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JAMA. 1916;LXVI(8):569-571. doi:10.1001/jama.1916.02580340025013.
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Hemogenic disease of the ovaries, arising by metastasis from disease of the tonsils or other distant foci of infection, is a condition which is probably far more common than is usually supposed, and may account for some of those cases of peritonitis which, because of their obscure origin, are referred to as idiopathic or primary peritonitis. Slavjanski,1 Pfannenstiel2 and others recognize the occurrence of ovaritis as a sequel of general sepsis, measles, typhoid, cholera and other infections, but the instances recorded are few and the general tendency of gynecologists is to consider ovarian disease as gonorrheal infection ascending from the lower genital tract.

The following considerations suggest that a considerable proportion of diseased ovaries are infected with streptococci rather than with gonococci, that these streptococcus infections are commonly blood-borne from some distant focus, and that certain cases of idiopathic peritonitis are in reality the result of such ovarian


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