If one tube is infected from the uterus many gynecologists are inclined to remove both tubes. When a single tube is affected the cause is seldom the gonococcus, but some other bacteria which are not persistent. When both tubes are affected the cause is commonly the gonococcus, and attempts at preservation then fail, as a rule. Norris, who is a reliable authority, holds that "the only cases in which a salpingostomy is justifiable is on old, non-active hydrosalpinges, and in those cases of tubal occlusion or phimosis resulting from extratubal inflammation, such as sometimes result from appendicitis or ectopic pregnancies."[179] When a tube is shut, if it can be opened the opening tends to close again. A few cases of subsequent pregnancy have occurred after salpingostomy, but such a result is exceptional, because the origin is usually the gonococcus, which destroys tissue and is very persistent.
[179] _Gonorrhea in Women_, p. 285. Philadelphia, 1913.
The ovary corresponds to the testicle, and the Fallopian tube to the vas deferens. Removal of the ovaries, or removal or closure of the Fallopian tubes, renders the woman sterile, but removal of the ovaries has other profound effects beside sterility. Loss of the ovaries brings on suppression of ovulation, menstruation, pregnancy, and ovarian internal secretion, various neuroses, and a tendency to insanity in certain cases.
The testicles and prostate gland produce an internal secretion containing spermin, and the ovaries a similar nitrogenous base called ovarin, which acts like spermin. The suprarenal glands secrete epinephrin; the thyroid gland and the pituitary body also make internal secretions, and these secretions sustain the tone of the blood-vessels and effect immunity against those toxins that arise from metabolic waste substances while these are in the body before elimination. If there is a hypersecretion from one or more of these glands, the excess causes congestion of the cerebrum and cerebellum and of the nerve centres there, and one effect may then be a sexual erethism that leads to masturbation and similar deordination.
Castration in the male or ovariotomy in the female stops all production of spermin and ovarin. In man the prostate gland also ceases its function after castration, and vasectomy lessens the production of spermin. In castration or spaying, again, when we remove the power of producing spermin or ovarin, that function of the testes and ovaries whereby the body is immunized against poisoning by its own effete material is also inhibited, and evil effects arise from this waste material. These toxins act just as would an excess of spermin or ovarin--they congest the cranial nerve centres, excite fever, neuroses, or temporary sexual erethism. This excitement may gradually subside as equilibrium is restored and neutralization effected, through a compensatory overproduction of the internal secretions by the other glands remaining in the body. Cimoroni[180] found after ovariotomy an increase in size of the pituitary body with dilatation of the blood-vessels. Goldstein[181] reported a case of gigantism from overactivity of the pituitary gland after castration. Acromegaly in cases where there was no castration has been accompanied by atrophy of testicles and ovaries. Cecca[182] found like effects in the thyroid, and several have observed these effects in the adrenals. All these results have also been produced experimentally on animals.