammation, involves the entire ovary, though probably in the first instance the stroma only; it is this that generally gives rise to the suppuration and abscess of the ovary noticed by ancient and modern observers. It not only varies much in intensity, but, like the other puerperal processes, in kind also; this is particularly evidenced by the product and the state of the tissues. According to the manner in which it is complicated with other puerperal affections, it plays the chief, or only a secondary part, as will become apparent from the follow-ing remarks.

The ovary may be swollen to the size of a hen's, duck's, or goose's egg, presenting various discolorations, and being at the same time collapsed and pulpy, its tissue distended by a dirty yellowish-brown, brownish-green, chocolate-colored fluid, or converted into a fetid pulp; this is putrescence of the ovary.

Or the ovary may present a pale greenish, or yellowish, or reddish gelatinous viscid product, which is deposited in the stroma in large quantities; the latter being at the same time friable or semi-fluid, the follicles tumid, their coats swollen, and their contents opaque and floccu-lent. The ovary is at the same time enlarged and tense, as in the former case.

Again, the deposit may be serous (of a pale yellow or reddish color) or fibrinous (of a yellowish-white color), and fusible; filling the tissues, and causing the follicles to present an opaque appearance. The tissue of the ovary and the coats of the follicles are congested and more or less reddened, and both are softened and friable.

Again, the congested stroma of a moderately tumefied ovary may be infiltrated with a flocculent serosity, which is rendered opaque by plastic exudation.

In all these cases the parenchyma of the ovary is more or less ecchy-mosed; its sheath presents exudations of various kinds, under which differently-colored, spotted, or striated suffusions are found; the tissue at the same time being softened, and extremely friable.

These are the chief varieties and degrees of puerperal inflammation of the ovaries; they enter into complications with other puerperal processes, and especially with endometritis and peritonitis, and give rise to the same products; they differ, however, in intensity, and the inflammation of the ovary may either be the predominating disease, or, as is commonly the case, the subordinate or partial symptom of an extensive exudative process of the uterine or tubal mucous membrane, of the tissue of the uterus, or the adjoining accumulations of cellular tissue or of the peritoneum.

We have, lastly, to allude to the condition presented by the ovaries in puerperal exudative disease, when they are not themselves involved in the latter process; like the other tissues in the vicinity of the seat of disease, they are infiltrated with serum, softened, flabby, pale, and friable.

Exudative processes either affect one, or, more frequently, both ovaries at the same time, though generally not in the same degree. They may run a very rapid course, sometimes even assuming such violence as to induce a spontaneous rupture of the ovary; they prove fatal by the intensity of the general disease; or by the exudative processes with which they are complicated; or they may terminate, after a slower progress, in suppuration (phthisis) of the ovary. In the case of recovery, sterility is entailed upon the affected ovary, in consequence of destruction of the germs and obliteration of the follicles.

Suppuration either commences at separate points which gradually coalesce, or it is set up equally throughout. The parenchyma of the ovary is by degrees consumed, and the organ converted into a purulent cyst, which sometimes attains a very considerable size.

The abscess itself is sometimes borne for a long time without marked symptoms, and nature does her utmost to prevent a free discharge of it into the peritoneal cavity; for adhesions are formed between the ovary and the adjoining viscera, either in consequence of peritonitis having been combined with the inflammation of the ovary, or from circumscribed inflammations of the peritoneum having been set up in the course of the ovarian disease. Thus the ovary may become agglutinated to the broad ligaments, to the pelvic parietes, the uterus, the bladder, or the rectum and the sigmoid flexure, to the caecum and the vermiform process and the small intestine; and it is generally attached to several of these viscera at the same time. When at last the suppurative process has eaten away the fibro-serous investment of the ovary, and caused its rupture, the discharge follows, from a yielding of the adhesions, into a circumscribed cavity; new partial inflammatory attacks of the peritoneum ensue, or the pus meets with an organ which presents firm attachments. In the former case, the circumscribed processes not unfrequently pass into universal peritonitis, or this is induced by an extravasation of the pus through the relaxed adhesions. Again, in either of these cases, the suppuration may extend to the adjoining viscera, and the contents of the abscess be discharged outwards, indirectly through a circumscribed peritoneal sac, or directly in the hypogastric or umbilical regions; or into a portion of the intestine, into the bladder or vagina. Suppuration occasionally takes place in the pelvic cellular tissue investing the iliac muscle; such abscesses pass through the femoral ring or through the ischiatic notch, and accordingly make their appearance on the thigh or the nates. They may thus discharge themselves at a considerable distance from the original nidus.