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Maps, plates, charts, etc., may be filmed at different reduction ratios. Those too large to be endrely included in one exposure are filmed beginning in the upper left hand corner, left to right and top to bottom, as many frames as required. The following diagrams illustrate the method: Les cartes, planches, tebleaux, etc., peuvent Atre fiimds A des taux de reduction diff6rents. Lorsque le document est trop grand pour Atre reproduit en un seul clichA, il est film6 d partir de I'angle supArieur gauche, de gauche d droite, et de haut en bas, en prenant le nombre d'images nAcessaire. Les diagrammes suivants illustrent la m6thode. 1 2 3 1 2 3 4 9 6 \ GI H( A TEXT BOOK OF YETERmARY OBSTETRICS INCLUDINa THE DISEASES AND ACCIDENTS INCIDENTAL TO PREtJNANCY, PARTUKITIOX, AND EARLY AGE IN THK DOMKSTICATED ANIMALS. MUlx ^iDo luubrcl) anb Ulucnty-six Illustrations. BY GEORGE ELE:MrXG, C.li., LL.I). (Glas.), F.R.C.Y.S., Principal Veterinary SuRfiKON ok the British Ae ■, Retikk:)); HONORARY KOREION MEMBER OK THE AOAni^MIK ROYALE DE MEDECINE DE BELGIQUE ; FOREICN CoUnKSPOMlINO MEMBKR OF THE SOVli'.T± ROYAI.E PR MKDECINE rUIiLIQUE DE BEUIKJUE ; FOREIGN ASSOCIATE OF THE SOCII^ITE CENTRAI.R VifeTlfRIN/.lRE DK J1KI)E( INK PE FRANCE ; HONORARY FOKEIrtN MKMHRR OF THE -OCIKTK NATIONAI.E D'AGHICULTURE I)R FRANCK ; HONOUARY I.IKE MEMBER OK THE ROYAL AGRICKLTURAL SOCIETY OK ENGLAND, ETC, ^L o-i. SECOND EDITION, REVISED. LONDON : P. A T L T. I ]>. 11 E . T r N I) A L L A X D C O X 20 k 21. KING WILLIAM STREET, STRAND. TOltOXTO : CAKVETH X- CO. 189G. PREFATORY NOTE TO THE SECOx\D EDITION. In preparing a second edition of this worlc, it „as been subiected to son,e alteration and considerable revision, in order to n.a,. 1 correct and, while introducing „nch new matter, to keep it wHhn reasonable dimensions. The iii.strative cases given in tbe L ed it^ have been almost entirely omitted, and for several reasons, the chie o wh,e was that to retain them and add others that hav since en reported would greatly increase the bulk of the volume, while perh contributing little to its usefulness. " makethisT""'"^''" ^'^'^ *^' ^™^^'""«' >>- "- ^»e to be t : " " '^""'"^ ^"^ ""^'"^"« ^ "' P-^«^ 'he est anthor.t.es on the different subieets included in the work have been consulted and utilised in bringing the information up to date ad r TT "''' '^™ ^''' ■ ^" "■"' ""^ '-' -«'' -tin:: ns.dered as at least e,ual to the best of those which haveappeared on th,s .mportant branch of veterinary science. HtoLsu L«,o„, Co>,BE M,i»™, Nob,,, Dsvok, yovember, 1895. GEOEGE FLEMING. Wi wei the whi civi thoi dev( incii For assi( Slice whi( Thi8 tion, gene It ! reprc poini raise often partu indiv treati how 1 a we. janimr multi] {book of the [Neat I [of tha vere c lays V Ibe sai( [Englai Jappeai Eountr: las un 5een a V^eterir particu Ijjareer ; }esourc PREFACE TO THE FIRST EDITION. When we consider the vast anrl v« i • wealth we possoss, the great skill nS'"'''"^^^'"" '^'"°"°* of animal the perfecting of ihe most iZkl ' oHL""? ''P'"^'^ bestowed on which are daily becoming nio?e essential fl.°'"'''''^*"'^ creatures, crvihzation, it is somewhat rerna kable anr?'' li °"^. Progressive though not altogether inexplicable Thnf^i^^ •''^^^^r discreditable, devoted to the parturition Sanhn^l and t^oth.';" '^' ^^^^ ^^ ^ ^orl' incidental to that period, has yeraCetedl^n ?rT%^"'^ ^^^^^^^^^ For very many years the Ando Sn vmf . '^f J^r^glhh language assiduously and^praisevvorfhir td "w th'fh"' '^'?*^^ it^elf^most success, to the multiplication and full 1! i greatest measure of which more particularly enhance H.lii'^^^T"^"*^ °^ *hose quahties This has entiiled unwearied effort tho"f ^""f ""i^*^ ^^ ^^ese animSs tion. and all the Judgmentld praet cal ^^^^^^^^^^ observa^ generations of men could afford scientific knowledge which -^^oSfr^Z.!;^^^^^^^^^ relating to the pome of view alone, be of grea^rroment nA onlw ' K°"V ^^terialistic raisers, but to the entire comm3'v r ' .7*° breeders and stock- , often is. quickly sustained arn^^^aniiSkV^'' ^^^^^^ partunent period, and this lo?s mav nnf ? "''^ *^^ pregnant or individuals, but make itself gavel/ fdt hUr' ''7 ^'^^°"« *« treatise which might aid, to however small Li . ^!"-'^^ P"'^"^- A how these losses may be averted or IJ 5- /i^° ^^^^''^' '"^ Pointing out a welcome boon to\hosT,ton^eZtl^^ ^"rely.^hen. ^rove animals, as well as to allwho are i^teSf „"i ^''^•"^' ^°^ ^^i^^^g multiplication and welfare At thp ..f ^^"""^ ^^'^ ^^^ "ot-in their book w j,,blished, entmed. -VpraS Tr;-"' "' f^^^ «^«*"ry ^ M '?n^f7' ^^" '^^ i^^xtractioA of the CpK ?7 J'^ °" *^'^ Parturition iNeat Cattle in General." The authm i '^^^ ^^f° °" ^^^^ Diseases of [of that part of the Veterinary Art ''burthafn^'^'^.K^^'"^^' " ^^^f^^Bor jwere certainly in a very crude mea'.np « .^ i^*"^ °*^^' P^^^^ of this art r^" .^^,«\Skellet venturerto' o2ur,on fh ''""'"'"i^ ^^^^^^^^^^ >^ the [be said to be the only attempt whch ZAl '' ' T^- ^"' ^^^ book may [England Papers on ObstetricT son ^.^ .? ""^^.^ ^" ^^'^ ^^^e^tion in ■appeared from time to time n p^r^fes ona in '™ f T'^ value-have ountnes many treatises have Cn '^od 1^'''^^' ' ^"* ^"^'^^ ^" ^^ber has undertaken the task of supplviL' wh«f f ' ""^ °"^ '^ *^^^« '^^"'^try een an urgent want-a texKo ?o7 Oh^?'- ^°' ^^^T ^^^Y years. Veterinary Science. The necP^.iH k Ofstetricy worthy of modern particularly by the Veteilary ^ tioner n Af"^^' ^"^ ^^^" '^'^ ^"r" f areer ; for only too frequently ho has had f \^ «°»"^encement of his esources. and to painfully acii];;rtt^ J^^ ^^S^y^ E y, VUEFACE TO THE FIRST EDITION. knovvledcre of the subject which was either very imperfectly or not at all tSt at the Veterinary Schools, and could not be found o bow hem To deliver one of the larger domesticated annua b ma case of d.l cult parturition requires special «"o^vledge and aptitudes and ever^to^ practitioners who are fortunate in possessi.ig these w b« ^ho hist to confess that to attempt delivery in many cases is really a work of the ^To'fhe members of the Veterinary profession, therefore, no apology can be necessary in ottering for tlieir acceptance the present book. Every endeavour^las been niade to make it a standard work, represen- faUve of the most advanced views relating to this department of Veerinary Medicine. Animated by the desire to present my colleagues in FrSsneakin.' countries with a text-book at least equal to the best of S matw wh ch have been published on the Continent-a hst of wh di is a ne ded-every likely source of information has been made rvailable aml^^^^^ or pains have been spared to rend.jr my onerous and ve 'V dm cult task as complete and as useful as possible. A glance at the references and illustrative cases will testify to the correctness of ^^iVhafoltrn been a matter for regret by the accoucheur of women tha theparturient period of animals was one upon which they could obtin biriitae! if any, information ; and its relations and importance wi h re-a d to t , 3 and the puerperal period in the human species has reauentTbeen nsisted upon. I trust that this cause for regret may be at Ct partially removed and that the text-book may prove of some service trthose medical men who are anxiously striving to advance luSmn obstetricy, and a knowledge of those pathological processes nrmmd which there is still doubt and uncertainty. tt . • My b St thanks are due to Professor Saint-Cyr, of the Lyons Ve en- nary^School, for allowing me to use many of. the drawings v.hich lUus^ trato his excellem. treatise on the same subjec . and to which 1 have of en referred with much advantage. I am also greatly indebted to Mr W A. Cartwright, of Whitchurch. Salop, for his kindness in look- in ^'over the proof-sheets containing the more practical Port^on of Jbe subiect • his long experience and skilful practice, combined with careful rSng'and study, rendered his assistance particularly valuable in this '''in this first attempt to deal with a very serious task, omissions and defects win doubtless be discovered. But in the circumstances in which I was pCd they were unavoidable, and perhaps, after all, they will not Interfere with the utility of the work. Now that certain prmciples fn animal obstetrics have been laid down, and a commencement has bee? nat to ertabTish the practice of the Veterinary Obste rist on a sound sc en iiic basis, it is to be hoped that rapid progress will be made n^-ende in" i more perfect. Humanity is perhaps as deeply concerned n th^direct on as in many others, and it must always be an important object with the Veterinary Surgeon to spare animals pain, and to abridge their sutierings as much as possible. (.eORGE FLEMING, Second Life Guards. Regent's Park Baiuiacks, Novembbi; 1877. CHRONOLOGICAL LIST OP WORKS ON VETERINARY OBSTETRICS PUBLISHED UP TO THE PRESENT TIME. France. liainard. Traito Complet de la Parturition des Femelles des Animaux Domestiques. Paris, 1H45. Snint-Cyr. Traitc^ d'Obst^triquo Veterinaire. Paris 1875 Saint-Cyr and Violet. Second Edition of the above.' Paris, 1888. Geumany. Jorg Anleitung /u einer Rationellen Geburtshiilfo der Landwirthschaft- ichen Thiero. Leipsic 1818. This is ahnost a complete reproduc- concelned ^ ^^''"^*'' ""* ^'"'"^^ '° ^^' ^' '^'^ ^^^^""^ ^''^ ^^%reTb^%''l830^'''^^^''^'' Geburtshiilfe fiir die Haussaugethiere. Crilnthar. Handbuch der Praktischen Veteriniirgeburtshiilfe, nebst einem Anhange uber die Wahl der Zuchtpferde Hanover, 1830 fin ^ Kenntmsse, Erfahrungen und Hulfsleistungen beiden Gebur- ten der Pferde. Glogau, 18oli. ScjiJlcH. Die Geburtshiilfe bei den Kiihen, 1838 ^'^^'^l oZ''^ft^\'f^I' ^"^^°'^ in'iKlichst griindlicher Unterricht iiber fchl^igen. 1838'' '"'''''" Landwirthschaftlichen Hausthiere. i;/6tcrinaria. Milan 1871. Boschctti and Bassi. Trattato di Ostetrica \'oU;rinaria. Turin, IHHO. A translation of rieniiug's Toxt-J3ook, witli additional roniarks by Profossor Bassi. England. Skellet. A Practical Treatise on the Parturition of tlio Cow, or the Ex- traction of the Calf; and also on the Diseases of Neat Cattle in General. London, 1HG7 Flemintj. Text-book of Veterino,ry Obstetrics: including the Diseases and Accidents incidental to Pregnancy, Parturition, and i'^arly Age iu the Domesticated Animals. First edition, London, 1S78 • second edition, 1896. lition, Vionna, TAIfLK OF ILLUSTRATIONS. Goburtshiilfo. (lobuitshiilfo .S78 ; second 10. 11. V2. i;i. 14. Kid. I. IVIvisof tho Mure - . . . •2. I'olvis of the C.w - . . ' ;<. PolviH of tho Hlioop - . . " 4. Latoral LigiiraontH of thoHiicrum and PoIvIh r.. LigamontH of tho Lumbar Vortobric, Sacrum u:)d PelviH, Hoon from below - (I. Longitudinal Hoction of a Maro's Pelvis . 7. Diagram of tho Maro's Pelvic Axis - K. fillet of the Pelvis of the Mare : Wide Pelvis ;>. Inlet of the Pelvis of the Mare : Narrow Pelvis ... Longitudinal Section of the Cow's Pelvis Inlet of the Cow's Polvis : Narrow Pelvis - Inlet of the Cow's Pelvis : Wide Pelvis Hones of Polvis of Mare Bones of Pelvis of Horse - ir). Median Section of tho Pelvis of tho Horse - IC. Median Section of the Polvis of the Mare - 17. The Generative Organs of the Mare in nitu 18. Section of Udder of Cow - 19. Lobule of Mamma) - . . . 20. Section of the Cow's Teat - '21. Generative Organs of the Mare : isolated - 22. Nerves of Maro's Uterus 23. Utricular Gland of a Pregnant Goat 24. Utricular Gland of a Pregnant Cow 2o. Horizontal Section of Uterine Glands 2(i. Uterus, Oviducts, and Ovaria of the Sheep ■ 27. Ovary opened vertically 28. Portion of tho Ovary of a Pig 29. Graafian Vesicle in Mare's Ovary - 30. Ovulum of the Mare 31. Formation of the Ovisac in the Bitch's Ovary '^^ Graafian Vesicle and Ovum liaumeiHter Ibiil. Ihid. Lfiyh /bid. Saint-Cjir Ibid, /bid. lint I litifff 32 33. Escape of Ovum from Ovisac 34. Successive Stages in Formation of Corpus Luteum in Graafian Follicle of Sow - 35. Impregnating Tube .... ■ Ibid. Ibid. Ibid. Ibul Ihid. Ibul. Frani'lc Ibid. Saint -Cyr Frunck Virchiiw Gnlhiiurt Chauveau Franch Ibid. Ibid. Ibid. Oivra Saint- Ci/r Ibid. Franck Ibid. Bixchof Barry Thomson Pouchet Lyford i'Aur. 3 I) 7 8 10 IB 14 • 16 16 17 18 18 20 20 22 22 28 34 35 36 37 42 43 4a 44 46 60 50 50 50 52 53 63 54 67 i X Fia. 3(5. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. 54. 55. 56. 57. 58. 59. 60. 61. 62. 63. 64. TABLE OF ILLUSTRATIONS. 65. 66. 67. 68. 69. 70. 71. 72 73. 74. 75. 7(). Section of Impregnating Tube Dilator of the Cervix Ovum from Oviduct of Rabbit A more advanced Ovum Ovum from Uterine half of Oviduct Ovum fvom Uterine end of Oviduct iilastoderm and Primitive Trace - Ovum Twenty to Twenty-five Days Old - Uvum about a Month Old - Chorion of Mare at Mid- term Footal Membranes of the Cow at Mid-term- * oetal Membranes of the Goat at Full Time Foetus and Fcetal Membranes of Cat Foetus of Mare and its Envelopes - Plan of Fcetal Envelopes in Mare ~ Portion of Chorion with Placentulse : Cow- Accessory Placentu]a3 in a Cow's Uterus - Accessory Placentula> on the Cow's Uterus - Fojtal Portion of Placenta Pr&via - Maternal and Fa3tal Cotyledons of the Cow Cotyledon of a Cow's Uterus Foetal Circulation in a Transition State - i^oetal Circulation : Advanced Period Male Foetus of the Mare Txenito-urinary Organs of a Fcetal Sheep -' i< emale Organs of a Foetal Deer - Female F(etus of the Cow - Genital Organs of a Hermaphrodite Goat - Vertical Section through a Portion of the Uterine Cotyledon of a Cow . The Gravid Uterus of a Multiparous and Uniparous Animal Twin Pregnancy : Cow A Mole . . . " " Hydatid Cypt or Mole : Human - -'ow in the Act of Parturition: Standing Position . . Mare in the Act of Parturition : Rec'umbeni Position Normal Position of the Foetus in the Mare at Parturition : First Stage - Normal Position of the Fcetus in the Mare at Parturition : Second Stage - Normal Position of the Fcetus in the Mare : Iniru Stage Diameters of the Pelvis Lumbo-sacral Posicion . Right Cephalo-ilial Position in the Dorso- lumbar Presentation - Ihuh Ibkl Bischoff Ibid. ' Ibid. Ibid. Saint-Cyr Ibid. Ibid. Colin Ibkl. Ibid. Buffon Ch auveau Saint-Ci/r Gurlt Franch Ibid. Ibid. Colin Pettigrew Saint- Cyr LfOtiii Franck Milller Ibid. Frunck Lcuclcart Franck Thommn Suint-Cyr Zundcl Boivin Original Baumeister Franck Ibid. Saint-Cyr Saint-Cyr Ibid. Franck I'AOE - 67 - 67 - 69 • 69 - 70 - 70 - 71 - 73 - 74 ■ 75 - 76 77 ■ 78 - 79 - 82 - 87 - 88 - 88 - 89 - 90 91 - 104 ■ 106 111 112 114 114 115 129 133 165 178 179 236 237 240 241 243 244 245 246 via, 77, TJBLE OF ILLUSTJiATIOSS. 101 lOU, io;i 104. 10;-). lOG. 107. 108. lOil. 110. 111. 112. 11-5. 114. Ilo 110, 117. 118. ini. 120. 121. Oephalo-aacral Position in the Dorso-lumbar Presentation . . _ _ Cephalo-sacral Position in the Dorso-lumbar Presentation - . . _ Left Cephalo-ilial Position in the Sterro- abdominal Presentation Mammary Gland durin.-j Lactation Completely Deformed Pelvis : Mare Pelvic Exostosis - Fracture of the Pelvis Uterine Hernia : Mare . . ^ Uterine Hernia : Cow • Incomplete Torsion of the Uterus^ - . Multiple Torsion of the Uterus - Diagram of Uterine Torsion Left Uterine Torsion Right Uterine Torsion Right Uterine Torsion : Manipulation - Left Uterine Torsion : Manipulation Left Uterine Torsion hi situ Darreau's Retroversor Barnes' Uterino Dilator - . ', Skull of a Hydrocephalic Calf Skull of a Hydrocephalic Calf Skull of a Hydrocephalic Foal . Calf affected with Hydrocephalus - . Extraordinary Development of the Cranium of a Hydrocephalic Calf Anasarcous Foetal Calf Anasarcous Foetal Calf Deformed Head and Xeck of a Foal Ectromelian Monstrosity : Horse - Ectromelian Monstrosity : Goat - Symelian Monstrosity : Pig Celosomian Monstrosity : Calf - Ectopia Cordis - . Pseudencephalian Monstrosity • Cyclopean Monstrosity : Earn Cyclopean Monstrosity : Ass Acephalian Jfonstrosity - ' Schistocephalus Fissislabrus Camylorrhacchis Contorta - Monomphalian Monstrosity . ^ Skull of Syucephalian Monstrosity '. Monocephalian Monstrosity ■y"-'"Qian Monstrosity Monosomian Monstrosity : Calf - Polymelian Monstrosity : Calf Double Parasitic Monstrosity : Covv 78. 79. 80. 81. 82. 83. 84. 85. 8(5. 87. 88. 89. 90. 91. 92. !);}. 94. 95. 9(5. 97. 98. 99. 100 Saint- Cijr Ibid. Franc h VircJiow Saint-Ci/r J hid. Ibid. Ihid. Zundel Ihid. Gar It Sdint-Cyv Gtirlt Ibid. Saint- Cyr Ihid. Rossignol Darreau Original Saint- Cyr tiueff—Baunieister Saint- Cyr Riieff — Buuineister Original Franch Ibid. Ibid. Zandel Rueff—Baumeister Ibid. Ibid. Ilering Ibid. Ibid. Gurlt Ibid. Rueff—Baumeister Ibid. Ibid. Franch Rueff—Baumeister Rueff-Baumeister Or'ginal Riipf—Batimeister Zundel XI PAOB - 247 - 248 - 248 - 272 - 290 - 291 - 292 - 298 - 299 - 313 - 314 - 322 - 323 - 323 - 324 - 324 - 327 - 333 - 359 - 382 - 383 - 383 - 384 - 385 - 388 - 388 ■ 392 ■ 402 ■ 402 403 403 404 404 405 405 406 406 407 408 408 109 409 410 410 411 XII KIO. 122. 12;}. 124. 125. TABLE OF ILLUSTRATIONS. 12(;. 127. 128. 120. 1.30. lai. i;}2. 133. 134 135. 13G. 137. 138. 139. 140. 141. 142. 143. 144, 145. 140. 147. 148. 149. Fore-limb crossed Fore-limbs flexed : E.\tending the : One Fore-limb Sysomian Monstrosity Celosomiiir. Monstrosity : Lamb - Twin Foetuses in Different Presentations - Anterior Presentation : Deviation of the Hind-limbs in the Pelvis Anterior Presentation : Hind-limb Devia- tion Anterior Presentation over the Neck - Anterior Presentation at the Knees Anterior Presentation Fore-limb Anterior Presentation completely retained Anterior Presentation: Both Fore-limbs completely retained Anterior Presentation : Downward Devia- tion of the Head . Anterior Presentation : Extreme Down- ward Deviation of the Head - Anterior Presentation : Lateral Deviation of the Head towards the Shoulder Anterior Presentation : Lateral Deviation of the Head towards the Abdomen - Anterior Presentation : Deviation of the Head Upwards and Backwards Anterior Presentation : Deviation of the Head Upwards and Laterally - Lumbo-Sacral Position Hock Presentation : Calf - Diagrams of the Hind-limbs in Hock Pre- sentation Hock Presentation : Hock Corded Thigh and Croup Presentation Thigh and Croup Presentation : Thiah Corded - . . . ° Thigh and Croup Presentation: Bodv Corded - . . . ■_ Transverse Presentation : Right Cephalo- ilial Position— Side View Transverse Presentation : Right Cephalo- ilial Position— Upper View Transverse Presentation : Vertical or Ce- phalo-sacral Position - Sterno-abdominal Presentation, Head and Feet Entr;igcd : Foal - Sterno-abdominal Presentation, Head Re- tained ; Calf Saiut-Cyr Youatt Suiht-Cy}' /bid. Franck Saint-Ci/r Ibid. Fratick Stmit-Ci/r Ibid. Ibid. Ibid. Ibid. Ibid. Ibid. Ibid. Ibid. Franek Ibid. Saint- Cyr Ibid. Ibid. Franek Saint-Cyr Franek Saint- Cyr Franek Saint- Cyr TAOK 417 - 419 - 423 - 430 - 431 - 436 - 437 - 438 - 440 - 441 ■ 444 446 449 450 454 454 456 462 462 406 467 469 470 474 474 477 479 480 Kin. 150 lol. liV2. If)-}. 154. TABLE OF ILLUSTRATION. 155 156, 157. 158. 15!). 1(10. ICl. 1G2. 163, 1G4. 165. 166, 167, 168. 161). 170. 171. 172. 17;5. 174. 175 176. 177 178, 179. 180. 181. 182. 18;5. 184. 185. 186. 187. 188. 18D. 190. 191. 192. 193. 194. Solid Repeller, with a Removable Spike - . himple-joiDted Repeller . . Jointed Repeller : Open - Jointed Repeller : Closed - . Traction Cord and Band, and the Manner of Applying them Schaack's Traction Cord - Binz's Simple Head-collar - ! Rueff's Head-collar, No. 1 - Rueff's Head-Collar, No. 2 - Binz's Forceps-band Schaack's Forceps-halter - Manner of Placing Schaack's Halter Schaack's Halter Placed on a Calf's Head - Halter with a Single Traction Cord Halter with Two Traction Cords - Defays' Wire-e.xtractor with the Torsion Rods Defays' Wire Extractor Applied - Breulet's Tube and Noose - Breulefs Noose Fixed on the Foetus Cartwright'a Porto-cord - Darreau's Porte-cord Giinther's Curved Porte-cord and Blunt Crotchet . Darreau's Curved Porte -cord . Darreau's Repeller ..." . Binz's Porte-cord - . . " Short Blunt Crotchet Blunt Finger Crotchet Short Sharp Crotchet, with Broad or Flanged Point - Short Sharp Crotchet, with Round Point - Long Blunt Crotchet Long Pointed Crotchet Long Pointed Crotchet, Darreau's Pattern Long Pointed Crotchet, Darreau's Pattern bchaack's Crotchet - Simple Short Crotchet-forceps Long Simple Crotchet- forceps Giinther's Long Crotchet-forceps - Jointed Crotchet-forceps - Nelson's Blunt Crotchet-forceps - Nelson's Serrated Crotchet-forceps Talhch's Short Bent Crotchet-forceps Andre'd Crotch Bitch Forceps "Weber's Forceps Defays' Forceps het-forceps J.ui.\ii. xiii Original Ibid. Rabiard Ibid. PAOK - 489 - 489 - 489 ■ 489 Baumeister - - 500 Saint-Cyr - 500 Baumeister - Rueff Ibid. Baumeister — Ri Saint- Cyr Ibid. Ibid. Detroye Ibid. - 502 - 502 - 502 leff ■ 503 - 504 - 504 - 505 - 506 - 606 ■ - 507 - - 508 - - 508 ■ - 508 - - 509 ^ - 509 - - 509 - - 509 - - 510 - - 511 - - 511 " - 611 - - 512 - - 512 ■ - 513 - - 513 - - 513 - - 513 - - 516 - - 518 - - 518 - - 519 - - 519 - - 519 - - 619 - - 52U - - 620 - - 622 - - 522 - - 522 ''iv TABLE OF ILLUSTRATIONS. ] 95. Diagram of the Pelvic Axis Saint-Cyr PAOB - 524 196. Obstetric Pulleys .... Hid. - 528 197. Baron's Obstetric Machine - Ibid. - 530 198. Straight Einbryotom Original - 535 199. Curved Embryotom - - 536 200. Gunther's Embryotom : Improved Pattern . - 536 201. Colin's Scalpel Embryotom . - 536 202. Unsworth's Spring Embryotom - - 536 203. Gunther's Long-handled Embryotom - - 637 204. Cartwright's Subcutaneous Spatula . - 637 205. Carsten Harm's Spatula - - - 537 206. Ungef rohrn's Spatula . - 538 207. Cartwright's Bone-chisel - - - 538 208. Cartwright's Bone-saw ... . - 538 209. Swedish Chain.8aw - - . . . - 538 210. Pad Pessary .... Saint-Cyr - - 588 211., Ring Pessary .... Ibid. - 589 212. Cup and Ball Pessary Ibid. - 589 213. Zundel's Labial Sutures Zundel - 593 214. The Loop of Delwart's Truss Franch - 593 215. Delwart's Truss Applied - Saint-Cyr - 594 216. Renault's Truss - . - - Ibid. - 595 217. Leather Truss .... Franch - 596 218. Lund's Truss Iron .... . - 597 219. Lund's Truss Applied Saint-Cyr - 598 220. Parturient Apoplexy : Cow Arniatage - 638 221. Teat-syphon .... Original - 891 222. Ring Teat-syphon - - - . m - 691 223. Liithi's Perforating Sound ... , - (".99 224. Armatage's Truss Applied for Umbilical Hernia - - - . . Arniatage - 708 225. Umbilical Clam .... Ibid. - 712 226. Armatage's ii. . Umbilical Clam - Ibid. - 712 TABLE OF CONTENTS. Prefatory Note to Second Edition - Prepack to First Edition - List of Works on Veterinary Oustetrics Introduction PAET FIRST. EUTOKIA, OR TOKOLOGY. BOOK I.— OBSTETEICAL ANATOMY - CHAPTER I.— THE PELVIS - Section I.— Bones of the Pelvis 1. Os Innominatum Ilium Ischium Pubis 2. Sacrum 3. Coccyx DifPerences in the Bones of the Pelvis of the Mare Cow Sheep and Goat Bitch and Cat Pig Section II.— Articulations of the Pi 1. Sacro-lumbar Articulation 2, 3, Sacro-iliac Articulations 4. Ischio-pubic Symphysis - 5. Sacro-coccygeal Articulations Differences in the Pelvic Articulation than the Mare - Coio Sheep and Goat Bitch and Cat Sacro-sciatic Ligament Section IIL— The Pelvis and its Cavity Mare - . . External Surface Internal Surface PAOE iii V vii xxxi other Animals than .VIS of other Animal 1 1 2 2 3 4 4 5 6 6 6 7 7 8 8 8 9 9 9 10 10 11 11 11 12 12 12 13 I XVI TABLE OF CONTENTS. Anterior Opening or Inlet Posterior Opening or Outlet Differences in other Animals than the Mare Cow - - . . Sheep and Goat Pig .... Bitch and Cat Differences in the Pelvis according to Sex Section IV.— Capacijy of thk Pklvis, ok Pkiai METRY CHAPTEE II.— FEMALE GENERATIVE ORGANS Section I.— External Organs of Generation The Vulva Differences in other Animals than the Mare Cow - - - . Sheep - - . . Pig .... Bitch and Cat Section II. — The Mamm^ Differences in other Animals than the Mare Cow - . . . Sheep and Goat Pig . Bitch .... CHAPTER III.-INTERNAL ORGANS OF GENERATION Section I.— The Vagina Differences in other Animals than the Mare Coto, Sheep, and Goat Pig .... Bite?: and Cat Section II.— The Uterus Differences in other Animals than the Mare Coio .... Sheep and Goat - - . Pig .... Bitch and Cat - Development Section III.— Faij.opian Tubes, or Oviducts Differences in other Animals than the Mare Coio, Sheep, and Goat Pig - - . . Bitch - - . . Section IV.— The Ovaries - Differences in other Animals than the Mare Cow, Sheep, and, Goat Pig - - - . ■ Bitch and Cat Development PAOB U 16 17 17 19 19 19 19 21 27 27 27 30 30 31 31 31 32 34 34 35 36 36 30 36 38 38 38 39 39 42 42 46 46 46 46 47 48 48 48 48 48 51 51 51 51 51 TABLE OF CONTENTS. BOOK ir.-OIiSTETPJCAL PHYSIOLOGY EEPKODUCTIOK . CHAPTER I.-GENERATION Section I.— Puherty SECTION IL-CESTKUM OR MENSTRUATION SECTION ni.-M.TUR.TK,N O. THE Gra.kUX VeSXC.S CHAPTER II.-FECUNDATJON CHAPTER III.-STERILITY CHAPTER IV.-CHANGES IN THE OVUM SKCT,ONl..-DKV..:u>,.MENTOKTIIKEMi.UVO ' cCJ'7^'""^^':-- — ^<-- Differences in other Animals than the Mare Ruminants Pig ■ . ." ■ Bitch and Cat Amnion - Liquor Amuii Pig - . ; ■ -Bitch and Cat . Allantois, - Differences in other Animals than the Mare nuniimints Pig - . ; • Bitch and Cat Umbilical Vesicle - Differences in other Animals than the Mare Jiuniiiumtnand Ph) The Placenta Differences in other Animals than the Mare Shec}) and Goat - Pig - . " ' Bitch and Cat . Functions - Umbilical Cord Differences in other Animals than the Ma.e Ruminants . Pig - . ; ■ Bitch and Cat The Organs of Sense The Skin and its Appendages - IheLocomotory Apparatus - XVII rAiJB 55 55 57 57 5'J 63 64 65 68 71 76 75 77 77 78 78 79 80 81 81 81 81 81 84 84 84 84 84 85 85 85 86 86 1)2 !)2 92 93 9.-} 94 94 95 9a 96 97 98 100 101 11 xviil TABLE OF CONTENTS. The Circulatory System The Respiratory Apparatus • The Digestive Apparatus The Genito-urinary Organs - Section IV.— Periods oi' Development Section V.— Physiological Phenomena in the Nervous Functions Absorption Nutrition - Circulation Secretion - Section VI.— Weight and Dimensions oi^ the BlllTll FcETUS FtETUS at CHAPTER v.— PREGNANCY - Section I. — MoniiacATioNs i.v thi: Uterus durinc Pregnancy Volume Structure - Sensibility Form Situation - Direction . - - - - Influence on and Alterations in the Position of Neighboui ing Organs - - ■ ■ Section II.— Position of the Fietus in the Uterus Section III.— Signs of Pregnancy Rational Signs Material Signs Sensible Signs Section IV. — Duration of Pregnancy Mare . - - ■ Coio - - - Sheep and Goat Pig - - - Bit(-h - - - Cat - - - Section V. — Uni parous, Gemelliparous, and Mult PAROUS PREtiNANCY Mare Cow Sheep Goat Free- Mar tins Diagnosis of Multiple Pregnancy Position of the Foetuses in Multiple Pregnancy CHAPTER VI.— HYGIENE OF PREGNANT ANIMALS i'AOK 104 107 108 110 115 118 119 120 121 122 124 126 127 128 128 128 131 132 134 134 135 137 138 1.38 140 143 148 149 151 152 153 153 153 153 154 155 l.")8 IGO IGl 163 1G4 166 IE F(ETU3 F(ETUS AT DURINfi Neighbour Uterus lnd Mui/r NIMALS rAOK 104 107 108 110 115 118 119 120 121 122 124 125 127 128 128 128 131 132 134 134 135 137 138 138 140 143 148 149 151 152 153 153 153 153 154 155 158 160 161 163 164 166 PREG Pkeunancy TABLE OF CONTENTS. BOOK III.-PATHOLOGY OF PEEGNANCY CHAPTER I.— ANOMALIES IN PREGNANCY Section I. — Supkrfo-itation - Section II.— Extrauterine Preonancy Symptoms, Course, and Terminations • Diagnosis and Treatment Section III.— Spurious or Pseudo-pbeonancy Moles • . . . Uterine Cysts - . . ' Hydrops Uteri or Hydrometra CHAPTER II.- DISEASES INCIDENTAL TO NANCY Section I. — Influence of PuEciNANCY on Ordinary Diseases Section II.— Diseases incidental to Pica Rickets and Osteomalacia Constipatiou Vomiting - Colic (Edema Hydraranios or Hydrops Aranii Symptoms Diagnosis Results - - . Etiology Treatment Paraplegia Treatment Cramp Eclampsia - Cerebral Congestion Hysteria - Amaurosis Cough Albuminuria Mammitis Red Colostrum CHAPTER III.— ACCIDENTS OF PREG Ante-partum Prolapsus of the Vagina Treatment Hernia of the Uterus (Hysterocele) Ante-partum Rupture of the Uterus Causes - Symptoms Treatment Metrorrhagia ANCY six PAUK 169 1(59 109 173 17(5 177 178 178 180 180 181 181 182 183 183 184 184 184 184 185 186 185 186 186 186 187 188 188 189 189 189 190 190 190 190 190 191 191 192 193 194 196 196 196 197 m r XK TABLE OF CONTENTS. 1 Abnormal Retention of the Fcetus Symptoms and Terminations Causes - Treatment Abortion ■ Sporadic Abortion Causes Symptoms Besults Pathological Anatomy Diagnosis Treatment Epizoiitic, Enzootic, or Infectious Abortion Causes Symptoms - ■ * " Pathological Anatomy - - " Treatment LOOK IV.— NORMAL PARTURITION - CHAPTER L_PHYSIOLOGY OF PARTURITION Section I.— Causes of Pakturition • Section II.— The Exi'Ellinu Powers - Section III.— Skins and Course of Parturition CHAPTER II.-PRESENTATIONS OF THE FCETUS MECHANISM OF PARTURITION - Section I.— Presentations • Section II.- -Positions Section III.— Mechanism of Parturition Mare • ■ ' ' ' Cow Other Animals - • " " CHAPTER III.-NECESSARY AID IN NORMAL TURITION - • - • Skction I.— Attention to the Mother Section II.— Attention to the Offspring CHAPTER IV.— SEQUELS OF PARTURITION - Section I.— Functional Modifications Section II,— Organic Modifications - PAOB 198 199 202 202 204 205 205 201) 211 211 212 214 210 217 222 223 224 227 227 . 228 . 229 232 AND PAR- 239 241 242 250 251 254 255 255 256 265 268 268 275 PART SECOND. DYSTOKIA. 279 General Considerations - - • " ' BOOK I.— MATERNAL DYSTOKIA - - - 289 "chapter I.-DYSTOKIA by PELVIC CONSTRICTION 289 Complete Deformity of the Pelvis - - "290 Exostoses - - - ■ 291 PAOK 198 199 202 202 204 205 2or. 209 211 211 212 214 21G 217 222 223 224 227 227 228 229 232 239 241 242 250 251 254 255 255 256 265 268 268 275 . 279 . 289 )TION 289 - 290 - 291 TABLE OF CONTENTS. Fractures - Tumours in the Pelvic Cavity Indications for Surgical Treatment ! Hernia of the Uterus-Hysterocele . Ongm and Symptoms in Uniparous Animals Pa'thoT Tf ''"'' ^" ^^"'^'P--- Animals Pathological Anatomy . Diagnosis Indications Deviation of the Utorua Diagnosis Complications Indications Torsion of the Uterus : Conto'rsio Uteri History Nature and Frequency Etiology Symptoms Diagnosis Prognosis Pathological Anatomy Treatment Torsion of the Uterus in the Mare Causes - Symptoms Prognosis ai^.l Treatment - Tcision of the Uterus in other Animals 1. Utero- vaginal Tumours - Diagnosis - . * ' Treatment - * " Tumours - . ' . L'pomatous Fibroid and Myomatous Tumonrs - Thrombi or Hasmatomata Serous Cysts - " ' " Treatment - . " " Tumours ia the vicinity of the Genital Orga'ns 2. Rigidity of the Cervix Uteri Symptoms - . ' ■ Diagnosis . . ' ' xxl PAOI 291 298 294 297 297 298 300 300 301 303 306 307 308 808 309 309 312 316 318 321 32G 326 328 840 341 341 342 848 344 344 346 346 347 348 348 349 350 351 352 353 364 354 356 '"^ir nil TABLE OF CONTENTS. Prognosit Troutraent 3. Induration of the Cervix Uteri Symptoms Diagnosis PrognoBis Pathological Anatomy - Treatment - 4. Complete Oblitt'ration of the Oh TItcri Causes Hym])tom» ... llesults Diagnosis Treatment CHAPTER JV. — OTHER CAUSES OF MATERNAL DYSTOKIA 1. Anomalies in the Placenta Schirrous Chorion 2. Morbid Adhesion between the Fajtus and Uterus 3. Stricture or Occlusion of the Uterus by External Bands or Membranes . - - . - 4. Persistent Hymen ..... Treatment ..... 5. Vaginal and Vulvar Constriction, or Atresia Treatment . . , . . BOOK II.— FCETAL DYSTOKIA GROUP I.-OBSTACLES INDEPENDENT OF PRESENTA- TIONS AND POSITIONS CHAPTER I.— VARIOUS CAUSES The Umbilical Cord as an Obstacle Diagnosis Indications Excess in Volume of the Foetus Causes - - - Diagnosis Prognosis Indications Excess in Growth of Hair .Anomalies in, and Diseases of, the Foetal Memlnunes Indications .... Ai^ac lis '! Qiiartity of Placental Fluid - CHAP'i CU I.- lUSEASES OF THE FG3TUS Hv'.^.rocophalus .... Pathoiogical Anatomy Diagnosis .... Indications .... Ascites, Anasarca, and Hydrothorax 356 356 361 362 363 863 364 364 365 365 366 36t; 36i; 366 367 367 367 368 369 369 370 370 371 372 372 373 373 374 374 374 375 •r;7 378 379 379 380 381 381 381 381 3«2 386 38G ;{87 'RESENTA- bsence of TABLE OF CONTEXTS. OauHe Diagnosis IndicatioriH EmphyHorua IndicationH Polyaarcia Indiontions Contractions Indications T'linours Indications Death - CHAPTER III. -MONSTROSITIES Classification CJ-.VSS I.— SiMl'I.E MoNSTKOSITIRS Order I.-Simplo Monstrosities through Parts . * Orde^ a-Sin,ple MonstrL-ities th;ough S.n'a„ness oi Order Ill.-Simple Monstrosities ihrough Abnormal Division of the Body . ^onormai """^ N,7-~i^"''' Monstrosities thro'ugh Absence of the JNatural Division of Parts " "i me Order V- Simple Monstrosities through Fusion oi^ Coahtion of Organs ^-usion or Order VIII.-Her.,iuphiodites Order I.-Tngeminal Monstrosities - Order II.-Monstors with Two Heads m V'.''""'"^ Monstrosities, with t"he Trunk Wholly or Partially Double . VZ^'^uT'"''' "f ^ ''"^'« ^^-^' ^»' the Order V Mon r l™"'" "' '"'^ Completely Double - rdei V.-Monstro8,ties w.th a Single Head and Trunk and more than Four Limbs ' Order Vr.-Mon.trosities with the Head, Tr'unk and Limbs more or less Completely Doubi; . ' Ougin of MoustroHities, and the La.s of Teratolo^v " frequency of Monstrosities . ' ^^'^^'^'og^ " Distorted Monstrosities . . " ' Cyclopean Monstrosity . ' ' Pseudencephalian Monstrositv Double-headed Monstrosities' Celosomian Monstrosities Diagnosis - . ' " fMn 889 890 391 891 391 392 392 393 394 394 394 394 395 306 396 396 397 39: 397 397 398 398 398 398 3!»9 399 399 400 400 411 415 416 416 416 417 418 418 xxiv TABLE OF CONTENTS. Prognos's - . . . . Extraction - - - . . Double and Triple Monstrosities - Diagnosis - . . . . Extraction - . . . . CHAPTER IV.— DYSTOKIA FROM MULTIPARITY Diagnosis - - - . . Extraction - - - . . GROUP II.— DYSTOKIA FROM MALPRESENTATION OR MALPOSITION OF THE FCETUS CHAPTER I. — DYSTOKIA DEPENDING ON THE ANTERIOR PRESENTATION A. — Normal Antekior Prkskntation Suction I. — Dystokia fkom Abnormal Positions Dorso-pubic Position - - - . Dorso-supra-Cotyloidean Positions Section II.— Dystokia due to the Hind-limus Extended Hind-limbs retained by tlieir Sti es - Hind-limbs flexed under the Body pass with it into the Genital Canal - - - . B. — Abnormal Anterior Pkesentatio.v - Section I.— D\.tokia due to the Fore-limus - One or Both Fore-limbs crossed over the Neck - Fore-limbs incomplete!}' extended One or Both Fore-limbs flexed at the Knees One or Both Fore- limbs completely retained - Section II.— Dystokia due to the Head Downward Deviation - - . . Head bent under the Body - - - . Lateral Deviation to the Right or Left • Deviation Upward and Backward Section III.— Dystokia die to the Head and Fore or Hind Limbs - - - . . Head retained, and with it One or Both of the Fore- limbs - - - . . Head or One of the Fore-legs retained, and One or Both of the Hind-legs in the Genital Canal CHAPTER n.-DYSTOKIA IN THE POSTERIOR PRE- SENTATION - - - . . A.— Normal Posterior Presentation - Section L— Dystokia from Abnormal Positions Lumbo-pubic Position - - . . Lumbo-supra-Cotyloidean Positions - Section II.— Dystokia due to the Head or Fore-limhs- Head and Contracted Neck - - . . Fore-limbs - - - . . PAOli 419 419 420 420 421 421 423 424 425 4-26 427 427 427 428 428 428 421) 43.S 433 434 435 436 440 443 444 446 448 4.^)3 455 455 455 456 457 457 457 459 459 4.59 460 it into the (>RE-LIMI)S ■ TABLE OF CONTENTS. B.-AUN<)KSIAL P(>STKR,OR PRESENTATIONS Hock Presentation Thigh and Croup Presentation '""^^IStItTZ^''''^'^ "^.^"^ TRAXSVERSE PRE ^""""'"noN"^' '"'"''' "''''''' '"^ DoRso-LUMiuB Presenta Cephalo-ilial Positions - . . ' Cephalo-sacral Position - . ." " Section II. - Dvstokia from the Sterno-abpominal Presentation - Cephalo-ilial Positions . . ." ' Cephalo-sacral Position ... BOOK Iir.-OBSTETRICAL OPERATIONS 'TpITation/^^™^^^^^ precautions axd 'TnD POSmZs™''^"^"^^ ^^ PRESENTATIONS Retropulsion Rotation . . Version - . _ Extension and Flexion - . " " ''^'^^llV^u^'^^'''^^''^'''''' ^^^^^« FOR THE EX- TRACTION OF THE FCETUS - . Section I.— Cords and Bands Halter, Head-cord, or Head-collar - Section II.-Pass- ok Porte-Cords - Section III.-CEOTCiiETs or Hooks - Section IV.-CRorciiET-FoKCEPs and Forceps - CHAPW:R^^IV_ THE EMPLOYMENT OF FORCE IN Section I.-Direction or Traction - Section II.-DE(iREE or Traction - SEc-noN III. -Means tor deveeoimn,; the Necessary roRCE - Section IV.-Comparison hetween Manual and'mechani- cal Force CHAPTER V. -EMBRYOTOMY - Embryotomy Instruments - Preliminary Arrangements for Emhrvotomy - Craniotomy or Cephalotomy Puncture of the Cranium - . \ Craniotomy Decapitation and Decollation . . ] Amputation of the Limbs - . . Amputation of the Fore-limbs XXV PA(JE ■ 460 462 467 472 473 473 477 478 478 478 483 484 487 487 491 491 493 498 499 oOl 509 511 517 523 524 524 528 531 532 534 540 540 641 542 642 544 545 r — xxvi TABLE OF CONTENTS. Amputation of the Hind-limbs Detruncation or Division of the Body of the Foetus Evisceration . - - - - Thoracic Evisceration - - - - Abdominal Evisceration . - - - CHAPTER VI.— VAGINAL HYSTEIiOTOMY CHAPTER VII.— GASTRO-HYSTEROTOMY OR CJESAR- lAN SECTION . . - - - Indications . . . - Operation . . . - CHAPTER VIII.— SYMPHYSIOTOMY - CHAPTER IX.— ARTIFICIAL PREMATURE BIRTH CHAPTER X.-SUPPLEMENTARY OBSERVATIONS RE- GARDING MOTHER AND PROGENY BOOK IV.— ACCIDENTS AFTER PARTURITION CHAPTER I.— RETENTION OF THE FCETAL ENVE- LOPES . - - . - Symptoms and Terminations Causes . - - - - Treatment . . . . CHAPTER IL— POST PARTUM HEMORRHAGE Symptoms . . - . Treatment . . - - CHAPTER IIL— INVERSION OF THE UTERUS - Syinj)toms . . . . Complications . . - . Prognosis . . . . Causes . . - - - Treatment . . . - Amputation of the Uterus. — Metrotomy CHAPTER IV.— INVERSION OF THE VAGINA - Symptoms . . . . Prognosis . . . ■ Treatment . . . . CHAPTER v.— INVERSION OF THE BLADDER CHAPTER VL — TRAUMATIC LESIONS OF THE GENITAL AND NEIGHBOURING ORGANS I. — Laceration and Rutture op tiik Utekus - Treatment . . - - - Rupture of the Uterus after Parturition II. — Laceration and Ripture of tke Vacmna - Complications of Ruptured Vagina III.— Thrombus of the Vacuna and Vulva IV. — Relaxation oe the Peia'ic Symi'hysis PAOB 547 548 649 550 650 651 664 556 557 561 561 562 564 564 666 566 567 574 575 57G 576 577 679 580 581 583 600 603 606 605 606 608 60it 601) 612 613 613 616 619 619 I C^SAR- TABLE OF CONTENTS. v.— RUPTUKE OF THE Bj.ADDKR VI.— Rupture of the Intestines VII.-RU]'TURE OF THE DiAPIIRAGM - ] VIII.-RUPTURE OP THE ABDOMINAL MuSCLES IX.-RUPTUKE OF THE SaCRO-SCIATIC LiGAMENT X.— Rupture of the Heart BOOK V.-PATHOLOGY OF PARTUEITION - CHAPTER I.-VAGINITIS CHAPTER II.-LEUCORRHCEA Symptoms Terminations Pathological Anatomy Causes - . . _ Prognosis Prophylaxis Treatment ^^'w^vv'^nT^^'"'^^''"^^^'^' ^^* PUERPERAL APO-" PLEXY. -PARTURIENT COLLAPSE Symptoms Duration, Terminations, and Complications - Prognosis Causes - . _ _ Pathological Anatomy Nature ... Diagnosis Prophylaxis Curative Treatment CHAPTER V.-POST PARTUM PARALYSIS . Symptoms Diagnosis P'thology . . _ _ Prognosis Treatment CHAPTER VI.-ECLAMPSIA ... Symptoms Etiology and Pathology . . " Diagnosis Prognosis Treatment CHAPTER VII.— EPTLEPSTA T^TFPw^ ^t^^tt.,. PERALIS . --"^ _'^'^'^^T^^^I^^^- -MANIA PUER- Symptoms Cause - . . Treatment xxvii PAOB G20 620 620 620 621 621 622 822 624 625 ■ 625 ■ 626 • 628 631 634 634 634 636 637 6J0 642 643 646 647 653 653 654 659 650 660 660 660 661 661 662 665 667 667 667 668 668 66!) 66y XXVIU TABLE OF CONTENTS. CHAPTER VIII.— PARTURIENT LAMINITIS Symptoms Causes - - - Treatment CHAPTER IX.— MAMMITIS OR MASTITIS Pathological Congestion of the Mammae Causes Symptoms ... Treatment Inflammation of the MammaB Symj)tom8 Course and Terminations Pathological Anatomy Causes Complications - - - Prognosis - - - Treatment CHAPTER X.— AGALACTIA - CHAPTER XL— INJURIES TO THE TEATS Fissures ... Causes - - - Symptoms Treatment ... Obliteration of the Galactophorus Sinus Symptoms Treatment ... Fistula of the Teat I'AtiE r.70 670 671 672 673 674 674 674 676 676 677 680 685 686 690 690 690 696 697 697 697 ()97 698 698 698 699 700 BOOK VI.— DISEASES AND ABNOKMALITIES OF THE YOUNG ANIMAL - - - - 701 CHAPTER I.— ASPHYXIA OF THE NEW-BORN ANIMAL 701 CHAPTER II.— UMBILICAL HAEMORRHAGE - - 702 Treatment .... 702 CHAPTER IIL— PERSISTENCE OF THE URACHUS - 703 Treatment .... 703 CHAPTER IV.— UMBILICAL HERNIA - - - 704 Causes ..... 705 Pathological Anatomy - - - 705 Symi)tom8 . . . . 706 Prognosis .... 706 Diagnosis .... 707 Treatment ■ - - - 70'^ CHAPTER V.-CEDEMA OF THE UMBILICUS - - 713 Treatment - - - - 714 CHAPTER VI.— INFLAMMATION OF THE UMBILICAL CORD - - - - - - 714 Symptoms - - - - 714 ANIMAL [BTLICAL TABLE OF CONTENTS. Pathological Anatomy Causes - Treatment CHAPTER VII.-ARTHRITIS - Causes - Symptoms Prognosis Pathological Anatomy Treatment CHAPTER VIII.-INDIGESTION Causes - Symptoms Treatment CHAPTER IX.-GASTRO-INTESTINAL CATARRH Symptoms Etiology Pathological Anatomy Prognosis Treatment CHAPTER X.-DYSENTERY OF YOUNG ANIMALS Symptoms Pathological Anatomy Etiology - Diagnosis Prognosis Treatment ''''''™^'~^^™™^ OF MECONIUM.-CONSTL Causes - . . Symptoms - . _ ' Treatment CHAPTER XII.-ECLAMPSIA OF YOUNG ANIMALS Symptoms Treatment ... CHAPTER XIII.-TETANUS AGNORUM Symptoms Etiology ... Pathology Prognosis Treatment CHAPTER XIV.-CYANOSIS ..." ""^^Imf^^^r^^^^^ DRYNESS OF THE KEW.BOEN CHAPTER XVI.-IMPERFORATE ANUS Symptoms Treatment XXIX PAGE - 715 - 715 - 717 - 718 - 719 - 722 - 724 - 724 - 727 - 720 - 729 - 729 • 730 - 730 - 731 - 731 ■ 732 ■ 732 732 733 733 735 736 737 737 737 739 789 739 739 740 740 741 741 741 741 741 741 742 742 743 743 743 741 ■ irj XXX TABLE OF CONTENTS. I'AOK CHAPTER XVII.— IMPERFORATE VULVA AND VAGINA 745 CHAPTER XVIII.— IMPERFORATE PREPUCE - - 746 CHAPTER XIX.— OCCLUSION OF THE EYELIDS - 74G CHAPTERXX.— OCCLUSION OF THE AUDITORY CANAL 747 CHAPTER XXI.-TONGUE-TIE - - - 747 CHAPTER XXIL— CLEFT PALATE - - - 748 ADDENDUM. — Infectious Ahoktio.n - - - 749 INDEX - - ■ - - - 751 I TEXT-BOOK OF VETERINARY OBSTETRICS. INTRODUCTION. The generation and development of animated creatures is correctly described as an " eminently physiological act." and one which is ordin- arily carried out, from beginning to end, as a perfectly natural process and without any extraneous interference being required for its accom- plishment. But, speaking now with regard to the higher orders of viviparous animals, this happy termination of a most important series of phenomena is not always observed; and not infrequently various causes-internal as well as external-may operate unfavourably in a number of ways, and more or less imperil the perfect development or existence of the young creature, or compromise the health or life of the mother. More especially is this danger likely to occur when the period arrives for the expulsion of the foetus from the abdomen of its parent. With the domesticated animals, when these obstacles to development or birth intervene, in order to remove or overcome them, and assist or supplement the natural efforts, recourse must be had to artificial means, and the resources of science and art are accordingly invoked. The term " parturition" (from imrturio, to bring forth) is applied to the act by which the product of conception, when it has reached a certain stage of development, is expelled from the body of the mother ; and this act 13 that which is usually considered to be the most critical in the I existence of the young creature, and to most frequently demand atten- tion in such valuable animals as the Mare, Cow, Sheep, Bitch, etc ^ The parturition of the domesticated animals, and the abnormal con- i ditions which may precede or follow that event, come within the province of Vetermary Science, and form that division of it named " Obstetricy " which has aptly been designated the "Science of Midwifery" when applied to this division of human surgery. Though it is that which has J xxxii introduction: been selected as the title of this work, and though it is also that which is most frequently employed in technical speech by the Veterinarian, yet it is not so correctly applied with respect to animals as it is to mankind ; inasmuch as, according to one derivation, it implies to " stand before " (from obstare, to stand before), whereas, in aiding in the birth of animals, the operator generally stands behind the creature which is in difficulty ; though if the derivation from obstare, which also means to " oppose," "hinder progress," "offer obstruction," be accepted, then the term is quite justifiable and expressive. The term " accouchement," so often used when speaking of the birth of a human being, is not always appro- priate when employed with reference to this event in animal life, as the larger domesticated creatures are more frequently delivered of their young in a standing than a recumbent position. Instead of Obstetricy, the terms "Tokology" (tokos, a birth, from TtKTciv, to brirg forth, and Aoyos, a discourse), " Tokognosia," " Toka- rexeologia," and " Tokarexis " — the practice of Tokology — have been introduced ; but they are not sufficiently familiar to warrant their adop- tion at present, and we have tjaerefore deemed it advisable to retain the better-known word. The term "Obstetrics" is not, as has been already shown, limited to the act of parturition — certainly one of the most important, and yet difficult, of all the animal functions ; for it includes not only rules which should be followed in order to remove or remedy the material obstacles or accidents which may hinder the accomplishment of that act, but likewise embraces everything connected with the health and preservation of the female parent and the young creature while they are in the closest relations with each other before parturition, as well as for some time after their disjunction. It therefore essentially comprehends a mechanical portion, which consists in devising means for surmounting obstacles that may impede the birth of the young animal ; and, scarcely less important, a thorough knowledge of those complex functions and conditions connected with conception, generation, and the parturient state. The Veterinarian, then, to be a successful obstetrician, must possess special and varied information of a highly scientific kind in the domain of anatomy, physiology, hygiene, pathology, surgery, etc., and to this must be added the benefits to be derived from experience ; for, as has been well remarked by Saint-Cyr, in proportion as his intervention is salutary and beneficial when it is intelligent and opportune, so may it be fatal and disastrous when it is irrational, or even inopportune. His knowledge of the subjects above named must be grouped in a certain INTRODUCTION. xxxiii order, so as to form a doctrinal code, and to constitute a perfect science having Its object, its rules, and its means completely defined The science of Veterinary Obstetrics, then, demands a perfect acquain- tance with the anatomy and physiology of the generative organs and the region in which they are situated in the different animals. The study of the organs concerned in generation is essential to acquiring a know- ledge of their several functions, and it is only through understanding these functions that we can appreciate the normal or abnormal course they may pursue, and be prepared to interfere successfully when required And a correct notion of the formation, structure, magnitude, and other features of the region containing these organs-and which has been named the i^c^yzccau%_i3 absolutely necessary if we wish to under- stand the act of parturition in the several animals, and be able to render useful service when delivery of the young creature is hindered by mechanical obstacles. A knowledge of the physiology of these organs and the phenomena pertaining to generation-the formation of the fcetus Its development and external conformation, and its connections with the parent, with gestation and the modifications it produces in the organism-as well as the anomalies, accidents, and diseases which may occur during this period, is required, in addition to an acquaintance with I that of the final act which we have named " parturition." I The four chief functions of the generative system may be enumerated as follows : menstruation or cestrnm, conception, gestation, and parturi- I tion, all of which are intimately related to and dependent upon each other-a failure or defect in one disturbing their relationship, and lead- mg to sterility or irregularity in reproduction. Deviations or anomalies in form or structure of the individual organs upon which these functions rely for their proper performance, will also tend to interfere more or ■less with their accomplishment. Everything connected with this portion of the subject, which termin- lates with natural or spontaneous parturition, has been included under ■the head of Eutokia (from d,, well, and toxos, birth). The difficulties attending parturition, whether they depend upon the aother or the foetus, or upon both, with the means for overcoming Ihem, and the accidents which may complicate difficult parturition borne under the general designation of Dystokia (from Sh,, difficult and roxos, birth). ' This arrangement of the various subjects is necessary in a compre- hensive treatise on Obstetrics, and it is the one which will be followed 1 this manual. The maladies to which the parent is most exposed after parturition. y xxxlv IXTnoDI'l'TlOX. ■ and thoir medical or Hui^'ical truatiiiont, as woU as the condition of the youHK animal after birth and up to the time of weaning, also form u portion of the veterinary ohHtotrist'H Htudy. Such is the plan of the work : and I liavo oidy now to state that the animalH more particularly n'forred to are of the llorso, Ox, Dog, Pig, Slu'op, ar.d Goat species ; tlio other creatures which man has 'lomesti- cated— Buoh as tin. Elephant, (!amel, Bal)hit, and Cat— coming but rarely within the observation of the veterinary pnn itioner. It maybe remarked that pregnaicy and parturition in the domesticated animals dilVer in several important features from these processes in the human species— the dill'erences hein^ mainly due to the dissimilarity in their respective attitudes : the (juadrupedal position of the former, and the horizontal direction of the trunk, giving rise to peculiarities which are not observed in our own species, whose vertical and bipedal char- acteristics entail wide contrasts in this respect. In addition to the knowledge which has been mentioned as necessary for the successful prosecution of Veteriiuiry Obstctricy, other qualifica- tions must be looked upon as essential. The practitioner must be pos- sessed of great tact in nuiiiipulation, a certain an\ount of mechanical skill, much patience, and readiness in device ; and in addition, for the larger animals, address, a fair amount of physical strength, and the advantage which long arms and fingers confer. We need not allude to the immense importance of this branch of Vetei-inary Science from an economical point of view. The ever in- creasing value of nearly all tlie domesticated animals, and the necessity for their multiplication to supply the demands and meet the requirements of a widely-extending and rapidly-progressive civilization, render every- thing connected with their reproduction of great moment and concern ; while to assist creatures in the pangs of protracted or impotent labour, and to prevent or abbreviate sulTering— in all probability to preserve their life— previous to, during, or subsequent to tlie occurrence of this physiological act, is no less a duty than it should be a source of satisfac- tion to the Veterinarian. I* ART FIKST. EUTOKIA, OR TOKOLOGY. Thobi; divisions of Anatomy PiivHroinov ..../i u ... diroctly related to the inZllLsoZ^^^^^^^^ ^»^'°h are mdj>arturitio7,, as well as tl)at art i^^', f ' ^f ff '"» o'.' prenmncy, tries to whieh the dlignation o I TO^^ BOOK r. OBSTETIUCAL ANATOMY. TfiK female organs chiefly concerned in ffonnrnfj^^ a .... either entirely passive, or tnoro or Va^ Sf, and partunt.on are con,po8ed of hard or bony or soft parts Thn " ^^^"'^^•"g "'^ tl'«y are while the second are cmnr osed of f E„ ^ ^'^" constitutes the first, within it, or more ;? 'ess Zctlv ..Hn °'•f"^f"d structures contained the passage wh^h the fc" ts h^^^^ 'S ^^" Pf^^'^ ^I«« f^'-"'^ I external world in the act of pal ''^°"«' "^ °^^^^ '° ^^-'^ ^he diately after birth Oftho'^i^nh^t P'^P"*' "o^^rishment imrae- are inL„aZ ; h^firs^aro the vn vn T"i ' '""'" ^''^ '^''^i'"'""'' ^"^ ^^hers the vagina, uterus, and o'aH^^^^ 'he second are the unimpregnated uterus are conta hied fn the cavvnT^h^'' ?°'^'"" 1 Ithe ovaries, as well as the utflr.ii ,w;»„ the cavity of the pelvis ; and (abdomen *^'"' "^"""^ pregnancy, are lodged in the CHAPTEE I. I The Pelvis, 1 OHSrKTRWA L A SA TOM Y. genito-urinary apparutim, as well uh thu tuniiiuul portiou of the ali- mentary canal. Jt is situated towards the end of the spine, and is sup- ported by the posterior extremities, with which it is connected by joints and muscles. For the hind limbs, as well as for some of the powerful muscles of the trunk, the pelvis constitutes a most important fulcrum or fixed point in various movements. It is one of the two mochanicul elements concerned in the act of parturition, and its form varies more or leas in ditt'orent species ; though its direction is always rectilinear in the domesticated animals, and not incurvated us in woman. SECTION I.-IJONKS OF THK I'KLVIS. The pelvis is composed of three principal bones — the two coxa or ossa innominata, and the sacrum ; and to a certain extent of the coccygeal or tail bones. At an early period of life these bones can bo subdivided, but after a certain time they become consolidated. Each coxal bone, for instance, is at an early stage of intra-uterino existence composed of cartilage only ; subsequently three centres of ossification appear, and these extend until at birth they have coalesced to form three bones, which are united by cartilage. In addition to these centres, two com- plimentary nuclei are present, one of which constitutes what is termed the anterior iliac crest or spine and the ilio-pectineal line or ridge, and the other the ischiatic tuberositij. After birth, the three chief portions of the coxa) are completely ossified, and meet in the acetabulum — where they are closely joined — and at the pubic symphysis, where the coxa of one side meets its fellow of the other. In youth, the different parts of each coxa are very thick, the spongy tissue being abundant, and the compact tissue scanty ; as the animal advances in age, the former diminishes and the latter increases in density and thickness, the two layers closely approaching each other. 1. Os Innominatum. The coxa or os inyiominatum is a pair bone, there being one on each side; it belongs to the trunk, through its concurrence in the formation of the pelvis, and also to the posterior limb, of which it constitutes the first ray or haunch. It is a flat bone, widely expanded at either extremity, rather con- stricted in the middle portion, and curved or twisted in two different directions, its anterior part forming an obtuse angle with the posterior ; so that while its external surface is inferior in the hinder portion, the anterior looks outwards, or even upwards, in front. At its middle portion it offers a wide and deep articular depression surrounded by a high rim — the cotyloid cavity or acetahduvi — in which the corresponding articular head of the femur is lodged and moves. Above this cavity is a marked, roughened thin ridge — the supra-cotyloid crest or ischiatic spine, into which the sacrosciatic ligament is fixed. Below the cotyloid cavity, and inclining inwards, is a large circular or oval aperture, which is occupied by the obturator muscles, and is named the fora??ie7i ovale or stcb-pubic opening or foramen. The two coxae are united inferiorly in the median line, and posteriorly by an artieulation or solid suture — the syviphysis pubis or ischio-jnihic symphysis, and form by this junction a kind of V-shaped figure, the widest portion of which is in front, and renders the lateral diameter of the pelvis more extensive before than behind. Above, they articulate with the sacrum. oi'tioa of the ali- Bpino, and ia sup- •nnected by joints of the poworful )ortant fulcrum or ) two niuclmnical form varies more ayH rectilinear in unian. 3 two coxa or ossa ) of the coccygeal an bo aubdivided, 3ach coxal bone, jnce composed of ition appear, and arm three bones, sentros, two com- !3 what is termed ine or ridge, and ■ee chief portions 3tabulum — where vhere the coxa of different parts of lundant, and the age, the former lickness, the two jing one on each in the formation it constitutes the nity, rather con- in two different th the posterior ; nder portion, the At its middle surrounded by a he corresponding 3ve this cavity is sresf or ischiatic a large circular muscles, and is en. ;, and posteriorly laped figure, the teral diameter of I, they articulate THE PELVIS. V they are separately Tea dbed af di'stincT' Tl^'^^ '"'" T r^'' ^'^ sions are iCum, ischium, and^^i^ '''^ "*'""« °' ^^««« ^i^i- the'i^Si^tJ^^i'^t u tt'£e^?^ tT'^'r^ '^^ "-- 'o l,eing that which Is most elevated ^n lam ifl" T^ ^'- ^"" *« and dat, and ia directed oblioudv dnwnw„?S ■ "''!'S^^''^h triangular it has two faces, three borctrand tZe a^^:;" ^ iackwSda; /ace, or dorsum, ia marked bv some nm«.nh? it^<'xterml or superior its widest part to for,n a t^cave anaco ff^« "npnnts and is curbed in lodges the gluteal umscles The K-« o^l^^^ ""^''^ offers a smooth external , ortion th« vf, /""■ ^*''^' °^' '^^''^'^r, ,>..n.»a the iilae p.oas or'a^^^^l^TlJ^'^^^Z. Fig. 1. Pklvis Of THK Mark. I Thn ^,./.^; '/"''"' ^o'^ articulation with the sacrum ■roughened, and grooved fm-th «;<,=? f IT""^^ *''''^''' ^^ ^^^^^^ and .has three nutrient foramina *^n.' J^f g« o^, bloodvessels ; inferiorly it lespecially in its pSS m J v ." 'T^ ^''■^^''' ^^ *^'" ^"^ concave. fco'cA; iLffords^Uachmen^to the'sLrn ^°"?^*"^^^ ^^^ ^^^«^ ^^fa^ic ■or;./., of the same n .^ pLE^y trg7toir'° '°^"^'^*- ^^^ ^^- tnd backwards to form an aSe wftlS '^^^'^^^^^ «"rving upwards fcposite nium-thesZZitoft^^^^^ corresponding portion of the h angle (concurring inXt^^l^SX SlSlS^tt;;^ Si OBSTETRICAL ANA TOMV. I 11 I 's' and prismatic in shape. Posteriorly, it offers a concave articular sur- face (acetabular), and above this cavity is the sui)ra-cotylcid ridye or crista ilii — an elongated eminence ])assing backwards, sharp at its summit, smooth internally, and roughened externally, which is continu- ous anteriorly w'th the inner border of the bone, divides its iliac and articular surfaces, becomes lost on the anterior margin of the pubis, and laterally limits the anterior circumference or border of ti.e pelvic cavity — the linca ilio-pectinca. The ilium is therefore united to, or in contact with, the sacrum superiorly, and inferiorly and posteriorly with the two bones next to be described. Ischium. — The ischium {os scdentamm of man) is next in size to the ilium, and the mosc posterior of the three bones. In form it is flat and irregularly quadrilateral ; and is composed of a thick solid portion — the body, and a narrow part — the neck. It has tiuo faces, four borders, and four angles. The upper face is smooth and nearly flat, and forms part of the floor of the pelvic cavity. The loioer or external face bears some rugged imprints, particularly towards the symphysis. The anterior border is thick and concave, and posteriorly circumscribes the obturator or oval foramen. The j^ostcrior border is straight and directed obliquely forward and inward, composing, with the corre- sponding border of the opposite bone, a large notch — the jnibic or ischiatic arch. Throughout its extent it exhibits a roughened depressed lip, which projects on the lower face — this is the spine. The external border is thick and concave, affoi'ds attachment to the sacro-sciatic ligament, and forms the small sciatic notch. The internal border joins its homo- logue of the opposite side, to complete the isckio-puhic symphysis. The external or cotyloid angle is the most voluminous, and shows an excavated diarthrodial facet, forming part of the acetabulum, and the posterior extremity of the crista ilii, limited by a small transverse fissure which separates it from the external border of the bone. The antero- internal angle joins the posterior angle of the pubis. The postero- external angle is the most important from an obstetrical point of view, as it constitutes what is commonly named the point of the hip ; with the corresponding bone of the opposite side, it forms the ischiatic tuberosity {tuh''r ischii) — a thick, up-curved prismatic mass which is continued l)y a prominent ridge elongated from before to behind, the th'n margin of which is curved outwards and downwards. Tho distance between the external tuberosities of the two ischii gives ihe width of the ischial arch, and allows an estimate to be formed of tho transverse die meter of tho posterior opening of the pelvis. Tlie postero-internal angle con- stitutes, witli that of the other ischium, the summit of the triangular notch or space named the ' ischial,' or ' pubic arch ' in some species. Pubis. — The pubis (pecten or share-bone) is the smaller of the three, and is situated between the ilium and ischium. It is irregularly triangular, and is described as having tu-o faces, three borders, and three angles. The upper face is concave and smooth, and concurs in forming the : floor of the pelvis. In the pe]\is of inn,nv Mares it has a more or less marked depression, apparently produced at the expense of the anterior portion of tiie bone, which is thin ; v/hile in the Horse it is generally much thicker at this part, and instead of a depression tho surface may be plain or even convex. The loxcer face is rough, and traversed on its articular sur- tylcid ridge or , sharp at its ich is continu- es its iliac and the pubis, and e pelvic cavity h, the sacrum nes next to be in size to the Ti it is flat and d portion — the ir borders, and irt of the floor 1 some rugged ' circumscribes 3 straight and th the corre- ibic or ischiatic depressed lip, external border iatic ligament, ./is its homo- npliysis. and shovi's an ulum, and the nsverse fissure The antero- The postero- nt of view, as it hip ; with the atic tuberosity 3 continued by B th'n margin iance between \ of the ischial i^erse die meter lal angle con- the triangular me species. ■ the three, and irly triangular, ircc angles. in forming the I more or less of the anterior it is generally iG surface may ■aversed on its THE PELF 1 a. 5 whole length by a wide groove which reaches the bottom of the acetabu- lum and odges the pubio-femoral Tigament and a very large vein The antenor border is thin and x^n, and is curved like Ihe arc of a circL . it concurs m forming theTnterior circumference of the pelvis The posertor border IS thick "and concave, and in front circumscrib^es the oval, sub-pubzc, or obturator foMien. It is channelled. neaT the aceta^ mtertiai, ooraer joins that of the opposite pubic bone in the middle line to form the antenor portion of the ischio-pubic or pelvic syrnXsL larS SSn oTth?''"'^"^^^^ It ^^^'hickest.'and co3t s the thracefabu lum Th/°"f ^'^1'^ depressed surface at the bottom of coJvt iCl thLTll'^*''. ^'"°^^^ ^°^™ ^^'^ ^"'' but retains its convex snape, while the part around the acetabulum is of considerable thickness : a circumstance which tends to diminish thepe vLStvt a notable degree. Dm-ing life, the pubic bones gradually loseTeSom^v rr pLl: .rtnstid" ^'" - °^^ -^' '' '- alfno^S^pr^d! concentiattcl , at this part, also, ossification commences. 2. Sacrum. The sacrmu (os basilare of man) may be said to terminate the vertebral spine posteriorly, and results from the fusion of five vertebrr into a single, voluminous, pyramidal or triangular mass It encloses the pelvic cavity above, and articulates in" front with the las lumbar Ihfo S' intm1n:fa' 't f'' °°"^^"^^^ '' ?^^-^°-' ^^ latetll? with ZnhrT.T.T^ ; ^' ^'^' ^''. ''^i'"' ^"^ ^ ^«'^«'- /■«'-'''. tn^o lateral ZniiaicamL "' '^^'■''""^■'/' ^'""""'^ °r posterior extremity, and iihlZhTltZ!^''^^ */'' s^*i^m-s;)i«ous processes or supra-sacral spine (tnough the processes only meet at their base). On each side of this sm^ h Tnd «r . H ^^ ""'^'T °'', *be inferior face. The lower face is tTepeMc c^; f ^7'""'/'°'" ^f °^'" *" behind ; this is the /oof of as w^.ll .^ tf^} and shows traces of its being composed of five bones. The ;; , ;^^ T' ^^>"'"^f°Vl^e passage of the%ub-sacral nerves raJced o 'f / "'' '''■' ''"^'^ ^"^ ^°"«''^^'"' ^"^ posteriorly show a hf o ssa i"nn,.n . 'ir ''}-^Sn^^\ oblique surface for articulation with which slil"'' ' *^1 'I ^'V^'^ "^*° *^« Portions, the lower of ^DDe is f^ >? '"■'""''"l- '•'''^ ^'^^-throdial, is the auricular surface ; the uppei 13 for the insertion of the sacro-sciatic ligament ine Oase or anterior extremity, is articulated by a slichtlv oval and convex surface with the last lumbar vertebra, and fm^n« titlf the U^^^e a Bahent angle looking down towards the abdominal cavity," named the Xrfif fild it'- ^'"""7; '' ''. ""^^^'^ ^" *be two c^;rbetween Tngof tt^piS catt'""°"''^ ''''''■ ^" ^^'°"* '' ^''^-^ *be open- * OBSTETRICAL ANATOMY. spinal craTl^^r'T'^f^''^^'^^/ likewise o^^rs the opening of the passage of the spinal cord In fh1i^. *^v.^ °'^^'' vertebm, for the circultr it is triarSX/«n^' v • • u ^^P^^-.^owever, instead of being Tho „" -l- ^"*°g';ilar, and diminishes in width posteriorlv 3. Coccyx. Fig. 2. Prlvis of the Cow. Differences ,n the Bones oe the Pelvis oe other Anim.,., ttii.;ltsrv:st4rf ""^ --^'^ ^- --'^ •>---«, a„d Cow. Mare. The iwr; tLu„h thtaMr than 'fnT" m''"""! *'"' '» ""' THE PEL VI a. y .narp^^bi,,. The sy^phTsl:™- osSL' rShZ tath Tare"' "^ h composed of the same number of X^hl '"*"'i°"^™'^'- " a.«u,ar surfaces for union w^Llr t^o^rfb^leSr d Je'c' siletrfrn't^rnlVe'r™^^' ="'' "°'= tuberous f. hey are from less volumiLus. w"°hall see hat ft flT'^ ' ' !,'■»' "'".Mgl'ter and direction, and that this has T,!^U^ •«"'"' ^'^^f '" "» '""" »"'' parturition. "'"*'''<' influence m the mechanism of J'ig. 3. PKLVI3 or THB ShEEI'. A, Ilium ; B. Pubin ; C, fschium ; D. Foramen Ovale ; E. Cotyloid Cavity. Sheep and Goat. of 1' Co?'"Ke"iS;.' tsteaTof '^' ^*'= ^^7"^ '"^^'"''^ "-o direction, however, SvrSn^f '"""1."""'=^ » " longitudinal divided into two poAiorbvr,miin' "f^, •^V"'"'""' "'"" '™»'' '» .he whole, is mor? borT.:n'tLV„7,!!n';Trn'tt"h:tow'"'''^ ''*'^' ■"" i?iYc/t and Cat. ILs S ?nr Tole y?f\r T-^''"?™"'^^ P^"^^ "^^^^ iurv br„,dLr.ocn^the .•'"'' f'?"' ''°'^'^'"' °' "''' "'''"""■ "&<=!> U lil.: which is direSd downwal'''''Thf '''' "'''=''°'"*' " " ^"''S''™"* t.il;twards^;X,r t^^^: "SrZ :.i';t,!?ee ttebS * OBSTETRIC A I. ^iNATOMV. foramina. Tho coccygeal bones are strong and tuberous, and the first nve or six are as perfect as the true vertebral bones. "' ■ ' ' ' Pig. The pelvis of th^'Pig rosoniblos that of tlio Sheep. The crest of the T" '^ m'?"^''^' ^^^ '^^°^"° '^^ "° «''t«»'»'il protuberance on the -ympliysia pubis. The pnln>i is narrow; and tho iscldavi, instead of a crest, has a tuberous prominence. The sacrum is formed by four vertebra, which do not become fully consolidated for a long time, and it is sometimes aioicult to discover where tho sacrum (!iids and the coccyx be-'ins The spinous processes are absent ; and tlio neural arch being de7ici(mt on each side, the spinal canal is open aboye. There is nothing particular to note in the cocciKjcal bones. '■■ • , SKCTION II.— ARTICULATIONS OK THK PELVIS. The bones of tlie pelvis are united by articulatiojis aiid ligaments, as well as hbrous bands, whicli are complementary. A knowledge of these IS of some importance to the ol)8tetrist. The articulations are i. Sncral Liga.nont ; c. Lateral Sacro-iliac sS Notch ^*'"^"-'""'**"= I^>g=»"-'»t ; <■■, S».all Sciatic Notch ; ./; (Jroat ^LltuT^''" '■ ^P ^^" >^Yo.hmbar. (2, ;i) the two sucro-iliao, (4) the ?. tw ?"'r '^''•^■' ^"'^. ^")- *'^" ^'^'^ro.coccjjiieal articulations The section! '^'^^■o-^^'^'^f'c hgaments complete the subject of this 1. Sacro-luinbar Aiiicidcliun. The sacro-lumhar articulation is formed between the anterior face or base of the sacrum, and the last lumbar vertebra- the union takes place by hve articular surfaces and thick libro-cartilage anrZierou strong ligaments bind the two bones closely and ve"-y tirn, ly to Xr so as to allow only a very restricted amount of moven.ent be ween^hem It would appear that tl.e^o bono- fi-on-)- « ^ l-- u- 1 "^"^'^^''Wt't'n cuem. on Pflpl, i^^ull,- ,.«f V.' ' '--'"f ■;. fMOU^h so limitud m their movements even fan H^o'.?H T^ ^^."'^'Y ^^'^d in old age nor yet by accident, solidated ' '"' "" *^^' ''S''^" ^^""^'^ '^^W'^^" ^o be con- ous, and tho first ccyx he^'ins. The eiiifi; doficionit on rUK PKLVIS. ^ This arrangement is particularly remarkable in the Mare, on which it oonlers great strength and solidity. It is not present in the Cow con sequ.ntly, that anmral is liable to a kind of incomplete luxation ^S may at tnnes become an obstacle in parturition ^"^auon, wmcli Wo have already alluded to the salient angle formed bv thfi nninn nf tho last Imnbar vertebra with the sacrum {sL^v^rthZlZ^ which looks downward into the abdominal cavity.' ^ ^' 2, 3. Hacro-iiiac Articulations. The sacro-iliac articulation of each side establishes the union of tho postorior imbs with the spine, and is formed by the sacrurra id ossa .1.. ; It belongs to the arthrodial class of joints. The twrsurLes wS conio into apposition have been already describ(>d nn7 if AmI tho ,.-ossuro it ha, to resist being tZl bl',"'' Me twnt "ouX'ie'i the bones at th.s ,,art is strengthened by three powerful bKaments the ZThr"""""';''" ""^ '"'°"°'-' """J '*>« »<"■'■«''•«» y'o»r There is also the sacro-scK,,; or mcm-Mnnlk l,> be noticed l,4atter Sl* ^ZIZZ ;,' uriSr tt"u"ra".'l"7 """f ' '^^ ^^ 4. hcJiio-puhic Symphijsis. pttX3raLl V ? T' T'""'^ '^'^""'""^ "-^^^^^^^^ more 01 less com- m Mito^us bres Lr.°' l" '" '^^""'"^ = '^'"^ ^^ ^ ^^^'^ ^^ ^hite liga- bolow ""he latterbe ^ '^^^ ^^-^ across above a"nd tion are very linii/< d „n^ ? " ' ? " '"ovements of this articula- intoro^ eous^ca Hat'- thev aT" 1 f f>^,"PT^ '^'^ ^^"^^^^^^^ °^ ^^« Tliis hannpn>, in H !" ' • !^ ^/f '^'^ol'^^^^ed when ossiUcation occurs, ti P.Zf. n f '"'N'^^-^ty of liorses before adult age; thou-h some tunes the posterior portion is cartilaginous after this period 5. Sacro-coGcyijeal Articulations. di?o'L'!f '" n '''"'•; '^ Vf ^^^•^'^^^^-^ ^" ««"«^--l. th«^-« bmn. a thick . tI 1 , f ' ^^'"'^ ^'^^''^^ '^^'^^^ ^^■^-'^°"«' *1^« first of which difficult parturition i,. i"t • w ile^ f o n ^^ I " "^"'''' r^""' '' ''^ frequentlya canac of P«lvi8jt offers no ob.,taclTi;rnim;iI '' ^^ ^'^'"l""«»t ''"d distance from the 10 OBSTETRICAL ANATOMY. IS joined to the posterior extremity of the sacrum. Their solidity is further assured by a common fibrous sheath which completely envelops them, but without interfei ing with their mobility. This mobility greatly favours parturition ; but it must be noted that not infrequently the first coccygeal bone is completely ossified with the sacrum, and as this necessarily limits the elevation of the tail, it diminis'hes the supero- inferior diameter of the posterior opening of the pelvis, and may in this way prove an obstacle to the expulsion of the foetus. Differences in the Pelvic Auticulations '"^xt Animals. In all the domesticated animals other than thi .wc species, the sacrum is joined to the last lumbar vertebra by viire,i diarthrodial surfaces only— the head of the body and two transverse processes; these latter on the vertebrte are not in immediate contact with the base of the Fig. 5. LiGAMlCNTS OP THE LuMBAR VeRTSBR.E, SaCRUM AND PkLVIS, SEKN FROM BELOW. a, Intertransverse Ligament of the Lumbar Vertebrae ; b. Capsular L=gament of the bpmous Process of the Fifth and Sixth Lumbar Vertebraj ; c, Capsular Ligament of the Sacrum; d, Inferior Sacroiliac Ligament; e, Obturator L,igament ; /, Transverse Ligament of the Ischio-pubic Symphysis. sacrum, an interosseous ligament uniting them. Therefore it is that m the Cow more particularly, there is greater mobility in the sacro- lumbar_ articulation, and the possibility of a greater increase in the supero-inferior diameter of the pelvis when it is subjected to such eccentric pressure as the passage of the foetus would produce. Cow. ,J\f^^ ^'°^^ *^^ ^■5c/^^•o-;» '^'''^^'^^ "^^^'l"^ downwards and backwards he dfirlf . ""^^T y !f ^''"^ ""."^ °"^y ^" ^'^^'^''^ breeds, but abo in different animals of the same breed and species. In the Mare it is occuS''thf« "rf -'hnf «'" *''/''''h ""' "^ *'" y"""^' '" *he body of the uterus ruight to be , u te eu p ; "^ ^"^'"' ''""«'"^' ''"'^ '^'" ^"""8 P^''^^'^ '^^ body of the uterus THE PELVIS. TY. h compose the d, it remains to its general con- es. This study and for the full ilet and outlet, e uterus, and in t the case with itude, until the } two openings, in capacity in cro-iliac articu- le latter is very urition, as well 3 in its passage the pelvis per- ■equently; this ;ression, which, ubt due to per- he floor of this sly cut into by me diversities, behind, or vice ay a transverse small conical upwards from ag the anterior ed to compare are represents of the trunk, of this conical 5, is anterior : igle, tlie sinus : the cavity is ionvenience of lings. i as consisting r croup is the ickwards, the s, but also in he Mare it is the uterus might tions of prfj,'iiant ody of the uterus J3 indicated by the droop or slope of the croup, which is generally greater than that of the Cow -It is more conspicuous in coiJ^^onTan fn well-bred horses in which the croup is almost horizc'tS and the tai^ nearly on a level with its h ghest point The wirlf h ni ? ' ■ , varies not only with th. hefght aLtlume o7S ali^sTody tt also according to breed-the draught or coarse-brn,! H^fvc! i, ^' wider croup than the thorou"h-bred one S! / • ^"''''."" ^ from before to behind, and shows on the inSdle Z°H " ^^^^'^^^^^^ cesses of the sacrum and the first rnpov/ii u' ^^'^ ^^1°°"^ P^'^ side the.channels into :ti%e'n"li.X^^^^^^^^^ - -^ The inferior region is nearly horizontal nnri ia J' l\^ Formed by the pu4io and ischial bori^fe, '„ tlfei'iddkThs symphysis pubis, on each side the subpub c chann,-!, n„^ n,r t? » foramen and outwardly tlio cotyloid cSes .Trough 1 ct twXu rests on tlie posterior limbs. ^ wxucu ine pelvis Fig. G. Longitudinal Section of a Mark's Pelvis. The lateral regions are more extensive than the others • thev are in formed nartlv ni hnn.r It a '[^ / ^^" already mentioned, is ol"; ortl: 'of' T^T"'''! ":' " "'"' '"'"""''' »i-^-tbe"rno; tC H. J. 1, J Pu''?- ^ 'i-ansverse section of this canal shows or wiciS, and a posterior opening or outlet opining by^he wlT^ce 'oT^lh^J "''"' ^^^""^' '' '''^ 'f '^^' P'^^^^' ^' formed oy me lower face of the sacrum, and is in contact with the rectum 14 UhSTKTnWAL ANA TOMl'. ?o"n Sina^r^'''''' °'"^ sympathetic nervos. It is slightly concave The inferior plane or /loo r of the pelvis, is constituted by the upper surface of the pubic bones and iachia. It is rectilinear from before to behmd and concave from side to side. The symphysis pubis occupies the median lino; it is salient, and varies in length according to the size of the animal, being usually about six or seven inches. In front at the pubis, is a depression more or less marked, in which the pre- viously-emptied bladder can be lodged during the passage of the foetus Un each side is the obturator foramen, which is partly closed by the internal obturator muscles, and through which the obturator vessels and nerves make their exit. The two lateral planes are formed by the inner surface and spine of the ischia, and in great part by the sacro-sciatic ligaments ; the sciatic notches belong to thom, and they are traversed from before to behind ! Fig. 7. DiAGR.'VM OK THK MaRK's PeLVIC AxiM. A, Inlet ; B, Outlet. by the obturator vessels and nerves, and pierced by the gluteal and and small sciatic nerves. As has been stated, it is the compression of these nerves by he uterus and its contents which causes the c amps pregnant animals experience towards the termination of gestatbn The lateral planes are readily dilatable during parturition. ANTEiiioK Opening OK Inlet (Figs. 7, 8, 9).-This opening, which is continuous with tlie abdominal cavity, and may also be designated the brmi anterior circumference, or abdominal opening of the pelvis is nearlv circular, or shghtly oval, the widest part coriesponding to^thrs^ys s pubis. It IS a little obliquely inclined downwards and backwS and IS limited above by the anterior border of the sacrum and itrarticula tions with the lumbar vertebra and ilia ; below, by the anterior border of the pubic bones ; and on each side, by the ileo-pectin.al or..iZdl portion of the inner aspect of the ilia.' Owing to this drcumference being entire y bony, and also to the solidity of the articulat ons^etween annrfSr'. ^°°''' *^' "^'^ °^ '^' P^^^'^ '^^^'' ^e dilated o any appreciable degree under the most violent efforts, even supposing the THK PELVIS. 1& ightly concave saoro-iliac and iBchio-mibio liKainents to become softened and relaxed before pregnancy— a cliango which must bo indeed rare in the Mare It is by the inkt that the fu)tus enters the pelvic cavity and a know lodge of Its dunonsions is therefore of nmch moment to the obstotrist These dimensions are ascertained by taking the diameter of theonenim^ at several pomts, but two diameters are generally recognised • a suvero i>'/erior 'ind a Jm/i5v.;-sc The .M^;cro-/y«nor, or sacro-pubi^ UiaLtc'r (I'lgs. 8, 9, a, 6), rather oblique, 18 the width between the sacro-vertebral angle and the symphysis pubis. This is generally tho largest diameter though exceptions are met with now and again; it is the diameter which should receive the widest part of the fcetus when it enters thn pelvis. It varies with the si/e of tho Mare, but is usually between eight and ten inches. The transverse oi bis-iliac diameter is measured from one ileo-pectineal crest to another, and is generally less than the supero-inferior, though sometimes it may bo equal, or even greater T^ is from seven to nine inches. • ■i-i> I'ig. 8. IHhRT OK THK PkLVIS OV THK MahK : WlI.K PeLVIS. ah, Supero-inferior or Sacro-pubic Diameter; c d, Superior Bis-iliac Diameter i e /Inferior Bis-iliac Diameter; e i, 'V^ Ohli.L Ilio-sacral or Sacro-ihac Diameters ; J K, iMiddle Diameter." ' It may be observed that Franck gives two oblique transverse diameters and bamt-Cyr, in the new edition of his work, follows him, though the two do not agree in their measurements. I do not see much advantage to be gained from the adoption of these oblique diameters, which render the measurements more complicated, especially in view of the fact that the pelvis varies in form— the transverse diameter not unfrequentlv exceeding that of the vertical ; but, following Saint-Cyr's example I give them here, as in some respects they may be useful • ' In this measurement there are two transverse, or bis-i'liac diameters a superior and ^nrnferior. The superior (Figs. 8, 9, c, d) is about the upper third of the pelvic cavity, and corresponds to the shoulder and h.p joints Of the fcRfcuB when it is in the dorsa- and lumbosacral positions -the most frequent; while the viferior {e, f) is drawn at the lower ourth of the cavity corresponding to the elbow and stiHe joints of the foetus. The upper diameter is sometimes less than the sacro-pubic (us in J^ig. 9) ; but more frequently it is equal, or even superior to it The 1« OHSTKTRWAL ANATOMY. I I (Fi«8 H 9 /t Vm n«„„ fi 'Z^'"' '/.'"-r"^' '^' °'* ^"''^■o-*^'"^- diameter, \il \ *^'f *'/«)' pass from tlm articultttions, the names of whioh ,y hoar through the iniddlo of the inlot. to the ilio-pecUnearcrrs on 1 X^ It 8»^«-JU8t about tho centre of the cotyloid cavUv Their ulth^v „'*'''? *^"' °^ '^'' sacro-pubicand Buperio^r bis-iliac Imotor outline (ings.H 12),a8 then the faitus may pas8 through tho cavitv with .ts dorso-Rternal dianieter corresponding to one of thorn • wlX n 3 > oval pdvcs It rotates slightly in its progress, its larger Lkiroorresno^ mg more or less with that of tho in^et^that is. to ^U drodTnrfn PoHTEKiOB Opening on Outlft (V\tt 7 n^ 'pu;„ • i named ti.^..,., c/.«4-^:iJ;fei;-^;;^,w';:^4° s;z in Its contour tho rectum and vagina, and is related to th^ vulva and Tni,ET op THK I'KLVIS OF THK MaKE Narrow Pklvis. a h SuptTo-inferior or Sacro-pubic Diameter ; c. d, Sunerior Bis iliar fhrM^^'""^ T ^l\^'''^^ 5^ -'■ 0'^'""^ <^° the horizontal direction of the Mare's pelvis, this outlet is limited above by tho apex of the sacru and he base of the coccyx ; below, by the ischial archrformod by tl e junction of tho two ischia ; and. laterally, by the uppe^ surface o^ e ischia and posterior border of tho sacro-s'ciatic ligamTts The opening The diameters are ordinarily much less than those of the inlet-t)Gr haps to tho extent of one-fifth ; but this circumstance has rarelTanv influence in parturition, as the opening is verv dilatable owln't^ the relaxation that takes place in the sacro-sciatic ligaments durnUhe later months of pregnancy, and tho great mobility of the sacrum and coccyx which allows the supero-inferior diameter to be increased consideraMv' It may be noted that the pelvis of the fp^alo \<,^ ^iff v i f r • V from that of the Mare, so f^r as' shap^ is rn e^l^' tf nS' be n^ generally oval from above to below, the sacro-pubic diametei liSv exceedmg the transverse in measurement. "lamecei slightly DiKFRHKNOKS IN OTHER AnjmaLH. Coxo. 17 V-slmpo, the opening being suporo noBtorl ' Kl " these bones is highe?. and thcStirsrZ "n. ''*'""'' ^""'^^^ ^^ thinner and more elevated. Ho tS „ ^h ^T'^'Cotyloid crest ia the Cow'H pelvis are niore xtensive co'iS r\*^' ''T^ P'^"«t«« « Mare's. The sacral surface is mL Zn„ ''^i^^'^'^fe'' ^^an the ligaments longer, tliough narrower ^''^' *"^ *^° sacro-soiatio The pelvic cavity (Fit's U lo\ ^f fu„ ri . . compared with its height. Kiy. 10. r-ON.arumNAL SKcnoN OK -nil.: Cow's Tklvih. oUique than in the Mare -are verv unPnn«l ■ fU a-cc the sacro-pubic and the tranTvl-I! I ""equal , the difiference between tlnrd (nine and six inXs vh 1« •fT''''^'"^ *° Saint-Cyr. being one- not so markedly oval as in^ thj MaVe CTd^'' '' ^',^ ^""^'^ P*^^^' ^"^ or some distance, so that i s s^ro iubio d f T ^''° "'^''^^ P^'^^l'el transverse; the difference vn. Sn? ^ ^ '''"^*'''' '^ S^'^^t^r than its inentsjn favour of tKrstE% TT'^''^^ *^° Saint-Cyr's measure- metres (Fig. 11) ^"^ ^'^^ ^^°'" ^ centnnetres (Fig. 12) to 104 centi- are'mo?::?r,:trnlt^r^^^l;^,-V?,^•^'^^^^ ^ ^ ^^^ ^^-e ; they •■"let. It there oi^resuls that /u f .t^^^ t^'ansverse diameter of the uud less conical thl'ttTof'the ^L^f ^b\f thS ?1 '' '5°" ^y''"'^"-' -"K i.uccr animal, vet this nrlviiifo,,,. .-^ -- t. ulko largei than m of the pelvic cavity, the Late^-P^^^^^^^ counterbalanced by the length marked curvature^of thf sva/nhv^ 1 ^^^ bony walls, and the vfry happens that the I once it has fairly ^^^T^O.^-^^^^^ 2 18 or.STETRIOAL AiYATOMF. I I L i ll longer, and it is not at all infrequent for the Calf to become fixed in the pelvis, there to r3main unless removed by artificial means. It IS also to be noted that the floor of the pelvic cavity is on a much Fig. 11. Inlkt ov thk Cow's Pelvis : Narrow Pelvis. a b, Supero-inferior, or Sacro-pubic Diameter ; c d, Superior Bis-iliac Diftineter ; e. f, Inferior Bis-iliac Diameter ; e i, f h, Obliciuu, Ilio-sacral, or Sacro-iliac Diameters. higher level than that of the abdomen ; consequently, the abdominal muscles are not inserted into the margin of the pubis, as in Solipeds, but more posterior and lower, and have a strong tendon fixed into the l<'ig. 12. Inlkt ok the Cow's Pelvis : Wide Pelvis. a b, Supero-inferior, or Sacro-pubic Diameter ; r d, .Superior Bis-iliap Diameter; e /, Inferior Bis-iliac Diameter; e , /" /^ oEe Ilio tcral or Sacro-iliac Diameters ; J K, Middle Diameter. ^^"'iue, llio nacral, pubic symphysis-the transverse ligament of Ooubaux. Therefort^ it is that a kind of steep step has to be ascended by the Calf before it can enter the pelvic cavity, and this explains why it often remains fixed against this upper level at the inlet. THE PELVIH. 19 S/jcep and Goat. With these animals the pelvis dope, nnf ri;«'„ * except, of course, in si.e-f rZ that of thf r*° ^"^^fotable extent- nearly rectihnear in its direct on and Ln ^^l- ^^" 'Vm^hysis is much later period than in the Cow or Mar. 1^ ^' n" ^'''"^^ ^* ^ ^^ry of the pelvic cavity to be increased d"H- ' . '•' ''"^''' ^^^^ diameters the rarity of diilicilt birtisTn t fe Sheep^rGoat""' '"^ "'''°""*^ ^""^ y/7/i7.v perfectly rectilinear. The we^ic^^W/'r.-."' ""^ "'^'wo-^j^^ic s7/m- to the si.e of the young at birth/herefore fis th7f ^''^'.'" proportion rare during the act of parturition. ^^''''^ '' '^ ^^^^ accidents are very Bitch and Cat. In these creatures thp ■^nr^yn ,-„,.t„i i , . in the Pig, and dinnni'h ^ h^ ntttf tS/? ^"I^ ""''^ ^^^^^ ^^^^n the direction of the symphysis is rpnHHn ^''^V\^'> ^ rotable extent ; the pelvic cavity is neL-lf CTlind rical hof/^^^ the general outline o than above. The ischiiLJh^Tei'J^^^^ ^"^? '^ ^'^ below IS wide and shallow, and r ses Xuntlv M ? ^ ^}'^ obturator foramen, the narrowest part of the "xnauS Lte i rtha't^f '^ ^"^^^ ' '"^^ ^ fa^tus .s obstructed in small females vvhTch W h ''• ^^''^^^ °^ *^« arge dogs. It nmst be reniarked Lwever fh f 1'' V^P^^gn^ted by incomplete, ossification of the svmphvrir nin *^' ^^.*"' ^°^ "^ten dilatation of the canal, and rendeis The^nas.f ^f ^ '"'^^^^ ^"^°'^'^t "f fcctus possible. "^^ passage of a comparatively large . ^ ^"^ ^^^VIS ACCOliDiNG TO Sex. Ihere is a considerable differencp in the .■ male and female pelvis in tS do " ^tf- ''l ^ ' '° ' "'^ expected from the sexual functronsbSrdt...r""? '' /^ ^^^^^^ be the female pelvis being larger in eve" se^s^ S ^^° creatures. Its transverse diameter. These diE,fu "' "'°^^ particularly in studied in the Equine species buSvf- ^^^' ^^^^ ^^^^ ^^refully degree in the pelvis of other species ^ '' '"^ ^ somewhat similar broader and more conca^ve O . he unSrt'f '''' l""u^"^ P^^is being be sacro-sciatic notches are vLydceTthpf'" °l^" ^^^^^'^'^ Pelvis! fo.n>s a very concave line, and tJi^'Sti. ol/""'! "'^f.^^ '^'' "^""^ ibc iluor 01 the pelvis is wide and thp K? " ''■'^^^>' ««Parated. tendency to assume the same horizon al ,!■!• "'^'"P°«'"g it have a Hi 41 ■ 1 .20 OBSTETRICAL ANATOMY. turned outwards and the two portions of the floor of the canal are directed very obhquely downwards and inwards. In the Mare the ischial arch is wider than in the Horse, and forms a regular curve in Fig. 13. Bones of Pelvis op Mare. joining the tuber ischii ; while in the Horse these tuberosities are not nearly so wide apart, and the ischial arch forms a somewhat acute angle, the margin of which is nearly straight. The obturator foramina Fig. 14. Bones of Pelvis of Horse. are also large and almost circular in the Mare, while they are small and oval in the Horse ; the iscliio-pubic symphysis is farther f™om the cotyloid cavities m the former than in the latter The sacrum is also broader and longer in the Mare, and in the THE PELVIC. ' of the canal are In the Mare the a regular curve in 21 berosities are not somewhat acute iturator foramina \ Y are small and ^•ther from the ^ e, and in the majority of animals It 18 more concave from before to hAliin^ rpi, . , coccygeal vertebra are larger and more flexible Inf.? •^\ The first elevation than in the HorsI flexible, and carried at a greater tol^e^T^Selit^^^^^^^ ^-e is adapted to appe^ar lo^er in theTorehand than the^'^^^^^^^^ -^"^^1 not so high. It is rare to find a Mare whirhZcfif ^ *^^ ''^''"P '^ JeLlfnrc"bIea'\°rt'h'tut1hev\.*''" ^",1 '^= ^orse are when the adult period has been reached Cdtf»T5"l "'°" "'PP"™' definitive form. In both sexes Hp .,,„„f- , ? ^"/^ ^'"' ""quired its is greater than the transverse in early hie ™' *™"'''^ °' *" '"'"=' the''rre't7^*stiS-Er„ltrea'irr;hrfo°L'''^ "^'^'^ --"^ '- of two animals about the same in siLe: "owing measurements Vertical Diameters. Maie Horse Between the Sacrum and Pubis. 9 inches. Between the Sacrum and Ischium. 6^*^ inches. 6 A „ Horizontal Diameters Between the Between the I ectineal Ridges. Ischial Spines. 9^^ inches. 8 74 inches. 64 „ ^* SECTION IV.-CAPACITY OF THE PELVIS, OR PELVIMETRY that these must vary STheSlinf ^^^^ and it will be inferred pelvic dimensbns— half an \noh r.,.^wu "i^Ke much difference in in the Mare or Cow if vve comnL?.« « ^ 'T'-lf *^1 variations. But human species a4 fhA f«moil ' i^ -"pOiLau. to che accoucheur oi the or defectfve n its propSSs^ tVI'' particu arly liable to be deformed the veterinary obsteEt?.' il 1"°^ °^^'^^ °^ '° '""'^ ^^^^^^t *o experienees n^ ^^r^rn^^L^^.^^^iS":^,^'^^ 22 OBSTETRICAL ANATOMY. I oulties, to sacrifice the toZraktt?: ""^ "Po™'^'-. when in dil! value of the mother *" "■*" «"\«- " i"feri„r apart from other causes the chi/f ^ K ^/""■''' '" ""«"' ""limals is. human female, it is the ead of th fJ^tT\^ Pirtlrition, In the vorous fostus is not nearly so deeii Lm„„, ,• ' ""'"' °' ">i Carni. adapted to pass through Cneal^IyrcE c™'' " " """'"'^ "^"^^ BetltrcStirsri?r;:ir:«^^ we may compare the capacitx of th«ri/' ^I 'T^^''''' practically, lumbar articulation Tothe sLl n ' ht " '"T'P}^^>i<^' ^^°"^ ^^e sacro! passing hotween the most conn. "^ symphysis; (2) a trmm-rrse oblique, from the Uio pectineaMrni^"^'"" °'.^'^^ '^'^' ^"^ (3- 4) two articulation of the other^ '"' °^ °°' ^'^« *" t^e sacro-lumblr THE PELVIS. Chauveau, in his measurements of the Horse's nplvio „; .u measurements for the inUt (mean vertical 81 inl' ^T^ ^^^^ ^"""^ inches; oblique, BJ inches); but for the awt/ .^ iu*'*'''^^"'^' ^\ transverse (mean vlrtical. 6* inches tr«n„v n^^ ?^ vertical anl for the inlet, gives three diameters H /a l^'!'^' 7 •°'^;'>- ^^'^^rd. lumbar articulation to the anterior birier S'ltrnuh^" *'^ r^^' (2) a /ranst;er.c, from the inner surface of the co S'^ i symphysis; to the same point on the opposite S VS o ^ • ,^°^^^ °° °"« side of the sacrum to the ischio-?5b ^ symphys^i inTet ' ^"^^^ *^^ T^^^^ to the sacro-coccygeal articuktion nhe^s^aUer Rn7f ^.?™^^'' ^'^^ has only two diameters : (1) a ^crM froT/hl" ^ ^°^ *^^ ^^'^^'^^ ^^ ischio-pubic symphysis peUndicutri^'rrhe 3^^^^^^^ f the t.n, the coccyx; (2) a ......... frL one^sXartuI;Sit7^°X the'sar^r^VnTtrrscht^^^^^^^^ ^^StJj L'^l'T^ ^'^ *^^ ^^^^^^ °^ the sacro-coccygeal articuCon S fscW^bL «?'\""^?""?^' ""^ smaller creatures. For it must be rPmS!^^ lu ^^^Physis in the domesticated animals offers a very iSnTdlTanp'^'^' ^f^"?^ °^ *^« the position of the human pelvis we draw t^t,r^''\ '\V^^T^ it in symphysis towai^s the spine^t wilT be found th«f'°f^•^^^"'?°^ *^« touch the sacro-lumbar articulation but the m^^^^^^^ ^^"^ <^^^« ^°t large, and the sacro-coccygeal articulation in A u ^^9'''''^ '° the point is the narrowest tSough wS^thrfltL'T^'^^^^^'^^- '^^^ which it will meet most resistance for whni?^ . ^^' .*? P^'^' ^^*^ i» towards the sacrum, its chesttfesting Tn the^'puS ^0%^^'^'^ '' pX^n^* ^'^^ ^^ -^"^ *^^ ^-^ -'^ -sista^nt^to b'e° ottlT^n^ Considering the variations in size in some species it i«nnf«. -ui . give general measurements for all • but we Zt f.li^ \u P^^^ible to Eainard, and give avera^P dinmlfovoT ^?«. ^ . °^ the example of are tabulated as follows^' tt^Srcol°um^ T''*/^''^'^^"^^^^- ^hese the length of the floor^? the pelvis. ' '^^'^ Symphysis,' gives I 24 OBSTETRICAL ANATOMY Measures. 15 hands 14 hands 12 hands Supero-inferior 94 in. Vertical 9| in. Transverse 9| to 9^ in. OnTLKT. Diumetors. Measures Vertical Transverse ^T^in. 7i in. 9 to 9i in. Supero-inferior 9| to 9i in. Vertical SrV in. " Transverse 8 ,V to 9 in. Medium Cow Sheep size Supero-inferior 8/^ to S^^, in. Vertical 7/^ in. Transverse 7| to 7^% in. Vertical Transverse j 6 to 6J- in. 6tV to 7 in. Supero-inferior 7,% in. Vertical b^m. Transverse 4^^ jn. Vertical 4,'Vto4,Vin. Transverse 5^\ to 5i in. 8A in. Medium size Ordinary size Goat Medium size Pig Supero-inferior 8,", in. Vertical 7 ..^ {„. Iransverse 7|i^ in. Supero-inferior 4 ('n in. Vertical 2^*^ in. Transverse 3 ,V in. Vertical Transverse 4A in. 3VV, in. 7iV to 7i in. ' 3ft in. Vertical Transverse 7A in. 7J in. 4/5 in. Vertical Transverse •'ij in. (varies) '■^A in. Dog Large 27i in. Length from snout to tail, 54| in. Supero-inferior 4.^ in. Vertical 2,^ in. Transverse 3^ in. 2 in. Supero-inferior 4 in. Vertical 3ft in. iransverse 3,*!^ in. Cat Small Supero-inferior 2^5^ in. Vertical 2 in. Transverse 2 in. Supero-inferior 2 in. Vertical \«^ jn. Transverse 1ft to 1,^ in Ordinary size Supero-inferior 2,[ in. Vertical 2 in. Transy^j^e , lift ,n. Some veterinarians, however, as already stated wlio Lave ..iadp fV,;c subject an almost special study, only specify two di^npfpr« ft! ^nferhr or sacro-pubic, and the tJislerTo^Us^^f T^^^^ are the measurements furnished by four of these authoritie^? ^^"^'''"^ THE PELVIS. MARE. 25 Diameters. Bauraeister anil Bueff. Carsten- IlarniH. 1 Arloing. 1 1 Salnt- Cyr. Kemarks. 1 Inlet. Supero-inferior Diameter Transverse Diameter Outlet. Supero-inferior Diameter Transverse Diameter Inchon. 9 to 10 11 to 1'2A 9 to 10 9 Baumeistcr and 1 Keuff. Inches. 7k COW. 1 Inches. i 9 9^ 7 7i I Inches. 8,3* 8iVt *The average of 28 mea- surements of Mares varying from 13^ to 161 hands in height, tTheaverageof 2.5mea- surements as above. Diameter-^. i 4 '■ .» Ciirsten- Hurnis. Arlolng. Saint- Cyy_ Honiarks. Inlet. Supero-inferior Diameter Transverse .jiameter Outlet. Supero-inferior Diameter Transverse Diameter Inches. 9 to 9i n to 7.3 9 9 , Inches. 7 i 64 Inches. Inches. lOJ* 7it *The average of 5 mea- surements of Cows of different sizes and breeds. flbid. It Will be seen from these measuremerits that no great practical utility can be derived from pelvimetry, so far ^.g-averages are concerned ; as the diameters of the pelvis must vary with the size and other peculiarities in an anima s conformation ; so that we may have considerable differ- ences. In the Mare alone, Saint-Cyr found a difference in the supero- infenor diameter of 21 inches, and in the transverse diameter of 2^ With the view of determining the capacity of the pelvis of the livin^ animal at a given time, external pelvimetry has been resorted to Thil consists in ascertaining the distance between the angles of the haunch on each side, that between the two ischial tuberosities, and that between the coxo-femoral articulation and the highest part of the croup To fand out the first, a piece of wood is placed vertically against each haunch, and the space between them is measured ; for the second a !uP''.i!"1f^"''^? the distance between the ischial tuberosities: and for the third, a piece of wood is placed horizontally across the summit of the croup, whi e another is laid in the same direction along the trochanter and the ischial tuberosity, the vertical distance between the two pieces giving the measurement. Taking into consideration the shape of the pelvis It has been calculated that the transverse diameter of the outlet should be nearly equal to one-fourth of the distance between the haunches, added to that between the ischial tnhfiro«it.ip= • whije the supero-inferior diameter of the outlet is supposed to be equal' to' three- fourths of the vertical distance separating the coxo-femoral articulation from the summit of the croup. These measurements only give the sup- posed diameters of the outlet; but Arloing, who has devoted much 26 OHSTETRKJAh AXA TuMV. I ^ 1' Mare, supposing that the two should be nearly always constanTn (hit heiL'ht of n^v Mnv /-^ ^ ;,' ^ ^^''"'*^ '*^ ^^^ necessary to multiply the nei^ht of any Mare to find the sacro-pubic diameter of its nelvis S peWc'cfiur'" ' ""^ '"'■"'*°' ''^ actual ^:.Se:;'otth: e ?her throullh" "^^^^^^^^ *" ^^^^e recourse to ' direct ex^ a on ' 1 Th , , .• "^"'**^ ^^^^ ^^ somewhat tortuous or )8 whereby the factory, that it as useful and inner, to arrive I pelvis — which 5 living animal. 3 heifjht of the nstant in their ired in twenty- le twenty-eight is, the quotient o multiply the s pelvis. For oup measured 3r between the i:ipas8es), was me co-efficient tic horses, the ic cavity less .'hile in those be soft tissues 'ely speaking, e former, ons are fairly jry widely in ement of the reliable, only nal pelvis ; it ir the estima- exploration,' lot only dis- le deformity. *vay; and in y simple and iment of the iompasses or lie hand may iameters by !r, and even 36 being pre- ;Ccuracy the line drawn lal distance ttvo axes — them is of '■ with each we observe tortuous or d'Obstt'trique KXTKliXAL OltHAXS OF <}ENKHATltus. The lips (labia; vulva'} are usually in contact, and they, with the opening which separates them (rimce vukue), vary in si.e according to age and condition. They are slightly prominent and thick, being com° posed of firm, ilexibe, and elastic tissue, which is covered with a fin^ smooth, unctuous skin destitute of hair, but rich in pigment in the majority of animals. Internally, they are covered by^mucol mem! nSnf ^°"*'""^tion of that lining the vagina, and which is constantly JhpT« • ^>;^ 8»-easy mucus possessing a special odour, according to IndThrskin ineei:'.'^^ ' °" ''^ ''^^ '''''''' '' '''' '^'^' ^^^^ ^^^^Le At the junction of the labia above and below arc the commissures, due this junction. The superior commissure is situated close to the anus tiom which It IS only separated by a narrow space-the perina'um It IS very angular, and corresponds to tlie fourchctte in woman. "The rnjerior commissure is obtuse, rounded and more voluminous; it lod-es in [nL'Jr ^'^" *^""^«P""'^ '" '^' '«'"■« '""./'"•« <'f ^votnan ; there are no 'labia miLa ,81 ;:i 'jil Ml 28 OBSTETRICAL ANATOMY'. I tUdUoris, and is situated iramodiatoly abovo the rmhi Th, ™,„v„ V ^inrataVrata'rriod°"','','r ">? 'T'"'' "'■'°" »S'a'e, ut m th^ interior ''Infr^K f": ™'™ °°,"r'' °' 'ho """"""' m«».Jm,«, lining its Near Jhfi rL ■' . u *''f P?"°'^ °^ '^''^''""> '^ has a bright-red hue Vig. 17. Thk Gknkkativk Organs ok the Make in situ. 8 Bulb of flw> V • r. r. ""* ' '' Constrictor Mit>ole of the Vulva. space between it a„SiXi.„f-'''y '"'"T'' "'" °'''""' ^nd 'te form several s ml? 8 XesmisZhT' "'""T "'!>' "SK^"'""''"' '» great numbers of nanml Th, L / T ,^ '■' *'f 'urnished with Irectile tissue w°th wide snae™ wSh?i *;'■'." .^''°'!>' ""'"P™"'! <>' This tissue passertrom tl!ri?„»; T, A """"'""''S'he i^faiK rcfa/omw. where it terSSel™;?,™, d a e r "orSi" like kbf C "' 'TA^' fh°f :r.nr '"f°' °' f ■^ -'™' "- burcorm:mmtls?„rrfor|^w S tt capacity orh^Vu"!™ ';!,:" bv ^on"""' 'n° "^ "«*es-aimiJ,iri;es of the c%ufatory c^at:;,^ e"ct p e^E^'^i^fo, f''- '"^ ""^''"'°" i- The cavity ites it from the atus urinarius franc lining its » ; an erectile iwo constrictor ous membrane i usually of a right- tod hue. ik pigmentary provided with EXTERNAL ORGANS OF GENERATION. '29 Bladder ; lie Vulva ; Fallopian • are chiefly jHs and the ggregate to ished with imposed of 5 rctiformis. f the vulvaj ered by the *riorly with diminishes coaptation The muscles of the vulva are constrictors — an anterior and posterior —and are voluntary. The anterior constrictor is analogous to Wilson's muscle in the male, and is formed of arciform fibres which surround the sides and lower part of the vagina at its commencement, its extremities being continued by means of aponeurotic fasciculi as far as the sides of the rectum, where they disappear. Posteriorly, this muscle is confouuvlcd with the next to be described. The j'osterivr constrictor (constrictor cunni) is analogous to the constrictor of the vagina, and forms a real sphincter ; it is comprised within the substance of the lips of the vulva. Superiorly, its fibres are mixed with those of the anal sphincter, and are attached to the sacrum by means of the suspensory ligaments. Inferiorly, the most forward are fixed to the base of the clitoris, and the middle are prolonged to both sides of the thighs, where they are inserted into the skin. Inwardly, this muscle is in relation with the vaginal bulb and the mucous membrane of the vulva. Its external face is separated from the skin of the lips by a very vascular cellulo-iibrous tissue, which is capable of contracting, and in the midst of which are observed some isolated red muscular fasciculi — given off from the principal muscle. Hhe posterior constrictor oiihe \\x\v& ie very powerful, and in acting during copulation contracts the vagina and compresses the penis ; by reason of its attachment to the clitoris, when it acts it erects that organ. In Mares which are rutting, the movements of tlie clitoris are frequent] and it then projects outwards ; this is particularly observed after mic- turition, and in this case the fibres of the constrictor attached to the clitoris ejevate the latter by acting on its base, those fibres which are inserted into the skin of the thighs depressing the inferior commissure of the vulva, which exposes that very sensitive erectile body lodged in this space. The muscular ligaments of the vulva in reality correspond to the lifjavientum suspcnsorium of the penis in tlie male ; they arise from the lower face of the sacrum, and descend as flat bands until they untie beneath the rectum, when they pass in several fasciculi into the lips of this part, and mix with the fibres of the posterior constrictor. They are composed of non-striated fibres. The skin, as already mentioned, is very fine and thin, black in the great majority of Mares, has scarcely any hair, and is very unctuous, odorous, and elastic. The bulk of the vulva is made up of subcutaneous fascia, to which the skin closely adheres ; as well as adipose and connective tissue, and bloodvessels and nerves. The clitoris is an exact, but miniature, counterpart of the corpus cayernosum of the male penis. From two to three inches in length, this body commences by two roots attached to the ischial arch, and which are covered by a rudimentary ischio-cavernous muscle. After being fixed to the ischial symphysis, by means of a suspensory ligament similar to that of the male, it passes backward and projects into the vulvar cavity, towards the inferior commissure, in which it is lodged. Its free extremity is enveloped in a mucous cap— the prcputium, which is plicated in different directions ; and towards the centre of the tubercle is a follicular cavity containing sebaceous matter, and which represents that in the extremity of the male penis. In every respect the"" clitoris resembles that organ, havin;^' a fibrous framework, erectile tissue, cavernous vessels or "plexus retiformis," and a pair of muscles— the erectores clitoridis. This organ is more especially the seat of venereal Ii'" " m i I •0 oxcitutioi ariiiiii (HISTh'.TIllf.ll. .tS.rrnMY. S?B^:;^'^:^;^^^.^^^^^^ with tiorvtiH, \vlii(!|i iiKunhiaiio ill whito liVim-ii of woin.u. . >"i "«.. It lias Ih>(>ii coiiipiuc.l Ir. tho wrinkles o,. ,auu\. .ruu.nur'hl.t.l't:,,."';''''^ ^'^"'''" "' """■^. the vulva,- opening i, „ ' ! d „^"^',,'^^, ' '?",'f 7'"'n,,,„,„ dexce,,,!,. tenacious stringy ,m.eu3. " ^""■I""K«<1 a <,ua„tity of . DlFKERENCKS IN THK* \-,.lVA OK OTHXK AnimALS. Coiv. ouned peak! is tunfisW ^a 'i 'o 1 SV'''"^! '";,f ''? '"■°'°"«°'' '"'° " posed as in the Mare; but in the intlrL ^ 't J eS:^^:;;:XS'»„t f i:xTi':nN.ii. nndAxs ith' aKNKiiATins, Miiostjo foiiialo at," IIH \V»l|| ilH iiorvoH, wliicli >iiH iiK^inhiaiio )iikIi ill whitd liicli JH a very ly hoiioiitli iJio courHo (iihoiit va>,'iiia, opoiiH xh'iior. TliiH a wido (liipli- dor is fcuriiod » (nwurds tho L<> tli(! vagina, na iH narrow, Mpanul t(; tho I aUaohud to it it was tlio li caiiHi'd tlio to tllC llOI'HO ho roforn— ai in tho Maro^; Kiiial cavity, tiiiilcroiioo to iitUM, and in 'ory small. I)ut that it is • t, and, as in tions. Not ( lated apjxiii- ' IJorso, and ■iiiiicnt, it is I downward, f tho instru- ? with Maros it as many pregnancy, descends, Ums , this IS not found iu any other of the domesticated animX The PKUIN.KUM is the name given to the space between the superior commissure of the vulva and the lower margin of the anus Its Ch varies in different species, and in difToront-si.ed animals of the same species; but it is shorter in creatures which have produced youm. than ui those which have not. It is composed of various tissues-exJernaSv IB the smooth, hue, and very elastic skin, with the verdcal prominent line passing down its middle-the " raphe ;" beneath this are corective |1 k ('. 32 OBSTETRICAL ANATOMY, »na adipose tissue, and fascia, with various muscles, bloodvessels, and mmmmM this kiur^rhicte-^LTtedfuTele^roft^: Es!' °°""'^"-^ °^ SECTIOxV II.-THE MAMM^. i. In early life they ai^TudTmentarv buf wZ S' 'T' *i^^' ^^*^^ ^^^^t^' attain their full dimens^onTwhp^/l.^ f ,^^ developed with age, and and especially at The uHneriod nf ;^^' '' ""T^^^ "^ reproduction ; about to be canSd on ac ivelv Aflf ^''""/•''^T ^^^'' function is Its centre, on each side of the mp^inn lino o • ,^^^,' f^'^^ ^^^ in prolongation named the /r«7or,^ .^»/. A ^"'''^^'/^'Shtly flattened orifice? from which tirmfeSai^^f and hv'Ji:' rit^''^ ^^' '""''^'^^ obtains that fluid by sue on The Z. ] ^ '^' ^^"^ ^'°""fe^ ^^"^at"^'^ position by the line tWn «k n ,;^''^*'^° g^^nds are retained in their hair at tho exLmitv of the t^T^^^^^^ 'u"'?' ^"^ '^''^'^' ^^^^^^t^te of soft short down rsS^ooth nlinhV. ' T^^ elsewhere provided with a sebiparous Sles if ^he^ti oTiheT^^^^^ '^'"" *^- l--«-«e of se:s:i^s:i:^ttStnds^^ST'"^^ ^--^^ '^>'— °^ suspensory ligaments of thf p^mt^lhcMnaL" ""^ ^"^^°^^ *° ^^« ia^ons,ucts, with Wc..o;;^,:;;,n!!^:;22^r;: '""""'"' ^^^^ *^-^ a6rfomt;/«/«; it furnrsl7es froni if. ntr w ^^^^'^<^^^^*^ f™"^ the i«',/ca which, crossing each o ?er in he n "^^^^^^^ prolongations t.ns that divide it into S^J^S^ S^r^llSSlr Unf ^^l^ ^ oodvessels, and EXTERNAL OMCfANi^ OF OENERATION. jS somewhat independent of each other • qn thnf «„« diseased or deranged in function without thp nT °\")°re may be Externally, this envelope is Sriy adLren to the'?kin'7g '"^^l^" med urn of a thin but d'ense layer ^f connective tLte"' ^"^'""^^ *^^ ihe glandidar tissue oifers the samo irrQr.,Torv,„ * xi rate gla'nds, and is composed orS rcS^^icTes^'ctst^^^^^^^^ grapes on their stalk, around the hcbicU /ac^^/.W oSmatP f p.^^^^^ of the excretory ducts. These, commencing hycTdtc exSZ Jf"" open into one another to form dilatations (avhum Zl fin«liv ' ' verge into a number of principal canals, wh ch 2idTn fh?^, ""T' phorous sinuses (sinus lactei) The aoin nf fV. i u ? *^® galacto- ducts, are lined iy polyhedral epithehun tbt^K °^"^''' ^'J""^^ ^' *^^ infiltrated with fat Liirialti^^^^^^^ "^'^ '^^'"^''"^ ^^'^ The galactopltorous sinuses or reservoirs arp Qifnof^^i ^i- u^, the base of the teat, and are generlllv two fn nn,l '^^"-^ ^^°^^ tlie other behind; though their^a^^ljrSm^s Te'e""^^^^^^^ They nearly always communicate with each othpv «n/ , . into the teat by a corresponding numbei of t^m nkPand Tnfe'n T1 excretory canals, whose orifinpa nv/^ oi„ ^^""liai ana indept. dent at the free extremity of that bodv ^hll ^"'^ ?f ''^°^' ^"<^ ^'^ «««° Collectively, these exLtorycLafc^ ^°""'3«d- teat than/t the extremityTtrodCs TtuXVe LL'd eth oth '^ and are about a hne apart; and the canals and 0^ are bnP^f ' a fine membrane which is continuous with the sk n the Tatfl, K -^^ closely adherent at this part ' ^^"^^ ^^^^g sun■o:nd'^^hL!^co^^^^^^ ^i'n'Zl; "?' '''f" "' ^^^*°^<^ *-«-^ fibres, renders them Capable o TinfTetolT^^' jnd longitudinal of stimuli. The extremity of tL\'eTt'ist: rpt%VeStU\^^^ which acts as a sphincter, and prevents the paLive flovv o H . f ''^' Connective t ssue, bloodvessel nprvp« o.^ I u °^ *^^® "^^^^• organization of the iiammi tK? .i' f absorbents complete the external pudic; the vZ^ ot to " d S-dLrwb" f /^ *S^ nS£rirpVxr^^^^^^ ''' -es°:?:ieritd\?mth:tnV'^ at Ih^l^r ss- 1!;^ r ^=-s rsr °st°- and can scarcely be pe;ceived n^n? I ';!'^'" ^^^'^' ^^^^ ^^« ^ard, increased in those whi?h have had fnlv" ^""?«^°"« ^re not much teats are usually la getha^^^^^^^^ °!,*^^° foals, though the foals, the mamL continue so^?.ewha In n'" *^^^y/^^^borne several gestatior. is not goin-T the Xndn^^v ^F^ ^''^ Pendulous. When wasted-looking ; the Hn L mentaniT. 'J T^' '''' ''^"tracted and with only a polygonal epiSum Z ' "^f «^ ^" '^^^'f. and covered however,'the ^ina^mn.' assume he fun tbns oTT if."" 1 «"^^*^"°°' e-.tent ; the vesicles become enlarged Snpw I. ^'','' ^? ^ °^^'*a'n epithelium present- a "PhpH-.! I ' ^"*^."^w ones are developed : the fills the aciS;"the entife Iknd'harb;'. '"'"'^''^ ^^^ *'^^ granules.and soon a«. . jt eve^.^ z'^z:^i::s^i:^^zs. :ii 3 i| IP I [ li 34 OJiHTJ'JTJtK 'A L .IN A TOM Y. assuino their maximum dimensions, which are mairttftined, with slight variations, during the entire period of lactation. When this period is ternuiiated, tlie secretion gradually ceases, and the gland again assumes Its quiescent condition, and nrjarly its ordinary size.i DiKKEUl'iNCES IN OTHKlt AnIMALR. Core. In the Cow the mamniaa are also inguinal as in the Mare, and each lateral mass, although enveloped in a single librous capsule, is made up of two quite distinct glands— or " ({iiarters," as they arc commonly termed— and which can be seen, or felt as limited by a slight depression. Each gland has its corresponding teat, much more developed than that of the Mare ; so that this animal really possesses four inamnuD and four teats. The glands are compacted into a roundish mass, wiiicli is more Fig. 18. Skction ok Uddkk ok Cow. a, Anterior Quarter ; h, ToKterior (Juarter ; ij. Septum between the Quarters ; c,c.. Section of the LactifenrnM ])uctK; (/,(/, LuctiferouH Sinus or Milk Ciatern ; v,c, Orifice of tiie Teut ; J\ Large L^iuph (Hand in the I'osterior Quarter. or less pendulous when they are in active function ; in the centre of each, and at the base of the teat, there is a single large galactophorous sinus, which is the general conlluent of all the lactiferous ducts, and opens externally through the teat by a single excretory canal! This canal is widest at its commencement, and narrow at its termina- tion at the end of the teat. The walls of the latter are very thick, elastic, and retractile. Not iiifrecpiently there are found behind the four teats one or two rudimentary teats, which are generally imperforate ; though in very rare instances they have been observed to be perforate and to yield milk. ' In tlie male Horse we find rudimentary teats, which .are concealed within the prominent annular fold of integument towards the extremity of the prepuce. They are not always present, however; though they are so in the Ass, which has them larirelv developed. * •' led, with slight in this period is again assumes riaro, and oacli ale, is made up are coininonly ^'ht depression. 3ped than that LininiD and four which is more ^ A'.V TKHNA L DIKiANH OF aKi\EJlA TION. 35 The teats of the Cow are generally from two and a half to three and a half inches m length, and, as has been said, this length varies accord mg as he ammal has reared a large or snmll number of calves The woantonor are generally the longest, and the corresponding quarters furnish more milk than the others. The dartoid tissu? arounll Sree ex renuty ot the eat, acting as^ a sphincter, prevents the passive escape of the milk from the onhces of the excretory ducts ; for if a small cannula scarcely larger than one of these ducts, be inserted slight J^Sevond^he onhce, the secretion im.nediately flows. And when the Jnd of a teat has been wounded, or when the elastic tissue of this part has been divided rti?lroUh:?Lr° °^^^^'°"' *'^^^ - "° ^'"^- anyobstadf t^ The arteries that supply the mamma) of the Cow with blood are derived from the external pudic. The branch of each side, on reach fng the lateral glands, divides into two principal trunks, one of which goef to a corresponding quarter; that which is destined for thlposterior le QuartcTH ; ma or Milk he I'osterior the centre of alactophorous iferous ducts, sretory canal. < its terniina- very thick, d behind the r imperforate ; be perforate aled within the jmce. They are UH them hu'gely r #9 Fij;. 19. A, Lobule of the Miuniiiie filled with Milk ; 1'., Milk (ilolmlcs; O, Colostrum: a, Celj with .1 Visible NueleuH; /(, Cells from whieh the Nucleus has disappeared. Fig. 20. Seci'ion 01' TUB Cow's Tk.'vT. rt, n. Principal Lactiferous Ducts ; /'. LacMferous Finus ; f, f, Acini ; but anteriorly by folds of pedLneum wlS' atta^ It to"? ^"'^ ? P°l"°" and to t;ho Kiajq^Jr- h-v-.^ti 4-u ^"icn attach it to the rectum nhove But t.is tissui whi.. at-VJte'i-^itt^trS7erL^lVelr.i°i INTERNAL ORGANS OF GENERATION. 37 e while they are 3f well-developed ieep fuivow. itained within 1 some writers ', and ovaries. e dimensions, pelvic cavity, 2orvix or neck The rectum e ureters and I adipose and in form, but f course, but id in position ■ectuni above ieing accom- J referred to. ;re close and firm and this fact may serve to explain why the rectam is so rarslv mvolved m displacements of the uterus, while the bSer is alwayl i^'ig. 21. Geneiutivk Ougans ok the Mahk: Isolatk,, axd Partlv Opknk,,, 4'/6r'?n',i;%^'''"T''"-^"^^«' ''^' I'"*^'"^^" "f tl'e Tube, External Face • Uterus, Upper 1^ I?r .S T """ ' / ' "^ ^"™ ''P''"'^'^ = «' ^^'^y of the fo\d., or plZanHcala'- P/"*'^.^'^"''""' ; 10, Cervix, with its numerous Vagina, wi"l Ts S ..V \r,,? ^vr'v"^ *^' ^'^S'"* = ^- I»t«"°' of the Valve, 4 15 Alucous i^.M Tv J-''"^fT." ' i'' ^""'^''^ -^^'^'^^''^ *"d its Vulva; 17, Ci torb 18 J 'l J f.i"^ .*^, "y™"" ' ^«' ^"*«"°'' "^ the ofthe VuWa ' ' ■ ^*^'* "^ *^'" ^"^^'*; 19' I"fe""«- Commissure Ss^^uX:;- in'^t'ti^it^irtr'f *° thon.uscularandaponeu- a thin mucous membrane t^.i!l.' ^?'''- ^"^^'""^'^^Z. it is lined by i^oyi^ niembiane, which is always abundantly covered with sa OliSTKTItlCA L ANA TOM Y. , if. Snof anTrSi« *"' Tr' /^ ^°"^' ^^ile that of tho utorus is nf fJin „; 1 ^ inoatus. ilus moiubrane 13 cont nuous with th»f Srcav^fcv T?l ^i'\' P-°,J^'*'' ''^« '^ cauliHower in shape, into epmielii n ff P'°n"^t'^ ""'"* I'^i^'""'' ^"'^ ''^vered with paven ont Sstrum^^^^^^^ T^"^ ^f V^"" i""'^ ^"«' but at the peS enSpeTbJ; an^'abunS \" "''7'''^ ^^ '^ '""^^"^'^•- '^'~'' ^^^'^h i« it, ?o pa8r;nV"s ;s '' '^^^^'^^ ^" ^ ''^^'^"^^•- •"'^""-- -^--'-^ veins'arSi^^^^^^^^ by the internal pudic artery ; its trunk of te artery The T^In"^' P^'""'/ "'"^ ^'^V"'"'^^^ ^" ^^'^ ^^^dlite of the fa'tn^ a7;i -^^^'^8'"^ ««i-ves for copulation and the passa-o sLSo's norfa th-cSf^'^?^''? and parturition, the LucoC after copulation i??!;? " '" ' *'^«''.*""««- I" youth it is contracted ; tion if the fmt « fc «««"^'thatat the commencement of parturi- post'e 1 u^that StTl ''^^^^^ ^' ^^« f»^"^^'«. t'"e entirely erJes he cavitv^of ^1^"'^"^ ^^"^ '"*" *^^« P^^^^^- n^a^'l}' or thrus Jit betw^:^^^^^^^^^^^^ in -e instances medtn,Tou«h incomnlot"^'^ rl""''^ '^^^'"^"'^^ i"^« ^^° ^--'^l^ by a it could ntbfsa^dT&'aloS Z^' '"^'''' ^^^ '^ ^^-' '^^' DiFFEUENCES, Cow, Sheep, and Goat. rugffi as in the humpn «nJ-lT a T ' ^^ disposed in transverse a mucous canal that odphs in^n ihl ,1 '""^'^"^.^^ layers, there exists the side of the meatus urinar/us ""' ''''*^' '" ^^''^"^ °^' ^""^ ^^ and'SrdrinVh'elir:^^^^^^^^^^^ "°' P[f?' - ^^e Sheep or Goat, Gartner.'- are unknown tL^ iL k T^'^l^ ^"°^" ^^ ^^^'^ " ^^nals of of the uterrand mninrtpTn^« . backwards into the broad ligaments function during fetalhL '''^"^"''^- ^^'^ ^'''^^^^y ^^^ ^'-'"e PtV/. IHTIinSAI. KlinAKS OF nRKKKATlOK. 39 tatween Iho vagina and vulva. The vagina i, from eight t„ „i„e inchl. Bitch and Cat. Thoro are no <• Gartner's canals " in the Bitch or Cnf TW. „ • • of oomparatively L'reat lenirth and h«.« inn, -f-i" i ^ ^^^"^^ "* intenuptod by trans verso fod^ In hnfh ^ "^'"l'"^'"' ^^^^^ ^'^ towards the vulva thin towards the utorn« „ "^^ ' the canal is wider very thick by white fibroTtLufi in /.^f'^ '^' ^^^^^^ ^'^ rendered n.U8cular fibres it contains ' ^^'^"'"" *° ^^'^ non-striated .SECTION II.-THE UTERir.s. The Utruus, or woMiWFi.rs 17 1 • oi o; ,• „„ , , , membranous sac which rocorvt'-s th.^ nv, ,' ^' i ° elongated musculo- tacle for the nutrition! dv^mnen and fi^aUv ''T'''''''\'^'' '^'^^P' the expulsion of the fcrtus It k' ^^h; ? ? ^^\^u*''' °; f''"*^^'" P^^^^ cornua; on each side ofTuppetxternl^^^^^^^ between the two of wide ligaments • and its s des an^ „ "f ^'*^ '^^^'^^' *'^« insertions the intestines. Its lowe^tr^ llnTonrct Sth K /? S"^^^^"^^^ pelvic curvature of the colon • wh ll [la ^I • **^® bladder and the with each of the cornua and'th?n<,f,'''°'''*^^^^ '^ continuous by the constriction Tm^d th fcJ t""^ T^af^'''^ ''^ '""t,^ cornua are cylindrical tuhp^ nn,l in!q i ' ^, °^ *^® uterus. The ing this regio'n. fr^lt^^l^ltlfSl theTodvIn"'"'"" ^^.^"P^^" tion, describing two curves-an inffiZ ^ody m an upward direc- superior, concave to whfchh^^,?' °"''^'^• ^^'""^ '^ ^'^^' ^"d a Each ho'rn has also a p^sSor extremirr^T ^'^''"'"*^. "^^ ^^^^^h^-^' body of the uterus • L^i an anf..W .^ °'.^^'^' ^ ''O'^'inuation of the a ^i^/«-sac. vSh'is Ji^rned ,mwr/^^'Tl^y °' '""^'"^'' r°""d«d into tubercle, th^ insertion o"ho ov'i^ucf ' '"' ''' '^ ''^ '°"°'^ ^ «--" als^:Sed,t^lt':;ft't;o';^ "V^^^^r^- ^^e uterus is them from th^ subSbar\-e Won li '^"°"' ''^"^^ ^^^'^^ ^"^P^'^d '>'o..^ or ....i^oSHzVaS of Jll'^nf consequent y designated the resemblance to the lings of a bat fhl . ""' ' ^ f °' ^'°"^ *^^ g^^^^^^ derived from the ^eSeum of the ahd^:^ resperHhoms. These bands, behitid, and in shane ar. h -Lni f^.<^o">e", are larger in front than to each othe;%ut n Ct di?en^^^^ '^^'"1' '^ey are close descend from the lower face of^H? I ''^^' °^ '^'^ ^^^^^' ^' They selves, by their infSbord^MH f""' /'t'°"' ^"^ ^^^^^^h them- body and the smaller cu 4^^^^^ °^ '''\"PP«'- ^^^'f^^e of the is free and susta ns the ovfd, w i ''"'•"''* = ^h^^'* ^"'^^^o^ border between theSlaye ^ri ^1 0^^ ."''^'rf ' V^^ ^^'^^ being included it. also receivrl [ayl LucheT from Th"^' "''-"^^^'y- P^^^^^ ''''^^ it foj-iio n HfH,. ,1 "™nert trom the prmcipal ono whioh wjfU band of pe toLmf is oU r^S''"-. ^"?*^^««^an. long,' and nar^^w can be trLed Seriorlfto fchf in'.l''''^*" *^' ^^^^'^ "g^"^^'^^ = this it presents a li^l^^lj^ ^:^''^S^ ^^^^^^H 4m 40 OBSTETRKJAL ANA TOMY. » bS "t^^:, t^: -S tfV^ ''^' — ^- of the .ale analogue of the round hj2'/ ° *^^ ''''o*"'" ' ^^^^ band is the tained in position by the vS ""f "'-^"i ^^'^ "*«r»« i« also main which at fhis part'Cs7cSrbS^";fc'"^/^/^« peritreurn. uterine. '^"'^ bands -the recto-M^cm^c and vesico. respoXtt^titisr^^ ^,"^° ^^- compartments, cor- body communicates 3 the "tiSa K^ '"'""''• ^^^ ^^^^^y " the he constriction or cervix of thTute^^u^s r^'^ '"""^ ^^"''^'^ ^^^^^'^^es the cervix. In all the dou estica^ed r,nin ^^«'gnatod the c«.a^ o/ fh^^ ^' Pf°^°"Sed into the TntezS IxtTe mit'of'^^ '^^' ^^^^it, this the end of a tap into a barrel fm-L!.^ °^ *^^ ^*^«i"f^l cavity like cervix. In this is the onenin:. ZZ'^ ^ ""V "^^^'^^'^ Pi-otrusion-the he vagina to the body of^ the utir { 7 ''''''t ^■^'^^'•'^""0 leading from this aperture the uteriva- nal ^^^7, '' 't '^"''P' "' ^"''^ ' aground in transverse ruga, dispose'd in a Z„ "''''''''"' ^' ^"^^^^^ly arranged this prominent part the aXlrnLl ? '"anner, and which gives to he rug» of the canal aSSlvdinosef^^'i"^ ^'T''' '^ ^^'nln from the stem of a tree ; conseLeK ^^ v^'"''""^^^ '^^ ^'^"^^es a --^^^^^ -^e.., or ..,.; or peritoneal membrane envelops a 1 tL' '«"^'«"^ j'""-«. The seroiis an expansion of the broad Seni tt- i!'^'^"' ^"^ ^^ ^" ^'eahty only on the posterior extremity ofhrvadnr^tirHP'^^^^Sed backLrdI pass to the rectum and bladder aIwSr'«f A ^^^ ^"'''^'^^^ ^"d then pelvis, constituting the four 1 a.n 'nt ti p^^ ^^/"^'^^ P^^-i^te^ of the the two cornua this membrane forms a ntnl^ f''''^ *°- ^^^^een developed in Solipeds. Owing to t ?. J^! ^'*°."™' ^^^°b is very receive any peritoneal coS. The t^^'T'",*' '^^ ^^^^^^ ^oes not ongitudinal and circular S .n„iV '!''"", ^^^^" ^^ composed of testines /t the insertions o he broTdT *° '^?'' '^ '^' «"^a" ^n- series of fasciculi are given off from thl ,'^ ""'"u' ,^°*° ^^^ "^^^"S- a the folds composing them and hJll^'^V^^'i'^' ^ extent especially towardrtheotres 5?^^?""'^ throughout their belong to the class of non-striated of inv^ ? '^' composing this coat up of fusiform nucleated fibreflod^edr^'^ "^'"''^''' ^^^ "^"^« coberent granulo,-. matter. The\nZlt.J f,!".^*"'^ ^^ exceedingly that of ordinary muscle, being 4chmnr£,°^ this coat is different to \^.(:''"^' y^A u -^"'""'^J' uiuscie, beincr much r they are thick and closed' fasciculi pass in different dfii cornua than the body; their 2 of the uterus during Vrturiau, ii.ii ^- ^^^ ^T^^^^y increased, ^^m^^^fS^W,^r-":'m^i^ i^^^^^' inciease is doubtless to permit thfi&^'^*^^^^ striatioi,.. Their without allowing its pa^Ss t!!^'£~^. ^''^'^'^-^ of t*^ uterus' tnuugii to some extent"thev do diminVlT^ ^'^•- iiuenuated and feeble; email /intestines. The Imal in their direction, »aeep set are circular,' jj.the.pfe.. uteri, where ;?*h©ge(,jfl^)re8 irregular ai«i *«^ 'thicker in the (nish the volume , i^Jbut^Hpliggesta- sst striatioij. Their ;-:,4 INTERNAL ORGANS OF GENERATION. 41 inembraTio of the uterus. A rich venous npfwrM.i, ;» 1 j j • muscular tunic of this organ. network is lodged in the The mucous layer is a thin rJplipnfo «,,i^, 1 ciliated columnar' ^Pithdium 'inlL?toJy"tnd^" r^^^^^^ ^^ ordinary cylindrical squamous or stratifiprl aSJ" ^ \^^ °^'^^^' the ceriixf like- that 2f the intest nes an te eTla;;.d or '^' ''"'^ °^ the ruga) of the cervix. Tliis difSs fm... ^r. squamous on brane iS the presence of a vey delicate Smi^^^^^^^^^^ '""^^ ?^^'"- in which the utricular glands bbod and Ivmnh? connective tissue, supplying the ine.nbraL. ai4 ?tlLd • ^oT^^ receive its vascular supply directlv frnm thl T f '^ appears to being continuous with^t^hle of thit K.-'^ Thi^Sir Tit related to its intennittent. though hi^h':;; orlaiiisJnSncTion ^"'^'^^ in the cervix, the basement membrane coverq mnUif, !i i -n- , points of which in woman are nipple shaDedwifT 1 i""' ° '''"'' *^^ centre; within the cervix these vflli SeTerV kl 1^7-''?/°"k'^ 'H the organ there are none. The nielrane hTre f ^en^aiCbS )"^l^^ series of longitudinal ruf'ffi formed nn if n,,^ 1 .'^/^"^^^^able for the ordinary dis^tention of tfe o ^n thoLhIhrv 'tr'^ not effaced by increase in size of its cavity in J^^e^nancv On 'thil ^^'''"' ^"^''^S the fossu3 between them, parliJula if towards th«? '"^'* ^"'^ '° *^« numbe. of simple mu^oL and sp Ll c'Sri a^ S ^ T"' particularly abundant towards the cervix ^mt/L I^f ^^^^ ^'^ closed mouths, are enlar.^ed and forni .m„lT ? """"^ there have the mucosa, and in such a manner hat numS ZlnchtTZr' °^ connected with a single stem or dand-duct Th^v «, f ^ T^ *",^^^ ""''^ cells, which project^erticallv hUo the Ind t^^.P \?"^ ^^ columnar ciliary movement. The utricula glands^^^ not^ist IrbirHf "' ^?-^ rS ^c^JraiTeri^t ^ '^^i^^^^^^nlZ^: ^ quantity oftrrtScirit'trt^pL^^ -^ ^ 4- layer, of the b,„:;^ Ik^^t'^l:^;^' ffS'^t™?^" *" ^vith the utero ovara,rlnr.'^, ", "''■■'■'°''' """"'""^inK its branches -~™ ='"rwitVsxv^Kr;aj^i'^=s.„iat •lii I i- -• i s; I ! 42 OBSiTETltlCAL AN ATOM Y. TuSu' h^ t'^rS ,^^,— P-ding v.-,„. which are .0,. have no valvos In I^Z^ t^.XlT'^t^ ^ ^^'^^ fiBtention. They greatly enlarged and "eTy fl^^it TnS ^r'l"^""^' ^^ vessels arJ Srt?rran^^:r^^^^^ their atSl'S;tor;''"\''°"lu*^^ °'-«^" ^'^ ^« remarkable for lumbar ilgion "'"^''' ^^"^ ^" ^^•°^^^^ ^"^^^^'^^ the sub- The «em« are derived from the small mesenteric and pelvic plexuses. Fig. 22. Nkkvks ok Marb'h Utkhi-.s. 1, 0.„i.,„ Art,,,; 5 1r?l^r '!"?",'',?■.•"•» '» 'k- P.lvi= Plei;™'; 1, Ovarian Artery; 2. irterinp ArfTJ.'^'r'TTx • ' ' " -.oiu nexus; Uterine Cornu. flex^reof he cTntte '"ST" '^ ^°^""^' '' P"^^^^ *h« Pelvic to the floor of which it aradn«l ^^^"'",' '"*°,'*^^ ahdonunal cavity, on tion of pregnancy. A ^^asboe^^^^^^^^^^^^ '^^ termina- it carries with it the cervk and vti n *^k- '! *^'' ^'^^^"'" ^"^ ^««««°t ened, the traction belnTp^^Pn^F^' "l^^"^! '' considerably length- to be buried bXeertle SaUc'',?h '° '^' ""''"' *^'^ ^PP«^^"g pregnancy. iscliiatic tuberosities toward the end of Differences. avuies, does not offer any striking differences .0 tar into thu lutter cavUv It tha ,!„?- w '' '', ' T ■'°' '""™'i transverse line drawnTorSs the abdo ^n^Xnrotth7ext°"T''''■,'' ° a;re^^er*^r=^ FoSraJttKa'rtrSr "-" ^^^^^=^Z noSwtthTfeai"ur°e^''Fo'r°T„rnce' "the™' "' ""' ''"'"'^' °'^''- -™ 7 oai/uioo. x'or instance, the concave curvaf.nrAn nf <-k« cornua look downwards vhfirflnH in Ihc iu-„- ^u ''"^a''"™s ot the horn isList^a out„„^5 a^^wt^ ^ Ksbt 'SS'^^^ Fig. 23. A, Utt icular Gland of a pregnant (ioat. Fig. 24. B, Utricular Gland .f a pregnant Cow. uterus, van^oh als" reSs he iser noMr h ^, r" ""''y °' ""» fo>«r ,,fa»„. Thi, insertion .am., th ! the broad ligaments on its ....ifc n th.. Mare n wl ^h th„T .""■"■ '° P™ '='=' "'" ™ "'em ; of th<^ .ody, tt'Se'r p4„t Sw "them" Tihe Co"" 1^"^ axed tothe ltT^:tui::^T^^:t°Z T^^-^'^"^^ '? «u r T"hi?;r,:sr;^ t ^-^^'^^^^ ^rtioTorth^ the Cow explains he „S,,^. ° '"fPf "'?■'>' "PP""'"!' ol ho uterus of 44 OHSThynuCAL .iXA TOM V. The cornua arc tliin and tapering at tlioir anterior extremity, and the body is short and narrow ; while the interior of the uterus ia not so ample as in the Mare. Hero it offers a peculiarity which ia not observed in the latter animal, the Carnivora, or the Pig, in the proaonco of rounded smooth prominences named caruncles or cotylcdonal jiroccssca {placenUc ntcrinai), which increase in number witli the si/e of the species. The niatornal cotyledons are most munorous in the cornua, and few and small in the body of tiio uterus ; they are about the size of a pea or haricot-bean, in calves; at a later period they iiavo acquired the dimensions of a button, and they increase largely and assume variable shapes during gestation. In the Cow they are Hat or slightly convex on the top, but concave in the Sheep and (loat, and their colour is usually pale ; after conception, howev3r, they become red from the afflux of blood to them. They are intended for the reception of similar processes on one of the fatal membranes, the chorion, and will be noticed more fully hereafter. It nuiy bo sufficient now to mention that their number in "the C,a\i sometimes amounts to thirty or if Fig. 25. HOIUZONTAL SkcTION OK TIIK UPPER SlIiKACK OK THK Mliors MkMUKANK, NKAK TO A COI'VLKDON, OK TIIK UtKKUS OF A NON-ailAVU) CoW : MaoNIKIKD 180 DlAMETKHS. a, Section of a I'tricular (Jland, and a' itH I'rojter Structure ; />, /^, Mucouh (JIaiids ; c, c, Adenoid Tissue. forty ; and after parturition there liave been counted as many as from eighty to one hundred and twenty. They are disposed in linear or longitudinal series which are all the more numerous as the cornu is wide ; there being four series near th(^ body of the uterus (which has none), two at the anterior extremity, and three in the middle. Each is attached to the mucous membrane by a narrow pedicle, and in removing the foetal placenta after parturition, care has to be taken not to tear them off. The cervix 7itcri of the Cow is from 2| to 3.1 inches in length ; it is narrow, almost as firm as cartilage in tex'ture, and irregular in shape ; the mucous membrane is more finely plicated over it, around the o's tincce, than in the Mare. The fibres composing the cervix are divergent. ^u'^u'j''^^^^" ^^^ ^" ^°'^'^^' '^"^ *^^^^ "^^"^^ '^^ nearly circular in shape, and the body of the uterus is so small that the cervix and cornua are close together, or joined to each other at their origin from it. Towards puberty, however, in all the larger domesticated animals it becomes fusiform, and shows two lips, about two inches in length— an anterior and posterior, the last the longest— which are pulpy to the touch ; these INl'EHXAL OnOAXS OF aKxS'KllATION. 45 I Fig. 26. I^TKUt'S, OviDLOTa, AND OVARIA OK THK ShKKP, . a, \agina ; b, Oi Men ; r. Transverse Folds of Cervix Uteri ; ,1, B„dv of y Uterus ; e, .. Caruncles or Cotyledonal Processes ; f. Confluence ..f the Cornua • //. Intact Cornu ; hh, Oviducts ,.r Fallopian Tubes ; ^ i, Fin.bri.. • k k } Ovaries ; I, Round Ligament ; «,, m, Bi„ad Ligaments ; n, n, Cotyfions.' ' ppsition, is useful when explorations by hand are necessary in cases of inversion of the uterus. 1 div^rt^icuH '"'^^'^'^ ^^"^"^^ ^^^ ^''^^'^ ^^'^"^ '" ^^^ ^^'*®' ^"'^ ^^^® ^^*^^^^ ini.*'5";'!!'''''^''n t""i« altogetli^r is thicker.in the Cow than in the Mare ; indeed the walls of the uterus in this animal are more dense than in any c! ^I'iT'^i .r^*"''^,-*^^ •'^"^'^^'^^ ^^^"^S ^ '^^ ti"t' and beini (-ontinaed wuii mto the bioad ligaments. • Professor Violet found two distinct cervices in the uteius of a Cow. both proiectinff SVetr'""' '"' '^' "'"^^ '" """ '' *''"" ^^'^ -^y ^hort, and 'terminE t^ 46 OBS TETllICA L A .VA TOMY. M i Sheep and Goat. In the Sheep and Goat the disposition of the uterus is similar to that of the Cow. The cornua are relatively longer, more tortuous and pendant, and expand more gradually from the termination of the oviducts ; while the longitudinal rugae in the body and cervix are dis- posed in a series of transverse folds in the latter, which gives them the appearance of so many ora tinccc. The cotyledons we have mentioned already; they are concave, or cuptoliform, in their centre in these animals. Pig. In the Pig the uterine cornua are long and tortuous, and float among the intestines, which they resemble ; the body of the uterus is very short, and the numerous irregular ridges on the inner surface of the cornua gradually subside towards the cervix, where they form two or three series of thick, soft ruga). The os uteri is marked by a series of narrow, close-set, longitudinal laminue, but there is no labial or valvular projection into the vagina; so that there is no exact limit between the two cavities. The broad ligaments resemble the mesentery. The utricular glands divide repeatedly in the deepsr parts of the mucosa, as in the Mare. Bitch and Cat. In the Bitch and Cat the cornua are also very long, slender, straight, and slightly compressed, with a number of flat eminences on their inner surface. They extend to the lumbar region, and unite externally for nearly two inches before they join the cotpus uteri. The interior of the latter shows a few smooth longitudinal rug*, and the os uteri is a smooth, thick, and even prominence, larger almost than the; body of the uterus, which iV, short. It projects very markedly into the vagina. The utricular glands are pyriform ; the round hgaments escape from the abdomen by the inguinal rings. Development. In the fcetus and the adult animal which has not been fecundated, th.^. uterus is comparatively small, narrow, and insigniflcant ; but it increases in volume with age after the venereal desires become manifest. In a Calf a little more than a month old, the total length from the vulva to the extremity of the cornua was about ten inches, of which the vagina formed about flve-eighths. In the I.amb the uterus and vagina only measure about six inches in length. From this period until the animal is capable of breeding, the uterus receives so little blood that it may be rei;ioved without much risk. During gestation the uterus acquires a great volume, and irs cavity, usually less than that of the vagina, is considerably increased, its shape then bearing some resemblance to one of the large intestines. The cornua vary in size, according to the dimensions and species of the diflerent animals. In those wliich are uniparous (one fcetus), as the Mare and Cow, they are short ; but in those which are multiparous (more than one fujtus)' they are long in proportion to the number of In oriter to avoid confusion in the employment of terms, and also on the score of convenience, it may be as well to oh-ervo here th»t iini/iaroiix animals are those which generally produce only one at a liirth • viuUij'aro'.f., those wlsich bring forth Dior^ than one ; prinipcirous, those which produce young for the first time ; "and pliiriparom, those which have bred more than once. similar to that tortuous and nation of the cervix are dis- ^ives them the ive mentioned ntre in these d float among iterus is very surface of the form two or by a series of iial or valvular t between the entery. The he mucosa, as ider, straight, on their inner 3xternally for nterior of the OS uteri is a u! body of the vagina. The ape from the 1 fecundated, icant ; but it )me manifest, •om the vulva )f wliich the .s and vagina ;od until the alood that it d irs cavity, iod, its shape stines. The )ecies of the etus), as the nmltiparous e number of r>ii the score of ire those wliich i>rth Diore than d /iliifijiaroKs, IXrEltXAL OJK/AXS OF OENERATION. 47 young they bear while the body is diminished in length. In the uni parous animal the foetus is usually developed in the bSy of the uterus and Its posterior extrernities only are sometimes engaged ,n one of the cornua ; but m the muciparous females the cornua reSmSe The intes tines, and the young are developed in them, the body o the uterus seldom contammg any In the Eabbit, indeed, there \Jr^^cormSui^i the cornua opening independently and directly into the vagfn7 ' After parturition the uterus gradually diminishes in size^and some of jt^s^supplementary structures disappear f but it never resume's its preWous ^yBjammts of the uterus suspend it loosely, yet securelv in the abdominal cavity ; and while allowing it a certai/rLge of ino^veLnt permit its full development during gestation. At this pedod therbe^ome developed in a peculiar manner, and, as we have seen, between thSr lamina, appears a layer of muscular fibres ; m the Cow theseTbres are arranged in fasciculi, one of which, larger than the others extends from the ovary to the cervix uteri. These ligaments wouiralS appear t^ stretch considerably n version or inve'rsion of the utei-us fn HerW vorous animals; even in the Carnivora they accompanv Eterus when hernia takes place ; and in the torsions of this organ which sometTme^ occur in Euminants-when its upper face becomes the lower or even FALLOPIAN TU15ES, OR OVIDUCTS. SECTION III.- The Fallopian tubes, or oviducts, are two small, cvlindric-I fS3?"^ ' l^K°''' \'v '"''^''^ ^°"S. white in appearance one o? which is lodged in each broad ligament, b.tvveen it. sei^ous layerJ andnrar its anterior border Each tube conunences at the extremtyonhl uterine horn, at a small hard tubercle in its cul-de-sac (o.^iW../c,?Lm) tS! tubercle IS Its opening into the cornu, and from this it pSs mo^e or less tortuously, and increasing slightly in diameter, towards ^ne of the ovaries, upon which it terminates by a free widp3 «vf^ • {ostmn alulonunalc) in the panlion of th^ Tub ^The eTlfbre of S canai IS small, and scarcely admits a thin straw at its middle p4ion cavity conmiunicating with the exterior) near the ovarian Hssurp?n » M ' I 48 o/isrKr/i/r'.u. ax atom v. peritonou.n. ^ ^ "'"^"' "^ *''" 'mibnu), wlioro it moots the DlI'KHUIONCrOS. Cow, S/wrj), and (ioat. su.i;.ce of the^,aviiion ^^j::^;!. t^^^^^^^js^^y^T wavy folds alul is'thon tthS .i^^ 1 hl^U fh <, 'Z wllT^' '"" ''"'• . In the Pijr the oviduct has few or no infl.'vmn« l.„f •. i IS proportionately ..-eater than in tirc\ tL ,oc>ie ' The .","''' IS wide and deej), and the urmnn nf if« .,i i .^,'^'^- /"^^' piivili„n even; its inner surLerau^m"/ .'"''''''''''''^ '*^ '^'">"«t highly vascula.- fohwhicVSa^ '^"^'' "^"■'■«^^'' '^"*' contrLtedpartofthetiU:;tex;:;^d:^pSn:'^^'^ "^ ^'^^ tot;;;t:tSS'i:i:j;;;;;^^:ft,:=''::;;;:.^ the tube itself, Ion.- ami line n„'ll';^^^^^^ ^^"^ ovanun. ; wliile anterioraspeetoftheltuerttiir^n" \CZT:^ Tfl ''' from two and a half to three and a half inches " ' ^"'^'' '' .SKCTfOX IV. THK OVARIKS. ...uateu ,„ the ab.,o„„„al cavity. They arc loL'ely »;"pe„dX„ "th INTKHKAL OROANS OF UENEliATlON. 49 4a l»ri.ical region, ocoupyhiK »"iall „avit 1 S l;i=™ found in the uppc. portion a mom o,- tesobl n u„Z .^,i'' ° "? '" ""^ "»<><"'' "f its liilus of tllu liidnov nnil wl,l,.l, ,',;,"'' ''■'*™i<-', icsemblinK tho I'allopian tnix,. K l^^t^r^i'S ^'m,' '" "'". P-»i°" <>' the" fact, a peritoneal tunie which rSvTnvr.ln/ ^7^^, '^'^^'nents-is, in the covering henoath. This s t e /; L^ ,^T- '^' ^'^''"^■'"" «'°««Iy *« lamellar prolongations intf t^ subZ.t^^f'Tlu'L'^f '^'^' ^"' ^^"^^^ appearance fuul struct re The ,v/X,T''' ^''""'^ ^^'^ '^'^*'"«t ^^ and is son.ewhat red and spongy ; tt'omd^'v H "''';^'' ^^^^ ^""^' connectjve tissue, non-striated'nuscu L- ^b es , : d b!- '" «r«^-°««i"g of of vessels which radiate from the ce2itro u.tl\ T .1 ^ "^ ^''^'^^ number organ and nerves. The co./.o«/ ay ^Lore^l'^? P^^^T^^^.^T °f ^^e It IS not very vascular, but it c^ta n. T?k . ''"'^ ^?' ^*^ b^«is; r^s/r/f.v or follicles, and for th s n^ .m '^s substance the Graafian These 6Vf,.y/«. r.".vS aro "en m I " ^vS^^^ T"''' ^^^^^ nient : the snuillest are situated ben >/h / °"' n^""""'" of develop- descend towards the d™ laver inn ' « f ""'''" f "^"g'"^^- and they When they have reached t^heirperbdS '" A'"^"."'" ^^ ^''^^ ^o so^ a transparent, citron-coloured ^ti^ and >''°'''"'' *'^7'"^'" «"^^ ^'^t^ capable of containing then. ^hVv f. ^ ^^^'^^nic layer being in- pro,ninence on the ^urf! e 'of th'e o'a" ' Tr ''.'"' -"-defable perfect, is composed of an envplir^ ^" •/ ^''''''Mn vesicle, when ccnprises two tunics-a fibrous nS^nbrane/f '°''f^ '^^' ^'^^'^^ope IS continued externally with he stroma of //'" "^ ^^'' r'^'^ ^^^^^ rich in bloodvessels; L nLr J.Iv'w! *'^^;, f ^'7. and internally is which derives its bloodvessel U7n' utef itiV'"°.t^ ""'"'^^^"^ I'Hl or granular membrane (tumcn L .i^ { ' ^'"^*^ ^^ ^^ «Pthe- polygonal granular cells At^trboCo??h '^^'"P^^^f.of rouSd or fonns an aggregation (the cunuXsoTl^^^^^^ and surrounded by an" "ll'^rs S^ l^ ."/''^^^ the cumulus, boon designated the .o,,.,,..',,.!;!.' ^ £m"rr ?s :'e'f„i il m OBSTETRICAL AXATOMV. layer, the vitellus or yolk, the larger granules of which are superficial and compact, while internally it is a transparent albuminous fluid, in which are but few granules. Enclosed in this vitellus, though nearer its circumference than centre, is thejnucleus — the germinal vesicle, or Fig. 27. OVAKY OPENKU VERTICALLY. a, a, b, h, (rraafian Vesicles at different stages of development. Fig. 28. POKTION OK THK OVARY OF A PiG. a, Point at which a rij)e Vesicle is about to escape ; li, Fissure by which an Ovule has escaped. vesicle of Purkmjc, a most important portion of the ovum ; it has the appearance of a very small clear ring, measuring about l-60th of a line m diameter, and upon its surface is a dark spot, the macula qcrminativa. Ihis IS always observed as a simple rounded body, measuring from Fig. 29, Graafian VfiyicLE i\ Mare's Ovary. a, Membrana I'ropria of the ( Graafian Follicle; h, Membrana (k-anulosa; //, Discus T'roligerus ; c. Ovum. Magnified 5 Diameters. Fig. .30. OVILUM OF THE MaRE. a, Z(ma Pellucida ; h, Vitellus, con- taining the Ve-sicula Germinativa ; c, Cells of the Discus Proligerus. l-200th to 1-poOth of a line in diameter ; it is rarely found double or as an aggregate of granules, except in miniature ova. Tlie large flexuous arteries supplying the ovary are from the utero- ovarian trnnif r fliftv a-n.-a^A ,-,»,,.« fv,,. , ;. /. . . ,. • Kr.f^.,„ i • ' " Iu~-iT — ; ■', ^■^^^" =i'-'^-3 in Liio tunica aiDuguiea, before entering the hiius of the organ to be distributed in its interior. )vAnY OF A Pig. found double or id in its interior LXTKJtXAL ORUA.XS OF aENEllATlON ^ Differences. Cu7o, Sheep, and Goat. or sacculus of the broad ^^mnenC^^^t^^^^^f^^^X^V^^^Z "he same Graafian vesicles are visiblV hrou^h Jhp \^ ™°'' Pu ^"'^ ^^ arrangement is observable i^ tt'sSeelf^nd St'^'^^""^^- vesicles, which, when well develonednrni^^^^^^^^^ ^^ ° '^^ Graafian organ, instead of reniaining w thin if wL°n T^ '^' '"^^"'^^ °^ ^^e the stroma is scanty in pronor on vJl *^'''' "^^'^''^ ^"large. peritoneal sac, near the opening of whSh it hl''^ '%«"«Iosed within a nient. The posterior wall of this sac 1, i T ^ P^'^^^'^^l^te attach- formed by the wide and deep ^S oTi: ^Z^^TiS:''^ ^^ '^ ^, . ^'ich ami Cat. O^Z:;:^t^!^^:Z:'Ztt^^o ovana o. the Bitch and short, and they are comained in So;v''ito"„eum ™"' "'" ""^ Develoi'.mext. The development of the ovaria anrl f^o ^ • the Mare, the ovaria of the fX US TKTltlCA L A NA TOM ) ' ili^;. 8.re attracted to the contiguous surfaces : some to that of tlie ovisac, which thus hecoinos lined by a thicker layer of cells ; others to the ovum, accumulating round it. With the onlargeinont of the ovisac, the stroma of the ovum condenses round its delicate membrane (Fig. 32, b), to form what has been called tlio " theca foUiculi '' of Baer — the fibrous tunic already noted ; this vascular tunic ((/)i witli the otlier (/>), consti- tuting tiie vesicle ; while the stratum of luicleato cells lining this double covering is the meiiihrana (jranuloHn, and ti'iOse surrounding the ovum itself form the ])rol.iiicroiis disc (e), the mass of colls adhering tliereto being the ciivi'iiliiy-. The In/aliiiioii, or proper tunic of the ovum, thickens into the clear substance improp(>rly named the zona pellncida,. if), which in reality is a bag. As tlie cells and cell-nuclei of the ovum become developed, they ai'e pushed deeper into the stroma by those of more recent formation ; while, as the ovum ripens, th(! cells innnediately around it become elongated and pyriforn), the tapering extremity being attached to the zona : those of the cuiuulus diverge irregularly into the fluid intervening between them and tlie membrana granulosa of the ovisac. Wliat have been termed reti- iKiciiht' ( ltd A AS or (IKXEIUTlOX fi8 Pig. 32. (JilAAFIAN VkHKXK AM) OvUM. succeeding ovisac with the ripenin" ovum hn^ >».<„,« ^^ . i , .ho surface of the ovary the 5d ovispo hn« in T to protrude from of it8di,nensions, and f>{llen nv^ards • X cWind?^^^^^^^ "'? ""''^ niiltrated with fat and is gradually atorbedTtX^^^^^ lapse of the wall, depresses^the cicaL^'^t^'ape^it^fSthte'sut Fig. ;j3. KscAr-K oi' Ovum i'I!(»m Ovisac tion of successlXva i's Syed anf f h ?" l^Y P^"'^'' ?^ '"^*"^*^- ovisac goes on to T V^^t^vl^tTi^^^^ change m the ruptured obliteraid for a con^p^'itu,. w'^C'l^ '^^^. Intenm not becoming or original ovisac is mnrVh a thickening of this lining has become ai)parent ; a! c it begins to present folds, which are deepened at d, and the clot of blood is being absorbed and decolorised ; a continuation of the same process, as shown at <', f, 7, h, forms the Corpus h/fcinn, with its stellate cicatrix. hue, and on section presents convolutions resembling those of the brain. When recent, the corpus luteum of the Mare is voluminous, and drawn towards the hilus of the ovary ; it has two layers, the internal being constituted by a clot of blood the size of a small nut. Franck has convinced himself, by post-viortem examination of Mares, of the possibility of ova being thrown ofif from the ovary during preg- nancy. It is to be remarked that the number of ovisacs and ova which became matured at each " rut " or "heat," depends upon the multiparity or uniparity of the species ; in the Mare and (Jow there is usually only one, in the Sheep and (ioat one or two, in the Pig from four to a dozen, and in the Bitch a variable number. nRPROmrCTION. 6S BOOK II. OBSTETRICAL PHYSIOLOGY. REPRODUCTION. IlAviNci described the situation, structure, and peculiarities of the external and internal organs of the female domesticated anirnaJs we have now to inquire into their functions. Some of these functions have or their end tlie conception, development, and preservation of the younR animal for a certain period, until it can maintain a more or less S pendent existence, when others of them are brought into play h order to place It in direc relation with the external world in the act of parturition, while others cease. But in order that generation should take place in the higher classes of animals, it is necessary that the two sexes be placed ,n favourable relations with each other. This p^e? im.nary condition is indispensable, as the essential of reproduction is the contact witli and action of the male fecundating fluid on, the ovum of the female Nature has ordained that this creative act shouW b^ accomphshed by engendering in these animals an instinctive, copuStive and irresistible desire at a certain stage of existence; which desire' contmuing only for a brief period, is renewed after part cular intei^^s' until the faculty of reproduction ultimately ceases. ^^^eivals, Ihe advent of the power of reproduction in the male and female sex t r,!,r ^' r :7y^^"^q."^l among the various species, and is generaHy n relation othe duration of their existence-the creatures which a e it thin H,nf "'r'r*^^' °^ ^^■"^Sing forth young at an earlier period of lite ttian those which enjoy a longer term The Elephant only brings forth one at birth, and this occurs but once n three or four years ; while the descendants of the Rabbit iL the same space of time may be reckoned at more than a niilS This grS? disparity has nothing of chance or accident in it, but °s'in admirable harmony with the designs of Nature. The individuals of every ZcS produce, as has been just y remarked by Verheven a Tc.^V\ J ^P^°^^^ germs which amply cotersk losses .Zlt^y'^^.l, and thHrema ture destruction of many of these germs is likewise a providential safe guard against their too numerous multiplication P^oviaential ^^i^- whlrtvfo*"'"'?^''^^^" fecundity; these compdse the nutritive excess which the maintenance of the individual renders disuosab e and Thp sum total of the materials necessary for the embryonTc evok'iion but d^y t:r""^ °' ''"^ ^"° ^^^^°^'^^-^ - extensiv'e^ tZe of'fecun- If we take the weight of the fa3tus at birth as the eou'valent t^ th« wSrbV thfnumb\\'o? ^""^^ '^^ ^''t'^'' i' -'''^ -^ nalfti ly^S Ti^r; tlTK of the'^f'T -'-'''l'^. ''^- -otltrand^JompariJS £ exce s and from tb if ^°'*^"'f^*^ f '^" '^"ye at the disposable nutritive fert%:?aspe ils luh'c^::i\v ^7'Y''' ^' ^ble to calculate the none thVle^Imonstrf '°^ . ^l^^^^^^^ approximate, it ^ne the less^demonstr;^, i-p •n.XrS;£nZ table dmwn^urhrTi*""!?'^ /^''"f^ ¥''' '' '^^''" '•""' t'he' following animals ^ ^ Leuckart, with reference to the domesticated y ri 1^ f>(l oltSThrrUK -.I L I'll YsKtl.iHi V If ■4i Hpiu'lvM. Horno Cow Fowl WiiIkIiI of M.Mly. OnimiiiuN. .'ll'ri.OOO i7r.,ooo ."lO.OOO o.uoo Aiiiiiiiil nil* Aiiniiitl Wi'lulit of Irtllvii 111. Koliitlnn Imtwi'i'li Niitrltlvi' Mitttoi Niimlpiiriif VuiiiiK. nirli VciiiiiK Alltlliiil. rcMn ipf Mm MhIi'I'IiuI till! hviiifc tlio Miillii' wiMmIiI of ' mill llmt jliil.lr.l toUiu OI'j^iiiiIniii. llf \\w \ oiiliK. I'tir cunt, of tlio (ImniinoN, O'liiiimcH. lIvliiK Mnti'i'iml W.'lKlit. 4 fiO.OOO •J.O.OOO 100 : 7,7 M 1 ;trp,oo() :tri,0(i() 100: •jo.o 20 2 •i.r.iio 11,000 100 : IS.O •JO 2,1(10 •IM.OdO 100: r>:i,o •A 18 0,410 7,!ir.o 100: ;i(i,o •J 100 0,01) 1,100 100: .' .00,0 I Tho mitiiiive icHurvo of the Hoiho, (loinparod with that of the otlitir animals, iH horo seoii to ho very Uiiiitod ; whilii, on iho contiary, tho Fowl yields in roprodnotivo niatoiial a sum (!(]uivalent to (ivd times tho wei^'ht of its own body. Wiieii a lialance is struck hctwcon tho piolits and losses in tho animal economy, it is found tliat tho ^foat dilTorenco existing has its own reasonahlo explanation. Tho function which makes the greatest demand upon the imtiitive capital, is doubtless that with which the imiscles are ..•.harf.;ed, and their maintenance in power exacts tho heaviest compensation ; as tln^y consume material in propor- tion to the weif^ht of the body, and the i^noiKy, extent, and froiiuencv of the movements. In proportion as tlie iieit,'"ht increases, tho cnbical weij^'ht augments at tho expense of the motive power ; while tho latter, equal to the square of the trimsv(*rse section of the muscles, follows an' arithmetical, and not a goomotrical, progression. The nutritive maintenance, then, demands in an absolute manner nn expenditure much more consideiahlo in tho larger than the snuiUer animals; so that tho latter are more fruitful than the former, and their economy renders them more apt to hold in reserve a much greater nutritive capital. A rich and abundant aliment, given regularly, increases reproductivo- ness ; as is evidenced in tho case of our domesticated aninuils, if com- pared with the wild creatures of tho same species; and their fecundity increases or declines as their food is plentiful and good, or scarce and bad. But this intluenco of alimentation on fecundity, and the faculty of living beings to maintain a nutritive reserve, has its limit ; for tho intestinal absorption goes on in direct proportion to the superiicies of the mucous membrane lining it, and this is doiinite. '^^^1 /"'" ^^ materials necessary for embryonic evolution is also founded on the nutritive reserve. In proportion as tho organisation is simplified and the various apparatus decrease in number, so does the maturity of the embryo gain in precocity, and tho nutritive matter serve for a larger number of germs. Thus, as'has luien aptly said, what would be required lo maintain the singh; f(i«tus of a large mammal, whose organisation is complete at its birth, would sullico for the evolution of many million of frogs. Besides, the parent having once evacuated the product of her fecundation, has done with it— the tadpoles issuing from the ova find their nourishment in the outer world; but tho young mammal derives its sustenance from the mamnue of the mother, at whose expense it continues, for a more or less protracted ptn-iod, to live as a parasite (as it really was la lUcro). With the higher animals, irry \ 'V". NntHllvfMiitUi ,.,,, I jl.il.lr.l to Uui .""" lAl.lllM. wliioh givo hiitli U I'd- rent, (if fliu llvliiu MHtoriml WolKlit. 14 20 9 3 'J r. mt of the otlicr conliary, tlio <) liv(i tiiiioH till) vi'oii (ho prolits KfoiU, (linbrtiiicc 'miction whioli i (loubtloHH that laiico ill power • •rial in projior- Hiid fri!(iuoncy <0B, tlu) cubical vliilo tlio latter, clt!8, follows an lute manner nn an the Hiualler niier, an! their much f^'reater !S reproductive- iiimals, if coni- their fecundity I, or scarce and md the faculty limit ; for the e superiicics of >]ution is also organisation is er, so does the fQ. matter serve id, what would laiiimal, whose le evolution of i evacuated the es issuing from but the young the mother, at period, to live igher animals, lished are four ; these aro ion : but It is only on the in frcundli V '>.,.hT .' ! ?,^ '"*^' *^*"''® "• obHerved an increasn 1. ...m.(. y .itch only yields two per eent. of its weiL'ht but tho ( a f absorbs I > ,„., cent, of its pareiu .veight ^ ' liiiH une.,ual stnbutio,, of fecundity among th.', animal snocies is a oonservativo el. nt n th,. „c1um ,. of' .ani. are. ThSroduc ti veness and the nuiiier. uh (diances of d. , r„undin rtS ? arc coii.pc, .jted for in just proportion ut of " la i^ h^^ Ids of ova furmsH by He most ,,i-ohr,o sp. uics, a eoinparatiUX ited -lumber only lind all th. ..ondi^ons favourable for their developine CHAI'TKR I. Generation. Till.; processes by which generation is acco' (vpiildtioii, / and they continue ho for a variable period, accor' ^"^ «'^'^^ ^hat puberty is sooner attained m tb.e female than the male, and also that domesticity has u 4 1.. '^. IMAGE EVALUATION TEST TARGET (MT-S) fe # f^ \ \ [V % rv «i* 'ij. 1^ 58 OBSTETRICAL PHYSIO LOOY. \\ : 1 1 r'he'5orm«r°?i^'\*^' periodicity of the procreative manifestations n«rin'«« """t^; Bui owner! hv Mr wl'^ i- • u?' ''^" '*^ *''^"^'"' ^''- '^ames Lowe, saw a younr S Lowe taSeS Zthlh "^'fhbour, jump over a hedge and run towards the^aif^ scene oTacSron the BuH hadTumi^K Cair3"' ^\''^l"'1 ""' '"'"''* ''"''' ^ *»>« ~ " -"• ■^"'^ ^' "b- aid not turn out Hatisfactorily afterwards. I 'EUTRUM. years of age. ^ twenty-eight, thirfcy-two, and thirty-eight pre-eminent part in the perpetuattcifnf fh •' °'^^"' '^f^^'^^*^ *° P^^y ^ are interdependent. Th^eXrvt donL,^ 'P^«^'^«>.a«d whose functions, agent in generation ; as it dvea tL "- ?"- ^^^ ^"^ ^'"'^*^*' the condition termed r^/l^or W rn^'^'^-T^* "?'°*^^« «<^i^"'«« to been, or is intended to bTLundat'd IT^'k^"' '^" ^"^'^ ^^'^^ ^^^ and the peculiar fluid ejected at tht ;r^'i' *^' "'^'^' '«"•«*«« ™^cus the decidual temporary or envelo2f '^ ' T''""'' *^^ °^^^^' f^^"^* nourishes the fc^tSs, aJd finaUy exS U So'tW '.". '''''■ '''''' uterus co-operate in the accomnliQhm??! f .u . *^^* *^® ovaries and the uterine 8y8tem--LTmr ..1 ? ""^ *^^ ^°^^ ^^^^^ functions of These we will cVsSerln Z ' S '^'^T' ^^'i^^^ion, and ^.ari^n7.o,. phenomena that characterise ortn'° ^^''^^f^y ^^^nd, describing the ditions upon which Sf eToULrm^Xt^^^^^^ "°*^^°" *^« -- Tho . ,1 ^^f ^^^N n-(ESTRUM OR MENSTRUATION the ovarian ova or ovumTccordin/tnTi'''^^^ °^ maturation in tent or periodic, not con toous it! chL„'if ' • ^5'?" «°°dition is intermit. excitement that usually cSupVIv ^'''u^ ^^ ^ P^^^^^^^r systemic two sexes. In the S and fpmnl '' ^r^''^ ^"^"^*« P«"od in the generative organs at this time beco^i' ' ^?««ia% the latter, the and the uro-glnital secretes a^eTc.S ^VnTh'T^r'^^^^^^^^' determmation of blood to the ov«H' such Eummants, small vascular mfl^PcT ^^ J ^ •* ^^^^ erectile organ Tn cotyledons, which mayt^ETo ^e/Snt Z "'^ °^^^-^^ "ar tJ^ human uterus. " ^epiesent the spongy texture of the an^e^tfn^^^ra^^^^ be established by severaf important ft\ ^PP^"^^g««. would appear to ovar otomy or '" spaying. '^^There is a ?T.'^'^ ^^*^ '^^ «^S of ZIZ ''''' ?^^'"*^°" °" Sow . Bit hes and S? ""^°"g *l^°«e who that It does not prevent their showing siirnf ^ ' "'°'« P" icularly, operated upon when pregnant • th^s if mn ""'^'"'^ ""^^^^ they are anunalswhichhavealread|producXoun^Tf'^?''^^"y the case with also sometimes with young Limalfi^? J^u ""^ '^ '^ nevertheless the case With regard to th'e sefson rlhTch tht'^.'h"T?.^^f^'^ ^^^^^^ been observed that it is usuallv /hi 'heat "takes place it ha^ plentiful, especially with H Sr^^ aSln?l"'""'n^;^^^" food becomes heat during winter. The Mare is ,?«^f„i1 •"''^- ^^'^ Carnivora are in later. With the Cow whose CairisoTJ^^ror' ''T ^P^'" *° '""« " with a view to utilising the milk thlJ: T °"^ *° 'wo months old IS taken to i-.duce co^nceptSn agafn t 'T '°'''-'' ^' '^^'^'^' ^^^^^« begins to diminish ; but it has hpS K^ ^^"i''' *^® ^^^^eal secretion particularly the rutting perSdlnd.r'.*^ ,5^"* "^^^summer is more naturally present in September is usual v'o f " ^" ^^^^P' thS because the Ewes are W ami fmm/ ^^^ '^°^" during summer order that the Lambs may bSni at "S' ^^'u,^* '^^ ^^^"ral time in and the period of suckling over Zr or fi!°"'^,H' ^^ason-the spring when the herbage is te?ider and „ut^^^^^^^^^ stances particularly with animals bid fot" .k^".^ '" °*^«^ c^rcum induced sooner by putting the Ewes n. ^\^ ^^^^^^^r- the ruf. is ihe Bitch IS in heat from Decern hp.f!! i!''?hings in the year, and spring-time. i^ecembei to February, or in the autumn under sSydays old "TfT ^ ^'^"^^^-^-^-l Wro'LdZ thjT ""-^^^ ^^*^^ «"»«- eight mo„ti,Ynd„;Svar "".'J,"^'*'' showed the symptoms "f'^nf."''f.* ^°""^ P'g« was brought aTainThJi^^r''^^^ "^"^ at from three to indicated incoST^ ^ ''^,*'''. ^f Barthelmy had given hh„nL" "^'T^' ^° a°"o" in each on«» th— r - '^ • "t veterinary sur.re,,,, Thi- -• 1 *''"*' ^•"'"^d be kill«rt <62 OBS TETRICAL PHYSIO IMG Y. \i : The Cat is in this state in January and February, and also in the spring and autumn ; sometimes the heat appears three or four times & year, and the animal may produce young as frequently ; though in the wild state it seldom does so more than twice a year. The Pig manifests rutting in October or November— at least that is the period when it is usually put to the male ; and it may be put a second time towards the end of spring, in order to have two litters withm the twelvemonth. The frequency and duration of the period of "rutting" or "heat" depend upon age, species, and other circumstances; but it may be said to persist in the domesticated animals from one to fifteen days at the most. The shortest period is witnessed in the Cow and Sheep, and the longest in the Bitch. It is sometimes only present from twelve to twenty-four hours in some non-fecundated animals. With impregna- tion, however, it ordinarily ceases until after parturition; and if impregnation does not occur, it gradually disappears until the next period, which is somewhat variable. Its re-appearance in the Cow has been noted every month or three weeks, and sometimes at closer intervals ; and in the Sheep and Pig it lasts for one or two days and again appears from the fifteenth to the thirtieth day, but usually every month. When removed from artificial conditions, it is stated that the Ovine species is in rut in September, that this persists only for a day, but re-appears every fourteen days until the end of December From the spring until the end of summer, it may be said the Mare manifests a desire for tiie Horse every three or four weeks, and the objective phenomena which announce it continue from two to four davs In the Bitch they last for nine or ten days, and, as has been stated' ■only appear in the spring and autumn. ' This periodicity is regulated by Nature, with a view to the preserva- tion of species ; and in animals not influenced by artificial conditions It IS so arranged that the young creatures may arrive during the season when their maintenance will be best assured. With the subsidence of venereal excitement in unimpregnated animals there succeeds a period of calm, which is almost equivalent to that of gestation in impregnated creatures. And, strange to say, with Biic^e at the end of this interval— from the fortieth to the sixtieth day— thera sometimes appear phenomena allied to the parturient period ; these are : tumefaction of the mammary glands, followed by swelling and increase of the opening of the vulva, with reddening of the vaginal mucous membrane and the escape of a viscid fluid. The animaralso acts as if about to bring forth— making a bed for her young ; moving about uneasily ; neglecting her food for three or four days, during which the mamma) become still more developed, firm, and elastic the teats elongated, and the lactiferous sinuses filled with an abundance of good milk, which is easily obtained by slight pressure. If a Bitch in this state is presented with a young Puppv, she will take to it as if it were her own, and rear it most affectionately. This strange condition has been observed, though more rarely, in the Cat : and Chauveau has also noticed it in a Mare which had been put to the Horse, but did not prove in foal. The years during which a;struin continues varies with species and particularly w th regard to the age they attain ; but it always disappears towards the decline of life. Climate, inseparable from the conditions of alimentation, exercises a I 3gnated animals, ion, exercises a MATUHA TION OF THE GRAAFIAN VKSWLKS. ,, marked influence on the " mf " i« i,„ * • periodicity; but the econom cai aw trXifh i'. ^'"'^^P^r' ^"^ ^'« not vary. With many species the rut on Wo '* '' subordinate does in others which are LSurabiy placea "^L^^^^^^^^^ ^vhile persists in every season, or at least dnTw IT'^ '° alimentation, it Domesticity, in assuring animals food anr fh u"^' 5^'^ °^ *^« year, from the risks and alternStions of an e"-at"c ut^Vy ''T'^^'^S them returns of this condition. Fowls Pkoons nt' T^^f'""^ 'he periodical of winter, and the domesticated mamnmr^;^-" Y^ ?^'P'*^ '^^ "g^urs Though, as a rule, oestrum dornotnnn.! "' \'^' ^' ^^°^* '"Nervals, achieved, and lactation Jms nearly or nuKL"T ^^.'^^^ Parturition is iind some animals-as the Mare and Rg-itnlf^S ' ?'• ' 'f "°' '^'^ *« and even copulate ; and it is no "ess a fac Zf . "^y"'"'^ ^^ *^« ""^^e. tion may and does occur soon affP. n„t f- "m^' ^"^ i'"pregna- Hheep. and, it is believed, the Ma^ewiRT?"- • ?" ^°^' ^ss. and of success on the ninth d^/after mr n f ^ !i^*' ^'^^ ^'^^^^' certainty As has been just stated variois^cnn^^^^^" ^^T ^* ^"^ °^her time. ^ this state, and more or l^ss cCn'e thf nf"^",^^'".''' *^^^^PP^^r^"ee of advent. Warmth, shelter rl'vic ssi?udes o?^ *^^,^'«rvals of its dance of nourishment, esneciallv thnf !.f . .® ? .weather, an abun- labour, favour its more ''6^ and e-'- '*"^"'^*^"g "^'ure. and easy judicious bringing togethe?o "tht^f^l ^ndTelT''' ?."? ^^^^^'^^^ ^ induced by the injection of certain sub tances XL J' ^'' "^'° ^^^^ The persistence of this condih'nn f^t i ", *^® vagina, is a symptom of uterine or n.l2 a ^°"°^' *^^" '^e natural period favourable. It rendo rM^res S ^^erangement, and therefor^e Tn dangerous, constituting the distu blnce dl^f '' f ^f'^^^ble, and even Bepeated intercourse with thT mat wHllPn*"'^ ''nymphomania." dition, but frequently aggravates it iT ^ -^^ ?^^" ^hnornml con- Ovariotomy is often practiced for ' i Lnh. ''"""^^' ^'^^ "«* breed, operation is frequently followed hv «?,K ?"'^' T^ ^^ ^^^ ^^ow the symptoms for a Le ; i^n ttuZl itt mtf irsu^Lsll.^^^^^^^^^^^ SECTION Iir.-MATURATION OF THE GRAAFIAN VESICLES of The ral^^rsltlh^arSLT""^- and dehiscence, or discharge cated animals. thTugh i„d" e^^^^ ^^ ^^e domes^ti! mtended to commen^ce the'^t oT?4nlaSn Tr', ^'V' ^°"^"^«« which accompanies the maturation nffh! 1^ peculiar condition the female for the mnt nn!? fu .^^^ ^^"'"' *^^ '"tense desire of thisperiod. w[thi sa^ %d ffor^roc'itt'" P^°t"^^^'^ *^« ^^^^^ a this. At this time, L ^ThL^seen t.^( conclusively demonstrates ovaries. A certain Graa kn vedcle or'vS'"^' '^^"^'' ^'^'^"^ i" the and whether the animal Ts urpa,oisomnlt^^^^^^^^^^ voluminous than the others raising fjL ^ultiparous. becomes more body, and makes a n.oVe or less salfent nroT/>"'^^ "membrane of that witnessed in the ovary of tL p'. Aroi^nK'"" °^ '.'u T^^'^' ^' '« enlarge, and the stroma is congested whlllf^'H**'' ^'°°^^^««el8 of blood takes nlace • the cansuKn, ' "^^'^^ " '^.^ interior an efiusion and at a particular point Xesw''"' -'"^ ^ ^^stended and injected, which the ovum (Fig^ 28 4 IscaS ' l7Z l"^ Z'^^'' ^^P *^''-«"gh of the vesicle, the corpus uteumTs red ^^^ Pig, during the evolution It is pvnhahle th5,f ^h-r ^^7^^ ^^.^ed, deep red, blue, or nAprlv biark- i -..able that thu Graafian vesicles open at any part ofTh7surface 64 OBSTETRICAL rHYSIOLOOY. H' llj u "1 J of the ovary, in those animals in which the pavilion of the Fallopian tube is largo enough to envelop it more or less completely. But in those creatures, such as the Mare, in which the ovary is so voluminous, the pavilion cannot cover it ; and it is not at all unlikely that in this case the rupture of the vesicles occurs at the hilus of the ovary, as the corpora lutea have only been observed at this part. In multiparous animals, the rupture of the vesicles at one period of rutting does not appear to take place simultaneously, but successively. The number of Graafian vesicles which come to maturity and rupture at each period of cestrum, depends, with some exceptions, upon the number of young each female brings forth at a birth. The Mare, Cow, and Sheep, having usually only one offspring at a time, only one vesicle ripens during oestrum ; the Goat has most frequently two young, and in this case a vesicle ruptures in each ovary ; v^'hile the Pig and Carnivora having several at a birth, a corresponding number of vesicles open, and their co.Ttents occupy each cornu of the uterus. The ovum liber ited by the bursting of the vesicle is seized by the pavilion of the oviduct, which is applied somewhat closely to the surface of the organ, and is carried down the tube to the uterus, where, if fecundation does not ensue, it remains only a brief period before it is expelled or perishes. The seizure of the ovum, as has been stated, is all the more certain in proportion as the pavilion is large enough to grasp a large surface of the ovary ; this condition is found most developed in the Carnivora. CHAPTER II. Fecundation. The effective intercourse of the male with the female is followed by certain remarkable changes in the ovum and generative apparatus of the latter, which, at first kno vn as fecundation, conception, or impreg- nation, ultimately results in the formation of a new creature possessed, to a certain degree, of individual or independent life. The intercourse, to be effective, depends upon the presence of a healthy ovum in the generative apparatus of the female, and the introduction into this apparatus of the seminal fluid by the special organ of the male. This fluid contains the essential elements known as " spermatozoa " — organic particles of a particular shape, and endowed with .notion. For con- ception, it is absolutely necessary that the ovum of the female should be brought into contact with these particles ; though whether this con- tact can occur in the ovisac, prior to its escape, has not yet been defi- nitely ascertained. It is certain that, by reason of their particular movements, and also doubtless through the aid they receive from the special motion of the ciliated epithelium covering certain portions of the lining membrane of the uterus, these spermatozoa, when the uterine opening is patent, are diffused soon after coitus to the most distant parts of that cavity, and high up in the Fallopian tubes ; though they have never been traced so far as the ovisac. Nevertheless, a very strong argument in favour of their attaining this region, and producing what is called "ovarian" or " tubal impregnation," is afforded in the occurrence of extra-uterine— ovarian or tubal — gestation ; for in this case the spermatozoa must have reached both oviduct and ovary. Before the ovum iea\o8 the ovary, changes occur in it which may be I STERILITY. 96 the surface, goes to the centre of the ^dj or' J,'/^'^^ T^ before at brane investing the latter, from beimr f h » ^'j^'^^««; while the mem- the ovum is discharged the LZ^^ . ^ / "' '"^?enly tliickens. When it through the sniall op n ng i^^^^^^^^^^^ into the pavilion or infundibulum of Hia i ii ^^ ^^"^^ ''^'"S received time is firmly applied aga n Hhe ovarv T""-" -S"^'' ^^^'^'^ ^' *^'* ovum is carried along h, the slow v?rm;- / '^"^^'3, ^^ this part, the of the tube, as well as by the c Cv '"^^' '"°*'°" <^^ contraction the mucous membrane ifnm? ? lis LcT''";?* ."V'^« ^^"« ''^^^ring uterus. ° ""^ ^"'=*' until at last it reaches the it which may be CHAPTER III. Sterility. certain period. Successful fecund ition hi "^ ^"'^^^^ ^^'^«« at a and in some species-particuTaSv he w^ permanent, in the female is far Lm ^^"^"^-^terility, temporary o; times serious. Sterility barrenness o inf^"f ""common, and is some- stud« of France the fruithl Mares L-e59.?7 '^.Tif ^^^'P^' ^« '^^ 4(i-43 per cent. The Due de Cninh! ^J o7, and the unfruitful ones ^^ares.^ At the haras of l^ndu^-i.': SSl''f ?"' '"'''■ ^' ^^^'^"d was a percentage of 68-27 fecund M« J ^ ?-^ *'''^"*y ^^^'-S- there 26-67; while a? the IWadour har«7 ' f''''^"' ^■^^' non-fecund chiefly bred, the births in three yearwere7qV^^"t"*f-' ^°^^^^ ^^^^ non-fecunds 20-4o ^ ^^® ' ^ ^^' abortions 2-27. and '^^^^tZli^^^^^^^^^^^ average about 79 per cent. Hohenheim, found among s'^SOOswtfv'?^^^ ^^^^' ^^' Sterility may depend upon orSc or i?'-,^''''"'-'"'^^^^^^^^ amount to peimanent imp^otence mor« ' ^ -^'f^ '^V'"^' ^"^ "^ay and located in the generaMvP An^Tf P^S^^^arly when congenital dites. animals in whlcronror mC^ovf °f *'°'^"^^' herm!phro apparatus are absent, and hybr d^are Sr ^^ °'^^"' °^ *^« ^^xual -sometimes pSgin°XHn''r '""*'='' '."""""'^ ™ '""""^i-'ty the animals iatecund fo S a Toilr ST"; "'"^ ^' °*«" rendering be impiired, or suspended inSi '''°'''"" P™"''- I' 'i>»y also thege„erati;efu„cS fadhJK!!''' P''™-"-'ly. by abL of 69 OBSTETlilCAL I'HYHlOLOa Y. It may likowiso bo due, though temporarily, to premature or tardy coition when the generative organs are not in a physiologiciil condition for conception, or when they are in an irritable, abnormal state. Under- fed or over-fed animals generally do not breed so readily as those which are in moderate condition ; fat animals are especially unfruitful. Excitable, vicious Mares are less likely to procreate than those which are of an equable and gentle disposition. Tlie latter are often impreg- nated at one attempt ; and it has been observed that v/ith Mares accustomed to work, active exertion, even to produce fatigue, before being put to the horse, is favourable to conception. So it is that the Arab submits his Mare to a severe gallop, and brings her almost breath- less before the Stallion, when, ihe act being accomplished, he leaves her quietly at rest for some hours. Various diseased conditions of the generative or other organs, as well as general derangements, may also prove antagonistic to fecundity. There may be disease or alterations in the ovaries. Fallopian tubes, uterus, or vagina, which will hinder conception ; and it any material obstacle to the contact of the spermatic fluid with the ovum be present in these parts, fecundation cannot take place. Tumours of various kinds in this region are not an infrequent cause of sterility. Eueff and others have observed an imperforate, dense, and tough hymen to be a cause of infecundity in the Mare. The fault may rest with the male, and be due to imperfection in his generative organs, the absence of spermatozoa in the seminal fluid, or general or sexual debility of a temporary or permanent character. Or the spermatozoa, when introduced into the genital canal, may have their vitality destroyed by the secretions they meet with ; or the im- pregnated ovum may be unable to flx itself on the mucous membrane of the uterus because of disease existing there, such as endometritis. In all these conditions a careful examination should be made, as removal of the obstacle to generation may, in many instances, be quite within the scope of surgical or medical measures. More particularly is this the case when the obstacle is related to some abnormal condition of the cervix uteri — a circumstance more common than is generally supposed. Occlusion of the canal leading to the cavity of the uterus — the os— has been known as a cause of sterility in the Mare and Cow from the earliest times. This occlusion may be complete during coition, and prove fatal to concotion ; or it may be due merely to a spasmodic con- dition of the musclec of the cervix. The oiled hand should be intro- duced into the vagina to ascertain the state of the part ; when, if the closure is suspected to be owing to muscular defect, the cervix may be smeared with extract of belladonna. If, however, this does not succeed, or if there be hypertrophy, disorganization, or rigidity, then an opera- tion will be necessary. Hypertrophy from plastic exudation and the formation of false membranes, is a frequent cause of sterility, and usually occurs during or after the first birth, particularly in the Cow. In many cases the morbid closure of the os can be remedied in a very safe and simple manner. The animal is secured — if a mare by the " side-line," if a Cow by fastening the two hind-legs together, though not too close — and the oiled hand, in the form of a cone, passed up the vagina to the cervix in a half-rotary or screwing manner ; on reaching this, the tips of the fingers ai'e to be gently insinuated by the same movement into the os, and jjushed on until the cavity of the uterus is reached. A i srEHlLtTV. «7 dense, and tough i8c ; /;, BiiJb. l''ig. 30. «KCT10.N OK lMPRK(i.VATIN(i Tlbk. a, lJi8c ; i,, Bulb. l-'ig. 37. DiLATOK OF THK CkkvIX. i;iiiiis^i:;-Sc^s^"sr°i ^^^^ **^-^ - ^-r si.es to stallion and Mare the d^^ Sv'^T^/ '^"n ^^«l°bjectionable to'the and very elastic, so' that conneclof b tween^'m l'' '^' ^^^^^)' '« ^°"ow almost as if no foreign body StervS T^^^'^^ ''"^^" *^^^« Pl^^e these articles are : close approximation tn f^^ ^^^^"tages claimed for cervix during copulation, TnTsornSin^ '°"'^^^^°" °' *^« the cavity of the uteru compete thus ^ in., "'""''^'^*^°'^ between semen ; they are easily inserted arpvl?^ assuring easy access for the are cheap and durabfe The dilator ?fL°^^ ^"^ the^ mtroduction of the tube, brdHaJin. t fe ^n. ,! ^- ''"'*i^ facilitates the obstruction that may ex st thufi £ • !; *^" ^"'^ displacing any inipregnator easily and doselv a. win ^"^ *^' ""'"^^^ *° ^"veloj the : ;t. This is acco^pl^.:d b^S^ Vn^Z'T''' *'^^ "^ ^"«^ti^ f^ ^-0 the canal; the ^.iC,-^ ^ tlJ^t^^S^^^^^ 68 oitsTKTnicAi. I'll ysiiii.oii )'. drawn. Tlio Stallioti is thou allowod accens to tlio Maio, and within tivo ininutoH aftor copulation tlio tubo is oxtractcd by moans of a tape attached to it, tho uud of which has a ring, and hangs outBidu thu vulva. Moderate rigidity of the cervix, which cannot bo ovorcoino by prompt nianipulation, may bo combated by moans of spongt* tisnts introduced into tlie OS. Tlioso are made by soaking a sponge of tho necessary Hiz((, and to which a long string is securely tied, in a strong solntion of gum arable ; it is then closely wound round with a thread, so as to form an elongated, pointed mass four or five inches long. When dry tho thread is removed, and the sponge, being slightly smeared with grease or glycerine, ia passed into tho os, wluue it is left to soften and expand, in doing which it widens the canal. In some instances it may bo neces- sary to assist tho diLtation by making some slight incisions through tho cervix. In rare instances complete dilatation may require to bo ot!octod by a cutting instrument, but this should never be resorted to untJ'. the simpler and safer means have failed. Disease of the mucous membranes, with altoroci secretions, must bu troatetl according to tiie indications. CllAl'TKR IV. Changes in the Ovum. DuiUNo the progress of the ov jni towards the uterus, and soon after its reception into that cavity, some renuirkahlo alterations occur. The ovum has encountered tho fructifying element of tlie male semen — the spermatozoa: at least, this has been establislu'd in tlie Habhit, in whose; oviducal ovum they were found to have passed through the znna jicUucida, though no opening has yet been discovered in that extremely tine evanescent film. The germinal vesicle disappears, or has changed its character, and a somewhat more opacjuo vinhriitnuil cell succeeds, which may be, or includes, a combination of the nuclear matter of the sperm- cell with tliat of the germ-cell. Then the vitellus, escaped from its enveloping membrane, becomes depressed in a circular manner, and breaks up into independent masses. This change, and others to be described, takes place during tho course of tho impregnated ovum through the Fallopian tube. It may chance, however, that impregnation takes place in the uterus ; for it is probable that the ovum may bo retained there for a certain time previous to perishing or being ejected, and that, should it meet the spermatic fluid, impregnation will ensue and tho usual results follow.' But it is more ' It may bu remarked that, with inultiparoua animals, the number of young in the cornua are not in proportion to the corpora lutea of the Hame period. Franck mentions an instance in which there were eleven corpora lutea and only fire fcutuses ; from which it might be inferred that six ova had perished, or, if tht^y had been impregnated, that the foBtuses must have died at a very early period, and been absorbed. It has also been stated that an ovum from the right uvary (which bore recent traces of the rupture of a Graafian vesicle), has been found in the left cornu, whither it must have wandered. This has been ok^erved in woman, in the Bitch, the Guinea-pig, and also in the Sheep. Kehrer, in the MonaUnchrift J'iir (lebnrtskumli; (vol. xxii., p. 'J'i.')), mentions finding; a fcetus in each horn of the uterus, and in the right ovary two true corpora lutea. One ovum had migrated to the left cornu by means, probably, of ihe uterine contractions. I ci'utions, must bu ''//.IXO/iS /X r/J'- nvuM. „ likoly that tho initial clmiii/os aro in fJm nmio-w,, ^r • . plisho.1 in th« tuho. There tho ;)vmn i« Sh / "^ '"«tanco8 acco.n- «l;.n« par... j;,r;,::'-r':^';.r;i^^^^^^^ With th(! formation of the oinbrvownll n,,. „:* n i or rutractod hy Hui,! fro thr/ona n nl ^' T ""Vr^"'*^' ^ thoroin : while ^ono or wo n Ue n W l' 1^ , "T"" '" ^'^'"'^ in the HurroundinK fluid (Fig MH) . °' "''"^'''^ ''°'^'"' ""*y Wear i.n ,.B„;t.,l paro,,to, y,-^l "jt°h L tlwl'"'''''"'''','''""' "'■ ""> ooio„H.» ,...,i„„,, ,™,„„^,, „,/j,r;;5 iX^rr^cror-'K Fig. 38. Ovum kkom Ovinicr ok nAiinrr, rKNKTIIATKI) IIY Sl'KKMA lOZOA I.N ITS V^ITKI.LINK LaVKU. Fig. 39. A.N OVDM MOKK ADVAVCKI) TUB Oviduct. IN mlty'tatHt'tho"'^ .1'"'"!? '■^^"i^'"' ^^ *^- final "s"egmentS when the Lrm'nL ' '^^ /I ^**^'"«''. ^"'^ ^^ disappears altogether consu„ ' £T -^.f f '' conip eted. The act of impregnation is? thus |investin"tho volt T u^^"" '""'' ''^'*^^«« ^^ *he membrane now to a Sra n pLf of tha? '^''2 ''''''''r J^^" P^«^^^ ^^°'" ^^e centre I those of tio fnrmer whe ^f''' '''''^' °^- '^^^ ^"""^ coalescing with I brane-the futuTamn S. "^ two set s are m contact, to form a'mem. cue luture amnion ; while the interior of the mulberry-like body III 70 Pi-i OBSTETJIWAL PHYSIOLOGV. 18 now seen to be occupied by a large vesicle, containing a fluid and dark granules. In the centre of this fluid is a spherical body, composed of a substance having a finely granular appearance, and containing a cavity filled with a colourless and pellucid fluid; this hollow and spherical body seems to be the true germ. The vesicle containing it disappears, and in its place is seen an elliptical depression, filled with a clear flui-^, and in the centre of this is the " germ," still presenting the appearance of a hollow sphere. The fluid presses the nucleate corpuscles of the yolk outwards against the inner face of the enveloping membrane, and as it imu-eases the pres- sure from within flattens these corpuscles, until they resemble pavement epithelium; and, finally, they all coalesce to compose a membrane lining the zona, which has been named the blastoderm. This blasto- dermic vesicle divides into two layers— an external and internal~i\i& first of v^rhich is pale and only slightly granular, while the cells of the second are filled with fat granules ; it is consequently of a deeper tint. Fig. 40. OVUSr KHOAf THK UtERINK HAt.K OK OvinioT. Fig. 41. OVLH FItOM THK fTKRlNE END OV THE OVIIHJCT, WITH AN ADDITIONAI. LAYKK OK AmU'MIK. HHC^l ■ I ^■B^K|>' Hift'ii Though the foregoing changes in the '"mpregnated ovum have been chiefly observed in the Babbit and Guinea-pig, yet there can be Httle doubt that they are of the same character in the domestic creatures whose embryology we are now studying. It is only to be remarked that, in hoofed animals, no envelope of the ovum 13 superadded to the zona pellucida before it enters the uterus; impregnation of the ovum taking place in the Fallopian tube, where it meets the spermatozoa, the first stages of cleavage in its interior go on there, but the germ-mass is completed in the uterus. In this process the zona thins away and finally disappears, and a mass of albuminoid matwer accumulates around the ovum, which affords material for imbibi- tion. The gerin-masa becomes fluid .at the centre, and expands into a hollow sphere, the liollow wall of which offers two layers : both consist- ing of coherent cel'«. and only differing, as just remarked, in the size and proportion of the oil-globules. DEVELOPMENT OF THE EMBRYO. SECTION I.-DEVELOPMENT OF THE EMBRYO. 71 lower or m.«o,«_°^d between °hth TX, "" "'^^I °' """''■ ""^ «■ i» developed, another Scation oecu s bv whFr^h' " ™.r'" '"!"»• embryo becomes evident ^ ™"''' ""^ """'"o °f tie .heite^!thereS:bs:,tdTcie:?rJ' V7r'i '° -"^-■"" the arJ^rji„era or^SSa, tn" Kt " ^f';!'" nd Jnthe?"'^* verse axis of the vitellus. thare ia ^ninc/^rT „ ,,.',•.. ^" *^® ^'^^"s- connected cells in a ^rr^ahrZ^tZ,^^^^^^ '^'fy area, primitive streak, or trace of VonTn '^°"'!^./°^'«s the germmative space-the arm m5;..fo.r-is deveW^^ around this anothar the centre where the blastoderm lommence^fn h?"'"'''^! f'-^''^" '^ external and internal layers The mTd^ ay ?. l\re^1;^"^^^ ^ foetal organs, not extending beyond the "gernfinatrve avea'' or ''streak '' ,uVii*,j*iji!i!!!Jlll|i Fig. 42. Bi,Asroi)Kn.M AND Primitivk Tuace. constricting in its middlo r,Ji IJ,1 a.L ^'^^^^ ^P'^*' "arrowing or In the n3iSdl"of tllseri^Tonira;^^^^ the area r a s^^^^^^^^^ furrow, due to chan-es occurrinr n H?Aff ^ v " '^""'^ ''"^' "^' '"'"^^'^^ round cord-the c Wa Trl //' f i P'""it>ve streak ; and below it a wh.oh is to d.v'lop tt ,S^^ °f.the future embryo, and dorsalis, and the portion of L\-dtnn\-''^\^' the streak is the lamma salis is the futm?e spinal cord ^"frf "^ ^^^^ ^^'°"' ^^^ «^°^^^ ^or- 72 OliSTETJUi 'A L I'lIYSIOLOG )' t ifc . «£, 1 thickens at the front part, to form the first appearance of the skull, and the fluid between the dorsal laminto is in larf,'er quantity, in corre- spondence vvith it ; so that the central parts of the nervous system and their coverings are laid down at the same time and grow sinmltane- ously. The separation between the spinal cord and brain takes place early, being coincident with a curving downwards, towards the yolk, of the anterior part of the laminto dorsaiis, which defines the limit between the skull and spine, brain and cord. Next follows tlie closing of the dorsal lamimn over the fluid which is to constitute the brain and cord. Two other laminio are in the mean- time proceeding from the axis of the embryo, one on each side. They grow out laterally, and tend to converge in the median line, as did the dorsal laminae ; but they form a larger curve, and follow a different direction, converging to meet hcloir the axis, where they join, except at the mnbilicus. After the rudiments of organic life have been commenced in the central portion of tlie serous layer, a fold of its peripheral portion arches over the dorsal surface of the embryo, so as to represent a sac whose opening is at the edge of tlio fold. The opening gradually decreases until the opposing folds of membrane are in contact; it then disappears, leaving the fuitus surrounded by two membranes. Tie one next the fci'tus is the cunnion, and tlie other is gradually separated from the amnion, and joins tlio serous lamina of the blastoderm, forming the " false anmion " of Pander, or tlie " serous covering" of Von Baer. The membrane surrounding the vitellus or yolk is very vascular ; it becomes oval in shape, and more pointed when" it is in contact with the embryo, until at length it contracts into a narrow duct, constituting the vcsicula alba and duct. Thus, then, we have seen the embryo developed in the layers of the blastoderm, and formed by a gradual closing in of the lamina) towards the median line ; the brain and spinal marrow, whicli are its earliest rudiments, are covered in, and the parts anterior to the spine — the thorax, abdomen, etc.— are formed. We will now direct our attention to changes occurring elsewhere, and return to the development of the embryo again. To\yards the twelfth day, in the higher orders of animals, the chief modifications which have just been described as occurring in the con- dition of the ovum after fecundation, are accomplished. The ovum then measures from one-third to one-fourth of an inch in diameter, and IS composed in reality of four layers or shells, enclosed one within the other, but only three of vhich are complete; they are : (1) the yolk membrane ; (2) the external layer of the blastoderm ; (3) the middle layer ; (4) the inner layer. By ulterior modifications, the layers of the blastoderm form the various organs of the fcttus, and what have been termed its annexes, or enveloping membranes. The different layers have also received other names than those mentioned, according to their functions: thus, the external or serous has been named the sensitive layer, because it originates the epidermis and the organs of sense ; the middle layer has been named the nisciilar or germinatire, as it contains the principal vessels of the embryo, and the "locomotory organs are developed in its substance ; while the internal layer is known as the vmcoxiH or intcstino- glanihdar, from its constituting the mucous membranes, its principal portion forming the intestines and glands. Each of these layers furnishes, in the course of its development, the intrafcetal and the UKVKIMI'MEST OF THJ-J EMJinvo 78 cxtra-foGtal parts. We shall examine the latter first • merely noting in the •"eantime that the intra-fa tal parts of the exte^nTl or sens ?ve ayor o the blastoderm form the epidermis and its appenda-^esTs the hair, claws or hoofs, glands of 'the skin etc.-tKentral Nervous system, and the organs of sense-such as the retin^and the labvrS ; d to^iVstiSrtoTrr ''^ ^^^^^-"^^ '^^^^'^ h..zt^o^r^^i ana to constitute two folds; one mvest ns,a^ ig elsewhere, and Fig. 43. Ovum Twkntv to Twknty iive Days Oi.u 1, Villosities of the Vitelli or .Second Choi the Inner Lay 5. Cephalic and CaudafPn. cesses ; ti, H,„l r f ":'*•',,*« V'llos.fes; 3, Umbilical Vesicle, formed b^ ^^ . Z^;,^"''''*"'''^'™ : ^. Vessels „f the Un.biliial Vesicle: >ry" ; Mlantoid Vesicle S ifack* ofthT vonni" '''' r™"' ^T'' ''^'''' '''^'^ «°o" ^eet above mnhiS • P^^^."S creature, and a short pedicle-the superior cl a p Ls~ nd tl o :,tT' P°- 'T' °^ '¥ bl'^stodorm. This pedicL^soon rrrSy f^^^^^^^^^^ Tho r^' v'' '; '" -^oponde'nt sac-the Penu^d::^^^^:!.;^^^,^-!^^- ^"-r face of the .ona internal wl' te'^^'f he noticed hereafter, and we now go to the rtt Selin n n? t? '^'^^ F"'^' "^^'"^ ^^■''^"^^ " "'^^ons layer '' the rS;ir?tot^:;rItu %^^^^^^^ the glands belonging thei^eto. are developed at-fee s^ne W^s tST^^i^-^SS;':^^^- ^^'"^ °^^^"^ bla toITmaVLr^uflf;^^ ""'vT ""^°f ^ ^ i^'^^*^°" '' ^^e internal nart-. i« fr? lY ' ^ ''^^ ""'°" between the free and the imprisoned parts 18 at hrst largely maintained ; soon, however, it contracrrd in ^UBttauatoBB 74 OBSTETRICAL I'HYSlOLOav. a brief period is only represented by a somewhat narrow canal, the ■inferior umbilical ring. The mucous layer is therefore divided into two distinct portions : the intestinal furrow, or intra-fcefal portion ; and the tmbihcal vesicle, vesicula alba, or extra-fcetal portion. These two divisions communicate by the omphnlo-mcsenteric or vitelline dmt. The " umbilical vesicle " is filled with a granular fluid, which is conveyed by the omphalo-mesenteric vessels for the nutrition of the foetus; when this almaentary reserve is nearly expended, the allantois appears. This begins by a small enlargement, which the intestinal furrow pushes towards the inferior part of the abdominal cavity ; the enlargement becomes elongated and vesicular-looking, and gradually increases in size by bringing tlie umbilical vessels towards its borders. Becoming Fig. 44. OvLii AliouT A Month Old. 1, Vitelline Membrar Primitive Chorion, which has almost disappeared • tlSftS vX%-' '''! l^^toderm or Second Chorion; 3, AUantorpene-' r?nhlv P ^'"''^'^'^^ : ^,' l^mbihcal Vesicle ; 5, Union of the Caudal and 7, AlSnto^r""''''' *"'•""**'"" "^ ^'^^ Cavity of the Amnion ; 6, Embryo ; Still more elongated, it passes through the umbilicus and spreads itself over the inner face of the chorion, between the latter and the amnion. ,U?i- T • '"A"" *'''° ^''°^ ^y ^ constriction, the nrachus, at the umbilical ring; the inner sac is the smallest, and forms the bladder; rSo/s external, the most voluminous, composes the proper We have now seen that the vitelline membrane, lined by the serous S''and"hartrf'*'''f!r?r' f' °^^"" "^ procesHf develop- ment and that the layers of the blastoderm eventually constitute three membranous sacs, two of which envelop the embryo^ These variou '^f.^^J'Z-""""''''''' the ..envelopes'" or " anne'xes " of the voung c..ature dUiing uicro-gestatiou, and in describing them it is usual to include he '. cord " composed of bloodvessels, as well as the capTla y ramifications which establish and maintain such important relation! between the mother and its offspring during this period. APPENDAGES OF THE FOUTUS. SECTION ir.-APPENDAGES OF THE FCETUS. 75 sac included within the lattm- and i ? •' ^^^ T'""''' * «««°"d ovoid a men.brane composed of wo kvlfl^-^u"^ *^" ^^*"^ ' ^^e allantois, face of the amnioSand theinnelZlJl'') f^' 'Pu^'^-^ °^^^ *^^ ^^'^^"^i the cavity formed by these two pnvif °^ *^^ *'^°"°"' ^"^ *h"« "^^es form shape, the umbiUcTtllrl J^ ^^f^ ' ^ ''"^" ^^^^'^^^ ^^ ^ pyri- tufts grafting thrfSturto thp 'n.i?h'^^"''"i'\^ collection of vascular posed'of vess^els that aUach the fX to'th'"^ '^' '"'^'^"i '''^' «°"- and which ultimately ramifv in H^. V the envelopes which contain it, of these in detail as^rc^rLt know pS'" \f ^^ ^' ^'" ^^^^^'^^^ each to the comparative obstetrisfc a =T f^^ °^ '^^.\^ anatomy is essential type of comparison. '''^°''' ""^ ^^" '^^^^ S^l^Peds as the Chorion. it ^sa^r^:'i:^^^;Z!i^V'oierto the ovum, is found covering n=en,.J.e lining the \rta^ti;l;?S2.r^TraTirlt Fig. ir.. Choriox op thk Mare at Mid-tekm : Inklatki. !:srs,:s',ffi t'i;re,.u\"i;'S; .^"^ -.tThS aT.*^ SuT' w'heJrirj' '■--"■■- - "-""e™i;e"«witi'fhL:^Vtr size, that in Sh the f,P.„« f, J ' , ° "f';™" "" "'^J" ""^qual in Th^.vter, "l .irft 7f ' 'J«™'<>P«i being ot course the largest. smaliledslw,r™',,Ml "■'"!: """'°"'' '" "'"''''o'' «'"h innumerable .anSXr- "-1-^^^^^^^^^ ^^ trying Ij 76 OBSTErmCAL rilVSIOLOGY. \\ lined by the external layer of the allantois, to which it is closely adherent except at the insertion of the vascular cord, where there exists a kind of conical infundibuluni occupied by the umbilical vesicle. On this surface the umbilical arteries and veins ramify, their minute divisions traversing the membrane to form the placental villosities. The Fig. 4li. F(1;TAL MEXIBHANfS OK THK CoW AT MiD-TEKM. A, Uterus (ipened "n its left side ; V,, 13, Cotyledons of the Uterus ; 0, C, Placen- tulp; U, J), Allantois; E, Vesicle of the Urachus ; F, Amnion; (J, Um- bilical Cord. H chorion may be divided into two laminae, the outer of which has been called the cxochorion, and the inner the cndochorion. From the endo- chorion are derived the vessels which pass to the villi, the chorion itself being destitute of vessels until the allantois is developed. The structure of this envelope is that of a delicate cellular membrane, traversed by the vascular ramifications of the placenta. In many places its cellular fhich has been ^'rorn the endo- e chorion itself The structure e, traversed by ices its cellular APPENDAUEH OF THE FCETUS. jj arrangement closely resembles that of vegetables Pnoh r.^11 ^«»f • • a distinct nucleus; the viUi have the sJ^ texte but t i^^^^^^^^^^ filled with a granular matter. The strength of the n embrace is -neatest n the early ovum ; it is formed by the zona pdlucida, which 3 Fined bv the external layer of the blastoderm. It is thought hat the pSiv^ chorion disappears by resorption, and that this blastoderm cLver becomes the definitive chorion ; also that when the allantois has spS i'ig. 47. F.KT.M. AlKMnrUNKS 01.' THK CuxVT AT VnA. Tl.MK : Tw.Ns A, Cervix of the l- teriin ; li. Left Cornu • C l>; ,h^ n .v ., -me of the F..tuse8 ; K, A m, ,„ . f Ttto F P V "'." \ i^-/^"*"*"'"*' "^ left at tl.e middle of t.s Bodj v e e the Ic.'tf ^p " '""-"^ *'"' ^''"""'^ W»» of the Two Chorions at the Cervix M' H '"'"' '"""^ '" '^^"^act ; G, Union tS'umS 'tXtir de^i^^r^r^ ^"^t^^- --ymg outward furnished with its nun;eious villosltlL. "'"" ^'''''''' ''''^''''' ^^'^ DiFFKnENCES. lilDuilUDlfs. ^] 1 78 OBSTETJiWA L PHYSIULOU r, in contact The middle of its inner surface is united to the amnion and the a,Ilantois by loose gelatinous connective tissue, so laminated that It might be mistaken for different layers of membrane. It is only covered by the allantoia in the portions corresponding to the cornua which are longer than those of the uterus. It offers numerous small red masses, studded at variable distances from each other on the surface next the uterus, and which effect a very important connection between the latter and the chorion These are the placentuke, to which we shall allude presently. In the Sheep and Goat, when there are two young creatures, the cornua of the chorion are joined, so as to look, externally, like one S£lCi Fig. 43. Fa;Tus and F(ktai, Mkmbh.^nes m the Cat. tt, rt, Chorion ; b, Zonular Placenta ; d, Umbilical Vesicle, with its Expansions, J, between Amnion and Placenta, and ,7, its Pedicle of attachment to a loop of small intestine ; //, Allantois ; k, Fujtus. Pig. In the Pig there are no cornua, but the whole appears as an elongated sac, whose two extremities, much exceeding those of the embryos, are related to the envelopes of the contained progeny. Its internal face is similar to that of Euminants ; on its external face are groups of numerous small papilla) ; so that placentation in this animal is dis- semmated, though here and there, between the innumerable groups of papilla), are bare spots merely covered with epithelium, and there are no papilla) at its extremities. Bitch ami Cat. In the Bitch and Cat, the arrangement of the chorion is similar to that of the Pig ; it has no cornua, its extramitits are obtuse, and its d to the amnion me, so laminated jrane. It is only g to the cornua, norous small red r on the surface inection between diUce, to which ig creatures, the srnally, like one its ExpatiHions, iiiiect to a loop as an elongated be embryos, are internal face is are groups of animal is dis- irable groups of , and there are )n is similar to obtuse, and its APPENDAOES OF THE F(ETUS. mu . Amnion. I'V 49. portion „t Ihe U„,bul?J;ri.'f5;^ST,'l'''V'^'r''ri B.AliS5 80 OBsrEritwAL I'liYsinwa i: is distended witli fluid, and so is separated from the foetus ; and after being reflected upon the funis, of which it forms the outer coat, it terminates at the umbilicus. In shape it is at flrst spherical, but is afterwards ovoid, and it has thin transparent walls. The external face is covered by the inner layer of the allantois, to which it slightly adheres. The internal face is quite smooth, and applied more or less directly to the skin of the fcetus. It exhales or secretes a fluid— the liquor amnii — whicli bathos the foetus, and serves an important purpose in intra-uterine life. In the fu tus, as above mentioned, the amnion is continuous with the skin around the umbilicus, and is constituted by two superposed layers: one, a very fine fibrous membrane that adheres to the allantois ; and another, an epithelial layer, which lines the inner face of the latter. At certain points of its internal surface in Solipeds, according to some authorities, though denied by others, there are small white opaque masses of what are supposed to be epidermic cells ; hence, this mem- brane has been designated a true epidermis of the blastoderm. Thou"h thin and transparent, it is nevertheless of a firm texture, and resists laceration better than the other membranes. It does not exhibit either vessels or nerves when in a healthy condition. When the anmiotic sac is inflated, there is observed, at the portion adjoining the infundibulum of the urachus, a kind of vascular plexus, having the shape of a goose's foot, between the branches of which the two superposed layers are much less transparent than elsewhere. At this part, between the amnion and the allantois, is the small membranous pouch, quite empty, in which the umbilical vesicle terminates ; and here also the amniotic sac forms, opposite the cord, a little conical cul-de-sac. Towards the termination of gestation, one of the extremitiesi of the pouch, corresponding to the posterior limbs of the fa'tus, is stretched into a very short wide horn. LiQUOK Amnii. The liquor amnii is an albuminous alkaline fluid contained in the amniotic sac, in which the fcjotus is suspended as in a hydrostatic bed. It is in greater or less quantity, according to the period of gesta- tion — being abundant and limpid, or shghtly lactescent, at an early period ; and becoming scantier, viscid, and citron or reddish-tinted at an advanced stage, when it is adhesive and agglutinates the hair. In a Mare twenty-one weeks pregnant, Gurlt found two pounds twelve ounces of fluid ; in another at thirty-six weeks, four pounds five ounces ; and, finally, in one about the fortieth week, the allantoid and amniotic fluids weighed collectively nineteen pounds and half an ounce. Its colour during this period may be due to the meconium thrown out from the digestive passages of the foetus ; and its composi- tion doubtless varies with the development of the latter. It is some- what salt to the taste, and contains 99 per cent, of water, as well as albumin, mucosine, kreatin, glycose, and salts, the chief of which are chlorides of sodium and potassium, and the sulphate and phosphate of lime. There is also a yellow matter analogous to bile, as well as urea. A peculiar acid, the avmiotic, has also been found in it, in addition to fragments of meconium from the intestines of the foetus, epithelial cells and their nuclei, besides portions of the thick epidermis which covers the plantar surface of the hoof of Solipeds. Towards the end of gestation the albumin diminishes. Probably the formation of the mucous layer ai'cn covers APPE.VDAOES OF THK F(ETUa. Soyler givo8 its chemical composU on T^Z^ I" ,*?•' "^''^- S°PP«- sniall quantity of casein krS hunf ^i ' ^°^^'"8 *" solution a plrbKralfsir;::^^^^^^^ it is not very intra-uterine life ; though U, as b/en f""-^^ ' '^' ^ '*'^^ ^'"°*^ °^ young animals which had been nunSv f? •" Z^- '*°'"^°^ °^ '^^oso then dissected ; portions of tJ^^^K I ff "i" '" ^^^'^ niembranes, and covered in the fa,tairomachi/n^.nl^''^^'"''""^ ^^^^ ^J«° been dis- the young creature; nSai s tl i'nteS^^^ temperature for is covered by the peculiar sebLeon, S 1^ ^'''^*'''°'" ''^^^^^ the skin its development, by removin.'TtZn?. ^ ' . "^""'^ '^^ "lovements and impressiof; from'suilen ext^;^! XemS 1^/??^^ ' ,?'^>«'«he8 the It from in ury ; and allows it to obn X^!f, T ^ '°.''^?' '^"^ preserving tects the mother fro.n iniurv hv f . 1 f f -'^^^'tation. It also pro gestation. During paZSfi^„XS^^^^^ "^" terminatioS of agent in dilating the mnl^^ Sl^XAl^^^ ^^ istheprimary of the uterine%ontrac ons' whoff ^^^J^^""^ ^'^^ the direct action existence; renders the ^atatTon of I^e nf ""S^^^^^'^Promise its finally, by lubricating the vag na cau es th^^^ ^""^ P'T?'' ^"^' through it to be more^entle and^pTS:^\^^-Mh^^^^^^^^^ Differences in the Amnion of other Animals. Buviinants. The amnion in Euminants is similar fo fV^of ^f <.u nr separated into two layers and <,hn^c 1 •. -^ '^^ ^^^^'■^- ^t is easily near where it invests ^tle' umbiltarcord a T'' '""'^^l^' Particularlj yellowish- white bodies In thp S T ' ^''''^^ ^^rnh^v of white or the form of priX at o her t^ml n'' ^'"-'"^"^^^^^ elongatea in raised patched, Shout tel^n^^T.r^l^' "sc^net'^^'vV^^^ single; occasionally they are in clus ei-^ 7?./' ^°'?^t"»e8 they are nucleated cells, resen.bC aTouamou, Pnm ^-'^^^^^^^ 9^ large, flat, that they are the seat of or,Ltion of '"1- ""' ' ' «°°«l"d«d certain period of intra-u ter ne life th.v fn^'"'" • ^**'.'^*^- ^P to a degenerate-theiroraanizationL/L 1 ^ '""^'I?'? '" ^'^^' and then to the developmenrof tit e^wLse fuSnIh ^ '"^ inverse relation to glycogenation. Externally he amnTontnu'^.f'"'" "^'^^ ^^gar. the allantoia and chorion. altogether in contact with It does not differ in the Pi<^ , Bitch and Cat. ^Vo'f^th^Jit^n^^^^ by the amniotic animal. In the aStic 1 quid^ cru^^^ "^"^^ «^«" in tha the end of gestation ^ ' •"' °^ meconium are found towards mr . Allantois. ine allantois arises on the front nnrf r>f +v>n v,^.*. • mucous layer which i, closingTo foCVheteS?:^ rgrilf o'i' S: 6 ■■i It m m ! ri,i J . 82 nnsTKTRICAL PHYSlOLOOr. intoatine, which proceeds very rapidly. It pasaofl out where the ventral laminuD are still uncloHed, in the region of the umbilicus, and roachog, either mediately or immediately, the inner surface of the exochorion. Bv the constriction of the umbilicus, it is separated mto two portions which communicate ; that within the body of the embryo is the saccu- lated urinary bladder, with the urachnu or tube of communication. It receives its vessels from the hypogastric artery; these are spread out as a vascular layer, especially upon that portion of its surface which faces the exochorion. The vessels form a distinct layer-the endo- chorion. As a membrane it lines tlie inner face of the chorion, and is reflected around the point of insertion of the umbilical cord, to be spread over the outer face of the amnion ; in this wav it transforms the chorionic sac into a kind of serous cavity, in which the amniotic sac is enclosed like a viscus. ., ■, , .i • .t, . The inner, or amniotic layer, is so loosely united to the amnion, that Fig. 60. A, Foetus ; B, Cavitv of the Amnion ; C, Cavity of the AUantois ; D, Um- bilical Vesicle : 1, Chorion ; 2, Chorial Layer of the AUantois ; 3, Amniotic Layer of the AUantois ; 4, Amnion ; .''•, Urachns, the expansion of which forms the AUantois ; (5, Pedicle of the UmbUical Vesicle. a slight dissection or inflation will readily detach it. When /nflation is practised, the separated membrane presents a wavy appearar.ce, h. la; "v covering it, we introduce a tube between the two membrci..' v" vv.iich is easily done near a large vessel, a slight inflation causes the air to penetrate between the allantois and chorion, though only in the track of the vessels of a certain size, where the adherence is slight ; a more powerful inflation will cause the air to follow the smaller vascular ramifications, and render the membrane still more apparent, but not at the points where the vessels have almost ihe amnion, that ssels have almost Al-rKXPAflKS OF THE FlETlfS. 99 beoome capillaries. If, instead of foroin^ the air tnwfl.ver ;.ncie„t times, t he^r^e nVm ? V"C ^ «» TsSW'T '" tlie consistency nnd elasticity ot .'Inten areSfL..! f ", '^ they have lit the border than the centre "to^' f. "f ffa. fud are thinner «oneially pyrifoim and theij ne,?, • '""'""' '° ""= ''"""'™' "o ^1 '.■•' if m 84 OBSTETRICAL PHYSIOLOGY. Differences. \K I Ruviinants. In Euminants the allantois is different to that of the Mare, being less complex. It represents a very elongated cavity, the middle portion of v?hich is not extensive, and receives the insertion of the urachus ; while its extremities, which are unequal, aro prolonged into the cornua of the chorion, where they are attached by a small ligament. This sac is in reality an expansion of the urachus ; it is always thrown back on one of the sides of the amnion. In the completely developed fa?tus, even at birth, the allantois still conmiunicates directly with the bladder by means of the urachus. Frequently in the Sheep this membrane exceeds the chorion, and in the case of twin embryos, although the two chorial sacs unite by one of their cornua, there is only a simple external union between the two allantoid membranes, the cavities remaining isolated. , n • Laminated deposits, lilie the hippomanes, are found m the allantoic fluid of Ruminants, though not very frequently. These deposits are less dense, smaller, and of a lighter colour. Pig. In the Pig the allantois does not offer any marked difference from that of Euminants, except that it is less sacculated, and shows.at the ex- tremity of each cornua a small portion projecting beyond the chorion, which : J seems to pierce, w^'ile it is strangled by a kind of rings formed by that envelope. In the gelatinous tissue connecting the allantois to the chorion are numerous small, white, spherical bodies, each possess- ing a distinct capsule; they are composed of multitudes of circular cellc, ..le size of lymph corpuscles, and quantities of granular particles being, in fact, histologically the same as the hipjwmanes, with which they are probably homologous. Bitch and Cat. In the Bitch and Cat it is disposed in the same fashion as in Solipeds. Its external layer adheres less closely to the chorion, except at the part corresponding to the placenta, where it is more intimately united. Umbilical Vesicle. The umhilical vesicle, saccus iniestinalis, or vcsicula alba, is a small fusiform or pyriform pouch lodged in the infundibulum at the extremity of the umbilical cord. Its fundus adheres to the chorion, while the opposite end is prolonged to a certain length in the substance of the cord, being even continued, in the very young foetus, to the abdominal cavity by a narrow canal that communicates witli the terminal portion of the small intestine. This pouch has a red colour, due to its great vascularity, its walls receiving a special vessel from the anterior mesenteric artery ; the ter- minations of this vessel give rise to a corresponding vein that terminates in the vena porta;. These are the two omphalo-mesenteric vessels. The umbiUcal vesicle in Solipeds is constantly present as a normal formation jj, the earlier months of foetal development, being formed frnni the Gxtra-f octal portion of the internal layer of the blastoderm. It is con- nected with the intestinal canal of the foetus ; being in reality the vitellus surrounded by the blastoderm upon which the embryo is first formed ; and it bears a perfect analogy to the yolk of the egg, except that it is not ultin^ately enclosed within the foetal abdomen. It is a. THE PLACENTA. 85 transitory organ, and in the last months of fcetal life, though in Solipeds traces of it continue until parturition, it is always more or less atrophied, Its cavity has disappeared, and nothing is left of it but a small reddish- brown cord, adhering to one of the sides of the infundibulum. Its vessels also atrophy in the same manner, the artery being nearly always found reduced to the dimensions of a thread. Its use is evidently to contain nutriment for the fcetus, before the development of the placenta ; though it may also serve other purposes. It is the first organ which elaborates and supplies blood to the foetus. In sonie instances the chorion has been found perforated at its junction with the umbihcal vesicle, which was therefore in communication with the cavity of the uterus. Differences. Buminants and Pig. In Ruminarf.s and the Pig, the umbilical vesicle is longer than in bohpeds ; it a io bulges in the middle, and its ends terminate in a canal. It is longest about the tweuty-fi^th day, and disappears very early ; no traces ot it can be observed between the second and third month after the abdominal parietes have been formed. Bitch and Cat. In the Bitch and Cat it remains very developed up to the time of parturition, and in form resembles the allantois of the Pig It IS a transversely elongated sac (Fig. 48, d), extending into the pointed cornua {ff) comprised between the amnion, the inner layer of the allan- tois (/?), and the placenta {h) ; it :« nrovided at its middle part with a narrow pedicle {(j), which is prolonged into the umbilical cord and has very vascular walls. The PriACENTA. The placenta varies extremely in different species. In Solipeds it is constituted by a multitude of short villosities or filiform papillte, which are spread in a uniform manner over the whole external surface of the chorion {diffused villi or placenta, constituting a chorion frondosum) ; though there is sometimes observed a tendency to bare patches, one especially being noticed opposite the os uteri, where there is no mucous membrane for the villi to penetrate. These villi are received into cor- responding depressions or follicles in the lining membrane of the uterus. The villi are very red in colour, and consist, like the chorion itself, of an epithelial and a vascular layer, they being, in fact, the terminal ramifications of the vessels of the umbilical cord. They are slender and easily torn ; and each is composed of a small quantity of delicate nucleated connective tissue, covered by a simple epithelial layer, enclos- ing the capillary vessels, which are arranged in loops made up of a principal arteriole and two veins, there being generally only a single, or at most, a double, capillary loop. The villosities of the fcetal placenta, penetrating the newly-formed crypts in the uterine mucous membrane, bring the capillary systems of mother and foetus into the closest relationship, only the very thin coats of t,)e vessels and the epithclimn intervening in the two circulations, ihere is no fusion, vascuhir continuity, or direct communication bet\\^en the maternal and fcntal systems, as was at one time taught ; all the important changes that occur taking place through the walls of the capillaries by virtue of osmotic force. The function of the placenta, then, is to minister to the nutrition OBSTErniGAL PHYStlOLOG Y. n and development of the foetus by means of its intimate relations with the uterine vascular system, until the time has arrived for the expulsion of the young animal. Notwithstanding their close apposition, the adherence of this papillary layer of the chorion with the inner surface of the uterus is so slight, that this organ can scarcely be opened with- out more or less destroying it. A small quantity of a brownish fluid is found between the two. At an early stage of gestation there is no placenta ; a temporary mass of albuminoid substance accumulating around the ovum in the uterus, affords material for its nourishment un'il the vascular intussusceptive relations b(!tween the chorion and uterine lining are established. When gestation is terminated, the placenta becomes remarkably rigid, the vessels are obliterated and transformed into fibrous tissue, and the external face of the chorion is wrinkled and withered-looking. Differences. Cow. In Euminants, there is an important difference in the arrangement of the placenta from that just described. In the Cow the villi of the chorion are developed and agglomerated in large numbers at certain points of its surface, to constitute a multiple or tufted placenta, which is composed in this way of from sixty to eighty lilacentulce, or " fcetal cotyledons." These are of a bright red colour, of various sizes, and generally oval in shape ; they correspond to the prominences on the lining membrane of the uterus from which the deciduous maternal parts of the placenta grow, and which have been already described as the "maternal cotyledons" or "placenta)"; into these latter the foetal processes are received. The maternal cotyledons are nothing more, as has been stated, tnan appendages or thickened points of the mucous membrane, whose utricular follicles, more numerous than elsewhere, have become eucrmously enlarged, and crypts have been formed. They are permanent, as before conception they are certainly present on the inner surface of the uterus, and traces of them may be already found in the foetus of four or five months; observation also appears to have demonstrated that they may be increased in number, or regenerated, when accidental circumstances render those in existence insutlicient.' They have been discovered in the foetus in process of formation, and regularly disposed, beside the ordinary cotyledons. Chauveau's experiments have proved, that after all these placentulte have been extirpated from the uterus of the pregnant Cow, sterility does not necessarily follow ; but if, on the contrary, the animal sur- vives the operation, it is still capable of breeding. In such circum- stances, accessory cotyledons are developed upon the surface of the uterine mucous membrane, where previously none existed. Chauveau lias also stated that during pregnancy the number of cotyledons is increased ; and Colin, in his Pli/jsiologie Compardc, makes a similar statement. Professor Franck, of Munich, in his dissections of the gravid uterus of bovines, has found, in a large number of instances, a more or less abundant quantity of accessory caruncles (kurunhcln) on the mucous membrane, and which had no eor-cBponding relations with the chorion. In one instance tlie ordinary cotyledons were entirely ' In thu Journal de Med. Vcterinairc de Lyon, M. Strebol, of La Tour, Switzerliiiid, gives an in.^tance in whicli there was ab.sence of tlie uterine cotyledons in a Cow, and thu placenta was like that of tl)e Mare. Conception took jijuce, yatiition weiii mi favourably, and parturition was normal. THE PLACENTA. 87 ite relations with for the expulsion apposition, the the inner surface ' be opened with- brownish fluid is 1 temporary mass um in the uterus, \x intussusceptive iablished. When rkably rigid, the tissue, and the ooking. e arrangement of the villi of the imbers at certain I placenta, which niulce, or " foetal arious sizes, and )minences on the IS maternal parts described as the latter the fcjotal nothing more, as iS of the mucous than elsewhere, an formed. They y present on the already found in appears to have ', or regenerated, jnce insutlicient.' f formation, and these placentula) int Cow, sterility the animal sm- Tn such circum- e surface of the sted. Chauveau of cotyledons is makes a similar issections of the 3er of instances, 3s (kariinkeln) on ng relations with ns were entirely a Tour, Switzerliiiid, iiiH in a Cow, and the went on favourably, absent in an unimpregnated cornu, and in their stead were thousands of the accessory processes grouped together in small clusters. The whole of the Immg membrane of this cornu had a peculiar mossy or velvety appearance. In a number of instances Franck has observed, in the immediate neighbourhood of the os uteri, where cotyledons proper were absent, groups of the so-called accessory cotyledons, in their form representing a placeyita pmvia (Figs. 53, 54). Certainly, this kind of placenta prcBvia in Cattle has not the disadvantages it offers in woman ; for although a premature delivery may occur, a sufficiency of the placenta always remains to maintain the nourishment of the foetus. Serious haemorrhage is likewise little to be apprehended in such cases; and even disconnection between the placenta fcetalis and the placenta uterina in the Cow causes no injury. This is not the case with the huQian female and the Bitch. Small haemorrhage streaks at the summit of the finer tufts, or on their upper surface, are often noticed in the Fig. 51. Portion of Chorion with PL.\oKNTLL.t; ; 1, Chorion ; 2, Placentul*. Cow. uterus of Cows which have been slaughtered and bbd. Birnbaum attributed these streak: so a plethora ex vacuo.^ The accessory placentul* are, both in shape and situation, as well as in development, different from the cotyledons proper; for while the latter, and of course also the foetal cotyledons, are art-anged in four regular rows, in the gravid uterus, through the rapid increase of the aiuniou towards the poles of the ovum, they lie somewhat cbsely to- gether, and the accessory processes are placed between these rows in ail irregular manner. In their highest development, the latter are so disposed as to constitute a variable-sized, felt-like patch ; the largest and widest are usually observed behind the ordinary cotyledons, and then; form is very irregular, but normal. As a rule, the largest are not so big as a walnut, and they are widest at their base. In structure they resttinblc the ordinary cotyledons, their bloodvessels being arranged in the same manner, while they are covered externally by a sheath of epithelium. In the early period of pregnancy— about the second or third month— they are found in largest number on the entire upper surface of the chorion, also on the parts between the ordinary coty- 1 UnU'rmchuHijvn iiher den liau der Eihunte der Saupthiere, p. 90. 88 OBSTETRICAL PHYSIOLOGY. J*f;-, -life '^^ '*vA-' *-4J«.^ Fig. 52. Accessory Placentul.k in a Cow's Uterus. They appear like innumerable miniature cauliflowers growing from the sutface of the mucous membrane. I'Mg. 53, Accessory Placentul.k on the Cow's I'teuis, constitdtino what is KNOWN AS "Placenta Pu.kvia." a, Internal^ Os ; b, b, PlacentuliE ; r, r, Eadiuting folds of Mucous Membrane, from which the newly-formed Placentulie have .sprung ; (/, d. Two Normal Placentse UterinsB ; e, c, Uterine Mucous Membrane, THE PLACENTA. 89 from the suiface ITIKO WHAT IS ledons and the finest caruncles. It may here be mentioned that the ovum of the Cow m the first week of pregnancy is smooth. Franck has never been able to discover the vascular semi-dstached caruncles which are afterwards developed through the prolongation of the blood- vessels ; though they are found in the Canine species. He has, how- ever, observed definitely-formed vascular chorion-cotyledons between the fourth and sixth weeks of pregnancy. The interposed cotyledons observed by Franck have been noticed by other anatomists. Birnbaum mentions them, but he is in error with regard to their development, inasmuch as he believed that they arose from the uterine glands, which is certainly not the case. The chorial tufts penetrate the uterine Fig. 54. FffiT.u. PouTiON OF Tlacknta Pu.kvia. a,n, Newly.forniod Fa'tal Placenta Pnevia, a Placentiile having been deve- loped on the Internal (). ; h. Blood-clot and portion of Fa-tal Membranes which lay in the Os ; c, Chorion. mucosa by four digitations, fixing themselves in the so-called simple tollicles, according to Franck. i \ This excellent authority also points out, witli res'ard to this circum- stance, that m the vicinity of the uterine glands there are found small ollicles which are nearly always unobserved. The connection between these chonal tufts and the uterine mucosa is extremely slight. At a later period of pre-nancy, there appear other ca "uncles in the tonii ot IcEtal tufts and cotyledons, which the previously developed and proiument maternal cotyledons and caruncles lie opposite to and in contact with. The reason for this fact is to be sought for in the circumstance, that the foetal caruncles pass into the most developed • DtntHche Zeilm-hrift J'iir ThiermcUcin. 90 OTiHTETltlCAL I'U I'SIOLOG V. Ml '. ; -m uterine cotyledons, and in consequence bring the larger tufts of the allantois into contact with the opposite parts of the chorion. The inter- mediate caruncles become entirely wasted. Nevertheless, with isolated tufts, sometimes in a great many, we find an increased development, which gives rise in ihe corresponding uteriao mucosa to a similar forma- tion, and a close co-optation, or even an inter-penetration of these accessory foetal and maternal cotyledons. When gestation has commenced, the surface of the maternal caruncles, previously smooth, becomes convex, and is covered with rig. 5-.. Maternal and Fit-.tal Cotyledons of the Cow. A, Pedicle of the Maternal Cotyledmi ; ]!. B, Maternal Cotyledon ; C, FcBtal Cotyledon ; D, Placental Villi ; E, Chorion. reticulate processes which border the crypts, and give it a finely cribbled appearance. The largest are found in the body of the uterus, and they become smaller as they approach the extremity of the cornua. They arise from the uterine surface by a somewhat narrow pedicle, through whicli they receive their bloodvessels, and their colour is nearly always dark yellow ; altogetlier in sliape, hue, and general appearance, they arc not unlike a more! iiuishrooisi. The " fcetal " or " chorial cotyledons " repeat the disposition of the maternal cotyledons. They are bright-red concave patches, each exactly fitting into the sinuses of the corres])onding uterine processes, with which they strikingly contrast in hue ; on their surface they offer a multitude of long, conical, ramifying, or branched villi, measuring THE PLACENTA. 91r ion ; C, Fcetal from 4 to 6-lOths of an inch, which are received into the depressions of the maternal cotyledons. This ramifying or racemose disposition of the chorial villi is pecuhar to the Bovine and Ovine species. The chorial cotyledons are attached to the chorion by a very short, thick and vascular pedicle ; between them and the maternal cotyledons there is always to be found a small quantity of thick, white, milky-looking fluid — the so-called " cotyledonous " or " uterine milk." According to Schlossberger, this uterine milk should be considered as a fluid analogous to milk or chyle. It contains 88 per cent, of water, 1-5 of fat, 0-7 of salts, and 9-6 of a protein substance. In the cotyledonal fluid, as well as in that on the surface of the uterine mucous membrane of a Mare towards the end of pregnancy, Ercolani has demonstrated the presence of albumin ; in the same fluid he has also proved the exist- ence of amidon, dextrin, and sodium chloride.^ /illi, measuring rig. 56. COTTLKDON 0¥ A Cow's UtERUS. a a, Surface of Fcetal Chorion ; h h, Bloodvessels of Fc«tal Chorion ; r c. Surface TLYn,'r"r.f "r-'n^'^'V^'"*"'^ ' '^ ''• ^bloodvessels of ditto ; j\ Secretion from Utricular Glands-Cotyledonous Milk-between Maternal and Foetal VesseT and which m necessary to the Mutual Interchange of Gases, and Nutrient Lflfete, and other Matters between Parent and Offspring. The reticulated surface of the maternal cotyledons is homologous with th^dcculua scrotina of other mammals; but it possesses a firmer texture and usually remains attached until the termination of gestation- -allow- ing the foetal vilh to be withdrawn from it at birth ; it is afterwards ' We must not overlook the fact, that the existence of the "uterine milk " in the ae, Auimaux, 18/2, vol. n., p. .s,0), who states that this Hnid is simplv a product of nosnv'id^nt'^"'"','' '"' '• "'". '"""' ^"""^ "f^' ' '^« ''^' '--^ assurld hinfselFin the r,,n,i^ V .;^^,°P'u'"' f''" "''='■"' "f * pregnant Mare and Cow. It is not SheS Zjh e :f in ni^'f';/" '" has demonstrated on n.any occasions in Cows an] Ssix wllv '^i . "^"1"'' ''^ "", l^'-'""'^'' "^ gestation ; it is not even observed attei SIX, twelve, or twenty-four hour«, or longer, when the surrouiidin- tuinourituro doc. SisUurL's'liTr'";-"- 'f " ""^^ ^^■'"^" the'placent. spontane^:iv": Jarate" stZe ti?i^- i^ . r'"''"' ;? \^''^^^:' «'• !««« time after death, according to drcum- ute ine'mu^n, « : T "'' ^^^^'^'^''-'-^'d .