The ovaries may be prolapsed, the left much oftener than the right.
When prolapsed, it drops backward, downward and inward.
Ovarian congestion, tumor, retroverted or retroflexed uterus, tubal
disease, and pregnancy are among the principal causes. Back of these
congestions, tumors and uterine displacements, are the osteopathic
causes, particularly spinal and rib lesions from the ninth dorsal
downward. Specific lesions at the ninth and tenth dorsals and
corresponding ribs, affecting directly ovarian tissues, and lumbar and
innominate lesions and abdominal prolapse disturbing uterine and tubal
tissues, are the most frequent osteopathic causes. A retroverted or
retroflexed uterus is often found. Uterine displacements bear down upon
the ovary and cause its descent, and also disturb ovarian circulation.
As has been stated, the left ovary is more apt to be displaced than
the right. This is owing to the absence of a valve in the ovarian vein
on the left side, and also, this vein opens at a right angle into the
renal vein; this anatomical feature easily leads to passive congestion
of the ovary, and thus to diseases of the organ. Then the rectum is
on the left side and large fecal masses are apt to crowd against the
ovary, which tends to its displacement.
Thus it is readily seen that osteopathic treatment is very applicable
to ovarian displacement unless the indications are surgical. A more
or less constant burning or sharp pain in the ovarian region, with
probably some feeling of weight, profuse and painful menstruation,
depression, irritability, etc., are =diagnostic=. However, a local
examination will reveal the status of the ovarian position and
congestion.
The same =treatment= as in other organ prolapse is indicated: toning
weakened tissues, relieving congestions, replacing organ, with careful
attention to the bowels and the general health. There are no tissue
disorders of any part of the body wherein osteopathy is more thoroughly
indicated and the results more generally satisfactory than in prolapse.
And especially should it be remembered that in prolapse of various
organs many vague intestinal and pelvic disorders and even ureteral and
bladder disturbances may be traced to bowel dislocations and excessive
kidney mobility in which osteopathic measures are often successful.
=Conclusion.=—The purpose of this section on Prolapsed Organs has been
to supplement the various articles on Dilatation of the Stomach,
Movable Kidney, etc., with an outline that may include relaxation of
a part or of the whole of the abdominal viscera. The physician is all
too prone to simply note the most offending or conspicuously disturbed
organ instead of carefully analyzing all the features, great and
trivial, that may be either apparent or marked. A general relaxation
of the abdominal and pelvic organs may be found, and a nearly complete
restoration take place under treatment, but still a lacerated perineum
may have to be repaired before a cure is completed. Or it may be in
a general abdominal ptosis that a floating kidney will resist all
measures for restoration, short of surgery, and before much improvement
can be obtained the kidney will have to be stitched into place. An
enlarged liver may crowd the kidney out of place or a transverse colon
may prolapse and drag on contiguous tissues and still the annoying
symptoms be referred elsewhere. Then the primal point of general
relaxation may not be in one organ, but there may be a simultaneous
displacement of several.
The thorax itself may be distorted from various diseases so that the
chest is narrowed, the diaphragm displaced with consequent descension
of the abdominal organs, and from the latter a displacement of the
pelvic.
“Far down displacement, marked changes of form, and real
disfigurements of the stomach are found in some cases of kyphosis and
scolio-kyphosis.”[46] The osteopath will not only find this true in
some cases, but in many cases, although he recognizes as causative
factors injuries to the spine causing curvatures and postural defects
as prolific sources of abdominal relaxation.
“Glenard’s whole theory of splanchnoptosia is based on the relaxation
of the suspensory ligaments of the intestines, especially that of the
transverse colon; and Stiller, the discoverer of the floating tenth
rib, says that splanchnoptosia is a descent of the atonic stomach, of
the colon (especially the transverse portion), of the kidney (the right
or both kidneys), exceptionally of the liver or the spleen. A descent
which has been developed mostly in tender age, in consequence of
general relaxation, especially of the peritoneal suspensory ligaments
in individuals with congenital general dyspeptic neurasthenia, tender
muscles, lean habit, and slender bone structure, manifested in a higher
degree by a floating tenth rib.” Stiller observed that when there is a
floating tenth rib there is a displaced stomach and a floating kidney,
although it is not found in every case, but never missing if the case
is pronounced. The tenth ribs in these cases have only a ligamentous
fastening and are as freely movable as the eleventh and twelfth.
That abdominal relaxation plays a very important part in many
diseases of the abdominal and pelvic organs, in cardiac and pulmonary
affections, disturbs the circulation in the legs, and is the source
of many reflex affections no one can gainsay. The osteopath should
always pay particular attention to tonic condition of the abdominal
viscera, for relaxation of the suspensory tissues and walls, and atony
and sluggishness of the organs are frequently paramount etiological
factors. And the osteopathic treatment is the remedy par excellence.