«»1"»'-"1 H"i J appears between the chorion and En h.r C linTh f""- ^" 1'71'"'^^"' .as_.lecon,po.ition has advanced, the fluid is dSti o? t ■' concludes that >t is a pro.luct of softening and progressive tl en e e '"'" """""' '"""^"•""^' *'»> '^'^ cotyledons, as well as the placenta -93 OBSTETJIICAL PHYSIOLOG Y. SI p} II. ; fc f LI K I shed or disappears in some obscure manner, and the caruncle again assumes its smooth surface. As in SoHpeds, there is no direct vascular communication between the maternal and foetal cotyledons, the villi of each being distinct, though in close contact, being only separated at points by the lactescent fluid just alluded to. This fluid, which is present in all the domesti- cated animalH, can be readily discovered by carefully withdrawing a chorionic tuft from the alveolar cavities of the uterine cotyledon. Sheep and Goat. In the Sheep and Goat the arrangement of the placenta is essentially the same as in the Cow, except that the maternal cotyledons are deeply concave or cup-shaped in the middle, and into this cavity the footal placentula is received and closely retained. This placentula is not so wide as that of the Cow, though it is thicker and the villi are more delicate. The mode of termination of the placental vessels in the Sheep is villous ; in the Goat it is pilose. Phj. In the Pig the placenta may be designated as " diffused," not " poly- cotyledonary " as in Euminants ; though the tufts do not form a con- tinuous layer, as in the Mare, the papillae being collected in small but closely-grouped clusters. When unipjo"ted they appear as white masses or spots scattered over the external surface of the chorion, thus giving it a mottled aspect, caused by the presence of feebly vascular and non-vascular areas ; but when the allantoic veins are filled, these are seen to form plexuses in the centre of each spot. The uterine veins have a corresponding arrangement, and the arterial capillaries form a fine network, the meshes receiving the villosities which carry the foetal arterial capillaries ; whence it might seem that the nutrition of the foetus is effected principally at the points of contact of the foetal with the maternal venules, while the respiratory process took place at the surface of contact between the footal and maternal arterial capillaries. The chorion is destitute of these papillte at its extremities, which are in contact with the chorion of other foetuses in the uterus. Bitch and Cat. In the Bitch and Cat the placenta forms a thick annular band or zone, about one or one and a half inch wide, passing round the middle of the chorion ; it is therefore suid to be " zonular." This zone is con- cave within, of a mixed grey-and-red colour when uninjected, livid or dark brown during gestation ; its foetal surface is lobulated, and the zone is limited at each side by a dark green border, the colouring matter of which can scarcely be removed by repeated washings. The placenta is studded with ramified villi of a leaf or plate shape, which are implanted in the uterine mucous follicles. The mucoup membrane in which these are situated, and which corresponds to the placenta, presents a kind of vascular fungous development that appears after parturition, but which at an early stage of pregnancy has a quantity of fluid along its margin; the maternal placenta, or scrotina decidua, is present during gestation, and can be separated as a distinct layer. There cannot be a doubt that the uterine mucous meinbrane iu Carnivora secretes a kind of plastic lymph, which forms this caducous lining, or mcmbmna decidua ; but it is only present at a certain period of foetal life, and forms the base of the uterine placenta. THE UMBILICAL CORD. 98: caruncle again ication between being distinct, jy the lactescent ill the domesti- withdrawing a otyledon. ita is essentially 3dons are deeply savity the foetal sntula is not so 3 villi are more vessels in the ed," not " poly- lot form a con- 3d in small but pear as white le chorion, thus bly vascular and filled, these are le uterine veins ipillaries form a carry the foetal lutrition of the the foetal with ok place at the n-ial capillaries, es, which are in nnular band or lund the middle 'Ills ;;one is con- njected, livid or ulated, and the colouring matter or plate shape, . The mucoup responds to the L-nt that appears regnancy has a snta, or serotma ed as a distinct Lis iiieiiibraiie in 3 this caducous , certain period Functions. The functions of the placenta are obvious : it is the nutrient and respiratory apparatus during a portion of intra-uterine existence ■ and for the accomplishment of these functions it must rely upon its intimate and healthy relations with the uterine surface. The special and tempo- rary processes of development being completed, and the task of provid- ing capillary superficies being terminated, whether on the part of the mother or foetus, the placenta of the latter disappears, as well as the decidua ; though they may not be thrown off together, and the maternal decidua may not be shed all at once, but in successive portions. The long period of gestation necessary to endue the young of defenceless hoofed animals with sufficient strength before birth, is perhaps a reason for the firmer texture, better organisation, greater extent, and more persistent character of their " deciduous " formations. The comparative study of the disposition of the different kinds of placentue, may furnish valuable indications as to the procedure which ought to be adopted in artificial delivery— the surgical manipulation necessarily varying with the extent and arrangement of the points of union existing between the uterus and the foetal envelopes. It has, therefore, been thought useful to arrange the "domesticated anunals into two groups— those with a single placenta, and others with a multiple placenta ; the first group being again subdivided according as the placenta is " diffused " or " locahsed." This arrangement and sub- division may be expressed as follows : — Single Placenta Multiple Placenta Diffused Zonular Localised 1 Horse. Pig. Dog. Cat. Cow. Sheep. Goat. Umbilical Cord. The uvihilieat cord, funis, or navel-string, is a collection of vessels which form the means of communication between the mother and foetus during the uterine existence of the latter, and which loses its functions when birth occurs. It is visible at the earliest period of pregnancy, and is formed by the vessels which convey the blood between the foetus and its envelopes— chiefly the placenta. It is divided, for facility of description, into two portions : an amniotic, the longest, always twisted on itself like a rope, and covered by the amnion, which passes along it to become continuous with the skin at the umbilicus ; and an allanloic portion, much shorter, less twisted, and covered by the sheath that con- tinues the two layers of the allantois until it is inserted into the upper wall of the chorial sac, between the cornua. Three vessels enter into the composition of the cord : two arteries and a vein, which are embedded in embryonic connective tissue {Whartonian gelatine), that make them appear more voluminous than they really are. This " Gelacine of Wharton " consists of a mucous basis, in the substance of which is fibrillar tissue. The umbilical arteries arise from the in- ternal iliac artery, and course along the sides of the bladder ; reaching the umbilicus, they pass through it and arrive at the terminal extremity of the amniotic portion of the cord, where they give off' some branches 1 I. If I r I ' ! I IS* m 94 OHl^r ETHICAL rHYSIOLOOy. to tho amniotic sac, and then continue to the end of the allantoic por- tion, where they teniiiiiate by an expansion of placental branches. The ■amniotic divisions of those arteries are extremely flexuous and few in number ; they are included between the allantoic layer and the mem- brane of the amniotic sac, within which they are prominent. The jilaccntal or chorial divisions are infinitely more numerous and arger, and starting from tho terminal extremity of the cord, nass in •every direction hotwoen the cliorion and the external layei of the allantois, beneath which they can be seen. By their anastomoses they form a beautiful network, whence proceed the c,.,illary vessels that form the placental viUosities. As we have already stated, these capil- laries have no direct communication with the maternal vessels, but after attaining their finest dimensions pass into tho veins which finally constitute tlie iMiuLicAii vkin. This vessel, tlien, owes its origin to the_ capillary radicles of the placental villosities ; which radicles, by their union between the chorion and amnion, form a voluminous net- work whose richness is even greater than the arterial arborisation. Two •chief trunks finally issue from this plexus, and these soon join to form a single trunk, which accompanies the two corresponding arteries in the ■cord. On reaching the umbilicus, this vessel, now the nvihilical vein, bends forward on the inner surface of the abdominal wall, where it is covered by peritoneum, and on gaining the liver enters that organ to open directly into the vena portie. Owing to this junction, it happens that the two vessels compose, in the interior of the liver, a single canal, from which proceed the hepatic veins. In other animals than Solipedsl this single canal sends off a particular vessel of considerable size — the dnckis vcnos'UH—timt passes directly into the posterior vena cava. The umbiHcal vein has no valves. Besides these three principal vessels, the cord contains, in its amni- otic portion, the duct of the umbilical vesicle, the urachus, and the omphalo-mcscntcnc vessels, as well as tlie extremity of the fcutal intes- tine at an early period. The urachus is an irregularly bulging canal, continued from what is eventually the fundus of the bladder, and on reaching the umbilical opening it passes between the chorion and the amnion to form the allantois. After birth it rapidly contracts, especially at the fundus of the bladder, until it is quite closed, and nothing is left but the fold of peri- toneum that sustained it, and which now becomes the middle ligament ■of the bladder. It sometimes happens with the Foal, however, but more frequently with the Calf, that it persists, the urine in this case escaping by the umb'licus. _ The om])halo-mcscntcric vessels are an artery and a vein. The first is given off from the anterior mesenteric artery, and passes to the amni- otic extremity of the umbilical vesicle ; while the vein arising from this vesicle terminates in the vena porta\ These two very thin vessels be- come obliterated with the vesicle towards the end of gestation, or the artery may be found reduced to the smallest dimensions. Differences. Ruminants. In Euminants, the two veins passing from the chorion remain sepa- rate in the umbilical cord until tiiey enter the umbilical ring, where they become one vessel. There are, therefore, two veins and two arteries ; the latter unite at the umbilicus, the resulting vessel enterin'' ho allantoic por- l branches. The jous and few in • and the mem- inent. E! numerous and 10 cord, nass in lal layot of the lastoinosos they ary vessels that ted, these capil- iial vessels, but IS which finally es its origin to ich radicles, by r'oluminous net- oorisation. Two 3on join to form g arteries in the vmbilical vein, 'all, where it is rs that organ to ion, it happens , a single canal, s than Solipeds, rable size — the ena cava. The s, in its amni- achus, and the he f(X3tal intes- ' bulging canal, iladder, and on lorion and the fundus of the he fold of peri- liddle ligament vever, but more s case escaping 1. The first is i to the amni- ising from this hin vessels be- station, or the 1 remain sepa- al ring, where sins and two i'essel entering THE UMlilUCAL VOIW. 96 the vena cava and vena norttp, between ivhiVV, if f vr u iiiunication by means of^hn .A./., ^ it establishes a com- amnion boing^inTrncdiate cotaS^r''"^ ^^', ''^^^^'^'^ "^"^^ *»•« vessels are reflected over thr,nn'r f ') \V'^"/"''^'^««' ^^o un.bilical on their leaving the amniotic Zof '?f °^ ]*''" hrst-named membrane tois, as in Sol^^ ' No ^r^co o hn' ^^ V? "°' ^^""^ " ^"'^^ "^ ^"^"- been found in the umbiLal cord am^ om,,halo.mesentovic vessels has ut an early period of fSllife? " '""^^'^"^^ ^'^''^^^ disappears In the Pig the arrangement of tholrd is the same as in Eunnnants. Bitch and Cat. In the Bitch and Cat the cord rosemhln^; flinf r^f Q^r i • , . an allantoic portion • but it i^ pvHv., V . ! ■! ^°''Peds, m having fold of allantois ke omnhn^n r'-"'*' ^"^ ^'nveloped in a large until the end of gestaLnScf;"'''"*'T- ^««««1^ ^^'^ very apparent peds ; this is due^ in a rp'rob^bil K irP°^'t'°"^^^'ly larger than in Soli- vesicle. These al- an a'^^-torfancV'.von' ?f/f ^"''^ °^ .*»'« ""^^^^'^^^ anterior mesenteric descends h^mnlf ' i- T''^' ''"'*'" ^^'^'^ t^e opening, and is expandecfif th "un S^^^^^ '"^b^^ *'^ ""'^"^^^ from the terminal divisions nf th« 1 f vesicle. The vein originates and terminates in theTena poru". ^''^' ^'''''' '°^''^'^' '^' ^^^"^^«»' ComAfid'witHrat ^'f^ tTe'hi^l^rttu? ^"^ V'^ ^^^^'^^^ °^ -'-^- Ruminants. At the commencemT^ nf . V^ ^^""'^ '" ^°^'P^^^« ^"d it is not so Ion. 'as L ^iX Zin 1 ?1 -'^^^^ •«» '" the Mare and Cow. termination of^estation ft ifnr'^r^^^^^ '^"^^"' ' *°^^^'-*5« the tall. Its lengtlfirtho Mare hi K "' -"""i ^' *^^.^' ^^""8 ^"^^^ i« ately before birth has been found ?." variously estimated. Immedi- long%ndthreeanda"al TnehoT i^trS '^* 'T ^^^'^^ mch in diameter). Daubenton f nn f/n ^ ^^'^^^^.-^oui'ths of an the umbilicus to the amnTon p,\.^hf^ . ''"A" ""'^ instance, from gestation is not me Lne^Lminf-'"'''^'*^^ **^^ P^"°d of feet ; Blaine, from two to two ami a iSff' 11*. '' l^'^'t *^'^""^ ^ ^^^^ measure, when untwisted^at^lix monui>^^^^^ *° l:;:nt;^?^-s';SS^tr ^^- *-- '^^- in t&^'^ls^-t?^ ■nches ; while Colin, in another So/S2^^^^^^ In the Sheep, at two months' ce^'ition if hnc Knwi inch ; Kainard gives it at from fW„ V Ii / ^^^""^^ measured one .•holo lengtirot theta r DlubenS',!°"5' .^°;™,'""'^« stretching the veiy laiely, however, this retraction is M OBH TKTIllUA L PHYSIOWn Y. Bl Hf not complcto, and hernia of the intestines exists at birth, or even for some tinH3 uftor that event. With regard to the curious torsion of the cord on itself — as many as twelve complete turns having been counted in the cord of a six-months- old ftrtus — it has l)ecn iield by some authorities that this is only acci- dental, and depends on the movements of the fu'tua during the latter stages of gestation, or the displacement it undergoes on leaving the uterus; consequently, that the spiral twisting of the vessels is not normal. It is impruhahle, however, that the twisting can he duo to nmscular movementb of the fu'tus ; as it is unlikely these should be entirely, or even mostly, in one direction. It bar. been recently attributed to the excessive growth of the umbilical arteries, whereby they are compelled to take a tortuous course ; and when a slight obliquity has once been established, every pulsation will tend to increase the spiral ; at the same time every movement of the fuitus or the mother would be taken advantage of, the cord and fu'tus revolving together until, with the growth of the latter, tiie friction of the amnion puts an end to the rotation. It does not appear tluit any advantage accrues to either firtus or mother from the torsion of the cord ; on the contrary, it increases the resistance to the How of blood, and also j,ugments rather than diminisiies the danger of stoppage of the circula- tion by accidental pressu)e. Examination of non-displaced ftetuses proves that it is far from being constant. At birth, the umbilical cord is usually torn or gnawed through at a short distr.nce from the umbilicus of the fcetus; the remaining portion dries up, dies, and falls off in a few days. SECTION Iir.— DEVELOl'MENT OF THK F(ETUS. Having studied the conception and partial development of the young creature, and described the envelopes which surround it, we will pro- ceed to notice the various changes which occur in it until gestation is completed and parturition is about to take place. This division of our subject is of much importance in several respects, but more especially with regard to the relation it bears to tenitoloiiy the branch of science which treats of congenital defects, malformations, and monstrosities. The transition from the condition of the embryo, when the young animal has scarcely assumed a definite form, to that of the foetus, when it presents the lineaments of the species to which it belongs, is very gradual. The dorsal cord, as has been stated, is a cylindrical body developed above the primitive furrow, with slightly attenuated extremities, and at each side small opaque quadrangular masses, the vertebral lamina:, which are in reality the ^j/-o^o-ct';7c/>/-a', or first rudiments of the vertebra). Each of these masses is perforated by a small opening, and is resolved into three portions— the proto-vcrtcbral caviti/, the muscular lamina, situated above the cavity, and the proto-vertcbra placed below the cavity. The muscular lamince, increasing in volume, are inflected upwards and at last unite on the median line of the back, chiefly forming the muscles of the verte- bral furrows ; they also send off prolongations downwards, which concur in the development of the intercostal and abdominal muscles, as well as those of the limbs. The proto-vcrtcbroi bend upwards and downwards on each side, so as to enclose the proto-vertebral cavity or spinal canal, liith, or even for ioli — as many as of a six-nionths- tliis is only acci- luiiiig tlio liittor I on leavinf^ the vessels is not ^ can bu duo to tiieat) slioulil bo ^1 been recently rteries, whereby when a slight tend to increase 10 fuitus or the fu'tus revolving II of the amnion any advantage he cord ; on the blood, and also e of the circula- splaced fu'tuses ed throu"'!) at a maining ))ortion rus. nt of the young it, v?e will pro- ntil gestation is several respects, to teratolofiij — malformations, rhen the young ihe foetus, when belongs, is very body developed remities, and at / laminie, which rtebra). Each of olved into three , situated above , The musadar at last unite on 33 of the verte- s, which concur scles, as well as nd downwards )r spinal canal, l>t:VELOVMKNT OF TBK FaWH. armut portforw^^^^^ the rudiments of the core constitute the vertebral bocTicH 1 ° ''"" ""« ^^^ the dorsal Th(! latoml Inmitia' ariso fm , » '^"'V'" <'''*C8 uniting them i.ia».odo,.,„ ,,,„„„, :„ s 'i 'J ';ir; s,™it '""'h^y-^ ", «.„ of the trunk these lamin,.. nrn sml .^. i r l'imin«.. I„ the region •attor ; but in the cephali ^^o f ' hevl> :'i '^ '"'"''''Jl ^'"'^ ^^oJTe and at this part they are usuallv L.h^^L /,"'''>'" adherent to them proper lateral /r»«/«Jare d ^^i I ^ l"'^ *''° ''I'^^^l^c lumince. The 'oconjes the /'/^■'''•o.;./,v7o..v,/ i. ■ ' ^^r tle'T" ^^T " «P'^°« ^^^'i^l' atera are joined to the vertebral /an ina Tl, ^"'";^^'°" °f which the ""il a,jrr envelops the deoner nmS t . "^ "\^<'>nal or Jibro-intes- .ntestinal furrow, the un.lS 'vf,^ ^ and t '' i^f "^^r'"'^ layer or " " f'brous and vascular parts of tZse n "^nl ? ^^ ^"'"^ = '^ constitutes sels to the inner face of U,e chor on ^'-"'^'^' "««'/"»! carries the ves- .s developed in two ways : above t.'bZ'K 'f^'^'^^or cutaneous layer and the L^tal portion of the exte na tv T?." *^." ""^««"lar lamiL tho cutaneous envelope o„ the baT bih v7 i'f '''' ^^^^^'^Aorm to fonn which receive between them th/« n.nl. ? ' '^ ''^Pa^'ates into two leaves ; ostined to constitute the ter oS T^bd^^^^^ "• '^"^ '"'"^"'^'- '^"^'"^ iHs part of the body. Of tIeseJwn «."'?'' ^"^ ''^'''^' '"^««leB of forms the skin of the trunk a 1 the^nf. T^ f^ ^'^^««' *he externa pontoneum The cutaneou" a„ ^ ^^"^i^'lV'^'-'^tal layer of the substance are aevelo;:;; "t i'wohlC'bodi " '"^^"" ^'°«' ^"^ 1" *heir kidneys, and the prin'cipal vessel^ of the t^S "^ '"''''^'"* ^^''•^"^"^ c'phalo-mtestinal cavity, which sdvS A \ * '^ ^"^"'"'"^ Pa^'t of the Plmryngeal and u'sopl^earctviUes Tlie n.'^'" cou.part.^,ents-the externally by the mcufh, and is narMv 111 P''aryngeal cavity opens pharyngeal arches. The ,rsop f„S c^,vi v .T^ T '^' ^'^es by^he which IS not long i„ communicating S^,,", ''^°''' ^ diverticulum, and subsequently contains the heart I ' Pleuro-peritoneal cavity ;j'^^(y. The cephalic lamina, also form hf f '^°''%""'"^^ ^^^ <^^rddc the fibrous layer in which are dev^lo^^^^ ste'oT t^if c:^^n-^^^^^^^^^^^^ ^^^ rp, , , ^/'« Nervous Si/stem. w:S^:^s:;5ri;^ t ™^^^ of the Bhght bulging Froni t e posSf or T ° '^^"^^'^^^" ^"^^o^ hm.bar nerves are given off. ^vhUeti; a, teo?^'^^^ . ««.. the s^cro This an erior enlargement appears as th 1 In ^'"''' ''P"'" ^^ ^^^ b^'ain. the ..;-./;,•«/ ,v.././.. or ..//., whLh are d Hn"f ''^'' dilatations named and posterior. They are fi led w h fbili "TS'"^ ^' ^"*^^i°r, middle lliounts th. other t^vo, which "tes h.' whole '.b""?'^^ ^'^^'^"^ ^-■ -angular :r:ass. The vesiel^Q in,..! • ?'^ the figure of a small ----- mM i i 1 bi l; ll. M OBSTETRICAL VHYSroLOaY. and the lateral ventricles. The middle vesicle forms the crura cerebri, corpora quadritjcminn, and the aqueduct of Si/lvius or middle ventricle. The posterior vesicle gives rise to the medulla obloiujata, pons varolii, cerebellum, and fourth ventricle. The middle vesicle increases more rapidly in volume at tirst than the others, but it soon stops and allows the anterior cell to develop : from this time the encephalon assumes its oval shape, with predominance of the anterior part. Towards the end of their first third of intra-uterine life, nearly all the parts of the encephalon are distinct ; the two hemispheres are separated by the development of the septum lacidem, and the convolutions are apparent on their surface : while the corpora quadrigemina and crura are well defined. At a later period the cerebellum is seen, as well as the pons Varolii, corpora restiformia, and corpora puraiindalia. With regard to the development of the .spinal cord, we have observed that the medullary canal is the first trace of this part. It occupies the whole length of the vertebral stalk, and its cavity communicates anteriorly with the fourth ventricle. When the spine is developed the cord only increases longitudinally to a certain degree, and appears to ascend in the canal ; it stops at the niiddle of the sacrum in the Equine foetus, but ascends higher in the other species. During this apparent ascensional movement is developed the Jiluvi tcrminale, and the termi- nating nerves of tlie cord {canda equina). The parietes of the medullary canal are at first very thin, but increase in thickness with the appear- ance of the nervous substance of the cord, and soon divide into two layers : an internal, the cpillieliuni of the central canal ; and an external, the (jrcfi substance of the cord, (iradually the canal contracts, and the cord shows longitudinal furrows. At the end of the first month the inferior roots of the nerves are in existence, as \ '11 as the spinal ganglia, which are developed at the expense of the proto-vertebra) ; the superior roots are not distinguishable for some time after. The envelopes of the nervous centres are furnished by the proto-vertebral laminm, and are developed after the sixth week, following the formation of the parts they are destined to cover. The nerves are not so definite in their development, and some obscurity prevails with regard to them. It would appear that the motor roots originate in the cord, but that the ganglia are formed separately in the pi-oto-vertebra;, and perhaps become the point of departure of the sensitive roots. The nerve ramifications grow from elongated ramified cells, which are joined by their extremities. The nuclei of the cells, joined to the periphery, become the nuclei of the sheath of Schwann, and the nerve tissu3 is afterwards deposited gradually between the axis-cylinder and the envelope. The great sympathetic nerve is perceived at an early date as a. nodulated cord ; it is probably developed in the same manner as the other nerves. The Organs of Sense. The principal portion of the organs of sense belong to the nervous system, and are, of course, developed with it ; the other portions belong to the external epithelial layer, and to the derm or germinative layer. With regard to the organs of vision, two tubulous prolongations arise- from the anterior cerebral vesicle and, passing forward, terminate in the p)riniarii ocular vesicles, traces of the ocular globes ; the hollow prolong- nients form the optic nerves, and the vesicles furnish the choroid layer and retina. The crystalline lens, vitreous body, cornea, and sclerotica e crura cerebri, iddle ventricle, a, 2>ons varolii, increases more ops and allows Ion assumes its 3, nearly all the !s are separated involutions are mina and crura 3en, as well as dulia. have observed It occupies the communicates developed the and appears to I in the Equine ; this apparent and the termi- ' the medullary th the appear- iivide into two anal ; and an anal contracts, the first month [ as the spinal -vertebrtB ; the The envelopes al laminye, and on of the parts snt, and some ppear that the iia are formed the point of ons grow from remities. The 3 nuclei of the irds deposited e. The great Lilated cord ; it erves. to the nervous; Dortions belong ninative layer, ongations arise iruiinate in the loUow prolong- I choroid layer and sclerotica nKVELOPMKNT OF THE FCETUS. 99 are derived from the external blastodermic layer Tl,« nn.f * .u mtegument not requ red to form fho lo.,. « i-; V , ■'•"^ ^^^^ ^^ the globe. The latter forms theTcltrnhV ^T'*'*^"'"' *^" ^"^«^°P« «f the burnishes the epitheHumtfthe latter whth T"""^ ' ^i^-^'" ^he epiderm sclerotica in about the fourth month ^ ''l^^ "''""'"^ - '"'^ ^'°"' *^" the fibrous envelope of the dobe fh;« t TTI^ f the lower part of the vitreous humour a S^ *° the developu.ent of slit and entering between the K and fh. f "' ^''.f '"« *^'°"gh this ocular vesicle vvhich apnea edsLrtfvhnfo.'^l^*'" ?^. '^^ «««o"dary becomes developed andTanltmS iJto the vif r ^'^^ prolongation one period is surrounded by vesS but , !„ '°"' "- '' ""^^"^ ^^ birth. It exhibits in its central' f,n """'^ '/""'^^^"^t^'y before branch of the arteriaVntXof%LS""' ''"^'' "'''^^^ ^^^^^ ^ vesl'lt^i^'^tl^^^^ntio'r^leXlli'e.f^^^ ^°""^^^-^' *he ocular inner layer of the s coXy oLlart^ic^ ir'l"'",^V^^^^^ changing its character in frS The Zn^iri .If "'^^ ^?- '^^" ^""^ ^" posterior layer of the ocular vesiclf- Tl f ^^ '! constituted by the is then inflected in front^ottVaTS; o^lhe' ir f ^Th^ bo "d^' ^"^ the pupil embrace the vascular en4lonfi nf flfo i -L he borders of face, as well as this pupil is covered h?n t '"?' ^"^ *^^ ^"'^^^o^ memhrana pupillaris ■ lelZdTZfhl 7 ''^''^"^^' membrane, the n..nbra»a ^^./.....-S^that pa^st tZ^ugl^ ^rptpil rthtf' t envelop it in a kind of sap Hmf ri;aoK>r,„„ '""fe" sue pupil to the lens to PrevioL to this tiillLf a^iSTv ;^^^^^^ developed the pupil contracts, and the vessels of M ^'"' '^ pupillary membrane diminish in size and numtrLtSatT^T^"', °' few are seen crossing the transparent membrane ' ^'* °"'>^ ^ aro^unVThlllo^L^^'C^:;^^^^^^^^ T '' g-^T"^ ^^^'^P^^ formed in the first third oTuSrinc 1 rinri^'""' i°^^'- ^^ich are margins until a short time before or after' birl^p J f'^ T^t ^^ ^^^'' when they separate Thev are mnL.f Ifn J ' ^^""^'^'^^ to the species, which disappears in SoliSkumZn/r'^ fT^^.^ ^ *^"" membrane in Carnivora it remarnTuntil son oTt J / V.^' ^'^' ^'^^^^ ^irth ; bu So long as the hds rclos ^ thTcSc"^^^^ Ts^inl^ '''" *'^* ^^^°*- eating with the lachrymal canal Thp^l^/ir T^^.* ^^"^ communi- new-born animal distinctly shows the fhf*^"^"f ^'"^ ^f ^^e foetus and diverge from each poleZ^ Ing^^^^ three appendage of the epithelial laver vvhi.h,-" .^,^^]^«hrymal gland is an at first compact, it^ectt s Tadua'"y\"clvS1nt^^ V^ ^'?'^ ' which arise the excretory ducts -xcavated into cavities, from form of a vesicle which is not in H .7 Z^" , 7 labyrinth appears in the bral cell, but is consltl^d b/a d^^s" n'oTtl'^'n ^" P°^*,^"°^ «^^■^- anditon/ fossa~th.d becomp^ mn. !i epidermic layer— the a closed cavity. A this t me t 7-"^^^^^ """^ '^ ^"^"^ epithelial niembrane but ?his fs loonl.^^^^^^^^ ^^ ?^>' ^ ^^^Pl« nective membrane which vaculaisestrnd thi'''''"""-^ ^^ " ^°^- layers: an external, which aZ-rpffn f»l .if- ^"'-^ "'- ^- t^^ee 100 OBSTETRICAL J'HYSIOLOG Y. ii - H, hf ' HI !;!' changes of structure are taking place, the vesicular shape of the laby- rinth is modified, and shows the cochlea, semicircular canals, tctricuhis, and sacculus. The middle and external ear are formed by the first pharyngeal slit, which is never completely closed, while the others dis- appear. At first there is a cavity communicating externally by the pharynx ; this cavity contracts, then divides into two portions by a septum in its middle; this septum becomes the tal envelopes. At mid-term, brown or black patches appear, if the coronet IS provided with pigmentary stains; but it is not until about the end of gestation that the horn begins to show the greenish tint proper to it when destitute of pigment ; though the remainder of this production, particularly its lower part, preserves its yellow colour until the young animal is born. In Solipeds the chesnuts are seen at mid- term, in the form of thin brownish plates, which soon become darker. The structure of the hoof is not tubular until after birth, when, the tootal hoof gradually disappearing, the horn that replaces it is fibrous and tubular, and much more consistent. The corneous substance is developed at the expense of the blastema which the capillaries of the modified derm throw out on its surface in this material appear nucleated cells which, pressing against each other, become at first polygonal in shape and flattened, then lose their nucleus and are confounded with each other. At a later period cells of a new formation are moulded on the papilte of the coronary cushion and plantar surface of the foot of Sohpeds and Buminants, giving it that Hbrous appearance which is so striking during extra-uterine life? The Locomotor!/ Apparatus. The development of bone, and with it the locoinotory apparatus in general, next demands our attention. Bone is developed in the blastema or primitive _ basis— a transpai^nt glairy mucous matter containing numeroTig mmute corpuscles. This progressively acquires increased drraness, sometimes assuming a membranous or ligamentous condition, usually of a gristly consistence before its conversion into bone The change mto cartilage is denoted by the appearance of minute nucleated » 102 OBSTETRICAL PHYSIOLOaY. iwm cells, which increase in number and size, and are aggregated in rows 71= ^"*Y,°«""l*j/racts where the ossification is about to begin. tS [nSf nf fl!.'K'''^^^lu°^' ^^'^' °^ ^°"- b°"««' ^^-^ vertical to its ends; rom th« ««ff ^ones they are vertical to the margin. The cells furthes JhTio! T ! °^'^fi«a*»°" are flattened and in close contact; nearest hnnp?« fW ^f ' -^T ^"^^'Sf^ ^"^ separated. Tlie first appearance of bone IS that of minute granules in the intercellular tissue . Canals are v!Jilo -? u ^ ^?i°^' ''y ^-bsorption ; these ultimately receive blood- vessels, and become the " vascular canals." The immediate nutrition ° lacuni'"^o° -llf^ ^°' n^ -w' production of minute "plasn.atic canals." laoun^B, or bone-cells from the vascular ones. Ossification begins hLi -f ! °V"°w ^°"^'' ''"^ proceeds towards the surface; in flat bones it extends between two membranes, and from a central point towaras the periphery ; in short bones, towards the circumference" and ZnZ^ fr"'' 7'°'" ^,««»*ri'l P«i"fc or diaphysis, towards another ^!«i« ? «i^!Mz/^'*". situated at each end. Particular parts or pro- cesses are furnished with a separate centre of development, named the mhysis Length occurs at the extren.ity of the diaphys s, and bulk t^i^z^j\^:Xr' ''' '''-'^-^ '''-' °^ '-'^^ ^-- ^-^ The spine is the first portion of the skeleton observed in the embryo oio7\l "TlT'^-i hythechonla dorsalis, which is composed of a mass nnnalin f '"*"'^f ^^ ^ transparent sheath. The proto-vertebra> tff snina^ .'^ l''^' ? ^^'^ '''^' ^'J^ "^timately enclose it and constitute the spinal canal ; m this way results the external sheath of the cord, and the superior uniting membrane. The vertebral stalk now exists as a t^Zn?"' "^'k ^""^ "°.' ^ ^°"^' ^^ '* b^'^"'"^^ segmented in order lJ^u2 tii« vertebrae, and these segments are gradually converted into vPrSS, ^J^^'^^pr^^^t^"] vertebra does not correspond to a proto- verteb i' Th Ta ^^/f '"« ^"1° *^° l'^^'^^^"^ ^^ constitute two vertebrae. The body of the vertebra is developed more quickly than bndiff "°"' P°r^°" ' ^' "^t '''^ °^ *^^^ second month all ?he vertebra" con^ ion ' Tn /h'°;r "/' ^^^^^.^ the laminae are yet in a membranous condition In the tlurd month ossification commences, and during this FtTfiVl ' ^^/f,<^^'\^^^^W^^rs, except between the'vertebra.. 5he e It 18 developed to form the intervertebral fibro-cartilage Iheface md cranium are formed by a membrane that envelops the '?anSt"' r*^ ''u''^ '' ^"^ *° **^' proto-vertebral laminl^ Thi ^ranial membrane becomes partly cartilaginous and partly fibrous the carilage existing at the base of the craniuni, and appeL^nTto be a Ew«^h'r °^ '^' ^?^^ "^ *h^ ^^^-t^bne: indeed, there is aresem bl re.nlvp7'f ? "''^'^'.^ ^"'^ '^^^ "■""*"'"' '" «° ^^^ '^^ the latter can be resolved mo four portions, each coir, spending to a vertebra This cartilage is slowly transformed into borfe; while thrfibroSs par answering to the roof and sides of the skull, passes directly bto^ the SSafor-./ '%^°"'? '' '^' ^''' "^" fonLdbythe^Xwat snrnini'f^i T r'^"'-^ "^'"« given to four lamina which spunging from the anterior extremity of the dorsal cord, curve down Zfeft't?'' /^.''^ "^ '^' Tf ^^^^ ''^' ■' the spaces between ISem re from the f^^^yri^l^^^^^^L^^JS^^, ^;|— -- nZ the handle of the malleus towards the lower jaw is a so Tap' pendage of it. This cartilage disappears about the sixth or sevent^h f ;rogated in rows, 1 to begin. These tical to its ends ; [•he cells furthest contact ; nearest rst appearance of sue. Canals are 3ly receive blood- lediate nutrition lasniatic canals," ssitication begins 9 surface ; in flat a central point cumference; and owards another ar parts or pro- lent, named the jhysis, and bulk •tain bones being I in the embryo, iposed of a mass i proto-vertebra^ it and constitute i of the cord, and [low exists as a lented in order { converted into ond to a proto- constitute two re quickly than all the vei'tebral a membranous and during this vertebrae, where at envelops the lamints. This rtly fibrous, the ipearing to be a lere is a resem- I the latter can vertebra. This e fibrous part, [irectly into the the 2)haryngcal, laminae which, d, curve down- ween them are uth, and nasal tj bones — come 3, which passes ', is also an ap- xth or seventh DKFKLOI'MEXT OF THE F(ETUS. 103 month. At first the mouth communicates with the nasal cavities ; the palate is developed m two portions, which advance towards each other but remam for some time apart; so that during this time the younc animal has a cleft palate.' The second pharyngeal arch fornis the stapes, the petrous portion of the temporal bone, the styloid arch and the hyoid branch The third originates the hyoid bone with its theXort " °"^ constitutes the soft pkrts in this region of The thorax consisting of the ribs and sternum, is an appendage of the proto-vertebral aminae, which incline towards the lower face of the vertebral spine. The true ribs are developed most rapidly, and before attaining the middle line they unite by their inner extremity to form a moiety of the sternum. A fissure at this part separates the ribs of one side from those of the other ; this gradually closing, ends by disappear- ing a together, and then the sternum is constituted. The ribs are after the petrous portion of the temporal bone, the parts of the skeleton which ossify most promptly; ossification begins in the middle bones. The ribs do not belong exclusively to the dorsal vertebrae, but have a tendency to be developed along the length of the spine; it is not rare to see a small cartilaginous nucleus attached to the lumbar vertebrai and which IS soon lost in the substance of the abdominal parietes; in iiirds this body assumes large dimensions on the last cervical vertebra ihe shape of the thorax differs with species, being round in some and oval in others, but it is always less developed in the fcetus than in the young or adult animal. l^hQ limbs do not appear until after the formation of the vertebral spine, the pharyngeal arches, and the thorax. They show themselves as four small prolongations from the pelvis and chest, slightly thickened at their origin and contracted in the middle. Their free extremity is flat and is ei her simple or divided, according to the foot of the species. whpn olt-J^'J r^^^'f' *^'^- ^r^^^^Sinous segments are formed, which, when ossifaed at a later period, constitute the bones of the limbs ihe muscles are divided into four groups, after their origin. They thp r^nS f\ ""tu^''' '"^^^^^ ^"^'^^ ^^'^'^ <^he muscular laminae of the proto-vertebraa ; the visceral vmscles for the thoracic and abdominal cavities, the neck and jaws, and having the same origin ; the cutaneous 7ltV l"^ originate from the cutaneous lamina of the middle Kw ;h[i^s'roS;;„Irsttd.^'"^^^^^ ^^ ''' ''"''^ *^^ development^f It was believed at a certain period, that the muscular fibres are l7ZJ^ i'" ^°'":i!^' together at their ends of several elongated ceUs It IS now known that each fibre is constituted by a single coll wh ch sn f«"; '^l.f'"th. and whose nuclei are multiplie^d and^aced Tt he entt a I'lhi ^" T w'^ ^''. transformed into a substance that pre! formld iftP, ftV^'T"' °^ «°"tractile tissue. The sarcolemma is rounding it ' ^' "" "^°^'fi«ation of the connective tissue sur- of '^nnim°«*i°"'°*°'^ apparatus of the majority of the domesticated species the vouni l?f "''"^^P'^^ ^' ^'"^'^^^l '^^' immediately after thatUnt the young creature can move with more or less alacr^^v With ih. In A^r'il t8?6' af ihe" Mlrfil' ?f'^*%T"''^. ''T'^*""''" ''^'^'^' *« P-^'"* ^^'^^ ^'^^^ !««! m 104 OBSTETRIC A L PHYSIOLOG Y. fit \\\ larger herbivorous quadrupeds, the limbs of the new-born animal are flight should danger be apprehended. ^ ■' The Circulatory System. ^«!'?%f ^''tlfP'"^"" "^ ^^'^ circulatory system is not apparent until some days after the appearance of the embryo in the blastodermic layer there bemg no trace of vessels in the germinative space. It is not long how! 371, 71 Fig. 57. F(BTAt Circulation in a Transition Statk. «, b c', Circle or Envelope resulting from the Fusion of the Vitelline Membrane Lxter,.^! Layer of the Blastoderm.c Vesicle, and the Transforn'aSon „ he Embrvo .';• Caud^rp"'.'^'"^ Uznbilical Vesicle ; d, Cephalic Portion of L ^mbryo d Caudal Portion ; e, Ventricle of the Heart ; /, Auricle of the Heart; , Aorta, forming the Aortic Arclus; h, Trunk rVrresentini the Thoracic Aorta ; >j, Vessel which becomes the Anterior Vena Cava? f Vena Vefm ';,^?"fl::^«"*^ °f .the two Veins ,7 and k ; m, ConHuent of all the Vems at their Entrance into the Auricle of the Heart ; «, Vessel resulting Ifl ^ -v ^."^t'^'IT Y™'^ Cava ; ;,, ;,, Allantoid Veins ; a, Omphalo-Mesera c or Umbilical Vesicle Vein ; r. Posterior or Abdominal Aorta ;., s, Allan oU Arteries j t, Omphalo-Meseraic Artery. ' ^"^^'^''^'^ fi!f;n-l57V^^ ''^''^I^^ ''"S,^" f circulation and some vessels appear in the middle layer and canals also spread to the surface of the umbiUcal ves cle. While the contents of the vitelline vesicle are being imbibed by the embryo, the heart is in course of formation • blnod-Pssel- ivp increasing and extending, the allantois is completed, and; finally,' the placenta circulation is estabhshed and continues until birth The pleuro-peritoneal cavity in the embryo shows a diverticulum in DEVELOPMENT OF THE FCETUS. 105 itont-iho cardiac cavity, in the interior of which the heart \b deve- loped. This organ is at first a small mass of cells, the innermost of which separate in order to leave a little space, and to create blood globules As soon as it appears, the heart contracts and re: axes alter- nate y, the movements being very slow, though they gradually become accelerated. Towards the twelfth day the organ has the shape of a cylindrical contracti e tube. From its anterior part arise two branches, the aortic arches, which at first proceed towards the head of the em- bryo, but afterwards are bent backward and downward. These arches join to form the single aorta, which in its turn divides into two branches —the siibvertehral oi- common aortcc-which run parallel along the lower surface of the embryo, giving off four or five branches, the omp}ialo-vicseraicj.rtene^, which ramify in the germinative area and end in a vein-the terminal sinus. From this ramification and sinus arise two vessels, the omphalo-vieseraic veins, which return to the posterior extremity of the heart. The circulation in the umbihcal vesicle IS very ephemeral in several species, while it is .s persistent in others; varying, of course, with the duration of the vesicle itself The heart, from bemg merely a cylindrical tube, undergoes consider- able modifications before it arrives at its complete development, passing through all the different forms which characterise the organ in the various vertebrate animals. The first change consists in an inflexion, by which the inferior part becomes the superior; then it dilates at three distinct pomts--one anterior and superior, at the origin of the aorta, named the aortic hulh ; a middle one, the ventricular cavity; and a posterior, the awricz^Zar cavity. The constriction between the auricle and ventricle is named Halkr's passage {d&troit) These twocavities are single only for a brief period ; the ventricular lirst divides into two— a division marked externally by a furrow which 18 visible on the surface of the heart of a fcetal Lamb at the nineteenth day, and the twenty-fifth in the Foal. This furrow corresponds to an interventricular septum which arises insensibly at the bottom of the ventricles and reaches the auricles, where it concurs to form the auricxdo-ventTicular orifices. The borders of the openings are furnished with a slightly salient lip, which at a later stage develops, and consti- tutes the mitral and tricuspid valves. The heart now contains three cavities-two ventricles and an auricle, but it is soon to have a fourth • lor the auricle becomes partitioned into two portions, and externally this division IS marked by another depression, corresponding to the septum ormed in the cavity It is to be remarked, however, that the partition remains incomplete du.-ing the whole period of uterine life, being per- forated by an opening— the foranien ovale or foramen of Botal The monar aiteT^ contracts and forms two vessels— the aorta and pul- ThQ arteries ^YQ developed, partly at the expense of the primary circulation, and part y in the vascular layer of the embryo. The aortic arches, situated at the inner face of the first two pharyngeal arches, form five new vessels, which are placed within the other arches ; ali vh?l!'fV,°'^7f '^° not exist at the same time, some becoming atrophied while the others are forming. For instance, the first two eomnletely aib_appear ; the third forms the carotids ; the fourth, the axillary artery bSf on HfJli°';°'°'%u ^^\^^'^^' the fifth is atrophied on the right, the Z^r T. 7T '^^ P^l.'"o^f y artery, the ductus arteriosus, and me aorta. The latter is continued along the spine by the fusion of the i« 106 OhNTETRICAL I'll YSIOLOQ Y. two primitive aortas, and shows at its posterior termination the small pelvic vessels and the large umbilical arteries. ••The peripheral vessels originate independently of the central vessels in the mterior of the vascular layer. They appear as solid cellular branches, which soon become hollow in their interior, and free cells become visible. As these new channels are developed, the omphalo- meseraic vessels gradually diminish and disappear, until at last only one or two pass to the umbilical vesicle. Pig. 58. FtKTAL Circulation : Advanced Period. A, PlacentuI^ ; B', B', Umbilical Veins, with their Common Trunk, B • D Vena Cava"' C Kilt v'lT'"^ ?r= ^' ^^^'^^^ V«"°«"^ ' *^ Pokerior V^na Cava , G, Kight Ventricle of Heart ; H, Pulmonary Artery ; J, J, Aorta • \l:X oVr U '^i^SrT-^ ^'*-^-> -'th th^eir An/^tom'osi'/atthe The umbilical veins are developed immediately after the formation of the omphalo-meseraic veins, and join these ; as the ramifications of the latter diminish m size the former increase rapidly, and when the liver is ormed around them they throw into it those b/anches which are the vpfn? fv, vr ^^P^*'^ P^'^^"'- ^^*^^^^" *^« postal and hepatic vei .ne iim,.uical vein eoirununicates with the vena cava bv the ductus ve7wsus ofAranzi, which does not exist in the foetus of Solipeds rnnifo f }" -^ gestation. The embryonic veins form four chief trunks— two anterior, the anterior cardinal veins ; and two posterior the lation the small DEVELOPMENT OF THE F(ETUS. 107 posterioT cardinal veins. The veins on each side unite in pairs to form the chcctm Cuvien which opens transversely into the omphalo-meseraic runk near the auricular cavity The anterior cardinal veins issue from the cranium, forming the jugular veins, and communicate by a trans" verse anastomosis between the right and left veins. Below this the left vein gradually atrophies, as does the ductus Cuvieri of the same side ; while the right vessel enlarges, and is ultimately the anterior vena The posterior vena cava appears in the liver about the fifth week • it receives the veins of the kidneys and the Wolffian bodies, and behind It anastomoses with the cardinal vein.. The middle portion of the latter disappear and are replaced by the vertebral veins, the right of which forms the vena azygos. There, then, only remain two cardinal veins for the two extremities-the anterior which enters the ductus Cuvieri, and the posterior which constitutes the hypogastric and crural veins. Tt therefore happens that the venous system of the fcetus, which was at first symmetrical, becomes asymmetrical in the adult animal i. WiH?^ o ^ successive developments, the placental circulation IS instituted and continues the same until the end of gestation the heart being the organ which circulates the blood in the fcotus This fluid, carried by the arterial vessels, reaches the umbilical arteries, and from them IS distributed to the placenta. There it is respired, depurated, or artermksed through indirect contact with the blood of the parent and IS returned by the umbilical veins. In the texture of the liver it is mixed with the venous blood of the intestines and the hinder part of the body, conveyed by the ductus venosus, and is finally thrown into the right auricle then into the ventricle, whence it is expelled by a contrac- Sn^ fi;?«l 'l-r ^- ^'''''^? °^ '"''""S *^« ^^""«' ^^hi^h do not act dur ng foetal life as respiratory organs, the blood is forced into the ductus arteriosus, and thence into the aorta. So that the organs of the young creature are never supplied with pure blood, but with a mixture of arterialised and venous blood ; this mingling taking place through the foramen ovale, in the aorta by the ductus arteriosus, and in the liver by the ductus venosus The head and neck receive the purest « .. If fl.'''°''"''\^''^u "T^'"^ P'^^^^^y ^^Pl^"^« the predominance in size of the upper to the lower parts of the body of the foetus At birth, the conditions of existence being suddenly changed, very marked modifications occur in the circulation? The lungs then become the organs of respiration, and rapidly increase in capacity, while the fZT. f"l^.^g^.V" ^'^°™"^^"!'T*e degree; the pulmonary' artery also IS obmPrafpdTn '^" '"??f '^ •^?^ °^^^°°'^' ^"d *he ductus arteriosus IS obliterated to prevent the mixture of arterial and venous blood The ductus venosus also aids in the isolation of the two kinds of blood by becoming atrophied, as does also the occlusion of the foramen ovale ibis opening, however, not infrequently remains intact in voune ?n.""t ' i°u^^' ^' ^ '"^^' *^^' ^°"^ "°' g^'^atly aifect the circulation o7thP o?fi ' heart contracts the auricles are isolated by the narrowing of the orifice and the elevation of a valve. ^ The Respiratory Apparatus, There is an absence of unanimity as to the mode of development of t e respiratory apparatus, and particularly the lunqs. Some assert that the latter are derived from two little distended cellular masses attached to the anterior part of the intestinal tube, and which afterwards become 108 OBSTETlilCAL I'HYSWLUG V. uL'^^'tmlta'^^ rannfying cavitiea, that comnmnicate with wnue the vesicle or enlargement represontin.r thelunau rHvirI«a ir.//!^ ' the same manner, at the pharyngeal openin" of thp tnL 'developed m fl.^^u*° birth the placenta retains the function of the lun-s whi^h ^rnwfh /'^""It ^''"''^- ^''^ ^I'P'^'^ *°^varcls the second month as a The Dujcstivc Apparatus. of Th! f,*r^'J°P"^^"t of the digestive apparatus comprises the formation of the alimentary canal and the organs attached thereto The SS tar,j canal begins to appear after the first outlines of the nervous centres" d^i K /ff'^^^' apparatus have been manifested. We have aS/,«n/«,r ando'soi;//.,V,,s lengthen and widen as the fcotus grows- the latter at hrst communicates with the trachea, but it gradual^ closes, and ends by separating entirely from that tube ^^^^^^I'^^'y The stomach is formed by the dilatation of the anterior part of the niddle mtestine This dilatation is fusiform, its larger axis be n' IranTersal ' '°°" ''''''' °" ''''^^^ '^"'^ *^^«" *hit axis becomes In Ruininants the stomach is single when it first appears, though it is no long before furrows are observed on its outer surface whe inter nally the particular septa are seen as in adult life. In he fitus the stomach IS small, but its volume increases rapidly after birth whe" the animal commences to take solid food. During the sucking period in Euminants. there is a predominance of the fourth over the other gastiS compartments ; but as soon as the young animal begins o consume largest c'avir "" """" ^"""^^^^ '"'^'^'^' ^'^'^ "' '^ by'^th^ The mtes}ines^,e at first of uniform calibre, though in a short time It IS easy to distinguish the different sections of%vh ch they ™e ultimately composed In hoofed animals the cmcum appeal very Lh^^ It IS situated near the omphalo-meseraic duct, which Fs detached hom Sm naf P vffi tV' '^T "^ obHterated, this loop ascends in the ^^^z^]^ z. SrrrJhi^:; sz. 7z the'^otVeTpoiiion:" '"" ''^ '''''''''' ^"^^^*"^^' '^"^ ^« ^^^^^P^^ ^^- extYjmitv TfTh J° /''' T'' *•''''"' '" "^^^^-^'^^ ^^^^'^^'•'^s the caudal extremity of the foetus a depression analogous to the buccal nd-de-sac This becomes deeper, and joins the rectum and genito-urinary or4ns " ihi^^ntarrrar ''"" ''' ''''''''' ^^^^" '^^^^^^ exclusivJi; t^^e fppT^l-'''''''''°''''"' '''' '"^^ ALiMKNT.uv CANAL are the salivary glands teeth, iver, pancreas, and spleen. The salinrn/ ,,lau,h are dmeloned in a solid cellular tubercle, which is conneetod wifh^ ^L ,.m i ^f upper part oUhe digestif.; apparlt" Wth\h"'^„tthSlh^Trerct If ™f' » 1 ™''™'l?'' "y gland appears first, and is entire in a tetus of only twelve lines m length ; the parotid gland is the last formed no nnsTKriin •. / a rirysioLoa y. if f! It. folHnl ff '''.f ° developed in tho interior of a cavity callod tho " dental ,-nl ; u^"^ T' ^ '.""''"^ "^ *^'^ tilornentfl of three germs correspond- ing lo f»ie ttnatotnica constituentH of tho teeth-enamel, ivory, and lavT r- ?" wl'^^" '' '^^ ""'^^ '^^^•'y ^'>"«" ^'^» coinprises two layors-an extern, ^rous sac, and an internal golatinouH lining, at tho bo torn o which 18 th. • v.n; yulp or ,,er,H. This is a pron.inence detached from tho bottom of the sac, and has exactlv tho shape of tho tooth. It 18 composed of a mass of delicate cellular tissue provided with vessels and nerves, and on the surface a layer of elongated cells. At the summit of the folhclo, facing this pulp, is the enamel pulp, whic fits accurately on the dental pulp like a cap. This is made up of a small quantity of mucoid cellular tissue, covered by a layer of cyindncal cells connected with the buccal epithelium hy ih^ mil >erna. ZiZ' li'':L'\ ^*^^:f'"'/'' <^'y«n manifestly exists in the lUl, being found at the base of the ivory germ, though it disappears quicklv after having performed its function. It is unnecessary in this place to enter into a consideration of the development of the teeth The /ti;er commences to be formed at an early period in all animals appearing at the surface of tho duodenum in the shape of one la.-o tubercle or two small ones, according to the number of lobes in the organ of the adult. To these external tubercles, corresponding internal ones arise from the intestinal epithelium ; the first increase and enclose the omphalo-meseraic vein, while the second ramify in their interior and form the biliary ducts. The liver grows rapidly, and when about one-third of the period of gestation has elapsed it nearly fills tho abdominal cavity. At a later date this increase is less marked, although when gestation is nearly terminated the gland is proportionately more voluminous than in the The pancreas, like the salivary glands, is first seen as a solid cellular tubercle, which is subsequently hollowed out by ramescent cavities Ihe spleen is developed about the second month, on the great curva- ture of the stomach ; it would appear to be formed at tho same time as the pancreas, in a band extending from the stomach to the duodenum • but It is separated from the pancreas and becomes attached to the stomach, where its elements assume the character of splenic tissue. The Gcnito- urinary Organs. The genito-urinary org-- •, are related to each other in their develoD- ment, and have some parts in common. Immediately after the fornriation of the intestines, these organs are anticipated by the Wolffian bodies or primordial hdnc„s These are glandular masses extending in front, or one on each side, of the vertebriE, from the heart to thi mlT -J ^^ t'! «°'".P°««' "'" «""''"", toithe retire, to the'botto„,"S"elvlrcrtv " '"""""■"^' »"'' «»' Wadder The l..dne,. appear a long time atLi- the VVolniaii bodies. They Fig. .r,9. MALE F(KTl-,S OF THK MaRK AT FiVK AND A H*,. Xf '■ ^STh; t^rSbni:SrS:r:'"4 "rb^^-"°1 r ^^' ^-"'•^ ■' ■•'■ B>'"Wer men, with the two Afferent c^'j; 'l^S'T^-^' J ''' ''°"^''*^' ''°'* Hulea; 8, Rectum; 9, Me„orchTn!'»' ' ^"^"ey« = ^ Supra-renal Can J^tJSr^J^^m^ll^^S^^ralS^^^^^^ by the tufts. According to soto' ob erv rs ho lidn" '"^^ /'^^ Malpighian communicate with the ureters uS '>>dneys only subsequentlv middle lamina of thrbkstodp^n « ^ ^'^ developed separately in the of the allantois. ^'^^^^oderm, and termmato in the pelvic portion of their d:v1lo^r:t!'the'''S::,'^^^^^^^^ *■■•,?' "" -"""encenient "npossible to distinguish thfsele, so ^h ?' ' " f'^"" '"""' " '^ to teiu, this the .. ii'ditierent '• sut rt^^JeSl^^g'l'r'SeS^ '' T 112 OBUr ETHICAL PH Y^lOLOCf Y. the sexes become defined, and at this stage the organs may be studied as mternal oi.d external. The indifferent stage begins about the sixth week, when there appears on the lower face, and near the inner border of the Woltlian bodj', a small white cord, which, in keeping this position, mcreases in volume. This is the cjenital gland, which is fixed to the body by folds of the serous membrane, and is composed of a collection of young cells enclosed in an envelope. The development of this gland IS coincident with the formation of Mailer's duct or the genital canal, which lies inside and in front of the Wolffian duct. Miiller's duct is at first a solid cellular column, but is afterwards hollowed out into a cavity ; it terminates in a cid-de-sac at its upper extremity, and opens below into the bladder, near the Wolffian duct. From these modifica- tions of the genital gland and the ducts of Miiller, it results that the testicle arises from the gland, which shortens and widens a little, while its tissue is transformed into the tubuli seminlferi. The head or globus major of the epididytmis, is formed by the middle portion of the Wolffian body; the tail or globus m'.cor, the vas deferens, and the ejaculatory Fig. 60. (iKNlTO-UKINARY ORGANS OK A FlKTAL SitKKI'. (I, a, Rudimentaiy Kidneys ; h, Vteteva ; c, c, Testes ; d, d, W„lttian Bodies • \s the testis below the kidney to the abdominal ring, where it rests for a brief space ; after which it reaches the scrotum, where it is found after birth with the remains of the scrotal part cf the guberuaculum. The iliac nay be studied ,bout the sixth le inner border g this position, is fixed to the of a collection t of this gland genital canal, ler's duct is at ed out into a ty, and opens hese modilica- suits that the a little, -while head or globus f the Wolffian lie cjaculatory ian Bodies ; )vidnct with siculce scinin- the posterior al sinus — the cloaca. The atained there ' the inguinal -ppearance of gof a central ted cells and 2d character- n the bottom rs arise from sue and con- iding "-o the ;, dra\\s the its for a brief d after birth [1. The iliac DEVELOPMENT OF THE F(ETU>% „3 is converted, b/obmeratfon'TZ nTklnto tt//"- ""^ '^'"^"^ testis. necK, into the ttmica vaginalis happens in the n a e don e.t,i™?J ^°* f "°' "PPear, as sometimes however, as has been alrpnrlv r,.^.^*.; ^ ^ ■, r' ^^"" ^^"^^ animals, the Horse and K. thar4v of W T ^^" "^^'"^ frequently with during life or only ore Znl / 7^.^ *''*''^^' ''^"^^^^ '^ *^e abdomen remain in the abdominal cavitv fL ''" "fural situation. When they " cryptorchid •'' andTt h., S' ^^^^^^^^l^s said to be " anorchid " or have the sexual pronen^tv weir ^^^^^ that, although such animals their se.en does rtCntLTn^^^p:^^^^^ ^'^ unproductive; production unimpaired '''°''°^''^^^' ^^^ possesses the power of re- whte''the^.:;il^" tmethr t?'"'-^"' T '"^ *^^ ^^^^^^ ^^ ^irth. the^mSl'^f %tat73"iK°' T ^'"'^--^/-e. -Penally about --:5--i^-p^^i^^ of mUlSSt' ;he?xht''>P"7"r-r '°™^^ b>'*fa^ anterior portion union and ^f^l^^^t^^^^^SZ^^ 2^° the^^' °^ oppnin" and ^h- nr^ "-".vint-s pne ca\ ty into two portions— the anal 8 114 OBiiTETRICAL PHYSIOLOGY. The male sex is marked by the rapid development of the genital Fi-. til. Female Organs op a Fqctal Dkeb. a, Uterus ; h, b, Co.nua ; c, c, Oviducts ; d, d. Ovaries ; e, e, Wolffian Bodies. tubercle, which becomes the penis, whose extremity is enlarged to con stitute the " glans. • The furrow or groove is closed behind'^and form the urethra; while the genital folds, meeting each other below the penis, join to complete the scrotum. Owing to these changer the Fig. 62. Female Fcetus ok the Cow (natural size). digestive are separated from the urino-cenitfll nr <^«*»;ihiie th: g„";^ai gTtrrcS'afre^pa'rof't'e'r^t form the ^cn«^?«ft. The wawm^ annPHrln^lc ^f *u *^. ®^*®°* *° appear i/the early months oTreSwefS /hptf"''"*^"' ^''S^"^' very soon. They are also seen very d ti^ctW in thptlf '? perforated early months. ^ uis>tinctiy m the male foetus m the In certain malformations of the generative organs, more or less of Tig. 63. /;/. uterine Cornua'; i ,j, Allopran Tubes!' ^ ^ "' ^^^^"^"^ ''^"'^ ^"S^"- ^ ^KssiTi^s^xr^t^fmpSSc^r ^^^^r °^ ^^- uncommon among the lower an nals an^? f ' ''^^'^ ^^ '^^ ^«^«« good example of" the organs o a hp^-?,!^ J-f^"^ drawing gives a parts predoniinatin^i " lieimaphrodite goat, with the male SECTION IV.-PERIODS OF DEVELOPMENT. Thus far we have traced the develnni-npnf /^f fi the uterus; but as our descrintion n .?S ? *^^ young creature in 116 OBSTETRICAL PHYSIOLOGY. I , 1 bodilv 117 '' I' -T^ be advisable to adopt the plan of dividing this Mea^of iL a^.^'^'V"'" P^"°^^:^hich will also give an approximate W«fl K A^-;, f"".""' conception to maturity, utero-gestation may 7?l.T P ' ^""'t^ '°*°. '"r" P^''^^*^^ °^ stages: as follows :- ^ n. „! ^^^^^--Towards the second week after conception, the ovum or germ has passed from the ovary into the uterus; it is then abouH hne in diameter (one-twelfth of an inch) 5eco«^Penod -In the third and fourth weeks of gestation in the t^e fiVST'"^"*^ Tu^ ^'"u' '^' '^''^ ''''^ ^" Carnivom ; there appear Sstinauishpd'% ^", ''^T' ^r *^^ ^'^^' b^^y- and limbs can be Ma^e'In/rnw:Ti.^^S/if /'T *^' ^^^ *° *^^ «^gl^*^ ^^'^ek with the thrWh fo Vh • ff ^-.^fu'"^^?'*^ ^^*^ *^^^ S^^^^P ^"d Goat; and aconiS « 1 fi' s/'^th with the Pig. The embryo of the Mare has iS ?h.f n?l V""^^'' Tn' *^^" 2 inches; that of the Cow If \ hu.K^J *5.^ ^^^^P ^"^ ^°^* li i»ch; that of the Pi- U inch- and that of the Bitch 11 to 12 lines ^ ' ^ "■ '° "^^ ^^°^ ' thfZVJl^fl''''^-~J^}'it ^'^^^ *^" ""^*^ *° the thirteenth week with the Mare; the ninth to the twelfth with the Cow; the seventh to the tLfA""iX't tfH *'^ l^^^Pu^".^ ^°^^ = *h^ ^-^h to the e^h h w ?h if .1 ^Vr ^- *^^. ^?h '^''^k ^^*h Carnivora. The length of the fcEtus Eui^',an?rs f ' r^'' \^Y f ^^' ^°^^ 'i "-h- ; that of the smai 2| inches ^ ' ^* °^ *^'' ^^S 3 inches; and that of the Log rrrfU^-'' ^u'"'''f;~^his extends from ^he fourteenth to the twenty-second t?n'f b f It" ^T '' J?"- thirteenth to the twentieth in the Covv ; the enth to the thirteenth in the Sheep and Goat; the eighth to the tenth f i^ ^l^ ' ^"^,th« sixth week in Carnivora. At thil sta-e the fSus o the Mare is about 13 inches long; that of the Cow 12 inches ;tha the Bitchi? rnche";?'' ' "''" ' *'^' °' *'^ ^'"^ ' ^"^^^^ ' ^^ ^hat of Mf J-^iff '^'^T^r'"^ the twenty-third to the thirty-fourth week in the Maie , he twenty-first to the thirty-second in the Cow ; the thirteenth the picf !fh ''"'^^ 'f^^^f ?^^? ""^^ ^«'^t ; the eleventh to theVftTentl a n'l^?; f r"*'' *° the eighth in Carnivora. The foetus of the Mare m Jiis period has acquired a length of more than 2 feet ; that of the a fooJ" Th°.?nf fv,'^^-^ dimensions ; the fcetus of the Sheep is more than a foot , that of the Pig about 7 inches ; and that of the Bitch 5 inches Seventh Pcnod. -From the thirty-fifth to the forty-eighth week-un thP^n Itr'^^fv; ? ' r Y"^'" ■ '^' thirty-third to the fortieth inThe Co7 the nineteenth to the twenty-first in the Sheep and Goat ; the fifteenth in the CaT '" ' ^'^' '^'' °"'*^ "^ '^' ^^tch ; and the eighth jJLhT^^f^T ^?>^^ ^\«asures about 3^ feet long; a Calf 2 feet; a i T^i^°°*[ ^ ^'- ^hout 9 or 10 inches ; a Puppy 6 to 8 inches and a Kitten about 5 inches. ^^^ ' cannof^flll f!fJ'' f ^t"' "^^'1*^°^ °^ the young animal in utero, one cannot fail to be s ruck with the slowness with which development pro- gresses for a certain period, and its rapidity afterwards. Tlfeslowness in growth may be accounted for by the extreme minuteness of the ovuS i'KlilODa OF DEVELOPMENT „- being at first no dirlot oonnectTon hiL„ ""'^k"' ™u'""°" '''?<"'<'. *ere vesseU. The par r wS in InH^t " '""'"'>'° "'' ""> '''«"'<> period of geetaLnfare'tht envl1,S'gSbr:/Zd'[hrfl!!!| 't' contain. In the Sheen f-nvvflv/la fv,^ j V " , „ ^"" ^'^^ fluids they tion. the membranes alonrweth Somfivel^ ^?-' ^""'*^^ °^ g^^*^ fetus; while the allantoic and amnToHrfl^^'^ times as heavy. These fliidsinnr^^^l "'? f ^ ^''°"^ «'g^* to ten commencemen^t, uiwwifhin ."£;?: ho'r'J tt^^f' "^"""^^ '^°"^ *^« at first, towards the middlp npHni f S- ^^""^^ '^^« ^f parturition. Eapid the mo're active t:^^^^,^^^^'^^^^:^^^^^^ -d. ^^en begins the proportion of the fluids • until nSii? ^ '^J^V'^^ diminution in they only represent sometWnil^e a tWrio^^ °^ l^.' ^t^^'^V^ "^°"*^ a few days after the fifth n on/h n. oi; . u- fu '^.®'S^^- ^" *^e Sheep of the wJight of the\oungrnfal °"* ^"'^ *'"^' ^^^^ ^^'^ ^ ^i^^g Lamb%l7ht?oTeL^day\:Tl?a;:er ^^^'-^ 5' f^^*' *^^^ ^^^ ^-^al weight it has at bftt f S ^^^ i o\^ hs^itl^ "nlf a' S f? °^ *'^ ?^^.Xi:^an:^traSr^!:Hf^ other organs. In the fo^f,i= of Tv^ t ",^^^f^^^ predominance over the proportion of the ente tX to that o'te'V d' fi%-seventh day. the 15; at the seventieth day t^s as 1 to 55 .n.1 nJ' '^ 1^'^^^ '^ ^' ^ *° mid-term with the Calf, its '4i4t is to ?h«f n^t k'? ^' ^ *° ^^^ ^t at birth as 1 to 120 ° *^^' ""^ *^^ ^°'^y as 1 to 53, and the'cKi'id-'tiii? iror?re*i^^isr ^ ^^7^^^^°^ ^^ ^--*^- ^- and at birth the 470th part ^nJlir ^^^ of.the weight of the foetus. 340th part of the body.^ "'' ^^"'^ ^* '^^^'^' i* i« ^^^al to the tbllotTdsThelS^^^ - the embryo of a Calf at mid-term ential?!^ ^"? ^^?^' ^'^"^h- ^he heart Lamb at birth the iSoTn the adult B"irf-^^ of the body ; that of a The lun,, have, rela?i;e to the to aT b U of Th J f\ ''''^ ^''''^ weight according to age In thosp of ftl t 1 /S"'' ^ variable they are equal to a 20 th nart of tbfw i -^^"n f^ ^ifty-seven days, 33rd; in another at eigh/ month thrsfh^ 'J' ^ ^,i^- "t '"j'^'*^™' ^he 55th ; in a Foal a little mo^-e ban ei'ht nn^ ?? i ^''^\^^'^ 35th and the 33rd; in Lambs and Goats at bfrt^^ltv ''^ "'T*^' ^hey were to the 61st part of the whob wei<^ht ' ^ ^'"''''""^ ^'°'" ^^^ 24th ing''lo'4rand''s;Tclf ' In a Slf "'", f ^° ^^^'^^^ considerably accord- in a Lamb ei^ht dav. after bMi If -S,''"'^^''^^' *^^ ^^Oth : and S|re-^rb;£SS^^^^^^^ not get beyond the anterior ineZLum a7d" i; . "t?"* " ^'^' per^tent. It ha, in rare caseAtntS fn loriTSr^S S 118 K; ■',' i M W'\ it I ft- OBSTETRICAL PHrSIOLOGY. and totT Hfe' h^^f "S'^^ voluminous in the early period of embryonic its cloTe In Ih^f f^^'^a^e^P'-oportionately as gestation approaches ound equal to i nth o?n 1 ^T^ "* the fifty-seventh day it has been birth toSth vv h Jl T^ °f ^"? y^^'^}"^ ' '^ ^^^^^^^ ^* mid-term and the same period T H A^ ^^^^^'^^ l-21st, and l-24th in Lambs at uie sauie period In the adult Horse it has been found to represent l-75th of the total weight, and l-8;3rd in the Ox represent ihe intestines, during fa3tal life, do not grow in len-th so as to attain tt^nT\"r'' dimensions they offer in adult liL^ In an EqS fee the turn r"" """f"'' "^? 'T^\ ^"^^^^"^^ measured abVuH? The general proijoitions of the body, and especially thoU of tl,„ skeleton, are not in facial lite what they are after Wrth Th„ 1 Tr * X fj^"" 8^'>-^ whole of its body, oi^vftXwripr ^f "- '^^PPlied ; it moved the the uterus and the eTvelopel In I' """ ^^^^^^/vhen pinched through from these and the mother ?t no In. ^"'^^''^^^' ^^ ^^ hour after removal five months has beTn seen to ll^^'/ '"'T^.' ■ ^^^« human fc«tus at from the uterus *° ^^^ ^"^ '^'^^^"^ ^ts limbs when removed f JaT;t:n^e:trSrrot.vL -M^^ - ^-^^ that the changes its position prepam ofv to nfc • ' Ti ^* *^/' P^^'^°^ '^^^ ^^^t^s the young Soliped, dmf^ the'^,i oje^of If?' ^'^"^^^ *'^" P^^^^^' ^hus with its abdomen turned unwn<^« 1 ^ .f '"^'^-''t'^^ existence, lay the largest of the two '0!"^ ^u if'n ? P°'^""^°^ ^'"^^^ ^^^g^^ in the legs downwards and th^unt IcTLT sides. '"^ umbihcal cord imssmg across one of its formerar:n"etlyT.:of /'"/ '^^^""'^'^'^ ^^^ ^'^P^ar to be per- are so often obse'vid ^^ o/aS,"^^^^^^^^^^^ hairs w£ have been discovered in the fotaffomaJh ^'''"^' "' '^' "'""'°'^« «^^^' m. , Absoyytion. mentor 'tre7org1.t7'ls trarif^^^^^^ P--t - the develop- the uterus, its vitelhne envelope or ndl.l h' '''''T''^'^' °^-"'« ^'^^^^^^s delicate, hair-like prolonSons vil 1= ^°"e becomes studded with steeped in the fluid thrown out o^^h!,'' '"*'f "^ vessels-which. the lamin.-^ of the blastoderm Af fi ^ T"' f'^^"' ^^'^^^^it this to small, and the growth of th?;, f '' *^''' absorbent surface is very less, this triflinf rC-ntinnl o'^ '' consequently slow; nevertS or fifty times its on^nal^volume hlTfl V'T^ "^^ ^^^^^ *« ^-ty germinative space are completed ° blastodermic lamina, and the ..Z^nZ' aMr^^^^ ""'^"^"^^ ^«"«i«^« i« formed ni, the ^^pense -";. ,,(iar ana mucous laitiijTn ifc ,,^ 1 1 1 ,~" '^-■vpense ui the are .ddea .0 the -ror^e^T^tetrat/forttrr^:/.^' ry a sufficient rt is tardy or ause becomes adually cease ;hey cease to e of develop- anifestations mere tactile iable. It is 3ir ingestion end of the ier montlis, y can be felt seen in the itic or refiex in this way ad occasion iwo or three 3 incision in very lively moved the ed through fcer removal iU foetus at 3n removed bt that the i the foetus vis. Thus stence, lay i lodged in belly, with 3 one of its '0 be per- airs which iotic fluid, e develop- e reaches Jded with 5 — which, lit this to ce is very neverthe- to forty 3 and the ;e of the ters that h of the Pm-SlOLOmCAL PHKXOAfENA IX THE F(ETUS. ,,, fulthed wrt^t's"'4^;i;t^ftscui:"°" -^1 '' '''' -g-i-cl, and natedor agglomerateTp a entL^ ab tS '^" ''l^ °^ ^^^«^™' actmty over the whole^ uterine surface £ teS^- ^''^ ^^^^gS^rated all the nutrition requuad for thp nni *^"^ ^^''^ure, in order to supply The nutritive ellm nts are absorLdT^'^'^°P"l^"* °^ *he fcetu^s^^ villosities, transformed into blood and cl ' ^;ff '^1°^ *^^° P'^^^ntal by the umbilical veins. TWs extra f^nH f °?'^^ '^^ *« .*he young creature that which is taking place in the Mo ?^°^'P^'°" ^« supplemented by organs and tissues of the f^tus itseH It I' ^"f^^Pf ' ^"d also in the placental absorption is bv far the mn«M 'f^^'"' liowever, that the development of ^the fc^tusL mainly Tf no XlTh*' """f *^^' '^' ^'^P^^ tive elements obtained there while ?°*. ^^^°f ^h^^'. ^^e to the nutri- amniotio fluid found in the sto'mnp) n,J • ! ^?* impi'obablo that the of these, modify the ac ion of the HH J . '"*''^T'' ^''^ ^«* ^« ^ dilator perhaps yield a^small anCnfo nutr moi^t^^/h^'^f "^ '^' ^^"^^'' -»d bered that it does contain much of 1 Pn, J ?""^' '\ ''''"^^ be'remem- the ootus which is unproviS with a mo^H '"7\'/"^"*^'^"'^t^^fc 2"ow.s nevertheless^as well Sop^d^^'l^at^ErgrtS Nutrition. 4 thL'„T?,,:';rhe?fhe't,s„?s'r ^'-^T' '= ^-"^ <""-' and only brought into conil nlnTl? , ^ *^° systems being complete .naterna'l blooS is "ot:;S'ty'ce Waifs'' or placentul.." TheStlfe or receptacles of the uterus conta nina fu Z '"^" P^^'ticular sinuses vessels, which emerge in o veins vhi,*A\"^^/'?^ '^^'^'^^^ of these a tenuated, dip down into hese'reonnfn f' ^"^^^^ '''''''^'' extremely blood of the pWnt, as the ''^L '' o/ti^^ ^ ^^'^''^ "^ 'h^ are m the water in which thev ve Rn h "".^^ ,^^"''*'° creatures and offspring never meet • thev are ^nWK "^^, f ^'"al blood of parent •and between them are the t in coats of\'°"fV'"'^ ^"^'^-^^"^ «°»tact ; and cells. This indirect contact is snffi /!''' ^^««'»ent membranes blood to become arterial, by enaW '"5'^ ^"<^ '^, P^"»i.t the venousfceta and also to get rid of excremenS matter'? '"''^] \'' ''"^'^^"'^ ^'^^' processes connected with tlie grS o ?bp ^''^ '""Z '^^" ''^'^^'^''^ m the blood of the youn- crL^urr,\,° . i w "'' f"'^ '^'^^^^^ retention to it. This arrangement of the wnf cloubtless be a source of injury been said^ allows certain nu iot e?en:;;;t n Jr^'' ^^^°' ^' ''^' ^^^ fluid portion only-to be taken m? inf ! ^ *^^ '"aternal blood-its this way, as has been poin ed out ^ hi.. ' 7'^"" °^ *'^« ^«^tus. In closely correspond to tL v Ilfof the m ' J'''"''''u °°*^^*^ ^^ ^he placenta and tlie analogy is rendl Id mo nSetT''!^'""' "^*^^ ^ nutrient material is selected ai d pre3 £l 7 '" T ¥°^^ ^^^^ ^^^ which-the maternal-transmks t ^S H ^ .*u''° '' ' °^ ''^"«' ^ne of same manner as the epithelial cells of ?l *^^^°t^er-the fcctal-in the up and prepare the nutrent matte. ?L/ ' ^"^^^.^'^^l ^^^li seem to take lated by the cells wh?ch float rntL^^ ' i .''^'"i^ *° ^^ ^S^^" ^^simi! njunication between two ^^?cu ar yst m^l'^'"? ^'''^ ^^'^^^^ «om- blood corpuscles nf .o^h sVl^Jf? ^^f- ^ ^^'^^^ ' ''^"^^ ^he fact thnf. fh- that the/must-be diSbS.' Ne'.lrC^^^^^^^ placenta, and the intimate reton pvS ' *^",.^P^«'^1 function of the «».^s 0, pa.„t ana ^<^^»^^n^r^t:t^tJ:'^Z2^ ■ M i( In! 122 OBSTETRICAL PHysiOLOffY. more or less noxious to the mother ^''"''''^*^'^ '" "'^ ^'^"e^' '""^y Prove Circulation. The fluid which is at first received and pronelled hv tli« J^on.f • isolated cells floating in the resulting H.?^' '^.i^^&A^/'^'",^'" ^^ sells are isolated cdis ,,oaii„g'i:;"tTe^.;;u' rS: "tIL^kL'.:/ fatty matter Mnnv.;. >pl;o^visli particles of a substance like little prominen ton thr urface o^ tV^' n ''''' T'"''"''^' ''''''^^'' ^^^'^ granular or tuberculated *''" '""' ^'^'^ ^PP^rently slightly in Se" tt nms^oTufeWooVr ''^' the multiplication of blood-cells the development of he red fromTr'' ^"^ '1' ^'^^°^•' *''"^ ^" ^^'^^^ °f is lost- whilst on fhpnfl? ™^th/^or'g'nal colourless formative cells liver a'ne^v production of coS *h^'•^*^^« P^f in the vessels of the around free ClTrd 12} nnf ^^"^^ ^^^ ^^^med duction of colour^ matS i ?u t'^^^ -"'^^"^^ "^^"«^'' ^Y the pro- This new format,"," 'S'lto^ cornu--r- ""fi.^f '^^ ^'^^^^"'^^ ^^"«- place during the whole" neHod of K f ni r'. '" .^ f ^7^'. '^""^'n^^s to take cells themselves u den o 7r« n«f ""}■ ^'^^ '■ ^^* T^'^^^' *^^^« nucleated tnseives undergo tiansformation mto the non-nucleated discs J impressed with the constitution atter may prove cental villi may cessary that a ito play at an f appears -vith .med the heart. the form of a it dilates and i then to propel y the heart is elements, and 3 been stated, I trunks of the i peculiar dis- [ans are to be ions of these ictive cavities, to remain as ated cells are t,'e, colourless, iUbstance like md flattened, 3sition is not ; at first very the complete up, as if by iquirement of the cell, and 3 blood, it is ain nucleoli ; cells, whilst When more id at a later , and about ircular, very iitly slightly f blood-cells all trace of mative cells essels of the are formed by the pro- leated cells, ues to take 3e nucleated leated discs PHVSIOLOGIVAL PIfEXoMEXA IX THE F(ETirs, uf^, which constitute a "radmllv \nny.^^ • con.ponents of the Wood dmnn'thtTf. P'°P°-'*r,°^ ^^"^ corpuscular whether these are formefo df bv S^^^^^^^ °/ embryonic life, or puscles, has not yet burLonnintd '"^^^'"°^P^°«^« ^^ lymph-cor- lif'S whirhas^rS^:irf '----ied^ ^-•"g ^-^'^1 po^er is centred n tirri^ht «.vi 'f k" T" J'^^*, *'^" ""^'^^ propellinfr lumrt being mablysint in of^^^^^^^^ *i' ^"^'S' ^'^'^ ^^''^^ °^ "^^ I^^^ and upper extreinitief A dhe tn-h I'' T^^^ ^ °°'^ *° ^^'^ ^^^^ bo the case, for th7wall ^ tL Im,*^^^ °f **{" ^^'' .P^°^«« *!"« to thick as those of the7e^ wL tho^vJir^*^^^ ^>T '^'^^ ^°""d as thicker and more muscuh\Th n h1 f .['^ 'w/'"'"' '^"^''^^^ ^'^ oven which persists for rsll^timrafterbirtL''^ ''''' ^""^^^-^ «°"^^"- io^:'^':Z'^ltt''^^^^^^^ ^>-«*-- -ig'^t lead the heart in the f^us ancUri of M °".*'''^'',''" '^^ contractions of proves this to be the case ZlltZoZT^^^^^^ "•' "^P",'^"«^ between the beats of the hpnrf nf fK . . * ^^""'"^ '^ "° relation mother's heart. By au cultat on 1 . wo "'n " /"^^"' .^"^ *^^°^^ "^ it« sounds of the fa>tal^ea^ and tour. ^ *° clistinguish the two per minute-never moie than Un i ^"1°".^" ^'^'^''^^'''^ ^'^^ times, that the beats we^Tensib Iv the ,?;."T ^'''f *^^" ^J^ ' ^^ ^'^ xei.,^rk,d thoy are first perceptible u^nUl bS "x; ^^''^^f ^ ^'''^^. "'°"*b^' ^^^en the same mode of iS:^at^o in V.; H° ^'"^nn, in resorting to was advanced eight Indflll Zn?u' ^^''^^^^'"^'^ that, in one which was 6.1 per nnnule, t^f^t^ be t Tvt i-m^-'"''"'"?^ '^'?? '"^°^^ P^>«« was ill, the pulse was fro?n 70 m i o .1 ' II' ^1"°/^'"'' ^'''^^' '^"t which to 128. " ^° '^^ ^^^' '^*"1« that of the foetus was 113 the uterus of theTla^ w xs onomi? „ i '.? ""^""i^ ^^'''' '"°"*'^^- When to extract the fatus thl iX ' ^"V^'°"*^'""^ ^"^'^^opes incised ohougIiatra\iin?eSs ThtnnM^^^ actively and respired deeply, blood, from thrsmaU n„nn ?, f ^^u*"''"^' ^"^^ ^'^^" yielded some throbbed with a c r^ n^amou t of'?'. "^'t ^'^^ ^^^"^ ' *^« ^^'^t When the cord w^sd vide and tLdfL7'V^'' pulsations were rapid. there v.nro no more sno tanonl . ' ^?*''' appeared to be dead : ceased. The thoiax amrthe Xln ''''''"^'' ^""^ '^'' respiration had was observed thS the hear coiSori """'''. "°^' '^''''''''' ^l''^"' ''^"'^ ^t the pulsations of tl e aoSand ? 1'^*'."^''"^°"'^^ ^"^^ strongly, and felt. At first the con^r^ofiof "" "^'^^^ .^'i'^^es coul.l be very distinctly those of the ietiS .s' a n mlfrd^Ln ^^tn^'^' ^^^^^"^^^'^ ^^•^''' expiring animals, the kuricles con mo\^l .,'.''* ''r"' ^' occurs in tion of the ventricles as if t rpnni. ? ^T^^ *'"'^' ^'>'' ^^^ contrac- ventricular cav e ' U eaoh ^2^ .'''''r.^' systoles of these to fill the in volume, became n;arlv e nX^nd T *^r"«l«« ^i'-nished much their redd sh-viol^t Som- i n' ^^""^ ^°°^'^ very pale, but assumed rhythmical mo4n4its bo^aSto r.!^^' '^'''' '^'%'''^'- ^^^ ^^'' the ventricles contracted si nUo^"T ^'^.^^erted ; the auricles and feebly, and final ^cld^t^^^^^^^^^ ^"If^^^' )''' '"^''^ ^"'^ ^O''^ been opened tL fW -.fl r ^ ^^'^ ^." ^°^'' '^^*^^ the thorax had i£o!i if^ ?£ Hr ^1~ - ^ IN V2i oitsTETJucAL I'lrvsiuLoay. 1 Ml f"' " ha' not thJtelni'S'^u„T"°V?°",''PP""«',,''°'J '^ remai-kaWy abundant. In LassMgne analysed that of the fcotus of a Cow six"™„ths old .n^' Snpaf o-SeTS; Sr ,ltr "-'^ ^^^^- maU™^Srin?'th''em''V'f"'"™ r"' '»' ">^ ta'-'i-es and the other that it has not h^EiailT ANJJ imtENHIONS OF THE FiETUS AT BIRTH. 126 a.>?arer,'r„",ri",ttj? nhe' W„ff''™/'V''"*', ■?"»-"ori„e life, quantity of arino i^fmXn tl '.Tll '""'^°' *•'''";'""•" """ » ""'"W" plllsillirs be admitted that the oilice uor ormn^ W "v ^PPf,^''«. however, to s^S;Sk ^^- ^-' --d Jd:L?ist£-^svi;; SKCTION VI.-WEIGHT AXI) DIMKNSIOXS OF THE FCETUS AT mRTH. The various plienomeua connected with develnnmpnf 1,0,/ u completed, so far as uterine existence is co cerned^ Cv h. ^^ note what has been ascertained with re-u-d to th)/ Z ^'^, "^ *° ;/o«. of the fa3tus at birth; the \ tt" beL^'^f ",3 'S^'T" from an obstetrical point of view, tliough it is a subiecfc wh ^1?^? "'? received all the attention it merit's f.onrvetcHnary o^stLS^^^^^ "" "°' Weight. With regard to tveight, we find, as might be exnected fhnf .K- varies consideraby, according to the siyp hr^J] r. Y .■' -^ *^'^ parents, and other'circumstances Sch more "^ j^^^^^^ °^ ,^/- For the Horse species, Boussingault estiinatecUhat T^^a ^ ^ ^ ^ weighing from 400 to 500 kilogrammes lyeShod^^^^^^^ k.logrammes.1 Franck estimated that t fltu w hs Tor?.-'°.f^ ^veight of the mother before parturition. Accord mrti.ffh?? "'" up by Saint-Cyr, it appears /hat a Foal atrrtrp^a; ^ary in wS between 31 and oO kilogrammes, according to bree'd an] indivSfal 1 The kilogramme is equal to 2-205 pounds avoirdupois. J! .V I 1 H S p I i' f !' ^1 m 126 OBSTETBICAL PHYSIOLOGY. peculiarities ; though between 38 and 45 kilogrammes may be accepted as the average weight. With regard to the Bovine species, Tisserant has stated that Calves weigh at birth from ^^^th to -^^th of the weight of the Cow ; whereas Eiedesel gives it as ^jfih. Magne mentions that Calves vary between 20, 25, 45, and 50 kilogrammes. Saint-Cyr alludes to the observa- tions made at the Agricultural School of Saulsie, France, where Cows of the Ayrshire breed were chiefly kept. The animals were main- tained in good condition all the year round, and though they were only middle-sized, their weight varied between 400 and 650 kilo- grammes. The Cows were regularly weighed, as were the Calves immediately after birth, and the register for 1868 gave the following results. The weight varied from 31 to 55 kilogrammes— the average being 32^ kilogrammes. The males were a little heavier than the females. In twenty-eight instances, the average weight of the Calf compared with that of the Cow was as 2 to 31. The average weight of one hundred Lavibs weighed at the Alfort pens, is given by Magne as about 4 kilograumies for both sexes. The males were heaviest. For the Goat, Colin gives the weight of twins in two instances. In the first, one twin weighed 3-530, and the other 3-585 kilogrammes- together 7-215 kilogrammes ; in the second instance, one twin weighed 2-6330, and the other 2-680 kilogrammes— the weight of the two being •6-310 kilogrammes. Dimensions. With regard to dimensions, Saint-Cyr justly regrets the paucity of observations which have been made on this important point. It is of ■course w-ell known that, in a general way, the foetus is larger than the pelvic opening through which it has to pass at birth, ])ut we have to ascertain how much larger it is than that canal, and what is the amount of reduction in volume to which it has to submit in passing the outlet of the pelvis. Eainard merely states that some measurements he had made gave the diameter of the thorax of Calves, from withers to sternum (vertical) as from 10] to 11 inches; and the diameter from •side to side (transversal) as 6^ to 7 inches. Saint-Cyr, anxious to arrive at some definite conclusion in the matter, in order the better to understand the mechanism of natural parturition, as well as to gain a knowledge of how to surmount the difficulties of protracted labour, undertook some researches in this direction. His object was to ascer- tain the depth and width of the chest, and width of croup of the fa3tus, these being the dimensions which it is most important to compare witli the different diameters of the pelvis of the mother, so as to understand how the former may accommodate themselves to the latter. He gives the name of steruo-dorsal line to the vertical measurement taken from the summit of the highest dorsal spines to the sternum, and hiscapulo- humeral 'ine to the distance measured from one scapulo-humeral articu- lation to the other ; while the hicoxo-fcmoral line is the measurement of the croup from one coxo-femoral articulation to the other. From tho measurements in the Horse species, we find that a Mare measuring a triflo over fifteen hands in height, and whoso pelvis was nearly nine- teen inches in width, brought forth a Foal weighing slightly less than thirty pounds, and whose stenio-dorsal measurement was nearly twelve inches, biscapulo-humerr^ line 7| inches, and bicoxo-femoral line nearly PREGNANUY. Tiay be accepted bted that Calves ! Cow ; whereas es vary between to the observa- 3e, where Cows als were main- 3ugh they were and 650 kilo- ere the Calves e the following ss — the average avier than the ^ht of the Calf the Alfort pens, ;es. The males I instances. In kilogranuiies — e twin weighed if the two being the paucity of point. It is of larger than the ])ut we have to i what is the t in passing the measurements 3, from withers diameter from yr, anxious to : the better to 11 as to gain a ;racted labour, i was to ascer- ip of the fojtus, ) compare with to understand ter. He gives 2nt taken from and hhcaindo- lumeral articu- measurement aer. From tho 3 measuring a s nearly uine- ?htly less than 5 nearly twelve )ral line nearly 127 8 inches. The other measurements of Mares and Vnoia ,.,vi;i ^ • -, results, and give an idea of ths ^vr^niV t ^"^,f °als yielded similar to expel the Ltus In the case fiS .Tf'l °?' *^' ?^^"^ ^^"«<= "^^k« the p&vis of the Mare had, approx Lt v' theTol ^' ^^f''^.'^^^ inlet of the pelvis-sacro-p;ibifd?a:^rer cj'in^ehes ilT ^'fC'^T '' —bMhac diameter 8^ inohpc! Tn ^^ ^ /"t-nes ^ miet ot the pelvis those of the Foa to which it Leh,-S"P,^-''"l *.'^^^« dimensions with the second edition of his work he livl thl ^ ^^''' ^"''^'^- ^^ parts of the body of the fcj^tn, uJT "?easurements of other plexity. In studyL he taS; t f ^^''^/^"^'^eration leads to com- measurementsintheloa h^tlfnkA ^^' drawn up of these various of the uterine co„ racJfon ne^^^^^^^^^^^ remarks that, even when the L.riZ 7^^^ the fetus ; and again exceeds that' of "hrpelvit int fof ?he "£' n'' °' ' 't.^'^-^^' '^'^'''^^ amount of acconamoda^tion must nevSthefess kl e' n^ *°.f ' \F'^' :;e!S-rsiS:-.^-:r-^^^ tho width of croup 18 »'f„Z;n„'S '^?",™» 121 hands high, .eve.ty41.ee pouf„]^thri\:^„'i:a?la°lrit"\rh:;\T' v^cipuiu liuiiitrai i-^ inches, and the b coxo-fpmnvnl sl ,-v,^i ^iSt^^^l^ t^' Calf bei^^Sr^^ Jt^ tivei;t"li:r1n1imts'^oTs U^^l^^^^^ '^^'^ '^'. ^^^^ ^ -la- usually muciparous the von w n.! „i ' T^"^"^- "' ^""^^^^ '''^''^"^ are thepei^ic inl?t thodgh Xnft hapnerjL 'h 'Y'''''''f '''''' '^^^ this is often so increased nsiltffr. .^'"'^ ^'^""^ °"^y °"^ ^«tus and may even be hni'ossible. ^""^ ^''''''''' ''''y P^'^tracted. CHAPTER V. Pr co„side.atio„ i, of IS^t:^^^^^^^ ^t'il'stu^a'; 128 OBHTETRWAL PHYSIOLOGY. :•« I.- HI it in this chapter from a normal or physiological point of view-noticina LoS rit itJt 'T"'""'^ alterations'atteSding it. the mocJrS recognismg it, its duration in various species of animals, and the exceo- yorgpSd" '"" ^'^ ^""^^ ^"^^^^^^ -^P-^ *° *^^ --be^'^f f.ii] ^f ^^'"''^^^ ^^^\ remarked that soon after fecundation the female becomes generally more tranquil, and indifferent to the male who also does not seek her company so ardently as before ; wh le a cer! tain amount of sluggishness may be observed in her movements These changes in habit become more marked as time advances, and along with them the other alterations referred to, and now to be described SECTIOX I.-MODIFICATIONS IX THE UTERUS DURING PREGNANCY. With the development of the foetus, the uterus undergoes imnortant ana onncal and physiological modifications; while the^ystem of the mother also, as stated, participates more or less -enerallv in th^ phenomena which mark the period of gestatioif The modifications and phenomena are worthy of attentive notice, not only from ?he importance they hold with regard to the reproduction of animals but also from the practical issues involved in the study '^"""ais, out stru^l^''t'^r^-f''T^^'' "^^7" "''■'"' ^^'^ those relating to its volume, stnccmte.joim, situatio7i, and direction. Volume. With regard to volume, we have seen that during and after conulation he uterus is congested, and that, when conception has tai^e^place the thin pulpysecretion corresponding to the clecidua of the hu nan fema e covers Its internal surface. The vessels, distended with blood Sdu ally enlarge to a great size-from the smallest to the largest fonnin^ most intricate and beautiful plexuses on and in the texture ofthfo 4? The coats of the arteries are thickened to compensate for their disten' sion.andthe additional labour they have to perform ; whle the veins are still more enlarged in calibre. The lymphatics avo likewise Z mented in number and dimensions; and the nerves, whicliwIJe com paratively sinall in the unimpregnated state, enlarge and ana tomo e so freely as to compose a network similar to that of tlie vessels-tie increase taking place in the nerve terminations, not in thlnerve s^b- In uniparous animals in which the foetus is developed in one of the ySTv,' ^u\ ^'TT' '^''""^^y increased, and appears \o be continuous with the body o the uterus, the other horn looking like Tmere appen dage projecting fi^m its s de ; but with multiparous fences tTe-cZua Sr (Fig (?of '^ " '''"' ""''"'' *° '''''' ^-^^ -^^ occuiierby Z Structtcre. These changes add to the thickness and density of the uterus • hnf there are others still more remarkable. While the^ gai is incre^sin ' in volume, becoming rounder, acquiring a greater capac ty and it! cervix widening, its proper structure is exagge"rated to an cS ^ord „arv ouTl- i» ntJVmaSl".'"^"^^^' '7' "°^- °^^"^- ^q-llyThroS ouc It i„ moot marked m tuo cornua of umlfciparous creatures at the points where he young are fixed-in Ruminant animals at the s tua° tion of the cotyledons, and in Solipeds at the part of the body of the f view — noticing it, the mode of }, and the excep- the number of 'ecundation the nt to the male, ire ; while a cer- i^ements. These nces, and along be described. 5 PREGNANCY. rgoes important ! system of the inerally in the e modifications only from the of animals, but gto its volume, ifter copulation iken place, the human female 1 blood, gradu- argest forming re of the organ. r their disten- vhile the veins 3 likewise aug- licli were com- id anastomose le vessels — the the nerve sub- in one of the be continuous a mere appen- .les the'cornua 3cupied by the le uterus ; but 1 is increasing icity, and its extraordinary lally through- eatures at the at the situa- 3 body of the ^VOBIFIOATIO.y,S IN THE UTERUS. Uterus corresponding in fl^n f *. i , ""^^ early months of p^eCncv tf,,^^^'^^'^- So that, at least in th. increased thickness of /h7n, J^"'"^'* *°^^ards th^ cervk T^ Ihe firmness or densifv nf fi,^ female this serves as a useful .midpm ^^/"S. or castration of the '"' *""^' '^^"'"""""^ '"^ '^-'"^ -- 'o ai.„i„.a as .ae „.,a„ -.». «»,„^ ™« 5, -»™^.. .. .,„ o„,..„„» „. . which l,e Fu.tal Cotyk.d,,„i'4-e i, erte ^ / rV'''''' f'^"' ^''t-^rspaces into &^^-!s.:^^^';^.:^S^^^^ T^^ ^f - -dition months in pregnancy, the th ck'ioss of X\"^^ ^"°^^' ^'^T^^'^^d ^ metres, while in the other hor^it was 4 n^ 'T ""'H '^'^ '^"li" Co«;at five months, it was 4 mi inwL .""""metres. In another ■" fnK3tres in the vacant one S ,u c.^n" 11^?''''^ ^"^'^ ^"^ ^ pulpy ..nd vascular, tlian before inm I atbn l '^'^'I' ^^"^^^^' ^^"^'^ hen exhibited gradually disappeai t"he n l' ^°»o'ituduial ruga) it loses -ts coUnnnar form ; tlie uKlar nln S V"" ""''"""^^ ^^ "^^ally and aeir orifices wider and fhn I T "^^ e"l"rge-they are lon-er ^'a.is. is increaso^r h" nS^nS;"H;'' ^^V^ '"'^'^^ '^^ o^r ^"-nted by multiplication o.l^:eSol'r sl^fl^S^^l^eill^S 9 130 OBSTETRICAL PHYSIOLOGY. sm proliferation of the corpuscles of the sub-epithelial connective tissue, so that the glands are more widely separated ; while the uterine cotyledons grow quickly, and there can be no doubt that new ones appear. Eainard speaks of examining the uterus of several calves and lambs, and finding only thirty or forty cotyledons ; wliile after parturition he has counted more than a hundred; and more recent observers have testified to this fact. In the uterus of a six months pregnant Cow, Franck found that the horn containing the foetus had forty-seven coty- ledons and weighed 3,5-i pounds ; while the other horn had only forty- two placenta), and weighed no more than 0,22 pound. In addition to these supplementary appendages of the mucous mem- branes, a new glandular apparatus, of which no trace was to be found previous to gestation, now makes its appearance in the form of a large number of small openings in the mucosa, each leading into a depression which was for a long time regarded as the dilated mouth of the tubular or utricular glands, but which is really a " crypt " formed in the hyper- trophied tissue of the uterus— a kind of open follicle placed in the inter- glandular part of the mucous membrane. These crypts are new structures, formed during pregnancy, and are for the lodgment of the villi that project from the chorion of the foetus— being, in fact, the maternal cotyledons or maternal portion of the placenta. They are small straight depressions, lying more or less closely together through- out the whole of the uterine muoons membrane of the Mare, their cavity being lined Vj a layer of tessellated epithelium, and a very fine capillary network surrounding each. In the Cow, these crypts are assembled on the surface of the projections designated cotyledons, of which they constitute nearly the entire mass during pregnancy. In the Bitch they are only developed where the ovum is fixed, forming then a glandular layer occupying the contour of the uterine cornu. The utricular glands do not open directly into crypts, nor is their secretion poured into them, but on a definite surface of the mucous membrane bcuween the crypts, the size and areas of which correspond, of course, to the size and arrangement of the fa'tal tufts. Betvyeen the foetal and maternal placentae there is always a layer of epithelial cells of varying thickness, which represents the viemhrana decidna or scrotina of woman. If mt during parturition, at least after- wards, all placental mammals are more or less " deciduate." With the Cow and Sheep, for example, large quantities of cells, possessing the character of epithelial cells of the pits and crypts of the maternal cotyledons, have been found, mingled with the villi of shed fcijtal cotyle- dons, in the fluid extruded during and after parturition— showing that a portion of the maternal structure is carried away at this time. The crypts possess the structural characters of secreting organs; and, indeed, we cannot but look upon the maternal placenta and the remarkably modified mucous lining of the uterus as a great secreting apparatus. In addition to the mucous membrane, the outer or serous membrane is also hypertrophied, the broad ligaments are increased in every direc- tion, but especially in length, and muscular fibres are abundantly developed between their layers, i. order to give them suiificient strength to sustain the weight of the uterus. In the Cow, the fibres even form very distinct intercrossing fasciculi. The greatest increase of all noted in the texture of the uterus, occurs in the middle or inuscular tunic. Thei'e appears to be a vast multipli- cation of the fusiform nucleated fibres going on during pregnancy, as tive tissue, so nc cotyledons ones appear, i and lambs, arturition he )servers have •egnant Cow, y-seven coty- id only forty- nucous mem- s to be found rm of a large a depression f the tubular in the hyper- in the inter- its are new pncnt of the in fact, the I. They are her through- Mare, their i a very fine I crypts are )tyledons, of gnancy. In ced, forming cornu. nor is their the mucous correspond, :s a layer of i memhrcDia least after- ' With the ssessing the le maternal :iotal cotyle- lowing that time. The md, indeed, remarkably paratus. membrane jvery direc- abundantly nt strength 1 even form rus, occurs t multipli- gnancy, as mmiFiuATioxs ix the uteiwh. well as an immense incrpnao ir, +u i Tins tunic gradually becomes JdS^jtnL'H '\°^^ ^''^^"^^ ^^'^^ing. fasciculi more distinct, and visibly more n ^ ''' ^"^ *^^ '""^^^^^^ power also mcreases. The inner xl^vZ^ZTT '■ '^' ««"tractile most conspicuous in the cornua of firiVivo.n,^ ^ of circular fibres, is contract ,n the interspaces betwee^^ he vT ''"'"''^'' ^"^^ ^here they marked constrictions. The connPnHl , ^ °" '^' ^° '^^ to form well iibres also increases du^ng p^e^n^ Iflf^V'^"'^ ""'^^^ *h^ -"«- - o ire„nanc>, and becomes markedly fibrous. !^ensibilit)j. \Vith the increase in volume wpirrhf o, i wise acquires a higher decree oi\rZ)/fr, } ^^P'^^ity, the uterus like- >nent of its nerves. So tha betwel & ^^^^'^^less from the devebp. cornua, there is established a svnnrfL ''f^}''' *^<^ body, and the not advantageous; for irritLS, ^f e e "v^f T '^'^ ^^ ^^"-^"^- may bring on violent contractions of the whn ' ^'°'^«°ever produced, premature expulsion of the fc« us ^^^^.^^^^^^ ^^'gan, and lead to the sometimes follows copulation? houiliL?"'^"' ^' '' ^^'^" ^^"own! not seek to copulate during piS^^^^^ ^T}^^' '^^ually do mstincts. It amy also be a'consemS o r . ° \''' °^^'" "^^ural of tlie explorer. ='«yuence ot manipulation by the hand This contractility of the nfp,'7,o ;. tuition when aniiLls have S^n kmaZT '"i?^"^^^ '^^^-^ ?- has witnessed well-marked movements „ 1^"/^ ^' T"^^' Colin contained five youn/r__th,eg i„\:™^'?'^^ "' ^^e uterus of a Cat whicli contractions were m^st enei'el at tl- '''? '^ ^" '^'' "^^er; I ese f-tuses. The same talent dv^t^i^^^^X^.^^.^'^.^Paces between the' pl.enomena in Sheep at diffeix.nfpS^.S ' .°\°"''* ^""^ '^^^ «i'»ilar tracted and dilated alternately an^l'annnlf'>''*^^°"'" ^^' ^^^"^^a con- other or the body of the utenU 1^^ ^''^^^ °^ withdrew ^'om each foi- foi.y or fifty ^.inutes at'he ai^n'l'^cCtf 'T'''''^ ^^^^^ opened when alive, the same conrrac ion. f*'' ^".^ P^'^Snant Cow more active and stronger undpr fT « '^""''^ ""^^d ; they becamp conuja changed theii^fon ^ fi ct n "i "'^ ll'^'t' --^aL" "L and became twisted on themselves at ttf,-' f^- '^'^'^'^''^^ sensibly, n'li "!,''?1 «°"^^'^«tions weS seen ""''^■'°^" ^-^tremity. In ^a getic in the pregnant Bitches, Ca^ts a dl^n ?) ? \*^'^^ ''''' "^°«t ^ner- ment was spontaneous and pedstaltt i;? n'^! ^'^ °P^"«'^J the move- it continued in the organ, evei when i^' '"* °^ '^'' intestines, and Those veterinarians who have hn^ V • '''''^ removed from the bodv uterus of one of the trgeradmaTs'To'^V^ ?ff * *^^^- ^^^^^ o he, object, must have been a Shed aid f '" ^''.'''' '' ^''' ^"y at the in-imiess witJi which ., ^^'^ "'"^"^d, and frequently embarrassprl .he expulsive ,,ro,.. the'^i^alurc 3r" '='"'*^^ ^' "■= ce.-vi?'Sl; lo. « cora„a, ,vitl, the }•„,.„« an ', « one If, ?*' '''«■ 1'™ very T1-. il ft . } I \lv I 1 ( [: .11 ' 132 n/lSTETJilCAL VllVSlDLof! V. which they roach tlieir apogee. Its contractility, which signifies also its retractility, enables it to contract on itself after delivery, and to nearly obliterate its cavity. This rapid diminution in the capacity of the organ closes the orifices of the vessels whicli open on its internal surface during the act, and thus prevents fatal hteniorrhago. _ Its main function, however, appears to be concerned in the expul- sion of the foetus, and then, as at other times, it is entirely independent of the will. Besides, tlie intensity of the contractions is not always related to the strength of the animal ; pain deadens and paralyses the contractile force, as is seen in primiparous creatures. When the contractions have been vigorous, tlie uterus rapidly diminishes; but if they have been slow and weak, the organ slowly contracts on itself. "When it does not contract quickly after delivery it is said to be inert, and the cause is to be found in tlie expenditure of its contractile power, either through excessive distension, a delivery too prompt or too slow, or general weakness of tlie maternal system. Uy prolonged exertion', like the voluntary muscles, those of the uterus become weakened ; so that when the act of parturition has been protracted, the contractions of the organ become slow and feeble, or cease altogether. Opiates and narcotics generally produce the same effect, and are therefore success- fully administered when t!,>j contractions are too energetic or painful during delivery or before abortion. The contractions are stimulated by irritation of the cervix or body of the uterus— such as is produced by retention of the whole or a portion of the placenta, titillation of the cervix by the linger, frictions on the belly, the application of cold to this part, or the administration of ergot of rye. Form. The uterus, after conception, begins to change in form as well as in volume and structure ; this alteration, like the others, proceeds pari passu with the development of the fci^tus. The body becomes round, and in tlie Carnivora, as already described, the cornua elongate and show the alternate dilatations and constrictions due to tlie presence of the young in their cavities. In the :\Iare, Cow, and Sheep, if there is but one fcLtus, a single born is enlarged— usually the right— to contain the posterior limbs, while the otlier is relatively smaller and contracted, and looks a mere appendage. When a Carnivorous animal contains only one ftt'tus, it is developed in the liorn, and not in the body of the uterus, and it is not until parturition commences that it descends into the latter ; should the creature die before delivery, the offspring will be found there. In this si)ecies eacli horn generally contains one'or more young ; should there be only two, one occupies each cavity ; but when there is only one foetus, it is then in one of the cornua. The changes taking place in the cervix of the uterus during pregnancy have not been accurately ascertained in the domesticated animals, as in the smaller species there is usually no occasion or necessity to make an examination ; while in the larger the risk of injury to the examiner, and of abortion in the animal, militates against such an investigation, 'it is only known as a fact, that it widens at the termination of gestation, and loses its cervical character, as well as its longitudinal mucous folds. It niay also he nnt<^d that, from being firm and dense at ordimiry times, its texture becomes gradually soft and elastic; while it diminishes in length, its projection into the vaginal cavity is lessened, and ii,deod at a late period almost effaced, it appearing merely as a kir.c^ of rin" uiJim- signifies also iveiy, and to the capacity n its internal in the expul- ' indoponclent s not always ,nd paralyses 1. When the lishes ; hut if lets on itself, d to he inert, •actilo power, i or too slow, f^ed exertion, ^^eakened ; so ■ contractions Opiates and jforo success- tic or painful tiinulated hy produced hy lation of the ion of cold to IS well as in )rocceds pari iomes round, elongate and ! presence of p, if there is ; — to contain d contracted, lual contains hody of the lescends into spring will be one or more y; hut when ng pregnancy .ninials, as in y to make an xaniiner, and gation. It is ;esration, and ous folds. It liiuiry times, liuiiTiishes in lid iisdcud at kir.i.^ of ring MOVmCATIOXS LV THE UTEIWS. 133 ""!> a plug of thick, aXronf ..] , 1!;. .?"'^ "' *= """i" '" «"<«' Fig. 65. two. on. of which is ex;,,s'd'; Hod" on;' "'"■'' "-^^ ^':^"'^'^y"^' °" t^e'righ or Ligament of mern, v'v^niy.rl" '' '''^'^^^^^^^ becon,i„g ,vider l„.e their WerteLl l»:S"cur^ °™"' '"»°' " 131 >>i!s TETRii '. 1 1. I'll ysmi.na j- l*lv n h s 'i\ ' i i i ! i Ik. i , i.Jo;;;:iTir.;;;r'°v:t';":;fV;;;:l'''"^^ floor of lw,;;,'rpmx;; , 7';r' !:''*'/""•'•■-'-■ ^o rest on tho h^^^^.oU^o^l2^J\^^:^^'''^^^ ^''«'."'1.V i'>«'i"i"^' to tl.o left. In Rinuin. UN V „ tli'' coloi, cccupym- the ri«ht Hank. the nunon in the . f , ^1,. ahdou.nuU wuIIh. Tho prosonco of In ,nul I, .r u '''V''\^'^^'«'.« 't to deviate somewhat to tlio ri-ht thJr™: ':,;;:'; ■'r^^':, ::;.',* ^t'on',""-',;"- "Th" t'I '- ^'" cumMn)\vards' in th,- I >,•,,,,• '' "'""' "' tlic ahdonien and in all anin a s ;ad t. nu ! \ ''"^'"'^'^''^^vhat to the ri.^ht side, thou-d, Whil.. fl, hes ahove its coiTospondin.' niainmarv line are ic i SI'h'''^"^ ^''^ '"'^'"" I^''^^^- ^»'« '^'"^ '^ thcri;;;tii:^twi;ts ^ t,nc I] hfc () left th,, cei'vix goes to tho left or riirht. Cases are mpn t.onense querra In iT t.oM of the organ near the neck, by the" suspensory ligime its so^t l-t Inllmncc, on and Alteration, in tl,c Position of Nci,jhhourin,j Organs. xheaterationsoccurringin the uterus necessarilybringaboutothers in the neighl,ounng organs with whicli it has n.eclianical relations The chauged pos. ion of the organ in the abdon.inal cavity lias bee alluded o In the Mare and Cow the horn in which the limb of the fu us is odged becomes extended and displaces the intestines ushes the S^nten'ntf f'n' '^^r' 'f'' "" ^''^ ^•-^•- ^^'^ ^ an obslacl to e tc -u e th-^/ ' '^'aphragn.. The suspensory ligaments of the pnv f ■^''"' '^'''^ ^*'" «°''"^«' '■" •^•'■"*.' l^ut When they in the early stage of gestation, begin to extend forward the vaS i« hi.ul liE'S h" ^"T''^ "^'7'"' i^^^vcho^ on the bloodvessels of the miui luubs and the vulva and rectum, retards the venous nnd Ivm h tS^uleli^r T '""^^'^ the Lnd of gest^^i^ralid c:^c!i^ u'de, n is ;i th " consi, erable a^dema of these parts This uwl.n ^''^'""^"^ marked, m the Cow as well as in the Mare tov^ .,k H "^''''""" '' ^''''^''^^ ''^ t'^« l^««t*'^i"^' Pa'-ts of the abdomen' tovv Ids the commencement of the saphena and mammary veins ' true in vv£l;\;r ^l^^^^y^g^•«atest in those cases, somevvhat rare it is fp .;d a d 1 ? '' "" ^'''^^^y "f the abdominal parietes near thp. hpini I T\ '"'^'^^■^ ^"^ "^ the mamma,, when the uterus forms a umlel^lSll^l^^ahe lim;r ' ''''' ''''^ ^ ^^^ ^^ ^-'-^ swellingr^: tei^st' t'^The'c W ' ""'h'^^ "^ '"'^•"^' '''''^ '' ''''^ '^' teats become tnso. in the Carmvora, the prominences of the mamma), especially 130 nliSTEritlCA L rilVsIOLOG y. m fi^ih^ulTV" ^'^T'•''''^ ^'^' ^^^'° '^''^ °^ elevations on each side, whiphfh ^-Iba. which correspond to the portions of t,ho cornua in ufcJni« i^n f """^ '" 7"'*'""'', ''"'^ ''''^ ^'^^i""^ «^^a"«''« ^vhich the gravid uteu8 undergoes, l,rm. ab..n, alterations in, and frequrntly derango sW n nd ' T l'°'"°'^?' I'e^tunately. howover, thesJ, alterations aro ada^fc In^r; ; '.? ^-'^^ *^' ^^'^^"'■'^"* °^-«'^"^ concerned generally adapt themselves to their changed condition without much inc mveni- desir'on. of T'T f r'"'' n'^^ ^"^^^ '^^"^^■*-'^' "' '"ovenient. and is more don^^r. ^^ T\ *^'^'"l"!"'ty as gestation advances. Thes, indi.a- enI«L«r ^^'^^^^^^''^ ''^ a." «'^i;b' Pori" 1. Ac che samo time the a ,domen betennS changes Its shape • it becomes rounded, and projects beiome hollow Th '"^' ^^Tond the crural region, while thi flLks andTxti nn?H',K T"^ T:i "^^'^ ^vasted-looking. and the sacrum and external tuberosities of the ilium more salient turhnn.« "^r*T^'i ''"'""''' *'^"^"'^ ^^^' '^'''^y "bserved those dis- ^re^nanTv -n ' '^'^'"'"^^^ "u^^^"^ ""'' '"^^'^"'^ '^*''^- commencement of . SSv be^an^'fv • Y"" 'V ''''^'^'^' innuediately after conception, dSSn f n^ °''^™'" ''? fl'sappeared, the appetite is increased digestion is usually easier, and all the formative phenomena seem to tS'poonnr''''i T'''^' ' ^"°^-^ '''' ^PP^^^^ to be made of the ood n the economy, and there is a notable tendency to fatten. Tliis tendency are d.'sHn ^'^ ^^^"tfge of b>- ', readers and feeders of animals which are destined more or food than reproduction ; and those intended for S o5T rr"^ T'^'^^ P''^^"'"^*' '^"d '^^ "'^t^l abou the mFd^e cond^ion ^n! f • A^'l] ^^.""^ ^'""''^ ''^''^''^ '^''''' "'««t favourable wT.f n°^-7 '''^' **'^^^'' P""°^ this tendency vanishes, and Tnd bLnl ' ^PPaj-^nt, due to the increased demands of the fotus and the enlargement of the mammary glands In some cases however, and particularly with the Cow. the appetite becomes somewhat depraved, the animals eating soH o,7a^S tl e walls or woodwork of their stable, drinking foul wat,7etfand\erv exceptionally there may be vomiting ' ' ^ abromilf'JliTn'^-^''''' °^ '^'' '^^^''•"^' '-^^ ^'^' been observed, the abdominal and thoracic organs exj-ericnce niur,. or less the effects of the compression it exercises on ihem. The diaphS-^ris pushed bSof^Te ll^nT'th" *!;^ ^'P^^^V^ °^ '''' thorai and "he e^pan ' mnty of the lungs; the ribs, encumbered by the weight of the fcetua are raised with diflbulty by the muscles of iLpiration. so liat re^p ra^ tion 13 frequent and shallow, and the croature is readily " blown "and fatigued. Digestion may be somewhat impaired and retarded and slight constipation is not rare. The strain induced by the uterus on ^:ss::^^^^:':^:^Z::^ t^:^'-' cLsos^rmfs i^J^Zr ^?w"^T^'!?' ''^^^™^' particularly in the Mare. In addition to all this, the blood is more or less modified Its abso- u e quantity is certainly not diminished ; on the contrary; it Lay be increased to a certain extent ; but its corpuscles diminish in number in anaemia than anything else. on each sido the cornua in u projections h the gravid ntly derango- Itcrations aro led generally ih inc Miveni- , and IS more rhcs. indica- tho a .domen and projects e the flanks the sacrum d those dis- loncement of . conception, is increased, ena seem to f the food in his tendency imals which intended for t the middle i favoural)le ■nishes, and if the foetus the appetite ;nawing the c, and very ^served, the le effects of I is pushed he expansi- the fa'tus, hat respira- alown " and tarded, and B uterus on es attempts on on the obstruction e Mare. Its abso- , it may be number in e allied to des Animaux I im/Tiox OF Tm: f(etus in the itkius, SKOTIOX II-POSITION OF THE KCKTUS IN THE UTERUS. 137 WsBmmmm he or. onc^ m such a manner that the I^nees reach tl ddle f tlu,' head aiid tiio fi>et the unihiUnna . ,v.i.;i *i i ■, i nuaaie of the Cohn states thnt towards the termination of pregnancy the fcrtus of the\tv[xXi';'"' "'' ''^" ^^"^--'-I'-bs and head directed to'wfrds thi^n^t^"'''' ''^'^'^".^'"g to Saint-Cyr, the uteru , is curved downwards he opposite sufc and wl.iH, i, also lower. OtluTSe like ?he Poaf the concave nortion ^^^'i^^^''^^ «'f*«^' '^"^ the ahiomeu lymg towards attached md't£'vos°s if enterTn t"% '^^^ "'"^'^ ''^""r^^ ''' noted fhnt H.<. , vtsbeis eniei. In the Sow, however, it has been bet. mtsLa; . t"h^« ' '" ^ T'^""'^ ^'^^'^^'°" ' '^'^ 1^^^^^' instead o" snond tn ft.1 '''^^^\^ ^g^ <^he ah- omen and mbs always corre- sftua?el' ^" '"''''''' ^^^■^^'' "^ '^' ^^-°«' ^« it i« there the plL.ata is in tSj^rlCornu'^rdTn'thelTt "^^'^ '"""^^"^ ^'^^^^^^-fi- *'- ^-tus ixiight be suprsed th the n '''""/" .T^'^'^-"?"- '^* ^''^ ^'^'^^t it the impediiS offoro i . i P r ^^as due to but tlm difference cannot have any influence in^::S^:!!!:!J^-^L^^ dehiscenc(^-thr^Z,;v: ,cles tiparous'ani.nah thter ^' '"""■" ^'^^^^^^ "'^^^ "^ the left. in mul- though ne t her of he h ^f r'' '^'"^^ '^^ '" "^"^^^^ i" both cornua. this respect ^"'' ^^' ''' '°"'tant advantage over the other in The position of the fetus towards the termination of gostation may ;i;fl 188 OnsTKTIUVAL I'll rsioLoi! )". HH MIXTION III, SKINS OF 1'|{K(;NANCY. toll:;l;7lf^siKnst"^'l;!ch';lr■""^^ uton.-«,.statio., wc3 have now vorv iiM.,,, h.M -^ . ""^ procuHs rnvwilH its.^lf. This study is conditio WHS m a U Jr- 7"'''^'^^ ^'"^'^ '^"'""^1« ^vI.oho H-es t; S^ r o ' i,'! f ';" !'^'"^"'^^^^-«'J. t'"^t at li.st tlu.ro is nothing conodml ""'"^' ''" "1"'""" ^^^ to tho animal having n.-J'"m!;::;::i's;:;,;:;!;if V:^ l^ r^-^^^^ «?'»'"" -"^y bo arrived at. the which irso,)^ 'an '"1 •".t^«"ri'l^''-'^tion, as well as those this very reas , f: r;'l'"^-"^^>^^'' ^'»^ '^ ^^ ^" ^^^ •-- div^'l> ttm i,:;o';£o c^t:;;!;'" "' ^^-'^'^^^ conveniently, it is usual to into thro at 'or es as fXr~ Tr'''''?-""'! "^^ ^"-"^'''''^" ^'^'»« = "^• tain the , osence oT h« f ''' '^"'^ /'f''"'i'«/<'//o., in order to asc4r- higher value an. , n' J ^ 'f '^'''''^ *"' '^^^'"'«^' "^ their relatively al^o bee. use fh^ v teHn^r'.'"^ '^''' ^"'°T ^"'"'"^ "^ ^'^^^t'"" ' ^""^ their condition '''"'"''^^^ ^^'^'^^'^ '« "'"«t frequently consulted as to national Sig)is. in th^'^Zn^'rll't^In^^'r '•" ^f *'- '-^''i-^-- 'n-ught about in ten,peran.:;ri,i|;^S::f-;;|^;;;;:i-"^ --i^-ted by alterations thot);;;, -ri^'c^iiainlv not"tl,':'f "'f "- ^"^'"^"' ^^^ ^^^^^'-^ ^^'^J-^ive, evenlead 'o n is ' £s Tf i. '"°^ ,^^^''t^"";, «'f^'" «f ^^estation, and may has taken pkce s tor ei di ,Csf ?' '"^'"'^'^^^''l ««"" '^fter conception nient which marks the .,St , ? ''' P' '' '^'i?'"^'"" '" ^^^" ^'^""-^^l ^'-^cite- tioned, is ci/npa mtith t n^ 1 ''''^iT ' ''^" ^'"'"'^'' '^^ ^^^^« ^^''^^ "len- a,aIo, ncitl i^doef^ i , 1 ^^ '""^ ^""^ ^^ ""'''^'"^ any dasiro for the syn.pt ,n,s of., it^' %r£'; T'' °' '^?^^' '^'' '''^-"^ concomitant not^xc,ted/and refusiL hn'^r.rT'^^''- '^' '^"^""^ '^^^^^'^^^ '^^'^ , «.iiu m icmsing lam the female may even resort to aggres- Ji f, .'<) roflox iiiovo- I'lits, it ciimiot fd'tus ol't'ci'H so wo luivo now Tins study is mtliolo^'ist, or oyoiul patlio- as to whctliof arioil, tliough 1 not poculiui" liinals wlioso ,', and otliors lat tlioy wero !ili'. signs ; or ical, or sub- 'Hsiblc signs ler to HHcer- ! the hirgor irrelatively tation ; and ulted as to )ught about alterations subjective, I, and may conception real excite- been men- sire fortius •ncomitant lesires are to aggres- S/f.'Xs "/'/'A'AV/.N-./W/r 180 tnn,. after coition, and the e .tl^s ^^o i^ ''''"^'' '^^^ allaye, . although in reality in ,,,,•, ' f "'"-ative organs is not exceptional instances the «' Ic^. •' w '' ^f""'' f'''^«'- '^"'1 i" very tliree months, and osprcially thos w h ' I f " P'"'^"'""'' for two or oarly n. the y„ar. will exiuhit iXaTo 0^^ .^'^ ''^' ^" *''" ^^'^"ioQ becomes warmer and the pasturt^s r n . ''"" ^''"'" ^''" ^«'^ther tlxs state the female nm/>^Unl^ fT"'' T'^''"'^"*- When in happen that a second f.^unrti.n^^i. t'u) male, and it may oven oecasu.ning those HonnJCunuZA ^"" ^' "'" ''' '^"' tin.e-thus Hi'porf(etati<.n ; thou-di if n •<,» 1 ^'^"''^'^Pfc'ons which give rise to 0U8. and nuty' occast, aS n ^' 'v T'"^''"^ ^/^vanced it is d nge ■? Ramt-Kegerstud, France wlic'ff T^'-''^' '" '"''^ ^^ '^ Mare in the yet showed syn.pton. o,':. h it'' ""l^uS'^'^'T' ^"' """^ '"-'tJ- to favour the desires of the animnl .V- '''''° '^'^« '""^e inclined (iarsault. the fan.ous e(,u( stria n. ^" '° ''"''"' *" ^he opinion of to the Stallion. This T^h d no i f .P''"'^''^' °'-'^«''^'l her to bo uufc aborted. ^^'^^ ^""'^. copulation took place, and Lult otallions cxclusiveh' ei I if approach pregnant Mares in wSoh tL-" l"'^';'^' ^''^^fl^^^tly refuse to tliough this is not always the , • 1 1 '""'^ persists or reapnears . In ti>e (-0W. as in thirii .^r^tv!;;;:^"' "'^"'^'' >'"""^' ^^Snr ' ecundatjon ; though as a rule, f lerve tl''''''!""" ^ '"^''^^'P^'^^' ^^t^r agum when the female is in this nn'. A ''^'"^ "'^'^"^^^ to copulate Orogmer, " the Mare and She', as w n ^^'^'?"- " ^'^^y o^ten,'' siws ' I'eat ' ; but the Hull, be tertl • u, the ''il "^r ^^'' ^'°^' '"^"^f^^t ^igns of d.eatu>ns of gestation andTu. tai ^ f om 1 '•" "' ^^'""' ^»°^^'« the in- wh'ch are in this state " M \ ''"'''"« '"tercourse with Cows to consort with pregnant CWs ,^ ellsTt tf'^ ''''''■ *\^^ ^"" -custon'd v.th ,t. but without being exci'ted hv t '" ''' '^ ^^°^^ ^^ others going however, it must be noted thnfr' >"" '''""^"'^tions. Pkceptionallv t o". But these instances are veiwnm' r" MV°"''' ^'^''"^^ P^rturi- ahnost certan, sign of pregnancy fvin the En H^'t' '^''''^^^-''^t is an n.ayUmlalt^^.^th'En''^'^^"'""^^ ^^^^- fecundation, and the Earn In general terms th«>M if 1 mme. mtely after co„ p? L the chn':'"''l''"'' "'■' ^''"«'i".eB aC t' 'i-vt-i^wWSBfe- .^0RiiTETlUCAL PHYSIULOGY. m ■J 111 If W {If 1 ! 1 i ■ If , i 1 % ji troublesome or unsteady when in "heat," are nearly always gentle and tractable when m foal; the genital excitement which caused their capriciousness or viciousness being allayed, they are no longer under its mttuence. This change, when occurring after copulation, is a valuable sign of successful impregnation ; and though it may sometimes fail, vet whtn present It can scarcely lead to a mistake. If, on the contrary, the animal has not been fecundated after one or more covering n previously vicious its vices become exaggerated whon again put to the Horse. ° ^ In the Cow a similar phenomenon may be remarked, though it is not so frequent or marked as in the Mare. The other animals are seldom so irritable in their disposition as to lead anyone to notice a similar change in them. A tendency to fatten is such a notorious consequence of impregna- tion, that with the Cow and Sheep graziers usually resort to it in o?der to get these animals in good condition for market, when thev are in- tended for slaughter. But this aptitude is most marked in the early months of gestation ; for in the Cow towards the last three months, and m the Sheep and Pig at the last month, when the mammae begin to enlarge, there is a tendency to lose condition. According to the butchers, there is less internal fat, and the animals altogether are not so heavy as they appear externally, when gestation has advanced. It often happens, particularly with Cows, that the appetite is depraved the animals eatmg earth, drinking filthy water, licking walls, and gnawing mnutritious substances. _ Coincidentally with the progress of gestation, those animals employed in labour for speed or draught lose their vigour somewhat, particularly towards, the end of pregnancy; they become "soft," and their paces slower and heavier-consequently, they require more urging to make them perform a certain amount of work. They, if Mares, tmt, gallop and jump with more fatigue, and yield themselves far less readily to inordinate exercise than before-either because their temperament alters, their instinct urges them to preserve their progeny, or the fcctus itselt physically embarrasses them in their movements. But this is not always a sure sign ; for sometimes, though rarely, Mares will perform their work with the same energy and s])eed as before conception, even up to a very brief period before parturition commences. Taken with other signs, nevertheless, this may afford assistance in diagnosing gestation. At pasture Cattle and Sheep are more tranquil, and rest much; as do also Pigs and Bitches during this period. Material Signs. The material, physical, or objective signs are those depending upon the change in volume of the abdomen and the viamvuc, the appelraTice of the milk in the latter, alterations in the composition of the nrine and increase in weight of the animal. The abdomen enlarges in every direction, and at the same time changes its shape. It descends or " drops," becoming larger inferiorly; the flanks become hollow, and the spine appears more concave in the dcrso-sacral region ; while the lateral portions of the croup sink so much as to make the sacrum and haunches towards the rnnf, nf the taU look more salient These phenomena are progressively developed as gestation approaches its term, when they are very evident In the ys gentle and caused their iger under its is a valuable imes fail, yet the contrary, )re coverings, lin put to the 3Ugh it is not losition as to of impregna- to it in order they are in- in the early months, and nnte begin to ding to the ither are not dvanced. It is depraved, ; walls, and ills employed particularly their paces ing to make trot, gallop, ss readily to emperament or the foetus 3ugh rarely, ad speed as parturition may afford much; as do snding upon appearance e urine, and same time r inferiorly; cave in the )up sink so t of the tail eveloped as at. In the SIGNS OF PREONANGY. j^j ^Z£i::iZ73Z ^and do nT'""^^' commencing three or four instance; for there'arT;omt anima s ?n"^^^^^^^^^^^ ^^^^^ '^ --^ at all unusually developed, and ra^icullJlv he Mare^^whi^h''"''''^ parous-until near parturition; and others crppp^. IK Vi" '' '''''■ or wliich have had a number of foak Th. / f f "^^^"/ ^^ose at pasture, siderably developed and penLloustd •n\v1Slt rdiffiLlt^ ^"^■ ceive any mcrease, even when they are in foal "'^^ *° P"'- besides, some diseased conditions— nq ovivinr. A,.r. l ■ pus, liydrometra, ascites, impervious vaSS/^^^' ''*?'^" behind; though repeated SaJSl^'^:'.;" it"?™",' 'uL-vT"' "■","■ partially disap;:a>rto^;:^,;rag^if;r"^ last thitd of the period of Sr'aveplf'^^ '""""'^ "'° this IkiuuI sometimes hpomnn ^^■h;^^ n i \\eekb ot pregnancy and is\hen proper milk mpnfh '^"'l°Pt^»«. ^^^ ^vell as less"viscid. the increase^in\he i.e of Uie udde';- t^Zf" '^"'^ '^!;'^^^ ''^^'-'^ ^^^^^^^ of gestation. In niilch Cows n L . i'' T'"^''^^ "* *^^« ^^^^^^ '^^ys Sood "milkers " a oThpv Jfn ^."'V u''"']^^'^-^ "> ^^^"^'^ ^^'''ic^^ are not tlie lacteal section and f. ^J' • ? • ^' ^fT^ ^" *^^« diminution of conception-^JlS;;^;^^^, t SenS ^/^^ ^^^"' ^°"^^ *"- ^^'- se^tS: K;i;^llSo^c:^Stme\'^^ V^^^ ^""""^^ -^^ ^-- *'- ani.nal appears to be aw^re of i^ f'"' ^^"'' parturition; and the between Z sixth and ei^hlh month ' " ^' "'""' ^^^ ^^^^^^ S^^^^'^^ apAS^^'S^U;:.^;!^^:^,:"^^^"^^'"^* V^^- — ^- and the than i„ the larger creati^ues ^ "''^'^ ''''^'''' ""'^ "^"^'^ ^^S^^^^ly, In animals whicli have borne young, similar changes to those 142 OBSTETRICAL PHYSIOLOG Y. enlargfnV" ^""'^P^'* ^^^" P^'^''^' ^''^ ^^'^ '^^'^^'^^ "^ay be later in to^'^°n"S'ii,nnnrf^";f '*^^'' "'" '"^'"'"'-^^T Stands are only intended and ac nvpTn ^. "^ ^,°"^^ ''f^''*^^ ""*^' ^* ^« suiliciently strong te^Ls as with thf'r *^^ r']'^''\ ^''^•^' ^^'^^•^^"^T power in ^ome species— as witli the Cow, Goat, and sometimes the Ass and Sheen- only \his"but'\Tr' "'!'; '"^°""^ ^^" ^^™°^* P'^^— "* function' Lt on y this, but at tnnes tlie secretion, as observed in the unimpre-mated Bitch, IS very anon.alous and unnatural. In the non-pregnant Yniale appea r^uSrX~nr '''''f''^''f ^^^-^ ^P^-^-tlL secretionmay appear natuially, or be induced by nuils on or frenuentlv renonfpd suction o the teats.even in very youn,^ creatures, a short'! elft ^'b h-th and what is more astonishing, male animals have in rare instances assumed a unction which is always looked upon as snechillv cimrac teristic of the female sex at the miternal period. So early a^theda^s nLnon 7^^" K^'"''""' '" '^^-S^^^* ^^-^"^h y'^'l^'^d niilkiths trance phenomenon has been at times observed ; and M. Lecoq testifies to Z?":."^ ^'""'T °^ ^"^'"""- ''^^^•'"^' ^^'- f°^^- rudinieiSy namm^ increased in volume and yielding milk which furnished cream and became casein when an acid was added to it ' noHod^'w ';;i*^''^*i°"' '" t'^'^ cowpositiou of the urine have been re- poited by M. Iveiner of Gunsback, which, witii other circumstances S tn n '^ t^t'^? t^-«stworthy, be valuable as an aid in the ia-moS of pregnancy. He has discovered that the salts of lime in the udne Its bones and his discovery has been tested by a chemist whose analysis of this fluid obtained from a pregnant Mare, shoui thrthe line lessens very niuch as the time for parturition dra^s ni.^) A he fifth or sixth month it is diminished 55 per cent., and to 70 per cent from the sixth to the ninth month. , t* u to ^u per cent. It has been proposed to u-eigh animals which are suspected to bp pregnant, at certain intervals; an increase in weight beh fan ev dent accompaniment of growth in the fetus. In this^lirect o"i Sivfl^ has ecorded that Mares, towards the fourth or fifth montli of mSmancy ave hown an average increase in weight of more than eleven pounds ZZtn ^^'"' Ti ''" P^^rticularly recommends this aid to dialnosig which appears to be most useful at mid-term "ici^nosis, Vvolel7ol'^e.T^irfr ^^^^^^'*^«"^1 ^"J i" diagnosis, that with the pro^,iess of gestation the mucous membrane linin" the vulvi nn-1 vagina becomes swollen, and assumes a rod or bluish-red hue i'lstead of Its usual pink colour ; and towards tlie termination of pr^mancT LcreaTed. "" "'"""' '""""' P^^'^'-'^^^'^y - ^he Cow. ^is "largS; All these numerous signs are by no means to be implicitly relied upon however, as they are not infallible in l^-oving the existence of pre^iS m every case ; some of tlien, are only noticeable at a late pL-iod'' whUe others may be absent. It is necessary in taking them intrcon^i era tK,n to distinguish those anin.als whicli are kept at pasture and Sued or breeding, from those winch are kept in the st..ble an used for various jDurposes With the first, the'cessation of erst m and the refusa of the male are almost certain indications of concept on wh lo u.m tne lailer, the same piienomena may be the result'^of fatigue or bad food and mismaragemeuL. lau^^uc or J be later in HIGX^ or PREGNANaY. j^g With regard to fattonincr, chan<^e of tpmnpv «f« \^ • ■-, they ..ay depend upon oH.'er cauls tt?p;.ctaneV" and'oh '^'' can only be very conspicuous in primiparousU" a s ^o'r tZt w^ ^ are not rearing young ; for Mares or other creatures nuV In ff ^''"^ few days after parturition, are not likely to accumu 1 f *. T^" ^ then- progeny at the same time. When however a 1. K ''"'^ •''^' are manifest in an animal, thev estabhs'h avpTv^f '"''' ''«"^ though not an absolute certain y^, Tst t con^lTt on TirT^'P*^?"' later period, when the abdomeA be dns to^m.1 ' "°* "*'*^^ ^ volume, the animal becomes llu^.isl and . 'n'! "'°'' ^^^'^^^ ^" secrete the viscid fluid iust described Hipffl 1 f '"'^ T^""'^^ ^""^ might safely be attirmed '''''^^'^'^^' ^'^^^ <^^'« existence of pregnancy fact-these indicative s,Csna7beabsonr '\'f~'^f parturition, in which an unfortunate M^u" Tf .' cfen o houndsMmtif T T^'T. ^" it gave birth to a dead foal, and perished? ^ "'" ^^^ ^^^"^^'^ Sensible Signs. When the contractility of the fmtal mii<5PlpQ )...r,;..„ + u ^ which is towards the fourth ^ontffiir K^ ^^ an mafs T^^^^^^^ creature can move, though the movem nts are too fe I Ir fTi. ^""''"^ nisable externally at an early perio . ■ but iL ^/n™, .u^^ '"'''"S- pregnancy, they become vigor^^^nd'mnisltw;.*^^^^^^^^^ *'^ '''' °^ io obviate as much as possible tlie risks of error in rlin. • pregnancy, various expedients have been resorted to in n^J°"?^ ascertain with certainty the presence of Hip Wn ?u ''''^'"' *" exciting these movements. Some of the e a?e tt ^ ^^' "^T"^' "^^ stupid. One especially n.erits' tl^e It .g^V^^tw^^^^ pourmg water into the ears of the \r-irA nr- r ^"'^"f ""f"on , this is that if the animal is not mpcm.nf ; , 'S u 7' ""'^^' ^^^" supposition rid of the fluid, 1 It f preS tha iTwiM ^' ^'f T*^"^^ ^"'^^ ^° Set ears. Another' cruel and^Ianleilus pJ « °^ ^- '^'u'" *^^" ^^'^'^ ^"'^ especially the Mare to run vp,"v n,?; M / ''''^''"^' ^^'"''^ '^'""^^Is, but them cokl water to drinToi o^ats to J.°i- ""1^? f'''''.' ''^"^ *" 8^^'^ order to excite inordinate niov^^nents fn tl Sus f ; '"'T''''.^^' '^ understood that these and othpr v Pim,l . ^t will readily be produce abortion, and tha^ <^^y sCid thSo^T IfT '"'' l'""''^ *° and discontinued. The only useful >nH .. t f u, ^ discountenanced , resorted to, are those wl ch anne.l Z tf ''^^'' .'""^"« ^^^^^ can be hearing. But it must be emaffi i .?t thLeZ'r f' '''''^'' ''s'''' ^^''^^ for their exercise, and are inore Ihnited in f pI. n , ''';^' «PP«^'tunities than in woman. "^^ '" ^^'^^ application, in animals the. a«-„...,, .t, U.0 o.i;W^:tT*^t\7-:S™^;'y^-;y. a^ 114 OBSTETRICAL PHYHIOLOGW In the Cow after the fifth or sixth month, the presence of the ta3tus can be readily ascertained by this means; but in Sohpeds it is not until tlie seventh or eignth month that the same information can be derived ; and, besides, it is not always easy to apply this mode of investigation to these animals, because of their fidgetiness. It is better to examine the animal when it is standing, as the signs are not so per- ceptible when It IS recumbent. TJie examiner stands on the ri„iri i . -,■ dangerous or irritable, the'twitcl may he apS ""^^' '' safety to the operator the hind limbs must Kl *« the nose, or lor the nose seized bv one hand of n !. f secured; wth the Cow, hand, will be sulHcient The bow?>l 1 iTl '""^ ^ ^^"^^ ^^ ^'« ^th- ' .nay contain, so us to allow the oil] l"^^^"* be en,ptied of the faeces it l)e introduced and freely mot dlou^'wh" T 'l*^ ^^P^^^'^' *° and pendulous, it is useful to \7Z hf V ""'! ^^'' abdomen is large nnd to have the lower pl^of the hX"^^ ^''^^u ^'^''^ *^^^^^ behind, side, by n>eans of a shee? or sack or ev/.^ ^'J-'sed by assistants on each so as to throw the uterus backwn.-r j^"'' ^'^"/' J°"^^^ '^^^^ath. ...ajontyof cases these^nelsuS:.;1;ot^ntrr"•'%htT^^"; ''^ passed mto the rectum to beyond the brbn o H ^" V^ ^^''^ ^""'"'^ and the pahu placed on the lower smf ace ^o^^^^ it is opened pressed downward, towards thTtlom.^ffi i^ mtestme and gently be felt, if the anin^al L ^retuft a W^^^^^ when thc;^. will voluminous according to die^ S^ of 1/ 7"" ^'' ,'"'"''' "'°^'« "^' !««« displaced to a certain exte t-even paSTv Sn' ^ '?"V^ °^' ^^"^^' parturition is near. In this cale fcL J oi' if'^ '"*° *^^^ P^l^'^' ^^ can be distinguished t Irou fhfts onv / o^" "tber parts of the fcetus walls. But if pregnancyl^r no so ad°n- 1 "'''''"' "''^ ''''''^ •nonth, the fa:tus cannot^be so leadilt f! 7-f ^ °"^ ^* ^^^ «i^th this period it is situated low down n^tl f n'vT'^ '' '"^^' *^^PP"" '^^^ ^^ one of the horns of the u er 7° Ivinf /"'!,'' ""': '''""^^ ^'^''^^^^^ i" (nearly always to the r gh ^ heCowf- ^H f ' "^ the mesiaUine cai'eless examiner nnghfrn ss^' t .bS V^ *'?^.,^" mexperienced or '"'bis error can be av!^ L bv c' In I? '' ^S*''" ^''^ exploration. "'0 right and left al f r as L i.hs ^ %'"" ''^' '''^'^^^<^^d hand to I'ocly inclined backwail and tL be vT' ^TT*' ''^'^' '^^ ^"'"^^^'^ 'Inscribed. The fa>tus shou d be excited '^ by assistants, as just guarantee its presence. ^ '" '""''^' '^ Possible, so as to The difliculties are greater if it is desired to kno- ^-hpthev f ' . H-. cannot .. ,„.,„ , „,,„ ,,„„,■ :::^,:^-Q •i:^.'^^^^- 10 " llfi onsTKTJtlVJL I'll YsmLi 111 y. ii.lrJJi several times This however, is not commendable, unless iierformed with the greatest gentleness and care ; and if there s nothii - i mpnf It would be preferable to make an examination at another t me S; than incur the dangerous results that might follow tSmaSafon animals; tor in conseaue," o ot the^r hori' ml oskL'",!"'"'"' '" oussion is not possiljle/ K.'itlier is ij so ™h thl/ iu ' ? "'''P.'"- fSrr"' '/'' »-'■-'•-".*: animalt™h^sa"Ltosut„°rr soap 01, betfc, still, w th olivii oil, is inserted into the vagina as far ,1 hL Zf "^'- ^" "'° "'"' "'°""« <"■ S^^toti™ the utCs descends every direction, approaches the vulva and the ^,„,l „(V ^'^1"'.'"""S ni shortened, it ean?/e perceived iii U^iSlc ^v , "^ TheSTaii™" latory mannsuvrcs as were nrarti^Prl u. n,,. .. V"^ , "^^"ipu- jn tl/e va,. la at this ^,n: STt^Z^l^^'i^Zil^TS lotaUy'^tL^^i'.^^""""''"" ''■-"'• '"-^'o- "^^^PS^^ na^;t^t::rr;,!3::K!;hi;?las^i;"rf;r1^^■>'.p^f«- ra^d^i"?""^-'" '-^A' -^'"-'^"^ ^^'''^'■'' "^- '^«"^/-' ^attcmcnt, consists of a ' The hallotfemdU or repercussion to ascertain the uresenre r,f ,. f f • produced by the operator placinL' his ifiti..nf i,v VJ. l."^«*;''"te of a f.i tus ni woman, is her shouidJr,s. The for'h^nL'e is then^n Z A ' 'T'^'^,* '"'"*'""• '•'" ''' "' ^^'^' '■'»i«'"ng cervix uteri, while the other hind is eLw^^^^ ^"^ I^'='^'^''^ "» "'« suddenly but slightly jerking C'ards^S nit .fT *!'V"r""^, ''•"""""■ "^^'^''^ • t^en experienced of .^.nethin.^ havT,rreceded ' r ,n InH 'I kJ^k'^ fin«er, a ser.satio„ is again on the point of ^^^ ^n,.r inT^,^ ^:r%£^i^:i't. T""^ *" !f head o the f,etu. causes it to Hoat now,.,.!. ,, li^^i^ n- th J," ,, *'"!.*"'^'<^;'-. "I"'" th. makes It descend ajjain. We have seen that t lT-Vh •'■/"*^ /"i""'' ^""J", and .Is »ve,ght can be practised in the Cow '"'^ "^ external, or flank hallottenw,!.. unless performed s nothii.g urgent, ather time, rather is rnanipulation. >r the hard masses can generally be ' appear and dis- ig creature, com- I intestine and its practised on the danger than the voman, especially irly so useful in ition, this reper- the exploration le position as foi- dcated with soft k-agina as far as uterus descends )nger and more nd reach of the in expanding in the vagina being le same manipu- ay be employed I being so satis- ver be preferred uals, by placing ancy are usual!}- by in diagnosing gnosis of preg- is undeniable : L«IH, its utility only to ascer- was alive. In i applied to the the sound is I'liEaxANcr. born child. In adriifio,, +^ i.\ 14 7 its most unequivSts ^ST^' ^^'t^^-^^'y ^^^^^^^ Te^ot '£tf ^^ord o, funic ^o.#., hearV n eel ''?' '^' ^^"^^'^^-^ of tt the a> us; it is synchronoirs witluhrfc^L^n", ^^^"•'able positions o In the larger animals, auscultation Vf^ Pulsations, discovering the existence ortW.m ^ ^^'^'"""" ^^' ^^e Purpose of because of the intestinal wal s the ,-, Kr ' ^' ^^^^ "^teu unsucSnl t.nes. and those of tlie niren in^e c"v tT,'"' "°^«^« ^^ T^t^l T f */'^ P°'^"«" o^' «ie fcetus etc wh7V ^ ^''''^'^ quantity of amniotfe the fa.tal heart ; so that it is s'eldon'i '"*"''^^>' '"^^l^ the XS if others, however, have resorU 1. .' ^7"^^' resorted to. Lafo>,i fvS pregnant ; though he also asse ts haf /l" °''' ''^''^ ^''^^'^ six months X/lf. "^'^' '^''^'^ ^'^^vards the end of n. ^'^ ''^""^^^ ^e heard in lessimg on the cervix Tin. i.>f """-«" oy the vagina its wi/la ^ i ithat this conditron'n '° ^''''^'^ ^* ^^'^^ ^^agelt is weltT^"'^'- ^."^^ I i- " oiM. use to tlie presumption \'\ 118 ' //;.v TKTUK 'A A /'// VSlOlJXI ] '. i I that an animal is pregnant, but no physical indication reveals this state the examinations must be repeated before a linal decision is arrived at' 1 he value of experience and observation, when added to theoretical knowledge, is well displayed in this branch of veterinary science. Not unfrequently the diagnosis of pregnancy is suri-ounded by great dilli- culties, and a guarded opinion must therefore always be given. SECTION IV.-DURATION OF I'JiKCJXANCY. The (luratioji of 2^0 [inane y varies considerably in different species of domesticated animals ; and even in the same species there are individual variations which, though not very great, are yet important • so that the exact term cannot be rigorously fixed. From tlie doe Jiabbit, which carries its young only twenty-eight to thiity days, to the lemale J-.Iepliant, whose period of pregnancy is, according to report two years, there are a number of intermediate terms ; and it is scarcely possible to establish a satisfactory relationship between the duration of pregnancy and the other conditions of organisation— such as size or longevity. In closely allied species, and which may couple and pro- duce hybrids-as the Horse and Ass, Sheep and Goat— the period is pretty nearly the same. With regard to breeds, Wilhelms has remarked that the Hungarian Cow averages ten days more than the Dutch Cow. With the male toctus, the duration of gestation is greater than in the case of a female Jt has even been remarked that the male parent may have an influence in this direction. For instance, a Alare which has been put to a tliorouglibred Horse will be longer pregnant than when impregnated by a common-bred stallion ; and the Mare which has been fecundated by a stallion Ass goes longer than wlien impregnated by a Horse The duration of pregnancy also depends upon the age of the female, and her strength and condition ; a weakly or much-worn animal does not go so long as one which is strong and well fed. The differences in individuals of the samt; breed or species may he partly accounted for by the fact, that impregnation is possible at any time during oestrum— a variable period ; and if coitus has taken place several times during this condition, it is impossible to predict when conception took place. And even when contact has only occurred once between the male and female, fecundation does not necessarily coincide with this intercourse; as the ovum may meet the spermatozoa in different regions of the uterine system, and may therefore only be ferti- lised some days after copulation. The time required for the ovum to pass through the Fallopian tube also varies in different animals In the Eabbit and Guinea-pig, for instance, it takes three days ; in Rumi- nants from four to live days, and in tlie Bitch from eight to ten days And, as has been remarked, various circumstances may retard or accelerate the development of the foetus ; not only this, but with some animals it may apparently remain for a number of days in the uterus after it is ready for birth, without inconvenience to the mother or itself just as it may be born several days before the ordinary period without compromising its safety. For these reasons, the period of pregnancy can only be approximately hxed, though there are of course limits beyond which Nature ev4 [jrovident and watchful for the preservation of species, cannot go without ceasing to be natural. DCllATlOX OF I'ltKi.WAXCY Mare. U\* /'n\,«f ,•„ or • . unyH— -01 a luean duration o 34() davt (rayot, m 2o instances noted at the Haras nf Pin .'. 7 -> , aven>K0 l,ci„s 847 days ' '^'^ ^'■^'- "'"^""U"' «i» days, the .sSt s,:i;:;:s,-;[f ,;!r^5, . '^^' "^V^' *" S^station i,oii„d was 341 days- .t?afe7;?^,J!»;~ With JOn-Hsh Af-irS fl - T^''-'^}^ *o/- "'^il«« and 342 for females. 339, dayfc^^ot^n^^I^lirL^S f;;^ ll^f "^"^^^ *^^ --^« -s at S;'t&,:S:;^;S;S r ""^'"'^^ ^° ^^^^^^^'^ observations, arrives of Foals are born ''''•''-*'"' ^^'"^8 ^^e interval in which the majority buuSt Sf ""^' '^ '^^^^ ^^'^^ ^-"^ ^'- ^^^^^1^ to the 310th day, y''^^{^>^CMi'ZntL^^^ t" th« ca.e of a .Mare seven u«ua tin.,, the cu.t„.na,/sig„, of ,1 it- h . 'h P''^«>"^"'=y. '^"l.v ...anifeHtin,' at tlu- "1 fifteen ^^ ^'^^^ ^« '^e extreme limits within ceases L h« nJ V°^'"'''}}'' '^ "'^ ^'*^« = ^elow or beyond these it ceases to be natural and really physiological. longer foTac'^flMf*^ ''f.T^^' °! M. Gayot, pregnancy is often a little Sound?dnn , ^« -^aK' ^"^^ **^°"«'> this conclusion is certainly ess ac^u1re^n^^l? ^''f ^'^ ^''T "".'"^'^'" °^ ^hservations, it neverthe- wrais:;b::r:s'i:!r^r^;^!^ ^^°'" ^^^-^ ^" --^^^-^^^ Mares XcTfnll"'^*'? //^ Pregnancy with thirty-three thoroughbred 187fi T « ^ foaled at the celebrated I\Iiddlo Park Stud, Eltham, in Sav? ron^inr^'^f '"\*^/^'^ 'f'^^ days-the shortest periods being 854 dais Zo n ;'"''^\^'"^ ^^.^. '^T (""^ '"^t^^'^^O ; and the longest 320t la^nd feh '^ ' ^"^^ '^^^ ^^>'^ ^^^^ instance), lietween the nd 340t d1. vi r^''' **'''" M^'" °"^>' ''^ "^^^'^"««« : between the 330th 348th davsr.'." ^T ^^ •"^^'^»«««: ^"'^ between the 340th and hav 1 been uTJ^^ ![' '"^^^^^^^S- O^ving to some of the Mares he W .nif? t^'' ''!^ ''^'^'^-"^ '"^^y ""t be absolutely correct, as one Mare ^Fntremln""/*^', ""' ''^''^ '' '^'^^'^'^ f^^'"- ^"^ -'th period vvn;q9i I ^ P" Only once to the Stallion (Eosicrucian), the pe od was 3S0 a7.l ' ''''^ Tu^''' P^^^^> P"* '° *be same Stallion the was 342 dayf ^^^^ ' ^'''^ ^''^b another (Iraogene) and this Stallion, it a.yTvlt 7Slfinn T- *!J''^. Yf ^'^''*''''" ^°^*« ^"^ seventeen Fillies: the Sfdavs^ Tho I^r^."^ °^- *b^^°™e^- ^as 33G| days, and the latter Jd4 days. The shortest periods 316 and 318 days) were with Fillies and two af 1 f1 " ! °'" ^'■'^ *° nineteen years ; there being three at five eStZ' nni flf ?'"' *'''" ^*^ ''^*^^"' «»^ at seventeen, one at 34I) Sm,? Sr "' "^"'^-^n'^ 1^" ^^"' '^^'^^ 8^-°"l'' P-«nancy;veraged fonrnfS^i ". ■''''°,"'^ '^•'^:^^ '^ay«; '» the third 328)^ days; in the seventh Ssir ' " • ^b^ A^th 33G days ; in the sixth 337'.', dlvs ; in the Srjenth q' 4?^' ' "• ^^? ''"t^'^ '^'^^ ^^y' ' '■" tbe ninth' 340.V '^ys ; in figures woul^^^^^ ^" he eleventh 330; in the twelfth 325. These and inred in i T.r J^^* *'^f P'"°'^ "^ ^^^^ation decreases with age ; nLeteen vtars old n • "^'1^7'''' pregnancies occurred in Mares y^^^:^;l^^s^^!:^'^' ^-^ ''- ^^-^'^^ ^^ ^^^ ^-^ --^ for breedi'r-^'n'^S'^S- '°"-!f ^f^^ ^" *be most favourable conditions douhfS^.T'f i*i?''' '^'^b their splendid qualities and precocity average ' '' P'''^'^ "^ «^^*^*^°"' ^'b'^b is below thl ordinary obML'ns"on''thrdn;';'r"''V'" ^''S-n,y.H.A., l,a« bec-n n,aki„K some interentin,. writes ''On the t^Oflfr. "^ I'^g^^^n^y '" Mares, as inHuence.l l.y the season. He fo owing ATav Th! n . "'^' ^^"^.' ^ ^'""' '^ ^f'^'''^^' ''^"^ '''"^ f""'^^'' "" t»"^ »Oth of the aboXlfven Indlh.u' T^'^J. ^'T^ "^ ^^^'"^^ ^"^''y' '"'^ ^hey carried their Foals in srri„rca Hed the? ''"?'','• ^^^ *''""^t' "'='^""-^'d '" "»^ ^''«" ^^at Mares bred early tLk charge o.lS,H Ia ' '""y''''',*'"*" *»'««« l^^ed later. For the next two seasons '[ Ser thi tlo,-^ V ->^'''''' -"-"^f"'"'^ ♦hat those bred in April carried their Foals n Tne d T 1 ^ '" -\'''J\^"/1 t''^^* ^^ose bred in May went longer than those bred J"n« and .Tuly. Since then 1 have had considerable bad luck with my Mares getting ■n.rriuN of I'ltmxAsvy, are ii leed ao I limits within jyond these it is often a little on is certainly IS, it neverthe- in conformity thoroughbred id, Eltham, in t periods being id the longest Between the een the 830th -he 34()th and of the Mares some cases at ;ely correct, as ai. But witli =jicrucian), the 16 Stallion, the lis Stallion, it en Fillies : the md the latter th Fillies, and ). The ages of ; three at five, twelve, four at iteen, one at ancy averaged days ; in the . davs ; in the i40.'; 'ays; in 1 325. These Lses with age ; red in Mares six and nine lie conditions id precocity, J the ordinary (ome interestiii!,' the season. He the ;iOth of the iried their Foals VI ares bred early xt two seasons \ Tied their Foaii> than those bred y Mares getting It i 161 ^ gen. ., -,, /."y.^-fl'^itted that pre«rmncy is of longer d'-ation \n tl. ua,. the i^quine species-fron. 358 to 385 days u u^ jioLsf, M.dnon, the i;t'riod of gestation is not so long. Cow. Jl^::z:::ilL, ^tS:^:^v^z''Tr ^-•^^— length average period is concerned bnf ^'^'*''^" '^^*^"<^ ^o^^'^ct, so far as the taken'^into account and "v'ichwllbon" ^'' ^^ -f '""^ ^^'^^^^^ '""^^ be lished results of various oerve^;" 0??^TJ ''"'''^ ^' .*'"« P"b- Agricultural School of SaS^ and hv uf "^^^^^-^vations nmde at the Fiustenberg, we find that n v ^ ^ f'"?' ^"'''^'' ^'"'"^ ^"^ fio.n 241 to2 Oda s Ufron 7^21) 1^ ^^'L'^^ ''' ^^y^' ^^ days. 2.30 fron. 2H1 to 2<)() days 70 from 990 o^'for t ^'■""/Ji u*° '^^^ •Ml days. So that it would appear t mt wi b ^ (^'"' ""''^ f^ -^'^""^ vorv rare bcforo tbo oiiaf ;i„^^ 1 ' "" ^'"^^' parturition is Dieterichs gives the shortest period as from 910 fr, oor i longest between 326 and 'V^^ rlivc „ J,. *° ^^^ <^a,ys ; the mei"ster and Itueff T^fvo the' £r?Tfi;r''K"'' ^?' ^''^^ ' ^^^ile Bau- longest 330 days-J^verlge 2af d ' " TlTT^ "' ^'? ^l^'^'.""^ *^^ Siimnenthaler breed at Holienhet^was 280- Zs'^,^ L''^;.,^"^^^^^^^^ days, and cow (Jalves 278 days " ^ ' C^alves 283 got' pSr tJlt"" no'Sl":i rV' "^ ':"' observations, which would The 313th day and tl^af it ^^ ^r^ °'^f ? ^'^"^'^ '^e 220th, nor after ^42nd day Those b U s vblb^"'''^'^!^ ^ c'^' *^°^« ''^™ before the sidered as^deck X p e .^^ ''^^"J ^^e 260th day he con- aays were classed as irii.na^^^ while hose which took place after 300 285th day, three wer't n S t^; -^nm ^ instances, 310 calved after the average giWn is >^84 to H-wl ^^' "^^y* ."""^ ""'^ *« ^^e 313th. The •290th'an'^l'300t /day hete vZ. dtSf **^' ''''r ^"" ^^^^^^^ ^^e those P'oducecl a^e|;t^rS d:/;^:!^^^^^^^^^^^ '' ""^^^ ^ ^" |.inetee„ Mares bred in April 'uSlVs ^rirf " r'•"';^r' '^T °^ ^^«**"- '-' IS 34;. days ; average for thirteen \l„? I ' j\*"^'*«'- ''"^ twenty-three Mares bred in Mav :;f any Mare bredSn^'iM \ ^dL^ioLrti^' "I"'^ '^ ^^.'^ ^T ' '""^^^ «-^ ^3:idays; longest time of any ^Iare Sin mIv i. i^o J *"l ^^'^ ^■"^'^ '" ^P"' '« bred ni May U 323 days • lono-ost tim 7 ,/ '"'^ '^'^y^' shortest time of any Mare shortest time of any &■ "d , T,?' "^ ^t^ ?'^''' ^"■'^'' '" '^""'^ «"d 'T-ly is 354 Ss was a virgin Mare.^L;:," ^^ry f t lu^^time olt'\''' ''^^^ '^'^^ ^-^^^ ^'-'' -^-^'^'to <'f foal.ng. Mares here in Ore.fo„ ,mZ ttllJ"^' '"V' ^.«»t'""«d -' "P to the time have an ah„„da,u.,e of nntriti.n.s^rfl r ^ ^ very poor dunnir th." winter in,.nths, but It ,s my opini.,,. ^^at Mares whil^haTe an Zndi;""/ '1'^^-^""? '"."^ ■^"■""-- '"-thi to foahng bring the f.etus to nmtuHtv^ o",ne tLn f'h ""*"*!""« ^°o'J f"'-'-^ time previous amount of very innutritions food " ^ *'''">' '^""^'^ ^*''''-' ""^^ ^ej.t on a small t mmm' ^, IMAGE EVALUATION TEST TARGET (MT-S) € % // ,<5' {./ % ^^^ 7a 1.0 I.I l^|2| 12.5 22 2.0 1.8 Lil 1114 11 1.6 ^ Photographic Sciences Corporation 33 WEST MAIN STREET WEBSTER, NY. 14580 (716) 872-4503 iV iV ?b^ '^ .r^ C^.. ^\ ^k\ % X <^ \>^ ■^■i- tA 152 OTiSTETHWAL PHVSlonotl V. obsl" vat'iolnn'62''cori--^ ^/- il/;./.'-/ Sciences for 1845. the result of shortest fl« 9?? A , ^'^^^ ^^"^ ^°"g^^<> P^^'iod as 336 days, and the Cows. 15 in 1877 averasfd 14 in 1878 17 in 1879 15 in 1880 9 in 1881 N'o. of davs. 287 286 285 286 28(i SllOltuHt No. of days. Ijoiigest N'o. of day8. 282 296 279 292 276 (twins) 296 280 291 282 292 stSngSS,:::.'^^.-??""^!?' T''''^'"' "- notion, notwlth. than a fenmle Calf °^^'^ ^ ^^*^«'^«' ^^at gestation is longer for a male being short'ened thoth ZV ", "'' ''IT "u"^^''^^'^^ breeds the period as th^ose of the conSl'b.e'eds.' '" '' '^"'^ ""^ "°^ ^° ^^'^^ ^^^^^P^'^ caSllf S •/'•- -«'/'-v. M. Magne school Ling a^SiW:;;;!?, %^^^:iJi:.{:!^tJ^-^y I ''-tances of 143 days 57 instances ofl^O days 15 22 30 55 68 80 144 145 146 147 148 149 49 23 13 7 7 3 151 152 153 154 155 156 anIXS p ioTwasTnl " /'^ f'^'T'l ^^'^^^'^^^ ^^^ ^-^-^ of births occunS.berweertLu-^^^^^^ ^lays by far the largest number 143 days and th^longes^^5?davsTh; .-'''' ^T ''/'' ''r'''' ^^^ was about 149 davs rp^.H ^ average duration of pregnancy male Lambs a^id tit Af„°."'''^' ^"""^■^' ^^''^^' ^^'^ female than the the male Lan^bs requhin' ^^^^?« i' " °""'''^ ^50- average. 144 days; nns lequinng. ,.s usual, the longest period. With regard to I 1H45, the result of J36 days, and the 3 being 288 days, al for July, 1882, )ted which had a Bulls accessible. average with the Longest N'o. of days. 29t) 292 295 291 292 notion, notwith- onger for a male ce on the dura- eeds the period I well developed '/'.v. M. Magne fort Vetei'inary ; result : 100 days L51 „ L52 „ '53 .. M „ r,(; „ en the longest largest number le shortest was n of pregnancy male than the reater develop- ion more ditti- l days, though ay. longest 157 — hortest period age, 144 days; Vith regard to nURATlOX nF PREiiyrANGY. \r,% breed, these authorifies found that the period of gestation in Merinon averaged 150-3 days; while with Southdowns it was only^ H4-2 days or SIX days less. "^ •'' ' In the Merinos, for the male Lamb the average period was I5L-1 days, female Lamb 150-6 days, and twins 149-9 days ; and in the South- downs, for the male Lamb 144-7 days, female Lamb 144-1, and twins 144 days. Mayno asserts that the Goat goes a little longer than the Sheep-the average being five months and some days; another authority gives it as 148 days. •' ° PUj. The Pig is usually pregnant four montlin, or according to some au- thorities three months, three weeks, and three days. Baumeister and Rueff give the longest period as 130 days, the shortest UO-average, 120 - while Dietenchs f,'iv;es 109 days as the shortest and 133 as the longest -average, 15 to 116 days ; and Magne says that it is rarely less than 109 or more than 120 days. Rainard noted the period of gestation in 6o Pigs, and reports it to be as follows : 10 23 27 2 1 2 instances 104 days. 110 to 115 days. 116 to 120 days. 121 to 125 days. 126 days. 127 days. ^r'^^lnT'T ''-^l' tji^'i-efoi'o, 119 days, the interval between the lon-ost and shortest periods being 23 days. '""n^^f" nilch. The Bitch goes with young about tiro months, or from 5,s to 65 davs • t: sZS n^S? f'-\ "'"^ ""?'?■ Bau^ncister and Kutff st'ate tut snoicest period to be oo davs and flinlnn.mof ^-n n i ■ 60 days. me longest /0—t lie average being Cat. SECTION \ -GEMKLLI PAROUS AXD Ml'LTIPAROUS PHKGNANCY. I nnfZa^. * n'vn"^^?"''^^^ ''"""^^' '^^'^ '^^'^ «P^^«'«« which are naturally wm; aro«A-produce only one at a birth ; and others which in a norm ,1 154 o/:srj-:Tni< 'a l rnysiouxi r. !i i \^- toh!TsToUo%l!™"' '"*'*• " -- ™" youne creatures at a to'stSre'o"! riS" 'y? ""' ™" --rtainea. It ,„ay be due rupturing at tS: Z°™L a C Se'^ape Ttt" ^"f"' ""■""• and which may become imnrflr/nVf«rl of '^^ , • °^* *^^y contain, vesicle may co'ntainTvoT Sore ova ^n^Zi\ ^^-f ^^^^/^" woman ; and these arrivin,, +!!„ fl • ' .^ -t^ischoff has witnessed n at one t me. Ot\1 mIvZL^?^^^^^^ '»^y be fecundated tains two yolk, as somJtlm. P^'" *^-^' *t' vitelline membrane con- vitellino miss i ' the esSntiarpaTortr '^' '?"^'^ ^-f ' ^"^ ^« ^^^ this con^„. ... , the jr. -t:; ^^^/Lc^,xj:s: ^^Jt: w/Tc^S^^en^^^^^^^^ the chorions appears to be thp Int nT^ ^^'Pothesis, this fusion of be independent and in 'th^"lS^te"taJ'Vr^?P'^ "^>^ ^^^° contained in the same vitelhno mpmJlf ""l ^^}^ *^° vitelluses also the fcctuses mTy become unSr.~T °° >' **^" envelopes, but rise to double mo>?sZs ™°'' °' ^"'^ ^^"^^l^' ^^^^ thus give o^'i^^^t^^^^^^ZT 'T IT''' ^^*-^^^ ^-- tbe fecundated, one after ano^hPv^f I '^^' ''"' successively; and be brief period. Occu" enL of th , r"'^""'^'''"''"' copulations within a wrongly adduced as invars of'supJS'a;tat^on^ "'''^^ '''''' ^^^^ *^-'^- Mare. only been able to cofet fSl™ n ."'ces "thtJ'V ""1 '"''^^y' "»» fortunate. Rueff ndm.-fa fW ^"^^^"^es, though we have been more in this animalTn every in norZl'"'' "^^ SemeUar gestation may occ^r always born dead o' dietoon afTer b'lrtr' Y ^^^' *^-' ^°""S ^^^ ^^^^^y one instance of twins waXnt in eve^ mfS^'^' '' ' ''^'' ^^^ Demoussv, cited bv Sninf n.,, u .F..al. though alive wLn bo n^^reVi:^:!:^:;'^'*^ 1 """"'^ ^««*^''"» ' ^ut the only that one of the frrt.ises was expelled f! I^""aitre gives a similar instancr was foaled alive at the „,s„al thne, anftrvrved T^I 'Jtl ^^'^^ '^' ""'^'^ ^^« r'^t-i'S; tenth month of pregnancy, cast tv;' well formed Foa f S^^wV ^^""^ ^'"*=''' ^* ^^e five tunes-on April 23, May 4, 16 and 25 Tnd T,?n r ^^u*" ^u^ ^^"^^ P"* *» the stallion ^^Jo.ne„waseno„nousVlar^ge;a„d:^lfL^:tSe\\^^^^^^^^^ a ^::^:i^t!^f^r:-:^ .^^-- >'->« - co. a^ tunst witnessed an analogou occurrence the nt'^- ^'"t-CK'« father, an agricul h.mself saw a twin birth in a >rrro„l 'o thf T.l ^ also surviving ; and Saint-Cyr ^•■'kilogrammes ; the other which ,vhH^- u- *'^ '^''"'h ^^'^ ^o"-" J«ad, weiahin^ In the r6/«-//(«,-m„ are fonnH a L ^'"ghing nearly 20 kilogrammes. ^'''i'"»ng Afr. Millington (v^l it p 424) ,?rM^" "^ "'•^*'^"^^*' "^ twinSoals n this country In vol. ix.Jp. Ao) an a^c^u.nt il^'ven if"" l^Zlr^ '^!".'- *,'^ ^''-Is being boralS'. were twin F.ials; in vol xii (x, -J^Z? '\,*I'»<^ ^^hich died of hydrops uteri in whioh (p. 177) a si„.ilar instance ^' ^ '" *""""''• '*''^°"»t"f **^« I'o"' dead, and in vol x!? ig creatures at a It may be due vesicles, which, >va they contain, . Or a Graafian las witnessed in ty be fecundated 1 membrane con- 3gg ; and as the ident that when ated, to produce appendages dis- he two chorions ituses will then , this fusion of slopes may also ! two vitelluses 3 envelopes, but r, and thus give iached from the sively; and be ations within a are, have been east frequently Saint-Cyr has ave been more ion may occur ung are nearly of a stud, only istation ; but the similar instance ; her was retained, re which, at the lut to the stallion March 15. Her eceived a kick in oals^aColt and ither, an agricul- ; and Saint-Cyr I dead, weighing H. in this country. aeing born alive, "tori, in which and in vol. xv'i. Un'icnllnrist for 'y. gave birth to GEMELur.inous jxj> MrLTirAitvus ruKaxA xcr vn i/erf»-y(J„Iy 23, 18^ a MarTat vhr -Cif «f. *"""■ ^T'^^^^ to the Lirerpool in the space of fifteen Inthsr -^^""«^*"> ^f*''^" y^""^"^ o^. brought forth /o«r Colts Raabe, in 18r.2, witnessed a triple birth in a fiveyear-old Mare • th^ fhr». v i born ahve and were c ..pletely developed, but they soon died ' "" *°*'" ''"'" Two instances of triple birth are given bv Saint-Ovr f'i« nV^af , u, , . recorded by Paugou,'.. This oca.rred ^th a IS SicJ prto «^^^^^^^ ^^^ '* February 17, 1343, aborted during the night of SemTe^2^28two^?n^^•"'^^'^"° one chorion ; on the 2r)th of the Mlnorir,^ tt L '^ •: j ' ^° *°^'^ being foundin formed, and which ivd In he c7n7ca^f3ed. v^n^ ' third Foal perfectly put to the Stallion seve al t"ires rMav W ^ a^^^^^ ^^""''^ ^'""^ '''^^n ;.r.proper.y.fori„ed but ^^^^:^^Z^^:^;t^t ^^J^t^ ^S£^^B^£B^ s fXSi -g breed, had Jone theU peld o W^^e;:" '^'^^ '"^"^ '''"^- ^^^ ^«-' "^ '^^ -rt' In tiie Vtterinarv Journal iov 'Marnh i^s-> -vr -n twentv.one years old, whicruroduceH S.' ^^^r^^''^^^^^}^^! reP^rts the case of a Mare years previously she hS twin Foak °' ' ''* "" ^'''^' ""'' "^ ^^"'"''^ ^"« ^ead. Tw.. ar ■e horver tThTn^^ ?^ '''''' "' *"P^^ "^^^^t^^" ^^ ^he Mare Saint rvih;: 11 f"^''^"*^^ to two successive fecundations, of which thp Affll I A "°"'^^*^^ ^'S^^t examples. In all of these, strange to say nsucc So^r andT/"^\°f' ^^^^T '^ '^'' ^'^^^l^^"^ andAsinin^e s^ m successioii and brought forth each a Foal and a I^Iule. In the maioritv of these mstances, the two fecundations were within a bret per od same dnv'T'^T^- '^' °*^^^' """'^^^i'^tely, or, at any'ate viSt^ Zl-h^ i ! elder of the two Foals in these births— the one first born "of mil w""''^ ' "^'""^'^ '" '''' '^""^^" species such a ques lo4al i?Serest hTf^. '""^'7'^'}^^' r'^'^ '^"""^Is it has only a physio- Met hifhl ' Y^ *^^ °['^'' '" ^'^^^"^'^ they were born would, never- tneiess be the only rational assignment. but e'ven^/n thfs'LZal suT'"*'^ ^""^'^ ''''''' *^^"^ *^^" '^' ^^^e ; thirty she \sses ken fnv f K °^/"?:«"«« « i'^^'^- I" an average of Chanelirw ni ^ *^^ production of milk by a man at La years. ^"'"^■^^'^^^' °"ly ^^^r had twins in a period of seventeen Con: and with individuals that it h!. i ' "". frequent in some breeds, a breed of Co ^wWch woild riih," if f '''°'' '° ''""''""• by 'election ".pie. quintuple, Strtlrtvf b^eer^orri "'"° '^™" ^^^^ I ic..., v.ntet, .--"A neighbour of mine, Mr. Pel 'narp Sf^ipnce Peter Low, had 156 OriSTETliKJAL 1'}[Ysi(>L(HIY. c^2v^'yVa'ri!"Ttri?'K^^^^^^^ »'''^ twin Calven yearly for six sue kept .J of her-Se wins. rBdl ""ThL'tTo P ' 'T ""^7 '^P^^'^^^^" ^I- W there Ts no doubt buT by prooer sZ!^^^ ^'■'"" '^'' »nd other similar oal.es, 1 1^ might be established ••\'nTa.,Tn^^;*Xs" "^FrZT"' ' ''^'=%"'. ^--be-ing cattle record what 1 believe to be a imSuc caT of^ ^IfTr /*?"" ""n^ ^^'"^ ^''^""' ">«• ^ "^all the particulars to Mr. Janais s3en R^lflni E,'*'/;P'-"ducmg Cow. I am indebted for ing a small Cow of the b «I p'?i 'h 'iS ^v 'i"?«?' ^^^'J"^' ' ^^'norandutn regard- Stephen, Farmton, Alford - ^^' '"'"°'' ^^'""^'"'^ *« ^^^ ''^'^ Mr. Alexander Vear. 1842 1843 1843 1844 184.'-. 184t) 1847 1848 Xumbcr of Cilves at a birth. 1— first Calf. 3— came to maturity. 4— one died ; seven in one year. 2 -came to maturity. 3 — came to maturity. 6— died prematurely. 2 — came to maturity. 4.' " oJ^^i:^!:^^:lr'^'' --^^ --- ~-n. but the instances n^ZZ^Z:-ml 18ls"an.Us7r t '"hTf ^.'" ^ ^T ^^'"■^^' ^* *»>-« »">«- were not reared by the mother • thei r^fv^ f.^ forth nine Calves, only two of which birth. Rainard speaks of onV nf v •? '"l^^F"^''!'^^ ''»'! "nly one offspring at each neighbourhood of 'Lyon,? arRlheLEl;^^^ ^ ^o w of three balL in the the first two Calves were born ali v. 1^ ^aT ^u""- '""'^'*'' "'^t«n<=es. In one of these in a bad position, wa/'m'r^^ll "iTix d.wf l.S;'"{n''t"h'"'' '"S^^*^ '''''' '^'^'^'^ -- after producing a living and properlv-devSrP.I p/ff r ?'""^ instance, the Cow. let,, eff jrts to get rid of the othTf ^^f„ ^J' \*"',?""tinued to strain and make fruit- Calves attache'd to each « thert thf,' ^l^.^'iir ^ ^'^ ''Z'''''' >*"— ^s, when two the case of a Dutch Cow wh'cl Vroduc^H hi P i ""'^ u *1" "'""^''- Sperling records a heifer, and the third ThSr ifa w, o,t 1 • 't ' '^^ ^''^ ^*' '^ '"*'«' ^^e secon.l a Cow which brought forth a H v^g clvt notZ; af!" ^Y^"^ ^^'- ^'^"'^^d°» ^as seen an anidian monster. ^ ""^ ''""'^ "f'*^'' '^ '^'^^^d one, and in a few minutes The Liverpool J/^>T.r ; April 9 TIlV WnH '"' n ^^Iv-^. then o. .„d again two. in eight yeai^-two Calves at six l.lr 1 thr' ;"" ''.^T ^'".'-'h P''-"^!-'" ««' sixteen Calves iJfar^- Zane Expre., (May 11 IS'.],.' t f ''^A'"''' ^'''^^' «"'^ "»'-' '■'<^ *""t'ier birth. The a birth-making ele e„ ^calv'e i^ ore shri° ^ *^"^ *'"'"'' *^''""-'^' f"''^ tbree Calves at reported in the W//o"/S,'^/"^:n\tr^ ^ similar instance i. Durham. On April 16, 1877 she "avThf. f : ■ The Cow was a three-fourths -March 19, 1878, she gave birth 'to trinff . *," *^'"'' ""'' "'»'« ^nd one female- in eleven month's andTree tys ; Jf. f 9 iX^l?"' °"t ■'r,"'t' ™'^''"^' «^'^ C'^^-^' October 7, 1880, she gave birth to trhtL u ' 1 »*r' ^"""^ *" '*'"»' ''"*»» males ; in the three years fivf mLths and tl1:'.,^^ryr 'Vt T Z'^"'^'^"' '"^l^'"*-; *'^" ^''^^^ t1*'1^.^«"'' ^^"dsome, and were raised o^n th!- firm' ^ ^''''' "'^^'^ '^" "^ 8"°-^ ^i'^^' oalvUyt^re^t^i^Vt^Srt^^ 'ttl^ fr'^ ^''-'^ *"-^r"«- "^ ^"-^ ^-^'v mentioned twins. ° ' * ""«''' ""^' *""ns, triplets, and then the abovj- by^c^^iir^iS'^iif s^'^n'f'tif ar r^ ''%''''' f '^^^^ ^-"--^ ^^-v- similar instance, but the Ca ves 'born d„rin , ^ -''k^ ('hro,>de (July r,^ 1344) gives In the Field for June 17, 1876 h" b rth" . ^b"'^''''^^'''" ^"""'^ '^'^'^^^ '" ^^e morning, reported. They were alive and do ng wL ' ''^" Calves-a Bull and two Cows-!. Quadrigemellar gestation is also sometimes observed in the Cow. SB t-^er, h I it the instances Rainard gives two instanppH • n»,^ u produced four Calve«4wo t.ale ^^''^"f'"'"^'""? * ^'"'« "^^t"" Cow which i„ ]sn« m 18.J9 two, m 1840 two, and in ISll four One "f \1 1 ^'^ '^'"^ <='«'^««. '" 1838 two developed and successfully rear».rf <.n^ A i . ^ *"^ '**** ^*'a« » heifer • all w,.r„ .„ i forty.five pounds each. ' '''''''' ""'^ '"« ^-^ four, at five weeks old? ^'hld^bT^ which had produced one Li^'feSh of Zeliirfhf tt^'r/" ^'^'^- ^i- was a Cow four dead Calves. This jouVn^i dsi H'l xiv""';:'T-;'' " 'f '^^'^>'' ^"'''^ ---^t-ce. of r--:.S;^-^--2 ;^-;:^:!;fr ''if^- "- a^: ■: -^^i^j Lint-iSCiS^-S;^^^ were well developed Ind allhorL ^ Toth 't';,";'"^''^ ^ '' '^^'^^^^> " e^cS According to the Che^i/er Vhronirh (\u l°- * '^'^ ■""»" 'if 'er died. '' ^*' mid in three days a fourth A^K i ^ ^ '"'' ' "' '''*'^)' * Cow brought forth tlir^P Pol In the /VcW for March '>9 1 S7q ^ .• • A farmer at Nethprat-ni w„ i j •'^ them bulls, all well deTeS. ed = '^^J; ^"f ^ Cow that gave birth to four Calves two of as did also their dam. ^ ' ■^'" ""^"^ ^'^^ °"« J^ed, but the others lived and did well of -^SrvS""^' '^'-^ ^-- o^^'. - 'ielivered of fou. ,.„.,,„,„ Ca.ves. but nouJ Quintuple pregnancy is, of course. ,noro rare in the Cow. ^Si?"'^^^--^^ Of Turin, describes each weighed about 37* pounds TW. ^,^^ *'^'"''*^ f'^"'''*l«s a»d two males InH .nother. either through irer^i^ture^S^e^vrrytr'Sn'^!"'^ '""^^ developedTtt' The and they were put to another Cow whose milk rovT ^^ ' -^^t. "'"'^^^ *« «"ckle them a single placenta, occupied ^trdrortSrt:^;^^' '^"'^ '"^^^ th^^thtti Ti?h^ fact was their being all presented for delivervTn . I f ^"'"P?'" envelopes. A singu ar «rcum.tance. The Coi had prod "ed tw ^ 'cIl v^t!;™''^^^^^^ ^'^^^ e.xtraordfnary Schumann, in 18.^4, reports a niiinH,r.i„ i • Vu 1,*"^ preceding year. ^ another, in which all the Calves lived -^nd'!?,?^"*^'"/*'''' "^"^ '^^^^-born. Rueff record* - -, h.. a .ore favourable report of a butb of this kind.-' ^. 'S'^w^g^vrJiVt'l^Jo' 156 onsTHTJtK'.tL I'liysinjjHiv. t 'W five living healthy Calven. all ,.f which were, when he wn.to (a week after births »li„ and vigorouH, and likelv to cot.tinue ho. Thev were n.-arlv „ll ..f „ • ''"^•'^)' »'»^« and stronger than could be supposed. Fou! T^rTull" :wL"''t •T-L'^'^no InIZ in i^'"'KVI''*'""-^f*''"'*^" "^ ^'"'' "' ""'"-'•""»*»'. 15avarin, dr..pp,.d Hve 0,dve« raniTin., ^;eSt;;£^,;;:s^'v;H;^;:^i;--^^^ Partur.t.on pr„ceede,l norn.ally, and the Cow did not uppcVr to /uZ , >or^^^^^^^^^^ £SL^;:2.!:;^lS;^;ir^.n^«-- ^-^^ The cajr;^i rsij r "«h- h'^!': '^^""^"'i/'r''^ .,o«,./,.. Calves at four bi^'tt. ' A 'h H sf dd^ery t 18/9 she had twins, which lived ; in 18S0 she had Hve-tw,. females and three iS only two of which survived and were sold ; in l.S>Sl there ^xJ^U^ V^,. „ a!' emale. only two of which were alive; at the ^rrU, ^r „ „: r lls^shf .iT'' grew wl'r ""'" ""'^ " '"""^'^' ""^ "' *'"-■ f"""- Jy"'^'^-t the o'ther tw.: Uved'and \yith the Sheep, twins are a very common occurrence; and it is a saying that m a good flock there should be as many Lambs as Ewes the double births compensacing for the losses. Instances of extra- ordinary fecundity are also by no means rare, and would appear to pertain to particular breeds. Daubenton states that in the counties of Julhers and Cloves, every Sheep brings forth two or three Lambs twice a year-hve Sheep producing twenty-live Lambs in twelve months In Irench Flanders, according to Magno, who cites CorneiUe as his authority, there is a very prolitic breed of Sheep, each ordinarilv pro- ducing three sometimes four, live, and six, rarely seven Lambs, at two births during the year. Tessier, speaking of this breed, while admitting that twin Lambs are not an ordinary occurrence with Sheep, assures us that in a flock composed of 371 Ewes there we - 22 double births ■ and I ek after birth), alive one size, and larger L! Cow, by no nieanH had never produced inifcHt any unusual he fifth waa a breech Hvo OrtlvcN, ranginj^ Jcolourand nil dead, Zeit, Haxony, which rds dropped another. !r more than usual ; > is recorded in thu of a f!()w which wan xirc f.t de Zootec/mif ler first delivery, in 1 and three uiales- -two males and two , in ISSli, she gavo ither two lived and imeid (Maijazinjur uterus of an animal iientions a Cow, gix re— five Calves at a hours, the fourth in Ben ten anrl eleven which lived. The •ely. In Eddow'^ w which had been u the following day being opened a fifth I the particulars of ng opened no fewt-c 3 nearly uniform in 1, they were n a i and a male, and ; the usual size of T time, they would some time, but up ect health. l>eath iuced by so many se ; and iL is a imbs as Ewes, ices of extra- uld appear to ;he counties of J Lambs twice velve montlis. irneille as his H-dinarily pro- -jauibs, at two hile admitting ep, assures us e births ; and i UKMmjJl'AHors AM> MULTlPAnnrs NiKUSASry. i6„ lH50two--in all seventeen Lan.bs at si^K birVs i-W ^f t.f ^ '" ^ males, and thirteen females. ""^ °' ^^ese were In our own country such fecundity is not very unconunon. For instance, in the ChamUtr of A.jnrulUu-t Jnnnml for March ls7l .K • notice of extraordmary prolificacy related by Air An, .,« f t .1 ' ' t'.'*®'"" '* * Hays:-''Lastyearoneof myEwes,of the Lh.c?,lnl^^^Ti ' |^''":">';rpe, Hull, who living. I had great ditticuUy in perm.iln, 'v '^/^^^^^^ -."th s.x Lambs, all the fact was .juite clear and well attesVeT I 1 h . " .''*'''^'*' ^^'''' ^'"'""gh Alichaelmasaseparateredmarka o Aswesaw^h '"^'^^ " i'"y«t« ear-mark, and l^t we kept h.r ,,uit^ separate fron.the resf ,fThe Kvte anTtast^Tf " T «f ""» ^''^'y' another six Lambs. Some of these will not survi v^aL tl. Thursday she produced proper time ; but all are complete an we 1 f..S and Yh'TT *" '"' '^^^^ ^'''''' ^^''^' ?:rLrt^rsi;^r£dtu!Sr;ffr^^ J.n^. .hile go,.d b.ek among the llS 1^ 'ksT^^le l^^i^lX^^':^,:!^:^:-^: onJte'^jr^'kHrn'S^ onell'fitiLJr "^7^ ^^"'f,-""^^' ^"^^^^ ^ 0/ie.ter C/u-ouirfe (May 2;1, 1867) ment onstha a ^H W !' k *r'"" ^",*^'*^ ^'^"- The two Lambs in the spring o l«tM n iS Vhr- " "' '^^ "* ^^""'^'^"'"^^d h'^'l 187.i five, four of Ihich live^ anVwere i„ ' " itja4 '"/i ';"^f lV''"« = '^'^'^ '" (June 29, 1S44) states that a farmer in K Jnt L 1 K w . ^ ". /^''^ ' J^'<^kf!/ Memevuer number of six Lan.bs. four of X^it reared Lrtlorhl'^^ '^\ extraordinary hand. The previous season the san.e EwTiod.ld fo, r T w """'n ^""''^^^ "^ ^'y reared and turned out well. According t..;;: C^cto^^vX^^ ^ 'LV^'^'l ^''''"'^ at Otley, Yorkshire, ha< a Kwe. five years nl.) wt.ini, i » i i ^ vl; ^' '■^^^)^ a farmer one yJr old it had 'two, at tw^Vears'w,^' 'tSe yet' tC^' aTfo """ '"/"'" ''^'^" five years three. The ,SWo/.«/(April ,i,'l872) speak" fr^we a^^ gave bu'th at one time ',o five Lambs the previous vear an 1 th n ' ^'*'"1'' '^'*"^'' this year six were born, five of which hredThrcCtrl" "'"''r'/"'^!:"'' ''"'^ '" alludes to a Ewe which produced an annual averagofflee I amCf ' <'^^"' ^'' '^"» annnal itself was one of three. The Shrtu-2in,('C^^^^^^ y^'*'"'* ' *•'« a, Shropshire Ewe lambed twice in six mS L "'^d, ci, / v '"' T''-^^''> ''^''"^"^ '^'^' (May 12, 187;!) gives a., instance of a 1 we havi . « T*' . «"«''/""'' = '^""^ the/'^VW days, but the others did wel T e 6^^,^^!" f,/*^. !/^'''"':'l' "T "^ ^''''■'' '"^'^ '» ^ ^^^ Ewe which gave nine Lan.bs in tw "setr-^,. ' l^'d ;T:-l3i';'rr 7. T'^ 'T""""'' '' health. An.l in the Camhrian newspaper f r the st.^, «h'e Lambs, and u. perfect "Mr. J. M. Harding, of the Town-H 11 Fa , S«,nn . '' l*' " '"«'t">n«d that piece of g„od luck in 'lan.bing Fr„m a s^.u 'flock ".T"'. t^' r "^ "! "^-'-'^inary less than thirty.seven Lamhs^ll alive an I ng well T'^^^ h"'?' ''^^^ ^ad no and three have l)r()ught ' triolets ' It is ,„ (• t^f i ^ V r ^"^ '"■""Kl>t ' doubles,' t^XX^^L-- ^'""■'' "" ^^^^^'^^^^'L f ;,t;.';r *;Tr^ op-ned wL ,„,„„, „, H„. f,!:, L,u"S,''L'k^;; rtir,*';,?'.?,"' -"» "■-"■ *^"'. ""^ td'r.E: f "" '""" "■ ^ ^ '" •"""- ' ^ '''!5:'3fitv:«r.' Sk i': 160 i)hsTh:Titn:iL iii y.s /(>/.,,(,• y. i 1 1 Hin^^lt) r. This aimnal hml pr-xluc.,! twrnt-ei^h l^ambn i, «.x year«- I ,„ l,s< i, 1 in hs7 . 1 in \»7u, -l in isr.i, .i i„ 1877. and (i in 1S7.S. Other Huuilar iiistancfH might be (pioted. It may 1)0 rcniaikcd, tliat extraordinuiy fecundity in Shcop is seldom observed ni tlu^ highest-brcd races, which ai.; UBimlly uni parous • it ai)pcars to pertuni more to the coiinnon breeds. Not only tills 'but certiun years are more ronuirkable than others for double, tVeble'and (juadruple baths ni this species. ' Goat. The (Joat is K(-nerally considered a uniparous animal, but it would appear that this is a mistake, as double and triple births may be said to be the rule ; not at all infrequently four are produced. ]iut usually witli thix'e or lour at a birth, one or more are feeble or born dead It is looked upon as exceptional for only one kid to be produced at a birth. The question has been much discussed as to whether tl.ese multinle l)irths in animals ordinarily uniparous, are the result of one or successive copulations. Tlie majority of the authorities in such matters are certainly of opinion that a sin-le copulation will suilice to fecundate several ova ; and they doubt if, after a fruitful copulation, it is possible for the sperinato/oa to reach the ovary, supposin- a second ovum to be developed, unless the second impregnation takes i)lac(! very soon after the first, and before the fertilised ovum has descended into the uterus The well-authenticated instances of superfietation, tliou-h rare never^ theless rather militate a-ainst this opinion ; and it would appear to be impossible to explain why one animal anion- several hundreds, perhaps thousan Is, should alone briiifr forth "doubles" or " trii)lets " while all the others, placed in the same hy-ienic conditions, have only one offspring. It IS a fact, hoNvever, that with certain breeds of Sheep an abundance of nourishment and plentiful years dispose to these multiple Cornevin. as the result of inquiry in and beyond France, comes to the conclusion that in the Mare there are twins in every thousand births; in the female Ass twins in every hundred births: and in the ( ow twins m every ninety births. He considers it exceptional to have multiple gestations in primipaive, and that a Cow which has produced twins will frequently continue to do so, or sometimes even to drop three at subsequent pregnancies. ^ What has been said of uniparous animals does not at all apply to those which are multiparous ; for although tli-i latter may be imi'ieg. iiiitc'd at a 8iiif,'lo copultttion im.l l.i-iM„ f n ru!o. tlH.y an,^oun(Vued ir Ian ^,I:1,T'''^ ^r""- •>'^'^' ^^ » Hook tho ...ale u,.til afto.- sovoral copS ' ^^ ^dlV^ "^ '^"^^^ ^^ 24 yoi.,.« VV.UC p,-o,luco,l Imfc tl.r.,SuV '"l ""*'' V^ '^ '"^^^ '" ^»'i«l' in which a Sow l.,-ou.ht fo th 4 t wo * ' "T ''^'" ' '">«tl'«r oano m-8t a,Kl 21 i„ the sooc,,,, and a, ofL '''''.'" ''"«^'«-i^ii in th„ hvi.., I'i,s i,. a litter, she v'i,. ! tt', n id ooIm "' ^?"^' '^''' ^^^ ''^ in less than two years Tho.7 w H \ "'^"'',^' "'"™ t'"vn eighty your,- rcco.-dof a St. I^or-.i-d's tha ' vo tl t^^T , " ''•" '^•'^''' ^ ^'''^ ^1- in the 8Ucceo<]i„fr Httei- tho,-e were 23 "^'^"''' '" °"" ^'"ur, and in those cases of .nultiole l'«>qfnf^^., ;^ one of tho f.otusns occup S th , onl^i^^^ ^^^^ '!''"''f ^ ""'■'''^^''"^. the head towa.-ds tho civix ..[(..?«,.,/• "^ T^'^^'' gestation-- hodyof the uterus, a..d the h . d urAo-s .?^ l'?"'" '"" "^ '*'^ ^''""'^ '" *'•" Tho second fa^tus occupies ti.e vv oTe o 1 1, oM ^^ '" """ °^ *h««"rnua. turned back, or, as occurs not T.X",ue,.tTv h'"™" = '''-" ^^^ ^'^^'^ and so on. nmcqucntly, in tho oppopito direction o^::J^^^i;t^:::z^^^^^ than that unusual distention, as well a Ina.^^^^nc^^^ "i consoquonco of tho the ...other. The woi^d.t of thTy^" 2l,^^^^^^^^ /.""'^tions in tho avera^re ; but, collectively ^t mavlie v.^v . .^'' " "'"^"^ ^««« 'ban one youn. c.-oatu.-o product^I at a S "^"nTu ""'^'^ ^T''''"^' *''^" '^^t of recorded by Magdinier each \aLl wo ihed ten 'tn" 1 ''" ^?^J^'"P^« ^'^^h .n that by Bouchard they o,.ly weisSlro.„ 2.!^ '''" ^.' "^^'^'"mes; ni the quintuple birth described hvWn^^^ " ''?r"'"^ kilogrammes; kilogran.,nos.\)r eighty-hve fo. Zontl) """n '^^^ ''''^^''^ seventee. Lignana, another ItaliL. vetcn na^'^rgc^^ 'TT''' ^^^S^'^" birth in a ('ow, one of the Calves whiK' ""-"^'""^ ''^at in a double tin.o, weighed twenty kilo:4i:.H..:sttir U.e° oth^cklf't^ i' ^"^^ ahve, weighed forty-throo In fh« ,ir.„n t -A , ^°'"' which was which both CalvosVo Lrn a .Ve nnl^t^'' *' "'^'^^'^^^ ^^ Saulsaie. in and the other thirty-one ' ' ^^^ twenty-eight kilogrammes I''ree-niartitis. unproductive. Joh'n HuntS- Iw lUTar^ttent/n "f It -^^ «^"^^^1 which has since received the notice nfn„ i°. ^° ^^''^ subject,^ agriculturists. Though tl.e:nZ%\l''Cn\'::^^^^^^^^ Bovine ammals, yet some authorities aSert t lafif lli ^T'"^'^^^ ''^ peds,but It would seem that the Ovinr^p^^^lTl^'exlmp^t^^^Svr of'£ bnngltlh/r that when a Co. theCow-calf is unfit for propagation, but the Si -if" *".*PP*^'*'-«nce » Cow, that amon\?"'/'=*'^ '' ^*"^'d '» this country a Free^iin afnT' '"*" * T^' P^^P^r Bull, among the farmers a, either Cow or Bull iV has 1^1 L^ commonly as well known namely, the teats, and the external fen e mrts ca Id hf/'"*' '"?'''« "^ * Cow-calf--- not show the east inclination for the BuH^ no does the Bnl^""""f l^' ^*""^- ^' ^««'' h.. "..'■'" u"^ "'"■y '""'^'^ resembles the 6x°,r smved H. T ''''^ ^^^ ^'"^^ "ot'^e of than either the Bull or the Cow havinV/LT ^^ ""^^'■' '''^'"g considerably larger that of the Cow than that of the Bull.-'-O.^r^J.lllZ^r.^'lLSZ^SS.''*"''^ *^ r> ■"I 16'i niisThrriui •.iL I'll ysiiium y. nitnmi spouioH. it Ims l),,,.i, usHortol that twirm an- Xmn prolifio than thoso horn HinKlo at ii hiith, uii.l thoir vitality is als,, (limiiiiHhod. Ih(> fact that twm (halves aro Homrtimcs mifruitfiil in well known in i.iany countnc'H, whoio th.- f,-nial.! ( 'alf ivc-ivcis a paiti(!ular (loHi.'i.ation • /Witt..,-.; or 'ZwilhM«"; n. Swahia. •' Zwiokor ": in I'imln.ont ftluKrm ; n, iM-ancc, " Lourcs," " TaincH," .-tc. Tlx, „1,1 Ito.nan fiKncni tunsts know thcao animals as " Ta.nji'." it is -.•M,.rally holiovod that tiio (l(-f,.(:t iH only [nvscnt wlu-n l.oth Calvc^w an, f..ina!eH and ccrtanily it is vi-iy laro indeed that tho male is inf..eiiiid. Hauineistcr however j,MveK an instanee in which a Hull a twin was nut to a hundred Cows, none of whieh produeed a Calf. In Switxerland it is tliehehef that when the (^ow-ealf is horn liist, it will not he sterilo • and that when, on the eontrary. tho nialo is horn heforc! tin, female it %vill he unprodue.tiv... Tlu- f.Mnal., twin is generally a hermaphrodlto and in form more of a male than a female; tin, vulva is execissivelv contracted, and tho vagina a cnl-dc-sar. The mammio aro a..,o feebly rtoveloped, sometimes app.-arin^' as a mere triHinj,' fol.l of skin, at others as a yoliimmoiis sack. The animal is usually lon--leL'-ed with nuisc.ilar hind .piarters. Jnternally. in some instances, the uterus ■, undovelop(«d ; m others the ovaries an- ahseiit. and instead of them there are testkles. With others, a-ain, there is no tnieo of a uterus the ya^nia endmj,' 111 an mluiidil.uhim~a condition which is readily ascer- tained ill the living' animal hy inrn)diiein^' the lin^'cM-. Tlu, clitoris is sometimes enormously developed, and not unusually the urine is ex- polled poweriully backwards. Ordinarily, the "free-martin- evinces sexual desire very rarely, if at all.' Uerln its stea.l was fibrous and a.iip..s.. ti,s.,e. In tine, h „ tw, waH destitute ,.f u erus and ovuluct.. and the vagina was slu.rt an.l constricted In the 0,stfrrnrh,srh,-. lMH,hrhthsvliaftlklu Worhchlall for 1.S78, the ..bservati..n« t vii cltr Th f'r '"'" '";""';"'•■ "'''''"-• "■" ^"''^"' "" *''" -amimui..n . t le he fo „ul t IM ■ ^ "'"'"' " ^•'"'"'" \" "" ^■'*''>' ^*'*t"' "^ "*'••'•""'' J'^veh.pn.ent, and in it f 1 r i : '"V" '='"V""^'""" "■'"' '■•^''■'■""> f'"'i"""' <"Kans. Thi other two were full.g own, sterile Cow-calyes : ..ne was aged three y..ar» and tw.. months, the other be inL' !,X InH ^''VT\ ^"^\"' "T' *'•'' ^'"'^■'"'^l '"'^''-d* were n.,rnm , he lal ia fi m puffy, and weU c ..sed. and the clitoris n..t unduly pr..mi„ent. The udder and he f^^ teats were small in deveh.pu.ent. ]?oth animals had in 8.,me degree a nmrat.i earance g.^eral y, and ne.tlu.r ..f them ha.l ever been observe.l t.. be in " rut •• KxnminZ™he mternal gen.tal apparatus reveale.l almost exactly the same state of affair „ eh case The eniale generative organs were not fully developed in either. In b,.th . t lem two ' g an.M ke b..dies c.nnected with the sexual aj.par.atus wer,. present, vi.., sn.all 1 . es i \ ,' inf Wl "o"' °;,'"'''; ''"^^ H" »^:'' ^""^'''•'' '"'""■^ ^''^^ i" the neighb..u. 1 .,... ( .r ner's ' duct, \\hether these latter bodies, which MuUer is inclined to consider ren> a is of ■■vt I lens prolific than tliiniiiiHluuI. I iit woll known in Duliir Mj,'-l(.f,'H.(.d, ^vith t3H, tiu) utcruH ..■; 'lid of thcMi tiicrc! of a iitonis, tho i« readily asccsr- TIh) clitoris is thu iiriiKi is ox- iiartin " ovincos till' «taiice wiiH found ine, thiH twin was cted. ^ the nliwervations niination of thrt-e li>liiiient, and in it he other two were hH, the other heinjj iial, the labia firm, Jtler and tlie four 1 male appearance Ixniniiiatioii of the IfuirH in eiirh case, both of them two ., Kliiall bodies in hood of (Jjirtiier's ider reninants of ^Hdevi ^■uitl r betw.cn ,; """ ."'^'-■'•"''1 fe't-nital orJans "J":" ,.^ "'"•'"•'n in co (•') Th ; •'.'"■■'' "^ reconleTl in Knurr r '^"^«j'^'""^ t'> this ni y in indifj J*- Th! r'''":r''''''''''''*f'-"'nth VV. LtTT'"^ '»'« genital «and« luithpHPtxi.iK'l ,..'r"^'^" "y the two f(v— ,.•) 1 .. ■• •^•'illy a iii.iIh n(.f f,,!!., 184 UliHTETRl'JAL I'llYHlOUni Y. Uiiil Jl Position of the Foetuses in Multiple Preijnancy. The relative position of the young in the utjrus in the cases already briefly alluded to, is important to remember. With regard to each other, it may be said that +hey usually occupy four different positions : 1. Each foetus may be isolated and enveloped in its own proper mem- branes ; 2. If there are two foetuses they may have a common envelope in the chorion, and otherwise have a second separate sac ; 3. Both may be developed in the same cavity and the same amniotic fluid, their membranes being common, and no partition existing between them ; 4. One foetus may be contained within tie other by " inclusion," as in some of the monstrosities of which we will speak hereafter. It may be necessary, however, to state that the included fa^tus may be contained in the abdominal cavity of the other individual, constituting deep and abdominal inclusion; or it may be enveloped in a subcutaneous tumour — when it is superficial and cutaneous. In the first variety of gestation, the envelopes, where they are in contact, adhere together by means of fine connective tissue; the placentte are often corfounded (in Euminants), or united by a kind of membran- ous conneeiion, though their circulation remains distinct. In such a case the young may be expelled from the uterus together—a frequent occurrence in the Goat, according to Kainard ; but more commonly, after the birth of the first foetus, the uterus contracts on itself, enclosinc^ the remaining progeny, which may not be born until some days after - long enough sometimes to give rise to the belief that it is a case of superfoetation. This apparently prolonged retention of the second foetus is generally due to the fact that the first is expelled prematurely, because of the excessive distention experienced by the uterus; this organ, having thus got rid of its embarrassment and become relieved, can then maintain the second fttitus until the usual time expires. An illustrative case is given in the Mcmoircs de la Societr du Calvados for 1831-32. A Mare gave birth to a dead Foal after four months' gesta- tion, and at the ordinary time a living Foal. If one of the Foals dies in the uterus, the other, being contained in a separate envelope, may continue to live and grow. In somewhat rare cases, the dead foetus remains in the uterus, becomes desiccated, and is not expelled until the birth of its companion at the usual period'; or, which is more common, it acts in the uterus as a foreign substance', the presence of which is irritating, and by inducing contractions of 'that organ it is extruded, while the living fu'tus is retained and grows until the normal time for deliver. The foetus that has died during pregnancy may be kept in the uterus for a long time, through close adhesions existing between that or^an and the placenta. A case is on record in which a foetus was retained in this manner for two years. Eainard gives an instance of a Mare which retamed a dead foetus for a year ; the animal was then fecundated again, but having died while pregnant with the second Foal, an exami- nation of the uterus was made, and the two foetuses were found— the first being mummified. Death of the foetus in these multiple cases appears to be due, either (1) to the Htrongcr vitality of the one which liv •s, and which, by alt -act- ing to itself a larger share of nutriment, starves the other ; (2) to the too considerable increase in volume of one foetus, which compresses and atrophies the other ; (3) or to the separation of the foital from the incy, he cases already regard to each ffereiit positions : wn proper mem- loinuion envelope ac ; 3. Both may iotic fluid, their between them ; nclusion," as in ifter. It may be my be contained ituting deep and Litaneous tumour lere they are in lue; the placentae nd of membran- nct. In such a ;her — a frequent iiore commonly, 11 itself, enclosing some days after ; it is a case of the second foetus ed prematurely, :he uterus; this aecome relieved, ne expires. An da Calvados for .' months' gesta- g contained in a somewhat rare desiccated, and sual period ; or, n substance, the I'actions of that uid grows until pt in the uterus ween that organ us was retained ;ance of a Mare ;hen fecundated Foal, an exami- vere found — the be due, either lich, by att'-act- ;her ; (2) to the compresses and foetal from the '-liMELUPAROUH AND MULTIPAROUfi PREifNANVY. 165 maternal placenta, which, of course, causes an interruption to the cir- t^Z^^^r^^' -^ ^ -P-^^on of n?urishment%Td in the second variety of gestation, in which the chorion is common soiTvoTelSk "tlw"'r-^^* ^^-P^^^*^^ ^y^b^ amnion there s only one placenta the two ha^mg a circulation in common throurfi hen- placenta, and the umbilicul vessels communicating bXirva^^^^^^^^ b'Lr aSTb;t i? T ?." *^-^-P"l-- of one f^a^tuVn^cessari^y I believe only t^yo instances are on record ut inclusion : that of the first mentioned vanety, in which one foetus was found in the abdominal Fig. ' ^'^^' ^■"'^ 't ^■'^^ ^"othe^- inside of tK,k . '^"^'^'•^' a.mens.ons; each had a perfectly formed shell"-' S^tu o^'llnHr"' i"'"""'' "-^ ^'''' - """^'^^^' ^Lt^iJg either a whot latus 01 portions of a pre-existing one, are common. [ ^^lanaziafih- Thierhiilkunde, 1860, p. 3; 7. In the Vetn-inary Journal for \m\ (d 88) n mala ITn... W ' /» ill a male Hare. Mahoti (leecribeN an instance of incluBion Ititi OnSTETIiWA L VHYm>LOQ Y. 'Ij CHAPTEE VI. Hygiene of Pregnant Animals. ■J HE hygienic measures to be observprl in fh. during gestation are, in general Thnl i^l™u°^«'''^^'^*^ ""^ animals irrespective of this condiS JBut hl?'?u '^""J'^ Trevail always, t.cular precautions to be a endPrlM ■ ^% ^^T *^^^^ ^^^^ ^ f^w p^r- safely and successfullyVaS^^^^ this period ma? be the more necessary a^ the period of k'^^^ precautions are all human female, pregnant animrit in. / ^^ approaches. Unlike the and minute attentiCs so Ts ential to h ^^^^"yf, ^^ose careful, numerous, otf?pring ; indeed, too Cchnt !.„'/''' ^"'^ ^^^ "^''^^^^'^ °f t^; animals further fmm theh natumi in^ ? Pampering, by removing hkely to do more harm thaL good '^''^°"' ""''' unnecessary, and be s.:i :erthe".!:^T4i^'ar 't ^^^"."^^*^^' ^* ^^-^^ -t domesticated creatures are usuallv Lnf ^'. ^''f '''"' ^*^*^ ^" ^^ich harm ; though it must be confessp^d f? f ^^t^^^Pts at coitus may do remains in the same pasture with thlf^*/r"^ ^^^^ ^^^ 1^"" often as safely as if they wL 1 1 s^o ex^' '' ''^'^ '^ "°""^^^'^^ ^^"^ soiS^°:^;S;:li;^t^-- empWed in labour-as the Mare, and them much, and particnlavlv la "^"'^ *^^"' severely nor fatlLme other hand.'absoluTe repose inerSf'"'^^ advanced /and. on Se and the most difficult caLs of pSriton'A ^''''''' '^ "'°^* "o^n^^^i^l, this IS denied. The prec^nant Mart " n °'''"'!^'r"° ^"^'"^'^ *« which tomed work, particukrlf ff t be Lw w1?hn7^^'^' ^^'^'""'^^ ^"'^ a««"«- benefit. until the seventh eighth T; .J"^' ^"y.^'^^'m. perhaps witu must be observed; but modS ?! '*t '"""'^h. when more care to the period of parturition Harness' i^.'^^^f^'^f^'^^^ ^« ^"^^^^^ "P pregnant Mares] and fast trot Hn? 11 P'^^^':able to saddle work for broken ground, ^r sevei? and sudd- ^P'".?' ^"^P'"^, travelling over any kind, are to be avoided -In ?tf ''r'°''' ^"^V^'^^^' "^ «bocks of against. ivomea— ni fact, extremes should be guarded be'LleSer^bSfse^rtt^^^^^^ ^^^'"^"' *»- "- of spurs should muscles which their application indn '''''^''^f^\ ^^ the abdominal abortion. application induces, and which may lead to to ?^£;r ^iS 'I s^^^r ^" ^^:^^^^' ^^- ^^ -^ht shelter from inclement weathe" ^"^ '" ''^ ^^^'^^'^'^ P^'^^'ided with sixth%?revlThto'l'" if kept";S' ''^^ r"'^^^, "-.derately until the should also cease about th ne iod f ' K^'^.l""*^""' *'^^ ""^^ing often prolonged until near nar?ur hI; v ^^ T/*^ '^'"'^^^ ^ows it is doubt that this practice L^nre I 1 /^^r'^^^^'^' *^«^e ^an be no retarding its development tluS dK \^ '^\ ^^t."^' ^^ ^^^^^^ting or the materials which should brSosdoJ"^' 'T '^" "^^"'"'ary glands Exercise at nasturp ; « k '"sposed of in the uterus. Bitch are greatirSeS/bX^Um'''' '"''""'^ ^ '"'^ "^ '''S "'' Creatm-eTh, "L'Stttn "Z'ut h" T, ,'?P°'f "' -"-'''"■"'ion. onsidcration. HYniKNE OF PREGNANT ANIMALS. ^j; appetite is genemlly increased, and there is, as has been already observed a tendency to fatten. This tendency should be someXrerarded against, as it may prove troublesome, particularly if it kaWd^rDro ceed to an extreme degree ; when it may retard the devebpment of E foetus, mduce abortion cause difficult parturition, or giveSS serious ^fter-consequences. This precaution is more to be observed in fl^! second than the first half of pregnancy, when the food shoi?d be £f ft f TK'"" ?f 'r- r^ ^-^^^^ mori abundant in the anhnaUhan fat. The food should also be of good quahty, very nutritious easy of digestion, and not likely to induce constipation "-^^^i^o^s, easy of Indigestion should be carefully guarded against, and unaccustomed hard, damp bulky, fermentable, mouldy, or otherwise hSX pH^.A' food, should be avoided, as it is likel/io prove i^digestSfLcfs on tympanitis, and produce other injurious results ^''^"o^e, occasion Grazing on pastures is favourable to the pregnant condition of her bivorous animals, and especially if the land is not too bSen or s^oDinT and the herbage is good ; as they take their own exercise and bvffi a purer atmosphere than that of stables or sheds St mL be re membered hat they should, if possible, be protected from Znp foS cold rain, stormy weather, etc. If the herbage is not surcienMy abmi ant oTfood "'"'' '' ''°"^^' '^ suppleinente'd by an adSaf atw-' ;];(.,•«„„ J i. ii T ,. . j'""'Jo Lieatuies, and other morbid r>nn. fJ,5l!'/^fP^''*f "'' necessary for the formation of certain tissues of the body, for instance, may be deficient in the herbal and th?s mav be compensated for by giving, in addition to bran, meal oH cake T^ and even properly-prepared bone-dust ' ' ®*^-' The water should be pure, and plentiful at all times • ac; then fb^ n inT to'he ' "k^' T'?""*^ ^"^"^'^'««' -^1 when ne'ces a y " anfma^Jtlnl^^rrcodte^nt^^t'f "d"°^ 't^^^'^"^' ^^^^ We have spph ILVlLf, ^^^^e*- "or eat food at a low temperature. obSTb;fiidi„''ri"'';^i,^^ '^'^f" '"i"' "'"«" ^^°'''^ "'-y^ ^e enforced tl, -eSTo t',„t "l l "'^ '"='"■ ""«'" '" >"= "go'-oudy 168 OBSTETltlCAL PHVSIOLOaV. h! tn^ T °! T'''' '^°,"'^ "°* ^^ ^"°^«^' ^'^^ every Cow, towards the end of gestation, ought to have plenty of room in its stall if a separate box cannot bo allotted. Stables, sheds, and loose-boxes should TZl 11/°?''' *° P'?^^P* "'J'"'^ *° ^^^'^ iexnsXes. With stalls, the floor should slope very little indeed, from before to behind ; as if the inclmation is at all marked, the weight of the gravid uterus is thrown backwards, and this may lead to abortion, prolapsus of the vagina, and even aversion of the uterus. The cow-shed ought to be kept very dean lut In "\ ^""^ '!.''f"'' ''"'^ ^'^^'^ Pl«»*y of fresh air The stalls Should have plenty of litter, so as to prevent the Cows soiling them- selves, bhould a case of abortion occur in a stable or shed, ainonir pregnant Cows, the one which has aborted ought to be removed at once and the place it occupied thoroughly cleansed and disinfected, every trace of the accident being most scrupulously obliterated. Cows which afford indications of approaching abortion, ought also to f.n.!f'. ']'''' '?™ ^^''^ vicinity of other pregnant animals, and kept apart trom them so long as there is any vaginal discharge ; the same precau- t ons which must be adopted with regard to thorough disinfection and Cleansing, are likewise necessary here. It is not advisable to have airiled '"° '^"'""^ ''^^''''^ '^^°''^ ^""'"^"'^ °*' gestation has not The cleanliness of the animals then.selves is not to be overlooked • as neglect of grooming and freeing the skin from dirt must operate per- niciously not only on the mother, but also on the fcetus. Mental and physical tranquilUtu are essential conditions of successful gestation. Harsh or cruel treatment on the part of grooms, cow-keepers, shepherds, and others, should be sternly suppressed ; and fear, gener' ally produced by young dogs hunting the animals, and particularly pregnant Sheep, is especially to be averted, if possible. It is advisable not to have animals of other species in the same field or pasture with those that are pregnant, more especially towards the period of parturi- With an irritable or timid primipara of the larger animals, it is well to De gentle, and to accustom it to manipulation, particularly about the udder, in order that it may the more readily allow its progeny to approa it without danger. F o^ y 10 Surgical operations, and medication in general, should be proscribed Z.f7^'''% ^'"^ bnrtful during this state, unless they ai^ urgentl^ needed for the cure of disease. Above all, it is necessary to guard against the use of drastic purgatives, or even laxatives, for the relief of constipation whicli may not exist ; as with some animals these agents by increasing the peristaltic action of the bowels, indirectly excite con- traction of the uterus. If there is constipation, suitable diet is a safer reniedy than purgatives. Powerful narcotic, sedative, and other life of The fSs ^' '^ '^'''•^ '^"^ "°^ '"^'"''' ^^"^ '"°''^^'' '"'''' ""P^"^ ^^"^ We have no sufliciently trustworthy facts to prove that female animals are amenable to those mental influences which, in the human species and known as "maternal impressions," have such a marked effect on the development or characteristics of the fa'tus. sri'Ei;y(ETATr()X. ]t)9 BOOK III. PATHOLOGY OP PREGNANCY. lln^imtholoop oi pregnancy may be said to include those diseases and ^cedents which constitute deviations from the regular rnormalLrres of physiological phenomena characteristic of this condlt'on These -"« ""^4 po'le\ha"3','°f'Hr°"^"? by con>pcte„t authorities would go to crilfevfa;.: in:":^c:r.^,r™cL7f:!^';;:\?Sh 't' "^ ""= "'"^•'^ 170 PATHOLOUV Oh' I'UKaXANCY. o'JcSlX^r^elL'Lr^^^^^^^^ •^-"der of horse., who had ^rell.formecn though weL;MurfoairnA;.fnn ', '"."'''u' ^'J'""' '" eleven months a same journal for 1836, there is LSerot/n.t-'l''^'!,^' ^"' '^^'*^> Horse-foal. In the put to an Ass Stallion a St Ma"xent andw^ l'\ """^ '■''°"'"'^- ^ ^are had been however, a Horse Stallion two vlar^nwf t ^^^'1 "P '" ''" *^"<=^"«ed space ; into this the cour.se of the «an^ K. ThHlLe obS T^ T'''.'^ l*^'"^ *"''"^' ^-^^^^ «">««" put to the Horse, accordin^g to a.^tor "^^J'"^*''-'^ re used to be covered when afterwards twoFoala nno„ 'm.,-.,- , ? "^"custom. At the usual period of narknrif;„„ ;► — a. j put to the H«rse,;cc;rdrng to aisTom' ""^''"^^''-'y refused to be covered when aft'eTward: ■■ ■ videntlybeWinftoThP VnSl "■' ^""'"'A "^ P*rt""tion it produced two V 1 "v->-"iuiiig CO cua Muir'^TC S'^S^SK 't^S t^ «p--^n^^e;tK;;ii:;h:r^ctS Vaublanc ; they were the", beit^rjk^^d'b AtfAT"""*'''."''^' ^""'^ P^"^^"'^'^ *" M. de fact was verified by the Mavoi of th^ r ^ ^l''^' ''"'^ ^'^'■''' '" Perfect health. The of the Stallion depi of St Ma.xent ^"'"'"""^' '^"'^ communicated to the administration Franct!°r£e'tL"*;:;t?a"rtS'A^^ Commune ^^J^IH;^. I^SZ^mI^^IIZ^S' ^I ^"^''^^'^ ''^^'^*- '''^^ ^ ^''^ tmued, ,t was put to a Stallion fi teen WsX.^^^^^^^^ a Stallion Ass. As oestrum con- gestation, and when parturition trn'^phL a fiIhu?''v'T """?"^ '^°°""'^^ '^"""g minutes' straining, to the astonishment of fh. ^ ^ ^'f "^'^^ ^°"'' '^"'> ^^'er ten Mare suckled the two, and they didwell ""' ^ ^""'^ well-formed Mule. The m twelve months had two Foa^ ptrfec Tn' th «"'"« "'""t'^^ afterwards by an Ass, and after birth, and the other, a Horse^f.S did well '=°"^'^^'°''^*-"-°ne. a Mule, died 'soon EngSaiSrd"o;.rVMTto:f£.'r ^-'fT ^""'^^ ''• ''''' -- P"* to an each resembling ,ne of he Stall ot Tp« ' "" ^ «'?'-"*F ^''' ^^^'^' '* P'-oduced twoFoaU •n 1852 and sixteen da s afte ward^ t^ a PersiTn t:,;" ' ''?" ".'"^^ ""^^ P"* "^ ^ Horse dropped a Horse-foal. a^.d in two htn:;Ve Tm^^^^^^^^ ''* "*-''* '"""*''«' P-gnancyit in the Vetermariau (vol xxx n 7S1 at. ^ i three times to the Horse about si^ weeks interflTnt i^ *" ^ u^*'"'^ ^'^'^'^ ^^^'^ P"t pnor to the ordinary p;riod of pa turUiO?? 1 ?)? ^'^'r'"■^'-■^ *™''- '^'^^ ™o»th« dnced, one alive and full grown e,X,T • '* '"^*"'' *^" *^"*1« ^^^''^ P^o- The same journal (vol. xxxk p "'u) confj^^^^^^ nrmiaiure that it died immediately, put to .. Cart-Horse on Alay' i?0 bu show "f/""" ^ '"«tf"'='^' '" which a Mare wL again put to him on June 19 Ktfhl ^ «>mptoms of csstrum subsequently, was fcBtuses were born, each being in a different'T"''"ri °', '^' '"""^'"^ ^^^^ '^- apparently a month older than the other Th.^ of development, and one of them year. "*" ^'^e other. The same Mare had aborted the previous des^ribt^h'^tl'^a'Mar^^ "^ Calvados, vol. ii.. M. Lemaitre . brought fon„ a Foal which cont^nnpH f r li'^Cfniber 2, and in the following June '«. v.;/ for 1844, mentions a AW eWe'vear^l^^ 'l^t '""""^ '^'^ ^^^-^^JZ H^ Health. On March 1 ^^^^^L^V^^l:^^^^^ Bu'fr^.\?oTed bTrd:r.-.^arid'cSm'm '^"-" ^--'e^by' -rious authorities lina, who, in irii, was deliv red of ^ ^^t'htT' ' ""T'l *■* ^^''-^1-*"", South Saro being blaok, the other white. On examinTt Sn th ^'^ "^"'^ "T "^ ''^'^ °"'er, the one day, immedately after her husband had tft h,/^"""''" '""^ '^'' '^^' on k certain threatening to murder her in case of refusal obtain H ^^'"^ ■^''^^'''^ ^""^ 'oom. and, by alludes to the case of a negro wom«n wl k "^1*"^*"^ connection with her. Dr Moselev size, one of which was a negro Tnd The l7^^' ^"1^ *^" ''''"'^^«" »** * birth' b7th of ^ the cause of their dissimilitude she safd ho"" %™"^"o. On being interrogated upon was that a whitp m»n b -) .^ ;!' ""r ^f"^ s^c perfectly well knew th« ^™u=.. „f it^^'^ ' was up. and she suffer di^ifSract'^'^''''^ T-*"' *" ''^' ''"* "»e mo"rn n/blrt she quitted her. Similar ill." tf^tiolte 1 teTbv TT'V'Z ""'' "^^^ hUand had Dunghson, and others. '"°*^'^ ''> ^^ Bouillon, Trotti, Guerarde. Helmas, ler of horses, who had liUPERFCETATKiy. Huffering any ill effects. The first Fon.1 h a ^\. mucous membranes were very pale th7. h^;, ^l *^"^"'' Protruding from the month m eyes were closed, the skin wa^s co ourfe « and°2?^ ""''•f *"^ '^"d tail were p«' uZ ea.s.Iy removed; the bloodvessels on ly con a neS /^ '^-. "'''="^**''''' "^"d the h2 w ^ Cauzit, in the yomta/ ,le MM Vf ■ ■ '« njiea with dean Colt, fully develoneH anH «»i, • *^""*™ ^'"'^■'tbach, of Snarta Mv f ,JJ'' a good Horse. ^The Ea^^tSjrb: ^'eT''^':? /" ^^^ pointTwlth g.'.To Se^Z 2nd of April following, six weeks after the btih of h" * v T^'''' °^ ^'^ owner^.S the which was sound, healthy, well develon! }■ ,^'"' *°^'' S^"^ birth to another rnlf be found in the State. ^' '^^^^°P^^' «"d m all respects as promising ToT.l ci Inthe/o«raa/r6Ym,m/re/W/«„eforl8-2S ft, • supposed to be superfcBtation. A fiL-woolLd Kw ' " *"' '"«**"''''^ «'^en "^ what was 1823, evinced in the following year at th. n ^''T'^' ™P''egnated at the usual season hi giving birth ; but these subsided wUhoutLrnl"*! "^ Parturition, the ordina y ^^ recovered. The footus was in the abdomen LT.'m k""^^ ''"'•"' '^"^ the anhnaf qui e was again impregnated • in th^ "uuomen, and could be easily felt T.. isoi It- ," and so^,n aftej Z'i'^^tZZ palSn°L''^"''' '''^' *h-"amini"c „' aVed m'^r appeared without any result. The animrthpn rf "^"'^''* ' ^»'^' "^^ before, they dii' and was not long in succumbing. On „r,.nS-i°'* conclition, became gradual y weaker in the right horn of the uteri,s,^;„d in the leffln ^.P""^'"!,'^, developed Lamb was found was discovered. The latter wiVC u , " another wel -formed ftEtus of thlr^ i except that a portion ofth 'f^^ShaVrcSd"' 'h ^f^ ^'^^ »*-'•- -vt? w'^^^e^^^^^^^^^^^ however, was constricted by the prelnce ol," V'"/"'*"" ^^*« ^^^^ ; the cervix tt"r' »«k.d „ii (or' .bo,/„ ",„,r.„;i 7h.n ;;s^'■' 1'"" """ ' ™ '-"'"B t. Th. c»: c™.d l„e,ve .,,j, o„ September 26 h. t,,„k thXlr"'? ,"" '"""■«'?. ."d .ho,% niilh.ne "numal with her, ihoMsh oon.lmil.' . ■ ^ ' ""'' '""" •!«" ''■»» I nolioed I S-- -• -- - - «^en to i: rtr ^^d^St— &£?£d times. It has been arJxeTL^tZ'it'fl''^ has occurred, several impossible, because a Ma e that ?. n ^^'*' ^^'^^ ^"Perfc^tation is jngly liable to abortion fsubmtttd to r«'""'f"'^-^^'°"^^ ^' ^^««ecl! than doubtful that abortion sTo id be tbo?n°"- f/'"'"' ' ^'''' '^ '« ^""^"^ peated copulation ; and we W ho h, "'^^"'^^'.'^Je consequence of re- ef the con.parativ.innocuoLtss of exSntr"" ^r^-'"^^ ^" P^'-f So far as researches have gone howevpv "f ^i"'"' ^\unns pregnancy. double conceptions have or^^x occTirred In ""'* ^^'^ ^°"^^«««^ that these cessive copulations on the samp .„ "°'Parous animals by suc- hire therf>fo"P ,v;ti ^^^ "^y, or with n a fpv dnvQ . ,i I -, meHio.e ^vlthou^; any ndication thof +k- «- /^w aa}S; and we 172 PATHtiLoay OF I'liKh'KA.ycV, ilii - Hi:' ^'1 ■ ;i intercourse vyith two dififerent animals within a very short period If a longer period -say three or four nionths-interVened, then super- ^ITlZT^^ ^' admissible, and would perhaps be undeniabloTo- vided there was nothing abnormal in the uterus-such as a double liainard remarks that torsion of the neck of the uterus in the Cow though provent.ng the birth of the fci,tus. may nevertheless permit new conceptions. With inversion of the uterus and torsion of the cervix parturition is impossible ; so that instead of attempting to deliver by a sanguinary and dangerous operation, the success of which is verv Sr fl /l ^^^^^'"'"^1'/ °°t killed for consumption .s food, is generally let to the efforts of nature; should the season be favourable it is allowed to remain at pasture, and frequently after some suffering the creature regains its condition, even becomes fat, and may then be adyan ageously sold to the butcher. Towards the spring-time, such an fu'tus ^^ <=o"«ei^'^' again without having been delivered of the first In multiparons animals there can scarcely be a doubt that superfceta- cTpd"S?p'»K-r/ ^"^^ P^^-i^r °^^" *'^"^« ^^^^«h have been doinesti- cated the Rabbit furnishes the most striking example. With this creature a new fecundation may occur in the middle of pregnancy This of course, can be accounted for by the anatomical disposition of the generative organs, the two cornua of the uterus opening into the vagina independently ; so that a primary fecundation may occur only froni^one occTied «o^"^'««PO'>^'"« l^o'n. the other remaining open and un- In the Sow, many instances are published in favour of superfcetation One of these is given by Miiller, of Hildesheim, in 18H7. Twenty-one oays after the birth of a litter of six Piglings, the mother Sow became restless and initable and refused to suckle them. Two days later that and healthy, appeared upon the scene. Five of the first and nine of the access tn'%r T ^°'"^' ^^'f " ^* ^^ ^'^'"^^'k^'^ ^^at the mother had Sh.n ° > ^Tu ^°' '"'""^ ■'"''''' ^""^' *^^« ^'^^ impregnation, and the authenticity of the account is stated to be beyond dispute In the Bitch, many observers have assured themselves that super- tcetation is by no means unfrequent. Rainard, Blaine, and others o1*nfhl ° /'• ^^rf ..^'^y«' r r a.n disposed to think that Bitche a capable of superfa" ation ; that is, they conceive more than once If this IS tlie case, a Bitch may copulate to-day, and become impregnated, nated. Ihis is not frequent, I believe ; but it certainly does happen or we could not account for the different periods at which the prog;ny sometunes appear I have known a week, and in one case even ten days, intervene between the puppings ; but ono or two days is not at all oTdiS'kind?"' ™°'' ^'""^''"'^"^" P''««f' '^'^ ^'^«ll'« often appear It must be reinembered tliat the bitch remains in " heat " for three d!i,w'fW^''' ^"^ ''t! '""'' ^'^l" ^'"P"'^^^*^ intercourse with the male duung tliat period. It must, therefore, either be concluded that the last intercourse was the successful one, nr that one or more ova were impregnated at each copulation. So far as our knowledge at present extends, we can neither positively negative nor absolutely admit the possibility of superfa'tation in the HUPEUFCETAriOX. jyj larger domesticated animals. The cases recorded have not been sulliciently investigated to convince those who deny the Ifkehhood of two conceptions taking place after a certain interval; andit must be : t'be:,! ofe ed ''7 lai; n'r ^^ ^"^' ^ ^•1^"''^^' occurrenceTaf n't jec Deen oneiecl. A lapse of time occurring between the birth of two aninmls is no strong proo of a second impregnation durim^ conception for. as we shall see herea ter. when twin/are conceived fr^in the same' intercourse, it may and does happen that one ovum does not attain maturity so soon as the other, and is either rejected or etained af er a inore or less lengthened interval-a circumstance which mS mislead And again, with regard to the size of twins, it is not at a U^unu ual to find one largex and more developed than the other, thouah bo"h were produced at the same period. Putting aside the question of super f^ta! t.on m animals the anatomical disposition of whose generatZ or^an: evidently permits such an occurrence, a little consideratbn will show that usually there are physical obstacles which would appear to offbr an insunnountable barrier to a second impregnation, after conception has been achieved for a short time. Soon after that ^vent has taken place the entrance to the uterus is closed by the shut sac enveS/ the embryo, and which adheres closely to the inner surface of th«™ t roughout its entire extent-coveLg the Sees S ^03 ut ri fnd Jallopian tubes. In addition to this, the canal of the cervS is durln^ gestation rendered still more iu.pervious by the thick vscid mucuf secreted by its glands. Such being the case, it will be obvious Zt a econd impregnation cannot occur, if it be necessary for this purpose that the spermatozoa pass into the uterus, or even to the ovaries for the whole IS hermetically sealed after a certain time Fol a second n pregnation to occur during conception, fecundation must take place before this closing-up of the uterus and Fallopian ^ubL-an interval too brief after the primary impregnation to make much chtterence in the respective developments of the youn° anhnals In cases in which there is a double uterus, or in which concep"r occurs SECTION II.-EXTKA-UTERINE PRECiXANCY. In studying the development and progress of the ovum after \i^ n:w "haf : Sr' -^P-^--^r ^y^*^^ spermatorof Uie ma IL A ^7 peculiar arrangement existed in the presence of tho ringed border at the extremity of the Fallopian tube! which gi^sped E uterus "tf""".'^^ '' '" ^' ^'^"^^'>-^^^ •"*« the canal on L'way to Jlo? T ""^'^T ''^"'^^ ^hi«h ^^^-e not yet clearly understood t sometimes chances that the ovum, instead of takincr this Us normal com. e either remains in the ovary, is arrested in its pro. e throTh the tube or, escaping the fimbriated extremity of the la'tei falls irfto the peritoneal cavity, or glides between the folds of per oneum o^" -'n "oftK-Tu" '-'^"T"/' T ^'''^'^'^ *^^ serous'LTmur^nZ: ment, the Iwtm perishes from lack of nourislimont. ' I 174 I'ATIliiljHiY UF ntKuXASi'Y^ i J lis 1| -'J i f^ th^;:^^:::; t;;S'\!r ^Ir^ «'^^^'^^'""' '-^^P'^y ve.y rare in from the situitio,, the ovu roccunLs '^ /a'/«« ^ubj the peritoneum, the un^i ical co -d tl f 'T^^ the fmtus is in uterus; (7) r«Ao-«6Jo;./. ^l^ hel «T ^''^""'^ **'^ '"*^« *° ^^e tube, but the fa.tus is de^ek^^d i / '^"^'^'^Pf^ are fixed in the ^''>^irnlova/,/nnunal.fnZ)onxvU^^^^^^ the peritoneal cavity; and (8) in the abdomen ; (9 (v,S ;;lr .""^'T ^' ^"''•"'^'l ^nd develops becomes developed iVthevaii'na'"'' ''^'''' '^'^ °^"°^ '« "-Planted am? •several of the Varieties jurt e u. e tc d h? '" ^'"' '^'^^ '" ^^^'^a" ^ been observed in then, Tl is "^ t^'i*'^^ •litferent arrangcn.ent of thei V^^^ative '1^.^?°""^^.:? '''' ^^ *'^^ tendency of these to disease. funcCnil r Lo..T^ ''*f ; '^'^ ^""«'^ Jess aoubtless, to their function b i ^0^^?'^.^^^^^^ '^^^T"'^ ' ""^ ^'««' regard to anatomical arran-^ement^as^vp,. ^ f ^'^P^'o^^ction. With this misplaced gestation, wf m^^^o nt ou''Lf ofT' M *"^' ^' '^'^«*' -thougli the same indication isapnhcablol f *'^^^^,^^^' as typical anunals. In this creature the lc«n?nf fl "" ''^'•'^"^ ^*^^' "^''^^i' large oavitycan only occur th ougl^s , fe^^.^'ifj^^^^ conformation of the limbriat^ed ex u^///it T th^, ? ""T"!^ ^" '^« normal condition, is applied to the base of th.. '^'' '^'''"^^' ^" ^^e durmg the genital excitement. Ne ther s ^ Uu7' T\ '"^''^^^P^ ^' through the cavity of the tube c^n be nl.lt i '''^',*''^*^ "^' ^^^^^-se ,'t(it(>n li.,« v....,, o n """'"outsell in them. searches have led me U omh S" ^'"" °^^^^""«^' «° f^^" as my re- animals is far from being £sble"ir'r'^%'" ^''« '^omestiJated vesicle or interior of tl L ova , u^ ^ T '%^^^'^'".P«^1 i" *!>« Graafian J>as left the vesicle and grWh^^a h "h^^^^^^^^^ 7^'''' ^''^ °vum only mstances on record\rc g vcm 1 KobKvI ?' i^ the ovary. The first observed this rare formC^stat on i S?"'^' and Plot. The pregnant twenty-one davs Th l m "- ^^^'^'''^ '^'l^'^li ^'ad been tained a small embryo in a ^^"''id''''y'l^^^^^' --^ con also in three Sows "^ ^°* observed it in a Cow, and tu£: if £:'t::i^„;;;^'tf- ^ZJ^'r^'^' '" *'^^ ^^"°p-n criterion. Kohlwes mentimw 1, Pauc ty of cases reported is anv left Fallopian tu^:;'"^^' C^r r'sl^^s'^lt^o^^ 'rY' ^'"^"^ ^""- Babbit. Carsten JJarms swik^ n( \^ . ' '"'^ ^^'^" "ote^^ in tiie rhage, by rupture of the tu^f tlul . rH'"""^' ^^^^^^ ^^t^'-al luemoi! <3.stend sufficiently for the devdo^S oJ theSf "' '"' '^""- ^° between the n4n.hn ! e ^« 1« VwaHs elf h'''" f'"^'^" '« ^«^^'"P«'l tibr(.s. at the point whore 11.^00^ r^ i ^ho utorus ; the niuacular taining the c.Uryo i X 'd bX^rn'^'"'''*"^' ''"l' ^''^ «y«t con- brano. This variety l.as not been noTed in h' T''°"' ^"-^^ """='^"« '"«"^- neither have the romainin" forma ™1 »,'?'"' ^"/"'^'^' ^ ''"'i«ve; cases of which are on i^c^ml ' ^ **'^ "Wo;m/.o/, houio very rare n4';Sri:;vs:^2:S"rtr"^'" ^^-r^-- the ovu. th/abdon,en. and the."3e'vcWd ■ orirLv ITf ^ 'i '^''''''y «^ other point-tke ovary, l<\illoi,ia , h,hn Z "T I'^/^.^^^'lopod at Home after rupture of the v'nichllZT^^^^^^^^ ^|- -»'^^^ ^ foreign hvhole or by fra^nnentg tln^nr/h H fi '"' f^^ ^'^^"^ "^^^ ^'« Passed or the vagin^a-fn Xos eveA^c^^^^^^ ^'''''''''' '^'' '"^^^^in-^. Irodal position of the domes^^n«J.?n • , T''' ^'"''"•'^ ^^ ^'^^ quadru- 17H I'.lTtlnl.diiy I IF riiHUS.t.Sr Y. iii * lilll '\ i RlpnptoiHH, Course, and Tcrmhintions. The syiiiptoins are j,'enc'rally those of conception uiid gestation, Tho ovum grafts itself on some part with whicii it chanties to ho in contact; an enihryo resultd, the phicenta huiiig attached to the neighhouring tex- tures and developing with tlie increase of tlio young creature ; these changes heing accompanied hy the ordinary external signs of uterine pregnancy. In tiu; majority of cases, when parturition should occur in the usual course, the premonitory indications of tliat phenomimon aro very slight or altog(!ther ahsent ; though tiie animal may now and then make expulsive eit'orts, which continue perhaps for a few days, and then suhsido gradually, or recur at intervals. In the most favourable cases, when the fcetus perishes, it hecoines encysted and muinmilied . the fluids and soft parts are absorbed, and the renuiining portions become dry and parchment-like ; or the creature may undergo a proce ;s of calcification by the deposition of carbonate and phosphate of lime !;' its tissues, which preserve its shai)e, and convert it into a " lithoptedion " or " osteopucdion." In this condition the foetus may remain for an indefinite period in the abdomen of the mother, without causing much, if any, inconvenience ; indeed, a most perfect state of health may exist, and the animal may become remarkably fat, or it may again conceive and bring forth as favourably as if nothing abnormal existed ; the indications of anomalous gestatioi: being ordy discovered by chance when the animal dies from some disease whicli has no relation to this accident, or is killed for food. Such a happy result of the accident is, however, very far from being the rule, and the chances aro many that a fatal termination will be the consequence of extra-uterine gestation, l^xpulsive efforts or other causes, may lead to rupture of the cyst in which the fuitus is contained; and this, with the fluids and ddbria of membranes, falling into the abdominal cavity, may give rise to such a severe form of peritonitis that death will ensue in one or two days. In other instances the kyst inflames, and suppuration is established, with putrefaction and partial solution of the fastus ; and if the mother does not at once succumb to pyuemia or septikuemia, adhesions and communications aro formed between the kyst and neighbouring organs, and the remains of v.he young animal, chiefly the bones, are expelled either directly, as by ulceration of the abdominal walls after the development of an abscess, or indirectly, as through the intestine, etc. Aftci- the foreign matters have been completely, or even only partially, ehmicated m this wn^-, the fistulous openings by which they escaped ciua^iisu aflci* a variaulu period of suppuration, and the female recovers — as has been observed in Sheep and Goats. More frequently, however, it loses condition, becomes emaciated and feeble, and perishes in a state of marasmus ; or it succumbs to hectic fever, septikuemia, or one of the many accidents which the presence of such e i idy may produce. The course of external ovarian gestation, whi. ?. ras bee ' stated by Gurlt to occur in the domesticated animals, apueti-x o ':> , as follows : the envelopes of the ovary rupture towards the dojoai or third month of the embryo's development, when the latter falls nito the abdominal cavity, where it constitutes what we have termed '* abdominal " gestation, leaving only a cicatrix on the ovary. With regard to internal ovarian pregnancy, the ordinary termination is rupture of the organ, and fatal haamorrhage. Diagnosis ami Treatment, 177 mu • I , . '' ""^ ■L'vuimeni, ex.stonoe of any deviation frLi normlf Zf„fT *"^^^T-*° *"^'°^te ^he the animal exhibits indications o7ann.nf'°"" »"^^ ^hen at Wth ho grave doubts as to the ac3 staK aff^'"^' parturition, there nmy certain signs may give rise to susption ?he' '""'^ ' '''' ''^''^^^ °^ strains, yet the vulva is not enlarged and th« fl T' " ""^^^^ ^^^ m the preliminary stage of orlwr . ^ ""^ "^ '""°U8 observed ilxploration of the cervix' utei 1^ Z vin'na'"''-n°" '^ "°^ ^PP'^'-^n* .Mcinrat.on or morbid tumefactioVL 2 „: T \P?^" '*'« ^^^^e of of the OS, notwithstanding the length of -^ /;''f\''*'°"°' contraction expulsive efforts. Palpation and insp/ct oTn^^ /^^^ *he lurn.sh certain information with rSd to " h ^' '"^r^" '"^y ^l«o the enlargement. Careful exp lomtfon nf 'i^V ''"^ '^''^ ''*"^*'"» "^ rectum will be found advanta^sn cases o? ^hl"'" ""! ^"^^'^y ^y the complicated with uterine pre-nancv C^ abdominal gestation un- utcrus be satisfactorily determin d hnf^ ''"'y^an the condition of the of that organ maybe di coCed ^n^^E ^7/"'"°"' independent can be fe t. In such a case, etForts .",71 be nL I^^'u'''". P^^*« °^ °"e, at parturition, though it must be cSsLd £?'''' "^' "'*^'"P*^ be successful. Sedatives, lar.^e doses of . ^hey are not likely to applications to the abdonien an ofl P'"'"' ''''^°'^^' hot water indicated. If the diagnos s ^ we o^IyTT'^'I ^^ ^^^is kind, are utilized for food, it is\^eneri ly bLer to J^'^' T? '^' ^"'""^^l «an be condition. In cases in which tlVm- riod °f '''1 '*• ^^^^^-oyed if in fair when the animal has be^ unwell ov« P^^.'"'''''"" has passed, and appetite, with marked depres ion '"ckS nni:'' '"i'^'*'"^ ^«^« °' perature and nothing' else to account for th^ ^ "^ f"^ increased tem- suspect the existence of extra nforin! ^°^*hese symptoms, then we may fcKtus. ^^^'"^ "'^^"i« gestation and putrefaction of the In the smaller animals-such as tho cjk abdominal palpation can be readily resorted t^^ ?"f; ^'''^' '''■' satisfactory results. ^ lesorted to. and often with most When elimination of the fmfna i.„„ just described, active int Jl-Lrent Z oT m^ "of b " '"^ '' '^^ -°^«« ing to circumstances. The fistnlonTJ • ^ "P^ ^e necessary, accord- by the eliminative process muTh?TT '"H'°^ '"^^ ^e occasioned Should the fcntus chance t^ be al vi .>^^' ""''f ^^ "^'^^^^^T fi^tu^ be removed by operation withour^'r^Jn' '"'^'"^^ P°^^^hle that it can mother. If in"^ abdominal gestat on^ n f,^ endangering the life of the onus on any part of the aSu^ this "r^b'^'^^fl?" ^" ^b^«««« tbe foetus extracted with a success ul ZuU n.?'^"">^ ^P^"«<^' ^nd mejjt. such as careful nursing aT/tUl^^'mea^^rerS^^^^^^^^^^^ annual shows symptom wh ch slS ild LaTr'? °T «°««"rrently. f he J en the f«,al tumour will\e"lli;t;°/.^li«-^-n of the vagina. attached to the floor of the VEis^f,al flZ ' u- l^ •'''" probably be removed. "^ pasbage. from which it can easily be 12 (I 178 PATHOLOar OF PREOXANGY. SECTION III. -SPURIOUS OR PSEirUO-PREGNANCY. fn ^.'1'''°"" Pf^g^f ncy is a designation applied by veterinary obstetrists nat' 5««^««'^^ts. Characterised by the development of special patho irfd whKfh '''*'°"'' T^''^ ■'"^^ P'^^^^^^y ^^ ^^^« t° ^ P^^vious conception and which more or less simulate normal pregnancy Such caspa nrn arfrom common and the principal of the^mVe d'escribed aslf^? nterme cysts, and hydrovietra or hydrops utcrL^ These we will allude Moles. Jfolcs, or more correctly speaking perhaps, anidian vionsters.ave more or less volummous fleshy masses constituted by a blighted embryo, the Fife'. 67. A ^loi.K. membranes of which have continued to perform their function, and to nourish the abnormal growth. They are, as a rule, met with only in miminants, and especially the Bovine species, though Koell mentions their occurrence in the Mare; and in nearly every case they appear to er?o"d ''' '^^'^''^"P"''^"* °^ ^^'^''^i^ iias been arrested at a certain The viole (mala crnenta) is more particularly characterised by the persistence of an umbilical cord which, thougli degenerated, yet seems in the majority of cases to maintain relations between the tumour and ' I am not aware that the curious and obscnre form of pseudo-preL'nancv occurring? in rnTa";.' '^'^"K"''*^'^ V^cndo-rnc.;. by the late Dr. Simpion, hal evtr been Sv"d i„ JGNANCY, aterinary obstetrists !nt of special pafcho- jrevious conception, y. Such cases are described as moles, 'hese we will allude SPURIOUS on PSEuno.PUEG.xAmjv. the uterus. With rpcrayA + au ^^'* distinguish the distorted remain's TnT ^*f ^^' '' '' ^^^^^ally easy to musces, and even organs o? sense in TJ''^'-^'^^^^ ^« «kin, bones! monsters have not attracted much attenHon' T'\ ^^^«« ^"idian of then- occurrence are published^n tl, ^°" ' *.^°"gh several instances Barnard and others' itLVVav^ Snf fit"- , ^ving round fibrous moles -(wo^^ : monsters, are more ighted embryo, the ■ function, and to met with only in . Hoell mentions a they appear to isted at a certain icterised by the ;-atod, yet seems the tumour and gnancy occurring in 'er been observed in Fig. 68. Hvi.ATrn Cyst ok Molk : Humax The Cyst, which filled the Cti-n... t » i of Hydatid Vesicles The S^'l-^ ^'''" "1'*^"^'^. and gives exit to .. n. u ;S",f^.:j'„';?;;:f:Sil°':^;,^s j-^. and .o„o 0...^ ,™,. tion of onp, horn v...,,?,.'':, , fu ' '^"^^ '"^^t frequently in th(> Ip=,f -'• ^ ;je dilatation, whicYl^olS mT^llrser'^Tr^ ^^ '- "f tepi'^Lfe-a^iJ^L'^ti'^ ii-i 180 PATHOLOGY OF ntEGKAXCY. lilii V t Hit I Ui Rainard was of opinion that they were embryos whose development was checked by disease. Demoussy states that the presence of fojtal mole in the Mare gives rise to the same phenomena as real pregnancy — enlargement of the abdomen, sinking of the croup and flanks, sluggish gait, and altered respiration ; and that the diagnosis is the presence or absence of move- ment in the fa3tus. Uterine Cysts. Uterine cysts are pathological productions, somewhat analogous to the vesicular degeneratit«n of the human placenta, in which the placental villi are distended with fluid, enlarged, elliptical, transparent, and loosely connected, while their vessels become obliterated and disappear. This constitutes what has been designaiid a " vesicular mole," of which many cases are recorded in veterinary annals. Hydatid cysts have been mentioned as occurring in the domesticated animals, and simulating pregnancy ; but the authorities who allude to these instances have not offered any details. They appear to be related to conception and pregnancy, and in some instances they may be a deformed embryo. The Veterinarian (vol. xx., p. 187) gives an interesting account of an immense tumour in the uterus which, in the living animal, led to the belief that the Mare was in foal. Hydrops Uteri or Hydrometra. Hydrops uteri, as the designation implies, is a collection of fluid in the uterus ; though it may not be of a serous character in every case, but may sometimes be purulent. There are many instances of this condition recorded in British and foreign veterinary literature, as occur- ing in the Mare and Cow — the animals which most frequently receive attention, though the Sheep and Bitch sometimes suffer from the disease. This condition appears to be related to gestation ; it is allied to mole pregnancy, and sometimes closely simulates real pregnancy, though it may also be a symptom of metritis. It may also be due to injury to the uterus. Rainard says : " "When this collection is forming, the abdomen gradually enlarges as in ordinary gestation : the animal looks healthy, and there is scarcely any diiference between this state and that of pregnancy before the second-third, or even the second-half of gestation. It is rare that these collections persist more than five or six monUis without being evacuated at least once, and it is usual to see this evacua- tion take place every month, or at least every two months. The fluid is greyish coloured, and it is often as much as an ordinai-y bucketful." Saint-Cyr, in alluding to the cases recorded since Rainard wrote these lines, remarks that it is usually after a copulation which is supposed to be successful that these collections form. They are gradually developed, and are accompanied by all the signs of ordi- nary gestation, with the exception, of course, of the movements of the f(Etus. Then, at a certain time, there appear the precursory indi- cations of parturition or abortion : expulsive efforts — certainly less energetic, painful, or piuioiiged, ,',s a rule, than those of natural parturi- tion, and rather resembling rhose of micturition or defecation. Tiie cervix uteri slowly enlarges, though the hand introduced into tlie vagina discovers the os to be almost impervious, and neither foitus nor ;e development was IXFLUENOK OF PREGNANGY ON ORDINAMY DISEASES'. 181 membranes can be felt ; when it is dilated, there is at once a angh of fluid, the aspect and quality of which varies. It is often levish coloured, thick, and more or less fcetid • thnnaV, ,> J! i ^reyisli- and serous. Its evacuation ma^ocTur at verv^l^^^ '^'^^" one hundred and eighty days, fi/e andrhaSX.tir^Xl: weTs' ratly-in SSr ''' ''''' '''''''' ^^ ''' Mare,^tr2 ^^ Eecovery has often followed the evacuation of the fluid when it ha<. been in the uterine cavity; in some cases the condition £sbecom« rniS""*'' '^ '' ''^"" '''^^^' °^' "--^i^-t^ the destLtiL Zh: nf I^.^fi?/r'' '' f r^*^ ^' hy "^''""^l exploration, and by the absence W^nl '""??• *^h^^^°*«"stic indications of pregnancy^ When the condition is diagnosed, and there is reason for interference the indications for treatment are plain— carefullv rlilnflH,; . ' give nourishing food, with tonics. ^^^ueter, ii necessaiy , and ,41 CHAPTER II. Diseases incidental to Pregnancy times call fe se bus nlw LTth '" "° °''''r'" "'"='' ""y some- pre" anc The e L „1 P'",'' ' "'■ ,"'''"'' ''"^ developed ,!uS lio,", .om*e-oflTor,r„reK i,::;'^'„r'"°'" "'= "=""''"'■ '° "- -°^■- SKCmuN ,._IX,.-HrKNCK „K l.„K..XANCV ON OR„rNARY DISEASES 182 I'ATHOLOUY or l\imiSAXC\\ •■II 111 ' m ^^\TIS::^ St!"'' '"' ^'- P-l'-^i- of albunnn is also normal standa d ' The amounr o^n" ''^'^ ?'."'™''^^' ^^ "^"«^^ ^^ove the variation is neither oconsUnMl ^'^""^''^"^^''^'^ ^''"•»^«. t^^^^^^^ this tuents ; bu, it general v im ons^ \ '°. "r/"'™ ^'^ '" ^'^^ °t^^«^- ^^"sti- Owing to this decmisenZ 1 r ?•*''" ternnnation of pregnancy.) larly in the red So n .f f '^ ^'""'^T °^ ^^'^ ''^0°^' and particu- plethoric It is no, \i;> '" ^"■'^'"''".* ^"'.'"^''^ '^ '"°^'« ^">^«'" c than ever, owing o he eeso7=bSnrr^ f'" inflannnatory attacks, how" those Phbgnuisii aiu, ,e i ^'^^^^.^^"^^^^ «a.nt-Cyr justly remarks, dilTerent cmn-se to thZ otJ 1^^^^ ''^ P >ysiognomy, and run aver; especially will 'Xr tc d.^ .? '" ""■''""''."^ conditions, and more re^ted^o or. '^^S^^Z^t::^''^ '^^^ '^ '^ «-^^^"y ut^r'i::;:^";:;: to^^ci tt:;;s^r"^*•^^ ^t-^-- ^^'"- °^ «- and more esneciallvflm^onffr' ,"^ "'°^* essential functions fore it is, thlT dui.i^p^,;!,X^^^^^^ thoracic organs. There-' tympanitis, enteritis of p^ en noni n f "' indigestion, colic, abortion a,u, slow co;.^eSn;"lXo?th^S;;:^^ followed by haf b^ i.;!SS'S "^E^^SJ"!^ if-- - «-f ion. It to prevent tlfe fa... Je;;;;i;:^el^!ul S ""'' '°" "°^ ^^^P^"' kini;'i;^hX,":usi°^bo:t:on"' '"? ^^^"^'^"^ *'^"«« «f -^ «p-ootic very often lead trabortionT, '" "'' ^"T"*^'"^'^ ^'^'^«"^- ^"^"en.a pneunmnia of cattle lu sf emu ntl '"!;"' '"'^ '^'^ contagious pleuro- ft-equent as pregnane i^?ell^vf "T" q"'"'*' '^'''^^' ^'^'"« '"ore serious and more o e i fatal in , . ci ^^^^«P-Po>^ is also more followed by abortion P»>'f?nant Sheep, and most frequently have anv very partic ,1 nfl ^ catt e-plague does not appear to said of ec;;e"L' ;;« ; ca i^foT.u^ "'"^ '^^^ ^■■^"- '>^« been tinental experience ZlTJf , "°^-'""^-'»outh disease "). But this Con- diseases in^u o'vn countn IKf' 7''^\'^'''' ^'^^^^^'"" *« ^^ese two both maladies, anc^Z -speci X Tf .^'? 'f'" ? "^'"'/^".^ ^^^"^^ °^ which the losses from fbi« ^i cl V • foot-and-moutli disease," in thirty, fifty, and ev^l^nole "ei eint" """'""^ """'"^^'^ ^« ^^^^y- th^Sf olC'tlmr ^''3 T ■"'^" '-- --us during pregnancy bate the non-appearance f ^^^^^''"'1 *° '^' ''^" "''-^^ *" ^t*"" intluence of this comhtion n^ ^/ T T '^^""" ^ rabies, <>tc. co"'"tion, as bpmola has done with regard to SECTION II. DISEASES INCIDKNTAL TO PRE.^.XANCY conditio a.^'"few;r!L'lo ff ' ''^ '"^'f ^^ ^^'^^^^ *o the pregnant averag.. of 70i to ti?., .!.;. „„d 02 per ],00o! ' ' "'' ^'"-' ■"'^'""'" '''^'*'«*'"'J« f'«^ «" isease," in 1>ISEASE8 imWENTAL TO PREGNANCY, i88 conditions which have hoon nr.«-n/i ,•« • i tho careful "dmini»t™tio„ „ SrtSt n'.''^ f 7.'™°""^ t^ •luanlity am) qiuility of the foi.l Tl„" II ' ""'' , ""f "''"n to the io,m„on salt i,l their foo,l,o,.t;|iek "'"■'"™'" ''"""'d f"= ""owccl liickcls and Chtcnmalacia youn J tlic two co m&ns ' in ' "'i ■ ^'P^^"^l'y ^hose which are hi thc'san^o Jreatt o Tl r s on^icw/.l ''-^'"''"^'^^ or coincident matter of the bones and a con.^l>^^ ^ ""'"^'^ '" *h« °^ganic constituents, especially oclmnur/.n"f '^^TT '\ '^^^ ^""^'g^^^^ particularly anbctedtLu.dtTe vv I ^^,V **'" '"\'- '^""^^ ^^« ^^^e bones beco.ne softenc^d m ,J t'n c n !• f '"^y be involved. The so that in advanced caser/rah^^^^^^^ ""'^'^ ^''. ^^"'^''^''^ '^"^ brittle; at all rare. The dise^e has bee wl^^"^' 'J^^^y' while defornuty is not Continent in lar.'e breedh?' e HbK ';'^ '" ''" """^'''^'^ ^°^"^ «" the Hocks of Sheep l.ave al K^ n rr ^^^^^^^ and Cows ; Bitches and S^in^ J '^"11"*^'^ 7 ''■ '' ^^ ^"^.^'^'^^^ '" cient food, or eatin-r that wh H i. i r- / "^ ^""'"''' ^'eceiving insufli- lime and «hos on/s-L weH^ t "T' '" ""neralnrntters-such as pregnant aiiin.als are not wdl fc>d ZT^^'^'^^'f constituents. When then, for growth n.^;:i^;^.^ h^^ ^ ^^1^ 1 'r'""'?,"^^" tlieu- osseous structure ' ' ^^^'^^ speedily, m sceS:;fflirSr '^;^S^,f T ?f ^T' *^^"--^« instinctively Jion i^the occurl^Ji^e ollrlSrS^ ^ t? ;^^iri;°^;:*h- -"^^ sSi^;^ a Sv^^ Th7;:i^t'« ^'^ tT ^ '-'^- po^o^! tures, thou.di tl?e Ion / honf.l . ^'^'''"■' '^ ^'^ ^^'^ ^^^le to sich frac^ oomnlonly In ted ti ts u^v'' T^''^^ ""^T" ^^^« «*«^-"""'' ^^^ occur, the^ anin^ appe! toX^ stPff Tf^ ^^'^«*"^-«« paresis or debilitv nml H . u ■ '^"'^ '''''^'^ ^^ '^ suliering from position i at S a n ,:;;;; ^l^'";" '^ r^^" - '^^'^'^ ^^e recumbent The condition is ways . e o I^ 's ''' '^?v,"^' P«rs"asion is applied. culty in dia.mosin Tr m r , '''^ '°"'' ^^^^^^ ^h^^^e may be diffi- Pre^ntio^Cn Vvi.;;' ;,n:::f^:^n;^^^ Y""^'"' "-^«- a healthy state and mt^ ni ih %ni">als good food, keeping them in curative \reSen is "i up r Ind i T *'l"" ""^''l '°" ^^°""^- ^be tious food rich in I no s .hf . I T''^^ ^''"''^^ '" "*i«^-'ng "utn- even for Bovines /w ?.l ! t '''"f '^ °^*' '^^^^ ^^^^^ f"^' ^ares, and forage or Cfli^ ' / r.^Xe^ ' rstr'l''^' "' '°"^'^' ^^'^^^ ^reen .-Panuions of cal^um phi^hai:^- ^^:^-S:^t:^ 184 PATUOLUaV OF PREaNANOy. Kl ' Hi cases. For the smaller animals the same drugs may be prescribed, with the addition of cod-liver oil, and milk-and-oatraeal porridge for Cojistipatioii, Constipation is, of course, due to many causes, some of which have no relation to pregnancy. This condition, however, is not at all rare particularly in the Carnivora, during gestation : and in all animals it may be largely remedied, or altogether removed, by suitable diet and exercise. Purgatives should be avoided, if possible, and only mild laxatives resorted to if necessary. For the Bitch, which appears to sutter most frequently from constipation, Saint-Cyr recommends the administration, every day for eight or ten days, of five to eight grammes ot white mustard; but I have always found castor-oil, with enemas When the constipation was very obstinate, quite satisfactory. Castor or linseed oil, or even boiled linseed, answers well for the larger animals. Voviitituj. Contrary to what occurs in woman, vomiting in pregnant animals is so unfrequent that I have been able to find mention of only one instance and that is m the Belgian Etat Sanitaire des Aniviaux Domesti,mes for lou. ^ Colic. Colic may appear in some instances during the early months of pregnancy in the Mare, the attacks being generally slight, and occurring at intervals. It may be due to indigestion, and only require simple treatment-as warm gruel, friction to the abdomen, enemas of warm water, and laxative food, such as linseed mashes. CEdcma. tl^^ ^^}^^'^^^°^ °^ serosity into the connective tissue of certain parts of the body of pregnant animals— almost exclusively the Mare-is some- what aUied to the anasarca serosa of woman. The period at which it 13 manifested depends much upon breed, conformation, and individual temperanif lit, as well as upon the season and hygienic conditions. With cominon-bred, lymphatic Mares deprived of sufficient exercise, it appears at an early period-from the eighth month of gestation, and sometimes earlier— particularly in winter. With better bred animals it is later and in summer may not appear at all in those which are well bred It 18 most marked in primiparoc. It commences usually at the inferior part of the bind limbs, gradually ascending to the hocks, or higher ; tlie fore linibs are also attacked, though not so markedly ; and the swellincr extends to the lower surface of the abdomen. Here it commences by a soft tumour in front of the udder; this increases in size and spreads over that gland, as high as the vulva, down the inner surface of the thighs, and towards the chest, sternum, and fore-arms. It readily dis- appears or diminishes with exercise, and is probably due to the pressure exercised by the fcctus on the pelvi-crural vessels, as well as, perhaps, to the amemic condition of the system. The exemption of the Cow irom aMiema has been ascribed to the great development of the mam- mary veins in this animal, and their free communication with others which permits a ready return of the blood from the hind limbs. There is nothing serious in this oedema of pregnancy, as in nearly every case it can be counteracted by exercise or hand-rubbing, and it disappears in a day or two after birth DISEASES INCIDENTAL TO PHEGNANCY. 185 Tf it causes inconvenience, frictions with soap or turpentine linimflnf., bandaging or even slight scarifications, may be eSoyed but th^ occasions for these must be very rare indeed. ^^"P^oyeci , but the Ilydramnios, or Hydrops Amnii. to designate It " dropsy of the fu3tal envelopes." S condition w£ very marked, is serious for the mother as well as the fLtus A numtr of cases have been recordprl nn^l QqJv,*- n "=> ""c illuus. a number thirteen of which ™ouS in theliovine tw^„' ha» e„„„erated sixteen, the Caprine species; onfhas ato been oCved i^tt'' Br,';,,""'V°"'' '■■ who l.as published an interesting acr„„rof1eve«r cases obsLr' tha It IS most frequently met with in poor, badly-M annnals and abdomen rapid y enlarges, especially to one side-<.enera Iv the rU? i: lo°st.'rumfna\i™ sluTpTlrdefSaSa'nd mil''>^' ' *° ''"f'' (edematous swellin^r of the imb, S Tj ">"=">""on are irregular, s££H '^Si£='' ?F— ^^^^ tedious. • ""'' "'" "'" "' l»'""i«on is consequently tha^"he?ase^Ja^s°™!r„,"V'"' ""f"""' ""8'" ''"d 'o the supposition per u i^ranrtie '^oLr-C'f ,r """ P^Snancy. Abdominal bej u id tno touch, and almost lost in the small ocean of H id surrouudin' Fol „"d uTurVrtsTil'th "''" •''"^'"'' 'iV f''° '-W .rnbratf or two a,ir;:n'b':rntroducrd iS: ""*"'■• "°"°™^' »™™'^ ""'' f"'<^"««« ^vere in a state o general anasarca, beinj,' completely infiltrated. f ronrthri f" "'''^' "' '"'''^' r,^ "V''''''"- O^ ^-^^ *^^«^e cases four perished a?on.^fn? ' ^"'^ V'''''""^^'*"""^a^^^«; another recovered after win fn ^In 11°"" T «"''f^^l"«»t>y ^old for food ; and seven or eight got well so rapidly and completely as to be bred from again. The results ancTauIy' ' ' "'"'' ^''°"^'"^'' "' assistance\as been pi?mpt tPv^nl" "^""^.f' "'f "'^^'"^ '' ^°""^ excessively dilated, its walls pale in loT.U ^^^ ^^''^'^hrr'" T '^' ^'"•^^^««- The fcx^tal membranes vary and f bio T? '^]l'^ru'^ T^ ^T^^' and at other times attenuate^d formic hH ^''"'^ ^''' ^''" ^°""'^ contained in alveoli or cells, thp nl / P'-ocf ««f ""'fng the allantois to the amnion; so tha etV2 '^"h •"""^'' ^' ^°^"" ^" ^'^^'^^•al places without all the fluh escap ng^ ,n this respect resembling the vitreous humour of the eye with „ «r'/!i"'"'' ^. 'f i""^ ^""^ transparent, or of a pale citron colour; with a slightly sweetish taste ; its quantity, as has been remarked, i^ rit?L:-"f.'t:t •„?{ '"-^ - ''' ''' 1^0. 1^0. ^50, and even 200 The digestive organs are nearly empty, even in Bovines. f;^n'^l'^^^''r''Tr^^ '^ woman, so in animals, the etiology of this condi- everal^verv ir^""'°°^ = '^"^'f T""^'^ ^PP^^^' *hat it'may be due to iffectpd Ml ' ''^"'^^- . ^^"It^Pai-* are much more frequently month^ nZ P^"""'Pa'-»^ and it nearly always occurs during the early Te maimUT-^"/'^^ '''' ^^*"V« S«"«™"y l^^le developed, and in tne majority ot instances is dead before it is expelled It has hPPn rfhe"uil;^hc1i^'"f ^" *^ ^'" '"^'^ circulation! inducei\y"toi'in unc on of tt Ir.'^' 1"^^ 'fK''\ P^'«^"«i"g it. or imperfection in StiP. .nin •"' ^T- °^ *^" ^^'^"^ ; tl^'^ ^«ath of the fa>tus, de- havP hPP^ "'°"^*^'°^lties, twin pregnancies, ascites, and other causes P knor. """'r^-ated as concomitant or exciting causes. But untU heir noTn^r *^^%^'""'°t>«. and allantoic fluids are formed, and wha neluSit^^r Pr^'"' '' ?r* 1"1^".^^^ "^"^^^ P^-^^^-'^^^ ^i" be made in elucidating the etiology of this pathological condition. the^fluid'^bv^ vn^.^l^f '''.^."^ indication is to evacuate at least a portion of nroved inpfLn ^ ^*.^^ membranes, as medical treatment has always Sd rd Z'^^rV I^ "l\\^t be remembered that the fa3tus is alwavs aeacl , and even f alive, with the view of saving the life of the mother a ctrta n nuantif 'f H "^^""^^ °1"'""" '''' anrnioticsac, and reroving existenPpTl ^'f'^*/^'" hquor. need not necessarily compromise the fn xvS ^be fa>tus; as a case has been published by Lhomme- l^ilvn f^ '^ P"-"*^'^' °^ *be fc.tal membranes, protruding beyond he eestatioT T'^f ^vitiiout interfering with the ordinary progress' S formal in,l" P^'-^'"-'t,on occurred three months 'afterwards, a rrv, u ^'^^ born and continued to live, and beforp"?h? ""^ 5"''"'' •"'- ^''''^''' "'^^ i''t^»-vention takes place early, serious v.ffPPtpir^"ur""'''''^^"^y distended, the respiration no seriously affected, and debility not great. ' Journal tie VtUrinairc (hi Midi, 1869. L. lU^EAiiEti JNCinKNTAL To I'ltKa^XAXVY. ig? Tho evacuation should be effi-cfwl tVir«,in,v, +u been made through a punctu^oTn the flank \f l^fTl ',^°"S\^' ^*« are in the vasina? thev niav hi inn n! ? k ;. I *^^^ ^"'*^^ membranes tho OS is sufficienly dilated for tho n ^ n^i ^ *^'' ??f 'f ^^""'^ ' '^ "°t. and ruptured in the uterus ff it os^d " Tould h^^ ^'".?' '^^^ T^ ""' the envelopes punctured if nopptrrv k ^ ^"""^^^ *^''"'*^<^> ^nd As soon as the\neSane a e n c ?c.^i ^l "^^^ %°^/ '?'^' ^"^ '^^"•^"l^^- abdomen diminishes nvounre he ur'lT'^ °^ ""'? *^^^T P^*^^^' *he Para2}lc(jia. often „v„„ >vl,e„ tlla lie' I «, 'oon.mSd ^ TiT," w ^ P""''""""". '"jd Goat, and^hou-h v4rv rarelv in tl ? M " ^^'tnessed in the Sheep and founded witli what has been emed '' n. tn^ f ""^ "°^ ^^ ^°^^- , natural, the head carrLxsnt ^^'' P^^^^ion is animal attoniuts to risP thJii^^lF- -. ^^ oidy when the 1 11,™ T i, S ( V, '™ ^r'" '""■""'!■" """' l"»-'"''i«<'". wl.en it di»am.ai-s ■ 188 PATHOLOGY OF PllECrNANGV. authority, however, states that he has occasionally witnessed the para- lysis persist for a longer time after calving, and either cause death or necessitate slaughter. I have seen a Sheep which eventually died from this ante-partum paralysis. When the paresis appears towards the seventh or eighth month the prospect of recovery is not so favourable • though the prognosis must to a large extent depend upon the cause' it the animal is old or debilitated there is less hopp for recovery When It can move the hind limbs after a day or two, ai 1 change its position Irom one side to another, a favourable issue may be predicted. The cause is somewhat obscure, bn^ ig supposed to be diie to com- pression, or rather straining, of the nerves and vessels of the posterior extremities by the I.eavy uterus. In five or six cases there has been found, on poshnortem inspection, infiltration of the dorso-lumbar and gluteal muscles, and discoloration of the muscular fibres. The spinal canal has also contained a large quantity of serum, and the membranes ot the spina cord are injected. From the rapidity with which recovery generally takes place, it is obvious that tlie lesions cannot be serious in inany cases. Debility from insufiicient or poor quality of food may induce this condition ; getting jammed and unable to get up in the stall may also bring it about, as well as slipping or faUing down and injuring bones or muscles. □ j e Treatment.— The first thing to be done is to ascertain, if possible upon vvhat the paresis depends, as upon this treatment must be based' It IS advisable in most cases to get the animal up, either with or without help ; but It It cannot stand, and slinging is not advisable, then it must be made comfortable in the recumbent position, and turned over frequently ; peat-moss makes the best litter. In the majority of cases and especially before parturition, little treatment is necessary. The principal indication is to avert or get rid of constipation by means ol laxatives and enemas, and to pay attention to the diet and cleanli- ness while enjoining quietude. If the paralysis is due to debility, then highly nutritious food and tonics should be given. If congestion of the spinal cord is suspected, then stimulating appHcations to the spine should be resorted to. Should the paralysis persist and the time for parturition be some months distant, it may be necessary to induce abortion, as protracted recumbency generally produces superficial sores of large extent. Should the paralysis continue for any length of time alter parturition, then more energetic treatment may be adopted. In these cases, the subcutaneous injection of strychnine is nearly always attended with success. j j i'mvip. Cramp— by which is meant a tonic, involuntary, and extremely painful contraction of one or more voluntary muscles-is sometimes observed in the Mare and Cow during the second half of gestation, the muscles of the thigh, and chiefly the principal extensor of the meta- tarsus, being almost exclusively involved. When affected, the animal either suddenly and rapidly flexes and extends the limb-strikin- the ground hurriedly and energetically with the foot, as if a fly had settled on the leg, or the whole limb is gradually and rigidly elevated without nexure ot the joints, except those of the phalanges, which are half flexed, the anterior aspect of the hoof being directed towards the ground; at the same tune the muscles of the leg are hard, tense, and painful to manipulate, and the animal betrays the torture it experiences by its J>ISK4SKS IXCWKKTAL TO PREONANaV, jgj lin.bis'„nu„tainodinapSc7n-,^'c^^ pain most marked. In a short t n H?." ' . ^ t'>« indications of movement is restored The era, nl„ synptoms disappear, and another alternately and appeals to Z\Tt ^T '^"'^ '""^^ ^''"'^ *« cised on the sciatic nerve in its course ovp, ff" ' co.npresHion exer- This cramp has nmch analo/rv T if "^ sacro-sciatic ligament, patella; from th s Tt niav he^ d «Mn .'{"T*".'"'' '° '"^^tion of the occurring n,ostfre;,entr'nyouf;:anfltbVt^^^^^^^^ '^ ''" ^^"«^ patella, and by the total inabStoTvH?' r <^'«I'lf cement of the been replaced. maoility to Hex the hmb un^.l the patella has fo'rSr^ls^^orbrs^nart^'frSon^ tT' '^ ^'^'^>' ^'^ -"-' parturition. ^ ^"''*'°"- ^' disappears altogether after Eclampsia. symptoms wore acute olo„ioconvu,Jn^J*r,'*""^ pregnaney. The Jith unsteadiness 0? t « TiX brwiut'.f 't^T 1" '""? ™'"""""' hoarins or vision. The sucSul tel eM^" ° ,,t\,tt'T'''''"''?:' grammes of fucs ne mornincr on,l j^»'""«nu was nillc diet, ten centi- periods enemata of chiralhy'diate "'' ^" ""^'^' ""^ ^^' *'^« «^"'« Cerebral Comjcstion. J^^iJir^rl^:^:,^^^^^^ ^-n-^- - one of the con- foreign veterinary" suSns con idel- if id''"f ^1 '"'^ ?^^"S^'«h and known as '< partuLnt C2xv " 1? ,f . " j,'^^ '^'^^' ^^^'^ condition partum cerebral con"esK s veVv v^v" 'J°"^? ^P^'^^' ^^^at tliis fl;^^c.- tion and lack of ex" re se thoS Zv, """k '' ^T '" ^ P^^'b°ri« «ondi- again remarked, this and otheTaCfn"' ^Tf.°^''^'"^^' ^"^ ^« ^i» be times witnessed'dur n^tl is pe'lf ;fav be dnP f "'''"^' ^^l^"^ ^°'"«- un. which are not ^^..^'^^^^-^^'^^^^^ wif ttXe^bllLSTntirfoJrr °^ ^•"^^ ^-- -"^"-^-" dealt with. ^''^ Post-partmn congestion or apoplexy is Hysteria. Olver (Veterinary Journal vol vii r, 'i«'7\ j Mare, four month, pre.nant which wa'n siidcfenW aTta r.^'^^r^ "^ " thoroughbred ment, accompanied by profus.- perspir^i.-n S Hi^^^^^ "'''"^""^ ^^i'e- continual micturition, etc. The HliLhTesrnnlT.-n ^'^ i" ^'^"^'"8. straddling gait, great rigidity of the' mu«clej, partS^^ \' excitement. Thefe^was permd volition appeared to 'be abolthed the In, ^f"*'"' ''^^T' ''"^ ** '•* ^^^er props ; the eye« were turned upwards .as if i'n a ra^e;^^^^^^^^^ "•^''t "' »'««hanical there was frequent neighing, and continual n,,!?,?^!' ^ '" *^"""*' '''''*' 1"''« Wind ; the expulsion of «mall %K»,tities of u Hn" anK W thejuU., with vaginal mucous membrane ; the pulse w-aT eiXv.n.-J'fi'^J;;"^:':''*'''^ .'^^"d't^ the 'Vcrc accelerated. There was every svn.nfnm ".Tf 1 ^ "'-nute, anu the respirations swallowing coni.e was injected sSutSu; LrwiTh'th^ '^T 7-"^ "'^''''''^y ^ ^extday8hewas still perfectly blind and even »?L T'* «'^t'«fictory effect. 190 PATJlOLoity OF I'ltKaXAI^aYt i i •T'f ■fi iind the inuHclBii hml lost much of their rixi'lity, while the norvoim exoitoiiient hart mib- •idea ; thoro wan, however, irrtiat thirnt and obHtinatw cr.imtipation. The lutter wcro reli3V.t(l by Huitabio roine.li.M, but hoiik- .layK .,lap»ed bt-f.iro vision was roaaiimd. She did well Miibsiequently, and proved to bo in foal. Amnurosia. Tho only instiincos of amaurosis occurring in connection with prou- nancy, are two given by Rias.' uii'*'^^'^'"^' ' "'"'" ^"*" "''' "'"' '" **'""' '"""'''■'"»• ^vh-n adviinced in pir^^nancy bocaiii.- blind. On the eyeH l)ein>{ examined by llisH, tlie hiiniourH and lens were found to hv quite healthy, but aniaiirosiH wan couipletf. A blinter wa« applied to each cheelc, and other treutment adopted, but without Hucceis. The day following parturition, which occurred about a month afterwards, viHion wa« perfectly restored. A Heven year« eyes, Huddenly became lilind from amaurosis. Rememboriti^r the other case, Riss ai)itained from treatment. Tlie Mare foaled in thirteen or fourteen days after loss of sight had been noted, and cm the third day after this occurrence it wan able to see aa well as ever. CoiKjh, We have mentioned hydramnios as a cause of disturbance in the reapiration, the obstacle to which is often a marlted symptom of that condition. But oven without tho existence of this kind of dropsy, the breathing is not unfroquently impeded in pregnant animals, and'this obstruction is sometimes accompanied by a very harassing nervous cough, which, in the larger animals, and particularly in the Mare may lead to injury. For the relief of this cough, Zundel recommends the cyanide of potassium, but other drugs will also act in allaying it. Allnunimiria. The existence of albuminuria in pregnant women Vis long been known, and Zundel gives it as one of the complications or acco?npani- ments of gohLation in animals ; though he does not look upon it as a pathological condition. Others, on the contrary, tiiink that thi? is a matter well deserving further investigation; for a.s,''a3 has been mentioned various kinds of nervous disturbance—eclampsia, paraplegia, amaurosis^ etc.— are probable consequences of albuminuria in the human female' there is no reason why they may not be so in animals. ' Mammitis. Mammitis is another very rare occurrence during pregnancy, and the cases recorded by Saint-Cyr and Violet only number three— two Iloifers five or six months pregnant, and a Mare. In the former the udder was much swollen, and from one or two of the teats a reddish serous fluid could be extracted, whih it was thick and syrupy in the others ; there was also fever, loss of appetite, and sluggishness. By means of 'appro- priate treatment all the symptoms were subdued ; but for a considerable time it was necessary to witlidraw the fluid from the teats. One Heifer went to the end of her pregnancy, but tlie other aborted some weeks before. The Mare had already produced Foals, but the udder had regained its natural si/e before she again became pregnant. The inflammation of the udder was not severe, though a large abscess formed in it ; this was opened, and recovery quickly ensued, without permanent damage to the gland. Bed Colostrum. Saint-Cyr speaks of red colostrum appearing In the Cow during the last two weeks of pregnancy ; it may suddenly disappear, or it mu,y con- * Recueil de Medicine ViUrinaire, 1831. AnaWKNTSi OF PHKaXAXfy IM tlio teats frequontly. ' ^°""* "^ bonofiojal to draw lootion with pro^- Cow during the tr, or it mu,y con- CHAPTKR Iir. Accidents of Pregnancy Cyr in ullolting ,„ a «opar„to dmS h„.„l"'3v""' >™ 'o"™ Saint- Antk-pautum Pkolapsuh of thk Vvoinv I - -S^nft;t°fr::;;:n;yiS^ •-.. ob^n^a. «o far as Maro or Bitch. It consistH in Z n.lf -^ ''"'^ ^'^^^'P '" '''^'•^'y i" the the vagina by tho utoir'amnts coSfnnf^T"' °' ^^"''^'"^ '"^«kwards, of it forn,s appearing bXeen /;L Z' , ?. r ^"""" P'^'^anc^-. cho tu.niur founded with ;.«^,ar/«;^prolpsus Tlli^^"!: .}''"»«t"ot bo con- prognancy, and may occur in wen slmnndri f'^'",* '' P^'^^^''^^' *« especially those of the gen Ul o ga s arn °^^^ 'i' '' ^^'^ ''''"''' ^"'^ a lymphatic teniperament, iS)d mflko^ «^"'l relaxod-ani.nals of are fed on an abundance of bulk buUnnTfiV '"'f P.'^^'f' ^"'^ ^^^ich CJows on a floor sloping too nS to ho ' r^"'^ wdl'a, Mf^'^^- ^'^.«'' of different kinds, distention of the rn, on fnV- / ^^ ^'^"^' '"J^^-ies lead to this accident in sucHn mal. wl ' ^'"''' ^"''•' '^''^ ^" ^'^ely to though very rarely, in priminar" ^ T P^'^"'"^"*- It is observed, third or fourth ges atbn t rmiod of ir'' '"°'' f^'^Quently after the varying; in certain Covvs ^^aifi^e ?fn° itJ^^f'L^'''?"'' '^T'"''^ ''^'^* ^'^'^ (though this is rare), and Eesfat" the Ind T!? ''' "^' u^^*^^^ "^°«tl» month, and even so'late as twenty 'ot fitonllstfoTd" r ""' "^^*^ The occurrence of thp nn..iVl««<. • "';^Y ""'}s netoro delivery. the vulva, of TcTrcula, bri 'h Tod H,?"'^' ^T''' '^>' '^^ ^PPearance, at of a variable but gradidly T^iia in" T'' ^"^'Tf!^ ^" '^'^ ««"t^-«. and exciting causes renmin in opoSi^^'om H, ^"''f ''"" f """''^^' °^' ^^e of the head of a child or niin ot ev7n : .e' ^TZ^'l ^ "^5 *^ "^^^ when the animal is lyin.r, and disannnn l ti . ?^ '^ '"^ ""^^ ^'^ible considerable volume it n'vereSJ? -T ""^ '^ P^^ "P ' '^"t when of even wi,en reduced by ^hand l^^Xlt? '" '^? ^^'''' ^'''''''^'' ^^^ ; If existing for some tinie howpvl. /""'"' '^"-^^' ^^'^^ "«"al. place and inHan.nS. Z; «:«« illen'^t" '"'^^ '^'''^^"^''^" *^'^- tumour projects pernmnentlv outsidl^H. ""^ - somewhat dense thelattofconstricLgitandieS^.ntff'' "^^ *''" circumference of becomes a darker red and pvI l " i^^ /^''' ''°''''- ^he colour now I abraded on the s'v;;■f::c^fr:n^C.Tubrit ofX ^ail" 'd"""' "^^ ^« i^e fecesand urine, while at its ^^.^l ^t ^^i^;:^'''^'^^' f^^^ l-ntensity. the cerVix. an^^n^^^S^^f ^S^^,:;;;^ S^l^rS^! 192 PATHOLOGY OF PliEGNANCY. I U "if.- i will follow the everted vagina, and a spontaneous reduction can no longer take place, while manipulation increases the straining. This is in reality now a case of j^rolapsus uteri, and an examination of the voluminous mass may lead to the detection of some portion of the fastus in its midst. Not only this, but the prolapsus of vagina and uterus will, in all probability, produce displacement of the bladder, and when this is distended with urine it will gravely complicate the case and render reduction more difficult. According to Cox,i Sheep, when heavy in Lamb, frequently evert a double fold of the vaginal mucous membrane. This happens when they are in a recumbent position, and it is in some animals of such frequent ( ccurrence as to cause excoriation and ulceration. TuEATMENT.— Tliis prolapsus, in the majority of cases, does not appear to cause the slightest inconvenience to the animal, and ofi'ersno obstacle to parturition- indeed, it has been noted that such Cows calve more easily than others ; neither does it predispose to chronic eversion of the vagina, as has often been supposed. After calving, the vaginal tumour disappears without any treatment being required. But if treatment is necessary, the first thing to be done, should the floor of the stall be lower behind than in front, is to level it, or even raise it a little behind. This may be readily accomplished by means of the litter. The diet may also require attention, giving that which contains sufficient nutriment in small bulk ; constipation should be guarded against or remedied This treatment will be sufficient in the majority of cases. In others, a bandage, to be hereafter described, may be required, and especially' if the tumour is liable to become soiled and irritated when the animal is lying- in serious cases, when the tumour is large and the Cow strains, and spontaneous reduction does not occur in the standing position, the mass must be returned. This is readily enough accomphshed ; but it some- times happens that reduction does not prevent a continuation of the straining, and even with the bandage the everted vagina again appears. This is due to the mucous membrane, which, not having been properly smoothed down when introduced into the pelvic cavity, is ridged, and these Yugic give rise to an uncomfortable sensation, and induce expul- sive efforts. It is necessary, therefore, in reducing the part, to cleanse it well with tepid water, and to smooth the vaginal mucous membrane by "entle pressure forward as far as the cervix uteri, in order to efface any^folds which may excite uneasiness. After this the bandage may be applied with a view to keeping the vulva closed, until its labia have retracted somewhat. Wire sutures through these have bejn reconunended, but they are very rarely required. In very exceptional instances, we may have not only complete pro- lapsus vaginie, but also, as has been said, partial protrusion of the uterus itself. Then the case is very serious, owing to tho excessive strainmg and the weight and bulk of the fcetus, which has to be returned beyond the inlet of the pelvis. But in the majority of cases reduction may be successful, and appar- ently desperate cases may be saved by the exercise of patience and laui. The Cow must be made to stand, with the hind quarters as high as possible, and to prevent straining the loins should be pressed upon ' VvtcriiKiry Journal, vol. i., [i. 'iOT. ACCIDENTS OF PJiEONANCY. in a forcible manner, as recommended hv ^a,-«f n u placed transversely, a man '^Te^^hllPlTu^^^^^ and pinching the septum of the nose A^n?^' ^f''f ""'}' '^'^ *«"§"« be made in the intervals of strainW n^^ T^^^ at reduction can only can be done is to retLtfuUr emulsion h! '^' ^'^'"'"S all thai placed organs into the pelvis the ann nnrl w'.f ^^^^n/ ^'eturned the dis- pressing on the cervix of the uterus so Ltt^ T'' ^°^^°^ ^^^'"' ^^^ by the vagina as to leave no foldrordsest^ '•"'"'?,"' membrane of ceased, which usually occurs vei-y soon thp „' ''" *^'f '^'^"^^"8 ^as though the practitioner must be^on the on?lo ?". "'"/ ^" ^vithdr^awn, prepared to prevent another extrusLn ?^,ii V^^ ^-^c^rrence, and by the use of a pessary consistin^o a wooden ?7,^' ^"^^'^^'^ ^^^^^^^ long, furnished with a head several ucChrdi^nl™'" T *^ ^^^° ^''' some soft material, or a rin- fixed hnn.n. / f/^'^f^^/" ^""^ covered with wide to go over the cervix °this end wpH^^ ^5 ^^^ ""^ sufficiently the vagina in such a manner as to i,7fLe^,T''^''''i° ^' ^"^^^^^^ ^^ the other end being fixed bv a co d if i ^"' '" *^^ P^^^^c cavity, body or elsewhere. %Vn ordinary q^^^^^^^ ^^^f/./^cle to a girth round th^e may be employed on an enier™^ a -onn. '''^\^ '°"'^^'« '^^ttom the neck making it sufficiently Ion / So In /''''.I °^ ^"^'^ ^^"^^^^ ^"^0 and it may be allowed to remain n"tl. f i""' *^"^ P^'^^^^ ^^ ^'o™~ period-tlie vagina should b^ p. '^dTiW^ ^^ ^ considerable -'d astrmgent. Death is often^ the L.^^/^.^l! iV^'"^:'" ^.^^^^ ^"^ a \^ r.tt. -^ " '^"~^' """V vviLu warm water and n ;:t°;r\ trt;:!f,:^l.!-^ ---icient?!^ mild astrmgent. Death .„ u^Len uie resvdt of .unh to prevent a fatal termination it his h.l ^"^^^ ^'^ accident ; and delivery siiould be effected withoudehv p' "f"'*'/,'^^^* ^''^^^'^^^ counselled in those cases in which t^rL ^'^/"^^"^'^ delivery has been the vagina, notwithstandbg land^^ ^^^.^^ -"^ evert when grave consequences are h e v to fol o v ' ^ °"''' 3"«a"«. and advice to be adopted when pre- Incv hi J i^lT ^«P^«'^"y is this the Calf is alive. Perforation of nl^ i ''''^''''^ ^'^^ -^^^h day. and fingers after they hat; dVS oV" TLt^Tno'd^r' f ^^-^^^^^ ^^ ^^'^ tiou, as a rule; but care is necessarv fn, 1'"'''''^^>' "' P^^'^^^'i- prevent inversion. "ecessaiy for some days afterwards to paJ!!iS;X^°:!;;;:i ^l^s irr^^r- ^"^^°'" *° -^-^ the other occasions a truss, s'h^ar^o that .fw ^''°'^'^^^ ^"'^'^^ ' «» Both methods frequentlv fai and i. H ' ^°' ''^'"le, is employed, well as the ring-shiped iss^y'f a'LiainLe""" '""'"° ^•^^^'^^ ^ IlKUXIA OK THE Utkuus (IIvsTEHOCELE) an?rX,!';;i,^j;;S in tht "Jr ■ Cow"sf'^ ^on.^stio.toa animals. -e latter a ,al the or.^ar ifof /-n d Vn^ ?i <^ °^^t, and liitch. I, tbo fc.tus is developed in Th hln , 1 ?'^vUh h 1"'' ^'^"'^^"P^i-^. and empty uterus is too far removed f on . '"""' creatures the from the cavity ; and it isoXv ho Tts vol n; "'"'"'^ ^""''f'' ^" '^^^''^P'^ advances, that it mav form i C if^l 't '''''•:^'^ ^'^ ^^^^ation opening in tlio muscles which enc 1 Z . > ^^^^^t an accidental ^nna may l,e inguinal ; in th "o! ^^ S^n" 1[is 'h *'" ""''"'l '''' -^:tss':?t;-bd^^ 13 194 PATHOLOGY OF PREGNANCY. contusions or strains, the viscus being generally only covered by the skin. It is rare in young animals. In the Cow it is not at all unusual to observe the hernial tumour in front of the pubis, towards the attachment of the rectus muscle, and near the udder ; here it may be of a great size, extending as low as the hocks, pushing the mammary gland to one side, reaching as far forward as the floating ribs, and containing, in addition, other of the abdominal viscera than the uterus and its contents. This tumour impedes movement ; the hind limbs are kept widely separated, and the animal is much incon- venienced. With the Bitch, ventral hysterocele has been noted in two regions — above the mamma;, where it might be mistaken for a scirrhus tumour ; and in one of the labia of the vulva, beneath the skin. In the larger animals, the foetus may sometimes be felt in the tumour, and its movements may be noticed ; though, owing to its being so low, it cannot be reached from the rectum. Very often, excepting the inconvenience to the female, hysterocele does not interfere with gestation, nor give rise to any serious symptoms; though, in some cases, it may render parturition laborious and protracted, ifnot impossible. In other cases this act maybe accomplished without difKculty or extraneous aid ; Cows which have been ruptured from the perineum to the ribs have calved easily enough ; ■ ad Leconte alludes to a Mare which had a uterine hernia nearly as extensive as this, and yet brought forth four living Foals in succession. Nevertheless, it is somewhat of a risk to attempt to breed from such animals. When treating of difficult parturition, we shall have occasion to return to this subject. In the meantime, it is only necessary to say that in order to obviate serious consequences, the hernia should be supported by a wide bandage until tlie uterine contents are expelled. Should circumstances render it necessary, abortion may be artificially induced, or hysterotomy niay be performed. It may be observed that care is necessary in diagnosing mammary uterine hernia in the Bitch, so as not to mistake it for a mammary tumour. I have known of one blunder of tliis kind, and have heard of another in which an operation was performed for the removal of the tumour, in which two fetuses were found, and the Bitch subsequently died. In my case no operation was attempted, and though the hernia was somewhat large, yet the animal brought forth her Puppies without any apparent difficulty. ANTK-rAKTUM Rri'TlKH OF THK UtERUS. Eupture of the uterus may happen before and during parturition, or in attempts to reduce the organ when inversion has occurred during that act. The accident lias been observed in the Cow, Sheep, (ioat, and Bitch ; it is not very common before gestation has teruiinated, and the symptoms by whicli it can be diagnosed are not very reliable, Spontaneous rupture of tlie uterus usually occurs at the antei'ior part of the organ, between the two coniua, or even in the cornua themselves; the direction of the rupture generally de))ending on the direction of the nmscular fibres — being somotimcs diagonal, at otlier times tran.sversal. and more rarely longitudinal. The size of tlie rupture also varies con- siderably ; though it must be remembered that in the dead animal ruptures only appear in their original dimensions when the uterus had y covered by the AVCI1>EXTH OF PREGKAl ^X'Y. 195 ost Its contractility before death nn70"^P/ete." In the first. tLcttof't^^^ ^'^ " ^ompletl" and freely with that of the abdomen , while ith.« °^f » «°"^«^"nicates or sometimes a portion of the muscXirye, is intact P^^^*°"«^"^' ".a/.7. «^.>-.., and which he believes^obe'SH'?."' ^^'^^^nate as sS condition in which the utern^ W l "'^^ *° rupture. This is a either at the body or the connn and roT' '''T^''^^^ ^'^'^^^^ acre's cavity, being only suspend dCheTr/r'''"«" '"^ '''' abdominal suigularfact connected with these cases i.^f 1^^'aments. The most torn lu this manner, its conte ts-tle Tj^s "/^"'^'f '^'' ^^^^'"^ i« escape; the wound cicatrises and fl p^., ^ membranes-do not tuuiou. Ercolani, Veteriii:r; pfofe or f S.^ff f ' '%^^^^«^ ^^^^oid met with four instances of this extram-^ nl J^ologna University, has globula,. form, an.l its perfectly s,n,ot„rf3 ''"*, J^'"'""" "^ the uterus has a Wfll as by the teeth, whicl> are cut. T^^e , , ^Mou, to j„d,.e by the hoofs as into the left e„rnu i)re8ont.s a larw tonsure wh,.,, ,, I i • ,"'''^* '''"''""' wliicli projects r^it:;;:' "^ '"-«" ^'-^^ ^^*"-" ^^e Si^h^h" tL;^^^^^-^;;;^ --d: 2. C,;rnu\.f the uterus of a pre.„.u.t Co. c. t • • """^ n^urked y nulnrate,!. This corn ,, .:.' L n l':; l"!"'"'^' ^ completely .leveh.pe.l fa>tus lianfe's ahimstfree in the abdonien • v lit , •' 1""'-. l'^"->"'-itio.., is detLhed and a a.^e kyst^ everywhere closed, and o a . ' £'^, Jr '"^^'""'' '"^'^ ^''-« ^^^nned t e ,Most part fibrous, and the f,.,tal en Xpe^ '.?,''• ^''^' .r""'' "^ *''^' '"""« are region had been out throuirh. "' ''•^"'' "''"-•'' ''"ached it to the sub bn! ^ ■'• ilie iitiiiis of a Sheei) arriiLil ..f (1, » ^-;"Sit;;^''^i:r;;:^.cii:-thi;ri-^£ -ri'os.t,en that the accident was duj to toi:;- .^^fSf j;!^:;^- ^ --'. which leac^ to tht II 196 PArHOLOifY OF niEGNANUY. 4. Posterior portion of the body of a Guinea-pig, which shows the right cornu of the uterus detached, and cicatrised where separation has occurred. This cornu, which was half free, was tilled with fluid blood ; the distension caused by the blood has been so great that the cornu it ruptured in the middle, and the fcetus must have died from hajmorrhage. Other examples of a similar kind have also been recorded. Causes. — Thinning of the uterine walls, hydramnios, and distention by the gas evolved from a putrefying foetus, have been said to predispose to longitudinal rupture, as well as contusions of different kinds to the exterior of the abdomen : the latter may cause immediate rupture, or this may only occur after the lapse of days or weeks. Enei'getic con- tractions of the muscular tunic may also lead to this result. Transverse rupture, Saint-Cyr presumes, is a consequence of torsion of the uterus on itself, or at a limited point where the circulation is interrupted. Symptoms. — The symptoms of rupture of the uterus are not well defined. If the accident is due to external violence, the signs will be in accordance with its severity, and the more serious indications may appear very soon after the contusion, or not for a considerable time. After showing symptoms of colic for a short time, the animal appears to be quite well until parturition is due, when after manifesting signs of that act the straining ceases, and those of peritonitis commence — hurried, short and plaintive respiration, quickened pulse, inappetence and suspension of rumination, insensibility to surroundings, coldness of body, looking round to the sides, etc. Examination of the abdomen will detect the presence of fluid in its lower third ; while vaginal exploration may reveal an empty uterus, or only a portion of the foetus in it — the rupture itself may be discovered. Or if the rupture has only ensued when parturition is advanced, the fcKtus may be expel^^'d in the usual way, and the symptoms of rupture only recognised when the birth has been accomplished. Similar symptoms are observed when transverse rupture of the uterus has taken place, except that, owing to the twisting or torsion of the uterus, the hand cannot explore its cavity ; the vaginal walls, however, are found very relaxed, and the uterine cervix extremely movable in every direction. If the animal survives, the straining soon passes oii', the external genitals resume their ordinary appearance, and every indication of pregnancy disappears except the enlarged abdomen, on tlie floor of which the foetus lies, and there it may become mummified, or in the course of time be eliminated by an ulcerative x^rocess set up in the abdominal walls ; or it may even live and grow for some time after leaving the uterus, but unless removed artificially it nmst die. Tlie mother may thrive, especially if tlie foetus does not cause any incon- venience or is expelled in some way ; and if only one uterine cornu was involved in the rupture, she may again become pregnant. Tkeatment. — But little can ])e said as to this. Looking at the serious nature of the accident, it must be a question whether, if preg- nancy is about complete and tiie ftttus is alive, it may not be advisal)le to kill the mother and jireserve the young one. On the chance of tlie mother surviving, attempts might bo made to treat tlie case as one of peritonitis, and resort had to surgical interference if there are any out- ward signs of abdominal abscess, for the elimination of the dead faitus. With regard to the smaller animals, gastro-hysterotomy might be practised with some chance of success in favourable cases. Energetic con- ACCIDENTS OF I'ltEGNANCV. 197 Though the accident is generally of a most serious character vet remembering that recovery does sometimes take place there need not be undue haste m destrovine the animnl wi,Jv,%.u * the dimensions of the I'upture are ril n.p7 ^ }"" °'^^'' contracts Metroerhagia. recorded. . Carsten Harms^ ^s'ibtCltir a^c d^ntTn^caftl'I^S acco.npamed by a small discharge of blood from the vaAnrpiticularfv during micturition and resulted in the death of Ife fSit^us Some observers have not not ced this discharcrp • h,« ki^^/i .^,- ^°™^ ■nained in the uterus, where it hartuto^ue LSu'ra^'Huted mass, to the amount of more than four gallons. In the maforitv of cases it would seem to be of^pq^innorl k,. „ 1 majonty ot more or less Pxfpnifvo «^« occasioned by a spontaneous separation— =00°' ' ^^strsr ft tc i:.' rr n'irl'Xir''z,*i s^ strteTi:i:\eSrj-ute^tS!^24r- ->■■ - -™ --" I. V.gVi (Journal den VeUrhmlres du Midi ISIO n n-n w.,= „ 11 ^ ^ which staggered about in walking, and 4d n t t^f ».( was called to see a Cow v n^ svmutrs. nri ' ^'^ ' '^ ^^^ ?'^ °^ a Mare which <)rooping heaJ, rigidity of th. "ins s?^^^, .^ P'egnancy : Anxious countenance, if from \ sprain! X^tnir ,ti o % =T "^ f " ''l^ ^T''''^^^ "^ ^^"^ '-^f^ bind leg, a was of no .a\ail ; pr st.ation Su iHet Tn""t^^ '"^- ''t*^ ''^ •'^"? ""'^"- Tre.atm'ent i^oon it could not stand, and whe it f fl nLfh ^'T'^' appeared extremely anxious, agony. There were neV any sp p , l^^oTtlir^ "nmediately without much examination, a five-inonths-old f,, 1 T v \ '?"'^''-"'ge «'f Wood ;<«• vidvmn. On was detaclie. nearly through, ut^^'^^^ '1 ""^ "«^* cornu.and the placenta and its volume exec^n 'T K f the ;!.! T" '""' t'^^^'i^V'*"^-'^^"^^' inflanmation, gallons, occupied this L„ Id tS^; '^^ft'f'-^ :r^;;LrS;s:\^t:?s-^^^^^^ one €X then "o th 1 :' 10 Sil "" "r' '^t' "^^^^^■■^''''^.' '""'^'"^ «-* ^^''-^^ds and venous pulso.tion in neck ni icons TT ""'""^' =, ^"'"''V'* ^^"^^ *!"''« '"'dible, l"^v-. J)ark.coloured blood iLweT,^ a, ns '^^^^^^^^^^^^ *''^' '"''y temperature on the sain(. f1..v .,., 1 ""^y«^ti in .1 pa.ssive manner from the uterus. The Alirr A\,^A blo,KLsrtha '^^cu was'f'"''rr?''"'"'^-'^" *'"-' "'«--. except the uerus almost pailsful- - wild wa , aX c? l!o 1 t"^ ^''-i'l'-'-'ably distende.l with blood-.ne^rly wo unrounded hy thJ i,S r ani ii^ ! ^ ^.^^ '=""»'""«'.;" addition, a seven-month. Ltus 4. Macgilli-^.r y ' V .n- 1 ' • / ''' ^■" "''•ly fq-arated from the uterine walls, n.ore than nine "^i;, , | V prj,^,,"i^''(;''^' ^''^^l' P" l^P , was asked to attend a Mare ::^::^^eheck the Ho^ s^vl::^- ^j'ls:'-;^;!;,^ ^il-l.^-^ Lehrhudi da- Tluvrarztlidien Ueburtxludfe, p. tJO. 198 PATIWLiKiy OF rJlEOy^ANCY. ' V ;»•, m XZSt^r%uT:^fc ?^ ^^"^r «ub«e4uently produced a strong healthy Foal the resul of ,nm; Jf ^ ^'^ no doubt that thi« was a case oi placenta prS=ei>ted and full of dark blood, which had partially separated the deJly.Ind trut^r".? of'SwcIrsr ^''.rj"'"' ^•'*'' '^'^° '"^■^"'''^"*' ^■'''^h died very sud- t, m uterus of which showed the same ai)pearances as in the above case. When there is no escape of blood externally, the diagnosis of this accident IS most dillicult; but when the hu^mon'hage is a^pa renr Sr heTl'rrfi '"f'f r^ '""'''r' !•] ^^^^^-^ ---> -°d i^ tEar 'of no men' ado f. J f^ '''^"''^ '^^°i!'^^ ^" attempted and the same treat- ment adopted as for post-ijartum hujinorrhage {which see). Abnormal Retention of the Fcetus. It was remarked, when speaking of the normal period of gestation emain LX nT'^"' considerable limits, and thSt tlie fa.t'i m^t Sarv til t^u' I""' ^ comparatively long period beyond the beaier """^ '"''""' ^"convenience to itself or its But when, from any special cause, delivery cannot take place then very grave results may, and indeed nearly always, follow ^ ' Cases of abnormal retention of the fcetus were observed in the last agnosis of this ACaiDENTH OF PliEQNANUW jgg century by BoutroIIe i Gprw 2 or,.! xi j exhibited to the Sodety oYlhe S^of S^'-^^^^.^^^V "^^ k^ tlie uterus of a Sheep containin/« r. Medicine of Paris, in 1815, three years. Since th^atprroffi Htem^^^^^^^^ ''?>^\" '^^^^ ^°^ very extensive, more than fortv in<,tnn. k "'^ '"H^°*^ ^^^ become veterinary journals alone Tu tho T. ^^^"8 /''horded in Enghsh from abnormal retention of tie f^ us ZTthfrn '"'""^' ^^^^u^'^'^^^ more exposed to it than any other t « ft ^P^^^u'' *° ^^ ^^^ being as twelve to one in the L^l'InTS^ '^^^^^'l .?. ^Jj!^ ^^"'-^^1 . .- . v.„ ia the 'nly 1 in the Bitch. th^^of '^^.^^^X-^ T^''''^'\ ^' '''' ^-' °^ — . duringpregnLcy whenabor on Snl ^/ "°/T P'-^^'t^rition, or even there are ifearly^all tlL s1.nTs Spartt^H '^^^ ^^T' '^' '^''' P^^'^^^ vulva, pendulous abdonien reLCne . T. '■ .^''^''''Sf »^^ni'««3, swollen begins, but the os uteri lemZTJTi '} '^"^i^*>^- ^^^^ straining condition may persis for nn W « I /'^'^ •^'^^ "° ^"^^^'^s appears. Thil to pass unobs^eiS n some Les h ^otr''^' T^ ^' '"^ ^^" '^ ^-'^^^ as three, or four days, the exnu^siVp Lft ^ 1 '^/"^^ ^°"*^"^^ ^°^ *^o. and frequency unt 1 thev a^ o Ifh 'r 8'''^^^"^% 'diminishing in force gains its ordi^r; s at Jnf ifa c:;^^;?!PP^^%. '^^'% ^^^^'^^ then re- if there were nothing th^ matter kIoM '^^^^'lon of milk goes on as this cause, and the co. ditimi of ^h. \'"'''^ "•^^"^' ^« ^'"P^i^'^d from if a Cow or a Sheep,Tt 1 4 ble, ^fl T^^f^ \°* ^" suspected until, for food, when the fStl it disxc^;' f^f. f"^ slaughtered by the butcher' does not appear in such LwT nJo ' -'" observed that cestrum though Bo^^ignolnienUonrrJoV^hicir^tain d^L"f'^f"^^^ T ''''' seven months, yet ^^avo an ihnn.l.n^ f ^^tained its fa^tus for twenty- went to the iiull.! d wa; rt liH '"''^' °ften exhibited cBstrum, More cases of a similar llind are r^cordid "'"'' '' ^^"^'"^ ''' ^^' ' and delivery may then be safeh nr-l,^ ?'^'""- f'^ ^-^^" manifested, ae^^^Pa^uilIi^^ becomes dn.d np lik, « ball. The Cow does hohP' ^'I'l'- '''-'?"'""' '" ^^e Cow and but many perish uhen, instead of d.T I mrtS. h? '" ''^ '^''' '^ '' '^ ^^^" '''^'^'^ ^"^ = Onv wh.ct. can-ien its dried up Calf in tt i becomes a mass of corruption. ThJ sary to take ca.e „f tl-ese Cows for fl Vu "* '^'"'' ""' '^"'^k the Bull It is neces when the Calf dries, fotJ^.;:.- little and f '"' '' 'T' ^"',' '" ^^"^ "'«'" -ell e Slly In about ten months or earlii tl erVi LvT''T '""^T'^^y «naciated for fifteen days^ ■■»>,' they fatten like others ; t e b che find Ih ^'^u'^^-'^ ^'''' ^'"^ P"' ""^ to pasture whicl"wa: £n'ofu./S'ch;S^v'2^'' 't^°' ^'T^'^ '^ ""> description of a Calf ;Hped, hut died soon after. 'Vt'^L".? '^^J^^^J^l ^*^)-. ^^ was alive when ^^^^^ a i,.a!e. ■-'-''- «"!'■ tiiouyh born without assistance ; it '^^''fr'^^'olt^^ (p. m,^ Mr. Tatao,, „f Horncastle. perm,! the s.ame (fiftytwo week. TJa dw) but h P .T"''*^' "' ''^'''^ »"* °»>y ^as the '^e, a„a ,,,it,j ^ ^i,,,i,^^ degree o wonder as th"?^''"' '1^"^'' ""' ^-^^raordinary in had he seen the other one ? wouaer, as the above. Mr. Tatam saw the Calf ; i'fi 200 favourable termi IJ ; 4 t \ PATHOLOdV OF PJiEGXA.yCV of es fortunate an ending, continues unwell ; it feeble ; hectic fever dies after a more or . ination oi sucn a conaition ih due to tlie inenihranes of the ftt;tus remaining intact, and tlie os sutticiontly contracted and close to exclude the atmosphere. p]ven under these circ.imstances, the retention of the footus may not have so Very often, after fruitless straining, the animal has little or no appetite, languishes, becomes appears; it falls into a state of marasmus, and less prolonged period of misery. When, at the usual time of parturition, the straining of the animal has ruptured the foetal membranes and the liquor amnii escapes, air at the same tune obtaining access to the uterine cavity, the case is in nearly every instance very serious. The footus soon perishes and begins to putrefy, and in a short time the decomposing mass causes inflamma- tion of the uterus (metritis), accompanied by frequent and exceedingly severe strainmg ; low fever supervenes ; a foul-smelling putrescent fluid escapes from the vagina, and the creature finally succumbs to metritis and putrid infection. In other instances the termination is not so rapid. The animal remains unhealthy ; tiie secretion of milk is sus- pended ; horribly fcctid discharges are passed j^cr raqinmn, containing pus broken-up decomposed tissues, and even bones of the fcrtus ; these discharges are increased by the straining which sometimes takes place at intervals. In the meantime, the creature loses condition, emaciation becomes extreme, and death ensues from debility and marasmus. With the Cow we may, nevertheless, have a vaginal discharge due to the presence of a putrefying fcctus, and for a long time, with- out any sucli serious result. Figuier removed from the uterus of a Cow the entire skeleton of a fcctus which had been tliere for more than fi_vc years, without giving rise to any other symptoms than a very disgusting intermittent vaginal discharge. The animal quite re- covered. Thierry reports the abortion of a Cow at the iiftli month of gestation, and the retention of the putrefied fcKtus for more than three inonths afterwards, without any harm ensuing ; Gervy also removed the head of a fcrtus which had lain in the uterus of a Cow for cnghteen months without the animal suffering much inconvenience during that time. In the Veterinarian (vol. ix., p. 454) there is an instance of a Cow carrying a decomposing Calf for two years with impunity ; and another (vol. xxix., p. 577) for ten months. It is not the same with the Mare, as death has been the usual ter- mination ; but it would appear, as already remarked, that retention of the tu3tus is very unusual indeed in this animal, the best recorded instances being one by llamon, in whicli death took place after seventeen months pregnancy; and another by Hammond, wlien the same result lollowed after twenty-two months. The period during wliicli a fcrtus may be retained in the uterus varies irom a few months to live years. We have mentioned that, in these cases of retention, the fo'tus may live for a certain time, provided tlie membranes are not ruptured when the symptoms of parturition first manifest themselves ; it may even continue to develop, as is evidenced by its si>^e, its bony framework, hoofs, teeth.^tc.^which often cause it to look like an animal that has I have some instance! of 300 days' pregnancy in Cows, the calves being born alive. in the Mare, prolonged pregnancy is not nearly so frequent, thuutth it sometimes occurs, the fa'tu.s being retained a month, or even a little longer, without prejudice to the ±oal 8 existence. ACCTDENTS OF PnEGNANVV the uterus varies been born xor two, four, 201 cases ^ u. , . ^''^ inonths. But in ot scarcely be a doubt that the ffrt.nq norJaVioc ,.,u„ i.u ,. expulsi've eflforts are made by th moS or even at a t"' i"''^f '"'^^ to the ordinary occurrence of mrturit m ' n= ? ^ f ®"?^ anterior of hai, and th\ s.all si.: and^ wJ? I^o? 2:i^Z!- If'e^ atin"l? may hve or some hours after rupture of the niembranls pr'ovE t can breatlie, or the placental connections are intact Provided it In all cases, as a rule if t,ho mV /j-^qc r,/^^ „Ui • ' . , cavity, putrefaction doe^ no en^e nnc^vht ti,"oT™.'° ""' "'"""I after death, it is found to be eloiely" co^n're t'ed ot u ^nTer," ta mucous membrane healthv or slio-hfiv PPr.i,,-,.,^„ ;i u t^ontents, its the cotyledons pale, waste^d;Ld s^Lt^fZn't e'pTce^tuf^^^t^ cotyledons, these being S^ed snon'v nnd IT^'f^^ "'" 1^'^^"*^^ clesloyed. The. li.uor^mnir^as^E^bee^n'aCblr's; membranes are in close contact with the fmtus, and nay even hav^ l,ecome adlierent to it in places. The fcrtus i self is desiccated hv absorption, and its skin is hard and dry as if tanr .d n, •7?''''**^^^ ,^1 and shrivelled while the flesh, if any rerins,Ts Either prf^twThUe' or pale and faded-look.ng in colour, and emits a kind of^ranc d ^dour' Other organs are pale and bloodless, and more or less undeZL fattv fhf rr/'T' ^^'''" '^"^ ^■'*^"'^^°" ^^^« continued for a S t"me al^ the soft textures may disappear, and nothing remain but tliel^onp. In other msances the fo parent bein" in cood health Rnf 'm ii.4iii 202 rATHOLoilV OF vnKasAmjY. The footus may also be retained in tlie vagina long after being pa^sod from the uterus, tlio os of which is closed ; l)ut then it is of very small size, and does not appear to cause serious inconvenience. Cauhkh.— Various causes have been assigned for the retention of the fuitus, several of whicii arc no doubt (|uito sullicient to offer an obstacle to normal parturition. Among these causes nuiy be cited: a diminution or loss of contractile power in tae uterus itself to expel its contents, and the absence of assistance when attempts are made ; adhesions of an un- usual character between the uterus and placenta; nuilposition of the ftetus ; displacement of the uterus ; deformed pelvis ; fibrous induration or spasmodic contraction of the cervix uteri ; torsion of the uterus, or adhesion of its ligaments, etc. Tkkatmknt.— The treatment of fcetal retention must greatly depend upon cu-cumstances. When the owner of an animal that has reached the ternmiation of pregnancy and begins to be in labour perceives that the strammg is weak and irregular, and not sustained, so that birth does not take place after twenty-four, thirty-six, or forty-eight hours, and even when the symptoms of colic are slight and the condition of the creature otherwise satisfactory, the atteiulance of the veterinary surgeon should not be delayed. The latter will inform himself as to the history of the case, and also its present condition by careful external examination and internal exploration. By the latter lie will ascertain m all probability, tiie character of the obstacle to parturition, and be in a position to decide whether delay is necessary, or if he is to promote mmiediate delivery. In some instances it will be dillicult to arrive at a decision. Some practitioners of note recommend abstention from interference and the adoption of expectant treatment, so long as the os is not sutliciently dilated or the festal membranes are not ruptured; and they insist on this course even when tliere is a material obstacle present— such as torsion of the uterus or degeneration of the cervix— which renders spontaneous or natural delivery impossible. This treatment is based on the relative innocuousness of the ftctus in the uterus, even for a very long period, so long as tlie liquor amnii has not escaped and the air has not penetrated. This course is no doubt most judicious in some cases, and is followed by successful results. Ah that has to be done is to keep the animal very (piiet— in a darkened place if possible— and to administer opium or chloral in full doses, both in draught and enema if need be. But in tlie majority of cases, if not in all, it is preferable to resort to active measures. The expectant method was all very well when art found itself disarmed in the face of certain accidents, such as torsion of the cervix, whicli rendered spontaneous dehvery impossible; but it cannot be urgently insisted upon now, when we are in possession of methods which enable us to overcome these accidents. Therefore, as a rule, it is the duty of the obstetrist to terminate as soon as possible the act of parturition, when it has once commenced. \\\ compliance with this advice, the veterinarian, after informing himself as to the nature of the obstacle opposed to delivery, should act according to the rules appli- cable to each particular case, rules which wiU be alluded to hereafter. When the membranes are ruptured, then delay may be out of the question, and intervention might require to be prompt, if serious conse- quences are to be averted. Attempts to effect speedy delivery should after being passed it is of very aiuall ince. 10 retention of tlio lo offer an obstacle lited: a diminution )1 its contonta, and (Ihuaioiis of an iin- nalposition of tlie librous induration of tbo uterus, or 1st greatly depend that has reached 3ur perceives that led, so that birtli forty-eight hours, d the condition of (jf tlie veterinary 1 liiinself as to the y careful external lie will ascertain, urition, and be in he is to promote licult to arrive at abstention from so long as the os re not ruptured; material obstaclu n of the cervix— blu. is of the foetus in liquor anmii has ourse is no doubt nccessful results, t — in a darkened 1 full doses, both ferable to resort very well when jidents, such as very impossible; ire in possession ints. Therefore, i soon as possible compliance with to the nature of 3 the rules appli- id to hereafter. y be out of the if serious conse- delivery should ACni DENTS OF PREUNANUY. 203 bo resorted to at onco, in the maioritv of cases if nnf ;., n xt theiess, even here wo find excell. nf mw-Hf? ' * '" '^"- ^"^^f" creature is n a natural nositinn \\Z. f .. r ^fi'^^'*7> '' the young , Ho .ill not ,ay ,„ „„.,^,' ZTi^T^.^S^'^ ^,:^ l^ ^ has ellected delivery ii t>-em fifteen fo fvv,.nf„ i ,f' though lie the '< waters," and the creatu e h s respirclT^.d^iver ff ^M^'f ^fv "f .Its, it\itu™i;: Scull':' 'i' "" JT"""' ""'" ""'1 «-''. " |_«k .Sutals of' :; f 'p^ ^tn^;,:'^ ■ -;- a"tWn.tr..ce„t liuid- ■rE^it tesS '^^T' 'r r ^ "^ r 'fin j^^i;- 'its //•«, June, 18r(j. 204 I'AriloUKlV OF I'ltKaSAMJY. W'd found that cai-o anrl patience, and, abovo all things, an absence of undue hasto, are connnendablo, and particularly with regard to the removal of the meuibrancs, especially in priniipann. The danger of septic infection may iio largely averted by intraviiginal emollient douches, and serious consequences may often be avoided by abstaining from premature and violent interference. When portions of the foetus are expelled through fistulous openings, even then surgical interference might be successfully invoked. AnOHTION. When pregnancy is interrupted by the oxindsion of the ovum, or of the fcetus at a stage when this has not attained suflicient development to live external to its parent, abortion {partus iinmaturus) is said to occur But when the fcitus is expelled before the ordinary period of parturition^ yet witli alHts organs sulliciently perfected to enable it to exist for at least some time in the external world, this is designated 2>rcmaturc birth (partus pncmatnrus). In the lirst instance, the young creature is either dead when expelled from tlie uterus, or dies immediately afterwards; and in the second, it may be weakly and immature, and succumb after a variable period ; or it may continue to live and thrive. In practice, there is no accurately defined limit between abortion and premature birth, and especially when the latter has been brought about by some of the causes which produce the former. Abortion may be said to take place in Solipeds, when the f(Etu8 is expelled forty days before the noi-mal period ; in the Bovine species, thirty-five days; in the Sheep and Goat, twenty days; in the Pier' fifteen days ; and with the Bitch and Cat, seven days. Saint-Cyr says that It may be acknowledged that abortion has taken place, when the fa'tus is expelled in the I\Iare before the 8()0th day of gestation, in the Cow before the 200th, in the Ewe before the 140th, and in the Sow before the 100th day. There is not the same tendency or readiness in all the domesticated animals to abort. The Bitch and Cat rarely do so, even after serious injuries ; and the Sow retains its fo'tuscs almost as tenaciously ; but the Sheep and Goat are rather liable to thii accident. The Cow' and Mare, but more especially the former, most frequently lose tlieir footus, In what proportion abortions occur is not ascertainable from any docu- nientaryevidence. For the Cow, Baumeister and EuelT state "tliat in trance, a dairy containing Durham Cows, and numbering 100 preg- nancies, there were 17 abortions ; and at Ilohenheim, from a register kept for thirty years, it appears tliat one-fifth of the Cows aborted, Among -5,HG4 Sheep of various breeds at the same establishment, there were only 26 abortions, or 0-433 per cent. Abortion may occur at any period of gestation within the limits above named, though it is mucii more frequent during the first than thej second half of pregnancy, and especially with the Mare. WhentliisI accident occurs at a very early stage, it may produce no appreciable' disturbance of health in the female, and the developing ovum escapes' intact, and often unperceived. Tlie accident is more serious when it: happens at a late period ; as it then not only causes the loss of the young ! animal, but may compromise the existence or value of the mother. Abortion may be either sporadic, enzootic, or cpizoutic. When cases occur here and there on farms or breeding establishments over a! wide extent of country, without any relationship as to causation, they j I, an absence of undue [urd to the removal of Igor of septic infection douches, and serious ^ from premature and ;h fistulous openings, lly invoked. m of tlio ovum, or of ullicient development turns) is said to occur, period of i)arturition, lahle it to exist for at nated 2»'07Hatiire birth un^' creature is either lediately afterwards; '6, and succumb after thrive. In practice, artion and premature •ouglit about by some Is, when the fcctus is 1 the Bovinu species, iy days; in the Pig, lays. Saint-Cyr says -ken place, when the f of gestation, in the iOth, and in the Sow all the domesticated 50, even after serious as tenaciously ; but dent. The Cow and itly lose their fcttus, liable from any docu- i Eueff state tliat in numbering 100 preg- loim, from a register f the (Jows aborted, establishment, there j thin the limits above 5 the first than the 3 Mare. When this' duce no appreciable! loping ovum escapes] lore serious when it! the loss of the young j c of the mother. zoiitic. When cases; tablishments over a j IS to causation, they | ALVIDKNTS OF PRKONANCY. gO.-J are s}marn at the proper time. " J te , •206 rATHOLOGY OF rREGXANCY \i :'• immediately.! Filthy putrid water has also very frequently a perni- C10U8 influence on gestation. Some plants— such as the horse-tails {hqmsctaccce), sedges {Cypcracccv), etc.-and the leaves of beetroot readily induce abortion, according to several authorities. Eue, savin' ergot of rye and other ecbolics will, of course, have a tendency to cause expuision of the foetus more or less readily ; and toxical substances such as canthandes, which act upon the uterus, will do the same' i urgatives, especially those of a drastic kind, are a fertile cause ; and opium, digitalis, and some other drugs have to be administered with caution. Food or herbage altered by the presence of cryptogamic vegetation, especially when damp, has long been known to cause abor- tions. Ergotised grasses and grains have often produced wide-spread losses from this accident.- Excessive muscular exertion and unusual travelling, and especially if there is a predisposition to abortion, is very likely to produce it • if the exertion is sudden and severe, or even moderate, but coming after a long period of rest, it is all the move certain. Contusions to the abdomen by kicks or falls, or squeezing through a narrow doorway or passage, railv ay or steam-boat travelling, blows and shocks, keeping the animals m stalls with very inclined Hoovs, are all so many causes" A case came under my observation recently, of a little Bitch, extremely fat, which aborted at a late period of gestation, through frequently ascending and descending a steep staircase. Access of the male not unfrequently produces a miscarria<'e • and exploration jicr vagtnam by the expert has also been blamed, as well as surgical operations performed on pregnant animals— bleeding for instance, or throwing an animal down to be operated upon.-' 1 Saint-Cyr mentions that Gelk^ has witnessed nearly one-fifth of a flock of SheeD i abcn-t i.nn,ed.at.ly after drinking from a pond, the ice on wliich had to be broken to water them. Audoy reports an exactly sin.ilar occurrence ; and Delorme, who has also observed analogous accidents, adds that they are most likely to happen when the Sheep ' have been deprived of wat-r for several days. Ifuvellier mentions a rich grazier of Alerlerault who owned ten bro.,d Mare«, one half of which aborted every year, because they were sent three tunes a day to drink cold water. Often, after .lue.iching th.ir t nrst they trembled, were seix.ed witli colic, .-uid aborted. The regime was chanced • the Mares received water at inorning and mid-day in the stable, a Iia.uiful of bran being put in the water ; and only in the evening were they allowed to be watered outside, after the stable-doors had been opened for an hour. The abortions ceased. Flandrin relates similar accidents occurring to the Mares belonging to the Prince of Conde, and from the same cause. ' * The ]\'hrhu,ry Jonrual (vol. i., p. .122) alludes to .an occurrence of this kind in New /eah-ind in l.s,.-, It appears that this .accident was comparatively rare in that colony until the introduction of rye-grass on the pastures, after which it was common, and a caus,; of gr.at loss when the rye became ergotise,!. The same journal (vol ii p..l) contains an account of serious abortions among Mares in Cerniany, due to rus IvH-hoonsi, ruhujo) on the straw on which they were fed. In A uimal Plaun, ,s (London IS^l) many lntel•e^tlng nonces are given of similar occurrences Haselbach reports that in a cowslied where mai/.e infested with its pa-a^-itic Umm {Cstilano )mn>l>s) was given to the cattle, eleven aborted within eight days. The food was changed at once, and the otiu r Cows escaped the accident. A certain ,n.antity was administered to two jjregnant I?itches, and th.-v both expelled tlieir young With regard to the ergot of rye, its action as an eebolic does not appear to be so certain in Herbivorous as in Carnivorous animals, huge .piantities of it having ban given to pregnant Cows without abortion resulting. 3 Profes.snr P.,mley p-rformeci tile operation of castration on three pregnant Cows; they aborted in tw.. days after, and one ,lied. X,.v,.,theleKB. Clhihel bus .seen a cas' trator ..perate on a how about two months pregnant. Thr 'n'twvii, the size of the middle hni-er, were removed, along with the ]M.rtion of cornu in whi.h they were con- tained llie poor beast lost much blood, ami was very ill for six or seven days ; yet in more than t«o months afterwards it brought forth five young Pigs, which it suckled. AtVIDEi\TS OF I'MKUXAXCY Ml Carrying a rider, in the case of the Mare and P«r,o loii -i used, is attended with much risk. especially if spurs are Excitement, fear.i sudden surnn'qp r.r nn,T„,, i thunder has sometimes been s io^in hi ?::;''Ltt°h''r''- ^^'^^ by Dogs leads sometimes to heavy losses^Llc, '"'.PT^""",^ running near or among pregnant Cattlpnr%f,^n'''''^~^°^^°""^^ able damage especiall,^ Lo^Tne^^l^ ZSl'^ '''''' ^^"^^ --^^- Certain odours are said to cause abortion 2. IntcrnalCauscs. — Badlv-fed anrl i,o,riQ..f'^i • i but not nearly so frequently pefhans rftuZ ^"T/''' ^°"^^t>"^^« abort, and extremely fat. ^t L^nSv adn ittS T, /'"T"''' ^°"^ there is a special predisposittn fabo t atl u n?V''''' ?T ^'^^'""^^ -especially previous abortions-and conw; ''"^'^ *".^'"S ''^"^^ at all, will iiduce this acdrnt • wMe o hi "^^ ^^"^« foetus, though exijosed to X nCnit ^ ^"""H' "^''^'' 1°^« ^^^ir causes. This predisposition is i ot man fel IIZZ'I' ""/' ^""^^^"^ it disappears as age advances. "^^"^^^^^ externally, and sometimes A more constant and notent mneo u^^r^ • i , , presence of grave diseases'^and espec SlyX "w^ I' IT,"^ '" '^' generally, producing more or less do-.^^llnf . . n^'^f The various serious epizootic mahdfp« ^ !* ""^ ''l^ *^'^ functions. minal disorders which giVerisrtorestle^^^^ a Ithose abdo- , well as those diseases wh ch i clice coth as\?'"t v^''"' '""°^' ^^ i asthma, etc.-pleurisv and otl or .ffs^f ° ^ ''"''^'*'^' Pnenmonia, by great pain ;\s welCs nervou oi ronvTsi^riZ"" ^f^'^P^-^ [tetanus, epilepsy vertigo, etc., are al^s r^o n Is lSs"^^~'''^ '' In acute febrile diseases nf Hio ,.,^fi i.u ^^'^-uses. I the abnorn,al accumu a ion of he^ or Son^! '"*"%"^"^' ^^^1^^ ^™"^ fen.ale may prove fatal to the f rtus' In otj ""' T^^ ^"^'^^""^ ^" *^« Certain violent disorder affccth^ the fn ^""T """"^^V:^ '" ^*- death and expulsion of the vonn 'nl,f female may likewise cause the and-mouth disease a,u tubeSfis Thr/'V''"'rf°^' ^^'^"i'^^' ^'''- contagious pleuro-pneunVonh as Lo, '^ "' u* ^ Cow affected with a simUar mfumer ;' a to J^^^ '''^\''' ^"""'^ effected in can be effected in thiTvay ^Shee, whi , ^^'''^"^'•'"^.r^" °^ ^^^^^^ '^'''^'^^ dam was affected witl/^\Sida s e , tw?^ A'"'"' -^^'^^^'^ **^^^'' tion with the virus of tiiat r^^tZllZi Z:I;T' '' "^'^^ "^°"^'^- 2t; u,:- :;;;iir::;^,;n,°L:f: -i^:,^ t«., .„„„u. pre,„ant without the f„ 1 tin. and .van.,1 its Calf if it ;,;;;,' lllft * ^.dt' ..^d"" '"'^"""^ *'''^^" ^'""^ c,.i;f Sts-ii,,rs:i:. -^ - -^r r^i'f- '?- -'•^" --^ ^ m.scarry,.andufrirndwholivesne^.n rhln, ?. l"i^'. ^^"^r'-tl-^'lfss, tlu.y ,nn. liable to iwereoxp.iJ:iit:;;;;;;;;^i^-,K.Str;;;;;^^^^^ =>" the cawes , The principal .svn,,,tn,ns were V, , , ' "' ,'^"''^ '^"'"" ''''"''^ ''-^Vs l-lonred nuK.„. fronah; nLtrils, and :rL;'V':r.:;:;i:' rale, . , ..s after- the discliari'e of riistv- >"'Ks were t.nnefied, rediaml H:.:i;;' .u.dZ'l.r'""! ''^T'^'i ^* ^''"^ ''"'"i-i- the at fl„»v,i frnn. M,., .'.,.....;, ., "'■ ">^- '""^ t'"' lj'-rinarv nbstetri«t no less than to the animals confided to his care, as Saint-Cyr propeily remarks, it is well that it should receive attention. This excellent autliority judiciously presents the problem in three diiTerent aspects: I. i rognosticate a possible, but not yet imminent abortion; 2. Distin- nantity of blood- tions of placental is rod and tliick- d the cotyledons, ;cident, if due to ig to the period [ to its expulsion ; p. no WG have ) a knowledge of •us on examining ycd, the body of servation. If it in is linn, white, id its flesh white, has taken place uterine cavity, •e marked as the L'tus is swollen, ent odour, while Vhon the air has jd, wrinkled and ydramnois, then ances, intensely tter were turbid, in, the envelopes ! referred to on 1. It is that, as Lilsion in a short iparous animals, ver, is far fi-oin foetus may be -ich multiparous d or been killed ctly healthy and its gi'owth, and isence has occa- and even the rition will bring ! or more dead .d ceased to live iidition, or even oes not always lie cases, is in tinguishing this nary obstetrist, it-Cyr properly This excellent I'erent aspects : ion ; 2. Distin- ^tV/DEXT.S' OF PUEGNANCY. jlS animal asks such a question as - Will thi! .lo^f ^^ • ^ pregnant full time ?" this must bo L.wn JI i fi-eature carry its young the you to think it wi I not ^'' FoTthol ^ ''T^'''' ?^T"°"' " W^'^t I«ads Already asserted^ her^) is a sneckl nr.'S" ^' "r '^""^^ *^^*' ^^ ^^^ been abort from the n os trifllniTnlr'^^ animals to cause at all ; and ve ev o" W n. ^^^ "" ? •'^*^°"' ''"^ '^^^^^"'^ Inthisaspectof thrnuest^L t is «lun ' ^"^l^^*^"" ^^ t^^i^ tendency, maxims. ?he most ?mpo L"; o wS ^i^';haT^'Vr""^ '^'^ previous miscarriages before .rivn Jo • • ^^ relating to several such an acciden and th s onir nn°l "^f^T ^'.'° *^^^° probability of of the causes capkbTo coXomis I.^H •' ^^''^- °'' ^""^^ knowledge the animal has b^een oi sTlTcTS ThT"' °- ^''T^??l '" ''^'^^^ plete as possible and the. nn nS • ^ '"^^^"'^ ^^°^^^ ^e as corn- many of the causes of abortfonT " °""'^' *" ^? ^"^'^^"^^y 8^^^" ' ^^ ...any circuiiista ices mav nodffv ?/^^-^'.'"yf ««%,known, and so .majority of cases it is Tly penn/i^ result, that in the after all, are more or less unSahr ^"""'^ presumptions which, 2. ]!eco(j,me an Actual Abortion —Rexa xvp bn,,n +« a- ,■ abortion in process of apon.m,i;.K. I we have to distinguish an would appea? more easv a^d ti f?? '' h '• ^ ^-^ ^'^^ «'-^*^ "^^hing allowed until all the chS'Xv\<^?. ! ' T^^""^' '^ '° ^^^^ '^ *""« be of the foetus a'e plain ydevXed "^H^ut'v"^ '' m"^"^." '^^ ^"^P^^^^^'^ suited at the coninenceniPnt dnlin. fh ''" "-^ obstetrist is con- of the fa' tus . £ich a nltakp^- J '^^^^ d'sappeared-after the expulsion pregnant; thlnCe ^xtrir 1 o ? '^ f """^^ '^"-^^ to whether it is L,nm.o-oug toLet'n hod wrt] ^eneration-the vulva and symptoms tluHi.ditfullv 3 s / f '' '^"■'' ^'^^^ **^^ ^^^^^^ found that this is a case o ?hrt^ \n T i! ^r'"^ '^°"'^' ^^ ^^^^^ °^*^e" be in time, the aeci J^it ^^1^^!;;?;::^^^^=^;^ that, when taken animal ; thougli t is in o nation t; V^T ^^f ^^'^"^'^'^'^ "^ ^« veterinnrian tC'in fron fl f f less hkely to be sought from the 214 PATIIOLOGV OF ntEONANCY. 8 !i«ii U 1 i i impossible after fifteen days to assert with absolute certainty that such an accident has occurred, the generative organs having at that date resumed their ordinary physiological condition. For it is only by an early inspection of these that we can enlighten ourselves as to what may have taken place. In this inspection is included that of the mammce, which are always a little tumid, liard, and painful, and often yield a small quantity of milk after a recent abortion ; the tail, the hair of which is soiled and matted by blood, mucus, and the liquor amnu ; the vulva, which is swollen and dilated, and its mucous mem- brane often presents, in addition to its uniform and more or less deep- red colour, ecchymoses due to the rubbing or bruising it experiences during the passage of the foetus. On careful vaginal exploration, if the cervix IS found to be softer than usual and the os partially open, and better still, if the hand can be introduced without much difliculty into the uterine cavity, and a quantity of sanguinolent or sanious fluid or remains of membranes, is discovered in it, it may be concluded that a foetus has been recently expelled, Tkeatment.— The treatment is jmventive and remedial. With regard to preventive treatment, this must mainly depend upon a knowledge of the causes which produce abortion -which we have seen arc numerous and care in avoiding or modifyin^r these. This pertains to the chapter on the hygiene of pregnancy (p. 166). With regard to animals which have a predisposition to abortion, they should not, if possible, be bred from. Should it be desired to breed from them, if they are Bovines they must not be put frequently to the male, and certainly not before eighteen months or two years have elapsed since the last abortion If the accident has been due to irritation of the generative organs, then these should receive appropriate treatment. When pregnancy has again occurred, every precaution should be observed to continue it to a successful termination, by avoiding or removing those causes which previously induced the accident, and attending to the general health- combating plethora on the one hand, or anaemia on the other ; guardiiiL' against constipation by giving proper food and administering mild laxatives, and against irritation, whether general or uterine, by doses of chloral or opium given by mouoL cr by rectum ; and allowing only gentle exercise towards tlie end of gestation. When abortion appears to be imminent, active intervention generally becomes necessary in order to avert it ; and therefore it must be ac- curately diagnosed. We have already alluded to the symptoms and means by which this accident may be distinguished. If the veterinarian is fortunately called upon in good time, and he is able to assure himself that the foetus is still alive, that the membranes are not ruptured and labour pains have been few and not severe, the accident may be checked or prevented by the administration of narcotics, and keeping tlie animal in the most perfect quiet possible— alone in a darkened place, with doors and windows closed, if convenient. Tlie narcotic may be opium (in the form of tincture if desirable^ chloral hydrate, or chloroform. baint-Cyr recommends laudanum (one to two and a half drachms for large animals) administered every half-hour or hour, in very small encmata (not more than a wine-glassful at once), which he tliinks pre- ferable to draughts, but wliich may, nevertheless, be employed concur- rently. Zundel prefers chloroform, which, he asserts, has yielded extraordinary results in his hands in these cases, by suddenly arresting I 'oneral health— ACCIDENTS OF I'REGXANCY, 216 the Straining He gives it in doses of about three drachms to the Cow, m the form of draught m oil or mucilage, repeating them every hour! ErffTssSSa"°°""'"'^ ^^"P'°^' °^ ^'^'"P^^'^ -^^ °P--' -d strainl!!'''^ ^''^ objectionable, as they have a tendency to increase the The abdomen should be gently rubbed for some time, and the stall well lit ered ; and if the animal will eat and drink, eauly-digested food in small quantity, and gruel, may bo given until all danger has passed -generally or one or two days -when it may be gradually put upon ordinary diet, and allowed to resume its usual occupation. When abortion is inevitable-indicated by rupture of the membranes and escape of the " waters "-and there are no means of preventing the expulsion of the fcctus, the object must then be to favour the latter in some cases as speedily as possible, and remove the envelopes, should there be any likelihood of their being retained in the uterus. In the majority of cases, active intervention is of little value here, and is only to be recommended when the labour is tedious, and the animal is be- coming exhausted by fruitless straining, or when labour is altogether suspended after ruptureof the membranes. Then, having emptied the rectum the oiled hand is to be cautiously introduced into the vagina, and if the OS IS contracted or not sufficiently open, it must be gently dilated by the index and other fingers, until the interior of the ute.-us can he reached, Nvhen the foetus is to be seized and removed in the usual way ; should it be in a wrong position, or should there be any obstacle to its egress, then we must proceed according to the directions given for overcoming such obstacles when they occur at the normal period of parturition. In abortion or premature labour, however, the foetus being smaller, the difficulties are less. If It should happen that the cervix is contracted, and shows no sign yielding to gentle manipulation, then after a sufficient time has been allowed ineasures should be adopted to relax it. Belladonna ointment one part to four of lard), introduced into the vagina and applied around the cervix by the hand or any suitable instrument, may be used with advantage. Mr. Gox also recommends rugs dipped in hot water and applied over the pelvic region. Injections of mucilaginous fluids or glycerine into the vagina may be resorted to if the passage has become Si 1 ' \ r°T^ ""^ ^^"^ amniotic fluid ; and, internally, extract of b lladonna, chloral, or ether or alcohol draughts should be administered, pait.cu arly if the animal is exhausted. Gruel, beef-tea, milk, or other stiengthening fluids may likewise be required. The ergot of rye is of ittle value in cases occurring in the larger animals, and its use is rarely to be prescribed. ^ If the inombranes come away with the fcctus, there is little more to be done; though in the contrary case, which is by no means infrequent m abortion or premature birth, the membranes are strongly adherent to u 11 erine placental, and their retention, particularly in Cattle, is oftea roublesome Some practitioners in these instances prefer to remove them immediately and mechanically by the hand, carefully separating ho placentnl.p one after another; and though this is easily enou-h accoinphshed so long as the os is dilatod-whidi it usually isii th^ee .1^^! W f ''^^~^wu ^^''? ^'' ''°"*'^"*^ ^^'^^^^ «°'"« «'"^Pl« precautions, aSa ho ''''r' When they And the membranes flrmly adherent and then separation from the uterus likely to be attended with incon^ 210 J'ATHOLOaY OF PliKaXAXCY, ]i I n; li. f <-! roTroufl?LTr!^ ^"^''."^ ^^'",^.^^ *'^^'"' *»>-^ ^°"^-^ --^ twist them 2e cervif^on^^^^^^^^^ '^-^^ i" tl^e vagina ; 8o that shou d thfimVn If n ' '"^y "°' ^^ niipnsoned in tho uterus. Others tie be^Xllv removed % ^"" "" becoajes looseued, and can then mpdiPnfnn ^^""yf^- '^ ^^^^ experienced obstetrists rely on internal medication for the separation of tho fcutal uhicenta / n iT f^ Sy d^ 'T"°;; •°^' '*" ;"^^^ ^^ iiHsee^!cX\'ls S^^ pints a day, when this result ensues about the ninth day the faSr T^ V 'M^^K^'^r"'"'^ ^''''l"^^'^^ ^"'^"ti'^" '^fter the delivery of food "hou.h not in . ^' ^T' f ?"• ^'^^'] "" Smol and easily-dlfeSJd whchson.eti.nes accompany this accident will be alh.ded rKerea t^^^^^^ not be' alToweT' ^ w" '' ""''"^^ Pf'^^^'^^'^"- ^1- anhnlrshS p^°r^a'p^ a^th:ttetZrpord"°"^^^' ''' ''' "^^^ '^^^-^"' -^ ^^'-^ must not be prolonged aftL-Vhe*°resJL i " et. s'rurrd'o?^ Epizootic, Enzootic, or Infectious Abortion. hZ}'^^ ^""^ ^i'" "''r"^^ epizootic or c«^o6Y/c flior//o«, but which w. have designated " mfectious," differs in its etiolo-^y and son e oth " features from abortion occurring in isolated or ^nn,"f/i. . , i . particularly from its attacking all Vr tady a iS^^^^^^ It is more particularly observed in Cows ^,Or^mn ,-» ITi ^^ oi yeais— t lus constituting itself a veritab e scourge to a-u-iculture • nn,l Epizooties of abortion have been recorded from the earliest time. •' Ba -H 7 P V^^ 'rr^^'^'' ^'"^ °^ '^' l-«t «-^tur " wl n Flan Ir hi invesSaS\rat f'"^ ^^--^'lJ^\-^--^^ry authoritic^' undertook h"' n tH?l, ' '^'"'°'''^' ^^"^ '^^™^-'^ ^l^^y "^^llicted. The observers agreed as Zi^ ? I'"' ^° '^f ", *''^* Continental authorities^re ,W? ^' u - ^'^ obscurity which attends its development For Aoc/mjyrs of PitKoxAi^ay. 217 .0 Harn,8, it is very prevalJ^tTn Llovt ^^"""^ ' ""''• '"'""^''i i. see™, to have ,nade ies^; .p^Llt el! l*" Sr"''iri^'riy"t" -.he losses throui Maras al/ok':,gll°J ti « to'lrr'fas 7 "«? cent, in so.ne regions; in others, one-half of the Mare"ahortQd Th„ fx;S; "?; is t\Ji'rrtoS "tf t"^:?« ''"^= ™""^^^' -»' unV I M ntaTit in^ '°""i''^ oxperieoced the same misfor- une. in nj mtana it inllicted much damage n the Horse ranohps in 1892, when ic first appearec tliero Tn iwdi n,^ r -^""^^^ lancnes in as entirely a novelty tahatrSrThl t ""''' ""^ ""= "'"'^""'y Australia .„ outbreL of epiS ahoS^nt'Sor^IZoSfro n :i"ong Kllrl'iv'aZ:." ^""^ '" '««"• ^^^^' -Portra^rutb^^k Causks.— It we attempt to study the causes which have been allooed .8 oi,erat,ng ,n the production of epi^o,itic abortion we are baffled SEES SS --F'^?^--.-^ able iijjht upon it! ^ '^ '^"' ""P'^^'""' ^'^'^J^^^' ^"^ throws consider- With regard to ,jencral causes, it is remarked that the disease i^ nm«f ri'L T^r''''^-"^ '''' ''^''' ^' ^' ^^-^^ '-^ South GeiraTin 185? S lu S i^" ^r' "';""" ^^^'^'^' ""^^ '" Haute-Saone Lquenti; w.ll .c : y 1 "-' couM ries ; then it is probably due to anaiinia as w as to forage da.naged by moisture, ergotized, or otherw! c Xred food fTr ^'^"^^tion of animals, brought about by tl^! weat er u d food., ni tiie opinion of Zundel, particukrly favourable lor the nnlti p catioii 01 imcrophytes, micrococci, and bacteria in the ■ cmito uHna v t.eut;;.„s;'BrinVdir'itetd--tf^^^^^^^^^^^^ if m i .m "h- - U •218 PATHOLoar OF PJlEOXAXVy. been a supposed influence of locality— the disease fixing itself in par- ticular places and sparing others. For instance, Heuz6 remarks that It the department of the Niovre, France, abortions are very few in the arrondissenient of Cla.nocy, while in otlicr arrondissenients there is scarcely a calf. With regard to local conditions or causes, it is certain that the r^igime to which animals are subjected cannot be adduced as in operation ; for the abortions occur under every kind of management, and as fre- quently, perhaps, with poor as with fat stock, and irrespective of a«e breed, or constitution. ' Malarial poisoning is a cause of abortion in domestic animals as well as m the human species; and in the malarial districts in Africa lloiida, and India, Weatherly asserts chat the natives of these parts are so well aware of this, that they send their Cattle and Sheep inland to breed, only bringing tliPin back to fatten.' The influence of inclement seasons may, as has been remarked operate in inducing wide-spread abortion, but this cannot always be adduced ; as the malady— speaking of it as we would do of a disease- occurs at all seasons and in all kinds of weather, and perhaps much more frequently among animals which are housed than among those living in the open air without shelter of any kind. Neither can the influence of food be adduced as an exciting cause in many outbreaks, for animals fed with the greatest care both as to quality and quantity do not escape; and as for ergotised grasses or seeds, admitting that these may induce abortion— though it has never been possible to produce this effect on Mares or Cows experimentally, no matter what dose of the ergot of rye was administered, nor how it was given — yet the most serious visitations have appeared where tlie herbage was free from this condition, and where the animals were stabled. Strebel, for instance, informs us that in 1H7H and 1H79-80 from 20 to 60 per cent, of the pregnant Cows in the Canton of Fr'eiburff aborted, though they were in very good cowsheds; and Bruin mentions that in November and December, 1884, and January, 18H5 GO per cent, of the pregnant Mares in his locality aborted, the majority of the foetuses being in their envelopes, or these were ex- pelled in from two to eight hours after birth, though in some instances they were retained from one to four days. All the causes that have been adduced as operating in the production of sporadic abortion, and even extensive outbreaks, will not account for every mishap of this kind ; consequently, there has always been something tjiysterious, something inscrutable and bafHing, to the pathologist who sought to account for their appearance and extension. bo long ago as the end of the last century, contagion or infection was believed to play the principal, if not the sole part in many out- breaks ; for It was ol)served that when a Cow aborted in a place where other pregnant Cows were kept, these would abort in succession until all, or nearly all, had miscarried. Not only this, but it has often happened tliat a newly- purchased Cow-in-calf has been introduced into a farm where the Cows had always calved favourably at the proper time; and when the stranger has aborted, first one, then another, then a third, and so on, of the others have experienced tlie same misfortune, and the :>ialady has persisted in the place for con- ' Brilitih Medical Journal, February 2, 1895, p. 278. ACCWKXTS OF VIlEaNANCY. 319 secutive years. It is not always the proRnant Cows next to the one Again when pregnant Cows which were living in a place where the d.soase had not existed, have been introduced into a Table where i? prevail , those that are at the end of gestation calve regularlv and nonually soon after arrival; but if they are a certlin time k^the uifocted stable before this period is reached, they abort !?ko he others So tha the presence of an infecting element, if not absolutelv proved »H at least admissible, after the very numerous observations of tlfo most coijipetent veterinanans-especially of Darreau, Cruzel F^li/et Bou ev La esse, Nocard, and others, in France ; and Rueff, I aubner Francf I ololt. and many more in Germany. The insalubrity and bad hSne of cowsheds and stables appear to have no influencrin the pa ho genesis of the accident, as it appears quite as severely and rldUv in those which are well ventilated and cleansed as in those in the opposite conditions; in fact nothing can so well explain the occurrence orpar icular outbreaks of epi.o.itic or enzootic abortion as the presence of a coiitaginm or a vuaHvmtic infection presence ot The existence of a contagium would appear to have been proved bv the result of an experiment performed by Fmnck, of the Munich Veterinarv School some years ago. It had boon established by microscopical in^S Si V found ' 'TS '"f"V^"^^^ ^^^ ^'^Sina and vu^a there Is constantly found --as on the buccal mucous membrane — a minute fungus mixed with the mucus, in every respect similar to the LcmZ /.,«/... which, according to liallier, is only an allotropic condtSn of the ordinary moulds-such as the Penicilliln qlauann or A^^tmZ -being, in fact, a knid of bacillus. Towards the period of pXS tl>ese bodies become extraordinarily abundant, and thev app^^^^^ r„" when the T"^?''"" "' ^'^ ^"^^^^ memb;anes and 'tlSrxpul- s on , wlien the membranes are retained and putrefy in the uterus .oy are extremely numerous, as are the micrococci. ^ IVanck showed Si, L !''"''.•' ^""^''^ ^''^ expelled membranes of one which had been delivered, abortion can be induced So that, as Zundel asserted, it is suflicient to introduce into the vagina micrococci or bacteria, which will multiply there ad penetrat ZriC' "'"'"• '°""""°^ '''^'' ^^'°^^ °^ doLWo^ition'Jo'^rolt finl°^ln;sl'n1o''th;'rl"'^^ that abortion is due to something which aborted, as well as in the drains of the stable, on the littei oTc JZ'j:^'^^^7''''^'^.r'' P-'-"t fron! ti've to seven Td w, ", '"fect.ve material, and i- twelve, fourteen fifteen It r ^k'"' ^'^^'^ '^?"^; *^^^ "P-^i-ation they aborted. ' ' oLidi ^ot Iron^b? one animal got rid of its f«tus prematurely and one whic vi r T^*^'"' °' '.""''(''«"-a very old notion indeed. one ^^hlch will not bear examination. Cows do not abort when 'J 220 I'V' VI" PATHOLOOY OF PMEGNAXCr. % lll'^^Z^'f^ them, and why should they do so when abortion takes place ? Sympathy should be shown as much, if not more in the first mstance as in the second. ' nrJJ'n?nV'rt'"'i?*^''l^*^*",''"*'^ *^"' ^'""^ °f abortion to the fact of pregnant Cows bemg brought mto contact with putrescent materials or norn'a'ndTf't'' they were derived from^ this was lother o I notion and so firmly was it believed in by farmers, that, in order to to Z^ ^7 P''^"T? ^°^" ^Sainst this accident, the^ were accustomed to smear the animals' noses with tar when any bad smells were evident But for this belief also there is no better foundation than for tht supposed sympathy; as it frequently happens tliat Cows go thefr fiH oSl ^""^\ °^i f^^'^' and it even happens that in a shed a Cow w suppoxtable stench of putrescence, and yet other pregnant Cows will remam unaffected; whe not unfrequeutly abortions tccur i n Twe be perceived'' '^''"^^"''' ^' '''^^ "^^^"^^^ *°' ^"^^ "° ^ad smellcfn The evidence in favour of the presence of an infecting agent in these outbreaks of abortion which cannot otherwise be expfained i^st ino onT for ir ad'd?;"' 'I 'T^^^^^ stronger froni^aiTet^^eHme ta naLWl WP hfi ?"" the investigations of the authorities already oK ?^ ' Tl . T^ *^'°f ^ °^ Nocard, carried out ten years a-o which fn elt V .oin ' W ' 'r ^"'^'""' ^^ ^^"^ ^'^''^ '^^'"-^^ -hausS on eveiy point, while his experiments were conducted with tint a3 Zt'Xr'"' "";^^- ""'' ""'' pathological inquiries He as "' tamed that there was nothing in the living animal to indicate that S formX'r f' ^'^^rl^'^r' °^ '''' ^°^^' - ^^1 the functon tPnH nf ^ perfonned, the temperature does not rise above the H.P hi A '7^' ' f'"" """" '^^'^^^^'^^ "Either sugar nor albumh' am the blood, milk, and various tissues are unaltered. The hSo"3 examination and cultivations of solids and fluids did not re eal'tlfe presence of pathogenic organisms. He examined the bod es of Cows which had just aborted, of those about to abort-especiX primimii Sn. I. ""' '''^".'^' ^'^'^ '^^"^'^^^^ b^t «till retained the fa'ta puSr'flakes''ofTt' -li^ "!! due precautions, fibrinous muo purulent Hakes of a bright yellow colour ho found in the latter' andThXTf '^^T'u'''^ "^ ^^P^^-^^'"" '^'^ '"^^--^^l -^^^ fcx.tal placed te' and the placental vilh were of a dircy white colour, lookin- as if in filtrated with pus or macerated ; around the base of the "co yledo s reouentTv ^^^^ f '"'''^' °^ "\^ ^^""« >'^^^"^^ ^'-'^^«- ^hnilar to tho cotvS f. o^f' '?. ^' Pf '^"S roni the vulva after abortion. Th cotyledons, after their placental covering was removed were firn flakes Scf.,i?^" f"T °^P"''^^l'^»t-Iool't'^« ";'^«^' "P in a mucus and iibrinous Tn shonch Jn r' r"" ""l"^'' of micrococci -isolated, double, and veS also a W~;i f. '"1 ° ^'^7;^' .^""'■' '^"^^ '^^•'^ '^"^'^' ; here and hore were also a few short thick bacilli, isolated or associated two by two ACCIDENTS OF I'REG NANCY. 221 su-race these organic,,. S;S' i'„" IVt" TuZSe'r itS^ sown with b.ood a„a nkk^'r^d'SZpid" 7''""'- ^"^ '"^°» Dimilar results were obtainp-l in ill fk^ ^ • , which had aborted the piovk.;; v^^^^^^ the experiments ; but in a Cow .^,.1 i-nc jjiuvxous jeai, and was afterwards sforilo q nnxed vanety ot^ oi-ganisim ,vas toimd, while the matter obtaMW scraping the uterine nmoons membrane "avo a sli.,hfl,, ™„fj ""^ "^''="''" '•^''°" ^crangenjent ean,cd l,y thrp^esl .e'roU^se" ierocoroi '° hT ,"' a.e d„c to th,8 cause ; he has e.amn.ed the mednlla oblongata of those ,' ' ; " r.™:'!,'" ' - 'if'; <" "- young ani„,al. TheSeZ iiiK at of micro-organisms in the ]• , ', " "^^6 existence to expulsion fron, ti,eute™r(Sg,T';;:;:'a*ii";hfShrrr' T-, ih.1 S/T^'^''^''' °f '■"f^'^tious abortion among Mares in Montana 00,, l™! ,"„°,i y" '"-■"" «l>s"lulcly deiuonst,'ated how the infection is ' '"^V-, i'"*'^''^*^*'"" *^oes not destroy thoir viMliHr t*. i *;n:;i:'i^vfrhiLlx;;';:'l^[,'"r^■™■"''™"'" ^o\v3 ^vluch abort, and that when not removed artificially 222 PATHOLOGY OF PIIEGNANCY tl Hi 11! [MM they only come away when decomposition sets in. The influence of these putrefying membranes has been noted by several veterinarians— Pelo, Barrier, Cruzel, Bouley, Eychner, Haubner, and others— who imagined that the putrescent emanations infected the economy of the animals breathing them; but Zundel think it more probable that direct infection takes place by the genital mucous membrane. In support of this opinion, he quotes the observations of Eoloff, who asserts that he always saw the disease or accident developed in stables or sheds where the distance between the mangers and drains was small, or where the drains did not have sufficient fall, whereby the hind quarters of the animals were readily soiled by the excreta in them. The micro-organism may obtain introduction to the genital passage of pregnant Cows through actual contact with these matters, or the air may carry it to them when the discharges have become dried. There is evidence, then, which leads to the belief that, beside the other causes which have been cited as giving rise to abortion, there is a specific germ that, when transmitted from an animal that has aborted, or from the aborted footus or its envelopes, to another pregnant animal of these same species, will cause it to abort. Clinical, experimental and hygienic observation are in favour of this opinion, which if it cannot be accepted as absolutely confirmed in every respect, yet affords at any rate a good working hypothesis that satisfies the exigencies of everyday practice. •' Whether the abortion germ is identical in every species of animal is a question still to be solved— though it probably is not, as Mares have aborted among pregnant Cows, Ewes have done the same, undi vice versa without abortion going beyond the one species. ' Symptoms.— It is rare that this kind of abortion occurs before the third or fourth month of gestation ; more frequently it is at the fifth, sixth, or seventh month, or even later. There are no premonitory symptoms, except perhaps a trilling uneasiness for a few hours pre- viously, with sinking of the flanks and descent of the abdomen • the animal generally looks well and hearty, and yields its supply of milk as usual; and soon after the foetus is expelled, apparently without any effort or inconvenience, and along with its membranes, if these are not ruptured, with or without them when they are. It is rare, however, that the ruptured membranes are rejected immediately after the fcetus; as a rule they are nearly always retained, particularly when pregnancy is advanced ; and they putrefy in the uterus, being got rid of only in shreds at intervals. When attempts are made to remove then) by hand this is found much more difficult than after ordinary parturition : owin<' to the membranes being very adherent, the cotyledons have to be enucleated separately, and even then the membranes come away in fragments. Then the animal generally loses its appetite and condition, goes off its milk, and sometimes perislies, probably as a consequence of this placental retention. If it recovers, u'strum appears unnaturally frequent, thougli conception is infrequent and sterility connnon ; and on the other hand, there are some animals which expel the membranes quickly, conceive soon after, but again abort as readily— perhaps three times in the courso of a year. The fcrtus is usually dead, though wlien it is expelled (in the Cow) after the hftli month it may be alive ; but it is weakly and soon dies, even when born near the termination of pregnancy. These Calves make ACCIDENTS OF PREGNANCY. 223 a rattling noise when breathing, accompanied by the discharge of a rusty-co cured mucilaginous fluid from the nostrils ; they are attacked by dmrrhoea ; they bellow continually, and are always emaciated and flabby the gums and palate being pale, and the umbnicrvessels hv^d and withered-looking. The dyspna>a and great weakness eviWdhv them shows that they are not properly organled. Nocard belS^es that such Calves die from the same cause as those which are aborted dead Those which are dead when expelled exhibit indications of hay W ceased to nve a short time previously. "civiug ceasea I As has been stated all the animals on a pasture or in a shed where he disease prevails, do not abort at the same time, but at TnteTvaTs after this it is the turn of Loth'r.^andt^on^^^tfl ^Zth rcl^ oT^ aboLd!' ^''°"'^' ^"'^'^ ^^y^'^*^ '^'^'^ -°'^^hs' ges'taTio^n ^e It has also been mentioned that it is only after being some time in sheds in which the disease is present, tliat newly purcha'ed^ pregnant Cows are attacked ; those which have passed thei? eighth mS and are near calving escape abortion. ° "'oum ana Darreau alludes to instances in which a pregnant Cow leavinrr a shed m which abortions prevailed, and transfer?ed%o anotljr where^he accident had not been seen, would remain all right for some thne then suddenly miscarry, and n the course of about fifteen days o iTer abor tions would occur in this shed-testifying to the dan-ir of keeninc^ pregnant Cows in contact with or in proximity to thosf which CI miscamed in this way. It has also been stated that an anTmal wS aborts either remains sterile or has always a tendency to abort laTn But It has been observed that if Cows are well fed, the period that e apses after each abortion is often longer ; so that if a Cow^ aborts the fir t tune at six months it wi 1 do so again at the seventh month and the third time a little before the ninth month, reaching its full pe k)d"n three pregnancies. ° i^t-uoa in The symptoms of infectious abortion in the Mt^re do not differ much from those observed in the Cow. Very often nothing at all s noticed the animal appearing m as good haalth as usual ; in otLVLsJances here is uneasiness, which might pass without att ractin^^ much at e" Z .^" '^\^^'^^^-'''^ outbreaks, very often the & h^dicatfon obsened was the return of oestrum m Mares supposed to be somP mon hs pregnant ; and the anin.als being at pasture the exnelled loQtuses escaped detection, until in some of the Glares precmancv 1 ad cov"^^^^^^^^^^ "'""-/^^ i^ '' *^^ abortions SCtlil I ZZi • ?!f ''•^' "^^- ^^^ l'«^>« t^^^t lived for a short time ad mluuumation of he joints, which often ran on to suppuration and this was ascribed to the same organism which had caused\he abortio" and'it'^^n'f''"^ A_NATOMY.--The appearances observed in the uterus and Its contents in infectious abortion have already been S v ut ot: ded'^The'^^t'^^1'^ investigations. an!l t'C ^^S jS ' loo' „? • ^f envelopes arc generally much altered in flakes wlH«" 1^' ;•" ^"^^^^■.^^^'^' and covered with pus or Ivmph-hke mtn,;. 1 "" ^"^i'^f ^'""" ^'- ^'''^'^' ^'''^ sometimes flocculent The mucous membrane of the uterus it often very con-esLed Tn \, n . 'u th. case of the Ma.es. the fetal membnfnes Y one' outLeXweTe Iff 224 PATHOLOGY OF PREGNANCV. H'^-iJ iii li , ii always found abnormal in appearance. In one instance the portion of the envelopes in the corniia was undergoing decomposition; havin- . deep-red congested appearance, followed later by a leaden-gray fee dplo. '^^ ^"^/ "^"^7 ^"^"^ °^°"''- ^^*«*^«^ "f *he membrane; were destroyed, and small quantities of a muco-purulent matter were found. TEEATMENT.-If the malady is suspected to be due to any one particular cause, or if there exist predisposing causes, then the iiidi^a- tions lor the prevention or cure of this accident are obvious The atonic state which seems to favour the occurrence of infectious abortion in or alter certain rainy seasons, should bo remedied by good food anri tonics-and especially preparations of iron. Tonics have been par f!Si "" ^'i^'"'"''!''^'^] "^ r ''^^ abortion was supposed to be due to ergotised food ; though Zundel recommends the internal administrat?on of carbolic acid. In cattle-sheds where Cows aborted year after year Brauer has employed carbolic acid with the most marked success He gave It to Cows which were from five to seven months pregnant bv subcutaneous injection in the neighbourhood of the flank, the dose being two Pravaz syringefuls of a two per cent, solution i It, however we admit the most common and eflicient cause to be in- fection or contagion-that abortion is due to the presence of a micro organism transmissible from an affected animal, or from something which has belonged to it, to another in hoaltli-then tho first and misch"-\'' ^^^^i^^t'-^- is to remove or isolate the source of the When therefore, abortion occurs, and there is reason to believe that this accident is in its nature infectious, the fcetus and all pertaining to ;L ir 1 i'"'°''"^ f • P^-°"^Ptly and completely as possible from the shed or place in which the animal is locatedf The Cow itse should also be removed-or, better still, the other pregnant ani Ss m the same shed should be moved away to another building -an either kept altogether isolated, or at least away from all other pregnait cattle, with a special attendant employed to look after it ; th?s a - tendant should not go near the unaffected pregnant cattle and tie excreta from the Cow should also be carefrJJy kept out of their way The shed in which tlie accident has occurred, and especiallv f it contain more pregnant cattle, ought to be innnediately clea^d o all manure and other matters of an objectionable kindf the drain and the floor-particularly that of the stall which has been occup d by tlie Cow--be,ng thoroughly swilled with water, and sprinkled wi 1, sonie good disinfectant ; the walls should also be li.nlwashed good layer of straw may then be laid down, and the cattle replaced' The shed should be kept clean and well ventilated for a iiumberof days, and the drains well flushed and disinfected ^'umuer oi The animal which has aborted must also be at once attended to. If trat:on of this .n,,.dica„.ent has quite recently W^nhl^i orwani ,Jah, S't uccessful ..,n,,l„yn>.„t is reported in the .\o,lk Bnfis/, J.>7!n,/nn-i IrjZl'JyV^ di.s<.lved in M.tHeient war. wat.:,- to make a ,na the" S- ..^^"^■ d^" ^ ^ V" iS'r ^;^- e':f^S,f --' '" - -- - "'-;^v;^;ed^:;i -:;n;-z Th.H medication nnyht be combined with Xocard'.s e.xternal treatment, n.entioned above. ttcnded to. If , mentioned above. ACVinENTS OF PREGNANCY the membranes have not hp«r, ;\\^ u i the case--they shouW be removed f^p??^^^ ^' ^^^' frequently to putrefy ; their ren,o ^1 sh^ulfK^pr/f^P^?^^^"' ^'^^ ""* ^"o^ed sohition of carbolic acid orro IrsiSat^ ''' ^'"^' ""^ '^ ^^^^ sunn, or salicylic acid ought to £7^^^ T f' P'^^^^^'^^ate of potas- per cent, solution of carbolic acid h.Tn^ ,° ^^^ ^'^'^ ^"'^ ^^erus. a vulva, over the tail and down the barLrTSfT^ J^T"^'^ ^^"^^ ^^^« branes themselves must be destroyed Sv K i*" ^^\^^^- ^he mem- not be allowed to go near others whch Z, "''"'^' ^"'^ *^^ ^^^^ «^^°"ld any discharge i^.r^./r.m forslfetv Z^T^T f- ^"f" ''^ ^^^^'^ '« extend at least to from ei-ht to fiffclf n 1 ^m"^ °^ isolation should good nursing in the meantime andTt th^'l I ^''! T ^'"^^ "^^^ ^^q^^"'- until every trace of irritatioTiL thLllt "°' ''T^ *° ^^^ "^^^^ If Cows show any syn^n/s of imS \°''^'^"' ^^^^ disappeared, pron^ptly removed from the v Lin tv oTofl ^^ l"'T^ ^^'^'^ °"S^^^' '^ be When this accident continuer/n n f , ' ^^Y"^ ^^'^ ^^ ^^If- necessary to recomm nd d^^^^^^^^^^ a 1 tbrr'^^'^^V^'^^-^^^^ '^^^"ks it introducing others into it to thomnl 1 ,^°'''' *^^'^^" = ^"'^ before removingallexcreta;renewi,tttsSL '"^ ^f- '^'^^"^^'^^ ^^ by the mangers, racks, and ^41^1 and wooaworr^;^''^ turesif necessary, and leaving it emptv with t 1 /''^ "'°'l ^^.'"^t^^^- open. for a month or six weeks ^' "^^"'"^ '^"'^ windows nilli: th?fdwLg^i:::^tu rn£i^"^ '^ ^^^^-'^*- ^ocard recom- sheds are to be welf cleansed 1 H. If ' V V^.""^ ^ ^^'^^^ the cow- spru.kled with a string 'outfon^oS^^^^^ '^^ ^°^^^' ^"'^ *hen -one part to fiftv of water 2 ThP K '^T'' °^' °^ ^^"'bolic acid wards to the hoofs of the hind li fh, V"""' ''"n'''' ""^^ infected sheds, to be ^on^t^^^^^^^^ "^^^^^^ nSHorictir^ : : l^-- Corrosive sublimate - . ^ ^n.. These ingredients to be thoroughly mixed ■ nn^ no fi poisonous to n.an and beast, care Zst belaken "'' P^^P^^ation is JetfratZr^r:nhhntcT^^^ ^?°P^^^' ^-^ '^-^ ^-nd tion ; though, as Noc^d rema ks in soT-"'^'' °^ V"^ ^^"^ °f ^bor- not wholly^cease during tlTSst «• lvin°T '"^^^^^^^ 'he accident does in the second season. ''^"^"'^ '^^'°'^' but it always does so Witli regard to infectious abortion in the Alare «lm;io those recommended for this acciden ^Ll^ ■ '^'^' measures to enforced. In Montana. U S A ' hZ n^ i!"^' '^^'"^^^ ^bould be 1. If tlie Mare aborted in an open nddn f ''"bed were as follows : fetal n^embranes were to Zx^LT^^A^.^^'^T.^i^^ ^^*"^ ^^'^ or small lot. where she could bo rasii;" Jea cd '"If't'" *° " ^^"^'" to a stable, this had to be anarr Zl ., ^^ ^^e was removed pregnant anin.als, and not on^ g ZdZn' hT ,'h''^ ^°"^^'"'"^' run on to other parts frequented hvnrl ^^""^^^hich the urine would -nail lot, this h^d to be Lw"m sit J-rd^'Tl ^^T ' '^ '^'"''''''^ '^ ■' '"'^'l>t not be a source of dam4r f Who,, mI ^be drainage from it are not doing well, their externa '.rnniVni! f ^^^^ bave aborted and with a solution of corrosive suinnri'^'itn tboroughly cleansed ■tself was to be thoroug ly 4 e t^i\ [i ^'^^^'^^ °^ "^^^^^ > the tail D y \\abnca with the same, and, if in Hy-time 15 !i Ml 22(3 rATHOLoar of piiEdNANcy, nw if: ti n a solution of carbolic acid (1 to 100 of water) was to be added. The vagina and uterus were also to be cleansed by injections of clean tepid water, and the solution just mentioned injected. These injections were to be made once a day for two or three days. 4. The attendant on these Mares was to thoroughly disinfect his hands, and, if possible, change his clothing before he went near other pregnant Mares! 5. After two or three weeks of treatment, the Mares might be allowed to be put to the Stallions. 6. Foals affected with joint-disease (this being considered of the same nature as that which led to abortion, and capable of producing that accident) were to be destroyed and their bodies burnt. 7. If, however, the foal were suffered to live, it was to be separated from pregnant Mares before the swellings had suppurated or become sores. 8. All Mares dams of Foals with affected joints, were to undergo the same antiseptic treatment as if they had aborted, if not doing well. 9. Mares that had aborted and done well, were not to be allowed to the Stallion earlier than two or three weeks after the accident. With regard to Ewes, similar curative and preventive measures are to be adopted. Those recommended by Labat at the outbreak of abor- tion among these animals in France in 1888, were perfectly successful. There had never been such an occurrence among the flock until this one, when a large number aborted without any assignable cause. The following pri cutions were recommended by him : 1. Evacuate the sheepfold. 2. Separate the pregnant Ewes from those which have aborted. 3. Place the pregnant Ewes in a clean, well-ventilated place. 4. Every week remove the dung, clean the floor, walls, and racks with boiling potash-water. 5. Every Ewe which aborts is to be imme- diately removed from the healthy to the second group (those which had already aborted), and complete delivery if it is incomplete ; replace soiled litter, the ftt'tus and membranes to be covered with lime and then buried in an out-of-the-way place. 6. Every morning sponge the vulva, anus, perina>um, and tail of the Ewes with a solution of corro- sive sublimate (1 gramme to 100 grammes of alcohol and 2 litres of water). 7. Feed on good food and avoid chills. Vaginal injections were not recommended for the pregnant Ewes, for fear of causing abortion if badly given. Only four abortions occurred within four days after tliese measures were adopted. The treatment was continued for eighteen days, and the pregnant Ewes subsequently gave birth to their Lambs at the usual time. The expense of the measures was trifling, and carrying them out caused little trouble, two men only having been employed for an hour every morning. Should abortion be traced to the food — ergotised or otherwise damaged fodder, or water, of course the use of this must, if possible, be prohibited, and a change resorted to. If the pasture grasses are ergotised, then the pregnant animal?, as a matter of precaution, should be removed from them, and placed in more favourable conditions with regard to food. It may be remarked that ergotised or mouldy dry forage may be rendered safe for consumption by scalding it with boiling water or steam, or pickling it in salt. It should not be forgotten that, whether abortion be due to casual causes or to a virulent micro-organism, and .vhenever or wherever tlie accident occurs— whether at pasture, in sliawyard, or in shed- the greatest possible care should be taken to isolate the animal, if it is with pregnant creatures of the same species, and to butus are com- pletely developed, certain alterations occur, both in the uterus and the foetal connections with it, which bring about the expulsion of the young creature. These alterations would appear to consist in a gradually increasing fatty degeneration of the decidua, by which the organic connection that had existed between the peripheral portions of the ovum and the uterus is gradually destroyed, by a regressive process in the cells lying between them ; while the blood which was sent to the organ is now diverted towards the mammue, for the secretion of milk. The exchange of materials between the uterus and foetus is lessened, and the latter— always more or less of a parasite— becomes like a foreign body in the cavity of the former, its greatly augmented weight and volunie also aiding in the change. At all the places where the cell degeneration has reached a certain stage, the terminations of the nerves are irritated. But to obtain a reflex action, and consequent contraction of the uterine muscles, as Schrocder observes, a certain amount of continuous irrita- tion is necessary. This sum once obtained, a reflex action takes place in the form of a contraction, which, however, is slight at the beginning. Then a pause follows, until the sum of the irritation is again suflicient to cause a contraction. By the increase in intensity of the contrac- tions the uterine wall is removed from the envelopes, and this separa- tion becoines a new source of irritation to the uterine nerve-tibres. The reflex action, in the form of labour-pains, becomes more and more powerful, until these follow at last in rapid succession jnd complete the expulsion of the ovum. This irritability of the uterine nerves progres- sively increases with the advance of pregnancy, and explains the regular setting in of labour, as well as the not infrequent retardation of the pains in cases where the separation of the membranes has been pre- mature. The sympathetic nerve is in vV probability that which is most con- cerned in the uterine contractions, as it is the'motor nerve of the organ ; and its influence is called forth by the irritation just mentioned as being produced on the terminations of the nerves on the inner surface of the uterus by reflex action, the irritation being transformed into involuntary motor activity. It is surmised that the sacral nerves are merely inhibitory. SECTION II.— THE EXPELLING POWERS. The expulsive force by which parturition is effected resides in the nnstriped muscular fibres of the ntcrus ; theKe cause the or^an to con- tract in a rhythmical and somewhat peristaltic manner, the contrac- tions of the abdominal nmscles and diaphragm being merely auxihary. The contractions of the uterus may take place although the organ TUE EXVEUAKn I'O IFEllS m PAHTUltlTIO V 22» been observed in the false trestation nf thn Rif^i V-^^" ^ '^^^^ the tenuinations of^le ,4i^ "s w thi jth« .^'^e pressure exercised on couMnon parlance designated 'qabou. min^''^ T/^^'''^' Z^^*^^' ^'' ^" while the resistance the^y have to ove coiSe is cei red'S it f^T"^^^ during which the organ seems to be gatLdnfstre^^^^^ 'T?' As in almost all unstriped muscular^fibres thf re/ex Ic i^f^ oTin-i:L\ion'or' "-^^"^ f^^i S-dual^a^Ad'^c^ordinrto^the^^^^^^^^^^^ ot nutation, of varying intensity and duration. At the commS? the iilerme walls arc not relaxed on their con lent. h;,f.,»* '• ™"8d in a certain state of contraction by thXn city" i ZsZ'"""'"* subsides ' P'''^'^' ^°' '^'^^ *"^^«' ^'^'^ tlien as gradually particularly in the early stage of paSoT's"bviouV°Sral°low force is centred and ii^.^/^''^ *^'^ '"'" ^^^'^^ °^ '^^^ expelling £ sf f ^^ V^ ¥ - ^^"^-^=^'^^ s. ^iSs ^^^ 00^ he to Xf ^ > ' ^''' '^;' "^ " ^""^"^"^ ^° *»^- uterus but they aireaa^Sal^^a^e^-SS^^t^;-^^^ -J 280 XOA'MA L PA n Tl 'It IT ION. tn I li 1 I contrac ions force the bag of waters against it; so that the 09 is gradu- ally wjdenet , and tho cervix really hccoriios a part of the uterine cav'tv. A8 soon as the os is slightly opened, the bag of waters enters it and acts as a niech.mical dilator ; then the lower parts of the fore limbs, succeeded by the head of the foetus, are introduced, and from their combined sha, •> ncr lik.. a wedge, until, by the eccentric pressure, the cnest 13 passt ,1 m, anu the cervix being drawn over the presenting parts, tne OS 13 of the same diameter as the vagina, which then, with the uterus, constitutes one common cavity. Every part of the cervix being acted on by the longitudinal fibres, the aperture of the os is perfectly circular at this stage-as is observed in the Cow and (I ,at when the uterus 13 pushed back, and its orifice is visible at the ulva. Irregu- larity in the contractions, howosM. ;md particularly \v hen they are rendered so from a transverse position of the fcrtus, delays the dilata- A?°« . iu 1% otherwise rapid according to their force and frequency. wV.i fu f 7^'^'^^'°" °««"r« ^-e'-y slowly, especially in primipara. ; and when the foetus prr-sents by the croup, or when the body of the uterus nclines too much downwards, causing the cervix to bend up towards the sacrum ,t is also very tardy. As soon, however, as the inechanical action ot the water-bag and fu'tus comes into operation, it makes rapid progress in natural parturition. If the uterus of animals usually uniparous contain two foetuses, the two cornua are about the same si^^e, each having a foetus in the same position as it there were only one in the uterine cavity. In general, the two foetuses present anteriorly, although it sometimes happens that the second, or the first, , even both, present posteriorly ; not infre- quently the second makes a mal-presentation. When there are twins parturition is more difhcult and slower than when there is only one ' possibly because the great distention of the uterus diminishes its con- tractile power Another feature in twin pregnancies is that parturition often occurs before the ordinary time ; and even when this has been reacned, one or both foetuses are smaller and weaker than when there is only a single foetus. When twin parturition sets in, the uterine contractions commence almost simultaneously in both cornua, which arc much less apart than in the non-pregnant state; but as the two foetuses cannot be born together, that which is most advanced is delivered first, the other, which nfi, Tk ! ' ™^«hanically aiding in its expulsion. In the Mare, the mterval between the birth of twins is rarely more than ten minutes • witb the Cow it may be one or two hours ; and with the Ewe half an Hour When the position of the second foetus is favourable, it is usually expelled more rapidly and easily than the first ; and when they are of a different size the largest is ordiiarily born before the other. When the number of foetuses is greater, they are also expelled successively at intervals of some hours. ^ In cases of superfootation, if such an occurrence can take place i animals other than in those the cornua of whose uterus open into the vagina, the uterine contractions must be limited to the cornu contain- ing the foe us whose period for birth has arrived ; otherwise, the other foetus would be expelled at the same time, and there would then he a birth and an abortion. With the small multiparous animals, in which ihe fa-tuses are expelled one after the other, it may be admitted that each fraction of the uterus corresponding to a foetus contracts in its turn-at first the TUK KXVKLLlNn I'OWERs IX f'.t Km/.'/T/uX. 231 more enertjetK- n the Miup H.nn fWo r'. "'juu^u im,y are always pan^. and the ex.stence of meohaniial obstLles to Zt2 of the bec^ins'and 'Jh"^'^'*' ^^ilatation of the os, th, third stage of deHvery .1 to the r ;' ° V'!f '.''^^''^ '''^^''' ^^* ^" the uterus .tself. boinK nJuu-U r. ''^ °^ **''' ^"^^^^'^ "-"^^ "ow the circular as well as the h ' uterin!;^ c ivi ? """ 1 "''' ''''''' ri-l^^neously. m orde. to d n n h m utenno c;ivity and quite expel its contents. In this thev ar« nnH Lw^'^^/ '^"^ --^Wonunal muscles a,,, the diapWrn whfch at rt^'pt'^.Th 't ^i".'V ^*^?"»"^ ^"^- Particip'atioS of U st laTe^ithS' it ^Net^itsl^ IstCt^'^; for birth n.ay take abdominal r-nvifv /^^^^ "i^'.t-S'S, it s a fact that, in diininishin.' the in r^nlT ^f T ^'^''T^ ^'" ^*' contents, these muscles concur Ired ?owL! r "\ **'" ^^"■"°''°" '" ^*"«h least resistance I ettectrvrsortLi /'';l''' ''^^''y^ '^"^^ ^« their contractions are enectivt, so do those of the uterus, which are coincident with thpm menfq ..i H,« f f ' must be remembijred that the move- mred w t H T ""^'^ 'V^'"^'' ^"^^ ^^ ""!« importance when c ui- parea witli th. resistance to be overcome at hirf-h • =o fuT*. I creature musi minin 'ihnn^t if .w T ^' .^° ^hat the young if thi« nr.f Ir !) '""lost. It not quite, pa sive dur ne the act And local sep.o»i, or pa^si. tafn Ktoo.rp'o ui'; ,' ^IZtZr" '" i. ™ t aTfo";;' :-";;:- »; "- J-f- aL.- .h. .,,,.* o?[he,„„ther, once, ami that ti™,. ,w- . ""* °''=''"' ''° ""' "^ase to live a ^.er.h^\,r^.^r^-l^^ X^;^t^^;;;;^i^,^;;'^,;:i7 ''''' ^"' ^^^^^ gast^o^iyj^'to;;^ woman; hX! iJZlL^^^^^ f" ' ' ^o contract as in the living Cat's uterus eve. whpnh '°"'. '""" °^ ^he cornua of thl erus, even when the organ was detached from the body • and $ 292 NORMAL PARTUniTinS', iAi> -ilf £;l!;:::°f^uty^::;i.:;:;i;:.:l::^;^^ ^'- -'«'•- «^ ^^-^p ^o contract for As wo have mul, tlio rosistanco winch the expellinL' forces have to overcomo is constitute.! by the fa^tus and its mcn.branes a Ttho 80ft parts covenng and hnrng it. The fa-tus participates in he resist he conformation and texture of the tissues which unite i to the mother, ec.; while the ^onital passages offer resistance from the r form width, extensibihty. and rigidity or softness. The faeces ac cumulated in the rectum, or urine in the bladder, soinetimes increase the resistance to be overcome. '^"""i^s increase In order that birth may be possible, the expelling force -nust hn greater than the resistance, and it is upon the relation between these that the manner in which the fcetus is expelled will ,,^7 rticularlv rlZt\r T;" 'V^f '^'"""^^y -ttendin,?its expuls on an'd U^S required for the act of parturition nnThn Tf f"^^ 'T ^° ''"".^l'^ ^" *'"^ influence of the expelling force nL Iftl '"^"•b^*^"««- , We have seen tiiat these, which we mav the^os ami thai r?/'' ^^"'^'"?^^' ^'"' " '''''''• ^-«'" ^«^-^ '" ^^^1^ "g vatinV in H I f .'""^ contractions propel them further into tiie vagina in the forin of an elongated blad.ler partly filled with fluid tumoui at the moment a pain occurs, but Haccid in the interval • and not long afterwards as a somewhat voluminous pediculated tumour to canntTelt'tb: i^' ' '''f '""'^ ^"''^' ""^'^ '^ ^-^ the membranS anSie nfii, strain, and rupture ; when the allantoic, and then the uter^ ^^r^P of .K ^' ^^'°"i ^^'''l' '^^^"'« ^ ^-^^-'^ble quantity in the nf InnA ^ *i''' IS. discharged into the vagina at the termination a din. ?n C"; """^ "''/!?' " ^"^^'^y^"g ^^^^ '""««"« membrane a°S aiding in the passage of the fcetus. It may be remarked that numerous causes influence the period when this rupture occurs. In the Mare the membranes are thicker more resisting and much less adherent to the uterus than in the Cow so ha rupture is later in taking place, and it not unfrequenly happens that the ioal is born in them; though the Calf. I believe neverTs Bu there are ndividual differences in this respec even and in some instances it will be found that rupture takes place at the comment ment of parturition, in others towards the cmd ; though when this takes place late it is more favourable than when i occurs eadv as the amniotic fluid preserves the fcetus from undue coinpresS 'by he tion of tt oV?r^", ""^ 'i.'^l V" .^^^ progressive and'regula" dota- tion of the OS and vulva, and lubrifies the pa^^sages, thus diminishing friction and protecting the maternal organs fron. inluA-. Whc^r S thTn'art:°l,r:^ 'f ""''T. *J'^ '"^'^^ ^^^^ l>een ^u^licientfy e^pS and difficult for the mother, while it is often fatal to the fcetus. SECTION III.-SIGNS AND COURSE OF PARTURITION. The physiological phenomena just alluded to, and by which the iu;tus IS born, are collectively designated as "labour." " The entire period of labour is. for facility of description and study, divided into a cer am number of stages or periods-usually three or four. These are • ) to contract for .S7^'A-.V AKn OOUnSK of rAHTmiTlON. 23,1 approaching terninaU^n of n^nnf Z'^. ''«"^ announce tho iVese nmy be o served «ome hou « L^ '"!'•* *''" '^''^'""^ "^ l'^»>«"'-- that event occurs """''• ««'""t""e9 oven for days, before «e^;;^H!y'o? Z'niZnrLthL^H" cnlar«en.nt and increased required in the utcrs is dimtfod Th '' T'T f ^'^'^"'^ "° !«»««'• hard and tender and this Xnnn',„^^''" «'^"*^^ '^.'^^°'"'^ voluminous. in those aninmlsXoifkT nruriil^Vr^f P^f''"'"^^^^^ weaned. The n.anmmrv danl ?Ln K ^^^''^"^t*^'^. y«"''K Jiave been and cease to sec.xTcr I^.Tch anh " k'^' H ' m' """'^'^I' '^"^^ «"'^"- Slands, ordinarily «nml a d s 'St po ' ;til 1 T f"'^ ''^^'^' **'«^^ become so remarkably develoDed as n f^'"'''^^'}'^'- 'l^fo^'" parturition not understand the cause ^Vith the ^Z '''"'• n ^^^VP^V^o do n.ent of the mamm«3 is some h s so cons dera&T' t I; f' ^''''''''^• ment extends alon^ the inferior sirface of f . i ' ^'l" engorge- a)de,na ; or it ascends bet^^e, t e t i'hs i" hi^^h 'as'^th"^ 'T^^'''' promment r dge, while the skin in (-hjl v •<• V- i ^"'^'^ ^^ "^ At a later period tie teat v.V,?. 1 /"'°^ constitutes a^rv^t around t 'tie fluid X^-w«"l ?' ^''''''''' °^ *^'^ lactescent, and finally appe^-s Is'the ''cdorut^' or hrrmUr'"''^ J^^ b^=SS :.l!Sr f^^^^r^ tl^vS.; iliLse of linin-Mnembrane is reddenV^d'and 1 .ISf '^""^'^'^^ ^^'^^ ^heir mucus, derived from the va-S linZ 5 7 '"'"' ^°'^^''' '*• ^'"^ abundant that it is disci arid in on" f "'^'fl^^'^n^- Boon becomes so in the Cow, and oil t e ta '"^?"«^^"«»to^^B streams, particularly the genital passageslliSVcTlltaTe^ll;^?^^^ yielding to the weigL of t^ld^l ^ Thrh'"'\'^°^"^^''^^'^^' ^^ ^^ wider apart, and the^ .duteal muSfto suS l-'^w^ '^' or niodilicat on of tlie sacro-scin.tir „o n„.ii .1 , " ■ '""'"g "1 Iron, serous infiltration ' "" '"' "'" ™l'-»''>'"i<:, ligaments, o£re'rntT;p':artfiSl^ro;!tr,i:;""'''''i'i ^"^ ''««™^'"« -"■ ' i.s^.een „,e„ti„„ra^, there ^SS^^S^:^,,^^^;^ whici, have previously iladyo!,;;"' " '''«''"^ °P'" '» "'°™ """""l' Tl'l„CrSCnTtor>Sl's''r P''°»°-°" »■■« more marked. toS, it stops for sJ™ nome S as' ^,'1:T'}"'"'^y "Seated ; if feed- «U(ii|il» toit.„K -„ _'"- """""".M. as It listonmj; to some sound onlv ^0" a'nd gr74l:':sYf3eriK3r'^ste^t^^^^^^^ 234 NORMAL PAllTUmTIOX. I ! \i\ mute, though anxious and uneasy ; while others, in addition to exhibit- ing restlessness and distress, utter a half-stifled cry of pain. The Mare whisks its tail, the Cow bellows, the Ewe bleats, the Bitch often whines, and the Cat emits a low cry as if in suffering. If the animal is at liberty', it seeks a remote quiet place in which to bring forth its young ; while some— such as the Bitch, Cat, Sow, and Babbit— prepare a special nest. 2. Dilatation of the Os Uteri.— The limit between this stage and the former is not so well marked as our division would indicate. Neverthe- less, it is meant to imply that the stage of dilatation of the os termi- nates pregnancy and ends with complete extension in width of that uterine passage. It is marked by increasing uneasiness of the animal : pa^ying, lying down and rising frequently in a kind of aimless fashion, while the expression of the physiognomy betrays suffering. When the uterine contractions really commence, the creature suddenly stops, as if surprised by the pain ; its eye looks animated and expresses anguish ; the skin is hot, pulse quickened, visible mucous membranes injected ; the abdominal walls are rigid and contracted, the flank is tense, and very frequently ftcces or urine are voided. During this pain, if the cervix uteri is explored, it will be found that its attenuated border has a tendency to become hard and prominent. When the pain has passed calm succeeds ; the cervix becomes thick and elastic, and the os is markedly enkrged. Each pain lasts for some seconds to two or three minutes, the interval of quiet continuing to about fifteen minutes at first ; though it diminishes when the contractions become more frequent, more energetic, and more prolonged, and dilatation of the os progresses.' Then the foetal membranes begin to be detaclied from the inner surface of the uterus and enter the os, whence they pass into the vagina and between the labia of the vulva, where they appear externally as the "water-bag." In the meantime, the fore limbs and the nose and head o; the foetus enter the os, and dilate it to its fullest extent, when the oavity of the uterus forms a canal continuous with the vagina. 3. Expulsion of the Faitus.—Tha pains become more severe, frequent, and sustained, and to the uterine contractions are added those of the diaphragm, and abdominal and other muscles. If the animal is stand- ing, it brings all its limbs ur.der the body, arches the back, elevates the tail, slightly flexes the hocks, makes a deep inspiration, closes the glottis to imprison the air in the chest, and by a powerful contraction of all the rnuscles of the trunk, it brings such an amount of pressure to bear on the foetus as to prope] it into the pelvic cavity and rupture the chorion At each contraction the " water-bag "—formed by the allantois and amnion—protruded beyond the vulva, increases in volume. It varies in different animals ; being in the Cow about as large as the bladder of a Pig, and in the Bitch the size of the carp's swimming bladder. When It IS very large in advanced parturition, it is reckoned a good sign • though It may not indicate a good presentation of the fa'tus, nor vet an easy birth. The water-bag soon ruptures, and its contents partly escape— that behind the thorax of the fd'tus l)oing retained, and voided only in small quantity as the uterus contracts. Wiien the membranes are thinner and weaker than usual, they may rupture before the os is completely dilated, and then the fluid escapes in a small quantity at a time ; this frequently happens with primiparu', tliough it is somet'iines observed in protracted labour, which is the most painful. In general, however, no harm results from this premature rupture if partuntion is'not too I'oiij,' SIGNS AND COURSE OF PAIlTUltlTION. 235 During this act the creature betrays evidence of pain especially if ifc "us'passS u/ro^h T '' P^^'^'W .-rked wCu'C oV he f wheats chesfn'r f/' '"''^"P'et^ly dilated os, and still more V 1 it ir;nrrLTof.r'T^ '''''' perspiration-or thelody'is Jid thro.;!h tl.: vilva "''"^ """■ ' "■'^' "^ P'"" - ^^- ^-^d --1 eldest p^ass placentl ^ ^°°'^ •'esult.ng from the sudden separation of the varhbkr'Tiri^''"'''''^-^^^',^"'!"^'^ ^^"""« parturition is sou.ewhat rth ueh^. I t?Z """;\"'^ which usually only hrin^ forth one at a dlhi portion iL;'".!/ M^ Sheep, ordinarily do so standing; an.le is el icod «n, ?. u ^^'\°^^'"" advantage : The vertebro-sacia i_i ^u ifi....nes t.ie yruuiid without uijurv (i'i" ()«J) Sucl- an attitude, however, is far from bdng constant with these 236 NOliMAL PARTURITION. f|. I; s? b 'J i f ill ill P , t'^ • \n \ Y 'ft ■'' animals ; and very often, especially with the Cow, they brine forth in a .-eclin-ng position— maintained from the very commencement of the act and only rising when birth is completed (Fig. 70). These cases, which' are qmte natural, though debility may be present, offer nothing par- ticular m the position of the female— it being merely that assumed on ordinary occasions, though, of course, parturition is more difficult Ihe animal rests on the sternum, the body inclined to the right or lett side, the foi;e Umbs flexed beneath the chest, and the hind ones beneath the abdomen. In this attitude labour is carried on somewhat as when standing. The creature, reclining on the breast and partially on the quarter arches the back in straining, slightly raises itself on the nind teet, and drops again when the pain has subsided. It IS rare indeed that these animals lie full length on one side of the body during parturition, and when it does occur it nearly always indi- cates a long, difficult, and exhausting labour. Multiparous animals-as the Bitch, Cat, and Sow— always assume the recumbent position, and lie reclining on one side, with the body Fig. 69. Cow IN THK Act of Tarturition : Staniiinc; Position. disposed in a semicircular fashion, the head towards the tail This position appears to be very favourable to birth, the sacro-vertebral angle being etiaced, and the young being spared the risk of falling • iu addition, each foetus as it issues from the vulva is within reach of' tlip mother s mouth ; so that it can, without disturbing itself, remove the membranes from it, divide the umbilical cord, clean it with its tongue put It in a proper position, and even direct its head towards the teat' ''^•.? .f' c" ^''°!^^ '^ '''^'^'^ another is born. It may be remarked that', with the bow, the young creature is expelled with such force from the vulva that It ten turns a somersault. It may also be observed that, with the small multiparous animals the "water-bag" usually only ap])ears with the first of the litter, the others being preceded or followed by their ruptured membranes. The total duration of parturition is, of course, extremely variable, not only according to acciden.tal circumstanccp,, ifidividual peeuliaritico, and species, but even in the same animal at different births With the iring forth in a lent of the act, e cases, which : nothing par- it assumed on ) difficult, to the right or the hind ones i on somewhat and partially iS itself on the ne side of the Y alw^ays indi- Iways assume vith the body e tail. This n-tebral angle falling ; iu reach of the ', remove the h its tongue, irds the teat, marked that, )rce from the ^served that, usually only i or followed variable, not liantico, and . With the SIGNS AND COURSE OF PARTURITION 287 an hour, rarely more. This raSv Vn 7 ''t'\^ *5 ^ ^"^^^^r or half the placenta is detached from ufe^Sfdn ' ^\t^ *° '^^ ^^'^ <^hat consequently the fa3tus cannot live on After tZ *^' ^arly pains, and bemg supposed to be the limit nSoV 'u °''°"'"^-*^rse hours The duration in the Cow i. '""'Jr^^'ess ,t can breathe by the luntrs it mayonlybeaft'ir'niThX::^^^^^ ^°"- '" ^^-S injury to the Calf, to one or tv4 days mth'r''" ^' ^^^^^^ without do no work, it is sometimes on?v fiflp;.. Y P°'^' f,* ^""^^'''^ ^^ which penod is also brief, bcing'bout' fifteen ZZtll Tft *'^ ^""'^^ *^^ Lambs, there is usually an interval of fif .. • *^^''^ ^^^ ^^veral between them-the second and sucledinf Wl.'''L""*'' f° *^^° ^^o^^s than the first. succeeding births being always quicker With multiparous animals— Sow Bitph -n^ Pof . penod of ten or flaeen „,i„,Hes, a;>f '.ii^tlit'ho'u^rSri^ Fife'. ;o. Maub IV THK Act ok rAUTruiTrnv v, AIITI UITFO.N : RkcL'MBK.\T PosiTIO.V. o-- even more, between each birth \Vf , t bnng forth ten young ones wl^ihtLcourle^o^^^^^^^^^ '^'' ^'^ will We have mentioned that wifh \u • , ^" ^'°"^- a standing Position,1he lit, ';";;^''r'V^'''f f ^ ^^^'^^^ ^^ creature reaches the >'pf'nrd when the voun^ '■'Other is recunibe.^when throffW,? ^' 't" '" ''' ''^'^'^^'"en. If thf gets up, wliich is usuallj i, ildi^:: .'":;^,^°^"'/l^e ^°^^^ ^« *°rn a she 'on in and by the cord bein- ncomi W T' m" u"^ ^^e circula I'^bour, Its texture appears to undergo kndr"l^""'" ^''^ 'i"^-i"g upture ; while owing^to the vessel^bein^ !l° !?^''"'"^''' '^'^^ ^^^ours "•ay HI which their rupture occurs 1%^""''^"''^^ ^^<^ also the I'owever, the cord is sufiiciently Siw^aL S^^^ '''^''"S- Sometimes! upture, and the young creatine i^^^'^rf^^.i^f J '? '° resist spontaneous to It by means of this bond of union T A m<^"ibranes attached able instinct, in cleunsin.. tZ T ^'^ i^^other tiieu, by a remirl J-Kh the cord amniS^f^^i^^^.^;-*"- -th its loi^^L^:^ ?^n Wwn to do this at tinX-o^^e.^lf ^^^ J^/W ha.e W^-her the cord be ruptured spontaneously or gnawn through by 238 NOIUIAL I'AHTURITION. If. If. the pa ent, there is nothin- to be feared from haemorrhage from either the tcotal or placental end ; for, contrary to what is observed in the human species the blood has very little tendency to flow from e Tnn ^'' iJ'^f ' '' ^""^ *^' ^!^<^^^^^^on and cold soon check anyTligh? escape. But it may sometimes happen that it is necessary to divTde llo^^ ^ ^ f"""' ^"'^"'' ^^'""^ '^^ umbilicus, and this is usually effected either by scraping, torsion, or cutting directly through it by the bistoury or scissors Even then there is little to Ipprehend from bleeding. Eamard in thirty years' experience, and other authorities has never observed any harm to result ; and the cases in which them was danger are certainly very few. P.ainard quotes from Brugnone that B,Tanger of Carpi has seen Horse and Ass Foals perish from haeinorrhage, through the cord having been cut and no ligatm-e applied- and Peueu h.c witnessed a case of umbilical haemorrhage in a new-born Calf from which notwithstanding a thread tied round the cord the blood escaped in drops ; another ligature placed above the other did not Si ^ T^"^^' ^r*^ '' 7"^^ necessary to lix a compress, steeped in pechloride of iron, along the course of the cord before the huemo^rha^^e could be checked. It must be borne in mind that similar accidents are possible, If a ligature is not applied an inch or so from the umb 1 cus Whe her it be tied or not, the portion remaining attached to the umbilicus soon becomes dry and withered, and falls off in a few days after birth ; the other end most frequently hanging to the foetal nS branes, which immediately after parturition prot"rude from the va^'a 4. Kvimhwn o ha Memhranes.~^\,^ expulsion of the fcxetal mem- branes or " afterbirth,'' as they are sometimes designated, may occur at birth, immediately after, or be delayed for a variable period-thi depending not only upon accidental circumstances and individua co'nneS?' ''^'" 'P'''"'' ""'^' '^""^^^"^"tly, the placental Immediately after the foetus is expelled, the uterus contracts and dt^fn i """^S^^'^^^^y T l^^'^^' ^"^ '^^ '"^^^'"^1 '^^Pa^ity rapidly diminishes • consequently, the placental villosities are detached from their alveoli, the uterme and chorionic surfaces become wider anart and the placenta IS ultimately separated from the uterus. The same contmctions which loosened them are also instrumental in forcin't^""f?' t° ^^ ^vith this expulsion, which is rarely laeitia of the uterus, this accident is not at all uncommon. Sometimes i! SndXm Z vXa'""" ^^ ^^^^^^'^^^ ''^ '''^ >°-S creature as With the Mare owing to the disseminated placenta and the slight nfa JrS *^' ?^T".^^ t\ '^''' ^^^-^^^ 'i the membranea takes place rapidly . mdeed, the Foal is not infrequently born in the intact e.n|elopes But generally only a few minutis elapse before the after b th detached. Ketention of the placenta is therefore exceedingly Kiie in the Mare, thout,di it is verv (Uwu.yau^ ■ a- in at^—>rt=n'^ ^- remove it there is great risk of hu,morrhage. '" ""' ° "' SIOXS AK,> aoUMSE OF PAUTURITlON. ,3^ With the Cow bppmiao r.t +1 1,. , which n.ay be ov^r rh^ndtd thT adh :• P^\«^f *"^-. ^^- nun^ber of la-tal membranes is very Sn« l- ,^T°". ^^^'^^^" the nterus and cotyledons offers but htl TSe forth ' „f" ''^''' '^'^^^ -' '^e npon So that while it happens t ha H,!r' u ""'^ contractions to act -ve opes, it is also the S that the aff k' f^"' ^°^" "^ ''' '"tact i-tuses, the birth of the hrst bein. follovved ^^^^^^ ""V^'^ """P^^ ^^^ inembranes; after which coa.es he eco" f-^ ^^7 ^nef spac. by its and soon; so that only those of tLw f""'' *^''," '^^ envelopes, accident which son.etimes occurs *7„^^f* f»t"«. "^ay be retainedlan appear to be expelled without anv d,tti!n?f '?i""^tI'' *^« "membranes runs mto a corner, and assun iri^osS ^ *^ ^k'''^" ''' "^^^^"^^S expels the secundines of the last^un v i ' '■ ,''^''''^ *" micturate tlie other puppies. ^ P''PP>' ^^^vours them, and returns to twJ'^or'mrjoa.^^^S TntfoT^' ^* t^«^ ^-^--s brin. forth diately after ij is boVn, oTo^tarthevT^ 'f'"^ ^^'^ expelled^imme passage of the next fa>tus^? fLf ^ /°*, ?"^'" ^° obstacle to the Ewe, a fa3tus bein^ ^^^^orn We may here note thp cfl f^^vmg been discharged. vorous and on niyolVs but al"f I ''T'''' ^"^^'^ ^"^P«^« "ot only carni Cow, and even sZ^etinltV^^^^^^^^^ sooa as they are expelled, if thev are^.Tf m "' *^^ "^e^'branes as ^l>ea- reach; at times h t eU d f^^^^^^^ extruded, and the work of delive-v ??^ ^'" ^' '^«>^ are bein- natural and disgustin, til m^p' fsi - "' ^'''*'"^^^- ^^^^^^^^ unl ^JzLs. ""^-^' ^^ ^- - -s;ra?:s^ri^^^^ 4^d^^ri:l^t-;-^^l^t^^^ creature is tl>eni by gnawing them throi^i • more r Sj d ^' f ^''' *'^'^<^^ ^* ^''^^ '^selt by Its own efforts. If the' n S. 'll^ u "', ^^'"^ P^'^-'^^y ^'elease a. HI a stall, assistance may be reou r'd ^^l^f^^^^^^ to be tied up, extract the young animal filn it?1 nn sonin'; "'' T"^'^'^'^^ ^^^'^ ^"d become asphyxiated. Tliis ixh„i;. / "" 'nembranes, else it may the Mare, with which hirth^^ ^vVv^ '' ''T' ^^^"'^"tly observed tn and easily detached from the uten Rn T'?'.^"^, '^''' '^^^°'-'"» strong m the Sow. "tueuteuib. Euetf states that it is not unusual CHAPTKR II P~tions or the F«tus and Mechanism of Parturition. 240 I 11: NOMMAL I'J ITIOX. sideration of which is, nevertheless, very important from a practical point 01 view. These acts are related to the manner in which the fa as presents at the pelvic inlet for passa-e through the outlet, and the way in which this passage 18 effected ; they belong, in fact, to the presentations and positions of the footus, and tlie mechanism of parturition The presentations and positions of the fcutus during parturition as we as theniechanism of that act, are of much practical importance to the veterinary ohstetrist, and demand careful consideration. Allusion has been repeatedly made to the position of the fcctus in the uterus during gestation, and to the fact that this position is changed as nar- turition draws ne;tr. What the agency or influence may be which induces this change, has not been ascertained ; but it has been surmised that It IS due to an instinctive tendency of the fojtus to assume, towards Fig. 71. NOHMAI, 1'O.IT.ON OK TllK F.KTUS IN THK M.MiK AT l>AinuurnoN (FlKST «TAGE). the termination of pregnancy, the position most favourable for its exit ;r?^«; f-^ 7''u-'^' '}'T'^' '* ^^ indeed very questionable whetlle the nstinctive faculties of the young creature are already sufficiently developed to bring about this result, which may, after all, be due to some reHex action. However this may be, it is certain that the fcetus IS very far fi'om being always in this favourable situation, and that the resources of r.rt are often needed to remedy the false positions he young creature may have assumed at the termination of pre-mancv In studying tne various positions and attitudes the fa>tus assumes at birth, and the consequent presentations it offers towards the anterior opening o the pelvis, there are to be considered: (1) the region of its body which ,s first presented to the pelvic uilet, and (2) the relations of, or corrospondence between, this region and the shape and dimen- sionp of the pelvic cavity itself. ^ uinieii The first has been designated the incsmtatian. and tJic second the position of the fcrtus ; and the inlet, instead of the ontlet, of the pelvis 3tn a practical us presents at way in which ientations and parturition, as al importance tion. Allusion in the uterus anged as par- nay be which been surmised mme, towards !ST Stage). for its exit able whether y sufficiently II, be due to at the fcetus a-nd that the lositions the lignancy. tus assumes the anterior •egion of its he relations and dimen- second the •f the pelvis is considered in this rPRnor.f ^««„ -^ • ., Hud the position maTbfi^'dVir ^^^ "^^f^ important in practice, ho long axis of thp '^orso.l.n,Jo::t!Z:ll::^^^^^^^ -ay aglt: V'-'^icn presents. These fovu' fundament. S.. "; ''• "'^'^ °^' "'« ^^^^^us 1. ^■J«/^7v:o. iV...'«/.//o;^Liie ,r "''t/ fj'^^f Nations aro. therefore : cntst ot the fcetus presents towards 16 '212 NOllMA L PAUTUllITIOK. ti the inlet, and is preceded, accompanied, or followed by the head and fore limbs : the situation and direction of whicli may vary without altering the essential features of the presentation. 2. Posterior Frescntatioii.—ThG croup or breech is facing the inlet, and the presence or absence of tiie Ihnbs there only constitutes a variety of the presentation. 3. Dorso-hmihnr Prescntulluii.— Any portion of tlie upper part of tin* body opposite the inlet. Lecoq and' Kainard admit presentations of the withers, back, loins, shoulder or hauncli, as distinct presentations; but I agree with Saint-Cyr in declaring tlie distinction to be practically useless. On exploring the pelvic cavity, no matter wliat part of the back is first touched, the hand always encounters the spine of the fcctus, either directly in the axis of the pelvis, or obliquely and at some distance from it. All these varieties may, therefore, be reduced to the one now named, and which may be either direct or oblique, according as the case may be. 4. Stcnio-ahdominal Presentation. — The limbs in this case are in reality first touched, and we may have all four, or only three or two ; these, however, are not the fixed point of the presentation, wliich is the inferior part of the body —or sterno-abdominal region — hence the designation. These four principal presentations have been divided into natural ox- normal, in which spontaneous or unaided birtli is jiossible ; and into tmnatural or abnormal, in which parturition is impossible without human intervention. The longitudinal presentations alone comprise the first, although they are not always normal ,• as a wrong direction of the head or limbs may prove an obstacle more or less ditlicult to overcome, and requires the aid of art. In the anterior presentation the head passes before the body, but in the posterior j^resentation it follows the body ; in the former presentation the extended fore hmbs accompany the head, as there is space for them, for the diameter of the chest bemg really greater than that of the pelvic inlet, there would not be room for them to pass through if they were alongside the thorax. In ihe posterior presentation also the hind limbs should be extended as if flexed they would add to the volume of the trunk. In the Carnivora the head is generally larger than the chest, so it does not matter so much if the fore legs are thrown back. Taking this view into considera- tion, the presentations may either ho simple, or more or less complicated according to circumstances. ' .SECTION II. -POSITIONS j The presentation being determined by the part of the fcetus which oflers at the pelvic inlet, it must be evident that this part, whichever it chance to be, may vary considerably in its relations to the circum ference of that passage. If the chest of the fu:tus first enters it, the attitude of this region may be very different in different cases; in one the withers may correspond to the sacrum of the mother, and I the sternum to the pubis, or the reverse mav happen ; in another the I fotitira may be lying on the right side, the sternum corresponding to I the right branch of the mother's ilium, and the withers to the left I ihuni, or vice versa. So that here are four different positions in the I same presentation— the anterior; and it will readily be understood | that It should be the same, or nearly the same, for the other present? tions. POSITIONS OF THE F(ETUS. 343 I'oint of the polvic circmX^noo Th< ^i^'V*° ^".^^"^"y detenninato concerned, may bo determined once lolJ ll'.^ ^"'-^' *'^" '^"^^er is the same for every presontaHm, f?. ' T^ ^^'^^ ^^^^ ^^^ays remain region above. theyKdorand Z ' ^"''./"«*^"««' ^he sacra" il the region of the w tiers Tx tL^'l'^''^ ? 'H" ^""''^^ ^'^^^'^bra. I'or the positions in throur'Hvn second, the lumbar vertebr*. fortunatJ iii a des -n-^Ln f, .i P^^^'^^^tations, he has not been so iudiciously p:^optX ts which '^e^more f't";''' f'^ ^^^ ^^ '244 NORMA L J'.t li TV 111 TION. the pelvic circumference. The determinate point on the fu3tu8 is the vortebruB of the withers ; and these may be in relation with the sacrum above, the pubis bolow, the right ascending branch of the iiun on the right side, and the left ditto on the left. i'Vom this wt; have four positions, named by Saint-Cyr as follows : 1. Dorso-sdcml rosition (Vertebrosacral Position of Bainard, Fiq. 73). — This is the most favourable and tiie most frequent of all, and is said to be the only natural position. The vertebra) of the foetus correspond to those of the motlicr, its withers touching the sacrum of the latter, the belly corresponding to the abdominal parietes, and its sternum to the pubis. This is sometimes named tha first anterior position, while its sterno-dorsal diameter corresponds to tlie sacro-pubic diameter of the parent (Fig. 74 a b). 2. Dorso-pubic Position {Vertcbro-pnbic Position of liainard).— This is exactly the inverse of the first : the fa'tus lying on"its back, its withers Fig. 74. DiAMBTEU.S OK THK I'KLVIS. « l>, Superoinferior, or Sncro-pubic Diameter ; r d, Superior Bis-iliac Diameter ; cf, Inferior Bis-iliac Diameter; ei,/h, Oblique, Ilio-sacra], or Saero-iliac Diameters ; J K, Middle Diameter. tovvards the pubis, and the sternum opposed to the sacrum ol the female. This is also named the second anterior jiosiiion. 3. liight Dorso-ilial Position {Rigid Vcrtebro-ilial Position of Bainard). —The fcEtus lies in the left Hank, its head to the right side of the mother, the neck being in the same direction, and when passing through the pelvic cavity, touching the ascending branch of the left ilium ; then the sterno-dorsal diameter of the faitus corresponds to the bis-ihac diameter passing through the centre of the pelvis (Fig. 74,/ k). the extent of which is slightly less than the superior bis-iliac diameter. The feet, when they are not in the pelvis, must, of course, be sought for on the opposite side, towards the right Hank of the mother. 4. Left Dorso-ilial Position {Left Vcrtebro-ilial Position of Bainard). —This is exactly the reverse of the last-described position, 'the withers corresponding to the right ilium. The two last are sometimes named the anterior lateral vositions. They are less frequent, as primary positions, than the first two, and 3 fojtus is the ih the sacrum I . iurn oti tho ve have four tard, Fiij. 73). II, and is said as correspond of the latter, ts sternum to osition, while 3 diameter of ird). — This is k, its withers Diameter ; Saero-iliac i the female. of Bainaril). side of the len passing of the left )onds to the ic diameter. !, be sought ler. / liainard). the withers 'I j^ositions. it two, and P^ ">'/■/ >ys OF TlIK b'lETUS. 24& iddition to those anforior positions, Saint-Cyr .dves other our d^ .neter'^thrL^l.:;i?^.rT^^ whe.f tfe/rn^^^^lf l..^ is (Fig. iCijl^. '^°"^^P°'^^^ '^oill-s "^"^ ^'^'''''''' '^ '^^ 5. Eig/'-t Dorso-ilio-aa, Thia \L fU^ • i. -,- finn between the do!<»n a. i ^ '• i . ., '"termediato posi- 11 I-'ig. 7r>. LUMBO-SACRAL PCSITION. t':^Z^:^^ ^"'^^' ^^^"^^" '''' ^^---^ J'- towards tho preceding' ^--^--^i^-^-co/^/o/./ Po.7/o..-This is the reverse of the naUa:i;t"dri^::;^p:triU^^ positions are qu.te <=orrespond8to hatfftre n^the?srr"^' ^f ^^"^^^ "^ ^he fSLtus of the lirst-thrce°^/.rz,/ V, f/ / ^'' /""^''^f ^/•'^ '"P«"«^- diameters .^'•ethe greatest are re afpd/n V, "'™^ ""'''} ^>"^o.vo,f\>moral~y^hmh pelvis. Thrtwo7oro™,i^^^^ '^'^■''''^'' dian.eter of the I ■ IMAGE EVALUATION TEST TARGET (MT-S) / O 7a 1.0 I.I 1.25 2.2 ui m m 1.8 ^ Hi 14 IIIIII.6 V] /f^ c*l ^# .^V .'^^" ■^ *.'*^ ''^M ^ \ ^ ''W 0^1 Photographic Sciences Corporation 23 WEST MAIN STREET WEBSTER, N.Y. 14580 (7 16) 872-4503 o .%^:%i '^. t/j >. "^ 246 NORMAL PARTUniTION. 1 .-J • SO that the footus experiences much difficulty in moving along. The thl Sncf'^ sti I more reversed between the transverse diameters of the .ootus and those of the pelvis when the first correspond to the inferior bis-iliac diameter of the mother. ^ hlS'^f^'f '"^ ''"'' PosTEiaoB PRKSENTATioN.-In this the croup or tetus wJlTi^-'"'.?^'/? ^^'"^ P'^^^'' ^"'"*- T^^ ^"'^^bar region of the I^.V^f/n .i '\^''^ determmate point, may be directed towards the sacrum, the pubis, or the right or left branch of the ilium of the Fig. 76. Right Ckphalo-iliai. Position in the Dorsclumbak Presentation. f !-*r^''^'.*^'' °^^'^"^ diameters of the pelvic cavity. Hence we nave eight positions as in the preceding presentation. These are • hate clSr'. ■''^^'■'f .'^'"•-^■^•^' ^«^*'^^ ** "^^^hat some authorities Xrr/i K "'^ "'^ ^f'*'"" (^'g- '^^)' b"fc which is asserted by others to be unnatural. The loins are towards the sacrum of the ^rl fv!": w/'^r'^ f^.o-fe'"oral articulation towards the right ilium, named thei?r''""*^°" *°^"^^' '^' ^^" '^'''''- ^his is sometime namea the jirst posterior position. 2 Lumho-puhic Position. — Some practitioners designate this the and loins corresponding to the pubis of the mother -.vhile the limbs I POSITIONS UF THE F(ETUfl, ig along. The le diameters of •espond to the 3 the croup or region of the d towards the } ilium of the 247 Sir^?" i^^ sacrum against which they are more or less pressed. This IS sometimes termed the second posterior position 3, Right Lumho-ilial Position.-The foetus is lying on the right flank i s croup and Imns opposite the ascending branch of the right ilium of he female and the limbs towards the left flank of the mother, where they must be sought for if they do not present in the pelvis 4. Le/t Lmnbo-Uial Position. — This is exactly the reverse of the preceding position. 5 Biiiht Luviho-ilio-sacral Position.-Hhi^ is intermediate between the lumbo-sacral and the right lurabo-ihal positions, the lumbar re-ion being towards the right ilio-sacral articulation ° 6. Lo.Jt L,nnkysupra.cotyloicl Position. — Thm is also intermediate between the lumbo-pubic and left lumbo-ilial position, being the reverse ot the preceding, as the withers are at the other extremity of the same obhque diameter. ^ NTATION. ^ Hence we hese are : e authorities 3 asserted by crum of the I right ilium, is sometimes ate this the -ck, its croup ile the limbs Fig. 77. CePHALO SACRAL POSITION IN THE DORSO-LUMBAR TkESENTATION. 7. Left Liimho-iUo-sacral Position is intermediate between the lumbo- sacral and left lumbo-ilial positions. 8. Right Lmnbo- supra -cotyloid Position is the opposite of the preceding. Tlie lumbo-sncral and hmbo-ilio-sacral po&itions are the same as their corresponding anterior positions, and therefore nai»mZ; but the limlm-puhic and iumbo-snpra-cotyloid are, on the contrary, the reverse ot these, and arc accordingly abnormal, while the liunbo-ilial, like the (lorso-uial, hold thcs middle place with regard to facihties and difliculties III parturition. Positions in thk Douso-lumhau Puesentation.— Here the foetus 18 presented across or transverse, and it may lie on one or other of its sides. Its head towards one of the maternal flanks, and the body curved like that of a Dog asleep. In this we have two distinct positions, according as tlie fcttus lies on one side or the other. But it may also assume a third and almost vertical position— the croup on the floor of 248 NOUMA L VA irrniirTTOx. Fig. 78. Ckphalo-kaokai, Position in thk Douso-lumiiau Thkhkntation. Fig. 79. LKKr CHrHALO-ILIAL TOSITICN IN THE STEBNO-AnDOMINAL I'UKSKNTATION. VOSFTIONS OF THE FiETUS. 24» the abc^omen of the mother, and the creature in the attitude of a Doe sitting. ° The important consideration in these throe positions is related to the situation or direction of the head ; if this is known, it is easy to infer that of the other parts of its body, and tlius appreciate the in- dications for dehvery to bo followed in this presentation. According to the direction of the head, the three following positions are described • 1. Right Ccphalo-ilial rosilion.—Tha fuitus is on its right side, which rests more or less directly on the abdominal vails of the mother the head in the right flank, the croup towards the loft flank, the body more or less curved, and the dorso-lumbar region towards the pelvis, in which it presents (Figs. 70, 77). 2. Left, Cc.phalo-iiial PosUion.— This is the reverse of the preceding. 3. Ccphnlo-sacral Pasilion.— In this position the foetus presents by the back, and in an almost vortical attitude— the croup resting on the floor of the mother's abdomen, the head more or less depressed, and directed forward towards the sacro-lumbar region— the creature being seated, as it were, on the udder of its parent (Fig. 78). Positions in the Stmhno-ahoominal Pkkskntation.— In this trans- verse presentation the fa3tus offers the abdomen to the inlet of the pelvis, and on deep exploration the hand first meets this part, and perhaps two or more of the limbs, generally a hind and a fore one. The head may be found (Fig. 7!)), or it mn.y be out of reach; or the head and limba may be doubled back, so that no part of the creatunj has entered the vagina, though the sternum and other parts on tiio lower surface of the body can be felt. In this presentation there are three principal positions : 1. Left Caphalo-ilial roHition. —The kvtm lies on the -ight side, the head towards the left ilium of the mothrr, and the croup to the ri"ht ilium (Fig. 79). " 2. lii(jkt Ccphalo-ilial Position.— Thia is the reverse of the preceding. 3. Cephalo-sacral Position.— In this position the foetus is vertical, the croup being downward ; but the abdomen and sternum are towards the pelvic inlet, all the limbs being directed towards the os uteri, while the withers correspond to the sacro-lumbar region, and the head is turned to the back or sides of the foetus. All thet.0 transverse positions are abnormal and dystokial. Saint-Cyr, who has mainly followed Eainard in the definition of these presentations and positions of the foetus, insists on the necessity for studying them carefully, as by so doing those who commence the practice of obstetricy will be greatly enlightened as to the difficulties they may encounter, and the readiest and most scientific way of overcoming them ; while this study will enable the skilled practitioner to describe his interesting cases with more clearness and precision. To render what has just been stated more convenient, the following table is given, in order to show at a glance the different presentations and positions : i:- 250 X(H!MA L PAllTI-RITIOX. 'Longituilinal Anterior- Natural Tositions 3 o 'Si 1^ CO •u u Ah PoHtnrior /'Dorso-sacral. I Right Dorso-ilio-sacral. ^-' Left Dorso-ilio-sacral. Right Dorsoilial. Left Dor.so-ilial. ( Right Dorsosupra-cotyloid. -[ Left Dor.so-supra-cotyloid. ( Dorso j)uljic. /"Lumbo-sacral. Right Lumbo-ih"o-sacral. Left Lnmbo-ilio-.sacral. Right Lumboilial. .Left Lumbo-ilial. / Right Lumbo-supracotyloid. \ Left Lumbo-siupra-cotyloid. ( Lu)nbo-pubic. i Right Cephalo-ih'al. Left Cephalo-iiial. Cephalo sacral. Right Cephalo-ilial. -, Left Cephalo-ilial. (Cephalonacral. The longitudinal presentations, with natural positions of the trunk oi tne toetus, do not necessarily imply an easy birth, as, independently ot disproportion between the dimensions of the passage and those of the lootus, there may be a misdirection of the head or Ihnbs, which would constitute dystokial presentations. Abnormal Positions Natural Positions V Abnormal Positions V Trans verse 1 i)or.>o-/«»ii'«t;'— Abnormal Positions Sterno-altilomlHal—Ahnorma,] Positions SECTION IIL— MKCHANISAr OF PARTUHmON. Under normal conditions, it may be said that the pelvis itself does not otter any obstacle to the passage of the fcctus, and that it is the soft parts alone which oppose its exit. Of' the difier nt presentatiouo er umerated, the anterior— in which the fore feet, head, and chest present simultaneously— is the only one wt- may _ designate as "natural," especially with the larger animals and primiparaj. Fromage de Feugro was the first to point this out, though Eainard was of opinion that the posterior presentation should also be looked upon as normal; while Desplas gave three natural positions— head and tore limbs, head only, and hind liinbs only ; and Delwart gives four normal positions. But experience abundantly proves that the first we have described is that which alone merits the designation, as it is the one m which birth can take place without artificial aid. It is true that birth is possible when the Foal or the Calf presents posteriorly at the pelvic inlet; but this is a rare presentation, and under the most auspicious circumstances it is much less favourable, and more difticult for the mother, while it is very often death to the young animal (espe- cially in the Mare). In the majority of cases, without assistance ex- pulsion proceeds no further than the hocks, and the fcctus dies ; and even sometimes with assistance much force is necessary to deliver. Whereas, in the anterior presentation, the cases are exceptional (and these chiefly in primipara)) in which even slight traction is necessavy. We will follow Saint-Cyr in first studying the mechanism of parturi- tionin this presentation, in which, of the eight positions pertaining to It, the i-crtebro-sacrai is by far the moat frequent and favourable This we will now notice. ll. o-ilio-sacral. •ilio-sacral. oilial, ilial. osupra-cotyloid. supra-cutyloid. al. bo-ilio-sacral. )-ili()-.sacral. bo-ilinl. )-ilial. )o-supra-cotyloid. i-siupra-cotyloid. c. ilo-ilial. u-ilial. i-al. ilo-ilial. o-ilial. -al. f the trunk of ndependently d those of the which would MECHANISM OF VARTUIUTION. Make. 261 is itself does t it is the soft -in which the only one we animals and ugh Eainard 30 be looked s — head and rt gives four the first we as it is the ; is true that ■iorly at the 3r the most lore difficult nimal (espe- isistance ex- .8 dies; and to deliver, ptional (and necessary. 1 of parturi- ertaining to rable. This I Anterior Vrcsentation. 1. Mcchanisin of Parturition in the Dorso-sacral Position ~Jn this position It has been stated that the foetus presents simultaneously with the head and fore limbs, the back directed to that of the mother and the withers towards the sacrum. When perfectly natural, the head and fore legs first enter the inlet ; the head is extended, forehead look- mg upwards to the sacrum, chin towards the pubis, nose forward the ower jaw resting on the outstretched limbs, the feet of which extend a little beyond the nose. Then comes the neck, and after it the chest and shoulders which arrive at the inlet when the nose and feet show themselves at the vulva. In this course it will be observed that, so far as the head and limbs are concerned, there is no difficulty, as the pelvic diameter readily admits them when the soft parts are sufficiently relaxed. With the chest, how- ever, there IS difficulty, as its diameter is greater than that of the pelvis ■ ?2?n Q ?"/!,*i°" IS, therefore, how it is got through the canal. In M/U, baint-Gyr saw four well-bred harness and saddle Mares give birth to Foals at the Lyons Veterinary School. Gestation had been regular, and parturition, which was easy and favourable, did not exceed he ordinary duration. In taking the diameters of the maternal pelvis by the me'liod already described, and those of the foetus (dorso-sternal, biscapulo-huineral, and bicoxo-femoral), it was found that in these four instances the biscapulohumeral diameter— the largest in the chest— was easily accommodated in the bis-iliac diameter of the female pelvis, which was gi-eater by 42 45, 48, and even 52 millimetres ^from Uto 2 inches) • whi e the sterno-dorsal diameter of the young creatures exceeded that of the sacro-pubic region in the mothers by 28, 85, 87, 88 millimetres from 1 to 3^ inches). This part of the body of the fcctus had, therefore, to undergo a corresponding reduction in a vertical direction before it could clear the inlet ; and even if we take into account the excess rf the lateral diameter of the pelvis, it will be found that the thorax and withers ot the foetus still notably exceed in size the opening through which they must pass. That they do pass through it, and with ease in the maioritv of cr -es, without injury to the mother or the young creature, is a matter «• //i^^^'Pu^"^"*'''' ,^"^ *^^ mechanism by which the reduction is effected has been much discussed. H.f'.^I^'f endeavoured, in the last century, to describe it, and came to the conclusion that the head once through the inlet, the shoulders of the loal, which exceed the withers, pass by their upper part in front of the neck, thus forming a kind of channel which glides along the maternal sacrum ; also that the spinous proc. .es of the withers, which are almost cartilaginous, bend back on each other, and to right and left of the spine S.^'fTf .'"° i?"" r -■'^•^ compression of the chest. Altogether, he con- cluded that .ne loal in its passage becomes moulded in such a manner tliat the chest has the form of the keel of a ship gliding on the stocks and in every way corresponds to the mother's pelvis, thelnternal contou^ of which it assumes. xvh^""'!!''^''!!"''''''^''/'?''' ^ "'^S^'^^y different view of this matter ; for «n;^l"fT''^'^^'.^"'°''^'*he inclination backward of the dorsal s nes as a first cause in diminishing the vertebro-sternal or perpendi- th^LflT' r' "^^ "'' l^'T''' ^'' ^^°"°' ^^""t that the upper bonier of the scapula) lie against the neck, but states that the shoulders, on arrV^ 252 XOliMAL VAUTUniTlON. '"« f*^ *.v® P^^vic entrance, come in contact with the ascending branches ot tlie ihura, and are thrown back somewhat, leavin- the front part of the chest free, and thus diminishing its diameter. He also adds that the witliers first enter beneath the sacrum ; that the sternum below is pushed back by the anterior border of the pubis, and the chest in this way submits to a process of elongation which notably diminishes its vertical diameter. Saint-Cyr agrees with Rainard in this interpretation of the real mechanism of parturition in the Mare. The sternum, in being carried backwards, also pulls back the ribs attached to it, and thin not only diminishes the chest in a vertical, but also in a horizontal direction as 13 witnessed in studying the mechanism of respiration in the Z:w^r^ """T 1 A" ''^'?.'^*'' '^y^"« expiration, the chest decreases in width and depth When the chest is so altered during parturi- tion, the foetus becomes, as it were, elongated by this part bein" depressed ; an alteration which occurs all the more readily, from the bones composing the thorax being soft and supple, and the organs they enclose (the lungs) not being so developed as they are immediately afterwards ; so that i' moderate amount of pressure pro- hli unit '^ "°' *°° ^°"^ continued, may be borne with comparative In the larger animals, the pelvis cannot undergo any sensible in- crease m size during the passage of the deepest portion of the fcetal body through the inlet which is, in the Mare, an absolute inextensible bony girdle. Lafosse has sawn through the pubes of Mares about to oal, and he found that during parturition there was only a space of two lines between the sawn margins. So that it is the "body of the oetus which has to accommodate itself to this part of the passage at this stage of delivery. f p5 "<' When however, it has passed through the inlet, extensibility of the maternal tissues can, and does, take place, and permits an enlargement ot the canal. The wide sacro-sciatic ligaments which enclose the pelvis laterally, are softened and more elastic during birth ; the sacrS-iliac and sacro-lumbar articulations are increased in mobihty ; and even the S! T' g^":,°l ^^^^ ischio-pubic symphysis may become slightly lelaxecl. bo that when once approaching the outlet the progress of bii-th IS more i-apid, and this progress may be aided if, as is pointed out by Lafosse, the tail of the mother is well elevated ■ .^/^'g^lj^p^^^ck to expulsion is observed when the croup ai rives at the inlet, as this part nearly corresponds in diameter to this opening, being. If anything, slightly less. However, notwithstanding this, in conse- quence of the croup being less susceptible of diminution than the chest, and although the bones may yield to some extent, friction will occur, 3!r' '''" n^ I *^'^ f °"P ^' ^^'"^^y developed, which is the case in some b oals One haunch may pass into the inlet before the other, how- ever, and thus facilitate the passage. 2. Mechanism of Partimiion in the Dorso-ilio-sacral Positions- ihese positions are two in number and symmetrical, and probably are wSnTy. ^ ■?.? ««"""e"f!"ent of birth in the anterior presentation, h^Z !l ' ?^ '\' P'^V' "^^""^' '^^ depth-the oblique diameters being then greater than the vertical-so that the fcetal thorax enters even more easily, and it is only when the croup reaches the inlet that the foetus IS compelled to rotate slightly on itself to assume the first position on its passage outwards ; when the depth of the pelvis is nding branches le front part of also adds that jrnuin below is iG chost in this diminishes its )n of the real 1 being carried I thif, not only ntal direction, iration in the i decreases in aring parturi- lis part being readily, from )ple, and the d as they are pressure, pro- 1 comparative ly sensible in- 1 of the foetal e inextensible [ares about to nly a space of le body of the he passage at isibility of the a enlargement ose the pelvis he sacro-iliac and even the 3ome slightly e progress of as is pointed ai rives at the jening, being, lis, in conje- lan the chest, 3n vi^ill occur, is the case in ;e other, how- Positions. — probably are presentation, [ue diameters thorax enters :he inlet that ume the first ;he pelvis is I MEviiANim OF PARTuitrnox. aaa greater than its width .ais rotation is effected spontaneously at the commencement of birth. So that these oblique positions are as favour- able as the dorso-sacral position. 3. Mechanism of Parturition in the Borso-iUal Positions.— These lateral positions— also two in number and symmetrical— are, accord- ing to baint-Cyr, rarely primary, but, as Eainard remarks, are some- times found as sccomlarn positions, due to the reduction of some mal-presentations. The latter authority asserts that spontaneous birth IS impossible m these positions, because the chest of the foetus presents its greatest diameter to the smallest diameter of the pelvis of the mother. This, however, is an exaggeration, as the bis-iliac diameter is sometimes equal, or even superior, to the sacro-pubic diameter; so that it is not always absolutely impossible for delivery to occur spontaneously in these positions ; though it is very true that it i^ahvcvijs more difficult, and sometimes impossible, if the position is not altered. Independently of the disproportion between the diameters of the pelvis and the corresponding diameters of the foetus, here also we hnd the two salient parts of the latter— the sternum and dorsal spines jamming against the two resisting parts of the pelvic circumference— the ascending branch of each ilium, and it will be readily seen that in some cases these will prove an insurmountable obstacle. Nevertheless as a general rule, this obstacle may be easily turned, if the pelvis is sufhciently wide, by merely causing the body of the foetus to rotate in such a manner that its greatest diameter will be brought opposite the obhque diameter of the inlet, which extends from the ilio-pectineal ridge to the sacro-iliac articulation on the opposite side. Then its entrance into the pelvic cavity, and complete expulsion, is rendered possible. But if the pelvis is narrow, the faulty position must be modified at the commencement of birth so as to make ii oblique or dor-so-sacral and if the foetus is not large the croup will probably follow without difficulty If however, the foetus is large, it should be placed in the dorso-ihal position in order to accommodate it to the larger diameter of the pelvis. It will be seen that the dorso-ilial positions may sometimes admit cf spontaneous birth, but that it will also happen that aid will be neces- sary to effect delivery. Posterior Presentation. Mechanism of Parturition in the Lumbosacral Position. — Oi the positions in which we may have a breech or posterior pr^aentation, only one is compatible with spontaneous delivery— the lumbosacral ' though even this is denied by other authorities. The foetus is pre- sented by the breech, the loins towards the sacrum of the mother, the hind limbs in complete extension and entering the inlet, so as to open the passage for the body; and though this position may appear to be favourable for the expulsion of the young creature, yet it is far less so than the first anterior position. The croup of the foetus is a rounded voluminous mass which dov -. not admit of much compression, and the diameters of which— particularly the trans- verse—are nearly equal to those of the pelvis; it is, therefore, not well disposed for passing through the latter, and, in addition, its upper part presses againpt the sacro-vertebral angle ; while the stifles, which are salient, press against the edge of the pubis, and the hip-joints 264 NORMAL PARTURITION. ngainst tho branches of the ilium. T']nfcranco into the inlet must thoro- foro be slow, dillicult, and painful for tlio mother, and when this first obstacle is overcome and tho croup is in the pelvic cavity, the chest has to follow, and to submit to tho same compression at the inlet as in tlie anterior presentation. But this part of the faitus is much loss favourably disposed for such a reduction of dimensions in this position • as tho resistance offered by tlie walls of the nuiternal pelvis has a ten- dency to erect the dorsal spines, and to carry tho ribs and sternum forward— all this goinj,' to increase tho diameter of tho fmtus in every du-ection. It is only, then, by direct compression or sijuee/inf,', that the necessary diminution in the diameters of the younj,' creature can be eflected, and not by a kind of physiological decrease, as in tho anterior presentation. There is also the obstacle offered by the hair of the foetus, the " set " of which is against the direction of movement ; and this obstacle will be greatly increased if the fluids have escaped for some time, and the parts are more or less dry. Taking all these considerations into account, it will be seen that in tins position, even wlien birth is possible with extraneous assistance, labour must be long and exhausting, and that the young creature incurs the greatest danger. Labour, however, is more likely to be successful and less tedious if the haunches of the ftetus present one after the other at the inlei ; so that a sliglit obliquity in the presenta- tion makes a great difference ; and it is just possible that when birth takes place in this position without aid, this obliquity may have been present. Cow. Anterior Presentation. Mechanism of Parturition in the Dorso-sacral Position.— In the Cow, the mechanism of parturition in this presentation is similar to that in the Mare. Saint-Cyr shows, from actual measurements of Cow and foetus, that the head of the Calf can easily pass into the inlet, owing to Its less diameter, and that the principal dilliculty is encountered by the foetal thorax, which is slightly larger in every sense than the inlet.'^ The bicoxo-femoral diameter of the croup slightly exceeds the bis- Uiac diameter of the pelvis ; but it is possible that the pelvis of the Calf, being more cartilaginous and supple than that of the Foal, may be submitted to a slight temporary compression. It is to be remarked however, that the progress of the Calf through the pelvis must be more protracted than that of the Foal, ow ing to the greater length of tho maternal pubic symphysis, and the more considerable extent of the pelvic walls, as well as the peculiar curve in the Hoor of the pelvis ; though these disadvantages are somewhat compensated for by the greater mobility of the sacrum. And, as we have seen, such is really the case, the duration of parturition being shorter in the Mare than in the Cow.-' The other positions in this presentation do not differ much from 1 Saint-Cyr in these observations measured the thorax after the birth of the yountf creatures, and when the lungs had become expanded. He does n(,t appear to liave made any allowance for this expansion, which of course makes a difference in the size of tho thorax after biith. - The fact that parturition is more (juickly performed in the Mare than .any other IN NOIIMAL VA llTUniTloX. 26& those in tho Maro with a narrow pelvis, to which that of the Cow bears con8ideral)lc resemblance. The same n.ay bo said of the positions in the i.ohtkuu.ii ntKHKNTA- I ON. In the lun.bo-sacral position, tho stifles of tho (Jalf, bein« more ob hciue ban those of the Foal, are not so liable to be 1,01?^^ be anterior border of the pub.s. while another advantage is to be ound n he smaller disproportion between the length of fen.urs of the Cal and uently born alive in tins position than tlie Foal, while the Cow is more rarely subject to injury, though extraneous aid may be necessar^a? Otheu Animals. With rcqard to tho smaller female animals, the same remarks are applicable to presentations and positions, as in the case of the Mare and Cow, and more especially with reference to the Sheep and Goat the same mechanism, and when there are more than one it is no less easy, as the fa^tuses are smaller. This is nearly always the case also with the Sow, and still more frequently with the Bitcl/arurCar' ' It may be noted that with the common-bred Bitch, which has a more or less elongated mu.zle, when fecundated by a Dog of the saine ^n- tormation and si.e, and which in due course brings forth from five ?o eight young, there is usually no difliculty in delivery. The conica form of the mu/.le of the puppies, and the softness of thei^r tissues permits their entering the inlet in this presentation, and pass ng easily hrough it under the influence of the uterine and abdomina conS tions. But when the Bitch is of small size, and is fecuid by a nnfh'''^"'°r'^'"l^ ^^^'^Y ^^- ^"^ especially if the muzzle of either or both parents is short, then the head of the puppies is usuallv We .tnd round, with the forehead high, and the presentation oSs grave o«t ^f r^ ^ insurmountable difliculties. This is more especialfy the case If he puppies are few in number, when they are usually largei This will be alluded to again when we come to treat of diflicultVarturi: It may also be observed that in the Anterior Presentation the fore doln '}'" f-tus-contrary to what takes place in the Mare and Cow -do not accompany the head, but are placed alongside the chest owbg to this disproportionate size of the head, which is as voluminour-ff not moi^ so-than the chest in some instances; but then the Tatter ilTerTlift^sT '^°"°"^'^ ''' '' ^^^"^ '^'^^'''^' -^^^'« ^^« ^-^ hWttJS'^f'^A ^T^'li^^''''' '' ^'^^"^"* "^ Carnivorous animals, but birth IS effected under the same conditions as in the other species. nmch from CHAPTER III. Necessary Aid in Normal Parturition. Although, as a rule, parturition is generally eflected in animals in what we have designated a " spontaneous^' manner (without rTnte^^ sndm;'- and' o? 1 '"1 ^II '^^^ ^^"^^^^ °^' P^'^J"^^'«« *«^i^« mother or of^'- spung, and alfliough these do not require that minute and scrnmilous VM NouMA L r.i liTirniriox. III! i i^ij I attention bestowed on woman and infant, even whon birth has been easy ; yet, from the nature of this act and the unfavourable conse- quences wliich are sonietimca noted, certain precautions should bo observed by the owner of the animals at this period, and especially if these should happen to be valuable and very artificially kept. These attentions and precautions should be entrusted for their carryinf^ out to conipetent persons selected by the owner ; as it is seldom that the veterinarian is called in unless Homethinj,' serious has occurred. The mother as well as the ollsprinf,' require watching, and more or loss nursing. SKCTIOX I.-ATTHNTION TO THE MOTHKU. "With tlie smaller animals, except, perhaps, the Bitch, little pre- paration is needed, and the act of parturition is accomplished with- out any trouble. But with the larger and more valuable creatures- such as the Mare and Cow, and even the Sheep— certain precautions should bo adopted. AVith the Mare and (Jow particularly, this function is accompanieil i)y pain, restlessness, and a certain amount of excite- ment, which necessitate attention. For instance, an animal tied up in a stall among other animals of the same or different species, is more exposed to accidents than one which i^ in a place by itself, or which is at liberty in a pasture or meadow. Therefore, the IVIare about to foal should bo allowed a roomy loose-bo.x, well supplied with soft litter; and the Cow should, if possible, be similarly provided. If cither animal must bo kept tied, then the fastening should be of such a kind that it can readily bo undone whon required. The Sow should have a separate sty, and even the Sheep may need a separate allotm.ent. If kept in a dwelling, the temperature should be comfoi-table and the ventilation good. A. DuiuNG Lahour. — When parturition conunences, it is rare indeed that anything requires to be done during at least the two first stages— those of preparation and dilatation of the os. Therefore, the animal should be allowed perfect quietude ; and if the light in the stable is too bright, it may be partially excluded. A trustworthy person may re- main with it, in order to avert accidents ; but he should keep himself out of sight, and meddle with the animal as little as possible. Some creatures, and particularly primipara;, are rendered peevish and fidgety if they see anyone present during parturition. Unless something irregular or abnormal occurs during this act, all should be left to nature. In the case of the Mare, however, it has been recommended to empty the rectum either manually or by means of oily enemas, if the faeces are hard, in order to avert rupture of the intestine. The irregularities are few in number, the principal being hurried and protracted partimtion, they being only modifications of natural labour ; the diflicult cases coming under the head of dystohia will be treated of in another division of this volume. Whether called in to a case of irregular or abnormal parturition, the first care of the veterinary surgeon will be to assure liimself as to' the state of the animal and the progress made in the act. In this direction, it must be remembered that for the accomplishment of this function in a physiological manner— i.e., by the forces of nature only— and without prejudice to the mother or offspring, there is required a definite action —proportionate to the constitution of the former— of the forces destined lor tho (.'xpiilsioM of tho lafctof Tu^ i i t .0 motlu... should not oxhibi any cL Utu 'f,' ""'' T' '°° «'"^^ = and ;lc-'I'"I>ty. In addition, tho f.,,trshou Id bn Y«'iknos« or phyHical bmn,.,s and tho ^onital passw o t^^^^ proper y forniod and healthy condition 7 . I ' ?''-'"^ ''^ *^" *" a natural in fo,-n> and sixo. pa^-ti" 1 v viM " ''T. '''°^''^^ '^" -^"^^^ ^"d head and thorax ; and i ou d t ? I ^ Z ?«'""^^ ^" ^'"' volun.o of tho expoUed without ansiHtaro" ''t ^f ",7"='^ ^ }'"^'ti'>" that it can bo certain dogroo of thickness and re istance soThi"/.? "''""^'^ I*"'^^««« «* too soon, nor yet resist tho action ,ffT'. ^^^ ^''*^y '"^X ""t nipture the mother sl/ould lutve a cowenithalr'^ 1'° '^"^ '^^''" "«'^'« «' passages soft and elastic; tho ^ i-d Tn^ capacity; the genital andcxtensiblo; and tho o her neU'i. f ' ^ ''"^''^ properly formed If the act of parturition is W «.^ •*''-"M" "" "'''■"''^' ^tate/ parts th. .ugh wLh tl fu.tus ha to nasr.'^ ""'l'''''''^' '^'"^ '"'« ^^^^ ought to be allowed for thi. to ake placo T'V''\'T''^^' •^"'^^•"'- *''"» 'mrry to interfere with tho pro- ' ess of tlin n "" '^''"' ^^^'^^'^ ^'"'"''J '^^ "o period is often quired for unmfr.ff; ?^f' ^'^ ^ somewhat loner the interventi<,n of art^cc de.r ,ro m^ '"n ' '^''' '' accelerated by labour had been long and protmcted '"'^^ '° ^^'^"^ '^^'^^ ^^ t^e in Co^t^^Jh'^lJCerlv^S^fel-^-; ^'Tr^^^^^- -- connnon •t has also been noticed that 1 o uferinot^lfi^ ""\'" ^"^='' '-^'^"««^ detach the f.etal membranes contractions «"ld be f^l^^^'^^!^^^^:::^^^^^^^^ far. as the fc^Uis may perisii of Lphy^ or 1^1^07 ^" "'"""' ^"^"-f^^^^' ^"^ ^^^e ;j^bi;^;;^£;[;ni:^r5^1°-ttend^^^^ ^„,,^,^^,^ ^^ decide as to whether parturUiou mav /nr, ^.°' -^'^^ °^ *'^« ^"'^us, and or If the existing obstLes are eSo oZ" ' '" u ""^'"''^^ "^^"'^e^'. certainly should not venture to attemnf Tl '■ i^ '^">' ^''^ "o^, he or to pull about tho mother ofa^u"^^^^^^^ *^>^ animal himself, vate tho accident, and render Sf mor. ifr^ ^^^ *'"'^ *° aggra- surgeon should bo sent for as his W.Tf ^'^\^''^^- ^^^« vetorhfary f^ve skill will, in tho nm^r ty of casi tin^ f, ^'"^"'^^ '^^^"'P'^^^^^ t tiJ: pr-::;r ^"^ '^^^^ -miS^is^ng^- ^ssrt^ or the eu.piric, and the loss oi\1^iuZrthtorT\T'^ neighbours. or, but now the case may bo one of extrom^^ "'"'/ ^« ^« «^"fc from exhaustion or injury extreme difiiculty or hopelessness "" """"""--i- '1"» Wud of laboSr the°aot o^' p„rt„,itio„ 17 2'.8 XDHMJ L rARTURITlON, is irregular and precipitate ; and though the pains are excessive and frequent, yet no progress appears to be made, the parts not being pre- parsd, while the cervix is often in a state of spasmodic contraction, rigid, and painful. Otherwise the maternal organs may be well formed, the passage roomy enough, and the fcctus in a good position. Sometimes the uterus itself is in a state of contraction, the con- tractions assuming the opposite direction of those occurring in healthy labour, — commencing at the cervix, they pass towards the fundus of the uterus. This condition, in which the phenomena are at first alarming, is most frequently ol)served m young, well-fed, vigorous, irritable animals, and especially primipara;, which are excited and troubled at the first pains, and give themselves up to violent expulsive efforts that hinder the natural course of parturition. In the majority of cases, amendment is ensured by diverting the animal's attention, walking it about for a short time, wisping the abdomen gently, and keeping it in a quiet and dark place. If, ]iow- ever, the pains are violent, and the agitation great and persistent, other measures m.ust be resorted to. Some authorities recommend bleeding, but this should, if possible, be dispensed with. Blankets steeped in hot water should be applied to the loins and abdomen, warm enemas administered, and, if deemed necessary, chloroform, ether, opium, or chloral given in draught or in enema — the latter being generally preferable. Not infrequently good results are produced by injecting tepid water into the vagina, and the animal's hind qu'irters ; and at other times, when the cervix is in a state of spasm, relief is soon obtained by applying a little extract of belladonna lo it. With small animals, a few drops of laudanum, either in draught or enema, and a warm batli, are usually sufficient. Quiet, soothing, and simple treatment will generally bring about a normal state of affairs ; the agitation and irregular straining subside, and easy parturition occurs in six, twelve, or twenty-four hours. 2. Protracted T'Cibour. — Protracted labour, due solely to the inabihty of the uterus to expel its contents, or to pathological weakness of the expelling forces, is rare, except in those cases in which exhaustion results from violent and long-continued attempts to overcome some material obstacle to birth. Then, most commonly, the membranes ha>^e ruptured, the waters have entirely escaped, and the uterus, in a state of general tonic contraction — tctamu 7iteri — is closely applied to the foetus, but makes no efforii to expel it. This usually, if not always, happens when the fcrtus is dead. But primary inertia, due to constitutional weakness, and in the absence of any material obstacle to the expulsion of the foetus, is not common. It is observed, nevertheless, in emaciated, puny, and irequently old animals, which are debilitated from lack of sufficient and good food, prolonged lactation, overwork, or worn by chronic wasting diseases. It may also be due to congenitally feeble development of the uterine muscular fibres, and to diminished contractility of these by over-disten- tion of the uterus during pregnancy, or by disease. The symptoms in the ^lare and Cow are : comparatively shallow and repeated ins])irations, feeble and unfrequent straining, weak pulse, restlessness and symptoms of suffering, extremely slow progress in birth, — parturition i;i the Cow being extended to twenty-four, and even forty-eight hours, though the foetus may be in a good position, of ordi- NECESSARY AID IX X(>i;.]L<^ PAllTrniTION. 259 nary size, and the passage cipar Tf fV,Q >, j • • vasina, it will be rliicovered h?f\v, *^,^^. "^"<^ '« introduced into the Thei'e is no urgent d^ter to 1 ^ ''*.?"' .^^"^f^'^^tions are weak, the lire of the fa"tus t oin in periled "?, '^"', ^^^'^^'^^^ ' ^^-"gh tached more or las. fronrthrSn« ' i f -P^^^'""*^ "^''^^ ^^ ^^^ consequences. "*^'''"'' ''^"'^ *•"« ^"'^7 lead to fatal th;^: j?::^^;^;: ^ 3^?;^:^"^' Ti°^'^[ *° ^^^^ -Aether stimulants may be ^h^en s ' ^-1..^ ''" ' "°^ ^' ^°''"'^' **^«^ particularly ergot of "^eh'avotnn ""^ ™e saffron, savine, and These ma/ be useful b-?i; Hll l.L ifT''.^'^'^'^^' ^^^"°"« ^^'^^^s. veutionispreferrble am noreU^n^^ '''^^^ '^^^i^e inter- to prevent^tl.e u tukZ n ea^^ T H'"''^ 1^ ^^"^«' '^ ^"ything. sufficiently dilated t ma^^^^^^^^ ^°/ «h""l<^ th^ os be in- to pass into the uter s^ Alode 1' 'J^?^'-^-''^«. ^"ough for the hand parts which present when the nwl J^'^^'^'o^^ traction on the ,uSrxCt^fetu7^d:x?:r'"°'^ '^?*^^^^^' ^* ^^ °f^- - is sometimes difficult. A sc Itation n ^h"' f"^ *° '""'^^'^^' ^* «™«% it may in the human spSmnkh I f'^^"' '''"^'"'^^^ «'''^"»«t. as spect.' The fcetor th? inum"^^^^^^^^^ i" tWs 'ro- of the fcx>tus ; but thou-drir s a Znd « ' ^!^l*° 1"'°^" ^'^^ '^^''^th Wlien decomposition as however^ wfll^^'' ^''S'* ^^"°* '"^^"iW«- emphysematous and its hah:, i; i oved""tw' tb' ''" '"^" '^ doubt as to its being dead The roMnll /?/ ^^'^''^ ^^^'^ ^e no vulva of the n^otheT^ when well mnvKS ^Y ^""'^^ ^^*^™^J *» t^^^ course, so long as the fS us li.nl. ' 1' ""''^ ^ ''-" «^ '^^''^th. Of but the absence of these no t^^^^^^^^^^^^^^^ n.ovements, it is alive: lives; for sometimes when it is pith- in H P™f .^^^^^^t no longer have escaped, so that the uteru en L it ilnShW"', '^.^^-^- itremams passive and cannot hp IV; i , i^^V' <^ho"Sh still living the presentation be ante'r then pa sin ' tt I "°''"""'- ^'^°"^^ and titillating the ton-ue will n oS" ^ ^% ^^''''' '"^^ ^*^ '"«^^th and tongue are almost cei^in Tmovelf^tli^ of movement will not be decisive thn If -n ^^^ ' ''"^ '^'^« absence '^vidence of death. If the um.iiic^"^^^:^" T''''''\' ^'"-V l^^'^^able Iw. Tins method consists i, nass n, , W,„i . , '"'5' "''v " ^'wi'M "f tho Cow, and lifting i up bv aSin f^t °''>.""".' "'"''»' ""^ ''""y ™».d the pelvic n,et ; it it has .JSi'i:^ tLTiiJem^nS^.e'al ce^x^n:-hiro-irc^urS°is!;-^e^^r-''^^.'r i 260 NORMAL PARTURITION. I III Bitch, it has been remarked that wlien tlie pains are weak, the first puppy that presents is usually dead. The causes of death of the foetus during parturition are not numerous, and nitty be enumerated as follows:—!. Knots on the umbilical cord, which, though not unfrequent in the human fojtus, appear to be very rare in animals ; 2. Twists of the cord around the body, neck, or limbs of the fcjutus, and which may be sufficiently tight to interrupt the circu- lation in the umbilical vessels ; 3. Prolonged compression of the umbilical cord, due to the foetus remaining a long time in the passage, whereby the circulation of blood is checked ; 4. Premature riijHure of the mem- branes and escape of the whole of the liquor amnii, which, if parturition is not soon completed, exposes the foetus to great danger from imme- diate pressure of the uterus upon it; 5. Disunion, more or less com- plete and extensive, between the uterus and foetal envelopes, by which the vital connection between the mother and foetus is interrui^ted, and if the latter is not quickly expelled it must die from asphyxia. Owing to the difference in the placentation of the various animals, it happens that this fcjotal asphyxia is not equally common in all — a fact which experience and clinical observation have abundantly demonstrated. Many veterinarians, and among them Saint-Cyr, have been struck by the fact, that no matter how soon they were called in tc a case of diffi- cult parturition in the Mare, nor how trifling the difficulty might be and rapid the delivery, the living foal was never produced ; while in cases in Cows, though incomparably more difficult, and requiring manipulation for more than an hour, living Calves were tiie rule. So common is this experience, that a very distinguished French veterinary surgeon — Domiarieix — has laid it down as a maxim that the Foal does not live more than three hours, often less, in the uterus after the first expulsive efforts ; while the Calf in the same conditions can live much longer — sometimes for several days — ^afterthe commencement of labour. The explanation be gives, and which we think is correct, is based on the manner in which the f(«tal placenta is inserted into the uterus. In the Cow, tlie placentuUc, multiple and independent of each other, adhere firmly and closely to the uterine cotyledons, so that the placental circulation may persist for a long time, notwithstanding the energy of the uterine contractions ; while in the Mare, the placental apparatus, being evei-ywhere distributed over the chorion, adheres but feebly to the uterine mucous membrane, and gives way as soon as labour com- mences, so that fu'tal asphyxia is iunuinent if birth be not prompt. There a»'e exceptions, of course, to this rule, and another practitioner asserts that he has delivered four living Foals three and a half hours after the parturient straining began ; one of them was even four hours in the uterus before it was born, and uud' rwent this straining without injury. The foetus may also perish when it is in a wrong position, or is of unusual si/ce, and force has to be employed in delivering it, in which case undue compression of the chest may impede the action of the heart. It was, and still is, believed by many that the foetus plays an active part in delivery, and particularly in rupturing its membranes ; while others consider that its death increases to a marked degree the difli- culties of parturition, because it does not then stimulate the contrac- tions of the uterus, and its flaccid tissues do not afford tliat resistance to the uterine muscles which they do when it is alive. But Saint-Cyr ! weak, the first Bnot numerous, umbilical cord, )pear to be very , neck, or limbs rrupt the circu- of the umbilical issa;^e, whereby irc of the mcm- h, if parturition ger from imine- re or less com- lopes, by which iiterrup)ted, and )hyxia. Owing lals, it happens 1 — a fact which lonstrated. been struck by a case of diffi- [culty might be luced ; while in and requiring e the rule. So inch veterinary the Foal does .s after the first can live much ment of labour, ct, is based on ;he uterus. In of each other, it the placental ; the energy of ital apparatus, s but feebly to as labour com- )e not prompt, ler practitioner id a half hours ven four hours •aining without ig position, or elivering it, in e the action of plays an active ibranes ; while >irree the difli- e the contrac- ;hat resistance But Saint-Cyr NECESSARY AID IX XOH.VAL PAnTUKITIOX. 261 diffio'nl/^ H *^''. 'Y'^f ^^^ Z"^*^"! '^""^^'^ parturition slower or more fhSp t; K^ ^! ^u "'^' *^^^^J^' ^* ^^^ commencement of this act, no' tion 7h.^"'' *K ^^ ^/"Z .*"^^"S irregularities in presentation o^ position, these niay be rectified to a certain extent by the automatic or more or less instinctive movements of the living f otus. He concludes hat though the death of the fcBtus has certainly a great importance so far as the interests of the breeder are involvedf as well as with re^'ard .^«,^t^ r°^'?^^^^^^ ^"^^^= y^* it has little or non'e so far as parturition itself and its results to the mother are concerned. In the expulsive period, or third stage in parturition, it is usual to consider such matters as when to rupture the%vater-bag, and when o points no'red°'' ' '^^'^" '"'*°"^ '"'^^ ^' ^°^^°^°^^' ^^^^^^^ liuptt^c of the Water-hag -This should not be artificially ruptured l?Hfi!.l'r ^"^.f5^'T *^' ^°^^* ^h°^^^ "^^'«^'' ^^« ^ ^-^le.be o^pened ait ficially, as it is always spontaneously ruptured at the proper time and not infrequently sooner than it should be. Besides, the want of tenacity in the membranes, their thinness, and the firmness of their adliesion to the uterus, render this non-interference all the more necessary. "luio ^.r.^l'*'!!,*^!^''"^' h°^^?:^'*; "^i^tters are different. In this animal the ;n fhnf h'"" i?^T' ^'' *^?'^' ^U"'' ^''^ ^^^b^y ^^herent to the uterus; so that the Foal IS sometimes born completely enveloped in them. It s, therefore, wel to incise them when the water-bag appears as a lar-e tumour beyond the vulva; until this happens nothing should be done unless the os is completely dilated, and the head and feet of the fcetus aie well in it T-.e membranes may be torn by the fingers, or cut bv scissors or a knife, care being taken not to injure the Foal ^ thSnc v'^^^r^'^'S '•'/"^P^i'y"'^ *°° early, the uterus contracts on he foetus, as has been said, and becomes moulded on it ; this is opposed fM= V^ »• ^^'l ' ,*^^ ^^""^^^^ Pr^''^'-" b^''^"^^^ '^^T '-^"d adherent, and ais IS an additional o'ostacle. To remedv this, recourse must be had to injections into the vagina of mucilaginous fluids, milk, glycerine and water oil, lard, bran and water, or even simple tepid water, which may raised ^ ^ ' *^^ ^""'^'^ ^'""^ ({^^riers being slightly Traction of the F^etus.---^hon the membranes are once ruptured, the natural expulsion of the foetus should be waited for. In some instances, however, this expulsion may be conveniently assisted by judicious trac ion on the fcetus. If it is in the dovLsacral positloi, geiS tiaction may be made on the pastern of each fore leg when these and he head have cleared the valva, the tractions coinciding with the throes of the mother, which they should supplement, but must not supplant. They ought to be made in a slightly oblique direction down- wards towards the hocks of the mother, so as to allow the body of the fcetus to follow the curve of the pelvis ; inclining the traction a little to t e right and ^eft^ will also aid in passing the shoulders and afterwards the haunches. The head and neck, when they are clear of the vulva, should be supported. If the fc.tus is in tlie Ir^o^Hio-sacral poS on he direction of the feet must be watched and directed, as they have a tendency to press against the sacrum, and may seriously injure the passage. They should therefore be seized while they a/e vet in the vagina, and brought gently outside the vulva along with the head, 1:1 262 KOIDfA L PARTURITIOK. h i ! !i5 m v!nv-l " . '""1^' \ ^'"Ploy^'^i- J^l'is should at first be marie whTI H ''" .^'''''' ^-^'^ '^'*^''"" '"'^'" *^^^ ^"'" ^^f the pelvis, against aure as in the other case is to be adopted. v„-o"^''i*'-^'^'^''''^''''^',''f P°si<^io»s, it is always useful, when they are reco"- nised in time, and before the chest has entered the pelvis, or even whmi It IS in the vaguia to attempt to modify them by converting them into one ot the preceding positions, and particularly the dorso-sacral, or dor8o-iho-sacral--though this modification requires the maninulative Skill ot an experienced veterinary surgeon. If the fcetus is already in the canal delivery must be attempted according to the principles aS.if ';^^-','^""^''l^n '''''''' *°^^^^"^^ the centre of th^Tassag^ and ou side the vulva, and by seizing the fore-arms using them to turn tt^'in'r trrimbs!" """" °' '''' ""*^"'^' *^"^ ^"^p^°>^"° "-^-^^« ^viS ni^*""*"". presents posteriorly, in the limbo - sacral position, with the croup towards the maternal sacrum, the only way in which tlf 'T V? f !f "^ naturally is when the feet of the hinder extremities lead and dilate the os. This position is recognised by the coronary and pastern joints being bent upwards, and by til's hocks, which are deeper situated, are flexed m the opposite direction, and are distinguished by their broad fiat sides and the blunt point of the calcis, which points two limbs are to be seized at the pastern, and traction exercised at first sightly upwards, in order to carry the stifles over the brim of the pubis, which sometimes checks them; then downwards, to bring the Z71 7i ul '^"'7"' ' r*^ ^^^'^y- ^^ alternate movement from right to eft and left to right to free the haunches, one after the other. It is well to see that the tail of the foDtus is in a right direction before traction has been much practised. In the Imnho-ilio-sacral and limiho-iUal positions, the fcetal crouu passes along easily when the pelvis is deeper than it is wide-as in the Co^y, for instance. The limbs only need careful direction through the vagina, and when the croup has entered the pelvic cavity the body should be so rotated as to bring the large diameter of the chLt to corre spond w'lth the vertical diameter of the inlet. If the Mare has a wide pelvis, it would be prelerable to place t),e foetus in the lumbo-sacral position. We may remark, however, with regard to gemellar parturition, that this bSb ^fir^'^^'r''''^' nV'°^ '''"^">: ^'^^°«"i««d in uniparous anin.als until bnth takes p ace. The escape of only a small quantity of liquor amnii vnmw i^ll '') ''''']""r' ^'' "°^ '"'■'^^^ indications that more young will be produced. Soon, howevei, another water-bag appears, and another £03 us presents at the vulva. Not unfrequeiitly,"wlieii the IZ'nT- ^ ' '' T^^^'^'^' ^« ^'^^tural, they present one afte; the other successively, and without any assistance being required. This is the oXn'^rod„r'r"^'''^ri^^^ ^^^^*'*^^"i^ ^"^^ C^oatlanlmals which so anhnX h, 'f '"?•. ^"* sometimes, and especially with the larger animals, the two fa>tuses present themselves simultaneously at the pe V c inlet, and neither can pass thrnu;;h. In such a case, which it W„ Kl''° *'''^*!-'''^'^''.'^ ^' necessary to push back the one least .a ourably presentmg and to keep it away until the fore limbs of the othei are engaged in the passage. If the two foetuses chance to be i-i NECE.SSARY AID IN KOIUIAL PAliTURITlON. 263 sTu^h/T"^^'^' P°'^f ,"' t f"*^^'°^' extremities of one should be pasteins), or the hind hnibs (recognised by the pasterns and hocks^ if ase 7T^:rf "^ '"'% P-'PT- -^^ ''-^-n exercised as n he takh>°Vn^-o " i""' T^ according to the directions given above, taknig caio to keep the other fa,tus out of the way. Should it not be possible to extract this foetus, it may be that certain pa °s o the other a thou df StirrV?' '^/ '''' f i'^^^^'^ ^'^''^ are expended on the latter although It is farthest from the os. It is then necessary to push back and turn the former, and endeavour to extract it by the extremTtv changed o ^TT' ^f -''^[^ *^' ^'^^' *^^« ^^''^^'^^^ "«^d not be ttoSf; f^P;^''-^^^^'^ '^-"S then the same as for a fa3tus dispropor- Another remark is with reference to the operator In exnlorin^ fhp genital passages gentleness and tact should^be crupulous^^ observed cu \uea" niodt^M ""j'V' "^1 "^" °'^'^^^' ^^^ "^^^ ^^ ^^^ Angers beSg ascer Lin bv h1 f ^ '^Z^' i" 'f^'^^^'^' ^«"^« experience to be able to ascutain, by the sense of touch, what parts of the fcctus present and ir in' nK i """"r °^^'''•^' '' ^"'^^ ' ^' ^^" -^ knowledge to guide one in i)lacing the parts :n a favourable position, and particularlv in Z:"'^:^:^''' 'T "^ l^-.^-^^-ted the -^nl^r^r^pts^ta JhP inhn, , . T"" ^°' exploration should be the interval between f lev arc 'sliH T^ "T 'T' ^' 'f '^^^ "°* *° ^"P^^^'^ ^he membranes^ It they aie still intact. The exploration may be made while the tWhihe'Sy? "' ^'^"= both^ositions ha^e certain advanLges It mn. nof '^g^"^ff"y Preferable, and is certnJnly less fatiguini. hP.ir n T if ^"ff'-^tt^n tliat. when traction is required, this should expulsive elloits. In many cases the resistance to be overcome is often violent and sudden traction is to be deprecated, as it mav inflict serious shS l^X^T%'f'%'' ^"^?^"«' '^ ^^'-S delivTyf'fnd even Swer o he nff ' '/* """'.^ ^l remembered that the contractile attemn?pd n K i'i deranged when the contents of the organ are sa t^t fction k'tw'"^^/",^ ^T'^l^ T'"''''^- The simplest and saiest tiaction is that made by the hands of the operator—for both hands may, in some cases, be introduced into the vagina Shoidd he around'Hr r^r' ''r"^'f^ '' ^''''^''^''' ^^ ^^^^^^^ant may clasp Wm du^f t te tlmfi "if r" "i! f,"^ ''''^ him-gradually Ld steadi^ cluiing the thioes. 13ut wc shall recur to this subject again. paftuituon'wnr'^^ff '~^^ attention to be paid to the mother after Lbnls 1 .^ n i n r'^ T\ according to the species to which it belongs, but also according to its temperament, strength, and the kind labour M'hich it has undergone. When this has been natural, and he a that IS necessary. It should be kept comfortable^ with plentj .pure £K "r. T Sfb^ V l/"-^ ^-" P-^P'-?g. the eody,^and'pa;! thYs^Hnfin. ,-1 r . ^■''" ''■'''P'''^^ '^ ^t '^ ^^ ^^r^e animal ; indeed nolo I? ? ''^'"^^^^ *^° ^^ recommended, as it often allays the restless- at on nnd r'^'^^r r'''''' f''' ^'^^'''^y-' it also reguktes tl e c rcu- nif ' . ""^P"^"' ,*^° ^'ten the retraction of the uterus. It may be necessary to cover the body with a blanket, as the animal is ve y U' 264 NORMAL PAR TUniTlOX. or^even\n„n ^* f '' P'''°^- ^ S^"°" ^^^ «° ^^ nourislunff, tepid «ruel the ani ml Ipff !t ^^f ""^ u^^. ^'^'"'^ '^^""''^ ^^ plentifully supplied, and visited ,!,Serednn« ^^l' ^H^ ^ ^°^^ "^^ ^°' '•^^^^^- ^^'l"'^^^ '^ ^^V be Cnot nS, f F-f^'^^"^ *^^ offspring assisted to the teat, if it shouM hp nlf^ 7""^ It From three to ei^^ht, or even fifteen days' rest lactatln fo h"Tn' "^^^"^.^ "8 *« circumstances, and in order to pern'i When nttuS f'^^^^'^^^' ^"^ the animal quite recovered. ^ much nnd n«n u ''''. ''f " protracted, and the animal has suffered ireiated „urTn?i^ m*^ ^'^"^^'^^^^^ ^^gans have been bruised and adopted Eve v^ ^^^'^ t «°"ti""^d Io"g«r. and greater precautions Soniii. In/ r!l^-^^V°.^^'^^^^ *° P^-«^^"t metritis or metro- remXed wn vn , .1^* u P^^^'^^nganate of potassium or chloral, nmy ligh dtt^witlTr iff '' ^''r- applied to the loins, the anin.al allowed a good stable and ?i °"'' °1 ''^^^^u^*" °^ magnesia, and kept clean in wu ^'^T^^^' ^""^ ^n a pure atmosphere. or if tW LTh'"^' r °'*^' r^'^' ^^ exhausted by protracted labour, that tKrmn £ ^, ^"°'''^- So"^etimes the debility is so extreme thrmore need fnt ^ ■'' ^i^'^^^'.^^y indication of life. There is then all of thrbodv .Ifl '^''^;3""'^^ ^"'^ quietude. Friction to the surface ractation ?; / Kr 7 '"T'^ ^ S°°^ ^^^^ ^''^ particularly necessary ; and as attended tn "?^^^^^^,^ ^^^ ^'^^^^^^ ^" ^^ese cases, this must be ous ?mntdiatJlvT' ^'J"'?'. ^^ "^"^^ *^^* ^^^^^ ^^^ ^^^'"P ^^e danger ?nvV^i f ^'?'"^ '"^^^'^ ^°^ some time after, parturition There- ion ifbadw^fh °"' *.° .P^^^^'^^ «^^^ ^^«^^^ be t'aken to afford protec- W Si rt^rd ^n''r "^ damp cold localities should be avoided.^ favlrable ^rff ?• ^'■^'' '^ '^e weather is mild and the situation van thei ;}?pSiv. °" '' "°' '''^""■^^ ' b"t if «old winds and wet pre- Tot produced th.' TTT^i. u^^^^ '^^°^^ *ban one Lamb is likely milk d^S wiA I f "^ '^°1^^ ^u" ^"P* ^"^"^^ ^"'^ ^-^^^'^^ ^ little Cow's T nl^Ki , ''?*^''' ""t'l the Ewe has finished lambing. Twin ^urlnr^f^^lV^^T^? by-^ ^^™"g '-ther,if supplie'd with a tW shoiXd be r^ fi' °°1= ^"..'' ^' ^ ™^"' ^^ ^^'^^•^ ^^« ^^°'^ than two, overrnmp H,« ^ ° ^"°*^^'* ^^^ °^ ''^'''^^ artificially. In order to Lamb 7f it nwrr'".''/° e^*^" manifested by the Ewe to a strange sSnof he doL if'/''^' th\foster-Lamb may be rubbed with the thln^L? creature, or the two may be placed togetlier during nduce^the F^T ^"' ^"*° ^ ^^'^ ^^ed along with a Dog, which S mduce the Ewe to protect and take to the L.mib. Sheep and no^rf "''P^'!? *° ^""^ ^"^ ^^^''^"^t parturition than the net?s;r;iTorr/Xt^^ "'^"^^'^^ ^^''''^^^^- ^'^ ^'^ -- ^ parturitfo7nnd",r"-^ '^^'^ ^'°'" weakness and prostration after When thi^'T ^Tu"' P^'"*>^ °^ nourishing and easily-digested food, its voun " aid ?n?. *^''' ^' ^'^' likelihood of the animal devouring peop?e " '''°'' '° ^^ ^* ^' "°^ 'Stated by the presence of wa™'th^a'£v'^^°v- "°5> ^' ^^i°^"f '^ *° ^■^"^' *°° '"^"■^^ P^PPi'^^- ^"^ dopTnn; .^^1 ^r^"*^' ^"d good lood must not be withheld. The Bitch its rni^k h!« K^ to strange puppies ; sprinkling these with some of Its milk has been some imes successful. Constipation is not unfrequent after parturition, and this may be removed by castor-oil or manna ig, tepid gruel, be moderate supplied, and cli it may be the teat, if it ;een days' rest ler to permit )vered. lias suffered 1 bruised and r precautions tis or metro- injections, to ■ chloral, may linial allowed kepc clean in icted labour, idministered, s so extreme re is then all ;o the surface 'Sary ; and as his must be p are danger- ion. There- ifford protec- oided. he situation and wet pre- tnb is likely b little Cow's bing. Twin plied with a re than two. In order to to a strange ed with the ither during :, which will >n than the ime care is ration after gested food. .1 devouring presence of 'uppies, and The Bitch vith some of unfrequent nanna. XECKSSARY AID IX XoRMAL PARTLTHITIOX. 266 SECTION II.-ATTEx\TIOX TO THE OFFSPRING. No special rules can be laid down for the management of new-born annnals, as this must vary more or less according to theTpecLs How S t wiirrerL'^""'^ "'" "'^^' '' "^^ '^ ^^" *° «b--^' -d With regard to the Foal or other creature which may be born in the fetal membranes, it is evident that it must be freed from them imme diately, or it will perish from suffocation; for having no oLrZ; blood cannot be oxygenated. If the umbilical cord is not ruptured it Svfded t^'^l-l'g^f^-d about two inches from the unibilicus^S then divided between the ligatures ; or it may be severed by scrapin- it through with a jagged knife. ^ ^crapin^ it Immediately after delivery, and having removed the mucus which sometimes clogs the mouth and nostrils'and hinders reSon he young animal shou d be examined to ascertain whether it be stron^ or weak, whether all the natural apertures exist-such as the eyes, moSth anus, vulva, urethra-and if any of them chance to be absent to make wardrbv°?h" "n '' Pr"'^^'^ ^.'^"^ °^ l^^"^^--^- -l-sC a ter! lit, etc^ ' """"^ preventing union by pledgets of Suspended Anwiation.-^^heneYev the connection with the mother is interrupted by rupture or occlusion of the umbilical cord, the young creature must breathe, respiration being now carried on by the Ws^ through the nostrils. ^ ^""oS. The establishment of respiration is a purely reflex act. The fcetus hitherto maintained at a certain and always uniform degree of wannth in Its liquid bed in the uterus, is suddenly ushered into the coW and dry air of the outer world ; and this transition operates chiefly on the skin, producing a peculiar impression -such as we ourselves exper^ce n being suddenly immersed in cold water ; this impression is at once ransmitted to the cerebro-spinal centre, whence the reflex "nfluence of the spinal cord is called into play, and the respiratory muscles are excited to movement by the centrifugal nerves issuing therefrom AU these muscles contract simultaneously, the chest is dilated, and^he air ushes into the air-passages and lungs, distending the air-ceUs in the latter and instituting the process of respiration, which is onl to cease with the death of the creature. This reflex act n.ay also be Vroduced by pressure on the umbilical cord, or anything which hinders Te oxy genation of the blood in the fcrtus ; hence it has been inferred that the sr obSraS.^^^' ^" *'^ '^^''' '^'' '''' '' ^ ^^^-^- *« ^^« ^l!iT^*""^' happens that the young creature is in a state of syncope when born, or very soon after, and gives no sign of life. Obseners have distinguished syncope from weakness, in which the animal is cold and does not breathe, the mucous membranes being pale and he body flaccid ; and syncope from plethora or cyanosis, wlien the mucous ^J'' ^^'^ ^l^^^'^'-'^J^'^^^^^^ci^^^ion is to be attempted bv pourin- cold water on the head, beating the body with a cloth dipped in co d\ater -particularly about the face and chest-dry-rubbinj the limbs tkU lating the nostrils with a feather, putting tobacco-smoke i to them 266 NORMAL I' A llTUniTlON. '^^^^^::^'^:::7Tt^^ ^^ asphyxia, and in- nostrils. So Ion- as t o hoLrn li^^ u \^^\]oss^, acting throu-h the tion to life. ^ '"^ ^'^'"^ W^^^x^^^ there is a probabihty of restora- con?, anVe\"f cuZ:,^^^^^^^^^^ ? ^'^^^^'^^-f^ '- "ow fron. the umbilical ha^umrrha^rris very L^^^^^^^ fo.nent.ng it with hot water to induce and cold vvier enemas But ^"""J""';*^"" ^^.th cold water to the head these cases orsync;.^" ' '" '"''' '^'^^"^ '^ ^^^^^^ "^^'"^nent in shSSrpl^S^^;i^^^'ll£- -'j-l^; the newly-born creature rally follovJ^s that she in tincUvely'l cks or^^^^ ^'T' "?? ^' ?"^- covers its skin; and in doin-^ thi« fl,,. ! ^ •^'^'^''^ "^'^'^^^ which and, by synip^tlv he ohI cutaneous circulation is excited, que^tly^ it'beLS ^^X^.^^^^"^ ^-"8 -i-al. Conse: i rare that th no h " dooT S v^ ''''' 'r^*-'"-l 'eat. It is ver? cleanse its progeny nevert dels b!? ^^^'' """'^ ^"^ °"'^«' ««"Hnence to the priniipiraC and "spec allv wlln Tl ^'', f ^^P^ions, chiefly among painh.1. But it vvill genSv bpfn, ". ^^^T ^^^ ^^^" ^°"« ^"^ animal with a HttleXuf C^^r saltTiH ^'> '^^'^^^^^^ ''^^ y°""fe' mother and induce the cleant^ p4 L lSd^^%'^''"'^°"u ^ *^^ creature must be well dried and rnhlL;i i '' "°* '^'^ ^°' ^^en the cloth, and kept warn . Thl is n o o il^;! 'l"" ^""^0. hay-wisp, or a mother is indiHerent to it \vl L c P^^^^^^^^rly necessary when the when people are present Iride / J" "m ^'"^^uP^"^ ^^'^^ primipane after partm-ition, aid wii not S ^''°'^" ^"^*^ ^^^^S^ will even kill it • thou^b Vm! } \ T ' ^ °^^ *° ^°'"« "^^r them, and tormented ^^^^^.^'''^^ ^^^ST^^^^^ f^ ^^ sometimes become remarknhlv n,„-nf t ' iu "? °^^°^^ parturition, side. When tliey exStw'a^SSon Ctl ef7 ^''' ' ''?^ ^>^ *^^^^' ^'T.t^^]'.^ ^]}"^tfy together fo^^ some time P'°«""^^' ^* ^^ ^^" *^ hour or 'o a";?tL^hTor' 11^^''""' "^^' ^^^ ^^^^^^^^ ^-^^ an inguinal, so tharthe ,"ung ^re aS^ri,"!.'' -"^'^ *^^ '"^"^'"^ are it will be found necLsaivIo a.sfirK k'^^'^ '"^ standing posture), applying the tea to Sutir. 1. ^ ^''."S'"" ^*^ ^" *^^^ "^°<^h^^' and the parent if dis nclined n /hJV^'' """'" ^'"' caressing and soothing This%oaxing a"d land^ °' '^Z painfiilness of the uddel^ tomed to the ani imT It fnnv 1.1 Performed by someone accus- at hand to ^^^^ -- ^ Po-n The Mare should be safelv sec, red n l ! P'^''^^"^g ^^'""^ starvation, push and support tL youn fa^hnal b.l •'''^ ^k''°"' ""8^* then to each, while the other hand "aie'nniv'i^^^' J°"''"- ^ ^^^"'^ «f teat, which it should be allowed n^^/" directing it towards the After one or two Xnmts of f nf I /If n^ r "^' ^^ree minutes. and if an animal Wifh f).« n IV . ,r ■''*'^' wuicii nas been drj With the Cow, these difficulties are seldom present NKCKSSAHV All) L\ NORMAL PAltTUJilTKiy 267 L i,,» -.,.1 t7 ■ ' ''"".'■'"« " '""» i""> i'» mouth while the Hncor T?7hr7/J i opposito conditions it may be necessary to remove one If the litter is large, pLty c(7ood fo^d tnt^^^. '°™" "' '""""'S. ™„,tha;eT:,uMz;"ou,°,i'i?s " ■" " '"""■■ ^''""■'""'''' »" dry aSde ''° ""' ""^"^^ ""^ "1"=°'''' ""--^ '"=>■»"'' " ««■", clean, and §mmmmm serious eonstipat on mav eusiip WJfl, „«„ i • , .^ "°'^' bepji^„isS't:'!,Ct.??hfs°„'„.:rr° ■'°"''"- "-^ ™'--"-m At birth the feet of hoofed animals are covered with a soft vpIIow Gentle exercise is as necessary for the Foal and Calf, as it is foi ;ir i 1 ■'T 26S XOHMAL PARTURITION. parents, a few days after birth Thorpfni-R if ia fv,„<. i Foa 9 travel soon after birth, even over bad roads and dur n« inclirent hnvr.'.i? ^ lard, or any mucilaginous substance. Sprains should with%:l^S!nr^v""/ ^?f ^^' ^■^^^•^^^^•-* lotiols, 01 frSn r;?ro%"su4tal tJIZen?"' ^^^^■^^'^°"^' ^^ ^^^'^^ ' ^^^ ^- CHAPTEE IV. Sequelse of Parturition. after deUverv Tvn. ^^i ^"^ ?'8^"^' alterations which take place r SHs™ 'BS" -F« =^ occurrin/dminrtfe ipfnvn nf f. ' ""'^ ^'"'7'^ ''^'"^^i" phenomena SECTION I.-FUNCTIONAL MODIFICATIONS indiValLTf nf'"'^"^J^''''^^'^ ^""'^ l^^'"^"^ sensations in the abdomen per ?st Xrl7 ' 1 ^'' f^^qr"*^>' °b^^^^^*l i" ^'^"^als, and which dn. f^ 1 the expulsion of the fcctus and the secundines Thev are due to the contractions of the uterus, that go on for some tfrnef and % meadow is bio nature of Mare light ng, and with ts dam, pro- illowed for it ve how well ng inclement ^ short each night, follow iiglit leagues 'hen parturi- nanipulation less serious, instruments water, with 1 as that of not be eni- ' be treated aid has been •ains should , or friction J, must have ilogical pro- But though iondition is her physio- nces, would ■ more par- take place jortant, nor ae of which phenomena itive organs ch are not on. These chia, oiUlk- 3 abdomen, and which They are 3 time, and SEQUKL.i': OF VAHTURITION. 209 Its cavity. After an easy labour, there are generally few or no symptoms of these pams ; and when they are present the onlv indi cations are wluskmg of the tail, at which time the walls of the abdomen appear to be harder. They seldom continue longe ?ha twelve o? twenty-four hours in these cases, and do not require\pe J reltmer.t In other cases, however, and particularly when birth has bee nv?.,;, sudden and rapid, they persist longer and L more s vere The anii a^ paws and exhibits sulTering; it also stretches as if trying to mictu e arches the back, contracts the abdominal muscles, and strai is The access of hese attacks is not regular; and when they arrequen severe, and continue beyond twenty-four hours, we may apprehend the retention of a portion of the fa,tal membranes in the^t^e^s or com mencing inversion o that organ. This will necessitate an explo^^^^^^^^^ in order to discover the cause ; which, when ascertained. shouFd rece ve appropriate treatment, to be hereafter described. receive 2. LocniA.—The term /oc/i/a has been given to the sanguinolent sero- sanguinolent, muco-purulont. and. finally, mucus evacuadons fmm the vagina occurring after parturition, and generally persistin" unt 1 the uterus has regair.ed its ante-pregnant condition. The existence of this evacuation, so marked in woman, has often been dcmied Tn anirnafs but here can be no doubt whatever as to the fact of its presence It has been witnessed by several veterinarians in the Mare, Cow Sheen and Bitch and we have noted it repeatedly in the Sow and Cat. But It IS cons derably less in these animals than in woman, and does not flow continuously as in her but at irregular periods; the discharge accumulates m the uterus, and only escapel whei the animal undergoes exertion and in defecation or micturition. In the Cat. however" we have witnessed this discharge-very slight-flowing constantly for four days after parturition ; and with the Bitch we have a sanguinolent Xu^nt to thattf nt^^"^^""^' ^^'^^^^ ^°""""^^^'^ ^^ — ^ ^^^^ In the larger animals, this discharge can be seen about the inferior commissure the vulva ; t sometimes accumulates about the tSs and tail m flakes and patches, as well as on the litter; and when the aninial has been lying it forms small pools on the ground When we remember that the uterus has for a long period nourished one or more footuses, we can scarcely wonder that it^cannot all at once cease its secretory function, and that its mucous membrane should con! tinue in a hyperasmic condition until the lacteal secretion in the mammae is fully established. As much as seven to eight quarts of sero-sanguinolent fluid have been removed from the uterine cavity of a Mare which had foaled three days previously When not mixed with blood, this discharge is albuminous and chylous-looking ; it is rarely purulent, and then probably only f ?om traumatic causes ; neither does it have a bad odour, unless the uterus o" vagina IS the seat of some pathological process, or a portion of the Finn'nffi ^' J'^'V"^'^- • According to some authorities, the average dura- ion of the discharge ,s from two to three weeks ; but Saint-Cyr believL Sna T t 'f I'^-^lf^f ^.beyond five to eight days, it is no longer a ph v - siological, but a pathological process. This is about the period whidi is necessary, in the larger animals, for the return of the vulva to is normal dimensions and ordinary form. % •J"0 xoiiM.il. I'.tnTritirinx. ?f |.o,M,.li,„™ ivtaino,! h, tlu, Cow for n„ al,„„ ■„ ,, . ?' "'" ' '"'" l». allow..,! to rcmun lon.-c- than fom orll^r.iV^ '' ""' .;,r,t,o„ l,a, not b,.., a:.,K„tlu,- nal.nal, "Ll on cat a T K tnunnatic fcvor «.ts in tl.is ..„,.„tion L ^.t'l/ ! ^ • t., S' """^ f„v ; '■'■ " '"'"'"i" '" •'''">• "'" ""i'tonoe of this so-ca o | " milk ta.nly not favo;::abIe to the .existence ..r iful < - 'i f " ''•'' VNlio ad.nit tliat it is scarcely percoptilJo ' "'" '"'" '"^"^ the,u>aoa;i.a-(in^.;io;:;t;!;;:i;;;;-,- ntonor) aorta; wlnlo in anin.als the uterus and niannn ^a rXnlitd b> the posterior aorta. In won.an. when hvctation is establishecrC ...m; ^'rillw.i'!:';;::,,;;'';:^",;^'''''' I"•"I"-^t^,n for .,0 secretion of rom th., (,,.Ht ; while iMUM..,liuteIy afu.r l/^v v m ''" «'^""'"'"'^ faction which had hoen (.hsorvrJ i i f , """.^"V- V" "'''■'"atoiiH tunie- to cliHa,,p.ar as Vh nn , ^ • -^ *'""' '''^«'"« activity is H.Khlenlv bro.i.'ht i„t/, f m ' /^ '""'^- ^''^'" ^hoir r(mc}u)Jitsniavi, nn. t w '1 "i;".''\'""; '^"•' '•"■!'• Hccrction four clays after pa^tn. 'ul'tir wi,: 't: 0;^ u;:^);^;' ^"^ ^^"T'^ iB a visdriirt:who'vdIo;ih(l''-f "''■'''' "'T''^^'^'^ '^^^^^ '^^'^vory tho tasto, ,;n.l .n«reat"!r d' H V tl ul' i """«'^ unpleasant to layer of ton,,, ^^-Jn; it^;;^; t ,^rl i^l^ll^eW 1 '^ 'l"^"^ uito a somi-Ho id mass It is vorv ru.l i r V , ^ '"^^ toniporature according to indivi.lnais. and c ,^ £. ' t'.' t'Z'ui ''"" ""^"« only n, comparatively largo number and „.nlo-^ '',"'''' P'^'^"<^ at a later period ; In.t tlu^n^ar n, n^^^^^ 1 f '" """ ^'"^" '" ""1^ of a large Hizo snl oS n, n i'''*'''"'^''"''' «'" I'UHclcs-bodies u.assos by a e./ac ^ '^i' 1? „aZ an;"^'""".^" '^""'-""r'^tod in -.^lowod'with n.ovon.ont as S as^u'' "h';'"^' ''"'" """^ ^^^^^^^^^ Boussmgauk g,vos .ts con.position in tho C^^w^s FoUows ^^l' Water Albumin and casein Butter Milk-sugar - Salts 75 -8 15 2-6 3G 3 But a n,oro recent analysis by Chapelle, shows it to be con.posed of • Albunnn . . ^ Albumin ("asoin Butter Lactose Salts Water irr9i}7 2-5o2 5390 1-361 5 300 G9-700 Dumas gives the colostrum of various animals as below :_ Water... Kat ... Albumin Mucu8 . . . Sugar .. Cow. ,so.n-.3 2(>-6 1507 20-0 traces A»8. S2S'-t 116-0 r-o 43-0 Goat. GH-0 52-0 245-0 30-0 32-0 n'ikuMlKi p Hit _. Ik li till r ;!■' lilSf ^ 1^ 272 XOllMAL PAJtTUllITIOK. It 13 admuted that milk is due to a fatty degeneration of the epithehal cells of the gland follicles, in which they are greatly multiplied and developed during lactation. These f^ells rupture, and nothin-^ remains but the fat globules of t!ie milk. ° But in the colostrum the epithelial cells have not undergone this change ; their wall is intact, and they still contain their oil granules and consequently constitute the colostrum corpuscles. Colostrum, as has been mentioned, is coagulable at a low temperature, and it may be said that the albumin takes the place of casein; but soon after parturition the former disappears and the lacter is present. Towards the end of lactation, however, if the animal is pre.^uant, the milk again loses its casein, and becomes very albuminous; consequently, coagulable by heat. Its sugar ako diminishes or disappears altogether. The leucocytes seem to be increased in number in the colostrum, when the animal is disturbed or its health deranged ; and as the young creatures are often attacked by diarrhoea, this is ascribed to the presence of these particles, il////v.— Towards the fifth or sixth day, or e\en longer, after par- Fig. 80. MAintARY (iLAND DUUING LACTATION'. A, Lobulo of the Mam (Jland filled with Cells ; B, Milk or Fat Globules • C, Colostrum, a, ChII HUud with I'at Granules and with a visible Nucleus ' b, Cells from which the Nucleus has disappeared. ' turition in the Cow and Mare, earlier with some of the other animals the colostrum disappears, and then we have the ordinary milk. This is an opaque, pure white, or slightly yellowish fluid, possessing a sweet taste, and a faint odour somewhat resembling that of the atiiTnal from which it is obtained ; it is unctuous to the touch, has an average density of 1032 to 1041, according to the species and other circuinstances -i and IS composed of three essential parts— water, butter, and casein We have in addition albumin, milk-sugar, and mineral matters. The three principal constituents are easily separated— the fat or cream by allowing the fluid to stand at rest for some time ; by pressure the casein is separated in a solid mass ; and the remaining portion contains the water. The milk varies considerably, as has been said, according to species breed, age, food, the period of lactation and milking, cliimite, state of health, etc. In Herbivorous animals it is generally alkaline • in Car- nivorous, acid. ' iaL^"w "''^ of good .luality, according to Voelcker, has a specific gravity of about 1030 ; Woman's milk, 1020 ; Goat's and Ewe's milk, 1035 ; Ass's milk. 1019. sequela: of PARTUIUTIOX. 273 a/0 ^^SSr.S'^t^^^i;^^^^'^'^ '-"-f "- --position of iWoman.l Cow. Goat. { Sheep. : Ca.nol. ] Jiaro. Ass, Sow. Specific Gravity - lOJt-'MwIin'iq-ix im-i-r.. in.n no' I Weif,Lt of Soli.l °«^U" 8UJ0 8J2 3.., _ I 001 -iO hdoIo 854-90 Fa?'"'':. : -;^^;]:;!;?^:!i:?|ii^iJ-io! 107-08 13.1-00 CaseinandExtrac'- "( '' '' "'^■«' "^'^^ ^^W tive Matters -| ;!i);..l s.Vlr,' 55-14 Salts (by iiicmera ' ' 6-18 7-lG — Bitch. tioii) I l.i'Olj 38-03 1-:!8| 6-64 1041-6-2 772 -08 •2-27 -9-2 S;S ^ S:?si Sis' «is' .i«:» '.'.") -70: 109-88' 145-10 '24-36! 18-53; 19-50 5-23, 5-24 10 -yo, -80 can^TttutTuutlJ^gi;:;* ""°*°'- '•■"=■-''"8 »al)-s"^^^ we Constituoiits. Water Fat - Casein Albumin Sugar Salts - M'diiiaii. Ciyv. Goat. Sheep. 87-38 87-60 87-30 81-60 3-80 2-20 4-40 7-50 0-34 3-00 3-.')0 4-00 j 1-30 1-20 1-35 1-70 7-00 4-70 3-10 4-30 1 0-18 0-70 0-35 0-90 Llamu. Ass. 86-60 89-63 310 1-50 3-00 0-60 0-00 1-35 5-60 6-40 0-80 0-32 .Ma 91-37 0-55 0-78 1-40 5-50 0-40 The salts contained in the milk- m^v^j ,T,;fi, +i i and also according to the imTthat 1^« if" ^ «liai'acter of the food, fluid heing particuFailv Scl i, ^ /'^'"^ ''"^^ parturition; this of the peHo'd of Leu i^f Ac"oX"to1hr"'^'^^^"^'^' *'^^ '''-' ''^^^ Furstenberg, there are in t l7000 pa ?s of ash "'T-^^'f "* /^^"^"^^^ ^'^^ magnesia, iron, etc. ; 219 carbonato of li,. 'i ''^ phosphate of hme, especially combined with the cTse hi 343 of^'^o r'^''' ''Y'^''' ^^'^ ^^^^'^ of sulphur andlluonde of LlcTu, ' tf*;^ °V°^^'^'"' salts, with traces carbonic acid, oxygen, l^^^.^^^^ -"^-^ ^^^^ gases as f^^i:^il^:l^^^::g^ ^^ ^^-^ ^ --'^ for about ten niontl>s, when the anim.l",f dnnnnshes in quantity first and second inont.srercalvrlden'tl '•'??'-"' ^■>'-" ^'^ '^^ generally more watery tha,rarm nt f l, '^ ^'if"^ '^ abundant, it is further Uie dinhnu o^n ^oln itv n,Sl J ^l^^'t '"""^^^ ^ ^nd the quanty other circun.tan"es^b:;;^'^qPir"'' '''' ""''''''' '^^ -- which it can be suI.sS ft d' o tl e ircr^w th °'. *^^' ^'"^^^^"^^^ ^^^^^ It is, when compared with th-it of inl f^ l """-^ ."'^^''^ *° ^^^ child. The nhlk of tile Goat is the nit nutS "'"f '"'' ^' ^^'^^^'" ^"^^ ^^t. but it is viscid and has aVeS^ii ' ' """'^ '.°!^^'""' '"«^'« ^^^ein ; cutaneous transpirati^ ^ ^^^'^^SSr^.:?";^ "[^^jS^ f ^ of the lULtmg season; this odour is not ^o nmvl,f,i • , ^ during the those without horns, if they are p XiKk . t Tlf " 1. ""T^^' '''' "^ contains n.ore fat than that of tl rCmv Ld Goat whiln t^ "' the Sheep la..or ,uant.ty, but is also viscid. It Zl 'C^i::^^:, th^T^/ t^^ 18 I lb I i7\ NOIIMA L rA i; TUniTlON. ■r" Cow, and altogether is particularly rich, esjiecially soon after lambing, lliis IS well seen in the subjoined analysis, and it will explain the difli- ciilty which is exin-rjenced in bringing up a Lamb wiu-n tlie I'lwe has died soon after parturition : Kwo'h Milk i KwcM Milk Tliifo Weeks Six WeekH ivf tur L,iiiibiiig, after Luuibiiig. 75 -00 8670 - 1 ]278 ri-(!r - 1 (i-r.s 1-11 - ' 4-(;() •100 ) - ' -98 Mil 1 100-00 10000 Water ]''iit • Casein Milk-Miij,fai' - Mineral Matters (As! The iiiillv of the Mare appears to contain the largest proportion of water and the smallest (juantity of fat, the milk of the Ass coming next to it in these constituents. This contains little casein, scarcely any fat and a small (piantity of ash. On tlie other hand, it is com])aratively rich in nnlk-sugar, which is, according to Voelcker, a very digestible material and a good aperient, particularly for children. " \\ui of all animals, tlie Carnivora have the richest milk ; the casein and fat bein" particularly abundant, and no other food will at all compare witli it in these constituents. Solid butcher's meat contains less real nutriment and more water than this description of milk. This explains at once the extreme dilliculty of bringing up a Puppy by hand. No kind of food is sulliciently concentrated adecpiately to provide for the nourishment of a rup))y, strong beef-tea l)eing perhaps the best substitute for tliat purpose. The milk of ('arnivorous animals has another peculiarity, in the very small i)roportion or entire absence of milk-sugar. This sub- stance is very abundant in the milk ci Herbivorous aniii'ials ; and when Carnivorous cre;iture8 are put on more or less of a vegetable diet, it appears in their milk, and increases as this diet is increased ; whereas by feeding them entii-ely on ilesli, the sugar vanishes. The proportion of salts is also comparatively large.' According to the richness of milk in fixed constituents, Colin classes that of animals in the following decreasing order : Bitch Sow Woman Ewe Cow Ass Coat Camel Mare Milk is a typical food, and when healthy and in sullicient quantity contains all the constituents for the maintenance and growth of the young creature.- This is particularly noted immediately after birth, ' Acmrdinj; to ,i Vrencli iiieiiical journal, I\[ontl)run-leR-Bains, in the Drome, is cele- brateci for nnrses, who continue to give the br.ast for two years and more. When one of these wonu.n loses her iiur.slin-, she takes a 1 uppy-d.^ instead, which then becomes one of thefannly. I'.nt it h.as been observed that all these do^^s beeon.e affected witli rickets, and this has led a medical man to eonelude that woman's milk is deficient in some i.rinciple contained in d(\ir'H mik, and that conse-iuently the Latter mi.dit bo a cure ..""rm "• ' "''»^'''\''t""' IHiblished by him would seem to coiitirni this view. - I he mammary seereticin may be itresent in animals without their belli. r in the preir- naiit or parturient state, or evei' h \\ e liave already alluded to ]5itches lie same without hav ing yielding milk without having Pupi)ies. Kabbits have done th. .,.,...■ „,u,uuu been fecundated, and have reared the young of other Kabbits ; Hitches have done the same \ irgin "r bin. en Kwes have also yielded milk, as have likewise Mare.-Mule and Jlorse— and lilhus. i fonblo thoir initiaT vc'X in'sK at^onlv''"rM""7^'^ ^'''^^ ^'"PPi''^ h-.-'ty Tv on nroo .V !^ , ' T""^, '''°'" ^*"'«"lt to rear, pa.-t of nurse. Ne 4^h" los/ nl /nhl l"°' ""^T'^' ^^^^''^^ P^'-^y the and patient nmnagon.e ,, d "/tifiH^^^^ T ^' l'""'''^ ^^ J^-^icious should conio as near as ^ss bh . ''•^ '^^^^^ furnished by Nature ^ ''' '" '^'^^'"'^'^^ con,position. to that enS.nr n!;;;;!r ^^:^:fT;;;;;r'i;^^*r 'r^ 'f ^°- ^ — of withdrawn when secre ed T i; hn" '' *°" abundant or is not Bitch, Cat, Mare, o, o hor ^^^i na ich 'T'" ff^'^'^t^^^' '^'^'^^ ^^e young by death, or for spociar^oain n . 1 H '"'^l''"i=^' ^^^P^''^«^ ^^ ^^^ often a cause of discoi ifor and °l V T "' ^^^''"t'on of the milk is quentlyin inflannnS of h^-lnd "•'Lr'''/^"^'''''"1^"^' "°* ""f^'- be withdrawn until its Lcretion is bnini 1 f' 'f '' ^^'"^ '"'"^ ^'^""Id ^liet hmited and nK,dif ocT anT mi Id dh f . °' '''^'°^^^ ad.ninistered to iuaston hi c„d C.fm ho? '' P"T'''^'^« '"^^y he closes, has been recommended vvih tM«T' '" "',';''^ ^"^ ^^-^^ue^t wahn.t-leaves and powSorS'tSteVtdc ''''^*' '"' "^'" ^" '^'^ '^^'f"^^"" ^^ tro):^!;:::::^^^^::;! brs^oSh^tt;rr\^"^^^"-- ^-^ nuich of the contents of the niZmn.'v "ll T ^'^'^'t.on to removing as K-ept healthy, or cured ^^^Z^^Z^T^^Z^f'' ''•"?,"">' ^« nient. Soothing liniments or en hm^nH """'^^'^' hy suitable treat- by friction to the skin coJi^ing then" "''^ '"^ ''"'^^^^^^ '^PP^'^^ SKCTIOX II.-0]i(;A\IC MOUIFJCATIOXS. Gestation and parturition beintr cr.mTiIpfo/l ;f ; uterus oven duiiii.- lal.our t, H rof, ^J ? ,", ''""""e'loed i" the particularly in th""ule is kna it^ ' ^ ° "".l.fieations occur more afterwards? Tl,cs° "h ;:"l't ^t eZTtl ' h','' T" "'^»°'"° '""= lil,„. „„nn,„«i„„ '^ uHdd e' ' ,t tl ' < """■s'riP"! "n.scular capillaries aud^Xrit tss i^p ' S," ll!™ '""Tr'""" '" "»' "-■us still c„„tractl„, at i™rs""a,^ lllSLl^r.irrSati^l;: Ifi ■! '7" ■ if. ilii .2 ( ■ n \ 216 XUUMA L rA lire III Tin X. known as " iiftei-pains " — thu contractions being slow, gradual, and continuous, and lasting until the whole of its inuei- surface is more or less in contact, and its cavity has regained its ordinary dimensions. In this process the muscular fibres continue to undergo alteration, the contractions of the organ diminisiiing in force as this change goes on ; and this change is essentially related to tl.o conversion into fat of the albuminous substance of the protoplasm of which their cells are com- posed. The fibres become degenerated and absorbed, and it is some time before they are replaced by others which have much smaller cells. The bloodvessels of the organ also undergo similar alterations, after the uterine contractions have more or less suspended the flow of blood in their interior. Tliey become wrinkled and sinuous and gradually less permeable to the circulating fluid, the walls of the veins and capil- laries are attacked by fatty degeneration, and are absorbed in large numbers. Tins gradual interstitial absorption occurring after parturition, brings about a considerable reduction in the weight and volume of the organ. Thus the uterus of the Cow, which, innnediately after delivery, will weigh from thirteen to fifteen pounds, will be no more than seventeen to twenty-one ounces when this process is completed ; and the uterus of a Ewe will be found reduced to a twelfth or thirteenth of its weight at parturition. At the same time, the nmcous membrane lining the organ is under- going corresponding, but perhaps less profound, modifications to those observed in woman after the uterus has got rid of its contents. When treating of the jihysiology of pregnancy, we described the manner in which this membrane became enormously thickened, either wholly or partially, to constitute a most important glandular and va=;cular structure for the development of tlie young creature. But after parturition, fatty degeneration attacks this structure and completely destroys it in Solipeds and Eununants, and this destruction takes place in a rei.iar'cably brief period in some animals. With the Bitch, Cat, and Eabbit, as with woman, the whole of the glandular layer of the membrane corresponding to the insertion of the foital placenta — the dccidna vent — is completely detaclied and eliminated. In the former two, this exfoliation of the maternal placenta leaves a depressed surface of equal extent, around which the thicker mucous membrane forms a border like that seen in a cutaneous wound after removal of the scab. On the surface of this exposed part, the mucous membrane, being deprived of its epithelium, is very thin, and so transparent that the muscular coat sliines through it. The uterus soon retracts and the placental wounds diminish in size, becoming covered with granulations like other wounds. In a Bitch wliich had only one puppy, five weeks afterwards the wound was not quite healed, and its width was then about one centimetre ; there were also observed other small annular surfaces, narrower than the preceding, separated from each other by nearly equal intervals, !ind having the mucous membrane very smooth, slightly thickened ard pigmented, and which, being found in all the pluriparous Bitches and Cats examined, were believed to be old placentular cicatrices. In Buminants the cotyledons, which had gradually acquired such large dimensions during pregnancy, shrink, their follicular receptacles contract so as to be scarcely visible to the naked eye, and many of these maternal placenta) eveu appear to subside altogether, or to be jnta leaves ^EQEL.i: OF PAUTURITinx. -jj; Sow'n^.ioh hr'^'^'T^^ "^i"", porporfions. With Solipeds and the Pla^^n a mniirn nf /^''1!^ ?'''''^'^' "^" ^^^'^^^^^ which received the «rS thiSd .«« ' chorion also d sappear; and the membrane, ?S.e7o foldfn^; 1 "^'^ Its ordmary ridged appearance., though the in a Mn vollll T • /'f ^"'^ '"^'^ numerous than before conception, found Ho , ' I ''f ''*''" °' ^^T^^y ^^°"^'^ ^ft^^- parturition, Ercolan found the matei-nal portion of the placenta rediced to one-half its thetln' 1 ' ''^ '"^?'> '"^''^''^^ "^ '^^^"" ^ '^"" ^'^'^l' I^'^^^ become yeUowish he folhcles fmm being one to two millimetres in length, weJe reduced wasllotg^rlilS'"'^^^^^'^"' '""^ capillary network aroundS aJar'enHvTo';""" ""^ *^'' A^t^<^h^(\ elements is accompanied by an SteswLlTl"'"'?' t«^,^*'°"^ ^vhich, often sanguinolent, con- stitutes what we have described as the " lochia " oeen shed, and the uterine interior presents the appearance it had before impregnation. According to Friedlander, the fomS of he new mucous inembrane takes place in the following manner ill tha? aswen^^s tho ^'"'"^ "V'^^ 'f'^''' '""^'^^ "^*^ly infiltrated with blood as well as the upper portions of the glandular layer, gradually exfoliates eShelhin lorl li;"""'""^'^' '°^* '"^'^ ^P^"^'^ ^P' ^"'^ their cylindrical of he n en , Th ' "''" T'°"'. ^P'^helium of the internal surface L^l A- ^^ «on»ective tissue situated between the tubular glands according y proliferates, and becomes reorganised. In con- Srs'll'' T'^'^- ^" *^;^V^^^ °^ *h^ -"-^^« membrine, the ?hnl wo. . ! <\epressions of the epithelium are deepened, and in membmL ""' ^ '" ''' '^'" ''^°'^"^ ^" the^ew 'mucous also°rr.nin".*K*^ '^'" f '""' *°r^'"^-"^^ proportions, the uterine cervix also legains Its former shape. During the passage of the fcctus in rvTnlmnHon"" T.?' and vagina form a Continuous canal wHhoi" an J interiuption and the cervix is effaced. Immediately after the dos'l wl?H?n'^ ''^'"^^^ '^°""^"^"' *'^^ '^''"^^ reappears! the OS i closed, and the uterus and vagina are again separated by the sphincter- hke nng which the uterine neck exhibits in the cavity of tile laSer. The cervix is at his time soft and flabby, and the os, not entirely closed, IS readily dilated by the fingers. But it gradually contracts and closes as its texture becomes firmer, and in ddng so i^t elonS nX^tf ^"T"' "^*°,^^'hich it projects, until it has regained its natural form and consistence; though it is always shorte ° and less regtdar in shape, particularly at the" os, in animJls which have had several young, than in those which have never been pre-nant The tZZT^' -^"7 not completely assume tlio dimensions itl"ad in non! moS tetuses!" ' '" ''^'' ^"^^^ ^^'''' '' ^^"^ contained one or 3hJttenn^' nYf T^^\ ^'-^ '^' ^''°'"^ hgainents of the uterus become the h nbnv , P^^'^"'-^t;"^ ^']^ consequently raise the organ towards the lumbar region, and in the direction of the pelvis ; while their r„^,,,n ar fasciculi undergo fatty degeneration and absorption. Hbom wl? "'"Ti"' '""'^•<'«'^tion« the genital organs undergo after tW tC ''i'^'";'"" ""'T^ regularly. But it sometimes happens ZXuf "''"^^' ^^'y'^' "^ t^^ ^^t«^-"« ^l'^^^'^ to be struck with parabsis soon, or even immediately after birth ; so that it remans 278 ^'OJiAfAL I'AnTL'ltlTJiiX. ducedSr Thi?"^*^;-' '° ^^'^' '^'^^ ^^^^ ^"» «^n easily be Intro asirwoman'thothrh^ "?* '°k/""^^ *° be dreaded in animaS them T^e rfJ?^"^^^^ f^^-", ^^'""blesorne aud sometimes serious in cumulate in s civi?! an/.T'^"^ T-'^' ^^'^ '^*^^^- ^^'^^^ "^'^"^^•«. ^c- the a r obtains nT.f' ^ *^'^ ?' ^-^"^S ^^^^^^ ^"^^'^ or less patent, X follow In cxn Zh ' P^'.^f^f.^^^"'^ commences, and grave Results and more or its fo?^.mi?r '^'IT^' a variable quantitv of sanious. untilXs is rer^ovid a^ l;^'' '"^""' "] *^^" ^'^^'^^y ^^ the organ ; and may be apprehrded *'" "■^''" "^'^ ^° '^""^^'^^^ ^^ ^^^^'f' ^-"g^'' i4^sf^l^-lS/o[t!::^tl^^^^ ^^^^- ^^ ^^--^- °^ --^^ PART SECOND. DYSTOKIA. GENERAL CONSIDERATIONS. trrminlnn!^ *)' 1 ^'y^'^'i^Sy °J Parturition, we saw that a favourable teimination of labour depended ou two factors, one of which waTn un.S y.^';^l'.' '" '°^^^^*'^^ P^"^^' ^' '^^^ obstacle which ^the proroftLt!^oJtrarsi ^^^^^^^ ^^^-^^--^ --^^ ^^^- - ---^ exnillimfin ''^'''''^l ^"'''^'^ ,*^ *^" "^*^^'^ of ^»d variations in the expelhng forces and also to the causes of protracted labour We have now to treat of the difficulties attending parturition wih their con sequences-proxnnate or remote, and the nieans to' be adopted W overcommg. preventing, or remedying these. This involves a ?tudv of fmZs:^o:^^^^^^^^^ ^-^<^-*« attindrg^Sw^- Seinlsta ; nVn? f-T*^ conditions more or less related to the ^pXbg;ofp;;:;^i?L:^' "' '^"^ '^ "^^^^^^^ ^^^^^' *^- ^-^ ^i oppo\'ed'^lo'?hi*exn?]n'"'^"'° partuntion depend upon the resistance of^ Uie obfec^t to b^P i "iirr?^ '^"'^ '^'' ' determined by the relation oi tne oDject to be expelled— the present ng part of the fcetus to tho ItTedf 'to''L,f„r''°r- °°"-5-;"y. » exaggerated 'Si tance may be due to abnormal conditions of the parturient nassacrp., nr fr» S:,-ri ";:; ^^''^^f^^^' ^^^ y^-g amnfal. m leTst^we Ce mr cu .r^S f • '' """'^ '" the second J<^«^a/ D^.toi.a. These necessitale paiticulai operations, some of which demand much studv address and manipulative power on the part of the obstetrist. In addition we have dangerous accidents sometimes occurring during parturition JhichTf they do not happen to interfere with the mechfnism of that Tct mav nevertheless inquire the highest degree of surgical skil to remX^ stafe so'^e' of'tLr/'^ "^^^'"^ "^^^^^ ^^^^^^P-^ the partS state, some of them being serious, and needing great clinical and thei-apeutical knowledge for their successful treatment gravlt'v'no wi {fn ^'''^'i'' ^"^ ^^'^^'^^ do not occur with the same fndeed wm, t^^e/anie frequency, in all the domesticated animals exempt from nX f ° '^'' ^''''''' Tf '^''^'^ ^PP^^^' ^o be altogether exempt trom at least one or more of them b <='■ in arott?^i'n°rSVr/'''''^''r'' ^''"^T''^ ^" ^^'^ ^°^i"« species than in ajiy othei ,i and least so, perhaps, in the Equine species. These two iiich is characteristic of Mongolia ^^ The Camel— and particularly the Bactriau vai iety wh frmn^^Jr":::^:^ !^ 'n}^!::^^^'''^'r:^^^"^^¥ P-turition. At leasVw^may i^f«?th^ from the statement of ColonelPre evaTskv 'w^' Partunt.on. At least we may infer this aav'< • "Ti.^ ... I '^oionei 1 rejevalsky, who, in speaking of the Mongolian Campl thSw^ill tT^rS TS^eTnoThertT ''^ -"'»/— '^hich i.s iT^lZT.ik of man is needettoZn^ZT^^^^^^^^ ""f'^^ "'""'^i"'^-. ^he interference at the expiration of whi^^;;ea^m%f^;.,^ri::n;:St^:^^^ 280 nrsTOKiA. n '!M fig ToSeVt' lilt! if'"''™' '' «""''■"">' ''"""I "PO" to attend second Tw ?n ^ifV?^^*^^ '"the Mare, the first has had 190, and the whi^h br.rfo?H7n'''^ '^'* the Mare is, "of all quadrupeds, the one But ?hi, n° ^f"\'t' >'°""g '«08t easily_a fact noted by Aristotle abnormal cases t?"-^ '^'^^''' *° T'"^*^^ parturition in that^an mal ; Tn of Hercules ihTet,thrr?i°P'^ '" *h" ^^^^"^ ^'^'''^ ^ labour P?acent^ in .nil? P'^^^'tl^^lar arrangement of the maternal and fecial Mare. _ 1. Delivery is often followed bv msuccess. '' 2. A wound inflicted on the genital organs is generally fatal. 3. Inversion of the uterus is nearly always irremediable. 4. Mares nearly always succumb to penetrating wounds of the abdo- men during parturition. 5 Delivery of the most simple Cow. 1. Delivery always terminates favourably. 2. A wound of these organs rarely causes death. 3. Inversion of the uterus is often curable. 4. This accident is not generally fatal in Cows. 0. Delivery, even in the most kind is occasinnnll,. f^ii "'T^^^ •^- ;^«"very, even in the most bad results In Ln"^?'^ ^l coniplicated cases, generally proves labonous partudtiofs noTun^^ comparatively easy, and' ^obste- quently mL anSl succumb " ""' °^""'^'"' ""'^^"'"^• He^rcSeanfasr/o'jf '°" n^'' ^ ^- ^"^^ Parturitions are not of iierculean task to the operator. much account to a practitioner skilled in the necessary operations. Trnthcv'ii t^nt^ . I I "'"»S'"ao'e, it must be lifted bv hatu nn-l plpc-d ■iiifl-r «hp u.inurr h teats but as soon as t mn «r^R- u «■, n T . . P"-^-'> .sini. r ine latter is so attached to her offC n- tb.ll ' l"7^ ^"^ f '"""^ everywhere, and the female Camel i. "ranted its iKS'f u T""''* ^T' *" ^'"^ '^''Pa'ated from it. The foals everv otherf ear ■'- Ao S A V'^"''; ^n""' ^"'' P.-vrtnrition ; so that it only Tibet, VOL i., p. lir London' 1876 "^ '''' "'"' "'' ^'^''''^''' of North rl OEXERAL COXSIDEnA I'JOXS. 281 wn to attend ititioner who r one case in ! Cow. Two :!, that while 190, and the in a district eds, the one 3y Aristotle. ; animal; in iger than in deed, a very xperience in are a labour child's play, •ractitioner ; sometimes t obstetrist, in the Mare I Calf when fore pointed I and foetal portance to ng obstacles comparison e Mare and terminates ese organs uterus is ot generally 1 the most rally proves and obste- sful. are not of practitioner operations. 1 Camel is the ed \\n<]cr the here, and the ■rom it. The tliat it only < of Northern T^Awr.— continued. 7. The duration of the life of the foetus, in a case of abnormal labour, does not extend beyond the fourth hour, on account of the young animal having to maintain its independent existence, as if already born. Cow — continued. 7. Fnder the same circumstances the calf may live four or five days ill ntcro, as life is maintained by the placental connections. These differences are explained by the mechanism of foetal life in the two species of animals, as well as by the anatomy of the uterus and foetal membranes. 8. The neck of the fcctus being shorter and thicker, the head is less twisted, and the operator can with greater ease bring it back into its normal position. In addi- tion, there are teeth in the lower jaw, the neck of whicli is narrow ; so that the slipknot does not leave it, and straightening of the head and neck becomes an easier affair. 8. The neck of the Foal being very long, the head is usually found deeply buried in the flank whenever it is turned backwards. The operator has very great diffi- culty in reaching the head with his hand ; indeed, it is often im- possible to bring it into its natural position. The loop slips off the neck of the lower jaw, and has constantly to be replaced ; it is scarcely possible to fix a cord there, this portion of the jaw being so short and the foetus having no teeth. 9. When once the amniotic fluid has escaped, the introduction of the hand is difficult, owing to the genital organs becoming dry ; this dryness causes an efflux of blood to the mucous membranes. The resistance made by the fretal membranes to manipulation, when made to ascertain either the posi- tion of the foetus or for correcting the position, together with the struggles and violence of the Mare, ■which now and then drops as if ■dead, are all difficulties to be over- come. Presentations which, in the Cow-owing to its phlegmatic tempera- ment, intervals of quietude, and more gentle and tractable nature— are common, and as a rule adjustable, are yet most difficult in the :\Iare, and if not quickly attended to, rapidly lead to a fatal termination. VVith regard to dilhcult parturition in the other domesticated animals, theLroat and Ewe come next to the Cow in the order of frequency; though cases of dystokia are not so often noted in them as in that animal. It is to be remarked, however, that assistance is not so easily rendered them, owing to the introduction of the hand into the uterus not being always possible. In tlrj Cloat the act is sometimes very prolonged, though on account of the multiple placentic the foetus may live as long as in the Cow. With the Ewe the same occurrence IS Observed, but m this creature it is sometimes possible to introduce 9. The genital organs are con- tinually lubricated by a mucus fluid which, while it facilitates the introduction of the hand, renders easy any necessary correction of position, and favours parturient operations. Besides, any move- ment made is not, in general, of much consequence. 283 ttvsroKrA. iiil « , ! [i- i-. ir ! Hi. . "iM ii-K to lo ;.:,,, M'''t'':;',, 'i;,. ';;;""'>■. «""■ ""' -"".u ciscao raohitism li.mv.v . ' ■ i"" <^iilluia in imili.iition. In elu.rt n„.o. Nu,„l„.,° „f S^i,,! f ' "'"' " ''"K" '"'""I l'«"l "n,l of llu'ii- I^l^MU." tl' " laf , . '■,'"'' """■>' >""■ ''■<"" "oii-.U^livorv ii • "pi'UM, mo.so latter inav al«n niifwiii,.!, i„ f n i "■""^'j' thoir piiroMt, as it often liaDpens n H?. r "^'*'"'' ^^'^ ''^'coaso of tion o„ the otliers Cats '. somofi t''^'' "^ °"" ^'"''^"^ dosti iio- and fn>.n the sa.ne eaus'os'Ls liitS'" ^"'^J^"^^ °^' 'li"-"!^ parturit.on. lab.>u;:i^SI^:^j'^;^^X!r^-;;l- -hid voterinary obstetrist generally called into rem eU a ^ n f ' T' '^"^ '"*'^'' '^'^ ««^'^'«^"« are paral.le. injury has been w'l "n,°I m^^ sor.ous and even irro- in ^vhich a li tie scientilic ma i^., / T^""' *""• '''''« '" instances would have, perl.rps al iV r^'"'; '''f «""'^' «^"•^'i«al knowledge Cyr justly sk^s, in^onnli^th ^S ^ne r^maW-: fnri"'"^f^^- ^T^' the services a veterinary sur-Con i.n v ,-, n 'Tn " '^^'^ ^'^^S*^^''^ ^'^ that these can bo beneiicial on^v o, S "^ ' "' '^'"'""^^ parturition, present in .ood time CatrC t '?!"^'^''°" ^'"^'^ ^'^" ^^ escaped for a long period nd 1°^. , ^^^V^'^^^" ^'.'^ " waters " have bis science, ag.^mva ed 'a Imd .m^^^^^^^^^^ '• "i'''"'" '"^« «-^lmusted organs by nuu^fpulatio s, t acl^ S ITol '7'^''"^ '^'''. m^ev^Hvo ability of the most experienced Zp/w '"'^ :""''"'= ^^^'^^ ^l^ t''« find the passages dry hun^il^"' ?/, '°"?' ".'^ '^" "«^'l««s. He will more or less advanced^into Zndv c o^?. ^ /"''^^'"".^^^tion, the fa-tus " wedged,- or like a nJ^M^^"^^^^: " SJ-';/^ '^; ^^^ ">ay be said, cally contracted on itself am «. i i ^^V-' V''' "'^"™^ spasniodi- fetus that it is almost i'noiil? . '^^^ ^^F^'"'^ *° ^''^ '^"''X of the How is it possible rnaruattin^^'r "'", ^^""^^ '^'^^^^^^"•' them, vicious position of Tf Xs^ ith " ' "l Place-how change the advance or retire? ?Iovv can . slar i. T'^^'''. f "''^^ cannot^nake uterine cavity and used with ^^^ fl ^ nstrument be carried into the be made to enter i^t " '*^' '''^'^" ^^"^ '^^""^ '^1«"« can scarcely tion to an agricultural cpasti^irsti^iT''^ \' f'^ ''7 ^'''^' ^'^^- be said to be special- , ,■ nKof V • '^'^^^'^t- ,^^"^1 tbis knowledge may veterinary surjerv in fo'mhv a nn^r' '"f "'^'^ ''^" ""^^^^ '^^-anches oi" On the contrary,^ srlX^n^n^.^T-"^.'''"^'^^ l»'^«tice. exclusively limited to ai h farreariiS Z ' 1 V " ''f''''' ^''' ''^ ^l'"^^'^ found the school in whid the nr.^^ r' ^'''''''^'^'^^ ^ tl>^=''^' alone is to be difficulties of this CO dex a ^ai d £T' T^ ^"^ ''V.^'^^^^^ '"^^ ^^^ ^ho mounting them. And it mus'lil? f .f"'^ 'i^'^'^''^'^ '"'^^^"^ of sur- is not pl-ticularly an u- n and "" f^'l "f ' ' f ^^^'^^^^^'^ ^^ *'"^ ^^^'^^ veniences, hardshins ,, i T,'f) u attended with many more incon- obstetrist ': ind e ,^ ^e tnow 0?!''' "^'" 'f '^ '^'' ^°^ ^^ '^'^ ^^^^^i^ tion than that of thrn,!^?^ , ° .'^"^ [S^f.f '.'^"'^"^ and anxious occupa- and he requires nhvai^nl 2^ i"^^"^^oncr m a cattle-breeding district by the attl^^nt' 0^:;;''""'"'^ '''''''' ^'^ ^'^'^^ not needed Veterinary accouchments are generally difficult and perplexing, as aEXKHAL f'ONSIDEn.t TIOXS. hat tlx! ob tliis luiinml iiiitioii. In ilijfoniiity of iTovvnt'Hs of particularly '•1 lioiul and lOM-delivoi-y ' (lucoaso of 'ils destiiio- I'arturition, ' obstotrist loi'vict's are oven i no- il instancos knowhulf^o JH. Saint- regard to larturition, that lie is ;ers " havo exhausted generative on all the He will the fa-tus y be said, spasniodi- "ly of the ion them, lange the lot make into the 1 scarcely )bstetricy t acquisi- tlge may 'iiches of practice, s almost is to be o all the s of sur- tliis art e incon- human occupa- district, needed xing, as 388 well aa fatiguing. Long and powerful arms are necessary, as well as much address m using them and the fingers; bodily activity is above all essential, m order to g„ about an animal, to place one's self m the most favourabh! position for exploring and operating, and to avoid mjury from the creature. The veterinary obstotrist should also be git ed with presence of mind, coolness, and fertility of resource • so as to take into consideration all the circumstances of the case, devise ins inethod ol i)rocedure, and carry it out promptly. Ihe conditions under which the veterinarian lias to perform his task an, not favourable or encouraging. It is anything but easy to practise the necessary manipulations in the larger animals— such as the Mare or .<-ow— in such a great cavity as the abdomen, and in the uterus which lies deep m it, and contains a voluminous fa,tus. In practising tliese manipulations, the operator has to contend with the struggles and disordered movements of the animal, which sometimes, in the midst of Its Huli(,nng8, does not hesitate t<, use its feet, horns, or teeth as weapons of olience, or to crush its medical attendant against the adjacent wa 1. In addition, the violent contractions of the uterus, and especially of the cervix, fatigue the operator extremely. Sometimes these manipulations have to Ijo continued for hours, until the various Obstacles to delivery are successively overcome, or the creature is doomed to perish. Add to this that Cows and Mares during i)arturition often inhabit Close, toul stables, with an almost poisonous atmospbei'e, destitute of hght, and perhaps also cold and damp. Here the veterinarian must do 1118 duty— cold wet, and dirty, exposed to draughts and every kind of discomfort Most fre• •- ''-'v-.tageous to examination is n ade vomf.; i ^ "^ ''^ ^" ^^^^^^ant, while the .ng the a„i.„al's head i. suflicient'.o make sta°d'.;,ier°° ""'" ''°"'- or5SSS~~^^s^-'^ fonva.. again. tael:;»!;:-rir;i:rtlre;Troi -r^^^^ Br no dolay By porcnivo Id caic'fiilly I'tus which unt at tho jtrics. Kiviiif^ his •(' dillicult, xl, but also d his own ith certain y moans of , tho most lents when akon with st bo pro- able: such omo other rriod in a should be condition, 1 ruptured, i ; it' it is a rable — all I CO of the ; and the /ell as the er this, if 3 internal the mode 3f its im- standing and from imination igeous to ngly, and r usually generally -vhile the 2ssary to pasterns, lan hold- 1 against ler side ; linst the s injury, inimal it s thrown e uterus, a EXE HAL CoysiI/EJtATlOXS. 286 ScHor!' ^'"'" '"°'^ ^'''^ """^ ^'"'''' ''^''i''"^^ ^°^' '"anci^uvres in its When tho operator has to explore in the lying position ho finds it much more fatiguing and dmicult, as he has then to kneel a.Kl to acconuuodato hnnself to the animal. In tho decubitus, it"s stil 1 e necessary t luit tho croup should be higher than the hont par > tho body, m ordcf to get tho digestive o.guns out of tho way • tho lateral pressure of the vMcera shouhl also be diminished by hZig the s Z L^hc^- than tho lunbs ; and it n.ust bo borne in mind that t^l.o mo o n Z uulatlor'l'tH ''" ^'^"^^"^^ '''''{' '' '^ ly'"«' ^''" oasior is tho manipulation lor the same reason, the smaller animals should bo raised as Ingh as the operator's hand: the Sheep, Sow and "oa o s";r 'ad^;r%"T= ^l-^^^^^ch and Cat on ^ablo" ^oveixTtit ^viZoU -totscrlt'cl/tro oTrat^r.""^^^ ""^^ '"^ '' ''''''^' ^^^^ ^''">' To compel a Cow to get up, Schaack recommends that a small Do- be_mh-oduced into the stable, and made to bark at and e.xcite the The coat must bo removed, and the shirt-sleeve rolled as hi^di is tho man"tk'tio;'r''' "''^ '^^^^^^-^^^ when there is a likeliholcf of much manipulation being required with tlio cavity of tho uterus, it has been s;;r Xtir""" ''' '''' "^' ""^-^"^^^<' ^--^'^ --s My friend, Mr. Cartwright, of Whitchurch, employed a lartje thick ^ "t'e^^v's -r f r?'"^ 'f' ''''' buttoned'clos^ u^ arounTt'he ne^k ;' this 13 very suitable or such cases, as it not only admits of the shir bemg removed, but besides keeping the operatoi^s clothes clo'u, i prevents him catching cold. Other operators wear a long gown 1 ke uissecting-room gown. o b^vvn, iin.c a The back of the hand and arm should bo well smeared with oil fZtllZ"""'' butter, not only to render their introduction into the genital passages more easy, and less irritating to the lining membrane but also to some extent to protect the operator against infection I is scarcely necessary to add that rings should not be worn on the fin4rs The right hand is usually introduced, but it is well to be able to use 1?« iJf"";! .f^^'",l"r'^^*^*^°"' '^""^- '""^-^ easily executed with the left tlian the right hand; and. besides, in protracted operations one hand relieves the other. pciauiuus Before commencing the examination of the genital passages, it is well to empty the rectu.n, and if possible tiie bladder. While cMnptyin- n'n r;r'T'"'' '''^^''\fonnation maybe gleaned as to the condi" tion of the uterus, as well as of the pelvis and pelvic cavity The fingers being gathered together in a cone-like form, the hand- which should not be cold~is inserted carefully and steadily into tho vagina at a moment when the animal is not straining-the outer mar-nn (little finger) being downwards, thumb towards the rectum, and pushed gently inwauls by a slight rotatory movement; but the advance of the hand must be inomentarily checked if the straining is at all severe or until the anima , if irritable, has become reconciled to it. When once through the vulva more room is found in the vagina, and the band and lore-arm can then penetrate with ease as far as the cervix uteri ihe object of exploration being to ascertain, in the first place." the condition of the genital passages, as well as tho state of the nelvic cavity m general, the operator has to satisfy himself whether the vagina 286 DYSTOKIA. Nltr is empty, or if it already contains some portion of the fcrtus or its n.embranes, and what these are ; if there is any normal condition or contraction ot the vagina, or any tumours either within or external to that canal, as well as the seat of these, and if possible their nature He has also to satisfy himself that the pelvis is wide, regular in form' or more or less deformed and diminished in si>ce from exostoses frac- tures, or other causes. ' The state of the soft jiarts will likewise engage his attention, and he n_iust learn whether the vulvo-utorine canalis drv, or contains sufli- cient nnicus to facilitate manipulation or delivcL-y, as well as its tempera- ture. Having satisfied himself on these points, the fingers are again brought together, and their extremity pushed as far as the cervix uteri the condition of which is carefully studied. The chief points to be noted are : whether it still projects into i he vagina, or if it is comiiletely eliaced ; whether the uterus has descended on the fioor of the abdomen or IS yet in its ordinary position ; wlietherthe os is closed or open and the extent of its dilatation; whether the texture of the cervix is hard or soft healthy or altered by mor])id degeneration, and if it lies in the axis of the vagnia or deviates therefrom, or is more or less twisted Passing tlie hand into the uterine cavity, if necessary and possible' and with all care and gentleness, the explorer wiir.neefc with the water-bag, if it is not already ruptured, and tiie foetus, if he has not already encountered it ; at the same time the ene-gy and frenuoncy of the labour pains can be ascertained. If the membranes are raptured the hand must be passed into them in order to discover the situation of the la-tus-the kind of presentation and position, the manner in which the hmbs are disposed, and any complications which may be present It the membranes are not ruptured, and it is deemed necessary to open them— which not unfrequently happens when an exploration has to be made, and labour is advanced, the pains being well marked the os dilate.., and tho water-bag in the vagina-the hand may be passed between hem and the uterus, the palm being towards the fa^tus or it may not be required to pass so deeply. When the membranes are tense, pressure against them with the end ot the index-hnger during a throe is usually sullicient to open them • if however, they are fiaccid, a portion is seized between the thumb and middle linger and torn by their nails, or by the nail of the first fin-er against that of the thumb. Sometimes the fingers alone are not sullicient, as when the envelopes contain but little fiuid ; then a pair ot^ scissors, a small trocar, or even an ordinary pen, will effect this In examining for presentation and position, each region of the bodv of the ftt^tus should be familiar to the touch, as it can be distinguished by Its own proper characters. Under ordinary circumstances, the hand of the operator first meets with the limbs of the fcetus ; if thev are the anterior limbs, and the plantar surface of the feet is turned downwards then the fcetus is in the natural or vertebro-sacral position, anterior presentation ; but if the plantar surface of the feet is inclined upwards and they really belong to the fore lindjs, then it is in the vertebro-pubic position To distinguish the foie from the hind limb, the shape of the jomts .and their mode of flexion must betaken into account— the fetlock and knee of the former bend in the same direction, wliile in tlie latter the fetlock and hock fiex in opposite directions ; the knee, in ai:i;. I Tioys. 287 ntus or its indition or 'xternal to jir nature. ir in form, ;oses, frac- )n, and he ains suffi- 3 tcnipera- are again rvix uteri, nts to be oinjiletely abdomen, open, and X is hard lies in the 3 twisted, jiossible, with the e has not qucncy of raptured, ;uation of in which l^resent. y to open lias to be \, the OS 3 passed us ; or it I the end hem : if, mil) and •St finger are not n a pair Cect this he body ignished he hand are the nwards, anterior pwards, o-pubic 3 of the : fetlock 10 latter ihhtion, attened on each side, and offers the calcis as an unmistakable guide. There is also a difference m the shape of the feet. ntW« f ^^''' f ''?l!^ ^''''"^ *^"^' ^° ^'^"''^ '^""««" of the real state of aha s, and conduct his examination with all the care, attention, and gentleness possible. The foetus may present in a variety of positions in which hi.Kl md fore limbs may offer first, either alone or together ^ and in the case of twins or monstrosities, the limbs of different crea- ^nZ-^^^^l . encountei-ed at the_ same time. If the presentation is anteuoi, the head will be met with, and this is distinguished by the presence of the moutli, eyes, and ears ; if it is a posterior presentation then we have the rounded croup, tail, hocks, and external gS f/ir* r ' ? ' P|f ^:"^^tions, the neck is recognised by the mane, if It be a loal m addition to its shape, whether Foalor Calf- the slioulders by the acromion processes and withers; the chest, by the ribs and intercostal spaces ; and so on. In addition to all this, the obstetnst should judge at the same time of the volume of the foetus a^id Its proportions. This is particularly necessary in the case of mon- strosities ; and m some instances it is most dillicult to decide what the hand may ahght upon 111 such an examination. Kopp alludes to the case of a Mare which he examined during parturition, when he found a fcetus affected vvith hydrocephalus to such a degree, that for a long time he thought the head was the thorax. o '« It cannot be too strongly impressed upon the minds of those who are commeiicing obstetric practice, that such an examination should be so complete as to furnish all the ro<,uirements of a sound din-nosis on w-liich the indications for affording assistance can b- readily Cased ' and this exploration can only be said to be complete when the obst^trist IS as wel acquainted with the position of the f.etus and the obstacles to Its birth, as if he had scrutinized the wliole with his eyes Then he can decide as to the measures which are indicated by his diagnosis in order to bring the young creature into one of the best positions for dehvery-either natural or artificial-so that this may be ettected with certainty and rapidity. ^ These measures being decided upon, a methodical procedure is as necessary in carrying them out, as in exploring the vagina and uterus. The required assistants should be selected, and to each should be allotted his share m theoperation, in which he ought to be instructed briefly and clearlj' ; the instruments, cords, and other apparatus ou-ht next to be_ placed in readiness ; and then tiie task may be be-mn ^Vhon this IS once commenced, it should be conducted with prudence' and yet with decision, all irrational and unnecessary man.euvres bein" avoided ; while every precaution being at the same time observed, there should be no fear of irritating the organs or textures by manipulation, as they appear to be endowed with a greater amount of tolerance at this than at any other time. In such cases, the operator should bear in mind tliat his task is remove or overcome everything which suspends, hinders, or inter- feres with the natural course of parturition, and to bring this as near as possible to a normal terminati .n. He should understand and a,,pre- ciate the part Nature plays in this act; only seekin-,^ to second her efforts so long as slie is competent to attain the desired end, by remov- ing any obstacles m the wav. When Nature's efforts cease to be etiec- tive, they should be imitated as clos.-ly as ])ossible ; and no more ou-lit to be attempted than Nature herself would have accomplished under 288 DVSTDKrA. m more favourable circumstances. Art should never undertake what r^atu e can ellect ; and remembering this, the obstetrist will not only seek to learn and appreciate the powers of Nature, but will be in a better position to calculate how far he should himself interfere Whatever is necessary to be done should be accomplished without tm ;li;n';.''l- ? ^Tt "" ^""ri P^J" ^""-^ exhaustion. Sometimes par- tuution IS di lieu It because of the insuhiciency of the expellin" forces as we have already noticed, and this may be remedied by hygitmic and nZ^T"./ ' ^"^^^"«' but more frequently, while the expulsivrelibrts are lom a there IS undue resistance. To increase the expelling forces in the latter instances would evidently be unwarrantable and iniurious ch^irL;,""'off 1 *'" ;r-t--^ by various means, accordini to its chaiactei. Obstacles m he genital passages must be overcome either Winn n? '' ^'°^\^'°'' '^ 1 ^'" ^1!-'*^' by manipulation, in changing the position of the mother, or by other means ; and it often happens that we niust combine extraneous force with the expulsive efforts of the mother, in order to extract the foetus artificially.^ At other times e an'ar ihd.at.":.n "'', '' T^T'' ""l -"bryoton^y, and in extremrcase fh... 1 ^ ^^'^ ^'f' *° be made for it by hysterotomy; though these dangerous operations may be occasionally averted by causin^^ safl'e'inol?' 1 H^- "' '] ^""°^^ '''''\'''' ''''''' - suiliciently sL 1 to be safely expelled through a contracted pelvis inJ^;h?iffo'°n?H''''r;"'™'^'^''"^'y°bstetri^^ hesitate in sacrific- ing the lite of the foetus in serious cases ; and in this resuect the ^actitioner is in a different position to the accoucheur of w-oirn-dnd W th animals there is only a material loss to be looked at, and the fctus must always be greatly inferior in value to the mother T he efoie m order to save the latter, it is more prolitable to sacrifice the former all ct.'^'nf f fT ^""^'1^^^^« ^^-bi-li we believe to be applicable to viried even f „nf '""'l n'"'' '''''' ^'"^ numerous and vaiSus-more vaued even lu annua s than m woman ; and in order to study them We tm Siow l^"?^ '' ""''''''' '''r "^ '' '"^^bodical nUner given below! ^'"'^^■^^^ "^ arranging and studying them m the order Dystokia Synoptic Table of the Causes of Dystokia i.v thk Domesticated Animals. ^Pelvic Constriction. Maternal. [''«Plaf ment and altered relation.s of the Interns j Morbid alterations of the Maternal Organs. I, Umbilical Cord. 'Excess ill Volume Excess in Growtli of Hair I'lU.VC'IPAL Independent of the Presenta-- Diseases tions, by : Monstrosities .Fu^tal ...-! iMultiparity i Dependent on f;^"'*'*''"'- the Presenta- 1 "^t«''ior. [ tions : Dorso-liinibar. USteriio-abdoniinal. 1 J of the Foetus. —VT take what 11 not only 11 be in a I'e. 3d without times par- ing forces, ijienic and efforts are ; forces in injurious, ling to its )nie either bnging the pens that rts of the times the 'erne cases ; though y causing nail to be 1 sacrific- spect the uan-lvind. , and the therefore, former, licable to us — more idy them manner, the order 'oetus. DYSTOKIA FROM PELVIC CONSTRICTION. 289 BOOK I. MATEENAL DYSTOKIA. The pathology of parturition, as has been mentioned, includes disturb ances produced by excessive or tumultuous pains and too feeble nains and derangement caused by too great an obstacle to bTrth WeTave sufficiently described the first ; and we have now to deal with the second in so far as the mother is concerned. The maternal rbstacles to parturition are re ated to the too great resistance offered by the parturient passages, either in their hard or soft parts. These obsLles have been grouped in the preceding table under the heading of ^tcS stnctwn, chsplacement or change in relations of the utents.JdZorMd alterations o/ the maternal organs. moroia CHAPTEE I. Dystokia from Pelvic Constriction. DYSTOKIA from constriction of the pelvis is sometimes observed in animals ;i though less frequently, perhaps, than in woman, in whom constitu lonal causes and the different position (vertical) of this region operate largely in producing diminished dimensions of its cavity Anv altera ion in the dimensions or shape of the pelvis, whether general or partial, is a more or less serious cause of dystokia, and in some cases may render delivery absolutely impossible. A pelvis geneJally reduced in a Its dimensions is sometimes noticed in the large, as well as the small domesticated animals. ^ On the Continent of Europe, this has been observed more particularly among some of the small common breeds of Cattle-such as the nretonne, and certain of the grey Swiss breeds, as the Fribourneoise These have the ischia pointed and the tail attached high above them Leconte has observed this conformation in animals the produce of a cross between large Norman Mares and pure-bred Horses, whch have a sharp croup There is often a relative narrowness of the pelv's in animals of small size that have been put to larger males. Thi^ has been witnessed in the Mare and Bitch; and as the young are po^^^^^^ t.onately larger than the pelvis can accommodate in parturitiL we have here a cause of dystokia. ^ "uuuon, we An abnormal inchnation of the pelvis has been supposed by some writers to exeixsise an unfavourable influence on parturition, but this has been denied by others. Provided the other conditions of normS parturition are present, no difficulty should be experienced in delivery nnif;- 1°/^''. state there is a narrow pelvis, tnen obstetrica operations would certainly be rendered more serious Deformities which occasion irregular constriction of the pelvic cavity • A iiatu, ally wide polyis-or rather an exces.s in width-observc^d more particularly in animals of a lymphatic ten>,>era,nent, and esp.oi.ally in Cows, al ,r .'"than exul^ ordinary suppleness an.l laxity of the soft parts in this^egion, has 1,0^, "nvenience of renderinj. parturition too easy, it would appear. For this facility is «uppo"^^^ without reason o bnng about such complications as inversion of the vSa and uterus apoplexy in tlie Cow, and metritis in the other animals. viiuiary 19 - 5 . ^■■i^Ht 11 i 1 K 6 290 MATERNAL DVSTOKIA. HI • ■ m are various. They may belong to the bones of this region, or to its connective tissue ; and they always more or less diminish one or more of the dimensions of the parturient canal, and offer an obstacle to the passage of the fcctus These cases, however, are somewhat rare ; they are generally found to be due to complete deformity of the pelvis exostoses, fractures, or tumours. J J ' i^'-"-". Complete Defokmity of the Pelvis. As has been observed, complete deformity of the pelvis is very rare among animals. When due to rachitism, it is most frequently noted in the Pig. In this animal the pelvis is sometimes greatly distorted and not unfrequently there is accompanying deviation in the vertebral spine. This condition is seldom seen in other creatures Saint^Cyr informs us that in the Museum of the Lyons Veterinary bchool, there is the pelvis of a Mare and another of a Female- \ss which Fig. 81. CojiPLETKLY Dkkohsiei) Pelvi« : Make. musThntT/ ^T"^'^'^'^^^ ^^.^S'-^« °f «^»eral constriction, and which must have offered a very serious obstacle to parturition if the animals had ever been pregnant. That of the Mare (Fig. 81) is singularly depressed on both sides, the ischia, and especially the pubisfbeTng atrophied with respect to size. The oval foraniina and cotyldd iTJi'Sr^ close together, the floor of the pelvis is ext. .melycon tracted and angular, and the pubic arch is hypertrophie('. In this specimen there is a very notable diminution in the different diame e s of the pelvic cavity ; the supero-inferior, instead of being about 8+ inches n to 8 inches ' bis-ihac diameter is but 4J, Instead^ being The diagnosis of this deformity ought not to be difficult, especialh- when It IS so marked as in this instance. Vaginal explora ion^hould soon discover it, and the diminution in si.e^may be approximate y determined by spreading the lingers, and in this way measuring the 1, or to its ne or more acle to the rare ; they the 2Jclvis, i very rare ntly noted distorted, 3 vertebral /eterinary ^ss, which DYSTOKIA FROM PELVIC CONSTRICTION, 291 two diameters. The diagnosis may not be so easy, however when the canal is partly or wholly occupied by the fcetus "^^v^'^- ^nen tne _ Another kmd of deformity described by several authorities consists EXOSTOSKS. Exostoses on the pelvic bones, and particularly when they proiect mto the pelvic cavity or encroach on its openings, may becS a more or less serious obstacle to the passage of the f^tus (pi 82° d whicli animals ngularly is, being cotyloid ely con- In this ameters h inches 3f bein^ pecially I should imately ing the l'"ig. 82. Pei,vu; Exostosis. Favre of Geneva, states that bony tumours situated beneath the croup at the inner and upper surface of the pelvis, render parturition (Umcult, even if they are not large and near the root of the tail He acids that such cases are not rare in old Mares. Feactukes. Like the exostoses, more or less completely consolidated fractures ot the sacrum or coxa), which have been united by an irregular callus may, for the same reason, prove an obstacle to birth. "As animah suttering from a fracture of any of the bones of this region are often destroyed, laborious parturition from such a deformity is not so frequ m as from some other causes ; nevertheless, it does occur now and aglVn wbnVZ /'^.'"^'^bered that fractures of the pelvic bones are sSme- c«rsror-=^^-'^"'-™ ^">^P-^- The most fracture is perhaps the external angle of the iliu m II 292 MATEMNAL JjrsTOAIA. m nh> .1 and the least frequent, the posterior part of the ischium and the pubis. Fracture of the sacrum and the internal angle of the ilium is also very rare. Simultaneous compound fracture of the two coxto has been observed in two cases by Lafosse ; in one case by Ciepin, and in another by Philippe. D'Arboval has witnessed a fracture of the pubis in a Dog ; and Carsten Harms alludes to fractures of tlie ischium occurring in the Mare and Cow. The latter authority has likewise found the two iUums of a Goat united at their posterior angle by a mass of bono as thick as a finger. Professor Ercolani has well described twelve important cases of pelvic fracture exhibited in the Pathological Museum of the Bologna University.^ The first of these is a compound fractu*- •' "-'e ossa innominata, the solution of continuity involving all the 1 the foramina ovale in the pelvis of a Mare; the second is a trac : ui the left ilium near its neck, and extending to the cotyloid cavity, also Fig. 83. Fhactuuk of thk Pel v is. in the pelvis of a Mare ; the third is a compound comminuted fracture of the left innominate bone in a Mare, the piece being divided into_ six principal portions ; the fourth is a compound fracture of the right ilium of a Mare, extending to the arch of the pubis on the left side ; the fifth is a longitudinal fracture of the right ilium of a Filly ; the sixth, a fracture of the external angle of the right ilium and the left ischiatic tuberosity of a Mare ; the seventh is a slightly oblique fracture of the ilium extending to the cotyloid cavity of a Mare ; the eighth is a com- pound fracture of the pelvis of a Mare, involving the internal angle of the ilium, the external part of the ischial tuberosity, the arch of the pubis, and the union of the pubis with the ischium ; the ninth is a fracture of the superior and posterior crest of the ilium of a Mare ; the tenth is an oblique fr.ap.tnre nf tlie neok of the left ilium of a Mare ; the eleventh is a compound fracture of the right coxa of a Mare, the 1 Descrizione Metodica dei Preparati del Museo di Anatomia Patologioa Comparata della R. Universitli di Bologna. Meinoria I. Bologii.a, 18G7, p. 38 -.—Fratlure dclla, Pelvi. '.^e DYSTOKIA FROM PELVIC CONSTmCTION. 298 cotyloid portion being completely isolated from the ischium, ilium and pubis ; the twelfth is a fracture of the external angle of the ilium! Lanzillotti-Buonsanti states that the Pathological Museum of the Milan Veterinary School contains a coxa which shows a fracture of the neck of the ilium, with overlapping of the disunited portions; and alsc a pelvis in which the pubic portion of the symphysis has sustained a comminuted fracture. Much will depend, of course, upon the nature and the seat of the fracture. When it is only the outer angle of the ilium (point of haunch), and even when the fractured bone is displaced by the action of the small oblique muscles of the abdomen and the fascia lata, pro- ducing much external deformity, no great effect can be produced on the act of parturition, as this part has nothing to do with the pelvic cavity. But when the whole of one side of the haunch is lower than the other, delivery is then undoubtedly interfered with, and perhaps to a most serious extent ; inasmuch as some one of the parts which concur in forming the pelvic cavity is implicated in the fracture, and consequently the external deformity corresponds to an internal diminu- tion and irregularity in its diameters, from displaced fragments of bone overlapping of fractured ends, the approach of the sacrum to the pubis' and consequent lessening of the inlet of this cavity, as well as to the more or less voluminous deposit of bone around the fractured portions ( Fig. H3). Many cases are on record of difliculty in parturition from this deformity. Fractures of the pelvis are by no means infrequent in animals, and are due to falls, crushing, blows, or other causes ; and, as the above instances testify, they may prove insurmountable obstacles in parturi- tion. Female animals which have sustained an injury of this kind should not bo employed for breeding purposes, unless a careful exami- nation has shown that it has not altered the pelvic diameters in such a way as to render delivery difficult. Such an alteration may be diagnosed by depression of the haunch or croup, and lameness to a more or less appreciable extent ; while rectal or vaginal exploration will discover the presence of a variable-sized hard tumour forming part of the bone, and projecting into the cavity The previous history of the animal may also aid in confirming the diagnosis. Fractures of the pelvis may also take place during parturition, and Rueff mentions two i istances in which they have occurred sponta- neously during very violent labour pains. In the latter instances, there may have existed a predisposition due to a diseased condition of the bones— a predisposition not uncommon in breedmg animals. TURIOIJUS IN THE PeLVIC CaVITY. Tumours of various kinds— such as fibromata, melanotic and cancerous tumours, in addition to those of a bony character due to injury- may prove a cause of dystokia ; abscess may also co-exist with pregnancy, and be a source of difficulty in parturition. But that form of melanosis which appears in grey animals, and particularly manifests itselt in the form of tumours at the root of the tail, around the anus, and in the connective tissue of the pelvis, should offer the most frequent obstacle to delivery. ■294 M/1 THItXA L DYS TitKIA. m ;j Iw.!^."^" l"*' ''f^^'^'f '" '»y "wn experience, in which an aged Mare, nearly white, .el nKin^' to a fnend was on my recon.n.endation, taken by a farmer, wh.. attempted ^^:::^^^:^^lXiiT^'^'''' •" '"•''^""^"''•^' ^"'^^"""^' •'*'*""^"'»' '^ ^'-' of mtT'".'^'''-r'lu""'' ,*''•'* delivery could not take place owing to great maHsoH ™ 1 /?™" '" *^'; l'"'"5 "'^^"y- '^^''^" «'^'^" t" the farmer there were only a few small nodular masses obHerved about the tail and vulvi MnU.?,r">/^''''"-/l'' ^" ^'''''' P""""''' ''« ^^^'''- '^'W'''""'>''. vol. v., p. 180) was con- whS r , 'T , *" '^ ^^,'"'''' ?'";"'^ *^""^"''' y'''''"'« "''^ •*'"> "'"">* «ve months pregnant, «h ch had such a large melanotic deposit around the anus that defecation was impossible ll\T\ n'-A T\, ^''^•' ''.•''l>'7'^ti«" discovered a very voluminous tumour situated oeiv.l W-i" "f .t''%!'^''^''«- '» tl'« centre of which a slight fluctuation c.uld be per- n^mlf A t »i 'i V.""^ to accelerate the maturation of the tumour, vesicatory agents were H n ,5-n A-f ^"''^ '""^ T"'fJ' ^'""^^'y ^''^^' the tumour was larger and more fluctuating and it was punctured, when about two pints of a dark, purulent, but almost dourless fluid escaped On the hand being introduced into the softening mass, a and w iTi ; "' *''" ""'^"^ '"" ^''ts. 'vnd partially detached ; this was removed, fivp nnT h T^^ m'"" ^"""^^"' ^" *^''^'^'-- '^'^y^ the wound had cicatrised ; and in ■ sitL^pH ;l I ?? 1" S'^tation being nearly completed, another melanotic tumour, Sri T ^^ ""^'y ^"T"^'' :^''"' "«''* «''^^' "f the pelvic cavitv, was also removed Cicatrisation took place rapidly, and delivery occurre.l without any d.tliculty. wa?r^!., '"'"'f r\' i'-''"''^"'' "' '''""'' '-' ^'''^^ *l"'"'tit.V «'f hardened fieces in the rectum was a cause of uystokiu. Indicnthms for Suiyical Treatment. The surgicul treatment of those cases in which dystokia is due to any ot tlie causes just enumerated, will greatly deuend upon circum- stances, not only with regard to the kind of t.-eatment, but also as to Its expediency. For instance, if total or partial deformity of the pelvis is present to such a degree as to endanger the life of the animal during parturition, orif there exist obstacles due to fractures or tumours, and which can- not be removed, then it may be advisable, if the animal be fit for food and in good condition, to send it to the butcher; or if it be pregnant and in inferior condition, to produce abortion at a sulhciently early period. ±5ut it parturition has already commenced, then, of course, surgical or obstetrical treatment must be had recourse to; and the nature of this will depend upon the constriction of the pelvic cavit> , and the kind of obstacle which causes the diminished space. The indications are : to forcibly extract the fcetus through the narrowed passage; to mid en the passage ; to diminish the si^e of the frntus ; or to make an artificial passage. But as artificial ahorthn may be necessary during pregnancy should the veterinarian be consulted, and from examination be ed to conclude that parturition will be dangerous or inpossible we shall include this as one of the indications, and com- mence with it. 1. Aktificiai. AiioimoN. .- Artificial abortion maybe rendered necessary not only during pregnancy, when the condition of the pelvic cavity leads to the supposition that delivery at full term is dangerous or impossible but also in metrorrhagia, serious inversion of the vagina, hydramnios, debility, or exhaustion, etc. Artificial abortion may be produced in several ways, and is generally more success ul with the Mare than the Cow, because of the greater excital)!hty of the cervix uteri, and the readiness with which it can be dilated in that animal. Three modes of procedure have been adopted with the domesticaed animals, each being attended with success, and each ofiermg special advantages in particular cases. These are : irriia- f UYSTOKIA FJtOM I'KLVW UONSTRIVTION. 29ft II !is;^.:^/S'w^;S;;^"'' '-' ''' ^""^ ^^""^^"- ^f ^^- --^^<^-^ ana u£>^m!u^J^'''?(J^^ f/^m.-.Thi8 is accomplished in the e [i S tw """"^-'^ introduced into the vagina, and first one ungei then two are nisinuated into the os bv a sen'i rotatorv movement, and finally the wliole hand is inserted, as tL m t u ktes the operation is repeated several times, labour pains soon en ue As oror;aiLrn''''f",;' ''^^'^"^ '"^'^'"'"g- ''^^ «l-"«« tent, "larc bags ucce u oT t ^' """^'T '""^ ^' ^'"Ployed. A better and more pSfof L n ' '"Production of a long elastic catheter, strong u eruH r,f ' ''''T "" '1'""' •'^^''""" *^« ^""^^1 membranes and the OS and s. n ™r' "n^ •'" P u "'°^''^ ^^ P^«^'"" ''^« hand through the OS, and separatmg the membranes from the uterus is so iXTlo r/'^ ^' ^-ecommended for Mares, the uterus of which n fh, V f } abortion sometimes takes place after manipulations ^tusorcurs'h 7 '"'"' V'"f- /" °rd'"-^T '^-^es, the expulsion of the Harl h? " '•'' ^'^ *r^^^ h^'^^'- ^^ '^ "ot applicable to Cattle, St witho ;i°"r' "'^"^^"lated a Cow in this manner for a whole fofsmllttiSfs"""^^"^^'^ ""^'^ '' '' *° b^ recommended usSriol^t?::!:!!^'^^-^:?^ --^^P- - P-ctured by Vnnfi r'"''V ^^''' r"^.*''°^ ^' particularly ellicaeious with Cattle. ,vnf ^ /'•'•'//''/io^s.-Irngation of the vagina with cold water (or water a a temperature of about 90" Fahr.). made by means of a syringe oi injection-tube, and continued for a quarter of an hour every thrS ours, will induce labour pains about the fourth injection, and effect This nS'^T -'^ '^'' ^"^*"'- ''r''^' ^he second, third, or fourth day. fchon.. 1 i/' /"°''' P^^'^j'^^l^l-ly adapted for the smaller animals ; ~i A a} '^l^^ «'^««^ed with the larger. The only danger to be apprehended from It IS an attack of metro-peritonitis. -^ ^ "^ wlf^n^T'Tf ^^"^"f TiON -The first impulse which presents itself when the foetus meets with any obstacle to its passage through the pelvis. ,s to " force it through - and it is this impulse which is carr ed into execution by unscientific people. Too frequently, however it happens that by this procedure some portion of the fcetu is sTtTghtly wedged in the pelvis that no amount of force is capable of movin- it ^[i^f Y"?. '^"^'''' ^b^?^^t«ly inipossible those other operations which might be the means of saving at least the mother or offspring, or perhaps both. For this reason it is, that the owner of an animll in this condition should not himself, nor suffer others to, pull at the foetus or at.euipt any similar man«3uvre, until the arrival of the veterinarian.' And the latter has a difficult task before him in solving the problem as to whether he ought to extract the foetus forcibly, or resort immediately o the other measures prescribed. This will render a careful examina- tion necessary, in order to ascertain the nature, seat, and degree of constriction. s ^ "^ The a-nimal is making excessive, nay violent efforts, and the foetus may be ma favourable position, but it does not advance through the pelvis. The parent is restless and sighs deeply; the flanks are covered with perspiration, and sometimes, through sheer exhaustion it I t i ' 296 MATKRiXAL DYSTOKIA. W\ mm^ {Mb, utterly prostrated by its efforts. As the uterine contractions Rene- rally increase in violence in the presence of obstacles to birth, there is the gravest danger to mother and offspring. n.ScT^fif ""^^l- ^''"^ veterinarian, having introduced his hand into the fhlrl wl ordinary way, endeavours to discover if the obstacle is tnere. With this object in view, he closes his hand to try if he can move his shut hst about in every direction, and with ease. Then stretch- nf.Zn K f ' "" "''" aPPro'^i'nately judge the distance which intervenes between opposite points of the pelvic circumference and in this way appreciate to a certain degree whether a moderate-sized fcetus could pass through. For if the pelvis is so contracted that the closed hand can scarcely move about in it, it will be needless to attempt forcible extraction, as the fcetus cannot be brought through Saint-Cyr has calculated that the closed hand Sf an adult man repre- sents an irregular mass measuring between three and four and a half nches in diameter ; but the head of a Calf, in its supero-inferlor diameter, SampTv r- T" *.° *^\^»«'^^«. ^"^ fo^"- to live inches in transverse fiv^ 1 IS therefore obvious that the head of a Calf could not pass le^^ft ^^^/P'jt^rei" which the hand cannot move freely ; and much depth ^ ' ' " '' ^^ ^^^"^ ^"^^^''^ ^° **'"''^«" i"ch«« i» It is also necessary to take into consideration the cause of dystokia iii^f '" Ali"" ^. 'complete deformity of the pelvis, then tlie case is serious, andthere is little hope of traction alone overcoming the diffi- ff fv" • 'f '^u *'',^ t"'"our, and localised, then it must be ascertained this IS of a bony character, arising from an exostosis or fracture : or It It 13 movable and independent. If the latter, the case is not so hl^T'T ^^r'"''"^ '^ *^? *'""°"' ^' connected with the sacro-sciatic ligament ; as it may be pushed out of the way of the foetus, and birth taice place. As Saint-Cyr insists, all these considerations should be weighed before deciding to terminate parturition by mechanical traction ; for if the im- possibihty of accomplishing it by this means is discovered when too late, the other operations are rendered more difficult and dangerous in consequence of the ineffectual attempts at forced extraction^ ' fKo J V *w°^ the entire foetus is discovered to be practicable and the position IS favourable, then there should not be much difficulty in Tfwni"L W "^rf ? "lay be achieved as in ordinary circumstances. il7J} T.t ^^^'1^*^*1^'. «bould the foetus and the passage be dry and tenacious, if these are lubricated with oil or soapy fluid be nnSTf ' *^u ^v'"' ^^l ^''°'!?^ '^"'^Sed in the passage and cannot ulSnil /""^^^^.u""^^ be useful to push it back a little into the uterine cavity and then lubricate it and the vagina with some oily matter to assist movement, before another attempt is made. in^^rtlff'''''T''lu'^ ''"'' PAssAaE.-This is nearly always impossible in practice, unless the cause be a tumour which can either be excised or moved temporarily out of the way, so as to permit delivery. ^^^5'^^"^^^ °'' '''''' ^{''^ o^ THE FcKTUs.-With the domestic to o^Dose n.'wV. ''V'^'^'"?^^ '^''^' ^^^'' ^'^ "° "^^'"^^ considerations the H?P of ^L 'I ''T'i *° t 'l""'*^^" °^ sacrificing the fcetus to save in thil direoHo^"'' 1 • ^""^ %'*^ *^" ^^^'' ^^^'^ ^^^^^^ ^e no hesitation m this direction, when a careful examination has proved delivery of .he li DYSTOKU FROM IHSPL.tCKMKXT iiF THK UrElWH. 2i>r living or ntire fotus to be impossible, particularly when we remember that the yuuiif. freature soon perishes. J' v «n we reraemner With the Cow, however, the case is somewhat different as wh^^n delivery IS unsuccessful this animal may be killed and Sed as Tood Lmbryoton,y IS, nevertheless, often resorted to before the case is con t^^lZ:^::^^ '' ^" '^'-^-'y -^^' good reSs.^^ We shall treat of embryotomy hereafter ; but it may bo useful to o theTorrn^ I'^^V'.I '^" ""'"''r- P^^^^'^tation. removui'ff one or bo S of the fore limbs at the scapula of the fa>tus, will often allow the remain x'ciS'orone hind 7'"^'^' '"'"'''r- ^^^^^ ^ P^^""'- P--" S. fmtus to \LaZt t ^ '« frequently sudicient to permit the body of the ittitus to be drawn through the passage. ^ 5. ESTAHLISH AN AuTIKICIAL PASSAGE FOK THH FoOTUS -When »l11 LZZZrl'lT ^""^ been recognised as impracUcabl! or t'oo aangerous, there yet remains another which, thou'rh it may clacp i\Z iLt and TmtV^r '' ^'"""''^ ^"^ «^«"'^ be consEd' on y'a MtnvJn^ . ^'^"'"''^ expedient, may be resorted to : this is the hS er "Tr "" f «tro-hysterotomy^an operation to be described tion sJ^h as th\ f °';'^ u u""'"^ '" *^"^ P^"''^' '^^' ^ formidable opera much exhausted bv inl'i ^^-^^^^^'^^^ '^ T'^Y' ^"d before the female is mucn exhausted by inefhcacious inampulations and impotent labour I CHAPTER II. Dystokia from Displacement or Changed Relations of the Uterus. S^Srorir^ ^% "-^^'t '^'f '"^^ ^y displacement or altered relations tha orShrn?,"vf'"'"^*^'/"'''"'~?^ "*^™^' ^i'^her from hernia of tnat organ through a natural or accidental opening in the abdominnl K 'a'iis Tt.'^'f "'"■ V'' .^--<^'-^on, whe?eby rh^os is no Tonge evohtioTof Iwnf f '• T ?'""•'! "^ '^' "^«^"' ^"^ *° i^^ having made a ^^.Z^^:Z^t' '^ ''' ^^^" ''''-' ^^"^""^^^ displacement Hernia of the Utekus— Hystekocele. to dIStn"? °^ \T^'^^ ^^™^^ '"^y be viewed as more or less tending n th^pt/nf ; *^' ^'"P^^-tf"* share the abdominal muscles assume in the act of parturition ; and when there is a tendency to hernia of any of the organs in this cavity, or when a hernia really ex^ists, this is 1 kely to be increased during labour, and may complicate delive y. But th^ .u?-^'"*f; °^ *>^ "*^^"«, is certainly not a very common accident: npyer- thclcss, jt IS lar from being rare, if we are to judge by the instances lecorded in veterinary literature, and it has beeii observed n^he Mare catld anS. """'V^r'' ^"1 J^^^^b-in all the more important domett': parturition ' ^^' °"''' ^^^'^''"^ ^ ^'^'^ ^^^^^^^^ obstacle to 208 .v.irh'/:.\.i/. hvsToKi.i. On,,iu and S,„nptom.s in Unijmron.s Animals. The symptoms and other foature^ of this accidnnt .nth,... v,n- ■ uniparous an.l inultinarouH animals Tn «,,.!?,? • '^'"'"" '" the Mare and Cow luM-ni ,.f /i . '''' ""'Parous creatures as profinancv i^ ,,V> tv^v^^^ i 'T""^ \' «"»«»^'ly "ot ooserved until ^k;H' SIS? — 'T-^^^^ f < ■' I i\- ^Mii«miil:-h Fig. 84. l^TEIIINK HkKMA : AFaKK. A, B, Hernial Tumour ; C, Te«.t carried .vn l.y the Tuuu.t.r. a^^y . time ^^;:^ai;-:ti;;^^;zeh!;^^^^^^ muscles, which Lads trth'S 'f'-''''^''"' ^' "'^^^^"i^g ^^ tlie abdominal times ve-j Inely and energefc inmate. The muscles are stretched VYSTUKIA FHOM I>ISI'I.AVKMKNT nF THE CTKnUS. 200 and attoniiatofl, thoir (il.ros are separated and Honio of them ruDturn am m tlus way in fonned a rent which gradually en age frm^^^ .creasing presHuro Then u tu.nour appears externally and towards the ower part of the abdomen, though 'always a little to one sTde "tnVortl^ »;;; — "^'r' ^*" "«'^ •" ''^^ ^'^-' and not mf^equeX fiont of the pubis, in the mainmary region. This tumour when first o cecl 18 about the si.e of a child's head, and not clearly d^l^ned bu It rapidly enlarges, and in a few days may ac rSTDKI. I. iii h-' imnnif-lll '"'"^ 'T ^''^" ''^'"''^ M->t\tixde for labour is also sor.iowhat impaired, as may bo imii|;itiod. Ori(/iii and Si/mptoiiis in M all i parous Animals. immals, hut ts manuor of pn.dutition would appear to Im diffcrout o what .t .s u, uniparous cnvalun>s. this takin, plaoo in o irm^^ botwocn Kostatu.us. Th. I.M,.tl. and n.ohilitv^, tho en "uch an annua as tho imd,. to-.-thor with thoir" doso prox ty o h^^^^ abdonunal walls, sullici.M.tly explain how they n, w pass into an ^T'ora';-;.;;.:""^; '^'"^ '^ ^r^'^^' '^^ ''-^ - ^mafiVun;::^;- thi 81/0 Of a p.goous or hona c^r. ; this tumour is soft, indolent more vh lie the annual is umnipre-nated, it remains stationary. After nupre^nation. howev,>r, it daily acquires larger dimenHions one o ^1^VX.v"L;m""''"' y>^'>J''^'-"i-l portion. locZ,d them- 8 owin :h Tl' "'^■*''''l»"'l i"to f<''ti'«"« without the Jiitch ano\\in,i,'inueli, it any disturhance. The usual s(>at of "the hernia is in the mamnt;.ry re-ion to tho ri-hl M\ example of inf,minal uternie hern a will be L'iven hereafter- w<. Ba „;r ''nf ^llf "^ r " ''T "^ ^^'^^'^^ "^^''•'- i^-^a^-S,ed b ca ed ilnJn^ '" ''"''i ^ '" "^^^'■"'' ^''*'''' '''"^ ^'''">' apparentlV e n h- " ' V'^'"'""' '•'"«' ^^'^« P"«''«<^ backwards thmuj,'!, the connectuo tissue ami app.>ared as a tumour at the vulva. The owner o 1 e ammal, not knowing what the swelling, contained, opened Tby mns of a penknite ; n. this way there was formed a lis t.lous wound rom which a viscid tluul escaped. Hainard incised this listuk d t and wi;rf \f '" '^T " '''T^ """'"''^''^"'^ '"^^•■"" «onu, luaic;^; IS the. e adhered a reddish-brown vascular network, which was the placenta, and winch was easily detaeluHl by the fino-er- withir t appeared a transparent l.ladder - the amnion- already ^1 ,V,tly r o - ated, and looking hke the envelope of a cyst. JlaviuL' opened h"s w^'ks .^ir'Tr 'Vri'f '^'•"! ^'"'*S'^"^^ '' ^^'^''^^ 'H'lnu-enti; tl!rror fo ; weeks old. The Biteh died next day ll j as^I'^h?/ l" ';T"'" "''"I'' "i *'^" '^iHlominal region, it usually appears Tdiffi- J t ' ' 'r '"'•■ r''^'-' ^'"' ^"""'•"' *^^^"' •« «"ft and fluctuating o 1 eS w^,l^^^ /'V""7n««// is, but linn and resisting at otheis where the fiotus chances to be. It may be noted h(>re, that there mav be other hernias of the uterus the uteune conuia which contained a Calf, and which had passed cases or tins Kind m the Bitch, PaiJioloijical A natomy. The uatholorfirnl anntomv nf iifnrina l-t.-Ki.-.;.. :, l -j.! • fo tho ■nK.f«f,.r;" 7 V. . "t ^ hernia is not without interest to the obstet • St ; and as ,t has been studied in animals which had ?h. Pvid '"'' ^"""^^' at parturition, or were slaughtered after that ac the evidence is as plentiful as it is reliable. DVSTOKIA FHOM DISl'I^AVEMENT (lb' THK UTKItUH. JiOl Tho chief and essential IcHion in, of course, to ho found in the ahdoininal panotcH. Tho flesliy or tendinous lihres of tho ohhouo muHclos may ho m.^rely separated, CHpecially at tho coM.niencen.ent • though most fnujucsntly soino of tliern ^m^ ruptured. The great rectus iinmclo always shows a solution of continuity, the rupture heinL' Hoinetnnes as clean and sliarp as if it had heen made l,y a knife • though at oth(,r times it is inc-ular and lacerated. In every case tliere results a varuihlc-si/.ed opening, more or less circular, oval or triangunr Its larger diameter corresponding to tlie axis of the animal's hody ; J{odot lias seen an opening of tliis kind measure nearly twenty inches. '' •' The K(^at of the iiipturo varies ; sometimes tho rectus muscle is iior- lorated at its puhic insertion, as Favre has seen it ; in other cases it is elsewhere, l)ut in csvery instance it is inierior posterior to the umhilicus and to tiie riglit or left of the Imm alluu The latter structure is at hrst never involved ; hut wluiii the hernia increases largely in si/e it Miay in Its turn give way ; so long as it remains intact it forms a kind of cord extending from tho puhi ; to the sternum, and by partially dividing the tumour, gives it a hi lohular appearance. In a few cases tiie lnnicaah,l(imliialis resists the strain imposed on it being only extended, and in this way the hernia has another covering in addition to the skin ; hut in many instances it tears, like the muscles De plaiupio has shown that the |)eriton(mm mayrsseape rupture, stretch and, accompanying tho desci^nding viscera, constitute! a serous tunic to the hernia ; most irequently, however, it gives way, the uterus passes through It, and then there is no hernial sac. In a recent luirnia, tlu; connective tissue surrounding it is greatly ecchymosed and inhltrated, and the muscular lihres broken up and separated; the tendinous iibres are also disassociated and torn and numerous red and partly decoloristid blood-clots lie anion-' their inter- stices. At a later period no extravasated blood is found^bcitween the skin and tiie uterus, but tins parts are uniformly red ; and, later still attempts at repair are evidenced by cicatrisation of the borders of the rupture, whicli have then a rounded, thickened, and iibro-tendinoua aspect, and are dense and resisting. The connective tissue beneath the skin IS condensed info a kind of smooth membrane, continuous with the margin of the rent, ami forms a second tunic to the hernia. Befort! parturition the hernia is occupied exclusively, or nearly so by the gravid uterus, which is wholly or in part lodged in this ac; idental diverticulum. After delivery, however, the uterus often, though not always, ascends into the abdominal cavity; but whether it does so or not, other viscera-such as the rumen with tho Cow, and the colon and small intestine with the Mare- find their way into the pouch- Hodet has even found the uterus and the entire intestinal mass included in it. THa(/nnsis. The (Jiagjwsis of uterine hernia in the larger animals is not difficult in the great majority of instances, and especially if labour has com- menced. In the first place, it is usunlly known to the owner that the animal is pregnant ; and in the second place, if parturition has begun there can scarcely be any mistake made as to the nature of the expul sive efforts. Besides, there is the abdominal tumour with its peculiar characteristics, and by manipulating it the fcjetus can be detected S02 MATERNAL DYSTOKIA. It will alBO be discovered that the tumour does not adhere to the abdominal parietes, and that it may be reduced by taxis ±Jut It may be necessary to ascertain the presentation and position of the foetus, and if it cannot be born, what the nature of the obstacle t which prevents delivery. In such a case vaginal explorat^^on mu be resorted to ; by it we may learn that the os is not dilated Som Tv LXl'T'' ^ ^^ ^^'''f "". ^'''''''''^ ' «>- *h^ non-dilatation may be due to the itenne contractions not pressing the footal mass directly against the cervix, in consequence of the altered ^{^0? the uterus, or the margin of the hernial opening strangulating he fSlus ™n-nr'"^ ''' '^'""''- '^^'^'^ °^^*^^^^^ "'"^^ be combated l; appropriate measures. •' _ In consequence of the foetus lying so far below the pubis the hand introduced through the os cannot feel it, even when the who flench of the arm is inserted ; in which case, if the animal is standin' the abdomen may be raised by means of a sheet or blanket, so as to bring he foBtus within reach. If the animal is recumbent and cannot rise then It should be placed on its back and secured in that pSon he croup being raised by bundles of straw. The tumour mayXn be' ex amined by externa palpation, as well as by rectal and vajinal explora- tion, and the position of the foetus determined expiora <^htL?^'''!u^ F°''i'°" 'f ''^''''^ 'l"^^^ "°™''^'- Tn the most favour- able cases, the head is found to be directed backwards and near nd d-^l.'^n^V^^I'"^'', ^f'^^ ^^ *he pelvis, with the face upwards against the body, which lies deep in the tumour, and the buttocks resting on the mammae of the mother-the foetus being altogether in the recumbent female, in the position of a sitting dc^ ao„ f ^^^A^ °^*^f ^°'^^'' ""^ *be hernial orifice should be carefullv o .nr'^;-'"l'^"^' ''''^'^''^ ""'^ *^'^«'°"' *°«^ther with the degree of constriction they exercise on the body of the foetus noted tS^ important examination should be made before any traction is exercised on the foetus ; for on the information so obtained will depend the choice of means to effect delivery. utpena tne With the Bitch uterine hernia is frequently most difficult to diagnose drfferentTTnf ' f ,^^"'?^^°'^f "^^««- ^^^ mammary tumours are ver? different to that of hernia ; they are generally nodulated, very hard, and not lt\n f"f^ " '^'''"'. '^ *t^'" ' ^bereas the uterine hernia has not the lluctuation of a cyst or abscess, neither has it the resistance of a carcinoma hbroma, or adenoma, while the skin coverin- it is smooth sTnf wS^n^rrn "^' "^^'"^^ "Z^^^^^'^^^^"' ^^-'-ation anTrhe; signs v\hicli mark tlie presence of mammary enlargements. Tlie iterme tumour can also be reduced by taxis or manipulation, wl ile t lie harit Is onW l'"f"V"^" 5f^ f ''''■ ^^'^•^' ^^s'^ber with the fa ? nrnll ^'"^y .^l^vdoped rapidly after impregnation, and without any S h T'7f '"/^"['"^tory symptoms, or disturbance of the general health, should settle the question. '^ tu^ZT'; f "';''lf ?y ^°"bt yet remain, or if it is desired to ascertain he exact state of affairs, a more careful examination will be necessarv It being always borne m mind ihat this hernia in the Bitch appears in diffeient regions, \agmal exploration cannot be resorted to with this animal, because of the smallness of the pelvis-unless the Bitch is a large one, and then the fingers are too short to explore to any depth DYSTOKIA FROM DISPLACEMENT OF THE UTERUS. An external examination must thprofrvv^ u^ i- i easier and more certain than wth the llmeV.^^^^^^^ "^P"^"' ^"^ ^^^ ^' of the abdpminal rent will beTscertalnpTiri '''^l ^^ ^* *^« ^^^^ can be passed through it into ThTbt men -tW^^^ *'^ '"'f possible, owing to the hernia occurring we " ihp n^f ' '' '^'^^^ and when it could pass through an openinfwh rh 1 i? was empty, cient for a foetus when fully developed ^ ^^^ ''°' ^^ ^^ffi" mu'ch sttSiSr po^^sibt ''irth^'^"^' ^^ p^^^"-^ -*^ - while the fe.nalt itself is very^fable to metritis'^"' '" "''^"^ ^"^^^' absolutely necessary. More especial vi. f^^'^'^r^ '""^^^^^ is not larger animals. Leconte mentioS a Mnrl t *^^ ^^'^ ^''^^ ti^^ five years, and which, notSstand^n^th/ "f '^'"7 ^" *^^«^^ ^^^ brought forth four li;in° foals ?hrL^ Sh'^\'*'"'." "^ ^^^^ condition, being in a wrong positiom -^^cTw'^ wh I td mosfjh"' ''''!''''''' have even brought forth twin Calves spintaneLsly ""^ ^"'^^"^ always mo^ ^Sr^ctd and'dlSt tlTr^ /""^^^ l-^^-^^on is and the assistance of the ve e? n uv oh« "f '^'"^'^ circumstances, delivery; and this, after all L n some iW. ^* '' ""''^^^ *" ^^^^^ ...other and- offspring are lost. This'^n S 'Sc^Txa^t^'' '""^ *\^ inultiparous animals, and especiallv H,p ?,fi u 7 .*^® '''''^^^ with all but impossible to reducrt^ie S„ ioi t ' "' "^.u 'V* ^' generally natural passage. Roll has neverthX. ^ '"'T". *u '^ ^°^*^^^^ ^y thi Bufferin/ fronx uterine trn Z wt:^ SouX^tl '''' '' ^ ^^^^^ natural manner; and Pran-e in 1844 nnW?=i J .u ' /*' progeny in a Bitch that, unaided -ave birth In fhl'/i^ ■''^ ^^ ^''^^'''^y ^^ another in a hernia of this kin^rv else oco,^^^^^^ ^^^^i been lodged terrier Bitch, which whirsawhrhid '7^ T\ ^^P^'^'^^^^^ of a small thought was a very aTge mamilrv h,^. what the owner and others forthtwoPuppiesZon'^der^^ ro7he'rTh"lar'e:raf " ^'^ ^ help, when the supposed tu nonr Pnm:.w if ' ^^'''""—^"^ without describes a case o?thl kind in whfch 1^ disappeared. Sheatheri without assistance. ""^ ^""^ ^>P'«s were expelled When there are several fcctusps cjnn-.» r.r m a non-he.-ni^ed cornu, and so ^an readilv L r"" '"^'^'.'•f contained in extruded horn may o'xperience d^Hc'fy ^a id ffX' hIrnh/'°" •^'^ *^^ -tely excelled by a ^::^'2:rS7t ^!:^L:^Z^ ^''' notwithHtanding this, and tl.o co^d S vS,'^ ^^.f "^L^'T;"'''''"'^' Parturitioil'^; b. aU„o^o.ed-.ei«^....„,.^^^^^^ ' i'eterinciry Journal, 1887, p. -234, ~^ kn ■ I gr 804 MATERNAL DVSTOKIA. 3JT. . I. fbd^^nl^-bl^^^^^^^^^^ di.i„.hed aistention of the ■nquiry, he ascertained that for soTe tLJ fS ' -^^ ?'l'''"^t °^ ^^'•«" ^'«t»«e«- On inguinal hernia on the left side and thf^ M^Jtl ^"H^^'^'^ ^'''" ""^^'''''g f'""'" ''" The skin was incised over the i8o"ated hlrlra^l '^ *•"" 'u ^'^"P* active n.easures. after largely opening the tumour as well .sH^f"' *' ^''^ *' ^^'^ '"g'^n^' """al ; then, to remove the ?hree^dead Su"es and their mmbranr ^Th" '* T'^T'^'^' ''*' "'^^ ^^^^ having been carefully clea.i^Pd w«. .i„o ^ k . " ^"'^ P''"l»P8ed uterine portion. cavity%nda.trongiy r pL d';^^^^^^^^ returned to the abdominal incised ; but notwilhstandingtL the "edition ^f fh l"^"'"^! ««n^l ^^d been widely «omo difficulties, in consequeLeTf^he grea iass^^ in'^™^"^ «'« appendages offered surrounding them. E verythinfr apneaied to p ll * "?.','" *'"* ^'"'"'^ ligaments when 'he a.umal suddenly succnnXd Death w«?nH %TT^^^ '^""' ''^^ "'"^^ day, produc.d through the agency rrsmailaScesorthe^^^^^^^^^ '" P"^"'?' absorption abraded dunng the operttion'^ofreduci^Trerew^S ""^'"^ ^^^. ''^^» the wound in the uterus, as well as in that p^tioiTrf thp ^ I? J^t^TP'^"'""'*'"' ^"'l was cicatrising most satisfactorily. According tKnnn f K ' '^^'''^ ^''^ ^^^'^'^ ligatured, extra-abdominal pregnancy at the fam^ t mP i^?^' T' ?\"''^''*"'=« °^ i"*^*^" and narrowness of the inguinal canal Z thenril ^MT^ *'' .*^'^' ^^ P'^'nt'^d to the impregnation. ^ ' "'"* ^^^ Presence of the uterine hernia previous to . JheTtetf '"*""' ""'^ ''^^'^^"P^^ '" ^'"^ ™1 hernia, and the fourth in the body hernied, was amputated loocuses, and which had been tion, as in diagnosis, Uu indTcate the „^:,a'°: """'' ^ "«<""' --">-»■ si>S;ir: '™To'ri:ti„Ll td'ie^'^-i^teT^^^^^^^ t? t prevent over-exertion or straining. ^ °''^'^ ^^ ^^'^^^ *« thS^^&s:Sn^!^^^^S:-^riK^^^^ and which is sometimes all that is neces TarfL ^o elT.? tV"?' "'•"' by means of a sheet or blanket passed nndp?iVo ^ ^^^^^^^e the hernia tant at each side of the an rSal ^SnJ^^^^^^^ by an assis- supplement this supnort and in th; ,„!! 1^ . ", ^'''' ^'«i/'"«w may abL^tely necessryCcompllthveT'^' ""' "'^ ^^"^ ^' Stances, but the preference is usnnlvJ; ?' according to circum- while the uterus and its contents by tZvoZweiShTl "°' ? ^T^^ ' to escape from the hernia and fal intnthl 1a ° ' ''^'''' ^ tendency '"ihi :j -- -=-^?t>""hJtndVrTb:Ltrt^ ^^"° "™ the ,ne,nb™„es are ruptured, irclrbe a th mt:1a^|L"'Jl*"^V ^"^ When the (oetus presents anteriorly and the head SeseS.' this r f ■■* I ention of the f'Btiiaes. On ing from an ve measures, cxnal ; then, , he was able :rine portion, ti abdominal been widely ciasjes offered id ligaments e ninth daj, i absorption, ;h had been itonitis, and •n ligatured, if intra- and inted to the previous to in the body on of one aad been e of the examina- hen pos- taken to f course, neasure, 3 hernia m assis- im msiy even be ram the Either circum- osition ; aced on emoved :nuscles tense ; ndency ae time ; if the 8 make ! fiascs, always ly, and ed. id, this DYSTOKIA BY DISPLACEMENT. gor employed ; then having secuLd the^ hild ?he fn.f f ' l^^'^^'^bed) may be and brought into the passage one after thto/hf "f^ ^re sought for, deliv'ery .^ay soon be XcW if thSe at no otE '"r" .*" ™e''"'' bedirecidtrmakeSXaiS^ may at the same time plate its reduction, whSh Ts eSS " Ln.l ' ^^'?^' ^" ""'^^^ *° «°™- ?eturned to the abdomen *^' '°''*""*' ^^ '^« «ac are diffiLlr^In t rau'S-t:^^^ ^* °*^^^ ^-- ^* - extremely external manipulatS^V" Tot too or^cSiri^Ti'Sf'T?^'^^* *^^ living foetus. Should the resistance prove .r^aerthnntr'"^ *° ^'"^^ ? may safely be emploved to overcome if Th.no ^^.^° *^e means which be determined on.^ When thrZ clesVthp .hr^'' °P''^"°" "^"'*^ to the escape of the fcjotus from thl I! ■^ ^^^""""^^ V^ove an obstacle strangulation, an incisfon nay^rtde t^L^^^^^ ""''t"' ' '^"^ °^ venient part, as in the operatic for stmnS h' '" /?u '?°'* °°"- In other cases the Caesarian nnLaf\!f^u '^™'^ °^ ^^^ mtestine. and speedily, if the motrerrpro'inTo^ '^^•^^*^^ *°' Recourse to this formidable meaCe\v if on l be £ ' ^^^'^ mstances: as when the mothpv nv f^^ • ,^ ,, ^^^^ ^^ particular have failed or are not hlJ^ylo succeed '" '"^^''^'^' ""^ °'^^^ "^^^"^ favrai^r^l^SLt^^or/^&ct^^^^^^^ ^ ?^ -- tate its adoption. In this accident o^y the sSr^nTn'^ ""'f ^■ occasionally the tunica abdominalis, has to be cut 'throtl m^^' ^''° the uterus, wh ch has not to be annaVf fL„ xu *^^°"g^ *» expose and laboriously withdrawn from fheir mi^^.?^ '^TT "/ ^"'^^*^^«« occupies the whole of the hern?altnnfnn I' ''\^^^?' '* generally no dLger of the intLt\sXing Zin^thl^tS^^^^^^^^ f incision— no larger than is necessarv tw^^ifu^ " , ^ ^"^P^^ through the fcetil membranes andThl^^^ '^^ °'^.^"' ^ ^^^g^r one therefrom pretty ne:HyrnrpleTe'the1ar^ ^^*^^^'^°° °^ *^^ ^-^- It the Caasarian operation is tiraeouslv resorted to fh« .\. greatly in favour of delivering a livinrf^tr Ivtl ;hrP ""'f ^'^ and perfectly viable Calf i^ fllm?..f . 1 • . J ," *"e Cow a living tured. And even witii lhe'"Marelt7rn^r.t'i,r"''''''€ '"" "•"?- a^HWng Poal, « .,e operation ^^^L^^^:^ ^pC ^JulVS the^'totaTS ^d^rSeloBrfav'"''.'?™' °'."°"»»' '-"» *■"• ™th the progeny, there „il stiff rlata^ht °?"'''"°°?. ''"er removal of be most difficult to keen the iXMnLf"" ''™"' "'°' "'"°'' " "'" difficult to cure in a ScSrS!!^'^^^^,' l^ ^ 306 MATERNAL DYSTOKIA. being nearly all that can be done to palliate the effects of the acci- dent. AH these considerations should, of course, be duly estimated by the veterinary surgeon in undertaking the treatment of such a case ; and it is scarcely necessary to say that, with the Cow more especially, the butcher will frequently have to be called in when the question of risk and expense has been fairly discussed. It need hardly be pointed out that it is generally very injudicious to attempt to breed from an animal affected with hysterocele, or an abdo- minal hernia of any description, notwithstanding the fact that this con- dition may not militate against gestation and parturition in every case. With the smaller animals, and especially the Bitch, the Caesarian operation has usually to be resorted to for various reasons, if birth cannot take place ; the chief of these are the small size of the creature, the difficulty in reaching the foetus or foetuses and extracting them by the natural passage, as well as the irreducible nature of the hernia, which is often extremely constricted at the neck, and attempts at reduction are often followed by death. Besides, the Bitch withstands very serious operations in the abdominal region better almost than any other animal, the entire uterus having been frequently removed by abdominal section without a fatal termination. In this animal the operation is also very simple, and demands only ordinary care and manipulative skill. Everything is, therefore, in favour of gastro-hysterotomy in uterine hernia of the pregnant Bitch ; but in order to ensure whatever success may be possible, it must be performed early, and before serious injury has been done by attempts at reduction or delivery in other ways. It has been argued that it might be preferable to open the sac, divide the constriction which prevents reduction, and return the gravid uterus to the abdomen, when delivery might be effected in a natural and spon- taneous manner. And it has been shown that this mode of operating 18 rational and possible, and may be followed by success should there be no adhesions between the misplaced uterine cornu and the hernial pouch. The experience gained in such cases, however, does not testify very markedly in favour of this procedure, and the evidence is certainly iii favour of the Caesarian operation, and particularly when adhesions exist. The dangers to be apprehended from gastro-hysterotomy are inflam- mation and strangulation of the imprisoned cornu and of the uterus which at this time is so vascular, impressionable, and particularly susceptible to the influence of the air on its internal surface. To avert these dangers, it has been proposed to remove the uterine horn altogether ; and we are certainly of opinion that, in certain cases the proposal is worthy of a trial. ' We will describe the Coesarian operation in another place. Deviation op the Uterus. By the term deviation, when applied to the uterus, is meant a change in the direction of the organ, by which the cervix and os no longer correspond to the axis of the vagina. This change of direction in ^he vaginal opening of the uterus may be productive of more or less difficulty in parturition. Changes in the position of the uterus are somewhat common in woman, whose vertical uterus may easily deviate in any direction producing those flexions and versions which not infrequently offer i the acci- ated by the case ; and lecially, the /ion of risk udicious to )r an abdo- it this con- every case. } Caesarian IS, if birth e creature, ig them by he hernia, btempts at withstands t than any mioved by ,nimal the ' care and in uterine er success ous injury ways. It divide the [ uterus to and spon- operating )uld there he hernial not testify Brtainly in ions exist, re inflam- le uterus, irticularly To avert rine horn cases, the a change no longer on in vhe i or less Timon in Jirection, itly offer nEVIATION OF THE UTJiRUS. 3^ serious obstacles to delivery Wifh n^^<.;\,.,. j 1 the uterus is horizontal S veteHnp J^S ./^^/V^T^^^"' ^« ^^^i^h one kind of deviatb^of the uteru^th '*f '* ^^' ^^* *° ^^^^ ^^^^ to anteversion in the human female ^"^^^^ ^^^^' ^nd corresponds serious cai„e of dystokia '^' """" '""""■stances, become a ver^ Cowtrrtt'citir']: Ev"e'a^i;'£ etL^\*"™^ " *« feature in the anatomy of thL an mal „hi!l,? f "^ ''^/" "''''•<==''"g notice by Professor Golbaut'ofX"Aif™tteterLat Setoff' ""'■"'• n. "crerl3Ttt' rhed°to''Z":;,tTrir'b' f '■ v'-ba„n,inal Solipeds. but are inseSil albS"'°L„e°„'t found at T"' ^ "j and inferior part of the nubic b^L. j u ■? *' "■' ''''tornal synrphysis pubis. It conseqSy tp,i„rthat aUhif b"""! ''''f u""' bones, the floor of the abdomen i. o„ S T 'to', at this border of these pelvic cavity ; so that Urere"s a kind o? IZl ?'"' '.t'" *»' °' ""= the height of which varies tndiffetsif ^'OP be'Wfen the two cavities, be as n?uch as threVfo™ and even fit T'T'"' ''t ^"^ ^""^ ™"'i '» strated that the Perit« t ta^^ the^w^'urf^r of hf aL^ cavity, on arriving at the pubis ascends f hfa J • • ^'^^ominal carpet, to line the upper surfece of th. , I ^^' '"^ °°''^''"S '^ ^'^^ ^ part of the pelvic caSty *^' P"^^' ^°"^« ^"^ *he anterior the'^rlvidlTutl^^^^^^^^^^ *^.tf .the fundus of downwards and 1 e on thispe&ten S i^^^^^^^^ will incline directly behind which it may even S so Si^^es^ 1??^^°"^ the umbilicus, a consequence of this airlnaemeTthT^^i. the same time, and as upwardi in the direction of th^sacroveri'r«l/^' cervix-is tilted compress the rectum against that nnrfTf 1 T* u' -^"^ ^* "^^^ ^^en this^great deviation in ffdirSior ' the'cTr ix' theT no'ln ' ^'^^^^ responds to the axis of the vflmnn fL i„ 1 i ,', • °^ ^° ^°°ger cor- same oblique ascending iTne If th^' cervix Sn.t°''^"t. °^ f-^"^^-^' '^' position of the uterus entails a sTmilpv^h ^ an alteration in the foetus, which, instead of bSn^rnCpio ff '"^ ^^^ ^"^*^^^ °f ^he or less verticd-the head trnvlfirfh. '^ horizontally, is now more on the pubic step '^^ '^^''™' ^"'^ *he buttocks resting During parturition we may easily understand hn^ „«• • changed with regard to the performanc " of Ws act The l?. -"^ contractions are no lon^Pr /Hro«f^;i <■„ j A ' -^"^ uterine dilates slowly or not at afl nrnnv? . 7u^'^/ '^^ ^^''^^^ ' ^^^ ^^ only the animal is^xhausted with ?npi"f *°, *^! *^'^'"" °^ ^*^^'^"^ obliquity; and if assistanceTs Ir rendered Tt "1T^'' *° f^^^ ^^^ '^'^^ delivered, or the uterus rnavruntui Tf fv?^ '"''^.""'h r'^h^*^* ^eing abnormal, then the case is^ sHlI w *^/ P°''''°'' °^ ^^^ ^^^t^s is concerned Garreau has observed .f!' Tv, ^^' ^' ^^'^^^''^^^ ^^^^^^^y is «ether: the fo^t^L beco,ne ^^^ be suspended altc- a very long time. ''e^o'^e. mum„ufied, and is retained for perhaps i^iai/nosis. much c^'Srt™ °ThelnrSc;!ro? n W-\'°,^« »"ended with J j.ne long dmation of labour, and the inutility of the 308 AfA TfUtiXA L I) VSTOk'U . expulsive efforts, prove that some obstacle to delivery must be present. Consequently, vaginal exploration is resorted to, and when the hand is passed into that canal it reaches a kind of imperforate cul-de-sac, at the bottom of which is a large round tumour into which no opening can be found. This tumour is the lower face of the uterus, which, pressed against the corresponding wall of the vagina, projects into the pelvic inlet. Raising the hand towards the sacrum, the os will be discovered much removed from its normal position, and situated above and in front of the uterine tumour just alluded to. Sometimes the os is completely closed, in other cases it may be more or less dilated. When in the latter condition, there is frequently formed at this point a kind of membraneous transverse fold, raised in the form of a valve, which has been compared to a fleshy band analogous to that which forms the sacculations of the large intestine ; this band is stretched across the lower part of the os, and it has to be surmounted before the hand can touch the foetus. The latter is lodged in a kind of pouch or excavation situated beneath the band, and constitutes the tumour met with at first at the bottom of the vagina. The more or less vertical position of the foetus should also serve as a guide. Complications. To Saint-Cyr, Garreau, and Schaack.we are indebted for our descrip- tion of the condition we have been describing, and to the two latter are also due the knowledge we possess of certain complications which are worthy of notice. Garreau has found the cervix in this uterine deviation thickened indurated, and the os closed. Delivery was impossible, and the foetus remamed for thrse months in the uterus without causing any great in- convenience to the Cow. At the end of this period the Calf was ex- tracted by CoBsanan section, and with perfect success; as the Cow quite recovered, and was sold at a good price eight months afterwards In one of the cases described by Schaack, the foetus was in the vertebro-sacral position, and the limbs and head having been secured by cords, delivery was accomplished by strong traction. In a quarter of an hour afterwards, however, the Cow lay down, trembled all over the muscles of the limbs and the eyes contracted in a convulsive manner' and death rapidly ensued. ' At the autopsy, which was made six hours after death, a quantity of blooQ, in the form of a large clot, was found in the abdomen, and the textures about the pubis were infiltrated with that fluid. The uterus had resumed its ordinary form, and its mucous membrane was intact • but at the inferior part of the organ there was a large triangular tear' about SIX inches long and four wide ; and it was noted that this lacera- tion had caused the rupture of two good- sized arteries, which of course led to the haemorrhage that caused death so rapidly. Indications. The indications for treatment in this deviation are aim.nlp • raise the fundus of the uterus, lower the cervix, and bring the os in line with the vagina. When this is accomplished, the uterine contractions will act directly on the cervix, and if this is healthy, dilatation of the os will Boon take place ; then the footus, pushed towards the vagina, instead of against the sacrum, will enter the passage, from which a httle judicious ft) TOllSION OF THE UTERUS. ;i09 SO serve as a manipulation will in all probability remove it, and thus complete delivery. Several modes of procedure have been recommended for adoption in carrying out these indications. Indeed, Saint-Cyr states that when the deviation is inconsiderable, and the band mentioned as obstructing the OS is not present, reduction is often spontaneously effected by mere decubitus. This, in pushing upwards the fundus of the uterus, brings down the cervix to its normal position by an easily understood tilting movement. Schaack has noticed this to happen in two instances. In such cases, says Rainard, if the animal persists in standing, it may sufiice to raise the belly by means of a folded sheet or blanket, or even a plank held by an assistant on each side of the Cow ; or the creature may be gently thrown down on a thick bed of straw. In difficult cases, however, these measures will not be sufficient, and Garreau recommends the following procedure to be adopted. Intro- duce the right hand into the rectum and the left into the vagina ; with the first press on the head of the foetus, and push back its body (the vaginal tumour), with the second, tilting, as it were, the young creature into its natural position. This will bring the uterus into its normal situation, and consequently place the os opposite the vagina. Saint-Cyr, nevertheless, gives the preference to the method re- commended and practised by Schaack in these troublesome cases, inasmuch as it is more simple, and experience has demonstrated its efficacy. This method consists merely in throwing down the Cow most carefully, placing the animal on its back, and keeping it in that position by bundles of straw. The weight of the foetus carries the uterus down towards the spine (inferior) ; the fundus of the organ is depressed, and the cervix raised towards the pubis (now superior) ; the obhquity of the uterus is thus got rid of. Schaack has on two occasions resorted to this mode of reduction, and in each case the abnormal valve disappeared, and parturition was rendered easy. Professor Peuch, of the Lyons Veterinary School, states that in a case of this description he employed Schaak's method ; when the Cow was placed on its back the obliquity disappeared spontaneously, and with the greatest facility. TOKSION OP THE UteRUS : CONTORSIO UteRI. Torsion, or "twisting" of the gravid uterus on itself— and which often involves not only the cervix of the organ, but also the vagina- is an accident unknown in the pregnant human female, but for anatomical reasons may occur in animals, and particularly in the Cow, in which It has been most frecjuently observed. The accident is rare in the Mare ; it has been observed in the Sheep and Goat, as well as in the Cat ; but though in the Sow and Bitch the uterine cornua may become displaced and twisted on each other, and even become hernied by the broad hgaments, yet torsion of the uterus has not been noted in them, so far as can be ascertained. ^ The accident will be first studied in the Cow, and afterwards in the Mare and other animals. History. Though torsion of the uterus is now recognised as a serious, but not insurmountable obstacle to parturition, yet its existence may be said ;uo MATi:i;\,ll, DVsTohl.t. dlt^^^Tl'il"""'?'^^^",?''""^''' '' ''''' «l''a,ly and explicitly i„- nnhci ciimiot bo passed into it, and tlio oponin-' is found to bo tiimina mi . t I T . t . . ' soon afto. tho publication of Houtroli.'s •' P,.rf,.ct Cowhrnl," yeJiU a ..™nc« o,- ,„o,o, ulity „my l,av„ prevail...!; ^3 it wTs not until «c i t'tra't'tlir. T' ""•"'°""'' ,""''""™ '» '"o oxiZc „t Ae N V ll Ims ?n :'r'''""'^^^^ "' "».«">•""•>• Losan to notico it. ' ' "^T'^'"' aft,.,wa.d8 ptiblished similar I ,7 . ^'"•piii'C at the si eiico urevail ii" jminnrr vMai- S^oTZ:'"' 'P'''' ^^ H''^ conditiL/which^aH^t^^S; describi ' L ' .' ? "^ '?' rV ^^"«"«'» '^»«^v to bicH.ders. In aesciibin- the symptoms he had noted, Lecor. says- " Th(> hand EVor . 1, f '''^ ^T'''''' ''*^^''' ''^^•i"^' ^^come the Thc^Trs r-n f 1 f '•^■\«".1''^<^. taken place from rigirt to left." UK Urst Continental veterinarian who observed or ratlier wl>n Swit. u hi rVe L ? ^^ r^^ ''^' ^''^T'' ^ l'^''^^'^^^"^' ^^t the Berne h^ )tsea^^es\.) tC^ R '^^ ^cl'ool, wno ,n his " Systematic Treatise on uit_ i diseases of the Bovine Species 'Wpubhshnd in IH40) mention'' it ^Ph li 1 ? ' ^li'^'^'-^nstorfer, professor at the Zurich Veterhmrv b hoo], also wrote a memoir on it. The first in Francelo direct spS ( omjUes Jiaulns ,/c fa SocMc mnvair. ,lv Culnu/o. ,f ,le la Ma.cI.e, ml TORSION OF THK UTERUS. su attuntion to It, wiiH Ma/uro, whoso description is ono of tho boat we p()ss(!S8. It IS puhliRhod in tho samo periodical which contains Lecoq'» account. Irom Ihh narrative, it appears that he was consulted by ono of Ins collea«uo8 witli re^'ard to a Cow, tho cervix of whcao uterus was HO twiste( that a lin^'or could not enter tho os. Mazuro cave an unfavourable prognosis; but. notwithstanding, it was attmrptod to reduce the torsion by making an opening in the right flank in order to reach the uterus. Tho attempt failed, though it demonstrated that there was a cpiantity of foetid serosity and fibrinous flakes in tlie peri- toneal cavity ; that the uterus had a rupture in its left posterior border, the rent Ijemg rounded in form and having a diameter of from twenty to twenty-four centnnetres ; and that tho fojtus was dead, as had been suspected. As nothing more could bo done with the Cow, it was destroyed, and It was then discovered that tho uterus had made a complete revolution on Its axis ; wliilo towards tho part adjoining tho cervix, there were found live spiral twists, two of which, more voluminous than tho others, were ot a groyisli colour and hard in texture. Throughout tho whole extent of these twists in the uterus, tho connoctivo tissue, infiltrated witli serosity, formed a swelling which rendered the dilatation of the posterior part, and the passage c the Calf throngh it, most difficult. Iho Imtus was jK>rfectly developed and intact, and did not appear to liave been dead more tiian two or throe days. Another Norman veterinarian. Pouchy, described four cases about the same period. Tliese Cows merely suffered from loss of appetite, great distention of the abdomen, unhealthy-looking coat, a fcetid and sanguinolent vaginal discharge, and suppression of milk, for six to eiglit weeks ; when submitted to treatment, and turned out to pasture they recovered sufliciontly to become fit for the butcher. In Cermany about th(! same time, according to Dieterich, torsion of tlie uterus had been the subject of investigation and treatment by bchimdt of Bavaria Vix of Cliesseii, Fricke of Hanover, and Irminger. ln-ici8arian section having delivered the Calf and its membranes, the Cow only lived a sliort time. The u erus was ound to bo " completely rotated, even to the termination of cue vagina. After this period, torsion of the uterus attracted a large share of uS.T' r'T^ ^ f '"f *^ accomplished Continental veterinarians, and pait cularl> after the o},..rvations published by Donoc, in rrauce, in Hw! R 1- o , *>V"l^Ject of animated and interesting discussions at n t T.!f''- ^^'"'/o^'^^^ Medicine, the Societe Central de Med. Veterin- ii 18-4 r^' ii f'^i "^^ ^■'^^P' '^" Veterinary Society of Wurtemberg in 18o4, and that of Denmark in 1855 ; and memoirs on it have been ' Veterhmrian, vol. xiii., p. 407. V .. . ai2 At.4 TKHNA I. I) VSTOKIA. imbliBhca by Uonlo.mat, RosHiKnol. (lavon. Jioulc^y, Catu. Loinairo o wo^''f ;;;;;^;;"i 'i''"""?^ ^^'"'^' '^'-•^-•'^' '>^^'u--. '---; Sud'Vto • "" ""'7 ""«'• .f^roiK.. v.aorirmrians ; vvhilo it is cl ami JrT '"■ r" ''"^r' '"..^'»' ^•••"^^'"'"^ of Jtainard. Hau- €yr etc ' ■'""• ^^'^"^•""'^•■^^""""anti, Cru/ol, Saint- v.,/!.'/'l'^ T"*y '^ 'I''' ""* '■''''"•^'" "•"«'' attention for some years if no (loubt tJiat tile accuU^nt fi(«(|ue!itlv occurred, liut in recent vearH 'mlT^^ r "" t'^'^'^h ''^ "^i'^^^^^'-'^''^ (Wh!;churc;;^:\Cs Tlw fr L rv • f* ^i"T'"'- ^^I'^««i»ivray. (JunninKha.n, and others. W f H Ir '' '.•^"^«'-t" torsion of the uterus in the Cow. h,>.n wif. V'i"' 'II u''"''' *'•'' accident ia n.-arly alwayn fatal, it has been witnesH,.! by liejlionnne. lOlsen. Dehvart, Ilanio,. Noll Devaiix < anu Leconte Schmidt. Mihnch. .Anderson, and (^x ' ' vrav mul in'.'i:; 'r'7T^ 'v "•" ''^^' ^^ ^^^'«' '" ^''« ^»t«'' '^v MacKilli- Ma),, anu in tlie Cat by Vivier. Nature and Frequency, thutiirrchielit*^/^''"'"';' ^''^„«:^'"Pt°'"« '^nd other features of frequency ' '""^ •'" """^ '° '"^"'^« *"'« ^^s nature and utmn' oV!u'axTs*'bv\"f ''f > ' **^° '^''"'^^"^ «""«'^^« "' '^ '•"Nation of the k eral ic inf.M in.X 1 \ 1 '^'/'^'^T '"''^^^^^ '"'^y successively become ateral ami nifoi lor ; and lateral on the opposite side and superior when i^n^itn i ".••' '"'l'.^'^'"'' '^*»'« ^-evolution may take Xce in two IT, f i] "fT^' "'^" "I'per face may at first be Uitlae^alovrZu loision may be »/c«m;>/c/c- or complete. There may be .///nr/cr-ZorAwu wl^ch the or r «' "*''r ^r °^P«r'«"««^- 1" those instances in 7o^tn ^ '"^'^" *'^'° '^^'"P'^*^^ turns, we have a double its^mXSn '''the '•"' ■■^''f" ^'i^ ^"^"y «^«"- The vagina and zB^F^^^'P tS-=. ts:J[ intt-si^ pSon or flln?^ "^^ uterus is replaced in its normal i;io ;X /r,?nr f'"'/'"!?^''^ ""^'^"^'^^^ tl^^" throu,-li the os. vvciss, and Zuiidel have often noted tl.ose cases in Miimnls; and the vmnha ,V Cn'''"' V^'" .f'"^'- '" ^^'^"'^t"^* proportion among the larger infeS some me?f!?' ^'"'^ f '^'' ""'''''' ^'^'^""^ ^^^^°"^^ ^^^^^al or interior, sometimes the gravid cornu occupies the inferior region of the TORSION OF THE UTKIiUS. .113 u, lioiiiairu, lu, LoHHoiia, ceo, Miirlot, wliilo it is biimrd, liau- ruzol, Saint- »irie yoars, if tluiio can b(! recent years -ch), \Voo(1h and others. fatal, it has )H, Devaux, l)V Mac ''ill! - features of nature and ;ation of the /ely hecome )erior, when lace in two ^ral or r'ajht >r.sio7i. rtcr-tonion, iling to the nstances in 'o a double vagina and -tachnients, a cord-like ti being all ssibility to its normal the OS. )untered in sed among tance, very containing to a condi- iiet with in :, Rainard, s ; and the the larger f a quarter lateral or jion of the abdomen ; and at other times, making a wider rotation, it is lodged in the opposite flank. There are scarcely any moans in practice by which wo can estimate, with mathematical exactness, tlio degree of torsion the uterus has undergone ; as what we have dcisignated a quarter-turn or revolution only signifies that the organ lias made a rotation of !)()', while the half-tutn is scarcely IHO . NevorthelesH, an approximation is all that can be looked for, and, indeed, is all tliat is necessary. As we have already mentioned, Ma/ure, in XM'l, had a ease of com- plete rotation of the uterus on its axis ; this was remedied by causing the organ to turn completely round in the opposite direction. Other writers have spoken of a complete rotation in some cases, but it may be surmised that it was only a half-turn. Double, treble, and even (juad- ruplo twists have been described ; because there have been found two, three, or more spiral ridges or doubles close together, hard, and resisting. Fig. 8(J. Inoomi'lktk Tohsion ok the Utkuls. 1, Body of the Uterus; 2, 3, 4, Spiral Twists directed from left to right; o, Cervix Uteri and V^aRina ; 6, Suspensory Ligament ; 7, Pelvis. and usually parallel to eacli other. ]?ut these multiple plies are only what a somewhat long and supple cylinder makes when it is twisted. lo account for these multiple pliac, which have erroneously been taken for so many complete turns of the uterus, we have only to accept the illustration offered us by Delafond, who, comparing that organ to a long stocking, puts a weight in the foot of the latter, and gives it a turn in the middle, keeping the open or upper end fixed. Or a small body to represent the foetus, may be enclosed in the middle of a handker- chief—the uterus— so as to make a sac. If the end containing the body be turned or twisted on itself, the neck of the sack will have a first ply, representing one-fourth of a complete twist ; a second ply will represent the half of a complete twist or turn, and will cross the other • so that when a complete turn has been made, it will be found that there are at least four plies or strands. 814 ^f.l TKllNA I. D VsroKlA. |i|9«eS| An li.ipoitant question is tliat rolatin.^ to tho pos siiln f^v n ;, . accident occurring to an organ like tlusrwlucl isK , '^^n fi ^^, ^•'^ by Its contini.ation--tlH. va^'ina-~smvenZT 11^,^^^^^^ Mll.TII'I.K ToHSlOX Oh' TllK UtKUUH. I, 15ody of the Uteriix- o •> o 'r • f.-oquc.ntly "°'' "'""'" '°''"°" '" '>l'>«'''vei' such an the polviH i-d'. in tho 1 addition, •gan ; I in the le most e stated )aratus, concave to these Ji'us be of each body of its, yet Tn/!.S10N OF TlfK rTTEimS. 3U^ retains its position, being (hmly maintained in it by tho body of the utenis which a sp receives the insertion of tho broad h<,'a.nents on its ower face. This insertion causes tbo uterus to project above the hKaments which are y.^ry bmad, particularly at theit anterior border, and widely separated from one another in front, near their lumbar attaoliment. iho ligaiuents suspend the uterus loosely in the abdomen, and allow it to become fully developed during' pregnancy. At Jhi^ period, too, they l)ecoiMo greatly increased in substance and'lenyth As gestation a. vances, nearly the whole of the great size of the uterus is due to the development of the one iiorn in wliich the f.e, so as not to be over- lapped by the cornua, then it might to a certain extent roll about in the hammock but could not twist around it. Even if the uterus were suspended at he extremity of the ligaments, as in the Mare, it would of pendXm "' """"^ ""^"''^ '^^''"^ *" '^^" ^^^°'"^'^ ^^^ ^ kind As it is the projection of the gravid uterus beyond its means of sus- pension the peculiar attachment of the broad ligaments to the lower lace and concave border of the cornua, and a lame proijortion of the weight being situated high above and in front of these ig4me".ts--^^^^^ r.^an"oritrhr'"^"" ""'^ ^" % '^'''^ "^ ^"^ ^'^^ ^^^ ^^'-w the organ off its hammock, and produce incomplete, or even complete EZ('^r^TT''^\ ''"^' ^"^'^""*^ ^-^'i^^^^-'"^' the'liainmock itself ' ... r V. ;. ■''°^'''. '. '**'''' witnessed cases in which the torsion was the body of he uterus, m front of the cervix. Most frequently, how- organ. " ' ''^^'•"^' '''' '^'^''^ ^^ '^''' ^^•^^^^ and body^^f the paiLT bf nmh?,^'"r"tl'^ 'v '^^ ^""^^'^' ^^' ''''''^'''' ^'^^ ^^'^" ^^^om- Dense ad \ h^ ^''^. \'^"i!"«»ts ; and instances are recorded by Mf R i'ff n n 1 "; ''''"'' ''' '?^'\'''' ^'''' ^^^'^"^^^^^ to the uterus he abdo nin 1 f ;' " ''''" "' ''^^•''' t'^^ ^'^'t"« ''^'^ «v^''' «««aped into he abdoannal cav.fy from a uterus thus ruptured, and, developin-^ in the peutoMeal sac constituted an extra-uterine pregnancy. ^ " mailta „of !h«\° ^; t'^'T °l '^'' ^"^^'""' ««^<^^^1 authorities have maintained that it takes place from left to right. Others however l^ave found ,t to be in the cc,ntrary direction, and^hei.,appeLtX ;n(3 .\M TEllXJL nVSTOKIJ. IP m '§mM H aovolopc.l ],, oithoi- comii irrospectivcly. Rovnal however bolifiv,.^ that the obh,,u.ty .f the innei- face of the runfen In S 't rsposo the s,:; tT: '°""''i '•" '■^^''^ ^^''^^^^-^ '^' -^ ts -uS^ ^a -^ . tuH mn^^ o? h"l ''''^1 *''^'' ^'^r- i'^^vardsand upwards-the ril'l.Tor lof[ J'animock causes this to swing round either to tho aniSr'is'ldtfil"ir'^' ''^- ""! °«?'-'-^'>'- '" tbc other doniesticated innnals, is undoubtedly owni^^ to the dilercnt arran<^(Mn(>nt of the uterus and Its suspensory ligaments. h. .an„eni(,nt ot the With regard to the /rrqno.nn/ of tiie accident, this depends unon latuie ol the country m which the animals are reared as well as to the ...inner of rearing tliem. TJiis will explain, partly or wloirw^^^ i^rer.r'::;!r"^""" laminar iith tA^.jaL:S'o& uiui as extensive experience never witness it lioconte states that he has observed it about a do/en tim(.s in between three and four Imndred cases of diHicult partu i?ioV, Wi ^ tn's'ser bo .rrr\ *'■'"' '^ 'T y'^'-'-' -"^^ l^°-« ^l-^ks of having prSmilcv ''[^h!Z h'"" T'.f "'^''''y "^"^'^ *"^^'^'''1« ^^« termination of Korv dt. f "^'''^'' °' "'"^'^ '"°"^'^' ^"'*^ 'ts causes appear to blfiJlbn^rr'thir^ohl^^^"^'^^^ ^'^^ ""•"^••"^'^ opinions whSi have The cause which of ali otbers, appears to operate most frenuentlv in For tins reason uterine torsion is oftenest witnessed amonL' Cows at m ' TlSo:?^"""?"\r^l"'? ^'^ ^'^"""^^ '« '"•"'-'"• intor^ecJeTl o Swif;,.vln r T ''; M '"• *'''-'* '*'^'- 'it'cidcnt is not at all uncommon in unknoun on tiie plains, and is very rare indeed among Cows kept in c.vJ'thron'h "'' ^°''-''''' '''I'P'^ "P°'^ '^^ hind-.p.arters and tumbled vei, thiough coming ni contact with another. Marlot and J.iautard avo seen it anse from a horn thrust in the flank by a co mpantn C'ov the b ow throwing the fcetus and the uterus round to the o fpo ite side ' It las noted it in a ( ow which was in the habit of rollin- like a horse • ikfXn ?.?'!?• '' rr''' 'V ^'^-^'^'"'^"^ ^'»- which leipt on Xrs ..ti«e Rc^ > ;7'';V ';'.';^'.^"t''^-'- that used to get its fore feet in the angei. Kocco states that it is produced in shoeing at the for-'e when ^Tu'V''""" ^''' '''^''' ""•°^^-" ^^«^^'" '"• P"t in the travis o be' shod the'm Z"'"r ' r' '" '''^'''^' '' '"^W-ened through casting a Co w has^^> sSnl ,i:f r""", '^^ «y--^^tion on it. In other instances it Keynal, Mignon, Chambon, Weber, and others, appear to consider ineteorism as one ol the most certain and mos fix^ouent causes nf uterine torsion, through the displacement of the s Jifwh ch t e dis tension occasions. Either the expansion of the rumen induces unusual IS tho faitiis ver, boliovcs (lispoao the , justified in ) wards — tho either to tho oinosticatod i(!nt of tho ponds upon atod to tho ljU as to the holly, why vhilo others 1 times, in . Lomaire s of having orty years' iiination of appear to vhicli have jquently in 'n tho hind ig Cows at rsected, or iouunon in b is almost vs kept in d tumbled Liautard ti ('o\v, the 3 side. It Cliambon 3 a horse ; on others feet in the rgo, when ho shod ; ing a Cow stances it ; up when consider causes of 1 the dis- 3 unusual TORSION OF THE UTERUS. 317 and inordinate movements on the part of the foitus ; or it acts directly on the uterus, and produces displacement of tho organ throu^rh the changes in situation and relations imposed on the otlier abdominal organs. Mr. Cartwright, of Whitchurch, was of opinion that great dis- tension of tho stomach may, either of itself, or especially in connection witli a fall, cause tho uterus to bo forced on one side, or twisted. Other authorities, among whom we find Ercolani, attribute the acci- dent to sovoro toil when (Jows are worked— as in draught • others to deformity or malposition of tho fVttus ; and others, again, think it inay bo mamly, if not (sxclusivoly, due to tiio spontaneous and energetic movements of tho foetus in ulcro, towards the termination of pregnancy. It is well known that those movements are sometimes very lively and powerful, and espiicially when induced by sudden jerks or blows mllicted on the pregnant animal, or when the abdomen is compressed after the ingestion of cold water, etc. There can be no doubt that the movements which tlie faitus executes in order to got rid of uncomfort- ahle sensations or avoid unpleasant positions, gives rise to those various attitudes and mal-presentations which so frequently render birth difli- cult, if not impossible ; and their occurrence may also explain how the young creature may bo the means of causing the cornu in which it is contained, to roll and twist around tho vacant cornu on the opposite Hide. In this way Colin endeavours to account for those cases in which the uterus has made several revolutions on itself when the movements persist—a very rare accident, it is true; while he admits that the (luarter or half revolutions— which are, after all, most frequent— may occur without the active intervention of the feetus, or even of the uterus and may take place through falls or slips. ' Torsion from the above cause is all the more feasible, as at the end of pregnancy the amniotic and allantoic fluids are diminished in quantity, and the membranes and uterus are therefore applied closer to tho foetus, and may follow its movements more readily, Chambon and other veterinarians are of opinion that the irregular and often violent movements which the pregnant animals, and especi- ally primipara), manifest when the labour pains commence— lying down and getting up again, throwing themselves first down on one side, then on another, and sometimes even rolling— are the most frequent cause of torsion, which, according to them, only takes place at parturition. The latter opinion is supported by a case described by Landel, in which, whon he made a first exi)loration of the genital passage at the com- mencement of birth, there was no obstruction ; but soon after, on again exploring, he found that torsion of the cervix uteri had occurred in tho interval. Other authorities have supposed the accident to be occasioned by premature straining in parturition, before the os is sufficiently dilated ; while others, again, have attributed it to pregnant Cows in sheds not having enough space to lie down, Lessona and a few others believe that the accident may be due to the habit that certain Cows have of rolling themselves alternately from right to left when they are lying. On tho sternum they may do this • but though among Solipeds and other animals rolling on the back is a perfectly natural movement, yet it is rarely if ever witnessed in the iiovine species. Sternal or abdominal rolling could scarcely produce displacement of the uterus. Eupture of no or both of the broad ligaments has been indicated by '•m MATHItX.IL nysTiiKl.l. (.IS 11 I<'H'<'M is f,„MHl t(, Ik, (.x(T(nlin.Yvr., .:,./; ''^"" '» ""-'''O''. hh such a oitlKT „r |.„t|, of tl,c,s. , , , S ffc Z, "'■ 'V'''''V '^"'' '"i't"»-" «f tl..'.M. Th.n il'U .< ulHv^,^^^: '^^^^ "train upon v^«.na, n.ay twist an., twin. <,n it seu' :^K;;f;;;r;:kl;L.ui; sis Torsion of tlio utcnis has hvm vvitiirw«,.,I »>., i> i i»';r!:!;::rr'i;;\i:;?;'--;»,'',y„i|; --mjof ,. ,, ,„,, ^i,,,,.,, „., ."o,.„ tl„„, Ihiily'tllnlo ;;„„„I;:, '"^ "■"" "' «'""' •"""• ""'' wiglR.,! VV.«^'(.r..r. Hrn.o ic^ ^,,tl . v. -^^ '*'' ^'' ^''^^ '"'"*'' "'"»t»>. But witnesH.l it .oi-anM Hm "n;;;;:;^' '^1;? ';"'^ t'-y ^'-^' correctness of tlu>ir observations ,., ,^\'t''«"t 'I'sputin- the «>arlv periods of i:p.i^T^^:^,^^^ bo m nntt,.l that, during the its situation ar.^u 1 « ntly ,^^^ '\'' ">""'•"« '« '•^'tained in this kind: and that it "onW c ta n^''''''''^''"^/*'■^I'''^'=''•'^^ «f fullv drv(-lop,>d, and w s ,„ . I '', f'*"'''"'^' ''^'^"' ^''^ ''""t"^ is 8i.e and ^voilhtl!s hi \ t^ri^' ; r"'' ''"' '^',''^V'^''^ ''^^ ""^^•'"""' renoe is likdy. An to exisl^nc I T^" •''"'':*^' ^'^'^' «"«'• '^" o«cur- covorod whon- tho .in.e fo ", u 'e , si ;n"f'\i;: TT"^' ''''■ ''''■ thou^'h it has been said that narturiVi n , ^''' "^ ^"'" '^''^ive^^ ! is present. ' tuntion takes place earhor when torsion in^':t'\h;;'n:!;:;;;;;;Xn:ltlM.;7ho^^^ ^^ inconvenience or sufibr- occurre.i before parturitbn a 1 v , ''"'" '"^«, '^'«^" 1>''^««. if it has on to its tern.inition S o.'.t m V n IT'"'''' **"^'' -^'"*'^t'<'" '"^y ^o anything hke functiondlSuS.IIJ'^l;:;;!;;!:; ^>"'l'^-- •--« ->tei or l>ave beconu>^nKun£.t^ ' ;,"V !^i.;;"^^.;^'f^t.on o^ tire vulva, etc., prove the existence c)f t Vion Onl? . "''" '^^ '""^'"^ "P«'^ t« ro.narked that the tunu.rctio\,ff-v, '^^""« '"Stances it has been oises, a.ul that it re is 1 ' '' "'^ "^ «''^''^t as in ordinary iH'tween the ischiartuiH.-ositi^; '"^ '^'f""'"" '" ^"^ '^"''^'^ '""re deepl^ ritfotziM^s, havr;!:^j;;.^'^r '"" '^ ''''-^' '^^^^ p-t- quantity at a tin.e : or th u^n^^^^^ -scapng only in sn.all <'"ce with the discliar.r. . f T^ ^ '' ,«»PP'-^"««n)n. This interfer- """»»i ^'iT-ars to i'„. m.,h rV 2iJ n" .;'. i;i,','r.'; ''"'■;"« ^^•'"°'' ""^ »', iiH Huch a i- iiipturo of y tako p](ico Htrain upon I'oUirif,' iil)()ut 1 cervix und occludo the H(!(]ucnfc to a if'H, throufjih 1)0 tlio sole ]/,' TllJi UTERUS. .,^5, pains succeed each other more ranidlu o»wi u hirth does not seen, to adZc^/jT "^Cater C'" do""'' Tl^''''' ^'^ aud nothing appears external^. This condiHon "°* -^'"T ^'=''^^^' twelve twenty-four, and even forty-eight horn's S ^T''. ^f\''''' tl.e veterinarian is perhaps requc^stedloatM ' '^ "°*^ ^"^°'"' In other instances, however the 4v.nnfr>.r.J severe during this first period Tfu" an Z T T'"" "'"''^^^ ^"^ pair, of intense uterine ami doniin. s s L ^''''T 1*^? '''^^'' ^^°'» ^^e ing, winch con.es on at W^^^ si^^^^^^^^^^ anxiously; paws onergetiS^ now an 'a Uf "u:^' ' /' ''^oves about rests on its chest or sits lii,ku!!l^^^^^ ^^V tangible sion of the fcetus now evidentKervenes . "' °^'^'^' *° ^^^^ ^'^P"'" probably bo made by the veter m In ff 1?'. T'''^ examination will and after he has heard thris^ symptoms. ^^"""^ ""^ ''^^ «a«« and noted the general wiSr^!:£tari:;..t^":Sr^t^l^"^ the vagma. meets at first soon encounter one or L^rfold or L "kT '"'°. '"" ^^'^ ^^K^rs ...ore and n.ore constricted to wardrtKV^^i^T^^^f « I^^^^ tennination of the vagina the fin.rpr« ,...,^1, ! i -^i r * , towards the by the mucous folds,"vvln=ch at tt.i na i In ""* o c,a,,Ie-sac, formed their direction being' either o ' ht oHSt 'MT'''} -^"""'^^' there appears to be no nassac,. v^f ,> -n 1 / ' .^^Ithough at first the hand in the sanie spir^aT ZctLn ,. h'" ''"^""^^ *^^<^ ^y turning ruga3 incline, the lingerTwil bo aSfn fn ' ""T^ '''''^'' ''' '^^^'^'^ tht and if one of the mos^n-on „eut Ses b,Ff ' if '"^'"^ *•" V^''"^^'" ^«Pth ; bo discovered that it his rrk:crefei";o^°i^e"'^ " ^'^^ "^^' ^^ -" ntlt: ^.d u r^iS3r sh ;;lif!;:;:iiiL7''^v^"^ °^ *-- of the In the latter condition ther "is Zsn rn h f °' ^^^'^l^'ty of the organ, fold of mucous nien.brane nassiniT' f^7^*'?g ^r ruga^. but merely a manner; while the llZ'Zll a sed with ^ ^''ni" T ^^^^'"« cervix, the os of which is usual If^n T i-, i"l^ difhculty to the fold of membrane, ir ute ine det^filn v \^''''^- ^* ^^ ""^y t^i^ of the fu3tus through teori^vHn^^^^^^^^ which prevents the plssage cervix. "^ ^ °^' ^y ^ludenng uniform pressure on the x^J-'"' ^'"^^of spiral infundibulum into which thp hnn-l > . to Z ^^!hr^^!' y--'- i" dimensior^tcordhi^"'-^""^^^^^^^ '" torsion. In ti;;:~;iu;:rt(;;*^;r<;r'S"Ho ^r'-^"'^to the amount of the hand into the ^constricSoiVthom ^Ith \; nS ^ff'^^ *° ^'' ^- as to touch the neck of the ^^r:;!'^^tli '^ Z^^I^Z 320 .)/./ TKllNAL DVSrUKlA. I'l.: dilated, and allow the position of the footus to be ascertained. In accomplishing this inanoouvre, the lingers can feel a large salient spiral ring which becomes wider as the hand enters deeper into the organ and which terminates in the cavity of the latter in a wide membranous' fan-hko manner. If the torsion is to the left, this ring inchnes to thd right, and the membranous expansion in the uterus is directed obliquely from right to left towards the fundus of the organ. The spiral twist is in tlio direction of the torsion, and the uterus is carried towards the left llank. In torsion to the right, the arrangement is the reverse of this. In the half-turn or revolution, occlusion is so marked that the fingers can scarcely be made to enter the obstacle, and the cervix cannot be reached unless the torsion is beyond it. There are always two prominent rhigs— two mucous folds which cross each other, but which, as they recede from the torsion, become wider apart and spread like a fan. We shall investigate the ciiaracter of this twist hereafter. In the complete turn, the occlusion is sucli that only one finger can penetrate to a very slight deptli in the spiral stricture, and the di'i-ection of the ruga^ is very ballling, as they seem to intersect each other, and to run in opposite directions. In some instances, when the mucous membrane of the vagina is involved, the spiral ridge may be distinguished in the roof of that^canal and even near to its commencement. ' When the hand can be introduced into the uterus, it is generally found that the fcetal membranes, as well as the foitus, are intact, and particularly in the half and complete degrees of torsion. In the quarter revolution, the membranes are sometimes ruptured and the waters discliarged for a considerable period. The f(i3tus is usually alive soon after tlie first labour pains ; but it quickly perishes, and its deatli is almost certain to have taken place within forty-eigiit hours after parturition has commenced. The period of its decease, however, will greatly depend on the intensity of the " pains." '' The position of the footus varies according to circumstances. It is most frequently in the dorso- or lumbo-ilial position, rarely in the lumbo- sacral, as it follows the movements of the uterus ; so that in reducing the torsion the fa>tus should be brought into its normal position. Some- times when the twist is slight and the passage sufliciently large, the fcBtus partly enters the pelvis, where it may not only be felt, but seized by the parts first presenting. At other times it is entirely lodged in the abdomen ; and at others, again, it may be felt towards the pubis, in a kind of pouch or sub-vaginal tumour, formed by a duplicature of the uterus beneath the inner opening of the os. In the latter case, torsion is complicated with obliquity of the organ, and the tumour not un- frequently considerably elevates the bladder and meatus urinarius. The form of the abdomen is sometimes characteristic. The fetus can generally be found higher in it, towards the flank, on the right or left side. This change in the position of the fa>tus mav also be recognised by exploration j;fir rectum, which may also possibly allow the torsion of the uterus to be distinguished, as well as its direcdon. The uterus can bo felt through the wall of the rectum as a tense hard mass, while the broad ligaments may be discovered as hard funicular bands. The Fallopian ligaments, which have encircled the cervix uteri and strangle it, can often be felt ; and in recent cases the pulsation of the uterine artery i I iertained. In 3 salient spiral ito the organ, membranous, aclines to the* icted obliquely e spiral twist rried towardn is the reverse lat the fingers vix cannot be always two 3r, but which, spread like a lafter. >ne finger can . the direction other, and to the vagina is of that canal, i is generally re intact, and n the quarter i the waters pains; but it ! taken place The period 3nsity of the tances. It is n the lumbo- ,t in reducing !tion. Some- tly large, the It, but seized lodged in the le pubis, in a cature of the case, torsion lOur not un- nnavius. The fffitus e right or left )e recognised he torsion of uterus can bo ile the broad he Fallopian mgle it, can berine artery TOnsiUX OF THE UTERUS. 331 of the teeth are lenuvrked f cm in < to t m H ' T^?'' '^"^- S^'^^^^^g had commenced is now sZe ed ^, '*'l^ '""'"^ •small; the eyes sink in fl,!.h^^..; f ' mamma) become soft and iiiRlv left to ita hfV. ,^^1 1 , ""' venfleral, aii.l the animal is accord- not L n t th»f th f' , ™"'f"T '» "-I'lt Kain^ ™" ''"-"•- "/ thiut^.s^ITratfefS'^StT'^" rooosnise the existence of torsion of the lingers niaypass wit d,T( nn?f ^ T''^ ""''" 7'"'"S. into which Wp h„,.„ ,1-'' , ''^"' and imally to assume a SDiral convsp -^o^l^tSS^^t^ r^^'T'' "^ '''' constriction is statenientl'od ood 'tlT^L ''!°V'^'^ *°^''^°»' ^'^^ this possible to make^a milke ' ""^'"'^°' ''''''' '' '''^' '' '^ ^^^^'^^^^ 21 I S22 MATERNAL JJYSTOKIA. x\i : in fron? nf H? ^ " instances however, the torsion may have occurred m fiont of the ceryix-ni the body of the uterus; and then the cervix may be easily reached, while the os may even be penetrated? withoit discovermg any mdications of the accident. Such occurrencrs have aSoHtr;A'^ by Stockfleth, Ercolani, and Ruoff; and tSese rxceUen? inL the t h I'^'^'r '° '"^'"f'''^ *^' f °'^'^°" ""^^^^^ t° *he cornu contain- nif^! ;• Hf'^^« ^^r^ "either the constriction of the vagina elusion Zl >^^°\tions of its hning men.brane. to guide us to a^con clusion, and we must mainly rely on rectal exploration J^ortunately, such cases are all but unknown in practice, and prob- iL'^.^r*^-"^"' ^''^ "''"*• ^* ^'" ^''' ^^""'^ that the twisting has taken fnS V / '• T'''' '"^''" ^" ^^'''^ ^^''^ '"^^"i^le distinctive sign-the spiral ruga) m the vagina. ^ 2. The Direction of the Torsion.-lt has been demonstrated that the uterus may revolve on itself in two different directions, and that in Fig. 88. A, Cord twisted to the Riglit ; 13, Cord twisted to the Left. order to make a complete revolution, its vppcr face may become riaht lateral, then mferior, then left lateral, and igai'n .«7;.;7o,- orTf it re vo ves in the opposite direction, it will becon^ succissive W miater!i mferior, right lateral, and once more sinwrior ^ ' We have casually indicated how the direction of the twist mav be discovered when it has not made a complete revolution Bufthe manner of discovering to which side the gravid uterus has inHinp? has been one of the most debatable in tire historrof thL acc^ent' and has occasioned much controversy and the most con radicton n terpreta tions ; up to the present tiine, in fact, the prc^b em has i^ot met with a satisfactory solution. The confusion prevaS with re- gard to wha appears such a simple matter, is well exemplified^ i„ the prolSd An^'?or\f"r'/'^ "'"^-^^ the most opposite notions we e proniuigatecl. And yet, next to assuring one's self that torsion doPQ exist, the ascertaining of the direction it°follows is of supremTlmpor ly have occurred then the cervix etrated, without pcurrences have these excellent e cornu contain- i of the vagina, ide us to a con- 3tice, and prob- isting has taken ctive sign — the TORSION OF THE UTERUS. 323 solely fron. a confusion onernTs-froz^^tlfrtinFf ''2 '^ '^"T ^"^'^'^ meant by torsion from left to ri./ht or rSht ??slH 1 "/?>''''• .^'^'"t-^^y win 1ms co„u, (o Mm rmuio, o n nt 1 i " '/"* ^''" ""'^'"'' ^" '^ "^"'*^' ''"^"^ '""«'' '^-^ J""'<«*i ^'' ^^" omiiiDiiLiy Hiitislactory. HIUIIH18, that. th.. p.r.vs am twimnl .ii opposito .hroctioiis : conl A boiiiK /v Imlt. 01. KuiliT rri:niM: 'Pousu^n : IM.WUTI.ATION. Kit,'. !>2. Lkit Utimum: Tcmision Mamiti.ation. t v.no.l io fho ,v,/ ,/ u.ul cora 15 to tlu- left. This disposition of the strands of a ropca,ouiK ^vncM-,tly rocogniscHl us oxact i, tho (.vhnicl lan^^VKo of mocl,an,e-s, as woll as in speaking of tho spiral indin S o t lu; tlnvad ol a sc.vw. th. sanu> application of the tonns should loh considimul' '"^'^^'^"'"'^^ ^^^•"^^'^" "f ^i>« ^'terus as that now undo ' Tlu'so diffeivnt torsions can be imitated hy the handkerchief as hns just boon pcnted out ; and thoy are well represenld ' • 's \4 (M tors,on)M (le tt torsion). <)() (noht nu.ltiple torsion), and l);i(Ioft to or?;" "'■''' "'"^''' ""^ nudtiple,as well as right ad left 11(1 (luhate, from ) to tlio roHcuo, JO lookod on U8 tnuuls of wliicli of tlio twiwlud coiirso of the H : cord A bi-inj; Tonsroy OF the vteuvx. 325 TcMisioN : IIUN. 'j^itidii of tlio tlio li'i'linicnl il iiudiiuitioii I sluHild hold t now under •chief, as has I'l.ns. HG (left 1)3 (loft tor- ight and left This l)oin<; fully understood, it ,li(r,...,,„^ („.u: " ,-,.-'.•- '1",^ domains to domoiistrato how the .M lunnl intro,U,ce.l in a state of prona^Pol (pahn .lownwards) nito ti.e y.t.Mna of a Cow Hupponed to be suff-r^n.' ho uteruie torsion it is evident that, in order to follow tho direc. on^o the spi.al lolds met with ,t nuist execute a kind of rotary or screw-liko rinr'of fr''l'''"lT''u '^ ,''''^ "-voment is such that the cubital tZ^\)^ ^^:rV^''' ''"-'''^ ''' ■'"''' (''•«■ •'^' t'"«i*'"" A), becomes itf nr. f l'^ dc,^^,.wardH-l,os■tion Ji), then intcrmd, so as to ";" t^;^tw,Ai"'^'''''''^ ^'^^'" ^n'wards ^-posltlon C)! then tke On the . .ntrary, if tin, hand, i„ following the spiral folds in tho In Ih, Icjt. l>or IMS ance, as ,n the other case, tho hand is introduced ... u state of pronation (l<'i,.. ^,1, positum A), bi'it instead of the thumb 1 ".ri trm ^i"^'^^^^^^ '^'^ "^'''^- '^ ^"«>''>- downward to th.. hM , r,l l' 1 '" '"'f "^"^''-li^' ""til it i3 uppermost, and the palm o[ the hand is turned outwaid , (position C) be TerVi'nrnortTnf "';l" '""''r'' '^Wa'"" '^^ ^"^ >'"^ '" I'^-^^^ice it mav impo.ta.i. Jt may be sulhcient, then, if tho fact is impressed 1 o iMr;.';: •; "^';'"^^ ^'!^^^ ^^»'-" the i,nlu. of the hand turns to the winls I • X \''IT' " '■" *'^" ''^^'' • ^^^ ^^hon it inclines oui wai (Is, or to the ri<,dit, then f ' le twist is to the left. diltJl^tharTo'-^ir '■•^■'"" -^° ^^^^o^i^^^n tho decree of torsion is more amicult thai t( , iscover its existence or direction- thou^'h overv It ms boon I l^T^.l' '*'" *"'''°" '^ «''«ht, and vice v!rsd It lias been stated that it may exist as a quar-er half three-nuarfpr or a complete revolution; and that it „ 'y even ^xte d t(^ aTubl' .vble oi (luadnipl,. twist. J3at it nuist be always do iV.t^l whettr we bri, l; wXin l' r'i'-'"?^'"^'^^^ ''"''^"•^'"^^ ^^-^^ °f torsion svhich miy DO met with in obstetrical practice ^ ..lire' wiH'nln'iT'''''"','' ^^'''' '^he greater the amount of torsion, so the "ndercH d icult""u ^ ''''''''r'f' "'^^^ P^^»«tration bj- the hand a!1T \l ! \ ^\'' ^^^^" already, in treating of the svmutoms o , simple CMOS. When, l.,r instance, tho hand ran be passed pe tatod";", T' 'T''}' f ^^'- ^'^ '''' ^^^•^'^- --^ the os c^u. be pe ted to sael a depth that so,,: parts of tho fcctus are felt then h t ^n'oritsS' X:^^''"^ ^"^ ^"'> "^' '^« ^^bout one-Wh .n c^e to .1 e T, i t . ' P'^^«'^^'« -s more cnstricted, the spiral folds SiHo Iv ;, he cervix .-an be reached --ith much difficulty ptiiiaps on y „.„. or two hngers enter ng the os— we mav exneot tl, ,r tho uterus has made a half or three-,iu.u-ter revolutTon ^ ^ ^ '^"' tin.irs1)eimM'Sv'!l'r T^''^ ««'hidod -ot far froui the vulva, the T^y^^r^,:^};^^^ '"i« ^he funu.. shaped mfundibulu,; for ono L <"^f"i"ce, and cannot reach the eervix, tiien there mav be n n"ous"uid7r/'H*" '^"^'^- .?'■' T'^^ ^°''^^ -'" -^^ be cbseLd So arcViuUii ''" "'^"^ '^''''' ^'''^''' ''''' ^- ^" the nue difTi- mo MATKHX^tL DVSTOKIA. ill A 'i f ^1 II i! J Proyncsis. -v-'iollt MorS'Tin'a 'll.w'' "'"'';" "'T' '"' '"'"""' "H"" "' " -''-"- "ot <=«".i.l.»- 1,,. o„a l,t ,t?''i,«'' "^^ v„l..,i„ary »„i„„co ,lo™ of courso (loi)oii(l nnon fl,,, 1,..: c , "- ^'/^"' '"''^ 'i*^ iiiV()Ui;iI)I('nc!SH \vi ti.e (loKrcH/oH s , ^..^^^^^^^^ *'f *.'"' l^'^'t'Tiont symptoms, been called in. ""''''""' '"anipulation before the vetoiinuiian has Potholo(jical Anatomy. el1^";;i!v;;;.;'rwl'ri^Z T"^'^^^' to •nanip..lato.y .nan<.uvros to 8i«ns of part. H io^Lvo i ^, ,,f,^!:" /;;r;."'!"^ '"^ ''"'^ "'"•>• ^'"^'^•^ ^f'«»- on open M^( tlu3 u 1,1 .en iJ^^^^^^^^^^^ "nportant alteration noted tifcy of blood-tint^l un ofTus^i w ' l'^'''.^"'"ti«- There is a .,uan- shreds of fil,rin • Id t he iSr I^'ntonoal sac, in which lloat :isi: St;;: ~S i^r- ;:.;ff' i;:;;'&Sn£ vagnm are exposed, and the torsion s visible 'mK ' "^'"'"r ''"'^ hard cord, coninosed annnmnM,, ^f i , ■ '^I"«ars as a larf,'e, si/o, the close t vined o \ ^ cViro in H '' "^ ^i'""i "y'^'"^" ^^ ""^'l^"'^! this cord-formed bv 1^ ternHnnH. f. '""^'"" "^ *'"^ strangulation ; body of the uteru LoU^ m,^ i s nn ? *''^^^^^'";^ '^"'^ ^>'« c^-'vix and twined portion towaX"he f „dns of "f ''^ '■''''^'' ^'■^"" ^^'^ '^«"««'y- vagina on the othm (Fig 'kJ) ' ""^ '''" "*"''"' ^" °"« «''^^'' ^nd to the connected that vcrXn thov ^n , Ti '^ ""'"''' ^'^'^'y^^''" «° intinmtely hasbeenuntwise7 I otten'twL h'"''""^ ""^'' '^^'^ "^erus in crossing it; so that throvt "nt^ fu' ^•^^'"^'■•''>' ^^''^'^'^^I' ^ the hgame^nts are ^:^SX^ "ZZ^^' '' '^^ ^^'^ though' r.: ::t ISrHuSti^-j ^'-^ '^^ -Ptured ; and in.polsible withm't one^r bo?b T '"^'"^ained that torsion is witnessed. I the lam. n,„ W f T^' *°™' T*^ ^'^'« ^««'«» ^^ seldom stretched, tig tly comnfess ^ £^ cases they are tense and greatly OS all the n.o?e rind Eut when ?)■'';" ''"^- '•^'"^^••'»^' occlnsion of the relations, they aJe found tot: inUcr'"'*" " ""^^^^^^ ^" ^^^ ""^^--' widJn, and are efflcedf X^' Z '. Inn'^K i' " "''"' ^'"^^"f >^ ^P^' comes into view and tho vnLn o " f "'' clisappeurs, the cervix as well as its alm't^JtdSHor "" ''' "°™"^ ^^"«^^ ^^ -'^^h' So that the hand introduced into'the vagina, per vulvae, no longer upon as a sorious UHsiHtiince is not 1. N('\(!rtholo88, aiy HC!i('iico (looH liat, l)y judicious iiK'iio'^iH must not <') of tli(! torsion tlu^ iitorus to its i"i<'%<^ven yielding gi^ n"''^irSSnoSll ''''°'"? ^"l^'^'^t'^^^ ^nd miserable-looking, peritonitis EffrnSoin^n'r^'' "''"' ^^ "'^r'^^^'^ ^'''''^' ^'^ ^''^""""'^ comniencenmnt a d we h V "'^' "^'' '"''."^'' '^'""^^' ^"«"^« ^^ the very uterus. putrSk o th itt^'tn/r ""^ 1^^"^°";^'^.' ^^-^^--- of tli conditions which qiickly tcvndn;t:i?fc ""'' ^^'^'^^^^'^^ ^^l^-' «^--ve bee,; ^iSd:''"''"''"^ ^''"■'^'"^" ""^^^^^"1 '^^^-"l't« at delivery have on?;\M: Sn ':::i;,?;:;,!;^;;!l '';;^">- -';- J-- •-- published, yet they Rainard,-. A'ie 1 rd n: a ' "s^ -n ' "V /^'^^'^'^'tboless, according to Cow and (^alf U u,^ i:?: . ^ ^^ ^"cceeded ni one instance in saving a case there ^s^^^J^out'^^r""^ "'"'"^^^ hysteroton.y. In this beyond the va'nna and show ' ^'", 'T'"" "^ ^^'"^'^ ^^^^ ^^^^ruded experienced much'c^cu V n, r " '"^^-^^-'b-^alient spiral rings. He sive incisions he v-xoJ>H^ "^'"""'"^ ' the\xten- becanie lacoratio. s In ""' ^"' 7 "^''^'^' ^^ ^'^^'""^•'^ ^^e f(x>tus, madeagoodrecmeVv T^^^t^^^^^^^^ Yettheaninm tator, and si ould n^ ^.ni e « ^^'t ''. "^''?'"'^ ^'''' '"^ ^"^"'^^ '^'^ ^'^i' there is eversion of iu> v .In "m 1^> ''"''"^i'^' "^ '^ «''"'^a'' ^'''^«^. ^vlien The princina in i>ed " , ' '^ ' r^ ^""''^ ^° '^'^ ^"'^'^^^^ ="'^ visible. accidont^•"T;/;S7L L ^'" ^•^^^^^'' "^ ti^'« restored to theii no. n 1 c /n ] m' i^'lf ^'"' ^''0 cervix and os arc wiuietheuter.;sitsd;':;lrr';£' ;;i;^:,2^^ -^^--^ P^^-^t. Thev are l^^^^f;. ; '^'''"''*^ ^^ accouiphsh this object. ^i^oyaieii) Abdominal L,.as; (-2) VayuuU hysterotomy; (3) Vaginal ' Oy. c/V., vol. i., p. L'lO, I- a. M^r li tliG length other or not sveii when it perfect pre- on, the hair lyseniatous, occur when is accident, after death the grc'ifc fc long ago, I'ering from ' consigned a some few arsion, and cjr fruitless luniniiiied; nit rallies, :)n yielding le-looking, to chronic it the very ■one of tlio tlier grave A'ery have 1, yet they cording to u saving a <• In this 5 extruded ■ings. lie the exten- he fo'tus, he animal id an imi- ■ase, wlien re visihle. f of this nd OS arc d patent, re or less ct. 1 Vaginal TORSION OF THE UTERUS. 329 ^ui'eCo^l!^^"lJ:^J^r'"'. ^^} ^^^^^■'•'^'"^'^ procedure; (6) notation of the Low, body . and (7) Gastro-kysterotomu, or Ca'sarian section. 1 AiiDOMrNAL Taxis. -Tlie idea of opening the ahdomen and thrust- ter r If;; ? 'r^"'-?-;"?" '''rr'^^ in ord-er to search for the tlrd Son tTthn '' ' '•' '^''"f ^y ''^ .*""""« '^ °" i<^« ^^^i^ in a contrary ueotion to the torsion, m order to deliver the animal hy tlie natural S rfe'vvlt h n ''"^' ^" ^'V'^-^^y ^^^--^ and practical proc ' u e,' i-csL; Ifco V \iT;'''"^; independently to several minds, has been md . . hlo^i " °^ ^'^'^^^•'"a^T ol^«fcotrists. But, however simple and feasible it may appear, yet it is very far from being an easy or always successful method, and this for several reasons. Amon'these r/nds tts imm T"' '^''t' ""' '^' ^"^^^^^ uterus-f.om 112^to 180 ounls-its immense size, its convex, smooth, and slippery surface • aM eob tSl^n'^^Th '' ^" '^^^ "'"^^'"'"^^1 cavity for^iLnipulation; iNothing, says I\ra/ure, after repeatedly ti-ying this met-hod hSeroTr/;;;'^^'' '° '^r^'''. '""^^ ^-^ -'- w'ith-tlieTuK'one If •esto n ' ?Lr /"'; ''"^. *^ r'""^ '^ ^"'""^' ^'^^^ especially as it is s com'?t' fc ^.^Z:; Its natural position. Yet no one whom I know is coiripetent to perform this simple movement " " but il wltTv^^f ^ n'"'^ *^ r "^^' ™"''^^ '^'^ ^t'^^-^^^'" ^^'^-itos Gosselin, its place'' ' °''' '^^°''^' '"^^'^ "'^'^ '^^''^» ^'^"^^ it to change faihn? ij; tt"^'*'^ "''' '"'*'^°^^ '" ^^■'^' ^>''' ^^i^^ ""t succeed. After d^ urlm d 7.""''"''-^° '^^T* *'^^ ^^^^^'^-^ "^ the uterus, in Sno W iw " "'^'IT' ^" '^^^'^ "-'^t flank, in order to try if he CO d ti m n h V *''" "^■^';"" ^'^'^"' ^-^^tore it to its ordinary condition. But he was disappointed : for the uterus, enormouslv dis- ^:^i::i:^^T'V^f the abdonnnal cavity that Z hand LuTd the s 1 •.. Tr f ^'^''''" '^ ^'"'^ ^^'^ ''"^'^^^ "f the ahdomen ; while not cling to ft. ' ^'^'^^'^^ ^^^^ ^°«'"o«th that the operator's lingers could inUi!Mf5|otoT!r'M^'''f ^l^«»'^tion-which, from having been performed fro, wr /'/''/ ^'^' '''T'^ '^'' '"y 1- ^'-n variable, exemplified in Obich's experience.-' This veterinarian had three '"Hi try to untwist it (the n^Jns 7 '"." f';" """l l""' ^''^^ '"'^ "" *''" "'^'''t 'we tl.. labour t„ talco its ,,.„•' ..: "Vr"^^,^'^'; ' ^'"'"•'1 ■^^'"- "I' th- w.mn.l and allow fo; such a suL.stion ^i d if on ^ M ? '.' -'S'' '^''"\rr ^'"^ "'■•'"'^'^ "^ ^h" profession if it does not, u^. ca,/hm Uforn tt - * ""''■ '"■^' '"^'''y '" •^'"-•«^'^''- ^t :».v n •atp. 330 MATERNAL DY ST OKI A. t- liS -^.'■K-M'r fi he failed to Itorrrt V" > °^ '""^ f " extraordinary size and weight that nc laiied to lestore it to its na ,dral position. He proposed in future ^o facihtate the operation by using a looped cord wit? w'hich to raise the Heichlinger operated successfully on a Cow in the same manner but It must tr:Tt P-ffd through gangrene of the uteTus ' ' ' suLrtt oLn nnl h''"' th%°P^^--tion has not been performed stances o in f"^^"] ^°"^^t""«s i" very unfavourable circum- Sp 't n !"' ^? ^T"" ^'^y s^^tisfactory conclusions as to its Ss- 'Drn^Vn^: \^'"' been fortunate in 'some of his attempts rdvanta^P« ? 1 ^ ^^ °P?"^"S i"ade in the flank has had some advantages I have even thought for a monient after mv first success info, t, IT *^ ^' *^' °"^^^ '"^""^ I ^^^^^^ ^--^^-t to for the^uture Bu unfoitanately, new cases upset my predictions, and compelled me to derable Wht of'tl^r? ""''^"^•" '^"^.^--^i admits tLt the Ln obstacle' ^ ■''' "'^^ sometimes prove an insurmountable be^ffeoted^'v! f '^'"•^^"g *^^,^ °Pi^^*;°"' ^^^« if reposition of the uterus be ettected, are as great as its difficulties. Several good authorities have therefore .>-ecommended its abandon:nent, or at least its be n°^; others hriw Ft dowf dses he ni^^^^^^ perhaps with more reason?S: w7th ho h[n?l • ,^^'"f-Cyr recommends the standing position whiWhf S -^ an assistant, to prevent the operator being kicked • arm into thP. •' ^'^^ ^^f^' 'Y "^telligent assistant introduces his unTJs tin? Thf '^' "'' T^Z ^° ^°"?^' ""''^ ^""«^"«^ ^^e results of the untwisting The opera or then makes an incision in the riqht flank lo allow the aim to be easily introduced. This incision should b<> fibreT7nd°r.r'' '"' forwards-and skin, muscles ("llow?nfth fibres) and peritoneum are to be carefully cut throu'^h The hand L made to rn /hP if ' • i "' u '^ '^ "' '" ^^'^ '-'r//'^- then attempts Bart of Lf ^H, ^^" '•" P>? ^>^ P^'"'''"8 ^"^ l'"«hi«« it i if any part of the fu'tus can be seized, the labour is lessened, and wearin- a holdinf "Thl 7:?^'l '\' ^""'^i" ' P^^^« '' ^hin cloth! will faclitat^ tiolding The task IS also lessened in having the abdomen raised bv a .J;"',"*' "*'"'""' ''o'"'*'"". 'to wound is ciosGd by suture and anti- ZltlZfZf"°T? '"''" "i ""■"=, hl"« '«'""-' by a "id" b^d. BeTiXtftlJ'^'i;.a,i» ™rbtr'°''- """'^ ■' """"■""» ""^ -' (ir8*Tn°ton'°i5„'.° °""''' "'""" "'«''' ''''^■' ""= ™°""<' ™'" ''«™ l.ealed !,y I -tion to replace e success ; but id weight, that id in future to 1 to raise the e manner, but iterus, en performed rable circum- ons as to its his attempts, las had some r first success future. But ipelled me to that the con- surmountable of the uterus thorities have leing adopted f, shows that untwisted in jcovering, the of operating, row it down, •e reason, in- ing position, s pulled back eing kicked ; itroduces his esults of the rigM flank, i be sufficient n should bo allowing the The hand, vc the uterus len attempts g it ; if any i wearing a /ill facilitate raised by a lan on hands he can raise e, and anti- wide band- tis had not 'e healed by I TORSION OF THE UTERUS. 331 . 2- Vaginal HYSTKiioTOMY.-Vieillard, so long ago as 1823, removed the foetus from a twisted uterus by means of vaginal section. In 1856 Ercolani proposed rary/nr/ hysterotomy, the opening being made throu-h the upper wall of the vagina, for the reposition of the twisted uterr^ The ope.-ation is of the same kind, and is conducted in a si^iTlar ma^'ner as that for the castration of Cows, introduced by Charlier; except that' instead of the ovaries being sei.ed, the uterus is grasped through the wound and attempts made to untwist it. Kueif speaks in favour of he proceeding; but we cannot find that it has ever been carried into practice, and serious doubts may be entertained as to the likelihood of Its being successful owing to the weight and size of the gravid uterus and only one hand being employed to turn the displaced mass, unless lucceeT""" ^'''"'y*^'^^'"g' '"^ which case a simpler operation might If attempted, not much risk may be apprehended from incising the vagina, as it has generally been found to be attended with little dan^rer and cicatrisation soon takes place. ^^'^'U^^i, 3. Vaginal Taxis.—AH sanguinary and serious operations for the cure of ut^erine torsion-like the two preceding-should be avoided if possible until he simp er means which modern veterinary science has indicated are tried. We allude more particularly to ^rsion, wh ch rarely fails to bring the case to a satisfactory termination. Th^t is of course on the assumption that this is resorted to sufficiently early • 'for and ?f' ll wIT K ''^ *51 ".°*^^"^' i' 8^^"^*^ by delay in this accident, «^1h! if be afforded it must be rendered prou^ntlv, and as soon as the existence of displacement is fairly established. ' When delay 1 .s been allo^ved to take place, more or less serious consequences Ws ensue to either tiie foetus or the maternal organs, or to both In certain cases of very incomplete torsion-quarter rotation of the Iterus, for instance-and when there is sufficient space in the vaccina for the hand to pass through the obstacle and into the os or ll^Z detorsion has been accomplished by seizing the most suitable parts of the foetus and exercising direct traction on it. Instances of success by Dar?S Ind Xr ''^'^ '"" '"'^^^^^-^' ^^ ^^^'^b°°' ^-"' ^--^ dir^^f^nrf.i?\^''°'"^"!? "'^yb' '^^ follows :-After ascertaining the direction of the torsion, the arm is to be introduced into the uterus as deeply as possible ; if the foetal membranes are yet intact, they must be In fh^srSn^'f ■;'"•, *^."'°''/?"^^"'^"^ P^^-t^ °f th^ f»t\:s sought 'oi' not offpr f?,' '' '''" ^,'' ^""r^ *b^* ^^«^y P^rt of the young animl.1 does 2rus Tp r'lJ' 'f '•''''/*^^'"' *°/^ °P^^'''^'°^' for reposition of the Hp h«n/ !l 'f ^""^^'l"',^"^ ^°^^ ""* ^ff°^-d ^'""'«ient hold for the hand the pasterns and knees are too much removed from the ihtlT^Z'T^ i ''"i^bf '^"^"^^ ^"^ elbows are, of all parts perhaps! those best adaped for this kind of manipulation. If one of them can rai ett'f;^ '^fT^^^^! firmly grasped, and endeavours made by it to raise the body of the foetus, at the same time giving it a turnin- move- SsTit "^ ° '^'' ""^''^ ^°'^^'^ b^ e^^'^" *« the%iterus in order to fooLToS J°' ''•T?^'' *''^* *^' *°^"''°" ^^ *° the ^^■^^'^' '-^"d that the ^voTu'tio^of^?^^^^ " ""' P^^^^tf ti°»' i«' from the fact of the quarter mu8 be to nl ^! T^^^^\ '"i^" '''^^'' dorsciUal position; then the object must be to place it in the dcrso-sacral position. 332 .VATFEiVylL DYSTOKIA. I wa^ds nnlm , n /f ^* ^TI ^" ^ '*^*" °^ «^^i«-«aizo,» (knuckles down- rsible^ Z Sr? ^^' r '"f * ^' introduced /^..m^/^ the fcBtus. and, if urn nrhi, ' i A ^'"'^' !!!'l^ 1^^ *^^^ ^^^"^^ ^ ^^^^ ^^e operator, mn nf Tt L Tn .r*^' 'ft'"' ^J^' ^"^^ °^ ^^^^ «^'^^*"^«' ^^ the same time tuining It so that the withers describe the arc of a circle from right to left-from the right flank of the Cow towards the sacrum ^ beinZxPoTJ /" *!"' ^°'*"' ^' ^"^'' ^'^ *^^^ ^^^°"^^"* tl^i« mancBUvre is the operator "' '^' "^ '"°''^'"^''' ^^^^^ S^^atly assists the efforts ol be^draJ^^'^inrf/ °"' f -^^'^ ^T'''' ^^'^^* °' ^*' ^^^ Hmbs of the foetus may ^^r^^^lX^-' -^ ^^ *^- ^^^^"^' ^^ t^e version incf t^iP^,'l?!?«''.f ''^ Tfu^^ obstetrlsts have been successful in readjust- Iscertainpd h ' h'°T^ ^^' medium of the foitus-the adjustment being vSa and .^^f/^^^/^^ ^arance o the spiral nmcous folds from the vagina, and the patency of the canal as onewolf/ri ' '^ ^f ^f ? remarked that this operation is not so easy reoui.tr ml f '"'^'?''^ ^° ""^^.^"^ ""'^^'^''^ *««t'»g i* i» Practice. It obstlcptilh^'"^ ""'-^ ^Tr^''} '^'"""^ contractions are formidable Obstacles to the exercise of that force m^T.UMfr''f''A' f '^^T'.''''^ ^°'"^^'' ^^^^ succeeded in adjust- Ind aidpd hL '• .'^."^''f ^^ introducing the hands into the vagina, mppn^ nf 1 ^ assistants, who manipulated either with their hands or b^ et the or.«n .' °', f'^rt ''^^^'''^ ^^nderneath the abdomen, so as to .noted irfl^pf ?'"'*• .^^ '°"f ^' ''''^' ^"^"^P^^ ™^«t be greatly pro- ^!^i^:^a^ '' '''''''' '^' '''^'' - - instrufnentfn'the v«f: .^^^^^'« PROCEDUUE.-Denoc appears to have been the first meanrsuled'' h ""'"'u^.'''^ reduction of this torsion by the sin.^ e de^natfon nf '' °'''' ^""X^^^^'^ '" ^^^^^ ^ "^^""e^ as to merit the designation of "original." His procedure marked a great step in advance so far as veterinary obstetrics are concerned. ^ ,;/;w ; he jlescribes the case of a Cow^ unable to calve, but whose os uteru whe^e ;r"f ^^. ^^ "^"^ '' ^^"°^^ ^""^ ^° P^«« 1"« i^^nd into the not be rvnel^'' "^'"'/^'^^ "^':i """'^ P°^i*^°"' b"t from which it could P,viv fnT f 'i"""^'"?.*." ^ '^'^^'^ membranous fold extending from the ceivix to the fundus of the organ. .,n?m^/l r"^' ""^ ^^^^'""^ '''^ °^ ^^^« '°^^i°" consisted in suspending the animal, by a very narrow sack passed under its chest ; and two puUevs heT?eli.Th?7.^".f%""\^ ""{'.'''' ^'"^^^ Bido-one'correspon£gIo Pord vl ' '''%«^H!'^- *« tl'^ Wnd ones-the fore legs were tied by a one we e .lin''''^ '^T'-^^' '^' corresponding pulle?, while the hind DuUev I'ivP . ''"'''' ^^' ^"°.^^''^" '""''^ ^''""""S ^'^'-""yh the posterior ?ni ;k. !, . " were posted to the distal end of each of these cords, sv un ntl . " ^'f- ^J^''' tT ''''' ^^°"«' '^' suspended Cow wa sid^ wr,?dt r?lP'''''\"";, ^^^^'^ *^^° ^t^'"^'- "'^'"' PJ^««d o" the left whichTa,?^p^^^ P,"'l' *'" '"'"'^^^^'^ body to the right-a movement wnich caused it suddenly to rotate An exploration with the hand led to the discovery that the uterus ' Jieriici/ (h: Mcilecine VHirhmire, lS-15, p. 69. nuckles down- foetus, and, if the operator, the same time from right to i manoeuvre is 3 the efforts ol the foetus may and while the f the !egs, an in the version ul in readjust- istinent being olds from the is not so easy practice. It vay ; and the ■e formidable led in adjust- o the vagina, • hands or by ;iien, so as to J greatly pro- ument in the en the first r the simple merit the •eat step in Dut whose OS .nd into the lich it could ng from the pending the two pulleys isponding to re tied by a ile the hind he posterior these cords, d Cow was i on the left 1 movement t the uterus TOJtSION OF THE UTERUS. gip had changed its place, but that there was eitlier a double torsion or the inversion of the animal had only incompletely turned the uterus' as the duphcature was still present at the cervix Another pull was given at the cords, and the previous manceuvre repeated, and this time with good effect, as it was found thaTthe obstructing fold had now vanished, and the uterus was in its orcmarv position. uiLaattiy The Cow was then left alone, to await the result of its own expulsive ettorts; but nothing having transpired after about an hour, a dose of ergot of rye was administered. Another hour had not elapsed when Stes beTngTorn."'""^ '^''^ ^'"^^ '^' '^'^htest diffic^ulty, two In E Fig. 94. Dakkkau's Retuoveusou. .--I- ..n(. t.„ u-st of tl,c iu:ras 6eizi;a_ii siate of aSaii-s, antor- 834 MATERNAL DY8T0KIA. f - Y' :• :!( vl.l ^'t fl^i^ys-T""' '"^^^^'^ ^^""^ often-present in tor .v., of this nnnn, if ^J^^^'"^^ ^"^ «°J"« others, however, while admitt: ^ .hat the apparatus is not very easily apphed, yet testify to its utility. itio apparatus 13 composed of three rods (A, A' A"- Fie 94^ • of a winch (B) ; of a screw, with a movable screw-nut ID), pierced by three holes ; and hnally, three cords (E, E', E") with a loop (F Se enl o each rod G) a ittle thickened, has a longitudinal ho e (H) ; the Tln.?n'l T;f^^.^^ ^'^' '^ ^'^^' P""^^^^^^ tlirough it, and a shoulder (KK ilus end of the three rods is inserted into the three holes of the winch ihe apparatus is put together for use in the following manner :_T]ie tw nf'';? fT'^ ^V^'^'' ^°°1^ <^'> *° *^^« *^^^ P'*^«terns and the lower jaw of the fa;tus and oerve as points of attachment as weH as con- ductors to the rods. With this object the obstetrist passes ti em. o^e by one, through the hole (H) in each rod ; then, by one hand he sei/es the extremity (1), and wich the second hand tii; ofherendla) direct! who kPPn.* Hl'°''Tf '^' ^''' °^ S^ ^?'^^ '° ^« P^"^'! ^t' an assistant who keeps the cord tense passes this through the hole (I). This done each rod IS inserted in one of the openings^of the winch, the screwTc) hi'hlf -^''ir^^' '^nTi^^:: ^^"^^' ^"^^ '^'^ '^'^' ^re passed thrlgl td^ «!.-". . ' ""^ ^?^ '^ ^^' ^"'"^^ (^)' by "^^'^^-« of ^vhich they a°e made as tight as may be necessarv. -^ nnTI'arreau are hkely to be useful only in cases in which tlie uterus is Slightly twistc a; and in these instances, and others in which the torsion IS much greater, the method about to be considered is so simple attended with so httle danger, and hitherto has yielded sucli favourable resul s, that it is certainly to be preferred, unless vaginal taxis can be resor ed to with every chance of speedy success. This method consists iL;.i"*'\ /"T^'^^ aHected with uterine tors^'on, in sucli a manner that the twist wliicli forms an obstacle to parturition is effaced, and tlie genital passages are open for the passage of the fu3tus ihis method has been in vogue for a long time, and its introduction 18 due, according to Dieterichs, of the Berlin Veterinary School, to f!.T !l'' ???''''"''"/''*^';""'"'>' ''"-'°'^- ^t ^^'''^^ t^"s ^vould appear to be the fact from what JJieterichs has stated with regard to Denoc's procedure in 184o 1 when he says that not only had Schmidt, Vix Irmmger, and Schenker-all German veterinarians -mentioned the occurrence of torsion of tlie uterus; but that Ericke, in addition, cured a Cow of the accident by tying its feet, two and two, then rolling it taking ca'-e to move it in a contrary direction to that in which the torsion had been produced. ,J!^''''^^\ ^'"'"^r"' Z^'"'''*^" ^'^''t ^^'^^"^"^ °f J^^-rne recommended rolling before either German or French veterinary surgeons did-tbe move to be made 11, a direction the opposite of the uterine twist, ^he Cow s body to be higher behind than before. However this may be, - liecueil de Mcdecinv. Vttdriiuiire, 1345. Ge pra ant in t Dei fat I i) aut tA tair the glar V reac on care i be Sho ■ secu 9 one m but 1 can rr-ii -)r ..-I of this C J, jhat the y- ig. 94) ; of a •cod by three '). The end )le (H); the houlder (K). )f the winch, inner : — Tlie fid the lower we.'l as con- ;s them, one id, he seizes (G) ; direct- an assistant This done, le screw (C) sed through ich they are ing or lying ry direction ['liculty, and je is at all ', passes his lis way aids naturally. Denoc and e uterus is wliich the i so simple, favourable Lxis can be od consists a manner [faced, and troduction School, to ild appear to Denoc's [nidt, Vix, ioned the ;ion, cured rolling it, which the )mniended ; did— the twist, the 3 may be, J TO/iSIO.V OF THE UTERUS. 335 ptTsedThirm^ttd^r VLtti^f/^^^^^ veterinary obstetrists have and altogether with most gi^tyinlresu^I lUl?^'' ""' '''''^'''''' in this country have also found the nipXr ;« ^"^^ J«/«"nary surgeons gland being injured during U.e'operatio" '"""'""' ""' care, the feet being fastened togethei Sie hTnd ill """ KT'^^^ be introduced as^'far into thf vagina ^ irlniff-"^ Should the OS be accessible and difcpr? ^Ll ? fll'"''. '^'" P^"^'*^- secured, and more espe all^ ^ i.l this inusfbe fi n l' ^^*.^V"^1 ^' one position. If the fcotus c innot 'h.l i be firmly maintained in but tS make the vvaU of the vt °na the noint nf ' "T "°'^""^, ^'^"^"^'^^ can be made available " ^ "^ °^ resistance until a better animal is raised on its chest bv th? «h.,^] f / ?^'°S '*°"^' *^^^^ over on the side on whicl^ I ^4s th own V"\1 •^"'''*'''^ *"™^^1 made a complete rotalion "''°''"- ^" *^"^ ^^>^ '^ ^^^^^ ^^ve in Tt'^:::f2:^ r ^^i;Se '^ ^7' theoperator. with his hand If the operation is well conducted, and"the bodv of fh« r^x. ^ • the proper direction the obstefcri^f vvfll f, '^°^y oUhe Cow moved in Thi. i;re;,;:.dred%'}':„"L.t'.r:rsi;,r "t,tt,^^^^^^ this rotat on o riC riH"conr;f°''- '\'T '■■'-"l"™'ly. i.owever! par.uri«„„ c:„'rer„;:;(^ei',Ti;:x'l.:^:;^x^^^" "^'"^™"- ^^- ".IreaJy been made sfZ ,, ,l l"",' P"'"'" '" "'"''' reference has i een made, borne autliontiM luive d«.l;,rcd that, to achieve 836 MATERNAL DYSTOKIA. I "1 ;s»> the reduction of the torsion, the Cow must be rolled in the same direc- tion as it ; others assert that the rollin<,' should be contrary to the torsion ; while others, again, pretend that both procedures are correct according as in one the uterus is maintained fixed, while in the other it remains free in the abdominal cavity. The confusion imported into tlie discussion was probably largely due to the manner in which eacli disputant looked at the questaon— or, rather, to the position in which he mentally placed himself during the supposed operation. For instance, one may have fancied an animal in a standing attitude placed before him ; another, with a Cow lying on its back ; another stood in front of the beast ; another imagined he°was behind it ; and another stood at its riglit side, while a se\°enth viewed It from the left. Consequently, each discussed the torsion, and the mode of remedying it by rolling, from his own particular point of view • so that the terms they employed in tlie discussion could not fail to be contradictory. Fortunately, in practice no great harm could result ; as in whatever direction the torsion may have existed, and however bafHing the spiral curving of the vaginal rugte may have appeared in bad cases, the grand test and guide was the effect produced by rolling. If, when the Cow was turned to the right, the vagina became shorter and more firmly constricted, then it was evident that the animal was being rolled in the wrong du'oction, and rolling to the left was indicated, when the con- striction would be diminished and the vagina lengthened. The pro- cedure might be empirical ; nevertheless it was invaluable. But there can be no reason why the remedy should be empirical, or why the coriusion in terms which has, unfortunately, existed should be allowed to hinder the progress of science, and even throw obscurity on the practice of such an important operation in obstetrical surgery. Saint-Cyr had already explained as succinctly and clearly as possible the exact meaning to be attached to the terms " right torsion " and "left torsion"; and he has set himself as diligently to demonstrate what should be understood by " rolling an animal to the right," and _" rolling it to the left." He supposes an animal laid on its r'ujhl side ■ if it IS desired to turn it on its left side, it is evident that this may be accomplished in two different ways : first, by rolhng it on its back and allowing It to fall on the left side ; and, second, placing it on its sternum and pushing it over on its left side. In both eases the result is the same : the animal lying at first on the right side, finds itself at last on the left side. And yet it is perfectly obvious that the second movement IS exactly the reverse of the first ; while it is not less evident that the creature in both movements has been turned from right to left: for this expression in its real sense simply means that the animal has been moved from its right to its left side. But in order to give to this expression a precise signification, a con- ventional interpretation is necessary. This, Saint-Cyr proposes, should be as follows :— " It ought to be thoroughly understood that, in the movement of rotation impressed on the body of an animal, we should always conunence by placing it on its back before bringing it on the side opposite to that on which it first lay." In this sense, " to turn or roll a Cuw from right to left," means that the animal, " laid at first on its right side, was placed on its back, then on its left side, then on the sternum, and finally on the side from which it commenced— the right." I TORSION OF THE UTERUS. jg- followed during torsion ; and itis also clear ,^n^?"''''^°" ''^^ "^^^us participate to the same extent as the bodtSthn^^ "'' ^-'^^^ ^^°«« "°^ movcnent to which the latter has been s4jctd"^ ^" *^° ^'^^^'^^^ Supposing, as Saint-Cvr has dono n,nf f !r f • , nised as left, and as is depicted in IV 93 fn so^"" ^"^ ^^^" ^^«°e- In such a case the animal would bo cast nn ;/. " if,--, successively on its back, ri-ht side =^1,?,,. 1^¥^ *''^^' ^^^^ turned rolled, in fact, from left tonight ' "'"' ^"'^ ^'^^ ^^^«-'^ ^'^^"^^^ ^^ If one complete rotation does not c:nffi^n +i ,, be continued in the same direction untTl^L V" V'" "^^^'^"^ent must the cervix and into the uterus ^'^""^ '^" ^^'^'^^y Pass to The soundness of these viewq of onv nc+,v 1 1 verified in the very numerous catfnfn *^'*'"^^'^\« colleague is amply been published during rfasttwlv vo'''°" ^^he uterus which have ticularly in France, of Sch he ^i^i^aTvv " '^'' ^^"^^"ent, and par- collected by him kre unanimous^7n just ?1 '?h7 ''' f " '^' '^''^ precept which he has formulated in hI 7 n^ ■ f^^^^Ptance of the mann^er, for applicationTnl te of en mes Z^^^u'^'^"^' ""^^ ^'^^^^^^ the left-lay the animal on ^/l 4 .L S ,o ^^f T'f '■ ^^'-^^"^^ '' to the right-kuj the annual on thlr^tdd^^i tj".''/ f ^- . torsion the same precept might be formula edn/ll ^r '^ '" ^^'^ ''^'J^'^- ^v toWt^U tJ. ho^fiom left /o^-S^^l^it/^^^^^^^^^^ animal execute an equafdetee of Lov^, iT/""' f ^^' '^' ^^^^ ^^ ^he tion, as that executed by tLo uten s vet i,!!" '"I * i' '""^^ ^^^^^«- apparent, not real. In fact, in thS maLnv -o ''^^^^'^^^^^^tio" is only does not really commence ^t the ,0^ when tCr"''"? '^ '°*""°^' side, IS turned on its back; but rather nffJ^In ^\^o^y , lyxr^g on its its side from the standin^pos u -e I :f ifn "' ''^''? '^ '^ ^^^'^^^^ °" left torsion, it really falll°f?om ght to left o^Jn h" '^'' ''% '''^' ^^'^ ^ the uterine twist. ^ lett— oi in the same direction as Since the publication of these valuable remarks further .nnfi .• t£z ^nS; ;;So^Ss^^^'^^ ^^ ^™ 5:^^- 1^^^^ in ofSSr "?Jj^;::J^^^,^i-o5^^^^ treatment from its stall, and time pern.it irshould hf fl . T^ '^" '^^ "^^^^^^ roomy place ; all the lin bs u ay be t°edw *,?'". '^"""^ °" ^''^^' ^" ^ two fore and then the two hind l^i *?-^*'^?^^t once; or first the afterwards, but not a lowed to c oss ^ F^v''' ^' r^' ^^'^^"^^ *°o'ether assistants are necessary IcoMhese I to L^l"'"?-'^'^^ ^'^^^ ^^^ head to hold it, and make t fo low fL J ^^^''""^ ^*^ *^^« a'iimal's second should keep t lie Ihnbs as cbse to TTfr'^ ^^ '^^^ body ; the Cow is rolled over on the U is vpvv i, f"^.'"'? ^°''^^^^' ^^^^^ ^he that the hocks be ke^t flexed as muo 7nf ^'° -n * '^''''''- *^^^ ^P^^'^^ion the udder being dama^fS d also " ^ "i' '"' ^^ P^'event upper part of the hind" Ihlib The 0^,:^^ "''^''" ''^' ^^"^'^^ "^ ^he and roll the Cow and a d fl.; c ^ • ^\\^^^ assistants should lift the animal is b^^/.^ef ,n f^? "J P^^l^g at the hind legs whrn . D„„^ ,,.aced on xts uack. We have already described 22 938 MA TKllNA L J) YtiToKIA. [U-l'! how, and oxplaiiied why, rotation should bo made either in one direction or tlio other. The operator need not endeavour to render the uterus perfectly im- movable durm« the rolling, as it turns a good deal with the body of the annnal, and particularly when the mass of the rumen presses with all Its weight on the organ. This is also the reason why, according to Zundel, a ha f or even quarter torsion requires for its reduction at least a complete revolution of the body. It often needs a number Bullicie'nt '''"'" t"»«'oii, but generally two, three, or four are There is therefore, no pressing necessity for maintaining the uterus absolutely fixed wnle the (W is being rolled ; indeed, as a rule it ^s no easy matter to keep it at all near the desired position, there being a great diHiculty to hnd a part (o cling to. The hand should rather bo employed m diseov(-nng tlie effects of the version, and linding when the genital passage is patent. ^ Violet attributcHJ his insuccess in some instances to the want of resistance ho could oppose to the turning round of the uterus as the Covv was rolled, when ho held the feet of the fcrtus. He therefore tied the two pasterns of he latter together, after he had brought them out of the vagma, giving the cords to assistants wherewith to exereise gentle traction A tinn piece of wood was passed between the legs of the fa'tus which served as a lever by which the creature was macfe to aid m redueing the torsion, the Cow being rolled half round, rarely altogetlier round, whenever moderate resistance was exi)crienced Tn tins way the spiral constriction was made to disappear and the genital canal opened, without injury to Cow or Calf. bt^mtai It is always a very great advantage in an incomplete twist to pull the f«>tus into ,t as much as possible, as its body can then be made a lever m the way suggested by Violet. ^ «- ie\tr An important precaution in this operation has been notified by some practitioners .and that is to roll the Cow on a slightly inclined flooi If possible. It nmy be observed, however, tliat while Wegeier and others recommend that the hind quarters of the animal should bet" liighest, Cliambon and T.iautard maintain that they ought to bo low,,, than the rest of the body. And we can scarcely be ii douU as to the correctness of the latter opinion; for in the position indicated le uterus falls towards the pelvic cavity, and this favours relaxation of the torsion, and the more easy introduction of the hand throu-dr he obstacle m the vagn I, ,f it is desired to attempt to fix the organ bv the hand while rolling is taking place. "= ^ Wegerer's position — the hind quarters raised — is nevertheless to be pi-eferred if ,t is sought to fix the uterus by its own ;^Sghtwlu n the^hand cannot be passed into the vagina, or cannot act advantageously As in the majority of cases there is only incomplete torsion, and all that has to be done ,s simply to replace the fcr.tus. or rather th,!, uterus on Its bed or hammock, reposition can sometimes be effected by nierelv rolhng the animal on its back. -^ "'^^'-^J In some instances, when slow steady rolling will not sufiice, a quick or jerking roll may be successful ; in other instances it has been lideto'str '''""' *' ^ '^'' ''""'''^ °" '''' ^"^^^' ^'^^ ^°" it f^°"^ Wegerer, Sacchero, Rueff, and some others have combined rollin- I 1 one direction Tojmoi^ < "UE uu.mr.y. with abdominal manipulation uud and uterus, or to push 339 tl' -n Ml T.!!:!'! '° '"''" ^^"^ ^°'^ ^'^^'«ut attoinpt- '^^"'■^ 'id many succesaful vayina ' « > liavo been aji af; (' ponse of tho '■ longer time ay be necessary whore detorsion; at tho same liroctions laid down. Numerous practiti^ ing to fix or maniji cases aro recorded by But this success iii> , « , ^^.v^ neeu Cow or Its fu3tuP, as tlio rotation had to be <■ than If the organ ad been fix-d ; several turn, one would sulhco ^ut^ the hand in tho va-'ina roiLn tr;;^^^^^;^rSh ./^^ ^^ r\ n T't^'^'' ^^^ ^^ - out. tho rotation may be co , ue . Veb^rw;"' '^''" '""^'^^^ '"^^« mention instances in which t In Covv h^a K ^^'""°^!^«' ^"d Fischer twenty turns before success c owned their Xrts ''it'?'" ''^^^" ^^ tioned that tho rollin" in somn Pn«r.a i, ellorts. It is even men- Weber wiites :-" The Cow "often rnS^^/7"^'"'^ '" ^"^ ""' "^°^'"- Tlie operation is laborious Sometimes painfui' "T. '^''''' ^" ^^"'•• demands an expenditure o st-^t h wK f ? operator; it JLX'^;corbs:*a';°ur^„;;f l;"«,inr? r'°' ""^. "r '-™ accnmon re.nark that reposiwZy oalier when ,hf f' 7""'"";''- ?" nh™ it is (load. """ '""*'^ « "en the ftctus is alive than Lhifortiinateh', cases will be met win. ;^ ,„i ■ l Uterus, and, consequently delirv oL^ • ^'."P^^^^"^^"* of the method of rotation and these Ire^ni- 1 ? 1' '? ""P^^^^ble by this torsion. Ruetf says that hnv n.l .^'''^'''"'''''■^y «^^^« of multiple position of the fi us when h^e T.oT^rT ^T^'T""^'^ ^^ ^^'^"m- inflate the organ, and ;;;TentfbX:^^^^^^^^^^^^^^^ there is plastic adliesion between tho s"n •« y^fi T o^her instances and other abdominal viscera or even t lie mSll'^ 'f ?.'*^Ti^ '^'' ^^^^'"^ When the uterus hv its exi on -n LV ^ ''^' °^ *^^^ abdomen. surmountable obstlir ^^^0^ It Z'^'^^^'^ *° °^^^ '^'^ "^- inmctureit throu^lithev-iainnn?.'!! ^^^" recommended to oi^^^^^ the digestive But we cannot find any notice of sl^ch ,o^ 1 f V^^'^^^"^^^' hernias, etc. If the diagnosis is correct Hnnnif '^°«if^entg having occurred. ascertained.^he animal not too n "'h ""^ . f\"'' "^ '^'' '°^^^°" ^^«" volvcd not seriously ured a suco ^5 1 ""*^^\f *"'^' '1"^^ ^^^ P^»"t« i»- the U.e^ ,„,o.t/ oe'easi-Xr^e' 1^:^:72 ^IS^ t -Cthe fcotus i„ a good attitude ^r^l.t Sre r^ht^'ri't us xjmpresbion, dO as to fix tho fai tho 'esired direction for etfecting rotation Id practised according to tho IMAGE EVALUATION TEST TARGET (MT-3) V // '% / ^^ ^j^ '^^ mo ^ A 1.0 I.I 1.25 S us IIM 1.4 m 1.6 Photographic Sdences Corporation '^^b iV .«s ^\^ :\ \ m^ %^ 'Q'' k .\ &. 23 WEST MAIN STREET WEBSTER, N.Y. 14580 (716) 873-4503 mo /i r ^ :\ \ k ^^ \ t^ ^^. ^ ''•" 840 MATERNAL DYSTOKIA. Nature to eflfect the expulsion of the young creature. Birth is generally not long delayed under such circumstances, and the operator has the satisfaction of knowing that he has been the means of saving the Cow, and very often its progeny, with but trifling inconvenience tn both! The after-consequences, so far as the Cow is concerned, are of no more importance than those of ordinary parturition. _ But not infrequently, deceived by the slighi; symptoms of indisposi- tion the Cow at first exhibits, the owner does not send for the veterin- arian until too late to save the foetus, and even the Cow. In some cases it will be found that birth cannot take place after re- position of the organ, from inertia or paralysis of ilis muscles ; this is due either to the great extension the fibres have experienced, the inter- rupted circulation of blood in the organ, or injury to its nerves. In such cases stimulants should be given, and friction applied to tho abdomen and loins. Ergou of rye is recommended by Continental veterinarians. Should uterine action not speedily ensue, and particu- larly if the OS is dilated and the membranes are ruptured, the iretus must be removed by traction. If the os is impervious, and atony of the uterus continues, then steps must be adopted to deliver artifi- cially. When the torsion has been in existence for some time, the liquor amnii expelled, and the uterus closely applied round the foetus, then extraction is difficult and laborious, and prolapsus uteri is not unhkely to^ follow. The genital canal should be lubricated with glycerine, and injections of tepid water m.ay be thrown into the uterus ; when the secundines are removed, it may be necessary to inject some anti- putrescent substance, if there are foul-smelling discharges or any apprehension of septicaemia. In serious cases, after reposition of the uterus and delivery of the foetus, grave complications may ensue— such as metritis, metro-perito- nitis, etc. It may also then be discovered that a rupture of the viscus exists. These complications must be treated according to their indications. 7. Gastro-hystkeotomy, ok CiESARiAN SECTION.— This operation has been recommended when the other measures described above have failed, with the object of saving the foetus, if it be alive, or to preserve the life of the Cow. Laparotomy may be resorted to sometimes, instead of abdominal section towards the linea alba. Epccoi has twice successfully performed the CiEsarian section in torsion of the uterus, and delivered living Calves. Lemaire- relates a case of torsion and rupture of the uterus, in which recovery was hopeless. The Cow was killed, the abdomen immediately and widely opened, and the foetus extracted from the uterus with all haste. The Calf was alive, and did well. "Violet has also had recourse to this operation for the same reason ; the Calf lived, but the Cow died two days afterwards. We shall describe the operation hereafter. TOKSION- OP THE UteKUS IX THE MaRE. Torsion of the uterus in the Maic is a rare accident. This is doubt- less owing to the direction of the uterine cornua, and the ir.annsr in 1 II Medico Veteriiiaria, 1863. ■ Becueil de Midecim Vilerinaire, IS.'iS. I •th is generally srator has the ving the Cow, ence tn both, re of no more ; of indisposi- )r the veterin- place after re- nuscles ; this ced, the inter- erves. ipplied to the 1 Continental and particu- ed, the foetus s, and atony deliver artifi- le, the liquor 3 foetus, then not unhkely lycerine, and s ; when the it some anti- or any rges livery of the metro-perito- 3f the viscus ndications. operation has above have r to preserve imes, instead n section in re- relates a vas hopeless, opened, and ilf was alive, ition for the }er wards. bis is doubt- ! n"iann3r in I TORSION- OF THE UTERUS. 841 which the broad ligaments are attached to them, which renders rotation the ar"?^"" ^^""^ diihcult, unless there is some anatomical anomaly in The possibility ol such an accident in this animal has been experi- mentally demonstrated by Goubaux, in 1864, while instances of its occurrence have been published by Tisserant^ in 1846, Belhomme^ in 18o0 Elson and Dehvart in 1852, Hamon^ in 1860, Anderson'^' in 1860, ^''I'o •'".ol^J^^' ?'='^n^'x,. and contained two twist at S ba n Ae p^eWcTnl^e "ttV™' '^f''''\ '»"' ''^"- right. P ^^ inlet— the torsion being from left to of Breulet's apparatus one o "L^ o ^T'"' °''' ^^ °"« ^^ ^^^^^ Guillebpnns hnJi oi ' . ^® ^""^ *^^ parent survived. posed PuS es afL a l"". 'T °^ ^ ^^V^^ ^^^^^ ^^P^"^'^ two decom- become twisted completolvrnnn^ ""' *° ^? «J'-anRulated by having Beyond tWs tw^^S L n ^' If^^^^^^g ^^^ broad ligament as well the uterus was nucratvnl TP^r^™^*°"' fetuses T and behind it that it woXbave bee' P-mn. """m '^^ '""^^ entirely obliterated ; so way. ^^^"^ impossible to extract the foetuses by this CHAPTER III. Dystokia from Morbid Alterations in the Oenerativo Organs. 1. Uteeo-Vagixai. Tumoues re^d SXr n:s.r^ori!:;n'^ssi;:: ^"^ '^^r^ ^^^^ --^ -^^ parturition. Sometii^eL the arf^^^^^^^^ °" 'l^ ^'^ «f organs-in the uterus or its oormin i ^ • ^^^^"tenorof the genital vagina, as well as on the lab ia of tL v,?l ''^'f "1°" *'^" ^^^"« °f the their seat in the neighl^^3udn^ 1- n7o ' ^* ■''^^' J"^^^ ^^^^ ^^ve or pelvic connectiveSr Th^Pv n °' K^^''"'--/.? '■ . ^^^^^er, rectum, or displacement of the e parls oVhv\.? '^^"f *^ 1^*^^ by degeneration there. P^'*^' °' ^y heteroplastic products developed eitW^aX^rcloIdTorToiX" t^^^^^^ ^7 ^TT ^ ^^^ '^^^ ^^y one case and movable n the oth- ^^ ^^ ' ^^ ^^ ^''''^^" *^^ by wide bases, others aie Sdicukt'pd oT' .'"'" ^^f^'*^ °^ implanted narrow pedicle. Pechculated or retained by a more or less doSSdlfn^ls'Ind'^t'iS^^^^^^ ^'"^-"r T ^^*^- -- in the under observation The fi t instnn'.T' ^^\b\^r i'^'^q^^ently brought Veterinary Journal, 1888, p. 153. Archives F^terinaire, 1882, p. 361. * /6«/., 1876, p. 424. Jiecmil de Med. Vmrinaire, 1828, p. 639 ident in the MOUBW ALTERATIONS IN THE UENERATIVE OJiOANS. 345 With regard to parturition, these tumours may be considered in a 1. Seat— The situation of genital tumours— whether in the vagina on the cervix uten in the os uteri, body of the uterus, or cornua-wili make a very great difference in tlio act of parturition Those tumours wiilch are developed in tlie uterine cornua may. by altering he structure of the walls of the uterus, hinder the amphhca- tion of the organ, impair the nutrition of the fcotus, and even cause it be expelled prematurely. If, however, they do not interfere with the regular course gestation, birth may take place in a natural manner and without interruption. If the fcetus is situated behind the tumour towards the body of the uterus, of course it meets wilh no obstruction in its passage outwards ; and if it should happen that wJV'.i^"?.' """^^ "!r ^'^'''^^ ^^^" ^^"^1- this can only be attd- buted to the alteration the pathological production has effected in the I^Tion WK "'' °^ the uterus, and which may produce a diminution in Its contractile or expelhng power. , When, however, the tumour is between the fcetus and the genital passages the case is much more serious. If it is lixe''. directly on the cervix. It may prevent dilatation of the os to the necessary extent, or perhaps altogether When it is situated in front of the cer4, towards the body of the uterus, but in the immediate vicinity of the former and IS movable to a certain degree, it may be carried into the dilated f^;.??^^ -J? "" greater or less extent, and render the exit of the tetus impossible, unless the tumour is moved out of the way. If the tumour occupies the vagina, it will prove a more or less formidable obstacle, according as it is large or small, hard or soft, and consequently diminishes the lumen of this outlet for the fcetus ^^^^^miy 2. Mode oj Attachment.— The manner in which the tumours are on thS. n.°f,-on' ^^^br^^^^f^"^ which they arise, has some influence pfflh I fu ^b^t^'^l^^ t? birth. They have either a wide base of attachment, or they are sessile or pediculated r^nnf T ^^"^"^^'^ ^^^ich have a very wide base are generally of a malig- nant character ; and though they may prove very serious, so far as the parturition, provided they are not situated in the vagina or on the cervix. Animals so affected do not generally breed, though they n ay regularly exhibit oestrum ; if, however, they should chance°to cZSvl n^lfb^e'cfeuJelLltrrurr''""' '^^'^ ^^^^^^^^°^^^ '^''^'^''^'^ ^^^ thJse%vh?.r'.f ^"^''','^1%*''"'°^'", ^'" generally more serious than those which are pediculated; as the latter may be more or less ZL ustr'n"'?.^'^^ T i" ^^^ ''■'^■' ^^^ cl'elivery rende'd as rpZlA ,u'' If Jhe pediculated tumours cannot be temporarily Rordd ofTv f"-^^'^ "^ the foetus, thoy may easily be altogetheJ aUeniated ''"'^ operation, particularly if their base is very imnmSnf l'"'''~^^^ hardness or softness of the tumours has an Ed= n T^ °" i^^'\ obstructiveness. Such tumours as the scaicelv TrnTn,- E^fv.^-'^ 'T^^'*^"' ^^^^ ^^^ ^^'^^"g^^* compression will scaicely diminish their volume or alter their shape ; while others- ^U --^li t I' 340 MJ T£JLVAL I) YS TOKIA. such as the condvlomata or papillomata— readily chance their form and dimensions when submitted to pressure. here^ft^^'^^ "^^^"^^ '° ^*°^^ °^ ^^^^^° "lorbid productions more fully Tiiacjnous. The diagnosis of these tumours is not always so easy in the domesti- cated animals as in woman. In the latter, the surgeon may sometimes have to discover the existence and determine the nature of such growths dunngpregnancy; and heinay, consequently, be prepared beforehand to overcome the difhculties which will present themselves at a later period. J3ut with the veterinary obstetrist's patients this is not so- and It IS only and always during parturition, in the midst of the trouble which inevitably accompanies a diilicult birth, that ho is called upon to give an opinion. ^ But as some compensation for this disadvantage, in animals direct exploration IS easier than in woman; while the entire hand can be introduced into the genital passages of the larger creatures with facility. ,^nd every part be explored ; so that if the period is late for acquirinc in- lormation with regard to the existence of tumours, yet these facilities enable the obstetrist to obtain most valuable notions with regard to diagnosis, prognosis, and treatment. But this exploration should be complete and intelligent ; as errors in diagnosis are easily committed, and may lead to serious consequences Here the hand not the eye, must be the guide, and just as the sense of touch IS well developed in it, so it will all the more readily distinguish between a tumour, the " water-bag," or some part of the fcotus which IS covered by or denuded of its membranes ; as well as discover the exact seat, volume, consistence, and mode of attachment, besides some- tning of the nature, of such pathological productions as are now bein^ considered. ° Treatment. The indications for the treatment of these obstacles to bi-th will of course, depend upon a variety of circumstances, the majority of which have been referred to. Sometimes we may be able to act directly on the tumour, and remove it ; in other cases, from its situation and nature, it may be beyond the reach of direct action. When in the vagina and not far from the vulva, and particularly when pediculated, it is occasionally extruded as the fastus is expelled from the uterus and may then be readily seized by the hand or forceps and taken out of the way. In such a case the tumour may be either drawn outside the vulva, pushed to one side so as to clear the passa-n or extirpated. ^ ° ' If it is situated beyond the os, and is sufficiently movable, it may be pushed in front of the pelvic inlet, and the parts of the foetus which present be immediately broaght therein so that the tumour may be kept out of the track of the latter. ^ ^ Should the growth be of the nature of a cyst or abscess, merely puncturing it by means of a bistoury, scalpel, or trocar, will evacuate its fluid contents, when it will collapse and birth be rendered possible When It is a pediculated tumour like a polypus, it may be got rid of at once by extirpation, if the pedicle is easily accessible. To this end the pedicle may be simply cut through ; but this measure, though the MO It BID ALTERATIONS IN THE GENERATIVE ORGANS. 347 most expeditious, is not always the best ; as there may ensue internal htcmorrliage, which will be all the more troublesome as hiemostatio agents are difficult of application to the wound. The pedicle may certainly be ligatured, either in mass or partially, previous to extirpation, in order to obviate the disadvantages attending simple excision. This means has been successfully employed, and though perhaps a longer and more difficult operation, it is to be preferred when possible. Eemoval by means of the dcraseur is preferable to all others when possible. It ia no more difficult than simple excision, and so far as hfEinorrhago is concerned, it is as safe as the ligature, while the conse- quences are much more trifling. When the base of tiie tumour is very small, and has but a slender attachment to the textures from which it springs, and when, in addi- tion, it is beyond the application of a ligature or the 6craseur, it may be torn off or removed by the finger-nail. The most difficult tumours for treatment are those which are hard and sessile, and to which the foregoing measures are not applicable. It sometimes happens, however, that these formations have only a very loose connection with the subjacent tissues, and it is often possible to remove them either wholly or in part, by making incisions through them, and enucleating the divided portions by means of the fingers. It is rare that neoplasms developed in the labia of the vulva offer any obstacle to birth ; should they chance to do so, however, it is easy to reinove them by means of the scalpel or bistoury. If the subsequent cjcdema of the labia has not disappeared when parturition commences, and if it hinders exploration by the hand, o the expulsion of the fcetus, it may be combated by scarifications. These, however, should only be made during parturition. There may occur cases, nevertheless, in which, either from the nature, mode of attachment, or situation of these tumours, their removal is not possible, and birth cannot be effected. In such cases it will be for the obstetrist to decide whether he will have "eco'^rse to embryotomy or Ctcsarian section— this decision being ar ived at after duly weighing all the circumstances and facts relating to them. Having completed these general considerations on utero-vaginal tumours as a cause of dystokia, and offered the above indications in the way of treatment, we will now proceed to notice each class of these formations, in so far as they have been recognised as obstacles to par- turition in animals. CANCEltOUS, CAKCINOMATOUS, OR SARCOMATOUS TUMOURS. Cancer of the uterus and other organs of generation would appear to be rare in animals, and very few veterinary writers allude to it. Even those observations which have been pubhshed have but little interest for the obstetrist, as nearly all of them have no relation to difficult parturition. Some cases, however, have been recorded in which cancer of the cervix uteri ha. produced contraction of the os, and necessitated operative interference m order to effect delivery ; and one or two instances fiT-e noted in which cancerous tumours have elsewhere proved an obstacle to parturition, and even when that act has been accomplished have proved dangerous from the haemorrhage they occasioned. When the cancer is situated at the cervix, and the os cannot be ilk^ I 1 348 AU TKRNA L D YS TOKIA. di ated by the foitus, then treatment must be directed to effect sufficient dilatation for its passage tluouKli the canal. In nearly every instance this must be accomplished by free incision of the cervix, C0NUYL0MAT0U8, I'Al'ILLOMATOUS, AND LIP0MAT0U8 TUMOUUS. These tumours are met with most frequently in the generative orcans of the Cow and Bitch, and piuticularly in the vagina. They seldom prove a serious obstacle to the passage of the fcctus. They first appear as soft, fungoid, cauliflower-Hke vegetations, which bleed from the slightest contact, and are readily crushed or deformed in the JJitch they sometimes completely fill the vagina, and give rise to a constant sanious, and most offensive, discharge from the vulva Lipomatous tumours are also most frequently noticed u the' vagina ot the ±Jitch; and in two instances observed by Oreste ana Falconio one tumour was tlie size of a filbert, the other of a large walnut The general mdicatious for treatment are applicable to these growths though they seldom, if ever, prove an obstacle to birth. FIUKOID AND MYOMATOUS TUMOURS. Fibroids are not at all uncommon in the generative organs, and are frequently the cause of difficult parturition. They have been observed in the uterus and vagina of the Mare, Cow, Sow, Goat and Bitch In structure, it would appear that the fundamental portion of these tumours is composed of connective tissue, which may present the histo- logical characters of areolar, mucous, or tendinous tissue, the fibres of which more or less closely interlaced, have connective tissue corpuscles or cells lymg between them, and are cemented into a solid mass by an mter-elementary, more or less abundant, amorphous substance that greatly contributes to increase the consistency of the neoplasm, giving It a dull white or nacrous appearance, as if composed of cartilaginous tissue. Ihe connective tissue corpuscles composing these tumours are sometimes considerably enlarged and hypertrophied, and this is more particularly observed in the fibroids of the uterus. This arrangement has been found to exist in the uterine fibroma of a Cow examined by i^rcolani in 185o ; cartilaginous transformation of the structure has even been detected. The fibroids are developed from the submucous or subserous connec tiye tissue, or from the muscular texture of the uterine parietes. When the la.ter the tumour is rarely pediculated, but nearly always remains sessilfc. ihe uterme fibroma of submucous origin is certainly at first sessile, and is covered by the mucous membrane; but as it grows it becomes pediculated. ^ The fibroids of the uterus, as well as those of the vagina, are some- times covered by the mucous membrane, and at other times grow beyond it. They are sessile or pediculated, and are of variable volume and consistency; their surface is either smooth or irregular, as if com- posed of a number of smaller tumours. Franck mentions that the pathological museum of the Munich Veter- inary bchool contains the uterus of a Cow, one of the cornua of which IS occupied by a myomatous tumour springing from the muscular layer ot the part, and as large as a man's head. Sometimes the pediculated fibroids of the uterus, in consequence of MORUIK ALTKItATtONS LY THE QENKRATIVK ORGANS. 349 the elongation of their pedicle, extend beyond the os into the vagina and even in some instanceg pass through the latter and the vulva and remain suspended between the thighs, A case of this kind has 'been observed by (iranaveri and studied by Ercolani.' As we have observed, the presence of fibroids has a variable influence on the process of parturition, according to their situation. Of course the larger, and particularly the submucous interstitial fibroids only very exceptionally allow successful fecundation to take place • though in some instances, when this occurs, absorption follows. During labour they may predispose to rupture of the uterus, from the alteration thev have produced in the texture of the organ. Subnnicous or subperitoneal fil)roids, when situated towards the fundus of the uterus, or when only of a moderate size, very frequently offer no particular obstacle to birth, and interfere but little with labour It IS only when they are very large, and situated towards the cervix or vaginal canal, that they may become a serious impediment to delivery Those with short pedicles, and which are designated " polypi " may be rejected backwards before the advancing fcctus, and be mis'taken for some part of the latter by the unobservant obstetrist. Sometimes the tumours soften towards the termination of gesta- tion, so that during parturition they may be sufficiently compressed and flattened for the ftctus to pass over them. If they have an elongated pedicle attached to some part which is easily displaced they may be pushed beyond the vulva by the foetus, or the pedicle mky bo ••uptured by the latter, and the parturient passage thus left un- obstructed. The recognition of these tumours is not very difficult when they are within reach of the hand. To prevent their being mistaken, durin" manual exploration, for some part of an ordinary or deformed foctus° their nature and mode of attachment must be attended to. With this object, the hand should be carefully passed between them and the uterus and vagina in every direction, so as to find their pedicle, and thus be assured that they do not belong to a foetus. With regard to the treatment, we must refer to the general indica- tions already given. We may only add that when the tumours are not very large, it is better not to interfere until Nature has done what it can in overcoming the obstacle ; for in these instances, a^ in so many others It sometimes effects surprising results. If tliey are pediculated and can be reached, they may be incised, ligatured, or removed by the ecraseur ; should the base not be attainable, or very extensive, they may be partially extirpated. ' ^ If, after parturition, there appears anything like serious hajmorrha'^e due to this extirpation, this may be suppressed by plugging with lint or fine tow, which may be steeped in perchloride of iron. THROMBI OK H.EMATOMATA. Thrombus or hasmatoma of the vagina or vulva, usually appears most frequently after delivery. Pfirter, however, has recorded the case of a Mare in which a large blood tumour, or hcTematoma, was caused by the rupture of bloodvessels and the escape of blood into the connective tissue around the vagina. It formed a great swelling on the sides of tlie ^Ortitc and Falconio. Studii sulle Xeoplasie a Massa distinta degli Animali Domeatici, p. Oo. 360 .1/.7 TKItXAL l> i'sroKU. Wm mii-A 1 va«ina and vulva, tho infiltration of blood extending to the porinumin Tina tiunefaction proved an obstacle to parturition ; so that it was necessary to open it freely, and take away tho clots of blood whicli had nf i"ani, f '""»7f^"^f vvhich ensucd was checked by the injection of a solution of perchloride of iron. j"»-i"ou Saako has observed tlieso blood-cysts most frequently in Swine ; death from lur.norrhaKo has soniotiniea resulted from thuir rupture Iho application of ice or cold water, or perchloride of iron, or oven tho bSn'*'' '^' '"' ^'"^'''^''''S *''" '^'^^'"''^ '"^'"^'' ^i" generally arrest the SRHOUH CYHT8. Kopp Ileriug, Ayrault Lafosse, Liautard, IVriiller, and others, have tXc!f^;^;e"M:^r:nd"co;:'^^^*'^^ '-"^^"^ '"'^"^^--'' ^^-^ --> ■- ^^o The vaginal cysts are of variable size, but most frequently as largo as a pear, which they are generally not unlike in shape. They are attached to the mucous membrane by a very narrow pedicle, and in some in 8 ances appear between the labia of the vulva when the uninuil is re- clining, but disappear again into tho vagina when tho standing posture IS assumed; tliough occasionally they are so large that they Co? return without assistance. "^ The cyst is smooth and transparent, and contains a clear limpid serosity, in which albuminous Hakes are often observed Not infrequently tho glands of Bartholin in tho vagina of the Cow are greatly distended with mucus, serum, or even pus' as a result ol inflammation. ^ , vo « tcauu ui Sucli cysts are not likely to retard parturition, and if they should their rea inent ,s very simple; as a lancet puncture sufS to cicatrfse' ^^ '°"'''"' '"^ "'" walls readily adhere and Hering has seen them occupy tho vagina and extend into the uterus • and in the la ter organ then- presence may be more serious than when they are limited o the vagina. They may prove troublesome obstades former'^' ^' ''' ""' ^^angerous to the animal in whose uterus they have r.nr^rf."ff ""^'^^ '' attached to the cervix or its neighbourhood, it may fhZT w.°' """'^ ?'''''"'^^ '^' '^"'^ '^"^ prevent%he fa3tus pass ng through. When very arge it may so closely simulate the " water ba"" as to be mistaken for it-though the mistake need not lead to cra^ve results ; indeed if ruptured the cyst immediately collapses, and can no longer prove a barrier to the expulsion of the foetus. If the cvst i^ situated towards the os and if puncturing it be deemed inadvisable pushing It beyond the pelvic inlet out of the track of the fcetus will be suflicient to overcome the obstacle. ^ Vaginal cysts may be mistaken for an everted bladder: a mistake which we are assured is often committed, from the external aspect of the tumour, its oval shape, and its colour. Of course, this mistake would prove most unfortunate, if the treatment we have Tcom- niended be adopted ; but a careful examination should always be made obvirirrerr'""^" ^^ ^^^^"p^^'- ^"^ ^^^'^ ^---^-^ -^ Hernia of the bladder through the ruptured walls of the vagina, may also simulate a vaginal cyst ; and if it be punctured in this position ^I porinunmi. tiiat it was xl whicli had tho injection Iwino ; death ro. i,or ovon tho ly arrest tlie Dthors, have 1 oven in tho y as hir^'c as lire attached in some in- nimal is re- ling posture .hey '-•mnot slear limpid of the Cow a result of hoy should, suflices to idhere and tho uterus ; than when e obstacles 3 they have )od, it may ;us passing vater-bag," d to grave md can no ;he cyst is ladvisable, ;us will be a mistake aspect of s mistake ^e recom- 3 be made ation will gma, may )osition it Afn/iB/n ALTKRATIOXS m TIIK aEXKniTlFE OlKhtXS. 851 S'Lsr'^ ^ '^^ **'"'' '^'"^'"''^^^*' TQ%\x\t%, in all probability, as in HEHNIA OP THE ULADDEU INTO THE VAOINA : VA(JINAL CVHTOCELB. Dystokia from the existence of a vaginal cystocolo is a somewhafc laro accideat and only a few instances are recorded as havinc been observed m the Maro and Cow during parturition. Inversion of this viscus may occur in two ways": — 1. When emotv it may, by spasmodic contraction of its walls, evort itself-tho mucous niembrano beconung external and tiie peritoneal coat internal— and thus turned outside-m, it may pass through the meatus urinarius into the vagma ; 2. It may, without being everted, escape into the vacina by an old or recent hssure in tho floor of tho passage. Most of tho cases occur during parturition, and when tho animal is straining violontlv whereby a portion of the contents of tho abdomen and uterus are pressed against tho bladder, and may thus produce its inversion. It is not at all iinprobablo that the viscus may, in consequence of the pressure it occasiomilly i-ecoives, be in a spasmodic state, or the cervix may bo dilated and relaxed at times (Gartwright). In the Mare and Cow tho urethra is short, straight, and wide ; and this no doubt renders tho bladder liable to inverskjn. Zundel states that it may, during parturition, acquire such dimensions from retention of unne tliat it will cmtirely fill the vagina, and protrude externally during the expulsive efforts of the animal ^ However this may bo it is certain that the cystocelo will present a different appearance in tho vagma according as its peritoneal or mucous membrane is visible : i.e., everted or non-everted In the first caeo wo find a somewhat hard, red tumour with a corru- gated surface, and attached to the floor of the vagina by a short narrow pedicle. Examining the lovver wall of tho vagina attentively, the meatus urinarius cannot be found but on the soft pulpy surfaco of the tumour will be obseiTed two small openings-the apertures of the ureters-frora w uch a fluid continual y escapes, and which may be recognised by its odour as unne ; his f^uid may oven be thrown out with a certain dc-ree of foi-ce during tlie labour pains. These characters should be sufhdent to indicate the naturo of tho obstacle. uuiciem; In the second variety, the bladder escapes through a rent in tho wall of the vagina, and this rent may only involve the muscular layer-the vaginal mucous membrane remaining intact ; or, which is more frequent tZ^ A Tt 'I *^'' T''^^/"'^ ^' ^■°""'^' ^'"°»^h' -"<^ fluctuating tumour attached to the f oor of tho canal by a pedicle more or less wide and beneatli which tho meatus urinarius can be seen or felt. The most striking pathognomonic feature of this kind of tumour is its rapid growth in consequence of the accumulation of urine in the interior of the di^'- placed bladder, the fundus of which is towards tho vulva and the nock directed forwards-its position being tho reverse of normal ; the fundus by pressing on the urethra-which is doubled on itself-prevents the urine rom escaping, and we have in this way a rapidly Lcreasn^ vaginal tumour. In a case recorded by Violet i the tumour hnS acquired, within eight hours, a diameter 'of from 'eigh^ to ten inches to partudUoT "'^''' '''^'''' ''"'"'"'' ^ "^"'^ °^- ^''' ^^"°^^ ^bTtacTe Ihcueil lie Miil. Vitirinaire de Lyon, 1862, p. 371, 352 MATERNAL DYSTOKJA. '^ M, m 1 1 1 tT„^r^ir Tn^^^'^'J °"V^''' necessity for a careful examination of the SHnln ? /'^"''^ •"„''"¥ ^ ""'*^^^' ^^ *h^ «y^to<^el« resembles eten thr° vvnV.TK "^1?^^'^">^ ^^'^ «y^*« ^e have -alrLdy described, or even the water-bag, and an error in diagnosis 211 ay lead to grkve ToniraZd r r'" error is recorded by Chariot.^ who, being c^alled 7.T. A ^ Cow which had been attempting to calve for three flnS^ff " . °" ««P'^^-^;-n^: .the labia of the vulva a°whitish, tense, and fluctuatmg tumour. Thmking that this was only the " water-bag " he punctured it, when the colour and odour of the fluid wS escaped qmckly undeceived him. When the bladder had collap ethrS T'heT'ow hoi? ''"■ "' f •' -g-a,.tlu-oush which the viscaK'd pass d had r.con,^« To'h ^ ?'^'"° eonditior; and the footus still alive. Chariot mothei died Caesarian section; the Calf was saved, but the nnnl*!!'' diagnosis of this accident is of so much importance, we will notice the symptoms in greater detail the^lablfwi!i?nT^' *^'' TT^ °^ **^^ ^"^^''^' °^' immediately within in .ii n,;7 , '^ ^^'^^^'^^'^'^ a tumour of a pyriform shape, and varying this Tumom It r'^'^f *° '^''' f'^^^*^°" °^ the accident. Sometimel r.«^l? - ^\ ^'f "^ ^'^"Sing from within the vagina by a kind of pfnt of riSd ^X' i?'"*' r "'f r}''^ """^ ^^^" «°"'^"^ ^-° - three pints ot tluid A. times Uie protruded part will be nothing more than a =nli -fl "t^'T^ ?-«»^ Its normal colour to that of an inflamed times it' wil/i ^""^ ^'''^ ^'''''''^ ^°^' ^""^^ *^"^«' *° ^ "^l^rker hue. Some times It will become gangrenous -ind slough; at other times its surface appears rugged and plicated, and on occasions a large quaSi y of bM na'ture^o? tSl i^" ''' 'n'''^^"- .^^^°"^^ '^^'^ '^''' aSy doubts L to the natme of the tumour, tlie meatus urinarius must be looked for • if that dsT Th;;^-7r'"'' f^Z '^? ^'^"^^^^^ circumspection should be exer- c sed The attachment and situation of the protrusion should be noted and also whether it is continuous with the vagina. Tlie nipple shaped proininences which mark the openings of the%reters into ?he bladder ^Iri «'''''" ^'^j't.'^^ for- a« their presence will at once denote th^ them '''^''''''' '"'' "' '''^^ "^'" ^^'' ^''^^' °^ urine from V Treatment. The chief indication in vaginal cystocele is rcdncfion or reposition of the d splaced viscus This, however, is not always, if ever. aiAa yLsk In a case o simple hernia, the bladder is soon distended by the udne and owing to the increase in size, it cannot be returned by the openW ^S sui^ce In T''' '^'r ^V"^^ '"''^'y- Compression; of iS waf win not suflice in the majority of cases to evacuate its contents, because uietiiia io empty the bladder a catheter must be employed • the shoot of an elder-tree deprived of its pith has been successfuil/tised for this purpose on an emergency. Once emptied, the bladder readi?v resumes its normal situation. f - t, uiauuei reaauy tr-^rTZ ■; ^^"^ °'f •" ^-^^ heen practised when catheterism was not tiled , a f^ne trocar being inserted obhquely into the upper part of the viscus-which was now of course the inferior part -U asTo inake it ' Journal Pratique de MM. Vmrinaire, 1826, p. 165. ortance, we will MORBxD ALTERATION IN THE GENERATIVE ORGANS. 353 pass for a certain distance between the membranes before entering the cavity of the sac, m this way imitating the entrance of the ureters^The operation was completely successful, al the : ladder had been little more than half emptied before the hernia was spontaneously reduced Cartwright says with regard to treatment of cystic inversion • "Pro- vided we are called to the case at an early period, and before a thicken mg of the parietes of the bladder and sphincte; has taLrp ace we mos probably wil succeed. We should, with the left hand press gently upon the sides, and with the right hand the fundus of the bladder, until we feel it gradually receding from us; after which we may carefully introduce a pessarj or cathete>-, so as fairly trforce it mto Its natural situation. If there should be violent strafn mg at the n-oment we are employing the staxis, we had better desist for^ a time until we have abstracted four or five quarts of blood, or give a dose of opium in solution, to allay any irritation or spasm, ButTwe ca ino succeed in this way I think a far more preferable plan wi bTto gS a stick with a round blunt point that will pass through the sphincte^-and force It against the base of the protruded fundus. A verexcellent ^uTZU """"u i!^' \?"'^^^ ^"*^^^^- ^"«h as is used for the Cow or Mare, as it would have the necessary curve. In thus trying to re invert It. we may use considerable force without rupturing it! thiu^ho course, we must be cautious in our pressure " •'"ouo". oi Sometimes it is no sooner returned than it is again everted and this repeatedly^ In such cases pencilhng around the meatus with nitrate of silver dashing cold water on the vulva, and walking the a Jimarquicklv about, have caused its retention. '"-"unai quicKiy Should the distended cystocele be immediately in the track of the tetus, and the expulsion of the latter urgent, if the bladder cannot be returned before birth it must at least be^mptied, to allow the youn" creature to get through the vagina. As the latter passes over ft the viscus should be protected from injury by the fingers thP po.Ti"*''™ ^""-^ consideration of this condition when treating of the accidents occurring as a sequel of parturition. ° TUMOUliS IN THE VICINITY OF THE GENITAL ORGANS. gromhretV^afwell'n'l'^r', "^'" °^ ^^'^' '^''-^' l^^'^'P^' steatomatous ^rosvtLs, etc as well as calcareous concretions, may hinder parturition or even render it impossiblo. Even an excessively distededWadde; may olfer an obstacle to the accomplishment of this acT eiS in Sr^c^^^ctr '' ''' '-'''-' '' '' ^^-P^^^-tically disturbinrti: The indications here are obvious. nf Hr«°T' ^^ ''^''°''' H""^^ '"^^^ '^' developed in the connective tissue of the pelvic organs, and cspooi ally between the vagina and rectuin and more or less obstruct labour. Ovarian tumours may also prove odWe hood of the genital passages. In some cases these may be successfX punctured; in others extirpation may be possible; whLTn otS SHa^setr^* ^^'^ °"^^' .i^oose\et.^en enibryotomy^^anrtS Distention of the rectum from an accumulation of fjrces mav nrnvp a cause of dystokia-particularly in the Mare; but thisXu^dL' easily 23 ^ kill 'i V, r f s t] i i I 'I ' ( i 1 . , I J t I ■il !l [Jll 854 MATERNAL DYSTOKIA. discovered, and readily removed. Tumours in the immediate vicinity of the anus are rarely a cause of difficult parturition. We have already alluded to melanotic tumours. 2. EiGiDiTY OR Spasm of the Cervix Uteri. _ Bigidity or spasm of the cervix uteri, or stenosis of the os, is a con- dition not infrequently met with among animals — most frequently in the Cow, next in the Goat, and less often in the Mare. It appears to be more common with nervous, irritable animals, and especially primi- parae, than others; though it is sometimes noted in emaciated and debilitated animals, and even in those which are old, and which have previously brought forth without any trouble. Without any modification in the structure of the cervix, but merely by a kind of rigid contraction of its fibres, the os remains closed, and cannot be dilatedby the efforts of the parturient animal. The cervix is not soft and elastic, as in the normal condition, but feels prominent and rigid, and shows less sensibility than usual ; while the os will not admit a finger, or if it does, it grasps it most powerfully. The majority of veterinarians admit the existence of spasm of the cervix, while others maintain that rigidity and spasm are synonymous terms, in so far as tliis condition is concerned. The first are ready to confess, however, that spasm is not always present, because very often the " pains " are feeble and few, and the abs. nee of dilatation appears to be due rather to something abnormal in the contractility of the uterus, as a whole, than of this part in particular ; whereas, when there is spasm, it has usually been observed that there are inordinate and disordered conti'actions of the organ. In short, it has been attempted to prove that in rigidity of the cervix there is a purely passive condition of this part, while in spasm there is an active contraction of the organ. In reality, tliere is no marked distinction between the two conditions, at least so far as obstetrical practice is concerned ; and this form of dystokia, in its more salient features, might be looked upon as merely an exaggerated manifestation of that derangement which has been designated tunmltuous or irregular parturition, or " false labour " {vietri2)ercinesis, as distinguished from mctracinesia, or feebleness of the uterine contractions), in which the contractions are irregular or partial. We have remarked that there are two sets of muscles in the uterus— the circular and longitudinal, and that there exists a marked antagonism between the circular fibres of the cervix and fundus of the organ, and the longitudinal fibres. So that if the first are more active than the second, and the latter cannot, as a consequence, overcome the resist- ance tb y oifer, the os remains closed and labour cannot advance. This is, we think, the true explanation of this condition. Siimptoms. The symptoms vary somewhat. In one case there may be at first nothing unusual to be noted, the pains being manifested with their usual regularity and intensity, and the animal in noways distressed. The only thing that is likely to awaken suspicion, is the unusual dura- tion of parturition, which may extend over two, three, or more days, if assistance be not afforded. As the period is prolonged, the animal may in some instances lose condition, exhibit indications of exhaustion and suffering, and gradually sink ; or it may appear ill for some days, then mediate vicinity MORBID ALTKUATIOX^ IX THE GENERATIVE ORGANii. 355 rally and assume its ordinary appearance- constituting a case of " missed In other instances, the creature manifests an unusual amount of ex citement at first ; there is agitation, straining, and symptcTs of col ckv pains; the abdomvn is frequently looked at°by the aniiiaT which £ down but soon gets up again; the pulse is full, strong, and frequent tlie conjunctiva, are injected ; the skin is hot ; f^cel and urine are passed at frequent intervals ; there is thirst and anorexia and some tunes during the throes the vagina is protruded beyond th^ vulva Lnd appears as a large red mass. vuiva, ana A vaginal exploration is necessary, in order to learn fhp r.a,,c. t obstruction. This should be carefully and gently Tde-theTaUe precaution being most important to observe during the throes It may be necessary, if the mucous membrane is dry, to inject some emouS fluid into the vagina, or introduce it by a spon-e emollient When the hand is passed through the vagina, the os will be found more or less contracted, so that scarcely one or wo fin-^ers can beTn troduced into it, owing to the spasmodic resistance it offe s while the cervix preserves its elongated shape. In the Cow, the cervix and vagina are freouentlv fillprl «nfV, „ tenacious gluey matter, which sticks'to the hn^'rSbhdlinTe and by iixing together the margin and walls of the os doubtless incr;ases the resistance the canal otters to dilatation. uuuuess incieases If the finger can be introduced into the os it will hp fnnn^ f l.of fu being occupied by a kmd of smooth-surfaced ball, in theTen tre of wh ch IS u narrow opening, and through which the fcitus can be fel The convex body is the posterior segment of the uterus which pressed bv This trace of the I instead ofti^g ^^^fl^.:t^^\ diflicdty"" ' — onally it can only b; found wfth i^uch f.r.f/w'''^"'' *° establish the spasmodic nature of the affection is the tact that in many cases, in the ntervals of the " nain'. " f hp^p, ,/ % i soft, and the os becomes dilated suihcient y to permi't of ?he n ' f no,nonic of uter^. dL'.f;ban n £ l:::^':^'!''^^''''^ as essentially patho,- designated .is utcrhie. These sim^ unon wh^ h'l, i f "''''''" '"'"^ ^'^'-'" specially are observed when the sick CmH /u ZcheLr t^.S^T" ' *^''''"'"'' diagnostic value, "suddenly elongates the neck exte ds 1 1 1,^1^ '" '''"^ '^'*^- ^'"'' ''^"^^1 then at the sa.f.e tim'; a kild o dul ml b . whth V ^h ^''"''''"^" ^^1 ""'^'''' "^"^ -"•'« real moan," When the.,. ^.n^^^'i^Z^tvl't "'"'? '?, ^'^^''^ expiration than a turl,a„ee-is in the uterus, ami nevereh "wh ^f 't^';?' ^*'. ^''^^^ ^''^ ''"'V" ddU-the dis- malpositions „f the f.^tus ,r n ortr n.s c' m oiLtiof 7p ^ parturition, cervix uteri, hydramnios, torsi..n of t^ uterus mr.W 'nduration of the "terus, retention of the placenta and vil., I 'r f ""• ['^'"^""tion, inversion of the these may give rise to thl mn" estuk,- thw T^ f'^ T'^ ''' ^^"^''""' V<^'^^y'''^ ^-^H witnessed in any other alfec^oSS^:;.: S'cSSii^^^o^riili '^ ''' ""^^^ IL- • H U ;i; I J I mm {<■' I MM 868 MATERNAL DYSTOKIA. Diagnosis. From the symptoms enumerated, there should not be much doubt or delay m diagnosmg this cause of dystokia. As in so many other mstances, however, the necessity for a correct diagnosis is imperative as on its accuracy will depend the success of treatment. ' If the exploration has been carefully made, the state of the cervix will at once explain the delay in birth. Perhaps the only other condi- tionof the cervix with which it might be confounded is " induration "• but in spasm this part is hot, tense, and painful, and neither hard' lumpy, nor deformed, as in the latter. Prognosis. Simple rigidity or spasm of the cervix uteri, provided there is no alteration in its texture, is not in itself of very much consequence In many cases Nature overcomes the obstacle, and in the course of twenty- four, forty-eight, or seventy-two hours of more or less severe and ex- hausting labour, delivery is effected spontaneously, and the animal and Its progeny are none the worse after a short time. This delay has been most frequently observed in the Cow and Goat ; in the Mare it is rarelv so prolonged. ^ But, as a rule, ic is not advisable to allow so much time to elapse after labour has commenced, without at least ascertaining the nature of the obstacle which delays birth; as during the longer intervals especially, complications may arise which might lead to serious results ihe foetus may die, or it may assume a wrong position in the uterus which may afterwards prove troublesome to the obstetrist ; the mother may become exhausted and the uterus paralysed, so that the fcetus cannot he expelled when the os is dilated ; or, still more serious the energetic contractions of the uterus may produce rupture of the organ So that a prognosis must be based on these considerations ; and both the owner of the animal and the veterinarian must bear in mind the fact, that while premature and too active intervention in such a case is to be deprecated, too long delay in affording assistance is to be equallv guarded against. ^ ^ Treatment. As this condition of the cervix uteri is, at the commencement of no greai unportance, Pnd merely retards natural delivery, active inter- ference IS forbidden for some time. When the first signs of parturition do not extend beyond some hours —one or two for the Mare, five or six for the Cow, according to Saint- Cyr ; when the obstetrist, by vaginal exploration, has assured himself that the genital organs, as well as the pelvis, are not in any way deformed or altered ; that the animal is all right otherwise ; and that rigidity of the cervix is alone the cause of delavin birth; then he ou^ht to wait, while being prepared at the same time for any emergen'^cy The glutinous matter which has been mentioned as occupying the vagina and OS, and covering the cervix, should be removed as much and as gently as possible from these parts, so as to permit dilatation to take place when the spasmodic constriction begins to yield. If, however, labour appeal's to be unduly prolonged without any progress being made in parturition, and if the " pains " are ener-etic while the animal's condition is not so satisfactory, then intervention may be counselled. But this intervention should be of the simplest MOliBID ALTERATIONS IN THE GENERATIVE ORGANS. 357 and mildest character and in the majority of cases it will be attended wth entire success Injections |;or r.ci.m or vaginam, ot emoll ent or oily fluids to which t;ncture of opium or extract of belladonna has been added ; the ointment or extract of belladonna smeared around the cervix or introduced into the os ; blankets or sacks steeped in hot water ?o"r ff il?r' '^' ^""^'f '^' ^^'^'' ^"^"^^1^. «r wLm-wate baths L«nlt. ri'- °"''' ^°^' i",««^*^i« «'^«es, the administration of diaugits contaimng some soothing medicament- such as chloral chloroform, or opium ;-these are the means to be adopted Bleeding has been advocated by some authorities-particularlv on ^•H.?"f ;r* ' ^''' r}''^ something very unusual in the general con qt^ilonib'eUr^^ '^'^^"'^ ''' '''' ^^^^^-^^*^- °^ ^^-^ - ^^ very , i?r""!j' °f '"''''^ ^^''''''^' ^''°'^' *^^ influence it possesses in con- tS'l^!"T''''" ^1^^^'"^ V it i« therefore to be recommended when the pa ns are severe and frequent. It may be given in large doses both m draught and enema, and frequently ^ ' Chloral hydrate and chloroform, particularly the former, are of great utility, and possess advantages over opium as soothing argents For a very long time, belladonna has enjoyed the rejutation-and apparently with justice-of being one of the best agents for coinbatin^ spasm of the cervix uteri, and permitting dilatation of the os. Occa° sional y its eftcacy has been contested, but the great balance of evidence IS in Its favour, and its employment is almost a matter of courle w"th every veterinary obstetrist. It is generally applied in the fornT of ..•^mci around the cervix, about a drachm or so being required foj one apphcation-it israre thata second application is needed. Time should dLe ifslcTent' ''"''"''- "^^^^ '^' ''''''' ""^"^^'^^'^ °^ one-fifth ofTie If cocaine were not so expensive it would also prove most useful in ;rot;?^^rdTSeir'^ '''''''' ^^^"^^^^' '- ^'°^^*^°" °^ ^^ -'^ ^" Sometimes it is attempted to dilate the os uteri by manipulation- !ilJlT'' y^^ t'''^ ^''""^ ^^" ^i^^t°^-^ •' b^t tl^i^ ^«eans should not be adopted until milder measures have failed, and until time and patience have been exhausted over them. The hand and fingers well o5ed or smeared with ex^tract of belladonna, should be introduced in theYorm H iJ.r ?r''u *^' °'.' '^ ^^'^^ '''^""^t be passed into the canal S hs shape then the insertion of one finger may be attempted, followed by a second, and so on until the hand has been pushed throu-^h «f Tfjl'^T t't^^'-fr^^* ^^ ^««o^^^Pli«hed at the first trial, nor yet conducted w?th i^t ""'"^ P't""" r^ J^^^^™^"* ^' ^'^^-^ly ^^^^'' ^"Z if kind should rpi! '"'u ^^d .g^f le^es^ which all operations of this 1 If !r ?-^^.' ^"';^ manipulation may be attempted without the The coSn'of'tt""'^' ?' 'J'^' ^°""' ^''''' ^^'^^"'^ with sTcce s! ine condition of the os should be ascertained, after a certain neriod Z^tnfrnLTlna''^'' atten>pt, every precaution being adopS to pie\ent injury , and an entrab' ■ ..o it ought only to be eiifeetpd wh^n the resistance has greatly diminisl.ed, and^can eas^lv b. ovS'n^e nuSh and'™/^?"'''' f n^*" °' ^^"'^^"^ ^^ ^^'^ sponge'teVt has been f 'anS f^r? .K ;ff '^""y* emp oyed in human obstetrics for a long bv Sims Tmflin ^°^l^' '''?!^*^^ been greatly simplified and perfected by bims, Jouhn and others. It is perfectly applicable to animals The tent can perhaps be purchased at any druggist's, but if not it ^easily i, u 358 MA TERXAL D I'STnh'LI. made. Joulin makes those he uses in the follovvinvci This dilator produces the same results as the sponge tent, over which It has some advantages. The only drawback to it is, perhaps, the thick- ness of Its substance ; as it cannot be passed into the os unless this is permeable to two or three fingers. A simpler contrivance than that of Barnes, and which will perhaps be found use ul on similar occasions, is that designed by Schnakenbm-, and named the « Spheuosiphon." It is merely the bladder of an animal tied to a syringe, and which, when water is injected into it, mechani- cally dilates the cervix. For veterinary purposes, the bladder might be attached to a piece of indiarubber tubing, which again could be fixed to the nozzle of the syringe. It and Barnes' dilator act in the same manner as the natural " water-bag." formed by the footal membranes and liquor amnii. =Siii.4Q^ Fig. 0.^. Barnes' Utkhine Dilator. Another means which has bean successfully employed in such cases, a. It is simple and without danger, and at the same time effective in mtioduced into obstetrical practice in 1848, by Kiwisch of Dresden ttl '? f "^/^^l y known as the " ascending uterine douche." and con^ sists ot a jet of water at a certain temperature directed against the po tenor uteniie segment for some minutes, and repeated, if necessai^ tn^ , T? %'^- VT- ""' ^^''^ ^^°''^'- ^' '^ -^^^^^ ^•^«°'^^ted to in woman to ta^oui the dilatation of an cntirchj closed os, and to prepare it for the kenburg's." "^ ^"''^'°^' ''''''^ '''^^ ^' '^'''''- ^^'^''' ^'^ S^^n^ TlPiL'"''*;^''''* ''"^^'^ ^? ^'^^Vted to animals in the following manner, on^ S '"'"'l ""T'^^. "'"'^^^^ °^ ^ ^''''^^^' °^- barrel with one end ?o ;l^'i'lV"^^>^ Z?"""^^ f. ^^T'* ^^^^'y ^t^b^« ^' cow-shed, and a can h? r,7n.n ^J^^^™ 7''^"^,^^^'''' haif-an-inch m diameter, which tbp ^fnf ? ^ T^'^^ and cheaply. To one end of this tubing is fitted s immerld''in'tr^7 synnge-either enema or garden ; the Sther end vaS^^^f ff f b'^^f ^,°^- pail, ^vhich should be filled with tepid To^^aVrr/stroTg jet^ '' '"'^ ''''''■ ' "^' '''''' ^^^^^^"^^^ ^^^^^ i 1 H i g) II m 860 MATERKAL DYSTOKIA hJlZt^ °.l .u*^^ ""^^u^" ^°^^"S' *^« *^be must be exhausted of air by suction with the mouth, and the end provided with the syrinae pipe ca ned mto the vagina and directed towards the cervix uteri^ eS douche should continue for about ten or fifteen minutes, or longer; tnLLul repeated every two or three hours, or even at shorte; produced. °'^'"^ ^^ circumstances, until the desired efiect has been Cazeaux speaks highly of this method of dilating the cervix in woman, and for the following reasons : ^ ^vin"fo^^ "*^-ul'^ ^'"'If''' prepares the act of premature birth with the d latatiorof'lh n"' •'"'''' ^^ T'r^°^ '^'^ ^°^^^"^"g ^"' t° "^^^g'"« ti^at because ie^orred to ""'' "^ ' '° "'°'' ^''''' ^""^ bJusqueness can be Forcible dilatation of the cervix, wliich is not to be recommended except perhaps in very exceptional instances, has its advocates and two cases reported by Oschner, a Swiss veterinary surgeon, prove that It may be successful, notwithstanding its disadvantfges X these cases, every other known means had failed ; so Oschner procured a pair of lai-ge fire-tongs used by blacksmiths, and wrapping their jaws round hrouI7i:^":t'''H ""^'^^'^^ ''•''}' ^''^''' ^'^ introduced thim, closed, through the OS then an assistant gradually opened the shanks or naiidlcs 01 the tongs, and so produced the desired widening of the passage. The inflammation set up by this manceuvre was dissipated by he employment of soothing remedies, after fifteen days' treatment It 18 obvious that such a mode of dilatation should not be practised, he cervix in organs, nor MORBID ALTERA TIONS IN THE UEXERATIVE ORGAXS 361 to be atony of the uterus or the mother is exCsid L if fh??'?'' and „°ot unfaquently 'afdTd tSXh the'sei^taUanll" "'"^"'^ '"^°^*- 3. Induration of the Cervix Uteri is no n/ n ? f"' °' " ^'^'i'^-hus," as it has sonietimes been desic^nated (lurated tumours vulgarly designated osteo-mrcomatoJ.Bo frequent on liiin (the o»ner) I woK i, i*: iC .? ■ '. I * f" "' """lio" » »leri. I told (.■om it. .pp..„„„, ■,„:! a Kltti',." ' Ti;i's:™rei^« '■"""' """ '-«'' If ? f^ 1. * 4" ^ IS r i,. I .! ■ i: P ilR ao2 M.t TEnXAL DYSTOKf.t. the maxilla, and which repeated irritation caused by tho prick of a needle are sufhcient to produce. This seems to be a general organic fact of vyhich induration of the cervix uteri is only a particular instance." This induration must not be confounded with the dense, fibrous though normal consistence of the cervix of the Cow's uterus, which theie can be no doubt, has often been mistaken for a diseased condition h«lr K T ^ '''^''" '" ^ "«"^ °*' spasmodic state. The distinction In^nTnlZ r '"'' fl?^ '^™1 *^^ functional dcnuujement and ih^ patJw Lmj^wal alteration of this part, is of great importance from an obstetrical point of view ; as the first may be remedied by the mild and innocuous measures enumerated, while the second can only be overcome by a more or less serious surgical operation. ^ n^n?;ff TmT''"' P^'■^^i^^ the induration is congenital ; but it must be admitted that, as a rule, it is due to the influence of disease or injury— past or present-in the textures. It may, therefore, be expected to be "T f quent in old animals, or those which have already been bred trom, than in those which are young or are pregnant for the first time, though these do not appear to be exempt Eancon assured Rainard that morbid induration of this part was wit- fm f hl;"°'^ frequently in the ancient Brianvonnais. where he practised wh t^X^'-^'T^' '^^f.^'' ^S''*'' '"S'°"^ ""^ l'^^"°«- We are not aware i^s nr Jnlnrf """T "^ ^'''*^ ^' ^'''''^'^^ ^'^' ^^^^ ^^served to influence Its prevalence in other countries. Symptoms. pn2;!'""-*°. *^-f '^^"«'*^°'? of tlie cervix, and the nature of the tissues Z Tt! T^° ''f ';°'"Po«ition as well as to the slowness with wS ence for a long time without any appreciable change being observable in the anima 's health. Therefore it is that Cows which are so aSted might lead a person to suspect the existence of uterine dfsease m some cases, however, towards the termination of pre^nancv there has been remarked a listlessness or gradually increasing^delihtf which has been so great at last that the animal assumed the "recumbent pos tion and could not get up without assistance. This general weakness to' be dup'^f r^^K '"■ ^^^'fb ''^^^o^ it has sometiines been supposed ipni v^ ° ^'""^*°° '. ?°"°^^ '^ "^^y i^^ve been merely a symptom of ^ But nl''"'T"' -"^'f''^^ '^'' ^^'' ^'''^^ b«i"S the^seat^of dancer But in the great majority of cases, the existence of induration is not suspected until parturition sets in. when the labour pains, wSchirv continue for a long time, attract more than ordinary attent on as b rth does no take place. And not infrequently during the pains and more Ia^dS:f^'?. *^' '""^^ "J>-"^- ^ l'-^- '-«g-I^---Bhaped%nd nX Satf cl^iruTeif^"""^ '^^"^^" '''' ''"^'^ '' '^- -^^- ■' ^h- - the In other instances, however, nothing is observable externallv and a vaginal exploration is necessary. The cervix is then disco ered to bS piotrude into the vagina, and form a voluminous, irregular nodula ed tumour which in some cases feels as hard as wood aud^ir others has a rugged soft, and ulcerated surface. Some veterimuy obstetrists have MOUnW ALTKIUTIONS IN THE OENERATirE OJtOAA'S. 3fl8 constricted, and the fcntus mayZ fl tlrou«h t X "i^ '* " "°' '? is irregular and deformed, deviated ^^8 utualrW.^ 'T-!' walls greatly thickened, perhaps corrurted Its de.r«n T'h''"^^ '*' and thickness will indicate whether and to whnf ilf f •^'*^"T' Diofjnosis. The diagnosis of this condition must bo left, to a larse extent to th. history of the^case n.a/JL^^rtun'lf ttSc'tir"' """ ''"™"» Prognosis. 4^rd":^ljpt™ol7hra£rtii„^^^^^^^^^^^^ £,'':;?; rthrinrat-:\zisr,i'-rr„sip^ :ss;^l:^nirL^!^rTe=S^^^^ i, laceration o, tho'cervix;f;om it^^ne .raTdSatn'"^^ °"^ °' """'= the™Sus''aTerSi:n\^l1or''?rnl''Selri^^ formation and cancerous degenerat"o„-vetTt isaZFt ,, H^Tfu """'■ benignant alteration is inflnTtehmore serious f™,,, t .^f ""P '"""' of view, than simple rigidityS the ee?i x eit ,er in i?sf '"°5 ?°'"' reinotfi vpcinlfa ^ni • r? . ."Vi , ^'^'^vix, eitnei in its immediate or rigidity than induralfon of tlfe "e'.t F^^a^ E^^d '"" V'^^^'l m 864 MATERIAL DrSTOA'/A. Pathological Anatomy. The lesions found after death are generally alluded to as "fibrous degeneration," " scirrhus." or '< cancer %f the cervix ; and itis usuTuv menfoned that this part was " hard and like cartilage," '- croak ngunde^ he kn.fo hke cutting an unripo apple or turnip" or that here was sdnrrus " or " cancer." " noduTar and hard like cartilage." r^in/rS ''^t'*''^^' that when the contraction of the os uteri is the whUe onT; '^:r'V ''r" r^'f^ '^" ^°""^ «^ ^ ^^^^^ fibroid natue ! mn.h'fV I 1''®' l'""?.' "^^^'^ ''^« contracted parts are soft and vor^ uch thickened, acute disease will commonly he found accoinpanvS the stricture " In hard stricture, the transverse rugm or fol s apS mate'riar?,,^' transformed into a compact, unyielding ibro-cartiLglu material , in one very serious case I found six of these hardened unvield ing transverse rugio or folds between the os tincce and os intcrnZr In soft stricture, without any actual disease being present, the contraction ute?r7n"L'°"'T^ *° '^' °^.^"^ '^'^ ^^g^"-l Portion of the 1 tvi^ uteu. In cases of complicaied stricture, or. in other words striof u't, accompanied by some active disease, it will often be found that the stricture is merely the concomitant effect of the disease and si ch s'Trou" ^::T "'" '""°^^ T^'^'^'y P^°- *° b« -*her ulcera ve, schurous, really cancerous, or fungous in its nature. . . . Denosits of a fibrinous nature are only too common in patients of rheumS constitu Treatment. no'dlir?.?l^!°" ?^ ^^^ '"'J''' "^^" ^^'"6 ascertained, there should be tn h. Ift- T-'^l^'"^ ^° ^'^'''^ measures, as it is impossible for delivery to be eflected, in the great majority of cases, without such interference STL I' "?'r^'^ for a correct diagnosis is as we have alrefdy u ged" of the greatest moment ; for if the obstacle to birth is only rigidity or spasm of the uterus, this can generally be overcome by mild measures and without risk or injury to the aninial ; whereas, in induration these measures would be ineffective, and valuable time m'ust be lost in tryh^ Delivery, in induration of the cervix, must be effected by one of two KSriL opeUbni.'°"" ^""'^ *° '""^ '^^^"^^ ^^^^^' '^ ^P^^-^ bt whir'^^^ necessary in this place to say that vaginal hysterotomy -by which IS meant incising the cervix, either ccnplctely or partially in one or more places-does not ofier any very danfeOvons^.o,LSuenr.es when the textures are healthy; though when thev a, o ...„J SeTra"od NeVr?2rdrtin^b°"°"^-\'^ *^°".^^^^°^ '' -* iatal I'suUs! moIhPr «^. '« r ^ ^^ 'f.''''^ ^7 '"^^'^°" ^^ ^^^"^ly so 3e"0"s for the rlfLr th. ! ^«r«^"^"f «t^o" J though the fa>tus may incur more risk, o^rltion fn ITf^^^ ^''" '">"'^' '^ '^ °^'^^^^ ^ t^<5^o^« ^»d diliicul ^-^'bi' mpl5' J'^'"^"'^'. ^"^ '*?"S traction may even be necessary, fhn: I '^'"'^ f^'^ 'i '^^^T^^ of «^vi"g both mother and foetus, it en • 'if /"lu' ^' P^-^fe^reJ to gastro-hysterotomy ; and this prefer- eii.'.. ... .HI ,,a-ther warranted by the fact that the life of the mother is ^ov^'dhJ'Jillf l^r ^^t°^ the fetus, and if one must be sacrificed it ff an ad^m nnir w- ^'^°^^^^*^« f«:tus happen to be dead, then there IS an additional motive in preferring incision of the cervix. MOHBW ALTERATIONS IN Th.: QENERATIVE ORGANS. 866 When the os has been considered sufliciontly dilated for the intro duct.on of the hand and arm into tho uterus, then tr'a-tus shou d be AUho same fmo, jud.ciou, traction should b^ „,ade ir!„V^o ,nZ„ai ,. tte' y™ ^T- ™''.''?"o others, have witnessed fatal h ^ ^^T^^^' ^^^^^ ^-"e"" -vS mence 1 and tl^^vi^.v.- ^^^^ ^•^''^ ^^^P'«^ ^^'^^^ parturition com- siSed"" htl?^ sr3ZT„!raf\:»i'^i;r'^rXre™ wUhott delay." ' '°''""*""'' "^ ''"'"°" """'"' ^^^^"^"^ i. Com-LETE OllLITEKATlON (AteESU) OF THE Os tiTEHI Sheep condition has been observed in the Mare, Cow, and Causes. the^wtotnf'T-^' ^"' to agglutination of the walls of the os, cLrTciifZuP f..''"°''' membranes or bands, the development o aS et ' ^°" ^°""^^' "•• ^"^^"^^ «^^*^i"«d i" previous preg- id 366 MATEKXAL LYSTOKIA. I SymiHovis. These r.-e, of course, the usual external symptoms of retarded parturition Internally, the hand, on being introduce,! into the vagina anu pushed towards the cervix, comes in contact with a round smooth, and tease, but fluctuating tumour at a variable distance from' the vulva, or even between its labia ; the fcctus can be felt through this tumour, and this might lead to the supposition that this is the " watev. bag. Jiut on passing the hand to the base of the tumour, instead of finding the borders of the os— as we should do if it were the fojtal membranes— there is discovered a circular furrow, one side of which is the extremity of the vagina, and the other is continuous with the tumour— which is the posterior segment of the uterus pushed into the vaginal canal. On the surface of this tumour may be found a small imperforate depression ; in other instances there is a kind of prominent ring like the top of the neck of a bottle, but without an opening- this IS the cervix. In other cases no trace of the cervix or os can be distinguished. Results. If relief is not afforded, the mother may die from exhaustion or rupture of the uterus; or a rupture may occur through which the foetus and its membranes will pass, and the mother survive for a longer or shorter period, constituting a case of extra-uterine pregnancy Or neitlier of these results may happen, but after a certain time the labour pains and the other indications of parturition subside, the dead foetus IS gradually desiccated a'-, the fluids surrounding it become absorbed and the pare it does not appear at all amiss, its condition bein^^ per- haps only accidentally discovered, either when it dies or is killed lon<' afterwards, or when the remains of the fcctus begin to be expelled in a vicarious manner. ' Diagnosis. The diagnosis of this condition must be based on the signs just alluded to The only other anomaly, perhaps, with which it might be confounded is deviation of the uterus, in which the cervix maybe tilted up towards the vertebro-sacral angle, even almost beyond the reach of the hand. The position of the cervix and os tine* should be the "uide m diagnosis. ^ Treatment. As in induration of the cervix, so in atresia; delivery must be eti'ected by incision, or puncture if the os is found to be obstructed by super- ficial fibrinous bands or membranes. For the latter, the extremity of the finger or a metal catheter may sullice, the pressure being gradual and the movement semi-rotatory. The bands may, in rare instances be ruptured by means of the finger-nails or divided by scissors If' however, the resistance is too great, and the os is closed either throu-h the production of cicatricial tissue or other morbid alteration, then it will be necessary to incise it as for induration, and in the way to be hereaiter described. But if the OS is obliterated and the cervix cannot be found, then the portion of the uterus which protrudes into the vagina must be incised and the foetus removed by this artificial opening. With this object iiuberc recommends a convex bistoury, the blade of which is covered OTHKIi CAUSES OF MATERNAL DYSTOKIA. 367 e signs just to within a few lines of its point. The instrument is to be directed to the part where the os is supposed to be; then the coats of the utfrus are to be carefully incised to a small extent— layer after layer until the escape of the liquor amnii announces that the fcotal membranes ara opened. The small slit thus made is to be enlarged by a probe-pointed bistoury— the enlargement being either crucial or T-shaped. Then the foitus is to be extracted. Hubert has performed this operation once on a Sheep, and a shepherd by his direction also performed it on another Sheep, and in both cases the result was favourable for mother and offspring. CHAPTEE IV. Other Causes of Maternal Dystokia. Thehe are some other causes of Dystokia which, though comparatively rare, yet deserve the attention of the veterinary obstetrist, and will complete our notice of the maternal obstacles to parturition These are: (1) Anoviahcs of the placenta; (2) irorbhl adhesion between the f^tus and uterm; (3) Stricture of the uterus hy external bands; (■4) Persistent hymen ; (o) Vaginal and vnlvar atresia. 1. AXOJIALIES IN THE PlACENTA. We are but little acquainted with the morbid alterations of the fcctal membranes of animals, and of those changes which leid to their more or less permanent adhesion to the fcetus and the icterus The subject appears to have received very little attention, and the observa- tions are so few that Saint-Cyr makes no mention of these adhesions as a cause ot dilhcult or impossible birth. It is very probable that animals are less subject to disease of the uterus and the placental membranes thiin the human species, and this would account to a certain extent for the absence of notice of such occurrences. Neveriheless, that animals are disposed to metritis, endo- metritis, and perimetritis, no one can deny; and that we may also have such anomalies as hyperplasia of the chorion, as well as rayxomata ot that membrane, in addition to new formations of the placenta as well as placenhtis, might be expected. But, as we have observed there IS indeed but little direct evidence to prove that any of these morbid conditions ever exist, thougli some of them at least may lead to abortion, while others might give rise to obstacles which would retard or altogether prevent birth. Scirrhous Chorion. According to Cox,i scirrhous chorion is occasionally met with in animals, and proves an obstacle to parturition. The membrane is found to be separated from the uterus, and envelops the fcetus as It xv;ere, in a leather bag, no part of the creature beincr distinguishable. This is probably the condition known in woman as myxoma fibrosum placcntcv,. The labour pains are seldom violent, though the fa'tal membranes 'I if {n^^^^yj I Veterinary Journal, 1877, p. 105. H! ,1 ' W ) El i |i 868 MATKRNAL DVSTOk'IA. (water-bafi) cannot bo expelled into the vagina, even when the os uteri offers no obstacle. An early examination is necessary, as the foetus soon perishes. An incision must be made through the cliorion, and the foetus extracted. 2. MoiiiUD Admksion uetvvken thk F(etus and Utekus. Adhesion between tlie uterus and its contents may be duo to in- flammation of a portion ot the mucous membrane, to hyperplasia of the chorion, or to disease of tho ovum or placenta, by which the two latter are brouj^'lit into direct contact with tho interior of tho organ. Or it may bo owing to a deficient quantity of liquor amnii when tlie foetus begins to be ft inod ; for if the amnion, in the course of its development, is not separated from tiio growing faitus by a suOicient quantity of fluid, connection between thorn is almost certain to be established oitlior in isolated spots (Simonart's "bands"), or over a wide surface. Adliesion between the amnion, chorion, and lining membrane of tlio uterus, is then not only possible but probable, and in this way the foetus is brought into a solid union with tho maternal organ. It can readily be understood that such an occurrence will prove a very serious ol)stacle to birth, and greatly endanger the life of the mother. Eainardi furnislies us with two observations, a writer in the Vetcrinarii Journal (" Nemo ")- with another, and Naylor' with two. liainard justly remarks that veterinary surgeons should be aware of the possibility of such adhesions, either with tho placenta or the envelopes, and, through them, with tho uterus ; and that they are otherwise easier recognised than those external to the uterus. The hand, introduced into the uterine cavity, is passed over its inner surface, around the fuitiis, as it were : and by this means the existence, seat, extent, and resistance of the adhesions will, in the majority of cases, be ascertained. When the adliesions are situated towards the fundus of tlio organ -its most distant part, and where the hand cannot reach, then there will be dilliculty ; but this must be overcome by raising the uterus and throwing it backwards, by elevating tho front part of the animal's body, and lifting tho abdomen by means of a plank, blanket, or yack. Most frequently the adhesions can Je broken up by the fingers ; but if they are too strong, then a bistoury or other convenient instrument will ha\o to be employed. Their incision must be carefully made, and the " crutch" or " repeller " (to be hereafter described) will be useful in keeping tlie hvtus away from the part where tho separation is being effected. The cutting should be done gradually and steadily, tho point of the instrument being kept at an equal distance between the foetus and the nmcoLis surface of the uterus. In alluding to tliese internal adhesions, it may be observed that some very rare cases are recorded, in wliicli parturition was opposed by external adhesions between the peritoneal covering of the uterus and the sac of a hernia, or neiglibouring viscera. '^ 7'rait,' Cnmpkt de la Partuvilioii, vol. 1., p. JOl. - Veterhwrii Journal, vol. iii., p. 202. ■' Vi'terimirlan, vol. xxiii., p. 3'21. OTHER CAUSES OF MATERNAL DY^TOKIA. S6» 1 the OS uteri 3. Stuictuke oh Occluhion of thr Utkrus by External Bands OH Mi;m]5Hanes. A number of writers, especially in foreign periodicals, have described the prestmce ot bands or membranes external to the uterus— either in the peritoneal cavity or vagina— obstructing the passage of the fcctus and rendering birth almost, if not quite, impossible without an operation. With regard to the treatment of these cases, but little can be said. When the bands are m the vagina, tlieir division is the principal object, after which, if no other ol)stacle is present, delivery can take place When, however, the uterus is constricted by an external abdominal band— tl:ough this condition will be difficult to diagnose— then probably no course can promise anything like a successful result except the Giesanan section. 4. Pehhihtknt Hymen. At p. 30 there was described a wide duplicature of the lining mem- brane of the vagina which covers the meatus urinarius, and which k)ok3 like while it acts as, a valve ^mlvala vaginoi) to that opening This membrane, whicii stretches across the passage and separates the vulvar froin^the vaginal canal, is the analogue of the hymen of woman- and, as in ner, it may persist after the impregnation of primiparte— having escaped rupture during coitus— and becoming abnormallv rigid may prove an nnpediment to birth in some instances, though it must be confessed they appear to be exceedingly rare. Tills cause of dystokia should be very much less frequently met with in the Lqume and Asinine species than other of the domesticated animals, in consequence of the size and conformation of the male organ of copulation, from which the membranous vaginal partition can scarcely escape rupture, when it is present, which is only occasionally i ^'"\*^?.,f°v'"^'^^aP^^'°e, Ovine, and Porcine species, however, the case IS different, as the penis, from its volume and shape, is far less ikely to lacerate the hymen ; and it is in the Bovine species alone that the persistence of the latter at parturition has been found— at least so far as published observations show ; and in all the instances the animals have been young and primipara3. It is just possible that in many animals of these species, the hymen may be more oi- less intact until parturition sets in, when the fcetus in its passage through the vagina, ruptures and effaces it without much delay resulting, or any other cause which might attract attention Bui in others— few though they be— the membrane would appear to PrrnJ!"! ^^""""^ 'l'.''"^'''-! *° *?" ""^^ f^ceptionally pre.sent in the Mare, though it is an evTorto assume that .t is always absent. N .t only is it sometimes to be found and occasionally o large size a.ul extraordinary tenacity, but it may even become a source of Bm h (l. h Injhcence of Food— There is no convincing proof before us that the ^ Op. cit., p. 247. * Veterinary Journal, vol. iii., p. 33G. EXCESS IX I'OLUME OF THE FlETUS. 377 us cause. us that the Zhnl t tf'""^ °' '""'^ "f ^''°^^ '^^^ '"""h influence on pregnant an nals 80 far as excessive volume of the fciitus, and consequent dilli- cult parturition.js concerned. ouyueni uuii Cox' says condition ys The size of the foetus depends considerably upon the nn^ f» ^''^'^i'' """'^ *''" '^'"^ °^ ^«°d given to it. Fat animals and those emaciated from the continuous use of food of a i.oornature or insufhcient in quantity, bring forth a small foetus. Where te Se- c£l a'ndtl^ rP''^"'"^''-'^"' t''' '''' ^«- «'^- ^f a nutrmous nromr .o,.?tl 1„^^^^ '/^^ ?^''"« ^^""^ P'^""^' '''" ^"^^us will be dis- S7h rS f ^-?' ^^" i"'^'^. nutriment having been diverted to its fn7nff;,- r^' o*^; depasturing,' causes the fcEtus to grow rapidly and atta n a great size ; but Nature compensates for this by giving with Tthe olaSnf 1 V'-^f r.°? the tissues of the dam. and an inci^se of the placental fluids to lubricate and assist at delivery." Diagnosis. nJ^hfy!'°^-\''i''''''''^^''''' ^°^"'"^ °^ *'^e foetus is fli'licult. and can only be established as a rule, at parturition ; for we do not possess Sr'e'lroSn'-^' ^^PP^T'^*'"« t^^^ dimensions of the fcutH o An unusual size o^/'i?, '"'^'f'^T uf'' '''^'''''''^ ^"^ '^' «« ^^ dilated. preCancv isannn. V'-'^'*^''?^ ^^'^"Z""" '°^^^^^^^ ^^e termination of pre nancy, is an uncertain and very often a deceptive sign ment mi:.hf^!™^" vetori^narian, imagined tiiat this excess in develop- ment might be ascertained by weighing the animal during pregnancy With regard to the Bitch, he thought there was danger when the weight was increased by two-iifths during tliis period he normal in cr1a^^nTfi^'^°"t*^^i^■'• ''''\ '' '^ evident 'that Itordhre n-' crease in weight may be due to other causes than the f«itu3 or fcetuses t"^c f ;,n ^'^ ""^^"^1 «"'"ber of these, an excess of amniotic or aUan! toic fluid, greater obesity of the Bitch, etc. Otherwise, if this test Zt^'f ^PP>'^ 'V^'' ?''''^' ''''^' P^-^«*i«'^l results, the conclusions Se on Tv'iit '°"\^ ^°^ ^? "?^" applicable to the other animals lonoation i^L " "" k' "^^'f- ""^ht give rise to suspicion, is the pro- ongation of pregnancy beyond its ordinary period ; though th s suspicion iTis onfv'';?'' '"'^l "«^^l^^'-.>-' "«^- y«t very often, be confirmed. ' It IS only then, at parturition that this obstacle on the part of the foetus can be ascertained. If at this time, in spite of ener^Sic and sustained uterine contractions, labour is protrLted and does not to rwI'lH.^ '^ T ^f ^°^^^T l^'' P^^^'^ ^^^ g^^i^^l organs are ound Tos^dri ^0?^^"°^'"^ '. *^^ OS dilated, the foetus fn a favourable Kh k dpni^" . "" f,!™f'^' '^ ^"'^y ^^ suspected that the obstacle to S p Ob ibTlnfi °" .' ^'''"'■'^'' °^ ^^'^ ^^^^''- ^ ^lo^^r examination win pioDably conhrm this suspicion. .rJI;* n *\'f ^i^''''. ^^'^ principal obstacle, as has been already said is Sent L^^^^^^ of the Puppy, which, when it is large, is fodged a the entrance to the pelvic inlet, where it can be touched per vaginam. fecundXd r";^''? ^'^fv: ''''^' "^^"^^^ '""^'^ °^- ^'^'^ elongated, when Shot l^ r V^' '""''V'' ""^^ conformation, a'^id bHnging Tt tap°Tn.or conSl f-r"f'.^' ^'^fy-o difficulty in pupping! entlrtC^t?. J " "^^^'^ '"'''^^^^'^ "^ ^^^ Puppies allows it to u?erine and n J' • "^, ^^'l ^""''^^ *^^'°"-^^' ^^"^er the influence of the si^e a^,d 1 ,= I ''^^ contractions. But when the Bitch is of small si^e, and has been impregnated by a larger and young vigorous Dog, 1 Veferinari/ Joimia!, vol i., v. '26'). J: 1 ,, ri* ' ' 'I V I s; I. r i^ II l-'l "1 1 1 F, < I 378 F(KTAL nVSTOKlA. .' li 1^ and espooially if tho tnuz/le of either or both of tho parents is short and tho cranium brachycephahc — as in tho Kin"? (Hiarlos Hpaniols, Pugs, and liull-dogs-- parturition is oftontiinos oxtreinoly dillicult, as tho forehead in these breeds is very largo and cylindrical. This diffi- culty, as has been mentioned, is increased as the number of Puppies is small, as then the latter are more developed. With tho Cow, tho head of the ('alf may also bo tho chief impediment, and provided the young ereatin-(« is otherwise in a favourable position, tho mullle may pass through tho inlet, but the remainder of tho head remains fixed like a wedge in tlu; long and almost undilatablo bony canal. Tho head is often so firmly wedged at this part that it can scarcely, even with much force, bo advanced or pushed forward, and this " wedging " is always ono of tho most serious dilliculties which the obstetrist has to overcome. With tho Marc, the head of tho Foal is smaller, longer, and more tapering than that of tho Calf, and meets with much loss resistance in passing through tho comparatively short and wide canal. iJut as Saint-Cyr points out, and as we have previously shown, in tho I'iquino and Bovine species tho young creature thids more dilliculty when the anterior part of its body — chest and shoulders — begins to enter this part ; and from their respective dimensions it is evident that, oven under ordinary conditions, the anterior region of tho foetal trunk must submit to a certain degree of diminution in order to pass the pelvic inlet of the mother. Tho limits within which this diminution is coiiinatiblo with physio- logical parturition are not yet perfectly ascertained ; though there can be no doubt whatever — for we have facts to prove it — that the develop- ment of tho young creature may bo so exaggerated that sutlicient reduction cannot be effected to allow of its being born. In some cases the head is so largo that it can scarcely pass through tho pelvis of the mother ; but it is generally the thorax that forms the greatest obstacle — especially in the Cow, and if it is to got through the genital canal this is the part that has to undergo most reduction by compression. In other instances, and especially with the Foal, the passage of the croup presents the greatest obstacle, and the ditiiculty may even be serious. Prognosis, In such cases as those we are now studying, in which birth is delayed through undue development of the fcotus, it generally happens that the membranes have ruptured and the liquor amnii lias escaped at an early stage ; consequently, the maternal passage is dry and tenacious, and perhaps swollen and irritated ; while the foetus, no longer protected in its hydrostatic bed, is directly exposed to the uterine contractions, and in proportion as those are energetic, so does it the more rapidly succumb. The mother, in turn, becomes exhausted through unavaihng efforts at expulsion, and if judicious assistance is not opportunely rendered, is not long before it also perishes. It will, therefore, be seen that a prognosis in such cases of dystokia cannot always be of a favourable kind, as very often the death of the tcetus, if not of the mother, has to be taken into consideration. More particularly is this the case with the smaller animals— and especially the Bitch, though, as has been shown, the larger females, if they do not die so frequently, yet are not exempt from danger. KXCESS ly nRDH'TU OF /fAIJi. 379 Iiii/icdtions. Tho indications for tho trcatinont of thoso cases anj similar to thoso given for constricted or contracted pelvis: (I) Extraction of tho fo'tUH entire by nianipiilation ; (2) Konioval by embryotomy ' Extraction of the J'',rl,ts ciitire.—U tho "waters" have escaped I. or any length of time and tho parts are dry and viscid, warm emollient tluulH— as linseed-tea-should be injected into the vagina, and if neces- sary the portions of tho fcutiis presenting may be lubricated with glycerine, oil, unsalted lard, or any other lubricant. Tho hand should then adjust the fd-tus, if this is requisite, and attempts be made to extract it by judicious traction— cords on the head and limbs, and other accessory means to bo hereafter described, being employed aa occasion demands. Tlie degree of traction will depend upon tho amount of resistance to bo overcome it being carefully borne in mind that a medium degree of torce well directed is often more effoctive than severe traction niia- directed and inopportune. For this reason it is that a careful adjustment of the fcctua should be made before any force is resorted to, tho " wedged " portions being '' eased "and well smeared. It not unfrequently happens that a very trilling displacement of the footus will allow it to pass gradually through tlie pelvic canal, and lead to the successful termination of a case which otherwise many would consider impossible to deliver. 2. Embryotomy. —V^hm forcible extraction is deemed impossible, or dangerous for the mother, and when the latter has ceased to aid ia expelling the fcctus, then the only alternative is embryotomy, which, entailing as it does the destruction of the progeny, yet aftbrds the only chance of saving the parent. The operation will be described hereafter. In the meantime it may be noted that if the obstruction is due to a arge head, this must be removed by decapitation ; then if the thorax bo also found too voluminous, perhaps a slight half-screwing movement of this part, coupled with traction, will move it outwards. Otherwise the body must be taken away piecemeal. In the Bitch a similar process is resorted to ; if the head is too large to pass through the pelvis by means of any of the apparatus to be here- atter described, it must be crushed in every direction by forceps ; then, It extraction cannot be eaected, the Caesarian section is the last resource. Excess in Gkowth of IIaij*. The only instance of this cause of dystokia I can find is that recorded by hberhardt,' of Fulda, who found a Cow unable to calve, and on examination discovered the fcBtus fixed in the genital canal, the presenta- tion and position being normal. A careful examination discovered no other obstacle to birth than a most unusual quantity of long, thick, shaggy hair— which was quite dry, from the waters having escaped some time previously. This offered most resistance at the upper part ot the vagina, and so great was it that the foetus could not be moved. Having secured the fore-limbs and head by cords, Eberhardt smeared ms hand and arm well with grease, lubricated the passage thoroughly, and rubbed the hair plentifully with the same material ; then by suitable traction and manipulation birth was readily effected. 1 Deutsche XciLschrl/t fur Thiermedicin und Venjlekliendt Patholoijie, 1877, p. 299. I 380 FUiTAL DYSrOKlA. 'T ■ f II Anomalies in, and Diseasr of, the Fcetal Membbanes. It is very rare indeed, so far as published observations are evidence, that anomalies in, or disease of, the fcctal membranes prove an obstacle to bii-th. That they may sometimes do so, however, is evident from what we have previously described. As Franck justly remarks, it is not unhkely that the retention of the foetal membranes after birth is du3, in many cases, to inflammation oi the j^lacenta (2)lacentitis). A not unfrequent condition of the membranes is congestion of, or extra- vasation into, the placenta, rupture of the capillaries {ca»illary apoplexy), and luemorrhage between the placenta raaterna and placenta uterina. Partial separation of the two placentas is also not very un- coimnon in the Mare ; and metrorrhagia may be due, at times, to placenta pnevia. Such hicmorrhage, wlien it occurs in the uterus (see Fig. 53, p. 88), and the blood mixes with the uterine milk, gives rise to a chocolat'i-colourcd iluid between that organ and tlie fa3tal mem- branes ; and in the asphyxia and intra-uterine respiration (pulmonary) of the foetus, this reddish-coloured fluid is often present in the lungs. Ilartmann alludes to a case in whicli the chorion papilluo of an aborted Foal were small, pale, hard, and cartilaginous; and Broers^ describes two foetuses in the uterus of a Cat, on the inner surface of the membranes of one of which were numerous vesicular extravasa- tions, while the other could scarcely be recognised. It may bo surmised that many abortions or fcetal deaths are due to disease of the placentas. The foetal membranes may bo too thick and resisting, or too tldn and friable. In the first condition, they resist the labour pains too long, and after the os uteri is completely dilated they may be found intact outside the vulva; the fcetus may even be expelled in them. Such tenacious membranes may, to a certain ex Lent, hinder delivery — though they seldom, if ever, produce dangerous consequences, except to the foetus. Very thin membranes may, on the contrary, not resist the uterine contractions for a sullicient length of time, and therefore rupture before the OS is sulTiciently dilated. The consequent escape of the " waters " will render labour longer and more dillicult. The utoro-vaginal canal is dry and retentive, and the contractions of the uterus are weaker and much less effective. The treatment for both of these conditions has been already indicated. At p. 308 we alluded to adhesions between the foetus and its mem- branes, and the uterus, as a cause of protracted or impotent labour. We have now to refer to adhesion of the membranes to each other, or to the ftt'tus only, as a cause of dillicult labour. These adiiesions are generally of the nature of fibrinous bands passing between the membranes, or from the surface of the young c-eature's body to the interior of its envelopes, due to the development of some local inflammation. Such cases are certainly rare, but their occurrence must nevertheless be taken into account. Rainard- mentions an instance in which a hairy band or cord attached the envelopes to the head of the foetus — a shred of skin having prob- ably been partially detached from the forehead, from a kick received by ' Caustatt's .Tahresbericht, 1861, p..*),". •^ Op. cit., vol. i., p. 492. DISEASES OF THE FCETUS. 381 the Cow some time previously, and, becoming fixed to the membranes, formed an obstacle to birth. Vincent describes a very interesting case, in M'hich the skin covering the joints of the first and second phalanges of the right fore-leg of the fa3tus had contracted close and strong adhesions with the envelopes, and these with the uterine mucous menbrane. These adhesions opposed a serious obstacle to birth, which could not be accomphshed until they were broken up by the fingers. Adhesion of the mem])ranes to the uterus does not always prove an obstacle to spontaneous delivery, however. Indications. Adhesions, when they exist and are a cause of dystokia, and when they can be reached, must be broken up or cut through. In the majority of cases, the fingers will suffice ; if not, then a bistoury must be used. Difiiculty in parturition in the Cow is sometimes experienced from the envelopes being torn in several places, and the head or limbs, or both, passing through these fissures. In such cases the entangled parts of the foetus must be sought for, released, and brought into a favourable position by tearing or cutting through the obstacles. AimouMAL Quantity of Placental Fluid. We have already described the condition known as " hydramnios," and have pointed out that when it exists abortion nearly always takes place. When the accumulation of fluid interferes with parturition, labour is slow and delivery difiicult, owing to the great distention of the uterus and the pendulous state of the abdomen. The indications for treatment have been given at p. 186. An unusually small quantity of the Hquor anmii, when it is not due to premature rupture of the envelopes, has not, to my knowledge, been mentioned as a cause of dystokia ; though there is no reason why this deficiency should not lead to protracted labour, if we call to mind what has been said as to the uses of this fluid. The indications will be the same as for those cases in which the fluid has escaped prematurely. ■i CHAPTER II. Diseases of the Foetus. While in the uterus the foetus may be affected with disease, which, causing Its death, will lead to abortion or premature expulsion, or per- haps undue retention. Other abnormal conditions, more or less allied to disease, may give rise to vicious conformation or excess of volume generally or locally, and thus prove a cause of difficult parturition' ihe.j conditions may produce hydrocephalus, ascites and anasarca, emphysema, polysarcia, muscular contractions, and tumours of various kiudy. HYDEOCErHALUS. As the term implies, " hydrocephalus " signifies dropsy of the brain, the dropsy being constituted by the accumulation of a more or less con- 382 FCETAL DYSTOKIA. li ft' m ■At 1:1 fll siderablc quantity of fluid in tiie cranium of the fcxitus, leading to a proportionate enlargement of that region. This diseased condition is not at all uncommon in the Bovine and Equine species, and some of the specimens of craniums found in museums are wonderfully deformed, tliroiigh the accumulation of fluid in their interioi'. Patholofjical Anatomij. Tliis diseased condition is recognised by a more or less exaggerated development or volume of the cranium, the vault of whicli has been elevated and distended by the iluid collected in the brain ventricles. In some cases tlie distention has been so slight tiiat the frontal bones are not much raised ; while in others the collection of serum has been so great that these and other bones of the cranium are displaced, and the forehead— rising almost at right angles to the face— suddenly reaches an extraordinary height, giving the creature a startling appearance. Tiie hydrocephalic tumour varies in shape as well as in volume. It is sometimes quite globular, and protrudes so high and so much over the Fig. 96. yKLLl, or A irYDIUlCKI'llAI.U; CaI.F : THE Cl'ANIAL BONKS AUK TARTIALLY DKSTUOVKI) AM) DKFKUTIVK. face, as to give the physiognomy a strangely human appearance (Fig. 99); in rare cases it is narrow, but excessively protuberant, involving only a part of the cranium (Fig. 100); at other times it is bilobular, and the divisions may be either alike or unequal in volume. Not unfn quently tlio diameter of sucli a tumour in tlic Calf measures more than a foot. The tumour is soft and depressible in parts, ha^-d and resisting in others, owing to the bones of the cranium being altered and separated in places. These bones— and particularly the frontal, temporal and parietal— are, as a rule, considerably deformed and thrown out of their natural posi- tion, and in places so expanded and rarified as to bo no thicker than tissue-paper ; when the internal distention has been very considerable, so that their borders do not meet as in their normal condition, but are often widely separated, leaving between tliem vast fontanella; occupied only by a thin translucid int-mbranu— tlie durd mater, which is in im- mediate contact with, and adheres closely to, the skin. In some instances — especially in the Calf — the bones in their upper part do not join at all, and the roof of the cranium— or, rather, of the leading to a e Bovine and d in musuunis fluid in their 1 exaggerated ich has been I'entricles. frontal bones am has been isplaced, and denly reaches appearance, jlunie. It is ucli over the // VDJIOGEPHALUS. 383 cranial tumour— IS entirely absent (Fig. 97). In other instances, and particularly in the Foal, a kind of bony arch extends from the nasal to the occipital bones, in the direction of the saggital suture, with only here and there, on each side, small osseous patches from the parietal or temporal bones, which adhere to the dura mater. rig. 97. Skull op a IIydrockphalic Calf : the Roof of thk Ckanium in absknt. The tumour is always entirely covered by intact, though sometimes very thin skin, to which the hair is ordinarily attached, and is indeed at times longer than usual, especially at the sides. This often makes the animal appear as if it wore a high fur cap (Fig. 99). Owing to the great development of the forehead, the upper jaw appears to be shorter than usual ; and, indeed, it will be found that it is rcallv so (Fig. 96). "^ PARTIALLY nee (Fig. 99); Diving only a alar, and the unfn ,|uently than a foot, ling in others, ted in places. )arietal — are, natural posi- thicker than considerable, ition, but are iWva occupied ich is in im- . their upper ather, of the Fig. 98. Skui.l of a UrnKotKi'HAi.if Foal: thk Cranial Rooi' ih Dki'icient AT THK HlDlCS. When the cranial cavity is opened and the dura mater incised, there is found a quantity— varying with the dimensions of the tumour— of limpid, colourless, or slightly yellow or greenish serum. The quantity of fluid varies considerably, but it is generally from two to four pints in tlie Foal and Calf. Rainard estimated the quantity of fluid that had been contained in the skull of a Calf sent to him, at two 384 FCETAL DYSTOKIA. and a quarter litres— the largest quantity he had met with. Drouard however, in 1842, published the details of a case of a Foal whose cranium held four and a half Htres (about eight imperial pints). Fig. 98 represents a Foal's skull, now in the museum of the Lyons Vetermary School, and which, from its dimensions, Saint-Cyr calculates to have contained eight litres (about thirteen pints). Kopp not long since exhibited the head of a Foal before the Veterinary Society of Alsace, the diameter of the dropsical cranium of which was fourteen inches, and which, it was computed, would ccaitain about twelve Htres of fluid (more than two and a half gallons). And Quesnel has also shown a skull of about the same dimensions, to the Veterinary Society of Calvados et de la Manche. Mr. Olvevi describes the cranium of a hydrocephalic Foal which measured thirty-six inches in circumference, ten inches from one orbit to the other, and twenty-seven inches from the occipital crest to the nasal bones. At least twelve pints of fluid were contained in the cavity, and the cerebral substance remaining was quite disorganised, the dura I iiUi Fig. 99. Calf affected with Hydrocephalus : its Skull is represented in Fig. 97. mater being much thickened. The cranial cavity was almost wholly surrounded by bone ; the only portion which was only enclosed by skin was a space about four inches in circumference at the top. In the Museum of the Munich Veterinary School is a skull, the cranium of which measures nine by eleven inches in diameter. Professor Lombardini'^ speaks of the head of a Calf, the cranium of which was more than fourt en inches high ; it was eight and a half inches long, and four and a half broad. This Calf, with two others- well formed — was aborted at six months, without any injury to the Cow which was six years old. There can be no doubt that if the full period of pregnancy had been reached, this Calf would have proved trouble- some to extract. But these latter are quite exceptional instances, and are three four times larger than those usually met with. ^ Veterinarian, 1874, p. 481. ' Giomah di Veterinaria, 1873. DISEASES OF THE FCETUS. 385 This accumulation of fluid takes place in the ventricles of the brain, as has been ascertained from dissection by Rainard, Taiche, Chouard, Axe, and others, who have found the tumour formed externally by the skin, and internally by the membranes of the brain, to which adhered a thm layer of cerebral substance. The spinal cord, plexus choroides, and cerebellum, have been generally observed to be intact, and only the cerebral hemispheres are destroyed more or less completely. Though this alteration, or rather destruction, of the brain is of so serious a character, and though it must have begun at an early period of uterine life, yet it does not appear to have much influence on the development of the foetus ; as this is usually found to be full grown, its skin covered with hair, and well formed everywhere except in the head. Exceptional cases occur, however, in which development is arrested ; as in some mentioned by Lecoq, of hydrocephalic Calves whose limbs were atrophied and the bones cartilaginous. If intra-uterine existence can be maintained by the hydrocenhalic foetus until the period of parturition, it generally perishes during birth or soon after— usually after one or two respirations. In some excep- tional cases, however, such creatures have lived to the eighth day after H ! •5 i I 1 !■<' Fig. 100. Extraordinary Dkvklopmknt of thk Craml.m ok a Hydrockphalic Calp. birth, and they may survive even longer if the dropsy is not very ex- tensive. In the most favourable cases, nevertheless, there is little profit to be exjiected from keeping such animals alive, as they are ordinarily weak and thrive badly ; they can rarely stand, and they refuse the teat, being usually in a semi-comatose state ; if the tumour chances to be pressed u])on, the young creature becomes completely unconscious and lies in convulsions. Very few cases of recovery, even in the mildest form of the malady, ai'e recorded. The obstacle this congenital condition of the foetus presents during })ii'th, must, of course, depend upon the volume of the cranial tumour. The birth of a hydrocephalic foetus often takes place spontaneouslw though perhaps only after much straining. If the crauium is not veiy large, and provided the labour pains are sufficiently energetic and the position favourable, the tumour yields, and the head becomes elongated in its passage through the os and the pelvis, or it may rupture internally and the fluid escape by the ears, nostrils and eyes. "When extremely 25 t !■ K IhiMt. 886 FiETAL DYSTOKIA. ! i large, the cranium may offer an invincible obstacle to spontaneous delivery, notwithstanding the most powerful labour pains. And, besides, the mechanism of parturition in such cases varies with the presentation— anterior or posterior. The head of the hydrocephalic t'ootus being more or less spherical — instead of conical, as in the normal condition — it results that this part, when the young creature is pressed upon by the uterus, no longer acts as a wedge to gradually dilate the 08 uteri. The head certainly commences tlie work of dilatation, but in a very incomplete manner, and when the jaws— particularly the upper one— have cleared the os, further progress is checked by the voluminous forehead. If the hand is introduced into the v::.gina, the cervix uteri is found to be contracted on the f; '-svs of the foetus ; and the delay in further expulsion depends u^.) si/e of the cranium, the pro- trusion of the uterus into the pel. avity, and the exhaustion of the organ by futile contractions. In the posterior j)i'esentation, birth takes place in the manner already described; the hinder extremities advance through the os, then the body and neck, and birth is apparently taking place satisfactorily until the head reaches this aperture, when further advancement is stopped — the resistance to expulsion being in proportion to the volume of the head. Not infrequently, with such a condition of the footus we have also a malposition to complicate matters. , DiiK/nosis. In the anterior position, there is not much difficulty in diagnosing the presence of hydrocephalus ; as the hand can feel the voluminous spherical cranium beyond the muzzle and eyes, with the ears on each side, and its unequally resisting surface— hard in some parts, soft or fluctuating in others. When, however, there is a malposition of the ftrtus, then it is sometimes more diflicult to discover the hydrocephalus ; and often this cannot be done until the position is remedied. The head should be sought for in every case, and it will be recognised by the mouth, eyes, and ears ; after which the size, consistence, and form of the cranium can be estimated by passing the hand over it. In the posterior presentation, hydrocephalus has been recognised while the foetus was still in the uterus. The greatly enlarged head may be felt per rectum, or even through the abdominal walls. But, as a rule, it is only at an advanced period of labour, and when the body of the young creature is already beyond the os, and perhaps without the vulva, that a difliculty is discovered and the cause sought for. In such a case manual exploration is necessary, and this should bo effected, if possible, by passing the hand between the footus and the wall of the vagina. This is diflicult if the body is still in the passage, and it may be requisite to liave recourse to traction to witlidraw it therefrom. If, however, it is beyond the vulva, then the hand can be easily passed along the neck as far as the head, when the real state of affairs can be discovered. I)uUcatio)ts. The indications for treatment in cases of dvstokiafrom hvdrocephaliis alone, without reference to such a complication as malpo*sition of the foetus, are few and simple. When the hydrocephalus is not considerable, judicious traction will often accomplish delivery ; and several cases are on record in which i spontaneous es varies with hydrocephalic in the normal uro is pressed illy dilate the itation, but in rly the upper le voluminous :;ervix uteri is and the delay uin, the pro- iustion of the anner already OS, thou the 'actorily until i is stopped — le of the head. e have also a iagnosing the oxis spherical ach side, and >v fluctuating (jutus, then it s ; and often head should mouth, eyes, the cranium 1 recognised larged head Us. But, as 1 the body of without the or. s should be tus and the the passage, withdraw it ;iand can be real state of drocephalus iition of the raction will 'd in which DISEASES OF THE F(ETUS. 387 I'Wls and Calves whose craniums were of large size and full of f1n,Vl tSrt'wJ S^^^^^^^ 'f "^'^ "^^^"^' ^°"- °^ th'-Xe "andtn he'^ s-' tenor as well as the anterior presentation. In such a case, supposinor the ore-feet present, these should be secured by cords, the eSof wh ch may be given o an assistant; then the hand should be introduced into o? an'o'Z: :"^'f "«--rT ''^"^/^ ^^°"^'^ ^^ ^^'^^*-i sulliciently to alow ot another cord bemg fastened on the upper, or nerhans hotfpr ThI '^^7l^^t''' ''''-'■ ^'-^^^ then^tee^J^ '^ ofSeh"e^id°3TiJ'''*^r^'"K""*^ '"■'^'''^ delivery because of the size be Dunoh irl '*'"' 1' becoming exhausted, the cranium must '::^^^^^:^:^:^:'-- '^^ ^^^-^^^-^^"^^ - ^"^^-^' ^^^ The puncture may be made by means of a bistoury, a scalpel or ordinary knife, or, which is preferable, a somewhat lar-e trorl^ nml cannula curved if possible. The most fluctuating parfoft^e tumour collanse cf'-'''^''^'.""^^ '^' "^^^^ ^^^^^"" ^^^^P^^ ^h« cmnia? pa lete collapse or give way to pressure ; the head ,s thus greatly redLed ^n size, and delivery can be completed. ^ tt^uucea .n Rainard recommends the puncture to be made on the side of the cranium ; and should it be necessary to still further reduce he size of ultX VZT^rT^' "• °^^^"- '"^^"^' the side will be found mo^ suitable. In the posterior presentation, the back of the head mav be Pimctured, and the weight of the young creature's bodf hSn' beyond the vulva, will sulliciently steady "the head for this purpose" ut in the anterior presentation, traction should be made by means of the cords while the cranium is bein^ opened ^ Rainard informs us that Conte, b'eing called to assist a Mare in foal- ng, found a jK^.terior presentation, and having diagnosed hydi^cephalus he was able by version to convert it into an anterior preseataSon^ when the head was easily punctured. ^ cacxitauun, wnen Embryotomy has been recommended in sucli cases ; but bevond reducing the size of the head, if that is the only obstacle, there is no necessity for resorting to further breaking up of the body of the f^tu" Indeed It will be found that, in ordinary cases, patience and iudSm,; mampulation will often enable the obst'etrist to'tpense wltlilr^ Ascites, Anasakca, and Hydkothorax. " Ascites '■ (fluid in the abdominal cavity) and •' Anasarca " (^n\^ beneath the skin), either partial or complete^,^do not appear to be S ^t^^^X^ '^'^' '' Mrocephalus, thJLse^^tS chferrnTh.!'?Mf''Tl''^''''''?,*'l *^" F°^'' ^^"' ^''^ I^i^l' a"'^ ascites cSnded pathological conditions have generally been With regard to ascites, it appears that in all the recorded obsnrvn lloTknd 3^:rt!r"- "t.^'l"^ 1-ve designated the '' ZZtl.tZlt on ancl position ; though m some cases these were complicated ;' tlUhe'h'e^ '"""' '^^' °^ '''' '''' ^'^^ ^^ ^'' ^^- liur^prett^ Sometimes the foetus has ceased to live before the full period of preg- i ' i I i 1 I 388 FCETAL DYHTOKIA. nancy has expired, and is expelled from the uterus ; at other times it reaches maturity, and living through a few of the early pains, it suc- cumbs before parturition is completed, either from the effects of pro- tracted labour or from the manoeuvres adopted to extract it. None appear to have been born alive ; nor would they be likely to live if by chance they were extracted before death seized them. In addition to the abdominal cavity, the scrotum is often enormously enlarged through Fig. 101. AnASAUCOUS FoiTAL Q.\LV. its communication with the latter, of which it is only a kind of diver- ticulum. Hydrothorax is often combined with ascites, and in one case recorded the scrotum was enormously distended with the peritoneal fluid. With regard to anasarca, Noyes^ has witnessed a number of cases Fig. 102. Anasarcous Fcetal Calk. of general anasarca in the course of a year, in the neighbourhood of Mirepoix, France. He states that the Calves were born at least three weeks before their time, and always dead. The connective tissue of the entire body— from the head to the croup — was infiltrated with serum, the young creatures being double or treble the size of ordinary Calves ; the head especially was enormously large. During pregnancy ^ Rainatd, op. cit., p. 476. DISEASES OF THE F(ETUS. 889 liber of cases the abdomen of the Cows was so developed, that their owners thought they w. re bearing twin Calves. Quctier has published details of analogous cases of general infiltration, in which the fcEtus was at least twice its natural size. This condition has been witnessed in the foetus of the Mare by Pauli' and Lehnhardt,'- and by Herran'' ir; the Goat. The latter authority made an autopsy of a Goat which had died from injuries inflicted on its head, and found in it twin fcctuses, the bodies of which were com- pletely infiltrated. Cause. The cause of this dropsical condition is not well ascertained. In some cases it may be due to uterine dropsy of the mother or to con- stitutional hydnemia ; but in other instances it cannot be so, as the mother is in good health, and it would then appear to be owing to derangement of the foetal circulation, and particularly of the venous system — probably congestion of the umbilical cord. At times, disease of such organs as the kidneys may produce it. Franck* remarks, that the fact that sometimes a Cow will for a number of years bring forth these dropsical Calves {Wasserkdlher) in succession, while other Cows in the same shed produce healthy Calves, shows that there is probably in these cases at least some anomaly in the uterine vessels ; the fact, also, that sometimes along with general anasarca and ascites, there are rachitic alterations of the bones, points to mal-assimilation, or deficient supply of the protein substances and phosphorus salts, the deficiency being presumably due to disease on the part of the mother, or to some anomaly in the composition of the uterine milk. The amount of difficulty met with during delivery in these cases will depend upon the quantity of fluid effused into the abdominal cavity, chest, or sui^erficial connective tissue. Sometimes delivery is possible with the aid of traction. But in the great majority of instances, when the head and fore-feet have passed through the os, further progress appears to be impossible. In these cases we have extreme distention, but even in some of them delivery by traction is not hopeless. Cazeaux^ says of this condition in the human foetus : " The abdominal parietes have been observed to yield in such a way that a large portion of the tumour remained above the inlet, while the trunk gradually descended into the pelvis ; and when oncG a part of the abdomen had cleared the passage, the fluid escaped into it and towards the point where there was least resistance, the volume of the part still in the pelvis progressively diminishing, and delivery being finally accomplished naturally." Saint-Cyr is of opinion that it is probable delivery has been effected in a similar manner, in those cases in which the dropsical foetus of animals has been extracted without operation or mutilation. Sometimes the walls of the abdomen give way, as in the case recorded by Courjon.*' This veterinarian attended a Cow, three years old, which ' Gnrlt und Hertwig's Magazin, vol. vlii. - Ibid., vol. ix. ' Journal de Vetcrlnaire du Midi, 1864. * Haiidhiich der Thierdrztlichen OehurtshiUfe, p. 429. " Train Thcoretiqtie e,t Pratique de I' Art des Accouchemenfs, p. 659. ' Rainard, op. cit., p. 485. J '•■ I 390 FCETAL DYHTOKIA. \V\ \u. i(i» i ! 1 liji escaped. The Cow was in great danger for a month afterwards. Diagnosis. The nature of the obstacle can only be ascertained bv vimnnl n.- the state of affairs Not unfrequently, however/the body of "he fS TandTi dtt'm^f h "P *'" P--ge that it is impossiill pLs h nand, and it may be necessary to remove the protrudin" limbs bv embryotomy m order to diminish its volume. niiU o "n resortiS dead anTir^lTv" "."'"""^ unjustifiable, as the foetus is ne^-lyXavf cieaa, and it alive it cannot exist after birth ^ or divjX h'" '^.^°™"i^"teri„ary School o7Hr„„veHorfc =a^^rai^SS°sSfe.tatrnTt1h^'^^^^^^ ' Der Thierarzt, 1808, p. 85. DISEASES OF THE FCETVS. EmI'HYHKMA. ;»9i Emphysema of the f(Etus is sometimes found to bo a causn of dystokia. Leconto mentions that he has met with a case in which a living foitus was partially emphysematous, the head and neck as far as the shoulders being involved. This case is exceptional, however, as this condition is, as a rule, observed only after the fcjctus has perished in the uterus. It sometimes happens that during parturition the " wator-bag " is ruptured before the young creature lias made sullicient progress, or it may be in a bad position. The uterus then closely contracts on it, over the; whole of its surface, and it soon succumbs. In the course of two or three days its tissues have become softened and decomposed ; the subcutaneous con- nective tissue becomes distended with gases — the result of this decom- position, and in a short time the entire carcase of the young creature is inflated. This inflation directly distends the uterus, and the foetus sometimes increases so immensely in volume as to cause rupture of the walls of that organ. On approaching an animal in which the foetus is emphysematous, a powerful stench is perceived coming from the vulva, the lining mem- brane of which is of a yellowish-red tint. On introducing the hand into the uterus, the inflated foetus crepitates on pressure and the gas can be moved beneath the skin ; the hair is loose and easily removed ; the skin itself is often dry, and the fluids small in quantity. Gases are not unfrequently disengaged in the foetal membranes, and particularly in the amnion. Bossetto^ mentions a curious case of this description, in which, after rupturing the membranes of a foetus that had been dead in the uterus for some time, on withdrawing his hand from the vagina there was a rush of carburetted hydrogen ; this became ignited by the tiame of a candle held some distance from the vulva of the pregnant animal. The flame— ten to twelve inches long — burned for some time, and the Cow did not appear to suffer. Indications. The dryness of the skin and the large volume of the foetus, as well as the inertia of the uterus, are the obstacles to extraction. Conse- quently, version and retropulsion cannot be beneficially resorted to here ; but deep incisions may be practised on the surface of the body of the foetus as far as the hand and knife can reach. The maternal passages, as well as the foetus, should then be well lubricated with some fatty agent, and if the carcase is in a favourable position traction may be tried — cords and hooks being employed in a manner hereafter to be described. If the position is not favourable, it must be corrected. Should mechanical extraction fail, then embryotomy must be prac- tised. After the foetus lias been removed, thorough cleansing of the uterus will be necessary. In these cases, the practitioner should take every precan.tion against danger to himself, as serious, even fatal, consequences have resulted from putrid infection. The hand and arm should be well smeared with lard, and thorough ablution ought to be practised immediately after the operation is over. POLYSAKCIA. German authors only, so far as I can ascertain, make mention of this condition, ni which there are abnormal accumulations of adipose ^ Giornale di Veterinaria Prnctica, 1859. VHpK 1 1 **■ I 39S FOSTAL nrSTOh'lA. matter in tho subcutaneous connective tissue ; so that at birth these fat deposits often cause the Calf to weigh more than a hundredweight. Such fajtuses are designated in Germany " lard Calves " (Sjjcck-kalbo). Indications. The indications for the extraction of these lardaceous Calves are, as might be presumed, the same as those for over- developed fcotuses in general. Contract' JNS. This designation has been given to the permanent contraction or retraction of certain muscles— and we might add tendons and liga- ments—which, in becoming hard and rigid, are at the same time re- duced in length and thickness, so as to form inextensible cords that rig. 103. Dbformkd Hkad and Nkck of a Foal, due to CoNTBAcxioy ano Pkkssuuk in THE Uterus. deform the part they are attached to. and prevent its assuming its natural pof ' 'on. ^ This state of contraction and rigidity only takes place slowly and progressively, and it chiefly, though not exclusively, affects the muscles of tne neck and fore-hmbs, giving these a vicious direction which it is very difficult to change, and which at parturition may become a rather troublesome cause of dystokia. The causes of these deviations, which bring about actual alterations m the structure of the bones and muscles themselves, are very obscure Bouley was of opinion that the lesion is solely due to the passive influence of a false position which the foetus assumes and maintains for a long time, and to which the muscles and bones finally accommodate thom selves. Kainard thought the cause might be of" a mechanical nature and due to the pressure exercised on the foetus by the colon of the mother— particularly its pelvic portion— when filled with hard faecal niSt'ASKS OF TllK Furtfii, Berlin, 1877. MONSTROSITIES. .'597 liliNHSS OK short), JV. brachychinis (anterior limbs too short), N. campylochirus (anterior limbs short an.^ crooked), iV. chiropterus (anterior limbs short, with cutaneous folds resembling wings), N. compyloscelus (posterior limbs short and crooked). ORDER III.— SiMi'iiH MoNHTUosiTiKs THROuaH AHNOKMAii Division OK THK J3oUY : 11. ScnisTO{!Ei>HAr.us. — Division of the head ; 5 species : S. hemi- r.eplialns (cleft in the middle) ; with the varieties : a, S. hanicej^halus partialis, or hydrenccjihalocda (partial hernia of the brain, with hydro- cephalus) ; b, S. hcmiccphalua totalis (absence of all the cranium) ; c, S. hamicephalus coniplicatus (cleft cranium, face defective) ; S. bifidus (face divided), S. Jissipalatiims or rictus liqnnus (clt-ft palate), S. fissi- iabrus or labium leporinum (cleft or hare lip), S. vmjalostomus (wide mouth). 12. ScHisTocoKMUH.— Divided trunk; G species: ,S'. fissicollis {neck cleft), ,S'. Jissistcrnalis (sternum divided), ,S'. sclnstepiqastrico-stcrnalis (division of the sternum and anterior portion of the abdomen), S. exom- plialus (divided umbilicus), S. fissiventralis (the whole of the abdomen divided), S. fissispinalis or spina bifida (division of the spinal column). 13. ScHisTosoMUH.— Division of the head and trunk ; 3 species : .S'. nficxus (division of the body and inversion of the spinal column), S. contortus (division of the body and torsion of the vertebral column), S. viicrochirus (division of the body and anterior limbs shortened). 14. SciiisTOMKi;US.— Cleft limbs ; 'J species : ,S'. Jissimamis (division of the anterior limbs), ,S'. fissumjalus (division of the phalanges). ORDJjR IV. — Simple Monstuositiks thuough Absence op the Natuual Division of Parts : — 15. Atki:tocki>iial,uh. — Absence of openings in the head ; 1 species ; .1. aslomus (mouth absent). IG. Atketogohmus. — Absence of the natural apertures in the body ; '2 species : A. aproclus (anus absent), .1. anurethra (urethra absent). 17. AsciiisTODACTYLUs.— Phalanges undivided ; 1 species : A. solid- ungulus (absence of division of the phalanges and claws in those animals which usually have them divided). ORDER V. — Simple Monstkosities rHuoiKiii Fusion ou Coali- tion OK Organs : — 18. Cyclops or Monophthalmus. — One eye in the middle of the face, and a proboscis in addition ; 3 species : C. megnlostomns (large month), of which there are two varieties ; a, C. vmjalostomus rhipi- chdHus (large mouth and proboscis) ; b, C. mcgalostomas arhync'hus (large mouth, but no proboscis) ; C. j)rostomns (irregular mouth), in which are two varieties : a, C. prostomus arhynchus (irregular mouth and no nose) ; b, C. prostomas rhyuchcenus (irregular mouth and nose) ; C. astomiis (without mouth), with two varieties: a, C. astomus arhi/u'- clms (mouth and nose absent) ; b, C. astomus rhyncluenns (proboscis present, but mouth absent). ORDER VI. — Simple Monstrosities through Abnormal Position AND Form of Parts : — 19. Campylorrhixus.— Curvature of the nose; 1 species ; C. lateralis (lateral curvature of the nose). I IP i I 398 FCETAL DYHTOKIA. 20. Camylokrhacchis. — Curvature of the vertebral column ; 2 species : C. scoliosa (lateral curvature of the spine), C. contorta (torsion of the spine). OEDER VII.— SiMPLi.; ]\ro.\STuosiTiKs thuough Excess in Forma- tion : — 21. Mfjgalockphaluh.— Head abnormally large ; 2 species • M Mjdrencephaliis (with hydrocephalus), M. polijccrus (head with large 22. DiPHALLus.— Double penis; 1 species: D. hnperfectus (double penis, incomplete). 23. Megalomklus.— Limbs with suuernumerary parts; 1 species- M. pcrissodactijlus (with supernumerary digits). ORDER VIII. — Hehiiaphrodites : — 24. HKinrAi'UKODiTrs.— Double sex, with predominance of organs belonging to one sex; 2 species : //. /«;cn///6> (genital organs to "one side), in which there are two varieties : a, II. lateralis mascidlnns (with predominance of the male organs) ; b, II. lateral^ feminlnus (with pre- dominance of the female organs) ; II. transversalh (the external genera- tive organs belonging to one sex, and the internal to the opposite sex) including two varieties : a, II. transversalls masculmus (external genital organs male, internal female) ; b, II. transversalls femlnmus (external genital organs feminine, internal male— often imperfect). 25. PsEUDO-HEKMAi'HKODiTus. — False hermaphrodites; 4 species- 1 . mcgulomaslhtis (male with large mamma)), P.vilcrophallus (penis un- usually small), /'. liijjiospadiatus (with the urethra 'Mvided inferiorlv) r. ^temuunus (false feminine hermaphrodite). ' ' 26. Andkogynus.— Double hermaphrodites, the male and female organs existing in a single individual, one sex being incomplete and the other predominating ; 2 species : A. -nascnllnus (the external organs are masculine with a small penis, the internal organs being male and temale— though the one set is more complete than the other), A feml- inmcs (the external organs are feminine, with abnormally lar^e clitoris the internal being male and female, with predominance of the one over the other). CLASS II. TREBLE ANJ) DOUBLE MONSTROSITIES. In these monstrosities there is a union of two or three individuals, neither of which is complete, but which are united at various points often with a completely-developed body is united a portion of a second individual. It comprises 6 Okders, 2G Genera, and 59 Si-ecies. ORDER I.— Trigeminal Monstrosities, in which are united one OR JIORE PARTS Oli ORGANS OF THREE INDIVIDUALS : 1. Cephalotridymus.— Three heads united to a single trunk - 1 species : C. loiicorporcus (with a single body). 2, CoRMOTRiDYMus.— Posterior part of the trunk triplicate, with more than four limbs ; i species : C. trlcaudatus (three croups with three tails but only one anus and four posterior limbs). • u ^f^'^OTRiDYMUs.— Posterior part of the body double, and more than eight limbs ; 1 species : M. dccapiis (ten limbs of unequal length). MONSTMOSITIES. ' 399 TED ONE 4. SoiiATOTRiDYMUS. — Triple body ; 1 cheats united). species : S. sternalis (three ORDEE II.— Monsters with Two HEABS—Cephalodidipni:— 5. DiPRosoPus.— Double face ; 3 species : D. sejunctus (the two faces separate), D. distans (the two faces diverging), including three varieties • a, D. distans distomus (a mouth in each face); b, D. distans monostomu's (a mouth m one face only); c, D. distoma heviicephalicus (without a cranium); D. conjunctus (two faces united,) has two varieties • a D coyi- imict^is distomus (double mouths); b, D. conjunctus monostomus (with one mouth). ^ 6. MoNocuANus.— Single cranium ; 4 species : M. mesognatus (the lower jaw included in or united to the other from the commencement of the branches), If. dujnatus (lower jaw double), il/. heteroprosopus (diverse faces), ill. bimandlbularis (upper jaw double). 7. Hetekocephalus.— Double heads, one'of which is complete the other very incomplete ; 2 species : H. interposltus (between the two branches of the lower jaw of the complete head is interposed the lower jaw of the incomplete one), H. oppositus (the lower jaw of the complete head is depressed in front, and on its upper surface— anterior extremity —It IS united to the corresponding part of the second jaw, with which it forms an acute angle). ORDER III.— DOUHLE-HEADED MONSTROSITIES, WITH THE TrUNK WHOLLY OR PARTIALLY DoURLE : — 8. piCEPHALUs.-Two separate heads; 7 species: D. Uatlanticus (double head and two atlases), D. subbkollis (double head with appar- ently two necks), D. bicollis (double head and two necks), with two varieties : D. bicoUis omocephalus (both heads alike), D. bicollis hetero- cephalus (one head perfect, the other imperfect); D. subbidormalis (double head, witli apparently a double back), D. bidorsiialis (double head with double back), D. bilumbis (double head and double loins) D. bispmalis (double head and vertebral column), has two varieties • a D. bispmalis quadrupes (with four limbs); b,D. bispinalis achirus (with- out anterior limbs). 9. Dicranus.— Double cranium ; 1 species : D. bispinalis (cranium and vertebral column double). ORDER IV.— Monstrosities with a Single Head, rut the Trunk or Limrs more or less completely Dourle— Cormo-melodidymi : — 10 DiPYGus.— Double croups ; 3 species : D. bidorsualis (double croup and biu'k), D. subbidorsiiaiis (double croup, with half the back doubled) D. biluvibis (croup and loins doubled;, containing two varieties • a D bilumbas tdcoccphalus (with head regular) ; b, D. bilumbis cacoccphalu's (with head irregular). 11. Heterodidymus.— Unequally-developed twins, the body of one being large and regularly or irregularly formed, the other being small and slenderly attaclied to some part of its fellow ; 3 species : H octipes (with eight feet), containing two vatictics : a, H. octipes cmprosihuduro- phorus{th(i anterior limbs of the parasitic twin situated in front) • b H octipes pleurochirophorus (the anterior limbs of the parasitic twin situ- ated at the side); //. ictrasulus (with four posterior extremities), also containing two varieties : a, II. tctrasukis monopygus (with one croup) • •Si* i I 400 F(ETAL DYSTOKIA. 'WW b, H. tctrasulns dipygus (with a double croup) ; H. triscelus (with three posterior limbs). OEDER V. — Monstrosities with a Single Head and Trunk, and MORE than Four Limbs — Melodidymi: — 12. — Opisthomelophorus. — An animal regularly formed, but which bears on its back or croup a supernumerary limb or limbs ; 3 species : O. trichinis (with an anterior limb on the back), 0. tetrachirus (with two anterior limbs on the back), 0. tetrascelus (with two posterior limbs on the croup). 13. Emprosthomelophorus. — With a supernumerary limb or limbs on the neck, thorax, or beneath the pelvis ; 5 species : E. octipes (with four supernumerary limbs beneath the thorax), E. trichirus (with an anterior limb on the thorax), E. tetrachirus (with two anterior limbs on the neck), E. triscelus (with a posterior limb beneath the pelvis), E. tetrascelus (with two posterior limbs beneath the pelvis). 14. Pleuromelophorus. — With a supernumerary limb or limbs situated on the side ; 4 species : P. octijies (with four limbs on the side), P. tetrachirus (with two anterior limbs on the side), P. trichirus (with an anterior supernumerary limb), P. triscelus (with a posterior super- numerary limb). ORDER VI. — Monstrosities with the Head, Trunk, and Limbs MORE OR LESS COMPLETELY Double — Somatodidymi : — 15. Octopus. — With eight limbs ; 4 species : 0. janus (two faces placed opposite each other, and eight limbs), 0. quadriauritus (eight limbs and four ears), containing two varieties : a, 0. quadrimiritus monoprosojms (with a perfect face) ; b, 0. quadriauritus aprosopus (face absent) ; 0. biauritus (eight limbs and two ears), 0. s7jnapheocephahts (eight limbs, and the heads joined externally only by the skin). 16. Tetrachirus. — With four anterior limbs; 2 species: T. sympho- cephalus (four anterior limbs, two lateral and two incomplete, on the back, and heads joined), T. choristocephalus (four anterior limbs, and heads separate). 17. Tetrasculus. — With four posterior limbs ; 2 species : T. sympho- cephahis (four posterior limbs, and heads united), T. bifacialis (four posterior limbs, and the two faces separate). 18. Gastrodidymus. — Twins united at the abdomen ; 3 species : G. quadrupes (twins united at the abdomen, and furnished with four limbs), G. tetrachirus (witli four anterior limbs), G. octipes (with eight limbs). 19. Gastro-Thoracodidymus. — Twins united at tue thorax and abdo- men ; 1 species : G. thoracodidymus octipes (with eight limbs). 20. Epigastrodidymus. — Twins united at the thorax and epigastrium ; 1 species : G. octipes (with eight limbs). 21. Thoracodidymus. — Twins united at the thorax; 1 species: T, octipes (with eight limbs). 22. Schelodidymus. — Twins unite -l at the posterior extremities ; 1 species : S. hcptamclus (with seven limbs, the posterior pair being united into one, the next pair at the side, and the other four in front). 23. Ischiodidymus.— Twins united at the pelvis; 1 species: I, ec- amelns (with six limbs, four anterior and two posterior). 24. Omphalo-Chronodidymus. — Twins united at the umbilicus and the head ; 1 sptoies : 0. disomatus (the bodies separate). { and abdo- ailicus and MOASTJIOSITIES'. ^qI 25. Pygodidymus.— Twins united at the croup ; 1 species • P aversus (bodies united at the ischia and sometimes at the buttock," and in opposite directions). ' 26. CRYi-TomDYMUs.- Inclusion oi one twin within the other • 2 sipecies- C abdovunahs (twin included in the abdomen), C. snhcuUumil (incomplete fcetus included beneath the skin of the complete onr) Such is the classification adopted by Gurlt, and it will be seen that It is very coniplete, while the nomenclature scarcely leaves anythin<^ to be desired. Nevertheless as Saint-Hilaire's classification and nom°en- clature are a so employed, and are in some respects advantageous to know we will now al ude to them, though not in such detad as we have done those of Gurlt, following the summary given by Zundel Samt-Hilaire separates monstrosities from vices of conformation which he distinguishes as Ucmitcncs, or simple and trifling organic anomalies, and Ilctcrotaxics, or mere changes in the situation oi oi-ans and nearly always without alteration in relative position and connec- tions, lor the Herviaphrodisms-dnQ to the union of the sexes or some of their characters in the same individual-he forms a separate class, which he again divides into two sub-classes, according as there is an absence or excess in the number of parts ; he distinguishes male hermaphrodisin, female hermaphrodism, and neutral hermaphrodism mixed ; coniplex-masculine or feminine ; and bi-sexual_perfect or imperfect. The monstrosities-properly so called-exhibiting anomalies which are more or ess serious, either because of the injurious influence hey exercise on the functions of the individual, or ihe vicious con- tormation they give rise to-are divided into two classes: Simple Monstrosities and Composite, Double, or Triple Monstrosities The fii-st class comprises three orders: 1. Autositic Monstrosities (avros-, seij a,To,, nourlsluneut)~^^■hose organs are capable of maintain- ing hem for a variable period after birth. Only one or more regions of the body are involved, the majority being httle, if at all, different from the normal standard ; the circulatory apparatus is ah -avs mo e or less complete, particularly the heart; the lungs, nearlv all the digestive viscera, and at least a portion of the headrare present ; and all the anatomical and physiological characters are manifested exter- nally by the general conformation, which, in the greater part of the Sst>^:Tr P"!"^^^^-'?^ . ^''^ f'^P^' "0""al. 2. Ompkalositic Monst)osities {o,i^aXu,, umbilicus, and criros-, noHrishmnt)—tho'ie which ive imperfectly, being maintained by the nourishmen derived froin he mother through the umbilical cord, and dying as soon as the coi^d IS ruptured These omphalosites are deficient in a large number of organs, and those which are present are generally ve?y imperfect externally all the regions appear to be anonmlous, and the sSetn' IS imperfec or even effaced. 3. Parasitic Monsovsities-the C h f- Ll n' ° • • """^ "'T™"'^^ '"^'^•^' "■^■^"^^^^- "^^^^'^S' «°"'Posed of bone adipose tissue, etc., destitute of umbilical cord, and a tached to the generative apparatus of the mother, at whose Expense they mainta n an obscure parasitic existence, by means of a vascular pedicle V<^^tt tC^T"''''' "'' ^T'^f ^"^" aulosUanau and double ^masitic The first are composed of two individuals more or le<^s intimately united, and somewiiat equal in development; this enialitv ndicatmg that they botli have been equally noui-ished, and thaUleu- functions have been alike complete. The second are composed of two 26 a: I m 402 FOETAL DYSTOKIA. distinct individuals, very unequal in development, the smallest being the most imperfect ; testifying that it, like a parasite, has lived at the expense of the other. It would appear that the triple monstrosities have not been met with in sufficiently large number to establish a trustworthy classification. Each of the orders of Saint-IIilaire, like those of Gurlt, contains several families, subdivided again into genera and species, according Fig. 104. EcTROMELiAN MoNSTKOsiTY (Saint-Hii.aiuk) ; Nanomelus Camj)ylochmiii (Gurlt) : HOBSK. to their aHinities, and which include all the monstrosities he had met with. With regard to these families, it may be mentioned tliat among the single autositic monstrosities, there are the ectromelians (e'xTpaw, to make abort, /teAos, limb), in which we have a more or less complete deficiency in the development of the limbs, either anteriorly or posteriorly, and involving one or more of these (Figs. 104, 105). Fig. 105. EcTROMELiAN Mo.vwTKOxiTv (Saint-Hilaihk) ; Xmiomeliis Campy lochirm (Gcult) : Goat. The Sj/vielian Monstrosities {avv, with, /xe'Ao?, limb) are those which Gurlt includes in his first Class and Order, there being an absence of parts, with fusion of others (Fig. 106). The Cclosomian Monstrosities {xv^V, Itcrnia, o-w/xa, bodjj), more frequent, perhaps, than any others, are those which Gurlt places in his third Order — Bchistocorvins, and are chiefly characterized by the absence, more or less complete, of the abdominal pan abrupt nallest being i lived at the monstrositieH D establish a irlt, contains 3S, according iruH (Gurlt) : 5 he had met i tliat among tans (e'xT/jaw, ess complete interiorly or 105). iru.'i (Gl'KU) : those •which n absence of ore frequent, in his third bhe absence, the abrupt MONHTJiOSJTMS. 403 curvature of the spmo backwards, downwards, or to one side • so that the pelvis and posterior limbs are directed forwards" to one sTde or over the back, while the abdominal cavity being open, allows iL viscera to float about unprotected. There are many dtgrLs of this deformTtv Some imes the abdominal cavity is open, the thorax beingundefoS Ih^ strmunrsS/ /^"'^ 'V'^ "'^pV^"'' ^"^ *^^ "^f attached to he sternum {Sckistocornuis fissiventmlis, Gurlt, Fig. 107) Sometirr.P« the posterior end of the spine is curved forwa;d to the middle of The Fig. 106. SvMKMAN MoN.Tno8iTV (Saint-Hilaihk) ; Perosomus pseudo.celu. i^ua.Ty. l-,u. back (Schlstocormus reflcxus, Gurlt); the ribs fnllnw ,-r, fv,^ duection, but instead offending downwards oLcIose the chest ?W spring upwards towards the dorsal spines • the sternnrn 1= olv' 7^ divided throughout its length isIZorZ jS^^.f XlT lig. 107 , with evisceration of thoracic organs-most re .ue'ntlC^^^^^^ heart iLcto„a cordis, Fig. 108); the diaph'ragm T^ot p^Stf 1' l-'ig. 107. hlt) : Calk. Ch,o«omian Monstuoh.tv (SAiNT-HiLAiRK) ; SdiUoconms MlventraU.s (Gu cliest is as widely open as the abdomen, and the viscera of both other't'irs th'''"'^ *° "r ^°^J ('^'- ^^^"■^'^F-i/a.^nco-.^cr'az!.) It r w'Lt'o'V ./T ^^' '^''^^' r^ '^' ^°^y ^"^ ^«-d divided !.^.j,..,„o.o,a,^. ^uatuHus); or other detoninties of a similar kind and ment of the various regions— the external surface bein- eenerallv in contact-while the lining membrane of the chest or abdomen or Sth becomes external; sometimes to such an extent is this inversion oftho I \ 40t FCETAL DYSTUKIA. U''S [iil- i^ m body carried, that it is turned, as it were, outside in : the akin forrainj^ a kind of internal sac — the hair to the interior — and containing the lioad and Hinbs of the foetus. With sucli a deformity, of course other serious nuilfoniiations or displacements co-exist : distorted pelvis, wasted or undeveloped limbs, atresia of the anus, w '"e or less complete absence of the generative organs, etc. Fig. 108. Ectopia Cordii : Schisloioiviunjiissisternaliii. This kind of monstrosity will have to be specially noticed hereafter, the eventration of the viscera of tlie fmtus often considerably batHing the obst(!trist ; while the frequent distortion of the spine and limbs renders delivery very dillicult. Fig. 10!». PsKLUKNCEi'iiALiAN MONSTROSITY ; I'rroceiihalun pHeudocephalun (Guui.t). The Exoiccphalian monstrosities, belonging to Gurlt's third O) der in the first Clasr-;, are those which have the brain defective, deformed, and external to the cranial cavity — itself more or less imperfect. The Fseudcnccphaliaib monstrosities belong to the third Order of Gurlt's first Class, the encephalon being absent and replaced l)y a variable-sized bright red tumour, composed of a multitude of small I skin forraiti'^ jntaining thu course other orted pelvis, less complete 36(1 liereafter, nably batlling no and limbs ,s (Guui.t). ;hird O) dor in leformed, and ct. lird Order of eplaced by a tude of siuall i m m MDNSTROSITIHS. 406 bloodvessols ; this tumour rests on the base of the cranium, the roof of which is absent (Fig. 109). The Anencephnliati monstrosities— Gurlt's first Order, first Class- are destitute of the encephalon or anything to represent it, and the roof of the cranium is entirely absent. Fiy. 110. Cycloi'Ean MoNSTiiosrrv : TIam. The Cucloccphalian monstrosities (x''X'^"«. circle, «« (/>uAi/, head)— Order live, Cbss first of Gurlt — are characterised by the; approximation, or more c/ less complete Tusion of tlie eyes into one organ, with absence, displacement, or deformity of the nose and mouth ; but the ears are Fig. 111. Ctcloi'ean Monstrosity; Oi/dops merjaloxtomm archynchut (Gvult) -. Ass. usually in their natural position, or perhaps are lower than usual. Not un frequently the nose is absent and the mouth greatly enlarged, while the fusion of the eyes m.ay not be complete (Figs. 1 !(), Ill), The Acephalian "monstrosities— Gurlt's first Class and first Order- are more or less destitute of head, and sometimes of neck, thorax and thoracic organs (Fig. 112). Si I ll. I i ,:y ii-. u 406 F(ETAL DYSTOKIA. ThQ Anidian or zoomylian monstrosities, wo havi^ already desodbod at p. 178 ; 80 wo need not again refer to them. '0fyi'i-'-^', Fig. 112. AcEPHALiAN MoNSTiiosiTV ; A. peroHomus hemiccphalicm ((Juklt) J^'ig. 113. Schktocephalus fssislabrus or lahium kporinum (1[aiik-lih). The SckiMoceph 1 If - 'I 408 FCETAL BYHTOKIA. m more or less incomplete double head : the two heads being fused as it were, mto one {Diceplmkcs hctcrocephalus of Gurlt— Fig. 116). Vis. 115, MoNOMi'HALiAN :Mon!stuo.sity : Cephalo-cormodidymu'i (Guklt) The Monocephalian monstrosities, as the name implies, differ from MONSTROSiriES. 409 the last in having only one head, but a double body, the separation of tlic two usually taking place below the umbilicus (Fig. 117). The Sysomian monstrosities (Fig. 118) have, two heads on apparently a smgle body, though a closer investigation will prove that the unicity IS merely superficial, and that at least some parts are double. Gurlt describes a full-grown Sysomian lamb he examined, and which had, apparently, a single body and only four feet, but two necks, two heads, and two tails, and the skin normally covered with wool. The trunk, thou,'^h somewhat small, gave no indication of its duplicity. It had] nevertheless, two vertebral columns, the inner ribs attached to each being shortened and fused together, while the external ones were at- tached in the usual way to the single sternum. The viscera were generally double, though they were confounded at certain points. A single heart sufficed for two pair of lungs, one pair of which, however, were only rudimentary. The two livers were combined into one, and Fig. 117. MONOCEPHALIAN Mo\- sTKosiTV: Cormo-Mc- lodidymi (Guklt). Fig. 118. Sysomian Monstrosity : bkoUiH (Guklt). Dicephalits m some parts the intestines merged into a single tube, again to become double, and finally to terminate in one rectum. The Monosomian monstrosities have, in reahty, only a single body the duplicity generally commencing towards tlie neck, in the cervical region, not unfrequently at the atlas, and sometimes as far as the facial region (^Fig. 119). Aiiiong the double parasitic monstrosities, we may mention Saint- HUaire s Hcteroti/jmws, in which the smallest of the fcctuses is attached tlie anterior part of the body of the other, at or near the umbilicus • me Hetcrahans m which the parasitic foetus is very incomplete, and perhaps reduced to a single region— as a head without a body-attached some distance from the umbilicus ; the l>ol,/odat ng i.self to its altered conditions, nnlJi ^ -^ ^""^ ^\^ expulsion of the remaining foetus ; while the Te^rrSZLr''"'"' r^^' ^i"^^' '' ^^^y^ ^"-^^^^ to' tL young creature alieady born, and manifests a particular anxiety which is an utiu^haT r Hd of -r^ '''^' P^'^^f ^°' '' ^°* --P^^'^^: When?h: S the ctfspnng occupants, the mother then turns its attention This is the ordinary course of affairs ; but it is not always so fortunate eizeT^i'ha'Snf "' ^I" ^^P"\«r °^ *^^ ^''' '^''^ tli uterus s seized with a kind of inertia, and labour may be suspended for hours even for days, and sometimes more than a week.i During this suspen lookin^n.^r"*/' '^'' Sf"^ indications of uneasinest by pSg iot Soultlf'KKv""'^ then, straining at intervals peiLpTand not inhequently exhibiting symptoms of colic, while the milk retains all the characters of colostrum until the other foetus is born detention of the second foetus after a certain time is fatal to its exist- ence ; even in animals with a multiple placenta-such a the Cow whose foetus retains its vitahty much longer than that of those whole S to SalL'cvthe^ f' ^''?~''^' ?^^"^^^^ ^-^-^ ^- never accord! of the first ^^' ''" ^"°''" ^° ""'^* forty-eight hours after the birth This suspension of labour in twin birth, and which is not at all infre medium-sized Bull-terripr Ritn^ ," , '^'^\^°- ^ *J»e of these cases may be alluded to. A the previousye;r: hr ughbJS^una^^^^^^^^^^ officer required my assistance time, and the head of a Pumw wL fn H, ^ ^' ^l'"^'^"'™'^! ^ad been in labour for some meni hereafter to be deserl^^ as wL !l ^""\- ?" '^''' '"'"^ '^"'"'"^'^ ''^^ '^^ '"^t^"' afterwards. These were all that tie .?tT ''^'•' T ''"'/'V^'^ *» ^^-'i^e immediately large for the ,^^^:^^£^ X fi^ut^n^ldrt^'jSTHt;^'^^ ^^'^"'^^ -'« "^ *- wr^tTto nl™ frtSiht^BitSr;^; "'" ■''-'' '" *'" '"^^"*"- --"-'^ ^- 1^-tsn.outh, acquainted wthTts uterine p/c«^^ =""^,""'"° V° '">' '^^""^ "-'^^ ^ir." its time was d,ie formDoiL R ' LI T '*"'"""« t^^n^^v what he should do when that nothing spec al s'h udd te aulTr'^'i^' ''u*^V° ^y^''™'° precautions, I advised occasion ; theuTdlrof tincture o??ro.t "'f'' ^"''\T '^i''^''^' ''' "" ^^e previous another f necessary Hubseauentlv T ^ ^ i IV ""''^ *" H'''^"""'^*'^^^'^' ^"""^^d by the Bitch had fours^;.al^l>rS • here't,: fsKn^ of^'IlL^"^ '""^ Thursday nigh^ given, as symptoms of const pation werrexhib ed due t 'J; ^^^^ °f .^f tor oi was retention) ; the following day the aninmrwasfn , S ' nnH . Probability, to f«tal in herself, I did not like to give the erirof i v« Z' M "' '" "^"e '*'°,"^ ''"^ "^"^^ she became very ill. and was scircelv aWe tf«f ^ / However, on Saturday morning about ten o'clock, I a^yJC Tdr-xcLu f r I T ''"'^ T' ^''""^ ^'^^ "" ">"><. So about five p.m' she passed a deadlZf '"^'"rj'^ ".^'"t of rye (our prescription), and (Tue«day, 1.1 right b^u\^St1.Sj;:jpSd7ett:t^ '''•" -'-• «^^ '« -^^' asSisr ttrs^vr'inXt'of :;:^:n^,T^^^' " -^-'-^ ^-r? = t|.at^.,n..ryto^;::j:S:i::r'i!J^rr;^::^j^^^^ ly one foetus, urition either 3. the progeny 3rm has been laller than in ed, a variable During this id conditions, s; while the ;o the young ', which is an I. When the 1 its attention i so fortunate, the uterus is ed for hours, ; this suspen- by pawing, perhaps, and milk retains 1. 1 to its exist- as the Cow, those whose ever, accord - ter the birth • at all infre urring in inul- ttlluded to. A my assistance labour for some id by an instru- ze immediately ly were not too ;o Portsmouth, ving made hir- hould do when ions, I advised n the previous 1, followed by 'hursday night castor oil was ility, to fcetal rong and well irday morning no milk. Sn scription), and She is now ;erine inertia ; a — its eebolic i death of one Icmonstrating the uterus of umbing, even DYSTOKIA FROM MULTIPAIilTY. 423 quent, is ordinarily due to malposition of the second fcetus ; and this cause of dystokia is one which nearly always demands the attention of the veterinary obstetrist. This malposition of the single f (Detus will be noticed presently ; we have now to consider difficult birth due to multiparity. Dystokia from this cause alway.^ happens when the two foetuses are about the same distance from the os uteri, and both present together at the pelvia inlet; the uterine contractions carry them simultaneously into the opening, but of course they cannot possibly pass through the canal at the same time; hence the difficulty in birth— a difiiculty which varies according to the relative situation of the two foetuses to each other. The foetuses may be so situated that when the hand is introduced into the vagina or os, it will either encounter the head of one fcetus MAJAiLl^.. Fig. 124. Twin Fcktuseh, in Dikkkuknt Prkskntations, passing into thk Genital Canal, j with the fore-limbs of the other ; four anterior or posterior limbs two hind and two fore limbs (Fig. 124) ; two, four, or six feet ; a head and a tail, etc. ,- miiH«j The cause of this malposition is in all probability due to the relative smallness of the twins, and the changes which occur in their position during birth ; and it will be apparent that the obstetrist must, in some cases at least, find it difficult to distinguish between such presenta- tions of twins and some of the monstrosities or deformities we have described. Diagnosis. In such cases the obstetrist has to ascertain : 1. Whether individual twins are present ; 2. To distinguish, among 424 FOCTAL DYSTOk'IA. ! II ! \v\ auUh^V t P''^'''"*' '''°'^ ^^^°h belong to each foetus. This can the hltrr.'f t^lf rA-'''^\f manipulation, and even then at times ore ^fePf n n ^^^ ^""'"^^ embarrassed. For instance, when the oJemto Iv i I tf v^'r''"^ u^^°"« ^'^^ ^^"^ 1^^^^ "f tl^« other, the Sn. h ^ ?• "^-^^ ^''^"?'''^ ^^'^'^ *^"'^ '« o"ly^"« animal to extract; nltLc Po^'tion ,s scemmgly favourable, and the ditiiculty only duo emova Thi^V^ '^^' fa3tus, powerful traction is resorted to for its exnlora hnn i« ' ^TT^' ^^'^^ *^° f '^"'^ ^*^ °''J««t ; and when another exploration IS made, it is discovered that the attempt lias so fixed the tSn wZ on,^P^ pelvis that the most energetic and skilful inanipula! tion w 11 scarcely move them in order to alter their position. ^/n.Lf/^''f instances we find the limbs of the foetuses so interlocked {locked fetuses) that they are with the greatest difliculty disengaged. Extraction. ovJrniir'fr^ f*-'^^' ^^^o'«o ■ '-^'""AK Positions |^''PJ'"}°-*1''*' ("g''* ^"^^ '^ft). ui 1^ \ Ceplialo-sacral. 1 HESENTATION. j Stbrno - abdominal Po.si- ( Cephaloilial (right and left). I I'lONs \Cephalo-sacral. Abnormal Positions O I Natl- HAL 2^ IS -^1 Head Limbs or Fore-- CHAPTER I. Dystokia depending on the Anterior Presentation. It will be seen from the preceding table, which is that followed by Saint-Cyr— the tables of Franck and other veterinary obstetrists differ- ing somewhat— that the causes of dystokia due to the foatus are numerous and varied. In each of the presentations there may be ditliculties, as well as in the positions, many of which may be more or less vicious and complicated, whether as regards the whole mass of the body or only parts thereof— as the Umbs, head and neck, etc. In this presentation the obstacles are somewhat numerous ; for while it may be normal the position may be reversed, or the hind-limbs may impede birth ; or the presentation itself may be abnormal and combined with one of the positions described. Rainard, looking at the subject from an obstetrical point of view, considered the head and limbs of the footus as appendages which, from their wrong direction, may more or less hinder its expulsion. Thus the head, one or both of the fore-limbs, or even the posterior limbs in Liio anicnor position, may cause the most varied complications, one or more of which may be found in the same animal, and even compli- idean (rij^ht or to one side of '•loidean (right DYHTOKIA FROM ABNORMAL POSITIONS. 427 eating each other. Thus, with a vicious positioia of the head oire mav have a wrong direction of the fore, and perhaps also of the hoad lirnb*^ Bat as the double or triple comphcations are difficult to describe and as the practical value of the descriptions might consequently auffer it is deemed the best course to study .iach complicacion separately • the complex cases arising from their combination being then easily under- stood, and the indications for overcoming them being also simplified These complications are very often found in the Mare and Cow 'ess frequently in the Sheep and Goat, and rarely in the Bitch, Sow, or'Cat We have no means of arriving at a knowledge of their relative frequency in any species.' ^ •' A. NouMAL Anteriou Pkesentation. In this presentation the extended head and the outstretched fore- limbs are towards the genital canal. SECTION l.-DYSTOKIA FROM ABNORMAL POSITIONS. Here we have three abnormal or reversed positions— a dorso-vubic, and two (lor so-supra-cotij loidean. ^ Dorso-Puhic Position. This position is difficult when the depth of tho foetal chest exceeds the vertical diameter of the pelvic inlet of the mother-a circumstance more frequent, evidently, in the Cow than the Mare-, eing, according to one practitioner, as twenty to one. In the natural or dorso-sacral position, the foetus readily accommodates itself to the canal, but when It les on Its back its shape does not lend itself readily to enter the pelvis, It having a tendency to jam against the upper surface, and the feet to penetrate the soft tissues there. On exploration the hand detects the positio:. by the fore-feet being upwards, and the fetlocks bending in the same direction as the knees ; while if tiie head is within reach the nose and lower jaw can be distinguished. To rectify this position, rotauion of 'the fcetus must be practised. The lower jaw and fore-ieet should be corded, the head pushed away from the pelvic inlet, and the body turned withers upwards by the hand ; then gentle traction is to be made on the cords, so as to bring the head and feet into the pelvis, the hand guiding them into the canal in tne tirst position, when delivery can be effected. «eve?if caut; T^fl'l ^^'^''''^' '" ^f ''^'''' "^ '^>'«*°^"* f"'""-^ t^"^"' *« be due to the Meverai causes m the following proportions : Abortions Occlusion of tlie OS uteri ,,. .,, '.' Torsion of tlie uterus .",. Latura" u.ct.!...tion of the head and neck of'the fcetus '.'.[ LAtnu.i indiLLition of the head and misdirection of the fore-liuibs Head ana :.eck under the foro-linibs Head b^'nt up on tile back Torsion of the uterus with posterior presentation Posterior preaentation with niiadirection of the hind-feet Liimb over neck Lumbo-pubic position [\[ Posterior and transverse presentation Rachitis affwting the pelvis of Gnv- and Calf Hydrops amnii Mummification of the fu'tus ... 31 30 10 16 4 3 2 1 2 1 3 1 1 1 2 » '■ 428 F(ETA • YtSTOKIA. In the Mare and other ani. ^.L there is more room for the passage ot the foetus m this position, and with the first-named delivery may be accomphahed m some cases by guiding the Hmbs through the genital canal, so as to prevent injury to its walls. Dorso-supra-Cotyloidean Positions. In these positions the foetus lies on its right or left side, and they must be altered to the dorso-sacral position before birth can be com- pleted. This change is elTected in the same manner as in the pre- cedmg position. SECTION II.-UYSTOKIA DUE TO THE HIND-LIMBS. As Saint-Cyr remarks, it is somewhat surprising to find the hind- limbs an obstacle to birth in the anterior presentation. The difficulty may arise from the hind-limbs being retained by the stifles, the irre- ducible mass of which is greater than the inferior bis-iliac diameter of the inlet ; or the hind-limbs may be bent under the body and enter the pelvis along with it, instead of being extended and following it. In both conditions the anterior part of the body presents in a normal manner, and nearly always in the dorso-sacral position; and birth appears to be progressing favourably— the fore-limbs, head, neck, and even the chest and body as far as the flanks, may have cleared the vulva— and i^hen the act is apparently almost completed, all at once there is a check, and notwithstanding the most vigorous straining of the mother no more of the fcctus can be expelled, neither can external traction remove it. As has been stated above, the retention may be due to one of two causes. The Extended Hind-Limbs are retained by their Stifles. This kind of dystokia has been hitherto supposed by writers and practitioners to be due to the hind-legs of the fcetus being in a state of extreme abduction ; but more careful study has shown it to occur when these hmbs are in a state of extension, and their stifles so voluminous as to check progress. This occurrence should be rare in the Mare, unless the pelvis is unusually narrow or the fcEtus is very large; but in the Cow it must be more frequent, as the pelvis is not so wide and the shafts of the ilia are more parallel than in the Mare, so that these joints are more likely to be retained when arrested in this way. It IS remarked, also, that they are large calves which are being born slowly and with difficulty, that are so fixed when the greater part of their body has got beyond the vulva. This cause of difficult birth can be ascertained by exploration with *"^ hand, but the almost complete expulsion of the fcotus and the sudden check to its progress, which no amount of traction can alter, should give rise to suspicion of its existence. The obstacle is a serious one to overcome, and it not infrequently happens that the young creature is lost— sometimes the mother also. A successful result depends not only upon the skill and patience of the practitioner, but also upon the size of the foetus when compared with the dimensions of the pelvic inlet, and whether amateurs have been previously at work attempting Indications. —V^Yien both stifles are together they form too large a mass '■'^ naoa thrO'lrrVl +h" rrr,nii-n\ «25,q1 « -, J . i- J.) !• 1 1 i . _«a^ „a — L...!,..j^.. „i..., g^vmvcii vanai, anu uiusi, ihcruioro oe Drougnt mto the inlet separately— one after the other. With this object in .;^ the passage very may be the genital le, and they can be com- in the pre- BS. d the hind- he difficulty es, the irre- diameter of tid enter the ving it. In n a normal ; and birth i, neck, and cleared the , all at once straining of ian external lion may be les. writers and ig in a state it to occur r stifles so be rare in itus is very elvis is not 1 the Mare, sted in this h are being the greater ration with as and the can alter, is a serious ing creature epends not o upon the the pelvic attempting too large a be brought s object in ^ ^ nySTOA'Ll DUE TO THE EIND-LIMlis. 429 view, Saint-Cyr recommends very oblique traction on the fojtus— to the right or left side, so as to force one stifle farther into the canal than the other; and this has always proved successful when the creature had not been already too much pulled at, as when such has been the case the stifles are hrmly and immovably wedged in the inlet Then it is necessary to push the faitus forward into the uterus, if this be possible or at least one of the stifles, and if this be efiected, then have recourse *r .u *IV^ traction, so as to get one stifle into the passage in advance of the other. ° If the Cow is lying on one side and exhausted, the same authority advises that the practitioner take the body of the calf in his arms and pull It up vertically ; if not successful on this side, have the Cow turned on the other side, and again try vertical traction. On every occasion in which this procedure was adopted the result was satisfactory Another method of overcoming the difficulty is by slightly rotating the body of the fcctus. This can be accomplished by passin<' a double cord around its loins, as near to the maternal vulva as possible and passing a strong stick through the loop, so as to give the cord two turns and make it tight round the body ; the fcctus is held up on a level with the vulva, and on the word being given its body is twisted from left to right, simultaneously with a turn of the lever in the same direction, when the obstacle is overcome and delivery can be com- Wlien it happens that unskilful people have been exercisin" .^reat force before the arrival of the practitioner, and the hind-limbs "are so tirmly fixed that it is impossible to move them, then embryotomy mus^ be had recourse to; the body being divided at the loins and the posterior portion pushed into the uterus, where it can be turned, and the stifles carried into the genital canal one after the other. The Hind-Limbs, flexed under the Body, pass with it Into the Genital Canal. This malpresentation, known to the German veterinary obstetrists as the "vertical -abdominal" or " dog- sitting position" (Bauch- VertikaUaje, Ilunde-Sitzige Laijc), is not very common, and is one of the most formidable, perhaps, v?hich can be encountered First described by Canu in 1837, 1 it has been alluded to by a number of veterinary surgeons, and it has also been mentioned in every work on veterinary obstetrics published on the Continent. Since that time it has been met with in the Mare, as well as the Cow, and consists essentially in the advance of the hind-limbs of the fcEtus into the pelvic canal, at the same time as the anterior part of the body, the position of the young creature being consequently more or less vertical, the body being posteriorly bent at the loins How it gets into this position is not accurately known, but the hind-feet must be closely applied to the abdomen as the chest is entering the inlet • and probably tlie compression the fcrtus then experiences causes it to struggle with the posterior limbs to free itself from the d'scomfort As in the preceding deviation, nothing is at first known cf the existence of the displacement. Parturition commences and appears to be going on favourably ; the fa..tus. in the dorso-sacral position; arrives at the inlet, the head and fore-limbs in advance as in normal birth Pro- gressive expulsion may continue until the head of the young animal is ' Ihcmilih. Mali'cine VMrmain, 1S;J7, p, H;'. 11 I 130 FiETAL DyfiTOA'IA. beyond the inlet and as far as, or even external to, the vulva-some tnnes the head, fore-lhnbs. neck, and even half of the body hanX outside the vagma. But further progress is checked, and neitherihe inos energetic straining on the part of "the animal, nor the most violent b:;rd"thYs ^poi^t. ''''-''' ''"'' '"^^ '^ ^^^*^ '^' -^ -^--- theVoSS in bh-V^fht'i^iV^^u ^'''"^ fl><'''«"lt.y in ascertaining the cause of delay tetus a7d whtt f/r^l'"^' ^"'* ^^P^"^^i"« ^U^on the volume of the toetus, and whether its body more or less completely fills the pelvic and tac^in o'"th ''" g«"-'^^"y «'% ^e introduced afLr much trouble and tact into the passage, and having got to a certain distance it encounters either under the body or head (Fig. 12G), to one side of the neck or head, or even projecting upwards above t e head Fi?/ 25) first one then a second foot or limb, which are recognised by a^careful examination to be those of the hinder part of the body. Sometimes the feet and metatarsal bones have alone entered the pelvis, the otCr parts Fig. 125. Deviation ok the Hinu-Limbs in thic Pelvi. in ,me Anterior Presentation. I'^vteintheinlrf '"^ ^^' "tenis (Fig. 126) ; in other cases the hocks may be in the inlet, or even well through the passage-dependin.^ unon the size of the foetus and the capacity of the maternal S" ZTe ra ely the stifles have cleared the inlet, and the hind-feet a^e 'a the ZaZn . ?' '"°'' ^t""f ^/ '^'^ hind-limbs are tiie more are they fiexed and so the more is the body of the fcetus bent on itself, until it L like a dog in a sitting posture. It is needless to remark that unless he etus exw?j°"'".l'^"'" " P^-°P°^-tion to the pelvic capacity, it canno be extracted m this position, when the hind-limbs, and especial y the stifles and hocks, add so largely to the volume o the bod^y ract on will probably kill the creature, and in all likelihood injure th^ mother Some cases are recorded in which delivery was effected, howe er but of The^fSus Tlf """. 'T''''''''' 'r''''' *° ^"^- -'d the positron ot the ;cx3tus. The greatest care is therefore necessary, in order to cannot be too often impressed on the mind of the young practitioner that a careful examination is absolutely essential before^attempling W Ailva— some- ody hanging i neither the most violent ce the foetus use of delay olunie of the s the pelvic luch trouble distance it e side of the a (Fig. 125), by a careful rnetimes the other parts iKNTATION. ■ the hocks iding upon Ivis ; more are at the bey flexed, it is like a the fcctus cannot be icially the ; traction le mother, vever, but e position order to lystokia it ictitioner, ttempting DYSTQKIA DUE TO THE HIND- LIMBS. 431 extraction. In this particular form of dystokia, the life of the mother may be preserved by timely and rational intervention ; while violent and miproper interference, even at the earliest period, mav be followed by serious, if not fatal, consequences. ' ^ The distinction between this form of dystokia and the last is, accord- ing to Saint-Cyr, not diflicult. When the fc«tus is expelled as far as the loins then it is the stiHes which are the cause of obstruction ; bu? when only the anterior part of the thorax appears at the vulva, we may bo certain it is no these articulations. When the feet are not visible then a manual exploration is necessary With regard to preserving the fcctus,'the prognosis must generally be unfavourable. The Foal is, in nearly every cas\ certain to perish at an ry f^'r- !?•" «°"'Pre««io.» of its body or the umbilical cord ; and though the Calf 13 more tenacious of life, and may continue to exist for Fig. 126. HiND-LiMb Dkvjation: Anterior Presentation. some time yet in the majority of cases it succumbs, or it has to be sacrihced to save the mother, which, if the practitioner can render aS sufficiently early, may survive. ^tnaer am M-c«ortant : ""owi 1 I'i'Hithc hind-limbs and secure them by cords around the pasterns ; i. C. rd the head and fore-lnnbs, and pull these mt as far d possible beyond the vulva; 3. Remove the abdon.inal viscera, and diS the ibar region as possible, taking the \ .^caui n to i skm attached to the loins, so as to novei the )"•o^ 4ie maternal organs being injured 'luring • action ; 4. Obtain a solid bearing un the witn the hand or the repeller, and push steadily ,, , . % - , 't".' " *° <^V"ect it into the uterus, when the cords in the hmd-pasterns being pulled by assistants, guided by the hand of : le 01 >tor, the remains of the fcetus can be removed. This part of he 01 ation is the most diflicult and fatiguing for the obstetrist, as well as the most dangerous for the mother, and requires both strength and dexterity to push hack the loins and pelvis of the fcetus while advancing the hind-hmbs, thighs, and croup towards the outlet • 5 Nothing now has to be done but to exercise moderate traction, and ter- minate in the lum', -pubic position of the posterior presentation, a birth commenced he dorso-.acral position of the anterior presenta- Di^etrich recommends eventeration ' the fcctus, removal of one of the hind-limbs, and the adjustm. t of the hinder parts through the abdominal opening; ,f this cannot be effected, then these parts are to be drawn into the vacant cavity of the abdomen When only one hind-leg is in the pelvis, retropulsion of the body .nay be tried, the fore-legs and head being corded, and the misplaced iind-hmb finally extended backwards in the utems If thS cannot be accoinplished the hind-leg must be drawn forward and amputated the uteiis °' ^^ ° *^^" carefully pushed towards Eemoval of the abdominal viscera favours these manoeuvres. wi!7ipn *^i? "?^lP^'esentation occurs in the Sheep or Goat, embryotomy will generally be necessary, as there is not sufficient room to attempt delivery in any other way. ciuieui^i B. Abnokmal Anteriou Pkesentation. In dystokia accompanying the anterior presentation, the obstacle may be due to the fore-limbs or head, or to both, 'as weS as to the hind-limbs ; and it may be met with in any positioA the fS us can occupy in his presentation, though it is most frequent in tlfe dorso sacral position, which we will commence with. SECTION I. -DYSTOKIA DUE TO THE FORE-LIMBS. In the anterior presentation, and what we have designated thp ' normal position," the two fore-limbs of the fc^tus are eSended in front towards the pelvic inlet, the head being also extended andTestin? either upon or between the legs, the distal e'xtremities of wWch extend beyond its nose-the whole forming a wedge-shaped mass Con sequently, the fore-feet should be the first parts to ^iL tW-h the 28'' ml i ;i. i: 1 IMAGE EVALUATION TEST TARGET (MT-S) 1.0 Hi 12.5 2.2 I.I s lis iiiiig 1.8 1.25 LA. 11.6 vQ <^ /2 m ^;. .>^ -> ^"^j* ^^.'^ '#. /^ % "w £ Photographic Sciences Corporation 23 WEST MAIN STREET WEBSTER, N.Y. 14580 (716) 872-4503 iV ^^<\ V % v '9> 4 ^ m ^"^^4 '% 434 FCETAL DYSTOKIA. !',i: genital canal ; and if only one appears along with the head, or I'f the latter alone offers, then one or both of the anterior limbs are in a wrong direction, and birth may be hindered if they are not adjusted. The ?oL''w!?? *^fy TO assume are generally four: 1. They may be in- completely extended m the pelvis ; 2. They may be crossed over the neck; tJ.fi'^T'', Z^^l ^i'\''''^<^' ' 4. They may be extended completely under the foetus. Each of these misdirections may be met with in the four principal positions of the anterior presentation, and, as has been mentioned, one or both limbs may be involvad ; if the latter, then the direction m.ay be the same or different. The cause of misdirection of the limbs is not wel7. ascertained. In ^K ?'^l '* T^ ^^ ^^^ *° insufficient dilatation of the os uteri, ^«.in. fl ' •^'' * u^'' advancing with the head : the joints of the limbs readily flexing when the feet come in contact with the cervix, while the uterine contractions propel the more rigid head and neck into the vagina. Ihe misdirection may also primarily occur during intra-uterine existence, and before parturition sets in, and particularly if the fcetus dies oefore birth, when its position is not the same as at that period. during pa^rturit^on' '^''' *^'' '^'^ ^''^'^'^' generally happens One or Both Fore-Limbs crossed over the Neck. freoulntTnThi'rnt''. '> """^ Tf '^ uncommon in the Mare, but is less sacSl i.^f nn n' '' ^f^ljy occurs when the fcetus is in the dorso- it TglSry'nl^rne^^^ '°*' '"'^ ""^ '' ''''''' °^^^ *^^ -^^' but f-h? t ^■{^do'^btedly, in many instances, an obstacle to parturition as bP n^iJ vf' f ^'%''° i°"§'' ^°^S'^ '^ *^« b°llo^ «Pace at each sid^ of of whth S ^•■' ^""'^ "' *n^tf ''^^ °^ *b^ '=^^^*' the transverse diameter thelmh, h^^l!?'l'^''- .^^' °b'*^^^' ^' ^*^" Sre^^'' " ^^^ or both of the limbs should chance to cross towards the summit of the head At V Lt? ^' i "^ complication is more serious if the labour pains are violent and irregular-as they generally are in the Mare when there is tion ot the roof of the vagina, perforation of the rectuir , rupture of the perinaDum, etc. In the most favourable cases, labour is Sracted and niore severe, and contusions of the genital cand are almos^t unavo^abL ±Cainard alludes to the case of an Ass in which spontaneous delivery occurred notwithstanding the existence of this complication. ^ h Jd wfn I '! discovered by exploring the genital canal, when the hand will encounter in the vagina the head of the fa3tus and one limb eehn. Ti ^hof '°^^^l°"^^ °"' \' misplaced), and the other limb fetWk fnJ n^u^'' ^u^^"" "P- ^^"^ "'°^^^"g tb^ "e'^k towards the tetlock-jomt. This is the usual state of affairs an?mafhr;,? i J, Y ^b'"" \^^^ P^^"" ^^'b^'^t help, or gentle traction on the head and limbs may be necessary f' ^ ad^nr/^^i^'''^;^'-"^' ''^ ?'°''"^' ^"'^ tb« '^^^^ is not too far advanced in the pelvis, cords should be fixed to the pasterns, and the tn eo th th ea im an CO du th( in int sac noi the lat to ma wh the the DYSTOKIA DUE TO THE FORE-LIMBS. 435 trunk pushed into the uterus ; assistants then pull moderately at the eords, and in such a manner as to bring each limb to its own side, if the hand of the operator cannot effect this in the uterine cavity. In this way a kind of rotation of the limbs is effected, and they are brought each to its proper side, and a little beneath the head. When the foetus is firmly fixed in the pelvis, and retropulsion is impossible, the limbs must be amputated, one after the other. Such an operation must, however, be very exceptionally required in this complication. Fore-limbs incompletely extended. This accident would appear to be most frequent in the Cow, and is due to the legs net advancing with the head in the ordinary way, after Fig. 127. Anterior Presentation : Fork-Limb crossed over the Neck.' they have entered the inlet ; so that the elbow-joints, instead of being in front of the thorax, are alongside of it, and they and the chest are intercepted at the inlet. It occurs when the foetus is in the vertebro- sacral position, and should not be considered serious if the case has not been tampered with. Its occurrence is recognised by the nose and the feet being together, or the former may even be in advance of the latter. Indications.— To bring the legs straight into the vagina is the object to be attained ; and if the body and limbs are not firmly fixed in the maternal pelvis, this can be accomplished without much trouble. But when they are tightly wedged in the passage, then there is more ' In this figure the anterior limbs, especially the right one, are inaccurately drawn bv the artist. They we too long, and the right leg should be shown as crosbini? the neck at the fetlock joint. hm 436 F(ETAL DYSTOKIA. hfltl^ tlTf^ *^T- ^"".t^y ?'"' *^^ lo^eraw and feet should be corded, this being done, the chest is pushed forward into the uterus, when the upper parts of the hmbs accompany it. The hand can now fully extend the legs and bring them into the vagina along wi.h the head, and traction will complete the delivery. ^ One or Both Fore-Limbs flexed at the Knees. The fore-limbs flexed at the knees, and fixed under the neck and chest are a very frequent and often troublesome comphcation. It is generallv found in the Mare and Cow ; when it occu"s in the Sheep and Goat it is rarsly of any importance, as delivery can usually take place without assistance ; in the young of Carnivora, the metacarpal bones are Zo short to otter any obstacle when the knee is flexed This misdirection of the fore-hmbs may occur in all the positions of the anterior presentation, but chiefly in the dorso-sacral position. One or both hmbs :imy be flexed, and the complication is not unusuallv I'vSnf'i^ ^ misdirection of the head; hence, there are several vaueties of the complication, the most important being those due to the general position of the foetus It may occur in thr'ee positions- he dorso-sacral, dorso-puhic, and dorso-ilial. Dorso-Sacral Position of the Fa^tus.-Ii at the moment when the limbs of the foetus enter the pelvic inlet, they are not quite extended and the fee are dightly below the level of the anterior border of the pubis, the uterine contractions push them against this border, and there they remain ; at the same time the heac^ enters the inlet, and as it pro- ceeds the hmbs become flexed, the knees are bent and advance with it but the metacarpals and phalanges are directed backwards beneath the forearms, and the limbs thus doubled are applied against the neck. We have therefore the head fore-arms, and metacarpals in one mass -ntering or being propelled into the limited space afl-orded by the inex- tensible pelvic circle, and, according to circumstances, the hand of the obstetrist will meet with these parts in varying relative positions dependmg on the stage of labour. When parturition has only recently commenced the head has entered, or is about to enter, the inlet, and if-, "^^ Plfed beneath it are still somewhat free in the uterine cavity while the foetus itself is not immovably fixed if the waters have not long S^r^.?''^'" i^^T ^'^^ ^'^^^ progressing for some time, thi head IS well advanced in the passage-sometimes as far as the vulva • but considerably behind it are the limbs, imbedded on each side of the neck-the knees towards the head, the feet at the elbows With the smaller Ruminants, as already remarked, birth mav take place spontaneously even now, as they often have more than one foetus, and these comparatively small, compared with the pelvic diame er; while the bones are elastic and yielding. But with such animals as the Cow and Mare the fcstus is 'nearly Always single ^nd vo uminous, and its skeleton is rigid and unaccommodating, and can theyrv?s'^° ^ ^^'^' reduction in size during its passage through Therefore it is that in the larger domesticated animals, such a devia- tion of the hmbs IS always a serious cause of dystokia-not so much from the increased volume that the doubled-up limbs gives to the neck as because the arms, incompletely extended on the shoulders, retain DYSTOKIA DUE TO THE FORE-LIMBS. 437 the latter against the thorax, and prevent their being lodged in the depression at the base of the neck — thus augmenting the vertical and transverse diameter of the chest, while at the same time the projecting elbows press against the border of the pelvis. It may happen that only one limb is flexed at the knee, and then, of course, the case is not so serious. Indications. — The indications are in this case also obvious : Find the retained limbs, extend i !ie fore-arm of each on the arm, and ex- tend them in the pelvic cavity, as in normal parturition. These indications are not so diflicult to carry out when the obstetrist is called in sufficiently early, and the head has made but little advance into the pelvis. We will suppose both fore-legs partially retained in the abdomen. Fig, 128. Anterior Presentation, Dorso-Sacral Position : Fork-limbs flexed at thk^Knkes. and flexed at the knees. The exploration which has led to this discovery has perhaps also indicated that one limb is not so much flexed as, or is more accessible than, the other. If this is the left limb, then the left hand and arm must be employed ; if it is the right leg, then the right hand and arm will be most convenient ; but if both limbs are alike implicated and accessible, then it is immaterial which is first manipu- lated, so long as the corresponding hand and arm are employed. The same directions are applicable to both, keeping in mind that the right and left hands are opposite. The object is to adjust the direction of the fore-limbs, so that delivery can be accomplished. This adjustment is effected in four movements : — 1. The hand is passed alongside the neck of the foetus, the fore-arm is seized in the middle, the radial border of the hand being upwards, the cubital downwards; then bending the hand, 438 F(ETAL DYSTOKIjL .•I ptheruptal'^^^bt^^^^^^^ the pelvis^hile the elbow is away from the pelvis thfi mlf „ ' \ P® ^'?^^ °^ *^« ^^'^^ being thrust and moving it ?nth;sa.rm^^^^^^^^ ^r\" ''^?^^ "^ *^^ ^°^«-^^m was, higher thai the pofnt oTtTe roul£%V m Z to'/f '% ^!f^^^' °^ the level of the maternal niiW« Tvi: ^'r . '• ^ *° ^^' ^°^ ^^e foot to flexed strongly on tbfl Wln^ol '^ " ^^^ ^°°' '" g^^^P^'^ ^^ the hand, canal; 4. Shmb t /bin ?"*^^Pll*"'"' ^"^ drawn into the genUa necessary a cord is Sa^d „^^*^"t? t°^ards the pelvic outlet, Ld i flexed, being then so5ibti«/? *^%P?«*«rn, the other limb if also Lecoq haf descr bed anlTb. *?u *^^ 'Vl '^^"^"^ ^^""er. arm alongsTdelK Wd and n„S- ^^^i' .^^^1 .<=°°«^«*^ ^^ Passing the seizing the foot in such a w^v S/?. ^^^V^ ^^*"'^ of supination, the fetlock the wrist Th! onpr«fn fi,P^''''V^''"' *^« P^l^ a'^d from him. at the Tame time LxK^^^ P'^'^'l *^« ^^^^ away possible, until gettirthTpasLr^a^ bfi^''"T °^ *^ ^^'^ ^^ '"^^^ as Fig. 129. Antkriok Treskntation : Extending the Foke-Limb. ^^^flSi^^'^'^tT^T'''^^^' *^« -ethod by pro- Wed. Sr-sriethodnX^^^^ that which should be gen^ei^lJy fcBtus'haTn' f Xaled t^int Etf'^". 4^ ^^^^^^^ ^^^ ^^e engaged the operatbn is much more^drfficuh' t? '' '^^^^^^-^-h necessary, and pxtpncmv, ^"''T ™V . ™°U"- ^etropulsion may be the fcetu^s'irclrrSThe inlet' Smi 1°"^^'^ °"?^P°^^^b^« -^-- possible, and often easvMpvt^J.^f 'u"^^'^^ pomtmg out that it is that the dimensions of^hrbl!?/^ ^T\^ ^^ *^^ ^°^'« Pelvis, and these manoeuvres Indsts that tb« * -"/""^r ^"'^^ ^^^^^^^^ ^P^^e for lower end of thfrndfus and no fbi^r* °^ 1^*1°^ '^^^^^^ ^e at the should be employed To extract tSbr^' 7^^^^ Schaack's head-collar ^- *^ ^k'^ V^^d wTrun^tg nSse'' ''' ""^ ^^^^^^ ^^^ ^^^ long eLapeT'^bt'i?''? •" P'°P'^ ^°^ «°"^e t^^e, the "waters" have no°!CyTpt;ear\Se;^fet^^^^ *°^^^^^ the vuL'the body of '^^z^^^:t^is^^i^o^^ Journal iU Mddecine VdtMmire, November, 1876. DYSTOKIA DUE TO THE FORE-LIMBS. 489 the elbow is being tJirust )re-arm was, high as, or I the foot to Q the hand, the genital utlet, and if limb, if also Jr. passing the supination, 3 palm and limb away as much as ightens the straighten- exceptional the limb is )d by pro- generalJv but in t' L when the jompletely •n may be jible when b that it is >elvis, and i space for be at the ead-collar The cord 3rs " have mlva, the jly to the at retro- pulsion fatigue the operator. Another procedure must then be adopted. The hand, carrying a pliable cord, must be passed alongside the head as far as one of the bent knees ; then the end of the cord is to be passed behind the joint and brought outside the vulva, where it is tied to the other end, the cord forming a loop around the knee. The second knee, if flexed, is to be secured in the same manner, and a cord is also to be fixed on the head ; thus there will be three points on which traction can be employed as vigorously as may be necessary. Some practitioners employ blunt hooks instead of cords, but it may be doubted whether they are so useful ; hooks are also sometimes resorted to for straightening the limbs by seizing the pasterns, and in some cases they may prove serviceable. The " repeller " or "crutch"' may also be most profitably utilised in retropulsion, and in keeping the foetus forward while the necessary manoeuvres are carried out ; it should be applied to the head or chest. Harms advises, in the case of one limb bent at the knee, that if this cannot be extended it should be pushed forward under the abdomen by the crutch, which is applied to the humerus, the other limb and the head being corded, and then traction employed. If both limbs are bent and irreducible, this plan might be tried in the Cow, and particularly if the foetus is not very large. Should none of these methods succeed, then embryotomy must be adopted, the limbs being removed at the knees, or the shoulders if possible ; though the advantages of this operation are not so great as might be anticipated when the limbs are only removed at the knees, while removal at the shoulder is frequently a most tedious and fatiguing task when it can be accomplished. Dorso-Piibic Position of the Fcetus.—lt is rare that this com- plication is found in the pubic position, and only a few instances are recorded. The foetus is lying on its back, and the head either presents at the inlet, or is more or less advanced in the pelvis, while the fore-limbs occupy the sacro-lumbar region of the mother, more or less flexed, and often crossed on the sternum. In this position the fontus is much less likely to become so firmly wedged in the pelvis as in the one just described, and it is consequently more easily extracted. If, how ever, the uterine contractions are violent, or care is not observed in attempting delivery, the fore-feet, projecting towards the utero-vaginal parietes and the rectum, may cause grave mischief. Extraction should therefore be set about early, and with every precaution. Indications. — Having ascertained the position, it is generally a good plan to empty the rectum before proceeding to extract the foetus. If the head is in the genital canal, it may be advisable to secure it by a head-collar ; ti n the limbs can be sought for and adjusted— an opera- tion much facilitated by a hand in the rectum. Delivery may now be accomplished by guiding the legs forward into the pelvis — cording them, and exercising traction if necessary. It is sometimes very useful, in more difficult cases, to throw the animal on its back. Version is rarely required. Eight or Left Dorso-Ilial Position of the Fcetus.— This complica- tion of the limbs appears to be rare, and it does not offer anything particular, except that the undermost limb is difiicult to reach and adjust by the hand of the operator. It is therefore recommended, after extending and cording the uppermost limb, to attempt rotation 440 FCETAL DYSTOKIA. Ono or ioW. i?o«.i,„,fa ,:omi,letai, retained ute!tTvtVSrnre'trth'ta°\V°';-''"'''' o' *= f"'- to .ha perhaps more frequenUvTn thT M.™ ^^^ domesticated animals, but It is always a serioSs cause „f ^v«i- "^ '5" '^'"' ^ "*«■• "K^'ure. the four anVor positions lhoLhTkl';°n "k^ """f '" «"'« "t -al position. I is, "o tt ;ore5l.t^',^l;-^/ ,f- Fig. 130. Antbrior Presknt^tion, Dorso-Sacral Position • One Pnn. T BBTAINKD. " ^ORE-LlMB COMPLETELY Sl^CtS Cains' in^alf ^''^"^"* occurrence with the limbs than the latter Und^erexciS' n '%'^^ ^°^^^^ having longer as Franck remarks, the Foalor Sf i^«v h^ favourable circumstanci, eBpecially of tt F^oal if iLTssS *N ^'t "-'^°"' *^- ^irth. traction is soon accompi shed X W, °* °"^^ ^^'^' ^^* ""^^ss ex^ asphyxia-indeed, the Foat' nearll «l '""i ,?''^* ^''^'^ ^^ <^yi^g from Pl-tion; so that ^eath^^VlhTfSulTa^t^-^^^^^^^^^ DVSTOk'IA DUE TO THE FOllE-LTMBS. 441 shoulder presentations. With the smaller Buminauts, owing to the tormation of the pelvis, birth is not often impeded. With the Sow and Carnivora— multiparous animals— this might almost be designated a normal presentation. It will readily be perceived how one or both of the anterior members bent back under the body will prove an obstacle to the passage of the tcBtus, after what has been said with regard to the relative dimensions ot the young creature and the pelvis of the mother. The shoulder or snoulders, and the muscles in this region, are the cause of dystoki'a— more especially the flexor brachii, which constitutes a tiiick and some- wnat tendmous elastic mass between the scapula and upper end of the lore-arm. This muscular mass forms a very prominent obstacle on Fig. 131. Anterior Prkskntation, Dorso-Sacral Position : Both Fobk-Limbs comi'lktely retained. the side of the chest when the limb is thrown back. There is also the large levator humeri muscle adding to the increased volume of the thoracic region, as well as the elbow and fore-arm. On exploration in this complication, the head is found to be in a good direction, the hand encountering it either in the pelvis or towards the inlet, or it may even protrude into the vulva, according to circum- stances The foetus, if a Calf, may be yet alive ; if a Foal, it is nearly always dead. If only one limb is completely retained, the other will be in a normal position— alongside or under the head (Fig. 330) If both hmbs are retained, though the head may appear in the genital canal or at the vulva, yet nothing can be discovered of them in the pelvis, they being entirely lodged in the uterus. At each pain the K) 442 FihTAL DYSTOKIA. head of the foetus is propelled outwards, but as soon as this ceases it recedes again, as if thrown back by a spring ,„a I- ^^T""^l''''^ f^""^^' ^^'^ ^'^"^ introduced deeply into the uterus MnL rin" f V^^'^/ty of ihe fore-limb ; but in large Cows, and in the Mare, particularly if the abdomen be pendulous, this is rarely, if ever trlw i-ft" u^'i°"'^u™'''^ ^^" ^™''« <^^" o"lybe reached with the fhTlvn. w?^*^^'i^°'?P^*^"^''' is generally no trouble in introducing w:\ \ .^ ^^" the hmbs can bo felt, they are usually found to be in one of three positions : directed nearly vertically downwards, the fore-arms resting against the brim of the pubis; lying beneath the ^nf r^'fl^^V^- ^^T^) '' °' "^°^^^y ^PP^^^^ '^^ai"^* the 4lls of the chest and the flanks. In many of these cases, the head is also in a vicious position. In the larger animals, when the two limbs are retained birth is nearly always impossible ; it may certainly be sometimes effected by v olent means, but then these are the resort of brute force, and not of humane and inte hgent device, and nearly always entail (he death of the mo her. With the smaller animals, when this complication is a S eSzc /orce ^ ^ ^^^""^ ''^^ generally be effected by simple measures Indications.~ThQ indications are to reach the limb or limbs with hrfni^f^.;r'r° # *°.^^*roP"lsion if necessary, to gradually raise and fh« f *^"V°^.^^!d' joint by joint, into the pelvis, Jnd then to extract wi?h^jffl^ i7 J."^i?.'°''' t»-action. These indications are not attended Tr nnlv^f^h^ '"^ f^^^^ ,"f ^' '^ ^^^"^ *^^ ^^^^ '^ ^^^ '^ ^^^ abdomen, fL M^ muP^^^'°, '°^*' ^"^ ^''^ e^s^e^ carried out in the Cow than refS to h^ereXf °' '' "'"'^"^ ''^ '^"'^*^°" '' *^^ ^^^^^ -" ^« wh^i!.i.'^?^*'{f ^^ happens, especially with the Mare, and with Heifers Irl.nn 7vfn^r ^dely manipulated before the arrival of the veterinary surgeon, that the foetus is so engaged in the genital canal that retropul- nZ Ta°T^^^: ^" '"^^ circumstances some authorities have re- commended forced extraction, traction being exerted on the head of «dviiS "^^ either by assistants or mechanical means; others have advised decapitation-skinning the head and removing it at the first Z. IZ cervical vertebra, taking care that the ends of the bones ZLZl" -^^ ^^.'^'"1 °^ ^^'^ «'^^^"' *° P^-event laceration; then be elcteT '' ^ ' ' ''^'' ^^ extended, and extraction may fr.^y^u^^^''^ *? ^°'''f^ extraction, there can be no doubt that if both tbp w»f ^'^^•^*^^^ed, the life of the fc«tus is endangered, and that of Sheen rn?f fV ^"«^ '^. ^^^ ^^ successfully practised with the irTtS'ATo ' n °'^/' 'T" ^"^"^^18. When only one limb is retained m the Mare or Cow, forced extraction may, nevertheless, succeed ; and S.oc7ki /""l'- T^^""' ^""^ °*^er practitioners, have proved that it is possible, traction being employed on the head and normally-presented n^'v.f ^V*^*'°'' -^^^ *¥ ^^^^ ^^" '^^t always prove advantageous IdvantaTe '■ '''^""^' '^ ^^" °^*'^ ^' found that it is a^ dis- th J^n."^!?'* '^I'r^i ^"^ ^opeful operation is detaching the shoulder from tne trunk , or the flexor brachtahs muscle may be cut through by means tL I ir^ finger-knife (to be hereafter described) in its thickest part at the shoulder-jomt. or above the elbow-joint. Then extraction may be DYHTOKIA DUE TO THE HEAD, 448 again attempted. If the fcctus does not come away, evisceration of tha chest and abdomen may be practised. Should delivery be still impossible (vsrhich is unlikely), the limb must be detached at the shoulder and the trunk withdrawn from the uterus, the leg being extracted afterwards. When one limb protrudes with the head, it may be removed subcu- taneously at the shoulder, as it is easier accomplished than amputation of the retained limb. SECTIC'N II.— DYSTOKIA DUE TO THE HEAD. Obstacles to parturition from a wrong direction of the head are quite as frequent as, and more serious than, those due to misdirection of the fore-limbs. It is stated that they occur oftener in the Mare than the Cow, but this is questionable ; though in the former animal they are more embarrassing, as in consequence of the longer neck of the fcEtus the head can be carried back much farther — even as far as the flank, while with the Calf it seldom goes much beyond the shoulder.^ The complication is all the more serious in the Mare from the fact, as has so often been stated, that obstetrical mana-uvres in this animal are iiiuch more difhcult than in the Cow : the straining being far more violent — paralysing arms and hands — while the impatience and restless- ness are generally so great, that it is often necessary to throw it down before anything can be done in the way of adjustment. Misdirection of the head usually takes place immediately preceding or during parturition, under the influence of irregular and energetic uterine contractions before the os is sufficiently dilated ; it is supposed sometimes to be due to premature escape of the "waters," to injudicious manipulation of the fore-limbs, maltraction, etc. Some of the cases, however, have doubtless occurred long before the period of parturition, ' Since allusion wns made to dystokia from excess in volume of the head of the foetus (p. 374), Colin, of Wassy, has pululished an instructive paper on the subject (Journal (It Mid. Veterinnire et dc ZooUclink, Nov., 1876, p. 529), which deserves notice here. Observing that in very bony Cows the size of the Calf's head is often an obstad to par- turition—especially in primiparse and in the Jnra.isi(/ne breed of cattle— while it is rare in improved breeds, in which the head is small, he describes the nature of the obstacle, and remarks that, if traction is ventured upon to extract the foetus, it must be very viole?it, and therefore likely to produce serious, if not irreparable injury. To avert this, he insists on putting Schaack's head-collar on the foetus, or a cord placed behind the ears, then each side looped round the lower jaw, to answer the same purpose. The head being thus secured, the protruding limbs are pushed forward into the uterus, after a cord has been fixed to each pastern. If the genital passage is dry, oil is plentifully injected into it. Traction being then exerted on the head, this readily clears the inlet of the maternal pelvis, its dimensions being no longer increased by the addition of the limbs ; it is drawn well into the pelvic cavity, and then the fore-limbs are easily brought through the inlet, now only occupied by the neck of the foetus. The head and feet are afterwards simul- taneously drawn towards the vulva, and it is rare, if the traction is judicious, that delivery is not promptly effected. Through having neglected the precaution of first pushing the fore-limbs into the uterus, Colin, at the commencement of his career, in 1853, lost two Cows. Since that time, in more than two hundred cases, he has been successful in delivering the Calf without resorting to embryotomy. Success is always certain, provided incompetent persons have not previously rendered it impossible. He recommends the same procedure in spasm of the cervix uteri, after reduction of torsion of the uterus, and in fcet.al hydrocephalus. In the latter, puncture of the cranium is easier if the fore-limbs have been previously pushed into the uterus. :'t' 1 ** f 444 F(ETAL IH'STOKIA. havV^LlcdUtr °i ''^^•"Ity of the neck or head, or hoth ; we It w n ..n„ n K^ " ^^*'" ^''^''''"« °f " Contractions," at p. 392 prove" or ousl^stacl':'^."!?'^.' "'^ 'l-'^i-«tion of 'the lead should nosramlTn.?' *'•*'' .^.'"''^''''y' ^'»"" WO remember the part the KeiTl^vr."-^^^'" ^''"^ *''' °' ''"^ «°"'*^^ canal, aff how ie^'dt e'^lS iu^^sf^^^^^ "^"^^ ^'' *° *^« '^"^^ of *he neck, and of ^he' aSor n ' ^T\'"''^ ^° 'r ^^^^'^^ •" *'^« f°"^ P»-i"«'P^l positions nLof! J^ -M P'^.osontation ; and they may occur aloni' or be com ? red t" bur;h'"h"''.°" % \'" ^"'^/'"^''^ These w'n'not a^ain be from thfi noo! hi-^''^^ '"'" ^" '^'^^^'"^ '" tl^ree dilTerent deviations from the normal direction : 1. Doromvard deviation, the nose bdng Fig. 132. AnTEHIOR PKESEXTAT.OK, DoHSCSaCKAL POSITION : DoWMVAIIU DEVIATION 0. THE Hkai). SanV'? ^ "^l left side,';heLrd be^Te^rt'dloVL^^^^^^^^^ L? f .. ""l *^^V' ■^'' t^" '^^e °f the neck presenting ; 4. V)marddevZ Z'l^l^^''^ ^^'"^^ ^""* "P^^^^-'^^ ^"*1 backwards in the direction o Loat eTC;rt^ to the right or left side of the chesTwith the inroat— either straight or twisted— presenting. Doivmcard Deviation. This is usually the deviation of the head met with in hvdrocenhalus Suf well Wed'^^^r """'r "^^^ ^ ^^^^--^ i^ nolTaTd the houthT/; w ; ^^"^"ally met with in the dorso-sacral position, in thf Cow ^"^^'^^"^^^ ^'^ *he dorso-pubic ; it perhaps occurs^oftenest meSbrrneTHf/r-"?^'""^"^ .*° premature rupture of the foetal Ss If t'hP ll„r-^^'°? °««^y""g ^vhen the foetus is entering the fll ?; ^? ^^"^ '',".°* ^^^°*'y ^" *h« a^i« of the inlet, but indines fn colct wTh '^^^^ 'M/^' l'"^ slightly Hexed, th^ nose com m contact with the brim of the pubis, and is retained there ; while the DYSTOKIA VVK TO THK UK AD. 440 uterine contractions, pushing on tut. body, propel the fore-limbs, if they are in a favourable direction, into the genital canal. Thus it will be understood that, if the expulsive eObrts continue, the head becomes more and more flexed as the f(utal nuiss is carried towards the vulva (as is delineated in the shaded and unshaded fictusea in I'ig. 132), until, from vertical and oblique, the face becomes horizontal, and rests on the floor of the pelvis of the mother, the lower jaw against the trachea ; the neck becomes proportionately Hexed, and as labour goes on the head is retained, as well as the cervical portion of the former ; so that when the obstetriat introduces his hand into the genital canal, the feet are found presenting towards the vulva, but far in front of them (or behind them, as the explorer stands) ; this may be designated a neck or poll 2>rcsentatii)n (unsJutdcd fu'tus in Fig. 132). The diagnosis of tliis deviation is not diflicult. When the anterior limbs are in a proper direction, the feet and upper part of them are readily found, and tlieir inclination should be noted ; but in a slight complication the wiioleof the head cannot be discovered— only the ears, eyes, nape of the neck, and the forelock and mane if a Foal. With the Co If, which has a shorter neck, it may be possible to reach the head or nose. The upper ridge of the neck is always a safe guide to follow in discovering the direction of the head. In(lications.—1\xev& is no ditliculty in adjusting the head, if the ob- stetrist is called in time, and it is movable towards the pelvic inlet, but not engaged in that opening. It is merely necessary to ghde the hand along the floor of the vagina into the uterus, pass it between the maternal pubis and the forehead of the fcetus, downwards to the nose, which is to be received into the hollowed palm and raised above the pubic brim, by flexing the wrist and drawing it towards the vulva. When the nose is brought into the genital canal, nothing more is to be done than to pull the head into the passage and complete delivery in the usual way. With the Calf, whose mutHe is wider and cannot be so readily received into the palm of the hand, it is better to introduce the fingers into its mouth, using them like a blunt hook, or to seize the nose by pushing the index finger and thumb into the nostrils, so as to throw the lower part of the head upwards When, however, through delay or unskilfui attempts at delivery, the nape of the neck is firmly engaged in the inlet, there is no room to adjust the head, the lower part of which is jammed against the mater- nal pubis below, and the vertex against the sacrum above. In such a case delivery has been effected by passing the running noose of a cord round the nose or the upper jaw of the foetus, and while an assistant pulled at this, the operator, by pressing strongly against the top of the head, made this swing backwards, the nose rising into the passage ; birth was then accomplished in a few minutes. And even with this degree of head deviation, delivery of the Foal without adjustment is not impossible ; for Lecoq gives an instance in which the upper part of the head and poll were so firmly fixed in the pelvis, that it was impossible to push the foetus into the uterus. This was attempted, however, by squeezing the head closer to the neck, the hand being passed alongside the cheek and the nose gradually raised ; at the same moment the Mare strained doubly hard, and gentle traction bemg applied, the Foal was expelled with its head in this position, but without injuring the perinaeum ol the mother. The latter soon recovered, III 446 F(ETAL DYSTOKIA. but^the Foal, as is usual in such cases in the Equine species, was wiuVe^IfforS'jfi ^l^viation, as well as in the others, reat assistance Tf one two orln^ f T^ ?^ ^''^t"' P^"^*' °^ <^^« "^°t^«^ to tl^e extent P acL; S l^fZ^^ '*••. \''°,^' ^V'^' ^""^ °*^^^« h^^^ recommended elevatf the hTn^ T ''' ^^^^' ^* ^' P^^'^^P^ b^"^^' ^°^«ver, to elevate the hind-quarters, and resort to retropulsion either bv the flufd, °'. Al crutch; then after injecting warn" water or oTea/nous blunt' wl!f ^,^'r^*^« ^l^d or to attempt forced extraction.^ The ui^l^n tt Sr^oTiir.'^ °^''^ °^ ^'^ ^-^^^' -^" ^^ ^-'^^ --^ In the dorso-pubic position, propulsion is necessary to adjust the rig. 1C3. AnTER'OR PF-IiSKNTATION : EXTKEMK DOWNWARD DkVIATION OK THK HeAI). hfl^^L fn'T'^'M *^/ ^'"^'^ ^'\^S pushed into the uterus, efforts must .LT vu ?''''' f^^ {"^^''^ "' *'^^ dor'^o-sacral position, which bein'^ accomphshed. renders delivery possible ' ° wiSI'fhrS? P^*°««^,r!rr"^'^^«^^^'y with the Sheep and Goat ; while with the Bitch and Cat delivery must be effected by means of forceps. Head hcnt under the Body. This is an exaggerated, but much more serious form of head and neck flexure, especially in the Mare, and it occurs in a similar mannei to the preceding— the foetus in the anterior prn^nntatiou advances to the inlet TpW H? f ^ "fu"^' ^?'^-' '^""^.''-•luently, the lower part of the head below the floor of the pelvis ; this misdirection increases as the uterine contractions force the foetus backwards, and the head is pushed low"? species, was .t assistance 10 the extent commended however, to ;her by the ■ oleaginous ction. The found most adjust the \ Head. brts must ich, being it ; while forceps. and neck ler to the the inlet ihe head e uterine ed lower DYSTOKIA DUE TO THE HEAD. 447 and more under the neck until it gets beneath the chest, and even the abdomen (Fig. 133), where it may deviate to one side. The fore-limbs are, of course, in the genital canal. The accident is discovered by manual exploration; the fore-limbs being followed by the hand, the crest of the neck is found pressed against the pubis, while the head can be traced by the ears and the orbits, the face being towards the floor of the uterus ; or the hand may discover the nose and mouth inclined upwards at one side of the chest behind the elbow. In this condition birth is impossible, as straining and traction only make matters worse. Indications.— When the upper part of the neck alone presents, reduction is still possible, provided no great delay has occurred, nor mismanagement by unskilful people has been allowed. But when the " waters " have been long expelled, the legs pulled at by amateurs and the uterus closely applied to che body of the foetus, the case is most difficult ; as then manipulation and retropulsion cannot efl'ect much in many instances. The doubled neck is too voluminous to enter the pelvis, and the longer the pains continue, so the farther is the head pushed forward from the inlet, and therefore away from the reach of the obstetrist. The contractions of the closely applied uterus also render attempts at dehvery almost iix^possible, by their paralysing the hand and arm. Large quantities of warm lubricating fluids must be injected, retro- pulsion attempted by one or two crutches applied to the shoulders of the fa3tus— not to the neck ; while the hand manipulates, aided, if need be, by the finger-hook. A blunt hook inserted on each side of the lower jaw— when this can be reached, towards the root of the ear, or into the orbits ; a cord round the neck— if it can be passed ; and other devices may be tried. If they all fail, then the animal should be thrown on iis back ; indeed, the success which has attended this change of attitude in so many recorded instances, should induce the obstetrist to adopt it wjthout much delay. Very often the altered position of the mother at once disengages the head of the foetus from its deviation ; if this does not happen, then the other means may be tried as in the standing position. Pelvic version may be resorted to in some cases, the anterior presentation being converted into a posterior one. When reduction cannot be eifected, and delivery of the entire foetus cannot be accomplished, then the obstetrist has no other course left open to him but the adoption of embryotomy. Indeed, it should be resorted to early if the foetus is dead, which is nearly always the case in the Mare. The head may be amputated through the presenting part of the neck, or the fore-limbs removed subcutaneously at the shoulders —the latter is to be preferred in the majority of cases, at least before incision of tho neck is begun. This gives more room foi manipulating the body and (jflecting extraction. In many cases the removal of one fore-limb will permit delivery. Whether one or both be removed, it is generally necessary to pass a cord round the bend in the neck and puH it so as to bring the head iieunr tho inlet, where it may bo possible to turn it into the genital canal, or at least to amputate it more easily. 448 FCETAL LYUTOKIA. W ^C Lateral Deviation to the Bight or Left. The lateral deviation of the head to the right or left side cf the bodv whereby the left or r ght side of the neck presents at the pelvic inlet is a very serious obstacle to birth, and is only too frequently one of the most difficult to be overcome. It is also one of the most freq^uent devSns Saake observing it in 39,^ per cent, of his cases of dyLkiaTt occurs much more often_ in the Mare than the Cow or other anknals With St be dltn'St' '' "f ^ '^-^ ''' ^^.J-^--*. a wide distinction features. " ^' '''''^^^ '"^ *^^ *'°^^ ^^'^ °*^^^' y°"°g The cause of lateral deviation of the head is not well ascertained in all cases. It is not nnprobable that, in very many instances, it is due not^ at S\ dnnT.d^"?^'"°"1 ^^'^' ''^''^ '^^ °^ ^''^'^'''- i'-PerfecJly or not at all dilated. In such circumstances, the uterine contraph-nn« propel the head of the fetus, otherwise in a good dkec^n, toward Z pelvis ; but as the os is not open, and as the impelling force cont^ues he body pushes the nose against either the pelvis oAhe occSed C and It turns to one side; then the deviation becomes increased with every contraction. Premature rupture of the facial membSnes and escape of the •' waters." spasm of the cervix uteri, torsion S the uerus and other anomalous conditions, n.ay all more or less occasion it. As with the downward deviation, if the nose is not in the a. is of the pelvis, or indeed of the os-even though the latter is parLlly dilated misdirection may occur, and all the more rapidly should the ioitSs chance to pass into the vagina. The accident appears to be most frequent with primipara^ In 108 cases of lateral deviation of the head, Saake found Si-oS^^erceT -m animals pregnant for the first time. The remainder were noted in animals which had previously bred, but in which labour wirprotmcted through imperfect or tardy dilatation of the os prou acted _ This deviation is more serious when the fojtus is dead than when it IS alive ; and when the deviation is only slight the head fittin.. \ntnfhl concavity on the side of the neck, birth may'even though Sed are W -occur without assistance, particularly iith the Foal, which has a onger and thmner head than the Calf. Some authorities have remarked andc^trft^fcontilL-r^'^ ''''^^''''''^ '^ ^'^ ^'^'^' ^^-" ^^^ ^eft^sit' hi^'trkpn '?IlT'' "''!•' ^^^IT'^^h' be any doubt that the deviation has taken place some time before gestation is completed, and is the result of a long-continued malposition of the fa^tus. In many Foals at birth the neck cannot ^e straightened, and the head is diSted from being pressed against the neck or side of the body (Fig. 103 -bone? muscles, and ligaments being involved. We have referred to theseTn describing ' Contractions ■' of the fcetus as a cause of dvstokia It is not dilhcult, as a rule, to distinguish the existence of Infoml deviation. Usually both ^ore-feet are in" the genita an^l bit trU does not progi^ss. But an important fact to remember is that one limb -that belonging to the side to which the head is bent-seems to be K"nd thesrt-'wT'^b' ''T\ *'^ ''''''■ ^^^ ^^-"^' - beinTpassed tcjond these tu-.vards the mlet, comes in contact with a convex mass more or less occupying the whole of it. and rendering access to the utS cavity difficult Patient exploration, however, discovers this to be he bent neck ; and if it be a Calf, owing to the shortness of this part the e of the body, pelvic inlet, is 'ne of the most snt deviations, kia ; it occurs limals. With de distinction I other young Lscertained in ices, it is due mperfectly or contractions I, towards the •ce continues, occluded os, creased v^^ith mbranes and Df the uterus, iasinn it. As ! a^is of the ;ially dilated, he fore-limbs irae. In 108 ■ 78 per cent, ^'ere noted in is protracted bhan when it ting into the ndeed rarely vhich has a iVe remarked he left side, he deviation , and is the my Foals at storted from 03) — bones, I to these in the uterine is to be the lis part, the DYSTOKIA DUE TO THE HEAD. 449 head is soon found, and recognised by the ears, eyes, and often the muffle turned towards the shoulder (Fig. 134)— ^vith this Bovine foetus, ui fact, the greater part of the head in the majority of cases lies a"ainst the shoulder. With the Foal, it is only too often otherwise. The much lon^^er neck of this creature and the more violent uterine contractions of the Mare, generally result in the head being pushed towards the side of the thorax, the abdomen, or even the flank or croup, where it cannot be reached._ This difficulty is greatly increased if the abdomen of the mother is very pendulous. Occasionally this is also the case with the Gov/, though it is rare that in this animal the ears, or even the eyes cannot be reached by a fairly long arm (Fig. 135). If the animal, be it Mare or Cow, chances to be lying, and the deviation is only to the Fig. 134. Anteriou Prkskntation, Doeso-Sackal Position : Latekal Dkviation of tiik Head towards the Shouluku. shoulder, it is most difficult to reacli the nose of the foetus should it be inclined to the side on which the parent lies — i.e., if the Mare is on the left side and the deviation of the Foal's head is to the ri^ht. The head may be raised as high as the back, or lie as low as the under part of the chest oi- abdomen. The foetus is usually in the lirst (or dorso - sacral) position, though the deviation may also occur in the second (dorso-pubic) or third (dorso-ilial) positions ; in the latter posi- ti(jn the neck may be bent uincards—ihQ head towards the maternal p-acrum, or doivniranh — the head resting on the floor of ihu uterus. This complication is not only a very frequent, but, as has been said, a very serious one for the obstctrist, and 't may be truthfully asserted that birth is not possible without his a, stance; indeed, it has been well remarked that " it taxes all his streugLii, patience, and iniad ones. Tl.ey c,.n.eo„tM7tTv o^h;.. /. ^f 'r^ the fore-feet in the vagina were force, and eight men Sledft 'the d ? '' /""^'' T' ."^'""^ '^^•''tracting the Calf by removed, but it wa dS iVe Cow wL u 2e t ' "" ^^'^ '' '\' ^"""^ "*^'^*"^« ^^« recovered. ""''^'*^ ^" *»*-'* "1' ^"'' '''Bht days, but eventually f 4 452 F(ETAL DVSTOKIA. t Strong y and equally on both cords. The Foal enters the inlet, but it otten happens that, at a given moment, it stops there, owing to the uterus forming a double or ring at this part and opposing progression. Iraction must then cease, but the foitus is to be held firmly in the posi- tion tovyhich It has been advanced; the hand is to be introduced between the latter and the uterus~the back of the hand to the fcctus palm to the mucous membrane-the fold sought for, and dispersed by raismg the back of the hand. Then the tractions are to be renewed and m the course of fifteen, ten, or even fewer minutes, the Foal iJ extraction ^^ ''"''^^ *° '''"^''^' *^° ''^''^""' ^''^'''''® commencing When practised with care and discretion, this forced removal of the l^oal may certamly be commended, especially if it is of small size and the Mare IS not exhausted ; but wh-n the foetus is large and the mother has suffered much, then there is certainly danger, and embry- otomy should be performed. But we should prefer, when circumstances will permit, to give a trial to the methods ah'eady enumerated ; seeing that this procedure is not always successful, and may be followed by untoward consequences. Eberhard gives an instance' in which forced extraction was attempted in a Mare, and was followed by rupture of the abdomina muscles, tlirough the powerful traction resorted to With regard to c?«ir^o '<«=' ""^ "> '"' di^o'ed should hrn be r/V' ™rd, .„'".'""">' '"=™">P"*'='l. 'he cords n^^-Tyl^, r SolL ■rpltl7eSei"''»8 '"^ '' ^°-P»'- i„. I> VSTOA'IA DUB TO THE IIKAD OH FOIIE-LIMIIS. Lumbo-supra-CotijloUlean Positions. 460 ThoHo positions— right and loft— aro so like tho corroHponding posi- tions in the anterior presentation, that tho same remarks are appUcahlo to thciii. When simple, tfio hind-liniys— perfectly extended— first enter the genital canal. Such positions aro very rare, and they do not oiTor anything very noteworthy ; they are recognised in tlio same way as tho lumbo-puhic position, and tlie indications aro tho same. As a rule, parturition is easier in these positions than in tho lumbo-pubic, as only one haunch is jammed against the brim of tho pubis ; the other, being in contact with tho mother's sacrum, can enter tho inlet without much diflir'ilty. Judicious traction on tho hind-pasterns is all that is needed after tho position has been rectitiod. Tho sn I no observations apply to tho /«;/t6o-(7/rt/ positions, which are sometimes, though rarely, met with, and are a cause of dilliculty. SECTION II.-DYHTOKIA DUE TO THE HEAD OR FORE-LIMBS. Obstacles occasioned by tho head and fore-limbs in this presentation aro less frequent, and not so serious as in the anterior presentation when the hind-legs enter tlie genital canal. Tho head, when not hydro- cephalic, is usually a cause of dilliculty when the neck is contracted and brings it round to the side of the body. Head and Contracted Neck. The head itself does not so readily constitute an obstacle to birth, though in the posterior presentation, being the last portion of the foetus to enter the passage, its widest part may become fixed, either in the pelvic inlet, or be retained by the cervix uteri when this has happened to contract earlier than usual. This sometimes occurs with the Calf and some of the smaller animals, but more especially Puppies. Indeed, it is not very uncommon to witness Bitches with tho hind part of the body of a Puppy hanging from the vulva, the head being firmly wedged in the passage. Very few instances of contracted neck are recorded, and they occurred in the Mare, with other complications — such as a transverse presentation, or a misdirection of the limbs. The head is bent round towards the haunch, and rigidly maintained there by the crooked neck; so that it is fixed against the border of the pelvis and cannot enter the inlet, which is already occupied by the hind-quarters. In these cir- cumstances birth is impossible. Care is necessary in arriving at a conclusion as to the nature of this difiiculty, but in repelling the hind-quarters from the inlet the head will be found at one side ; nothing else abnormal being discovered, it may be inferred that contracted neck is the cause of obstruction. Indications. — When the head alone is the obstacle, traction will re- move it from the genital canal, the body of the foetus being at the same time moved from side to side and up and down, so as to engage the head in the passage by all its diameters. With small animals, such as the Bitch, an emollient hip-bath is very useful; as are also injections of warm water, oil, or glycerine into the vagina. When the neck is bent or contracted, the hind-limbs should be 460 VOiTAL DYHTOKIA. iHi then bv hr^i.^?^'^ V *^^' ^'" ^'^^ passage, and traction nmde on means progress will bo n.a.lo. and delivery ultimately completed Forc-Limhs. an^obsiL?U>1o'bi..rf "*'f " '' "';^y.»»'H>P"" that the fore-limbs offer « do^i^nZr^^^^ alludes to tins accident in a presentation which o the Tcnn 1 f ' ' ""^^ characterised by the entrance into the os sent tio \vi:V :■ T""!""'^= t'^i« '"^^y occur in the anterior pre- and i n med in " 1^ .«>^t^-<>'"it.cs are Hexed beneath the al)donu.n the is H . f. ^ P^' 'T ''"" ''^ '^''^'^" ^''«^" '^^•« t'^" ntation is secondary, an« 1"»1'« are jannned against the Te Xrij : "'"'/ °'' ^r!""'"' '^"^^ t'-'^^^'o'^ ^vill load tonipture of at f 1 ,n tl erefore advises amputation of the fore-lind) or limbs V dt;"- ie has aKv"^ T''' "^^'^' '^'fl ''"^'^ ^^^'^ withdrawn to nea t lo W li tl,o r n? 1 ^ ^' ^T 'T''''^^'^ '" ''i« ''^^^^ ''V «»ch treatment fort A ; -' ^^°^^''^^'«'-' 1>« ^'^'"its that tlie fore-limbs may bo pushed fonvnrd mto thn uterus, and delivery then eflected ^ ^ by .nean'of "^^^ '''''''' -^-l-^-" of the fore-lind. or limbs DonZ'ieix'rnd'J.i ""f ^JT'" .^f "" '' '°"^' ^'^^ troublesome operation, bee " r e^^^ C ,''^7'/* ""^ '"^ ^?}^''''''^ ^"^il otlier nieasures have and if t i. .,''?';""''''" • P™l'^lli".^- ll>o fore-hnd.s into the uterus Tnl t r n ' r^ '^" f^''^^^''.' P"f^i"^' the upper joints beyond U>e o o on.. ^1 loco nmeuds cordn.g the hind extremities, grasping the be dm s nen- H , ^'''''' attempts fail, then the fore-legs can shouirr ;.; Lapula "'"^ '^ ^""•"^^' ^"' ^"'l'"^^^^-^ ^^^^^^ ^^ ^he B. AnxOKMAL POSTKUIOK PuESRNTATlONS. thJdLSn'c^^tKfSdnd7'?""''?"f • ""^ "^'^y •^"•^ ^« ^«viation in a«ai St tho H i..h n ^ ' ''"^ ^^ ^'''' ^"^^"^'^^ or the hocks-tho leg kt'BS^'^^- Fr^^ -^^'^ ^^i rouncttd mass-the croup and th.ghs-which is not at all adapted f or A IINOIiMA L VOtiTEHlOn VUKHENTA TIONS. ■1CI cflbcting a passage through tho Htnitod spaco. When to this Ijiilk is added tho flexed portion ol' the hrnhs, it will ho seen that this cause of dystokia, generally most forinidiihle in all cases, must bo more so with [)riniiparu', and (jspecially if some time lias been allowed to elapse since the connuencement of parturition, if the " waters " have e8ca])ed, and if amat(>,urs and (iiupirics have hwM interfering. With regard to tliis interference, however, it nuist be admitted that it is less to ho dreaded in this jjiesentation than perha])s in any other ; incomp(;t(!nt people are, fortunately, at a loss how to act, as tliere is nothing to lay hold of, and the luUui'o of the malposition or the maimer of remedying it is obscure, perhaps unknown to them. Fn the diverse com])licated positions of tho posterior limbs in this piesentation, it nuiy bo reuiai-ked that they are more frcfpioiit and diilicult in the Mare than in the Cow— the increased dilliculty being (l()ul)tless due to the greater length of the limbs in the Foal than the Calf. The mdposition of the hind-limbs may be of three kinds : I . Liiiil)s incompl' ',oly extended in the genital canal; 2. Flexed hocks, tiie (loul)led limbs (;nga^.'<(l moic or less de(-ply in the passage ; 3. Mind- limbs completely retained in the uterus, and applied more or less closely against tho abdomen of the fo'tus, the back part of the thighs and the croup i)rosinting at the inlet. Wo Iiave mentioned that one or botli limbs may be in a vicious posi- tion ; even when the two are misdiiocLcid they may not be in the same deviation— -on(! log being porliaps iloxed at the hock and tho other ex- tended forward towards the chest, one Hexed at the fetlock wliile the otliei- is lient at the hock, etc. Tins presentation is somewhat rare, and though differing little from tho natural one, yet frequently U^ads to death of the Foal, as birth cannot take place without assistance ; though the Calf, having more vital tenacity, can live longer, and tlien^fore has more chance of being born alive, even if help be not al'forded for some titno. It is generally (Tue to the jjroininent stillos being arrested at the inlet l)y tho thin margin of the ])ubis in the Mare, or tho inclined plane this part forma in the (!ow. When tlie hind-limbs become fixed the body of the fcetus continues to pass outwards, so that the fennn-s become more vertical, and tliis causes the croup to be raised against the lumbar region, and finally to bo jammed tliere. The accident is much less fi-eqiient in the Cow than tho Mare, probably because of the sloping border of tiie pubis. P^xploration discovers the soles of the hind-feet uppermost, ^vith the shank incomi)letely extended on tho tibia, wliich again is ])artially Hexed on the femur; the stifles are also found pressing against the margin of the pubis, while beyond this the croup is jannued upon the sublumbar arcii. /«f//crt^;o»s.— These are : push the croup forward in the uterus during the intervals between the pains, while traction is made on the cords which have been attached to tlie lower part of the legs. If the hind-legs chance to be incompletely extended in the reverse or lumbo'ilial position — which is possible, particularly in the Ccnv — the fctttus should be pushed forwards, its hind-legs extended, and tlie creature placed in the lumbo-sacral position, when delivery can be completed. I ^^^ FCETAL DYSTOKIA. Hock Pkesentation. f.i?''' '"«°ha"'f»l of .liock presentations is supposed to be as wr^~^i^' fo^us m the posterior presentation, linnbo-sacra? position, andunpelled by the uterine contractions towards the cervix Fig. 139. HucK Pkksentation : Cai.i.-. reaches the inlet with tho hind-limbs not quite extended, nor the axis consequently, the legs come in contact with the pelvic brim below by B A riy. MO. DIAIIHA.MS OF Tin: HiKD-LlMllS IN HocK PhKSKNTATION. the posterini' surfaop nl iho clianl- ti!.;! u sacro-vertobral an Je above ' " "'^"^^ encounters the „»?''' .I;^l'0"i--pains continuing, the croup hits a tcndcncv to descend and. with the pomts of the hocks, to advance through tl"c'L thelatte; i ^ uiitei's the An NORMAL POSTEJilOJi PUESENTATIONS. 463 joints become gradually flexed until at last the cannon-bones press against the thighs, and the doubled legs and croup, jammed in the inlet, form far too largo a mass to advance further (Fig. 139). Labour is therefore suspended, and the animal becomes exhausted with futile straining. The increase in volume is well exemplified in the annexed outlines (Fig. 140). In figure A, we observe that tlie direction of the femur (a b) is much more oblique than in figure B, which shows the limb extended, and that bone {a //) in its usual position. The consequence in figure A, is o.pparent in the elevation of tlie stifle to the middle horizontal line, and the inclusion of the hock and greater portion of the metatarsal bone in the line below, which only touches the stifle (a' b' figure 15). ^ ' The mechanism is quite the same in the lumbo-pubic and lumbo- ihal positions, the parts of th(! pelvic brim against which the croup and hmbs impinge being alone difi'erent. One limb only may be retained in this malposition, as already remarked, the other being extended in a normal manner ; but this does not in any way alter the state of affairs — neitlier with respect to the mechanism, nature of the complication nor measures to be adopted. * In hock presentation, the point of tlie os calcis is always the first part the hand encounters in exploration ; but it may be found at various depths. Sometimes the hocks alone are in the canal, the body of the fa3tus being still in the uterus ; while in other cases they and the croup are within the inlet, and are wedged in the passage. But it is not so much these which form an obstacle to birtli, as the phalanges of the hind-limbs, which, owing to the extreme fiexion of the hocks, are Hexed to a corresponding degree, and so form two hooks which cling to the edge of the pubis. Consequently, birth is impossible without extraneous aid. Indications. ~'n\Q dil'liculties vary according to circumstances. With tlie larger animals at tlieir full period of pregnancy, birth cannot take place, as a rule, until the deviation has been rectified ; and to attempt delivery before this has been done is to expose the Cow or Mare— particularly the latter— to great danger. With the Sheep, Goat, Sow, and Bitch, the foetus can be, and often is, extracted in this mal- position. Tile indication is, therefore, with the :\Iare or Cow, to give the hind- limbs a favoural '^' direction, by extending them in the genital canal ; and this is more easily accomplished in the Cow than the Mare, owin" to the smaller size of the croup and shorter limbs of the Calf, Some authorities are even of opinion that the latter may at times be extracted without the limbs having been adjusted ; while others assert positively that delivery may bo eliected in the Cow by mutation of the fa^tus, but that this is impossible with the Mare, unless a particular operation— to be noticed immediately— is adopted. Saint-Cyr, however, has, witli more or less trouble, and the Mares not straining severely, succeeded on four or five occasions, wlieii the Foal made a liock presentation, in ex- tending the limbs in the genital canal, and el't'ected deliverv witlioat resorting to tliis operation. He points out, nevertiieless, that the Foal dies very quickly in tliis position, while very often the Calf is extracted alive, even after long and laborious manipulations. Other writers corroborate Saint-Cyr's opinion with regard to deUvery. ' ) t i 464 F(ETAL DY ST OKI A. The method of adjusting the hind-limbs is as follows : 1. PnsU thcfcctus as far as possible into the uterus. This retropulsion can be effected without difficulty— even in the Mare— at the commence- ment of parturition, when the foetus has not yet entered the pelvic inlet, or, at most, the points of the hocks are only engaged. But at a later period, when labour is more advanced, and the croup is in the passage and on the vaginal side of the inlet, the ditliculty is greatly increased m the Cow, and retropulsion may even be impossible in the Mare. It should always be attempted, however, and in the Cow the attempt will be generally successful. The hind-quarters must be raised as much as possible, and the hand should be applied against the buttock of the young creature, the thumb on one hip, the fingers on the other, and immediately below the tail. If the repeller is used (and it is very convenient in these cases), it should be placed across the thighs. The retropulsion should be made by steady pushes in the interval between the labour-pains; these pushes should be directed slightly upward, so as to raise the croup. At first the resistance seems to be insurmountable, but gradually the foetus begins to move forward, and finally is entirely propelled into the uterus, and at a sufficient distance from the pubis to allow the limbs to be extended backwards. When the animal persists in lying, the hind-quarters may be raised by trusses of straw ; and it has happened in some cases, especially with the Mare, that retropulsion could only be achieved and delivery effected by putting hobbles on the hind-pasterns, and drawing up the hind- quarters by means of the rope attached to them, and which was run over a beam in the ceiling. Eainard points out that it often happens, during this retropulsion, that the foetus is pushed into somewhat of a transverse position,— tlie head and fore-limbs approaching the pelvis, where they may be seized and version effected by moving them round into the anterior presenta- tion, bringing them into the passage, and then completing delivery. This fortunate movement, however, must be extremely rare. 2. When the body of the foetus has been pushed sufficiently far from the pubis to allo\N^ the limbs to be seized, the hand may then fasten a cord on each jmstcrn (by means of the porte-cord, if necessary), "in order to assist in extending the limbs at the proper moment, by a few moderate pulls in the desired direction. 3. To extend the limbs in the genital canal, the lower parts must describe the arc of a circle, the hock-joint being the centre, the limb below this being the ray; so that the foot, which is at first directed forward, may be brought directly back towards the vulva of the mother. The limb wliich is most convenient is first extended. Some obstetrists begin by seizing the hock, the fingers in front and below tlie joint, the palm and tliumb on the calcis and shank ; the lower part of the limb is tiien dravyn backwards, while the thigh is pushed forward, and by a turn of the wrist the leg is carried througli the inlet and straightened. The same procedure is carried out with the other. Other practitioners endeavour to Jlex the limb as completely as possible, commencing with the tibia and lifting it well up against the femur, then the hock is bent; the limb is now seized at the lower end of the caimon-bone, or even at the fetlock, and is then lifted into the vagina. Schaack's method does not differ much from this. He flexes the leg on the thigh as much as possible, raising the point of the hock ABNORMAL POSTERIOR PRESENTATIONS. 465 as near the buttock as he can ; this elevates the foot and brings it it' mu;t h' f^: ^^^T'^-P^i"/ ^«"^"y PUBh the fa3tus too near the pubi nointo the WV "^"""^f again by acting more particularly on the point of the hock, using it as a kind of propeller. When sufficient soace has been gained the hand descends abng the cannon bone aTd grasps the front of he foot-the thumb and index-finger meeting rounTthe coronet, so that the toe is in the palm of the hand; in this way the pastern and fetlock are forcibly Hexed, when, by a vigorous effort- seconded, If need be, by the cord placed round it-the foot is raised above the pelvic brim, brought into the vagina, and the leg extended- an easy operation, generally. With the Foal, however, ?t sometimes happens that owing to the length of the limbs, the calcis presses aoZst the sacrum of the mother while the foot jams on the pSbis. In° such cases the pastern-cord is most useful, as the operator may allow the foot to pass from his hand, and press the point of the hock towards the uterus ; while an assista,nt pulls at the cord with such an amount of force and at such times as the obstetrist may order. The other limb is to be brought back in the same way. " ia i-u ue Cartwright mentions that, in those cases in which the hmb cannot be suHiciently extended backwards, the hock should be drawn as far as possible into the passage, and the tendon of the flexor metatarsi divided above Its point of bifurcation, in front and at the upper part of the joint; this allows greater mobility. If the foetus is dead, of course sideratfon ''° °'^J^'^'^«" ^o this section ; if alive, it will require con- This is the method to be recommended in every case; and it will very often be attended with success, even in the Mare, when the foetus is not too firmly fixed in the pelvis, and can be pushed into the uterus But It frequently happens that retropulsion is not possible ; the hind-feet cannot bo reached, and delivery cannot be accomplished in the way in- dicated. We must then adopt other methods applicable to the Mare and Cow. With the i¥arc, when tlie fa-tus is impacted in the pelvis, so that it cannot be moved forward, it may be presumed that it no longer lives, or that It will perish before delivery is completed. There can be no objection, taen, in resorting to embryotomy, so as to relieve the Mare as quickly as possible. The hind-limbs of the foetus may be amputated either at the stifle or the hock-some authorities recommend the former, others the latter • while others again, advise excision at the coxo-femoral articulations! J<.xtraction of the Id^tus lias been elfected after amputation in the three re-ions but preterence is generally given to division at the hock. This is effected by drawing tlie joint as far into tlie vagina as possible, either by the hand or a cord passed round the part (Fig. 141); if it can be drawn beyond the vulva, all the bettor, but this requires much force, ihe joint IS then disarticulated, and tlie separated portion of the limb withdrawn from tlie passage. The otlier leg being served in the same way, delivery can be completed in the ordinary maimer— the obstacle bcintr now removed. "Now and then," as Cartwright remarks, " we are not able to bring tlie legs straight into the passage, but have to get away the foetus by means of cords around the hock or hocks, with one or both of the legs doubled forward against the thigh. I n these cases it will be advisable to 30 i nI h J. 1 V •■'1 1 460 FCETAL DYSTOKIA. (livido the tendons (gastrocneniii) at the back of the logs, just above the point of tho 03 calcis, and also the flexor tendons below the hocks, by which means tho flexion at tho hock-joints will bo more perfect, and tho leg and thigh approximate better. After we have done this, wo may pull at the cords around the hocks pretty freely ; but wo must not omit forcing tho breech into the abdomen, so as to allow the limbs or the stifles to become straightened, and prevent the latter wedging against the anterior part of the pelvis. ... In some cases, I have known tiio foetus to come away in a breech presentation, witliout the legs being straightened at the stifles ; but it is bad practice. In some cases wo may remove tho leg-bone, by sawing it tlirough, close up to the hock, and afterwards passing a cord above tho os calcis to pull at, and then pushing tho breech forward." Fi;;. in. IfOCK PllKsKNTATION : IIOCK COKPKD. _ With tlie Cow, the Calf is very frequently alive, and an important con- sideration is how to deliver it in this condition. Should it be impossible to effect retropulsion, forced crtrarlioit in this malposition should he attempted ; it has often proved successful, and particularly when only one lindi was retained. r^Ku^' "'fCl" * To effect forced extraction with one limb alone flexed, the leg extended in the vagina should be corded at the pastern, or above tho hock if this can be readied. A cord is then to be passed around tiie bent hock by means of the poite-cord, and traction exercised during the^ labour- pains. When both legs are flexed at tlie hocks, a cord must be passed round each, as in Fig.^lll The necessary force can then be exercised. Should forced oxtraction not succeed, the limbs may be amputated at the hocks, as with the INIare. AUNOJtMAL PVSTElUOll rni^:i!ENTATIONl^. 467 It is well, in this malposition, when the hind-li.nbs have boon either reniovocl or adjusted, to ascertain tlie direction of the tail ; as it is so ne- the dif iculty to be surmounted. It may readily be brought back to its natural position by passing tlio hand iron, the root to'its extre ni y and bnngmg it into the vagina by witlulrawing the arm. In sonfo mstances rotropulsion may be necessary before the tail can be adjusted iliis hock presentation may occur in other than the lumbo-sacral posi- tion, and it certainly has been observed in the luinbo-ilial The crouo does not enter the inlet, but presses against it; so tliat, especially with he Cow the f(X3tus can be pushed forward, the limbs extended, and througli them the position changed to lumbo-sacral. With the Mare however, the violent straining may prevent tliis measure being carried out Fig, 1.12. Thigh ami Cuoii" Pkksentatiox. until the f(i3tus is dead, when it may be removed by drawing the hocks nto tlie vagina, dividing the gastrocnen.ii tendons, pushin" the bodv |nto_the uterus, rotating it into the lumbo-sacral po'sition, a!id extS U-^lu^ ^^"^ n^^''P """'^ ^^""^^ ^^''^ '''''"« procedure is applicable, but the Thigh and Ckoup Pkesentatiox. „ Jj'^'^';^'^ °!u*'"i lualposition is the same as that operating in hock presentation ; the deviation is not at all unusual in Mares or Cows with theVodT ^^' ^^"'^"^''' ''" "^'"'^ "^°^'' or less under When the thighs and croup alone present at the inlet, the joints of - .! I ^ I |j||l! Hi. 468 F(ETAL DYSTOKIA. in )' 'mm i] the hind-limbs being partially or only very slightly flexed, it is evident that the voluminous mass cannot pass into the pelvis. Some part of the posterior region of the footus— as the hocks— jams against the pelvio border and cannot get beyond ; while the points of the buttocks, placed in front of the inlet, are engaged somewhat in the passage. With the continuance of the labour-pains, this part gradually enters the pelvic cavity, while the retained hind-limbs are proportionately forced forward beneath or on each side of the abdomen of the foetus, until at last they are closely applied to the body ; the creature has assumed the position of an animal lying in a natural manner, and the posterior part of tlie trunk is firmly fixed between the sacrum and pubis of the mother (l^^ig. 142). The tail and buttocks of the foetus are, therefore, the first parts that the hand encounters in exploring the genital canal; then the croup and haunches, and below, beneath the pubis, are found the hocks, which may be more or less accessible to manipulation, according to circumstances ; though, when the limbs are fully extended under the body, they are beyond reach. Though the croup and haunches may have passed into the pelvic inlet, yet nothing of the foetus is discernible externally, except perhaps the tail, no matter how long the labour may have been in progress. In the majority of cases, perhaps, the young creature is in the lumbo- sacral position ; while in others it ma^r he in the lumbo-pubic, or right or left lumbc-ilial positions. _InrZ/cai;/o»s.— Authorities are generally unanimous in asserting that this is one of the most difficult malpositions the veterinary obstetrist can encounter. Very frequently the mother perishes without being delivered ; and though sometimes a live Calf may be extracted, it is rare indeed that a living Foal is obtained, and only too often the Mare succumbs after parturition has been accomplished by manual force. The chances of success in saving eitlier mother or offspring are dimin- ished in direct proportion to the time labour has been going on, the foetus advanced in the pelvic cavity, and the maternal genital organs injured or irritated by improper manoeuvres. The difficulty is also greatly increased in Heifers, or animals whose genital canal is smaller than usual ; a large fcetus likewise makes the malpresentation more serious. The rational indication is, of course, to extend the limbs of the foetus backwards, as in ordinary breech presentations, and to give these and the body a direction in harmony with the axis and dimensions of the pelvic inlet, so that birtli may "be effected by the combined efforts of the mother and the olistetrist. But this indication is often most diffi- cult to fulfil ; though in some instances, and even witli the Mare, it is possible when labour is not too far advanced, and when tlie foetus, still in the abdominal cavity, is movable, and can be pushed sufficiently from the inlet to allow the lower part of the limbs to be seized a'ud brought into the vagina. Pushing the fcrtus as far into the abdomen as possible, one of the limbs IS seized above the hock, and the thigh and leg ilexed as completely as circumstances will permit, by lifting that joint towards the mother's sacrum. Still pushing the foetus off by means of the re})eller, the hand is passed down to the lioof or claws until the toe and front part of these rest in the palm of the hand ; by adopting this precaution, danger of injury to the uterus or vagina is averted. Tlien the foot is i-.L ABNORMAL POfiTERIOR PRESENTATIONS. 469 brought into the passage by flexing all the joints on each other. Again pushing the foetus forward, the same manceuvre is repeated with the other limb, if necessary ; though forced extraction has sometimes suc- ceeded with only one leg in the passage, that which is retained finding space in the abdomen, and even facilitating the passage of the thorax, according to some obstetrists. This manipulation is rendered more difficult than in hock presenta- tion, from the fact that the hocks in this are deeper in the uterus, and jam against the brim of the pelvis, where they cannot be freed by the hand. The difficulty is surmounted by passing a blunt hook round them, or a cord as in Fig. 141, the two ends of this outside the vulva bemg twisted and drawn upwards and outwards by an assistant ; while the operator, pushing at the croup, throws the body of the footus for- ward, and thus allows the point of the calcis to rise above the pelvic brim, when the leg can be extended backward as in hock presentation. This method, however, does not succeed in every case ; and when the l! >l| rig. 113. Thigh and Ckoup Presentation : Thigh corded. croup is firmly wedged in the pelvic canal and the thighs have cleared the mlet, it is only too often impossible to effect retropulsion. Conse- quently, there are but two courses open— extraction of the fcetus in this abnormal position, or removing it by embryotomy. Forced extraction of the foetus, without adjustment, is a very serious, because a very violent, measure, and is frequently fatal to the mother, as well as to the offspring. It should, therefore, not be lightly adopted, and every other measure of a milder kind should be tried if it has any probable chance of success. Throwing the mother on the back or side may effect a change for the better in the position of the fcetus ; or if standing or lying, then raising the hindquarters as high as may be without injury should be tried. These failing, then Lecoq's method inav be resorted to. This con- sists in passing the hand, furnished witli a cord, between the wall of the pelvis and tlie body of the fcetus as far as the thigh of the latter ; the cord is then pushed beneath the thigh as far as possible and left there, while the hand is passed above— between the leg and body, so as to bring the end of the line up around the stifle and back through I i!l' km J 470 FCETAL DYSTOKIA. 1 if i ( i i^Q tliG vasina. In this way the thigh is encircled by a loop, as in Fig. 143. Ihe other thigh may be secured in the same way by another cord, and this part of the opeiation will perhaps he much facihtated by usiny the long bent porte-cord (Fig. 171). ^ ^ Saint-Cyr states that one thigh corded may bo sufficient : but it is undoubtedly better to cord both, if possible, as traction on the two limbs keeps the body of the foetus in a straight direction. The ends of the cord being juined together outside, assistants, under the direction of tlie operator, pull with the necessary amount of force • while the hand of the operator assists in the va-aia, either in guidin^ the la^tus, seizing on and pulling at any part that may offer, or smootlv mg down the folds of the mucous membrane in the canal which mi-'ht otherwise increase the obstacles. The fa"tus has been extracted alive by this procedure. Saake's inethodi is somewhat similar, except that there is only one cord, and that encircles the body instead of the thi"h The cord has a ring or noose at the end, and this or the other end is passed between the thighs and brought out at the Hank of one side ; then the other end is also brought out in front of the other Hank. Both ends are earned to the top of the back, the plain end is passed through the Fig. 144. Thfoii and Croup Phkskntation : Bonv coiiDEn. P"? (^i(^- 144) and brought outside the vulva. The body of the foetus IS, It will be observed, enclosed in a loop, the upper part of which - that over the loins-is carried back over the tail to the buttocks, so that the cord now only encircles the flanks. The advantages of this method over the other are chiefly its simplicity, only one cord being required, and the better direction in which traction can be exercised. in three cases this method was successfully employed bv Saake. Deneubourg makes use of the tail of the foetus fo/traction. Ihere can he no doubt that the foetus may be removed in this mal- position, with both the hind-limbs extended forward under the abdo- men. Cartwright says : " I perfectly recollect, in one instance, delivering a Cow of a very large Calf with both its hind-legs under its abdomen" and I never saw a Cow after calving ao better." In those instances 1! .f'wl"''."^^'' by success, it will generally be found, however, either that the foetus is small or the pelvis large and well formed bomo practitioners resort to the sharp crotchets, fixing them in the muscles of the croup, towards the hip-joint; but unless the hook has a bearing on the femur the hold is not very firm. In a case of this kind Drouard found that the skin and muscles yielded, the femur was disarticulated, and the hind-limb itself entirely torn away from the ' Magazin von Gurlt und Hertwig, 1869. Ali NORMAL POSTKltWn PRKSENTATlONti. 471 body. Notwithstanding this diminution in the volume of the foetus, dohvery was still impossible ; the other limb was torn away in a similar maimer, after which a crotchet was fixed in each cotyloid cavity, and the fuitus was then easily extracted. In addition to the malpresenta- tioii, the young creature was affected with hydrocephalus. Tlio use of sharp crotchets in such cases is always attended with risk ; should they slip during traction, or not bo carefully implanted in the fcetus, they may do great, if not fatal, injury to the mother. To escape the dangers which accompany the use of the crotchets in this way, another method has been proposed and practised by many veterinary obstetrists. The perineal region of the fcjctus in largely in- cised, and the hand, armed with a crotchet, is passed into tlie pelvis by this opening, the crotcliet being fixed either in front of the symphysis pubis, on one of the branches of the ilium, or, which is perhaps better, in one of the oval foramina. Two crotchets — one for each side — may be used. ]3y this method, a more soUd hold is obtained, and greater force can be easily exerted. Cartwright observes : " In those cases in which we are unable to extract by the breech, through not getting the legs up straight by lay- ing hold of the feet, or when bent at the hocks, we should make pretty free incisions through the skin about the ilio-femoral articulations or rump, and afterwards cut or tear the muscles around these asunder, and then we can secure cords around the iliac processes and coccygeal bones, and hooks against the edge of the obturator foramen, by which means we can remove the pelvic and coccygeal bones ; and having done so, we can apply a cord around the head of the thigh-bones and pull them out. We must next make an incision into the abdomen and remove the viscera, as they are sometimes pushed forward, and prevent our removing the other parts of the fcetus. Then we must either pass cords around the skin that surrounds the thigh, or insert hooks into the skin, and draw the remainder of the foetus out with its hind-legs under its belly, and so complete extraction." Bueff proposes to detach tlie coxte from the sacrum, by operating in the pelvis of the fcetus, and afterwards to extract the hind-hmbs tlms separated from the trunk. Others recommend symphyseotomy — an operation to be described hereafter. When the fa3tus is in the lumbo-pubic position, the same obstacles are encountered. Very often the hind- limbs are bent at the hocks, and these wedge against the floor of the sacrum. The same order of manoeuvres has to be adopted. Eetropulsion allows space to flex the upper joints, then extend the limbs. When extraction cannot be accomplished with the animal in a standing attitude, it should be placed on its back. When success does not attend the ordinary mani- pulations, then the hind-Uml^ of the fcetus must be disarticulated at the hocks, or higher. In all manoeuvres of this kind, great care must be exercised in pre- venting injury to the maternal organs by the feet of the young creature, or the jagged ends of bones ; and while traction is being employed, the hand of the operator should be busy guiding these parts through the genital passage. The smaller animals— Bitch, Sow, Ewe— may be delivered by the forceps, small crotchet, or the tube-noose to be hereafter described. The Cuesarian section may also, in extreme cases, be resorted to with the Bitch and Sow. I »l m\ ■I II'. m ■4;rn,.m oi- bdly, or (which Ih ncr aps most froquc.l) all of tho lin.bH colloctod to^ , her. Th f cr t , S;;::.u,^;::rthrp:K.;;'::;,.;i'" ''^^ i-i--'-"- ^o ti. antoro.po.torio; uto^ruH Cl;i!i!^' f "",' ^"'"' ''"""'"'"« '^ transv.rso position in tho hrohi. , T^ on various occasions by Oouhaux, who hascs UU.-US ^Z ";;,';7";',"<'-l'''>-oloKical roasonin,'; contorulinK that tho UtuuH cannot contani tho young creature when so placcul if tho various dunens.ons of tho latter bo couipare,] with those of the uZld^Z In the fust place, however it nn.st be ren.en.bored that ¥l ' m;;^ is not an unalterahly-shape.l body with rigid walls, but a m... 1 ous wTth tyr.ifsnV;''" "t r'-t ""* >''''''^'"«= '^•"' ^'"^^ ^^^ '•-•■" •''• y - y dianut r u ^ i'." '/^/-"^^nts-in a word, that its transverse iianute. nia> l,e nicreased at th(, expense of its length. Besides the ftctus .ts.>lf ,s not a compact unyiehlmg nmss. but is so flexible tha it may assume the most varied attitudes juhI shapes Jiut tiie slrong,>st proofs in favour of the possibility of such nreaen- 1 host' 7Z:^f by obstetrical experiencL the facets publLlled l^y notions I /be ,ri 1 f" '^"'"°''«'"nt ">" antagonistic theoretical hMK ?Ies . n h-1 ' ' '>°^^'r';- ^'''^t though tho p.'esentations are us 1) 1 esigm t(-d transverse, yet tho body of tho fee us is «enorallv a httlo oblKpie m one direction or tho other feuiciaiiy a Though tho transverse vertical or horizontal pres(.ntations are not altogether rare, yet they are nmch less conunon ban the 1, n-MtudinU presentations, and especially tho anterior presentation S do o appear to be prnna.y, and they are nmre frc.juont in the Ma 'than th^ ho Id tt latt^^^n'.M""' '^":r''"" 'T''-'' -^1i-t'-"t of thofletus con en es Wh, n 1. i'''" '^' "••' ^'^^'"^''•'^bl'^" P'-'tion when labou.' L s ill mmv lil l! \ l"luorannu, escapes prematurely, tlie deviation dilat4 Tmsiof n^r"'; ""'^ l'=^"^''«"l^^''ly if the os is not sulliciently ailattd. loision of the uterus ; spasm of the cervix ; violent straining and disordered moven.ents of the n.other; deviation of so o as o^f L w7irE;fit"l'^-'"^'= Hydrocephalus, monosonrnlL f;o;,o 7^ f V\ "°.^"^ *"' ^^'"^'^ '^^ "^ ^'^""'^ of transverse presenta ^^i^j::^::!^t '^^ '''-^ '-'' ^° '''- ^--"^^^-"' -^^^^ the^fotus^lTS'norm".? ^ '"^^^'^"^'f ">' ^l>'«^°kial ; as it is evident that rne icrtus, it ot noiimil sii^e, cannot pass crossways or sidewavs thron.rh Sv^ lllrtr^lf ' " "^'^ ''"^"^>' ''''''-'^' ^1'^- ^-- '^^ pa^sag Ton's ally Bath, therefore, cannot take place without assistance • version must be practised in order to change the presentation andZ'or o her of the extremities of the oval mass which the body o t lie fc^t,™e sents must be brouglit towards the inlet. The nialprese at o, th ^m th --j^i hYSTOKIA FltoM rUK DOUfiO-IMMnAR PIIESKNTATION. 473 As mentioned at p. 217, tlio transvorso prosentations of the body may be limited to two kiiidH— the durHolumbar, in which Bonie part of the bacit pioHentH at the inlet ; and the Hlcrno-abdominal, in which the lower part (jf the body (belly) oilers. The fo!tU8 may (iither be hmzonltd or vertical ; wlion the former, it may bo dirtr.t or uhluiiio, in direction -i.e., placed perpendicularly or oblKiuely, with regard to tli.) axis of the mother's body. Saint-Cyr romarks tliat the first is the most serious, because the extremities of th(! ovoid f(rtal mass are eijually dlHtant from the irdet ; with respect to the other intermediate presentaLions Ixitween tlie direct longitudinal and transverse, they are evidently less unfavourable because one of the extremities anterior or posterior, as the case may be- is found nearer the geintal eaiuil, so tiiat version is h'ss dillieult. Tlio oblique presen- tations are uimost the only ones compatible with the vertical position of the fo:tUH. The direct horizontal presentations may bo often suspected from the appearance of the mother, the abdomen showing groat enlargement laterally ; not unfrerpiently the movements of the foetus can bo seen on both sides— on tiio right as well as on the left. HKCTION I. - DV'STOKIA KROM Till': DOHSO-LUMIJAU J'KKSENTATION. This presentation is somewhat ran; ; the body of the fujtus is curved and the limbs are direetiul forwards. When it is lying horizontally, the fore part may occupy the riglit or left side of the mother; henco Saint-Cyr distinguishes tliem as ri(jht or left ecphalo-Uial positions— though this docs not imply that the iu'tal head is necessarily in con- tact with the ilium, for it may be turned round to one side or bent downwards. When the fcutus is vertical the liead is usually uppermost, the hind- (luarters being inferior, as in Fig. 117— Saint-Cyr's ce2)halo-sacral ])()siti()n ; though it may also— for all positions are possible— have this position reversed, the head being downwards and the croup towards the lumbar region of the mother— the cci)halo-abdominal position. Cki'HAlo-Ilial Positions. To diagnose this cause of dystokia— or back presentation —is not always easy. Labour has been goitig on for some time, the " waters " have escaped, and though the straining may bo very energetic— even violent— yet nothing is seen of the fuitus. When the hand is intro- duced into the genital canal, in order to discover tlie situation of the fo'tus and the nature of the obstacle which liinders birth, it encounters at lirst a more or less rounded surface, which does not offer any special character by which it migiit be recognised. The hand is then passed deeper into the uterine cavity, and turned in every direction over the body of the fcetus (for such it is), so as to find some parts which may be distinguished, and by which the position of the young creature in the uterus may bo learned. By this methodical exploration, the obstetrist recognises that the body of the fcctus is more or less curved in the back, one of the regions of which presents at the inlet ; while the head and limbs, more or less entangled with each other, and more or less accessible to the hand, are i I %\ 474 FCETAL DYSTOKIA. directed towards the fundus of the uterus (Figs. 145, 146). It now remains to discover the region which first met the hand, and the following memoranda will assist in achieving this point. The loithcrs rmm Fig. 145. Transverse Presentatio.n : Kight Cepiialo-Iual Position— Side View. are recognised by the prominences which the spinous processes form at this part; the thin wedge-shaped outline of the pai t ; and the hair of Fig. 116. Transverse rHEHENTATio.N : Riuiir CKrnAi.o-Ii.iAr. Positio.n-Ui.i-ek Vikw. the mane which, in the Foal, ends here. The luvilmr region may be distinguished by the large and almost level surface it oflers ; the pro- jecting external and internal angles of the co.xa; in its vicinity • the DYSTOKIA FROM THE DORSO-LUMBAR PRESENTATION. 475 hollow of the flank leading to the thigh and stifle. The dorsal region, or hack, is discovered by the arches of the ribs springing from each side, with the intercostal spaces. Having diagnosed the presentation, iha position vanst now be deter- mined, and this is done by ascertaining the direction in w'.iich the head lies. With regard to this, we pointed out at p. 249 that there were three positions of the foetus : The ccpkalo-ilial iw/itions, two in number, in one of which the fcctus has the head directed towards the right Jlank of the mother (rigJU ccphalo-iliai position), and in the other towards the left flank (left ccphaloilial position), the head and feet occupying the uterine cornua ; wliile in the cephalo-sacral position, the fuotus loolis as if seated on the luhhr of the mother, the head being directed forward, the mane towards the sacro-lumbar region of the dam. It can scarcely be necessary to mention that the exact position of the foetus should be ascertained before attempts at extraction are ventured upon ; as this presentation is, in nearly every case, a very serious one, and only too frequently requires all the skill aii^l judgment of tlie obstetrist to rectify. The gravity of the case will, however, mucli depend upon the period when the veterinary surgeon is called in, and the condition of the parturient animal. When sufficiently early in his attendance, however, a favourable result may often, if not always, be anticipated : the mother may be saved, and frequently the offspring — particularly in the Cow and Goat. This favourable issue is due to the fact that the presentation does not admit pf the foetus entering the inlet, and it therefore remains in the abdominal cavity, where there is space to manipulate it, and thus remedy the presentation. The obstetrist, though he may have to con- tend with the paralysing and fatiguing uterine contractions, has not to overcome the wedging of the fo'tus in the pelvic canal — so common in the defective anterior or posterior presentations. With the IMare, however, tlie case is always more serious, because of the energetic contractions which— unless they can be controlled early in parturition by partial antusthesia or other means— offer a formidable obstacle to mutation of tlie foetus. Indications. -The principal indication in such cases is to convert the dorsal into an anterior or posterior presentation, according to circum- stances. Hippocrates has well said tiiat the feel us is like a cork which has fallen into a bottle, and which can only be extracted by one end or the otlier. Certainly the presentation offers se:rious difficulties, from the fact that there is nothing about the foetus to lay hold of advantageously, or to which cords can be attached. Tn the majority of instances, a long interval has elapsed since parturition began ; the " waters " have escaped, the genital canal is swollen and congested from the attempts of amateurs at delivery, tlie interior of the uterus is dry and adhesive, the organ lies as close to the fcetus as a glove does to the hand, and the parent is exhausted witli unavailing straining, and perhaps mal- treatment — though tlio most trilling manipulation in the uterus will excite it to the most vigorous contractions. It is ordinarily in these circumstances that the veterinary surgeon is required to save mother and offspring. What, then, is the first, most urgent, and indeed the chief indication? Tliis must be rc/-i'/o/;. The presentation must bo converted into an anterior or posterior one, and m \' '■ I' '■■ i I w 476 FCKTAL DVSTOh'fA. ,\ P'E ' this at the expense of nmch pationco, fatij^aio, and skill. But in wliat direction is version to ho practised ? Kaiiiaid lays it down, as ii rule, that the extremities of the fu'tus whicjli are nearest the pelvis are those which should bo hrou},'ht into tho inlet ; and that if both ends of the f(Btus are at about an ecpuil distance from it, the anterior should be chosen, because it is the easiest for delivery. This rule, however, has not been recognised by tlu! majority of tho best authorities. On the contrary, experience and theory have demonstrated that in the majority of cases pelvic version is tho most advantageous; inasmuch as, when tliis has been effected, there are only tlio hind-limbs of the young creature to deal witii, whereas in anterior version tiiere is tho head in addition to the fore-legs, and this may ol'fer dilliculties which have not to bo encountered in the posterior "presentation— more especially if there is anything abnoiinal in the condition of the head. Not unfre- quently, and particularly when tlie fcetus is yet alive and vigorous, a kind of spontaneous change is eflected in an unexpected direction ; for it has been found that, in acting on the croup of the fcetus, this has, by energetic movements of its own, and coincident with sudden con- tractions of the uterus, described nearly a half circle ; so that instead of tho loins being under th(! hand, the withers and upper part of tho neck are encountered, and delivery can be readily acconii)! siied. But this spontaneous mutation cannot take place if the footus is torpid or dead and then version becomes imp(native. Hefore this is attenii)ted, the intra uterine injection of emollient lluids should bo practised ; this is most essential if the waters have escaped for some time. Tlum retro) mlsion must be had recourse to. Tht; fcetus must not bo pushed directly forward into the uterus, but rather oblicjuely, and in a dn-ection the opposite to that of tho part we wish to bring before the ndet. The hand or repeller must be used for this ])urpose, and in proportion to the dilliculty of effecting it, so nuist the intra-uterine in- jections be frecpient. Tho retropulsion and injection, together with the uterine contractions, have the elTect, in many cases, of making the body of the fcetus glide around the inner surface of tlie uterus, until a convenient part presents. Then the limbs and liead— -if they are recpiired, or only the hind-limbs, if it should be so decided— are brought into the genital canal by the hand or by cords. If the occasion demands it, rotation nniy beresortcnl to, in order to convert tlie vertebro-ilinl position into tho vertehro-sacral or vertebro-pubic. ])elivery is completed by moderate traction. The manipulations will, of course, vary with circumstanccjs ; but it wdl generally be found that, in all cases, raising thehind-ciuarters of the mother will render them nnich easier of accomplishment. When these manceuvres have failed, embryotomy must be practisiMl The intestines and other organs can be extracted by an incision in tho flank ; the vertebra; may be divided at the presenting part, and the entire body cut through at this division ; then each half can be extracted m the best and easiest manner possible. Tho same indications are applicable to this kind of dystokia in tho Eweanddoat; though if version be impossible and embryotomy not practicable, t!u; Ciesarian operation may be successful. In the Hitch and Cat, when other measures fail, the hitter operation may bo attempted with some prospect of a favcHU'able result ; though version by means of forceps or external abdominal manipulation is often effected. i DY^TOKIA FROM THE DOUSOLUMHAU rUESENTATION. ClOl'HALO-SACUAri POSITION. 477 As has been montionod, in this position tho, anterior portion of the body is higher tiian tho posterior, and tho head may bo either turned to one side or bent downwards. This accident is more rare than tho in'eoeding. On (exploration tlie back is discovered to bo nioro or less vertical, instead of horizontal, as in the cephalo-iHal positions; though it is seldom directly in front of the inlet, for ono end or otlier of tho body is generally ncsarest it — sonuitimes it is the ])osterior, when the presentation somewhat resembU^s tlie lumbo-sacral (b'ig. 147); at other times it is tho anterior, when it is like tho dorso-pubic. It therefore happens that the hand will meet with the anterior part of tho croup and may feel tlie base of tlie tail in the first case, and in tho other it encounters the back, withers, and base of tho neck. FiK. 1 17. TltAN,SVK".SK ruKKKNTATION : "N'lniTICAI, OH ( 'kI'MALO-SacUAL POSITION. This position is not so diiiicult to deal with as tho horizontal lumbo- sacral, as it approaches the longitudinal presontatiojis. IiiiUcdtidits. —\n endeavour must be inad(! to bring one of the ends of Uie body of the fcjotus to tlie inlet —that which is nearest this 0])ening. lletropulsion is therefore n(!cessary, pressure being made on tho end fiirtl)(!st from tho inlet. If ilu; mother is placed in the dorsal position and the posterior parts of the fcetus manipulated through the abdominal walls, the task of the operator will be facilitated. Wlien the posterior jiarts of the fo-tus are near(>st the; inlet, an assistant should push a"ainst its luinbar region, so as to bring tin* buttoelcs and thighs in front of tho opening, while the operator with his hand on the repeller pushes the dorsal region forwards. When the antei-ior part of the body is nearest the inlet — the mother being in tho dorsal position — the assistant pushes tho hind-quarters forwards and downwards, while tho operator endeavours to bring the neck towards him, using tho crotchet if need be. The object is, of 478 FCETAL DYSTOKIA. 1 1 L' ■' I course, to bring the foetus into the posterior lumbo-sacral position, with the limbs forward and completely retained ; or into the anterior dorso- pubic presentation, with the head and limbs retained. It can then be dealt with as has been described for these presentations. No mention appears to be made in the literature of veterinary obstetrics of the cephalo-abdomiual position (vertical dorso-lumbar pre- sentation), though such is possible. The head of the foitus would be towards the floor of the abdomen — though lack of space would prevent the body being directly vertical, and either forward or backward. The measures necessary to remedy the position should be similar to those recommended for the cephalo-sacral position, except that the external manipulation would be exercised on the head of the fcetus, instead of its hind-quarters. SECTION II.-DYSTOKTA FROM THE STERNO-ABDOMIXAL PRESENTATION. The sterno-abdominal presentation is a rather common one, particu- larly in the Mare. The fcctus is lying on its side, with the sterno- abdominal region and crossed limbs — either flexed or extended presenting at the inlet or engaged in the passage, while the dorsal region is towards the fundus of the uterus. There is no difficulty in discovering this malpresentation, the hand encountering the feet — usually all four— in the uterus, and generally two or more of them in the genital canal. Nevertheless, as there are two positions in the presentation, it is necessary to distinguish which of them we may have to deal with. The situation of the head, of course, defines the position ; so that we may have a right ccphalo-ilial in which the fcctus is lying on its left side, the head directed tov.'ards the right flank of tlie mother ; and a left cephalo-ilial, the reverse of the preceding. If the foetus is vertically "placed, with the head upwards, then the position is cephalo-sacral ; when the head is downwards it is cephalo-abdominal. CErHALO-lLIAL POSITIONS. In these positions the fcEtus is placed horizontally across the uterus, with the body curved — the back convex in the majority of cases— so that the abdomen is farther from the inlet than the back was in the dorso-lumbar presentation. The left cephalo-ilial position (Fig. 148) is, according to Saint-Cyr, much more frequent than the right. Usually, one or more of the limbs enf^er the genital canal, and even protrude from the vulva ; but occasionally they are doubled against the body and remain in the uterus, where they cannot be detected by the hand. The head may also enter the ca.5al or be retained in the uterus which is most frequently the case, and then it is either turned back- wards, or placed above or below the body ; when the latter, then it is either deformed or the neck is contracted. When the limbs appear at the vulva, if they are the hind and fore, two — a hind and fore — are at the right side and two at the left, thoucrh they are sometimes crossed. When they project equally, then it is an indication that the transverse presentation is direct ; but if they are unequally protruded it may be inferred that the foetus is lying obliquely — more in the vertebro-iUal position. In some instances only one limb 1 DYSTOKIA FROM THE STERNO- ABDOMINAL PRESENTATION. 479 appears ; it may be there are ^jyo— either anterior or posterior, or one of each ; or three— & fore and two hind, or two fore and one hind. In other instances, again, there is nothing of the foetus to be found in the genital canal. It is only by a careful examination of the presenting limbs— their conformation, number, direction, and degree of projection— that the practitioner can decide as to the position of the foetus ; though those parts of the body accessible to the hand will supply valuable informa- tion as to whether the limbs belong to one or more foetuses or to a monstrosity; while the position of the head should be ascertained if possible, in order to decide which kind of version is most likely to be successful. When the limbs are not visible, they may be found in the vagina or at the inlet, where they are usually crossed; though it sometimes happens— especially with the Mare— that the arm extended into the Fig. 148. Sterno-Ahdominal Pubsentatio.v, Hrad and Fket EMiAGKi) : Foal. uterus as far as possible, can touch nothing, even with the tips of the lingers, except the belly or sternum of the fcctus ; or pushing the hand obliquely to one side of the cavity, the stifles may be felt, and on the other side the elbows. This may be all that can be discove'-ed of the position, owing to the foetus being curved and the hmbs and neck bent m different directions ; so that the difliculty in arriving at a correct notion as to the state of affairs is much greater than in the dorso- lumbar presentation. In the Cow, however, owing to the wider abdomen, the foetus being also shorter, the latter is nearer the inlet, and therefore more accessible to the hand. It is generally admitted that this presentation is one of the most difficult and serious the obatetrist can meet with ; though when the hmbs can be seized it is not, as a rule, so troublesome as the dorso- luuibar presentation. In order to effect delivery, the presentation must be modified, and it is often most convenient to resort to posterior version and bring the hind-limbs into the genital canal. The two fore- -r- IIH ^ i :j I 480 FCETAL DYSTOKIA. legs in the passage make the case more difficult, and one only yet more so ; while it is less embarrassing if all four limbs come together, or two hind ones and a fore one. This statement is made on the understanding that the presentation is either altogether transverse, or, if oblique, that the hind-quarters of the fojtus are nearest the inlet ; but if the anterior part of the body is nearest, and if the head is engaged, or can be easily brought into the passage, the fore-legs there are an advantage to the operator, while the hind ones present at the same time would be baffling. "When the limbs cannot be laid hold of, th-^ skill of thj obstetrist is most severely taxed, and all the more if u . ,: ,i 13 has elapsed since parturition commenced and amateurs have i • work. Indications. It has just been remarked thu' ^^osterior version is most Fig. 149. Stickno- Abdominal Pukskntatiox, Hind Limus most advanckd, Head rktainkd: Calf. favourable for delivery in this presentation, and with this object in view, the hind-limbs should be secured and corded at the pasterns — even one limb is often sufficient if the other is not attainable. Should the head be engaged, it must be pushed as far into the uterus as possible, and if the fore-limbs are likewise present they must also be repelled. This retropulsion is comparatively easy when there is plenty of room and the straining is not very severe ; but in the Mare it is often the opposite, and some authorities assert that it is impossible or very dangerous to push the fore-limbs into the uterus, while others declare that it can be done if the rcpcUe;' be employed. If they cannot be pushed into the uterus, then they must be amputated at the knee, elbow, or shoulder, and the foi-e-part of the fa'tus thrust forward while traction is made on the hind Iiml)s ; gradually these approach the vulva and pass through it, the hind-quarters follow — the body being ne only yet me together, lade on the tinsverse, or, it the inlet ; the head is re-legs there esent at the obstetrist is lapsed since rsion is most DYSTOKIA FROM THE HTKHNO-ABDOMINAL PRESENTATION. 481 very often in the lurabo-ilial position, when it can now be changed '^^\tt /hn"?°";''''^ • t"^" °'2'' '° P'"^"^"* *^^ hind-quarters jamming agamst the maternal ilmm, the traction on the hind-limbs should be obhque-fron| right to left or left to right, according to the position of the lootus— when bringmg it into the inlet. f "" ^^^ When the hind-quarters are too distant to be brought i5rst inio the inlet then anterior version should be tried. The hind-legs are pushed ITn^h i7 S'''' V*^'T°^ f^ ^?*"? "^^y ^^ ^^"^^^«d with one, or even both of these, flexed under the body-but it is well to have them corded before retropulsion is attempted. The head and fore-limbs should also be corded, and knots ought to be made on all the cords used in oi^er to distinguish the parts to which they are attached. \ ']:i K [■''^i'r '' '^'^^^ °" *^^ ^^^^d ^"^ fore-hmbs, the croup should be pushed forwards into the uterus ; if the head cannot be got into a proper direction it, or one of the hind-legs on the side opposite to It, must be amputated. If the foetus cannot be extracted from the uterus without risk of bringing that organ with it, then-provided the chest and abdomen can be reached-evisceration should be resorted to In those not infrequent cases in which the fcetus has the limbs doubled against the body, and can only be touched with the tips of the fangers, the hind-quarters of the mother should be lowered by placing her on a sloping lloor~on the back if necessary; an assistant then manipula es the fcetus through the abdominal wall, so as to move it towards the inlet, where one or more of its limbs may be secured and one or two repellers-or a repeller and crotchet-might now be utilized to etiect either anterior or posterior version. It must not be forgotten that, in some "instances, the uterus itself in this presentation offers a serious obstacle to deliverv when its mucous membrane forms folds or bands towards the os, which prevent access to its interior, and imprison the limbs of the foetus. Throuc^h these tlie hand must pass, and in trying to smooth or lay them down the legs must be freed. "^ 'O An retained: >]ect in view, s — even one the head be sible, and if elled. This if room and s often the ble or very hers declare y cannot be it the knee, rward while )proach the body being CEPHALO-SAciuii Position. In the sterno-abdominal presentation, this position is said to be less frequently noted than the last, and of the cases reported the greater Tiumber occurred in Mares. The foetus is more or less in a sitting posture, the breech being towards the floor of the abdomen, and the withers and head in the direction of the sacrum, or to one of its side= All the hmbs are usually in the genital canal, and they may extend to or beyond the vulva, the soles of the hoofs being inclined downwards though It may happen that only two or three are visible When all protrude equally, it is evident that the position of the fcetus is vertical' but should the two fore or the two hind limbs project most, then the position IS oblique. It has been found that the fcetus nearly always succumbs in this positmn, though the mother may be saved. Indications.—IIere again version must be resorted to, and this should be posterior when all the limbs, or only the hind ones, protrude : the fore-hmbs must be entirely, or to a great extent, pushed forward into the uterus or, if that cannot be done, amputated at the knees or elbow-joints— if possible at the shoulders— then traction on the hind- limbs will complete delivery. 31 m IC 482 FCETAL DYSTOKIA. m Should tho foro-limbs be most advanced, anterior version must be attempted— this will bring tho foetus into the dorso-sacral position ; but it is a troublesome operation, and necessitates retropulsion of tho hind-Hmbs, or their removal wholly or partially, as well as straighten- ing tho head and neck. If neither of these measures appears advisable, the fore limbs may bo entirely removed or amputated at the elbow- joints, and posterior version adopted ; evisceration of the foetus, by diminishing its volume, will facilitate delivery. A cephalo-abdominal, position— vertical sterno-abdominal presentation —has been described, but it must bo exceedingly rare, and the remarks that have been made with regard to the cephalo-sacral position are equally applicable to this. A lateral or costal presentation has also been noticed by several writers. In this the foetus, having the limbs doubled under the body, presents at the inlet by one of its sides, as it lies horizontally on its chest and abdomen. Tho limbs are more or less accessible to tho operator, and therefore the mode of extraction is obvious after what has been paid of tho other presentations. c OliHTETltlCAL OPERA TIONti. 483 BOOK TIL OBSTETRICAL OPERATIONS. In tho various inalprosontations and malpositions, as well as for tho other causes of dyatok.a already onu.norated, tho indications for reo?i° fioation and extraction were alluded to and described T sulTicien length, and the means to be adopted for carrying them out were Tko wise mentioned. It was shown that, in many cases, it is suEnt to correct the abnormal presentation or position, and rectify the devia ion of hmbs neck, or head, to effect delivery in tho ordinary manner bv means o the hand alone. For, as has well been said, tCpSsS hand IS the best and most perfect of all instruments, and it cC effect in obstetrical operations what no instrument is competent to achtve rherefore it is that an operator with a long and powerful arm and a small hand with strong lingers, possesses many advantages as an obstetrist, and ,s in a better position to afford relief than one wfth a short arm and large hand -especially in the correction of thoseXia tions which are so frequent, and oftentimes so bafllin- Extraction by the hand alone may bo effected hi many cases of difficult par urition, when these rectifications have been made; though oven then it is essential that the os uteri be fully dilated! the vagba and vulva dilatable, and sufficiently prepared to allow the yol^ne creature to pass through ; it is likewise necessary that such a reffon lup in propor ions should exist between the volume of the fJtus and nn.Kn- ^?^ the pelvis, that extraction can be accomplishe^wfthout much d n.culty. Finally, it is particularly desirable that the uterus s^dr^s^oix^p^rtor^^ ^'^^ ''' ''^- -^^-'^- '^-^ In only too many cases of dystokia, however, one or more of these conditions are absent, and the unaided hand-no matter whether it be ever so well endowed and practised-fails to effect delivery so that m order to overcome the difficulties, recourse must be ha7to va kms sugical mstruments and appliances, and there must be performed either on the mother or foetus, more or less complicated and serTous operat^ns which demand strength, expertness, and an accurate know- edge of anatomy and physiology, and even of mechanics, in addS to a thorough acquaintance with surgical pathology Some of th« them a? '^h'f ""' ""T "T """^^^^ ° ' ^^' '' is necessary to stu^ ^ t^ltner ?nthith T^l^ ^^^^^^^^i These operations have for their object either to auDDlemfinl th. °eatu« Na'ure which are insufficient I secure the birthTth young oicatu e to rectify its presentation or position; to diminish its si™ tTl IT^^:^ Z ""•?■ ""? <>='»"«* - '00 deviated oTtoLTd / T., y »" '^"'^ maternal passages; to enlarge the latter or M o7tt a^imf " T^h^^^'l artificiaf passage when these last dfn'o't TdmS ot extraction. This leads to a consideration of : (1) Preliminarv U\ wJ -^f ' ^^X^^,f'^^^<^'^^ means for the extraction of thefJtus ■ (4) Embryotomy; (5) Vaginal hysterotomy; (6) Ccesarian slctZ; fr 484 OBSTETRIC A L OPERA TIONS. (7) Symjihysiotomy ; (8) Artificial pronnture birth ; (9) Supplementary observations regarding mother and j^i'ogeny. In several of these the obstetriat requires the aid of assistants, who only too often have to be instructed in the part they are called upon to perform at the very moment their services are required. Not only tliis, but far too frequently the veterinary surgeon is not called in sutiiciently early, and the delay, and perchance the mal- treatment to which the parturient animal has been subjected by unskilled attendants, has resulted in most serious complications, which the most competent assistants can afford little service in remedying. CHAPTER I. Preliminary Precautions and Operations. A FEW observations may be made on certain precautions and operations which have to be attended to before any active measures' are adopted in cases of dystokia. And first as to the animal whicli is to be handled. With the larger creatures, and especially the Mare, the position of the veterinary surgeon immediately behind the posterior limbs might be considered perilous, did we not know that the most irritable and vicious animals are generally rendered tractable by the parturient pains ; and even the hand and arm introduced into the vagina, instead of provoking resentment, appear only to increase the expulsive strain- ing. But it is sometimes necessary to have a strong assistant to hold up a fore-foot — in the case of the Mare — while the hand is being passed into the genital canal. And while manipulatioi- is going on it is advisable that the Mare's head should be held by a person the animal is accustomed to ; while a strong man on one side of the hind-quarters steadies this part with one hand and holds the tail aside with the other, and another on the opposite side also steadies the quarter with )ne hand, and the other hand pinches the loins when the Mare attempts to strain or be restless. But it sometimes happens that a twitch has to be applied to the nose, or side-lines or hopples put on the legs ; for the Mare is, as has been already remarked, very often a most troublesome and dangerous animal to deal with, and unsteady in the extreme. Not so the Cow, which rarely requires any more constraint than a person holding the nose and horn ; though it is advantageous to have a man on each side to act in the same manner as for the Mare. Obstetrical manipulations are usually effected while the larger animals are standing, and this is undoubtedly the most convenient position. But it not infrequently happens that the veterinary surgeon is called when the animal has been in labour for many hours, and per- haps been roughly handled by novices; so that, being exhausted, it has assumed the recumbent position, and is disinclined to get up. This is more especially the case with the Cow, for the Mare can generally be induced to arise by mild persuasion ; and it has been found that the sight of a dog will cause the first-named animal to start up when other means fail. But it may be that the creature really cannot arise, or if it gets up it cannot stand ; then the operator has to do as he best can while it is PliKLIMlXAUY PRFX'AUTIONS AND OPERATIONS. 485 recumbent, and must kneel, or oven assume the horizontal position. With regard to the animal itself, the lateral and ventral positions are very unfavourable, because of compression of the abdomen, which greatly hinders manipulation and interferes with delivery. To obviate this, the animal ought to be placed on its back, and kept in that position by having previously had the feet brought together by means of a rope or hopples, and tying another rope to these by which assistants can steady the body ; a truss of straw placed close on each side of the back will greatly aid in securing this position. In some cases it is most advan- tageous to liave the front-part of the body raised by litter, so as to bring the fc^tus nearer the pelvic cavity ; in other cases it may be equally advantageous to have the hind-quarters raised either by litter or by suspension, the hind-feet being fastened together by a rope, the end of whicli is passed over a beam and pulled until the required eleva- tion is obtained. This raising of the hind-quarters has been success- fully^ employed, as we have remarked, in reducing torsion of the uterus ; and it has been no less useful in cases of dystokia due to bending back of the head or neck of the fcetus. Cases are met with now and again in which it is desirable to place the animal in the recumbent position, and then the greatest care is necessary to prevent its being injured in laying it down. The Cow has been placed on its side by passing a bed-sheet, folded lengthways two or three times, beneath the abdomen, in front of the udder, two men holding each end and lifting up as if to carry the animal off its feet ; the Cow immediately turns on its side and the bind-quartcrs fall softly on the litter, but the sheet must be kept tense. Another plan is almost as simple : A long rope is provided, with a noose at one end ; this is passed around the horns, the rope is carried along the ridge of the neck, and a turn is made around the shoulders, another behind the shoulders, and a third around the abdomen, the rope being then brought along the sacrum. A slow and steadily in- creasing pull is made upon it, and the animal soon bends the fore-legs, then the hind ones, and Hes down in the most gentle manner. Sheep and Pigs are generally recumbent, and the operator has to kneel ; but they are more easily handled than the Cow or Mare. Dogs and C'iits are also readily managed, and can be placed upon a bench or table, and moved about to any position required without restraint. When about to deal with a case of dystokia, the practitioner has, of course, first ascertained its history, and satisfied himself as to the general condition of the animal before commencing his exploration. With the larger animals it is necessary that he divest himself of some of his upper garments— how many will depend upon the nature of the case ; it may suffice to remove the coat and vest, and roll up the shirt- sleeves, or it may demand removal of everything save under-vest and trousers ; indeed, for such cases it is well to be provided with a long sleeveless blouse, fastened round the waist' by means of a band, and a pair of waterproof trousers. Before introducing the hand and arm into the genital canal, they should bo covered with olive-oil or grease, in order not only to faciUtate their introduction, but to protect the operator against septic infection. It is very fortunate for him if he can use both hands alike, as the left hand is sometimes more convenient than the right, and in tedious !? f 5I< 4- n fel operations the one relieves the other. The fingers are brought together S. \i . ;l I >t 486 OJiSTKTRWA L OPERA TIONS. in cone-shape, and pushed into the vulva gently, then into the vagina, with a sUght rotatory motion, while the animal is not straining ; should It stram, the hand must not be pushed on, but wait until the animal is again quiet. In this way the vagina is explored, and if necessary the hand is carried into the uterus, should there be no obstruction. A careful exploration makes the practitioner acquainted with tlie state of affairs— the condition of the genital canal and the presentation and position of the foutus, if the membranes are ruptured, as tliey nearly always are— and allows a diagnosis to be formed, from which indica- tions for treatment can bo arrived at. It should not be necessary to add that all this procedure— much of which has also to bo observed in cases of maternal dystokia— ought to be carried out carefully and methodically, and without undue haste ; and to accomplish it satisfactorily a perfect knowledge of the obstetrical anatomy of both mother and foetus— familiar to the hand no less than to the mind— is of the greatest value. Mention has already been made of the necessity for employing some bland emollient fluid with which to lubricate the genital canal when this has become dry ; as owing to the " waters " having escaped for some time, the uterus is applied close to the foetus— which may have made some progress towards expulsion— and much manipulation may have already taken place before the arrival of the practitioner. Any oily or mucilaginous fluid will answer the purpose, but perhaps the best of all is what is known as " linseed tea," or " hnseed jelly," mixed with some oil— olive to bo preferred. When there is not time to prepare this, it has been found very serviceable to inject first a few ounces of oil, then tepid water, and, finally, another quantity of oil. The chief thing to be observed is to inject a sufliciency— say two or three gallons for the larger females, and from a few ounces to a pint for the smaller. If the manipulations are long continued, it may be necessary to repeat the injection, and for the Cow or Mare it is most advantageous to introduce a long piece of india-rubber tubing well into the uterus, and inject the fluid through this by putting the nozzle of the syringe into the outer end. When neither syringe nor tubing is available, a bottle may be used, and in this case raising the hind-quarters of the animal will facilitate the introduction of the lubricant. With the smaller animals much benefit is often derived from immer- sing the hind-quarters, or even the whole of the body, in warm water for som.e time, as thi snds to relax the parts. The expulsive efforts of parturient animals, and especially the Mare, when violent, are generally a great hindrance to the operator in cases of dystokia, and sometimes prevent him from attaining success in delivery. To modify, or partially or completely suspend them for even a short period, may be of the greatest service ; so that various measures have been resorted to in these cases— such as, for the Mare, a twitch on the nose, and for the Cow, pinching the nasal septum, pressing on the loins, or raising the hind-quarters. Causing the Mare to walk on soft sloping ground or in a straw-yard, and not allowing it to stop, has been found to allay the pains for a sufficiently long period to allow what was required to be done. The administration of narcotics is also frequently adopted with this object, and anaesthesia by ether or chloroiorm has been found of great service with the Mare. It is seldom necessary to place the animal in the recumbent position, as complete insensibility is not required— RECTIFICATION OF PRESENTATIONS AND I'OSITIONS. 487 indeed, is not desirable ; for partial unconsciousness will allay the oxoitement and abnormal straining, but will not suspend the uterine contractions. The chloroform may be inhaled from a piece of sponge or lint placed in a basin or similar vessel and held under the animal's nostrils, a blanket being thrown over the head to keep in the vapour ; or the sponge may bo laid at the bottom of a nose-bag put on the nead. The antcsthotic sliould be inhaled until the introduction of the hand into the vagina or uterus no longer excites the severe straining. Partial narcosis might also bo tried in some difficult cases of parturition in the Cow, but then it must bo remembered that in the event of slaughter the flesh will have the odour of the drug. With the smaller animals the production of this condition is often beneficial. We will now consider the principal mutation movements required to efTect a change in the position of the foetus. ii ■ I ■ Hii CHAPTER II. Rectification of Presentations and Positions of the Foetus, We have seen how numerous and varied are the presentations and positions of the fcctus, and how, in order to effect delivery, some of these must be changed or modified ; this can only be done by moving the fcctus itself, and so altering its relations to the adjacent parts of the mother. These movements are sometimes designated mutations by obstetrists, and the procedure necessary to effect them varies with circumstances ; sometimes, for instance, the object may be achieved by merely altering the position of the parturient animal, or by sustaining its abdomen and manipulating externally ; but in the great majority of cases it is necessary to introduce i he hand into the genital canal, and operate directly on the foetus. The principal of these mutation movements are four in number : Bctroindsion, Rotation, Version, and Extension and Flexion. In order, however, that these movements may be effected, certain conditions are necessary. In the first place, it is essential that the os uteri be sufficiently dilated, or relaxed and extensible, so that the hand may reach the interior of the uterus ; next, the body of the foetus must be movable in the uterus — a circumstance not always noted, as the organ is often contracted closely on the foetus when the liquor amnii has escaped, or the foetus itself may be fixed in the genital carol. And, finally, the foetal envelopes must be ruptured, as it is impossible to manipulate the young creature effectively while it is entirely invested by them. Before any alteration in the presentation or position of the foetus can be accomplished, these conditions must be assured. Retropulsion. When the foetus, in a vicious position, has entered the pelvic cavity and become fixed there, or even when in the uterus and approaching the inlet, before the nosition ca.n be corrected it is nearlv always neces- sary to push the creature forward again into the uterus ; as there only, from the greater space this organ affords, and the elasticity of its walls, can the impediment be overcome and adjustment effected. "Retropulsion" is often necessary during protracted labour, even •i I ■ f i^ 488 OBSTETItlCAL OPERATIONS. To^-ds to H!?l[n.K' ^^ ^ 8°'^^ Position- to enable the obstetrist to attach coids to the hmbs or Home part of the head or body. to be pushe'd for°v3'r''*^';°"' ^T- ^"^*""°^' ^^^ ^ox^-^^r^^,^ have often arm nZ find re r? ^^e pelvic cavity, in order that the operator's to be oLhed in?nf^ ''f'""^' ^?' ^V? '"'"'' *^" ^^^^ ' °^- the latter has even irthia n,.°n r"*"'"! *° ^'^.°^^ *^^" ^""'^^ *<^ ^e felt for; and nicessarv Tl,?; ^*'°" retropulsion of the hinder limbs may be presenSon^Zrr'^^T- "f ^^ ^^'° ^^^'^ *° ^^^ '^'^^P*^^^ "^ ^^e posterior has to hi n, I^ i .''^ ^T^'^' f ^ ^^-^^^ '" *he uterus, and the body extendpdnn^^T '^^?"^^'■''/' ^''^^' ^^ P^^^^blo, so that they may be ?n S™ .^^^^^^^^^^ ;"'" '^^l^^^^''' ^"^«*= ^'hile it is also advantagLus TbT. Ih P ^.sentations when version has to be attempted. and laboHou^^ «nS '' '°"^f ""«« ^^^y- ^^ other tin.es it is most diflicult possible ' "^^'^'''^ ^^^'^^ ^*^ '"^y ^^^^ bo altogether im- larSr aZill\Ti''''f'-^"'*^^^\^°^;,P"^'^°^'"^ ^^^^ operation, in the largei an mals at least, is undoubtedly the standin^r one • buf tL bnrlv wilird""'^ .^'f "^^^ "^* '^P--fectlyLri.onLl fc a ,Veat adlantaS Ts we twrv,^'"^T-' ^"^ l>'"^-q^^^rters to a considerable degree' t!^, .u , ^ *b^°'^ *''^ "^^^'"^ '^"d its contents forward and awav placed m£"th"''' ' "^'^ ^''l^f'"'' "^^^ ''' ^^^^^^ brstraw or S tion pro intlv fl r""''' ^^f^-^^^\- In order to obtain this inclina- Kre iS^^^^^^ ^"^^« to kneel, two assistants keeping upriSit polom "'' "''' °''"' '"° "^'"^^'" *^- hind-quarters in' an" is hlJifif nnvff-"'^^? recuinbent and cannot be induced to rise, there IS little. If anything, to be gained by raising and supporting it bv means ?L if °'' °*'''' '-appliances ; as the pressure whidi lese produce on reputtrtZSr? '''. """T"'^' ^^« ^^^- mentioned' Not un the^Si t\"f up°' ' '*^''"^"^ ^'°^"' ^^ ^^^ '^^^^ "-"^'--l. -i" cause inirdlTnJ'r"''''' *^^^^^'•^ 0^- ^ow is exhausted, and it would be at emnted in th"^'°'''''^? '°."^^^" ^' ^*^"^' *hen manipulation must be attempted in the recumbent posture. When this is decided unon in infh^rinJf? fw^^ l^^^'^"" *^^^ '^"''"^^1 «" its back, proppin.r it up he c ou'p bv ^nt^o' ^ ''"''"' f/ '^'"^^ 1'^^^^^^ «" «^«h side, in'd m i ^ With ?e .L r? M H "^' ^ n°*^''' *^'"^' '^^"^^"^ "^^ hind-.parters. ° placed on thet bapk^'^^^'K,^"""'?*^' ^"'^'^ ^^ "^« ^^'^c'', they can be as STs mnv h. 1 %*^^''' ^"'^ '^'^ ^^^'^*^"t will raise the pelvis be effected wfthth^ ]'?.''• ''TT'^- ^^tropulsion of the fo^tus'may hLself firin^v on iwi I ^'l*^,^^-'^ '^"""'-^l^- the operator supporting it wL 1 ^ Ins legs; but the arm must bo strong, and very often It has to be engaged in the genital canal as hi-h as the shoSr T may sometimes happen that both hands have to bo empbyed a Se ?S the dhlir/^ °' J!" r ^^^r^' l'"^'^^^ ^---^-l bv aTsSnts. handTnd arm aro nl/!^^^ *^^'' operation, and finding tliat the for a loii timp "°t "7?""^'^'"*' Continental veterinarians have rLlssoW^ cZJ^ ? i"^ ^? -^Z:''^^^^^ «^- "repellor" (French, repomir , Cxerman, Gchnrtskriickc). in conjunntion xv^th the hand Ien«^- it'harrt '\?' "°"' ^"^'^^ b^^^^-» ^-« --' tlm feet in like^th; head of n l\Tf ' ^ .T' "'Z'^' ""^^ ^ ^""^^'^^^ transverse piece, or io nted mi iS 1V "I rj''%°!^^'. '^'^'^ ^^'^^^ "^^^ ^o either solid or jointed (iMgs. loO, 151, 152, 153). Provided the latter is sulliciently rist to attach )s have ofton he operator's he latter has felt for; and nbs may be the posterior .nd the body ihoy may be idvantageous ied. nost difficult ;ogether im- ition, in the )ut the body t advantage ible degree, , and away •aw or litter bhis inclina- nts keeping arters in an 3 rise, there it by means produce on .. Not un- l, will cause t would be on must be ed upon, in bble advan- pping it up md raising irters. hey can be the pelvis foetus may supporting very often Julder. It I ployed as sistants. g tliat the rians have (French, '• hand, "t feet in 3rse piece, ither solid ufliciently heotification of pp.esentatioiVs and positions. 48» strong at the joints, it possesses advantages over the soHd instrument, the prmcipal of which is its easier introduction into the vagina and uterus. The crutch end being carefully carried by one hand through i' w ^ > I' Solid RKrELLKit, WITH A Kkmov- AIiI,E Si'IKK. Fig. i.*;!. Simple-jointed Kepelleii. Fig. 152. Jointed Kki'ellku : Open. Fig. 153. .TOINTED RkpKLLKR ! Closed. ; i the genital canal, towards the foetus, is applied to the most convenient part of Uie latter ; while the handle is seized in the other hand, and propulsion eifected either by this hand, the breast of the operator, or by an assistant. t' i 490 OBSTETRICAL OPERA TIOiVS. w Many authorities speak very highly of this instrument, from the fact that it permits the displacement of the foetus much further forward than the hand alone can effect, and thus allows a wider space between the pelvic inlet and the body of the young creature ; consequently, adjustment of the latter is more easily and promptly accomplished. An assistant can maintain the body of the fci^ous some distance from the pelvis by this instrument, while the hand of the operator is making the necessary rectifications ; the latter is therefore much relieved, and to some extent he is also exempted from the difficulty and fatigue caused by the uterine contractions. The ordinary repeller has some disadvantages, the greatest of which, perhaps, is its being inapplicable to certain regions of the foetus which may chance to be in an oblique line to its direction — such as the head, limbs, etc. To remedy this defect, I have added a short, pointed spike, which can be screwed into the middle of the crutch, opposite the handle, when necessary (Fig. 150), and this effectually prevents its slipping ; the part in contact with the foetus, when provided with this tooth or spike, resembles a trident. While the instrument is being employed— all propulsion should only be made during the intervals between the pains— one hand of the operator must guide and maintain it against the foetus, to prevent injury to the maternal organs. Some authorities, however, object to the employment of the repeller — or, rather, assert that they have never required its services. Brunei and Shaack observe that when their own strength is not sufficient, they are aided by an assistant. Brunet has the hand and arm of the latter acting on the foetus at the same time as his own— both arms being in the genital canal ; while Shaack gets his assistant to seize his right arm with one of his hands, resting the other on his left shoulder, and pushing him forward — Schaack's right arm and hand in this way playing the part of the crutch. In order to propel the head, Binz invented an instrument like a goblet, furnished with a long handle ; the hollow portion fitted on the muzzle of the foetus, and the head could then be pushed forward. Solid rods to be fixed to the limbs of the foetus, in order to push them out of the way, have been proposed, but their utility is questionable. It must not be forgotten that, after all, the hand is the safest and most perfect of instruments, and should always be preferred — at least at first— to such appliances as we have described. For it feels the parts on which it is placed ; it adapts itself more exactly to the su>-faces with which it comes in contact ; it perceives the resistance they offer, and warns the operator as to the amount of force necessary to effect a certain object ; whereas the presence of a hard and rigid instrument increase.-) the uterine contractions, and however well adapted it may be, it may suddenly glide off rounded and slippery surfaces, and cause serious injury. Nevertheless, there may be, and often are, occasions when the hand cannot accomplish what is necessary in the way of retropulsion, and it is then that the repeller may be most useful; it will generally be found quite safe when employed by a careful and experienced operator. The spasmodic contraction of the uterus, especially during the labour pains, is a great obstacle to every kind of manipulation in the interior of the organ ; the way to subdue them has been referred to. Eetropulsion, as we have said, should only be effected in the RECTIFICATION OF PRESENTATIONS AND POSITIONS. 491 intervals between the "pains"; th igh during these the expulsive efforts should be resisted, so that what has been accomplished may not be lost. The propulsion should be done by jerks, which are far more effective than a continuous push, and they are not productive of any inconvenience. It is nearly always necessary to secure some part of the fcetus which is to be repelled— head or limbs— by cords, so that it may be readily seized again and brought into the pelvic cavity, This will be alluded to presently. EOTATION. " Eotation " of the foetus consists in turning it more or less round its longitudinal axis, with the view of changing the relation between the presenting parts and the maternal pelvis, or modifying the position without interfering with the presentation. It is required occasionally in all the domestic female animals, and most frequently in the Cow, when the greatest diameter of the foetus is presented to the smaller diameter of the pelvic cavity, as in the majority of the lateral positions. After pushing away the body of the foetus— but not its limbs, if they are well placed— from the pelvic inlet, the hand and fore-arm are introduced in supination and well forward between the body of the young creature and the floor of the uterus ; then resting the arm on the pubis, it is employed as a lever in raising and turning the part of the foetus in hand to the right or left, as may be. If the young creature is alive, this manoeuvre is much more easily executed than when it is dead, as it seconds the effort. Boutrolle advises that the abdomen of the mother be raiscl by means of a girth or folded blanket, while rotation is being effected ; and other authorities have recommended the employment of a lever between the foetus and the uterus to effect this turning. Eainard recommends, when the limbs are in the pelvis, to tie them together, draw them beyond the vulva, put a piece of stick or any other convenient article between them, and to use this as a kind of lever to turn the body of the foetus round to the necessary extent ; or, which is preferable— as in the latter operation the limbs of the young animal may be seriously injured— to give the limbs to an assistant who, acting under instructions from the operator, turns them one over the_ other in a kind of twisting and swinging manner, in the direction indicated by the operator, whose efforts are in this way greatly assisted. The operation of rotation is completed when the greatest diameter of the foetus is coincident with the sacro-pubic diameter of the pelvic inlet— a right or left vertebro-ilial position, for example, being trans- formed into a ve.tebro-sacral position. This modification need not always be so complete, and it fre- quently suffices to convert a lateral position into an oblique one, by making the dorso-sternal diameter of the foetus correspond to the oblique diameter of the inlet— measuring this from the supra-cotyloid crest of one side to the sacro-iliac articulation of the other. The same observation is applicable to posterior presentations. Version. "Version," or " turning," in veterinary obstetrics signifies effecting &dian(je of presentation, or, in other words, bringing towards the inlet a part of the foetus other than that which presented spontaneously, and thus correcting a faulty presentation. ( i| 492 OBSTETRICAL OPERATIOXS. %y , li A longitudinal presentation is that in which spontaneous birth can be alone effected ; transverse presentations render birth impossible, and these, consequently, give rise to dystokia. Version is therefore in- dicated in all transverse presentations, no matter what region of the body may first offer at the pelvic inlet ; it may even be required in certain forms of anterior or posterior presentation ; and in all cases it IS necessary to repel the presenting part, so as to bring one or other of the ends of the oval mass formed by the body of the foetus to the pelvic inlet. Hence we have two kinds . .f version : one which has for its object the movement of the head of t\w fcetus towaids the pelvic inlet— anterior or cephalic version ; and the other the posterior part of the body to the same o-gemiv^—postcrior or pelvic version, corresponding to the p)0(lalic version in human obstetrics. Each of these versions has its advantages and disadvantages, according to circumstances ; though the majority of authorities prefer pelvic version, for the simple reason that with this there are two mere appendages to care for — the hind-limbs, to which it is comparatively easy to give a good direction ; while in cephalic version there are not only the fore-limbs to attend to, but also the head and neck, the unfavourable direction of which may give rise to much trouble in delivery. Version can only be effected in the uterine cavity, and when the uterus is entirely in the abdomen ; so if any portion of the foetus has entered the inlet, retropulsion must be resorted to. Then the operation can be commenced. It is divided into two principal movements: Bep Ills ion and Evolution. In these manoeuvres, the veterinary obstetrist, as in so many other instances, has not the advantages which the accoucheur of woman possesses with regard to manipulation, and especially that which can be practised outside the abdominal walls in conjunction with the version movements in the uterus. Bcpnlsion.—'I^he hand— usually the right— being introddced into the uterus, reaches the presenting part of the foetus, and by a succession of forcible pushes, moves it away from the inlet— in fact propels it ; though this retropulsion should not be made directly forward, but obliquely, so as to press the region we desire to get rid of upward, downward, or to either side, according to circumstances. In this way, the opposite parts glide over the uterine walls— previously lubricated : they move round towards the hand, and are more easily reached. Evolution.—S;^\\Qn the parts which are sought for reach the hand, they are firmly seized by the operator and drawn towards him. The uterine contractions assist in this operation, the version movement is continued, the fa'tus becomes lengthened, as it were, and unfolded, and when Its larger diameter is brought into the axis of the pelvis the manoeuvre is completed. VeiMon is not always successful when first attempted; indeed, it has often to be relinquished and again tried, until successful— notwithstand- ing the fatigue and demands on patience these repeated efforts entail. Complete version is required in the transverse position of the foetus, and is generally difficult ; it, and indeed all degrees of fcuniiiig, and all vicious positions of the fcntus, demands that the first thing to be done is to secure the most useful parts which present— as the limbs or head —by cords or other appliances, so as to be able to find and utilise them again if circumstances require that they should be used to assist in I 0U9 birth can npossible, and therefore in- region of the e required in in all cases it ne or other of 3 to the pelvic f-ji' its object pelvic inlet — r part of the responding to 2rsions has its 3 ; though the e reason that le hind-limbs, ion ; while in d to, but also ay give rise to .nd when the he foetus has the operation movements : many other tr of woman at which can ion with the deed into the succession of jls it ; though 3ut obliquely, lownward, or the opposite i : they move ch the hand, is him. The movement is unfolded, and be pelvis the indeed, it has lotwithstand- forts entail, of the foetus, 'iiing, and all ig to be done imbs or head 1 utilise them i to assist in RECTIFICATION OF PMESJ-JNTATIONH AND POSITIONS. 493 delivery. Very frequently traction on one or more of these cords, and the manipulations of a hand in the uterus, will greatly facilitate turning. As in so many other obstetrical operations, undue haste and violence are to be guarded against in these mutations, and gentleness, patience, and perseverance should be observed. We not unfrequently find that, when the presentation is anterior or posterior, and the limbs are in a favourable direction, though the body of the fcetus may be somewhat inclined to the right or left, the uterine contractions are sufticient to effect adjustment, gradual and well-directed traction being alone re- quired from the operator. Extension and Flexion. Independently of the general mutations which have for their object the movement of the whole mass of the foetus in the uterus, it is some- times only required to resort to 'partial mutations— SiS in the adjustment of one or more of the Hmbs, head, neck, etc., these consisting of extension —as when the arm is extended on the shoulder, the fore-arm on the arm, the head on the neck, the latter on the trunk, etc., and Jlexion, in bending the various articulations— as those of the limbs, in order to place them or the body in a better direction ; and rotation. In all these mancEUvres a rudimentary knowledge of mechanics will be of great advantage, and especially that pertaining to levers, which is particu- larly applicable to manipulations of the limbs that so frequently prove of the greatest service in obstetrical operations. It only too often happens that the arm of the obstetrist is found to be sadly too short in version and other manccuvres, and these are conse- quently rendered more diflicult of accomplishment. With regard to this, it is well to point out— what is not always known— that the obstetrist should always employ the arm corresponding to the side of the foetus on which the limb, the part sought for or to be manipulated, is situated. For instance, if the fcetus is in the anterior presentation and dorso-sacral position, with the head bent round towards the left flank, or the left fore-limb (right hind-limb in a posterior presentation) doubled under the body, he will use his right arm ; but the left will be employed in the opposite conditions. By doing so, the operator gains in length of arm, particularly towards the shoulder, and can consequently reach deeper into the uterus. Flexion and extension of a limb are often made simultaneously, and it sometimes happens that in extending such a part as the head to straighten it, it effects its own rotation. Extension alone serves to bring the limbs from under the chest or abdomen ; flexion is rarely re- sorted to, and chiefly when it is desired to return an extended limb again into the uterus. In these operations on the limbs, when the weight of the foetus is an obstacle, the body of the creature is inclined to the side opposite to that of the limb to be manipulated ; thus, if the right limb is flexed under the body, and we desire to extend it, the foetus is inclined from right to left, so that tiie right side being raised, the Hmb can be taken from under it. The body is turned in the way indicated for rotation. Wo have casually alluded to the attitude of the larger animals during version, retropulsion, and rotation, and pointed out the advantage to be derived from elevating the hind-cjuarters, either by placing litter under the hind-feet, or causing the animal, if a C'ow, to kneel on its knees. And we have also remarked that it is not always possible to obtain the I 1 .! i 494 OBSTETRICAL OPERATIONS. desired attitude, but that these manoeuvres must sometimes be performed when the animal is recumbent. It may even happen that it will be advantageous to place the animal in a recumbent position. Leconte strongly recommends laying it on its sternum, and flexing the fore and hind limbs under the body ; as in this attitude the uterine cavity can be more easily explored, and th6 necessary alterations made in the position of the foetus— the operator lying extended behind the animal. Some obstetrists place the animal on the right or left side, the operator lying on either of his sides, according to the arm he intends to use. Throwing down an animal for this purpose is always, however, to be avoided if possible ; and if it is already down, it should either be placed on its sternum or compelled to get up. When the uterus is lying very low in the abdomen, should the latter be extremely pendulous, or when the foetus— as in the Cow— is fixed beneath the brim of the pelvis, it may be found very advantageous to place the parturient creature on its back. As for the operator, he must conform his attitude to that of his patient. _ We have already written on this point when treating of parturition, and we have nothing to add. If the animal is standing and the hind-quarters are raised, and particularly if the obstetrist is not tall— and more especially if the patient is a Mare— the plan adopted with much success by Dickens may be followed.^ This consists in placing the animal, if the case is likely to be protracted, under an open shed*^ tying the head to the manger or rack, and supporting the body by two sacks passed under the belly and attached to ropes which pass over a beam above. A partition on the right side, to prevent swerving, is pre- ferred, the assistant being placed on the left side. Immediately behind the animal is put a strong, four-legged wooden cow-crib, which serves many purposes. Firstly, it prevents the Mare backing ; secondly, the operator standing in it is perfectly safe from injury during his manipu- lations, while it gives him a great advantage in the elevation it affords —especially with tall animals ; thirdly, it forms a convenient stage whereon to place cords, instruments, medicinal agent ,, etc. We will briefly notice some of the occasions when these movements have to be effected, though reference may have been made to one or two of them already. Extension or Straightening of the Head and iVcc^-.— This is resorted to when these are not in a proper direction, and the foetus must always be pushed into the abdomen in order to carry out the operation. The head may be flexed at the occiput, so that the chin is applied to the lower border of the neck, and if it has not entered the pelvis and can be moved somewhat, extension is easily effected by passing the hand into the cavity, insinuating it between the pubis and the forehead of the foetus until the nose is in the hollow palm, with the fingers if possible under the chin, or the thumb in the mouth and the fingers in the intermaxillary space ; then it is lifted sidewe-^s above the margin of the pubis, when it can be brought straight into the genital canal by gentle traction. ^ When the neck has entered the pelvic inlet, then it is imperative that it be pushed into the abdominal cavity ; before this is attempted, how ever, cords should be passed round the fore-feet (though these are not to be pulled at first), and another around the neck of the lower jaw or the under part of the head ; this cord the operator holds in one hand or * Vtttrinarian, vol. xxxiv., p. 2G0. RECTIFICATION OF PRESENTATIONS AND POSITIONS. 495 gives to an assistant, while he presses the neck forwards and to one side, raising the nose by means of the cord and hand when there is sufficient room. An exaggerated and more difficult form of this condition is the head and neck flexed beneath the chest, but it can be remedied if the labour has not been protracted. The lower jaw should first be corded, the cord being pulled by an assistant while the operator pushes the body back until the head is somewhat relieved, when the propulsion ceases, and the hand seizes the lower part of the head and raises it and the forehead ; and so pushing away the body and guiding the head alter- nately, the latter is brought into the canal. When, however, the practitioner is not called in— which is usually the case— until after the waters have escaped some time, attempts have been made at delivery by amateurs, the genital passage is dry, and the uterus is applied close on the foetus, then adjustment of the head and neck is a serious affair ; as the prolonged straining and pulling have put the head farther beyond reach —pushed even beneath its abdomen ; so that the tips of the fingers can scarcely touch the nose, much less grasp it, while the contractions of the uterus— closely enveloping the foetus— paralyse the arm, which has to be bent downwards in search of the head. In such a case retropul- sion is futile, and the first thing to be done is to inject a large quantity of strained hnseed-jelly, or some other mucilaginous fluid, into the uterine cavity, to compensate for the absence of the waters— unless it be decided to place the animal on its back, which is decidedly advan- tageous in this embarrassing case, when the injection should not be administered until the animal is cast. Having had the passage well lubricated and the uterus separated from the foetus, this may now have the fore-legs secured by cords, and the front-part of the body pushed forward, downwards, or sideways, so as to reach the head, which may be seized by the ears, orbits, or lips, until the neck of the lower jaw can be grasped and corded, when, with steady manipulation and traction, the head and neck can be adjusted. PuUing at the limbs, then pushing the body forwards, so as to effect displacement of some kind, will often assist the operator when the head is beyond his hand. Such cases in the Mare are nearly always impossible to rectify, and even in the Cow they are most formidable, and not always satisfactory in their termina- tion. _ When the head is bent upwards and backtvards — the opposite condi- tion to the last — somewhat similar measures must be adopted. The fore-limbs should be corded, as well as the neck of the lower jaw if it can be reached. Then the Ijody is to be pushed away from the brim of the pelvis — employing mucilaginous injections, if necessary, before attempting this, and by means of the hand in the uterus and alternate traction on the head-cord and retropulsion, the foetus can generally be got into a proper position for delivery. A somewhat frequent misdirection is the head bent round to one side —extending to the shoulder, or even as far as the chest or flank. When only slightly inclined to one side, reposition is easily efi'ected by seizing the lower part of the head, raising it upwards and bringing it round to Liie genital canal. It must not be forgotten that the hand employed to bring the head round must correspond to the side on which it lies : for instance, if the head is bent to the right, then the left hand must be used to manipulate with. When the head is as far back as the elbow, even, it may often be i 1 496 OBSTETRICAL OPERA TIONS. brought straight by first cording the fore-limbs, then reaching the neck of tho lower jaw over the shoulder, and cording that also— retropulsion and manipulation, with traction in tho intervals of tho straining, will effect tho rest. The case is very different, however, when the head is carried as far back as tho Hank or hind-quarter, and especially if the uterus is retracted on the foetus, and the interior is dry and adhesive. In tho Mare this is always a most formidable affair to deal with. Here the nmcilagiuous and emollient injections are indispensable, and should be at once resorted to. Then the fore-limbs must be corded, and pushed into tho uterus if they are in tho way (using Darreau's porte- cord if necessary), tlio hand passed along the convexity of the neck, and between it and the uterine wall, until the lower jaw is seized and corded. Pressure is now made on the breast of the foetus, so as to push it away from the pelvic brim and towards the side of the uterus opposite to that on which the head lies, so as to bring this nearer to the inlet. Then the hand turns the lower jaw upwards by placing the fingers in the submaxillary space, and pulling the head round by means of the cord, the hand in the uterus keeping the body away from the pelvis and to the opposite side, as well as protecting the uterus from injury by the incisors. If there is a tendency to twisting of the neck, this must be overcome by manipulation of the head, which must be brought gradually and carefully round. But it only too frequently happens that the hand cannot reach the head, or can only touch tho ear-tips, and then the difficulty is very great— it may even be insurmountable. Various plans have been tried, such as exciting the foetus to move if it be alive ; raising the abdomen of the mother, elevating tho front part of the body or placing her in the dorsal position ; or implanting hooks in the foetal orbits. But there is no certainty in any or all of these methods, and the only one which has hitherto been most successfully employed is that introduced by Delafoy, more than sixty years ago. Having satisfied himself as to the state of affairs, he passed the end of a strong rope, about twelve feet long, with a knot at the end to prevent it slipping from his hand, between the neck and chest of the footus ; this end he passed down- wards, seized it at the lower side of the neck, -^nd brought it out of the vaginal canal, so that the middle of the cord was inside the bend in the neck. Again introducing his hand into tho uterus, he pushed the loop of cord by the tips of his fingers as near to the head as possible, when he directed an assistant who held the two ends to twist them round and round each other, until the cord was quite tight around the part on which it was placed ; at the same time his hand prevented any of the placenta or cotyledons from getting into the twists. This having been accomplished, the hand was placed oh the breast or one of the shoulders of the foetus, and while he pushed it towards the fundus of iht uterus the assistant exercised steady traction on the cord. In this way, by good management the head was brought towards the cervix uteri, where it was immediately accessible, and could be placed in its normal position. A small weight of any kind attached to the end of the cord, instead of the knot, would carry it more readily between the neck and shoulder or chest, and the portu-cord might also be used to pass the cord if the hand could not be extended sufticiently far (see Binz's porte-cord). Extension of the Limbs. — The limbs are not unfrequently a cause of difiiculty in parturition, and have to be adjusted before delivery can be ling the neck -retropulsion training, will the head is ecially if the nd adhesive, with. Here B, and should corded, and roau's porte- of the neck, is seized and tus, so as to 3f the uterus lis nearer to Y placing the nd by means vay from the uterus from of the neck, lich must be lot reach the 3ulty is very '^e been tried, the abdomen acing her in 5. But there ly one which itroduced by self as to the i twelve feet m his hand, assed down- it out of the 3 bend in the led the loop as possible, 1 twist them 1 around the revented any This having r one of the tie fundus of )rd. In this .3 the cervix placed in its the end of between the ) be used to itly far (see y a cause of livery can be ItECTIFICATION OF PRESENTATIONS AND POSITIONS. 497 effected. The difficulty is usually duo to their being flexed at the knees or hocks, or completely retained in the uterus. With regard to the /Grc-limhs, their adjustment is more difficult in the Mare than the Cow, in consaquenco of the different segments of the leg bemg longer. When Jlcxed at the knees, if they have entered the genital canal or are at the entrance to the pelvic inlet, they must be pushed forward into the uterus before they can be extended, and it may be advantageous to cord the lower jaw or head previous to this being attempted Then the foro-arm is brought into a horizontal position, if it was not so before, the shank is seized and smartly extended on it, its lower end being adducted and the knee directed upwards and outwards so that the pastern is opposite the inlet ; the hand is now passed to the fetlock and hoof, which is held in tho palm, the pastern-joints are well flexed the lower part of the limb is pulled into the genital canal and the whole extended there. With the Calf flexion of the phalanges is not so necessary, as they are shorter than those of the Foal, and they may be immediately extended ; but the hoofs should be covered by the hand to prevent laceration of the genital mucous membrane. The other limb is adjusted in the same way, if it be at fault, and the head is then brought into the inlet by means of tho cord and the guid- ance of the hand. Should retropulsion be rendered very difficult because of the condi- tion of the uterus, injection of mucilaginous fluid must be made, the hmbs corded at the pasterns or shanks, and an assistant pull on these cords while tho operator raises the knees upwards and outwards at the same time pushing them forwards ; this manipulation is alternated with attempts to bring the phalanges into the inlet by the hand, and straightening them there, at the same time guarding the maternal mucous membrane from damage by the hoofs. When the fore-limbs are completely retained, the head or lower jaw is first corded, then steadily pushed forward towards the fundus of the uterus ; if the fore-arm can be grasped, it is flexed, so as to bring the knee upwards, and— provided parturition has not long commenced— the lower part of the limb can be extended in the canal. But if the fore- arm cannot bo firmly seized, so as to alter its direction, a cord must be passed between the leg and the body— as with the head doubled back on the side— tue two ends being twisted outside and held by an assistant, while the loop around the fore-arm is brought as near to the knee as possible by the hand. Then the upper part of the leg and the body are pushed forward by pressure on the point of the shoulder, while the assistant pulls steadily on the cord until the knee is in the pelvic cavity, when the limb is extended in the manner just described fsee p. 438). ^ With regard to the hind-limbs, the same remark applies as to the greater difficulty in adjusting them in the Foal than the Calf, in con- sequence of their greater length ; and as they are proportionately longer than the fore-limbs, while the movements of the principal joints are so interdependent that one cannot be bent without influencing the others, thfiir rectification is much more troublesome and laborious. When the hocks present in a Jlcxed state in the Mare, it is generally considered hopeless to attempt extension, especially as the' fcetus is nearly always dead; therefore it is advisable, in order to spare the 32 f.- .^ Sl akii . -l r ', Stei 498 OBSTETIUGAL OPERATIONS. I: ,1 Maro pain and exhaustion, to divide the gastrocnemii tendons, and so straighten the limba. With the Cow the case is not so serious, and the Calf may bo de- livered alive. Retropulsion of the hind-quarters and hocks is ah :)lutely necessary ; this can be effected by persistent effort and the exercise of patience, the pushing forward being done by jerks in the intervals of strain- ing, until the footus has been removed some distance from the brim of the pelvis. Raising the hind-quarters of the Cow is very serviceable in this measure. Then the tibia is placed in a horizontal direction, the pastern or shank is corded — as with the fore-limb, and the hock being kepi as far away as possible from the inlet, and towards the maternal flank, the lower part of the leg is carried backwards by cord and hand until it is in the canal. In doing this the operator uses the point of the calcis to push the hock, the body of the foetus being kept obliquely, and care being taken that the points of the hocks do not damage the uterus, by covering them with the palm of the hand — a procedure which must also be adopted with the hoofs. When the hind-limhs are retained in the maternal abdominal cavity of the Mare, the case is quite as serious as when the hocks present ; but in the Cow it is not so formidable, and a similar procedure must be adopted as in the hock presentation. The body of the fcutus is pro- pelled forward as far as possible, and the tibia is flexed on the femur, so as to bring the hocks up towards the inlet ; this is not very difficult if the foetus can be readily moved, for the hand can be then passed to the stifle and the limb drawn towards the pelvic cavity, when, r,v\'/Ang the tibia, this is flexed on the thigh. A cord may be passed round the thigh and brought down to the hock, or as near it as possible, in par- ticularly diflicult cases ; and in propelling the buttocks into the uterine cavity the assistant steadily pulls the cord, the hand of the operator not only pushing, but also guiding the direction of the lower part of the limb and preventing injury to the uterus, until the hock has reached the inlet, when the leg should be extended in the manner before described. In this diflicult and fatiguing operation, a repeller used by a second assistant will be found most valuable. CHAPTER III. Mechanical Means for the Extraction of the Foetus. Mechanical means for the extraction of the fretus are required when the expulsive efforts of the parent, and perhaps the hand of the obste- trist, aro insuilicient to produce delivery. These means are employed to effect change in the position of the foetus, or to apply force sufficient to overcome the resistance offered by the obstacle to birth ; they com- prise a number of articles, the chief of which are cords and batids, Jialters, crotchets or hooks, aw^i. forceps of various kinds. The uses and advantages of these we will now notice. But before doing this, we must again point out the great advantage, should the " waters " have escaped, and the genital canal and interior of the uterus be dry and tenacious, of moistening these parts well before resorting to mechanical operations. Ions, and so limy bo de- s aK :)lutely ! exercise of als of strain- tho brim of cable in this the pastern iing kepL as ernal tlanit, hand until oint of the liquely, and the uterus, which must lal cavity of 5ent ; but in re must be !tus is pro- le femur, so r difficult if issed to the f>('izing the round the ble, in par- the uterine He operator part of the las reached iner before ler used by MEVIIANICAL EXTRACTION OF THE FCETUS. SKCTION I.— CORDS AND BANDS. 409 etus. uired when the obste- e employed !e sufficient they com- ind bands, le uses and iig this, we bers " have be dry and mechauical Cords and bands are, of all mechanical means, the most useful in veterinary obstetricy, and are more to the animal obstetrist than forceps are to the human practitioner. Thev have the additional ad- vantage t^hat they are readily procurable, are cheap, very portable and can be employed where and when other means are inapplicable' Owmg to their pliability, they can bo pulled in any direction desirable' without much danger of injury to the maternal organs. In all cases of difficult parturition, it is an axiom with the experienced veterinary obstetrist that the first thing to be done is to cord the prosenting limbs ; or if they do not present, to seek for and cord them as soon as possible. When this is doiu;, then they may be returned to the uterus, or put out of the way, as the cords will always bring them to hand again when required. While they are admirably adapted for exercising traction upon the fa-tus, they may also in certain cases bo of great utility in changing a malposition. They are used with the view of applying traction to the foetus, and they can be attached to the head, body, limbs, or tail, according to circumstances. The ''mbs are more particularly the parts upon which they can be most usefully employed, .ecause of the length and sohdity of these, tlie facility with which they can be seized, and the prominences of the joints and hoofs, which prevent the cords from slipping. For the Foal they are most advantageously fastened around the pastern, hut with the Calf above the fetlock-joint is hotter. Tlio head cannot be so advantageously " corded," though it is a most important region of tlie body to secure in certain cases ; the neck of the lower jaw affords a fairly good hold, and if the fu3tus is alive the cord, made into a halter, can be put over the head. For the jaw the cord should be rather thin and soft, but strong. The neck can be corded, as can also the loins and croup, as already shown. In embryotomy cords are also of great service, as they can be fixed to parts of the body, and even to shreds of skin, to aid in removal. The cords vary in thickness and length ; they are usually about five or six feet long, though they may be nine or ten feet and, if spun rope, from a quarter to half-an-inch or more thick. At one end may be a small loop or iron ring, by which to form a running noose (Figs. 154, 155, 158). Some piactitionurs recommend strands of Manilla hemp, and in par- ticular instances, as when a somewhat rigid loop is required, it is very useful to have a long piece of copper wire twined in the cord or hemp. Other obstetrists prefer a leather band. The Manilla hemp, and web or leather band, are resorted to in order to prevent damage to the foetus during traction— the cords, from their hardness, thinness, and strands, being liable to cut. But this accident need not be much feared, and the durabihty, convenience, and other advantages possessed by the cords, are greatly in their favour. They retain their hold better than anything els3, and particularly if they have only a simple loop at the end, instead of an iron ring. If it is desired to render a hard cord softer, it may be partially untwisted at the part intended to go round tlie tissues of the foetus. Sonie practitioners have cords ready prepared, which they use for a long time; but unless precautions are adopted they may become a source of danger, as they readily absorb septic matter. They should therefore be thoroughly cleansed after each operation. : ■ i 600 ons TKTniCA L OVEIIA TIOXS. When running knots or loops aro iniulo, these hIiouUI bo so tied that tiioro is no chunoo of their beoouiing untied throuj,'h Hlipping, wlien thoy come in contact witli lubricating lluids and are Htraimid. Wimtover is used for this purpoHo should bo very pliable, and yet Builiciently strong to withstand energetic pulling. A very good pattern of cord is that used by Hchaack (Fig. l-Of)). This is merely a cord with a running noose at ono end, and a small piece of round wood at the other, to give the assistant a bettor hold, and enable him to use more force. When cords aro employed on the limbs, thoy are generally applied to the pasterns of the Foal, as these parts aro most accessible, and alTord the most sucuro hold. Thoy can also be applied above the knees and hocks, when it is necessary to amputiite the limbs at these joints. The head may bo secured around the lowor jaw, but it is sometimes bettor Fig. l.'il. TiiAiTioN Colli) AND Hand, and tiik MaNNKU 01- APPLVlNd TIIKM. Fig. 155. Schaack's Tuaction Cokd. to pass the noose into the mouth and around the top of the head, like a gag-rope. When the cords are to bo applied to the limbs, either of two modes can be resorted to with this object. If the limb is bent, it must bo ex- tended and brought opposite the inlet, or into the genital canal, as the case may be. Then Raiuard recommends that the lingers be gathered together and slightly bent, so as to form a kind of cone, on which the running noose of the cord— sufliciently wide to pass over the foot of the foetus— is placed, as in Fig. 154. The noose is kept in its place ou the fingers, in tightening the cord by the free portion which passes along the under side of the hand and arm ; unless this precaution is adopted, the noose will be pushed back over the hand when introduced into the vagina, and cannot easily bo got forward again. The hand and cord being oiled, aro introduced iiito the passage, and when the foot is reached it is seized in the fingers ; these are then suddenly bent, so as to shorten the cone and cause the noose to run on to the pastern by I MEailANWAL KXritAUTinN OF TllK FiETUS. 601 so tiod that ;, when thoy bio, and yot 50od pattoi'Ji and a snialL buttor hold, y applied to ), and alTord i knooa and joints. The tinius bottor x Conn. e head, like two modes must bo ex- [inal, as the be gathered 1 wliicli the the foot of its place on hich passes recaution is introducfifl The hand hen the foot nly bent, so I pastern by a ^'(intlo pull of tho cord, which can then bo tightened and given to an assistant. Tho other method, which is Schaak's, and by Hon)o obHtotrists con- flidored preferable to that juHt doHcribed, conaiHtH in placing the middle of tho nooHO on the dorsal aspect of tlio ends of the two middle fingers, tho finger on each side holding it against these, while the thumb keeps it in the palm of tho hand (l''ig. KU). Tho left hand maintains tho cord sulliciently tense to assist in keeping tho noose on tho ha:id ; and if the part of tho cord which runs through the loop is placed towards the thumb, tho latter can readily increase the size of the noose. The hand is passed into the vagina sid(!ways, tho little fingor downwards, and when the foot is reached, the thumb and index-finger are placed within the nooso, which they enlarge in separating from each other, while th(! retiiaining lingers. Hexing on the hand, are passed around tho foot, and cause the noose to glide over the hoof on to tho pastern. The lingers now press on the loop, while tho other hand, drawing at the cord outside the vulva, tightens the noose around the limb. When the limb is flexed and cannot be extended, as at the knee or hock, tho looped cord may be employed ; though a long cord, doubled, will be found to answer very well. This is passed round tho flexure, tlie doubled end pulled to the vulva, and the other end passed through the loop ; this done, the loop may be tightened, passed up to the elbow or stifle, or down to the pastern. Tho lower jaw is "corded" in a similar manner; tho mouth of the fuitus being opened, the noose is passed around tho neck of tho jaw, and the knot or loop placed beneath the chin. In embrj'otomy cords render good service, as they can be attached to any part within roach ; after decapitation of the fciitus, for instance, a cord passed through a thick fold of tho skin on the upper part of the neck affords an excellent means of traction. When long cords are used, and energetic traction is likely to bo em- ployed, it will be found convenient to have knots at intervals, to pre- vent the hands of the assistants slipping. Halter, Head-Cord, or Head-Collar. In addition to the limbs and other parts, we have stated that the traction-cord can often bo advantageously applied to the lower jaw. Indeed, in the anterior presentation, even when the fore-limbs are " corded " and the head is in a favourable position, it will generally be found very useful to apply traction to the head in addition, as not in- frequently pulling at the fore-limbs alone only fixes them more firmly in the passage. We have also mentioned that tho interdental space, or " neck " of the lower jaw, is tho most convenient for the attachment of the cord ; but nevertheless it will be found in practice that this does not afford nearly so firm a hold as the limbs, and that if the noose does not slip off the jaw, which is often the case, should tho ti'action be at all energetic the bones will probably be smashed, the foetus, if alive, irreparably damaged, and an important accessory means to extraction lost ; besides, traction on thia pnrt thrnwF, the hnad too much npwords. Rb.nnld the hep-d be turned back towards the side, cording the neck does not reduce the deviation, but only allows it to be brought in a doubled condition into the genital canal. It is, therefore, most important that means be at hand to secure the \ 602 OBSTETRICAL OPERATIONS. M' head firmly and solidly, either with a view to correct deviation when this part is in malposition, or to exercise traction upon it when it is adjusted, and when the foetus remains immovable by pulling at the fore-limbs. We have suggested that the noose of the cord, sufficiently widened, instead of being placed on the lower jaw, should be first passed into the mouth of the fa3tus, then carried up over the head and behind the ears — the loop of the noose remaining, of course, tightly drawn in the mouth, as this must be the direction from which the traction is exercised; if pulled at from behind the ears, the noose would be drawn off. In placing the noose in this position, the straight porte-cord — and especially Mr. Cartwright's pattern — will be found very useful. Instead of this simple noose, which can readily be made when needed, rarious kinds of head-stall have been proposed by veterinary obstetrists Fig. 156. Fig. 157. BiNz's Simple Head-Collar. Ruefk'h Head-Collar. No. 1. Fig. 158. Rcekf'h Head-Collab. No. 2. from time to time, and some of these possess certain advantages. Giinther, many years ago, pointed out the advantages of a head-band like that represented in Fig. 154, the upper part of wliich was passed behind the ears, while the inferior part witli the running knot lay between the branches of the lower jaw. Binz soon after proposed a kind of head- collar, or halter, which could be adapted to diffcrent-si/ed heads (Fig. Id6). It is made from a long piece of cord with a loop or eyelet at one end, and at a certain dist-ince from this— from fourteen to si.x- teen inches— a second loop. The other end of the cord is passed through the first loop, so as to make a noosu wliiuh goes rouiiu the neck of the fccti^s ; then through the second loop which goes round the lower part of the head, and may be made large or small. The remain- ing portion is used for traction. This improvised halter is lield at its upper part by the ind..x-finger and thumb, passed into the genital canal ation when when it is Uing at the ly widened, ised into the nd the ears awn in the is exercised; wn off. In d especially hen needed, 1 obstetrists MECHANICAL EXTRACTION OF THE FCETUS. 503 or uterus, where it is placed on the head of the fcotus and the sides applied to the cheeks ; the lower portion, which was open, is now closed by running the end of the cord through the second loop, by which the head is firmly secured, as in the figure (156). Instead of having the first loop at the end of the cord, Baumeister makes it nearly in the middle, with the second loop at the same distance as in the other halter. This allows of two cords— one on each side of the head— to pull at (Figs. 157, 158). Binz has devised a special head-apparatus (Fig. 159), to which he has given the name of " Forceps-band" {Zanrjcnbancl). This is a band of flax, silk, or some other woven material, which is at its widest part about four inches broad, and in length about six or seven feet. At one end is a moderately large opening, while the other is divided into two portions to within some distance from the loop ; these last pass through a round, movable, cork-shaped piece of wood, metal, or leather. The head of the fojtus is passed between the divided ends of this band, which are then tightened behind the jaw by running the keeper close up to the chin, the undivided portion being brought over the forehead towards the nose, and the divisions passed through the luop. In this Fig. 159. BiNz's Fouceps-Band. -Collar. idvantages, head-band was passed ay bfitween nd of hcad- L/ed heads p or eyelet eon to six- is passed rouiui the round the 'lie remain- hold at its nital canal way the head is firmly held, and powerful and direct traction can be made on tlie head, above and below, by means of the upper part with the hole at the end, and the two portions beneath. It has been found particularly useful in cases of hydrocephalus. Schaack, in IHiS, introduced another kind of head apparatus, which he designated a "sliding head-stall" {UHidre d coulaiit), but which is perhaps better known in France as a " forceps halter " (licol-forceps), by reason of its shape and use. It is composed of two doubled cords, one of which (Fig. 160, 1, 1) forms the headstall, while the other (3, 3) makes the nose-band. The two arc united by a metallic runner (5) which allows the apparatus to be increased or diminished in size at will. The runner, which forms the key of the apparatus, is a piece of brass or pewter a little more than an inch in length, about an inch in breadth, and half an inch in thickness. It is perforated by three holes, two of which are parallel and pass through the wider part of the metal, while the third, placed between them,ruu3 through its narrower surface. The two ends of the head-stall loop go through the parallel holes, the cord composing this being nine or ten feet long and one-third of an inch thick, the loop itself being intended to lie behind the ears of the fcrtus. One side of the loop is fixed in the runner, by rings of waxed pack-thvead I ■ .1 •■ i"- I . 504 OBSTETRICAL OPERATIONS. .'!. S I III lit above and below the hole ; this waxed thread being also run up on the loop, to give it a certain degree of rigidity. The other half of the cord is freely movable in its hole in the runner, and a knot tied near its end allows it to be distinguished from the fixed half. The /, -.c-band (3, 3) is made of two strong but soft strips of leather sewn one within the other, and doubled in the middle to constitute a loop eight to ten inches long : the two portions being made into a single cord (4) between three and four feet long, and which passes through the single hole across the runner. The middle part of the nose-loop has a kind of shield or button of thin leather, to prevent the loop slipping through the hole. This was the apparatus first devised by Schaack, but recently he has somewhat modified and simplified it, by dispensing with the nose-band Fig. 160. Schaack's Forckps-Halter. 1, 1. Head-stall; 2, 2. Two Cords, its con- tinuation ; 3, 3. Nose-band ; 4. Single Cord forming a continuation of the Loop con- stituting the Nose-band ; 5. Metal Runner, uniting the several parta of the Halter. Fig. 161. Manner ov placino Schaack's Haltei!. altogether, as he found that the nose of the foetus could be better guided and held by the hand. Experience has proved that this simpli- fication allows the halter to be more easily applied. The manner in which the original halter was employed is described as follows :— The head of the foetus being in front of the inlet and readily accessible to the hand, the nose-loop is pulled through the runner until stopped by the leather button, while the head-stall loop is made sufficiently wide. The middle of the latter is placed at the end of the middle fingers, the movable part of the cord bein^ long, and half an inch thick. The wire may either be of copper, brass, or iron, about sixteen inches long (we have Fig. 167. Breulet's Tube and Noose. generally used a piece of catgut, and prefer it) ; this is doubled, passed through the tube to a certain extent, so as to form a loop or noose at the end (Fig. 1C7). When it is to be used, the first finger of the left hand carries the loop into the vagina of the Bitch, and slips it behind Fig. 168. Breulet's Noose fixed on the Fqctus. the occiput of the Puppy ; then the two ends of the wire are passed through the tube, and this is pushed into the vagincu under the chin of the foetus • the operator now tightens and secures tl;e wire, by giving it a turn round the first finger of his right hand, placaij": hia thumb at the end of the tube (Fig. 1G8). A little traction theu .-xtracts the foetus, and without doing it or the Bitch ;the least dai'vupe. I have MECHANICAL EXTRACTION OF THE F(ETUS. m huSanltetricr "■"' *° "'°°" " ''°' -"*« *^ " filler ■ used in ^mh^^^mJA I Fig. 169. Caetwkight's portk-cobd. Fig. 170. Daubeau's POUTK-COIII). Fig. in. GOnthkr's CunvKD rORTECoun AND ]5lunt Crotchet, arjiki) with a Cord and Ring. Darreau's Curved Porte-Cord. SKCTIOxV II.-PASS. OR PORTE-CORDS •ir, 1 1 J filO OBSTETRICAL OPERATIONS. sufficiently long to pass them to the region where they might be most effectively fixed ; while the energetic uterine contractions paralyse the hand of the operator, and often prevent it manipulatmg accessible parts which it is desirable to secure by these means. In such circumstances the porte-cord, or pass- cor d—vihich. has been sometimes referred to— is of great service. The instrument is of two shapes, straight and CUTVCd The straight portc-cord is usually a rod of ^ inch iron, furnished with a wooden handle at one end, and an eyelet or double open- ing at the other to receive the cord (Figs. 169, 170). The curved porte-cord has the end through which_ the cord passes more or less bent, and in certain cases it is more useful than the straight one, from which it only differs in having this curvature (Figs. 171, 172). Different forms of these instruments have been described, but in principle they are all really the same. The straight one can be used to pass the traction cord around the limbs, or the neck of the lower jaw, and may act with the cord in pulling these towards the vulva ; or, if properly constructed, it may also be most serviceable as a repeller in pushing them forward into the uterus. A very good and simple pass-cord of this kind is that introduced by Darreau (Fig. 173), which can be employed as a re- tractor and repeller. Two of these may be used at the same time, on two Umbs. For instance, in nie sterno- abdominal presentation, when posterior version is decided on, the hind-limbs are corded in the usual way ; then this repeller, armed with a noosed cord of suflicient length, is introduced, the noose passed on to the pastern or knee of one fore-limb, and the cord drawn tight and fastened around the handle. Another pass-cord is attached in the sp.me manner to the other fore-limb, so that each instru- ment becomes a sohd fixture to the leg, and is con^aled to an assistant. The operator then pushes back the fore- limbs as far as possible by hand, while each assistant seconds his efforts with the repellers. When all has been conveniently adjusted, traction is made on the hind-limbs, the repellers being still employed to overcome the resistance of the fcetus and follow its mo ..ments. The curved pass-cord has its uses in certain cases when the straight one cannot be serviceable— as in passing a cord round the head or bent neck, thigh, or loins ; there are also several patterns of this instrument, but if the straight one is made of iron, it may be bent sufiiciently to answer the purpose in the case of fiexed limbs or bent neck. An ordinary walking-stick with a crook handle may, on an emergency, be made to serve this purpose by making one or two holes in the handle for the reception of the cord. Or when this cannot be procured, an excellent substitute will be found in a piece of iron or lead attached to the end of the traction cord, the weight of which greatly facilitates the passage of the cord around the straight or bent neck, hocks, or knees. i- ■ i Tyvaert^ has for a long time made profitable use of a simple ports- 1 AnnakH de Medicine Vdterinaire, 1876, p. 320. I Fig. 173. Darreau's Repeller. it be most ralyse the sible parts amstances iired to — ■aicjht and shad with ible open- 3). .vhich the ases it is h it only described, stion cord and may vulva ; or, dceable as s. A very ntroduced I as a re- ;ed at the le storno- is decided then this length, is or knee of I fastened led in the kch instru- lonialed to the fore- assistant . has been lind-limbs, resistance ases when iing a cord there are le straight to answer neck. An lay, on an laking one when this a piece of weight of le straight iple porte- MECHANICAL EXTRACTION OF THE F(ETUS. 511 T},^ -1^'^ '^ composed of a somewhat short piece of iron wire about the thickness of a goose-quill, and bent a httle round the length and a small ring, while the other is bent to make a hook a little longer than wide. A cord being attached to the ring end, the wire is passed round the part it is sought to seize ; the hook end remains free, and afterwards receives the traction cord, serving to torm a running noose on the part. This porte- cord is very simple, and may be made on the spot when required ; it has proved most useful for securing the neck or hocks. Binz's pass-cord (Fig. 174) is much used in Germany. It is sufliciently large to pass round the doubled neck of the foetus, while its shortness allows it to be easily manipulated in the uterus It 13 from twelve to sixteen inches long, and made of 'T u^fu '■°" ' ""^ *^^ ^^'^'^ '^"d is an opening through which the cord passes. The instrument (named a Gehi^tssonde by the Germans) is passed to the middie of the cord, and may then be introduced into the uterus, where, from its curvature and its shortness. It can be pushed behind or between the limbs, in the double of a bent neck, etc. The hand seeks the half of the cord on the opposite side of the part, and pulls it into the vagina ; the in- ttTofd^eft tdrSngt""' ^^' '''' '''' '^ '^^'^ '^ ^^ P^"«^ ^* ^^ The ordinary curved pass-cord is introduced into the genital canal in the same manner as the other form, but with only a loop or rin° no noose-at the end of the cord; the curved portC is pushed a?o";;nd teSe o°f ,t'''T'^'.""^-i^' ^^'?^' ^^^^^"8 ^'' '^' Passefto the oppo site side of the part, where it searches for the loop or ring which when Sawn IhJT, "*° '^' g^'^i*^! «-^-l- The insl-umenT il then wS mS hro^l irT'^'S around the part ; the free end of the cord is passed thiough the loop or ring, and being pulled at, the limb neck body, or whatever it may be, is secured in%he noose so formed and traction can in this way be directly exerted upon it. ' SECTION III.-CROTCHETS OR HOOKS. ^imil?*''''''^ croic/icfs or hooks are iron or steel instruments of variable dimensions, more or less curved at one end-which is blunt, sharp or Fig. 171. BiNz's POKTK-CORD. Fig. 175. Shout Blunt Crotchet. Fig. 176. Blunt Fingeb Cuotchet. pointed— the other end having a ring (Fig. 176) or evelet (Fi^ 17^5^ if short, a handle if long. The latter il Vrom thiity t^tWrty sfx LcLs 1 '^M 4l ' i 5ia OliSTETltlCAL OP Eli A TlvNS. in length (in. 'uding the handle), and acts directly on the fcrtus without any other appliance intervening ; while the short hooks have cords attached to them, or they may fit, on the linger of the operator by means of a ring. Some sharp ciotok^tH .no jointed at the end curve, so as to permit them to be more readily and safely introduced mto the genital passage by bringing the sharp' point near the stalk, tlio curve being restored by a sprin.' wlien the fcjotus is reached. But the advantages of the jointed hooks are very few, while their strength is impaired and their expense increased. In using tno long or short pointed crotch ..ts, risk of injury to the maternal organs may bu obviated, it the Iui'mi is not found sutlicient to guard the instrument du^'ing its introductioi by fixing the point in a piece of cork or soft wood, to which a long i uce of twine is attached ; when the crotchet is r(;quirud to be implanted in the fcctus, this shield may be removed from the point, and withdrawn from the genital organs by pulling ..t the end of the twme outside the Bliint and sharp crotchets are much employed in veterinary obstetrics, and are very valuable. G'lie blunt crotchets are more particularly resorted to when the foetus is ahve, and it is hoped to extract it before it is dead ; they are most serviceable in correcting deviations ot the head or limbs, and the long crotchet is especially useful m finding and i . i I Fig. 177. Short Shaiu' Cuotchet, WITH BiioAU OR Fl.\nc;ki) Point. Fig. 178. Short Hhaui' Cuotchkt, WITH Hound Point. strai"-htening the latter. The curve should be about four inches wide. The finger crotchet may be usefully employed when the hand is fatigued or paralysed by the uterine contractions. Blunt crotchets of a much smaller size than those required for the larger animals can be most successfully employed in deUvering the Sow, Sheep, Goat, Bitch, or Giinther's long porte-cord (Fig. 171) can be most effectively used as a blunt crotchet and at the same time as a ( urier of the cord. A German Ion" blunt crotchet has a concealed sharp blade in the concavity of tlie curve ; by means of a spring in the handle this blade can be projected, and the instrument will then do good work in embryotomy. With the sharp crotchet, the curve should certainly not be very wide; the smaller it is the more readily it can be passed into the genital passage, and the less chance of injury is there to the mother or operator ; it should not be greater than the hand can cover. At the same time, if the curve is too small, the crotchet does not obtain sufii- cient hold of the foetus, is readily torn out, and for this reason may be most dangerous. The point should be so bent as to readily penetrate the part in which it is determined to fix it, and the angle of the curvature should be such that the more the crotchet is pulled at, the deeper and more firmly the point will enter. without ve cords y means 90 as to e genital ve being vantages ired and rotchots, liu'Mi is ctioi by ng 1 oca anted in ithdrawn isido the bstetrics, rticularly it before IS of the ding and hes wide. s fatigued )f a much t be most Bitch, or used as a \. German dty of the projected, /ery wide ; he genital mother or \ At the btain suiii- nn may be ' penetrate gle of the led at, the MEailANWAL EXTIIACTIDN OF THE FCKTUS. 618 So :t is that the point should not be turned round in a semicircular mariner, but rather at an acute angle, as in Figs. 181 182 fr^ulT ^^/""i^l^^u ^'™^y o^ opinion with regard to the preference nnn« f T"^"'^ ^\^^^ crotchets ; some practitioners preferring the short Zf'Z *^,«yf"/^« readily carried into the . erus guarded by the hand naft Tft f ?' *''T,' 'ir *°^ i'npiantcd in the most convenient part of the foetus; while the cords attached to them allow traction to be made in the most favourable direction. Other obstetrists prefer the ^ <1 -4 n Fig. 179. Long Blunt Crotchet. Fig. .aO. Long Pointed Ckotchet. >ig. 181. Long Point i Darreau Fig. 182. Crotchets, 1'attern. long rigid crotchet, which hey affirm is more easily placed-one hand handl? ^'°'''' ''''^^ ^^^ passage, the other hand acting on the These preferences depend .... much upon whether the operuLor i« more practised in the use of one or other of H,e crotchets, and also doubtless, upon circumstances peculiar to eacL ase requiring the em- ployment of such instruments. Both long and short crotchets are nost useful, and the obstetnst should have several of each, of various 83 I 614 OliSTETIlWAL ori-JIiA TIOXH. hi I IM: ; forms and dimensions, so as to bo ablo to select that which is best adapted to meet the requirements of |)articular cases. It nmst bo observed, also, that many practitioners are not in favour of crotchets, and decry their use. But there is something unreason- al)lo in this, and the experience of almost every day goes to prove that those instruments alTord a simple and ready means of getting hold of the foetus in regions of its body which the liaiul cannot possibly reach, or if it did, where it could do very little service either from the shape of the part, its slipperiness, or the paralysing elt'ect of the uterine con- tractions on the liand and arm of the operator. Tliey can also bo prolitably employed in cases in which cords and halters are useless ; for not only will they serve in allowing traction to be made on parts which actually present at the inlet, but they can also be utilised in effecting those nnitations which are necessary in order to bring par- ticular parts of tlie young creature in front of the pelvic opening or through the genital canal, and which the hand could not seize or move. It is no doubt true that the sharp or pointed crotchets iiave certain disadvantages which nmst not be lost sight of, and which lead to pre- ference being given to the cords or halter when they can be employed. In the first place, their introduction into the uterus is not such an easy matter as it might appear without trial or consideration ; for tlie contractions of this organ may paralyse the hand wliich carries the in- strument and cause it to escape, or its point to wound eithcu- the mother or the operator. Their employment often produces serious lesions in the body of the foetus, which are certainly of no importance when it is dead, but may be of much consequence should it be alive. Then, again, the tissues into whicli they arc implanted are not very firm or resisting, so that only a moderate degree of traction can be expected from them, and which is often insuflicient to overcome the resistance that prevents the birth of the foetus. In such a case, if, through forgetful- ness or maladroitness of the operator, tlie tissues suddenly give way and the crotchet slips into the maternal organs, serious, if not fatal, injuries may be indicted ; or the hand or arm of the operator may be the part to suffer. These are undoubtedly disadvantages of a weiglity kind ; never- theless, the veterinary obstetrist has always to contend with disad- vantages in cases of dystokia, and must overcome them by prudence, patience, and skill. When using the crotchet the same qualities must be brought to bear. His hand must diligently guide it, and note its effects and movements ; while, at the same time, he must vigilantly exercise his judgment in directing his assistants as to the amount and direction of the force they are to use, so as to proportion it according to the resistance of the tissues in which the crotchet is fixed, and to desist from traction as soon as there is a likelihood of the instrument breaking away or slipping. With the evidence before us as to the numerous and incontestable advantages offered by these appliances, and the knowledge that their disadvantages can be overcome by intelli- gent watchfulness, there is every reason to recommend their adoption in those cases which call for their employment. " In all cascH where the head of the fit-tus is back," Cartwright says, " I am verv partial to using tlie long sharp-pointed hook in the orbit ; even if the iiead is at the crtrevic distance, with care we can insert it in the orbit and get the head in the passage. Of course, it requires great h is best in favour unroason- )rovo that f^ hold of lily reach, tho shape jrino con- n also be 3 useless ; 3 on parts itilised in bring par- pening or seize or /e certain xd to pro- 3mployed. t such an 1 ; for the ies the in- le mother IS lesions iG when it e. Then, ry firm or expected tance that forgetful- give way not fatal, 3r may be id ; never- ith disad- prudence, ities must 3 note its vigilantly lount and according ed, and to nstrument as to the -ppliances, by iuteUi- ■ adoption fight says, the orbit ; insert it in aires great MECHANICAL EXTRACTION OF THK F(ETUS. 616 care in watching that tho hook does not break loose and do mischief I have found that we may pull by the hook in the orbit with grc^ force without tearing the skin of tlio Calf, provided the latter is not in a de- composed state. Fron, my oxperience. I can speak highly of the hooks ■ mdoed. you cannot g.t tlic head up without them sometimes " nd hi embryoton.y they nuty be mont usefully resorted to for many r,u™e8 Beference w,l now be briefly made to the parts of the iaus unon Pauts into which Tin: Chotchkth may hk implantko -The narts mto which the crotchets may be implanted are nume m s but £« which are selected by the obstetrist will not only depemj upon the nature of the malpresentation or malposition, but alL upon the shnnbst mdications ior the adjustment of these. Wlien the de I'rable Z^^^^^^ been reached, the point of tlie crotchet is inserted in such a wat that the ins rument is directed towards the source of traction-the Stant When blunt crotchets are employed, except in cavities, it will bo ece " sary to make an incision through the skiA before thev can be inserted Cartwright s ates that sometimes the sharp crotchets cannot be used without making these preliminary incisions ; but then the in tniments must be rather blunt. The best parts for implantation aio m fh« 1. The Mmcuar ^/..^..s.-Tliese tissues are not advantageous for the employment of the crotchets, for although they are easily K ted thev are as easily torn out. Nevertheless, these instruments,^ hen Mxed in mo resSlttheTItr' ""' ^" f"" "T?' *^'"'^^' ^oi-and neck- more especially the latter, may render useful service in rectifvin" devia- lons as the skm oilers a good amount of resistance. But^ fi^m the ragile and yielding nature of the textures, it must be borne nmnd liat the hand ot the obstetrist should never leave the crotche" w He ti-action IS made on it, and tiiat its position in them inust be n o t 2 Tl,e lhu„J. The licad offers many good points for implantin- tho crotchets-such as the symphysis of the lower jaw, tlie palate and he occasions.""" "" ''" ''' "^^ "^^'^^ '' '''' ^^^^"°^- --i" "' on partili^? vnf.* '""Si ^^ °^'^!7^^^' liowever, that all these points are not of eoual value. The maxdlar,, symphysis is convenient, but not veiv firm moc era oly strong traction will rupture it, and damage may Ihen occur' Still, there are imes and occasions when this part may be advan thf S 'Tt^^^y''^' «-tchet, which may be inserted i/two ways in?r / ^^^^'"^trument may be passed from below the chin into the mouth or Irom the cavity of the latter through the mucous membmne beneath the tongue, to below the chin. The first is genera y referab e ^\hen traction begins, the operator must be on the look-out or tearing away of the two brandies of the jaw. teaung The orbital cavity is the best part of the head for a solid hold Some authorities have expressed doubts ns to the ^.ropHctv of fiH, ! crotciiet in the ocular cavity of a living"fa3tus, ftiS a belief t^"t^' he ZnS '"r\'^^^^'^'"^S«d, and Eainard goes so far as to advise tha it should only be done when the creature is dead ; though he adds tha If there is no other means of remedying a devia ion of^he head in the it 'fr i ' It I i i! i I i 51C fit nli OPSTETPdUAL OPEUA TIONS. 1^' > ».^" III f ^ livinff Calf, it is well to attempt it, -' as it is better to Lave a living, if blind. Calf, than a dead one with both its eyes intact." But it is rare indeed that the eyes are seriously damaged by fixing the crotchet in their socket ; and innumerable instances testify that, if the fttitus is alive, the ocular globe is retracted to the bottom of the cavity when the instrument begins to be inserted, and so escapes injury. Schaack, who has freely resorted to this mode of adjusting the head or neck — in the Sheep and Goat more particularly (tlie small- ness of the pelvis not allowing any other means to be employed) — describes his manner of operating as follows : " The o'otchet I use," says he, " is a solid (or long) one; the point is blunt and slightly flattened (Fig. IH3). When it is desired to pull at the head of the foetal Goat or Lamb, the left hand at first seizes the nose, and tlie crotchet is fixed in the right orbit ; with the right hand the other instrument is passed into the left orbit, the thumb of the left hand keeping the hook in the other orbit by pressing the stalk against the check. In this way I can ))ull with the two hands on both orbits, so as to keep tlie nose in a good direction." lie has never seen the point of the crotchet cause the slightest injury to the globe of the eye, although he has had, in the majority of cases, to pull very hard. The meanf has answered very well. And Cartwright states that "it is astonishing how wounds heal up in the cheek where hooks have been in the orbit. I liave had two or three men pulling at the rod (of the crotchet), and the hook did not break out." This immunity from injury in the case of tlie living foetus, does not, however, absolve the operator from exercising all due care in fixing and pulling at the crotchet. The inner aspect of the orbital cavity is the most favourable, and if the fu'tus is alive, the blunt instrument must be first tried, the sharp-pointed one being kept in reserve until this has failed ; or ib may be used at first when the young creature is dead. Thejicilalinc arch affords a very solid and useful hold for the crotchet. and many obstetrists have successfully utilized it in extracting the foetus ; some authorities — among them is Schaack — asserting that hook- ing this part is easier, and the results more certain and direct, than fixing the instrument in the orbit. The stalk of the crotchet is some- what long ; the hook end is passed sideways into the mouth of the ftttus, and over the tongue until it gets beyond the palate, when it is turned point u})wards and seizes the base of the vomer. A very strong degree of traction can be made on this part without inconvenience to the young creature. It appears to be an excellent situation to plant the crotchet in the Calf — ])articularly if it be dead, and it is desired to effect extraction as quickly as possible. It may be also employed in the Foal, the only risk being more or less disunion of the palate, which may render sucking dil'licult or imperfect for a short time after biith. Of course, the head must be in a good position either in the inlet or in the genital canal before tlie crotchet can be placed beliind the palate. Traction nmst also be moderate and steady, and the usual pre- cautions observed. 3. The Spijic. — When embryotomy is practised, or the foetus is dead, the bodies of the vertebra) or tiieir transverse processes, or the ribs, Fig. 183. Schaack 's CkOTCHKi'. I .^: a living, if 1 by Ijxing 38tii'y that, torn of the 30 escapes : adjusting (tlie siiiall- jans to be IS follows : long) one ; 3). When or Lamb, 3rotchet is the other iinb of the y pressing ])ull with 3 nose in a le crotchet , although lard. The ght states tlie cheek ad two or .1 the hook 'ing foetus, srcising all The inner ble, and if first tried, ,iled ; or it e crotchet. ictiug the that hook- irect, than t is some- ith of the when it is ery strong enience to n to plant desired to iployed in lie, which •r birth. be inlet or eiiind the usual pre- .18 is dead, ■ the ribs, MECHANICAL EXTRACTION OF THE FQCTUH. 517 afford excellent hold for hooks, though care must be observed in placing them securely, and guarding them when they are being pulled at. 4. i/ic Pcte/s.— In posterior presentations, when cords cannot be employed to the hind-limbs, the loins, or tlie croup, or when they have not sulhcient power, then crotchets must be resorted to ; and with this view the fcrtal pelvis offers several very advantageous points. After removal of one or both hind-limbs, the cotjiloid cacUics, by their depth and the hardness of theii- walls, are admirably adapted for receiving the Jiooks and withstanding energetic puUing. If both limbs are amputated rom the hip-joints, then a hook may be placed in each cavity ; if ablation of only one limb has been effected, then one hook wiJl be most useful. The piilnc arch and the oval foramina of the pelvis are likewise well suited for crotchet traction in the posterior presentation, when the la-tus IS dead. In some cases the sharp-pointed crotchet may be passed (hrectly through the rectum, and pushed forward so as to seize the border of the pubis, the margin of one of the oval foramina, the base ot the sacrum, or the shaft of the ihum ; care being taken that the pomt does not pass through the skin. Or the crotchet may be passed rom without inwards— the safest method— after the pelvic bones havo l)een denuded as much as possible of their soft tissues. This is perhaps, the most practicable method, if the hind-limbs have been already removed. ]3ut if they have not, then all the soft tissues of the foctus--lroin the root of the tail to the ischial arch— should be largely incised, and the hand passed through the incision into the pelvis, to )emove the viscera. The crotchet is then pushed into it, and planted either on the brim of the pubis or in the oval foramen. SKCTION IV.-CROTCnp:T-FOIlCEPS AND FORCEPS. Tiie introduction of forceps into human obstetricy marked a new era m the accmccheur's art, and has been productive of the greatest benefit in dilhcult cases of parturition in women. But they have not yielded much service to the veterinary obstetrist, except with the smaller animals; notwithstanding that Jlurtrel d'Arboval, at the commence- ment of this century, asserted of the forceps that there are circum- stances in which great advantages might be derived from them, and ^hat tlieir use is perhaps the best means of completing parturition whe-i it cannot be terminated naturally, etc. Attempts have been made at various times to introduce them into general use for the larger (toniesticated animals, and various models— more or less modilications ot the Juinian patterns— have been proposed, but with very little if any, success. ' The forceps used by the accoucheur of woman are, as is well known, composed of two branches or blades, which are nearly or quite alike, and form levers of the first cMxler ; tliev are united at the middle by a lixed or sliding joint, and one end— the " bow," or widest part-which IS intended to grasp the fcetus, is fenestrated, or perforated by a wide opening ; at the other end is the handle. The reason wiiy forceps have never come into general use in veterinary obstetrieal ()perations— except with the smaller animals— is not so much Irom a prejudice against novelties and innovations, as because they are really not adapted for tiiis kind of practice, unless in a very I I 618 OBSTETRICAL OPERATIONS. Ill modified form, to be presently noticed. Eainard^ remarks : " Medical men will be astonished that I have not mentioned the forceps, from whi^n they derive such great advantages. This instrument, which can seize a round head, like that of a child — when each blade fits exactly throughout its whole length — will have much less hold on that of animals, which is elongated, flattened at the sides, and otherwise but little yielding. When the forceps is applied to the Foal or Calf, it slips and is useless. Otherwise, the readiness with which cords can be attached to the head and limbs renders these in every way preferable to this instrument. What the forceps cannot do, the cords can ; and Fig. 184. Simple Short CuoTCHKT-FoRCKra. they have the additional advantage that they scarcely occupy any space in the pelvic canal. The pelvis of our animals is nearly rectilinear ; with the cords we pull in a straight line ; what more could the forceps do ? The entire hand can be introduced freely into the pelvis, and moved about easily. This cannot be done in human accouchements." There is no known forceps capable of affording such a solid purchase, and at the same time one so harmless, as good cords fixed on the pasterns, or a halter properly placed on the head. 11 il Fig. 18.5. Long Simit.k Cuotchet-Foucei-h. Though an instrument resembling the human forceps is not at all adapted for extracting the foetus in such animals as the Mare or Cow, and though in the cords and halter an excellent substitute is found ; yet modified forceps, which might be designated — if not from their shape, at least from their action — crotchet-forceps, have been long employed by veterinary obstetrists, and with mucli advantage in certain CLses. The simplest of these consists merely of two short crotchets, the points opposite each other, and a cord passing through both eye- lets (Fig. 184). The Jiooks can be inserted near, but opposite to, each other, on each side of t\m spine, pelvis, he;!fl- llanke., etc., the cord, ' Op. cit., vol. ii., p. !)8. MECHANICAL EXTRACTION OF THE FCETUS. 519 " Medical rceps, from which can Bts exactly on that of lerwise but 'alf, it slips rds can be r preferable 3 can ; and T any space 'ectilinear ; the forceps pelvis, and chements." i purchase, ;ed on the not at all ,re or Cow, ) is found ; from their been long ) in certain crotchets, I both eye- te to, each , the coi'd, when tightened, bringing them closer together, and so concentrating the traction. A longer crotchet-forceps (Fig. 185), with a wider curve at the points, is not infrequently used with success in breech presenta- tions with the hind-limbs retained ; the points are inserted towards each flank, penetrating as far as the shaft of the ilium. Giinther has spoken highly in favour of a long, blunt crotchet-forceps Fig. 186. GtJNTHKu'a Long CROxcHET-FoRCKpa. Fig. 187. Jointed Crotchet-Forceps. to answer the same purpose, and which has what is considered an advantage — a series of notches on each side towards the traction-rope, oil which runs a clip that binds them together, and prevents their flying outwards while the assistants are pulling (Fig. 186). The two crotchets A B, C D are brought together at A C by the cord E, which passes Fig. 188. Nelson's Blunt Crotchet- Forckp.s. Fig. 189. Nelson's .Skukated Crotchet-Forceps. through their eyelets ; d is the clip on the ratchet c c ; //, the curve of the crotchets ; and g (j, their blunt points. To render their hold more secure, these crotchet-forceps are some- times jointed; and in this form they are preferred by some practitioners. Fig. 187 represents a very useful model, the points being sharp, and one point lies in a alight notch on the opposite one, to render their introduction into the uterus more safe, and also to prevent accidents, -d 520 OBHTETllKJAL OPERA TIONB. should the tissues in which the points are implanted give way. A cord passes through eyelets at the extremities of the blades, as in the other models ; but sometimes the eyelets are in opposite directions, and the ends of the branches in which they are pierced are bent towards each other; this variation is supposed to be accompanied by certain advan- tages, as m Nelson's blunt and serrated forceps (Figs. 188, 189), some of the uses of which have already been noticed. Some of the models of crotchet-forceps have a spring introduced between the branches, and behind the joint, as in Tallich's short instru- Fig. 190. Tallich's Short Bent Ckotchet-Forckps. ment (Fig. 190), the jaws of which are bent to one side, and toothed ; it is intended to secure a hold of the foetus, and make traction on parts to which neither cords nor crotchet can be applied — as the skin of the cheek, or the nose or ear, when the head is thrown back towards the flank in the anterior presentation. I Another instrument of this description has been devised by a Belgian veterinary surgeon, Andre, which he designates a pincc-forccps or accroche-fmtus. This is not unlike the instrument fixed in the nose of iiti lii Fig. 191. Ani)h|!:'s Chotciiet-Foiu'ki's, a Bull in order to lead the animal. The points of the jaws are bevelled to fit into each other, the bevel being grooved. In one of the jaws is a small hole, into which is fixed a string that passes through the eye- let at the end of the opposite branch, and which is pulled at when it is desired to open the forceps. The two branches behind the joint are very short, and through the e>elet of each passes a strong cord, the two ends of which soon unite into a single piece (Fig. 191). Wlien this is pulled at the jaws close, as in the other jointed examples, and they remain all the more firmly closed as the traction is great. In order to use the instrument, it is passed by the hand into the uterus ; the jaws MECHANWAL EXTIIAVTIOX 0)>F THE KETUS. 521 are fixed on the part to be drawn at, by first pullin-, outside the vulva par "th n;"ih ;" ; °P'"f '.'^"' ^r""^^ *^^ Points%,Jains; . ter the for lioldin'or i X in. n \ '^«'^"°^^ledged to oe rather an instruirent fr^Lr " \ . '"" ^ certam region, and not for exercisin.r fn^-Hlfi ulerTw • ?^.f ''^' °"'? "Pi^"^^ ^* successfully to the lower and S ;r^V/ "'? "T' '°-^^""" ''^^ ^^^^^ i"^° «' f^'°od position! to the or ftnt^ 7i'Tw'^ *° '^'^ ''"''"'''' animals, such as the Bitch, Sow Sheen or ?s,ml « "I" ^\ Tl "u^^'^^ "^" *^^« '''^"t^bet, small ordinary forceps' or a small-si;^ed model ot the human forceps, with advanta-e VarS SX"enrwhiiroH°^ then, fenestrated: others not ; lo^me re'sS: Sids of tho'vIJ r '^"^^".'T' -'°°^^^^' ^^rr^'^^^, ^ • toothed at n tli forpLi ? '^T- '^u ^^^""^'^1 ^vhich should not be lost si-ht of in the forceps for such small animals as the Bitch or Cat is that thfl i-f nofall o'th 'r sufficiently long to seize not only the head bu mu h r.nnnf 1. I .'''^^ °^ ^^'"^ ^^^'^"^^ ^^ ^^ey are short in the blades thev ioTn^i '"i^" *? ^T'^ ^""'"^''^"t °f theLtus to remove it whie the oin being close to the vulva, or even within the va' '^''^ thickness-the%vho\ constitSg a mass greater than the pelvic cavity will permit to pass throu-h it so nctasl'SiZr ™r"\''" • ^°"'P^' *^^^^^ '-• '- small Bitches mnv! f u *^'"^^ltie3 of parturition, and these difficulties are all the SruTnel^H^"'''''"^ "it^" ^"'™^"^ '' diminutive. Eecourse to this in! strument is consequently contra-indicated, and if delivery is to be effected rZZ T"' ^f ^^bstituted which presents less inconvenience As a the ninHnnT nt'^f K°' ^T ^"PP^^^ '^ "°^ ^ '"^t*^'' "^ '""^^ moment, mrtur Hon 1 ?^ '* ^'?" *° '''^^ *he mother by bringing the act o Breuk^i Lnli P^-'^'/^Pt ^^^■'""^''^tio"- Therefore it is that Defays' or Breulets appliances (p 507) are to be preferred in nearly all cases CHAPTER IV. The Employment of Force in Dystokia. In connection with obstetrical operations, a rather important question to be considered IS the employment of /o,-6-. in the artificial extraction ot the t.Btus. x^or, as has been shown, more or less energetic traction IS very frequently needed to remove it from its parent ; and those who do not understand or are inexperienced in animal obstetrics, are some- times astonished .f not horrified, at hearing of the amount of puUim^ which the foetus has to undergo and the parent sustain, before ddiver^ can be effected in some cases. Yet force is, as a rule, absolutely neces sary, even in embryotomy ; and though some of the various points with legard t<) it are not yet sufficiently ascertained, and diireronces of opinion o? H p'nh '.'^"-T '° 1*''""' ^'"f/* 'f " .'"hject well deserving tlie attention ot the obstetnst, and especially the junior practitioner. i he indications for lorced extraction have been given in precedin- chapters ; they are chiefly to be found in the smallness or deformity o1 the maternal genital canal ; excessive development of the foitus— wholly or partially, or distortion ; malposition of parts which cannot be remedied; or morKd conditions that hinder birth. Forced extraction IS usually preferable to embryotomy and Caesarian section in those cases m which the passage of the f(X3tus-whether alive or dead-appears to be possib e without serious injury to the mother; and because of the STv, f ""'"^ * ?K'-^''' i'^^^''^' ''^ the Mare, it is more likely to be successful m that animal than in tlie Cow. The dirrctioH intensitjj, and nature or means of devclopbui the forte to be r,nploi/cd, have first to be considered, after which it will be aesirable to compare viamial with mcclumiral forro anrl ,.oint out ^h--- respective advantages and disadvantages f.-om an obste'trical point of I" 1 • 1 624 oiiSTETJilL'A L Ol'EllA TIU.XS. SECTION I.— DIRECTION OF TRACTION. Since the forceps was introduced into human obstetric practice, the direction which the foetus should be made to follow in the pelvic cavity of woman has been continually discussed, and has been acknowledged to be a very diilicult, as well as a very important problem to solve. This dilliculty is mainly due to the fact that the pelvic canal in the human female is not uniform in its dimensions, and that the head of the fojtus must pass through it by always offering its greatest diameter to that of the cavity. Consequently, it must execute during its passage a rotation movement in one or other direction, according to the presentation— a movement necessitated by the different planes of the cavity. In addition, the canal is curvilinear, its axis not being represented by a straight, but by a curved Hne, the form and direction of which are, besides, modified by those deformities of the pelvis that are so frequent and varied in woman, and which constitute one of the principal indications for the use of the forceps. So that the dilliculty in the question is to determine, in a rigorous manner, the direction in which to exercise traction with Fig. 195. DiACKAM OK TIIK PELVIC AxiM. this instrument ; though it is generally agreed that it should be made according to the pelvic axis. "With animals, the problem is, of course, much less complicated, as their pelvis is somewhat cylindrical ; and its axis— almost rectilinear — can readily be determined by a line passing from the centre of the anterior circumference to the centre of tlie vulva, or somewhat towards the middle of the line uniting the two superior ischiatic tuberosities. Traction should therefore be made in the direction of this axis (Fig. 195, A B) ; and this line of traction, happily for the veterinary obstetrist, and thanks also to the flexibility of the cords which, in his practice, take the place of the forceps, oi'fers no serious dilliculty. At p. 261 it was shown that this direction can vary, and may be niodilied according to the presentation — and more particularly the position— of the foetus, and also according to the period of labour. SECTION IT. DEGREE OF TRACTION. When passing through the pelvic cavity, the fcetus undergoes a certain amount of compression, proportionate to the uterine contractions or the ctice, the /ic cavity owled^ed ve. This human the foitus to that of a rotatio)i tation — a addition, aight, but luodilied varied in 19 for the etermine, tion witii be made icated, as jtiUnear — tre of the it towards berosities. this axis veterinary ich, in his culty. At e iiiodilied jsition — of !S a certain ions or the TJIM! EMPLOYMENT OF FOIICE IN DYfiTOKIA. 525 external traction which determines its progression outwards • at the same tune, this compression produces a kind of reaction in tho'bodv of the toitus, and gives rise to an eccentric pressure against the walls of the passage, related to that which itself experiences. The question is therefore, limited to the amount of force necessary to overcome the resistance that prevents the onward progress of the fcctus without injuring either the latter or the parent. In veterinary obstetrics we have no hxed data to rely upon ; but tlie experiments of Joulin, Delore, and PouUet alluded to by Samt-Cyr, may afford some idea of the resistance chered by the pelvic girdle to the eccentric pressure. These authorities found that if a rounded body—a ball, for instance, to represent the head of a tcetus— is attempted to be pulled through the pelvis of a woman it requires a force represented by 375 to 441, and even as much as 635 pounds (estimated by the dynamometer), to produce such serious lesions as fracture in the bones or disunion of the symphyses But it must not be concluded, from this result, that such powerful traction can be practised with impunity in woman. In the first place, the child could not be extracted alive, for its existence appears to be comprouned if the degree ot traction by the forceps exceeds from 132 to 154 pounds • and in order that the pelvis of woman could resist such pressure certain conditions are required which we never meet with in ordinary practice' for instance, the pressure should be equally applied to every part of the bony girdle in contact with the head of the fcetus. But this does not take place with the ordinary forceps, which, even in the hands of the most expert accouclieur, not only acts as a traction agent, but at a given moment is unfortunately transformed into a lever of the first or second kind, whose power is incalculable, and which, resting on two opposite points of the pelvic circumference, may burst it, witliout the dynamometer showing anything more than a relatively feeble decree of traction. ° Otherwise, it is not only the bones which have to be considered but also the soft parts, which, pressed between the fffital head and the hard pelvic circuinference, may be bruised, cruslied, or lacerated to a variable degree, if the compression exceeds a certain limit. This pressure how- ever, is always considerable ; for, according to Chassagny, when a tractile force of fifty kilogrammes is exercised on the head of a fcetus seized by the ordinary forceps, we may calculate that each square centi- metre of surface of the pelvic walls sustains a pressure of 1,H00 grammes even in the most favourable conditions ; though it may be as much as six kilogrammes or more, according to circumstances. These observations, though doubtless valuable and significant for the accoucheur of woman, are only very indirectly api)licable to veterinary obstetricy. Without taking into account the strength of the pelvic osseous girdle, so much greater in the Mare and Cow than in woman several other circumstances enable us to understand why this bony circle may, in these animals, resist an amount of strain which would appear to be altogether unreasonable, if judged according to the principles which should guide the practice of the human obsteLrist. But the veterinarian is in possession of means of traction whicli give him a great advantage m this respect— an advantage which the accoucheur has not yet been able to avail himself of ; we allude to the cords the former so frequently employs as traction agents, and which can never be transformed into levers, like the forcejis. In woman, as with animals, the foetus, in passing through the pelvic ; i ■ : I 626 OBHTETRICAL OI'ERA riONS. ill , i j! hi I' cavity is presBed upon by its walls, and in turn it presses upon thorn, in the manner of a wedge which tends to tear them asunder. But nere is a "reat diil'erenco in woman and animals. On the one hand, it is a liard, bony, and little reducible region-the head-which presses against the pelvic walls, to which it transmits, almost undimimslied, the pressure itself receives ; on the other hand, it is a bony cage— the chest— formed of numerous very movable parts, and which can submit without injury to much distortion, in addition to its being covered by soft and readily compressible tissues; consequently, we can easily comprehend how inucb in the latter case— that of animals-the eccentric pressure produced by the passage of the fa>tus should be attenuated. In addition the head of the infant is spherical, and therefore comes in contact with the interior of the mother's pelvis by a circle or narrow zone ; the surface of the pelvis in contact with the hetal head has been estimated at sixty square centimetres, and it is to this limited space that the head transmits the pressure it sustains. Chassagny, from a series of experiments, estimates that, for a traction of sixty kilogrammes— exerted under the most favour- able circumstances by his forceps on the head of the human firtus-each square centimetre of tlie surface of the pelvis in contact witli it should support a pressure of about 500 grammes ; in less favourable conditions it may even be much more. r .. ht From some measurements made by Saint Cyr, the pelvis of the Mare and Cow, which is nearly cylindrical, may be reel^oned at 1 bOO square centimetres ('JlH inches) of internal surface; and it is on this expanse that is distributed, in a nearly uniform manner, the eccentric pressure which the chest of the fcetus transmits to the walls of the genital canal, to which it is very closely applied during its passage outwards, it, then, it be admitted that the total of this eccentric pressure amount to about one-half the tractile force expended on the ftutus, it will be oasy to hnd, by a simple calculation, tlie pressure on each square incli. Supposing the traction to be equal to 1,540 ponnds-the estimated strength of seven or eight men pulling witli all their force at the cords—the pressure on each square inch would be about 1% ounces; or one-half that exerted on the same extent of surface with a tractile force of l.t2 pounds, m woman ! , , . ■ • i Saint-Cyr does not pretend that these calculations give a ngcirously exact measure of what really takes place during parturition but he beUeves thev may assist, up to a certain point, in explainmg certiun tacts in comparative obstetrics whicli otherwise would remain obscure— liow, for instance, natural birth, which is always so painful in woman, is comparatively painless in the larger animals; and why traction, the very idea of which alarms the accoucheur of woman, is in the majority of instances so well sustained by the veterinary surgeons ^^^It^must be confessed, however, that we have as yet no certain data by which we can estimate the exact amount of force necessary, or which may bo employed witliout danger; and on this point the opinions ot the best autliorities are widely divergent. Some declare lor modera e traction— two, three, or four men at the most, pulling simultaneously at the cords with all their force, are, in their opinion, quite sulhcient in all cases, if well managed ; and they assert that it is rash and dangerous to employ more. Others do not hesitate to have recourse to more cnev-etic traction, and are not afraid of employing the combined strength of six eight, or ten strong men ; being convinced that the parent sutlers THE E\{PLOYMENT OF FORCE IN DYHTOKIA. 527 But Here d, it is a 28 against 3 pressure , — formed lut injury id readily low much aduced by the head 10 interior ice of tlie >;ty square isuiits the estimates ost favour- itus — each I it should conditions f tlio Mare )00 square is expanse c pressure lital canal, 1. If, then, it to about asy to iind, Supposing strength of cords — the le-half that L32 pounds, b rigorously on : but he iertain facts cure — liow, in woman, ly traction, 1, is in the y surgeon's tain data by y, or which inions of the )r moderate lultaneousiy sutlicient in id dangerous rse to more ned strength larent sutfcrs mor lom protracted labour than from powerful traction— and not mfr. 4, ntly .lioir success justifies their boldness. i'lunarieix admits that three assistants arc usually sufliciunt \, it.h tlm ' -one at the huad, an :')er at the tail, and tlio third to ai(. the lator ; while ten are needed for the Mare— one at the liead. anuiijrir 1, hn^ the rope wl ch c^ » jh thick ; nont can )no-hand y-shaped i I. 209. i-EDISH IN-SAW. ing about nd some- dsing the lose and )x on one Bide, concavo on the otlior. The o^hor end has a wide eyolot as a handle (Fig. 20G). The section of bones, though not often necessary, is novortlioless sometimes required to be made, and it is found to be no easy matter — with tlie larger bones espoeially. For this purpose chisels, saws, and forcejjs have been proposed and employed. Cartwright has a model of an instrument for slitting up tiiu skin of a limb, whicli may, on occa- sions, be made useful as a bone-chisel. Including the handle, it is about thirty-two inches in length ; the chisel portion is a little more than two inches long, and one or one and a hailf incli broad ; only the middle portion at the end is sliarp, the two corners, which project a little, being blunt and rounded, as are also the sides (Fig. 207). Margraffs " Stemmeison," or chisel, is not unlike a joiner's chisel in shape ; the instrument itself is seven or eight inches long, and at its cutting edge (end), which is very sharp, it is one to one and a quarter inch broad. The sides are well rounded, and the instrument gradually tapers as it reaches the handle, into which it is fixed. This handle is a round piece of hard wood about three feet long and about two inches in diameter, with a ferrule at the end i: to which the chisel is fixed, as in the ordinary carpenter's chisel. The cutting end of the instrument is carried by the riglit or left hand to the part of the fcetus to be incised, while the handle is held by the other hand. The two hands can in this way be employed : that in the uterus guiding the movements of the chisel, while that holding the handle applies the necessary force. This simple instrument has been found most service- able in dividing the vertebr«3 when the head of the foetus had to be bisected, dividing the head, or, in double-headed monstrosities, the two heads ; as well as slitting up the skin. It has been suggested that if the cutting edge were made slightly concave the chisel would be more useful. For the same purpose a saw has been proposed. Such an article has been successfully employed when the occasion demanded it, though some authorities consider it to bo of little value. Cartwright's saw is figured here (Fig. 208). The stalk (of iron) is sixteen inches in length, the saw four inches long, and the handle six inches. The saw-blade should bo of the same thickness throughout, the end and back being well-rounded and smooth. Sjostedt^ draws attention to the value of the ordinary surgical chain- saw, which a veterinary surgeon at Stromsholm (Petersen) had suc- cessfully employed. That which he recommends is about a foot in length, and an inch wide. Each end has a ring to which a cord is attached, and to the cord may be fixed a short, transverse wooden handle (Fig. 209). The chain-saw has the advantage of being perfectly flexible, and can therefore be passed around bones, joints, etc., and the necessary movements performed in cutting through these — by pulling alternately at each cord — without endangering the organs of the mother. One hand of the operator must, of necessity, guide the saw and ascer- tain its progress. Bone-forceps might be used advantageously, but we are not aware that they have been employed in veterinary obstetrics. They should be made with the jaws bent, so that the cutting edge would be concave, u,nd they could be made sufficiently strong in jaws and handles to cut through the largest bones, A screw at the end of the handles would ^ Handhok i FOrlosmings KonUen fOr och upp/iidare a/ Husdjur. 540 OHSrETRICAL PER A TIONS. bring these together with suflicient forca to divide the strongest pieces of bone. In the foregoing, allusion has only been made to the instruments which are generally approved of ; many more might have been described, but no particular advantage could have been derived by doing so. A multitude of instruments can only be embarrassing to the veterirary obstetrist. Besides, it must be confessed that too little attention has been devoted to the perfecting of thowe already in use, or to devising others more simple and eflicient to supplant them. There is here a wide field still open for those who desire to cultivate a most important department of veterinary surgerv. Instruments necessary for partici^lar operations will be referred to as these are described. Preliminary Arranijcmcnts for Embryotomy. There is not much to arrange before commencing embryotomy. The operator is supposed to have made an exploration of the genital passage, and to have ascertained the state of affairs ; lie may even have attempted everything possible in the way of extraction and failed. Being satisfied that nothing rL>mains to be done to preserve the life of the parent but re- moving the foetus piecemeal, he has to decide, from the nature of the case, how this is to be effected. The necessary instruments he may liave with him, or they may be devised on the spot ; if the case is more difficult than usual, they may have to be sent for. But, as a rule, the operator must utilise to the best of his ability whatever is to hand ; as he usually finds his patient greatly exhausted, either from protracted labour or the mischievous meddling of untutored hands. The animal must be detached from the manger or rack, and kept, if possible, in a standing attitude : this position being the one best suited for such an operation, or it may be tied by the head to a stake, by a rather long head-rope. A rope, or better still, a rug or blanket, should be passed round the hind-quarters, a little above the hocks, the ends being held by assistants standing towards the shoulders of the animal. This precaution is required to steady the creature, to keep it in a stand- ing position, and to assist it in resisting the traction generally employed in removing the foetus. It may be necessary, if the animal is much exhausted or suffering much pain, to administer a stimulant, meal or flour gruel, or an anodyne draught. CUANIOTOJIY OK CeI'HALOTOMY, Every operation which has for its object cranium, when that part offers an obstacle is designated by these names. Hydroceph most frequently calls for the operation in certain malformations and monstrosities, volume of the head of the foetus in the quire it. Craniotomy comprises seveial distinct performed independently or simultaneously incision, or crushing of the cranial parietes the diminution in size of the to the passage of the foetus, alus is the condition which the larger animals ; though and even an exaggerated Bitch or Cat, may also re- operations, which may be These are simple iiunctnre, {Cej}Jialotri/psy). EMBRYOTOMY. 541 pieces Pimcture of the Cranium. In order to allow the es -ape of fluid from the cranium — as in hydro- cephalus — and thus permit the Ijirth of the fojtus, a simple puncture is often all that is necessary. The fluid having escaped, the thin fragile bones of the cranium readily collapse from the pressure they undergo in the pelvic lavity ; so that the head and body can bo removed by traction. Supposing the presentation to be anterior, it is first necessary to fix the head, unless it is firmly wedged in the passage ; this fixation may be effected by using a head-stall, Schaack's head-stall forceps, or even a cord on the lower jaw • exercising sutlicient traction on the cord to prevent the head from slipping from under the hand of the obstetrist during the operation. The head may bo punctured by a scalpel, straight bistoury, finger- knife, or even the finger in certain cases. If a long-bladed instrument is used, tlicre is sometimes a good deal of risk, so far as the maternal organs are concerned ; it is advisable to wrap twine, tow, or tape, around a good portion of the blade towards the handle. The best instrument, if it is at hand, is a long, medium-sized trocar and cannula, the end of the latter fitting closely on the stalk of the trocar, which should be very sharp. It is introduced safely into the genital canal by drawing the point suHiciently far back into the cannula to be entirely concealed. This end is then seized between the fingers and thumb in such a way that the index-finger extends a little beyond the extremity of tho cannula ; the other three fingers holding it in the palm of the hand, while the right hand sustains and guides the instru- ment. Should the trocar not fit the cannula tightly, the play between the two renders their introduction somewhat diflicult, and the point may glide through and wound the operator. The trocar may, in such a case, be pushed quite through the cannula, and the point fixed in a cork, which can readily be knocked ofi" by one of the fingers when the instrument has reached the head of the fcetus. Having arrived at this part, the proper spot for puncture is selected, and then the instrument is applied to it — perpendicular to its surface if possible, to prevent slipping. The trocar is made to penetrate slowly by a slight rotatory motion from side to side, and when all resistance ceases the cranium is perforated. This perforation should not be made at the sutures, if they can be avoided, as they overlap and close the opening. The cannula is now held firmly in its place by the left '^and, the trocar is withdrawn by the right, and the fluid escapes. The instrument should be sulliciently long for the end to be near, or even outside the vulva, when the point is on the cranium of the foetus. There is no difficulty in performing this operation when the head presents first, even though it should not have entered the inlet, so long as it is easily accessible to the hand. With the posterior presentation, however, the operation is troublesome ; as owing to the body of the fu3tus occupying the passage, it is extremely difficult to pass the hand armed with the trocar so far as the head. Nevertheless, it may be accom- pHshed in many cases by patience and tact. There is no reason why the trocar and Ccuaiula should not be passed through the mouth of thofa-tus in some cases, and made to penetrate the cranium at the base of the skull, when the frontal region cannot be attained. If the head cannot be reached in this presentation, then the body of the young creature must be divided, and the parts removed until the head can be manipulated. 542 OBSTETRICAL OPERATIONS. Craniotomy. Craniotomy is resorted to when puncture has not sufficiently reduced the size of the head. It is an operation of great antiquity in human obstetrics, and various instruments have been introduced to faciHtate its performance ; but very few of them have been utihsed in veterinary obstetrics, and indeed for the larger domesticated animals they are of no use. A simple straight or curved bistoury, Giinther's sliding embryotom (Fig. 200), finger-scalpel (Figs. 198, 199), the long-handled embryotom (Fig. 203), scalpel embryotom (Fig. 201), bone-chisel (Fig. 207), or saw (Fig. 208), may one or all be employed, according to cir- cumstances. It cannot be denied, however, that the operation is very difficult to execute, and is not without serious danger for the parent. Even in woman, with all those advantages and appliances of which the veterinary obstetrist cannot avail himself, craniotomy is always a for- midable undertaking. The cephalotriba and cranioclast, so useful in human obstetricy, cannot be employed with our animals, it would appear ; but there is no reason why modifications of these instruments might not be devised to answer the same end. Hurtrel i^'Arboval recommends that craniotomy be performed with a convex probe-pointed bistoury (sharp on the convex bordei-), the middle of the cranium being incised ; then the fingers compress the bones, and so effect delivery. Eainard advis 3S two incisions on each side of the head, in the parietal region. Giinther mentions that if, after puncture, the operator cannot crush the bones of the cranium with the hand, they should be cut by his secator, and removed piecemeal. Carsten Harms states that when the head is an obstacle, it should always be crushed, if possible, the bones being broken beneath the skin. Sometimes it is sufficient to remove the lower jaw ; and in order to effect this, the jaw is first fixed by a cord, the skin is then cut through on each side — from the com- missure of the mouth to the temporo-maxillary articulation, the masseter muscles and the ligaments being divided ; a transverse section of the skin is now made between each joint, the finger separating it, and then two or three assistants puUing at the cord, the jaw is removed. If it is the transverse diameter of the head which forms the obstacle, the divi- sion must be longitudinal, and great service may be derived from the use of the bone-chisel— either Cartwright's or Margraff s pattern. As much of the skin should be left as possible, in order to cover the jagged ends of the bones. With the smaller animals, puncture and craniotomy are not at all difficult operations, the bones being fragile and easily perforated or crushed. Decapitation and Decollation. Decapitation, an operation which consists in separating the head completely from the body, so as to allow these parts to be removed one after the other, is not very often required ; and fortunately so, as it is not without great danger to the parent. More frequently the head is partially removed, the fore-limbs amputated, or evisceration of the chest or abdomen — or both — practised, rather than resort to decapitation. Decollation is necessary when the neck is distorted and cannot be straightened, and has to be divided at the point of curvature, the head and portion of neck attached to it being then extracted. EMBRYOTOMY. 548 Decapitation is indicated when a double-headed monstrosity monosomian or sysomian— is presented, and in certain irreducible mal- positions of the head or limbs— especially in Heifers, when the head of the Calf is in the genital canal, and can neither be advanced nor pushed into the uterus. The operationis more or less difficult, according to the situation of the head — if entirely in the uterus or fixed in the passage, or if it is at, or can be brought near or beyond the vulva. In the latter case, it is easily accomplished ; although, except in the case of double monstrosities, it is rarely very useful, as when the head is in this situiitiou it is not 'an obstacle to birth, and its removal deprives the operator of a most powerful _ means of exercising traction on the parts which are firmly retained in the maternal organs. When wedged in the canal, however, the head may prove a troublesome obstacle to the performance of those manoeuvres necessary for the reduction of other parts ; as it may not be possible either to advance or repel it, nor yet to pass the hand between it and the pelvic walls to search for a deviated limb, for example, or to bring that limb into a proper position. The passage must therefore be freed from the obstacle, and this can be accomplished in various ways, the most common of which is as follows : The fore-limbs, if present, are corded and pushed as far towards the uterus as possible ; then the head is secured by cordin^ the lower jaw, a pointed hook fixed in each orbit, or a head-collar over the head if it can be placed. Four or five assistants now pull at the head by these appliances, so as to bring it as near the vulva as circum- stances will permit ; while another assistant keeps the labia apart, in order to expose as much of the head as he can, and prevent injury to the organs of the parent. The operator, with a convenient knife (the curved finger-scalpel is very useful), incises the skin around the neck- first one side, then the other— close to the occiput, passes his fingers between it and the muscles beneath, and pushes it well back on the neck— the assistants pulling at the head at the same time, facilitate this separation. A few cuts now divide the soft tissues down to the vortebriB, and nothing more remains to be done .han to produce dis- articulation by vigorous traction and a twisting movement of the head at the same time ; the ligaments gradually yield and tear, the head extends and at last comes away, and the body of the fcetus recedes more or less suddenly into the abdominal cavity. If the limbs have been previously secured, they are brought into the passage by the cords attached to them ; or if they are not so accessible, they must be sought for in the way already indicated, and delivery completed ; care being taken to cover the exposed bones of the neck by the surplus skin, while the foetus is being brought through the passage. Another method is to make an incision through the skin across the forehead, in front of the ears, and to separate it by means of the finders or spatula, as far as the occipital articulation. The knife divides this joint, as well as the soft tissues around it, and particularly the liga- ments ; traction will bring away the head. The upper part of the neck is covered by the loose skin — which may be fixed there by ligature • and directed into the middle of the passage. Crotchets should now be placed on the bodies of the vertebne. or even on the ribs if they can be reached ; as the limbs do not offer suiricient resistance when they alone are pulled at, neither do they bring the body fairly into the passage. 644 OBSTETRICAL OPERA TION&. Traction should be made on the sternum, not the withers, as the latter ought first to enter the inlet. A third method consists in removing the lower jaw, and excising the head from below. Or this incision may be practised from the mouth, the chisel being used to divide the vertebrie, after the cheeks, masseter muscles, and soft tissues behind the lower jaw have been cut through. Decapitation, under the most favourable circumstances, is often a long and fatiguing operation, as the greatest care has to be observed in order to avoid injuring the parent. But this fatigue and anxiety are* vastly increased when the head is deeply buried in the passage or the uterus. Then the hand— moist with the fluids of the genital organs, embarrassed by shreds of the fa3tal envelopes, hampered by the pre- sence of the limbs, compressed and paralysed by the uterine contrac- tions — can scarcely hold and guide the cutting instrument, or distinguish what belongs to the fcctus and what to the mother, and has scarcely strength to divide the tissues, which are all the more difficult to cut by reasou^ of their softness. It will readily be understood how such an operation must be difficult for the operator and dangerous fo;- the mother. It might also be deemed impossible, if veterinarians had not attempted it and succeeded ; though the majority of them have said but little as to their mode of procedure. It is always preferable, if possible, to remove one of the fore-limbs, as this is easier, quicker, and less dangerous. But decapitation must sometimes be performed, and then the above instructions will be found useful. In the case of double-headed monstrosities, the saw and bone-chisel, or a pair of strong bone-forceps, will be valuable. When the head of the fcctus is retained in the uterus, and bent back towards the shoulder or flank, then it may be decided to amputate the head and a portion of the neck. Disarticulation may be commenced at the most convenient part of the convexity made by the bend of the neck, cutting through the soft tissues down to the vertebra? on that side, then on the other ; then sawing or chiselling through the bones, and afterwards using the crotchets carefully. Amputation of the Lijibs. When the limbs are so deviated that they cannot be straightened, or when by their presence in the genital passage they prevent the neces- sary mancEUvres for the adjustment of other parts of the foetus, then it may be necessary to amputate or disarticulate one or more of the extremities. Some of the indications for the operation have been referred to on various occasions ; they include all those foetal mon- strosities which have supernumerary limbs that require removal before delivery can be effected ; those cases in which the foetus is exaggerated in volume, either normally, or through having become emphysematous after death in utero ; those complicated malpresentations — such as the abdominal, hock, thigh, etc., and certain deviations of the head and neck in the anterior presentation. In the latter it is well to hesitate before deciding to remnve the limbs ; for if it is true that their ablation allows more space for manoeuvres, and more facility for adjusting the head, it is not less true that, should these manoeuvres fail, by the loss of the limbs we are deprived of a poNverful means of traction when we are compelled, as a last resource, to adopt forced extraction. Besides, the latter cising the be mouth, , masseter through. is often a 3served in ixiety are* Eje or the al organs, ' the pre- 3 contrac- istinguish 5 scarcely to cut by ' such an IS fo;' the 3 hail not have said Dre-linibs, ihe above me-chisel, 3 head of ! shoulder portion of Dnvenient y through le other ; using the itened, or he neces- itus, then re of the we been ;tal mon- '^al before iggerated sematous ch as the lead and ) hesitate • ablation sting the I the loss when we Besides, EMBRYOTOMY. 545 it must not be forgotten that embryotomy is itself an extreme measure, which should only be adopted when every other fails or seems to be really hopeless. One or both of the fore or hind limbs may be required to be ampu- tated, according to circumstance. In the earlier days of veterinary science, the obstetrist was content to pull at the limb of the foetus which he wished to remove, either by mechanical or manual power, until it was torn off by brute-force. Fromage de Feugre mentions that Texier had in this manner torn away the limbs of many Foals which he could not extract— the separation of the limb always taking place between the chest and scapula, by rupture of the muscles uniting these two parts ; and he asserts that by this procedure he was able to save many Mares— though he says nothing as to the suffering of these before the limbs could be torn from the body. Subsequently, it was discovered that the skin offered most resistance to this kind of avulsion — the muscles and ligaments being much more easily torn. Then the knife was employed to incise the skin, and thus get rid of the chief difficulty. On the Continent, in amputating a fore- limb, for instance, the skin and muscles were divided as near the shoulder as possible, and the bones, united by their ligaments and covered by the skin, separated by traction, Skellet,i in his crude and imperfect work published in 1807, writes : " Take a sharp knife, and cut from the point of each shoulder of the Calf to the muscular or thick part of the fore-leg ; then cut round it, so as to enable the operator to skin the upper part of the shoulder. A knife is then to be conveyed between the shoulder and brisket, so as to cut the muscles which unite them. When so done, the leg and shoulder may be easily pulled off from its body. The other fore-leg, etc., is to be taken off in the same way." But the subcutaneous method of excision was greatly facilitated by the directions published in Giinther's work in 1830, and also by the publication of the procedure of Huvellier- in the same year ; while the parent was protected from some of the dangers and pain which attended the old plan. Since the introduction of this method, it has been adopted by every obstetrist of note, who has either kept to the original procedure, or modified it to suit his own fancy or convenience. Amimtation of the Fore-limbs. In order to amputate a fore-limb, it must be more or less advanced in the vagina, or partially beyond the vulva. So that, if it is still in the uterus, it must first be removed therefrom and brought into the canal. If both limbs are to be removed, they must be secured by cords around the pastern in the ordinary manner, the cord of the one which is to be first excised being pulled at by two, three, or four assistants, so as to ■draw it as near, or as much beyond, the vulva as possible. Another assistant thsn keeps the labia wide apart, in order to allow the operator more room. .' circular incision is made above the fetlock— or, better still, the knee, caking care not to go deeper than the skin. From this incision, gliding his hand into the vagina, along the limb, the operator gradually makes a longitudinal on3, extending higher up as the leg becomes elongated by the traction. Some practitioners make this incision on the inner aspect of the limb, ^ A Practical Trvatine on the Parturition of the, Cow. " Jiecueil de Midecine Viterinaire, 1830, p. 449. London, 1807. 35 546 OBSTETRICAL OPERATIONS. Others on the outer side. On the latter there is perhaps less danger of wounding the maternal organs, and it may be more convenient for the operator. But this is a matter of minor importance ; it is more neces- sary to be careful in incising the skin beyond the articulations, so as not to divide the ligaments of these, as this might lead to the limb being torn avi^ay at the v^rong place ; no such precaution is necessary with the muscles. This longitudinal incision having been made, the skin is separated from the structures beneath, either by means of the fingers or the spatula — pushing it up towards the shoulder as it is detached, until at length, as the leg becomes stretched, the incision and the detached skin are as high as the shoulder. The dissection being then deemed sufficient, and the limb being only retained by the muscles which attach it to the thorax;, the operator, either by his hand or the crutch, makes pressure on the fcetus, while the assistants are ordered to pull energetic- ally at the cord on the pastern, and in a kind of jerking manner. Soon slight cracking sounds are heard, the muscles are rupturing and giving way, and in a very short time the entire limb — scapula and all — is removed. The removal of one limb usually leaves a considerable space in the genital canal, and this allows delivery to be completed. Sometimes, however, and particularly when the head is deviated towards the flank, it is necessary to remove the other limb ; and this, when effected, permits the head to be sought for and rectified, version accomplished, etc., according to 4ie requirements of the case. Some practitioners operate in a somewhat different manner to the foregoing. Lecoq, for instance, connnences his incision at the upper part of the shoulder, brings it down over the head of the humerus, on the side of the forearm, and as far as the middle of the cannon, where he makes his circular incision ; the skin is separated from this part up- wards. In some cases this procedure may be preferable to the other, and it certainly is less dangerous for the parent ; but it sometimes happens that the shoulder cannot be reached. Giinther pushed back the fct'tus as far as possible by means of the crutch, with the finger-scalpel divided the skin before and behind the scapula, then across — below and above ; then cutting through the pectoral muscles, and extracting the limb. Cartwright operates in a similar manner to Lecoq. He first has a leg drawn out, and divides the skin as far as possible; or he introduces his hand, containing a knife, as high as he can on the side of the scapula, and makes an incision thence down the whole length of the limb to the pastern bones ; the skin is separated by the fingers or spatula as far as possible from the entire leg, and the transverse pectoral muscles cut through. The limb is then disjointed, either at the pastern or fetlock ; the foot being left attached to the skin, as it is afterwards found to be useful in the extraction of the body. Cords are fastened around the limb above the fetlock-joint and knee, and the Cow being firmly tied by the head, the necessary force is applied, and the whole limb drawn away. He writes : "I have known, in some of these cases, the limbs to separate at the shoulder joints, and yet tho foetus has been extracted— both from the Mare and Cow — with the shoulders attached, the points of the latter having, fortunately, not caught the edge of the pelvis. The great danger in these cases is, that the shoulder-joints may catch against the pelvis and thus prevent extraction." EMBRYOTOMY'. 647 danger of it for the ore neces- )ns, so as imb being { with the separated fs or the '., until at detached 1 deemed ch attach sh, makes jnergetic- er. Soon id giving d all — is 36 in the raetimes, the flank, effected, nplished, sr to the tie upper lerus, on n, where part up- le other, )metimes IS of the hind the ! pectoral I similar the skin >, as high n thence ) skin is le entire b is then attached iction of )ck-joint ocessary "I have shoulder [arc arid having, mger in ilvis and Meyer recommends that the circular incision on the cannon be not made until the skin is detached above, as this facilitates avulsion. It is well to divide as many of the muscles uniting the limb to the chest as possible, and also to apply counter-extension by means of the arm or crutch placed against the chest or opposite shoulder of the foetus ; this also spares the mother much of the pain and exhaustion attending extraction. Amputation of the entire fore-limb, including the scapula, is a very useful operation in the most serious cases of dystokia ; but there some- times occur instances in which the whole leg need not be excised — as when the legs are an obstacle rather from their length than their volume. This happens, as has been described, in the abdominal pre- sentation of the foetus, when the limbs so often render version difficult — all of them being perhaps in the genital canal, from which they cannot be advanced or pushed back. In these circumstances, disarticulation of the limbs at the knee or elbow joints is often practised — the latter being generally preferred; though it must bo remembered that excision at this part can be but of limited value, and, in fact, is only useful in the presentation just alluded to, because it does not give so much room as removal of the scapula and humerus. In the abdominal presentation with four legs in the vagina, Don- narieix lays down the following procedure : Three pieces of supple twine are got ready, as well as a strong cord. "With the twine the pasterns of three of the limbs are firmly bound, while the cord is fixed on the limb which is to be detached, and confided to five assistants, who pull at the cord while the other limbs are pushed towards the uterus. The knee, then the forearm appear, and the lips of the vulva being kept widely separated, the operator makes a circular incision through the skin at this part ; traction is again applied, the muscles tear, and gradually the joint is reached. The tendons and ligaments are cut, and the leg being twisted as it is pulled out, another cut of the knife finally removes it. With the Sheep or Goat, amputation of the fore-Hmbs of the foetus is very rarely indeed required, though, if necessary, it can be effected. The same remark applies to the Bitch and Cat. Amimtation of the Hind-Limbs. When the foetus makes a posterior presentation, and a hind-limb appears at the vulva, it may be necessary to amputate this limb ; or with the hind-Umbs flexed at the hocks, and so firmly wedged in the canal that they cannot be extended backwards, nor yet sufilciently bent to permit delivery — which is far from being rare in the Mare — these joints are disarticulated. In the latter case, it is accomphshed by passing a running noose round each leg, above the hock, and tying it firmly there. Powerful traction made on one of the cords by four or five assistants, will bring the point of one of the hocks to the vulva, the lips of which are sepa- rated, while the operator divides the gastrocnemii tendons and the lateral ligaments of the joint, so as to produce complete disarticulation. The tibia is then pushed into the vagina, the other limb is amputated in the same way, and birth is accomplished by pulling at both cords, which remain attached to the lower end of the leg-bone. When the limbs are completely retained in the uterus at this presen- tation, the procedure recommended at pp. 471 and 517 must be adopted. The following procedure has also been recommended : A long incision is 548 OBSTETRICAL OPERA TIOXS. made through the skin and muscles behind the hip-joint ; the hand removes all the muscles around the upper part of the femur, round which a cord is then fixed and pulled by two assistants, while the operator cuts through the attaching muscles and ligaments— especi- ally the capsular ligament. In this way the joint is disarticulated, and a circular incision through the skin completes the task, as traction will remove the limb. It may be remarked that Carsten Harms recommends symphsiotomy to be practised on the fcEtus when the buttocks present at the inlet— the symphysis pubis being cut through. By this means, the two borders of the symphysis can be made to overlap, and the transverse diameter of the pelvis is thereby diminished. The finger-scalpel and spatula are the instruments he prefers. The saw might be advantageously used. In certain kinds of monstrosity in which the posterior parts of the foetus are double, or when the hind-limbs are in the vagina, and in con- sequence of the narrowness of the maternal pelvis, or width of the croup or haunches of the young creature, birth cannot take place, then amputation of the legs at the trunk may be necessary. Such an opera- tion can be rarely required, however. It is performed in a similar manner to that for removal of the fore-limbs— subcutaneously. A cord is fastened to each pastern, and, one after another, the limbs are drawn towards the vulva ; a circular incision is made through the skin above the hock ; then a longitudinal incision is carried as high as possible on . the thigh, and the skin separated in the ordinary way by means of the spatula--always ascending towards the croup; the gluteal and other inuscles attaching the thigh to the pelvis are cut across, and the limb is at last torn away by strong and sustained traction. Amputation of the hind-limb is a much more onerous and fatiguing operation than the removal of the fore-extremity. The skin adheres very closely to the subjacent textures, and more labour is needed to separate it from them ; the muscles attaching the limb to the trunk are more numer- ous and powerful, and when they are cut through there remains the resistance of the pubio- and coxo-femoral ligaments (in the Foal— the pubio-femoral ligament is not present in the Calf). Harms estimates that if three assistants can pull away a fore-limb, four men will not in every instance remove a hind one. However, the difficulties are not always insuperable, and many cases are on record in which the opera- tion has been successfully performed. After avulsion of the limbs, crotchets should be fixed in the cotyloid cavities or oval foramina, and delivery completed according to the directions already laid down. Detruncation or Division of the Body of the Fcetus. When one half of the body of the foetus has more or less passed through the pelvic canal, and the other half is retained, so that it is im- possible to extract or return it, it is recommended to cut the trunk in two— division or detruncation. It has been shown that this retention may be due to malposition or malpresentation, excessive development or deformity of the hind-quarters of the foetus, as well as ascites, anasarca or emphyp.ema {fhysonictra). ' If the hind-parts are retained, and the head and fore-limbs are not much beyond the vulva— if so far— cords should be placed on each pastern and a head-stall on the head, and slow, gradual, but stron" traction exerted on them, so as to expose as much of the body of the EMBRYOTOMY. '49 the hand nur, round ■while the its — especi- ulated, and action will iphsiotomy 5 inlet — the > borders of liameter of iula are the ised. irfcs of the md in con- clth of the place, then 1 an opera- a similar y. A cord are drawn skin above possible on ians of the and other i the limb 1 fatiguing Iheres very separate it ore numer- jmains the Foal— the estimates vill not in 9S are not the opera- le cotyloid ng to the 5TUS. 3sa passed at it is im- 3 trunk in ; retention velopment , anasarca, bs are not d on each but strong 3dy of the young creature as possible. This done, the operator, with a sharp bistoury, incises the body in a circular manner as close to the vulva as is convenient (the labia being kept well away by an assistant)— -the incision commencing below, which allows the elongation of the spine ; then the skin and muscles on the sides are divided. When the vertebrae are reached, the bistoury is passed between them, and as close to the loins as possible ; slight pulling and twisting will then complete the bisection. It is a good plan to incise the skin at some distance in front of the place whore it is intended to divide the spine, and to separate and push it back over the portion of trunk in the genital canal. When the division of the body is effected, this superfluous skin is pulled over the remain- ing part of the trunk and sewn together, so as to enclose the latter completely, thus preventing injury to the parent during the subsequent manoeuvres. Should the hind-limbs be doubled under the croup in the passage, or should they still be in the uterus, they ought to be sought for and corded at the pasterns, the cords being given to assistants. Then vigorous pressure is applied to the divided end of the spine in the remaining part of the trunk, while the assistants pull until version is effected ; extraction is afterwards easy. In some cases it is not necessary, nor is it always possible, to secure the hind-limbs before the trunk is pushed into the uterus, version taking place merely by the retropulsion ; and sometimes when one limb has been found, there is much dilBculty in discovering the other. In such a case, and when version cannot be effected, the limb which has been secured should be drawn towards the vulva and disarticulated ; this will enable the operator to find the other leg. When the foetus is altogether in the uterus, division of the body is a formidable business, even when the hand can reach it and move about it easily ; it is still more formidable, if not impossible, in large-sized animals when the foetus can scarcely be touched. When the foetus is in the horizontal dorso-lumbar presentation, Saint-Cyr suggests that the maternal straining, if too violent, should be subdued. The hand, armed with a bistoury, is passed between the uterus and the foetus, and the latter is cut down through the back to the vertebrte ; then the knife is passed into the body between the last rib and ilium, and the flank cut through, another incision upwards reaching the under side of the vertebrae— a hook fixed in the abdominal walls makes this region more tense and easier cut, while it brings it nearer the hand. A cord is now passed around the exposed vertebrae to bring these closer to the operator, who divides them with a knife or saw. The body of the foetus is then in two portions, the most con- venient of which is first to be extracted, while the other is pushed out of the way. In extraction the crotchet and cords are employed; the first portion being removed, the second has to be found, secured, and got away likewise, care being taken to guard the maternal organs from injury by the exposed vertebrae. If necessary, the body may be divided into more than two portions at the spine, and the ribs and sternum may also be removed. In other presentations the details of the operation may have to be modified, but the principles are the same. Evisceration. When it is ;' ed to reduce the volume of the thorax or abdomen, or both, the organs they contain are removed. This procedure is r>r,o OBSTKriUCAL OPERATIONS. I III I In bodv oSh A T?!f "' ^^^^' ''^'"°^^^ °f °"° o*- '"oro of the limbs, the siderS dimfnnf ''°'\T^^^^ ^y''^ ^« obtain a con- SaniDulat,nr?„nV °" • " ^^e dimensions of the body, more room for S h t^he mo5 n«o7f ''°"' T^ P-'^'^'^P^' °^^* *° *he removal of the limbs, n IS tne most useful operation in embryotomy. accordin. '^r •'''^' ^^,^«°«^ation of either of the cavities may be practised, reaucing tlie volume of both— thorax and abdomen. Thoracic Evisceration, wh^n'th?rhnri?ni\f°'f */"'"' practised in the anterior presentation nenderMv nf „S -1 "" "' '' -"^ ^'''^''' ''"'^ '"^^ ^^ performed inde- E « y of abdommal evisceration. The chest is emptied of its con- head and ii'^h'" i^^T^^°^ ?^^' °^ '^' ^'^'^' '^' i" th« Pa«sage The bettPr ff h.?°"^^ ^ corded-if one of the latter is removed all the better, if not, the cords should be pulled well upwards in order to SormaT. "?Th^''"'^"-'^^^"- '^°"'^ *^- ^^^ b'ean obstacle to th^ thluXZ^S *^-! ^P^'^^V""; ^* "^^y ^^ amputated ; but if it is back in handle T; fin'" '' T^.^^ let there. A strong scalpel with a long fLs "hn om ^'';r^lP'^: ^' "'*^'' °^ *^^ ^^^° embryotoms shown in vaf na untH th I'y!^''.^''^ instrument. It is passed carefully into the vagina until the hand reaches the breast of the fcotus, when the blade 8 thrust deeply into the chest, between the two first I'ibs, and as close to the Sl^""'''' ^"^'"S '°"" *°"^^^^ *^^ sternum'and upwards tV. J«^ ^'"'^® '^ """^ dispensed with, and the hand being re-introduced the lingers are pushed into the chest and the two first ribs removed The luL's a7dT 'f '"^* ^°°™ '°^*^^ ^^^^^ '^^^^ to enter the Taviy.' thp h?^ and heart are torn away from beneath the spine, and with good S"but' fth/rr '"^ '^""^ *^f J?*^"-"^- T^^ «h^-^ coUapsrs a Dusltd Svn, 1 .u J'^^u^ *'^""°* y^* b^ extracted, the hand may be twor fivf^TJ^'"' -u'^f ^ °^ °P""^°^ *^^ tbor^'^ i" front, incise from chest hv.r ^''^' ^^°'' *.° *^^ ^*«™""^' a^d pass the hand into th^ cbest by the aperture so made. Others divide the ribs on hnfvT cJ^i and ren,ove the sternum as well as the visc^a. It 'Z often be found cutdng'tSdbs.'^^' ''^ ^'^^^ ^"' ^^^°'"^" -" ^^ remo^ed'^iS i4 bdominal Evisceration. the^tWx'^iwfplr'' ''^^^"'u^ "^."^ ^ ^^^«^^'^' ^« i^^t stated, through me tnoiax, by tearing away the diaphragm. ^ ,.rp;«nfif • posterior or adominal presentations, and indeed in anv presentation or position in which this region is accessible to Hip Ln7 eventra ion can be performed. Nevertheless, ^ I no Swavseasv on the contrary It is sometimes most difficult and dangeroir^ '"'^ ' °° em^p;oy:d tlTbdrr^ ""' ''- ^^'^^^^^-^^^^^ °^ ^^^ «^-^* -y ^e Tlie edge of the instrument is applied to the wall of the cRvitv whi^l, thlgh"tTe'di^Lagm "'^' ^"'' " "^^^ ''^' *^' °' *= "l^-' -'»! VAniS'AL HYSTEROTOMY. 551 1 limbs, the } in sterno- ain a con- 5 room for ' the limbs, I practised, le mode of esentation med inde- )f its con- age. The .^ed all the 1 order to icle to the is back in ith a long shown in y into the the blade d as close I upwards troduced, removed, tie cavity, md, with illapses a i may be m carried cise from into the th sides, be found without through 3 in any le hand, asy; on may be J, which e whole st also, CHAPTER VI. Vaginal Hyaterotomy. At p. 361 reference was made to induration of the cervix uteri as a cause of dystokia, and the indications for overcoming the obstacle were de- scribed more or less fully ; allusion was also made to the manner in which these indications should be carried out. As we are now treating of obstetric operations for the extraction of the fcjotus, it is necessary that we describe more fully the operation and its consequences, as these are of much importance. Vaginal hysterotomy consists in incising the indurated and inextensible nock of the uterus in such a manner and to such an extent, that it will allow the foetus to pass through its canal. For this purpose, the only instrument necessary is a strong probe- pointed bistoury, a bistoury cache, or one of the tinger-scalpels or other embryotoms. When the straining of the animal has propelled the cervix uteri towards the vulva, with partial prolapsus of the vagina, the operation is simple, as the eye can then aid the hand. All that has to be done is to glide the instrument into the os, and make the necessar) number of incisions through the tissues composing the cervix — the situation and depth of the incisions depending upon the extent of the induration and the atresia. In other cases there is no prolapsus of the vagina, which is quite soft and elastic. Then the left hand may be passed into it, and the index- finger being introduced into the os, draws the cervix towards the vulva; the labia of the latter are separated by an assistant, and the operator passes the blade of the instrument — guiding it by the index-finger of the other hand — into the os, where he gradually and steadily incises the tissues. When, however, the walls of the agina are involved in the induration, this retraction of the cervix cannot be effected, and the part must be operated upon in its ordinary situation : the knife being carried care- fully into tlae vagina, passed to the necessary depth in the os, and the incision made. Perhaps the bistoury cach6 is the best instrument for such cases. It is rare indeed that one incision is sufiBcient ; generally from two to four are required, and it is better to have a larger number than make them too deep : they certainly must not pass through the entire thick- ness of the cervix. The situation of the incisions is a matter of some moment. The lower portion of the cervix should be avoided, in consequence of its proximity to the floor of the vagina, which is in immediate contact with the bladder and urethra ; should these be wounded, the results might be serious, if not fatal ; and if the peritoneum is cut or torn during the passage of the foetus, fluids and discharges will esc»- 1; ut ■ the abdo- minal cavity, and give rise to peritonitis. Ther ^ t danger in incising the upper part of the cervix, as the rec; lOt so near ; nevertheless, in induration there may be adhesions DeL^veen them, and an accident is therefore possible— though it must be rare. So that, if only two incisions are required, it is advisable to .nake one on each side of the cervix ; and if four are necessary, to have them at each corner. flsa I I OBSTKTJiWAL OPERATloXS. .-,4 S^ curved bistourHb ou font in h' T '"^^^'^^ » stout, sharp-,, ointod. by two indS-allvfi '' ^?"«T.d'v.ding tho stricture lateral ly' after which hfli^Tnf^!. '^''^^^'"K .^ho bistoury towards the operator • other, am ro s u/e"m 1^. ^°;^^"d«.- ^^th^ho Pabns towards eadi dilate to the properS.eln1|- , k"' """ ""^^ *^*" P^^' immediately then proceed to extracT^;«?nl%?T '"''?' ^V" »^t"»^ally ; cr he may The obWf ?n T the Ca f if labour has been protracted." depth aninofc th;"''"!!^.*^" ^"P'^'°"« °"^y *° ^ comparati;ely slight ext^er^i^olacomSZ^h ^n'^ °^ *'^« °'' i« t° P^'v^n will generally bo ?ound hn^ f" '^"""^ he passage of the foetus. It time-perhana two ?n ^ '^'''^' 'f^°"' ^^' ^een going on for a long uterine^coSctionsare^Pi.h' "'°''' ^'f/'^^"' ^« exhausted, and the hope of tS exSn^ th«^''i''"'^'^"»?'v' °^/°^«^ble, as to preclude all be udb^u &^^^^^^^ f^ traiion ^resorted to must in order to albw theTssuea nUh^ ' T*^^^f *«' gradual, and sustained, to the eccentrirnloo^ ^ '^^/^""^'^ time to accommodate themselves actothS's tHcnr h;«'P°''^ "^^ *HT ^y*^« advancing foetus. To possibility of repak and r'^f -"^^ °^ ^^''^^^u*^"^ *^^ "^^^"^ beyond tho incisions. ^ ' ^""^ '' 'l"'*^ ^« reprehensible as making deep adSdTaf it°ifn!.f'°°f.^"fi''' °^ ^^g^"^l hysterotomy, it must be resu ts. T^reaVe no rpTi^M '^^^ ^^^^^ not infrequentSy the amount of success on on ^^^ '^ " '''"' ^' ^ ^"'^' '" estimating all-or perhaps nofmanv of tb' ^""^""'"^ ?,^ performance, as nol collected forty cases an ^,ll.-ir ^'^K^'^ published. Saint-Cyr has commencement of thVcentmlLn^ '" ^ ;'^"=' f "^ ^^^^^""^ «i"«« ^i^^ ing results: ^' ^"'^ ^" ^"^^^^'^ ^^ t^^se gives the foUow- Mother and progeny saved in - Progeny saved, mother died, in - . " " ,. Mottr :Xror/n7^- ^^^^^^^^^^ ^ -tionedJin 5^ pef°ce?tllcc'umbrd^°S'^ >f "' ^8 survived, and twelvs-or 30 were delivered a^^e and Int1;,rpS 'P'^ *.° *^« P^^g^^^' ^^ Calves caid as to the o^herH '°''*^^""^ *° ^^^^' and 6 were dead ; nothing is ^'^^eZ^^^^^ZSrir^T^-^'f 18atIeast-or inclined to think that if ^u\]t ^' "P'^^'^^ou. Lut Saint-Cyr is the. . .eason ££SL^£j^ S^^^^S^^Z^ ^vVnt'/S ' Veterinarian, vol. xviii., p. 215. 14 instances. 9 6 rAOIXAL HYSTElHtTinrV. 668 the fifiger or larp- pointed, lure laterally he operator ; owards each immediately ; cr he may ed." tively slight I to prevent fcotus. It nth a little '; seizf^H the hie position delivery is favourable n for a long d, and the preclude all ust then be ed to must 1 sustained, themselves fojtus. To beyond the iking deep it must be ifrequently estimating rice, as not nt-Cyr has 1 since the the foUow- istances. >> >t ve— or 30 14 Calves aothing is least — or nt-Cyr is mblished, not ; and he is apparently oonfirmod in thin view by Bugniot,' who writes : " Distinguished veterinarians have published very interesting observa- tions on this important ^'^'^^"^^"^^ ^^^^i- discnnf' Af of/ ^^°^b ''Quia ca^so matns uteru in lucem pro- -a noblp HtC ^fu' Pf ^^"^ ?"'^. P^^-«°"« ^vere designated " C^sares/' asser" that f r^ ?^' ^'-^^^ ''^"" demonstrated^ it is a mistake to patr^nym ^'' '*' °"^'^" *° ^"^^^^ C^sar-this being merely his nrS«!^*^^^^ ^^'^^ J^""^"' abdominal hysterotomy has been oftt:n ZTTertZ'^'Hlul '^^^^t- \-- first Ittempted'^on animals is no" Apsw?u? and HreroPir' i''^ *° ^'^r' *>^^ the Greek veterinarians- And even BourJfnf ' nnl ''P^'"^*'?" .^as ever proposed for animals. ntlnoS^AU ^""'^eelat- only suggests it in cases in which the dam is o qtt:?x'pired'"47rtsfir^ ir^ m-nlnt^ 1 ' ^"^,its hfe may be beneficially sacriliced in favour of Its ptogeny which is to be quickly removed from the uterus Tn 1 7H1 It was not apparently until 1813, that Morange, and in 1816 Goheir^ be a'beU:rtrf"S:;it\':: ^"••" "'^P--^'-^.-' -■ ">aparo.h,«teroton.y." would Mimoires sur la CInrar.ji, ct la Afal.dn, V^terinaire, vol. ii., p. 40. [ GASTROHYSTEROTOM Y. 655 it is well to come putrid, 100) or the particularly r the opera- Herotomy, is IS or foetuses *ed 2}er vias B abdominal practii-3d on , it hat« been eoOTO/XOTOKU) . it Piter the born \\ ere )f that god, >^sterotomy. method of ) had been i fortunate. iius Citsar, eceived the lal incision lucem pro- ' CfEsares," mistake to merely his Dsen often nals is not inarians — on on the i< mistake, founder of appear to )r animals, le dam is bas nearly favour of In 1781, on Mares irgelat, he 6 Goheir* my," would attempted it on the living animal, though unsuccessfully. Morange operated on a Cow, and it was to all appearance in a fair way to recovery, when it succumbed to an attack of indigestion caused by improper feeding. About the same period, Eohlwes^ operated on a Mare. Since that time gastro-hysterotomy has been practised comparatively often, both in this country and on the Continent ; and there can scarcely be a doubt that it was mainly indebted to its general intro- duction, as an obstetric operation, to the fact that the abdomen of animals could be opened with impunity in such operations as ovario- tomy (spaying) in Swine and other creatures ; as well as from the experience that, in abdominal hernia in the pregnant animal, the foetus had been often extracted in this way and the mother did not succumb. Gastro-hysterotomy has been practised both on the large and small domesticated animals, but perhaps with most success on the latter. In 48 cases of this operation, Franck finds that 25 — or 52 per cent. — had a fatal termination. Saint-Cyr, from a smaller number makes the morta,lity 71 per cent. Franck can only note three instances in the Mare, and they were all fatal, though the Foals were saved. For the Cow he has 17 instances ; 6 of these recovered (one of them, however, was Morange's, which died from overfeeding fifteen days after the opera- tion, and another was Sacchero's, which was sent to the butcher in six days). This gives 35 per cent, saved, and 65 per cent. lost. In three Sheep there were no recoveries, and in two Goats only one. With the Pig the operation appears to have been wonderfully successful. In 8 instances all recovered — a result Franck is inclined to attribute to the different arrangement — or rather attachment — of the placenta, which renders this animal less liable to septic infection through injury to the uterus. With the Bitch, the mortality is about the same as in the Bovine species ; in 15 case?, 6 — 40 per cent. — lived. Franck thinks this percentage might be much increased if the operation were performed on the right side and antiseptic treatment adopted, or, if necessary, even extirpation of the uterus ; as putrid infection readily occurs in the Dog. With regard to saving the young, the operation is not very favourable. In nearly all the instances in which the parent recovered, the progeny has been dead, or died; and in only 4 of Franck's cases were the parents, and one or more of the young creatures, saved. Three of these cases were Bitches, and the other was a Sow. With the Cow, the Calf is often saved, while the parent dies. Of 7 instances, the (Jalves were extracted alive in 6. With the Mare, the operation must be resorted to early in order to save the Foal, as, for the reasons already given, it perishes quickly. It is only on a knowledge of the length of time the foetus may live during partui-ition, or after the death of the parent, that the operation can be undertaken with any prospect of success — so far as obtaining it alive is concerned ; and this is an important consideration with regard to the Bovine species. Kehrers, in his observations on the Bitch, found that three minutes after death the foetus began to show symptoms of asphyxia, and in thirty-six minutes it was dead. In pregnant Cows and Sheep which were slaughtered, the foetus moved about in a very lively manner for eight to ten minutes, but death ensued soon after. Sauer observed an unusual instance of footal vitality in a Bitch which 1 Das Gnnze der Thierheilkunde, 1822, p. 143. 'I > :1 I 11] ill III ; 4 556 OBSTETRIUAL OPERATIONS. co-a d not be delivered, and was poisoned by cyanide of potassium, i.ight minutes after death the foetuses were observed to move in the abdomen, and this and the uterus being opened, they were extracted After fifteen minutes, Franck has found in slaughtered Sheep that the foetus was usually asphyxiated ; and he concludes that during the hrst eight miuutes after the death of the parent, the fcctus can be ex- tracted alive ; even towards fifteen minutes there is a chance o-f preserv- ing it, but by that time it is usually dead. When extracted late, and m the first stage of asphyxia, though it may rally for a short time, yet It usually succumbs to inflammation of the lungs— through the amniotic fluid having penetrated into the air-passages during the convulsive gasps the young creature makes. There can be no doubt that much of the great mortaUty which follows the operation is due to the circumstances under which it is undertaken. It is, as a rule, never resorted to until every other means of delivering the animal has failed, and the creature, worn out by suffering, is already almost dead. In addition to this, the fostus itself— subjected to long- continued and severe manipulation— is either dying or dead ; indeed, it may have perished days before, and, becoming putrid, has already in- fected the parent. ^ Death is usually due, when not immediate, to putrid infection— to peritonitis or metro-peritonitis. This is more particularly the case with the iiitch, in which, when the operation is performed early and the young are extracted alive, recovery generally takes place; though franck remarks that wherever the green colouring matter of the placenta imparts a similar tint to the textures it comes in contact with very often septic inflammation begins there. The same authority points out .hat there is no great reason otherwise why death should be a frequent result of the operation, when we consider the hundreds of similar operations performed in the study of embryology, by Bischoft' and others, on l^itches, duinea-pigs, and Babbits, the majority of which did not have a fatal termination. He also alludes to the success of Nature's Cajsanan section, wlien we have mummification and maceration of the toetus, consequent on occlusion of the os uteri, and the remains of the creature l.nd their way ont by another channel without much disturb- ance to the mother. Certainly, the brilliant results obtained from antiseptic surgery in other directions give reason to expect more successes from this operation —at least in the case of the smaller animals. The most dangerous cases for operation are those in which the foetus IS dead, and more or less decomposed. Indications. The operation should only be resorted to in those cases in which delivery by the natural passages— the footus being aHve-is altogether impossible, or so difficult and dangerous that the mother incurs nearly as much risk as from gastro-hysterotomy itself, while the young creature must be sacrificed ; or when the owner prefers having the latter alive mstead of incurring the risk of losing both— the progeny being the most va uable The ojieration is therefore likely to bo demanded in those deformities of the pelvis produced by fractures, exostoses, etc., which, considerably diminish its canal, intra-pelvic tumours, hernia of the uterus, extra-uterine fa-tation, certain cases of uterine torsion irredu- GASTliO-HYSTEJlOTOMY. 5r,7 potassium, aove in the 'e extracted Sheep that during the can be ex- 5 0-f preserv- )d late, and rt time, yet he amniotic convulsive hich follows andertaken. f delivering I, is already ed to long- ; indeed, it already in- ifection — to le case with ly and the 3e ; though he placenta with, very ■ points out a frequent of similar and others, ch did not jf Nature's tion of the lins of the zh. disturb- surgery in s operation I the foetus in which altogether iurs nearly ig creature Ltter alive, g the most i in those 3tc., which, lia of tlio on irredu- cible by the methods we have described. Atresia of the os should be more advantageously overcome by vaginal hysterotomy, unless the owner is desirous of saving the foetus and sacrilicing the mother. The operation is also indicated when an animal, near the termination of pregnancy, is so seriously ill or injured that it cannot live until birth takes place. It may then be most judicious, if the progeny is valuable, to kill the parent and extract the foetus at once. If the parent has just died, or is dying, the operation may also be practised. In considering the adoption of the operation, the species of animal will, of course, weigh a good deal. Those which can be utilized as food there need be no hesitation in operating upon and sacrificing imme- diately afterwards ; the value of the carcase and the living Calf or Lamb, diminishing very considerably the loss which would otherwise be sustained. With the Mare, as we have said, the Foal may be much more valuable than the parent. "With the Bitch and Sow, there is much more prospect of a favourable result from the operation ; and as difficult parturition in them is often so serious, it is advisable to operate in good time. Indeed, in all cases when the operation is once decided upon, no delay should occur in practising it, if it is desired to preserve the progeny and give the parent a chance. We have seen that the Foal soon perishes when it cannot be born, and though the foetus of other animals retains its vitality longer, yet there is also a limit here. Besides, it must be remembered that the strength of the parent is an important factor in the case, and the longer the delay so the less chance is there of a successful result. It is, therefore, most important that the obstetrist lose no time in making his diagnosis, and coming to a conclusion as to the course he must pursue. Embryotomy will, of course, present itself to his mind before gastro-hysterotomy, which is, after all, only to be an ultimate means of saving either mother or progeny, or both, in very exceptional cases. It need scarcely be pointed out that in irreducible uterine hernia, there need be no delay in deciding, and that this condition gives good hope of success — especially in the smaller animals. Operation. Looking at this operation from a purely surgical point of view, there can be no doubt that, so far as the larger domesticated animals are concerned, it is one of the longest, most fatiguing, and most difficult in veterinary surgery. There is also the great extent of the wound, as well as the opening of the peritoneum, the haemorrhage, and the escape of blood or liquor amnii into the peritoneal cavity, to be considered. Besides, the animal is, as a rule, in a state of extreme prostration, and the results of mischievous interference may be already apparent before the operation is commenced, or even before the veterinary surgeon is called in. The after-treatment of the mother, too, often requires much attention, and is expensive ; and recovery requires a considerable period, as con- valescence is only too often protracted. What, however, makes the operation so formidable, if the mother is to be saved, is the quadrupedal position of animals ; for, after section of the abdominal parietes, the mass of intestines presses heavily on the part which has been incised ; so that it needs much careful manage- ment and supervision to effect cicatrisation, and to procure such a 1. 558 OBSTETRICAL 01' ERA TIONH. solid adhesion of the margins of the wound that hernia may not result. If the mother is alive, the operation is a painful one, and of long duration in some cases, while the pain niflicted causes the animal to struggle ; this inconveniences the operator more or less, and — not to speak of the humane feelings which should ever be predominant on such occasions— induces him to avail hhnself of the advantages of amcsthesia, if they can be obtained. Perhaps no agent is so useful in this respect as chloral hydrate, though chloroform or ether may be administered in the usual way— by inhalation— and produce their elfect. The objection to the two latter substances, however, is very great, so far as cattle are concerned ; as they taint the flesh, should it be necessary to kill the animals, and utilise their flesh as food ; where- as the chloral hydrate has not this objectionable action. The latter is perhaps best administered in enema ; for Horses and Cattle, the dose may be from fourteen to twenty-two drachms ; about two or three drachms for Dogs (depending on the size), and three to six drachms for Pigs. It is best given in mucilage or bland syrup of any kind. In a quarter of an hour or so the animal is in a state of narcosis, and the operation may be commenced. Unfortunately, the drug only too frequently causes the death of the foetus — a matter of some importance when this is of more value than the parent, but not to be considered when the life of the latter is to be preserved. When the parent is doomed to be killed — as in the case of a worthless Mare, or one suffering from an incurable disease or accident — and the young animal is to be rescued, the best course to follow is to pierce the medulla oblongata, and operate at once, as Vollmar has done with success. By this means insensibility has been produced, and the young creature extracted alive. Giinther recommends dividing the posterior aorta after removal of the foetus, as it is close to hand in the abdominal cavity, and death quickly ensues. For the operation but few instruments are needed. They consist chiefly of a scalpel, probe-pointed bistoury, scissors, forceps, muscle- hooks, and some connnon suture needles, pins, and sutures — silk or catgut. For the larger animals a strong suture needle, suture wire, and waxed carbolised thread, catgut, wire or twine, teased oakum, tow, small pieces of wood or whalebone for the sutures, and large pieces of linen are required in addition, as well as a body-bandage made by fold- ing a linen or cotton sheet. If the parent is not to be preserved, or is already dead or dying, of course no such preparations need be made ; as a scalpel and probe-pointed bistoury, or even an ordinary pocket- knife on an emergency, and used with care, will suflice. The operation should, if possible, be performed with all antiseptic precautions. The incision in the abdomen may be made in either of two regions — at the linca alba or the right flank. If it is desired to preserve the parent, the flank operation is certainly to be preferred with the larger animals and the Sow, as no sutures can resist the weight of the intes- tines when the incision is at the inferior part of the abdomen. Even with the Bitch the flank operation should be adopted for the same reason, and also because wounding the mammaj is avoided — an im- portant consideration in more respects than one. It is true that Bourgelat, describing how gastro-hysterotomy ought to be performed in the Mare in order to obtain the living foetus, says that the animal rfASTRO-HYSTEltOrOMY. 650 should be carefully thrown, placed on its back, and there secured. " Then a crucial incision is to be made at the middle of the lower part of the abdomen, and it should be about a foct-and-a-half in length — terminating at the pubis. If the large intestine, forced outwards by the struggles of the animal, appears, it should be carried to one side, when the uterus will soon be seen ; then an opening, corresponding to the other, must be made with the greatest circumspection, so as not to wound the foal ; the membranes are to be opened, the ' waters ' they contain escape, and the young creature is to be immediately removed. The success of the enterprise depends upon the attention paid in order to prevent the death of the Mare ; the more time lost, so the more is the foetus weakened ; the less time is there to spare if the Mare is dead, for then it is certain that the Foal will not live longer than a few moments." The umbilical cord was to be ligatured at four or five inches from the body of the Foal ; " after which it is only a question of providing means for rearing the young animal, until it can attend to itself." But Rainard points out that nothing ij said as to closing and ban- daging the incision, or the after-treatment of the Mare — thus indicating that preserving the Foal only was in view. With the Mare or Cow the operation is sometimes attempted in the standing attitude ; but it is obvious that there must be great inconveni- ence and danger in this. It is much better, therefore, to place the Mare, Cow, Sheep, or Goat, on the left side — right side uppermost ; either side suflices for the Bitch or Sow. If the animal is narcotised and insensible, then it is not necessary to secure the limbs ; but if it is only partially or not at all unconscious, then means of contention must be adopted, for the safety of the animal as well as the operator. The right hind-leg should be firmly fixed backwards, so as fully to expose the region to be operated upon, the other three limbs being secured together in the ordinary manner. A small animal can be held by one or two assistants. The incision, as has been said, is made in the right flank, rather below and in front of the anterior spinous process of the ilium, so as to avoid wounding the circumflex artery — an accident which might embarrass the operator; if this or any other artery is wounded, it must be tied immediately. If there is no great hurry, and the hair is long, this had better be clipped off. The incision should pass downwards and forwards, in the direction of the fibres of the small oblique muscle of the abdomen (no muscle should be cut across) ; it ought to extend through the skin to the muscles, and even if it passes into these there is no danger to be apprehended. The length of the wound will, of course, depend upon the size of the animal — for the Mare or Cow, it may be from twelve to fourteen inches. The layers of muscles are to be gently cut through until the peritoneum is reached, and into it a small opening is to be made ; but in doing this the greatest care is to be exercised, so as not to wound the viscera. The two first fingers of the left hand are passed through this opening, the back of the hand downwards ; the blade of the probe-pointed bistoury is placed between these fingers, and carried along — cutting through the peritoneum and muscles until the opening is of the same length as that in the skin. An intelligent assistant should be at hand to prevent the escape of the intestines through this large aperture. The arm of the operator is now pushed into the abdominal cavity in search of the uterus, which, when found, is brought opposite the inci- I 560 OBi^TBTJilCJL OPERA TJOJ^S. sion, should it not be there at first. Two assistants compress the sides of the wound, so as to maintain them closely against the uterus ; this the operator cuts through slowly, layer after layer, using all diligence so as to escape wounding the footal membranes. Two fingers are insinuated between the walls of the organ and these membranes, and the bistoury is again employed to dilate the opening, as in the peritoneal incision, so as to give it nearly the same direction and extent of that in the abdominal wall. Should the membranes be still intact, they are to be torn, and the " waters " allowed to flow — but only outside the abdomen, if possible. The operator now, plunging his arm at once in the cavity of the uterus, seizes the first parts of the foetus that come to hand — fore-legs, head, or hind-quarters, if possible — and removes it quickly ; the umbilical cord is torn or tied, and the young creature given to those who will dry and rub it, wrap it in a warm blanket, and otherwise attend to it. The obstetrist immediately, if the parent is to be preserved, removes the foetal membranes — an easy task comparatively in the Mare, much more tedious and difficult in the Cow, as all the adhering cotyledons must be separated one by one. Then, by means of a sponge, all the fluid remaining in the organ is to be cleared out, as well as any that may have escaped into the abdomen. It might be well to damp the interior of the uterus with a very weak solution of carbolic acid, or potassium iodide (1 to 500 or 700). This accomplished, the great wound is to be closed. Nothing is done to the uterus, as a rule ; the organ soon diminishes very considerably in volume, and it would appear that the wound in it is not long in cicatrising. The borders of the wound in the abdomer. however, must be speedily and solidly united. The best means of union is undoubtedly the quilled suture, which is to be applied accord- ing to the ordinary rules of surgery ; care must be taken to make the sutures enter at a good distance from the border of the wound, and to include the muscles as well as the skin. If the cord fixing the out- stretched hind-limb is slackened a little, it will facilitate closing the wound. A small corner should be left open at the lower end of the incision, to allow the products of inflammation and suppuration to escape. External to the wound, either a layer of fine tow or lint, slightly carbonised, or oakum, may be placed. Over this, long narrow strips of canvas covered with melted glue may be fixed, to support the sutures and retain the dressing ; then on these another thin layer of carbolised tow or oakum, and, lastly, the wide body-bandage around the abdomen and loins of the creature. Though it is somewhat diffi- cult to apply, yet it is essential that this bandage or compress be put on before the animal is allowed to rise. Afterwards the bandage may be adjusted and tightened if necessary. When the incision is made at the linea alba the procedure is some- what similar ; but, as we do not recommend it for the reason above stated, we need not allude to it further. The after-treatment of the wound is that followed for all such serious traumatisms. If possible it should be kept perfectly dry, and dressed with antiseptic powders — such as boric acid. The diet should be light and sloppy for a short time, unless the animal is very feeble, when nourishing food must be given. With the smaller animals the operation is similar, but with the multiparte the cornu containing the young is drawn partially outside s the sides jrus ; this . diligence and these ! opening, direction branes be to flow — , plunging rts of the if possible [, and the ip it in a [, removes are, much sotyledons le, all the f that may le interior potassium id is to be iiminishes ound in it abdomer. means of 3d accord- make the nd, and to ig the out- losing the 3nd of the uration to w or lint, 3g narrow apport the n layer of ge around what diffi- ess be put dage may i is some- son above ich serious id dressed unless the 1 with the lly outside SYMPHYSIOTOMY. 661 the wound, opened, and each foetus and its membranes removed separately. The after-treatment will be the same. For enlarging the abdominal and peritoneal incisions, small sharp scissors will be found very useful and safe, the blade with the blunt point being introduced. The bad results to be apprehended from the operation are septic metritis, or peritonitis, or both ; abscess at the seat of the incision, or adhesion of the abdominal organs to this part. CHAPTER VIII. Symphysiotomy. Symphysiotomy, as the name implies, consists in dividing the ischio- pubic symphysis throughout ; so that, by allowing the bones to sepa- rate somewhat in the pubic region, the pelvic .v'ity may be enlarged, and the passage of the foetus through it rendered possible. But even in woman, with every advantage and appliance, and after a most serious mutilation, the separation procured between the bones is infinitesimal, and therefore can have but little influence on the progress of the fcetus. And when we remember that in woman the mortality is more than 32 per cent., while among those which survive many are permanently disabled, and those which recover often require months before conva- lescence is estabhshed, it will be understood that the operation can never, with our present knowledge, be reckoned among those which the veterinary obstetrist can successfully practise. It may also be sufficient to notice the fact that in animals the symphysis pubis, as a rule, soon becomes ossified. The operation does not appear to have been resorted to in veterinary obstetricy, and it would require a bold operator to attempt it. CHAPTER IX. Artificial Premature Birth. At p. 294 it was explained that, in order to obviate some of the diffi- culties occurring in pregnancy and parturition in animals, artificial labour might be induced — i.e., birth effected when the foetus has attained such a stage of development as to be viable, but before the period of normal parturition has been reached. Such a procedure may be necessary when there is deformity of the maternal pelvis, or tumours thereon or therein ; excessive size of the fostus — absolute or relative ; protracted gestation ; serious paraplegia ; eclampsia ; cerebral conges- tion ; ante-parturient exhaustion from the presence of too many fa3tuses; prolapsus of the vagina and uterus ; transverse presentations, etc. This measure is often resorted to in the human female, and with great advantage, for by it both parent and offspring may be saved ; whereas if not adopted, one or both might perish when pregnancy came to an end. It has even been suggested that in animals it might be made available in those cases in whicli they have become pregnant when too young, when the male has been disproportionately large, or — as is often the case with Dogs — belonged to a large-headed breed. When the foetus is expelled from the uterus before it is viable — before 36 I n 662 OBtSTETltlGAL OPERA TIOXS. it can maintain an independent existence apart from the parent, this constitutes abortion. In the Mare this would be the case if the accident occurred before the 300th day of pregnancy ; in the Cow before the 200th day; in the Sheep before the 130th day; in the Sow before the 109th day ; and in the Bitch before the 50th day. So it is estimated that the foetus would be viable, and yet notably less in size and weight than when born at full term, if removed from the INIare 20 to 40 days before that period ; from the Cow 15 to 30 days ; and from the Bitch 10 to 15 days. Operation. — The operator has merely to induce labour, Nature carry- ing on and finishing parturition in the usual manner ; so that he has only to dilate the os uteri somewhat to effect this ; then the " water- bag " is extruded, the uterus commences to contract, the animal also begins to strain, dilatation of the os is completed, and the foetus is expelled. The different ways in which the os may be dilated have been already described in treating of sterility, and rigidity of spasm of the cervix ; but it may be remarked that, in the case of the larger animals, and especially if near the end of pregnancy, the hand alone may be used to open the os, slightly detach the chorion from the uterus around that canal, and even perforate that membrane a little to hasten the forma- tion of the " water-bag."i In the smaller animals the sponge tent, a long probe, or uterine douches, will suflice. CHAPTEE X. Supplementary Observations regarding Mother and Progeny. The condition of the mother after obstetrical manipulations and opera- tions generally demands attention — all the more if these have been severe and protracted. In trifling cases, it is true, no care beyond that usually given after normal parturition is required; for as soon as delivery is completed, she will seek her offspring — if it be alive — and manifest her interest in it, though she may have suffered considerably before it was born. But in the great majority of difficult cases, such as have been described in the preceding chapters, the animal is much pros- trated from prolonged suffering and straining — so much so, indeed, as to lie extended in a comatose condition, or apparently dead, from nervous exhaustion. Though the Mare can endure very much suffering during parturition, yet this state of collapse is not infrequently observed. So stout-hearted is this animal, that when she has ralUed from the effects of parturition and evinced maternal solicitude for the Foal, she begins to eat and drink ; when she does not do so, it may be regarded as a very grave sign. To render the mother comfortable and restore her strength should be ' Andre {Annaks de Me'decine Vilirinaire, 187", p. ITiG) was called to see a Mare, eleven mimths pregnant anri very hi-avy, which ennld nut ho got np, and had been lying so long that her siilus were contused. He h.ad her placed on an inclined plane, with the front of the body higher than the hind-tjuarlers. Then by means of a finger, and after- A'ards by the whole hand, he succeeded in dilating the oh, and soon a large living Foal was born. The Mare was kept quiet and nursed for two hours afterwards, when she got up without difficulty and suckled the Foal, which was well and lively. parent, this the accident ■ before the Sow before is estimated 1 and weight ) to 40 days m the Bitch ature carry- that he has the " water- animal also ;he foetus is 3een already the cervix ; mimals, and y be used to around that 1 the forma- , or uterine Progeny. s and opera- 3 have been beyond that as soon as i alive — and considerably ises, such as 3 much pros- 0, indeed, as dead, from ich suffering tly observed, ed from the he Foal, she be regarded th should be to see a Mare, liart been lying plane, with the iger, and after- rge living Foal 'ards, when she CAllK OF Mother AXD PROrfEXY. 688 the first consideration. The body ought to be rubbed and dried, and covered with warm clothing ; stimulants must be given, as well as warm gJ'uel and tepid water to drink. If resting, she ought not to be dis- turbed ; though, in the case of the larger animals, some authorities assert that if recumbent they ought to be got up if possible, as the internal generative organs then assume their natural position more readily. But unless there is apprehension of inversion of the uterus, it is generally the best course to allow repose. For Cows much exhausted in calving, it has been recommended to give a subcutaneous injection of veratrine (4 to 5 grammes in alcoholio solution, 1 to 25), which soon rallies them. When, after delivery has been effected, animals remain lying or are restless, and apparently suffering pain, they should receive soothing medicine, especially opium or its tincture, either in gruel or enema— or morphia subcutaneously. If the young animal is alive and able to suck, it should be put to the teat ; if it is dead or unable to suck, then the mother nuist have the milk taken from the mammary gland. Any contusions or injuries to the maternal generative organs should be attended to next ; the treatment to be adopted will depend on the nature and seat of the lesions, but it ought to be antiseptic whenever possible. This must also be the rule when the foetus has been extracted in a decomposed state ; the uterine cavity must be well syringed out with warm water, and subsequently irrigated with some antiseptic fluid — I have used permanganate of potass with good results in these cases. With regard to the young animal when it is extracted alive, the damage it has received should be ascertained ; this can be done when the cords are removed. The slighter injuries are usually simple wounds and soon heal ; but fractures of bones are more serious, and generally necessitate slaughter of the animal. If looking healthy, yet it cannot get up or stand when lifted up, this is in all probability owing to strain of the limbs, and passes off in the course of a few days. When apparently dead, besides the measures already mentioned for this condition, veratrine has also been given with great advantage sub- cutaneously, one or two centigrammes being the dose. In other cases in which the Calf could not respire — though the heart was contracting rapidly and violently — it has been placed near the open door, with the head pendent, in order to send blood to the brain, while the limbs were vigorously rubbed and the chest compressed and relaxed alternately ; these measures not succeeding, a small quantity of brandy carefully administered has produced the desired effect, and respiration was soon established. Sometimes it happens that the Calf has been retained in the genital canal for some hours, with its head partially out of the vulva, and owing to the pressure on the neck there is much swelling of the head, especially of the tongue, which is turgid and projects from the mouth. When extracted, the creature can scarcely breathe because of the tumefied tongue, and asphyxia is imminent. Scarifications of the organ, or leeches applied to it, with turpentine or mustard rubbed on the limbs, soon bring relief. il '^^^ AVVWEXTS AFTEH PAllTrniTloX. BOOK IV. ACCIDENTS AFTEK PARTUKITION. The accidents occurring subseqiK itly to parturition are rather diverse, and not infrequently complicate the ditticulties already alluded to as hindering natural birfh. They may occur either during parturition, immediately after delivery, or within a few days subsequent to that event. ^ In addition to the accidents, there are diseases which appear durin^' the puerperal period; though the distinction between them and the former is not always easy to establish. Some of the compHcations just alluded to may succeed a perfectly normal delivery, or an accidental abortion, as well as a difficult birth. The accidents consecutive to or accompanying parturition, may be enumerated as follows : (1) lietcntionof tlie fatal cnvelojies in the uterus, and Its consequences; (2) Post padiim Juemorrhaqc from the genital organs; (3) Displacement or hernia of one or more of the internal genital organs through the vulva; (4) Traumatic lesions of the genital orneinh- bounng organs. ' Some of these accidents are either very serious in themselves or in their consequences, and require the greatest skill to remedy ; or they are comparatively trifling, and easily repaired. CHAPTER I. Retention of the Foetal Envelopes. The retention of the foetal envelopes, placenta, "secundines," or "after- birth, beyond a certain time after the expulsion of the fa3tus from the uterus, must be looked upon as an accidental or pathological condition which requires attention. It has been already shown that the placenta IS usua ly shed or expelled soon after the young creature is born, and particularly with such animals as the Mare, Sow, and Bitch, the placenta of which is diffused or zonular ; indeed, with multiparous animals— as the two latter— the placenta of each fretus is extruded soon after its birth, by the succeeding foetus; so that if retention occurs at all, it IS only the last, or the two last placentaj which remain in the cornua of the uterus. With Euminant animals, however, retention is far from rare ; though even in them there is a difference in this respect, according to species —the accioent being much more frequent in the Cow than in the Sheep or Goat This frequency in Euminant animals is doubtless due to the peculiar formation of their placenttc— the cotyledonal arrangement beinff evidently opposed to ready separation. But if the Cow is the animal of all otherB in which this accident occurs, it IS also the one which appears to be the least inconvenienced by It ; for it is not uncommon to see Cows which four, six eight and even ten or twelve days after parturition, have not got rid of the placenta, and yet are lively, the appetite is unimpaired, and they con- ' iij HETENTIOX (>F TJIK FOCTAL ENVELOPES. 565 lier diverse, luded to as parturition, ent to that pear during m and the a perfectly 3ult birth, on, may be the uterus, the genital mal genital il or neigh- selves or in y; or they ' or "after- is from the . condition le placenta born, and Bitch, the lultiparous 3 extruded iion occurs lain in the e ; though to species the Sheep due to the nent being 3 acciucnt ivenienced eight, and id of the they con- tinue to ruminate and give milk as if there were nothing amiss ; though in some instances the animal may stamp with its hind-feet, raise the tail, and act as if about to defecate or micturate, while a small quantity of foetid sanious fluid escapes from the vulva. Si/mjdoms and Terminations. The symptoms are generally so marked that the state of affairs is readily discovered. Nearly always there is a more or less considerable mass of the foetal envelopes — sometimes only the umbilical cord — hanging from the vulvar orifice, the labia of which are often swollen and injected. Occasionally the mass is so large as to reach below the hocks, with little bags of liquor amnii at the lower end ; it has, if recently expelled, a fresh tint, not unlike that of the intestines ; but if exposed for some time, and especially in summer, it is greyish-coloured, somewhat adhesive, and generally soiled by fa3ce3 or litter. In other cases nothing is noticeable, except when the animal is lying on its abdomen ; then the pressure on the uterus pushes the cervix into the vagina, and if any portion of the membranes is through the os, of course it is visible. In others, again, nothing whatever is to be seen whether the creature is lying or standing, the whole mass being retained in the uterus. After the third day of delivery, the os is usually closed ; and unless a portion of the membranes chanced to be in the vagina before this period, the entire placenta is imprisoned in the uterus, and a manual exploration will not always discover it. Sometimes only a fragment of the membranes is so retained. It has been mentioned that in many cases the animal does not evince any uneasiness at first ; sometimes when the portion of placenta hang- ing outside the vulva is large and heavy and the creature is standing, the meatus urinarius is pressed upon, and micturition is rendered diffi- cult. There may also be symptoms of abdominal pain — whisking the tail, stamping \ni\\ the feet, and making efforts as if to defecate or micturate, with slight and brief uterine contractions, which may eventu- ally lead to the expulsion of the placenta. It often happens that when the os is not completely closed, owing to a portion of the membranes lying in it, spontaneous expulsion takes place after a variable period. Deneubourg asserts that it occurs at fixed intervals, which are almost regular " tertiary periods"; that is, if expulsion does not ensue in the first twenty-four hours, it should take place on the third day ; and if not then, it will be either on the sixth, ninth, twelfth, fifteenth, or other tertiary interval — but most frequently on the ninth day. How far this assertion may be correct, experience can alone decide ; what is more to the point is the fact, that when once this spontaneous expulsion has been effected there is little to be apprehended. It is not so if retention be accompanied by decomposition of the mem- branes. This occurs when the air has access to them ; and all the more rapidly does putrefaction progress if the temperature is high, and they are imprp.gnated with discharges. The odour is most repulsive, and a sanious brown-tinted discharge, composed of iUbris of the membranes and secretions from the irritated mucous lining of the genital canal, flow from the vulva — soiling it, the tail, thighs, and hocks, and often excoriating them. This discharge is most abundant when the animal extends itself to micturate, and it is I 566 ACCIDENTS AFTER VARTUPdTlOK. then horribly fa)t,d The hand, on being passed into the vagina, is covered wjth the fluid, and it may encounter shreds of the placenta. m such cases the health of the animal often sufVers ; there is dulness, prostration, dnninution in the secretion of milk, decreased appetite, respiration perhaps quickened, temperature increased, and other indica- tions of illnosa. The complications from placental retention are somewhat numerous. »^ontaot with the decomposing membranes may so irritate the interior or tne uterus as to occasion metritis, or even metro-peritonitis— a con- dition which IS always serious, and often fatal. There is also risk of septiciemia ; and even under the most favourable circumstances there sometimes remains a local irritation-a chronic vaginitis or metritis tliat leads to leucorrhcea. o«5"T ^"'^i°»"*!^'«8 have observed trismus, tetanus, metastatic arthritis, and chest atiections, as HaiucUe of placental retention ihere is no danger when the retention has only lasted for two or three days, particularly if a lart;e portion of the membranes protrudes beyond the vulva, and it has a fresh tint. Attention is necessary, how- ever, wlien the placenta begins to putrefy, and a fetid discharge com- mences from the vulva; though even so late as fifteen days after parturition tlie membranes may be expelled spontaneously, without any »il'"'^u''''""'-"^ from the prolonged retention. But the case is serious When the animal begins to show syaiptoms of general illness, and par- ticularly if no portion of the placenta can be seen or the os be occluded. J^lastic adhesion of the placenta to the uterus is also a grave complica- tion, though happily rare. In these instances, the animal gradually becomes listless, weak, and eniaciated, loses its appetite and ceases to yield milk, until at length it laiis into a state of marasmus, and perishes from septiciemia. Or in more rapid cases, with these general symptoms the lining membrane of n„rn "itK-'"!? "" ^^^P'^^^ ^o^O"^' ^nd intensely hot, a fetid sanguineo- purulent discharge escapes from the vulva ; there are tremblin|s over the whole body, hurried respiration, intense fever, and all the other signs or metritis. Though retention is not, in the majority of cases in the Cow, a very serious aflair, yet it should be attended to even in this animal. With Tivlfr^ ^ '^ '\ ™"'^' "'°^"^ *° ^^ ^^^^^^^, as they incur greater risks from prolonged retention. e ^ Saint-Cyr mentions the case of a fine Mare which died in less than fhnnlh .1' »^«t"ti^. due to the foetal membranes being retained; though the cause was not ascertained in time. Causes. Retention occurs most frequently in cases of abortion, or when birth 5h«r//?f'' 'T'l ^^^f .M°'^ *¥ P'°P"^' *^"^^- It has been remarked of L fir J ? /? ^tf^^"^^^*^ Pl'^^e^ta unusually long after the birth iLt\ A A ?i' •'^'" u^ Z*". ^* ^""^''y succeeding parturition. A pro- IXltT ^f°'\?' ^^1'^ •' ^^,'° ^^^^ ^y ^"•"'^ authorities to favour L if^f "^ ; u "" °*^'^1'^ ^'''^^''''' *^*^' "'^ converse is true. The accident 18 stated to be more frequent with old Cows, and especially when these adhS r. '" '^raiaght-as in France and other countries. Abnormal adhesion between the maternal and foetal placenta? would, of course be a sure cause of prolonged retention, and we have given instances of -Ll RKTKNTIOS OF THE FiETAL FXVKWrHS. 667 I less than such adhesion ; indeed, every obstetrist knows that at times there is much ditticulty in disuniting the cotyledons in the uterus. When tlio cervix uteri contracts rapidly after delivery, and the os is consequently tirinly closed, the placenta, though non-adherent, will be retained. Rueff mentions that the accident is especially frequent in certain years when the herbage and forage is not good, and particularly when the latter is mouldy ; it has long been known that these conditions favour abortion. He also alludes to a popular belief in (jermany, which attributes this Zurilckbleihcn der Nachajcburt, as it is termed, to allow- ing the Calf to take the teat before the placenta has been expelled ; the irritation of the udder so produced reacts sympathetically on the uterus, which contracts at the cervix, and so retains the membranes. According to Baumeister, milking too sojn, or giving cold water to drink, is supposed to act in the same way. Numerous other causes have been mentioned as influencing this reten- tion ; but they need not be noticed, as there is really no proof that they do operate in this way. The accident occurs under all systems of management, and all kinds of conditions ; it is, therefore, probable that several causes may produce it, and that some of them are still obscure. Treatment. The treatment of placental retention appears always to have been a subject on which diverse views and opinions have been held; many obstetrists maintaining that— with the Cow more particularly- -this retention is never dangerous in itself, and that, unless there arise com- plications, the removal of the foetal membranes should in every case be left to the efforts of Nature ; while others assert that there is great risk in this retention, and that when it has exceeded two or three days after the birth of the foetus there is need for active interven- tion. The experience of the majority of obstetrists will negative both of these opinions ; for it is a matter of almost daily observation, that in many instances the placenta remains without inconvenience in the uterus for several days— six or eight— before it is spontaneously ex- pelled ; while in other cases retention for the same period is marked by more or less serious symptoms. This difference undoubtedly depends upon circumstances, the precise nature of which cannot always be fully ascertained. Nor can positive rules be laid down as to when it is time to interfere, or when abstention is the prudent course :— this can only be learned by individual experience and the tact of the practitioner. It may be remarked, however, that when parturition has been normal, when the Cow does not appear to suffer pain or inconvenience, when the " straining " is unfrequent and slight, the appetite good and lacta- tion established, and particularly when, during a low or moderate temperature a portion of the membranes protrude beyond the vulva, then there is no great reason for interference until a week, or even more, has elapsed. But if, on the contrary, the external temperature is high, if the labour has been difficult, the genital organs irritated or abraded, and if fever, restlessness, and suffering are noted, with strong and frequent strain- ing, especially if there are foul-smelling discharges from the vagina, then intervention is called for, no matter whether the time which has elapsed since parturition is long or short. « \ 568 ACVIDEXTS AFTER PARTUUiriON. !i::' When the envelopes form a somewhat large mass hanging from the vulva, it may be anticipated that early and spontaneous removal will take place ; though it sometimes happens, as has beei pointed out, that the weight oi the pendulous portion causes inconvenience in micturition; while it fatigues and pains the animal by dragging on the uterus, and induces expulsive, but f itile efforts. Schaack has shown that in nearly all these cases it will be found that a loop of the membranes has become twisted around the pedicle of some large uterine cotyledon ; and as this is the obstacle to separation, it is necessary to release tlie loop as soon as possible, in order to prevent accidents. It has also been remarked that, even when birth has been easy and favourable, primipixro) are often irritable and impatient, the presence of the secundiues in the vagina and vulva increasing the restlessness, and occasioning frequent and energetic uterine contractions. In such cases it will generally be found judicious to remove the membranes as soon as possible — on the same day, or the day succeeding delivery, if necessary. If after the birth of the foetus nothing is seen at the vulva except a thin cord, formed solely by the umbilical vessels, it is almost cer- tain that there is strong adhesion between the maternal and fcotal placentas, and that the separation of the latter will be protracted— in all likelihood require to be removed artificially. But even in such a case there is no occasion for immediate interference ; on the contrary, it is more judicious to wait, and allow time for the placentas to soften and the adhesions between them to diminish, though the opportunity for complete detachment must not be overlooked. When nothing whatevi is discernible externally, there is reason to surmise that the placenta is completely retained. But even in this case there is no_ need to resort at once to its removal ; though it may be necessary, in order to prevent imprisonment for some time, through the closure of the os uteri, to introduce the hand into the uterus, and if it IS already partially detached, to extract it. If it remains firmly adherent, however, it is better to gather as much as can be seized into a single mass, carry it through the os into the vagina, and tying it there by a long piece of cord, to leave the latter lianging outside the vulva. This prevents the os from closing, while the cord will assist in effecting artificial removal at a later period, should such be required. Certain medicaments, more or less of the nature of eramenagogues— such as rue, savin, laurel, stramonium, carbonate of potass, etc. — have been for a long iime credited with the power of liastening tlie expulsion of the placenta ; and their administration has been recommended before resorting to manual force. Some of the recipes for these potions are very antiquated, and others are quite modern, and lauded by the highest authoritiee. Zundel, for instance, extols laurel berries, and gives the following recipe : Laurel berries - Aniseed - Bicarbonate of Boda 120 grammes. 60 120 t) These are infused in 4 litres of water, and given in two doses. It may be repeated the following day; but, as a rule, the membranes are expelled within twenty-four hours after the last dose has been given. Zundel asserts that this infusion has rendered excellent service, sue- IIETKNTIOX OF 'HIE F(ETAL ENVELOPES. 669 ceeding in 60 per cent, of his cases of retention. Hering and Stock- fleth also speak highly in its favour, and assert that it is always successful, provided there is no mechanical obstacle to expulsion. Baumeister and Rueff recc-mmend potass carbonate in the dose of 45 grammes daily, at thvee times, in an infusion of chamomile or savin. Hummer prescrib^.s 90 gramme doses for three consecutive days, and Hertwig, Lund, and others also prescribe it with the same object. Hering gives the following formula : Carbonate of potass Savin leaves 15 grammes. 30 These are infused in 500 grammes of water, filiered, and administered tepid. The dose to be repeated every six hours. Garreau lauds Caramija's uterine tincture, which he states always succeeds in producing expulsion of the membranes, even when they have been retained for two months after parturition. The formula for this tinctuiM^ is given by Tabourin as follows : Powdered savin Treacle - Powdered cumin Essence of rue ) savin/ Alcohol - iiii 250 grammes. 190 125 80 2 kilogrammes. Garreau prescribes this tincture in doses of 100 grammes, given in 2 litres of savin infusion. Cruzel has his favourite potion, composed of 30 to 40 grammes of green rue, or 10 graumies of ergot of rye and 20 grammes of powdered savin, made into a decoction in a litre and a half of water. Delwart, Rainard, and Schrader recommend ergot of rye, and Ungefrohrn stra- monium seeds (30 grammes in two litres of water), which he believes to be specific in then- action ; he advises that linseed decoction be given in the intervals, as it acts as a diuretic, and Rychner asserts that this simple medication is particularly useful when the fcntal membranes are so decomposed that they cannot be removed by the hand. The subcutaneous injection of ergotine, or ergot of rye, has also been advised. Extract of ergot of rye, 1 to 3 grammes, dissolved in glycerine and spirits of wine (15 grammes of eacli), has been used for injection. Though medication has been so highly vaunted by some authorities, yet some others have not much faith in it. Deneubourg thinks its chief advantage lies in inducing the owner of the animal to exercise patience until spontaneous expulsion is effected, the least active measures being the best. Other obstetrists entertain the same opinion of these emmenagogues. For a very long time, an empirical mode of removing the placenta when a part of it protruded beyond the vulva, was to exercise slight and continuous traction on it by attaching a weight to the pendulous por- tion \ in FrajHce the farmers attach a sabot tilled with craveL Favre of Geneva, who notices this rude method, admits that a weight not exceeding two pounds may be suspended from the membranes, which are collected into a mass and tied with a piece of hemp. This method is, however, objectionable from several points of view. Manual traction is often employed when a portion of the membranes 4 If -'■ 1 [ 1 i .' ill i; . It •' ( I 570 ACCIDENTS AFTEJl PARTURITION. is visible. This is seized either by the hands, or by meano of a towel, or wisp of hay or straw, and gently pulled at — particularly when the animal strains — twisting it at the same time, until the whole mass is removed from the uterine cavity. This traction is not likely to be productive of much injury to the Mare, Sow, or Bitch, as the adhesion of the placenta is not great, and is usually limited to a few points ; it is, therefore, as a rule, generally and quickly successful in these animals. With the Cow, however, it is not so, owing to the numerous and often strong attachments of the placenta, and its fragile texture, which renders it easily torn if too much force be employed; if it does not give way, and the traction is immoderate, then there is risk of irritating the uterus, tearing away the cotyledons, or producing partial or complete inversion of the cornua, or even of the entire organ. Should the placenta give way, this may lead to greater difficulty in removing what is left of it in the uterus. For these reasons, some practitioners discountenance this mode of abstracting the placenta ; but there can be no doubt that if the traction is moderate and judicious, the membranes not very adherent to the interior of the uterus, and a )od part of them beyond the os, the operation is quite justifiable and will be successful. When, however, the resistance is marked, or the membranes begin to tear, it is better to desist. Deneubourg recommends the following method, as better than em- ploying the hands : The protruding umbilical cord is seized between two pieces of wood, the length and size of an ordinary walking-stick, and rolled round them until they are close to the vulva ; there, by a slight and gentle circular movement, the portion engaged in the vagina produces a kind of titillation which induces the animal to stretch as in micturition — an act it nearly always accomplishes, and during this period the membranes are rolled round the pieces of wood as they are detached, which usually occurs in about six days, when the whole is removed. When resistance is experienced, and anything is found to tear or rend, it is evident that adhesions still exist, and the rolling must cease ; but then, by a kind of jerking movement from side to side, there is communicated to the uterus a series of shakes more or less energetic, according to the state of the organ. Deneubourg says that there need be no hesitation in employing a certain amount of force in practising these movements: "We may act strongly, but gently." Great success is said to have attended this method. But, after all, it is doubtful whether the more scientific and surgical, if old plan — that of direct extraction by enucleation of the cotyledons — is not preferable. This method consists in passing the hand into the uterus, and detaching or enucleating the cotyledons, one by one, so as to destroy the adhesions between the maternal organ and the foetal envelopes, when the latter can be taken away. When this extraction should take place will depend upon circum- stances. It will generally be found that it will not be successful before the third dav, as the cotyledons are too closely and firmly united to allow their disunion without injurious force, which may bring about inversion of the uterus, or laceration of the maternal cotyledons, and consequent huunorrhage. About the third day is generally a favourable period, as the cervix is still sufficiently relaxed to pass the hand through the 03 into the uterus; while disintegration between the fcotal and nETEXTIOX OF THE F(ETAL ENVELOPES. 671 f a towel, when the e mass is ury to the great, and generally and often ch renders B way, and tie uterus, I inversion senta give eft of it in 3 mode of le traction jnt to the he OS, the , however, it is better ' than em- 1 between king-stick, ihere, by a the vagina stretch as uring this bS they are e whole is s found to ,he rolling im side to es more or bourg says amount of ongly, but I. d surgical, cotyledons hand into ne by one, ,n and the )n circum- isful before I united to ring about edons, and favourable ad through fcotal and maternal placentae has advanced sufficiently to permit tlie hand to com- plete the disunion without need for violence. It sometimes happens, however, that extraction can be effected so late as the fifth or eighth day after delivery ; but then the membranes are extremely friable, and will scarcely withstand any degree of traction. Besides, the operator himself incurs great risk of infection, either local or general, from the absorption of the putrid matters in the uterus by the skin of the hand and arm. An assistant holds the tail of the animal to one side, and the hand and arm, well oiled, are passed into the vagina ; if a portion of the membranes is in this canal, then the operation is not so difficult, as the OS will probably be more or less relaxed, and this portion lying towards the palm of the hand — the back of which is upwards — serves as a guide ; while the left hand pulls at it gently, as occasion requires. When, however, nothing of the envelopes is to be found outside the OS, and that opening is firmly closed — as happens four or six days after birth — then it may be very difficult to reach the interior of the uterus. One finger must be at first introduced, then two, three, and so on, until the hand in the form of a cone, and by a semi-rotatory motion, can be passed through. This operation is often long, troublesome, and fatiguing, and requires to be carefully managed, so as not to bruise, irritate, or wound the organ. When the hand reaches the interior of the uterus, it is pressed forward between the nmcous membrane of the latter and the chorion— the palm towards the latter — separating them as it advances until it meets with the cotyledons. Some of these — the mriternal--may be detached from the membranes, while others are still imbedded in them, as it were, through their foetal cotyledons. These last have to be enucleated ; and to effect this, the cotyledon is gently pressed at its base between the thumb and index finger, and, if necessary, the fingers are moved over each other as if removing a button from its buttonhole. Other practitioners make pressure on the summit of the cotyledon by the three first fingers, and thus destroy the adhesion. In this manner the hand passes from one cotyledon to another, effecting disunion as rapidly, yet carefully, as possible. At times a cotyledon will be met with which adheres so very firmly that it cannot be detached in the way just mentioned. Then the nail of the thumb or other finger must be gently insinuated at the border, so as to gradually raise it, and pass the finger over its entire surface. The tediousness of the operation will be inferred when it is known that the number of adherent cotyledons may sometimes amount to more than a hundred ; and the fatigue is often so great that the right and left hand have to be employed alternately— a circumstance which has advantages otherwise. When a certain number of cotyledons are detached, the portion of envelopes so released is carried into the vagina and beyond the vulva, where the other hand, or an assistant, seizes and pulls gently on it. As the bulk of this increases by the detachment of more cotyledons, the pulling must cease, and the mass will require to be supported so as to prevent tearing the membranes, or painful dragging on the fundus of the uterus. As the hand reaches the cornua the cotyledons increase, and it becomes difficult to reach them — particularly the cormi in which the hind-limbs of the Calf were lodged, because of the insutlicient length ; lii'iiii 1 Is i - 1 672 ACCIDENTS AFTER PAnTURITIOX. il I of the arm. Moderate traction, however, on the part just detached v/ill bring the_ others nearer, and facihtate the task; but the traction must be judiciously managed, so as to avoid tearing the membranes or the adherent cotyledons, invagination of the cornu, or even inversion of the uterus. So likely is this accident to happen, that some practi- tioners, instead of pulling at the membranes in this way in order to disunite the most distant cotyledons, are content to await their natural separation, merely tying near the vulva the portion of the membranes separated, and cutting away the parts beyond — the separation generally occurring in from two to live days. To facilitate traction, Gunther recommends that the abdomen of the animal should be well raised by a plank placed under it, and held by assistants. It has sometimes been found, as already mentioned, that the greater part of the membranes has been expelled, when all at once expulsion ceased, notwithstanding the volume and weight of the pendulous mass, which caused so much disturbance to tlie animal that it has refused to eat, persisted in lying, and when compelled to get up has kept stamping its hind-feet until it could lie down again. On introducing the hand into the uterus, it is discovered that this unusual interruption to the expulsion has been occasioned by one or two large maternal cotyledons becoming entangled in the loop of a fold of the membranes. Sometimes the drag on these cotyledons has been so great that they have been brought as far as, or even beyor.d, the os. Eclief has been given by cutting the membranes off by scissors, close to the vulva, and then releasing the cotyledons. When extraction of the membranes has been properly conducted, there is no haemorrhage ; if bleeding ensues, then one or more of the maternal cotyledons have been injured, or perhaps torn off altogether —an accident not without danger sonietimes, and all the more serious if a number of the cotyledons is involved. This injury may lead, in addition to hajmorrhage, to uterine irritation, metritis, or uterine phlebitis. Still, such an untoward accident is not always the result of injury to the cotyledons, as instances are recorded in which great numbers, or even the whole of the maternal placentic, have been torn away by ignorant enipirics, and yet the animals have survived ; at the commence- ment of this work it has been shown that fecundation and gestation may even take place after ablation of the cotyledons. Nevertheless, these cases nnist be looked upon as entirely exceptional, and should not be relied upon as evidence that these bodies can be injured with impunity. The disaggregation of the placentai has been, in some instances, greatly facilitated by injecting into the vagina, os, and uterus a small quantity (1 to 2 drachms) of tincture of veratrin (1 to 25), which produces continuous expulsive efrbrts, and in a few hours slight traction will remove the membranes. With the same object, some practitioners have successfully injected a quantity of warm water into the uterine cavity. In order to he assured that the whole of the footal envelopes has been removed from the uterus, it is well to make an examination of them.^ Knowing tlieir formation and extent, there should be no diffi- culty in ascertaining whether they are all present. After the removal of the membranes, there remains in the uterus a quantity of thick, grumous, diversely-coloured, and more or less un- RETENTIOX OF THE F(ETAL ENVELOPES. 573 pleasant-smelling liquid, which is derived from the foetal fluids, the blood that has escaped from the umbilical cord, and the partly- decomposed envelopes. As its retention is likely to do harm, par- ticularly if there is any wound or abrasion of the mucous membrane, as much as possible of it should be removed by the half-closed hand. It is often advisable to wash out the interior of the organ with tepid water, and to inject a weak solution of cresyl, carbolic acid, chloral, or permanganate of potass. When extraction of the envelopes has been effected in good time and with the necessary precautions, the Cow bears the operation very well and does not appear to be much inconvenienced, so that little after-treatment is needed. Gentle walking, if the weather is fine, in order to calm its restlessness and to allay the straining, if it is still present ; keeping it in a well-lighted and properly ventilated stable, with a blanket over the body if the temperature is low ; a few enemas, if constipation threatens ; and a light laxative diet, with bran, oatmeal, or linseed gruel, are usually all that is necessary. When the envelopes have putrefied in the uterus, through delay in removing them, and an abundant and fetid discharge flows from the vulva, the animal itself being unwell and feverish, then the case is serious, and requires instant attention. The uterus must be cleared without delay from its putrescent contents, and in order to accomplish this the hand must be passed into the organ, and everything removed which it can possibly seize. Before doing so, however, the hand and arm should be well and frequently smeared with carbolised lard, butter, or oil, to prevent septic infection ; if there are wounds or abrasions upon them, the greatest care should be taken in this respect — indeed, it is questionable whether they should be introduced at all if the skin is not intact. When everything has been taken away which the hand can remove, then the interior of the organ should be thoroughly cleansed by the continuous injection of tepid water from a large syringe and tube, until the fluid comes away perfectly clear. Very weak solutions of the before-mentioned antiputrescents should also be injected, but they need not be allowed to remain. Should the discharge continue, this treatment may be repeated daily until it ceases ; and tonics, stimulants, and antiputrescents (as sodium sulphite or small doses of carbolic acid) be administered internally. Good food and clean- liness are also essentials in treatment. It must be remembered that cleansing and detergent injections are absolutely required when the mucous membrane of the vagina or uterus is inflamed, abraded, oi wounded, and has been in contact with putrid membranes or fluids. More particularly are they necessary when ^ this occurs in the Mare — an animal peculiarly liable to septic infection. Indeed, so much is this the case, that it may be laid down as a rule that manual extraction of the membranes is always indicated in the Mare, when they are not expelled immediately after birth. The injection of warm water will materially facilitate the operation. With this animal, however, retention of the placenta does not in- variably load to serious results, as several cases are on record in which it has continued for two days, and even longer. Binz mentions an instance in which the membranes were not thrown off until the ninth day, owing to adhesion of the uterus to a hernial sac. The hands and arms of the operator should be thoroughly washed 574 ACCWENTS AFTER PARTVniTlON. as soon as possible after the uterus has been emptied ; for this purpose nothing is better than carboHsed soap. On the slightest sensation of uneasiness in the arm, advice should be taken with regard to it, as an attack of Ecthyma j^nt'titritionis is often &, serious affair, and has necessitated the amputation of fingers, and even the greater portion of the arm. So dangerous and unpleasant, indeed, is the removal of a putrid placenta (the odour being often most sickening), that disinfection by intra-uterine injep^-'ons of scluLion of cresyl, carbolic acid (2 per cent.), boric acid, con- Mimate (1 to 2,000), etc., is regularly practised by some veternfc. ^eons. The interior of the uterus is first washed out with warm wi.* . . by means of a powerful syringe, or a long india- rubber tube to which a funnel is attached, and into which the water is poured. The injection is continued until the water that comes away from the vagina is colourless and odourless ; then the disinfectant can be thrown into the uterus, and the arm introduced to remove the placenta. But the latter measure is rarely necessary, as the injections generally suffice to detach it. As the practitioner is also exposed to septic infection by inhalation, and as this has occurred most frequently while fasting, it is advisable to fortify the body against this risk by taking some food before pro- ceeding with the uterine evacuation and cleansing. ii, ';:'. CHAPTER IT. Post Partum Haemorrhage. H^MOBUHAGE from the uterus or " flooding," after abortion or the birth of the foetus at the ordinary term — an accident so frequent and alarming \u woman — would appear to be far from common in the domesticated animals. This difference between the female of the human species and that of animals, is evidently due to the dissimilarity in organisation of the uterine mucous membrane in them, particularly at the insertions of the i)lacenta fu'talis ; as well as to the absence of those immense vascular lacunar which exist in the uterus of woman, the walls of which are so thin and fragile as to be easily torn when the placenta is detached, and which renders insufficient contraction of the uterus after delivery such a grave matter. Another reason for the infrequency of metrorrhagia in the veterinary obstetrist's patients, is the great rarity of placenta pravia in them,i and which is a somewhat common cause of hatmorrhage either during or after delivery in woman. Nevertheless, whether owing to some anatomical or pathological peculiarity, to atony of the uterine walls, rupture of vessels during removal of the fa>tal placenta, or even during its spontaneous expulsion, almost every practitioner of any experience has met with cases of metrorrhagia of a more or less alarming character. So serious, indeed, is this haemorrhage, that the mortality has been estimated as high as 73 per cent, of the cases reported. At p. 197, metrorrhagia was alluded to as occurring during pregnancy. ' Franck (Ilandhiich de. ThieriirztUchen G ebnrfs/iiiljle, And Zeil.^chri/tfiir Thiermedicin) has clearly demonstrated the occurrence of placenta praivia in animals. At pp. 87, 88, reference has been made to it, and cases of it are frecjuently mentioned in veterinary literature. '■^Muiimnvm'*! POST PARTUM HAEMORRHAGE. 576 bhis purpose sensation of [ to it, as an ir, and has sr portion of of a putrid nfection by I per cent.), y practised first washed , long india- li the water 3omes away ifectant can remove the e injections inhalation, is advisable before pro- tion or the requent and non in the aale of the lissimilarity particularly ) absence of of woman, ■n when the jtion of the 3on for the patients, is ii somewhat ^in woman, pathological ;sels during s expulsion, th cases of ous, indeed, 1 as high as ; pregnancy. Thlcrmedkin) At pp. 87, 88, I in veterinary In what Cox has designated " pre-placental presentation," * we may have hasmorrhage ensuing. According to this authority, such pre- sentations are rare, and if they occur at the termination of gestation maybe looked upon as unfavourable ; though they are most frequent in cases of abortion, and are then seldom followed by serious results. Metrorrhagia ensues when the usual period of parturition has been exceeded, and the " water-bag" has been presented and ruptured, the entire placenta fcetal is coming away before the foetus itself. " In some cases, a considerable portion Df the membranes envelop the fore- parts of the foetus, and occasionally to such an extent as to retard delivery ; this may be shredded oii" and removed without risk, but it will be found that the posterior portion remains attached. The fatality attendant upon these cases is due to neglect of examination and proper aid, and this negligence, again, is owing to the absence of 'pains.' After the removal of the fcjotus, it is found that haemorrhage has taken place from the open vessels, and the quantity of blood indicates that it commenced immediately after separation of the placenta. I have seen these cases only in cattle." In certain instances there can be no doubt that, as in woman, insuf- ficient contraction of the uterus is a cause oi 2^ost imrtum ha3morrhage ; and, according to Schrccder, this atony of the organ is especially observed after a rapid emptying of its cavity, whether artificially or naturally produced, also after a previous and very considerable disten- tion. It therefore occurs in her after very rapid delivery, too early turning and extraction, in hydramnios, and at the birth of twins. The haemorrhage is sometimes also due to general debility, and feeble development of the uterine muscles — either congenital or depending upon previous very difficult labours. Partial adhesions of the placenta to the uterine wall, which, howevei-, are rarely caused by real connec- tive-tissue bands, may also give rise to profuse hfemorrhage, as the separated places in the vicinity of the adhesions can only imperfectly contract. Symptoms. The symptoms of post partum htcmorrhage are not well marked unless the bleeding is visible, though they are those of profuse haemor- rhage in general. There is the quick, weak, running-down pulse, which becomes imperceptible as death approaches, and the throbbing, irregular contractions of the heart ; the decoloration of the mucous membranes, rapidly increasing prostration of the animal, with the unsteady stagger- ing gait on movement, and the difficult}^ of maintaining the standing position towards the end ; the haggard fades ; with chilliness of the surface, cold clammy perspiration breaking out over the body ; and, finally, the recumbent position, convulsions, and death. Sometimes there are indications of abdominal pain — indicated by paw- ing and looking anxiously at the flanks ; but these indications are only likely to be present when the htemorrhage is due to traumatic influences. When the haemorrhage pier vnlvam is discernible — coming away in a fluid condition or in masses of clots — then, of course, there can be no difficulty in diagnosing the accident ; but when it is entirely internal, the manifestation of the symptoms above indicated should give rise at once to a suspicion of the state of affairs, and lead to a manual explora- tion of the uterus. ^ Veleriiiary Jonnial, March, 1877, 'p. i7S. ilPffli!! L«.._.JIJt I ^^PPw i' -< i .176 AOCWEXTS AFTER PAKri'lUriON. Treatment. The essential indication in the treatment, is to suppress the hiemor- rhago as speedily as possible ; the next, to sustain the vital powers of the animal. If the foetal membranes have not been expelled, they must be re- moved without delay — yet as gently as possible; for until their removal is effected the uterus will probably not contract. The contraction of the organ is very important, and when the membranes are present it often happens that the manipulation required to remove them brings about this result. If the membranes are not present, then the hand and arm nmst be pushed into the uterus and gently moved about, in order to excite contraction, if the organ is flaccid anduncontracted. At the same time its interior should be freed from the blood and clots it may contain ; cold-water douches must be applied to the loins and vulva, as well as injections of the same into the uterus. If deemed necessary, a towel, or sheet steeped in cold water, or a large sponge impregnated with vinegar-and-water, perchloride of iron, or any other styptic, may be passed into the vagina, or even into the uterine cavity. Should the haemorrhage persist, revulsives in the form of mustard cataplasms or stimulating liniments may be applied to distant parts of the body — as the chest, neck, or limbs. Internally, tannic acid, salts of lead and n.orphia, perchloride of iron, tincture of ergot of rye, or any other agent likely to act as a haemostatic, may be administered. Hypodermic injections of morphia have been recommended, and large doses of oil of turpentine — for the Cow from three to five ounces, mixed with the contents of half a dozen eggs — have been successfully employed by Macgillivray. CHAPTER III. Inversion of the Uterus. Inversion, proculcncc, jn'olaj^sc of the uterus, or rciglno-uteral inversion, signifies a displacement or kind of hernia of the organ, which is partially or completely turned inside out — the inverted fundus escaping through the OS uteri (partial inversion), vagina, and vulva, and perhaps descend- ing as low as the hocks [comidete inversion), where it forms a more or less voluminous tumour. When the inversion is very partial, nothing whatever is seen exter- nally, and an exploration alone reveals the existence of the accident ; if more developed, the uterus appears as a round tumour between the labia of the vulva when the animal is lying, and especially if the floor of the stall slopes backwards, which causes the gastro-intestinal mass to press upon the organ. Sometimes the procidence is so very slight that there is merely a bulging inwards of the fundus of the uterus, or of one of the cornua. In complete inversion there is frequently prolapsus of a portion of the vagina, which appears in two forms or degrees, according as there is inversion of the body of the uterus, or inversion of the cornua as well ; sometimes it is only one cornu, which is then deviated to the right or left of the vertical direction of the body of the organ, just as it happens to be one or other of these parts. If both cornua are completely inverted, they terminate inferiorly in the form of a cone ; but if they are INVEnSION OF THE UTERUS. he hoDmor- powers of mst be re- 3ir removal traction of present it lein brings I the hand 1 about, in racted. At nd clots it loins and If deemed rge sponge any other ine cavity. )f mustard it parts of acid, salts rye, or any •ed. inded, and ive ounces, uccessfully inversion, is partially ag through )s descend- a more or leen exter- ccident ; if jtween the the floor of lal mass to slight that , or of one L'tioii of the IS there is la as well ; le right or it happens completely if they are only incompletely so, then they remain cylindrical at their lower end, at the centre of the cylinder being a depression or ccecal cavity. Inversion of the uterus is, of course, only possible when the os uteri is dilated ; consequently, it occurs either immediately before or after birth. Again, inversion is simple or complicated. It is simiAe when the viscus is intact, uninjured, and not accompanied by the extrusion or displacement of any other organ. When it is wounded or torn, or wlien there is accompanying hernia or protrusion of other viscera, then it is comiMcated. As we have said. Ruminants are most liable to this accident : the Cow coming first, then the Sheep and Goat ; the Mare is less fre- quently affected, and the Sow and Bitch perhaps not so often as the Mare. Inversion of the uterus has been observed in the Cat and Rabbit. With the Bitch and Sow, incomplete inversion of the uterus is far from uncommon, as is also simple inversion of the vagina, for which it might be mistaken. In uniparous animals the whole of the organ is usually inverted ; while in muciparous creatures, generally little more than the portion which contained the foetuses is involved. The accident has been observed in animals kept in houses and stables, as well as in those roaming about at liberty ; and it has been known from time immemorial. The Roman veterinarian, Vegetius, alludes to it, and recommends the employment of an inflated pig's bladder as a good pessary. Symptoms. The symptoms of uterine inversion vary with its extent. With uniparous animals, inversion always commences at the fundus of the organ, most frequently towards the largest cornu where the greater portion of the foetus was lodged. Underthe influence of an irregular, and kind of spasmodic contraction, this part is drawn or pushed in- wards, just as the foot of a stocking is inverted ; and this action con- tinuing, the fundus or cornu is more or less rapidly carried towards the OS, through which it passes into the vagina {incomplete inversion), dragging after it the body of the organ, which also becomes inverted as it proceeds. It is rare indeed that inversion does not go beyond this ; for the con- siderable alteration in position and relations which has already taken place gives rise to sensations of discomfort and pain, and these re- act on tlie nervous system, inducing contraction of the uterine and abdominal muscles. Powerful and hurried expulsive efforts ensue, and soon the organ is pushed beyond the vulva, where its own weight carries it downwards, and renders the prolapsus co??i2;Ze I I! I, ii 584 ACCIDEXTS AFTER PARTURITION. tie CO vledoC pn^T*^.'^ ""T^ ^^ ^^^'^^""^ ^^^^^^'^ without injuring described TrAvf^""^'"." ^^'"8 ^^^^^^^ i" the manner alreadf hZorlLJ 117 f^ performed, this removal should not cause any hX? tn f ' . any pulpy gangrenous cotyledons are found it is eliminated rth.' T "' °"'' T*^ ^«'«^°^^ '^^" ^^^^^^ them o be tir need not h. T'"? ^^^ ' • l^°"Sh if they show any vitality at all cney need not be mterfered with. Torn or gancrrenous norHonQ nf ThTsXr tr^"" ^^f ^?.^^ ^'^^^-^ - theCne manne^r " °' surface sShn«''lH^ should be cleansed from matters adhering to its hv mpn7« nf T "f ' ''^''^' ^''^' ^^^*h °^' blood; this may be effected cold o, . % ^ ^T ^°f^fPO"S« or cloth, the fluid employed bein' either 'f here is^nf„rif'r'' T^V """^ ""*^^' ^°'"^ astringent or^soothin| lot on iiinf J r . tumefaction or irritation, or a stimulating fluid-as the Some nSjo °' '^^""-^^ '']' °'°^^^ ^^ "^"^^ bruised and ongested eiTlwof Tlit i''V"""T' '^^' ""*'^'^ uterus in a bucket containing the or°an fn ^"^^.^= .^"? r"« particularly prefer cold water, allovv n| meansit k f^.ITJ''"' '" /^ ^°'' "' ^°"S as five or ten minutes. By thif "Xn s Ula^5^ 3 ^f ^^^"^'^"^ '"^tters and cleansed ; while thJcon „escion is allayed and the mass considerably reduced in size i Mever WnnTl '"'"^ «■'^''' ?^*" ^'^''^'^ this immersion in cold water has S astomshmg effect, and gi-eatly facilitates reposition. Schnee oven recom mends the application of ice, which, he asserts, not only din^n'shes the WheraU^m.trifo'r'^^ in S hIS" a|plii^1rtle^\r ^ '' ^''''''' ''' ^""''^ ^ ^'^^ ^' ^- mnimZlioTfhlTr'''''' ff. consequent congestion, infiltration or When the organ is so increased in size that it cannot be returned it iSlLuempted " """'■ """^ '""'' ''^ """''^^ f™"' " before redue- the a.iiiiial in a standing attitude" nnri n, ^- ''f ''"^^, ^"-^ '"ainly dueoteU to keeping or torn, as well a.s sSn Tl^'or^^fn '^.'^r H?, the uterus from being soiled, bnLed by receiving it on a sheet or arL-e^^tHr T f' ^ ''".•n"'*"!^ f*-*"" injury it wen raised until profersLlialtsYstant'arrivea '" '""' " '"'^* '' *'-^^' '^"^ "^^P'"'' Journal dts Vmrinaires du Midi, 1862. INVERSION OF THE UTERUS. 585 lOut injuring ler already t cause any found, it is them to be itality at all portions of er. liering to its ' be effected 3eing either hing lotion, uid — as the congested. containing er, allowing s. By this ile the con- 2.^ Meyer, ter has an 3ven recom- linishes the )ntractions. )iece of ice Itration or ' it appears ace ; these ay then be ;st circum- st be quite lage prove 5 are deep eturned, it intestines e inverted fore reduc- uterus has and cle-^.n to thirty ! up to the f the ends the entire t. Tepid gradually it advantagu terns, btfoie I to k^eJ)ing iled, bruised from injury md keeping tightei-jd every minute, by placing the open hand beneath the mass, and with the other hand pulling at the upper end of the wrapper. This equable, gentle, and sustained pressure over the entire organ in fifteen to twenty minutes brings about a marked diminution in its size, and renders its reduction easier. Esmarch's india-rubber bandage has been suggested to overcome the uterine congestion in these irreducible cases, but there is no record of its having been tried. If the uterus is torn, it may be necessary to close the wound by the continuous suture — but this must not bo drawn too tight, mere apposi- tion of the edges being all that is necessary. If the wound is not exten- sive, it need not be closed ; indeed, there are many cases on record in which wounds of the uterus have not been sutured — the organ having been merely returned to the abdominal cavity, and yet recovery has taken place. Careful washing with a weak solution of boric acid is perhaps the best course to adopt before reposition is attempted in any case. If hernia of the intestine or any other viscus is present, then, of course, this must be reduced before the uterus. Eeduction oh Eeposition. — Wlien inversion of the uterus is incom- plete — a very rare occurrence — and the organ has not passed beyond the vagina, reduction is cou\paratively easy. It is sufficient, with the larger animals, to introduce the closed fist into the vagina, and to push the uterus as far into the abdomen as may be deemed necessary. When the animal strains, the operator must not push, but maintaining what he has accomplished as well as he can, recommence as soon as the expulsive effort has ceased. Whether inversion is complete or incom- plete, and if the animal is standing or lying, it is always well to have the hind-parts higher than the fore. When it is complete, then four assistants are generally necessary. One of these stands at the animal's head, and holds it firmly — if a Cow he may seize it by a horn with one hand and nasal septum by the other; if it is a Mare, a twitch on the nose or ear may be required, and it may even be necessary to have a side-line on one of the hind-limbs Another assistant holds the tail over the croup with one hand, and with the other he presses or pinches the loins in order to diminish the strain- ing ; while a man stands at each side of the croup to aid in raising and returning the uterus. It is well to attract the animal's attention as much as possible, as it then offers less opposition to the manipulations, and does not strain so violently. Pinching the nose and loins will be found very effective in this respect, and if a Cow, a Dog may be intro- duced in front of it. Should the animal be much exhausted or un- steady, two additional assistants may be required to stand at each side. The uterus must be placed on a cloth or sheet in two or three folds and well moistened, the ends being held by the two assistants at the croup, so that the organ may be lifted as high as the vulva. By doing so, there is neither traction nor compression on the mass, and as the circulation in it is thereby nmch facilitated, the tumefaction subsides to a corresponding degree. It also allows the operator more freedom, as he could not sustain the weight of the prolapsed organ — which is some- times as much as 100 to 140 pounds — and at the same time attempt its reposition. Indeed, some practitioners recommend that the two corners ill \m h ! I {ise ACCIDENT a AFTER I'ARTUltlTIOX. ?m,n^ fho ^} f u°*^ °" ^^^^^ *^e "*«ru8 ^8 placed, should be tied \T^?A,t °l'^^ assistants, so that their hr.nds may also be free would im„li?T '" i^ia manoDuvres : though the device must, one wf '""fSine, have more disadvantages than conveniences. timp« h"„i^! ^""T '*'^'"' y^^y '^^^'^ly ^"^ continuously-as some- as f?n.K^P during reposition-it is useful to constrain the chest nmvpvi I' ^°'''^'^ ^y "- S^'*^h' '° a^ t° P^^^ent its expansion. It ODium nr h "^"'f f •V'^ ^^"^^ ^ '^'°"- ^"°^>'"« *^^'^"g^t «f chloral or S 4 a/ ^^ .°^ ^^''"^"^ suHicient to produce semi-narcosis. Indeed, chlnrnW, ^^''^' /^^^ '^'^/o"^ c^ses it is most advantageous to administer attemnHn ^^\. A^' !u '''^^' *° P^'"^"'^^ ^^^^^^^ anaesthesia before attempting to handle the uterus. For effecting reposition, two methods are recommended, and these we TL1^7 notice-merely observing that, whichever be adopted, the iWpL! ^^' ^^""T ^"^"^^ directly behind the animal, with the mverted organ nnmediately before him. JinUMethod.—li the inverted tumour formed by the uterus is not very yoluminous, and if by the application of cold water to it-should nLco .?"'.* IS reduced in size, then reposition may be effected by pressure on the fundus of the organ. This pressure is to be made by the closed fast _ against the central part of the tumour; and in some ms ances, if it is well directed, and the inversion not serious, the organ Sy'it intoTe'abCeV^^"^ ^'"^^ '^ °"^ ^"^'' "^'^^ ^^°'^^^ -" Eainard and other practitioners approve of this method, and describe t somewhat in detail. The oj ,rator is to seek for the largest cornu- bv nusS'r^^'""^^*^" footus-seize it by the fundus, and\educe this bLrtm3 if T ' ""' T' '"^"^^ *^^ ^"Ser of a glove which has untn fhp fil 1 IVi!"":"""*^"^"^^ *^" reduction by successive portions 1. P Pn^fnf !?f °^ *?u *""^°"^>« ^-^'^ched, when more serious resistance itprn? •« ? ^"''''^ ^^^ °' V*""" ^^^''' *^^*"g overcome, the body of the n J n, K "'"'•'^P^^'''^' "'*^'"' ^y *^^^ fi^* Pr^««i»g against the widest &S ^J "''"if.u P^r^y- .^^" P^^«^^^-^ i« to le directed straight forward, through the vulva and pelvic canal, upwards and inwards. be applied while the animal is straining. During expulsive efforts the operator must be content to wait, merely keeping the parts where he ^teldv'and ^Tl"'."""; *^ straining has c'eased' ^The prLsure must be steady and well directed, so as not to bruise or lacerate the uterus. Sp ft P°f '"'' '' ^""^ T^''"" ^^^ ^"^^^' i* ^« l^'-^ld there by one hand, m if bp'pff f' i"^"^P"lates the next part to be returned."^ Reduction reSced -f iff. nrfi^''''"^'^^' '° -^^^^ *^" °^"«^" "^^y ^^ ^onipletely replaced , it it is not, then re-inversion is certain to occur borne practitioners employ the pad or cup-shaped pessary, to aid them in this operation ; the round end is applied to the fundus of the uterus^ and pressure is made at the other end of the instrument by the ches or abdomen of the operator, whose hands are thus at liberty to direct the viscus into the vulva and vagina. Second Mcthod.-Ii the uterine tumour is voluminous, and hangs fm^'f^^ u"^ ""% " '°''^'' ^^'^" ^'^'' ^'^^ ^"«^'^od is dangerous, if not S^^\ : ^"? '''^1 "°^ ^^ attempted. The best method now un- nni.M- '" .1° ''^^''?' ^/^\ ^'" 1'"'^' ''f ^^"^ «'■!/«» '*^«^««^ the vulva, and not act directly on the fundus of the uterus until the greater pokion has been replaced in the pelvis. ^ lould be tied Y also be free ce must, one 8. y — as some- in the chest pansion. It of chloral or sis. Indeed, o administer hesia before md these we idopted, the lal, with the iterus is not ) it — should i effected by be made by nd in some s, the organ another will i.nd describe ;est cornu — reduce this which has ive portions 8 resistance body of the the widest ed straight iwards. should not ! efforts the >s where he ire must be the uterus, one hand, Eeduction completely ;o aid them the uterus, ' the chest ;y to direct and hangs •ous, if not )d now un- viilva, and ;er portion INVEJISION OF THE UTERUS. 537 In order to accomplish this, the assistants on each side of the croup raise the uterus in the manner already described, so as to bring it near the vulva, and opposite the axis of the pelvis. Then the operator gently presses with open hands at each side on the parts close to the vulvar opening, in order to force them gradually into it. By acting in this way with care and patience, and preventing, as well as he can, the expulsion of those portions he has already reduced, the tumour by degrees becomes diminished, and may even be entirely returned. But it is not necessary to continue the method after two-thirds or three-fourths of the total mass has been carried into the pelvic cavity ; for it is then more ex- peditious, and quite as safe, to apply the closed fist to the extremity of the tumour, and push it directly into the vagina and abdomen. In some instances it will be found that, towards the terminai.on of reduc- tion the organ itself returns to its normal position, and often quite suddenly, as if it had been thrown forward by a spring. Sometimes a combination of the first and second methods is most useful— an assistant pressing on the extremity of the tumour, while the operator manipulates near the vulva. When the uterus has been returned to the abdominal cavity, the operator has then to ascertain if it is properly disposed. It sometimes happens that the extremity of one or other of the cornua remains invaginated in itself to a certain extent, and thus renders reduction incomplete; this will undoubtedly induce renewed straining, and in all probability bring about re-inversion. It is, therefore, essential that the hand of the operator should carefully examine every part of the interior of the uterus and the genital canal, and particularly around the cervix. '' This is more especially necessary when, after reposition has been ettected, straining continues— a sure indication that the parts are not in their normal position. The hand must be again introduced, and if any abnormal folds of the mucous membrane— any commencint^ inva<^- ination— is encountered, they must be gently smoothed down or adju^ te°d —not forgetting, should the cornua be involved, the very dissimila- dis- position of these in the Mare and Cow. When reposition has been finally accomplished, the straining ceases, and the animal soon appears to be quite easy: that is, if reduction is inade early— on the same day, for instance— and provided there is no injury to the organ. It is generally advisable to keep the hand in the uterus for a short time until the latter begins to contract freely ; if this IS not done, the flaccid organ may again become inverted. With the smaller animals, reposition is rendered diflicult because of the pelvis not admitting the hand ; and with some of them, and par- ticularly the Sow, reduction of the prolapsed cornu or cornua is often a serious matter. The cornua must be reduced in the manner already indicated, the finger, or even a tallow candle, being employed to adjust them, then the body of the organ should follow ; a small pessary with a handle, or retroverter, may be used to complete the operation. Frick.i a Swiss veterinarian, has adopted a plan which has succeeded in his hands, and also with other obstetrists who have tried it. The inverted organ being reduced, the animal is raised by the hind-limbs, and a quantity of mucilaginous fluid is injected into the vagina and uterus, until they are filled. This fluid acts in a mechanical manner, forcing the uterus to distend and assume its ordinary form. It has been ' Sclncfizer Archiv., vol. xii., p. 2-19. i'if < i J. .,„ IIIJ! i !■ |i . i; ''SS ACCIDENTS AFTER PAIITURITION. ammalT^ *^^* *^^^ distention plan should also be adopted for the larger It should be observed that reduction has been effected in large and v^rnLrr !^y elevating the hind-quarters until they are almost vertical, the weight of the uterus, with careful manipulation on the part 01 tne operator, carrying it down to its normal situation. Betention OP THE Utehus.— Eeduction of the inverted uterus having been accomplished, and everything done to remove the slightest traces oi mvagination, the animal— unless serious injury has been inflicted on thQ organ— immediately begins to look easier and happier, and the inex- perienced would suppose that there was no further occasion for inter- lerence 1 ne experienced obstetrist, however, is well aware that certain precautions must be adopted against a possible recurrence of the accident irue, this recurrence is to a certain extent provided for by raising the croup of the animal as high as may be convenient, either by means of litter or boards, and keeping the forehand low. But this is not always a preventive, and veterinary obstetrists have therefore devised other means lor retaining the uterus in its place until all risk of another inversion nas passed away. These devices consist of pessaries, sutures, and li Fig. 210. Pad Pessaky. Pessaries. — These are instruments of various forms, which are intro- duced into the genital organs, and kept there for a certain time in order to prevent displacemc it of the uterus after its reduction. There are several described and used by veterinary obstetrists. The 2)ad ])essar7j (Fig. 210) is a round piece of wood, from twenty to owenty-five inches in length, with a hole at one end, through which passes a loop of strong cord six to eight inches long ; at the other end IS a round pad, three or four inches in diameter, composed of tow or ^^°n' ?°^^^'e? ^y ^ Pi^''^ o^ soft cloth or oiled silk, and firmly tied to the stalk by a piece of twine fixed xi a small circular groove therein. In using this pessary, the pad is steeped in oil or melted lard ; it is then carefully introduced into the vagina, placed against the cervix uteri, and cords from each side of the loop at the other end, attached to a surcingle round the chest, keep it firmly in its place. The pad por- tion of the pessary may be of wood, though the elastic material is to be preferred. A transverse piece of wood, with an eyelet at each end, and made to move up and down the handle by means of a screw, is sometimes substituted for the loop of cord. _ This pessary may be most usefully employed as a repositor, in effect- ing reduction of the inverted uterus. The ring pessary (Fig. 211) is equally simple, and is preferred by some practitioners to the pad one. It is composed of a wooden, or better, an iron ring, about two and a half inches in diameter, pierced by an elongated or mortised hole at opposite sides, and of a strong wooden Dr the larger 1 large and are almost . on the part ;erus having htest traces inflicted on ad the inex- n for inter- that certain he accident, raising the y means of Lot always a ither means ^r inversion itures, and 1 are intro- ne in order There are twenty to ugh which other end of tow or tied to the •ein. lard ; it is the cervix I, attached le pad por- ial is to be li end, and sometimes •, in effect- iferred by ifooden, or pierced by 3g wooden INVERSION OF THE UTERUS. 589 stem about twenty inches long, cleft in two as far as the middle, where it is tied by a piece of twine or wire. The ends of the two branches (A A) are firmly tenoned in the mortises of the ring ; and the other end of the stalk (B) is flat, and passes through the central opening of a transverse piece (T T), which is about eight inches long, and has at"each end an aperture (0 O), in which are fastened the cords or straps destined to fix the apparatus. When required for use, the ring is wrapped in a narrow piece of fine linen, which is rolled round it in a uniform manner, so that it may not irritate the neck of the uterus, with which it has to come in contact. rig. 211. Ring Pkhsauy. Fig. 212. Clp-axd-Ball Pessauy. This part is well oiled, and being passed through the vagina, is so placed against the uterus that the cervix will be in the middle of the ring, which should make pressure on the cul dc sac of the vagina. It is secured by means of cords or straps at the end of the transverse portion, in a similar manner to the other pessary. The Cup-and-hall pesmr// (Fig. 212), invented or first described by Chabert, is not unHke the last. It is composed of around iron or steel ring (A A), about the same in diameter as the other ; from this arise three stalks (B B B) ; these unite about six or seven inches from the ring into a single stalk (T T), which is screwed from a little beyond this 590 ACCIDENTS AFTER PARTURITION. 11 : [: ("c crbV!ismiddle^o"nin-' ^''^T^ P°^-''°" ""^^^^ ^ ^^'^"^verse piece ings G G aU s extrTSf """wT^^ '■''''' ^^^^ ' '^'' ?'««« ^as open- To u^^LlhlTl^T "^^'"^ ''^°«^v« straps or cords, then cooled and Sntf ' ^^^^^ branches are'dipped in n^elted wax. ment has acqu"red^fl «,fffl • T'" f 'P^^*^ ^"*^ ^°°^^^^' """' ^^e instru- reduced L Snnf suflhcient volume, and the middle of the ring is gen^Morl^^^^^^ " half inches This prevents its injurSg'the precedinTpessarv th«-^-^ ? exactly m the same manner as the A " ? pessary— the cervix uteri being n the centre of thp rina 4tS=?i-- «) '^ rates:.-- - suitblf vi TZ ^^' ^^q"«"*Jy ^one good service, when nothing more n,|h b 'empWeTth : tlsTt^^''''^ '^'^ «arfelTair pessary ; ? i. . .'"F^^.y'^'*- J- nis acts on the same m'lncinlp ni;er commissure ; it is then passed through the left lip, from within to without, towards the inferior commissure. It is then cut from the suture, sufficient of the latter being left for both ends to tie in the middle of the vulva. A second suture is placed in the contrary direction —upper part of left to lower part of right lip— so that the two sutures cross each other obliquely, in an X fashion. The ends are now tied towards the centre of the vagina; and, if thought necessary, a third suture, directly transverse, may be placed between these. It is more convenient and painless to pass the needle first throut^h the tissues, then the suture through the eye of the needle, withdrawing the latter, which carries the suture with it. This labial suture is painful, as it is placed in textures already swollen and sore, and it does not always retain a sufficiently solid hold to pre- vent the uterus tearing it out when the straining is very severe and violent. The hip suture has therefore often been resorted to in these iitr 092 1 AVaWENTS AFTER PAUTUHITIOK. cases, and with advantacre. The needle— either the above or a small seton needle- 18 passed through a fold of skin lifted up at the point of the hip or ischium, on a level with the upper commissure of the vulva and carried across to the other ip. The next suture is a trifle lower,' and the others below tliis : there being, in all, about four to six sutures' the ends of each being tied in the middle, or fastened to bits of round wood at each side. In this way the vulva lies behind a number cf strong cords — their strength and durability being in proportion to the width of skin they are made to enclose. The sutures may be drawn more or less tightly, and they maj either be transversely parallel or cross each other obliquely. When the animal is not pregnant, the vulva is not nearly on a level with the ischial tuberosities. After parturition, however, it is swollen and prominent, and projects beyond these parts. It will therefore press against the hip sutures, and may even become excoriated or cut by them ; so that, to avoid injury and diffuse the pressure, it is well to place a thick pledget of tow or other soft material on each side of the vulva, on which the sutures may chiefly rest. Though good service has been obtained from these sutures in a number of instances, yet many practitioners prefer the metallic suturr This may be of lead, or iron wire softened. The needle is like that used for the otlier sutures ; a pair of wire-pliers is necessary, and two sizes of wire are recommended. The thickest size is cut into pieces of a convenient length, and an eyelet turned at one end, while the other is made into a hook. The left lip of the vulva is seized by the left hand, and the needle pushed through it from the outside, a little obliquely upwards, so as to bring it out above the superior commissure ; the wire is passed into the eye at the point, and the needle bein^ smartly withdrawn, the wire is pulled through. The needle is intro° duced into the right lip in the same manner, but downwards, and the wire pulled throu[.,^h it. The hooked end is now passed into the one with the eyelet, drawn sufficiently through, cut off, and the end bent also into an eyelet, the suture constituting an ellipse at this part, which is opposite the vulvar opening. Beneath this suture one or two more are placed, and all are joined together by the thinner wire, which, doubled, is longer than tiio space occupied 'by the sutures ; each piece is passed into each eyelet of the upper suture, and firinly crossed and twisted as far as the two points of the suture ; tlie same is done with the second and the third -luture— the whole being joined into a solid piece, which, according to report, does not interfere with the physiolo- gical functions of the animal. The same objection applies to wire sutures through the vulva as to vegetable sutures ; but there can be no doubt that they are less painful and more effective when passed through the skin at the point of the hip. Two wires across are generally sufficient; the ends are bent round by pliers after they are inserted, and through these eyelets on each side a vertical wire is passed (Fig. 213). This keeps the horizontal wires together and in place. Metallic sutures in the form of pins, screwed at one end to fix into plates after being passed through the labia of the vulv.a, .and other con- trivances of this description, have been described ; but in principle they are all the same, and there is no manifest advantage in their employment. In fact, it may be said of all the labial or other sutures, that they in INVERSION OF THE rTEUUS. SQS or a small le point of the vulva, •ifle lower, ix sutures, 3 of round number cf )portion to y be drawn parallel or on a level is swollen efore press or cut by is well to iide of the tures in a llic sutur/" i like that ^ and two ) pieces of the other by the left e, a little cnmissure ; edle being e is intro- s, and the the one end bent )art, which two more ire, which, 3ach piece ossed and done with to a solid physiolo- ulva as to 3SS painful lint of the bent round 1 each side ntal ■^vires bo fix into other con- i principle [e in their lat they in no respect prevent the inversion of the organ internally, but merely hmder its escapmg beyond the vulva ; and as their utility depends not only upon the material of which they are composed, but also upon the W" ' f iW i$J Fig. 213. Zundel's Labial Soture8. ' t integrity or power of [resistance of the textures through -.vhich they pass, it often happens that they either give way, or they " tear out " prematurely, leaving sometimes troublesome wounds or cicatrices. Fig. 214. The Loop of Delwaht's Truss. Jt must not be forgotten, too, that even under the most favourable circui^stances, these sutures, both during their insertion and their maintenance, are a source of uneasiness and pain to the animal. 38 594 ACVIDKNTH AFTER PAHTUUITWX. ^w Bamhujes or T/^sses.-To dispenao with tho inconveniences of the pessary and suture, the bandage or trms has been proposed and oxten- sively employed ; and ni tho great majority of cases of uterine inversion, shouW be adopted in preference to the other methods of retention. ine truss or bandage may be composed of cords, surcingles, leather, canvas, etc., which are so arranged and disposed as to make pressure upon the sides of the vulva, and, by keeping it closed, prevent the ox- truBion of tho uterus without interfering with defecation or micturition Ihere are several kinds of truss in use, and these vary somewhat in tlieir details though in princiiilo they are tho same. Some of them are nxed around the shoulders and neck, others round tho chest only, and others, again round both regions-most frequently to a collar or surcingle Allusion will bo made to those which are recognised as most valuable ' Fig. 215. Delwart's Truss applieu. Two of the most useful and readily-made trusses are composed of light rope orthick cord-something like a clothes-line. One of these IS termed " Dehvart's Truss," and is formed by cords united by a loop in their middle, in such a manner that an oval space (a, Yia 214) sufficient to admit the vulva, and compress it laterally, is formed-tlie inferior conimissure being left free, to allow the escape of urine, and uterine discharges, should there be any. The two portions of oAe of the cords {h h) passing over the back, are secured to a collar or band round tlie neck or chest ; while those of the other cord {c c) pass between the tnighs, and are tied to the lower part of the collar or surcingle in th3 manner depicted in Fig. 215. The loop may be wrapped in tow m- ciotn, to prevent chahng to the parts under the tail Another rope truss, described by Eenault.i is perhaps more simple, yet quite as, if not more, effective than the preceding This is com- ' MaUon RuHtique du XIX. Siicle, vol. ii., p. 286. Slices of the and oxten- 10 inversion, 'etention. ;le8, leather, ke pressure ent the ox- inicturition. )mewhat in of them are t only, and 3r surcingle. i valuable. INVEHSIOX OF THE UTERUH. 595 posed of a leather strap which buckles round the neck, and a rope from twenty-four to thirty feet long— the thickness of the little finger, or a tntle less, according to the size of the animal. The neck-strap is not indispensable, though it is useful in giving more firmness to the truss ■ It may be replaced by a thicker rope, or in the case of the Mare by an ordinary draught collar. ^ In order to apply tho bandage, the neck-strap or collar is first to be put on ; the cord is then to be doubled in equal parts and put across the back, behind the withers, so that each portion may fall behind the shoulders, to be passed under the chest. In front of the chest, the two portions are crossed, the lei't passing to the right and the right to the left. Each side is carried through tlie collar, and Ijack over the front of the shoulder, at the top of which both are tied in a simple knot, so nposed of ) of these by a loop Fig. 214) med— the irine, and of one of ■ or band 3 between cingle, in in tow or e simple, i is corn- Fig. 216. Rknault's Truss. as to be easily untied when required. At ten or twelve inches from this, a firmer knot is tied, then several others beyond it towards the loins— according to the length of the animal— and at nearly equal distances as far as the root of the tail, where a simple knot is tied. The branches of the cord then separate on each side of the vulva, and unite again by a simple knot below the inferior commissure; again separating, each cord is carried between the hind-legs, brought up by the flank towards the loins on each side, and tied over the' back to one of the loops there, as shown in Fig. 216. This truss can be made as easy or tight as may be necessary ; its simplicity is its great recommendation.^ ' Horsburgh ( Veterinarlaiu vol. xiv., p. 490) describes a similar truss, which he applied to a Mare that had inverted tlie uterus three days after foaling. Giving the animal some extract of hyoscyamus and gum opii, dissolved in a pint of warm water, to allay the straining, as soon as this dose began to operate he reduced the organ. This was done by securing the animal, sponging over the uterus with a little vinegar and water, and "taking hold of a clean towel in the left hand, doubled, and the corners of the towel Dli I ACCIDENTS AFTER PARTUMTION. A very efficient and suitable truss is that made of a piece of stout leather, with a round opening in it above, corresponding to the anus and an oblong opening beneath this, through which the vulva passes Ihe leather is so shaped as to embrace and lie close to the root of the tail and between the buttocks, extending for some distance below the vulva, as in Fig. 217. It is maintained in position by four strong leather straps— two above and two below— which pass on each side to a surcingle around the chest, which may again be attached to a collar or breast strap, should the straining be violent. Another kind of truss is formed by an ordinary crupper attached to a surcingle, and, if need be, this to a breast-strap or collar. From the part of the crupper under the tail proceed, two, three, or four narrow leather straps, which, passing over the vulva, are attached to the loop Fig. 217. Leather Truss. of a ^oubled rope in the perinaeum, each portion of the rope being passed between the hind-legs and tied to the lower part of ^the sur^ cingle. Or a cord may be attached to the crupper at each side of falling back on the arm-made bare for the purpose. I then applied the doubled fist to thefunduBof the uterus, with the assistance of the right hand in be^riC it ud bv a irvSftfweV o °"f' '"^"^ ''T'^^' '" "« ^''''' ''^^'y withdrawh^J'tl^ ha7d. /„d leavmg the towel for a few mmutes. I next proceeded to remove the towel bv intro ducng the hand greased for the purpose, into the vagina, taking it by theJo nJrs Z?ohV- rr^ ,*T' '"""^' ^"'^ ** '^' ^'-^"^ time bringing it^ut slwly aS which I introduced the ar.ii to the full length, in order to ascertain whethTr it wis in Its proper position, using a little force on the further end. in order to stretch it I the withdrew the arm, and proceeded to apply the necessary bandages! F rst a s L J^Ith or surcingle was buckled tightly round the abdomen, to prevenfthe mrscies acting wih such force as agam to expel the uterus. This is essentially necessTy. I tSo^k a small rope or narrow web (the one used on this occasion was a cave/son for breaking piece of stout ; to the anus, vulva passes, le root of the ice below the y four strong 1 each side to id to a collar attached to a r. From the ' four narrow i to the loop INVERSION OF THE UTERUS. 597 rope being of the sur- jach side of doubled fist to ing it up by a the hand, and owel, by intro- y the corners, ilovvly. After Bther it was in eh it. I then a strong girth 38 acting with I then took a for breaking 3ver the neck, he bell)' — one exactly at the ying the ends the neck, and be dispensed > pudendi. the vulva, and carried forward between the hind-legs and underneath the belly in the same manner, two or three transverse narrow straps passing between the two, immediately over the vulvar opening. When there is much swelling, a soft cloth doubled several times, or a sponge steeped in cold water, may be placed over the vulva beneath the straps, though in such a way as nob to interfere with micturition or de- fecation. Various other trusses for the Mare or Cow have been proposed by veterinary obstetrists, but in principle they are all the same. We need only notice one of these, which has been proposed by Lund, a Danish veterinary surgeon, and which has been greatly lauded by Dieterichs and others for its cheapness, simplicity, and efficiency. The chief part of it is a narrow piece of iron, nine millimetres thick (about one third to three-eighths of an inch), welded at its extremities, and turned into a triangular shape that enables it to include the vulva, while the loops at its three corners allow it to receive cords (Fig. 218). The Fig. 218. Lund's Truss Iron. base of the triangle, which iits under the tail, is about two to two and a half inches wide, and the sides from five to seven inches long. The loopholes at the angles may be replaced by small hooks to receive the cords. This metal plate — which may be of round iron and convex on one side, concave on the other — fits over the vulva and the base of the tail, the apex being below the lower commissure, while the convex side is towards the animal. Cords pass through the loops or around the hooks, one above, another below — as in Fig. 219— and are fastened to a surcingle or collar, or both, like the preceding trusses. Any black- smith can make the plate in a few minutes ; and from what has been said in praise of this cheap and simple method of retaining the uterus, there can be no doubt that it will be found most useful. All these trusses are intended for the larger animals, and cannot well be applied to the smaller creatures, with the exception perhaps of I -„. 598 ACCIDENTS AFTER PARTURITION. Lund s plate, which, much diminished in size and made of a piece of strong iron wire, might be serviceable for the Ewe, Sow, Goat, or large ±Jitch. J^or small animals Eainard recommends a bandage made by lolding a piece of stronp^ cloth in a triangular manner. The base of tms triangle hes over , e loins, is carried down the flanks to beneath tne abdomen where the corners are tied ; the apex of the triangle is passed over the croup and vulva— a hole being made for the tail to pass through and another for the anus— brought between the hiad-legs, and either by means of tapes attached to it, or, if sufficiently long, by splitting up the end to a short distance so as to make two strips of it, tastening the piece to the ends already tied beneath the belly. It must be acknowledged that these trusses, no matter how skilfully they may be contrived or however well they may be adjusted, will not Fig. 219. LuNu's Truss APPUEn. hinder vaginal inversion of the uterus ; all they can do is to prevent the^organ from being suddenly protruded beyond the vulva again, and so exposed to the air and the irritating effects of extraneous matters before it can be returned once more. This alone, however, is an im- portant object achieved, and is a great step towards permanent reten- tion. Besides, by maintaining the labia of the vulva in close apposition, the truss, if well applied, prevents the admission of air into the genital canal, and thus does away with one source of irritation. And as the apparatus does not cause any pain or inconvenience to the animal, it is to be preferred to any other means for retaining tlie uterus. With regard to the best kind of bandage, this is of secondary im- portance to its proper application. Simplicity and efficiency are the desiderata, and these will be found, we believe, in the trusses we have described, and particularly in those of Eenault ar t Lund. If reposition of the uterus is properly effected and the truss well a piece of at, or large e made by he base of to beneath triangle is the tail to } hiad-legs, ly long, by itrips of it, f- iW skilfully d, will not ^V;.,-M.Jw-: »^^ to prevent again, and 13 matters , is an ini- ent reten- ipposition, ;he genital nd as the animal, it ndary im- y are the 3 we have truss well INVERSION OF THE UTERUS. 599 applied, there is little reason to apprehend a recurrence of the accident. After Treatment. — "When the uterus has been returned to its natural situation, an antiseptic injection or " swabbing" of the interior should be carried out, and precautions against a recurrence of the inversion adopted ; then little more remains to be done except to observe some simple directions, which are to be followed for a few days after reposition. If the weather is favourable, and little or no fever present, the animal — covered with a rug — should be walked about for a few minutes ; as this takes away its attention from the accident, regulates the general circulation, and allays the expulsive efforts. The animal should stand with the hind parts well raised, and it ought not to be allowed to lie down for a day or so. Great attention should be paid to tb '.let, particularly with Eumi- nants, from their tendency to tympanitis and constipation. Indeed, tympanitis may be sometimes considei-ed a cause of inversion in the Cow and Ewe ; and the rumen is at times so distended with gases, and so proves such an obstacle to reduction, that it has to be punctured in the usual way before reposition can be effected. For the same reason, this inflation of the digestive organs has to be guarded against in the after treatment. For the first day, only oatmeal gruel with barley- water — both tepid — should be allowed in small but frequent quantities. For some days, easily-digested sloppy food may be given, and if the appetite is lickle it should be tempted by choice portions of diet; though the quantity must not be large at any time until all danger is past. If there is apprehension of inflammatory complications, such as metritis or peritonitis, emoUient poultices or a strong rubefacient may be applied to the abdomen. It is advisable in all cases in which the mucous membrane has been injured or exposed to the air for some time, to inject some antiseptic fluid— such as boric acid solution — into the uterine cavity for two or three days. Should there be a tendency to constipation, soap-and-water enemas may be administered. Micturition is rarely deranged ; but if no urine is passed within twenty- four hours after reposition, an examination should be made, and the bL?,dder emptied in the usual manner. The different disposition of the urethral valve in the Mare and Cow will, of course, be borne in mind in passing the catheter. Nearly always these simple measures suffice to restore the animal to its usual condition in three or four days, in uncomplicated cases. In exceptional instances, however, metritis, metro-peritonitis, or leucor- rhcea will follow the accident. The animal may go off its milk and fall into low condition, without exhibiting any acute symptoms ; or indica- tions of puerperal fever may supervene. Sometimes the animal remains sterile for a variable period. Witli the Ewe, chronic inversion of the uterus often leads to loss of the wool. In complicated cases there may be wounds, lacerations, rupture of the uterus, cornua, or vagina, lesions of neighbouring organs or textures, etc. ; these will be referred to hereafter. A curious complication of uterine inversion has been mentioned by Ayrault.i who witnessed ii in three cases. This was great lameness ' Recueil de Malecine Vetdrinaire, 1857, p. 723, Tf i.f j lit:!., 600 ACCIDENTS AFTER PARTUPdTION, lii* ovel^Vtftn'^it°.';^ swelling of the joints, but with marked knuckling and thf nW f . • *^^t, provided there is no serious complication reposSon o th? n^' f}^^ ^^ ^ood time, with patience and skiS wE hp .if ""^^^i "^^''^^ ^« possible, yet cases will occur in tie first Zo?°' '^^^'^ ^" ^^^ ^"^"^P*^ "^^ ^^^'^'^^^i^^' °r when. I mpossiblf or n..! ""^''f. r ^^^"^i^^tion, he has to recognise this as •Thave been oftn • ^."^'^ ^ ^"^^ ^^^" ^'^ P^^«"««'" ^'y^ ^chaack, and from v^St T h«v'^""^ "t^^" *? ^"""^'^y *^^^ ^^^^ ^^ displacement of reduction f, ,L ^ seen I am led to believe that the impossibility selves as t°\'- »^ ^""^ *° *^' difficulties in the cases them- Neverthelei if n f u"^ i"anoouvres which have been performed. Wa and th^.i •^'>^%^l''"°^'^^^""'^ *'^^* *^^ development of the reouirP. « . f • ^''^'^y °^ *^^ *^^^"^« ^'^^ sometimes so great that it ToSed nof n'f"' -r^""^ ^^ confidence in one's self not to be di - to ins St in snitp'^nf ' " \Z^ ^^ ^^^<^^^^i^^\ it is necessary to insist- aLZt ve nn?nf nf f^^^mg-on applying one's self to seize each ?n the vXa^^ ? ° relaxa ion ; to engage, bit by bit, the displaced organ tLnsr.P«t- 1 °nTi'"''"S'''^^'' that which is nearest this opening tnen successively all the remainder. " "peumg, cai, fl. . '? '^ judicious and sound; but, as has been said, in certain or gVorant men'ln ?r '^ ^? ''''''T^^ ''''''' ^^ ^^^ unskilfu/attempt"s certffn doathTf,° ^^*F"/t, or from other causes, that it would be now to Pv « 1 ^"'^^^ *° ''"P^^«^ '^ i" the abdomen. We refer become ^^iZT ^T'^^''^''' ^"^ ^^"^^^^' '' ^^en the organ has alwav. mo i • """^ .p"gi-enous ; and lacerations and ruptures are ulrp:rwT:ftrSus.""^^ '^ remembered, m the lower^ha? the^ remains^morf nr'lpl^'" ''^"'^^°'^ ^^' "°* ^^^^^ «°"^Pl«te. and one horn aS«d^n • '' .jj^^-aginated. or the body of the organ is not well at ie e^ln ?nd^M ' T'i ''"? "^ain occuJ^ in spite o^f all attempt that there ?s'no hoi P of "."i^^ *°° frequently leads to such grave injury should JLodtinnK . f T^^"" regaining its normal condition, even softened and Wablpf^. h'* ^^^^^^^^^l" Indeed, its walls are so (if Xl;;Tarir =* <" *e -'e™. veteriiL.rsumerv"VBin/'rf 'IV' ."P"™""" ™^ introdueed into 3 knuckling ihe patients should be amplication and skill 11 occur in )r when, at ise this as s Schaack, placement, ipossibility ises them- performed. ent of the 3at that it to be dis- to insist— seize each iced organ 5 opening, in certain I attempts would be We refer )rgan has )tures are than the one horn 3 not well attempts ve injury iion, even s are so pressure, into the ixtremely ; as the jlvis, is a le uterus ced into Jenne, a I painful le whole, i-Cyr, no ck refers !ows and 30unt of INVERSION OF THE UTERUS. 601 the operation. Of these thirty cases only one was a Mare ; 17 were Cows ; 3 Goats ; 4 Sows ; 1 Ewe ; 2 Bitches ; and 2 Cats. He remarks that, of the unfortunate cases, there were probably some which died from other causes than the amputation ; while others evidently perished from septic infection. Recoveries have taken place after the Cicsarian section and excision of the uterus practised on the same animal, at the same time. The operation might be more successful did it not happen that it is late before it is resorted to, and very often the animal is already greatly exhausted. It is curious to note that it has been recorded by several observers, that some Cows which recovered have shown signs of oestrum— doubt- less because the ovaries were left intact ; while other Cows have yielded milk after the operation. Lecoq knew of a Cow from which the uterus had been removed, and which gave an abundance of milk for two years afterwards. Operation.— Y&v\0Vi& modes of operating have been practised and recommended. With the larger animals, the hind-liinbs should be secured — especially with the Mare — or they may be thrown down, or fixed in a travis if there is one convenient. Chloroform, chloral, or morphia should be administered to the animals about to be operated upon. It is also a good plan to tie the uterus up in a large cloth, so that it may be easier moved about by the operator or his assistants, and render the operation cleaner and less repulsive- looking. The oldest, and perhaps most popular, method is the ligature in mass. A piece of strong whipcord, well waxed and made into a running loop, is passed over the tumour as near to the vulva as possible, but without including the meatus urinarius. When evenly placed around the pedicle, it is gradually but f nnly tightened by pulling at each end, so as to completely intercept thj circulation in the organ. This done, the cord is tied in a knot. Though this method has been much employed, and with a fair amount of success, yet it has been condemned by some good authorities, on the plea that it is dangerous to tie such a voluminous mass ; as all the parts cannot be sufficiently and equally compressed to become mortified at the same time. Those parts which have not been firmly constricted still retain a certain amount of circulation, become inflamed, and occa- sion violent pain. Rainard therefore recommends the double ligature. A long sacking or saddler's large needle, is armed with a somewhat long double piece of whipcord. This is passed through the middle of the pedicle of the tumour, from below to above, and the needle cut away from the cord. The pedicle is thus perforated by two pieces of cord ; one of these is very firmly tied round the right half of the pedicle, tbe other round the left, so as to include the whole in two separate li^'alnres. Claverie^ reports a serious ha;morrhage from the employmeiit of this double ligature after removal of the uterus, which necessitated the application of a ligature in mass above the others, as well as the appli- cation of the acttial cautery to the cut surface, Tt is possihle that the needle wounded some large vessel, which, of course, would not be in- cluded in either of the ligatures. ' Journal dea VdUrinaires du Midi, 1860, p. 535. i!;.i ■iPi ti02 ACQ ID EN TH AFTER PARTUKITIOX. ■MBj! ^^^^^HJ^D'' i _ The uterus of the Cow has been successfully deprived of its circula- tion by means of clams about an inch thick and ten inches long. They were applied close to the vulva, and the two ends fastened together by twine. Saint-Cyr alludes to a successful case of amputation of the uterus in a woman, by means of caustic clams, or rather a clamp ; the operator being M. Valette of Lyons ; and he believes that the same procedure might be advantageously adopted by veterinary surgeons. He recom- mends the long curved clams used for hernia, and suggests that the groove be filled either with chloride of zinc, or with tallow powdered over with corrosive sublimate. By whatever procedure the pedicle of the tumour is rigidly com- pressed, the uterus has afterwards to be excised. Some veterinarians are of opinion that it is better to wait until it is completely mortified, or even until it sloughs away spontaneously ; and they allege, in justifi- cation of this opinion, the danger of huamorrhage when dealing with such a large and vascular organ as the uterus is at parturition. Others, dreading the dangers resulting from the retention of such an enormous mass suspended behind the animal, counsel its immediate amputation. The incessant traction it exercises on the vagina, the obnoxious odour it gives off, the contact with the absorbing surface of the septic products resulting from its mortification, expose the animal, they declare, to serious accidents, which can only be averted by at once cutting away the uterus. These dangers are certainly most serious ; and as the risk of htemor- rhage may be obviated by sufficiently constricting the base or pedicle of the mass, it is advisable to amputate it at once, and at a short distance — from an inch to three inches— behind the constriction. Trasboti brings under notice the use of the ecrascur in amputating the uterus. The case to which he refers was not successful ; but it is probable that this result was due to the imperfecu or improper manner in wliich the instrument was used. With the ecrascur, the tissues should be slowly and gently cut through. The entire pedicle may be included, or the chain may be passed through the middle of it by means of a needle, like the double ligature. But there is grave risk in this mode of amputation, as the abdominal cavity is opened when the pedicle is divided by the chain, and through the opening the intestines may escape, or blood and the products of in- flammation and putrefaction may enter the peritoneal cavity, and give rise to a grave condition. The elastic ligcUii.re (Dittel's) has been suggested as worth a trial, and if properly applied the result might be favourable. Indeed, it has been successfully employed in amputating the uterus of a Cow, a Sheep, and a Bitch. The operation is simply applying a long piece of india-rubber tubing around the pedicle, and tying it firmly there. The tissues are cut through by the continuous pressure, which causes obliteration of the vessels and cessation of nutrition. It has also been sug^e^^ted that Esmarch's method of amputation by elastic compression or thn part to be excised, might be most successfully employed in ablation of the uterus in animals. Considering the volume of the uterine tumour and its great vascularity, there must be an immense ^ Bulletin de la SocuU Centrale de Midecint Vdirinaire, 1870. ts circula- ng. They )gether by 3 uterus in e operator procedure 3e recom- 3 that the powdered ;idly com- ;erinarians mortified, , in justifi- aling with 1. Others, enormous nputation. ous odour c products :leclare, to ting away of heemor- L' pedicle of L't distance mputating ; but it is sr manner it through, id through JUre. But inal cavity irough the icts of in- , and give I trial, and t has been jheep, and dia-rubber issues are tion of the utation by lecessfully he volume a immense INVERSION OF THE UTERUS. 603 advantage in sending back into the circulation of the animal the larger part, or even the whole of the blood contained in the organ, before separating this from the body, and, in addition, performing a bloodless operation. Coculet's method of reducing the volume of the inverted uterus by compression, has been already alluded to, and is the same in principle, Esmarch's method essentially consists in winding around the part to be amputated— commencing at the distal extremity— an elastic band, so as to press the blood from this part into the body ; and above the band to tie firmly a piece of india-rubber tubing, so as to prevent a reflux of blood by the arteries. The elastic band is then re- moved and the part— pale and bloodless— is excised. When the uterus has been cut away, the portion of vagina or cervix rema,ining should be returned as far as possible into the genital canal, and if there is any hiPmorrhage injections of cold water will probably check it. Cicatrisation generally occurs within fourteen days. If i.blation of the uterus is not effected immediately after constriction of ne pedicle, but allowed to take place spontaneously, mortification and loughing are completed in from six to ten days. In some cases the animals do not appear to be much disturbed after the operation, in others they are very uneasy. Ledru^ describes an instance in which the Cow operated upon was for an hour as if mad. It lay down, got up, rolled about, kicked and stamped, and climbed into the manger. The eyes appeared to be starting from their orbits ; it flexed its hind-limbs like a horse attacked with paraplegia, and it was impossible to get near it. These symptoms appear to have been caused by the intense pain ; though they gradually subsided and the animal ultimately recovered. In many instances no unusual symptoms have been observed, and the mother has anxiously occupied itself with its progeny. This has been noticed with the Sow. After the operation the cows appear to have fatted well; and when killed, in those which were examined large masses of fat have been found in the place of the uterus, and filling the pelvis. It may be remarked that in one case recorded — in the ^ow~a portion of intestine had become prolapsed with the uterus, the interior of the sack of which it occupied ; another similar occurrence was noticed in a B'tch. Franck insists on this complication being always looked for in the Mare, and he reconunends that this animal be either narcotised by morphia or chloroform, so as to get rid of the violent s'l'aining to which it yields itself. An exploratory incision may then be made in the body of the uterus, and if any intestine is found in its interior, this must be returned to the abdomen before amputation is ventured upon. CHAPTER IV. Inversion of the Vagina— Inversio Vaginae. iNysksios, procuieucc, prolapsus, or fall of the vagina, is a hernia of this part through the vulvar opening, analogous to that of the uterus, and with which it may be complicated when inversion of the latter is ' Rtcmil de Miihcine Vitirinaire, 1866, p. 115. 1?| ,r Mi 604 ACCIDENTS AFTER PAllTUllITWX. extreme ; though in such a case it does not add to the symptomatology or gravity of the accident. It may occur in other than pregnant or parturient animals, though rarely ; the cases recorded of Mares had no assignable cause for the accident, though those occurring in the Bitch were observed immedi- ately after copulation, and ascribed to anatomical and physiological peculiarities. It may also take place during pregnancy, particularly towards its termination, when the gravid uterus pushes it outwards. Most frequently, however, it is witnessed after parturition, particularly when delivery has been diflicult and protracted, owing to a disproportion between the size of the fcetus and the passage through which it passes, and especially when force has been necessary to extract it, and the ex- pulsive etibrts have been severe. It often occurs when the " waters " have escaped for some time, and the young creature, lodged in the genital canal, is extracted without the precaution of lubrication. The progress of the fcetus through the dry, tenacious passage causes the mucous membrane of the vagina to gather in ridges and folds ; the connective tissue beneath is torn, and this leads to inversion, which may occur immediately, along with the exit of the foetus, or when the animal afterwards strains — sometimes so long as four, six, or eight days subsequent to parturition. Fatigue, such as that induced by travelling, or severe exertion imme- diately or soon after calving, or keeping the animal in a stall the floor of which slopes too much backwards, are also likely to produce, or at least predispose to, the accident. It may also take place after abortion and retention of the placenta. When inversion of the vagina occurs without that of the uterus, the latter is propelled backwards by the contractions of the abdominal muscles, pushing before it the walls of that ;'anal until it has extruded them beyond the vulva, and itself occupies the cavity of the pelvis. During this extrusion, the connective tissue which attaches the vaginal mucous membrane to the adjacent organs and the pelvis is more or less lacerated ; and it is this laceration which constitutes the serious character of the accident, and different!; ^tes it from simple prolapse due to relaxa- tion of the connective tissue, which is of no great moment. The latter condition is not very rare towards the end of pregnancy, and under cer- tain circumstances may lead to complete inversion. Eainard mentions having seen a Goat which had inversion of the vagina fifteen days before parturition, and to such an extent that the mouth and nostrils of the fujtus protruded through the half-open os uteri, so that it could breathe and lick the hand. This simple inversion of the vagina during pregnancy, however, dis- appears spontaneously after parturition, as it is simply due to the backward pressure of the gravid uterus ; but that occurring after birth has no tendency to spontaneous reduction any more than complete inversion of the uterus. Very exceptional cases have been reported, in which the simple form was succeeded by the more serious one ; but Saint-Cyr insists upon these being so rare that they only serve, when compared with the latter, to prove the rule. As has been said, this serious inversion of the vagina occurs far more frequently after abortion and parturition, though not so often as inver- sion of the uterus. tomatology als, though ise for the id immedi- lysiological )articularly outwards. )articularly iproportion ti it passes, nd the ex- 3 time, and 3d without irough the vagina to 5 torn, and y with the nietimes so tion imme- .1 the floor iuce, or at er abortion uterus, the abdominal ts extruded the pelvis, the vaginal nore or less s character 3 to relaxa- The latter under cer- d mentions fteen days nd nostrils at it could iwever, dis- iue to the after birth 1 complete •eported, in s one ; but ,erve, when rs far more 3n as inver- INVERSION OF THE VAGINA. Symptoms. 606 Of course, the chief symptom of this accident is the presence of a tumour protruding from between the labia of the vulva, and which may hang for some distance below that opening. In this respect it resembles mversion of the uterus, though the difference is otherwise very marked. In the majority of cases the tumour is most voluminous when the animal is lying, and can then be best examined. It is circular in out- line, varies in size from that of an apple to the dimensions of a large melon, and is not unlike a sausage in shape ; the surface is smooth, more or less of a deep red colour streaked with darker patches, and covered by a thick white mucus or a fibrinous exudate ; in other cases it is inflamed, excoriated by the tail or litter, and covered with foreign matters. There are no traces of coti/ledons or j^laccntal follicles. On the under surface of the tumour is observed a longitudinal depres- sion or furrow, which leads to the urethra. At its end is a round opening, into which the finger can be passed as far as the os uteri, which will be found either completely closed or partially open. At the vulva the tumour is narrow, and exhibits longitudinal folds or ridges, due to the constriction caused by the vulva. Passing the finger between the tumour and the vulva, there is found a depression, or cul-de-sac, formed by its direct continuity with the vulvar mucous membrane. In certain cases the cervix uteri can be seen in the middle of the tumour. Not infrequently the tumour is invisible when the animal is standing ; though it may show itself when it lies down, micturates, defecates, or strains. When, however, the inversion is extensive, or the case is chronic, the tumour often remains external to the vulva. There is generally more or less diflficulty in micturating, arising from the pressure on the urethra ; and instances are recorded in which extreme distention of the bladder from retention of urine had occa- sioned serious symptoms, and led to paralysis, and even rupture, of that viscus. There may also be more or less straining— indeed, this symptom is nearly always present ; febrile symptoms may likewise be noted in some cases. When the mucous membrane has been long exposed to the air, it becomes thickened and indurated, from the constant irritation giving rise to efi'usion and exudation ; it assumes a grayish tint, and is covered with a hardened epithelium, which gives it a leathery appearance. The local symptoms we have indicated should suflficiently distinguish between this accident and the presence of tumours in the genital canal. In the Bitch, inversion of the vagina has been sometimes mistaken for ' a condylomatous tumour ; and cases are recorded in which tumours of this kind, protruding beyond the vulva, through insufficient examination have been mistaken for inversion. Inversion of the bladder has also been confounded with that of the vagina. The pyriform cysts that sometimes form in that canal, and contain a clear citron-coloured fluid, have likewise been occasionally considered as inversion of the vagina. To avoid errors which might have a serious result, a careful examina- tion must be made, and nothing should be attempted in the way of operation until the state of affairs is exactly determined. Prognosis. Inversion of the vagina is not nearly so serious an accident as inver- sion of the uterus ; and Cows, Mares, and Bitches may often suffer from r 60ii ACCIDENTS AFTER PAltTUllITWN. thia condition for months without showing much apparent inconvenience. This is the kind of inversion that is hable to recur ; reposition may be readily effected, but no sooner is it accomphshod than inversion again takes place through the animal straining. In other instances, however, the accident is much more serious. The mucous membrane of the vagina, exposed to contact with the urine, faeces, and litter, in addition to frictio.i from the tail and other objects, as well as the attacks of flies, etc., becomes iiiitated, excoriated, abraded, and indurated, while it is greatly thickened from exudation ; a mor<' or loss fa3tid muco-purulent secre: ion covers its surface; cicatrisation of the torn submucous connective tissue Lusues ; new adhesions are formed which fix the part in is abnormal situation, and offer what is sometimes an insurmountable .bstacle, i" not to reduction, at least to retention, after that has been effecttul. If assistance is not afforded, the animal gradually loses condition and becomes emaciated; hecti< fever sets m, and it falls into a state of marasmus. At other times the extruded part becomes acutely inflamed, intense fever supervenes, and the creature succumbs to the effects of vaginitis either simple or com- plicated with metritis — and almost as rapidly as from inversion of the uterus. Trcatvient. The more speedily treatment is resorted to ulter inversion has occurred, the more easily is reduction effected and likely to prove per- aanent, while the risks from injury are greatly diminished The treatment is somewhat similar to that recomui nded for inversioi i nf the uterus, the preliminary steps being the same in both accidents, and reduction is accomplished according to the same rules. The part of the vaginal membrane nearest the vulva is to be carefully and gro.dually returned, should the tumour be large ; if comparatively small, then it may be reduced en masse, by applying the closed fist to the centre of the most dependent part, and pushing it into the canal. When redaction hag been effected, it is particularly necessary to observe that every part has assumed its normal shape and position; as it often happens that the mucous membrane, particularly towiuds the bottom of the canal, forms a thick fold, which must be effaced if it is desired to obviate renewed straining and a recurrence of the inversioi All the folds and inequalities from one end of the canal to the other, as far as the cervix, should be smoothed carefully down by the 'and or a soft damp cloth. If, after reduction, the straining continues, il may be inferred that the mucous membrane is irritated by the existence of wrinkles or fold' m its surface. The hand must then be introduced again into the \. la and the ridges effaced either by passing the hand over them, so as to carry the membrane onwards, or bygetale pressure entirely obliterating them. If the membrane is irritated and infl; aied, astringents — such as acetate of lead — and anodynes — such as opium — may be applied to it ; and as a matter of precaution, a truss maybe used for a few hours. When the foitai membranes are still in the uterus, some obstetrists recommend that they should be removed before reduction of the inver- sion is attempted ; but other's are of opinion that reduction should be accomplished first, and removal of the membranes afterwards, unless the latter are so lightly attached that they can be pulled away without introducing the hand into the uterus. In any case the membranes ionvenieiice. tion may be irsion again rious. The I the urine, her objects, ed, abraded, . ; a mor(3 or itrisation of lH;sions aro )ffer what is 1, at least to ifforded, the hecti' fever times the jrvenes, and iple or com- rsion of the version has prove per- inversioii nf jidents, and i part of the d grn,dually nail, then it lentre of the m red'icMoii t eveiy part appens that : the canal, L to obviate le folds and ; the cervix, damp cloth, red that the or fold^ on the va, aa, m, so as to obliterating s — such as plied to it ; hours. ; obstetrists f the inver- n should be irds, unless /ay without membranes INVERSION OF THE VAGINA. 607 .Bust l>o removed, as their presence is certain to cause expulsive efforts which will inevitably lead to protrusion of the vagina again. For retention of the r(>duced part, sutures aro often preferred ■ they are passed through the labia of the vulva. Harms and Schleg' einplov rmgelns with this object. Schleg's ring is a thin flat band of steel pointed at one end, and with a round hole and slot a little above the point ; at tl other end is a kind of button rai'^ed on the su>face. The point is passed through the labia, and tha ba 1 bent roui 1 so as to meet and button at the ends. This ring has been worn, according to Schleg, from a few days to more than five months. Other sutures have been described ; but they are all on the same principle as Zundel's already mentioned (Fig. 213). In some cases one of (' o trusses alluded to for inversion of the 'iterus may be found useful, especially if the accident is recent. Pessaries should not be employed. When the submucous connective tissue of the vagina has been much lacerated, and abnormal adhesions have taken place, then a recurrence of the inversion is to be apprehended. This iccurrence is, of course, most likely to take ^ lace in chronic inversion, and all the skill and patience of the veterinary surgeo, will be required in dealing with such a case. At times the accident has proved so troublesome, and retention has so bailled every attempt after reduction was eli'ected, that amputa- tion of the protruded portion has been practised, and with success. Rainard appears t' . have l)een the first to venture on this bold measure, and he practised tl; operation several times on Bitches. He ligatured the entire inverted mass close to the vulva, in one case ; but as this gave rise to intense fever, and, when cured, the animal suffered from incontinence of urine, he adopted another procedure. Instead of including the whole of the tumour in one ligature, he divided the pedicle into three portions, which he tied separately, so that each ligature only enclosed one-third of the mass. After tightening the ligatures, the Bitcli was allowed to run at large, the only attention it received being the injection of emollient fluids into the vagina, and a smaller allowance of food. The pain was much less in intensity a- I duration than in the first case, antl the tumour came away in five or \ x days, when recovery took place. Bainar however, advises imm 'iate excision of the portion of the mass I -yond the ligatures, when these have been drawn tight. Daprey operated on a two-year-old Filly in a somewliat different manner. Inversion of the vagina had l)een present for fiftr days, and the tumour was as large as a man's head ; it was cold, of . dark-brown colour, and the iinimal was greatly agitated ariil feverish. As gangrene was approhendeti, it was decided to remove the w' ole mass. This was done by practising a kind of saddli 's stitch around it, by means of two needles armed witli a waxed thread ; an when sewn round, the two ends of the ligatui were drawn so tight a '0 raise tiic enclosed sides of the tumour into plaits like the mouth of a tied sack ; they were then fin ily joined. The Filly was kept standing with the hinder part of the body raised, and the tumour was dressed with chl »rinated water and vinegar. Between the seventh and eighth days thf mass came away ; tiic uischarge diminisliod in quaatity and fooiidiica; , and on the tenth, day the anin.al was nearly well. Bernard, o' 'he Toulouse Veterinary School, operated upon a female ^ ^ilagazinfixr Thierheitkunde und Viehzucht, 1869, p. V3. i I mw I «08 Ai VI DENTS AFTER PARTl'lllTION. Ass, which had tho vaj^ina inverted for morn than a month, and every moans of retention liad failed. Amputation was practised, by a circular incision around tho base of tho tumour. At tlie first cut of tho bistoury, it was observed that tho mucous membrane was very much thickened, and easily detached from tho other parts ; so that, instead of making a total amputation, it was considered better to make it only partial, by dissecting,' away all that tissue to the extent of four or live inches. This was done, and the liaMuoirlmt^'c was inconsiderable ; but it persisted so long afterwards tliat the animal was seized with symptoms of syncope. However, these symptoms passed away, and the creature began to eat. A rope truss was applied, and for eight days there was a discharge of pus. At the end of that time, when the truss was removed, recovery was found to be complete. On exploring the vagina some time after- wards, a tliick but dilatable ring, about tho middle of the vagina, was found, through which first one fmger, then two and three, could be passed. Beyond this ring the canal was normal in width. There can bo no doubt, then, that tlio inverted vagina may bo ampu- tated without much risk, when reduction is impossible or incomplete ; but whether an animal which has undergone this operation can be utilised for bleeding purposes afterwards, we have no evidence to prove. It is possible that the cicatricial tissue uniting the wound nuiy bo siitli- ciently yielding to allow of gradual dilatation by manual or mechanical means, and thus not offer much impediment to impregnation or parturi- tion. CHAPTER V. Inversion of the Bladder— Prolapsus Vesicae. At p. 351, allusion was made to inversion of the bladder as occurring before parturition, and the symptoms and treatment of this accident were described. The remarks there made are applicable to the accident when it follows delivery. It is of somewhat rare occurrence, and is perhaps more frequently met with in the Mare than in the Cow. We have particularly insisted upon tho necessity for a careful exami- nation of all vulvar tumours before adopting any surgical measures ; and this precaution is above all things necessary in this accident, as incision of tho bladder is certain to lead to a fatal termination. Reduction should be attempted according to the directions given at p. 352, and care must be taken not to lacerate tho organ, as this also will prove fatal. Elmue^ relates an occurrence of this description. Reduction has been accomplished successfully in the Mare two months after parturition, when the accident happened. - In desperate cases, when reduction cannot be effected, or when tho organ is so much injured that reposition is almost certain to be followed by death, amputation may be ventured upon with some prospect of success. "With regard to tho operation, Cartwright remarks : "It is be observed that the ureters enter the substance of the neck of the bladder obliquely towards its sides, but their orifices are to be seen when the bladder is ij^yerted, the Cow or Mare standing, at the upper surface of the viscus, about half an inch apart. To detect them, we must draw the bladder ' G»,x\fitaXt'» Jahrenhericht, 18r)9. " Archives Vetirimnre., 1877, p. 801. and overy \/ a circular bistoury, thickened, f making? a partial, by lies. This leraisted so af Hyncope, f^an to eat. scharge of 3, recovery bimo after- agina, was !, could be { bo ampu- icompleto ; on can be ;o to prove, ly ho sufli- nechanical or parturi- INVKUSION OF THE JiL ADDER. «oo sufficiently down, so that wo may bo able to inspect the parts. Where they enter, the u.ner membrane (now the ureter) will have a soft and jelly-hko protuberant appearance, in the midd.e of which will bo detected vvo very sn.all openings of a nipple-like shape. To be certain that we have hit upon tf,e>n wo may introduce a probe, and pass it down towards tho suspende. fundus. Having discovered the orifice of the ureters, and passed a ligature around the neck of the bladder below them we have nothing ...oro to do than occasionally tighten it, so as to effect complete strangulation and sloughing of the body of the bladder • though, as soon as we find it dead, we may, to save time, cut it away with a scalpel Wo should also, after having applied the ligature, puncture tho distended fundus ; since its great weight may cause dragging and inflanimation about its cervix, or may force the ligature over the mouth of the uterus, which would occasion the death of the animal. After tho separation has taken place, the roraaining portion wi 1 contract within the vagina, and tho cavity will be closed by tho vulva. The urine will generally ever after run down the thighs, excori- ating them ; though in other cases the fluid will accumulate within the vulva, and be from time to time ejected in large quantities." When excision is not resorted to, spontaneous amputation may take When the inversion or prolapsus is complicated by rupture of the floor of the vagina, then the accident is of the most serious character though not invariably fatal in its results. ' 1 occurring is accident le accident ice, and is ow. jful exami- measures ; 3cident, as n. 3 given at s this also escription. wo months f when the 36 followed )rospect of e observed r obliquely l)ladder is tlie visGiis, ae bladder CHAPTER VI. Traumatic Lesions of the Genital and Neighbouring Organs. Either during or after parturition, the genital and neighbouring organs are exposed to injuries of a more or less serious character, according to their situation and extent. These we will now consider in the following order: 1. Laceration and mpture of the uterus; 2. Laceration and rupture of the vagina; 3. Thrombus of the vulva and vagina; 4. Belaxa- tion of the pelvic symphysis; 5. Bupttcre of the bladder; 6. Bupture of the intestines; 7. liupture of the diaphragm; 8. Rupture of tlie abdominal muscles; 9. Bupture of the sacra-sciatic ligament; 10. Bupture of the heart. ■' I. — Laceration and Rupture op the Uterus. Laceration and rupture of the soft parturient passages are very far from being unusual during parturition in the domestic animals, par- ticularly in the Mare and Cow, and of these the uterus and vagina are most frequently involved. Solutions of continuity of the uterus are often met with by the vete- rinary obstetrist, and they are either incomplete— \vh.Qn. the organ is only partially torn or lacerated, or coHipZcfc— when it is torn through and the uterus opens into the abdominal cavity. These tears may occur either during pregnancy, during parturition, or at a variable period after the foetus has been removed from the uterus when it is generally a complication of inversion of this organ. Ante partum 39 610 ACCIDENTS AFTrU; VAllTUBITION, ' i ' t'\i\ [ilil III I? ' =11 { rupture has been already fully alluded to at p. 194, and we have now to study its occurrence during and after birth. Rupture durhuj Birth. — Eupture of the utarus may occur spon- taneously in a complete or incomplete form during parturition ; and though the accident is perhaps not so frequent in animals as in woman, yet there are many cases on record in which it has undoubtedly occurred in fchem, and it has been iffirmed by highly competent authorities that it has been observed in Cows which had not received any assistance during parturition. It can easily be understood why, if there is any material obstacle to the passage of the foetus — such as induration or torsion of the cervix, or malposition or deformity of the young creature — the violent con- tractions of the powerful muscular layer of the organ should overcome the resistance of some portion of its own fibres, and thus lead to a more or less extensive laceration, which may involve the other tunics and produce complete perforation. Non-perforating or incomplete lacera- tions occur, in the majority of instances, towards the cervix, and are usually longitudinal. Complete rupture may take place at any part of the organ. This accident is more likely to occur spontaneously when there happens to be an alteration in the texture, wholly or partially, of the uterine wall ; thouirh this predisposing cause does not appear to be so often present in animals as in the human female, in which sudden per- forating ruptures never take place wlien the organ is healthy. Never- theless, there can be no reason to doubt that in animals alterations in the tissue of this organ may and do occur ; and, as in woman, this may assume the form of anomalous development ; interruption of the normal tissue by interstitial fibroids or cicatrices ; separation of the muscular fibres by submucous fibroids, or by projecting thin parts of the fcBtus ; inflammatory softening of some portions of the parenchyma during pregnancy ; or thinning of the wall at some part by pressure. This pressure may arise from contact with the brim of the pelvis, or exostoses in or upon the bony canal. The exciting cause, however, proceeds from considerable impediment to the progress of labour, and the accident is due to the energetic con- tractions of the uterine walls and abdominal muscles, as well as to the pressure, direct or indirect, of the diaphragm ly the fully dilated chest. In such cases the rent may be so great that the fcutus passes entirely through it into the abdominal cavity, enveloped or not in its membranes; or only a portion of it escapes through the tear, and it maybe extracted therefrom with more or less dilliculty per vias iiaturalcs; in some recorded cases birth has taken place by natural efforts, the existence of rupture only becoming evident when the uterus was accidentally extruded after birth. More frequently, however, the accident arises from artificial mechanical causes, brought into operation in the course of manoeuvres for elTecting the extraction of the fcetus. The various instruments employed may either tear or incise the uterus ; or the organ may be lacerated during traction on the foetus when the " waters " have escaped, and its walls closely envelop the young creature ; or during retropulsion or version, The thinness of the uterine wall at this period renders such an accident as laceration one of easy occurrence ; and, however large the tear ina\ be during life, after death it usually appears much smaiUr, because oi the contraction of the muscular tissue. e have now to occur spon- turition ; and as in woman, bedly occurred ithorities that ny assistance al obstacle to oi the cervix, } violent con- uld overcome ead to a more er tunics and nplete lacera- irvix, and are it any part of I when there rtially, of the Dear to be so 1 sudden per- Ithy. Never- alterations in nan, this may of the normal the muscular )f the foetus ; hyma during essure. This 5, or exostoses .^fla 3 impediment inergetic con- .vell as to the dilated chest, asses entirely 3 membranes ; y be extracted les ; in some 3 existence of tally extruded al mechanical s for effecting nployed may 3rated during and its walls n or version, h an accident the tear may rt, because ui TIUUMATIG LESIONS OF THE GENITAL ORGANS, ETC. 611 In all these cases when the organ remains in situ, the diaajwsis is difhcult. and genemlly it is only on post mortem examination tha the lesion IS discovered The moment of its occurrence may be inferred when a crotchet suddenly loses its hold, or the feet of the fcEtus pene trate the uterine walls, ^ Certain clinica! symptoms are often observed during life, which if thev were constant, might lead to a suspicion of the existence of rapture Thus, the expulsive efforts are very energetic and regular up to a certain period when all at once they cease; the animal begins to inanifest symptoms of abdominal pain-lying down and getting up stamping and pawing, looking towards its flanks, moving about uneasilv moaning bellowing, neighing, or even screaming, when the rupture occurs. It has been stated that the Cow opens its mouth and protrudes the tongue, extendr. the head, and utters a moan or grunt at each ex piration, but does not strain— these symptoms being indicative of uterine rupture. Non-perforating lacerations do not, as a rule, give rise to very marked symptoms immediately; though subsequently they may produce metritis or metro-peritonitis, or induce septic infection. Their presence is not easily diagnosed during life. In some few instances, the existence of complete rupture has been ascertained by manual exploration of the uterus ; in others it has been discovered de visu in inversion of the organ. The pulse soon becomes teeble it there is much haemorrhage, and exhaustion quickly supervenes It death does not occur promptly, acute fever ensues, with symptoms of peritonitis or septic infection. The complications attending this accident are always serious, and render the prognosis unfavourable in nearly every case. When 'how- ever, the laceration occurs at the upper part or sides of the uterus the accident is not so grave as when the floor of the organ is involved • if the OS remains closed, so as to prevent the admission of air, the pro^-- nosis 13 still more favourable, though this can rarely be the case. ° The chief complications are hcemorrhaije, hernia of the intestines, and peritonitis. Death from direct haemorrhage is less frequent than might be antici- pated, knowing the great vascularity of the uterus at parturition. This infrequency is explained l)y the fact that bleeding from such a lacera- tion 13 less profuse than from an incised wound of the same dimensions Nearly always, too, the foetus is partirUy or entirely expelled from the uterus into the abdominal cavity, or is born immediately after the accident, and the organ then may firmly contract. Nevertheless, in some instances, the hasmorrhage is so great that a fatal termination soon takes place, with all the symptoms already described at p. 575. Hernia of the intestines occurs when the rent is somewhat large, and the uterus, flaccid and uncontracted, allows them to enter its cavity— they being pushed therein by the action of the abdominal muscles. In some instances the intestinal mass received into the uterus has been so large that they have passed through the vagina and vulva, reached the ground, and the animal has trodden upon them— thus hastening death ; while in others, the hernia has been reduced and the creature survived. Peritonitis may be primary or secondary. When prhnary, it is due to the escape of blood, the foetpl fluids or envelopes, or tho fcetus itself. i .S"'; 1 612 ACCIDENTS AFTER PARTURITION. \?-"\ w When secoyidary or consecutive, it may result either from the extension of the inflammation to the peritoneum, or the discharge of the lochia, pus, etc., from the uterus. The escape of fluids is, of course, more likely to take place when the rupture is inferior than when lateral or superior. Death is nearly always the result of peritonitis or metro- peritonitis. Treatment. The treatment of rupture of the uterus during parturition is generally very unsatisfactory. Very little can be done to check the haemorrhage, if it is great, and consecutive peritonitis is always a most serious complication. If the fa3tus remains within the peritoneal sac, a favourable termina- tion can scarcely be hoped for ; though in some rare instances, if air does not obtain access to the cavity of the uterus or abdomen, it is possible that the case may terminate in one of the various ways of extra- uterine pregnancy. If the foetus is extracted, the rent may heal up ; though this is very unlikely if the edges are much contused, and the animal will, in all probability, perish from consecutive purulent peritonitis. If the foetus is still wholly or partially in the uterus, it and its enve- lopes must be extracted without delay, and as gently as possible ; as haemorrhage will probably only cease with the contraction of the organ. If the uterus does not contract, but remains flaccid after removal of the placenta, then it may be stimulated to do so by introducing the hand into the interior for some time, after removing the coagula. If this fails, and the rupture is not in the floor of the uterus, small pieces of ice, cold water, or astringents may be introduced, and ergot of rye administered ; a jet of cold water should be allowed to play upon the loins, wherever the rupture may be, If there is hernia of the mtestines, these, of course, must be promptly returned into the abdominal cavity before anything is done to the uterus. Some authorities advise that the uterus should be gently inverted, brought outside the vulva, in order that the rent may be closed by suture, and then returned. But this course is not to be recommended, as it is very dangerous, and the wound will unite without sutures if the organ contracts and no complications follow. The cavity of the uterus should be swabbed with a weak solution of carbolic acid (1 to 100 — 250) or cresyl, and to prevent septic infection by admission of air, a pledget of carbolised lint or tow should be placed in the os or vagina, and changed now and again. Straining must be subdued by doses of opium or chloral, or the subcutaneous injection of morphia, and the diet should be carefully attended to. If there is constipation, mild laxatives and enemas may be administered. Consecutive fever and peritonitis must be treated by cold afl'usions, and large doses of anodynes — such as opium, as well as counter-irritants. Metritis nmst be treated in the same manner, by the gentle injection of cold water ; or the introduction of small pieces of ice into the genital canal will bo beneficial. Should symptoms of septic infection appear, stimulants, with small doses of carbolic acid and sulphite of soda, must be given. When the foetus has passed through the rent into the abdominal cavity, dehvery per cius italaraics is tiien impoHsible, and the Coisanan section must be resorted to ; unless it be decided to allow the animal the extension of the lochia, I course, more 'hen lateral or litis or metro- ion is generally e haemorrhage, , most serious rable termina- istances, if air abdomen, it is ways of extra- may heal up ; tused, and the itive purulent i and its enve- ,s possible ; as n of the organ, removal of the cing the hand igula. If this mall pieces of i ergot of rye play upon the the intestines, iominal cavity ently inverted, r be closed by recommended, lout sutures if jak solution of tic infection by )uld be placed jhloral, or the d be carefully d enemas may ust be treated opium, as well same manner, 3tion of small )uld symptoms f carbolic acid the abdominal I the Caisarian ow the animal TMAUMATIC LESIONS OF THE GENITAL ORGANS, ETC. 613 to take its chance, and get rid of the foetus as in extra-uterine foetation, should it survive the accident. Rupture of the Uterus after Parturition. Rupture of the uterus after parturition generally complicates inver- sion of the organ, and is due to mechanical injury either on the part of amateurs, or even of the veterinary surgeon, when endeavouring to replace it ; sometimes it is produced by the animal itself, or by other animals when the prolapsed organ gets in their way. In some instances it has been caused by the jagged bones of the foetus in embryotomy, and in others by pessaries introduced into the genital canal to retain the inverted organ. In such instances the diagnosis is easy; for if the uterus is still inverted the vent is visible, and its dimensions, situation, and gravity can be taken into account. It is somewhat remarkable that laceration or rupture of the extruded organ is much less serious than the same amount of injury to the uterus in situ, and it would appear that in inversion there is the greatest tolerance of the most serious lesions. Why this should be has not been explained; but the fact is nevertheless patent, that in very many instances, when reposition of the uterus has been effected, the rupture has readily cicatrised, and union has been so complete and substantial that the animals have afterwards been successfully bred from . Some authorities .lave closed the rent by suture ; but very many have not, and the termination has been as favourable in the one series of cases as the other. Unless the rupture is in the lower wall of the uterus, sutures are at least superfluous. Beyond the measures for reduction of the inversion, and the necessary antiseptic after-treatment, little more has to be observed. When the rupture is serious in inversion, and grave results are to be apprehended should the uterus be returned, then it may be advisable to amputate This may be accomplished in the manner already indicated. the organ II.— Laceration and Rupture of the Vagina. Ijacerations and rupture of the vagina are not at all infrequent in the larger domesticated animals, and they are generally as serious as those of the uterus. They may occur during copulation, as well as in parturi- tion ; but they are more common in the latter. Trifling laceration of the vagina and vulva is often observed in primiparue, or those animals in which the soft parturient passages are narrow or rigid. The injury may be either spontaneous or accidental. The accidental injuries are those produced artificially during assisted labour, and are due either to the instruments employed — hooks, forceps, knives, etc., the hand or the nails of the fingers of the obstetrist, Uie sharp exposed bones of the foetus when embryotomy has been practised, or from some salient part of the young creature during the uterine contractions. In the latter case, the feet generally cause the laceration or rupture. Deformity of the pelvis, or roughened nodules of bone in the vicinity of the genital canal, may also lead to serious lesions of the vagina. When the luaion occurs in what we may call a "spoatancous manner,' it happens either that the vagina is lacerated along with the uterus, I * 614 ACCIDENTS AFTER PARTURITION. during natural labour and from continuity of texture ; or when the oa is amply dilated, but the vagina is overstretched by the foetus. In some instances such an accident as rupture of the vagina may be secomZar//— as when the textures which form its walls are much bruised and contused during the passage of the foetus. Then gangrene may supervene, and the mortified tissue be thrown off in a gradual manner, until complete ^jerforation has taken place. The lesions arising from these different causes are extremely varied — from removal of the epithelium or simple abrasion, to laceration of the mucous membrane, or even complete perforation of the vagina ; they may be situated either towards the vulva or cervix uteri, on the sides, floor, or roof of the canal ; or they may only concern the vagina, or involve at the same time the neighbouring organs and textures. Consequently, the gravity and the symptoms of such lesions vary con- siderably, according to their simplicity or complexity. Nevertheless, as will be noted hereafter, a trifling abrasion may bring a.bout very serious consequences ; while an apparently formidable injury may be followed by no unfavourable indications. With regard to rupture of the vagina, and particularly that which may be designated " spontaneous," it may be remarked that when the lesion occurs towards the cervix uteri, it is nearly always transversal, and, as has been before stated, the vagina maybe completely separated from the uterus. In other instances, the form and direction of the rupture will differ considerably. Longitudinal rents often extend into the cervix uteri and body of the uterus. Of all the domestic animals, the Mare appears to suffer most frequently from lesions of the vagina produced during parturition. The reasons for this liability have already been alluded to ; they may be chiefly referred to the length of the limbs of the footus, and the energetic and rapid contractions of the uterus, as well as the greater susceptibility of this animal to morbid influences— such as septicTsmia. Nevertheless, in all animals these injuries are notoriously serious, and if the laceration occurs when the tissues of this part are bruised, chafed, and irritated by manipulations during a laborious delivery, they are all the more grave. Eairard justly remarks that Bitches and Cats in which such a condition of the tissues exists, all succumb if there is the most trifling rupture of the vagina, even if there be no hernia. If the laceration is extensive towards the bottom of the vagina, the abdominal cavity will be opened, and the fuitus, if it has not been expelled, may have partly passed through the rupture ; in consequence of the walls of the passage being much less contractile than those of the uterus, the accidental opening is more pervious in the vagina than the uterus, and thus all the more readily allows the intestines or bladder to pass through. Laceration or rupture of the vagina is more easily diagnosed than when this accident occurs in the uterus, as it is nuich more accessible to the eye and hand ; though in some cases it is difficult to arrive at an exact knowledge of the situation or extent of the injury. With regard to in-ognons, this will nmch depend upon circumstances and the complications met with. Sometimes a mere abrasion of the inucous membrane which produces a raw surface, ca laceration extend- ing to the submucous connective tissue, may lead to iici)tic infe.cticn. This is particularly to be apprehended should the foetus or membranes have undergone decomposition, or any putrid matter— as the lochia— when the oe is us. vagina may be ! much bruised gangrene may adual manner, tremely varied ) laceration of )f the vagina ; : uteri, on the jrn the vagina, and textures. >ions vary con- Nevertheless, ng a.bout very njury may be rly that which that when the y's transversal, itely separated rection of the ill extend into lost frequently The reasons nay be chiefly getic and rapid tibility of this rtheless, in all the laceration , and irritated all the more 1 which such a e most trifling he vagina, the has not been n consequence m those of the igina than the i or bladder to iagnosed than ore accessible to arrive at an circumstances n'asion of the ration extend- •jjtic infection. Dr membranes s the lochia— TRAUMATIC LESIONS OP THE ((ENITAL OmASH, ETC. 615 been allowed to remain in tiae genital camaL especially during hot weather. Wounds or lacerations of the floor of i;he vadm are ge-erallv more serious than those on the roof or sides, for the reasons mentioned with regard to rupture of the uterus. And even woundn, or rapuwf^ of the sides or roof of the canal, are rmch more serious than the inciKions made through its walls m ovariotomy, owing to the presence during parturition and the puerperal state of fluids which may quickly become or are already, putrescent. ^ i j . Ilcemorrluuje is generally not so much to be dreaded as in lacerations of the uterus ; though occasionally it may be so serious as .0 endanser the life of the animal. Hernia of the intestine occurs when perforation of the vagmai wall near the cervix is complete, and the peritoneal cavity is opened. This IS a serious complication, as is also hernia of tlic bladder, which may happen when the rent is adjacent to that viscus ; though sometimes it is deemed a fortunate circumstance that cystocele is present, as she bladder effectually closes the rupture in the vagina, and thus prevents the escape of the lochial and other fluids into the abdominal cavity. Vaginal fistula, due to perforation, has been described. The single opening is on the floor or at the side of the vagina ; an exploration by the finger proves that the canal runs in an obUque direction, and does not communicaLe with the bladder or rectum. It contains a quantity of thick yellow pus which flows intermittently from the vulva, and might lead to the supposition that the case was one of vaginal catarrh. Cagny, who gives this description, sa>.^ it is readily cured by tearing the superficial wall of the fistula with the finger, so as to convert it into a simple wound which needs no further attention. It might be well, however, to apply au antiseptic dressing until cicatrization was well advanced. Peritonitis and ijelvic cellulitis are also very serious complications of laceration, and are a consequence either of the extension of vaginal inflammation to the neighbouring tissues, or the escape of septic matters or inflammatory products into the pelvic connective tissue or the peri- toneal cavity. It will be observed that, if extensive laceration of the vagina does not produce rapid death, there are other grave dangers to be appre- hended from either present or subsequent complications, The inflamma- tion of the vagina and submucous tissues, with suppuration and partial gangrene, may lead to the formation of tistul*, or even of wide-spread destruction of the soft pr.rts in the pelvic cavity, which sooner or later induces a fatal termination. Should this not occur, and some of the neighbouring organs have been injui-ed at the same time as the vagina, then there may be such important damage inflicted as to render the animal nearly valueless. Some of these injuries will be alluded to presently. The sipnptoms of injury to the vagina and neighbouring organs will, of course, vary with their nature and extent. Much constitutional disturbance is generally only manifesteu when the lesions are serious, or when septic infection has taken place, Small rents may not give rise to any perceptible derangement, except perhaps a little fever and tumefaction ; but if they extend deeply into the con- nective tissue, then acute fever, infiltration, and other grave symptoms may supervene. % f-^ I ;' )\ 4i 616 ACCIDENTS AFTER PAIITUIIITION. iu. When ;upturP n f h '^' ^^'^ ^''° "'"^* -^^P^"^ "P°" circumstances, should be effecSrlilo ''^f-,"^ ^' recognised during parturition, deUvery to prevent th?o? as speedily a. possible, and with every care, in order uniKnnLlv ^^'''"^*'«" extending and the fc«tus passing into it. If viscera ThlTJ^, T *^ '^*"'°^*^ precaution, so as not to injure other possiS; THii? ^"e'^branes should also be extracted as soon as pressed bv II' .^^ haemorrhage from the vagina, this may be sup- lateral i/,- . ^"J««t'ons of cold water if the rent is superior or the canal Sho ,ld T^'^'u^'l °^ ^'"^ perchloride, should be placed in musfbe replaced at one?. '' ^"'"' '' ''" '^"''"' '' ^"^^^""^^' *^-- cauLf ^nnU^^K^^^^u ^'' ^^rasious, or rupture of the vagina, every pre- lection wftht'h^'r^f .t'^ " "^^^ *° '^' ^'^'^^'''^ °f septic &n ZZ: ^'^ "^'J^*'' *^^ greatest cleanliness must be observed possfble bff "^ T''T'' ""' *^^°^^ likely to decompose, should if Ta soiu^tion/oT^°r^ ''"].°^^^' ^"^ ^^J^^^^^^"^ °^' '' ^wabbings ' ' o Ts n uch danTr if h °^^" u'^^ °'' °*^"^' antiseptics, practised. If there saturaL tn^ of hicmorrhage, a suitable tampoa of lint or fine tow for sSie time '^"'' ""^*^'' '"^^ ^' ""°^^'«^ '° ^^^^^^^ ^^^ the vagina Coviplications of Buptuml Vagina. in wM?ir^^"'''"H°''^'^^°'"^^^"°^« comphcations of ruptured va-ina Se re ctm'^Elr^"'".' '"^ '"^^^^^ "^^^ ^^^^l^'^^- ^h^ese a'e clfiefiy fora ed .^ ^1 I ' f"*^ P^^^^^^"™. one or more of which may be pei- extenTn.i f' ^^°^^S with the vagina. These ruptures varvt soI'L'hef mf/ietdV''"' '°"f ^ "^^^"^"^^ fatal, "^others are'not accomZ^^ deformity and inconvenience, such as y?si«/a Sr.ror//,. iniportant regions. They are recto-vacjinat the vagina ^ i^«'"'^^«'«, vesico-mginal fistula, and occlusiL of du?e^d IhmuTfh ^^^;^,"^,^-7-I"i"»es to the rectum are generally pro- misdirected and p?ess?dlw'^^^^^^ "^"^'^ 'TT^'^ '^' ''''' ^''^ thp vpr.fi,„, ^vT P . 1 up towards the sacrum of the mother, and if but hi^v T^ *° ^" distended with f.eces, not only will the VaSv BooVayer^ --« p--t-" of the fS:;;^ be posE to ni «h T { . J^ *^'' ^'""l""*^ '' discovered in time, it mav cLS nnd r 1 .'''''i ^,^^ P^'^' ^^'''^ misplaced into their natural thrraiprLmlSn 'tl e '"^^ '^ the vagina ; but notwithstandin rectum vervoipn'-"' communication between the vagina and esSbhshe7 ''"'""^' permanent, and a recto-vaginal fistula is st^~ £ ~' - - '- - ----- p.-ev rrconstimi ,,? "° ; ^' 'f '',"*'"' '"Jectionsi,,.,- ,-„„„,„„ and rcclm. circumstances, rition, delivery J care, in order ng into it. If, ent, it must be to injure other ed as soon as i may be sup- is superior or in cold water, 1 be placed in testines, these ina, every pre- tion of septic b be observed, se, should, if wabbings " of sed. If there b or fine tow, I in the vagina itured vagina, 3se are chiefly 1 may be per- bures vary in others are not ence, such as 3 recto-vaginal I occlusio)i of generally pro- of the ifoL'tus. the feet, are lother, and if II the vagina, of the foetus 1 time, it may their natural withstanding ! vagina and lal fistula is , so far as a employed to this surgical ne is to keep I and rectim, nciples — not supported by la. TltAUMAriC LESIONS OF TUK GENITAL ORGANS, ETC. 617 When the limbs or other parts of the fcctus protrude through the anus, it is nearly always advisable to amputate them, in order to move the body more easily in the vagina, and with less risk of further injury to the parent. Once in the genital canal, then the fcjetus can be extracted m the ordinary manner. Opiates should be largely administered. EuPTURE OF THE Pekin^-um.— Laceration of the vagina is not at all mfrequently complicated with more or less extensive rupture of the perinaeum, and occasionally rupture of the vagina, rectum, and perinaium may be met with in the same animal. Sometimes it is only the fourchette and superior commissure of the vulva which are involved; in others the entire extent of the perinanum is lacerated, and the lesion only ends at the anal sphincter ; while in others, again, the sphincter and part of the rectum are included. If, in malpositions of the fcctus, assistance is not timeously afforded— particularly in the Mare— the young creature is pushed onwards by the violent uterine contractions, and should it enter the rectum the anus is dilated ; while, if the expulsive efforts are continued, the sphincter and all the tissues between it and the vulva are greatly stretched and strained until they tear. Then the foetus is finally expelled— sometimes dead, at other times alive— and there remain inunense lacerations which convert the rectum and vagina into one vast opening, in which the termination of the digestive and genito-urinary organs open in common. In rare cases the injury is not so extensive, owing to the anal sphincter being sufficiently elastic to yield to the pressure without being much torn, in this way exempting the perinaeum ; so that there is only a wide recto-vaginal fistula to deal with. These ruptures, occurring immediately after birth, appear two or three times larger than they are some days afterwards, when the dis- tended textures have contracted somewhat ; the borders of the lacera- tion are sometimes even, in other cases uneven, ragged and shreddy. The consequences are variable, according to the extent of the injury. Moderate laceration does not usually prove very prejudicial; but if severe, serious inflammation of the perina3um, extending sometimes to neighbouring tissues and organs, sets in. If the tear involves the anus and its sphincter, there will be involuntary escape of faecal matters and flatus ; and in the most formidable cases — those in which the vagina and rectum form one wide gaping cavity — the mucous membrane is irritated by the free admission of air and excreta, inflammation and suppuration ensue, fistulao are formed, and the poor animal only too often presents a painful and repulsive spectacle, In other instances, partial recovery takes place, and the animals do not appear to be much affected or inconvenienced. They maintain good health, rear their progeny, if born alive, and may even bring forth young again, though the wound has not cicatrised. Indeed, in severe cases, union of the edges of the wound is exceptional, and in the large majority only the margin of the tear cicatrises, and a gaping, unsightly cavity remains. The treatment will vary, according to circumstances. If there is much haemorrhage, styptics must be employed ; if the bleeding is slight, cold may check it ; but if severe, iron perchloiide must be used. The lacerated margins, if nmch torn, must be freed from shreds which are hkcly to loau, or ha,vc already lost, their vitality. They nrast thcu be brought together by sutures— either of metal, carboHsed silk, or • :i-i I I ei8 ACCIDENTS AFTKR PARTURITION, catgut. Cold-water dressings may then be applied ; or styptic colloid, iodoform, boric acid, collodion, or carbolised glycerine may be employed. The parts must be kept as clean as possible, and the animal not dis- turbed or allowed to lie down until union has been effected. With this object a narrow stall is to be preferred. The sutured septum should be supported from the vagina, by a tampon placed therein. This will tend to prevent the pressure of fseces tearing away the sutures in the floor of the rectum, and this result will also be greatly obviated by administer- ing enemas frequently, and covering the mucous membrane with lard. Sloppy food should be given as diet. Fever and other unfavourable com- plications must be treated according to their indications. Opiates will prove of great service ; if there is much local disturbance or straining, suppositories of opium are to be recommended. Vesico-Vaginal Fistum-:. — When the floor of the vagina is ruptured, it may happen that the neck or walls of the bladder are involved in the lesion, just as that viscus may, as we have seen, become prolapsed or hernied through the vaginal rent. When rupture of the bladder occurs in this manner, the case is indeed serious. The urine is no longer con- fined to its receptacle, but escapes through the laceration and becomes infiltrated in the pelvic connective tissue. Hence arise most serious complications — pelvic celluHtis and urine-abscess, which rapidly lead to a fatal termination. In less formidable cases the urine may escape by the vagina, but involuntarily ; so that incontinence of urine not only proves a troublesome infirmity, but the constant passage of this fluid over the membrane lining the vagina gives rise to intense inflam- mation of that canal, and leads to the formation of a vesico-vaginal fistula. This fistula may also be produced by pressure or bruising. When the foetus is very large it occasions over-stretching of the vagina, and if it remains for any length of time in the passage the distention weakens the vitality of the soft tissues ; so that the compression to which they are submitted between the fcjetus and the floor of the pelvis will produce mortification, which may extend to the neck of the bladde)'. The resulting sloughing, should the creature survive, will establish a direct communication between the vagina and bladder. An animal may live with a fistula of this description, provided urine- abscess, uraemia, or other serious complications, do not occur. The si/mptovis need not be specified. The chief is incontinence of urine. When this fluid is observed to be constantly dribbUng from the vulva after parturition, the existence of the accident may be suspected, and an examination 2>er varjinavi will confirm the suspicion. Treatment ^nust be mainly palliative. Occlusion of the Vagina. ^ — ^This has occurred after parturition, as a result of injury to the mucous membrane of the canal during delivery — union taking place between the sides of the vagina. Occlusion may be more or less complete, and its seat at any part of the canal, but always beyond the meatus urinarius. Such cases have been observed in the Mare and Cow. A careful manual examination will detect the state of affairs, and if cicatrisation is recent the new tissue may be broken down by the finger, finger-nail, or finger-knife (figures on pp. 535, 536) ; but should it have become firm and unyielding, then careful dissection will be necessary to separate the sides. If the adhe- sion is situated some distance from the vulva, the operation will be facilitated bv em.Dlovin^ a vaginal dilator. THAUMATia LESIONS OF TllK (lENITAL ORGANS, ETC. «19 yptic colloid, be employed, rnal not dis- 1. With this am should be ?his will tend n the floor of y administer- le with lard. ?^ourable com- Opiates will or straining, a is ruptured, volved in the 1 prolapsed or ladder occurs lo longer con- and becomes most serious . rapidly lead e may escape irine not only ! of this fluid bense inflam- /esico-vaginal ! or bruising, of the vagina, ;he distention Dmpression to r of the pelvis )f the bladder, ill establish a •ovided urine- 3cur. icontinence of )ling from the be suspected, n, )arturition, as aring delivery )oclu8ion may the canal, but been observed ill detect the issue may be e (figures on yrielding, then If the adhe- ration will be III. — Thuomhus op the Vagina and Vulva. Thrombus or luematoma of the vagina and vulva, is sometimes observed in the Mare and Cow after parturition, and is due to an infil- tration of blood into the connective tissue of these parts, from the almost inevitable injury they sustain during laborious parturition. In such cases, when the fcutus is very large or in a wrong position, considerable manipulation and traction are often necessary to adjust and remove it ; and this leads to bruising of the soft parts against the pelvis, and laceration and rupture of the bloodvessels and connective tissue. The bloodvessels are larger, and probably more numerous, during pregnancy than at other times ; consequently, there results extravasation of blood, and considerable tumefaction of the genital canal, particularly in the vagina and vulva. Sometimes this tume- faction appears during parturition, when it may form an obstacle to birth. The mucous membrane is raised into irregular masses, perceptible to the eye, and still more markedly to the touch. The membrane itself has a blue, violet, or black tint ; the labia of the vulva are consider- ably swollen, and the engorgement may extend to the thighs and croup. If there is not much extravasation, the effused blood may be absorbed in a few days ; but if the thrombus is extensive, the blood becomes decomposed, gives rise to inflammation, which may run on to gangrene, and septic infection consequently ensue. As to treatment, scarifications are, above all things, to be recom- mended. Samson, 1 who has had much experience of these cases, says that the labia of the vulva should be well separated, and a bistoury plunged into the right and left walls of the vagina, as if to open an abscess ; the incisions should be large, and proportioned to the quantity and situa- tion of the clots ; pressure must then be made, so as to remove the latter. The operation appears to be quite innocuous ; though a case is recorded by Cartwright,'- in which a stream of blood issued from one of the punctures, in consequence of a large vein being wounded. "When all the extravasated blood has been removed from beneath the mucous membrane or skin, cold water injections and sponging, and weak solutions of carbohc acid, permanganate of potash, or other deter- sive and antiseptic fluids, should be resorted to. The same treatment is to be adopted when suppuration has set in, only more attention must be paid to the antiseptic treatment. Should haemorrhage from the incisions prove troublesome, styptics —such as dilute iron perchloride— and tampooning the vagina, may be had recourse to. IV. — Eelaxation of the Pelvic Symphysis. This accident, which is far from common in woman, is still more rare in animals ; and there appear to be only two cases recorded, both being Cows. With regard to the cause, there is probably a natural tendency to the 1 Recue.il de Midevine Vtteriiiaire, 1863, p. 106. '^ Veterinaria7i, vol. xix., p. 386. N { 1 ■ I 620 AVaWENTH AFTER I'ARTUHITIoX. accident, which is increased by pregnancy, and the volunin an^^ malpre- sentation of the foetus no doubt Ifad to its occurrence when aturition takes place. The sacro-ihac arL ;ulations may also parti( ^ ♦^e in tliis relaxation, the symptoms of which are deformity of 'u pelvis, and altered movement of the hind-limbs. The animal lies almost continually, and rises with oat difficulty. When up, it can scarcely move, and the hind-quarters \y 'rom side to side — the ilium of either side rising or falling a^ the corresi tending limb sustains or is relieved from weight. The hu id, passed into the rectum, will cause pain if pressure is made on the sacio-i! j,c articulation. The internal angle of the iliums projects much beyond the spinns of tho sacrum, and when the animal walks movement can be detected uotwc the pubic bones. The condition is considered incurable. Wii n I V. — Rui'TUHE OF THE BlADDER. Rupture of the bladder alone, during parturition, would appear to be an unusual accident, from tlie infrequent mention of its occurrence. That it may happen, however, is beyond dispute, and the cause of it is obvious. In the Mare the act of parturition is hurried and energetic, and if it occurs while the bladder is distended with urine, the pressure of the fatus during expulsion may rupture this viscus, and particularly if the rectum above is also full of fieces, the foetus large, and perhaps in a wrong position. The extravasated urine gives rise to peritonitis, and the animal will present the symptoms of that most painful intlamniation. Death is inevitable. VI. — Rupture of the Intestines. There are some instances recorded in which rupture of the intestines — small and large — has occurred during parturition, without the uterus or other organs being involved. The accident may have been due to over-repletion of the stomach and intestines with ingesta, and the energetic action of the abdominal muscles upon these organs during the labour pains ; or from the anini, ' throwing itself down violently, under the same circumstances. Schaack mentions a case in which rupture was due to a loop of intestine being compressed between the foetus and the brim of the pelvis, when the former was passing through the genital canal. Such an accident is beyond remedy. Invagination of the intestines — rectum and floating colon — in the Mare, has also occurred during parturition, due probably to severe expulsive efforts. VII. — Rupture of the Diaphragm. Rupture of the diaphragm is a rare occurrence during parturition, and I can only find three cases recorded. They were probably due to the same causes as those which produce rupture of the intestines. Death resulted. an'"' malpre- loUritioii e in t'iis yeiVlS, and at difficulty. ly Toni side orrefiiionding sed into the articulation, spines of the 3ted betwe appear to be 1 occurrence, cause of it is id energetic, the pressure particularly and perhaps n. animal will Death is -he intestines at the uterus been due to 3ta, and the IS during the lently, under to a loop of brim of the mal. olon — in the ly to severe I parturition, bably due to le intestines. TEAmUTIC T^'^WN. op THE GENITAL ORGANS, ETC. VIII. — RUPTUUE OF THU DOMINAT, MuSCLES. 021 At pago J93, when treating of " Hernia of the Uterus " during preg- nancy, it was explained under wl t conditions, and the manner in which , i'ture of the abdominal muscles occurp Th'' ccide' can scarcely be designated as one consecutive to part itiou but nevertl nlpss engage the attention of the votenuary *p-.. s been emptied of its contents. In t'e samo .ae to the appropriate measures. treatment may igeon, after the section allusion IX. — Rupture of the Sacrd-sciatic Ligament. We can only find one case of this accident on record ; so that it must be extremely rare. It is given by Naylor,^ and the subject was a three- year-old cart Mare, which had a malpresentation. The animal was down, and the fore-feet of the foetus protruded beyond the vulva, but the head was not visible, it being bent back to the side of tne chest ; the young creature was dead. Embryotomy was resorted to, and one limb v'ls about to be reniived, when the uterus suddenly contracted with it violent 0, and half expelled the foal; traction then removed it. -\\\ attempts to get the iilly up were ineffectual, and an examination showed that a ruj^ 're of the sacro-sciatic ligament on the right side, with other lesir 's, had taken place." Stimulants and laxatives were administered, a^.d a mustard plaster applied to the loins. "In two days she was on her legs, and tottering about the yard. Suffice it to say that she ultimately recovered, and though for two years the off-quarter was less in size than the other, she ultimately got quite well, and had two or three Foals.'' X. — Rupture of the Heart. This is also an extremely rare occurrence, and I can only find one case — that of a young Cow which had been straining violently for some hours, and suddenly fell down and, gasping, died. At the necropsy a transverse rupture, two centimetres long, was discovered in the right ventricle of the heart.'- 1 Veterinarian, vol. xxxiit., p. 321. '^ Mimoires de la Societe Centrale de Mcdecine Vetirinaire, vol. v. '■, ipH iiilii I 'I sTk IMAGE EVALUATION TEST TARGET (MT.3) 1.0 III I.I 1.25 1^ |2.8 ^ us. 14 25 2.2 12.0 1.8 1.6 6" -^ Fhotograpliic Sciences Corporation 23 WEST MAIN STREET WEBSTER, N.Y. 14580 (716) 872-4503 f/u 1^ 622 PATHOLOaY OF PARTURITION. BOOK V. PATHOLOGY OF PARTUEITION. U JDEK the head of Pathology of Parturition, it is intended to include those diseases which accompany or follow this act, and are more or less reiatea to it borne of these maladies are of great pathological interest and practical importance, and deserve the closest study. The parturient or It the term might be employed, puerperal period, is a very remark- able and critical one m the life of the female animal, and it becomes all tiie more so as the creature is submitted to the influences of domestica- tion, and renaered more and more artificial by skilful breeding and management. ° During pregnancy, a large amount of nutritive material has been abstracted from the parent to nourish and develop the fcetus. and when birth takes p ace this is retained until the Ipcteal secretion has been fully estaohshed. Consequent upon this reflux, there is established a Jcind ot plethora which, together with the nervous excitement and succeeding prostration induced by the straining and pain of labour renders the animal more susceptible to the influence of morbific causes ot various kinds. Hence we have maladies peculiar to the parturient state, or if witnessed at other times, at least much aggravated when they appear at this period. Though the parturient diseases of animals are not so numerous as those of the human female, yet they are neither unimportant nor few; and it is possible that, with the advance of veterinary science, their number will be increased-so far b-, exact detinition and differentiation are concerned. In this respect, the prominent part infection by septic material- produced by the action of micro-organisms-plays in the development of parturient diseases is to be remarked. It is but recently that this agency has beer recognised as one well worthy of consideration in veterinary pathology ; and the closer its effects are studied, so the more inchned are we to attribute many diseases-and particularly those of the parturient state-to one common source, septic infection. Of course there are other maladies or disturbances, chiefly of a local character the etiology of which cannot at present be traced to septosis and which merit notice in this part of our work. The diseases which we have to consider are": 1. Vaginitis; 2. Leu- corrhcea; 3. Metritis, Metro-peritonitis, and Partttrient Fever ■ 4 Par- turient Apoplexy; 5. Postpartum Paraplegia; 6. Parturient Eclampsia; 7. Epilepsia Lterina or Mama Puerperalis ; 8. Parturient Larnhvitis ; 9. MamviUis; 10. Agalactia; 11. Injuries to tiie Teats; Diverse Lijunes CHAPTER I. Vaginitis. Inflammation of the vagina may exist independently, but it iseenerallv an accompaniment of inflammation of the uterus, or " metritis " which being the more serious evil, masks this malady. When occurring after partunuon it is generally due to protracted and laborious delivery to include nore or less cal interest 3 parturient sry remark- jecomes all domestica- 3eding and I has been , and when I has been ablished a 3ment and of labour, )ific causes parturient ated when 3f animals ire neither jdvance of c a^ exact uaterial — velopment that this eration in ) the more y those of of a local septosis, ; 2. Leu- ; 4. Par- olampsia ; laminitis ; ! Injuries. generally I," which, ring after delivery, VAGINITIS. ,23 which necessitates manipulatory efforts, the use of instruments etc the passage of a very voluminous fcBtus, the pressure of a pe88a;v or any other cause that may lead to irritatior hmidnt, L P^^^^^^' ^\ the mucous membrane. In very exceS onal instanoi^^/lf^ • T^^^^'^g "^ may be indirectly due to the ac^tion of 3 on tt ^k ^ ^ the^W ' r^^ The 'abia of the vulva and the linine memhrnno nt fk« , • more or less swollen, the latter being i? a deep or brirfit rp7S^'°^ ^'' Hyid hue ; there may be also patch'es of c?CtKnd"ih™^^^^ with wounds or abrasions, and in rare cases phlyct^n^ may be ob^^ed on the surface of the membrane. The temperature of the canal isTlto greatly increased, while its walls are dry and often adhesive mcturf tion IS generally painful and difficult, constipation is often presen and there 's sometimes much itching in the region of the vulva whi-ht indicated by the continued attempts the animal makes to rub The part If the inflammation is severe and extensive, fever will be present ^ . ?u !u''^^°''?"'*'°° ^^^ existed for one or two uays themucu-i secreted by the membrane is greatly increased in quantity -it is SfirsJ a serous limpid fluid sometimes streaked with blood; then it graduallv becomes thicker and^ sero- or muco-purulent. soiHng the taifand £ of ?h.' W^ ^°?'' ^"^ «°°^«^™?« he^o^ing so acrid & to cau e removal of the hair and excoriation of the skin. ^cmuvm Simple vaginitis, of itself, is not a serious affection, and the infiamma- hon of en subsides spontaneously in the course of a few days, or rapSfy yields to treatment. In some instances, however, it assumes a troSble^ some, if nut a grave character. When gangrene ensues there mav be also infective inflammation in the surrounding parts, and large por^ tions of the membrane, or even the skin of the labia, m^y slough wMe he discharge is sanious and foetid. Baumeister describes a diphtheri c form of vaginitis which he observed in a Cow th^t had calved a few days before, and which died on the third day. .„ the autopsy th^ vagina as well as the uterus, was found full of pseudo-membranous productions. Another Cow which stood beside this one. anTvS had calved four weeks earlier, contracted the disease a few days after the Cow that died and also perished-leading to the supposition that this form of vaginitis is contagious. The treatmc7it of simple vaginitis does not merit much consideratioi Cleanhuess, attention to diet, and injections of cold or tepid water oi mild astringents, into the vagina, generally succeed in subduing the inttammation ; but if the injections induce straining they should onlv h&- administered in small quantity, and in combination with anodynes When, however, there is any tendency to acute inflammation and can^ grene, or there exists ulceration, sloughing, or even abrasions, antiseptic treatment is advisable— a solution of carbolic acid (2 to 10 per cent ) permanganate of potass, boric acid, or chlorinated or tar water bein<^ perhaps the best local applications. General constitutional treatment may also be necessary, and especially if the fever runs high and there are indications of septic infection €24 PATHOLOGY OF PARTURITION. m CHAPTEK II. Leucorrhoea. When inflammation of the vagina, and perhaps also of the lining membrane of the uterus, becomes chronic, the more acute symptoms disappear; but the vaginal discharge continues, and may even increase in quantity. Usually the fluid is of a white, glutinous, and odourless character ; or it may be purulent, muco-purulent, or even chocolate- coloured and sour-smelling, or sanious at times. The secretion is mainly composed of mucus. Histologically, we find mucus corpuscles, an abun- dance of epithelial cells, probably some pus corpuscles, and at times micrococci and infusoria, particularly the Trichomonas vacjinalis, which IS also found in healthy mucus from the vagina. Sometimes the secre- tion is only manifest in an intermittent manner —as when the animal is lying down or in movement, or during micturition. It is more frequently observed in the Cow— particularly if lymphatic— than the Mare, and especially if there is had hygiene; it is somewhat rare in the smaller animals. The appetite is in many cases unimpaired, and the creature does not appear to be inconvenienced in any way ; in other instances, with the increase in the discharge and the duration of the disease, there is loss of condition and appetite, the yield of milk is less, and it may be Viscid ; signs of oestrum are more frequently present, but fecundation does not take place so readily as in health if the os and uterus are affected ; if it does occur, the chances are that the full period of preg- nancy will not be reached. When the discharge is chiefly from the cervix uteri, it is more trans- parent and watery-looking than when it comes from the vagina or interior of the uterus, and the os is usually more or less dilated when these parts are involved, while the uterus itself is not so firmly con- tracted as when in a sound condition. The mucous membrane of the genital canal is pale, relaxed, and insensible ; in other cases it may be roughened by granulations ; and sometimes it is tumefied and red. Vaginal catarrh in the Bitch is often associated with, or dependent on, the presence of papillomata or epithe- liomata. In rare instances the tissues forming the canal become indurated and lardaceous, while its calibre is diminished. Lafosse has even observed adhesions between the sides of the vagina in an old Mare. With regard to treatment, if the disease is not of very long duration it may yield to cleanliness and astringent injections— such as solutions of sulphate of zinc, alum, permanganate of potass, tannic acid, etc. When it has been in existence for a long time, however (it may continue for months, and even years), it is generally very obstinate, chiefly from the relaxed condition of the membrane. The uterus or vagina, or both if affected, should be thoroughly washed out twice or thrice daily with warni water, which ought to be injected until it flows out quite clear. A solution of carbolic acid or cresyl in warm water should then be injected. A solution of the sulphate of iron has likewise been successfully used. Nitrate of silver has also been efficaciously employed iu solution (1 to 10), as has tannic acid (1 to 70). Tonics should be freely administered, and good food allowed. If the discharge continues after two or three weeks' treatment, it may be found useful to apply a blister to the loins, croup, or thighs. METBITIS, METRO-PERITONITIS, AND PARTURIENT FEVER. 625 the lining 3 symptoms /en increase d odourless 1 chocolate- on is mainly es, an abun- id at times lalis, which s the secre- te animal is 2 frequently Mare, and the smaller tie creature • instances, sease, there i it may be ecundation uterus are od of preg- lore trans- vagina or lated when firmly con- laxed, and tions ; and :ch is often I or epithe- iirated and 1 observed I duration 3 solutions acid, etc. y continue liefly from la, or both daily with 3 clear. A e injected, fully used, ition (1 to d. nt, it may i. CHAPTEE III. Metritis, Metro-Peritonitis, and Parturient Fever L^e^nTwtt^^ft^^^^^^ -^y b^.^ited to one or more of outer coveringlTh?peSon?um Sl^tS^ and?;^ ^ ^"' *° ^-^^ signs; while the introduction of septic Ste^sl^l;^^^^^^ P^ert^in very often a result of this inflammation wUverL?n ' ^^'f '^ of PopticaBmia. The latter complication, f^om the febrile ^-nT^?^' which accompany it, is anDronrinfplv /UcY- .^'?-^ ^^^P^^e indications " Parturient Fever "-a SnSn L" i^ i"^""' ? ^ *^' ''''^' °^ very different malady of this peS Pnl]^- T^^^^^, *° "°°<^^«^ ^"^ co^/a^..-and which'wUl be stSd iTefeatr"' '^'^'^^^ °^ ^^'^^^^^^^ 4ic^^ra-rie::t rL';::ry"iiiv^^^^^^^ without fever which accompany the formL are "eneS^nor * * ? symptoms of and it is often difficult to discoverwhen'^seS inf^Jri ''! fPP^rent, Symptoms, Z n ''/^''' \' tumefaction of the vulva, with^heat and redness of t^he Ifon nf' /r'' P/J^^^^g'.diffi^'^lty in micturition, diminution or suppres sion of the milk secretion, inappetence and dulness Wifh nn^^ (>f without, treatment this conditiJJpasses off in aew days In t'aumatlc markSv ' "^"^^ ^^^Ptonis are observable, but soon there are wet n the rZ'' J°^,^°rripilation; if a Cow, rumination is suspended • m the Cow and Mare the pulse becomes small, hard and auick fh^ sXhJ 1^/^^ '' '*°PP^^' ^^^ the udder dim?nTshes in^ ze and and sh^lLv ^h^^''H^'^'^?' '^^^^^^ ^^^ '^^ -^^V^^^on is hurr'ed branes intctPd whT ;^' ^* ^""^ l^^'^' ^""^ ^^^ ^^^^ble mucous mem- Dranes injected , while the horns and ears are very warm The ammal grinds its teeth, and betrays the existence of colicky pains 40 I- W ( Ea-i^Mi '!t«:H' 626 PATHOLOOY OF PAllTURITION. by lying down andgettins up, stamping, striking at the belly and turning the head towards the flanlis, whisking the tail, and making more or less energetic expulsive efforts. Signs of pain or lameness in the hind-limbs become apparent. When the uterus is more inflamed, the animal does fi? "® "°^"' because of the increase of pain produced by pressure on the abdomen. The smaller animals, however, maintain the recumbent position. A very marked symptom is tumefaction of the vulva— the labia of wbich are separated— and the discharge therefrom of a fluid at first serous, and either transparent or having a yellow, chocolate, or reddish a'I *i ^*^ becomes gradually thicker and more abundant, and is modified according to the termination of the disease. Manual explora- tion of the vagina discovers it to be very hot and sensitive, particularly towards the cervix uteri ; when its lining membrane is exposed, it is observed to be swollen and reddened, and sometimes there are found diphtheritic ulcers and croupous deposits on the inflamed surface. In some cases, when the uterus is very much swollen— and particularly in lean, flat-sided animals— the inflamed organ can be felt on the right side, and pressure on the abdomen often, but not invariably, causes pain. Kectal exploration generally discovers the uterus larger than natural and more or less distended by gas. Defoecation is painful, and the fsecos are hard. The Mare attacked by metritis or metro-peritonitis generally main- tains the standing posture, with the back arched and rigid, and marked indisposition to move— only lying down on the approach of death, or towards convalescence ; whereas the Cow persists in lying, and this is supposed to be due to paralysis of the hind-quarters, but it is more pro- bably owing to debility or prostration induced by the pain. In Euminants there is generally distension of the rumen with gas • there are also acid eructations, and even regurgitations. When the tem- perature rises very high— and it may reach 107° to 108° Fahr.— death is certain. In rnetro-peritonitis there always occurs— and sometimes very rapidly —an efiasion of serum into the abdominal cavity. When this is in great quantity, ti.e abdomen becomes enlarged and rounded, as if the animal had been feeding freely. There is then dulness on percussion in the lower part of the abdomen, contra ng markedly with the tympanitic resonance of the upper regions ; wiine sudden pressure by means of the open hand on one part while the other hand is placed at another point, will cause a perceptible movement of the fluid. Terminations. _ The course of metritis, metro-peritonitis, and parturient septic;- mia, IS generally very rapid, and may not occupy more than a few davs- usually three or four, rarely five or six days. In some cases a chronic form may be met with— and particularly in simple metritis, due to retention of the foetal membranes, and sometimes to abortion But these exceptions are few, and the disease or diseases just named may be designated as serious, when we learn that death carries off mora than one-half of the number of animals attacked. Though so serious, however, in those animals which are about to recover convalescence ensues very rapidlv, especially witli the Cow A few hours often suflice to bring about such a change for the better, that one could scarcely believe it unless he saw it, audit might excite a doubt and turning more or less i hind-limbs minial does pressure on J recumbent he labia of uid at first , or reddish lant, and is aal explora- particularly cposed, it is e are found urface. In •ticularly in n the right :auses pain, an natural, rally main- i-nd marked thrombosis of the veins, with secondary pyemia. This may explain the occurrence of •.i i it I 630 PATHOLOOY OF PARTURITION. abscesses appearing at the joints, and inflammation of the feet super- vening on parturition. Thrombosis of the lymphatics has rarely been observed in animals ; it is noticed within the inflamed spot. - The coagulated lymph either uniformly fills the vessel, or gives the appear- ance of a string of beads. Sometimes, also, single larger dilatations of lymphatic vessels are seen. The thrombosis may bo due to the direct innuence of the infecting matter, but more frequently it is caused by tne inflammation of the connective tissue around the vessel. The pro- aucts also of the inflammation of this tissue have a tendency to coagu- late, and the contents of the vessels participate in the process." sometimes the lymphatics are filled with pus {Furnlent li/nwlianqitis). and the neighbouring glands are swollen and softened. Thia thrombosis ot tne lymphatics has been considered a favourable circumstance, since tne occluded vessels are prevented from conveying the infecting materials: the inflammatory process being at least delayed at the nearest group of lymphatic glands. The lymphangitis is therefore con- smered an accidental change, which usually remains limited to the diseased part, and may disappear; and it has been remarked that it rarely extends further towards the thoracic duct, unless there are other very considerable changes. Sometimes the thrombi in the vessels of the uterus soften ; so that in cutting into the walls of the organ, they appear like small abscesses! varying in size from a pea to that of a nut. They can only be dis- tinguished from abscesses by their smooth walls, since the afferent and eflerent vessels cannot always be found. In intense parametritis, with extensive infiltration of the subserous connective tissue other organs may be involved, and especially those which are directly connected by means of this tissue-such as the ovaries. The peritonitis may extend through the diaphragm to ichoiTh"^'*-' °^ inflammation in both membranes may be due to aJ^ i!^°^^ ?f ^ ,'" ^^'^^ thrombi in the bloodvessels have become detached and broken up, the fragments may be carried in the circula- tion, and give rise to embolism and haemorraghic infarcts, or to meta- 8lJeLlM'neTs!e^.'^''' parenchymatous organs as the lungs, liver. In the most rapidly fatal cases, in which death is due to septic para- metritis, there is no time for fibrinous exudation, and there are appearances not unlike those observed in splenic fever. The blood is n,™° T? ^""^ non-coagulable, ecchymoses are found in various oigans and tissues, and there is a marked tendency to rapid putrefac- nf on T^«,e*^."^entary structures of organs show the commencement ot an acute mflammatory process - the fine granular infiltration cells ^ swelling," fatty degeneration, or even disintegration of t.? ^!'l ^^^" already stated that there is nothing exceptional in par- ^rT u:- ^""^ '° ^u'' ^' '^^ pathological anatomy is concerned, the same alterations are observed in non-parturient subjects. Parturition only predisposes the ammal to its occurrence, from the fact that there are wounds and bruises inflicted on the soft tissues of the genital canal ; that there is present a quantity of matters-fluid and solid-either de- composed or decomposing; and that the bloodvessels and lymphatics ot the uterus at this time are in a favourable condition for the reception and action of this septic material. In animals whicia have succumbed feet super- rarely been 3ot. " The the appear- latations of 3 the direct I caused by The pro- y to coagu- ! procesa." ij)ltan(jitis), thrombosis ance, since I infecting ^ed at the refore con- ted to the ied that it 3 are other I ; so that, abscesses, Illy be dis- lerent and subserous ially those ch as the hragm to be due to ve become ie circula- to meta- iigs, liver, iptic para- there are e blood is n various putrefac- encement 1 filtration ration of il in par- srned, the arturition hat there tal canal ; sither de- iiiphatics reception iccumbed METJilTIS, METJiO.PEJilTONITIS, AND PAHTURIENT FEVER. 631 ?ou^nV^° operation of ovariotomy, similar pathological alterations are With regard to chronic metritis, various changes have been observed In some cases the uterus has contained a consideiable quantity of fetid pus, or muco-purulent matter of a white or gray hue • while the mucous membrane has been gray or dark-coloured, thickened and softened, and the cotyledons infiltrated, softened, or even indurated • the vagmal mucous membrane is also infiltrated and indurated in some cases. Causes, The prcdisposinri cause of metritis, metro-peritonitis, and parturient fever, is the parturient or puerperal state. It is true that septic infec- tion, with Its train of symptoms, may occur at other periods and from various causes; but metritis and its complications are, as a rule observed only after abortion or parturition. ' The occasional causes of metritis, and therefore of metro-peritonitis and fever, are injuries to the genital canal or interior of the uterus during or after birth. The manipulations necessary for the artificial removal of the foetus or its envelopes, and by which the mucous mem- brane is abraded or wounded, are a frequent cause ; inversion of the organ, and especially when it has been exposed for some time to the air and the action of irritating substances, or bruised o: lacerated in returning it, is another cause. Eotention of the fcetus or fostal envelopes has also been given as a cause of metritis. But other cases have been noted in which birth was easy and natural, and at the usual time ; and yet towards the second, fourth, or sixth day after parturition, the animal began to lose its appetite, the vulva became swollen, fever set in, and all the symptoms of metro-peritonitis became rapidly developed. In these cases, the occurrence of disease has been attributed to some imprudence in management, which brings about derangement in the functions of the skin or digestive organs- such as exposing the animal to wet and cold out of doors or draughts of cold air in stables, giving it cold water to drink, or unsuitable food. Sometimes the disease occurs among such a large number of animals almost simultaneously, that it has been looked upon as epizootic, and due to a miasma. More particularly has this been the case with parturient fever, but which must now be considered as due solely to the absorp- tion of septic matter. The production of parturient fever in animals, as in the human female, requires two conditions : (1) a fresh wound by which the septic poison can enter. The wound need not be large, but it appears to be almost essential that it is recent — for suppurating or granulating sores do not absorb, so long as the infecting agent does not destroy the surface. If the mucous membrane is intact and protected by its epithelium, absorption is also prevented ; (2) an active septic substance, either produced in the animal which is to be the subject of parturient fever — auto-infection, or introduced from without— external infection. Birth rarely takes place in animals without more or less laceration or abrasion of the cervix uteri, vagina, or labia of the vulva; and those injuries which are on the floor of the genital canal are more likely to be followed by septic fever than those on the sides or roof, simply because they are brought more directly in contact with the decomposing m ,1 *s SI ,i i 'J . r w :. ^ li! J I: Ui 632 PATIIOLOOV OF PARTUniTWX. I Se ut«n,« '"^r " ^^^f freouently takes place from the interior of there from fhl ' "°""al conditions, as injury is not so likely to occur there fio n the passage of the fcotus. Exceptionally, it may take place durn,H "' through the cotyledons, when some of these are torn duung the separation of the fa-tal membranes. f^. fi '^'^^, "*^®" mentioned, the parturient period is eminently favourable ien tirL'^T °" °^ septic mitters; as the mucous membmne of the fyrXti^ratiUHotrp^^^^ "^' '""^ '^°°'^""'^ ^^^^ vjh^^Tufr^^'''^' °f "'' generally when there is a fresh wound, and wnen the tootus is dead, and. still retained in the uterus, has become factioTnTH'^''^^^^ '^"^ ^^''^^^ °^ '^'^J °r f^°"^ r«t«""on and put?^ laction of the envelopes. The ichorous putrefaction of wounds or fecrion!"!""^ '"^ '''^''''^ "'^ ^''^''"''' "'''y "-^^^ ^^^<^ *° septic in- onSati^^Jnlr^' ^^T v.*^" ^°°^"« '^ decomposing, is a dangerous operation if a wound chances to bo in*^icted during its performance. W-. wf T. ^'^^ '^« ^«'"°val of the fcetal envelopes.-' h«^o„ ^^""^4 removal of tVe footal membranes does not appear to for if ?r'?'' T.^.^A^^''' retention is not usual* • followed by infection dlL^"-.- '^ *^? ^^''^"^ °'' ^^•^'^ day after parturition that their aecomposition usually commences ; so that if small injuries have been produced during birth, it is most likely that they will be suppurating nnSS°''^^^;°^ ^f't^ *"^^^' '^"^ *^b"« b« P'-oof against the passage 0? putrid matter. If however, a fresh wound is n'ade. or the%ranula- tions are mjured by mechanical means, then removal of thi putrid envelopes is full of risk. Foelen mentions that a Cow had a wound ?o^,rfhM f; ^'lu *^^^.wa« infected by putrid membranes; on the septLmL ' ^""'""'^ ^'"^ ""'^^ ^" '^^ symptoms of parturient am^fcf nniIni''/''^'Tf /^?'' °°,* ^P^"^" *° ^^ SO frequent as auto-infection among animals. It takes place when septic materials are brought to pleml?tS ^''"' ^^^ following illustrations, which could be easily and largely sup- Embryo\Uyh\VL\p*frfT.'^''''' '!! ^^^ «*«"«. and much distended with gas. apparentlv without p.,,1 *" J" "'.l"" •*"• ^^^'"''^ '* ' *»'' *'»« ^a« accomplished, «e%c^^l•iT!n=^rd^L^^^^^^^^^^ «" *^« *^'^ ^^; creatut orit^s'msS^ttL^H " " -^-^V"^""^' ' ''"^ **>« *>-' "^ *he young afterwards a second rllf in * . . ?^'"* T^f " •'""^" *°""'^- Twenty four hourl withoutfnjur ^g tt Sow In two'davs^'S" S '" "" r?^^/ '^•V'"^' ^--' ^"' and was killed. ^ *'^'' ^*"" ^"^ attacked with puerperal fever, matio!f rt'heiera"3 peS^neP'^" '^ ^'^^ :i*^';J'' '^ ^^ryotomy. Septic inflam- 4 It is wpll tn I *r. «". T '*'* '"' *"'! *''«' C"^ died on the seventh day. anvlenUhrf Jm -"i *'''* ?'*''''^' ""'"'^ '"«*'*•" ^he fa>tus in the genital cLal for ZVveraU. Thi^ ^n^*'*''f ^"1" °'' ^^"^••^abouts), frequently perish from SepZmTa oZ'gloL sJieroTtl: u'mtliiV''^ !f^\*'^* theV.ppy ^. retained quic^klyZ titi. 7^: 5lf i - -:'£ fcta ^a .ady^m;. for^t.^.^ remotS°''The 'oDerSor^hl"/ '"• f^T" ^"'" ^'/ '^'^^^ ^^'^^ parturition, when they were membrane in doinfsoa^ Et ^'Ih'""^ wounded a cotyledon or the uterine mucous was aCterwithK^rient fever an7rr'H'''"M "'-^ ^^""\ ^° three days the animal on post-mortem exSSn ^ '^''^' ^° ""^"'^ *" '^' "^^-^^^ ^""'^ ^^ '^^^^''t^d interior of 3ly to occur take place le are torn favourable rane of the easels and round, and las become and putre- i'ounds, or septic in- dangerous rformance. appear to ' infection, that their have been ippurating passage of i granula- ihe putrid 1 a wound i; on the parturient )-infection )rought to largely sup- d with gas. complished, e third day the young 'four hours il force, but peral fever, ptic inflam- day. 1 canal for Septihemia lickly dies : icenta, and 38, and the 3 direct in- itch is the I they were ne mucous the animal )e detected MKT/UTfS', METUO.I'EIilTONlTIS, AND PARTUniENT FEVEH. 033 •In recent wounds or lacerations of the cenital nraano K„ „ as directly by the hand. instrun,ents, sprges «' fw'etJ "r'iidZctW through the atmosphere, when the siptio micro-omanisms are 8u« pended therein-the so-called nuasmatio infection TherrisTclose relationship between abortion and parturient f.ver-a Cow «uff«in^ from the latter being undoubtedly dangerous in a stable or asluf TrnLV^'r? "? ".""'"•^"^ °^. P^^^"'^"^ «^' "« ■' while a case o'aEotbn or placental retention occurring in a stable, might be considered nearlv as serious among parturient Cows. ^ consiaerea nearly A retained and decomposed placenta is undoubtedly a fertile source cIl'lTf- ^'^''- ^'r^"^ •^'^^"^^ *« **'r«« instance's, in which the PnTour 1 o^ir/nft "°T'/ TT' ""'^ '^^^ ^"'^^^ membranes clme away m four hours after ; but a trifling wound existed in the mucous mem- brane at the entrance to the vagina. In two or three day aZrward lod n«i'r ' f^'^'^n^ "^1 ^°"*« symptoms of parturient fever. They stood near another Cow whose uterus contained a decomposing placenta The emanations fro.n tlie vulva or discharges of this ai^mafhad there hav« b^ L^' "" doubt infected the three; or the soiled straw may wounds th«fn-r'r.l°p'°""'^'"^' the septic matter to the vulva? wounds; the tail of the Cow may even have W n an active agent in by tC '"'^'" discharges about, as it is generally much soiled „„?^*t'"^^ ^f^^*?°", '"^'y also be conveyed by means of cords, crotchets, and other obstetrical appliances, if they are soiled with septic matters- which they may be, if previously used in the removal of a decomposing oetus ; and the operator himself may be the means of infecting An 'Z^'f^ °! this kind 18 related as occurring in Switzerland, during :.,Si 1 ' '"" ^ ^f ^^ cowshed containing about 200 head of cattle! suddenly a number died of parturient fever, though they had no d ftculty in calving. For a long time afterwards no other births took place, so no more accidents of this kind were observed; but it was strongly suspected that the herdsman who attended the first sick ammal, cleaned it, etc., in assisting the others during parturition, had conveyed the infection to them. And it is quite possible that ianv serious and wide-spread outbreaks of parturient fever in cattle are due to an obstetrist who has been engaged in removing a dead foetus or a retained placenta. The same cause may be in operation among iiwes during the lambing season, when, as is well known, parturition occurs in the flocks within a limited period, and under circumstances favourable to the spread of infection ; and not infrequently large numbers of Ewes perish from parturient septicicmia (" heaving pains '') We have mentioned that exposure to cold is supposed to be one of the causes of parturient fever. Franck, however, is of opinion that real parturient fever cannot be so produced, and in this he is correct ; the malady is of septic origin, micro-organisms (the Micrococcus septicus pmrperalts of Arioing?) being the active agents in engendering the General infection takes place when there are parturient sores or ulcers in the vulva, vagina, or uterus, and this infection is manifested externally by the high temperature and other serious symptoms. In u u'^^^^^L "^^^^ °°ly a s"^all quantity of septic matter has been absorbed, the symptoms have more of a local character; they are less severe, and though the fever may be of a continuous character, yet It IS not so acute, and indications of peritonitis are generally absent. V^i I 634 PATHOLOGY OF PARTURITION. disturb iT^ "^^^ ^*^^ ^™^^^ metritis without much constitutional Prognosis. The prognosis of parturient fever must be, in the majority of cases, untavourable, as the veterinary surgeon is only too frequently not called in u..til too late. When infection is but slight, or when the local innamma.iou is not very severe, then careful treatment may restore the patient to health. It must not be forgotten, however, that what appears at hrst a mild form of metritis, may become a very grave attack Prophylaxis. From what we hrwe said with regard to the causes of parturient lever and metro-peritonitis, it will be seen that in obstetrical operations great care should be exercised, so as to avoid wounding the genital canal and especially the interior of the uterus. Should injury be untortunately inflicted, cleanliness and careful dressing with some such antiseptic as carbolic acid, should be enforced. This is especially necessary when extraction of a dead fcctus or retained placenta takes No person who has been handling a creature suffering from partu- rient fever or any decomposing animal matters, should be allowed to assist animals in parturition ; and the same rule ought to be observed with regard to instruments and other obstetrical appliances, unless thev have been thoroughly cleansed. If a case of parturient fever should occur where there are other preg- nant animals, or animals which have quite recently brought forth, these should be immediately removed. An animal which retains a decom- posing foDtus or foetal membranes, is also dangerous among them. The same remark applies to animals— such as Ewes and Cows— at pasture ihe soiled ground should be most carefully disinfected with lime, when possible, and pregnant or parturient animals kept away from it. Treatment. Metritis, metro-peritonitis, and parturient fever being grave disorders and rapid in their progress, demand prompt and energetic treatment indeed, it is well in all cases in which the genital canal has been injured, or the placenta or dead fostus has been retained until putrefac- tion has begun, to prevent evil effects by cleaning out and injecting antiseptic fluids into this canal and the uterine cavity -such as solution of corrosive subhmate, 1 to 2,000-3,000. The first thing to be attended to m treatment is the condition of the uterus, and the removal of any intectwe matters it or the vagina may contain ; as well as the disinfec- tion of any wounds or abrasions in these parts. The genital canal should be thoroughly cleansed by injections of warm water, and the wounds dressed with cresol,i or carbolic acid and olive oil (1 to 10), applied by means of a brush or feather ; or salicylic acid JL part, spu-its of wine 20 parts, warm water 24 parts. After the interior of the uterus has been cleansed by injections of FllnT"^'*"^'^^" "^fT^^'C «"'^- ,^hich enters largely into the comnoBition of .T«y«'. vJfJrinnrt„=r """^^ • "",'*,■' '^^'-•'^""l'^ untisept.c, and 18 preferred In 'many Continental vefennarians to corromye sublnnate and carbolic acid. It i« not poiHonous, like tliene, and mixes readily with water, a 1 per cent, solution being a most powerful antiseptic. It is also recommended for internal medication instead of carbolic acid, and for the same ionstitutional fity of cases, tly not called en the local by restore the :, that what grave attack of parturient al operations g the genital Id injury be ih some such is especially acenta takes from partu- 5 allowed to be observed , unless they 5 other preg- i forth, these is a decom- them. The -at pasture. 1 lime, when n it. ve disorders '. treatment, il has been til putrefac- id injecting 1 as solution be attended loval of any he disinfec- Dns of warm d and olive il icy lie acid njections of tion of .Teye's ly Continental like these, and tiseptic. It is for the same METlilTIS, METRO.PERITONITIS, AND PARTURIENT FEVER. 635 warm water, an injection of carbolic ac^d solution (l to 20— 50^ horn glycerine (1 to 20-40 of water), or the above solution of corrosTve' sublimate, should be made every day, and the woundrif accessible dressed at the same time. Permanganate of potashTl o 50 of water) l^sTacutT^ ^ '''^''* *^' ^''''*^^ '^^^^' ""^'^ *^« disele is All fluids injected should be warm— 80° to 100° "Pahr • and anlntinn of opium or extract of belladonna may be advantageously employed °n the uterine mjections, to allay pain and straining ^ ^ ^ The external treatment must be hot fomentations, cataplasma. or counter-irntation to th« surface of the abdomen_or all three combined, ihe smaller animals may have linseed-meal poultices applied, or be immersed in hot water. ^^ ' With regard to the constitutional treatment of puerperal septicaemia, this must be directed towards neutralizing the effects of the septic matter by the exhibition of antiseptic remedies, and reducing the high tempera- ture ; as a long continuation of this leads to rapid waste of the tissues and is fraught with danger to the system. ' There is do specific remedy with which to neutralize the action of the septic matters in the blood and tissues. The sulphites of soda and potash have been recommended, as well as sulphurous acid These appear to have acted favourably in some cases. Carbonate of soda and permanganate of potash have also been well spoken of, as well as large doses of quinine. Carbolic and salicylic acids are now most in repute and are given in small and frequent doses. If there is a tendency to constipation, a purgative maybe administered • indeed, unless special circumstances forbid it, a purgative may prove most serviceable in assisting in the removal of the septic matter through the intestinal canal Dogs which have been poisoned by this matter, o ten recover aiter profuse and foetid diarrhoea ; and a purgative gener- ally reduces the temperature. In acute cases, in order to obtain the more prompt action of anti- septics, it has been proposed to introduce them directly into the circula- tion by intravenous injection. Solutions of cresol, carbolic acid, and iodine have been employed successfully ; and in woman a desperate case has recovered after the intravenous injection of liquor ammonite (1 to 3). As a last resource, and to substitute healthy for poisoned blood, trans- fusion has been also practised in woman, and with good results. The experiment is worth trying in the parturient fever of animals. With regard to the diminution of temperature, quinine has been highly lauded. Bleeding is certainly not to be recommended. If the tempera- ture continuously remains very high, then the application of cold water to the surface of the body is indicated. The cold water may be applied to the larger animals by means of cold wet sheets wrapped round the body, and kept cold for an hour or two at a time by pouring on water, at intervals, by means of a small vessel. Smaller animals may be put into a gradually-cooled bath. The skin must be well dried after the application of the cold water, and wirh ; ■ larger animals a dry blanket should be thrown over the body. Food should be sloppy and laxative. The stable must be kept scrupulously clean and well ventilated. Tonics and good food must be allowed when recovery is taking place, and the scqueUe of the disease treated according to their indications. m m i 686 PATHOLOGY OF PARTURITION. dofps nf^nt f ^ yr «°^bated by the exhibition of large and frequent infll^i '^'^- ^/" ^"" ^'^^ a°d Clement were successful in treat- n^lif.?« cases of metro-peritonitis by administering calomel, and ^W^h ^ ^^ercurial ointment to the abdomen. ^ nf ^\TXa P^'^ ^V^"^^ ^^^^'^6' mustard may be applied to the surface on which So ' 'u"" *^ °*'^ °^ «™^^^ ^°i™^l«' linseed-meal poultices o? mnrnhr„ ""1? ^^' ^^^" sprinkled ; while subcutaneous injections colSic, .?^^ \\^'^^^^ 'f'^'^^^ *«• When great exhaustion or stimulan/, £? f K ' ^'^- ^"^ ^'^^''^"* draughts, containing diffusible anrals miirn. K^??^'"^'*^'^' ^^*^ ^^t^itious gruel. To the smaller animals milk or beef-tea may be given. 80 far ntfh?''''' ^^'?' °^ metritis, the same treatment may be adopted, charJe tb. f ^f'*^^ '^^^^^ '' concerned; and if there is vaginal dis- tKpV,* c • *'"^^*'^^"* recommended for leucorrhoea will be suitable. If preVarSn: oT^otXe'' ''" "'^ '^ ^""°*^' '^ *'^ ^^^^^^^^^'^ °^ the''ca^rP«Si°^f';u "^^^^ u"?''/"^ ^om parturient fever, or in examining tne carcases of those which have died, the veterinary surgeon should be whi^ If f ^^^1"'' moculation More particularly is this necessary luZ.y^?^^ *^^ P""'^^^ «^"^^ of the living animal, or removing a reirsiTa J?*^>r ^-f *H ^T^°P^^- ^^^ ^^^^^^^ ^and should then be soan Xn ft °'i-°' ^^''^- ^"'! thoroughly cleaned with carbolic acid soap wnen the operation is c. ?mpleted. CHAPTEE IV. Parturient or Puerperal Apoplexy or Collapse. If^^Zl °° ^'^^^^^ affecting animals has received a greater amount of natme ?Ln%r''' V'^ ^? "^^^^ ^^^^^ divergent opinions as to its Sfven ;i ? ^ T^^^l *° ''^^"^' 'Chiefly for convenience, we have Veterinn^v1?r^T ^^ parturient apoplexy or puerperal collapse, wffh Z7- ^ ^^^'^t^'^^' ^'."«^ the commencement of the century, teems rLntvpS""' and discussions relative to the disease, and th; most r o^t nSfr^^r*''"^"^'^''' ?^" ^PP^^'^ *^ he far from unanimous eitSr indfoawv.. ' ^''^* '^''^'^r °^ "^'^^^ g^^^" to it-some of which canspV i f ? .''P""°''' Pr^^^^lent with regard to its pathology or certainfcv wlS°; I, ^"^ P^^o^^^/^t symptoms-are evidence of the un- certainty which has prevailed, and now prevails, with regard to it. For TiZrl'ef^trT ^ff 'f ^ted yuerperal fever, nervous ov paralytic form ZSn7 I fJf^^ \ puerperal apoplexy, paraplegia, puerperal Ge^rma^?ff''l '^ '' "^T^}^ designated " Vitulary Fever," while in Germany it is commonly known as " Calving Fever." In England it ''Mi?kFe'ver.'-T''' "^^^^™t Apoplexy," << Weral Si," thp^«r«r''^^^'L"PP-^'' ^"^ ^^'''^ '''^" ^"°^«^^ f^"'" a^ early period, but Skplifff'^r^ description of the symptoms we can find is that given by Skellett,! who names it "Milk Fever, or Dropping after Calving Vn the ' Practical Treatise on the Partuntion of the Cow. London, 1807. id frequent ful in treat- lomel, and the surface il poultices I injections austion or ? diffusible the smaller le adopted, aginal dis- iiitable. If hibition of examining L should be necessary emoving a lid then be rbolic acid amount of as to its we have collapse, iry, teems the most nanimous i of which ihology or : the un- ;o it. For Uyticform puerperal processus eclampsia while in ngland it Fever," iliod, but. given by "; in the PARTURIENT APOPLEXY-PUERPERAL COLLAPSE. 637 foUowing year it is alluded to by Jorg.i who evi'lflntw tnn^ qi n .., work, as the latter's plates are copied lome vears pft.^i.^'"""! the disease began to attract mu?h attenS ^af -1 • '■^'' P®"^'^ in the breeding'of Cattle it gradri^^tame mo4 pr^vaW ^^^^ the literature of the subject is very extensive P'^^^^^^^*' "^^il now Without entering at this moment into a discussion «« f« fi,« * of the disease, it may be sufficient to say that iris'Tveryserio^^^^^^^^^ acute affection, almost special to Cows in the nartiiS !fX ^ particularly those of the iSiproved Milch breed, in' whi hi is ftoTe'nf that Its invasion is sudden and its course rapid ; and that it is character' ized by loss of consciousness and paralysis, seldom by convulsions li 8 extremely fata , death ensuing in a very short time; oJif recoverv ifh^^hf'' ? '' 'S'f^'^t "'"'^y ^^ ^^P^^ ^« *^« attack was sudderf It has been confounded with parturient fever, or considered to be onlv a nervous or paralytic form of that malady ; while Franck, who appears to have studied It very carefully, is of opinion that it is identicaKifh the eclampsia of the human female, aSd considers rhar''Spera^ eclampsia {Eklampsie m Folge der Geburt) is the best designatioS for t. He asserts that to look upon it as a " fever " is a mistake, as a hirh n'^fn^! /fr'^" '"r ^'8!! °^ ^"'^^ ^ condition-is not present ; wh§e to name it calving fever is not quite exact, as it has been known to affect oxen and other domesticated animals— though seldom We shall, however, revert to this question presently. Symptoms. The disease sets in suddenly after calving, and without any premoni- tory symptoms It may attack the Cow so early as twelve o? twenty hours after parturition, but it is most frequent on the second or third day, and generally follows a rapid and an easy birth. It has, though very rarely, manifested itself before parturition, and also during that act. It IS seldom that it appears after the third day; though Harms says It may occur so late as the tenth day ; Hess records an instance on the fourteenth day, and a case has been witnessed in the fourth week • while Gierer states that he saw a Cow which uJered all the symptoms of the disease seven weeks after calving. j v ^» In some instances, before the symptoms commence, the lacteal secre- tion IS either dinunished or suspended. Generally, however, the first indications are the Cow hanging back in the stall, or the head drooping • there IS uneasiness, whisking of the tail, striking at the belly with the hind-feet ; the appetite is suddenly lost and rumination ceases • the feces are hurriedly expelled, and the animal becomes indifferent to its Calf. There is often a shivering fit, but this is not followed bv an increase of temperature. In a few cases, congestion of the brain appears to be present at the commencement ; the Cow presses its head to the wall or leans against the stall-post, bellows, looks stupid, its mouth is hot, the eyes are reddened and the eyelids wink, and it half uncon- sciously treads with the hind-feet. The respiration becomes hurried and plaintive, though the pulse may be normal ; and if the animal is conscious. Its physiognomy expresses anxiety and suffering. Unsteadi- ness and staggering are manifested ; the animal can no lon^rr gtand and it either lies down, or falls on the floor of the stall. ^Ther^e it may remain tranquil, merely moaning or bellowing, or striking with its feet at the belly as if affected with colic, and making convulsive 1 Aukitung zur Eimr Rationdlm Geburtahul/e, etc., fur Thierarzte. hi (. I rlk '. iJ 638 PATHOLOGY OF PARTURITION. "movements. Other signs of congestion of the brain may be more or less niarked; the ears and horns may be warmer than natural, and in °' An^°" *° *^® redness of the eyes, tears may flow down the cheeks. All these changes generally become developed in a very few hours ; so that an animal which was left in apparent good health only a short tinae before, is found lying, cannot get up, and is in a soporific con- dition. This is the stage of the malady at which the veterinary surgeon is usually sent for. Then he finds it lying tranquilly on its side, fully extended; or, which is far more frequent, resting on the sternum, and the head turned round towards the shoulder or flank (Fig. 220). This position of the head is supposed to be due to contraction or tonic spasm of the cervical muscles of one side of the neck. It is sometimes observed at the commencement of the attack, even while the animal is standing. The neck is so rigidly bent that force cannot extend it, and the temperature is distinctly increased on the concave side — that on'which the muscles are contracted. * I Fig. 220. Parturient Apoplexy : Cow. From time to time it may attempt to rise, but it cannot, as a rule, do so ; the knees may be flexed, but the hind parts of the body seem to be fixed to the ground. If assistance is afibrded, it cannot avail itself of it; or if it chances to be raised, it falls again as soon as let alone. It appears to be insensible to blows or pain of any kind ; and if the head is lifted and let go, it drops an inert mass, or is again pressed round against the shoulder. The teeth are ground at intervals, and the stupor or coma becomes more marked. The animal pays no heed to surrounding objects ; the eyes are half closed, and they either move convulsively in their orbits, or are fixed, dull, and lustreless ; the hair is erect and dry, and flies settle on the surface of the body. The pulse does not vary much in the earlier stage ; it is generally more frequent, and may number fifty, sixty, or seventy beats ner minute ; or it may be fewer than in health, but it is very full and soft. When coma is well advanced, however, and paralysis appears to be complete, it becomes small and quick, numbering 100 to 120, and at last is irregular and almost imperceptible. ' more or less ural, and in be cheeks. y few hours ; only a short oporifio con- e veterinary ctended; or, id the head ?his position ipasm of the observed at is standing, it, and the lat on^which •t, as a rule, ) body seem annot avail soon as let r kind ; and or is again it intervals, nal pays no they either ireless; the ody. is generally beats ^er ill and soft. )ear8 to be 120, and at PAHTUEIENT APOPLEXY-PUERPERAL COLLAPSE. 639 Toff rtLSr ^^^h^^^^ -ss t:^.x the respirations are often 'sbwa'd^e^p-ff^^^^^ minute, sighing or stertorous-indicating^Ssis of th« «off '", ^^^ at other times it is calm and regular. All Kse varin i.n! ^u^^^V served in the same animal-theLrried.^rrtrsrSn^^^^^^^ he quiet and deep respirations in a very abrunt mannpr f ! fK i^ increases in frequency the breathing soLtLe's^rme -sbwer'^ ^"'" The temperature of the body is not increased, as a ru7e on the contrary, it is very often below the normal standard when c^n?^ If! in-Harms and Adams have found it as low as 35» c!nt (95° Fahrt According to Thomassen,i it may be 102-2° to 103^ Fahr at the oS' uiencement, and in a few hours fall to 100\ or even 96° to vIp. I when there is improvement. Cases have been reported twhicf^^ was as low as 89-6° and 90°, and in the latter it ascended Tnthvi hoursto 100°. the animal recovering. It is possible hat L the a e^ in which these very low temperatures were noted, the ana^phincter has been relaxed, so that the air passing into the rectum would make It cooler. The extremities are generally icy cold, and the Turface heat of the trunk is irregularly distributed. aunace neat The mucous membrane of the mouth is pale, and saliva accumulates about or flows continually from it (hence the disease is so^Tetits designated Abtropfeln aus clem Maule by the Germans). Food and water are refused, and. indeed, at an early period there Appears to be paralysis of the pharynx and oesophagus, and if care is not taken the solids or fluids attempted to be administered may find their wav into the air-passages, and if they do not quickly produce asphy^af they will probably give rise to pneumonia. Whe'n fluids are admbis ered^ they pass down the oesophagus with a gurgling sound. The functions of the rumen and digestive system are more or less suspended and the peristaltic movement of the intestines decreased. Hence we have tympany, eructations, and constipation. The eructations may carry fluid and food from the rumen into the pharynx, and even into the nostrils, and they may pass thence into the trachea. So that we may have pneumonia from this cause alone, and without attempts having been made to administer food or medicine. Constipation is also a marked feature of this paralysed condition, and if tympany appears at an early period, it is considered an unfavourable sign by some practitioners. ^ •' All these changes in the functions of the digestive apparatus, together with those of the respiratory and circulatory organs, show that the pneumogastnc nerves are seriously involved. Micturition is also, as a rule, suspended from the commencement • consequently, urine accumulates in the bladder, and it usually contains sugar and a certain quantity of albumin. The sec o-on of milk may be diminished or suspended, and some- times very suddenly, even before the voluntary muscles are paralysed • m other instances it may be uninterrupted. When the animal is about to leoover, these svmptoms may persist for some hours, or even for two, three, or four days. Then it appears to rouse up suddenly from the stupor into which it was plunged ; the 1 Recueil de Midtcine Vitirinaire, 1889, p. 491. :(- ■^-:- i M 640 tongue PATHOLOGY OF PARTURITION. raised; attemptE som( is moved about ; the hea elevates the fore-part o. „^« finally gets on its hind-legs and stands. The first favourable indications are elevation of temperature and resumption of the intestinal peristalsis ihe latter is assured when the rectum is found to be filled with fieces alter it has been emptied. The animal's physiognomy changes, and becomes natural— though it may still look half stupefied; it drinks and seeks food, and is not long in commencmg to ruminate ; its calf is caressed ; urine and faeces are passed; and recovery sets in so promptly, and goes on so quickly that in many cases it is scarcely possible to believe that the animal' which twenty-four hours previously appeared to be dying, is now not only recovering, but apparently completely recovered without being convalescent. ° When death is about to take place, the more serious symptoms are still more marked. The coZfa^s?is— the coma— becomes more and more complete. The nose rests on the ground as if the animal could no longer support the head, and at times sways from side to side The decubitus, instead of being sternal, becomes lateral, and the body IS stretched out at full length. The eye is glassy, and there IS no movement of the eyelids when the cornea is touched ; the body and mouth are colder; the tympanitis increases; the pulse becomes small, irregular, intermittent, and very quick, until at last it is imperoaptible ; the breathing is pulfing, slower, and more stertorous and the animal dies without a struggle, or in the midst of slight com-' vulsions. ° In some cases there are epileptiform movements, or there may be symptoms of delirium : the animal throws its head about violently Irom side to side, or bends it rigidly backwards, struggles, bellows groans, extends the limbs convulsively as if undergoing an electric shock, and appears to be unconscious ; the breathing is deep and spasmodic, and apoplexy— parturient apoplexy— seems to be the cause 01 death. Duration, Terminations, and Complications. The duration of the disease is very brief. There are instances on record m which it has been less than twenty-four hours; but two or three days is the ordinary term ; it has rarely extended to five or six if there are no complications, the terminations are death or recoverv Ihe chief complications are broncho -pneumonia, milk -metastasis amaurosis temporary or permanent paralysis (sometimes in the form . '^onoplfgias), gangrene of certain parts, and swellings in the region of the thigh and hocks. *= Pneumonia is due to the passage of foreign matters— either food or mediciiie-into the air-passages during the period when the animal cannot swallow, or when it is comatose, and meteorismus and eructa- tions are present. This is often a cause of death when the Cow has recovered from the parturient malady. Indeed, the animal may perish trom suttoGation alone when the quantity of matter that passes through the arynx is considerable. And not infrequently, when the creature has hngered for a few days and is then killed, the existence of pneu- monia from this cause will be discovered on making an examination made to get le struggles I indications [ peristalsis, with foeces, :al — though and is not e and faeces so quickly, the animal, is now not hout being nptoms are more and limal could de to side. I, and the and there ; the body 36 becomes last it is stertorous, slight com- re may be t violently s, bellows, an electric deep and i the cause stances on but two or five or six r recovery, netastasis, : the form the region er food or be animal id eructa- i Cow has 3ay perish !s through 3 creature ! of pneu- imination PAl^TUJUE^r APOPLEXr-PUEnPEnAL COLLAPSE. of the body. Adami beheves that ten ner P«nf f .u ^ recover from parturient collapse eventuXdirof '^' Cows which extraneous matters introduced during the nai«wf Pneumonia, due to pharynx. Sometimes the animal ap|eara to h?l^ condition of tha the attack of parturient apoplexy, when svmnL"'°f/""°^^^'«d ^'^^ or inflammation are suddenly ^de^elope/Tn ".k""^ congestion Paralysis of the cosophagus, 4ich mav nerc^5 ?^*^ '°°^ °°°U"- recovery, has in some cases been the cauX dfat^. «o«^e day, ^^^^^ Another complication of narturi^nf o i . ^'^°™ chok ng. metastasis ^hil^oe^ norappear o h-^°^^^^ *^' so-called m7/fc- but which is alluded to by Violet in Francelf ' ff'i ^" '^' «°««try, in Germany, and Allemani irfta^y Oeci?^.?°™' ^ after an attack of the disease, a white mXlnnJ-^ ^^'^'? observed to chyle, expelled as urine, o; as aTscCgJ W H? '""^^r ^^^"^"^ one time it was imagined that this w«« f>, n ® J"?'^"^^ ' «'^<1 at being got rid of by the mammr wa,M k / ""'^^ ^^^«^' ^^^tead of acted U the nJrvous rtStaTd wtThe^e^^^^^^^^^^ *^^ ^^-^' manner. ^" expeuea in this vicarious lymph. The milk-metastasis theorVisu2nahl'r'>-°"' ^^^^^ ^'^^ to what we know of the lacteal sS on ptt?-?,' ^l 'V« ^^ite opposed With regard to^a../;^ this is fot eSS^^^^^ this disease.^ consciousness, and begins to look bri'hfnnT! • *^« ^mmal recovers is found that it cannot be made ? se SeT ^T -^^^^^ ^^^^ ^* various parts, but it is usually hmited to one linfh ? T.f T^ l^^""^ hmbs iparaplecjia), or to one side of the body ( wij^^ ^^""l- he has sometimes seen instances in whiVi. f v,{ y'""f ^^,!7'«)- Raake says while the posterior ones couTd'be ^t f^ee 7 '^^^^^ paralysis of Ihnbs is accompanied bTmusciar^atrophv '^" ''''' *^' Amaurosis is read ly discovered frnm fho tv,- Tu^-' , generally persistent. ^ Breulet GaWer Don.Tf ^ ^''"1 S^"^' ^^ '^ recorded instances. ' ' ^°'^^elen and Festal have V^^TT^lTt^T^Tco-^'^:^^^^^^ °f*- -t with in some parturient collapse from ten to fifLnT '^^^^''^^ 1'°"^ ^" ^'t^^^ of exuding from be^tween the claL and .rnf '7.^.'" ^ ^^"^ ^"^^ ''' f°^^<3 ^ T^ochemchrijtfur Thierheilhmde, 1870-71 - J5entele ( Woche.mchrift fiir Tkierhpilhin„lJ io-t i ,rv by calving.fever, lay for sixty hourrin a sta e of S'lf' ^^ ^^^t^''^'^ that a Cow attacked six hours afterwards, was milk ;"wL dots-la iitl^J^ ^^^ ""^^ '"^''^ ^«« P^«««d from the attack, but some weeks larer it h id ^ ll IS?^ '^~'" '*' ^^^ ^"™'^1 recovered -probably pneumonia from extraneous mau!rs '^ '" consequence of diseased lungs J^ ;^atru.I?ii:'^S;^lf Sv^^^r^^ - -^^^ -^^ «o-^ ^- the bei;Sr3!^'i;!:^Z|;S'SiSd'';f'22iJ^%r ^^ * ^-P-Fietor who of a yellowish-white c,.lour~contained pSi?, T^' T^\«"PPo«ed niilk-which was epithelium from the kidney, W.^i^uti^^^^ condition disappeared. The flnfS iX^i' tT - ^ '"'"• , "^"^ «°"^^ ^^^^'^ ^^^' Violet (Saint-Uyr's7Va»Vc^,r0W<;rWg^^^^^^ ^ . , ,. . of the urine. This came aw-iv tUr,J,h\l "^''^Vu ' • P". , '^^ ^''""'^ ^ similar condition white that the attendants thS it was mtik n'"' ""f T'^ ^''''' *"<* '^ ^''^ «" champagne or bottled beer. Kni^marreeo^^^^^^^^^ ^"""^^ '"^,'? f f^^escent. like for some days. '""mai recovered, but the urine was slightly effervescent 41 (niII! 5 |- '.II t ; ll " 1! I . 642 PATHOLOGY OF PAllTUlilTION, 3 The animals are slaughtered. From time to time in the same country, dry gangrene of the teats is reported as a sequel of collapse. StveUings in the region of the thigh and hock, and laceration of certain muscles — chiefly of the hind-limbs — have been observed in many cases. Sometimes both limbs, and at other times only one Hmb is involved, the injury being generally so serious that the animals have to be killed. In all probability the damage is due to the struggling and slipping that takes place before the animal becomes unconscious and immovable ; and the damage is not discovered until consciousness returns and it is observed that it cannot get up. Prognosis, The prognosis of parturient apoplexy is generally unfavourable, as a fatal termination occurs in a very large proportion of cases. Of 721 cases treated by various methods, Eranck states that 294 either died or vpere slaughtered — 40-8 per cent. Of course, no definite conclusion can be drawn from these figures ; as it is possible that some, if not many, of the cases may have been parturient fever, while of those killed prob- ably a few recoveries might have been noted if treated. Saint-Cyr, in 466 cases gives 45 per cent, deaths ; Stockfleth gives 50 per cent. ; and Violet 25 per cent. Some practitioners have a large percentage of recoveries, while others are unfortunate in obtaining only a small number. Often cases which appear very trifling at first, have a rapidly fatal ' termination ; while others which commenced with alarming symptoms, "^ quickly reco^er. Therefore it is, that perhaps in no other disease of animals is a reliable prognosis more difficult to be arrived at, not only in the earlier stages, but during the whole of its course. " There is no absolute critcrium," says Lauzillotti-Buonsanti, " by which we can positively say whether we can cure the case, or whether death will ensue ; and it often happens that the result contradicts the prognosis." And Allemani states that he has seen cases which looked so favourable as to lefi.l him to believe they would recover, suddenly become aggra- vated without any apparent cause, and succumb ; while others which exhibited the gravest symptoms in all their intensity, and gave no hope of recovery, have been restored to health. This is probably the experience of everyone who has had to contend with the disease ; it is in consequence of this uncertainty, and the fatality attending the malady, that the butcher is so frequently called .') in, and the animal is killed and its flesh sold as food. As to the pro- i» priety of utilising the flesh in this manner, there have been difl'erent " opinions ; but provided the animal has not been drugged to any con- siderable extent before death, and it is killed early, there is no evidence that the flesh possesses pernicious properties when utilised as food. But with regard to using the flesh of animals which have been affected with, parturient fever — a disease with which parturient apoplexy is so often, and has been for so long, confounded — that is quite another matter, as in this we have a blood poison — sepsin. Though the prognosis is generally so uncertain, yet there are several manifestations which may assist us — at any rate to some extent — in forming an opinion as to the probability of recovery or death. Thus, the earlier the attack occurs after parturition, the more serious the case may be considered ; while the longer its invasion takes place after that act, so is it less likely to be fatal. When it appears within twenty-four > ^5 ne country, )n of certain many cases, avolved, the s killed. In ig that takes e ; and the is observed irable, as a 3s. Of 721 ;her died or elusion can not many, killed prob- aint-Cyr, in cent. ; and rcentage of ^ ly a small ^ ipidly fatal symptoms, "^ disease of I not only in ^here is no 3h we can death will prognosis." ,.*' favourable ^ mie aggra- lers which '" ve no hope ^ to contend y, and the ntly called the pro- n different ) any con- lO evidence d as food, en affected )lexy is so te another ire several extent — in th. Thus, IS the case after that iventv-four -I PARnmENT APOPLEXY-PUEnPERAL COLLAPSE. ,43 coma, rapid and generarSL of hea? .rlTT i ^^^"^ *^'^' '^ "^^'^^^ (which mV speedfly cause asVy^^af^iS convn^'^ "'. '^' '"'"^^ rdhs in the trachea and bronchi lustrP^rs.pL.°°l',^^^P "'"^^"^ toi>ch; paralysis of the SVe mltns^S^^^^^ '? ^'^^' ""^ torpidity of the bovvek ^n fhn/+L ,. 7 • ^^ meteorismus, been evLated ; a well as pa a vsis^^ '^"Pf^ ^^^'^ ^' ^^^ ZlZ.^i'l '^' ^T'l' i"*''°<^"«ed into the ure hm .and aSorZ; fo/o'? ^T^ ''T?' ^''T^''''^' *^^^'« appears to be slight recovery and vet i^t '.I ^P'' ?M ' P^^°"- ^^^ P^l^« ^^i" ^1«« aid'in fonXg an optnfon as to the probable termination of the malady. ^ ^ ihe longer the disease continues, so the more hope there is of re ouI7a'ttersTn^h'.T " f '"^T^' '^^"^^'^ '' pneumonia tfn extrane ous matters m the bronchi, if the coma or the paralysis of the muscles of deglutition lasts for some days. Weigand says that when an^nimal s"oS:fe/°-^ '''' *° ^^''' '^y^' -^-^ ^'- eat :n7driXil Causes. The unanimous opinion with regard to this disease is that it is peculiar oHhernwTi ''^"f t^°"' ^°d. that it has a close relation to the state of the Cow previous to parturition, and to a more or less marked breed or "UtTlZ P'-e^^P^f/tion So far as breed is concerned, it is a fac tha the Cows most hable to be attacked are those in which the secretion of milk IS abundant-'' deep milkers "-and which are in a more or Us £ fhir", '*^'°''- ^^''^ *^'" perfecting of Cows for the production of milk, this disease has become vastly more prevalent Numerous Cow hf.'h '''^^^ i° *^f ^'''\-- : S^"*^^ i" Algau,"^rites Bentele ' ?he Cow has been so largely utilised for the production of cheese-converted IppearS ■• '"^''^'°^' '" ^^^t-the previously unknown calving-fever has f. ^?^!^- '^^ ^^^\}.'' '^^^^t^^^s 0^- districts where Bovines are reared more IZIa^'"" A,t T * ""'r "''^''' P'^^'^^^^-ient apoplexy is not a very common malady, and the losses from it are comparatively small. It is, therefore a disease almost peculiar to the best br^'eds of milch Cows, and the malady has extended with the extension of these breeds. For instance, in ^orth Holland it appears to have been completely unknown forty years ago ,-^ but when attempts were made to improve the milking qualities of the Cows by impc r numbers from South Holland— where they are deep milkers," anu where the disease is very frequent— then it showed iKW I i| I ;r: I 1 S I 644 PATHOLOGY OF PAllTUJtITION. tself, much to tho surprise of the veterinary surgeons and cattle-owners, Who were previously unacquainted with it. And it is supposed that the greatly-increased prevalence of puerperal apoplexy in other countries— as Italy Spain France, and the United States of America— is due to the introduction of these South Holland Cows. in our own country there are districts in which it is rarely seen, w*^ If ° ^^ ^^ ^"'^'^ frequent. With regard to individual predisposition, there can be no doubt that even m these predisposed breeds there are animals which suffer from parturient apoplexy more than others ; and instances are reported of pf n^ attacked after several consecutive births. riethom, no doubt, exercises a great influence in tho production of the disease ; for it is chiefly among well-fed Cows-particularly those Kept tor milk in the vicinity of large towns, which seldom or never leave tneir stable, and are abundantly nourished immediately before calving — tnat parturient apoplexy prevails most seriously and extensively jven among Cows at pasture, when the herbage is luxuriant, the aisease is far from infrequent, and the fatal cases are numerous. It is true that it may attack milch Cows in moderate, or even in compara- tively poor condition ; but then it will be found that their hygienic management is at fault. They may be Cows which, having been scantily led during a long winter, are abundantly suppHed with food in the spring; or they are Cows which, purchased in low condition, receive a large supply of food from their new owner. Kohne^ states that he had occasion to observe eighty cases of this disease at Kemper (Rhenish riussia), and that the majority were Cows which, bought lean in ±iolla,nd, some time before i)arturition, had passed without any gradual transition from the Dutch pastures to the stables of the Ehenish feeders where they received a large amount of food. Kniebusch-' and others nave made similar observations. It has also been remarked that a uniiorm and even abundant diet, is less dangerous than an abrupt change from scarcity to generous allowance. When pregnant Cows which have been for some time at pasture are taken into the stable a few days before calving, they are often seized When age and other circumstances predispose them to the disease. ihe risk IS all the greater if the secretion of milk has been suspended tor some time before calving, the Cows meanwhile receiving the same amount of food. Permanent confinement in the stable also acts in a similar manner to abundant and stimulating food, by inducing plethora and laxity of fibre. Ihus It is, that while the disease is prevalent in the cowsheds of towns, or m those from which the cattle are seldom driven out to graze or for exercise, it is almost, if not quite unknown in hilly pastures _ Age, or rather the development of lactation, has also a powerful influence. When the secretory function has reached a certain point, the Low appears to become much more predisposed to an attack Thus It IS asserted that parturient apoplexy has scarcely ever been observed in a primipara, and very rarely indeed before the third Calf, when the lactiterous system has almost attained its maximum development in the more Precocious breeds. In 29 cases reported by Haycock,^ 3 occurred after the third Calf, 5 after the fourthflG after the fifth, 2 after the 1 Maqazin/iir Thkrheilkundt und Viehzucht, 1855. ^ laid. * Veterinarian, 1851. ittle-owners, sed that the countries — s duo to the rarely seen, doubt that suffer from reported of eduction of ilarly those never leave ore calving extensively, uriant, the rous. It is 1 compara- ir hygienic len scantily )od in the , receive a lat he had f (Rhenish lit lean in ny gradual sh feeders, md others ed that a an abrupt t pasture, ten seized ease. suspended the same manner to iy of fibre, of towns, ize or for powerful aiu point, ck. Thus observed *vhen the ent in the occurred after the rARTUniENT APOPLEXY- I'UK/IPKIUL COLLAPSE, Sixth, 3 after the eighth. After the third Calf, or even previous to its birth, dairy-keepers are averse to purchasing the better-bred milch Cows Icmperature is supposed to influence the production of the disease and especially exposure to cold. The suppression of the cutaneous functions, and the determination of the blood from the surface of the body to the internal organs, must favour congestion of these organs Therefore it is tliat currents of cold air. lying on cold ground, and cold fluids ingested immediately after parturition have been looked upon as powerfu occasional causes. Sanson thinks that the sudden expulsion of the blood so abundantly contained in the uterine mucous membrane and cotyledons-and which sliould be only slowly diffused-forces that fluicl into the neighbouring vessels, and surcharges them beyond measure • while Ayrau t is of opinion that the cold air, entering the uterine cavity by Its partially dilated os, drives the blood from the mucous membrane into the other viscera, suddenly checks the lochial secretion, and thus gives rise to the disease. This lochial secretion plays an important part in the genesis of the malady, according to several authorities Other writers suppose that the disease is more common during warm than cold seasons. In fact, it prevails in the most diverse temperatures and It IS as serious in cold as in warm weather. Sometimes the number of cases is very great, without any reference to heat or cold; then almost suddenly they subside, and no more outbreaks occur for some time This has led to the supposition, again, that it depends for its developl ment on a pecuhar condition or epizootic constitution of the atmosphere, but in what this consists no one has attempted to explain. Kohne says: " It IS certain that when one of these periods of vitulary fever prevails," a change of atmosphere has occurred or is about to take place, though the converse is not true— for when an atmospheric change takes place we cannot predict an invasion of this fever. But if it happens that several cases of the malady follow each other immediately during a certain atmospheric constitution, we may assuredly predict a change in the weather. This change most frequently consists in a transition from settled to rainy weather, bringing about a diminution in the barometric pressure." Some veterinarians have ascribed the disease mainly to infection- assimilating tlie puerperal fever of woman to the parturient 2>toccss2tal mSl f T farnily contractud. JJofore the a very few cases tln„H«I' '^"'"''' '' exceptionally ran . In still iewe^befSb irth vJ LTh^?^^^ 1"""« parhn-iti^on. and in Constipation ^ml^J^u .}^ ^^ ^?^ '''"T^'^" ^'^ " ' ^PPoared. writerstobecause. n^nJ^f I'epletion have been held by one or two before parturition ^''' ^"'''^"*" '^ ^° over-repletion innnediate^y the^ p'odu'irion 'of'^tifil "'"''' ^!i^''^'' '^^"'^ ^^«" «'^«" ^^ "Peratin. in are Sutt ient^" n u,t ouTall' '"''"'V T} '' ^^'" ''^ seen that tie? the disease is^b cu^e-so^t^ *°-r"" f'^'^^ ^^e nature of The chief points to be L";^ulw I ' as .ts etiology is concerned, apoplexy as 2r^^.J^Tn^ "?''>' ''^ '^^*«'^ as follows : parturient tiL!aS•erpe'cLll^:L''LtTcl hL?!'^ '^"^ *° "^" ^""^^ ^'^' ^^ the animals whkjh Ire at^^ertd „, .k''" 'f ^r P?'"P^' ^"'^ "^^ural ; milkers, in a state of nle£ f ^°'^ °^ *^'^ ^^'"*^«^ breeds, good to another. S leads to a .An "^ P'^'^^T 'u°"" ^^^'^'^'^ predisposes and natura of the malady '°"^'^^^^^^^" ^^ the ^^^ai/.o/o^^/ca/ anatomy ^ . Pathological Anatomy. toms whLhS'fhis di?."""'?."^' ^^---^--tic. and striking symp- whether theSm Tafbeen k n' f'' T''"^ ^PP^arances, no matZ part of a somewha vaded ciarSr^' InT^ '' ^''l ""'% ^°^ '^' '"^^^ tions there is much confusion fv!!i ^" *^^« majority of the descrip- mistakenfor those of mrS,/^? T'°"' of parturient fever being two diseases are confounded wiH^^."^' n"^ '''^ '''"'' J"«* ^^ ^he generative organ' are usuallv S "i ' ''fZl ^" "^'^ ^^^^^^y the gested-whicg it alwa^i nmcTli'v"^ n.ay be%on- even be paler than usual • but T i 'n" Pa'-tmuion, or it may The digestive organs ar.n if ^^' f -^^y "^-'nly contracted. ^ are •"uch^distended-perhan^^^^^^ *h^^^' bloodvessels of nerves. The rumen kSLfi. pamlys.s of the vaso-motor system third compartment of Ho c"'^?'^'''^'; -^' '" niany cases, and the between it^lSvTs wh e the'inttr' '^''" ^'""^ ""'''' hard 'dry food fffi-^es. The -all hi.Li. -^ mtestmes contain somewhat hardened -e norn'a , peSs'Sltiv TT'''' T'^' ^^^^^M. The lungs congested, of in^dTCS'li^^ySfpZ ?Zia?^ f^' *""^^^^^T ^^ We .ot discovered ST^J^ ^HS^^X c^^i^^tSS^t xpulmion of •anoH at the y oiisy and iihno boldly od by this poaitivo in enta is re- ioaso. But >rmal size, longer it le chancca i'hieh have Licifore the / mrr . In on, and in peared. le or two iinediatoly arating in that they nature of loncerned. parturient !!• parturi- 1 natural ; jeds, good ■edisposes anatomy ng symp- lo matter the most ! descrip- er being it as the 'lady the i' be con- r it may 3dves8els ir system and the dry food lardened le lungs they are era have le brain thorities lither in PARTURIENT APOPLKXY-PUERPKRAL COLLAPSE. the brain or spinal cord, or their envelopes ; while others have found well-marked and iuipurtaiifc lesions. These varied from venous con- gestion to uxloina, anuomia, and exudation. Violet, in addition to finding a. quantity of foul-sinelling reddish tluid in the uterus (which was not inflamed), observed congestion of the pia mater with very dark blood ; . Iiero was also congestion of the vessels in the brain tissue, and a long clot in the groat vena Oaleni. In other instances a similar con- dition was observed ; but in all the spinal cord appeared to bo healthy. Bragard and others have constantly found injection of the brain and its meninges. Saake and Festal have also witnessed congestion of the vessels of the encephalon, sub-arachnoideal effusion, extravasation, and blood-clots on the surface of the cerebrum and cerebellum. Others have seen serous effusion in the lateral ventricles and traces of spinal meningitis ; while Bin/, has observed sanguineous extravasation and gelatinous nuittor at the origin of the sympathetic nerve, and Fabry blood-clots at the base of the brain, with serum in the cavity of the arachnoid. In one instance Schaack met with a clot, three-fourths of a line in thickness, covering the left side of the medulla oblongata, and serous effusion into the lateral ventricles ; and in another instance an in- flammatory exudate on the right side of the cerebellum. Harms has found, in many cases, air in the cerebral bloodvessels ; and Noquet and others have reported alterations in the spinal cord, which was reddened, congested, more rarely covered with exudate — chiefly in its lumbar portion, and sometimes the sciatic plexus of nerves has been involved. Nature. With regard to the nature or efficient cause of the disease, there has been a great diversity of opinion, and even now the most eminent veterinary authorities are net at all agreed as to its pathology. With some it is a fever — a nervous or paralytic form of parturient fever — closely allied to the puerperal fever of woman, and due to blood- poisoning, the two forms only differing in degree. But it should be remarked that in this Bovine malady there is no fever; that the temperature is generally below the normal standard ; and that recovery is often rapid, if not sudden. Other writers have imagined it is a grave form of gastric fever, because there is constipation, and impaction of the digestive organs with hard dry food. But such impaction may occur at any time, and it does not give rise to the symptoms of parturient collapse, neither does it cause death so rapidly. The more prevalent opinions as to the essence of the disorder may be classed under five heads: 1. Hypera3mia of the ner . e-ceutres ; 2. Anajmia of the nerve-centres ; 3. Derangement or paralysis of the nerve-centres ; 4. Alterations in the constituents of the blood ; 5. The presence of something abnormal in the blood that leads to the develop- ment of the symptoms and lesions observed. 1. Hyperemia of the Nebve-Centees.— Since 1847, when Festal read a memoir before the Central Veterinary Society of France on this disease, the opinion has been held by a large number of veterinary authorities that it is due to plethora, and consequent congestion or apoplexy of the nerve-centres. Festal found blood-clots beneath the ^'11 M 648 PATIWLOOY OF PARTURiriOK. ^^&%oX:S':^S^'^^^^ -hich he attributed to hype.a.n.ia. In cerebro-8pinal "ervous st^t.f. "^'*lf ". °^ *^' trisplanchnic nerves and engorgement TS^llo2^^\ '"^-'^ *"'• «°"f ^-^^^y fo""^, to plethora. For Sanson i "11^'=°" ^ch, and intensity of the milk-fever. suddl d' s urbance in thf "i! °^ ^^^^'^^^^^^ ^« '"^^ consequence of a parturition coSin" in ?>^^l''°^°^^''"^ ^°"^'"°" °f *he uterus after fhe organ kt thaf tim t'duS' "'^r^ °' '/°"' ^""'''^ ''^"g-*^^ fluid is diverted towards' the noil,/ ^ ''*'°'l ^ \^^ P°''*^°" ^^ *hat After parturition tCmucol^n^^^^ ^\'''^ lie uterus is lodged, have lost their functL 4d thlT ''"" ^"'^ ^^otyledons of the organ tained is suddenly Lr^^^^^^^ blood they con- bouring vessels bevon,! ., the circulation, surcharges the neigh- of the blood igS;!^^!!^^^^^ ; this diversin at the autopsies he Li S^ ^^ cutaneous cliills. In proof of this, and cotyled^rwere at'a?r?on f^^' ^'^' the mucous membrane colour. ""^"^^^ ^°"'^^ bloodless, and of a pale-yellow alSrirp^eirln'/s^f i° '''^\'' ^'^^•-«'^' -'-1^ -H be spinal congestTon was bilm^t n h ^fT "^5. ^'^^^^^ '^'""^ '^'^ «-rebro! the uterus^ from Xch T.?? 1,?!°^ '^' '^'' '?''."' ^'^''^^ ^^ ^^^^ on advanced the theory tl^t this .. ''"r ''P'"''^-, l'^^^^*^*' '"'^ 1«66, removingtheCaf Imn 1p r conges ion was the moral result o fessor violet is sa isf d h" ? ''' ""''^'^ '':^*^^'y ''^^^^^- parturition. Pro- intra-abdoniial l^otp^tu^^ ^1'^*^"'^ suddenly diminishes the during pregnancy, and tHSf it tndoH'''' '*'" l'""'' ^° '"^^^^ m. date themselves H' H, foi • °*''''^'' °'«^"« ^ave to acoom- toact in a fa So\rto ^dl dUle W *^ ^^^'^^-^ «-"tinues are not accustomed so that It^^^'^^^^^^' P'-^^ticularly the capillaries, finally congested; hence i^ptures Infh '"^ ?'''"^' distended, and fatal termination Other -amon/ttn;r''^t"'' '"^^ "^^^^^•' ^"^ ^ mencement of the disease To mS 'T,"''°"'^-~^^^^^^^^ originated by a rapid and easvdol^^r"' *^" '">'"'^^^^' ^^ ^^'^ich, ment and secretory power of the mnS^ "' proportion to the develop- is spread over thj ^en^re econon v ]''f ^'^^T^^^'"" disturbance the stomach and the prlexS nniot nV '""',f ^^ ''^'^ ^"'^P'^*'"'^ "^ mass of blood which Iroes to tS lf^^^°^^-.s"ddenly increased by the by the state of the nervous system f?' "V"", Pf "!^^"«y-as well as have induced, exciti .rave ?listi K S^"!^''^ ,^^'i\>«h the pains of labour digestion, circulati^i ancrimSv^t^^r'n:/^'' "uportant functions of more sudden and serioi s T nt ?' 1 ?:^^"««/^"s« disorders as much plethora are grea- the blood iviM^ r\^'^ -^^^^ ^*"""^«'^ '"^"d the of the nervous sykenLesnecklK V'"'^ Plastic, and the irritability sequently, there ira "onoS C ;• ? «angl,onic_is excited. Con- " congesting ■' ac tontl aU tl e t^f '^'^^"'-^^^^ ^•^^"Iting from the ganglionic nerves ^ cerebro-.pmal and trisplanchnic or ^^t^^^^Z^^S:^^ '^ Y essentially an encephalitis, according to the chamcter or .00^ T'.t''" °' medullary apoplexy But some of these on nions ^-nn i\'' 'f'^"' ^°""^ '-^^ter death lesionp- on which fffv .^ 1 i^PP"'""^ ^^ ^'^^ f'^^t that many .of the ^^^o.eryof':^.^^::i^::^^^P observed, and that the ' Jonrmd de Vamnairta du Midi, 1851. ^peraemia. In iiic nerves and A, to plethora, ver. sequence of a 3 uterus after licli congested rtion of that irus is lodged, of the organ ood they con- 58 the neigh- this diversion •roof of this, IS membrane . pale-yellow Inch A ill be the Cv^rebro- 1 of cold on et, in 1866, •al result of rition. Pro- ninishes the i't so much e to acoom- I't continues 3 capillaries, tended, and Dccur, and a ce the com- ■ of which, ;he develop- disturbance LX'pletion of ascd by the —as well as IS of labour unctions of rs as much :h and the irritability ted. Con- ig from the mchnic or icephalitis, apoplexy, ?ter death, my .of the i that the PAJiTUJiimT APOPLEXY-PUEIIPEIIAL COLLAPSE. 649 Professor Trasbnt asserts that the disease is thp VA .u ^* • i gestion, with consecutive paralysis. ^"^^^ °^ ^P'°^^ °°^'- In England the opinion has long prevailerl tVmf T^,.,„ ^ is the consequence of cerebral c^nSn Jn^lr f^''^^ ''^"^P'^ ha.morrhage,\nd that the peculiL dl tr Sulio'n of th^ ceTeZf S^ f vessels m the Cow predispose to this accident A tl I ^ ¥°u^' a similar arrangement of these vessel Ts pre entnZpL\?A?'.' accordmg to some German veterinarians a disease verv 11 .^if' ^ ^^^\ collapse of the Cow is ob<5PrvPrl j^q'™^^'^^^'-^'^^^ the puerperal GermV; but Th'^assS^^oSts'ou't^:: i^PortS^dlff:" " ^"^^ much as in the Sows the paralysis is not SnS fb!^— ' T^' fever, and the animals gene4lly recover. '°'^P^^'^^' ^^^'^ '^ intense caLt^cSncS^Sr^JS^lSC^d^^^; ^^"^^ anemia resulting from an e. ri:^:^^::,^^J^^ as Covvs o a certam age were predisposed to this congestion from S of contractile power m their abdominal parietes. AC^and pSJ were also of opinion that cerebral anaemia was owinTto ablminal congestion. Bi lings'^' supposed that an exaggerated sensLlitv oT tbp uterine_ nerves induced, in a reflex manner, sjasm of the aSoL S the brain and kidneys, and so caused an^^mia of these oXns Franck believed the condihon to be owing to secondary an^mil s.cceedbs congestion of the brain, occurring in Cows which btr nn !„ f rapid delivery. The sudden contraction of he uterus and itt^li ^ T^ capacity brought about by the ,ost luu-u:!:^.]^^^^^^^^^^ ance in the blood circulation. The organ receive much iSs blood and this, m ordinary cases, is compensated for by the increased afflnV^^ the mammaj and the skin; but a chill to tL letter n'ayups^tths physiological compensation, and the repelled blood is dimS e ge where; if this be to the brain, then there is cerebral coSon and consequent «3dema, resulting in anu^n.ia by compression ofihe blood vessels There is a predisposition to serous elfusions in animals af°er partur. ion, because of the hydru^mic condition of thei blood and especially when there is passive congestion of the kidneys and albu minuria towards the termination of pregnancy. The great freouencv of cerebral hyperu3mia in tlie Cow, was "regarded by 1^-anck Isl co J sequence of the division of the internal carStid into! number of small vessels before It enters the cranial cavity, as well as the fc^ .^ation o irteries. ' "" '°"""°" '^'''"''^ '^^^' ^'''^' °^' *^^« ^^^'^bral T7,5n't*^'°'r' adopted by Goring, who edits the second edition of pStio^nr' °" "^^^^--'"-y Obstetrics," and is accepted by many WernerV' theory is somewhat analogous to that of Franck The vascular system is involved, as shown by the diminution of temperature and the lacteal secretion, as well as the nervous system- ?rfl'pnrd f/ h'' T'^'f ^^^P'-^^^i^". l«f of sensation, inactivity of the spinal coid in the dorsal region, suspended digestion, nuicken-d a-^ion Sp nnif^'f* ^"/^.f ""^T^' °^' *^^ ^-espiration. Too rapid evacuation of tae contents of the uterus causes descent of the abdominal viscera : rii ^ RecKcilde Miilecine Vt/rriuairc, 1889, p. 784. - American Journal of Comparative. Medicine, 1S84. \yochemehrijtJ'iir Tliierhellkunde und Vithzitcht, 1868, p 363. 6S0 PATHOLOGY OF PARTURITION. dilatation of the posterior aorta, and slowing of the circulation. The pmnary cause of all this is bad management of the Cows, and pressure of the tcotus on the stomach and intestines, diaphragm, vena cava, and posterior aorta. 3. DroKANORjiENT OH PARALYSIS OF THK Nerve-Centres. — Many- high authorities— among them iuihne, Binz, Carsten-IIarms, Wan- novius, Busch, Eoll, Eychnor, Baumeister-Rueff, Barlow, and others- have maintained that the disease is primarily a derangement or paralysis of the ganglionic nervous system, which affects, or is extended to tlie spinal cord and brain during the course of the disease. The followiii',' explanation is offered in support of this opinion. A too easy birth throws out of play a certain amount of the nervous force destined to the accomplishment of this act. Hence, there is a disproportion between the polar tension of the force conveyed by these nerves and the muscular irritability, and conseciuently an obstacle to the conducti- bility of the nerves charged with the distribution of this superfluous portion of the nerve force. Barlow thought that this disturbance in the function of the sympathetic nerves produces arrest of secretion and general congestion, especially of the brain and spinal cord. Contamine is more or less a partisan of this theory, as he explains the origin of the disease by stating that a reserve of nervous influence which is not expended in the animals that calve easily, by a reflex movement acts at first upon the spinal cord, aud afterwards on the brain. 4. Alterations in the Constituents of the Blood. — The opinion has been emitted that the collapse is due to an undue preponderance of water in the blood of some Cows, during the later stages of pregnancy, and that this results in cerebral oedema after parturition. Another opinion is that tlie collapse is a kind of leucocythannia, from the increase of white corpuscles in the blood during pregnancy, and after par- turition. But neither of these opinions can be reconciled with the symptoms or post mortem featui'es of the malady. A third opinion attributes the disease to an excess in the proportion of red corpuscles, and this certainly is more acceptable than those just noticed. 5. The Presence of something Ahnoumal in the Blood, which leads to the DEVELOrilENT OF THE SyMI'TOMS AND LesIONS OhSERVED. —It has long been a popular notion in several countries that puerperal apoplexy is caused by the absorption of the mill: into the blood circula- tion ; hence the designation of "milk-fever" given to the disease in England, France, Cermany, etc. Lafosse's theory had something of this notion in it. According to him, the malady is due to the circum- stance that the milky fluid secreted by the cotyledons, and absorbed by the chorial villi for the nutrition of the fcrtus, "being no longer separated from the blood after parturition, remains in the circulation and accumu- lates there until the mammary glands eliminate it. When these glands act promptly, the fever is imperceptible or almost nil ; but if they are slow in secreting, then arises a morn or less intense morbid disturbance, due more especially to the presence in the blood of a product foreign to its normal com^josition. Without connnenting at any length on this theory, it may he sullicient to mention that in some cases of parturient apoplexy the function of the mammary glands is not suspended; though Illation. The and pressure ena cava, and ?REs. — Many larnis, Wan- and others — aiigement or )r is extended iisease. Tiie . A too easy 'orce destined disproportion e nerves and the conducti- s superfluous isturbance in secretion and Contamine i origin of the which is not 3nient acts at -The opinion reponderance of pregnancy, on. Another 1 the increase d after par- !e symptoms le proportion an those just LOOD, WHICH iii Ohsekvkd. lat puerperal )lood circula- le disease in ;ometliing of the circum- absorbed by i^er separated and accuinu- theso glands I if they are disturbance. let foreign to ngth on this of paiturient ided; though PARTURIENT APOPLEXY-PUERPERAL COLLAPSE 651 the theory would seem to receive some support from the fact, that when the milk is abundantly secreted the animal usually recovers rapidlv Carsten-Harms considered it an ajra^mia, dr having entered the uterine bloodvessels by aspiration, after shedding of the placenta • and in proof of this he asserts he detected the presence of air in the cerebral vessels. Stockfleth LanziUotti-Buonsanti, Zundel, Eaynaud, and others, have maintained the hypothesis that the absorption of septic matters formed in the uterus from the lochia, blood-clots or tissue dibris, acted upon the central nervous system and produced the rapid and characteristic alterations that mark the disease. _ Abadie thought it was a mephitic poisoning, induced by the absorp- tion into the blood of gases evolved in the stomach by indicrestion • while Hartenstein attributed the malady to absorption of certain matters formed in the muscular tissue of the uterus, and especially to the pro- duction of uric acid during parturition. In 1885, Schmidt Miilheim pubhshed a theory with regard to the genesis of the disease, which has since been adopted by some veterinary notabihties. According to this authority, it is of toxic origin, and is analogous to the condition observed in Man, and known as^Botulism, due to the ingestion of sausages and flesh in which a ptomaine or leucomaine has been developed. These animal alkaloids produce paralysis of the tongue, palate, pharnyx, larynx, cesopliagus, etc., and even of the digestive organs and bloodvessels, and the author of this theory fancied he could trace the same morbid symptomatology in the Cow as in Man. The toxine, he believed, was generated from the albuminoid matters contained in the closed uterus. The supporters of the view that the active agent is a poison elaborated by an excessive cytolysis or histolysis of tissue— processes which, it is pointed out, are extremely rapid at the pre-parturient and parturient periods— appeal to clinical facts in its favour. The disease is most frequently seen in plethoric animals, which also yield a large quantity of milk, in which the act of parturition has been brief and easy, chietly because the progeny is small, and in which tlie lacteal secretion is partially or entirely suspended ; while it is rarely witnessed in lean Cows which give a comparatively small quantity of milk, are moderately fed, have exercise, and are allowed to suckle their Calves. To the objection that, at the parturient period, tissue changes are equally active in other species, it is stated tliat the great difference in the placenta of the Cow as compared with that of these creatures, the larger vascular development, and the relatively enormous size of the udder, with its vast secretory capacity, predispose to such a malady. At the parturient pericl, it is argued, cell destruction in the Cow must go on at a rate quite disproportionate to that at which it proceeds in other animals, and that in every case the pi. )ducts of tliis cell change must in a greater or less degree gain access to the circulation. Under certain influences— dietetic, thermometric, or barometric— the milk- forming functions of the udder may be arrested, and the gland-cells be diverted from their natural function. The products of cell change being absorbed in undue quantity, may act piinuuily as nerve excitants, and, secondarily, as nerve depressants. Still further to confirm this hypo- thesis, the striking analogy between puerperal collapse and ha^moglo- binuria in the Horse is adduced ; and the fact that both diseases can frequently be arrested or their violence ameliorated in the early stages I ' I II ' 11'- i 652 PATHOLOGY OF PARTURITION. by evacuants, with external and internal stimulants, is offered as addi- tional proof; though it is not contended that the toxic agent is the same in both maladies— the agent in hacmoglobinuria acting alike on the nervous and vascular systems, while in puerperal collapse its direct action IS exerted on the nervous system only—any vascular phenomena observed post mortem being merely the result of vaso-motor paralvsis ( Wallei/). But It may be observed that even this hypothesis does not meet all the requirements of the pathologist ; for if the malady were due to a toxine, surely the flesh of affected animals would prove toxic when used ^^i°° I ^^^^^^ '^^ ^'^^ *he case, however, as all experience, experimental and other, goes !.o show ; and there are other facts as important which cannot be explained by this hypothesis. In trying to account for the evolution of the malady, it is necessary to remember that it exclusively affects Bovines of the female sex ; that It is observed chiefly, if not entirely, in well-bred and well-fed animals which yield a large quantity of milk, are of a certain age, and usually after they have had their third calf ; that it most frequently becomes manifest in two or three days after parturition, rarely before that event, and always after an easy and quick delivery ; that its advent is sudden and course serious and rapid, the terminations being death or speedy recovery, generally without any period of convalescence. It may well be questioned whether an animal toxine in the blood would produce the phenomena denoting this disease under such circum- stances, apart from the fact of the innocuousness of the flesh of affected animals when consumed as food. It must be remembered that the predisposed Cow during pregnancy and before parturition occurs, is in a state of exalted physiological plethora and high vascular tension, much beyond that of the females of any other species at the same period, owing to her organization and the great artificial development of the lacteal apparatus. In other female animals when birth takes place, the extra blood de- manded for the development of the foetus in utero, is now diverted to the mammary glands to supply it with the nourishment it needs tor a certain time after it is born ; in this way the vascular system IS enabled to maintain its equilibrium immediately after parturition, and gradually to resume its normal condition as the young creature IS competent to subsist independent of its parent. In the non-predis- posed Cow under natural conditions this also occurs, and nothing different is observed from wliat is seen in the Mare, Sow, Bitch° or other creature at the post-parturient period. But when, from any cause, the excess of blood which was required for the growth of the fa>tu8 is not diverted to its natural purpose after the young animal IS born, there is a rapid transition from physiological action to patho- logical processes in ail animals, as well as in woman, in whom, owing to constitutional fault, or causes interrupting the due course of involu- tion, the work of metabolism or conversion of the now superfluous tissues formed during pregnancy, and of absorption and elimination, is imperfectly performed. i Predisposed as is the Cow by artifio.ial managomont, and possibly by anatomical and physiological peculiarities, the pathological changes which ensue more or less promptly after parturition when the vascular tension is not reduced, and the substitution of absorption and milk ^ Dr. Barnes, The Lancet, December 1, 1894. jred as addi- agent is the iing alike on pse its direct r phenomena tor paralysis not meet all ere due to a ic when used 3xperiuiental Drtant which is necessary lie sex ; that -fed animals and usually itly becomes e that event, nt is sudden h or speedy in the blood juch circum- h of ail'ected g pregnancy )hysiological the females organization paratus. In I blood de- ow diverted int it needs ular system parturition, mg creature non-predis- md nothing Sow, Bitch, 1, from any growth of )ung animal )n to patho- liom, owing e of involu- superfluous mination, is possibly by !al changes ;he vascular 1 and milk PARTURIENT APOPLEXY-PUERPERAL COLLAPSE. 653 secretion for construction does not take place, are chiefly located in the nervous system, and especially in the brain. Congestion of the cere- bral vessels at first, which may speedily lead t ) effusion of serum or htemorrhage, is indicated by the symptoms and lesions observed in many cases ; while the rapidity with which recovery sets in, and the reported success attending the adoption of a certain method' of treat- ment, supports this opinion, and negatives that of septic infection^ or the presence of ptomaines in the blood as the cause of the disease— did not the history and symptoms otherwise contra-indicate such influences. The mechanical effect on the blood circulation of a sudden diminution of pressure on the bloodvessels in the abdominal cavity, if a factor in the causation of puerperal collapse, would, it might be expected be witnessed in other animals in which distension of that cavity durint^ pregnancy is quite as exaggerated as in Bovines. Besides, there is no evidence that vascular engorgement of tlie abdominal organs is a con- sta,nt feature in necropsies of Cows which have succumbed to the disease; neither is aniEmia of the brain always, or evan often observed. That puerperal collapse in the Cow is chiefly, if not entirely, due to vascular disturbance, may be inferred from the physiological condition of the animal previous to attack, the clinical history, and the necro- scopical appearances, no less than from the results of therapeutical measures in certain cases ; and that this disturbance assumes, primarily, the form of congestion of the nerve-centres may also be accepted, as this theory forms a good basis for the adoption of a rational system of prevention and cure. Diagnosis. Puerperal collapse has been confounded with parturient fever and metritis, post partmn paralysis, as well as with parturient eclampsia ; so that a distinction from these is important, especially with regard to medical and sanitary measures. The symptoms of parturient fever and metritis or metro-peritonitis, as we have described them, when compared with those of the disease now under consideration, differ so widely that a mistake should not be made if ordinary care is exercised ; the thermometer will establish the chief difference, while sensibility and consciousness being present in one affection and suspended in the other, should fix the diagnosis. In post partum paralysis, the animal is conscious, often bright and attentive to surroundings, generally free from fever, and eats and drinks as usual ; the only symptoms usually noticeable being inabihty to get up, and to stand when raised. By some authorities, and especially by Franck, it has been maintained that puerperal collapse and eclampsia are one and the same disease. But as will be noted when the last-named malady comes to be dealt with, there is a difference between these diseases, though a mistake is more pardonable here than with the preceding disorders. In eclampsia there are successive and alternating attacks of convulsions and coma ; whereas puerperal collapse is marked in its later stages by coma only. Prophylaxis. In view of the great and rapid fatality attending puerperal collapse, and knowing that the subjects of it are hearty-feeding, deep-milking Cows in a state of extreme physiological plethora, with a strong tendency to vascular congestion of important organs, there is every t li m ■ J H^^^H * ;;: 1 654 PATHOLOGY OF PARTURITION. ^ 1 reason to lay great stress on preroitive treatment, and to combat the predisposition to the malady by strict attention to hygiene, particularly during the last months of pregnancy and immediately after parturition, ihe diet should be soft and easily digested, so as to avert constipation and the allowance ought to be rather sparing. When it is possible to permit exercise for some time before parturition, this should not be with- held. Nothing is so likely to prevent an attack of the disease than keeping tiie Cow in as natural and free a condition as possible, with all the functions of secretion and excretion in full play, more especially at birth and immediately after that occurrence. Exposure to cold and currents of air, and everything likely to diminish the functions of the skin, should likewise be avoided. More special precautions have been recommended by various authori- ties, founded generally on the opinions they may have entertained as to the pathology of the disease; but the utility of these prophylactic measures has been more or less disputed. Bleeding during the month before parturition has been highly lauded, but there is every reason to believe that it is more injurious than useful. Others recommend the administration of nux vomica, tartar emetic, nitrate of potass, sulphate of soda or magnesia, and laxatives of various kinds— all of which may prove more or less useful ; while otliers, again, speak favourably of milk- ing the Cow by hand a few days bcfoi-e calving, and thrice instead of twice a day for a short time after that event, if the Calf is removed or cannot abstract sufificient milk. This they more particularly insist upon doing if the udder is largely developed or distended. As Cows which have had dilliculty in calving, and whose genital organs are more or less irritated or injured, are rarely attacked by puerperal collapse, it has been suggested that a counter-irritant, sue'- as mustard, should be immediately apphed to the loins or hind-quarters of those which have calved easily and are likely to become affected. As there may be danger if the newly-calved Cow is allowed to drink much cold water, this should either be very sparingly given, or, better still, warm gruel, in small but frequent quantities, may be substituted. Curative Treatment. The different methods of treatment enumerated for the cure of this disease are completely bewildering, and they are so diametrically opi,osed to each other— from the obscurity which prevails as to the nature of the malady, it may be inferred— that we can scarcely be astonished to find that they are all more or less unsuccessful, and that the majority of the most observant practitioners are inclined to believe that recovery has followed most frequently when, without adoptiu" active measures, the attendant has waited for the curative effects o1 nature— usually decided about the second or third day, only attempt- ing to combat certain morbid conditions which might aggravate the case. Nevertheless, it is evident that some mode of treatment must be resorted to ; and that this should be based on the indications furnished by the symptoms during the course of the malady, or upon what we know of its pathology, is obvious. We sh.all glance at some of the means which may be employed in the curative treatment of the disease. Previous to doing so, however, attention must be directed to i\\e position of the affected animal, and we cannot do this in better terms than those i i to combat the le, particularly ;er parturition. -J constipation, t is possible to Id not be with- ) disease than 5sible, with all 3 especially at e to cold and notions of the irious authori- ;ertained as to } prophylactic ng the month ery reason to commend the tass, sulphate of which may irably of milk- ice instead of s removed or .'ly insist upon kvhose genital attacked by ■irritant, sue'-, hind-quarters B affected. )wed to drink *^en, or, better ! substituted. ) cure of this diametrically iils as to the 1 scarcely be jful, and that led to believe out adopting Ave effects of )nly attempt- Lggravate the ent must be Dns furnished pon what we some of the nent of the :0 the jjosition ns than those i PARTUMIENT ArOPLEXY-PUERPERAL COLLAPSE 655 of Williams ■} " If the Cow is already down when first sppti Kv fi practitioner, his first care must be to see that slTeiTmade to he as^near the natural position-on the sternum-as possible; and this he wiU di by having her packed up at the side by Indies of sL\ror what t better, sacks failed with straw, firmlv wedded imrlpv /il ' . ? shoulder, the head at the san.'e tim^ b" in^'prZ' ly topped W Tl.^ same means, and care being taken at all times that theCowTp-evenS from injuring her head by striking it against hard bodies.'' I nlav be added that some practitioners are particularly careful to have tie head well raised above the other parts of the body, especiaUy w en the animal IS con.atose ; and this is sometimes effected by u.eanLTa halter on the head, or a rope round the base of the horns, the other end bein" passed oyer a beam m the stable. This elevation of the head prevent! increased congestion of the brain, and facilitates the re ur of blood from that organ. ^"um ui oiooa It is often beneficial to alter the position at " ,ervals-every two or three hours ; and Williams recommends that tlie mammary glald be also " stripped (emptied) and hand-rubbed." ^ ^ The abstraction of blood has found much favour with many authorities Williams says : " In the earlier stages, whether the animal is standing or lying pi^ostrate and in a state of coma, if the pulse be not excessive^ weak and the heart s action almost iluttering, recourse must be had to venesection Slow and deep breathing, with a tendency to stertor add greatly to the necessity for immediate bleeding. The beneficial action of the withdrawal of blood is shown by the pulse becoming fuller stronger, and better m tone. Tlie opening into the jugular is to be a large one, in order that the blood may flow freely to relieve the con-es tion— to check, it possible, a further extravasation of blood or effusion of serum, and to divert its active fiow into the head ; but it must not be carried out so as to debilitate the heart's action. When the nnkfl becomes fuller and stronger, the bleeding is to be stopped: from three to five quarts will generally be sufiicient/' Theoretically, venesection is to be commended. If the theorv be accepted that the condition is due to hypera;mia-and it has been shown that this opinion has a better foundation than any other, then a sudden depletion of the vascular system, by which the pressure is diminished must stop the attack. It is known from experience, says Schroeder' that after venesection the quantity of the blood soon becomes the same' through the serum taken from all the tissues, whilst the qualitv is greatly deteriorated by the abstraction of blood. A short time after venesection, we shall expect to find the former blood-))ressure in the arterial system, but the blood far more watery than previously From this theoretical consideration, it follows that abstraction of blood must be attended by an immediately favourable result, and under certain cir- cumstances the whole disease may surely be cut short by it But if all other conditions remain the same, the blood-pressure will" after some time, again reach its previous height ; the quality of the blood has in the meantime, been greatly deteriorated, and consequently the da^'^rer of the disease will be increased. ° WilliamR adds: " The bleeding is for the purpose of removing pressure from the brain, and although the pulse may indicate stimulants rather than depletion, it will be found that as the blood fiows the tone of the pulse will improve ; for the weakness of the pulsation, the want of 1 Principles and Practice of Veterinary Medicine, p. 418. 666 PATHOLOnV OF PAItTURITION. impulse, and debility of tlie heart's action, are results of brain-pressuro. If, however, the surfaco of the body bo cold, if the animal be tympanitic, tlio heart's action fluttering, and tlie pulse almost undetectable, bleed- ing is calculated to do more harm than good, as the heart's action would now be further impaired, and the amount of arterial blood sent to the brain diminished. For it must be remembered that the cerebral congestion is now less duo to an over-abundant supply of arterial blood than to pressure upon it by venous or capillary engorgement ; that, in fact, the brain — engorged as it nuiy seem — is in an anunnic condition in regard to its arterial supply ; and when this is the case, paralysis of the heart is to be prevented, if possible, by the use of stinmlants." If abstmction of blood is made from the jugular vein, the neck should be constricted as little as possible in " raising" the vessel, and as soon as it is opened the constriction ought to be removed, lest it add to the cerebral engorgement; indeed, to avoid the risk of this it has been reconnncnded to open the mammary or other superficial veins. A principal indication in the treatment of the disease, viewing it in the Hght we have done, is io favour the cutamious circulation and stivm- late the skin by every means in our power, and thus relieve those organs in which the blood-pressure is too considerable. With this object in view, the skin is to be well-rubbed with straw wisps, and then warmly clothed. Or the course of the spine and for some distance on each side, may afterwards bo stimulated with stroiig ammonia liniment. Some authoriHc^ /ecommend the application of a mixture of croton-oil with oil of turpentine ; others employ a thick layer of mustard, after the skin has been well cleansed with warm water and the hair removed ; others, again, resort to sacks steeped in boiling water applied to the spine — sometimes after deep scarifications have been made. In addition to the applications of turpentine or nmstard to the spine, they are often made to the limbs. In some cases, a hot iron — the laundress's flat iron — has been applied to the back in an " ironing " fashion, and at a somewhat high tempera- ture, a piece of flannel being interposed between it and the skin. The action of the skin can be ;;reatly augmented by covering the body with a wet sheet, and above tliis a thick woollen one, surrounding the animal with plenty of litter. Cold water or ice may be applied to the head ; but this application requires care, as the resulting coryzaand other complications may prove very serious, should the animal recover from tlie collapse. But it must be remarked that tiiis hydropathic treatment haj! proved a great success in the hands of some practitioners, who were unsuccess- ful with other methods. Ilartenstein and Mauri,i for instance, have cured cases which appeared to be hopeless, by first abstracting a quantity (4 kilogrammes) of blood, then placing a wet sheet, folded in four, over the head and along the back, and keeping this constantly drenched with cold water. Wlien the animal began to recover this douching was stopped, the body was rubbed dry and covered with warm rugs. In twenty-four to thirty-six hours recovery was complete without any niedicine — another proof in favour of the congestive nature of the disease, and against its being due to sepsin, ptomaines or leucomaines. With regard to the Ijimpanilis which is so often present at. a conse- quence of the torpidity in the digestive organs, this should be combated in the ordinary way, by the administration of stimulants. These are ^ lievue Vtltrinaire, June. 1889. :am-pre8suro. le tympanitic, ctablo, blcod- loart's action il blood sent i tho cerebral irterial blood ent ; that, in 5 condition in ralysis of the ts." 3 neck should and as soon t add to the it has been jins. /iewing it in )H and sthnu- those organs his object in then warmly on each side, nent. Some )ton-oil with ifter the skin )ved ; others, the spine — addition to ley are often been applied igh tempera- 3 skin. The le body with g the animal 1 application IS may prove t haj! proved e unsuccess- stance, have ig a quantity in four, over enched with )uching was m rugs. In A^ithout any .ture of the iucomaines. at. a conse- be combated These are rL-S'rSwZi' 'Vf ifcarrtf^'^.r" - *^« «-^ ^--. » by n^eans of the stomacL-punp or proband n.^'^ '""^ ^. administered recommends giving carbonL o^f anronlt bol-"/.? ^vf^"^" u^'"'^"^« oiled .8 to be pushed as far as poss ble nfn M,« I' *^^ ^''"?' ^eingwell " wdl slowly gravitate into t^eC/e^ Should^ ^r'^''.^*^''^ *^"^°«« promptly, or the tympanitis be sn l^^f fi 1 !■ ^^"^ ^"^dicme not act hended.'then the ruE ouj^rtoTn,^^^^^ suffocation is to be appre- may be effected by the oSry'^o afant cfnrml^tt fr J'^^ allowed to remain in the rumen for somo t^l A ' ¥ ^^**^^ ^^'"S cork, which is to be withdrawi whpn f " ^^ '"^^ ^^ ^'^^ed by a exercised. Huid medicaments may be i n tro?n^^2 accumulates. If care is the cannula. ^ ^^ introduced mto tho stomach through and S^^^:^i«£,;-°|;-t.me. ^t.the animal is comatose rumen; as b^ this means^tre entrance of foodtS^^^^^ \° ^r^'"^^ *^^ prevented, by allowint- tho cases to Psr.«LfK u ^\:^ *''^''^^* "^f^y be of by the cosopha-us ^ '^^^ *^'*°"gh the cannula, instead those of a stinmlant or laxative nat.nnn J ^"^"'^8 of warm water, or enemas of Hnseod-oil, commo^^^^^ ^^ *h« r««tum tobacco, oil of turpentine camnhor f.?!^ f ^^^oda or magnesia, aloes, rectum forms a s^afe and Sen^^ adm mistered. The medicines, and especially thoseTntendpdfn^ u^ mtroduction of organs, when tho Limal crnToTonger Iwa,^^^^^ '^t 'T^ ^^'^f ^*^^« small quantities has even been Sr^^^^ • ..u^""^^^'^^ ^^'^Pho^ m aloes cStorrot liZtlZTt:^:^'-'''^''''^''"'- °' '"''•'■ bufi„'tsirn:fh°o'tirbrr °«^"" -^ -' «'™'' >'°-. Nux vomica Tartar emetic Sulphate of soda Common salt 8^ drams. 2 ounces. 18 „ U .. • ■.■*l ■ I . 1 B' I ■■ 42 668 VAT IK) LOU Y OF rAitruniTiox. These aro boiled together for about a quarter of an hour in four pints of water, and one-fourth given every hour or every two hours. HarniH phices groat confidence in tartar emetic. Jle gives eight and a half drachms in about two pints of water, in four hours three drachms in a pint of water, and in five hours two drachms. In one serious case he gave as nmch as two ounces in fourteen hours. In thirty-seven cases of the disease, only two died. When it is desired to increasi the activity of any of the ordinary purgatives, croton-oil is generally added in the proportion of six to twelve or even forty -drops, or oil of turpentine one or two ounces. Some practitioners uxtol nux vomica in tolerably large doses, to aid in ruising the action of the intestines. S(ini/il(()its -an aiinnonia--are often administered, and in conjunc- tion v/ith bleeding they may prove of the greatest service at tiie com- mencement of tile attack, or they may be associated with the purgatives. If given alone, they should be exhibited in small doses and very often. Chloral hydrate has been conunended. Other medicaments have been employed — as aconite, bryonia, camphor, phosphorus, datura, quinine, gentian, digitalis, etc. — with varying success. The subcutaneous injection of some of these medica- ments has been mucli resorted to, and some of the reports as to their effects are in their favour. Strychnine has been administered in this way, also veratrine and eserine, and their utility lias doubtless been due to their action on the bloodvessels, more especially the arteries and capillaries. When recovery conmiences, small doses of stinmlants may be bene- ficial if there is much debility, and the aninuil can swallow readily. But in the administration of fluids when the animal is comatose or degluti- tion is impeded, tlie greatest care is necessary to prevent their entering tlie trachea — an accident which might prove fatal. To test whether the animal can swallow, a little cold watc^r may be poured into the mouth from a bottle. If swallowing is ditlicult, then the only safe mode of administration is by tlio stomach-pump or probang, or directly into the rumen Ijy the trocar and cannula. Large quantities of fluids are objectionable, and the amount in any single dose should not exceed a pint. It nmst also be remembered that, if it is probable the animal will not recover, but will be killed and its llesh consumed as food, drugs of a poisonous kind, or likely to flavour the meat, should not be given. Many cases are recorded in which ])eople have been poisoned, through eating of the flesh of Cows which had received large quantities of poisonous medicines before being killed by the butcher. Electricity has been employed with success, both in the comatose stage and when paralysis has renu\ined after the attack. Neumann, Holden, and others relate instances of recovery. The Leyden jar, or, better, the induction coil, may be employed. To sum up, the treatment of parturient collapse consists chiefly in relieving the congestion of the brain (at tlie commencement), restoring the functions of and stimulating the skin, promoting the action of the intestines, and removing the milk or stimulating the function of the mammary gland. All violent and heroic treatment should be avoided, as well as large doses of medicine. Consecutive congestion or inflammation of the lungs must be treated 1 four pints of ). /es oiffht and hroe drachms 3 Horious caso I thirty-seven the ordinary ion of six to wo oiincos. doses, to aid I in conjunc- at tlio com- le purj^atives. il very often. ite, bryonia, I, etc. — with hose medica- 8 as to their tercd in this )ubtless been ! arteries and lay be bene- readily. But se or dogluti- lieir entering test whether ired into the lie only safe li, or directly ties of fluids d not exceed inial will not :1, druf^s of a ot be given, ned, through quantities of be comatose Neumann, ^den jar, or, ts chiefly in it), restoring ction of the ction of the /ell as large 5t be treated J-OST I'AltTIJ,, PAHALrm. ^ Willi diuretics and pu™itive» ""'""""""<"" '"jection ot strychnine, .nd^KCstible'^food.norbop^LSedto^'ry'or'lXr""' '^ «™"" ""^ To prevent mjury to the surface of thn S,? 1 • „ position of the animal two or trrL i, esS; /' T",-^" "^^"g^ ^^^ peat moss-cannot bo procured In rni^ V' ""^^ I'tter-such as the movement should be on the under tSr\'"\'"^^^^ *° .'^"«*her, have been doubled under the I ody-no "n ^ i, 'r'"'' "'"' ''^'^ "'"^« be taken that tympanitis is not interfer n!r w h ' "" -^'' '^°''^*^ In some cases there rem«in« . ,1 f • ^ T *"" respiration, after the more urgent y om havo'di/'"''' "/ ^'^''''^' ^' '"^^tia, animal looks bright anKe ho t at it tyT"'^"'"^^^ ^^hen the condition has been comLte Uuccissfu Iv lnd"n o°' 'fT' r'' '^'"^ tration of an enema containin'" a cuS turpentine. " 'l^'^^tity (10 to 15 ounces) of oil of turilr'SpT "mlei'^vSJr ' "i"" ^^'"^'^ ^^^ -^"^-^ ^-" P- calving period ' ^ Precaution is taken towards the next CHAPTEB V. Post Partum Paralysis. may affect n a ly the wide o the''dr',!,'rH"''"""j"y """■ ""^ The symptoms are similar to those of antepartum paralysis ihe animal continues to lie and nnp m- K^fi, i • ^ r l This condition may contin have to be killed in for weeks or months, and often animals \ of it 660 I'ATJlOLOOr OF PAltTUniriOK. Dint/uosis. There should bo no diniculty in diagnosing this condition from puer- peral colhipso, metritis, or other affection incidental to parturition. If the paraplegia does not appear until a sliort time after that event, and no accident has occurred to cause it, then it has been suggested that myelitis has probably set in, and especially if the paralysis follows mauimitis ; in that case there is not only tlie loss of power, but also diminished sensation in the hind-limbs. But if duo to a sprain of the back from slipping, then sensation is not impaired, and pain may be mdicated on pressure of the part injured. When duo to fracture of the pelvis, crepitation may be heard on movenient, or an examination per rectum will detect the damage ; or if there is dislocation of the hip-joints the accident will be manifest on movmg the limbs. Injury to the hind-limbs from fruitless attempts to rise when recovering from puerperal collapse, can be detected on examining them. When parturition has been very difficult, and great force has been employed in removing the foetus, serious injury may have been done to the organs in the pelvic cavity, and the lumbar nerves themselves may be involved. Congestion of the spinal cord will produce the same symptoms, but there are, in addition, fever, pain, and sometimes convulsive movements of the limbs. Pailiologi/. Little is known as to the nature ci this affection. Harms and others thought It was due to injury inflicted on the sacral and other nerves during difficult parturition. The sciatic nerves are particularly liable to injury. Post mortem examination, however, has only furnished nega- tive evidence of this. Franck thinks that injury to the cervix uteri may give rise to reflex paralysis ; this has been witnessed in a Bitch ; and reflex paralysis of the legs has been seen in woman, and ascribed to uterine injury or derangement— when this was remedied the paralysis disappeared. It is not at all improbable that the same causes will pro- duce the same effects in animals. In some cases the spinal cord has been found injured and its vessels congested, with blood-clots in the spinal canal ; and in others the roots of the abdominal nerves have been surrounded by serous effusion. It can easily be understood how paralysis is induced in parturient apoplexy. WiUiams states that it is due to inflammation and red softening of the spinal cord in the lumbar region. Pro(inosis. The prognosis must necessarily depend upon the diagnosis. The paraplegia, real or simulated, is due to various onuses, and therefore the likelihood of recovery must bo based upon the nature and degree of the injury. If it is only simple congestion of the spinal cord, recovery may take place in a few days ; but if decubitus persists after a week, there is reason to apprehend hajmorrhage as a complication of the congestion ; though injury to the pelvic nerves will also cause the same symptoms and prolonged inability to get up. These cases are generally hopeless as are the great majority of fractures. ° i "> Whatever be the cause, if the animal can remain standing, when got up, for ever so short a time, it will in all probability recover, though it may be lame in one or both hmbs for a considerable period. on from puer- krturition. If at event, and iggested that ilysis follows ivver, but also sprain of the pain may be be heard on amage ; or if manifest on 3 attempts to detected on lit, and great injury may Limbar nerves will produce id sometimes 18 and others other nerves :;ularly liable nished nega- fi\ uteri may . Bitch ; and 1 ascribed to he paralysis ises will pro- id its vessels ers the roots ffusion. in parturient ion and red jnosis. The nd therefore nd degree of ry may take eek, there is congestion ; e symptoms lly hopeless, ig, when got jr, though it POST PAHTUM PARALYSIS. ^ Treatment, Treatment must also depend upon the diacnosis WKn« *» plegia 18 due to congestion ol the spinal cor IcoW If «.\*'"'' "^T. to the loins continuously by mea^o rugs koit 8^^^^^^^^ (luent intervals by a large syringe or L'ardon hZ ^°'.'y/*'«^' O"" ^\ ^^^- In all cases, the state of the uterus should be asesrt«ir,„,1 „„j i< •. .sj„sat,sfaotor,, then reu,eaial .neasures should\rrprd 'witT regird CHAPTER VI. Eclampsia. There can be no doubt that the malady described in this work as parturient apoplexy or puerperal collapse has often been confounded wi h the disease known in woman as ''eclampsia," and which is also witnessed with some sHght differences, in animals. For i seems o be now admit ed that the eclampsia of woman and the maladv oT the Cow are nearly, if not altogether, identical ; and the same or^^milar causes maybe in operation in the production of both. In the first place, the eclampsia of woman is essentially epileptic or convulsive the convulsions being of a tonic and clonic nature ; and in animals con! lympZr' ^'"''^ ^ P'"'""'' ""^' '''^''^' "^^y ^^ ''^-'^'^'^ ^' ^ ^oJZi nni^!i/^-i"]|'^°"-^^°^°^'y °^ ^^^ ^^*'^^°« '" *he human female and in orTntat?on'''T^" '""" particulars, owing no doubt to differences n organization In woman there are premonitory signs-such as uneasi- ness headache nausea, twitchings, sudden vertigo. Then the attack begins by rapid contractions of the muscles of the face, eyelids and eyeballs the latter rolling about in their orbits. These movements soon extend to the head, neck, and other parts of the body, and are lapidly rep aced by tonic contraction of all the extensor muscles either t^.! f 1 ?.'',?'''•. ^^'"^ respiration is stertorous or suspended ; the pulse— at first full and strong-is so weak that it is scarcely perceptible • the tongue is protmdpd froiP thp month inrl .ofHr. Kin-r.- f- °^^'"'°' ^,afv„«^« ii r "V . "'""^») ^"(i oitcn bitten, tuaiii appears between the lips, and unconsciousness is complete. The attack may last tor twenty or thirty seconds ; then the tonic convulsions are replaced by those of a clonic kind, preceded by a general state of rigidity The movements are jerking, and so convulsive that thev shake the whole r 662 I'ATHOLOGY OF PAllTUllITION, pals^e resumes iKat?..f^fu"y '"V"^'"' *° '^^ "^''"^^ «^^*«' and the subsides, Xsnira on ?. '^^*^"' '\ *^" J^'^"^« °*' '^^ ^^'^bs and body tranquil KSato^pP/'^/^.a"^i!\f^^^^^^ °ne *« five minutes all is but the pSent awls. '"^IV"" T^^^°^^ supervenes varies in duration, ally, there is on v nn^ ^I ^ ' ^''' ^''^^ observed. Exception- succeed each oth^er o IJr^' generally there are several, which^nay between the pauses and Sf^; T '"v ^1 ^'''T'' /".^^ f '"^^" «°^-^'°«« from oedema of th!i, '"^ ''f'"^'*^ °^ '^^ ^^^^""^ ^^a*^^ '^^ay take place become lon'ef the 2ltv\T^^V- ^" ^"•""^^"'^^^ «^^^« *^« i^^^^vals theyfinallyfease T ht^ hen>selves more mperfect and shorter, until during prjcnancv aTid i ^^^l^' considered very serious when it occurs every 350 cases oHabour ' ' estnnated that one case occurred in 1ms beenSef h''' '^'^ ^-T' ^^°'^*' ^^'^^^' '^^^ P^^'^^^P^ ^he Sow. It Crnti^ent Id n^l;?°"'t'^'^^'^ ""?^^^' °^ observers on the European StorrarRolls and C Lr Ph'"'"' f ^* ^""' ^^^" ^'^P'^^'*'^^' ^^^'^^ by being a'Bitch 'suckling foo Jany Pu^l^er '^ "" ^^" °^ ''^ '^^ ^"^'^^ Sijmptovis. before p'ar^uritiSn tftTmn T'f "' '" T^'v""^ "^^^ ^^^'^' occasionally soon ; thou' it '„ at 1,P / ^'"'T'^'^y "^served after that event, and Priuiiparrol tpn «,y ^e delayed so long as the twenty-sixth day. Cow ?n poo ' condi bn ; •' "'''\ 'V'''''''' ^^-^q^^^ntly (vitnessed i^i pregnancies in fM^-l ;,•«' "°*^ f''''^>'' recurrent at subsequent whfch ifcl!' 11 "^'^^^ dihermg from the affection in woman in Ttt^cks he rw T"^ f "^»?only seen before parturition. When i and contleseln^f r^^ " ^^^'^^^^ '?. '" ""^^">' ^^^"^ '-d""-" induced. ^ recovery may follow without labour being lesri^tarfhourdurin' 'tr'^Tr' f "^ ""'""' ""^ '''' ^'««^«« ^^ f^^' her, in at leas^l^^Je::;^.!^;^-;^,--— - ^^ ^^°1-^-^. - i" heard bellovvrothers d^^^ "'^^S .S°'"« Cows I have limbs (clonic snasmf dUVouh ' '''^- '"''' ^witchmg of the body and attack The cC'lfo^^ '" rr^^'°'' according, to intensity of the majority o case df not .e 'oh H ^' "'' ''? °' '^'''' ^^°^^^'^' ^"^^ "^ ^'^^ oasis which have done so. •• '''°' °^ '^°'"'"' "^'^^^^f-''^ ^ ^^^^'^ ^^^ wards. On' the following- .rnL-"th. ',,' i;'^^"«"t'\be.ng expellee] tw„ hour« .ffter- state, and the abs and body minutes all is 3 in duration, ing of pain in i Exception- al, which may lain comatose lay take place 3 the intervals shorter, until vhen it occurs 3e occurred in an correspond the Sow. It the European ed, chietly by i, the animal ' occasionally at event, and y-sixth day. witnessed in subsequent 1 woman, in 1. When it ut mid-term, abour bein'' liseaso is far lished, as in sudden, and ' well for a ■vith that of itoms were : •taring eyes, etimes lick- ^ows I liave le body and nsity of the and in the I have had vaa four years > h()urn aftor- ;■', refused aii [jasture, it wiw 28. ECLAMPSIA. 668 brought, it remained completely indifferent To t A \ exposure, and its Calf being «ent for. He found it IvTng exVnrd on t^e rtht side thet''' " r "' '^"'^ ^^'^"^ **« entirely diaphragmatic, and it Wf,s difficult to ?,.L' 1 re.spiraticn appeared to be the pulse was iufperceptible, but ^ Lh^Tv' b^^^^^^ "^ *he Ha„k« ; the mouth, an.l the air expelled carried a lar.re ..uantitv f f t'.ngue hung out of senses appeared to be complete)/ abolished, a,^ he evehJll T'^ T''' 'r'*" ''■ '^^'^ looked fixed in a remarkable manner The li 1! 1/ >,"*""''*'' '^'"'^'^"y upwards- the trunk, jerked in such a vi,.le,U manne tj^t The ^^^ they, with bemg displaced. The udder was norHacdd ami mk f '""'^ ^"' '^'^^'' ^'">°"t obtained trom it. ' ""'^ ""'"^ "^ ^ «o'«i 'l»alitv was readily out his p..««eriptions. the Cow got".;^?'a":d ^t'lm. ^d^^aT rhTsiJe^Tr'^^ S' T' hour, and the aninud 1^ „, S hidf^ "t i^^'' U ^^ ^- ^^ou't half ''an of disease. It had no inore attacl s mt ""d-day it did not present any signs it two months afterwardra-ul Si hnt Sd7c':f''i^ '^Pprehensive of future dange'r, s'old Calmettes 'noted tha e hiSou; rL? we ^ v^v ?"',? '"'"ll''^- '^' ^'^^'» "■«'"'"' ap,,eared to be increased, and essure on lledo /l . ' ' *•''" ^"'"'"^ sensibility the skin was very hot and the esn^-^f !, n ,. '•'"*'^l"'".l«/ region caused much pain ; r..ick, the mucoi:s^L"brant"r t r'Zn"d '"idlh^^muS'l "^^ ^'^'"' ^"^ its slle ^h^Xne f sensibilitv ' w'^s'V " "'T T"' ^'Y' '^'^'^ ''^'>'"'^' '-^ f^"- «" time to ime i^UTrrLrarked tl ail f,'""";'^^''' ""'^ V«^ ''''" '"''' '''y ''"'d' l>om which threw the latter nto r lmc f.ttlZ T "k^'^T "^ '^' "'"^*' "^''^ convulsed, and nKuutcst...,! the same general i.isensibilitv it disiikyed in the morniu.r Thi« rnn tinned for only three hours. Next n.,.rni,„- it^appearii to be ,, ito rec e td iMfteen mouths previously, and eight days after p.rturitio , th s ( W hiul another ^onlL H ^^^ '"' *"'";■ ••^ff"'-^^'^'''-^ it was completely ins.osible, and sensa- crt^^Th-.n f'';r'"r'"':" ""^ "'"""' "•"■'"^^'' *'■" P^'^^'' i-",^rceptil.l.. thoughThe c nt.acfon of the heart were powerful, an.l all the svmptoms already enumerated were hLlf lumrs! " """" '"^"'"^ ^^^<^H^^± The cnvl.lsions conti.med for two and a h.,uTs'afttw?H 'l'"""''"''" ' -l t ^."^' ^'"^* ?^^^'"' '" ''"^ "^"■"t f^^vourable manner, and four I e 1 s .1 . !^ H r"""l" '''^'."r'",' ''■"' 'i'""'^'^'' ■• ^""" •■^ft^'rwards, there were convulsions of H an T " ' ' "■""'' ■'^'" '""''■^' '.^"'l -' •""'-•'' W'^ak-'e.ss s.t in that the aninml could not the Cow ,n ~ ''"'. "f^'^", P':"J'"-'tf I f--"'" the mouth and foam fl„wed ther.fnnn : .esniratLn m,.rt'/''-^ "'" '''!""? ''^ '^""•^'^- '^'"^ I'"'^*^ ^^=^^ intermittent, and the Tw d. 1. . . T '"'^':T^''^'^'- ,^" '^'""" '«" '"'"" it .nose and gradually recovered. I wo days after, ,t had another and a tinal attack, which lasted for three hours Jtfnie Vvteriniiire, 1S70", p. ()< - Ib'uL, p. 70. 'Hi 664 PATHOLOGY OF PARTUIIITIOX. with'^'rrsLnrconSrsSs^rd l^"';^''"'' ''!''^^' t ^'^ »>°"^« after calving, was seized possible -presenting in faof nil fu g'^ieral weakness, which rendered standing im- tinued for three hours, and knolhiffT'^^r' °^*^^ P'''^',""' ''*'^- '^'^'^ attack con- day elapsed, when the fits «,^?i''i'°'''^ °"u*''' ''""" ^"y- '-^f^^" a" ^"terval of a intensity, that the animal dLdfrl asphyxia." ' '" ^'^l"*^""^' ^"'^ ^'**» «" ">««'' ^hif £:r L'^°^f,S^J";-^^^^^^^ Of the usual symptoms observed in examined in onlv onp fn^ ^°''':. .P^ ",u"' -^PP^^"^^ *° ^^^e been the crisis, Xh lasted for ?h'' ^f '^'l f v""'^^ ^^! P^'^^^"' ^^^'^^^S valescence had set fn? ^^' ' ^''* '* ""^^ "°^ ^°""*^ ^^^" «o"^ an[ma?ha1'tente.d''' ?if ' ^T ^'^P^^'^^^-'hat by Lafitte.^ The and for which^t K'u ^^'^^ "^etro-pentonitis following parturition, quently it apnea ed?o t^"" .fPf •oP^-'«'t«ly ^^ated. Two days subse- particularlyTo^^^^^^ ^"'J restless ; all the muscles, and there was abSant\«liv ^ ' T ''^^^'^^^ > ^^'^ ^Y^^ rolled about ; There was on v. ^^/'^f '°"..etc., and the creature could not stand Thp d , «L I ^l ^^^^''^' '^^^'«^^ l^ste^ for several hours. HertwL^ 1. ^' been observed most frequently in the Bitch i?/S a^fz^derdv: !"^ ^« ^* ^i'f-*^ the animal. The latter 1.1^ ^n^ilar account of the symptoms in that disease, though He;tv.^'h.d'''TT''''"''':^ premonitory signs of the sucklina nn^"! 7 1 T , ■ -^^ ^^y^ ^^^^ ^^ith Bitches which are nofrnvf'f^ 1^'''^''"''''^^ *^°^^ ^^l'^ '» tiie house and well fed it is with r f 1?^'''''" '^ '^^*" °f t^*^"'^ rigidity and incomplete mralvsis TeasfandaSs'^'Zer" ^'^"'"'5^ '"'^^"^^ co.^mrnc'e^tTe hot • thTt^Wul, ' ^^^^ ^'^ haggard, sometimes the nose is a little ch St o;abdSX^s^T^ '"' quiclc though pressure on the quarter oFan hour XrtheTffi'^^ In a short time-about a animal cannot ^LJk f.n*^^ '" '^fP'''''t^°" '"'^^ observed-the extended oTpnti,' ^"* j^.^^ «" ^^^ ^ide, and lies with the hmbs still qSlke^^^fr^t'ooT'lio^r^^ i^'^^'- ?-f '?^^^^^"^' ^^ « small, hard, and h-re-mla ri^ ""^"^ '" '''^''^^ ^'^'^ P"^^« ^^ ^OO- the aAinml xfuls food n ;.l ^ f '°^'"f ' ^,PP"^^"' *° ^^ ^•'^t^"^^'^. bu are suppressed tK '^'"''^^''^ tbe alvmeand urinary excretions abu'i^s i7;;^vided vX;;nk^i7 fn^vr' f"f"^ ^^^^-s'^- ^-^' -'^^^ be altered o- iniurLu o t le v^ n? ^ h f °^ "^ n ''' ^°"' ""^ ^PP^'-^^* *« before This sN > noL 7 V^' ''■^''''' ''^"^"^ continue to suck as occurs from Inonl! '°"^'T'' ^''^' ^".^-^y^^^obt hours, when death generally ' /I'srae Fe(((VjH«!Ve, 18"(5, D 71 •> i- ji. •. , ,, ECLAMPSIA. ggg cas'lTeXettdntyri" ^ ^^^P^-- i" the several quick, irregular, noisrand.nJ^ J'*?? '".1?^^^^^^ ^^^^^ is very movements! as in S horse^aS ^'' *^k '^^' ^^'""^ ^^^^ in their deviated to^he le?t L one oThis ^ :' Tnd thf r^'v; ^""^ '''' "^'^^ period, or thLe ma^^^^^^^ f^^' ,^ «^ore or less considerable intervals. LafitXw a Bitch wS^^^'^'^ °*^u'^' ^^ ^°"g«^ °^ shorter two days previouslvTnd wSh t ^^ ^/T"^ ^''^^^ *° ^^^^ P'^PP'es. ecbmpL^that contiCd for a day another 0!"?. ' \' ^^^ ^" "*'^^^ °^ following day, and a last and sft one'^he nexfdav' ^""tI'^'^-^I '^^ covered, but some days aftprwnrrlo fvil % • , .^- ^^^ ^^'^h re- seizure, less intensrSd shoX fn / J^^'^^ ^ad a similar convulsive desltalf ptlS SLsIt '%^°";'' '""^^ "''^*- '"« "-»- indications wEbdo,r„hSl V ""^T^'T Certainly tliere are it is the lattZ fl,„ u *,. 1, °"; '^^'^''ises. but 'te prohnbilities are that w/rf i\tac1:d'S"E'':':'''r "W^'T^y "t seeing, the animals seTmtion Tl A 1, '"""*"! '^'^^^ dnninution or cessation of milk temDera^uro lot f\ ^^.^" "^ '^^^' ^^^^ ^^^^ «1°«^<3' ^"^ the body temperatuie lo\y , at times there were feeble convulsions The resnira- tion was irregular, deep-drawn, and moaning; the pu"se 80 to 90 ner mmute ; and tnere was great loss of sensibihTv Nothing was observed mpr vetenf S'nh "T'"' ""'''' '7'^'y''-^- to "Sirt" ?x Ws mvXnHnnfn P^^««' ^^^^s Were voided, and the animal began to pajatten ion to surrounding objects; the temperature rose- the nulse and \:t^ltTL%'-''T' *'" '^^'"''^ ^"'^ "^^'^ ---tioii letuS suivivldtho 1 f 1 r "^'^^^ '^'''''^'y ''"''^ complete. All the Sows smvived the attack. In one case reported by Seller^' the svmntomc, were more of a convulsive or epileptic nature. symptoms Etiologi) and Pathology. widllv'nnf H^ '° *''' '^l°l°^y °^ *l^.' ^^^■"«*^^«" •" ^^•°'"^"^. opi"ions differ ^\ldely, and they are not less conHictiu" with regard ^o nnimal" Th- cnumeiated will have been noticed. It occurs in the Cow and Bitch I Mai/a-Jn/or ThkrheUkiimh mid Viehzucht, 1869. - tanotatt 8 ya/(resicnt7u, 1862, p. 48. R^ I It 666 I'ATIIOLOQY OF VAllTURITION, I! tim LrplTS '*^- '''^,^^" ^ ^^"^'^ble period after parturition, and in thouX P^n« ""' "\pluripara3. The symptoms are very analogous, anSl a. in r'"''' '\^^ "^'^ ^ear to be so often in abeyance in d"s nction hnT r^"- ^"^^'»i"»^a certainly would appear to'nmrk a wh e i I'n f ' condition also has been noted in some animals, affected «n n ,1= f"""*^*^"* symptom in woman ; besides, the urine of albumin ^n "t °"^y, ^"^'^'" «^«"^"y *««*«^^' ^»d the presence of ThP diffiMv n-^ "'""^ ^'^ '^' ^'"^q^«"<^ ^" them as in the hunmn female, tion c^Zl^ '" symptoms may be due more to the higher organisa- anv d Lrr" ^"\f^^ circun.stances in which she is placed, tlmn to SDedes m^u- f 1 '\ *''' Pathology of the malady, in the three or four species m which it manifests itself neuroSrr^ ?"^°J'' ^"^ '°'"^ °"^^'"^' ^^^^^^^ ^^e disease to be a QUO es n nn I ' f u-ntation of tiie spinal nervous system. Playfair^ San?.v" f ?L"?''^r^ authorities to show th'at its etiology in see t, ,7v ^ ^"^""^f^ though the coincident existence of albuminuria in Hio to P^ove Its dependence on the retention of the elements of urine lar* nronoff" f ^'"' "'?°'-^ ^'^^^ ^^^^^ controverted by the fact that a and v?fT ^ " of women had albuminuria before and during pregnancy, V sionV ?*J "o eclampsia ; and also that albuminuria followed the con- Sicod hvl Pi-ecede them, rendering it probable that this was T nni ^ t^'^^,^''^'"« cause that gave rise to the nervous symptoms. cerPhrtl ''" l^o^enstein ascribed the occunencc of eclampsia to acute pregnancy ^'^^"''''' ^° ''^^'"°'' occurring in the blood during of;hTvaso\.';nf'''"^^;^'^^'^;'"''^'^^ ^""^-'"'^^^^ '^ '^ ^-^"^^^ ^^y irritation n mdnl,qT fi ' ''"*'"'• ^' *'^^ '•^'"^t of an anaunic condition of the blood o remove ^.'.' TT-' °^ ""^''^ -atters which the kidneys had failed nsuf cien.'v H .Haultain-' considered it to he due primarily to renal Si' In^' .''' ?'"' rise tolits, from a poisoned state of the blood S^enffar;:rioles""'^ "'"'"^ ^"""" '''^'^'^^ ^^^^^'^^^^^ °^ the PIertwi'/"3^1 *'' *^' f'^^W l^n'l pathology of the disorder in animals, bv ch Ik Kp r^' *? '' ^''"'^' ^.'^"""'^^ ^'^^ ^'««^«^ "^'"ht be caused a enta e„ otiin °V T,'""' ""^^ f >'r'^^"«"t stagnation" of milk, and mental emotion. Zundel asserted that it only occurred in Bitches hile suckling, and only in those of the s.naller breeds had he observed oth rT'thiT?; Who ""^^ 'f ""^ •;f "" ^"^'^'^^' p^^^^--- ^f-»^ ^1- -"i ec amns n. J °''^ ^ avourable condition for the development of in oo^onSif ?'"'"'' °hf ^-^'^^I't in lean animals ; but in Cows those fi rn fv beS^ tLTlT'' ° ^' ^'' ^''"^^^ '° '"^ ^^^ highly-fed ones. Clark is relx 1 rinti . f ' ^'T"^''^ '''^''"' ^^P^'^ially in post partum cases, Ob efvation ? 1 f uterine nerve-centres, basing this belief on hi ei lith to the^ t^ the Cow occur most frequently from the fy »(■(' of MiihnjWfi ■ous. Kdiiihitruli Mi;i;l„l 'joiniKi/ irition, and in sry analogous, 1 abeyance in jar to mark a ome animals, , the urine of e presence of luman female. ;her organisa- laced, than to three or four ease to be a m. Playfairi ts etiology in f albuminuria lents of urine le fact that a ig pregnancy, iwed the con- ;hat this was anptonis. psia to acute )lood during by irritation 1 of the blood ys had failed .rily to renal of the blood ction of the r in animals, it be caused of milk, and : in Bitches he observed -uri also, and elopment of I Cows those nes. Clark irtum cases, )elief on his tly from the )d at which her was un- winds ; and liich., acting irritation of to attribute lerous. ECLAMPSIA. 667 (iiscovered only congest on of 1^,,.. ""'"P'"*"' but McDonald cerebro.spi„alc'entr:trd"„o'e"l,;c:''<;t"a:f^'- ™»- »' 'he Diagnosis. occurs at and after tl,„ third oalvin.- ireirindln^l I,? '*™''™''>' and usually within t»o days alter paTtir tion tha? ,,7^* If g-ancy, in (at or plethoric anii,i».l« ■ tl.o. l'"™' ""V ■ fat it is most common tho..g.i thL ."a7brexcrtt.nu„d t,:«xitSa4to tn *" and coma rapidly ensues. oo""o. incre aie no convulsions, Prognosis. wt°;; itratSf^' ^z^"- '"™'^-"r ^-->--s ..id i * Treatment. Plertwig recommends the abstraction of blood from the iu^uhr ih^ quanity varying with the si.e and condition of the a ml s" and 1 e S S:;'' Ir' V hn? H "\'{ "\^ "\t ^^"i^^""^ ^^^"--h coLXably: oi fv n a spoon'ui of tea w.;.'?^ '' '^°"- "T ^""^''^ '^'' ^^^^^'"- ^^^ adndniste's potasr If tU howH ^ ' "'f-^^ ^T'' '^''^' ^'"^" d««^« «f titrate of r.Tht !^ , '?^' "-'^ constipated, an enema is to be given Zundel small aXueirr"'^ -^'^ ^^'^'"P ^' chloroform whic in small and tiequeut doses, keeps the animal in a state of semi-aAfcsthes a- n:nr 'tIS ^ZT"}^ '^ ^ '?" "^' ^'^^^^-^ '"-^'-- and r 01 wo Bromide of camphor has been favourably spoken of as has chloral Sc'ifdorn V"' r •^""^^f ^"^'"^ 1-df belladomSas "int^ ri specihc, in doses of from two to three drachms, repeated in two or threa 1 ours, If necess.u-y , he finds the glycerol of bdladonna eou^ pu of d Sni'l?V''""r ,°"""^ Vr' '^^"^'-^^^"t preparation .?s it i^el ily d sponsed and rnad.ly nnseible with water. He beUeves bleeding may tleltS'th"?^^'/""''^^'"'^"' cases when belladonna fails to "arril tiie attack, though he is not much in favour of it. Ill PATHOLOGY OF PAliTUIUTlON. CHAPTER VII. Epilepsia Uterina.-Mania Puerperalis. UteHna ■• has ^.^^X^^':^ be cSXitL ^^Sat lous chapter, has been named '< Eclampsia," did it 'at irom it. nnrl rn>lio.. voaQ.nKI^ — ;i \.^. _ i . Tot diffeVctSl^L^^^ '^f^" "^'^^'^ "Eclampsia," did it Harms hasTX^«. Mai ^'l 'l'^'" rese.nble epilepsy, or what is better defined it win t P^^^Pef^'is. Until its exact pathology aetined, it will be convenient to retain Storrar's designation The disease ap agitation, sometin .0 affect the Cow only, and is marked by c^reat intwo^.;sr;:;;dti;Sr^^^-f:^^^ foShtTrevil'l/ra^S faTeaS't^e'dT -^.^-^fi-/-- "'d- which had calved a the aninml had „„t been well and"ts CaU h^H r '"■ *''" fT ^"^"''^ ^^ ^"« *='^»'^d in a wild, excited expreJor;!" taHni "'"""""' *^P'*^^'^^^^ I* bad quick; jawH continually moVrn^^'ifi'^ft, :';^;,:77.": '"'^ ^""' '''''^''' «'^°"fe' '^"d under part of the ton/ue purnk and viH I t -^l^' ^"•'''"'"S at the mouth ; the not be st<.ppedbyholSXmtor.thl T""',"^'- T"" '!""\«"'''nt of the jaws could continually biting at i ts h, S« f both u'!?.,' I'" *^ *"""*' '"'^^ ^""^^ *« '^s'^'f ^^ wan it gnawed the ,n7u.ger, woXSk'of the Ktn 1 "'m'"^' '' '"'""'^ ' ^^^'' interrupted offered it would seize it TnLtTcate t wifh H ' °^?"y*'""^^ presented to it. If hav was to, and swallow it. It t "^ ome lln , o l' "°,"*'"";'"« ^^^l ^'»l«nt movement referred nothing else, it looked fuLnH ^''^""'^f'' «"d chilled water, and though it partook of suffering gastrirderaSZt Tl ''''" *'"• r'""'' «°"'' °'^"'"' °^t«« '"^tvvith in Cow Bloodwls^abstrLt;d,an'dreladoni3 -'-"'* .occurs soon after partunS afterwards, the conv/dsive rn„ eCnts "^Sl^^^^^ ?"^^u""* ^^'^^^ »'""^« rel'^fdTrorS'" Sx^r.r^il t wa's T '"h r';^''™.^ •^''^*"'^^* ''^'' '^^ ^alf was the jaws moving in the same co nvf,W "^ *" u" '"'^'^""S ^'•°'" '^ ^'^i'^^r attack. that the Cow lorked-.ranTexLXZr:;f^.'},* ""' '" ^'"'^'""y- ^^"^'^ ""^"^ pulse eighty per minute and f^,n nnA . ^ ^ r 'i*"' ^^''^^ '^'-''"•^ ""'''nal ! ears warm • tongue livid ;'^grind;;,7t^;rtee h ,cc"fionaTlv' '' tCTS '* ^'^'^ """^'^ ' ""^^ P^^ "'' ■saliva, from gnawing ?hem The an-ma w ' • ^''^.^f^^ T'r'^ ^et and covered with soon took place. """'^' ''"'' '^t'*'" ^''^'^ a"'^ had opiates, and recovery ^^^^^-X::f^::^^^^S^: ^''^^'^'^^ doselyresembled those of On the day on which R.fbd et was sent L it h T ^T'Tf'^' Parturition being normal, panions, and constantly Sed L fore 1 ^ f t 'f^'^ *"• '"' •"* P''^*"''"' ^'-"^* '^^ '=°"'- everything about it. Kobellot found ha ^h hid b tir^f""^' " ^''"^ '*^f"^^^' '^"^ ^^' allowing tile latter t.. fall fnmi its iruthwifl, f '""'^" .'''«. '"anger, rack, and food, and fore-legs, but with.u.tLeak n^ thf sl^^in The t' r"**'"^ '/ j, '' ^j-.-'^ed it^ breast the eyes, unnaturally open, were red five. 1,,, IK ^ 7*' ^."".''"'^ «ixty per minute ; buccal mucous u.em'Lra'ne \varslS tlj i\ fla «1 ^f^^^^ *'",J^"P"« •^"^''^^ = t^J borders of the lips ; the resniration w w TT\ ' *i J ^'"* '^ ^'''^'^a surrounded the fore.limbs, bellow^ed pawed 'the ground th t he for > f'T' '^^^ ^"" !.*^'^*^'^^^ «"* ''« visible enemy. The handle of a stable fol b ^"^'^^-fe.it, and seemed to defy an in- frantic mannW and bit it, nLvkingShid tiSly""""'^'' '''' ''^"""'^' «^'-<^ '' - " chain, and an ounce and a ZuZ Jhl ,ra?a 'in,- 1''"' ,'• ' ^""^'■f ' "'''''*'^ ^^ '-^ '^""We of an hour between each dose sUeial ^nin^t f '''''.V'' *^" ^'^'*"^« '» t*^'-^--^ quarter had continued to show the same s^npSms Xl^^^ ''T'^ ^.?"'' '^' Cow,' which Byinpcoms, imng its head, and, without staggering, fell 1 Veteriitanj Journal, vol. iv., p. [,3. ■* I/mL, vol. ii., p. i;. ■' Jte.cueil lie Mtdecine Vet&inaire, 1874 of " Epilepsia ith the disease mpsia," did it epsy, or what :act pathology designation. rked by great the symptoms 3nce. ch had calved a he was called in us night. It had ther strong and the mouth ; the f the jaws could t to itself it was I'hen interrupted < it. If hay was )vement referred igh it partook of let with in Cows fter parturition, bout three hours be much better. 3r treatment it Id the Calf was similjir attack, y. Kolla noted al ; ears warm ; ; under part of id covered with 8, and recovery smbled those of 1 being normal, re, left its coiii- •estless, and bit ick, and food, eized its breast ty per minute ; 8 dilated ; the iurrounded the ■etched out its to defy an in- I seized it in a as to inocuJa- d by a double tea — a quarter tie Cow, which itaggeriiijr, fell EPILEPSIA UTERINA. like an inert maBs on the ground th^n m,^ „* . . afterwards the same occurrence was agaTn noted-trCow"'' """ "T^"^' ^en minutes up ; It remained in the excited condition already deecHbed k"T/""'V,«^°'^ J"™?'"? symptoms had subsided ; there was no fover or excitement n fK-* '^^^ *" *^*-' ^"^^^^^^^ ness and prostration. It had fallen . third tfmeon^r"^ ''''*=^P' ^''^''t «eak drowsy, and ren.ain.d lying for about three hourl after *h,^?h*^r''"' ^*-^' "*''" ^«<"»"« well. ""'^'' ' «"er which it arose, apparently quite Kobellet'a father had seen two similar cases. it broke all the incisor teeth excpnf Anl Y- , """^ desperate effort fractured the alveolar procesesZofchpr' r" '''^ °"* °^ ''^ J^^' ^^^ severely injured the bwer'aw that^ he ircis^orcS^rh' '^'"r' 'I for some time; though the molars couldTe used when thrf"'^^''^ placed m the mouth. "^" *"6 food was Giintheri and Landel-^ have observed similar cases Thpv ^ u the annnals as extremely excited and violen h tine « .t^ describe them-even people-climb-im into tl^P man " everythmg around wall, roused to lits of furv a fhe slth 1/ ^'''. '"""'"° ^S^i"^^ the and sometimes toss^ngS tfd and'b S^^^^^^^^^ ^^3 ^''''l 'T^^' quick, but the heart's action is weak °* ^ ^^^'^ '' ^^^'^ ^^^ Cau&e. itsS tste cat^of'thV:?!^^ 'Sf '"' '^^''^H *^^ ^"-^ ^^ chills which Produ^ b1aL^:Sio.f r^^ malady as epileptic, dyspeptic, and uterin^ ' T^e an ,nal IffpTS t^ calved some few days previouslv-sav from fnnv f^f ^'''^^ ^^' more days; she has been heartily Sin° LLd L?^*^^^"' .^f «^«" largely, or, more correctly, her milk has hLlrL.T^^' ""u ""^'^ throwing up, when left fo/ ^ time a veiv heavv lavP o '^'^ "'^'.^?^ usual uterine lochial discharge has bee7supSsed O. tT'" ' ^"^-^t^ be thus stated : An excessive drain upr?he system hv h' ""^^^"^'^^^ glands, causing, perhaps, the suppression of thp ffp.in^ ^ '"ammary the peculiar smfll ab'ou't the a^n^md and . Se mX^^^^ which is referred to by Mr Rolls follnv3 W „ '"^^^^^ 3" ^^r milk, developed attack of indl^estfon ' Ttsrcaus'^^ ''''''^^ dSSd" ^Th^ T^^'V'"'- -^--^^-ry^rilnlrhich ^haTbTn^ descubed. The dyspeptic signs are the more prominently shown S as a desire to eat anything unclean in preferenceTo good food or 7oarse Tl^^^^'S^lSr^Z:^- ^^^ ^-vels becometrXand inf}npn.'''^'''^!i^ -f 'l^^ *° ^^^'^^^ ^^^* *his condition is due to psychical ntiuences, and it might more correctly be attributed to cerebral hr ta tion from some physical cause-either indigestion, constipation or deranged circulation in the brain, and related tl the partuHent statk Treatment. ste" rwltlf rtim^lanf ^'Pf ^'°" '^ ^•■'''"*' P^^g^tives should be admini- Wl !n\r .^*"""^^",^ o^" tome medicmes, according to the indications When there is much fury or excitement, narcotics In lar.p do«e= m"': bo given-the best, perhaps, being chloral hydrate Belladonna miah't also be very serviceable. Great\ttention fnust Le paid to the ^S '_ Gehurt>ihidj\-, p. M.i. -' liejjtrtorium der Thierheilkumle, vol. viii. f!l T r-. 670 PATHOLOGY OF PARTURITION. applied Strom. «H.nni ^ «"PPosition that the brain was congested, applied strong stimulants to the back of the head and to the spine. Il CHAPTER VIII. Parturient Laminitis. sInTtiL\?ot;v.'d^r ^T.^^'r ^°^^'"^^ °^' ^b°^"°"' there has been whth^ln Jl • ^'^ ^"^"''^ °^ congestion or inflammation of the feet ^La nin ?k '^ simulated the painful and serious malady knovvn as disease doS nnTf ^^^Tl^ *" ^^ '^^""^^^ *° *^^^ parturient state. The clisease does not seem to be very conmion; though Obich-' assort-, fhnf T «„^„4. • viT. . ,. "-^ '-^^'^"'S anci omitm in i^ngland; Fabrv Cluiln Germany ; and Ayrault" and others in France also as a complication of ruptured vagina. in It has been observed zischm Staate, 186.', 1866. p. U,i oZred^^^ K'"-'"" '" ^'•«'«- supervening on parturition.^ So.nc , sys af^erthi L '1 T''*',"" °[ '^'" ^'^^"^ "f Cows, was observed to be reddened sw,. Inn ,1,^ "lat event, the skin between tlie claw^ extended to the coronet aSheelMfe,) the" skin T' ^'^'^'''''^^ '^'^ "'"-"Nation and immediately above the claws w.^niS^^l^v^ .nH''"'!,"'T '"'"^'^'^'^ ^"^^ '^*^"««. formed at the coronet, the horiTbeca m^ SaTateS an,l « n'^V J" l^T "^'^^ ''^^'^'''^^ The infl.ammatio„ extended to" bovrand Ed tit f H u^ ^ "u*"''" ''''^^ ^^''"^^ «hed. that the animals ate but littlerand c^ntMuentttv^^' ,''*"'' *''" P""' "''^^ «" S'-eat limbs were most frenuently a tacked firs? ,. f '^17 .^"on lost condition. The hind- affected than the otLr. T " Cows had onW c Iv H ' ".''^l'''/.'^^ being .always more supposed that the disease wa due lo c n^-^ct ? ^h S^-'"' '. '* *'u'"'^ previously/ Koloff substance which had escaped nrmurS^^^^ the utmost cleanliness being observed ■ had the sLr« ■'^'- 1*" '^'^'''^/"•■^ '"■^i'^t^d on chloride of lime every day^hc S^feet dlnl,«H •.t''",f ■'"* ''^"*' •'^pHnkled with between the claws, and aftVrw rds ^"vel/ed S^^^ w.th chlorme water, p.articularly of the disease was at once checked. ^ ^''''' measures the extension ;■ Wochenschriftfur Thitrheilkuvde, 1869 p 105 ■' Journal dts VeterinaireH du Midi, vol. ix n .34^ irinarian, 18,01 ^4 rmales pp. M, 258 0/J. ei/ deMedecine VtUrmai're, 1860, 1861, 1868. few liecueil de Midecine VeUr •inaire, 1866. let of 8tramo- is congested, he spine. 3re has been in of the feet, y known as i state. The asserts that in the Mare. 3 ; since then iry, Guilmot, ; Obicho in len observed irring under e second or th day, and ition of the parturition, rs after the '6 has been ! naturally; nitory indi- , and moves after parturi- t.>is in Prevs- ft'Ht of Cows, :;en tlie claws infiainmation ed and dense, ases abscesses !aw was shed, was so great • The hind- always more 'usly. Koloff Bt, with some B insisted on Jiinkled with particularly ilie extansion I'ARTVRIKNr LAMWITIS. . .. o71 '^f^^ ^^ ^^^^ Signs of all the other signs of thi^ most dis^sin/fnnf '•^«'"''^ respiration, and marked of which at this timeTs the d s^rd^'/'lSr'^ '?^ ^°«^ cases the attack is more gradual ; there fslo^c, if *^^ ^'i^f "^^ ^" °*^^^ depression, hurried respiration f^ll hard „n!l "^^PP^V*«. ^reat thirst, etc.-premonitory symptoms which mlv nn ? '^"'".^ P"^'^' constipation, days. "^The fore or hind feet mav be nZ.7", ""rp^- ^°' *'''°' *h^««- ^' ^^uv say the former, Deneubourc^he latter ^hnfl' • ^''''^'""* ^"^ ^""^^^'ot feet may be involved The no^iHnn .f Jt ^^ '"f^"'^ instances all the the feei^aiiected! and thllai^e found tob?"'?"^' ^\''T'^^^f.' indicates arteries throbbing, and percussion of th. f^**;" "^^^ hot, the plantar During the ir.flanfmation^tl e Ce ev nces t^e .r^^^? ^"'^"^^ P^'"" the feet are implicated, standing nmy be imptsiEtt'^°"^- ^^ ^." anxious and pinched ; the respiration i7hu Hed Wkin^ expression is and the nostrils widely dilated ; the sWn is usuaHv .ot^".^ ^^T'''^' spiration, and the production o milk is cohSp v T T^ with per- the rapid disappearance of this sec etion hn« nH ^f t'?'^" ^"^^«^' nearly every observer In tl « Pv!nin , t ^'"^f ^ed the attention of dant suppl/of n Ik and in the mo nf. "^"'^T' *^"'" '^'^ ^' ^n ^bun- obtain a'L^lrops of rt^ranstrnroT^dard^^h^rl".". "''^ °"^>^ may look as full and as vvell developed as u^nnlTl^^^ ^^^'"'^'"^ supply of food is soon testified to by1heFoai;vhlhh''.PP'''r" °^ **^ tjo^of burner by becoming less t.lit^:^,^SlZZ:'-^ The duration of the disease is from four tn piaV^f ;io„» . -o from eight to fourteen davs THp = ll f ^ ^^P ' ^^^anck says between the fourth and eighth d'^^^^,^ ^^ ''''^f^ ^"°^* ^"*"""'« recovery, if proper treatmentas been adLtedTSn?*^ '' ^'"'^""^ the malady Lsumes a chronicTrmvl;?lff' °"^^ '" "^'^^^ ^^^es and disorglnisatic^f of the fee k la e n'stan'or^r^il"^ "^''''"^''y from nervous exhaustion caused by thre^s^iv^^^^^^ '"^1 '"'"^ Causes. Th^'T"^ °' °^"^«^of parturient laminitis are imperfectlv known thonih ihf ''-"^ """"T'.' ^'"^^■''^^^y recognised to be the^ ur Lt sLte" SancHf f^l^^rf'^t^r'' -^'^^^ '^^°^-^'-' there is mar^^eTty a dfs Guilmot thinks that the space left by the foetus must necessariTv brfnt about a series of exceptional phenomena, whose po nt of depaiture if peAaps the superfluous ..pplj. of blood thrownSn^o the drCltion bv throldt-"''.^-^r°^'"J^'""" ^ JustnerofT:^°Li:n mpw'd by the old hippiatnsts, that " the fever has fallen into the feet," he Is lil'il U' I: fl Hi f II if ^T''^y ^"eceeds intestinal congestions from imvS h« Z' ""' ^T\^''''^'' purgatives; and that both varieties ^6^0 tfe t .""'' °^ ^' momentary paralysis of the vaso-motor a nrofonndlv ^ ^^•^''""l^PP'"'^*"' °^ ^^'^ ^°°*' ""^'^'- the influence of a proioundly depressing action none of'Z'i^'^-^ "''"''' ^'' ??^^ -^^ °^'''^"^«- Tisserant asserts that none of the ordinary causes of laminitis are special in their operation here ; while Deneubourg adds that it attacks Mares withou disS on as to age. constitution, condition, or hygienic circumstances. Guilmot however, remains that Mares which are submitted to moderate work attacked whTh'" ""^rf' °^ ^^^ "^ P^°P°^*'«" thereto arl not attacked, while those which are fed on oats have alwavs been the subjects affected, so far as he has been able to observe ^ mrturSon ^rf T'" ^'7'^'^^ of opinion with regard to the influence of nn li^ •? ^ Producaon of parturient laminitis. Tisserant has a£ed atT.r"^l '1 '^' S'^^^^ "^^i.^^'ity of cases, in Mares which had aborted at a somewhat advanced period of gestation, or whose deliverv had been laborious or very difficult, from the wro^g position of thl foetus or from some maternal obstacle. Deneubourg. on the contrart condit^''"'^ '' n"°^'T Parturition efl-ected in the L favouS condtions.as wel as after abortion or difficult labour- with Mares 7}llt ^l^'P'^i^^ ^^'' ^""^^^ membranes, as well as with tTiose wh ch retained them ; but never after a laborious parturition which reo^ked h Sw rr 1'T °'/"'' P';°*^"^''^^'^ ^"^^ P^'"f"l; though he adds that his brother had witnessed a case following laborious and artificia fol r^- ^'rr- ^' "°*^u^ '^^' ^^°^g^ «•-«« ^» instance "n whiS ? followed an abortion at three months Obich attributes the disease to the action of cold upon the skin. Treatment. In the treatment of this disease, the rules observed in the ordinary attacks of lammitis are usually applicable. In the majority of cases the treatment need not, and should not, be heroic. If the fever run high, sedatives~as the tincture of aconite-should be given ; and i may even be necessary to administer narcotics-as chloral or ^pium- of h!nS'^-;.7"'"' ^""^^K ^""'"'^ authorities recommend the abstraction treatment. ^'"^^ ^' °' ^°'^"^' ^^' "^"">' ^^'^ ^^'^^^^ to this ' Veterinarian, IS.'Jl, p. 14. Iden Buppres- 3 not exempt place on the known as the nee — a fever, ary surf^eons our opinion, e tendinous, •'hcumatisviaL is evidently »gy with the 3 propose to uish it from illied to that Bstions from 3th varieties vaso-motor influence of asserts that ir operation t distinction I. Guilmot, lerate work, eto, are not ys been the influence of sserant has i which had ose delivery tion of the le contrary, t favourable with Mares ihose which )h required ! adds that d artificial n which it i skin. le ordinary ity of cases fever runs en ; and it )r opium — abstraction se to this PAitrrnrRsrj, LA}rixiTifi which carries the fluid direct fro hn^n?' °^ india-rubber tubing ;s thickly covered with piect o ' hieniann; f^ ^'^^^ '°°*- ^he laJte^r' the water around it. The shooi «(,lnul ^ °'' *"^V' "^ as to ditfuse wall of the hoof lowered so as to aHow H P^-^^^^^^'y removed, and the much of the weight as p^ssiWe ifisl ^o^dt;"! ''^^ '^ ^"«^-" - ou saw-dust or peat-moss. ^ °'^ P'*'" *" l'"er the animal ^^ Wa™ ap„n„,«„„, ,h„„,„ „„,e.„„ any ac.„„„, ^ ,„,„„^„, ,„ e J;r o?Sat"n I S^rat'oX^' ^'i '"' "' — ^">» 'he Inul. Astringent and antiseptic 1o°i„„, or flvr.,"'" "'^P" of the At the commencement of the disease aS »„,„ .° ""'" '""y ^ "«tul. when i, threatens to hecon.e chronic stinulalr' °' ," later period bhste.-,„ay be applied with ad;:'ntS"lolGe"tS'X™Th^ b^Sat'^'" ""' ™™'y-'°'hed,l'd"f4"ro^; to'^^he'^n'tle": s;liL',:iij:;iT't^o is^x, ^^tSroTtK^sir rt - "»>->' already remarlced, a most tavonrab™ s^gn ' "'' "' "' '""' '"^'=1 e.no„r Sr a^ « iXlZ oSnt, tZS' ^^ CHAPTP]R IX. Mammitis or Mastitis eases when it may b'e indepem l ^^p . rcv'or?)"'^' 1" ^^^'^ period, and even manifest itself in the male sox'T. i^ . *''' Pa^turient the period of parturition and rea^rof theVoun " %"'"'"'l^' P^ '^^^ tlie progeny is born, tlie nmmma) Ce' n ^ eS''"^ ^'"^'' "''" ^'^ pendulous and tlieir density incix^ases wlHo tLv n ^ ' ^^'^^ '''''°^^« not marked by dark pi-ment theirpnln • i ^ ""'^ "'°'^ vascular; if and the teats 'are con'Sbly rveTope" '^^'^J' ''T .^^-S^^' glands have attained dimensions nlu off ^ n. ""^ parturition the those exhibited a short t'mTp cv ousW ^ST"'^ very different to IHwided by Nature for the sustf no ?rS;i ^^'"^ «"id-the milk- is secreted hi niore or le s coS, W y«""g creature after birth, tion to the developnlt :? Zu^ luantity-generally in propor: .anently-the fm.ctioii i^^:^:.^;;^;!^!^:^^ ^' ^^ S^ 43 I'll' '-■1 1 M I '1 674 PATIIOLOaY OF PAHTUniriuN. :. i : (luring the parturient or jnierperal period, and ceasing when the progeny no longer retiuires milk. It is during this period that the activity of the nianiniu! exerciHes so much inlluence on the health of parent and off- sprmg, a»ul it ia also at this time that these glands are most liahle to derangements which are more or less serious. Hven their normal physiological development, when it occurs rapidly and considerably under certain conditions, often occasions uneasiness and pain. Their temperature is increased, and they are much more sensitive than usual. lint this disturbance is usually ephemeral, and rarely continues for more than a day or two. It may be relieved by "stripping" the teats— the importance of which, as a preventive of parturient collapse in deep- milkers and plethoric Cows, has been pointed out— rubbing the udder witli olive-oil, or fomenting it with decoction of marsh-mallows. This might be termed the nornuil or plii/fiioloi/icdl engorgement of the inammaj ; but there is also a jxUholoijical engorgement to which attention has been drawn by various writers, and particularly by Zundel, and to this reference will now be made, as it is often tlie commencement of inflam- mation of these glands. Pathological Congestion of the Mamm.e. Hypertomia or congestion of the mamiiun is not very uncommon, and all female animals are liable to it ; though it is most frequently observed in the Co\y, Mare, Ewe, and liitch, in degrees varying rather with the causes which determine than tlie i)henomena that accompany it. Causes. Congestion of the mammip is duo to various causes: among which may bo cited injuries, exposure to cold air or water, or over-repletion the stings of insects iiave also been blamed. There is generally a sympathetic excitement existing at this time, eitlier from the animal having been immediately or recently delivered, or even when it is in oestrum. Most frequently, however," it occurs either when the progeny cannot empty the glands, when it has been removed from the parent, or when the latter has not been uiilkod at the proper time. The tendency of the mamma; to become engorged when the lacteal secretion is not removed, is often made available with a fraudulent motive when dis- posing of Cows for milking purposes. The milk is not withdrawn for some time, the glands uecome greatly distended and assume an excessive development (" overstocking"), which may impose upon the unwary, and give rise to the belief that the animal possesses extraordinary lactiferous properties. Franck is of opinion that this congestion may be due to obstruction of the circulation in the posterior vena cava, towards the end of pregnancy. It may also arise from obstruction in the milk-ducts. Siimptoms. When the congestion is due to accumulation of milk, the symptoms are, of course, only gradually developed ; but if arising from injury, then tliey may appear suddenly, a certain part becoming all at once swollen, hard, and tense, but without altogether losins its softness and elasticity. There is neither redness nor great sensibility; the swelling" is not a'dematous, and does not "pit"; there is but httle fever, and the appe- tite 13 not much affected. n the progeny bCtivity of the rent and off- nost Huble to heir normal consklerably pain. Their e than usual. lues for more le teats — the ipse in deep- !<,' the udder llows. This ihe nmnimae; ittention has , and to this nt of inflam- onimon, and itly observed lier with the my it. monp which I'-repletion — {generally a the animal .'hen it is in the progeny lie parent, or he tendency etion is not e when dis- ithdrawn for an excessive the unwary, straordinary gestion may ' vena cava, struction in e symptoms injury, then nee swollen, id ftlap.ticity. lling is not id the appe- M AM MIT IS on MAHTITIH K 878 An important consideration in these afT»>r.f;ona ^» *u relatmg to their anatouw. As vvaBshown n? °^'5« I"ammuo, is that I'iwe. and Goat, they are formed of wn nl "PP;. 32-3.5, iu the Mare, together in the^nguinal rS' whi e W^ ^ t.'^'"''' ^''^"'^^ P'^°«d at least four glands or ''nuarters^in nloJ \^^. *^7 ""'^ composed of in« one mass'in the prepE^U td rt^^'^ 'ffT"*^ ^°'-"'- they are numerous and distinct fro.n eaohnfl °^' ^'''^' ^"^ ^^^t. inguinal to the thoracic reZn When 1 J ' ''"' ^"^^'"^ ^'''^"^ the may become congested or Smed o onlTonr'' '''"* '^^ **^« ^l^"'^^ number of ac/^u" in each «land^wa Zn^t^ ' u''' ^''°" ^^'^ '^ certain •nay give rise to very divert svmntorr^l '^ '"^''^^'^ conditions peculiarities. ^ symptoms, due to tliese anatomical Sea "^iin'r tt "Si rii '-^ .^r- ^*» -- \ .naramic: there ig always a fist ^.nll """""'' ™'"' ""'"^ous anally localised. Thermotactfon paTk™' sSXr„",'' "Z"'" j' '' Its readiness to pit on nressurp nr„l tl,„. • L ?' "dema, from around the udder, «hio^ rso^ril 1^ " ° '=", " ''■'"eby swelling its degree of Huid°tv is chanl^" nrl'it'h "^•''"" ?°"''"'^«^' ^^°^^^«»-. being partially coaguVtedntfelanHlvl'"'' ^"'?JP^ ^"'^ ^^^^^d. coagula of casein ai-^ evaciat d nf f h 'l""'"' ^"^ «^"^1^' ^^^ the of Tae milk, whicl^is somftht. n serum, having T Lveet tas/p In? r ^ ^"^u P"'" ^•^'''^' yellowish cylindrical masses-obstrucT h^ T f "'^ ^'^''^ coagula-r-ound or n'ilk. Fiirstenberg states that b.h?' """^P^^^f ^ the escape of the lial cells in them^and that nhnn/ n '^^^^^ globules of coloJrun T^i alten ti^'in Ih °'-/r^"''' 1"^*^^^^ ^'^ that from the affected yi„,;^^. '*1°" " ^^? ""^"^ '"^y be limited to be healthy, tLl.dfL'sjSndL'Jt'"''^^ ' " ^^" ''''''' '''' --«^-" "-y h^ =n.S: --£S^^^ abscesses. ""pervenmc,, and the formation of one or more comVetef in^'^ifll^.^^l T''^ '' '' P^'^^able that this condition veceiveTri^OKLll' ppt fltd^^^ThitSslof ''''''} 7^^^^ (li+.;r>r. o,,.! , ■.F^y.. '^'uou. 1 HIS leaos to a Congested con c intcilobular connective tissue. According to VuM.nhei- i miaais more narf.mnlnvlAr tu^ „^i,m „i, .^ "_/• ,, • ,.,='- tion into the .uLi^riuouiar connective tissue. Ar-nnrdin" ^o Vur^frrhpr^'i aKo"tii'SM-" '"°^! particularly the solid ele.nenttof thi f u d ISd dieted L^C^r "'' ""'"°^^ ^^^-^^ ^b-id he CO- ' MUchdrilsen der Kiihe. .,/ II:, 676 TATHOLOGY OF PARTURITION. m I ? This condition has often been confounded with inflammation of the udder, though it must be admitted that it sometimes constitutes the initial stage of mammitis. It may be distinguished from the latter by the non-existence of general symptoms, and also locally by the absence of the peculiar density or hardness, and the extreme painfulness and sensibility, which mark the presence of the latter. According to Franck, this mammary ccdema (or Floss) is peculiar to many parts of the Bavarian Alps, and he appears to consider it as inflammation of the skin and connective tissue of i\\(i^d,x\di{Entzilndung der Ueberziifje des Enters und dcs Zellgcivcbcs). It always appears some days, on occasions some weeks, before parturition, and the whole udder is involved ; though one side may be more affected than the other. The swelling sometimes extends as higli as the vulva, and even beyond it. Sometimes the skin is reddened, tense, and shining {Erythema mammilarum) ; in other instances it is normal. The health is seldom unaffected, and this is a characteristic feature of the disease ; there is also rarely any pain, or alteration in the secretion — colostrum or ordinary milk flowing from the teat. When, however, the connective tissue is involved, there is swelling and "pitting" on pressure, the skin is reddened, and the finger indentations last for some time ; there is also more pain. This latter condition has sometimes been designated the " erysipelatous " form of mastitis ; though it must be observed that the secretion of milk is unaltered to any extent. It continues for about eight days. When the skin is i;)uch inflamed, as in the erysipelatous form, Franck thinks it probable that a special cause — a kind of infection of the skin — is in operation. Treatmeiit. This malady, in the greater number of cases, does not require any special treatment. If the animal eats well and is not much incon- venienced, the mammae should be relieved of their contents either by allowing the offspring to suck, milking by hand every two hours, or draining off the fluid by the teat-syphon. When the swelling is great and the skin tense, smearing with lard, butter, or olive-oil will often give rehef, and aid in dispersing the tumefaction. When mammitis is apprehended, Ziindel highly recommends in- unction with camphorated pomade, wiiich, lie asserts, is almost specific in its deobstruent action. At the same time salines, and particularly bicarbonate of soda, are to be administered internally ; while a moderate quantity of easily-digested food is to be given. When the redness or inflammation of the skin has a tendency to become erysipelatous, Franck prescribes an ointment composed of sulphate of iron (one part) and lard (eight parts) ; or a liniment of carbolic acid (one part) and olive-oil (thirty to forty parts). iNFLAMJrATION OF THE MaMM^. All the domestic animals are liable to inflammation of the mammaB ; and it is somewliat frequent after parturition, though it also appears after abortion. The Cow is oftnnost attacked, and from the importance of the lacteal secretion in this l. .mal it is always more or less serious, especially as it may continue during the whole period of lactation ; it generally affects the best milk-producers. It is not so common in the tion of the stitutes the le latter by the absence "ulness and peculiar to sider it as intzilnthmq ys appears . the whole i than the I, and even ; {Erythema is seldom ihere is also )r ordinary re tissue is he skin is tiere is also gnated the 5d that the J for about rin, Franck )f the skin equire any uch incon- 1 either by ) hours, or ig is great will often iniends in- ost specific )articularly a, moderate mdency to mposed of ininient of I mammas ; 30 appears mportance !ss serious, ctation ; it ion in the MAMMITir on MASTITIS. qjj former it is liablf t„ l'„«^^'„ i , ' ^°!'°'' '''"'" " ^O"" <>^ "-y '^-^ ^° the'spolneous coagulation of the milk, without any acidity being present. Symptoms. c.nll'' ^1''"? '^""f \'°* ^*^ "''* ^W^ear to be much affected, and the swollen gland or glands are evidently not very painful, the pain beinj probably of a dull character. The skin is tense and shining, though perhaps not reddened ; the teat is greatly enlarged, hard, and som'e- ^ino -fiTi!;?! T " "/ampulation. The swelling fs rather cx^dematous supeificially, but when deeper the tissue of the gland is found to be somewhat harder, and towards the teat rather lumpy, from the presence 01 coagula or casein. By mulsion a rose or red-tinted fluid is obtained, which looks like decomposed clotted milk. Witli careful and frequent milking, and attention to diet and hygiene, complete resolution may take place within three or four days the secretion gradually becomes normal in quantity and quality, thou-h for more days It may contain numerous colostrum and pus globules. If neglected, however, or mismanaged in treatment, tlie inflammation may become more serious, and attack the milk vesicles and their parenchyma —the real glandular tissues— giving rise to parenchymatous mammitis; or it may remain localised, though increasing in intensity. Then the secretion of milk is greatly diminished in the gland, and what is with- drawn by mulsion is altered-containing, as it does, mucus, pus, and clots,_Mll enj.itting a higlily ammoniacal odour. This catarrhal condition may continue for a considerable time, and it may happen tliat the matter contained in the sinuses and ducts be- coming inspissated, escajies from tlie teat with dilliculty, or not at all • 80 that, in accumulating in tliese cavities, it forms deposits— half milk, n 678 PATHOLOGY OF I'AltTUllITION. half pus— which are oftentimes considerable. When they have acquired a certain volume, these deposits break up and escape, either through the teats, or by ulceration of the walls of the duct. When opened by ineans of the lancet, these "lacteal abscesses" discharge a large quantity of foetid matter. Th^n the general phenomena disappear, the tumefac- tion and sensibility aiminish, the suppuration— though it may persist for some time— gradually decreases, and the normal secretion of milk is fanally established. In other instances, all the symptoms disappear except the clotted character of the milk, and tlie tendency of this fluid to coagulate in the ducts and sinuses. There it may form solid masses or concretions of variable size— from a pea to that of a nut— which become dense as dried cheese, or hard almost as a stone. They are sometimes cylindrical in shape, at other times elongated, being moulded by the part in which they are formed ; they are usually movable, and maybe displaced in the operation of milking; hut they always constitute a more or less serious obstacle to the iiow of milk. When situated at the lower end of the teat, they almost entirely obstruct the canal ; higher, they render the flow of milk more or less dillicult, and in all cases they may give rise to extreme distention of the gland, and lead to the formation of abscesses or parenchymatous inllammation. An infectious or contagious form of catarrhal mammitis which has been observed in recent years, has been carefully studied by Nocard.' In from fifteen days to a month after a C'ow lias been located in a stable where the disease prevails, a quarter of tlie udder is discovered to have a hard lump or induration in its centre. The milk is as yet unaltered in appearance, but it is diminished in quantity, and coagulates so rapidly that it cannot be kept ; linally, it becomes serous, Haky, of a yellovyish tint, with sometimes an unpleasant odour which necessitates its being thrown away. If mixed with good milk it rapidly coagulates it. It has an acid reaction, and contains a special bacillus. The inflammation is at first limited to the mucous membrane of one teat, but it gradually extends to the interstitial connective tissue, which becomes so hypertrophied and indurated as ultimately to cause atrophy of the adjoining glandular acini. The general health of tlie animal does not seem to be affected, though it appears to be more diilicult to fatten. So long as the disease is hunted to one quarter of tlie udder, the Cow is still useful as a milk- producer, though the quantity is of course less; but when two quarters are involved, then the animal is not worth keeping, and should be sent to the butcher. The ■phlc(jinonous vunniiiitls described i)y Saint-(,'yr, is always morp serious than the catarrhal form. It commences with several generally very well-marked feljrile symptoms : the animal is dull, loses its appe- tite, and ceases to ruminate ; the temperature is elevated, the pulse becomes frequent and quick, etc. These symptoms of general disturb- ance, according to some autluuities, may manifest themselves three or four days before the local disorder, and occasionally diminish consider- ably when the latter appears ; this rule, however, has numerous excep- tions. What is certain is, that there are rigors and unmistakable indications of gentiral febrile reaction at tlu> vevv cnmniencemcnt of phlegmonous mammitis. In a very brief period the udder ac(iuires a considerable, sometimes a great volume— in the Cow, often reacliing as low as the hocks, or even ^ Arc/iiixa Vc/vriiiaire, 1884. MAMMiriS on MASTITIS. 679 ive acquired lier through opened l)y rge quantity ihe tumefac- niay persist )n of milk is 8 disappear of this fluid iohd masses nut — vviiicii . They are ing moulded lovable, and ^s constitute situated at the canal ; , and in all and lead to which has by Nocard.' il in a stable ;red to have 3t unaltered •agulates so flaky, of a necessitates / coagulates iillus. The of one teat, ssue, which use atrophy !te(l, though le disease is .1 as a milk- wo quarters luid be sent hvays morf' al generally !s its appe- 1, the pulse !ral disturb- ves three or sh consider- rous excep- imistakable ncemcnt of iometimes a jks, or even lower the swelling 13 cedematous, "pitting" deeply on pressure; but It is hot, inflammatory, very painful, and extends beyond the gland— at times towards the vulva and umbilicus or sternum with the Mare and I'.we Beneath the oedematory tumefaction the gland texture can bo felt hard, dense, and nodulated in places ; while the skin is red tense and shining and extremely painful to the touch. This painfulness causes the animal, at other times quiet and docile, to be irritable and fidgety, and averse to have the part touched, either for examination or milking Irogression, or even standing, is painful, the animal being evidently afraid of the hind-hmbs coming in contact with the gland • so that It either stands or walks with them wide apart, especiaUy on 'the affected side of the gland. The creature, for the same reason, seldom If ever lies down ; when it does so, it is on the side on which the ^land IS least affected. There is often much restlessness and anxiety" and the Mare may show symptoms of colic. The secretion of milk suldenly ceases and pressure on the teat only causes a small quantity of reddish-coloured grumous fluid to flow. All these symptoms may become aggravated in four, six, or eif'ht days, when the malady may terminate by resolution, suppuration, gan- grene, or induration, according to circumstances. rarciichnmatons mavmutis, or inflammation of the proper "landular and connective-tissue structures of the udder, is not, as a rule,°so acute in Its manifestations as the preceding, nor yet does it differ materially from It, so far as the general symptoms are concerned. The appetite is diminished, but not altogether suspended ; there is much thirst, and rumination is irregular ; the physiognomy betrays sulfering, though not of a very acute kind ; the pulse is full and quick, respiratiort short and hurried, and constipation is frequently present, while the urine is less abundant and dark ; the temperature of the body surface is variable, and the mutlie hot and dry ; there are rigors, and muscular twitchings or tremblings, particularly towards the shoulders and flanks. The conjunctivte are injected, the skin more sensitive than usual, and the Cow inanifests pain wlien tlie loins are pressed upon ; with the Mare the loins appear to be stiff and sore. There also appears to be lame- ness of the hind-limb of the affected side, due to the cause before men- tioned ; and when more than one quarter is attacked, the Cow seldom lies down. The swelling of the gland is very hard and hot, but not cedematous, as in tlio other forms, while the skin preserves somewhat of its natural hue, and is not thickened ; the subcutaneous veins are much distended over the whole surface of the gland. The intense hardness of the in- flamed mass is very characteristic, and is noted throughout the whole maiuime ; though it is always greater on one side than another, and sometimes only in one quarter— most frequently a posterior one in the Cow, both mainmu! in the IMare. When the inflammation is intense, and has commenced in a particular part of the gland, it generally spreads rapidly until the whole quarter, frequently the whole of the udder, is involved. From the commencement the secretion of milk is almost, if not quite suspended in the diseased gland, and much diminished in the others, mulsion only yielding a very small quantity of a red clotted fluid, mixed with blood ; in very acute cases almost blood alone may escape. In other cases the fluid is composed of transuded serum, and small pieces of coagulated casein. In a short time this fluid becomes of a purulent %i.l V i 680 PATHOLOGY OF PARTURITION. character ; at other times it is putrescent and footid. Microscopically, Vl T ?i, r «°'^Posed of particles of solidified casein, a few fat globules, epithelium from the milk vesicles and ducts, but more espe- olo ^ P"s and red b ood-corpuscles ; sometimes bacteria and micrococci are noticed in considerable numbers. When abscess forms and ulcera- tion takes place bundles of fibres of elastic tissue are often discovered K^.f 1'^ u \ ^^'lei^ically, it contains little casein, milk, sugar, or fat, but much water and albumin. ' fe > The progress of_ the disease is very rapid— more so than in either of the otaer forms ; in twenty-four, thirty-six, or forty-eight hours-some- times (yen in less than the first-named period— the disease has reached Its greatest intensity. The attack is generally very sudden-the animal Sfn ^PPt'!^'^^ '^"'^^ ^^^^ '^'^^^ ^^^^ f°^ tl^e "igl^t, and perhaps pre- senting all the symptoms described when seen again next morning. fl f .u ''^^^^/^ 'ts culminating point, it may remain stationaiT xoi two, three, or four days before passing to one of its ordinary termi- nations. Towards the third or fourth day the vicinity of the oland becomes oDdematous, and this oedema may extend to beneath the chest down'thetnllegs.'"^"'-^" ''' ''""' *° "" ^"^^^^ '' *^^ ^^^S^^ -'^ Course and Terminations. The cours.^ and terminations of mammitis are matters of much im- wfif''^" 1 ''T^^^^ 1'.^''^^ through its different phases until the Z :.k'1^ n^'^ the sixth day, when it terminates either by resoln- WW,T ' °'" ?-^'''^ "^"""'■^ '''^'^^^^ P^-o™Pt treatment ; atroplui ; inch ud on; supimratwn ; gangrcm ; or even the r/m^/. of the animal Hesolutwn is, of course, by far the most favourable termination. In he parenchymatous form it can rarely be rendered complete, even by ^nt ° .J fr^ ^""^ vigorous treatment, after the second or third .fli. 'J the phlegmonous form it may occur so late as the fourth to the Sn L5^' 'P^'^.^^^^T ''^^^' ^"'^ "'-^^^l^- I^ ^s ^^arked by a gradual mrl ouhviV" }r intensity of the symptoms-general and locld, and and inSii"„ '' ^'''"' ^''* ^'^^PP^^^^' ^hen the tumefaction Saint-Cyr lays much stress on the decrease in density, with regard ortv efoh?^^- " •' '^''''''\ ^^^""^^ '^'^ ^""« «^^ted a^^ove-if after toitj-eight hours in pai^nchymatous nmmmitis, or six days in the SiST.".' Ti '^1 ^''""i^^"^ "°*' *° any marked extent, ?ost some wi nnf ! ''°°^f ^^1^^-^^"^ «. there is great reason to fear that resolution tTit hP ^7°""^-? V'' '""^ "-^t '""^" 1'°^'^'°"^ ^^'^" ^•^"^ai'^ indurated, or that the mass will become either partially or totally atrophied. in^Pn.fnlvl'«%' Tr °^ *^^' ^""f ^"'^ ^^"-^^^^ °f the swelling are n themselves favourable signs, yet they may bo deceptive with regard when thel^ssnrof H°" ' ,'"1 '' """^ ^' ^'^^"^"'^^^ ^^ "-^-^ ^^vourfble than\!] Pn H? •' ^'^"^^'^^^"'"es ,ts softness and suppleness, rather litUe aiteied "^' ' '' '^^''^^^ ^^"^ *^'" h^vdulL remains but .^£^^^:^^l^r^l^J^^ -f-^^ of the normal does not occur very ra^dl j!"^ L^:! cf^^ Si tr toSl/or SsTir'"^' Huid obtained from the teat of the alTecLd quarter 'le- Zm eel ''^' T-'^ ^^'^ '"T' -^"^^ '^"^^^'^'^ ' ^* «0"tains numerous colo- stium cells, and is more albuminous than caseous-coagulating readily jroscopically, jin, a few fat i more espe- id micrococci s and ulcera- !n discovered sugar, or fat, in either of lours — some- ! has reached — the animal perhaps pre- 3xt morning, n stationary iinary termi- Df the gland ith the chest e thighs and »f much im- es until the jr by resohi- t ; atrophy ; ihe animal, ination. In ste, even by nd or third ourth to the y a gradual d local, and tumefaction with regard ive — if after ;lays in the t, lost some- It resolution idurated, or ied. swelling are with regard I favourable mess, rather remains but the normal ^iiough this ) twenty, or quarter re- iierous colo- ting readily MAMMITIS OR MASTITIS. 681 by heat, and having little cream or sugar. But it gradually recovers Its usual composition and increases in quantitj-, until at last, in amount and quality, it does not differ from that furnished by the other quarters of the mammai. It sometimes happens, however, that with regard to the lacteal secretion, though the gland regains its normal size and soft- ness, it does not acquire its full functional activity until the next pregnancy and the next period of lactation. Complete recovery appears to take place during the period when the Cow is " dry." With the Cow, it generally requires four to five weeks before resolu- tion is complete ; with the Goat the period is less, and it is still less with the Mare. Atroplni of the gland occurs generally when resolution is not com- plete. All the indications of that change are present, though they take place more slowly ; but the lacteal secretion does not return— recovery is not perfect. The glandular acini, obliterated by the proliferation of the interstitial cciinective tissue or the intlammatory exudation which took place in their interior, are no longer capable of performing their function ; and in proportion as these products of inflammation are absorbed after its sub- sidence, so does the diseased gland diminish in volume, and the mammse become deformed and asymmetrical ; the teat retracts and assumes an abnormal direction, and httle, if any, milk can be obtained from it. On manipulation, instead of the gland structure, nothing can be felt but a very firm, dense mass, which feels like indurated connective tissue, having in its texture some isolated nodules that appear to be, and really are, lobules of the gland which have remained intact, and yet secrete the little milk that is yielded. The loss of a quarter of the mammae in Milch Cows is, of course, a somewhat serious termination, so far as the yield of milk is concerned, as this is materially diminished. Nevertheless, the other quarters sometimes partially compensate, by their increased activity, for the injury, and the animal is otherwise in good health. Induration is not at all an uncommon termination of mammitis, especially in the Cow and Bitch, and is often the point of departure, in the latter animal, of various and serious degenerations of the gland tissue. This termination is to be apprehended, in the Cow, when the inflam- mation persists in a somewhat acute manner beyond the sixth or eighth day. Then the general symptoms diminish, the animal sufl'ers less pain, the appetite returns, as well as rumination, if any oedema was present it has disa])peared, but yet the gland does not regain its healthy character. The inflannnation has gone, the morbid products are partly absorbed, but in different parts of the substance of the gland there are more or less voluminous, well-delined, and rounded masses which have an almost stony hardness, and are apparently adlierent to the surrounding tissues. These are evidently indurated lobules which have not undergone resolution, and their secretory power is therefore lost. In other instances in which the inflammation has been very in- tense, recovery does not even proceed so far. The febrile symptoms disappear, and the pain in the udder to some extent diminishes, as well as the swelling ; thougli for a long time the local temperature is higher than usual, and the animal evinces uneasiness when it lies down. The induration of the swollen gland, often visible externally, ■ i 682 PATHOLOGY OF PAllTUUITIOX. instead of diminishing, appears to increase, owing to the progressive organisation of the inflammatory products, and from the teat there can only be obtained a small quantity of yellowish turbid serum, with perhaps a tew coagula of casein, epithelium casts, and sometimes even veritable diphtheritic false membranes. In such a case, all the parts ot the gland so altered are irrevocably destroyed, so far as the lacteal secretion is concerned. It is from this indurated condition that those degenerations and neoplasms arise which are met with in the mammae of animals, but especially the Bitch. These are the adenomatous, sarcomatous, carci- nomatous, enchondromatous, and fibromatous growths which have been described so often as found in the mamraaj of this animal, but a consideration ot which cannot be entered upon here. Siqypumtion—hy which is meant the formation of abscess— is a rather frequent termination of mammitis, and particularly of the phlegmonous form. The abscesses may be single or multiple, and vary in size as well as situation. Sometimes they appear immediately be- neath the skm, and between it and the tunic of yellow fibrous tissue covenng the gland ; in other cases they are formed in the interstitial connective tissue separating the glands, or even in the interlobular tissue; while, though rarely, they may be found in the connective tissue between the mammae and the abdominal wall _ Suppuration generally sets in from the eighth to the twelfth day, and IS marked by an increase, instead of a diminution, in the symptoms- augmentation of the fever, swelling, and pain. If the abscess in pro- cess of formation is superficial, the pain and redness appear to be greatest at a certain point ; there tlie skin is at first of a bright red, but changes to a violet hue, and at the same time this part becomes more prominent and circumsci-ibed. Soon there is fluctuation and the other indication of abscess, and if not artificially opened this takes place spontaneously, and the contained pus escapes. Then the tebrile symptoms diminish, and the general condition improves ; the swelling in the gland ubsides, along with the pain ; pus escapes trom the opening for two or three weeks, and finally ceases, the wound becoming cicatrised. Recovery is now complete, and nothin^^ remains save perhaps a small mass of indurated gland where the abscess has been. This subcutaneous or superficial abscess is not generally very injurious or serious. It is not so, however, when the abscess is developed in the inter- glandular connective tissue, or in t.iat between the mamma3 and the abdomen. Here the pus is deep-seated, and it burrows or spreads vyherever the resistance is least ; in this way it leads to the forma- tion of sinuses, sloughing of the skin over a wide surface, isolates masses of the glands—thus destroying their relations with neighbour- ing parts, and causing their mortification and total destruction. This mammary suppuration is always serious, as under the most favourable circumstances it generally ends in the animal losing a large portion ot the gland; while in some cases it may cause death from the violence of the inflammation and intensity of the pain, or through eximustinn from the long-eoutinued aud prcifusc suppuration. ^Vhen the abscess is situated in the interstitial or lobular connective tissue, the case is no better, but perhaps worse. Owing to the nature and disposition cf the tissues, which resist distention, the pain pro- duced by the mflaniMiation is most acute and distracting; while the progressive teat thei'c erum, with times even the parts the lacteal itions and limala, but ;ous, carci- hich have mal, but a cess — is a iy of the , and vary [lately be- ous tissue nterstitial iterlobular 5onnective 1 day, and uptoms — 3S in pro- ear to be right red, t becomes ation and ened this Then the 3ves ; the s escapes lases, the 1 nothing 'here the iss is not ;he inter- 1 and the • spreads le forma- , isolates eighbour- m. This ivourable B portion from the through )nnective le nature )ain pro- vhile the MAMMITIS on MASTITIS. 993 process of suppuration destroys a greater or less number of the acini and the pus-deep-seated -is long before it reaches the surface oTthe gland, causmg great havoc in doing so. Sometimes the interstitial abscess opens mto a milk sinus, and partly escapes by the teat dudtS miking. The pus is then mixed with the serum of the milk, and perhaps here are clots of casein and shreds of glandular tissue, the fiuidTavin. a highly ammoniacal odour. The pain is less, but does not cease! and It is generally necessary co make an external opening for the readier and more complete evacuation of the matter There is generally much destruction of tissue, and cicatrisation is difficult and tedious, particularly Avhen there are lacteal fistula). Not infrequentlv the abscesses are multiple, and in some instances there are as manv as there are inflamed lobules. In other cases one abscess succeeds another, owing to the presence of dead tissue in the mass of the gland • iJ"""-,) .T *^^ ^^'"'f^^ °P^"' externally, and the other quarters yield milk, the pus is, of course, liable to pass into that fluid, and to render it most objectionable as food. So that during the whole of the suppurative period, the services of the Cow as a producer of milk are lost. Such milk has usually a greyish tint, and often a peculiar odour— something similar to that of pus. .u^"^'?!"'^^''.^ ^^^ "^^^^^^ attention to a cold abscess, often observed in the udder of Cows niore particularly, and due to the spontaneous softening of a chronic tumour or induration— the softeniu^r beia<' the result of fatty degeneration. The tumour loses its hardness, and the sottening process gradually extends; the skin covering the mass be- comes pulpy and thin, and often the tumour opens spontaneously and externally, a thick, yellowish kind of pus escapiug ; or it may evacuate its contents into one of the milk sinuses. The secretory function of one or more quarters of the mammce may be quite destroyed— a serious result with valuable Milch Cows Gangrene of the whole or a portion of the udder, is not an un- usual termination of mammitis, and is, of course, the most serious one, except the death of the animal. It may be limited or diflused. The first frequently succeeds phlegmonous mammitis, and particularly when suppuration and diffuse or deep-seated abscess exists. In such a case the suppurative process has isolated a large portion— say a quarter— of the mammiu by the pus burrowing around it, and thus cutting oli' its nutrition— the bloodvessels being the last to give way to ulceration. The dead gland is encapsuled by its fibrous covering, and there it may remain for some time unless removed by a large opening— though sometimes the capsule gives way, and the mortified mass 13 found lying on the ground among the feet of the animal. In this way Nature gets rid of the diseased portion, and recovery be- comes possible. The gangrene is generally limited by a dense band of fibrous tissue. In many cases surgical interferer oe is necessary when tlie mamniie mortify; and when tliis is judicious, and the animal is not too weak or exhausted, success is complete ; though, of course, the lacteal apparatus is mutilated and greatly damaged. When difluse, gangrene of the mammoo is generally fatal. All the domestic animals appear to be liable to gangrenous mammitis, but more especially the Cow, Mare, and Sheep, the latter being oftenest attacked. The symptoms are described as extraordinarily intense from the very commencement. There is great depression of strength, and the animal ill ■ti, Jpl ( t ' if 9 M f , 684 PATHOLOGY OF PARTURITION. ill looks pmstrated ; the appetite is lost, rumination ceases, the heart beats loud and frequently, and there is grinding of the teeth and convulsive tremors. At the same time the udder swells enormously, the tumefac- tion extending along the abdomen and up the perinueum. At first ocdematous, hot, and extremely painful, the swelling soon becomes emphysematous, cold, and insensible ; the skin, which was previously intensely red, assumes a violet, then a grey, leaden, or dark hue, and IS cold and clammy— vesicles containing a limpid or reddish serosity appearing on its surface; the mammary gland can now be readily enucleated by making an incision through the skin. The general symptoms become more grave ; the animal appears to be completely exhausted, trembles continually, and the pulse becomes im- perceptible ; at last the creature falls extended on the ground and dies —sometimes within ten or twelve hours, rarely longer than a few days, after the conmiencement of the attack. Death sometimes occurs in phlegmonous and interstitial suppuration. Then the intense pain continues, or becomes still more excruciating ; the animal is continually moaning, lying down and getting up again, as the recumbent posture increases the agony, by making pressure on the mammae ; the temperature is elevated ; attempts to milk, which cause the utmost distress, only result in obtaining a few drops of reddish or semi- purulent Huid from the teat. All food and drink are refused; emaciation sets in rapidly ; the animal is indifferent to everything around it ; the expression is haggard and anxious ; the conjunctivic are livid ; the respiration is quickened and often noisy ; the muffle is dry and some- times cracked ; the pulse is thready or imperceptible, and there are constant trembhngs ; the prostration is soon so extreme that the animal falls, perhaps turns its head towards its shoulder, and dies without a struggle. Ewes are very hable to mammitis during the " yeaning" or lambing period, and in very many instances it assumes an almost epizootic prevalence, and the fatal gangrenous form. This is more particularly observed in large flocks, where gangrenous mastitis may be said to be the rule. Of this there are many instances to be found in veterinary hterature, and particularly those given by Toggia, Yvart, D'Arboval, Roche-ljubin, Lafosse, Nocard, and others. That recorded by Yvart, as occurring in the Alfort flock in 1833, is interesting. Kotelmann^ gives a very good description of the disease, as he observed it. Ik the majority of cases he saw only one half of the udder affected, and gener- ally first around the teat, extending thence in every direction. The seat of the inflammation was in the substance of the udder — the gland parenchyma, the swelling being hard, and the skin covering it light red; the pain_ was very great. Before the inflammation had reached its culminating point, a thin serous fluid (viilchwasscr) dropped from the teat, and when the latter was squeezed curdled milk, or milk in firm clots about the size of a pea, was obtained. The affected Ewe kept apart from its companions, did not eat, looked very dull, head and ears drooping, back arched, hind-limbs widely separated, and movement diflicult, the hind-leg towards the inflamed side of the udder being most slowly and cautiously extended, as if lame ; when both mamma° were aflected, the gait was markedly straggling, and the steps short. When the Lamb attempted to suck, the Ewe sank to the ground from pain, and could not rise again without assistance. Sometimes in the evening the ' Zeilschrift fiir die P. Thierheil/cunde ron Nehd and Vix, 1836, p. 423. leart beats convulsive B tuinefac- At first I becomes previously c hue, and ill serosity be readily )ears to be comes im- i and dies ievf days, ppuration. ruciating ; ) again, as re on the I cause the ih or semi- smaciation id it ; the livid ; the md some- there are ihe animal without a r lambing epizootic irticularly laid to be veterinary )'Arboval, ■ Yvart, as inn^ gives . Iix the md gener- ion. The the gland light red; sached its from the k in firm Ewe kept I and ears Hovement eing most ma; were t. When pain, and ening the 423. MAMMITIS OR AfASTITIS. 686 quarter yielded good milk, and in the morning blood or reddish-coloured serum would be found dropping from the teat. In twenty-four hours from the commencement of the disease, death not unfrequently ensued It, m the farst twelve hours, the malady did not yield to antiphlo^'istic treatment, the skm covering the part and the hard gland, hitherto" hot became cold, pamless to the touch, and assumed a dark-blue glazed appearance. Then an edematous swelling showed itself in front of the udder, and which soon extended to the umbilicus and sternum along the side of the body, and down the thigh to the hocks. The develop- ment of this oedema was a sure sign that gangrene had commenced in the mass of the diseased gland, and the sanious fluid which could be drawn from the now insensitive teat was a further proof of this condi- tion. When this change took place, the animal seemed to be much easier ; it looked livelier, began to graze and eat, and even to ruminate But the dark-blue colour of the udder, and the ccdema extending there- from, were unmistakable signs of approaching death, which "usually occurred in thirty-six hours, when operations on the udder and scarifi- cation of the swelling did not avail. This form of mammitis attacked young and old, good and bad, among the Ewes, but more particularly those of the improved foreign breeds —the Ewes that reared weakly Lambs which could not sufficiently empty the udder, and which were well fed. Kotelmann believed that this insufficient evacuation of the mammiE, mechanical injury to the teat, etc., was the cause. Pathological Anatomy. In the majority of instances, the interlobular connective tissue is the principal seat of the infiamraation, particularly when the disease has been neglected. The layers of this tissue enveloping the lobules and acini are swollen and infiltrated, and compress, or even efface, the proper substance of the gland, as well as the vessels of the part. It is this swelling and infiltration which cause tumefaction of the mamma) ; though the inflammation of the proper gland-tissue will bring about the same results. Eetention of the milk is caused by the inflam- matory infiltration of the connective tissue surrounding the milk ducts and canals. When inflammation has gone on to suppuration, we find, on section of the affected part, the gland tissue more or less occupied by large and small abscesses, adjoining healthy connective tissue; these abscesses may be isolated, or communicate with each other and form one large irregular cavity. Sometimes there is necrosis of the liga- mentous bands which form the principal septa between the glands, and in this way are produced fistulte or secondary abscesses, which may open externally or into the milk sinuses. These latter are generally lined by a large quantity of cylindrical epithelium ; in severe cases their walls are thickened and of a dark colour ; their cavity, as well as that of the teat, being dilated with the altered fluid. The matter in the abscesses varies exceedingly in its composition. Along with cylindrical epithelium are blood-corpuscles, fat-crystals, fragments of yellow elastic tissue, colostrum corpuscles, and an extraordinary quan- tity of micrococci of various shapes. The interlobular connective tissue is thickened, dense, and like tendon or cartilage (sclerosis). The gland tissue itself has, instead of a yellow tint, a marbled aspect ; in chronic cases calcareous salts may even be found in the textures. So that parenchymatous mammitis is not only ^ 1 11 '. ' 'i- 686 VATIIOLnar OF VAllTUniTlOK. an inflammation of tho acini, hut also of the iiitorveninf,' connectivo tisHuo, inyolvmK the lymphatic system ; conBcquontly, there is reason to suspect the disease to he infectious. When circumscrihed ^aiifrrene b rs occurred, and elimination of the diseased part is accomplished, tho dead mass may \voif,'h as mucli as five or SIX pouiulH in tho Cow; it is somcwliat regularly oval, hut rather ilatteued and discoid in the Mare ; the colour is a li^ht or pale yellow, and m consistence it is pulpy hut not ('lastic, and tho finger cannot he easily passed into its suhstanct' ; traces of its lobulated structure can still he ponnuved, and if a section ho made of it, all tho ciiaracters of the maiumary gland can h(( made out in its interior. In diffused gangrene, however, the glandular tissue is deep-red in colour, softened, and filled with pulpy cavities ; the ducts and sinuses are disteiuled or choked with coagulated milk, pus and serum, the whole fornnng a diversely-coloured fluid, fn the veins are somotinuis blood-clots, variable in colour and consistency ; gas ami fcetid fluids escape from tlie tissue on section ; and i\w. o-dema is found to be duo to infiltrations of yellow serum in whicii are brown and greenish streaks. This fluid, examined microscopically, has mucli the appearance of that found in animals which have died from septiciemia. Shreds of necrotic tissue are also met with. Causes. Manimitis appears to be due to the most diverse causes. Among the princi])al predisposing causes, the ilrst is lactation- the disease appear- ing immediately before or soon after parturition ; and the animals whose mamnue are most active at this period, are those most frequently attacked. Tn the great majority of cases in the Cow— in which animal It IS most serious- it follows witliin a month after parturition. It is true that, in certain maladies -as foot-and-mouth disease, cow-pox, sheep-pox, etc.— the udder may be affected at any time ; yet the lacta- tion period— that wlien the mamnue are at the height of their function, is the time when this inflammation is generally met with. Witli those animals whose milk is only utilised to rear their progmy, sudden separation from their young without any precautions is often noted as an exciting or predisi)osing cause. The great activity of these glands in the Cow, and the long time during wliich this activity is maintained, 18, there can be no doubt, one of the chief reasons why ihis animal so often sulTers from this affeetion. Mechanical causes may produce this inHamination— such as con- tusions, wounds,' injuries in milking- or sucking, blows fmin the liead of the young creature, etc. rarenchymatous inflammation of the gland may also be due, according to Franck, to a deep purulent wound in 1 G.itze [SacU. J ahn In 1H84, Nocard had an opportunity of confirming Franck's views while investigating an enzooty of mammitis that had prevailed among a number of Cows tor six years. In milk from tlic affected udders, he constantly found a special micro-organism which could be readily culti- vated in milk and other fluids ; when the twelftli culture of this "erm was injected into the teat of a Cow or Goat the milk become acid'' and clotted, and the tissue of the gland after a time was denser than in liealth. This injection had no effect on the Bitch. what consistent, slightly or not at nil sensitive, and dark or black in line. The line of demarcation bttween the healthy and diseased portion is perfectiv defined ; the former being of a ro,-y colour and normal in size and consistency. The diseased condition spreads beyon.l the udder to beneath tiie abdomcM, and when an ulcer appears on the gland .lischarging a fo'tul sanguinolent Huid, the animal then becomes depressed and levensli, debility and emaciation set in, and the cr-ature succumbs to an attack of septikiemia. The numerous necroscopical examinations made by Riv.ilta confirm, in his opinion, the distinction he has established between this special malady and erysipelat.Mis mammitis. With regard to the causes, the sliei.herds affirm that the malady attacks those sheen which are kept for a long time on a thick bed of litter ; others, again, assert that it appears when tliey are allowed to pasture in tlie open air, and are not confined. The same uncertainty luevails with regard to its contagiousness. The shepnerds carefully isolate till! affooti'd nniinals • Td 't vin'if! s-rcm flnf it- tk ;.. -i :., - iu i- • i^,,if.^ f.. .!,....„"«".:/::: .:,! -" ^-f^"" ^f^^t. 4 then- domg bo, the disease » limited to those first attacked. Kivolta is of opinion that this form of manimiti lotng s is produced and maintained by ^ ^ I! '. '^1 it ! special vucrocucci and bacteria, which penetrate by the teats, or at some part of the skin covering the gland. U nt 690 PATHOLOGY OF PAUTURITION. Hi Several Italian authorities, and anions them Brusasco, Oreste, Metaxa, and Provizano, have drawn attention to a pecuhar disease of Goats and Sheep, accompanied by the gradual loss of milk. Often lameness is observed, and within fourteen days the secretion of milk is reduced to one-fifth of the usual quantity. This fluid soon j^ecomes Gour. The disease appears to be contagious, for it could be Produced by injecting the milk from affected Sheep into the teats of healthy bheep and Goats. All the animals so experimented upon became aflected, the period of incubation being six, twelve, fifteen, or twenty days. The secretion of milk ceases in from eighteen to thirty days. In the gangrenous mammitis of Sheep which Nocard investigated, and. which was due to a micro-organism, it was found that five drops of the altered milk from a diseased gland, when injected into the teat of a healthy Sheep, produced the disease and caused death in forty-two hours. Tuberculosis of the udder is sometimes a cause of mammitis, and in all cases, when severe, it diminishes the secretion of milk. The mammae are greatly enlarged, hard, and nodulated, and softening of the tubercular masses may give rise to isolated or diii'used abscesses. Complications. With Ruminants, the digestive organs are generally involved in the disturbance, and require attention. Inflammation of the joints (arthritis) is a frequent complication of mammitis ; any of the articulations may become aflected, but the patellar and tarsal appear to be the most pre- disposed. Septic infection and pyannia arc grave complications, and appear when gangrene or extensive suppuration is present. There are also the degenerations and new formations in the mammae which com- plicate the malady when chronic, or subsequently. Prognosis. The prognosis of mammitis is generally unfavourable, unless the inflammation is superficial and limited, not severe, and treatment is adopted early. When the inflammation, and particularly in the Cow, attacks the whole of the manmu«, it is then most serious, and I'arely indeed can a favourable result be prognosticated. Wlien the inflammation is local- ised and not likely to extend, and particularly when the suppuration is superficial, the results may be trifling— provided always that judicious treatment is early adopted and energetically carried out. With cattle and sheep at pasture, mannnitis is often a most serious disease, from the fact that its existence is generally not jiorceived in time to check it, and the causes which produced it are perhaps still in operation. The permanent induration or sloughing away of one or more quarters of the mammuD, is always to oe apprehended when the inilannuation is inter- glandular or interstitial, and especially when it is acute. Gangrene, and even death, may result ; indeed, the gangrenous termination of mammitis is fatal in nearly every case. Treatment. However sliglit the attack or mild the form of mammitis may be, in view of the serious consequences which it may entail, treatment should be prompt and judicious ; as in two oi' three days alterations may be produced in the secretory apparatus of the gland wliich medical skill may be unable to amend. ICO, Oreste, r disease of [lilk. Often n of milk is on becomes produced by althy Sheep affected, the days. The nvestigated, five drops of the teat of a y-two hours, litis, and in Che mammae le tubercular solved in the its (arthritis) ilations may he most pre- cations, and There are which com- , unless the treatment is attacks the indeed can a ,tion is local- ippuration is lat judicious With cattle disease, from e to check it, sration. The lartej'S of the ^tion is inter- . Gangrene, rraination of ;is may be, in .tment should tions may bo medical skill MAJLVITIS OR MASTITIS. 691 When the udder or quarter is simply engorged with milk, nothing more has to be done than to thoroughly remove this fluid This of course cannot be accomplished at once, and it maybe necessary' to milk the animal several tunes during the day-five or six times, or even every one or two hours When this causes pain, the milking should be gently performed ; and if pressure on the teat causes so much dis- turbance that the lluid cannot be withdrawn by hand, then the teat syphon (Fig. 221). well oiled should be passed into the milk duct should It be necessary to retain it there, then the ring-syphon (Fi^ 222)' mav be employed, its retention being effected by a cord or tape passed throu-h the rings and tied over the animal's loins. In all cases in which hau"d milking causes pain, and is likely to increase the evil it is intended to Tig. 221. Teat sypiio.v. avert, the teat-syphon should be resorted to.i It may be necessary to remove the progeny for a day or two, or allow it access only to the healthy quarters, if the animal is suckling ; and should it be required to lessen the secretion of milk until the gland has recovered its normal condition, this may be effected by a suitable diet, and perhaps a dose of axative or purgative medicine. Application of vinegar to the gland has been recommended; painting :'t over several times with a solution of cocaine might be useful. When the pain has diminished it is generally advisable to allow the progeny to withdraw the milk. Should the gland remain hard, tense, and painful, and the superficial Fig. 222. RlN(i Te-vt-syphon. veins be gorged witli blood, much relief will be afforded by bleediu" from the corresponding mammary or " milk " vein, if a Cow. ° The animal should not bo exposed to cold or (h-aughts, and it may be advisable to cover the body with a large blanket. If fever is appre- hended, enen.as may bo administered, in addition to the exhibition of nitrated gruel. Should coagula or solid caseous concretions have formed, they must be removed. This may be accomplished by moving the masses up and down, when possible, by careful and gentle pressure. When they can be easily displaced, they m.ay then ho pup-lied down to the end of the ' Franck very pronTly drew attention to tlie neccs.-ity for tlioronghly cleansing these syphons in boiliiiLf Wiit^ror cubolii: iiciil sy animals, is obvious unless this precaution is adopted. 692 PATHOLOGY OF PARTURITION. A coagulura or concretion manner. as large as a teat, and pressed through. __ ^ nut has been extracted in this manner. When it is too volumnious, however, it may be necessary to introduce a sound carefully into the canal, in order to break it u^ or it may even be required to incise the teat, when the mass is too large and dense to be got rid of in this way. Retention of the milk is sometimes due to atresia or obliteration of the milk canal in the teat, and will then demand an operation which will be referred to presently. When phlegmonous or parenchymatous inamraitis is present, the treatment must be energetic and adopted early, in order to prevent those serious alterations in tlie gland which take place so rapidly. In the Cow, bleeding from the corresponding mammary vein has been recommended by many excellent authorities, from the speedy relief it gives to the congested gland ; in the Mare, if bleeding is neces- sary, the blood must be abstracted from the jugular, though this can rarely be productive of much benefit. Leeches may be most usefully employed, locally, for the smaller animals, and ]^,ouley has even had recourse to them with great advantage in the Cow. In inflammation of the gland, emptying it of its secretion, or removing from it the products of the inflammation, must be scrupulously observed. Milking by hand must be persisted in for brief but frequent periods, even though only a few drops of serum be withdrawn each time. The teat-syphon mcy sometimes be usefully introduced ; but its employment requires much circumspection when the inflammation is acute. With the smaller animals, as the Bitch, milking is not so urgent. The general treatment must depend upun the condition of the animal and the nature and degree of the distui'bance, and must be, in principle, that of all intlainmation. The local treatment is a matter of much im])ortance, and here we find the most diverse recommendations. Zundel, Baumeister and Euoff, Gillibert, and others, have lauded the advantages to be obtained from the application of collodion, particularly with small animals. With the larger animals, as Mares and Heifers, it has been most successfully employed by Zundel, who adds a few drops of castor-oil to the collodion, wliich is applied either over the whole gland or the inflamed quarter or quarters, commencing at the teat, the orifice of which must not be covered ; a second or a third application may be made. The evaporation of the ether produces a salutary degree of cold, while the continuous layer of cotton, closely adhering to the surface of the skin, affords equable compression and support by its con- traction when the ether evaporates. Astringent and refrigerant applications have always held a high place in the treatment of nuimmitis, and every authority has his own favourite application. In this way we have cold water, either alone or with the addition of ice, acetate of lead, or Goulard's extract ; clay tempered with vinegar or salt water ; evaporating lotions of various kinds, etc. These applications may be usefully and safely employed when there is merely congestion, or at the conunencement of slight inflammation ; but when the intlainmation has become fairly establislu d, and there is exudation, they increase the tension, and, without allaying the pain, promote induration. So that, as a rule, they are to be avoided until the inflammation has been greatly subdued, when the; may be resorted to with some advantage. EmolUent applications, and especially when warm, afford more luminous, r into the incise the 3f in this eration of ion whicli jsent, the prevent dly. vein has le speedy ; is nsces- i this can t usefully even had removing observed. b periods, me. The iployment ;e. With be animal principle, of much )ns. luded the ,rticularly Heifers, it few drops the whole i teat, the pplication ,1'y degree ng to the ly its con- nigh place favourite with the tempered winds, etc. 1 there is inmation ; d tliore is the pain, ded until e resorted jrd more MAMMITIS OR MASTITIS. 693 satisfactory results. In this direction warm fomentations and poultices appear to be most grateful to the animal, and to dissipate the inflamma- tion most readily. They must not be too hot, as the skin of the udder is 80 thin that it is easily injured by inordinate heat. Poultices of linseed-meai, oatmeal, marsh-mallows, dough, etc., covered with olive- oil, laudanum, opium, or extract of belladonna, are especially to be recommended, in preference to fomentations which require much time; and as they cannot be applied continually, the udder often suffers from the reaction — the change from heat to cold, though this may to some extent be obviated by drying the parts well, and smearing them with lard. An excellent poultice is furnished by spongio j«/tnc, which, if covered externally by oiled silk, and holes made in it for the teats to pass through, makes an excellent and clean cataplasm when steeped in warm water and applied to the udder. Wi'^'-^ms recommends " spent" hops, which are very light, contain much iiJv..oture, are soothing, and do not irritate when they become dry. The drying of a poultice can be averted by placing it in a piece of waterproof material or oiled silk. Poultices and other appUcations of this kind are best retained by a wide- tailed bandage, in which are holes for the teats, and which, passing upwards on each side at the flank, and back between the thighs, is secured over the loins and croup. This bandage is at all times bene- ficiai in relieving the pain and congestion, by the support it affords the swollen organ. It should therefore be adopted early. Lotions of belladonna, opium, tincture of camphor, poppy-heads, etc., are convenient applications, and if warm do good ; but to prove effica- cious they must be applied frequently, and at the commencement of the disease. A sponge, or rubbing in with the hand, is the best means of applying them. Fiirstenberg recommends continuous tepid alkaline lotions applied by the hand for twenty-four to thirty-six hours ; and Schaack asserts that, employed at the commencement, they have a remarkable effect — often arresting the inflammation in that interval, the swelling disappearing in one or two days. Eychner states that nothing can equal the success resulting from the employment of alkaline lotions. The owners of cattle in Switzerland are well aware of this, and as soon as they observe the slightest altera- tion in the milk of a Cow, they take a handful of wood-ashes, which they moisten with milk, and making a lotion of the mixture rub it on the udder. Eychner is of opinion that tlie potash in the ashes p*-events the coagulation of the milk in the udder— this coagulation being, according to him, the point of departure or initial phenomenon of mastitis. For this reason he gives the following recipe, which has obtained more success than any other, when applied before the inflannnation had attained its greatest intensity : Potass ------ Water Olive-oil These are to be well mixed, and then four or five parts more water are to be added. Often, after live or six hours, dunng which nothing could be drawn from the teat excejit a small quantity of thin curdled milk, there is obtained a whitish-yellow fluid, more hke pus than milk, which is a very favourable sign. Ointments and embrocations of various kinds are also employed— as those of belladonna, henbane, morphia, camphor, laurel, etc. In iit 1 part. 2 parts. 5 „ ft I 694 PATHOLOGY OF PAllTUrJTIOX. <:! England, the extract of belladonna is much used as an application to the intlamed gland. Eychner recommends an ointment made with soft soap and this extract ; Hertwig gives his testimony in favour of cam- phorated pomade ; while some prefer simple lard. Strong mercurial omtment has been greatly extolled as an anodyne and emollient, and justly so. Its constitutional effects should be watched, and care must be taken that the progeny is not allowed to suck the teat. Stimulating apphcations should not be employed, unless the disease IS in a chronic form, and then their effect must be noted. ^^.^" suppuration appears to be inevitable, this process should be expedited by every means, so as to concentrate the pus at one point, if possible. The warm poultice or fomentations should be continued, and It may even be advantageous to apply mercurial ointment, ammoniacal hniments, and such other " maturatives " as blisters. The abscess is to be treated according to general principles ; it should be opened as soon as fluctuation can be detected, and for this purpose the bistoury or lancet may be employed ; though some practitioners prefer the actual cautery, which, they believe, does not entail so much risk of haemorrhage, favours the exit of indurated parts, affords a better means for the escape of pus, and the resulting wound heals up more readily. When opened, the wound demands only ordinary treatment— cleanliness, detersive or stimulant dressings, carbolic oil or lotion, etc. To prevent the opening clooing too early— wliich it may do when the abscess has been opened by the bistoury, it will be necessary to introduce a small tent of lint or fine tow. _ Sometimes several abscesses are developed simultaneously or succes- sively in the tumour, and are separated from each other by thin septa. In such a case, having opened the largest abscess, it often happens that the pus from the others drains through the opening, converting it into a nstula. In such circumstances, a counter-opening must be made; and it there is any necrotic tissue to be found, it should be removed. In all operations on the mammary glands, tlie incisions should be carefully made, and no larger than is absolutely necessary. When the abscesses are deep-seated in the texture of the gland or the connective tissue, it frequently liappens that, in opening them, one or perhaps more of the milk-ducts are wounded, and then we may have "lacteal listuUe." From these the milk escapes, and this renders their cicatrisation diflicult and tedious, if the gland is active. The treatment must chiefly consist in the application of caustics to the walls of the fastuUe, in order to hasten granulation— the nitrate of silver, chloride of zinc, tincture of iodine, or even the actual cautery, being generally resorted to. Sometimes a cure cannot be effected until the gland has become " dry." In some cases a pitch plaster or one of marine glue is useful, or the pressure of a broad elastic band when the fistula is situ- ated at the base of the teat. Tlie occurrence of gangrene is always serious, though of course it is not so grave when limited as when diffuse. It generally leads to the loss of one or more quarters, or even to the death of the animal from iccThtenna or septikiemia. Wlien limited, little can be done, and in some cases it is best to wait for the spontaneous elimination of the dead portion: waiting and watching the process, supporting tlie strength of the animal, accelerating the separation of the dead from the living- tissues, .avouring the free escape of pus and putrid matters, so as to hinder their absorption, making counter-openings, and applying anti- MAMMITIS OR MASTITIS. 696 lion to the with soft ar of cam- mercurial llient, and care must be disease should be e point, if aued, and nmoniacal scess is to 3d as soon istoury or ;he actual morrhage, the escape sn opened, itersive or le opening en opened of Hnt or or succes- liin septa. )pens that iiig it into be made ; oved. In 3 carefully md or the m, one or may have deis their treatment ills of the ihloride of generally gland has ine glue is lia is situ- aurse it is ,ds to the mal from :e, and in f tlio dead ;rength of the living , so as to ying anti- septic dressings — as chloride of zinc, carbolic acid, permanganate of potash. In other cases, it may be necessary to expedite recovery by excision of the mortified mass. In order to do this, it is sometimes, but not always, requisite to cast the animal, and to fix it as for castration. The opening by which the pus escapes is enlarged, and the tissues still adhering to the living parts of the gland are separated from it by the fingers, keeping clear as much as possible of the arteries, which should be ligatured, if injured. When the separation is complete, ligatures may be placed round the principal vessels — the ligature being a piece of narrow tape or ribbon, as their walls are fragile and easily torn. If any htemorrhago occurs, the actual cautery or percbloride of iron may be employed to subdue it. The wound is then to be dressed with dis- infecting and stimulating applications, until it ceases to give off a bad odour, and is throwing out healthy granulations. The animal must be well fed, and its strength sustained by stimulants and tonics if neces- sary. When gangrene threatens to become diffuse, there must be no hesita- tion in resorting to deep scarifications, in order to limit its ravages ; these allow the escape of the septic fluids, which would impregnate the healthy tissues if permitted to remain ; and the isolation of the diseased parts may be still further secured by plunging the actual cautery deeply into them, and applying oil of turpentine, carbolic acid, perchloride of iron, or tincture of camphor to them and into the wounds. It is often advisable to trace a line around the gangrenous part, so as to circum- scribe it. When it is surrounded by a ring of inflammation, then emol- lient poultices may be applied to hasten its separation ; indeed, if the part is quite dead, it may bo judicious to cut into and remove as much of it as can be done— cauterising the wound well with the hot iron or perchloride of iron, and afterwards dressing it with chloride of hme, carbolic acid, and other antiseptics. At the same time, antiseptic medicines, tonics, and stimulants, should be administered internally. It might be well worth trying tiie injection of antiseptic agents— such as carbolic acid, tincture of iodine, etc., into the gangrenous tissues, by means of deep incisions and a Pravaz syringe. Induration following mastitis can rarely be remedied, but it may be useful to continue the inunction of ointments which contain prepara- tions of mercury— as the iodide, or iodine for a certain time. Armatage reconnnends the following ointment to bo applied once a day, with smart friction : Soft soap Hb. Mercurial ointment - - - - 1 oz. Camphor ointment - Extract of belladonna •4 drams. G oz. 4 .. Or the following tincture : Tincture of iodine . - - Tincture of opium Soap liniment - - - - Fretjuent and gentle milking may also prove serviceable, as well as dry friction. . As a preventive measure when infection is apprehended— as m reten- tion of the placenta, metritis or vaginitis, etc.— it is advisable to mject I' I'l 696 PATHOLOGY OF PARTUrJTION. a weak solution of carbolic acid (2* per cent.) or alum (2 per cent.), up tne teat by means of a glass syringe, always after milking; the fluid snould be at a temperature of !)5^ Fahr. Franck has proved the value ot this precaution, and also its utility as a remedial measure ; indeed Armatage had previously recommended the injection of weak solutions ot carbonate of soda or potash in mastitis. Franck has employed a ten per cent, emulsion of carbolic acid as an injection in artificially-produced mastitis (sixty grammes daily), and by this means suppressed the aevelopment of micrococci and bacteria in the milk, as well as prevented curdling ot that fluid in the ducts and sinuses. Solutions of alum— ten per cent., 100 grammes injected daily-appeared to be also beneficial in tnis direction. And Nocard successfully treated the chronic catarrhal lorm ot mammitis in which he found a special bacillus, by injecting up tne teat of the affected quarter a four per cent, tepid solution of boric acid ; this was done after milking in the evening, at intervals of ei"ht days two or three repetitions being suflicient. The induration of the gland gradually diminished, the milk resumed its ordinary characters and the bacil us disappeared from it. In order to prevent the spread of the disease, the person who milked the cattle, before doing so, washed his hands and the teats of the animals with a three per cent, solution ot carbolic acid, the affected cows being the last to receive his attention iheir milk was kept apart and given to pigs. Armatage recommends that animals suffering from gangrene of the mamma? should be removed from those which are pregnant, " as sreat excitement will be produced by the odour of decomposition," and abortion IS probable. CHAPTER X. Agalactia. " AG.4LACTIA," or absence of milk in the mamma3, is not uncommon in animals, particularly the Mare and Cow, and more especially in those which have not been bred from for a long time, or which have brought forth their first young, though themselves aged. This absence of secl-e- tion may occur even when pregnancy has been normal and has reached Its full hmit. The udder is small and soft, and attempts at milking only result in the production of some drops of yellowish matter, followed sometimes by a few drops of white watery fluid. There appears to be a want of development in the lacteal apparatus, which various causes concur in producing. The principal of these causes are: previous or present chronic disease in the mamma! ; atrophy of these glands ; ex- haustion following disease ; severe labour ; insuflicient food, either during or immediately after pregnancy ; natural debility, emaciation, etc. in some instances the milk gradually appears some time after parturition, and a tolerable qunnuty is secreted ; but in the maiority of cases It IS either not produced at all, or only in very small quantity. Ihis condition is very unfortunate for the progeny, which will suffer from hunger if not observed, and must either be artificially reared, or put to another animal to bo suckled. The treatment of this condition frequently proves unsuccessful. It must chiefly consist in givin- good food, particularly of a leguminous kind, with aniseed and fennel, fennol-seeds, water fennel, ilfc«w miudli- imm, antimonials, and other agents which are likely to stimulate the INJURIES TO THE TEATS. 697 cent.), up ; the fluid I the value e; indeed, k solutions oyed a ten ^-produced ressed the prevented alum — ten ineficial in catarrhal ijecting up n of boric s of eight ion of the haracters, ! spread of o, washed t. solution attention. sne of the " as great d abortion )miuon in in those e brought 3 of secre- s reached t milking , followed rs to be a us causes evious or inds ; ex- )d, either laciation, ime after ajority of quantity, /ill suH'er 'eared, or 3sful. It ^uminous li miucUi- alate the secretory function of the mammae. Great attention must be paid to the digestive organs, and the teats should be frequently stripped and the mammae rubbed, either dry or with some stimulating application. Macorpsi records a case in which the udder was rubbed with brandy, friction applied to the abdomen, and warm milk and fennel-seeds ad- ministered ; in two days the milk began to appear. When the absence of milk is due to disease of the gland, this must be combated according to the indications. CHAPTER XI. Injuries to the Teats. FiSSUKES. The chief injuries to the teats consist of wounds, in the form of fissures or " racks," which are most frequently witnessed in the Cow a few days after parturition; and though apparently unimportant, they nevertheless may become very troublesome and serious if neglected, and even lead to mastitis and icorrhaomia or septicaemia ; while they render the animal fidgety and averse to being milked or suckled — the latter being especially inconvenient, particularly in the case of the Foal. Causes. These injuries are generally produced by the powerful traction of the young creature on the teat while sucking, and mainly when the teat is empty, the milk scanty, and the skin very thin and fine — as in primi- parae. Even when the milk is abundant but the skin thin, these fissures may occur. The teat is alternately distended by milk — when it is covered and softened by the externally warm saliva and buccal secre- tions of the progeny, in the act of sucking — then retracted and corrugated when emptied. At the bottom of the folds the epidermis is rendered soft, and its cells become loose and swollen ; these finally, instead of forming a continuous layer capable of protecting the subj, .ent derm, give rise to a whitish unctuous pulp, which accumulates at the bottom of the corrugations. When this is removed a sore is left, and the devel(>pment of this sore is hastened by cold, which still further corru- gates the part ; as well as by want of cleanliness, contact with dirty litter or manure, which irritates the organ ; besides the act of milking or suction, which extends the sore in length and depth. It may be that certain conditions of tlie saliva in the young creature also lead to irrita- tion. Cows with voluminous udders and long teats are often the subjects of this injury. Sipnpioms. The sore appears as a more or less deep, narrow, and sinuous ulcer, running transversely around the teat, and having indurated, thickened, raised margins, greyish at the bottom, or very red and erythematous, and containing a variable quantity of the thick unctuous matter just mentioned. The teat is apparently not much deformed — at least after milking, when it is retracted ; and the fissures might readily pass un- perceived. Then it is necessary to pull the end of the teat gently, in order to discover them. When superficial, they are not so troublesome as when deep, irritable, ^ Canstatt's Jahreabericht, IStJO. (598 PATHOLOOY OF PAltTUlUriOX. and bleeding; then they are extremely painful, and the animal refuses to be sucided or milked, while attempts to handle the teat cause the creature to oU'er great resistance. These fissures have an almost natural tendency to increase in depth, so long as the young creature is suckled. Sometimes they form at the very extremity of the teat, and the sinus and milk ducts become in- flamed, the viscid matter secreted becomes hrm and blocks up the canal, which may ultimately be completely obliterated, causing retention of the milk, inllammation of the gland, and perhaps leading to a fatal termination. Treatment. Fissures in the teat should not be neglected, however slight they may appear to be. They might be prevented by cleanliness and care, and keeping the animal from draughts of cold air. It is a good plan, par- ticularly with primipara), and especially the liner bred Cows, to examine and wash the teats for a short time after parturition, and if there is a tendency to sores, to dress them with some bland substance — as lard, glycerine, or olive-oil. When fissures are present, and especially when they are deep, an essential condition for their recovery is preventing the progeny from using the ail'ected teat or teats. By this abstention, and the use of the teat-syphon (well disinfected every time) to empty the gland, recovery in the most serious cases is comparatively rapid, and sometimes even spontaneous. EmoUient lotions are generally recommended, and the ordinary fluid is the milk drawn from the teat, which is to be frequently applied during the day, the part being well cleaned with a soft cloth after each application. This and other mild emollients miy be useful when the injuries are very slight and superficial ; but when they are more serious, or a rapid recovery is important, then recourse must be had to more efficient remedies. For this purpose, perhaps nothing is better than carbolised glycerine (1 to 20), or, \n very severe cases, a watery solution of silicate of soda. Dry dressin- = — as iodoform or boric acid — may be employed in some cases ; an ointment composed of tannic acid 3 parts, water 2 parts, and lard 25 parts, has been recommended. It may expedite recovery to touch the fissures lightly with nitrate of silver, and to cover the teat with an india-rubber capsule or ring. Obliteration of the Galactophokus Sinus. This may result from fissures, disease, or growths of various kinds, or it may be congenital (atresia), and is most frequently observed in the Cow. It may be either partial or complete. Symptoms. "When due to fissures or disease, the symptoms are gradually developed; but when the occlusion is congenital, they suddenly appear either imme- diately before or after parturition, when the gland becomes active. Then the udder is distended, but no milk issues from the teat ; the distention increases, and if relief is not afforded inflammation and suppuration may result. On examination of the end of the teat in con- genital atresia, pressure— as if in milking, and if the skin alone be the obstacle — will cause a slight prominence where the opening of the sinus should be, the milk being felt in the sinus. Should the occlusion extend INJURIES TO THE TEATS. 690 iml refuses cause the J in depth, >rm at the jecome in- I the canal, jtention of to a fatal t they may care, and plan, par- te examine there is a i — as lard, e deep, an geny from use of the i, recovery iimes even 3 ordinary tly applied after each [ when the )re serious, ,d to more etter than ry solution d — may be lid 3 parts, It may silver, and s kinds, or ?ed in the developed; ther innne- les active, teat ; the ation and eat in con- .one be the f the sinus sion extend higher, and the whole or a portion of the sinus be obliterated, then this prominence will not be produced, and the obstacle will be discovered towards the base of the teat. Occlusion brought about by inflammation, hypertrophy of the mucous membrane lining the sinus, or the development of any growth — as a wart — does not occur suddenly ; and in milking it will be observed that the stream of fluid gradually becomes smaller, until at last it can only be drawn drop by drop, or its flow has completely ceased. Treatment. When the occlusion is only due to the skin — which is not uncommon in primiparae — a small crucial incision made through it by the bistoury or lancet is generally all that is necessary. The sinus of the teat is distended with milk by pressure from the base, and the prominence at the end is then incised. To prevent the wound closing, a small bougie is introduced into the sinus for four or five days until the wound has cicatrised ; it should only be taken out at milking-time. Fiirstenberg states that he has seen the opening thus made remain permeable during the whole period of lactation, but close again when this period expired ; and a second operation had to be performed at the next calving. A. n. Fig. 223. Li'Tiii'.s PEi(i'oiiATiN(i Sound. A. Half the Natural Size. B. Natural Size and Section of the Cone. When the obstacle is in the sinus of the teat, at the narrow part of the canal, and immediately above the sphincter, a fine trocar or stocking- needle, previously cleaned in boiling water and dipped in carbolic acid solution, must be passed into it and through the obstruction, when the milk will flow. To prevent closure, the cannula of the trocar or a teat- syphon may be inserted for some days, the opening being closed by a cork except at milking-time. Or a solid gutta-percha sound may be employed until an artificial mucous membrane is formed, removing it when milking. When the canal is only partially obstructed and the milk yet flows, the introduction of a small feather — pigeon's — or a piece of thick catgut, will, with a little patience, gradually effect dilatation. But should it not suffice, and particularly if a wart is the cause of obstruction, an incision will be necessary. Various instruments have been proposed for this operation, but Liithi's sound (Fig. 223) is perhaps the best. This is an iron wire about eight millimetres long and two in diameter, having a ring at one end, and at the other a steel cone screwed on to it. This cone has a very sharp point, and both sides have cutting edges at the base or widest part. It is passed into the opening of the teat, pushed through the obstacle, and then gently turned round from side to side until no resistance is felt. Then it is withdrawn, and a bougie or teat- IhW. 700 III PATHOLoay OF pahtuiution: syphon, or a piece of thick carbolised catgut, introduced. Zundel mentions that Li.thi and Strobel have been very successful by this method of operating. '' f^/!Vt" «""^"« operations on the teat, every precaution must be adopted for Lhe prevention of mastitis; and this must chiefly consist in follow pol*iblo '^'''^''^P*'^ "'^'^^°^ "^ treatment of the incisions as closely as Fistula of the Tkat. fvn^Ki ^^^'^ '?'' "''"'^''^^ ""^^^^ °^ ^ '"^a ^'f th'^ teat which proved vcrv troubUsome to cure during the p( , ,od of lacLation. From injurv or disease an opening is established between the milk sinus and the side ?b« nvf n ^'° ""' **"". "''^^.' '"'^^^^ °^ 1^^^*^'"^' th'-ouK'b the canal ui sLnf Tm'^' '''^P'' '". f J'' '^^''^^ ''^^' ^"^^ ^t« «°^ i« nearly coi ! TfTfia J -"i ^ 't '"'''"'^ ?^ ^°''' ^"'^ ^'^' ^'f^«" ^^" unpleasant appearance If it IS decided to cure the fistula during Uie lactation period, and the opening m towards the middle of the teat, then the ring toat syphon mus be kept in the s nus for some time, and the fistula tr^eated accord- oftli t.«?!''^ principles. When the fistula is towards the extremis ot tlie teat, however, the case is more diflicult, and the teat-syphon onlv the Cow is "dry, when, with a httle attention, the fistula i. readily I Zundel 'ul by this be adoi)ted t in follow- 3 closely as •I'oved V{'iy I injury or id the side le canal m learly con- ppearance. d, and the jat-syphon ed accord- extrenjity 'plion only wait until i'' readily AHJ'JI} XIA OF THE XEIV-BOJtN AXIMAL. 701 BOOK VI. DISEASES AND ABNORMALITIES OF THE YOUNG ANIMAL. The diseases and abnormalities of the young aniu i, observed inme- diately after birth, are, many of them, of the greatest importance, and deserve far more attention than they have yet received in this country. Their consideration forms an appropriate complement to what has been said as to the pathology of the parturient state of the parent ; and a notice of them, however brie and imperfect it may be, is all the more necessary, as few, if any of them, are referred to in works on veterinary medicine or surgery. They will be ilescribcd in the following order :— (1) Asphyxia, (2) Umbilical ILrmorrhagc, (3) Persistence of the Uraclms, (i) Umbilical Hernia, (5) (Eilcma of the Umbilicus, (6) Inflavwiation of the Umbilical Cord, (7) Arthritis, (8) Indiijestion, fO) Gastro-intcstinal Catarrh, (10) Dysentery (;, Yonnii Animals, (11) lictention of Meconium, (12) Eclampsia of Young Animals, (li,; Tetanus Agnorum, (U) Ci/anosis, {lb) Skin J)ri/ness, {IG) Imperforate Anns, (17) Imperforate Vulva and Vagina, (18) Ivtperforatc rrej'uce, (19) Occlusion of the Eyelids, (20) Oc- clusion of the Auditory Canal, (21) Tunguc-tic, (22) Cleft Palate. ii m pi I CHAPTER I. Asphyxia of the New-born Animal. At p. 265, under the head of " Suspended Animation," allusion was made to asphyxia of the new-born animal— a condition similar to that ot the new-born child — and brief mention was made of the measures necessary for restoration. The immediate cause of this condition was also referred to. It has been recognised that when animals are sub- mitted .luring pregnancy to insuHicient food, to se-^ jre exertion, have suti'ered from chest disease or from colic a short tinn ofcre parturition, or when labour has been irticult and protracted, tht joung creature at biifh is often so exhausteu that it lies apparently dead— all the tissues being pale and flaccid ,.iui the body low in temperature, while the heart's beats and the respiratory movements are very feeble ■ r quite imperceptible. There may also be syncope or asphyxia from ])lethora or cyanosis; asphyxia may likewi>! be due to interrupted circulu Lion in the umbilical ■ord, and int a-uterine respiration. Apparent death, or suspended animation, )iust be treated in the manner indicated at 2()5. The mouth i^nd trachc should be cleared of mucus aim anmiotic Huid, if any oi ihe latter has passed into tho air passages ; as it may give rise to pneumonia should the creature be resuscitated and live for a short time. With the Calf or Foal, it is possible to pass an elastic tube or catheter through the nostril into the trachea, and by means of a syringe to remove i nch of the fluid thciofrorn. Aspersion of ti •■ skin with cold water, or flicking it with a wet to vel, may also be usei. in stimulating tiie respiratory nerve-centie, by the reflex action it induces. This is more particularly indicated when asphyxia is due to an excess of carbonic acid in the blood. Stimulation It f II lili 702 DISEASES AND AnXORMAUTIES OF THE YOUXG ANIMAL. of the akin may also bo useful in this direction. Direct electric stimu- tion of the plu'onu: nerve nuKlit he attempted. Artificial inflation of the lunKS should not bo tried until the moutli and fauceH have been cleared of mucus ; this may bo effected by suction, which has a very beneficial action otherwise. Indeed, some authorities prefer aspiration to mspimtion or blowing,' into tlio mouth ; and Albert' has restored 41 out ot -17 cases of apparently dead animals by aspiration or suction irauHfusion ot i)l()od by the umbilical v(!in mi^ht prove useful ; between one-halt and a litre of blood should bo sutlicient for a Foal or Calf according to Franck. The fumes of ammonia or some other powerful volatile irritant may be applied to the nostrils. A few drops of brandv might also bo poured into the nostril. ^ CHAPTER 11. Umbilical Haemorrhage H.EMOUKHAOK fioiii tho Umbilical cord does not appear to be a very common accident ; nevertheless, it does sometimes occur, and in some cases so copiously as to cause death. It ensues immediately afterbirth rarely after some days ; and it may continue for a short or 'long period —producing more or less debility, or even dissolution. The luemorrha^e IS generally due to imprudence in cutting the umbilical cord too near the abdomen, or to laceration of the vessels of which it is composed durin-^ dillicult parturition, when violent traction tears it close to the abdominal nng ; m very I'are instances it may be due to a varicose condition of the vessels. Zundel alludes to a predisposition to umbilical luemorrhafe— a kind of hicinophilia. In one or two instances the bleeding has been induced by either the mother, the young creature, or its companions sucking or^pulling at the remains of the cord. In the Foal the hicmorrhage may take place from the artery, as that vessel is firmly attached to the umbilical ring ; with Ruminants it takes place tromthe vein, because of the existence of the ductm Amntii, and the retraction of the artery within the abdomen. Treatment. When the bleeding is trifling and not likely to continue lonrr, little if anything, requires to be done ; but when it is copious and continuous active and prompt treatment must be adoi)ted. If the cord is extremely short, astringents-as alum, tannic acid, etc. —may be tried, or such haemostatic agents as the sesquichloride of iron nitrate of silver, etc., or even the actual cautery in a fine point If' however, the cord is sufliciently long, it is better to apply a ligature,' this will check the bleeding, and the cord will slough avvay in four or ^V'^\ }'''■ '''I'P y"^S the ligature, however, the operator must be care ul not to include a portion of intestine within it; and when there is much infaltration of the cord, as sometimes happens, the serum should be got rid of, as niuch as possible, by squeezing with the lingers or scarihcation, lu order that the ligature may exercise sufficient com- pression. _ Artificial respiration is sometimes required when syncope or asphyxia is present, and this alone often causes the luemorrha^e to cease The transfusion of blood may be urgently demanded in extreme cases. * Henke's Ztlt>-:<:hrift fUr StaaUair.imkande, vol. xxiii., p. -ll'i. iNDfAL. I'EltSISTENCE OF TllK VUAClIUa. 708 iloctric stimu- li inflation of c'H have been h has a very for aspiration s rostorcd 41 ir suction, oful ; i)ot\veen Foal or Calf, ;her powerful )ps of brandy to be a very and in some ily after birth, ■ long period ! huMiiorrhage I too near the posed, during he abdominal idition of the Dmorrhage — ing has ijcon companions tery, as that lants it takes Arantii, and long, little, if continuous, nic acid, etc. oride of iron, e point. If, f a ligature ; .y in four or tor must he situation of The intes- the urachus e the blood- atrisation is he umbilical er remain in n the pouch , the vein or a,, the former 3 born ; and emaius open y succumbs ion after the 3t being that ibilical ring; J noighboui- is in reality find in adult 1 alluded to, UMBILICAL HERNIA. 705 according as the viscus is intestine or omentum, or both ; thus we have Tht?asTs1no;/'r""''''M °V^^'^^^«;»i^^-^'"'. and c«<..o'-.;,.>/oj;/.S I he last IS most frequently observed in Carnivorous animals. Cannes. We have just alluded to the cause of congenital hernia. Acquired or aTwhTnleZro'T", " ''" '""'''''^ °^ "^^'^^ rnusculafrrtion as when the J'oal or Calf runs or jumps very actively during its trambols or when pursued, or i^^. falls. It is so.neti.nes produced when tL young creature is separated fron. its parent, and being kept in an isolated p ace It rushes about and cries energetically. Umbilical hernia has di'rh'Sa. "" '' '""°" '" '"^'^'^ ^^ ^°^'''' ^"^ ^"-- constipron or There appears to bo generally present, in umhilical hernia, a certain organic predisposition due to the suppressed or imperfect organiSn of the Wharton.an gelatme ; and it has been remarked that^ommon bred animals are more liable to it than those of the higher breeds Nevertheless, in all those in which it manifests itsolf-no matter what tlie breed may be— there is usually constitutional debility present due in many instances to the mother having been ill-fed and badly cared for during pregnancy Zundel says that there are years in which the accident IS unusual y frequent, and particularly wlien much rain prevails, as then the food of Herbivorous animals is more aqueous than at other imes. Low, wet, marshy pastures are also believed to predispose to hernia; as in them the tissues become soft and relaxed, and tte digestive organs inordinately bulky; Foals and Calves kept in these situations have the belly voluminous, and the extrinsic pressure weakens lie abdominal walls. Bernard, Hamon, Cruzel, Bouley, and others, b(. lieve in heredity as a predisposing cause. Mares which were affected this lesion '"''' "" ^'°''""' ^'''^'' P^'0event ,S T^'f' ^°°^ *°"i« ^^^d in after weaning, and bath.ng tLluouflfr.n ?"''?' "^ '^^ ^^'^^"^^n astringent lotion. "^ lumoui wiJi cold water or some mild foSFSt:r^lr:*?iS^;:1,*^:^^ ^^ generally recognised that, and stronger, and le s S Z to fSfLtTT' '"' '^' ""'"^^^ ^^ ^^^e The methods of treatment coLriim/ *''^ necessary operations. (3) constnction, (4) o^Zt^^^l^j;!^::;^^;^^' ^'^ topical a.lucations, '^^^^'^ie^'^t^ *he cu^ of umbilical body, by the aid of which there is m in f ?^^'' ^H^^*^ ^^'^^^d the against the umbilical openin. .' iu LnH^f .°''''' *^° *""^°"^-' ^^d fi'on. again descending w en't e^ ern n . ^" P'"!'"* *^« ^^^^^era means temporary mechani, n J-.f, • , \'^^ ''^^" reduced. By this tbephysiol^gicafandt'm^alreh"^^^^^^^ ana it« borders are hrmly united '''"'''' ^'^'^ '^^' effected, 708 DISEASES AXD ABNORMALITIES OF THE YOUNG ANIMAL. he claims solidity, fixity, and elasticity. This consists of a kind of well- stuffed saddle, from the four corners of which pass leather straps, which are buckled to two girths— one of which is of canvas webbing, and passes round the chest ; the other, of india-rubber webbing, goes round the belly, and maintains a pad against the umbilicus. Tliis pad is a wide, but not very thick cushion stuffed with horsehair, and which a broad longitudinal band uniting the pectoral and abdominal girths prevents from shpping backwards. In Italy, the Massiera truss is employed. This is also a kind of small saddle with two wide girths passing under the chest, that presses against the sternum and epigastrium a plate of iron, the posterior extremity of which, corresponding to the umbilical ring, and covered by a leather cushion stuffed with horsehair, is applied to the seat of hernia. In Germany, Strauss's apparatus is in vogue. This likewise consists of girths disposed in a similar manner, v/ith a kind of martingale to prevent them gliding backwards. If a pad is used, Lafosse recommends that it should not be too convex or elevated in the middle. Fig. 224. Aumatage's Truss applied for Umbilical Hernia. :l 1 M Armatage advises the employment of a similar arrangement or harness, which furnishes a compress at the proper part ; it is merely a number of straps, capable of being shortened or lengthened, as may be necessary in order to fit animals of different sizes (Fig. 224). It usually requires from one to three months to effect a cure, the period depending chiefly on the size of the hernia. A tonic regime hastens recovery. Some veterinary surgeons combine agglutinative agents with the use of the truss — employing, for instance, a pad steeped in a mixture of pitch and turpentine. Befo'-e the truss is applied, it is, of coarse, necessary to reduce the hernia, and place the pad exactly over the umbilical opening. Trusses arc chioily objectionable from the long time vhey must remain on the animal, and the tightness with which they must be applied in order to rxt beneficially. This inconveniences and often injures thp young creature, and not infrequently causes it to fret, impairs its api^etite, and induces loss of condition ; and though highly recom- mended by MiU'lot, Lafosse, Perosino, SchregfU', Strauss, Ungefrohrn, IMAL. iiid of well- raps, which , and passes round the is a wide, ch a broad IS prevents employed, ising under a plate of e umbilical r, is applied 3 in vogue, ner, v/ith a pad is used, ated in the UMPILK'AL HERNIA. 709 or harness, I number of ; necessary a cure, the nic regime th the use mixture of reduce the ust remain applied in njuros tb.f^ mpairs its ily reconi- ngefroiu-n, ofireXfent.^'''' *^'^ ""'" ''"^ ^^''^^' *° ^' "^'^^^"^^^ ^ ^^"^^^ n^t^ofc 2. Topical Applications.— Topical applications havf been for centuries employed for the cure of hernia, Celsus huving recommended the use of sulphuric acid, which was resorted to at a later period bv the early hippiatnsts; and since 1833, when it was brought ^to notice by Hertwig, It has been used in Germany, being appliecl to the ™ur every two or hree days. The subcutaneous serois infiltration aiS^S^ ahdnmp^rn '°" '\ *^''' ''"'"^^u '^1* t^"" ^^^ misplaced viscera inEo tine nfthf. ''f ' \\b^-°°'«l"g absorbed afterwards, produce obliteration of the cavity and its opening. Blisters act in the same way; and appU- cations o alcohoVcreosote water, and other agents, have been lar^ ly tlTthl;; ^"^ """' r'^' ^'^^^' '■^' ^^^^^'^' ^^^ ^^^Snon have asStS that these topical applications are very uncertain, and even dan-erous as the irritation produced readily causes adhesion between the wall issibir'' '''°''"^ '^ contained, and thus renders reduction im- But in 1848, Dayot, and more recently other veterinarians, had drawn attention to the value o nitric acid cauterisation in mnbihcal hernia. iJie acid IS applied to the skin covering the tumour until at first an eschar ,s formed, and, finally, detachment of the cutaneous hernial sac IS achieved. In order to effect this, ;,he 'air is removed from the skin and by means of a spun-glass brush or cottoix-wcol fixed on a glass rod' nitric acid of commerce is appHed aroimd the base of the tumour at first ; then over the other part it is used in sufficient quantity, and with friction, so as to destroy the skin and ensure its speedy mortification and sloughing. Experience has proved that ihe more profound the dis- organisation the more certain is the beneficial action. Accordinc. to Lafosse, it requires from 24 to 32 grammes of acid for a hernial tum°our the size of a fist; and the friction, which ought to be as equable as possible over the vhole surface, should be .ontiuued for three to five minutes-supposmg the animal to be quiet and the rubbing not inter- rupted. _ A smaller quantity of acid and less friction may be employed to hernia3 which are not so considerable in volume, and are covered bv fine skin When the animal has to be thrown and placed on its back, the quantity of acid and amount of friction must also be diminished Dayot recommends that the appHcation be repeated once or twice in the hour, according to the thickness of the skin ; but it has been found that one application is generally sufficient, fifteen days being allowed to euipse in order to watch tlie result. If at the end of this time the skin is not destroyed, the application may be repeated, ^he nitric acid produces a yellow "eschar, which, if not dry on the first h \°°" beconies soft, unctuous to the touch, and easily destroyed. .V ith the formation of this eschar there is much swelling, either imme- diately on the application of the acid, or soon after; in some cases the"e IS but httle it any swelling. The tumefaction is due to the action of ne nitric acid on the subcutaneous connective tissue, which becomes infil- trated and causes a uniform pressure on the hernied mass ; this leads to the latter boing pushed into the abdomen and kept there as if by a truss. The (edematous swelling established external to the tumnnv i« oblong and depressed in the centre, in consequence of the diminished elasticity of the ceii' ^nl portion of the escharified skin ; in a few days it IS gradually absorbert and becomes more consistent, while the skin in ll 710 ])i: i ! ''>i AM) AllMjliMALlTlKH OF THE YOUN,! ANIMAL. hern a ttro is I 7 '"'^ ^T^^ ^^"^^ parch.nent. Instead of the is S, Ilv T^^ ^ newly-ionncd mass of libroiis tissue, which ScSiTc al Hs r'" a1 n ^°^"'""' condensed, and partly absorl>;d! 1 ke Svn o f it ^^* *•'' ^f'"'^ *'"'" '^'^ cauterisci^l skin bo-nns to bo centre wLrn ff f T'"'"?' *1^«. P™««^« of separation extendrn^r to the Sns oT ho Kr ' ': ^°"H ^"'»« ^° J^e coinploted. because oF the re- " rulat n LalSv r '''^- ^^^" con,pleteIy detached, there is a Cses n fu n? r °n.>"^' ^"""'^ ^''^^' ^^'"''"'^ "'^^^ i^^ve son.e fibrous cmst « 1 ! '^f"-n ^y^ «"PP"^-*ttes, dries, becomes covered with wen nd To t ib?. l'^ '"''^' epitlielium. In retracting the w umi cohtiibi tes hirgely ni closing tlie hernial openin- while the ir. vXTLtwVlh:' "^r''"'^^. ^7' ^'^"'" ^''"^ ^° ^^''- to the abd n in^l bntes ts s are T ""k'"1" ^^ ^^^', ««»^^«"«"'^ connective tissue, contri- ro;pn?^s;^te^ ^?:^':.zfi;!n:?^ts^ ^^ '''-''' ' ^'^ ^^-^^'^ occasion o throw the animal dow., and Le assistant only is rcessavv t IS rarely followed by accidents. These do occur, ho we e and h,' hlrSt^i ".^^""S? '"'? '''''^' '' ^1- intestines through i escnai, about eight days after the nitric acid has I,een annlied TM. Jiie^StJr"^' I-s been attributed to exces^ve ^^S^i ^ occn!'''T nl" '^''^^f ^"'^f '«" l^f "ofc l^een sullicient, a relapse is likely to occur , Latosse has observed one in twenty successful cases This in dS'"^ou,:?of :^S."°"^r'^:i ^"^ ^°"^'"^ aay,t^srab^t "; nitdS^ml^'lli'^'V""',''^""'^^: reconnnends sulphuric instead of means o a .dl?o^ frV^ ^'"'^^' "'"^''^ and morning, for two days, by S m he c ,n.nvh 1 f"^ '°°? ''^.' "^' ''^"^^ ^* "^^^y ^e increased by ^o) VlesXhu i?^i?1''" ''"''^ "'^ "^ tu..pentine and oil (one to nTtr c itvoXu.J' l^^^^ever, appears to be less prompt than the nhl .^^"""'^^'^'^enugomtment applied at intervals of three davs • fiv minute T:ilT''T ^""'^ *° ''''^'^ '""'^'-^^ '" once a da/fo; of nerrf nndn ?''^ «"l»tion of bichloride cLSu llv cMnnlovnd V °P''f/ '""'^"f^' '""^" ^" ^een more or less sue Teenres^ort d to^ 1;,f ;rV^'.^'''^^'^ '^'^"^"'■>^' '" ^'''^^ ^"'^ Poi"t«. ^^^^ certa n «nr oM ' f . "^ ^enehcial effect to be derived from it is un- ceicam, and at best it is very painful for?tJifcurfoTcon*'''-;T. *" ^"'""'^ '"^^'^"^^ "^ subcutaneous injections mm" XntalnTrfr ^^ ^'"'"f "^ ^"'■'^"*"' '^"^^ ^^^^^^'^^ ^^ will be found Ea in atS. t'"; ^"^ ""'7 ^^-^'^^^^'^''t yet attempted for umbilical Son of a few 1±« r^ "" ^^ i""''"^' '" '^^ subcutaneous injec- bv means of th?n.^- '°'"'"T 'f ' '°^"''"" ^"'"""^^ ">« ^^^-^^'^i^^l ^^"lo^i^-. irrita^^r irL .?'^ subcutansous-injection syringe. Under the uiitat.n^ mnaence ot this injection cedema sets in, and this mechanic ' Iti'.'iit'U i((' JfiJdtri/ir I'tte riiiUiir.. is: UMlilLli'AL U mix I A. -J J ally repels the contained viscus tho mirmn • ^r n v ;3 • . come into apposition and wiM, ^\t ""^'"'"^ <^' *^^« abdominal opening' soon unite. ' ' ' ^^^ connective tissue, are inilamSd and conne'cMrotssue.'^' '^""^' ""'' "°* P^^^ ^^^^^^^ ^^^o subcutaneous i^ by u.ortiacal'n TaJ^^n^tdh" oiraToVH^^^ ''" 7"^^ ^'^l^^°^^"« taken place, and includin^seco darv rtnfl ' P^^t where this haa sloughed away. The constrinHnn // ^'«,^*^^«'jtf » when the sac has but before this^i^ 1 1, ' td Tt^"'^ ^? "T^''^^ "^^ ^^^^^' ^e thrown; order to ascerta n ?f it is^i u i L ;'Z '""^^> " ^'^^^ examined, in the abdominal opem',,.^ • "d t ' li, n .^ ^^^l^^^^"'' ^^^^ ^^'^^^^^ ^^ ^.pparatus should be app£ ' '' ^""'^^ ^'^'^^" ^^'^"«^ *1^« constricting anmSlTl^:!:;":,,^,;,^;;^^- -d constriction is the dorsal. The us bad . W often ?hJ 1~ / '' ^v'^ ^""'Y ^'"^^•' '^"^^ P^^^^^^ «" .ontle HuanipuLicira d^p S ^^";.'^™i[! ' ^^ -^' sac is pulled well awav fm, , ft^ K^i ^"^i^^, ^^is, and then the empty Tlie oldo«l ,.,.^ A^ ■ ^ ^^°^^y' ^"^^ ^be operation completed i;;s^^^f ESf ???■" i« s^it ^7t surfaces. A„iece of whiLSi ^ '''^ '^^*^«?3«'^ of the peritoneal venes. Soiiietim,." .?„;?' , ''J' 'h« swcllinj; wh.oli quickly super- (lio ur.iwEl o .";", ; " ,1 = "l>loyo(l, wiiioh is loss i,i diameter than »eh separSldro'Sir ly'roZlYheSr °ir:t ,ni^ luutple; and I,P. IIMAL. screws. To perfect, and 1, as well as one, variouR branches of ough which dxed on the anches, the inds an iron nd into this ;. 22G). To e animal is re is drawn antral lonfjji- ad from the to descend, as possible, ivere, or the (EJ)E.VA OF THE UMltlUVUS. 718 Sutures S.XQ frequently employed, and there are various ways of using them. One method is the "twisted" suture, which is applied as follows : iho hernial sac is included between two round ])iecos of hard wood or aron, which are drawn tightly together by whipcord passed round their extremities before and behind ; double sutures are then passed through the sac, one of which is tied to the piece of wood on one side, and the other to that on the other side-so that the sac is com- pletely invested between the wood and ligatures, which divide it into two portions. Another procedure by suture is to make a thick longi- tudinal fold of the skin covering the hernia, to pass the suture needle- armed with a waxed thread or cord -as near to the muscles as possible, and about three to four inches from the ring, from before to behind, or one side to the other ; the needle is again passed through in the con- trary direction about half an inch from the lirst perforation, and the two portions of suture firmly tied, so as to draw the skin together like the moutli of_ a sac. Sutures are then passed through the sides of tho pedicle and tied, so as to include tr.i. whole of the skin in the multiple loops. A cure by this procedure is usually effected in about fifteen days, llie only objection to the operation appears to be the danger of wound- ing the intestine by the needle. To obviate this, some operators, after reducing the hernia, pull the empty sac well away from the abdomen, and pass it through a partially split piece of lead which is applied close to the Ijelly ; then the needle can be used without risk, as the lead— whicli IS secured m sUu-iovms a shield as well as a truss, and prevents the descent of the intestine until adhesion has taken place. When tlie hernia is irreducible or strangulation has taken place, then it will l)e necessary to carefully open the sac. Should adhesion have taken place between the latter and the intestine, or between the skin and peritoneum, this must be broken up ; if the umbilical ring has to be incised in order to return the viscus, this may be effected by a probe- pointed bistoury. The incision should be no longer than is absolutely requisite. •' The after-treatment of operation for hernia must be conducted on surgical principles, and according to the necessities of the case. Easily digested food, in small quantity and frequently, should be given until the cure is effected. ^ j » aay escape. two strong . opening— by a finger \.bove these his can be . In order withdrawn, r beneath it. CHAPTER V. (Edema of the Umbilicus. Tumi: FACTION, o" rather " codeina " of the umbilical region, is not at all uncommon. Often it is simply due to an eli'usion of serum in the connective tissue of the umbilical cord, and sometimes to an infiltration of blood in this part and the surrounding connective tissue. The accident is cisually produced by contusion and laceration during birth, though at times it may also be caused by the young creatures, when two or more are together, sucking and pulling at the remains of the umbilical cord. It may also be due to chronic inflamm .tion of this part, or thr formation of abscess in the umbilical ring. The accident is readily recognised ; the swelling is often very con- siderable, and always cold to the touch. It often persists a long time in Bovine animals ; and Zundel says that it then constitutes a grave 714 hlSHASKS .1X1, 1' ■ inXonMAlATlHS i>F Till': YdI \^ ./.\ /)/ /,,. , dilating, ■fsibto'-f. defect in youi,^ Hi.llg, which it inochaninillv prcventK I,.. vviKMi (hio to Hclerosis of the coriMoctivo lissuo, it is u^uall 'riidliitcnl. of ^"|*V?''^''h*''"",?"'^ ooinprosHos have heeii roco „ .| i„ the wav pupa.at oMs ol ,o,],no, incrcry, oto. Tiics... ,. ten fail, /^.wev.-r and i/ uS'l!;]" V"f? '' '"^"''^ to'scaridcatioMs or Ir .hoH ar on. o ^^1 an r I u f ''^ M ^'^'^'" ''""•^"•t'^^i-"«- Wl.-M th. sw, Uin^ is 'h onic ;-.:'^.^:nuSi:!r' ^"'^' ^^ ^"'""""^^ ^"^ c..o.^aun.ei«;: CIIArTllR \1. Inflammation of the Umbilical Cord. orsluMr^r.^^ f ^''" "I"^""^'"«:!"' '""^'/'"/'''^ (tl-o so-called " ,nn-d-ill" 1)1 slupiiculs) IS a srnous accident, and oflon t(-nninates fatallv T^ cons.sts .ssent.ally in inMaunnatic.n of thn nn.hilical voi' wi cl L^ or later uivolvrs the adjoining tissues, and is often follow^c^^bysuZ ' .on and pyaMnia which causes the death of the yo-urcr dun ^ 7 iJ rare n.deed that the inllanuuation remains of a simple^! d tlrou..i,o, ts oours. . As a rule, it is not n.erely an on,,lutlo-phlehi Vu T.S the ahdonunal p..rl,on of the mnhilical vdn. There is a th Zh >? winch soon suppurates; a fistula ap,,ears at the undalicu^ the ,Z 1 1 V n ;s in la.nc-d as far as the liver, to which the thrcMnhos extend and the portal and hepatic veins may even he affected As a cont quence, the „,ost serious accidents nJay arise. Mn.h lie in arotiou oI Si/iiiji/o)us. The inllaniination c .iuinenccs soon after hirth. The remains of flu. lunlHhcal cord .n the norn.al condition, quickly e mistakoi. at tlu. lirst pint ot |)U3 escapes m some iiistaiiccs fmm iMMhoIism' \"^''"''"^''"" '\"'' ""t quickly follow from septikam.ia, or r 1 1 n. ' '-'P-H'tan o.^ians, tiu'ou^h detached portions of t u tiuombus hem- earned into them by the circulation we mav have chronic mornd conditions of a {.yamiic character set up w Icl ar vai™;;;;t'o^ ...(lannnatio,. of the serous nl 'n^^nr;!'^ i- X3;-;i^ '''''''■ 'I'l'""^ <-"tinental veterinarians, that the a • ^h I f . "i ■'•r^''.'''^''^" "f ^''^'^'^. ^'^'vos, and Lambs is a ,t bio to .,nip ,alo-phIebit.H. Inflammation of the joints-especi- alU ol the hocks~has olten been accidentally produce.l by the in( am- mat.on excited throii^u li^.iturin^. the umbilicvil cord ^ of tlu I mnlvMi!' r"'''l "''T'"'' '"'^ "^' ^'.'" ^y^'- <^i'^'''"''a, tumefaction ee h'u . o " "'t' '^^««'^«««'^ ^" t'"^ '""scles and other ,,arts, clrd ''''■' '^" ^^ ''^"^'^t '>^ inflammation of tlie umbilical I'atliolofjical A miloiiii/. In animals winch have died or been killed in consequence of this ' '^« enumerated umb U^l ;.A 1 "^ ^" °' '°''""'^ "^^^"^''^ t« the interiorof the umb heal vessels; bruises or nijuryto the umbilicus, either during birth Zi^"'ZT{ ■r^'^'r °^ >H^ P^^-' ^'^''^'- »'y t'- litter, manure or then pio^reny, or of youn,^ creatures to suck the ren cord of each other ; rupture of the cord close mnin^-iof the unibilieal to, or within the abdomen ; "fc. ^. ^J^ ^^- .0. IMAGE EVALUATION TEST TARGET (MT-3) k A O '/-^ .ST A^ 1(5 1.0 I.I 1.25 111 2,5 2.2 ^ 2.0 1.4 6" 1.8 1.6 PiiDtDgraphic Sciences Corporation 23 WEST MAIN STREET WEBSTER, N.Y. 14580 (716) 872-4503 ^ ^^ o ^v ^ %" ^ '*^' . ; ?^ - , o .** m ^ 'i 716 DISEASES AND ABNORMALITIES OF THE YOUNG ANIMAL. improper food given to the mother ; exposure to cold and wet ; and infection. Bollinger admits that in certain establishments, in conse- quence of over-crowding, the omphalitis of young animals may become erysipelatous, and be due to an analogous infection to that which pro- duces the oftentimes fatal inflammation of the umbilical cicatrix in new- born children in maternity hospitals. Eueff asserts that omphalitis is more frequent in some years than others. _ There can scarcely be any doubt that, as Franck remarks, this inflammation is due to contact of the atmosphere with the umbilical wound, and to the ingress of germs which excite zymosis ; or to contact With filth or putrid matters containing these germs. There can scarcely be a doubt, also, that the manner in which the umbilical cord is divided at birth has an influence in the production of this inflammation ; indeed, t\v.t separation or rupture of the cord neces- sarily produces a wound that is readily absorbent under all circumstances, until the remaining portion attached to the umbilicus becomes dry and shrivelled. The exposed umbilical vein and artery in the Foal, the double vein in Euminants, also increase this readiness to receive infection, and consequent tendency to phlebitis ; and these vessels are occasionally laid quite bare when the cord is divided close to the umbilical ring, and their protecting sheath is removed. Franck gives an instance of this accident, which was witnessed in the breeding sheds of the Munich Veterinary School. A Cow brought forth twin calves, one of which— A— had the umbilical cord ruptured in the usual way, while the other— B— had it torn asunder in a markedly abnormal manner. Alongsidt, this Cow stood another which had recently calved, then was attacked with puerperal fever, and eventually succumbed to that disease. The after-birth of this animal was allowed to he behind the Cow which had given birth to the twins ; so that there was no lack of infection-producing material— the floor, straw, imple- ments, as well as the hands of the cowmen, being impregnated with it. The calf— B— which had the umbilical cord abnormally ruptured, became afl"ec<-ed with omphalitis ; while the other— A— with the wound better protected, escaped infection and remained in good health. _ This cause of omphalitis must be frequently and extensively in opera- tion among the Lambs of flocks of Ewes when abortions occur among these, or when putrid matters are discharged from the vulva, or even when gangrenous or septic mammitis is preseno among them. It is often remarked that omphalitis sometimes appears among a greater number of Lambs on a particular pasture ; and it is extremely probable that careful investigation will lead to the discovery that many of these outbreaks are largely, if not entirely, due to septic infection of this kind. Franck has observed such occurrences in extensive cowsheds, when sometimes of ten to fifteen Calves born witnin a few days of each other and kept together, half the number have become afl'ected with this inflammation of the navel, and the remainder has escaped. It must be remembered, too, that the discharge from one diseased uinbihcus may afford sufficient miterial to infect a great many newly- born animals, should circumstances prove favourable. Not only may contamination take place through actual contact with objects soiled or impregnated by such infective material, but the air itself, or flies, may prove media for its conveyance to the umbilical wound. There may also be a special infection, as a consequence of over-crowding in badly-ventilated dwellings— something analogous to 7MAL. d wet ; and s, in conse- nay become which pro- ,trix in new- mphalitis is ;narks, this le umbiUcal r to contact which the 'eduction of cord neces- 3u instances, nes dry and e Foal, the ve infection, :iccasionally al ring, and 3ssed in the ■ought forth ;ured in the a markedly which had I eventually vas allowed 3 that there raw, imple- .ted with it. r ruptured, the wound ilth. ly in opera- ccur among va, or even hem. It is g a greater }ly probable ny of these if this kind, beds, when each other i with this ne diseased lany newly- ontact with but the air e umbilical 5equonoe of lalogous to INFLAMMATION OF THE UMBILICAL CORD. 717 the puerperal infection observed in certain maternity and other hospitals. A malignant and a benignant form of omphalitis have been described by various authorities ; but the diatinction, if it really exists, is of no practical importance, and it is perhaps advisable, in so far as treatment is concerned, to consider the disease always as malignant. It would appear to be fully ascertained that septic infection gives rise to far more serious and destructive inflammation than that due to entrance of the air, or an aerial ferment, into the wound or open vessels of the cord. As has been remarked, this inflammation of the umbiUcal cord is more frequent in Calves and Lambs than in Foals ; and the reason for this is probably due to the fact that in the former there is a ductus Arantii, which is absent in the latter. There may also occur a kind of aspiration of air into the umbilical vein. However this may be, it must not be forgotten, when considering the etiology of omphalitis and its frequency in different species of animals, that putrid or septic diseases are much more common in Cows and Ewes than Mares, and that the latter do not so often receive manual assistance during parturition ; so that they are less liable to parturient fever and other septic disorders which might involve their offspring. When the remains of the umbilical cord are once fairly dried and shrivelled, omphalitis is very seldom, if ever, witnessed. Ulrichi reports that he saw an extensive outbreak of the disease in a flock of Lambs, many of which died from abscess in the liver. He attributed the outbreak to feeding the Ewes on rape-cake. Changing the food to oil-cake, and administering Glauber salts to the Ewes, checked the malady. Franck was inclined to think that infection may have had something to do with the outbreak. Treatment. The 2}roplu/Iaxts of omphalitis, or purulent phlebitis of the umbilical cord, is very important, and must be based on knowledge of the etiology of the malady. This has just been alluded to. Cleanliness is absolutely necessary, and the young creature should be protected from every possible source of septic infection. The danger will be greatly obviated if the extremity of the umbilical cord is dressed immediately after birth with a concentrated solution of carbolic acid, which destroys germs, keeps away flies, and renders putrid matters innocuous, while it quickly shrivels up the cord itself. This preventive treatment is strongly to bo recommended for Lambs, and particularly when there have been abor- tions among the Ewes, retention of dead Lambs or the placental mem- branes, or any other likely cause of putridity on a sheep-run or pasture. The same measure is applicable to the Cali and Foal under similar con- ditions, but in all cases care must be observed not to apply the acid to the parts surrounding the umbilicus. Curative treatment must be principally of an antiseptic kind. At the commencement it should be chiefly local, and the applications most likely to prove beneficial are lotions of carbolic acid, boric acid, salicyhc acid (particularly if fever runs high), salicylate of soda, permanganate of potass, borate of soda, alum or other astringent. If the umbilical vein is readily accessible, one of these lotions may be introduced into it, either by a fine bone probe wrapped round with lint, or by a syringe. 1 Caastatt's Jahresbericht, ISGO, p. 41. 718 DISEASES AXD ABKOUMALITIES OF THE YOUNG AKIMAL, Franck states that a five per cent, solution of carbolic acid may be passed ni this way into the abdominal portion of the vein of small Calves ; this vessel can be penetrated to a distance of nearly ten inches. He does not approve of injecting the solution, because of the danger of injuring the portal vein. If suppuration is superficial, the same lotions may be used, or the part may be cauterised with solid nitrate of silver. When the inflainniation is very intense, several authorities recommend recourse to vesicating agents; others employ ammoniacal liniment, and Kueft advocates tartarised antimony ointment. When there is danger of genenJ infection, or this has already occurred, then the internal administration of antiseptic agents must be resorted to. Franck recommends salicvlate of soda in doses of about one gramme every hour. Carbolic acid, sulphite of soda, quinine, or other agents of this class, may also be given with advantage. Constipation may be averted by castor-oil or a suitable diet— skimmed milk alte- nately with new milk. Preparations of iron may also be administered ; and if the young creature is still at the teat, its dam should be well fed. Franck notes that, during the course of omphalitis, the most serious complication is inflammation of the umbilical artery, the existence of which can generally only be detected on the posi mortem examination of an animal which has died, or been killed because of the disease. This complication is more frequent in the Foal than the Calf, probably because the vessel is torn at the umbilical ring in the first, and in the abdornen in the second. The peripheral portion 's thickened and contains a reddish-coloured thrombus, or it is filled with a puriform breaking-up mass, and often the vessel is surrounded by, or imbedded in, an abscess ; a sharp line of demarcation separates the inflamed from the healthy portion. General infection or pyujmia rapidly follows umbilical arteritis. CHAPTER Vir. Arthritis. Disease of the joints of young animals, occurring soon after birth, has been for a long time recorded in districts or regions where breeding is largely carried on; the animals affected belonging to the Equine, Bovine and Ovine species— much less frequently are Dogs and Pigs attacked' In France it is usually known as the " Arthrite " or " Paralysie des Jeunes Animaux," in Germany as the " Fohlenlilhme," " Kalblilhme " and " Liimmerltihme " ; and in this country— where it has evidently been but littls studied, it has been popularly known as " Joint 111," and technically as " Scrofulous Disease of the Joints," or " Specific " or "Constitutional Synovitis." The disease was first described, we believe, by Brugnone -i then it was noticed by Eoupp,-' Lecoq in 1828, Strauss'"' in 1831, B6uard^ in 1 Trattato dc/le Bnzzi' (W Cavalli. Tni'in, 1781. iJ Recueil ''--'a<>y wlitoh has ^^^^^i feata-e, as it is ,,Sed in'^^Sbs inTSnd""'" '° "^ J"™"*^' .ste rrirs cLis^T ir=fe rwt: :s-s' consnier u as essentially py.„,ic, and a sequel of punUen't^oaaio: Kl.^?"'!'" "t"!?'"'"" ">»' 'lie affection is due to an alteration in tl,» blood-to a diminution in the amount of mineral salt. ,, th„V fl, °j veritable cachexia, in tact, allied to rachitmol osteomalacia In twt connect ve tissue, and periosteum hnpeZ'lyZZlU tt^t^^^^^ unequally consistent bones, when the animal moves * ^""^ Walley defines it as an inflammatorv affection of tho svn^--;oi Causes. disre^^r^-rafm-SlletiSe'-ulir^^^^^^^^^ view IS not borne out by other observers. Eoloff wiSaed its adven? WalLttardThaVth'' '^ ''°"^'* ?* ^"^^ ^^ sometin'f congSl w alley stated that the causes are entirely local, and can be tracpd tntr, impure or anaemic condition of the milk of tha dnm «« Vvf u^ improper systems of management or jL^ food 'deficientTtl?! necessary constituents of thi blood Hence° he asseited^J ilJ when Ewes have been fed on an abundance of turnips S^^^^ cient allowance of hay or corn, particularly if the turnips are decav^n^" or have been unduly forced with artificial manures. decaying, \FohlenkrankheiieM. Berlin, 1839. " Recneil de Medevim Viterhmire, 1842 " KalherWime. Zurich, 1848. ■• Fohknliihme. Berlin, ISOo. « iZt^V'^y"-, '^r .f «^'««/'V''W''. Virchow's Archiv, Band, 58, 18r.3 ;; D^ntwy ZeiLschriJt/iir Thiermedidn, 1875. ' ' Joint III in Lambs," Veterinary Journal, 1876, p. 406 720 DISEASES AND ABNORMALITIES OF THE YOUNH ANIMAL. It has also been remarked that it often occurs on heath lands which are much exposed, and have been top-dressed with marl ; but the appearance of the malady only when the young creatures are a,t the teat, rather negatives the idea that exposure has anything to do with it. It has likewise been noted that when Ewes arc fed on decaying turnips or mangold-wurtzel, the Lambs are frequently the subjects of effusions of lymph between the muscles— the effusion being arrested when corn is given to the Ewes. Walley insisted upon an altered condition of the milk as the cause of the disease. " That it is due to, and must be associated with, an altered condition of the mother's milk, is proved by the fact that it only attacks young animals while sucking the dam ; that the Ewes coincidentally die from malignant parturient fever (though it must be borne in mind that it is not necessary that the Ewe should exhibit any external symptoms of a diseased condition of the blood) ; and that it is frequently found to disappear on farms which have been heavily limed and drained, and also when a different system of management has been adopted. Again, the general post mortem appearances bear a strong resemblance to those of distemper in the dog, especially of the hepatic form of the disease ; and the enlarged and softened state of the liver, where external symptoms have not been manifested, points to disease of a typhoid character, brought on by the imbibition of impure milk.' He enumerates the exciting causes, as " exposure, cold damp pasture (hence the more frequent locahzation of the disease in the joints), neglect at birth, allowing the young animals to become covered with mud and dirt, thus preventing the dam licking them, excess of wet weather, etc." Eoloff, as just mentioned, thought the development of the disease was due to the insufficient ingestion of calcareous salts ; and as the malady is originate d during intra-uterine life or the sucking period, it is evident, he added, that it is in the regime to which the dam is submitted during gestation, when the osseous system of the fffitus is being developed, and when suckling, that the oause of the disorder must be especially sought for. Careful analyses have shown thr t the ash of the herbage or hay in the locaUties where the malady makes the largest number of victims, does not contain more than six to eight per cent, of limv- salt ■ while that of good quality should have from eleven to thirteen per ce- It is also remarked that this form of arthritis sometimes prevails in those places where osteoclasty of cattle is frequent : and this coincidence, it is affirmed, should indicate a common oriqin of the two affections— a defective supply of calcareous salts, and particularly of the phosphates. This deficiency is sometimes noticed when the food is relatively of a rich character ; though then the amyloid and proteic constituents are in excessive proportion. BoUinger, whose scientific and most valuable researches in compara- tive pathology entitle his opinions to the greatest consideration, enter- tained different views as to the origin of the malady ; and his anatonio- pathological investigations in this direction are of the highest interest and importance. His observations on the disorder commenced in 1869, at the Government Stud at Graditz, Silesia, where it prevailed enzoiiti- cally and caused considerable loss. In that year forty-seven Foals were attacked, and in 1870 twelve. Nineteen cases were not very serious ; but of the other forty, twenty-nine succumbed— a mortality of 72 per cent, of those affected. The Foals were generally seized with it (75 * IMAL. ands which I ; but the are at the > do with it. 'ing turnips of effusions . when corn ihe cause of ,, an altered )nly attacks incidentally :ne in mind ny external s frequently ,nd drained, m adopted, •esemblance form of the ere external ' a typhoid milk.' He ip pastures the joints), Dvered with ;cess of wet disease was the malady t is evident, itted during /eloped, and ially sought bage or hay r of victims, salt ' while 065- It is dls in those ncidence, it ,ffections — a phosphates, iatively of a itituents are in compara- ition, enter- is anatomo- lest interest ced in 1869, iled enzooti- 1 Foals were ery serious ; ;y of 72 per with it (75 AUTHRITIS. 721 ten in fifteen dlysind the' o her ^irthV\^ ^''}^ '^'- ^'^' ^^^^^ ^^y«' period cf the maladv w«« ^( f ^°i'''*^ °^ ^''^^^ ^eek. The April, May and June Af^.. '°"'ff ' '^^^^^^ ^° *^« ^^^^^^^ ^eason- omphalitis in infants li^ITi^ 0^^107 hisToinT",-^^ " consequence o^ plications, is duetomPtncf«Ho ^^^^^^^ '^'^ 3<^\n' disease, with its com- in the pu^uLS omXln nM K?r^'^' ^-^'f ^^^ ^*« P°i"t of departure this wo?k °^"PhaIo-phlebitis described in the preceding section of a.fterairdbftrL^Sm:t""^^ returns to this subject; and support of Ts supposr^^^^^^ ^'/>ves further evidence in the umbilicarveins nfn<^JT, ^'^T. *° ^^°^^"* inflammation of vemsus ArluZd. F^als have no ^^,^'^'''7^^^'-^ ^"^^ ^ ^^"^^"^ into the posterior vena cava 1 ri~Av^ '' T"'"- °^ *^^ ^^«««1« latter, causes a pronortionTphMo ^' *¥ ^^T^^ implication of the Foals! ThrinflSces Tt work T^^Tu^'^'^b^ °/. ""^^'f ^« ^^'^ ^^an in been enumerated but B^l^n'i? ^ Production of omphalitis have which k nc o 1 u ? "Ser lays great stress on the want of care antaa.3, and to le-colI^utt'aSoVo^ S ^iSs"°°'-^°"°"»« »' P'™ary lesioia in these organs, and%vhen attacking the'?!"" I'ganrentous structures of SS r ""^"C'd; while fn'.'JVinT'^V*'' '°'"'^ f"™"''"' .inimal becomes emaciated diai-rh,„„ . f '■ ""J '''^ " Probn-ed the variety ot changes are dSted i„ .^ "^ '°' ""= """I Wis off and . rcl'X'%''rPP-™- i' "a tiTarts of T*^,!"'""' '"«™"- especial y at the external orifice of tl,^ ■ ""^ *» of 'lie bodv enncroscope.of altered bTooleeir^S T '";^^ ?° '^^ -"rb; of the other parts of the clofc anrT ila "^^'^^eposit lacks the firmness fermented damson pulp. Bacteria l^T^ ^ '/°'" resemblance to half! after death, and long before anvnn If '1'^°^^'^ '^ *^« blood shortlv Absorption of pus into thblooTlpC,^^^^^ can be detected^ he te„,p t^re, fcBtor of the brep^d^'V"'^^''^^^'^ by elevation o colour of the mucous membrane^rnncl' ^^'^^boea, dark yellowish-red -in the latter, t '-> swpllmrro k "iteration of the joints I 5iaSis'-:?a„S™Llpft- ^'^"-^ t 'h^SmTn^Erd^ sweIlir,D.o p..| "_ ""^t^" otner portions remflininfr -oli ^ tv.^^ "quened, ° -t-J along the thee, or sheath-s ofTh-etndonslt: iSf '»' ir 724 I>ISEASES AND AliNORMALITIES nF TH/C YOVNG AMMAL. Often becoming in this way connected -jth each oU^^^ over tho most prormnent Porti«"^^°f *!L", ^°'L accidental violence, ulcerates, and if not divided by the lancet or i)y gemi-solid bursts-allowing the escape of the ^^^^^ "\^^,^"^^^ abscess proper, matters, and being followed by sinuous ^^««^^^' .'3; aigtance fr'om tho of the joint. The sinuses may ^^^end a considerable ais ^^^^^ joint, and discharge an ichorous unheal hyiluid .''o.Ses the Luded if bony or ligamentous ^^^^^^^f ^^^^^^^V ^',1,^,1 without any external lymph simply becomes liquefied and ^^soibe . w .^ |^^^.^ ^^^ opening being formed; m oth/«-«-^-V,riAw or 'anisatio^ the constitution sttong-it undergoes he'^Jf y ^^^^^^ th ckening, dis- as a part of the joint, producing, however, permaneni in b. tortion, and stiffness. Trognosis. From what has been stated, it will ^f ^^.^f etecS^^^^^ regard to this disease must always be unfavoi^rabe, especia y cilature is very young. The -ortah ty r^^^^^^^^ - ^, J^^^^J;^ sixty, and even more per cent. I^^-P^' ^''"L that the breeders in out of everv twenty Foals die; and Lecoq sa>s ^""^'- , „ Normandy have an axiom, " Poulain boiteux, poulam peidu. Pathological Anatomy. _ According to Roloff, the P-aominant lesions a- th^^^^^^^^^^^ alterations of rachitism and P«f °/*^^/,^; ^^^^euX pr^^^^ epiphyses to the shaft of the bones is soft from ^f^^^^'^^ V^g^g^^, j^ also iSectid in places by h^emorrhagic spo ^>^^^ thickened, injected, and here and ^^f,^^ ^^^^^f ^^,"3 jg .neatly inVolved. towards the diarthrodial surfaces ^^^ ^ ^f but hfy are of a much There are, in fact, all ^^^^.^^f V^j^^^^^f ^^^^^^^^^^^ The more serious character than ^^"^^ .^^^'^h^re is great infiltration of synovial membrane is highly inflamed, and there is great short space of two to five days. appearances are Walley remarked that, m i^a,"^."^^' ^^%^2ier sta<^es, are effusion of general and local The ?«f 5^^' ^Ji,*XS^^ iymph be ,ween the intercostal ^t^' ^,^",^^^^^^ of the S SlfoivVs^ ofTfrnuru^s S= of the° stomach (fourth tions are found under and y.^^^^^^J^^f J^^t^^^^'onnective tissue and the parts, or effusion serum (dropsy) into the conn c^^^^^^ ^^ ^^^ various cavities of the body ^.^/i. damson- co^^^^ blood; the brain— are filled with dark, 8^/"""" ' . ^^ enlarged, friable, and structure of the brain is dark ^^^^^^^^J^^^ f^ 'pearLce that i^ fre- full of n^i-.^J\^bsS'J!i,:,Ssfs al the organs and tissues are tinged quently mistaken for tuberculosis au b ^ ^ the omentum with the colo^.r/,«g ,^^^,^^^^7.^ the bUe t^J^^^ ^ ^^^ ^^^^^^ division of Z tS:Ltoo^:^tk^^^^^^^^ -ilk has lain in con- MAL. y, the skin absorbed, a,l violence, semi-solid less iiroper, ce from the ;d by fcutor the exuded ny external plastic and ,nd remains kening, dis- ignosis with ly when the forty, fifty, lat eighteen breeders in baracteristic uniting the [eration, and um is also acnes; while tly involved. re of a much limals. The nfiltration of ARTliniTlH. 72ft joints, deep- m, which are form in the )earances are 6 effusion of i and into the jment of the mach (fourth latous exuda- of dependent ssue and the n those of the I blood; the 1, friable, and ce that is fre- ues are tinged the omentum ■th division of 13 lain in con- tact with It. In many cases the urachus is black— a bluish-black hue extending some distance along the mucous membrane of the bladder The umbilical vein is also black, and tilled with a clioesy material— de- generated lymph, or coagulum of blood. The local appearances— i.e., in the joints— are, in the first stages, inflam- mation of the synovial membrane, which in a short time extends to the ends of the bones and to the ligamentous structures— the whole having an intensely scarlet hue, which diminishes in a few days. Coagulable lymph becomes effused into the cavities of the joints, forming perfect casts of their interior, and filling up the interspaces between the bones. In time, the exuded lymph commences to soften and break down, and owing to the contraction of the mass the fluid portion is pressed out and intermixes with the degenerated lymph. Fluid is also thrown out from the irritated vessels of the joint, and aids in the softening of the lymph. After a time suppuration is thoroughly established, and pus cells are distinguished by the aid of the microscope. The sheaths of the tendons running over the fronts of the joints becomes excessively inflamed, and the bloodvessels of the ligamentous structures are filled with scarlet blood. The cartilage covering the articular ends of the bones becomes ulcerated and blackened, as is also the cancellated structure of the bones themselves ; extravasations of blood, from perforation of the coats of the vessels, take place, the coagula either undergoing degenera- tion or healthy organization. In the latter case, distinct granulations are formed, which, on recovery of the animal, fill up the cavities pro- duced by the lymph. The flakes of lymph which are found floating in the fluid contents of the joints or adherent to their sides, are often mistaken for scrofulous deposits. If animals have lived suffi- ciently long, multiple pysemic abscesses are found in the various organs and structures of the body. Blood from deceased Lambs introduced into the veins of a Dog, has given rise to the formation of multiple hepatic abscesses. From this description of the pathological anatomy of the malady, there can scarcely be any doubt as to its pya3mic or septic origin, and this IS further demonstrated by the description of its morbid anatomv by Bollinger. 1 ^ ^DtiU.^che Zntschrift fiir Thiennedirin, 1875.— A male Calf born at the Agricultural hcnool of btnckhof, near Zurich, showed symptoms, soon after birth, of inflainination of tlie umbilicus. As the joints began to swell, and there was no hope of saving the animal from the effects of the dreadful joint disease—" gelenkseuche "—it was destroved eight days afterwards. The body was dissected an hour after death, but the examination was imperfectly made. The umbilical ring was discovered to be still open ; it formed a cir- cular aperture about two centimetres in diameter, the sides of which were covered with ulcers and a greenish-yellow pus. The umbilical veins and the joints had been thrown away, and therefore the investigation could not be continued. Projecting about the upper margin of both lungs were several cuneiform tumours of a dark-red colour, and of a solid consistency. In the pericardium was a quantity of pale serum, in which floated loose stringy hbres. In the cavity of the heart were a few detached fibres and blood- clots, lieneath the endocardium were various-sized patches of ecchymoses and blood Woodl""? Nothing abnormal was observed in the liver and kidneys except Another Calf was born at the same establishment on February 6th. Its birth had been laborious, and the umbilical cord was divided in the ordinary natural manner. The animal did not appear to be as lively as it ought. About eight days after birth a swell- ing showed Itself in the neighbourhood of the navel ; this, however, disappeared after the application of poultices. Fourteen days after birth the Calf could not stand, and painful swellings appeared on the inner aspect of the knee joints. Until this time the creature had a good appetite, and had taken a plentiful supply of milk regularly every •lay. On February 27th, the appetite entirely failed, and on the 28th the Calf wwi |R#P" i ' J DISBASKS AND AILVORMAUTfhJS "F TIIK YOUNG .tXlMJL The result of hia autopsies, together with the symptoms obseryod dudnR We led Hollin«er to the conclusion that ^he dovclopment of t^ie pa Kical process is as follows: inllammation of the ^"Jjb^^^oal vc^s e^^^^ Sotablytho vein, with its decomposed and ^f^'l^^'lllllZTorZTcl passes into the vena porta,, and forms thepomt of departure or^sm^^^^^^^^^ of a metastatic pyicmia. and from it embolism of the lun^s '^^^"^^^^^^ directly oricinated ; or at other times, m consequence of ^Horatio »n the blood, which is'septie, aml_of_the Rene_ral_chamcter of the_mtlani^ were Hei.t to Bollinger, and their examination y'7*'.^ *^*1.7' '^,,,f ,,,,„ . fihro-pitnUenl generalised iclerm. The partn BU^rounding *»'V' "" "'"^XTed In h/cavity of the Infiltrated with a nero-purulont duid, and '""fV^*"^^^*'''':^"^ the synovial me'mbrane joint, there wa« a tolerable .,uant ity of dark-tmted ««'^'^;^;'^.^ ' ^X„t matt about two mote especially waa a mass of yellowmh-Kreen an.l hrm fibro F*"''^"^"'" Jf ^^^ j^i^tB centimetres thick, which projected into the «y"7'» Xf,;,,^7«'^^^^^^^ The entire were covered with nimilar matter, and in Bome P'f <='-'« ^'^^y;''^'^;^" trachea ant' bronchial capHule of the joint was inflamed. Boftened and purn en ^ ^^^^^^^^^^^^^ tubeH contained a .luantity of mucopurulent fluid, .^^''^l'' '"X had ecchymoBed one mass. ThemucouB membrane was pale ; the f »""«' ^.^""^"d nm^^^ the sLe of a BpotB beneath the pUura, and m ««« P''^^.^'; « ^ m!s in'theCtre The heart and pea, which on being cut open were found to ^'^^rP^TvaWe, which was of a dark- pericardium were normal, with the f ««Pt'»\''^ *1}%\"''" ' "^^^ ,^ JeH • by means of the U colour, thickened, and exhibited h^en'o^h^gic , f Itj^^ tissue close microscope, a notable cellular opening could be perceived » *J^^ ^ 7,1^',,^,,,, the li.er to the haemorrhage. The spleen was of normal size ^"* J'*,;^^^,"';, J^^t^ hffinK.r- was enlarged, full of blood icteric in tint , in parts we B«mV^ Bubi^m ^ _ .^^ rhagic deposits. The umbilical vein was distendea tn'^''"B"" " , dirtv-crey colour, w^lls were considerably thickened, and the inner ".7^;^" ,^^«J4 * This alteration in rough, uneven, and studded with greyish-white P""^"^,'^/'',^^^^ the^mbilical vein extended «« far as its junction wih the p. ^^^^^^^^^ ^^^_ owing to the closure of the ductuH venosm, is not in ** "f „''°'"!", " t ^ beyond umbUical vein. Where the latter enters the P"'^*'.! vem ^^^ ^cavity of the latter which was a large thrombotic puritorm "V^^^ *':,** ?^^'*j£^^ vessel as far as its bifurcation. As fatty Regeneration o the liear^wa y ^^^^^ its appearance, the tissue of that organ was «''™'=d "'l^^^^X^J^s d ' jo nt and which to be normal. The voluntary muscles m the ^'^'"'^y °^X,J'^^^^^^^^^ The puri- appeared very pale to the naked eye, were only clouded w^hi^am^^^^^^^^^^^ ^ .V^^^ form contents of the umbilical vein consisted . f ^*"y t'^^""l*r '^^^y; ,;,ber. The liver difficult to detect piis corpusc es ; ^acterm couW not be o^^^^^^ ^^^^^ „. offered indications of a violent icterus, and e'chibited all ^"« *'^. ^j n,, chymatous hepatitis, with marked granular degene^^^^^^^^^ ^^,;,i,., In the three autopsies of Foals '"''^e by Bollinger at j rami ^ pulmonary 1873), he found double broncho-pneumoma of the interior lobes ot tne '^'^K ' P^ ^^^ abscles, purulent arthritis, intra-muscular «;b««f-^«; .^^"^^Ve „lt^^^^^^ °^ ^^' degeneration of the muscles of «n™'^lVf«> fT.^''=itrMi«suriiver^ and kidneys. In afflcted joints ; as well as fatty degeneration of the hea t W hver ^"^ ^ (^^.^ .,f the intestinal canal were lesions of catarrhal f^tj"*^','^^°°'^P,*";tthefr autopsy, were the mesenteric glands. Neither in the animals when aln^ nor at 1^^^^^^^^ there any of the signs of rachitism mentioned by Eoloff. ihe umuiucaic tunately not examined. <.„„:„„,.„ r-othnlntrist examined the bodies of On another occasion, the same exceUent veterinary pathologist examim^^^^^ two Foals-one three weeks, the other fi-7«flt^;3*„'}'^tt IbiS^^^ malady. In these there was if animation and thrombosis of th.umt,u^^^ _^,^ ^^^ tinuation of the thrombosis of the ""jb'l'cal vem (in p^^^^^^^^^ portal vein, which was also afifected with thr"'nb"^««. as weU as 1 s p ^^^^^^ In one of these cases there was I'^ewise thrombosis of the PV^^^^^S intra muscular L'landa. iins observed ipinont of the )ilioal vessels, )inbu8, which lire or source , is soraotimos alteration in ,{ the intlam- Important organs niltM : There was I ; /ihro-puruUnt 'cic/iHobronchitis, Unit mloes, and ile-yellow colour, the cavity of the novial membrane natter, about two IftgeH of the jointB )ugh. The entire fieii anc' bronchial formed itself into a had ecehymoHed asscH the size of a J. The heart and eh was of a dark- ; by means of the lective tissue close oodless ; the liver peritoneal hsDmor- eiitire length ; its dirty-grey colour, This alteration in vena cava, which, inication with the ent cloaca, beyond Livity of the latter van suspected from f, but it was found jointsv and which matter, Tlie puri- UH, in which it was lumber. The liver DPS of acute paren- ,ic cells. Virclmv'a Archiv., e lungs, pulmonary u bones, and fatty ghbourhood of the f, and kidneys. _ In id by hyperplasia of their autopsy, were lical cord was unfor- mined the bodies of succumbed to this ibilical vessels, con- ippuration) into the epatic ramifications, nary artery, double vast intra- muscular case there were pul- tis, and, finally, in chial and mesenteric AnriiniTis. 797 mations, there are metastatic ir'l (.nimationa of the serous and synovial tnenibranos (pleurisy, pericarditis, arthritis), of the lungs, iris and choroid coat of the eye, abscesses in the muscles and connective tissue — in a word, the entire scries of clinical and anatomical alterations which constitute the complicated arthritis of Foals. More recent investigators have detected special micrococci in the fluidi and tissues, to wliich the origin of the disease must be attributed. The most important of these is the Streptococcus mjixjencH, to which the more diffuse suppurations may be due ; and tho Staphylococcus vyogcnca (ilbns and Staphijlococcus aureus, which probably produce the more localised lesions due to inflannnation. These find easy access to the body through tho umbilicus when circumstances are favourable. Treatment, Curative treatment of this form of joint disease being, under tho most favourable circumstances, very unsatisfactory unless it is adopted at the very commencement, tho greatest importance must be attached to jirccciitive measures, and especially if the malady is enzootic. On the Continent, those veterinarians who adopt Roloff's view lay great stress on the necessity for preserving the young animals, and particularly the female parents, from the effects of improper feeding. The latter are to 1)6 well fed during pregnancy, and aliment rich in earthy salts is to be given. In addition, bone-dust is to be mixed with their prepared food, or with bran, meal, or oil-cake. When it is continually prevalent in districts, it is recommended to improve the pasture lands, and to restore to them, by means of top- dressings, the mineral elements abstracted by the growth of forage or the herbage consumed by tho animals grazing upon them. Attention is drawn to the fact, that in a hundred days a medium-sized Cow will remove from the soil about a kilogramme of phosphoric acid, which is present in the milk yielded during that period. But as there is every reason to believe that the malady is of septic origin, the preventive measures recommended for omphalitis must be adopted. Curative treatment, as has just been said, is generally unsatisfactory, and this not only from the comparatively small value of the animals affected, and the difiiculty in applying remedies to them, but also from the very serious nature of the disease, and tho character of the tissues involved. Even when the life of the creature affected with arthritis is preserved, only too frequently its health and condition are irretrievably impaired. The umbilicus should be treated as in omphalitis, a solution of corrosive sublimate (1 to 1,000) being a good dressing, and some of the same solution may also be injected into the umbilical vein ; this may be repeated twice or thrice daily for the first few days, the animal being placed on its back during the application. If the urachus is in- volved and open, a solution of boracic acid (2 drachms to 16 ounces of water) should be injected into it ; it should not be hgatured. Hot water fomentations ought to be appHed to the abdomen, and the animal should be kept in a clean cool place, great attention being paid to the diet. Zundel remarks that counter-irritants to the joints augment the pain and increase the debility, and emollients have only a doubtful effect. In the hands of Strauss, refrigerants were productive of good results, Jj ..>^. i: 728 DISEASES AND ABNORMALITIES OF THE YOo'NG ANIMAL. the inflamed joints being enveloped ^^^^'^^'t'^ J"^^2ntFi^ Anodyne lotions and embrocations have also been ^ecommenaea, m order to allay the pain and irritative fever ; as well - the appl.a^^^^^ of tincture of iodine before the suppuration period ^ 7;^ PPP^'^^"°" is established, the abscess should be opened at the proper t^me Tonics have been given with ad^antage, as well as cod-liver oil castor-oil. and even ordinary cils and fats. These ^^^ only aid xn the assimilati^on of earthy salts and nitrogenous matters but to some extent act as a laxative-a service of «°'7 ^J^P^^tX' be S^^^^^ of sulphate of magnesia or soda, or even aloes, may ^1^" /^^^^^f" ^"^ '^ ?he la^st-named object, or to produce continuous purgation for soma *' With regard to the treatment of the disease in L^^^bs, Walley ad^ses tha^t those affected be removed from the/am and rcewe milk from healthy animals. This milk may be m^^ed with bea^^n^up e gs and good nitrogenised gruels may also be allowed ^^^ce in ary vrarm" houses, and give gentle aperients- as «a«tor-oil-o bet^^ small dose of mercury with chalk ; follovv up by febrifuges ana diuretics, as nitrate of potash and camphor, with ^^^^^^^^^^f^^^^' °' .^^^^ bonate of ammonia; i much pain is evmced, give small doses o^^^^^ -Dover's powder being the best agent of this class > or in ect a s al quantity of the solution of morphia underneath the skin of the ]oims. In the course of a few days, tonic treatment should be adopted ^f^^*^^^^ of iodine ointmeS?-all round the joint, at the ^^-^XS to keep disease; and when the subsequent inflammation has subs d^^^^^^^^ the loints at rest and in their proper petition by the use ot 'g^t BP"'^^^ and bandaees leaving the joint exposed for further obseivation. as ana oanaages, "^aviuo t j i- . „ . guppuration is perceived, fnd hf n terta wa°Sed ont wi£ a solution of '^'"o'^^Z^^il':^'':: and warm water-one part ot the first, two ot the second a"* fo^ty " fifty™ he last. Afterwards, pads of soft lint or l™""fj^7i;^Xf a^ in carbolised oil (one to eight or ten) should be W M. teavmg an .perture interiorly for *» e-ap. o fd.scharge fto dre^^^^^^^^ to be renewed every day. Mild caustics or astringent lotions are to be irirerifranurations ^rofect "above'the skin. If the ends of the bones SS^^r^!ir?bf;:it^;=;rcH^^ rssVs'oSytundr^ rt^^-e'i^^^Slyiln'l^irtrbSa^^^^^^ wound is soon concerted into a comparatively simple one ^nimals. Too ma^fwith a?Utle trouble, be fattened and their flesh utihsed ; few can be preserved for breeding ^^^^^^^^^ properties, and par- As sancylic acid la uiiruaiioa f- 1— -"-ir-v-- t^ t- 4i.„ ;v,i-prnal ticularlv in inflammation of the fibro-serous membranes, .^ts internal adiSration should be tried in this arthritis of yonng animals The . The flesh of animals .vhich have been sutfenng from thin disease should be interdicted as food, as it is oositively dangerous to those who consume it. t. -^ w- ANIMAL. len bandages. )mmended, in he application en auppuraiion ir time. ,3 cod-liver-oiU )nly aid in the , but to some ). Small doses :> be given with ation for soma Lambs, Walley id receive milk beatan-up eggs, " Place in dry, il — or better, a febrifuges and c ether, or car- doses of opiates ' inject a small a of the joints, adopted, as the um ; or mineral ow a little wine, mends, as local mpound tincture sncement of the ubsided, to keep ;e of light splints Dbsei'vation. As ;ion is perceived, ■oducts removed, ; acid in glycerine )nd, and forty or nd tow, saturated plied, leaving an essings are to be otions are to be ends of the bones itic acid applied ; id by the use of jating them after- of this disease, it jarative processes a very formidable le one. Animals, lesh utilised ; few operties, and par- •anes, its internal mg animals. The i should be interdicted INDIGESTIOX. 720 soda salt (salicylate of soda) is the best form, perhaps. The internal administration of other antiseptic remedies— as preparations of carbolic acid and boracic acid, sulphite of soda, quinine, etc , might also be tried. CHAPTEE VXII. Indigestion. Indigestion sometimes attacks young animals soon after birth, and is perhaps most frequently observed in Calves, seldomer in Lambs ; in Foals and the young of Carnivora it is rarely met with. Causes. The principal cause v/ould appear to be too rich milk, or even milk diffi- cult of digestion from its poorness, or from its containing some extraneous ingredient to which the young creature is not accustomed. The quan- tity of milk may also prove as potent a cause as its quality. Therefore it often happens, that too copious sucking after abstinence will give ris(> to an attack ; and among Calves reared by hand, those which receive artificial food of improper quality or in undue quantity, are frequently the subjects of indigestion. An alteration in the milk of the Cow, pro- duced by fatigue, Oi: bad food or water, will also lead to the same acci- dent ; while altered secretions in the stomach of the Calf itself — as too much acidity — will undoubtedly cause coagulation of the milk, and, as a consequence, indigestion. Indigestion is often witnessed in high-bred Calves which are un- naturally forced, in order to produce greater and premature develop- ment. Siimptoms. The young animal looks dull and dejected, and evinces uneasiness or suffering ; the movements are torpid ; the coat is dry and staring ; it yawns now and again, and there f.re sharp gaseous eructations which cause it to elevate its head. Soon it refuses to suck or to partake of food, and the nausea is more marked ; there may be vomiting of coagu- lated milk ; the breath has an acid odour, and the tongue is coated with a white or greyish fur ; the abdomen is swollen and tympanitic, and pressure made towards the upper part of the right side, as well as along the cartilages of the ribs, causes pain ; flatus is expelled when diarrhoea — the fG3ces being yellow and foitid— sets in, which is frequent — thodgh constipation is not rare ; and at this period symptoms of colic are often noted, and the respiration is at times hurried. The diarrhoea is a means of cure ; though should it persist too long, inflammation of the stomach and intestines may ensue. Then there is emaciation, the abdomen is retracted and flanks tucked up ; fever is present ; signs of great pain are manifested ; the dejections are small in quantity, t.,nd consist of a yellow glairy mucus, mixed with lymph or false membranes. Indigestion runs its course rapidly in the Calf — in the majority of cases only occupying two, three, or four days. It may be considered a serious coudiLiun, as death often occurs. As it is frequently induced by causes which are in operation for some time, even when recovery takes place relapses are to be apprehended ; at last the stomach and intes- tines become inflamed, and enteritis brings about a fatal termination. 730 niSEASi:s' JX/> AnXOIiMALITIKti OF THE YOVyC ANIMAL. Under the most favourable circumstances it causes loss of condition, and often rotaids growth. Trcaimcnt. Prcc^ntive treatment is to be based on the predisposing or exciting <,ausos just enumerated. Over-repletion with milk should bo guarded against and if the animal is being reared '^ytificially, great care ms^ be paid to the diet. If at the teat, tlie food and water of the mother should be attended to ; and if the milk is too rich, this »"^yt'« denied ed by giving less stimulating food. With Mares which are worked during the suckling period, tlie niilk is often retained for a long time in the dder, and becomes altered ; on returning to tlie Foal this is ravenously h ngry and over-gorges itself with the unhealthy lluid. The preventive measuies are obvious in such a case. , ., . . . .1 ^ .^;ii. Indigestion may be due to an insufliciency of oily matters in the milk of the mother ; here the diet of the latter must be altered. The curat ice measures in mild cases are simple, hoino Irench and Italian veterinarians recommend the administration ot barley-watei 01 very weak beef-tea, and if there is not speedy amemlment they prescribe a spoonful of rennet, wliich, they assert, readi y effects a euro- When the indigestion is due to acidity, alkaline agents-as caibonate of potass or soda, lime-water, calcined magnesia, ^^tc- - and aftei wards castor-oil-are gonerally effective. A mild purgative-su< ^ J^« «^«tor- oil, manna, cream of tartar, olive-oil. or a dose of glycerine i" albumin- ised water-is very useful, even when diarrhoea has set in. Ma^na has proved an excellent remedy for Lambs, and even Calves, When con- stipation is present, enemata of soap and water may prove serviceablo^ Vegetable bitters-as tincture of gcntian-and mild stimulants, are often beneiicial; much success has attended the administration ot a spoonful of very finely-powdered vegetable charcoal, given twice a day mixed with water in which an egg has been beaten up. When there is pain and uneasiness, chlorodyne will be found an excellent medicine, particularly if diarrhea has persisted for some time. Of course, a change of regimen is generally necessary In chronic indi- gestion of Calves, Philippi omits all medical treatment which he asserts is usually found to be ineilicacious in these cases, and puts tliem to be suckled by Cows which have newly calved, dieting them carefully at the same time. CHAPTER IX. Gastro-intestinal Catarrh. \cconDiNG to Fricdberger and Frohner,^ by its etiology and course, as weU as in the treatment to be adopted, the gastro-mtestinal catarrh o young animals differs essentially from the same affection in adults^ t Ls been confounded with the dysentery of y^^'Jg.^'^i^^.tdXr mo e first edition of this work, this error was committed ; indeed, for more than a contnvv tho. two diseases have been, and are even now, described us'one. BaVa "distinction must be made, and they are separately dealt with here. > Lfhrhu-h der Specidkn Pathologk und Thempte der llamthkn, vol. i„ p. 199. Stuttgart, 1887. (} ANIMAL. OSS of condition, osing or exciting liould bo guarded great caro must icr of the iiiothor may bo remedied re worked during time in the udder, ivenouBly hungry, 3ventive measures atters in tlie milk ared. ^omo Frencli and )f barley-water or ent they pre8cril)0 ;8 a cure. ints — as carbonate . — and afterwards ) — 8U( h as castor- cerine in albumin- 3t in. Manna has lives. When con- prove serviceable, id stimulants, are dministration of a given twice a day P- will be found an sted for some time. \(. In chronic indi- t, which he asserts id puts them to be em carefully at the f.'AST/iO-nyTKSTIX.IL OA TAIIIUI. 731 )logy and course, as ntestinal catarrh of sction in adults. It animals, and in the I ; indeed, for more even now, described are separately dealt Uiuathiere, vol. i,, p. 199. Sipupto^ns. The early symptoms vary somewhat, according to the exciting causes. Sometimes tliey are suddenly manifested, and at other times they are so gradually developed that they do not attract attention for a day or longer. Witli suekhig animals the principal symptom, diarrhea, is usually preceded by slight anorexia, dulness, and weakness ; but with animals which avo weaned, and especially if the attack is due to drinking very cold water or an external chill, the first signs are fever and general disturl)anco— the temperature of the body being irregularly distributed, limbs cold and nmille dry, and much nervous depression — sensory and motor. Diarrhcna soon sets in, the dejections quickly becoming watery, and frequently energetically expelled ; they are not long before they are fcntid and mucous, yellow or greenish-gray in tint, spumous and foul-smelling, and containing fibrinous flakes or clots ; at a later period they are blood-streaked or sanguinolent, and ejected at very short intervals, soiling the hind legs and tail, and by their acridity causing the hair around the anus, perinaoum, and thighs, to be shed. Usually there is tenesmus and signs of cohc, the animal standing with its back arched and its feet drawn together. The skin is dry and there is horripilation ; the debility becomes extreme, and the exhalations most offensive. Tympanitis is often presojit, the gases accumulating in the rumen and intestines of the Calf producing great distension— though this may be present before, during, and after the diarrhcea stage, being duo to abnormal fermentation. In some cases death occurs within a few days or as many weeks, and is generally the result of exhaustion, aniemia or hydraimia; though sometimes tlie disease is complicated by catarrhal pneumonia— a con- sequence, probably, of pulmonary atelectasis, which is so frequent in weakly new-born creatures. Etiology. With animals at the teat, it is recognised that the health or alimenta- tion of the mother has a powerful influence in the production of this diarrh(ca. Constitutional diseases, aniTcmia, debiUty and disturbance in tiie digestive apparatus or in nutrition, which are usually accompanied by alterations in tlie milk, have an unfavourable effect on young animals; infectious maladies — such as aphthous fever, generalised tuberculosis, etc., are very inimical to the progeny; while simple congestion of the udder and mammitis may be the cause of gastro-intestinal catarrh in the Calf. The food consumed by the parent has likewise an influence on the quantity and (juality of the milk which the progeny receives. When it is too rich or too poor in nitrogenous constituents, or of inferior or bad quality, it may produce diarrhoea in the young ; or excessive fatigue will so alter it as to render it no less objectionable ; while certain medicaments given to the mother will irritate the intestinal mucous membrane of the offspring. Irregular lactation, cold, or cold and wet, overgorging with rich milk, and constipation from any cause — as when the meconium is retained in the intestines from the first milk or colostrum not being allowed — all these may induce gastro-intestinal catarrh. With weaned animals this may also be due to inopportune weaning ; improper food, which gives rise to acetic, butyric, or lactic fermentation, and so irritates the stomach and intestines; cold and damp weather; as well as the ingestion of 732 DISEASES AND AliXOIlMALITIKS OF I'lTE YOUXa ANIMAL. t I n injurious forei^'ii matters, and the presence of entozoa in the digestive canal. Of course, the occurrence of the disease is favoured by general pre- disposing causes — such as innate weakness or great sensibility of the digestive organs, disease of the mesenteric glands, etc. Patholocjicnl Anatoviij. The changes observed after death in fatal cases, are not unlike those seen in the same malady in adults ; though in some instances in which the morbid process has been very intense, the alterations do not always correspond with the symptoms observed during life. The stomach usually contains large masses of dense clotted milk (casein) in sucking animals, and in those which are weaned there are similar masses of undigested matters. Tlie mucous membrane of the stomach and intes- tines presents variable appearances — redness, tumefaction, follicular catarrli, acute ulceration ; with atrophy, thickening, granulation, pig- mentation, etc., in the chronic form ; the mesenteric glands are enlarged. Emaciation is marked, and all the signs of anaemia or hydroomia are present. Pyoiinos'ts, Tlie prognosis must always be carefully given, and will be based on tho cause or causes of the attack. It is generally unfavourable when the diarrhoea and tympanitis have continued for a considerable time. Trcatyncnt. If possible the exciting can ;o should be removed; and with sucking animals the condition of the parent should be more particularly attended to, in the direction already indicated. The diet of the young animal must be regulated according to circumstances, and especially in the allowance of milk, which ouglit to be given in small and frequent quan- tities, and diluted with lime water. Calves should not be weaned until they are from four to six months old, and Lambs not under three or four months — the weaning being gradual, and the food given easily digested and non-irritating. The diarrhoea is to be combated by gum or linseed mucilage, raw eggs, gelatine water, d(>f''\;tion of malt, almond milk, rice pulp, etc. It may be necessary to clear out the intestines by means of a mild laxative — as castor-oil, or sulphate of soda, or magnesia in small doses. When the diarrhoea is due to intestinal fermentation, the carbonates of soda or magnesia may be advantageously administered, in addition to the castor- oil. Three to five drops of creosote have been prescribed for the Calf, and a half to one drop for the Lamb, in a mucilaginous excipient ; also creolin, salicylic acid, and some other antiseptics. Should tho diarrhoea be due to worms, these will probably lead to their expulsion. When the diarrha-a is very intense, opium and rhubarb have rendered good service, as well as Dover's powder, tincture of opium, or, perhaps better still, clilorodyne. Styptics or astringents are likewise useful when carefully given ; and astringent enemas — as solutions of alum or tannin (1 per cent.), or nitrate of silver or lead (^ per cent.) have been recommended.! Filliatre- lias beep, particularly RnccHSHful with enemas of tar water, prepared by mixing a small quantity of vegetable tar (150 grammes) in boiling water (6 litres) ; when tepid one-third of a ' Friedberger and Friihner, op. fit., vol. ii., p. 380, -' liicueil lie Mt'ikcine V^tMnaire, 1886. ANIMAL. n the digestive )y general pre- nsibility of the DYSENTKUY OF YOUNG ANIMALS. 733 litre 18 given in enema every half-hour until the diarrhcca is arrested. In some cases this rapidly ensues. Milk diluted with one-fourth of the tar water is to be given as food, and the treatment must bo continued for two days. ot unlike those es in which the do not always The stomach ein) in sucking lilar masses of lach and intes- tion, follicular anulation, pig- Is are enlarged. hydroomia are 11 be based on rable when the 3le time. \ with sucking alarly attended young animal pecially in the frequent quan- e weaned until under three or d given easily ilage, raw eggs, ), etc. It may id laxative — as Bs. When the ates of soda or Q to the castor- id for the Calf, sxcipient ; also d the diarrhcBa lion. have rendered in, or, perhaps ikewise useful ons of alum or 3nt.) have been il with enemas vegetable tar one-third of a CHAPTER X. Dysentery of Young Animals (Dysenteria Neonatorum). The peculiar dysentery which attacks young creatures while at the teat has for very many years attracted particular attention, because of its specifac nature, its almost incurable character, and the great mortality which attends it ; but as yet it is perhaps the infectious diseases of animals of which least has been ascertained. Known by various names in different animal-rearing countries (as *' White Scour " in England— the " Weisse Euhr" of the Germans, and the " Diarrhoe des Jeunes Animaux " of the French), it is generally acknowledged that Calves are far more frequently attacked than other animals ; though it is also an extremely "atal disease among Foals. Brugnonai long ago asserted that it is one of the maladies which cause most destruction among Foals in breeding establishments ; and to my own knowledge, it is sometimes a most serious scourge among the young thoroughbred stock in this country. It is also a fatal malady among young Lambs; and it is observed in piggeries and kennels as a very destructive disorder. It appears to be much more frequent among animals reared in dwellings than among those at pasture, and seems to be related to the artificial way in which they are kept. Like the pyemic polyarthritis of young animals, i*- is one of the most fatal disorders to which they are liable. According to EoU it is very prevalent in some parts of Austria, and in one region alone, of 3,318 Calves, 1,196 were attacked, of which 1,152—97 per cent.— perished ; in 1884, in the same districts the mortaUty was 55 per cent. In the order of frequency, the Calf stands first ; then the Lamb, the Foal, the Dog, and the Cat. It sometimes haunts breeding-stables and cowsheds for years, and among Calves is seen more frequently in some localities than others— low-lying districts being perhaps more often and severely visited than elevated, dry situations. Epizootic abortion and this disease have been noted to co-exist, and it has been supposed there is som.e relationship between the two maladies. It generally appears within a few days after birth— from the first to the third ; beyond the fourth day it is much less frequent. In some instances the young creatures are affected before they have sucked ; so that the milk could not have had any infiuence in its production. Symptoms. The symptoms are described as some\/h..i similar in all the species it attacks. In Foals it usually appears within the first three days after birth. The animals are dull and restless, and the dejections are mucous, or very fluid and extremely footid ; while the expired air iind cutaneous exhalations often have a foul odour. The eyes become sunk 1 La Mascalcia, Turin, 1893. 'S m 'M'' I .. 734 OiSL'A^ES AM) AnXOHM JLITlE^i (jF TIIK YUUNd AXIMAL. in tlioir orbits ; j^'roat dobility sots in ; thirst is intense ; the abdomen is retracted ; and in some eases a cutaneous eruption is observed, which is ^enerahsed or is located in the parts around tlio anus. iMoro tlian a century a^^o, IJrugnonc described the symptoms in tlu) Foal as follows: The\liarrhn;a connnences two or three days after birtli ; a yellow, acrid, sometimes purulent-lookin;,' fluid is evacuated; the animal becomes rapidly emaciated, and is nearly always lyin;^' ; ib is weak and staj^'fier? about, sucks little or none at all, and at last ialls into a state of complete marasmus. Durinjj; the ih-st period, it is nob rare to observe a general ophthalmia occur ; the humours of the eyes aro turbid and these organs are painful ; tears How contiimally ; the eye- balls become buried in their sockets and are atrophied; and vision appears to be lost. When the Calf becomes affected, it ceases to suck, if it lias begun to do so ; for J'\-anck has known the dianhtra to appear inunediately after the Calf was born and before it went to the teat— indeed, it was dead before it could do so ; though in the great majority of cases it has two or three good meals from the udder before acute diarrha-a sets in. When ib no longer sucks, it becomes uneasy and bellows ; the fuoces, expelled violently, are at first very soft, then fluid and white (mucous diarrluea), or mixed with particles of casein (white dysentery), and very often streaked with blood ; at a later period the evacuations aro con- tinuous and made involuntarily. J'ixhaustion is rapid and the creature cannot rise ; convulsions occur fnMpiently, similar to those witnessed m infantile diarrluea ; sahva or foam Hows from the mouth; the expired air has a sour or fcetid odour, and great emaciation is observed. There may be slight tenesmus, and the anal opening is dilated as if the sphincter were paralysed ; while the air passing into the rectum pro- duces a peculiar sound. Towards the end the creature lies immovable, and dies w^ithout a struggle in from one to three days. Allusion has been made to its fatality ; in Bovines from .00 to 100 per cent, die, and in many outbreaks it kills all the Calves in an establishment ; if any ciiancc to survive an attack, thoy are sickly and feeble for a long time. The Lamb, when attacked, also ceases to suck and becomes dull and very weak ; the dejecta are watery and mucous, and foul-smelling ; frequently there is tenesmus ; and the temperature may rise to IOC)* Fahr., though it quickly falls again. The respiration is hurried, and foam and saliva accumulate about the mouth. The disease generally manifests itself within three days after birth; Nikolskii jrjves its appearance as 30 per cent, the first day, 40 per cent, the second day, 25 per cent, the third day, and only o per cent, for the fourth and succeeding days. It runs its course, on the average, in from one to three days ; though in some cases death may ensue in a few hours.- ' Vi'tiriudrij Arcliiras of St. I'ctcrshimj, 1885. - With reyard to the diseas.' in Lambs, V.mtidikt {ffarItii('nJahre»bericht, 1871, p. 140) describes it iindorthe liuiid of " typhous ° r^d ?SeSrof'^.:^^' *^'^^°^^ gives rise to constipation, and thT is o f. n n "" meconium The animals in which it occurs am in.^n? ?7'""' condition, developed. ^ ''^'^ generally weakly, and not well Causes. in5Sr;"o?iL"r'L^ndth"L'da''°t "t^ ^^^ ^^^^ ^-PPe^ dry fodder during th^winLTLlh'' }^?r ^""^ exclusively on if the dams have\ en wo ked until nea fo' ?'" T''"' ^^^^ '" ^°"°^ then deficient in those ZrStive m,nS. i-"fe^'*""'- ^^^'' "^'^^ '^ the newborn animal It ^f the^.^^J '^^w,^ ^'^ f necessary for stall-fed all the winter wih d y food ■ "^nd thrcll'"' '^^^ ^^^" certain to suffer from retenf inn nff i^f ' ■ -.^ Calves are almost milk, even if JlZullZX^Zl'^Z'' "''"''' "' '"» "* Sijinptovis. Jls.T7e'r4rtiri,t.i2.1-°«^Lfiis?^^^^^ Treatment. T'he preventive treatment consists in attendinr^ rn fh« f..^- j condition of the pregnant animal some thne b2re paiturtl^S^ young creature should be fed on the first milk it parent Si f tw' cannot be given, then the animal should have a dose of citor oil The curative treatment must be directed towards m^oS^n; fh« TS^^Z^Vt^'T^'- ^""'^ "^^^'^^ eifecTed bv^.rnra^n%^ oiled fi'ngeT' i''""""^^>' ^'^^^^^^^ ^^« "'"^h as is accessible to a weU^ brmflV"^""'' k' ^'^°'''^ 'f '^' °^ ^^'^ fi"§^'^' Fi-anck recommends to be ihlco^TJir^"' °^" ^^T""^'' ^"' "«* ^°° ^^^^k, noose wire ihe Cow should have an abundance of fluid to drink, and this may be 710 I'lSKASKS ANIt AltNtHiMAl'lTlKS OF 'I'llK YOlfSn ANIMAL. rondoiod slightly laxative* by tho addition of croain of tartar or aulpliato If tlui constipation porsiHta, purgatives may bo aduiijuatored. Tboso may bo castor-oil. mainia, sulpluito of soda, aloos, otc If thcro is pain from U) to '20 dropH of chlorodyno in water should bo udmnnstorcd. Froquont onomas will aid tho action of the purgatives. .-r • i Soniutinios constipation is duo to giving too rich food, or, in artiticia rearing, to an oxcossivo allowance of meal or flour. Tho treatment will bo tho same. I CIIAPTIUI XII. Eclampsia of Young Animals. This nervous alTcction has been observed in the Calf, Pig, and Dog within a variable period after birth, and presents some vy hat the same features as that disease {ccluiiipsia iiijunlnm) in young children. Siimptoms, In the Calf no premonitory symptoms have been observed, except that perhaps when it goes to tho teat it is not so lively as UHual, lags behind tho other Calves, and is rather unsteady on its limbs. Uoioro it catches the teat, or very soon after, it is suddenly and violently seized with spasms of the voluntary muscles ; all the limbs become rigid, the jaws are convulsively champed, and foam flows from tho mouth ; in a few minutes tho creature begins to bellow loudly and repeatedly, and to perform strange antics-junipi"K forward as if thrown by a power ul spring, and heedless of injury. The eye looks haggard and wild tho respiration is hurried, and the heart beats tumultuously. When hold, it continues to struggle and bellow ; at last exhaustion ensues after an hour or two, and if tho Calf does not succumb it lies in a state of extreme lassitude for a long time ; tlien it gradually regains its faculties and in the course of some days is well again ; but for some months it does not look thriving, and not infreciuently there is a renewal of tho attacks before that time elapses. i -t i The animal may die from the first or second attack— rarely it has more than two. Revel> states, that of eleven Calves on a farm, live were affected— three males and two females ; the males perished at tlie first seizure, but the females survived it, though one of th;_,.. diud f-.oin a second attack three days subsequently, the other reinaim ng well. In the P'ui the symptoms are similar. Before thosoi/r ■ i. > oi-c:^ ure perhaps sucks less than usual ; it begins to cry and become restless- - running here and there and standing up against the side o its sty, screaming loudly ; suddenly the screams cease, the linimal falls down in convulsions; the respiration is noisy, the eyes pirouette in thoir orbits, the 'i;a--^c^.er muscles have clonic spasms, tho limbs are violently agitated, an l there is J'SS of sensation and consciousness. The attack n?ay contir -i, io: a v.riable period— from fifteen minutes to an hour or more, arid ;;.:.3tii ^nay occur at the first, second, or third attack— it is usually the second. . , -i -u i In the Do" »'>""« CUAPTHR XIII. Tetanus Agnorum.— Tetanus Neonatorum. TMTANnH, or a form of that disease, is not infreiuontly witnessed in LambR and sometimes it is so prevalent tiiat it is -e-'ar LrLs on^'or.t " It most frequently afreets I.ambs of the finer breeds, and usuallv during tho first two or throe weeks after birth. ^ Symptoms, ^nn.^Hfn'^'l'f '* symptoms are weakness, loss of vivacity, and diminished appetite, then the iinbs become st.fT and the gait stilty, the back is arched, and the neck and legs undergo convulsive contortions, so that there ,s difhculty in rising or walking. The cramps extend gradually to other parts of the body, until at last the aninml cannot move, and to obtain food it has to be carried to tho mother's teat, where it needs to be supported. "couo There is generally constipation at the commencement of the attack but at a later period diarrha^a sets in, though there is no fever Under ordinary circumstances the animal succumbs in about eight or ten days-rarely after several weeks-in a state of marasmus, the fatal termination being preceded by grinding of the teeth, diarrhoea, con- vulsions, and not infrequently complete paralysis. Etiology. It is believed that, in many outbreaks, the Lambs are predisposed to the disease through improper feeding and management of the Ewes whose milk may be obnoxious from the food they receive. Exposure to extreme heat ana cold, and particularly to cold winds, is supposed to have much influence in the production of the malady. Pathology. _ Little appears to bo known as to the pathology of the disease, but it is evidently nervous -in its origin at least ; though no alteration has as yet been detected in the spinal cord to account for the tetanoid symptoms. Only the characteristics of general anaimia, with some- times congestion of tlie true stomach and intestines, have been hitherto noted. Prognosis. This is generally unfavourable, as a complete cure is very rare; while dehcate Lambs perish quickly, those which become convalescent are a long time before the rigidity leaves their limbs ; they do not thrive, and often succumb to some other disease. 742 DISEASES AND AIIXO/LVAUTIES OF THE YOUNa AXIMAL. Treatment. Preventive treatment must be directed to keeping the Ewes in a healthy condition by proper feeding, and sheltering them from tlie weather if this be severe at lambing time. The Lambs should also bo kept from cold winds and wet, especially if they are of the more delicate breeds. With regard to medical treatment, it is recommended to give a purgative at the onset of the disease, and especially if there is any reason to apprehend that the meconium is retained in the intestines. Chloral hydrate or chlorodyne maybe given in small and frequent doses, alternated with sulphate of quinine. Friction may bo applied to the limbs, either without or with some stimulating liniment. CHAPTER XIV. Cyanosis. At page 105, in describing the fa-tal circulation and the modifications which occur in it at birth, it was mentioned that the lungs then becouK the organs of respiration, and rapidly increase in capacity, while the thorax enlarges in a commensurate degree ; the pulmonary artery also dilates to admit the increased How of blood, and the ductus arteriosus is obhterated to prevent mingling of the arterial and venous blood. It was also stated that the ductus venosus likewise aids in the isolation of the two kinds of blood, by becomin;,' atrophied ; as does also the occlu- sion of the foramen ovale, .'•lOUgh tlie latter opening not infrequently remains intact in young animals. Eemarking upon the patency of the foramen ovale, it was stated that, as a rule, this accident did not greatly a*'' ct the circulation; for wlien the heart contracts, the auricles are i.njuited by the narrowing of the oritice and the elevation of a valve. Cases occur, nevertheless, in which, either from the persistence of the foramen ovale, with perhaps defective auricular contracjtion, or an abnormal disposition of the large bloodvessels at their oiigin, the arte- rial and venous blood is mixed, and we have the condition known as cyanosis or the " blue disease." Then there is a deep-blue or violet coloration of the visible nmcous membranes, more or loss debility and difficulty in respiration, especially during exertion, coldness of the limbs and surface of the body, and a great predisposition to haMuorrhage.i Cyanosis may occur in otlierwise welI-d(!veloped individuals, and be due to a congenital adhesion between the lungs and pleura or pericar- ' Vernant (Recueil de Mid. Vt'ti'rinairA, 1887, p. r)92) waw called to see a Calf which had been born the previous evening;', and with such eam; that it was found behind the Cow, no one beinjj presiiut at its birth. It was viable, in very good conditinn, fat, and 80 well developed that it looked as if fifteen days old. But it could not stand, ind lay constantly in the sternal position, rtjfusinK to suck. The syniptonis it presented were markedly those of a.sphyxia ; the tonj,Mie w«s half-protruded from the mouth, the eyea prominent, the respiration plaintive and hurried, and the llaidis very agitited. When raised it could not stand ; its limbs were constantly and convulsively moved, and were unable to sustain the weight of the body. The animal was bled at the tail, but this afforded no relief, and in forty-eight hours after birth it died. The lungs were tlien found lo bu eoiNipsed, and looked very con- gested ; the anterior extremities of the lobiiles floated well in water, but the t-ntire mass was rather iieavy. The foramen ovale was incompletely closed, so that the two auricles could communicate with each other ; the opening was aii large as a live-franc piece, and the auricular eeptmn was eNtreniely thin. 7 AXIMAL. ; the Ewes in a them from the 3 should also ho ;ho more delicate inded to givn a \f if there is any n the intestines. ,d frequent doses, e applied to the it. ,he modifications mgs then become pacity, while the onary artery also luctus arteriosus id venous blood. is in the isolation jes also the occlu- not infrequently le patency of the it did not greatly , the auricles are ion of a valve, lie persistence of ontra(!tion, or an r origin, the arte- ndition known as eep-blue or violet less debility and Iness of the limbs lueniorrhage.^ dividuals, and be pleura or pericar- i to see a Calf which was found behind the lod conditiiin, fiit, and dd not wtiuid, ind lay oiiis it presented were the iiKinth, the eyea \iiity agit'ited. When vely moved, and were id in forty-eight hours and looked Very con- ;r, but the t-ntiro mass ) that the two auricles a five-franc piece, and SKIN-DRYNKSS OF THE NEW-BORN ANIMAL. 743 fn^c'^licl'fh^^i? "" symptom of asphyxia, and is sometimes witnessed m colic in the Horse, complicated with metcorismus : it likewise accom- panies certain forms of poisoning. "Kewise accom- When due to the first-named causes, this condition is manifested t::LZlTf\T' ^'''\'''^t''' '' °"ly '^ '^^' instanceTthat Is citveloped at a later period. It 13 needless to mention that such a conforniation is beyond remedy, though animals so affected wUl some SilVln Ui^s-^^Sn?^^^"^^^ ''' ^-" ^ ^-- -- y--^ CHAPTER XV. Skin Dryness of the New-born Animal. OmcHi is, to my knowledge, the only writer who has alluded to this peculiar condition of the Eoal at birth. He says • " In the case of some nrmnparous Mares, a fatal accident often happens to thek proger, /. Wiien parturition takes place without anyone be" m^ present tne yc;a„g creatur. on being expelled from the mother, con Unue S away from her unt. its skm is dry. The consequence is that the Sire uoe. not care for it does not lick or attend to it, and opposes aU attempts to compel her to suckle it. For some days con^aint's necessary, and much trouble and danger may be incurred before she s accusto.ned to it This may be averted if Ihe new-born creature nibbed over wi h the ' after - birth ' (placental membranes). The Z Tn t^l^ the Mare impels her then to lick and fondle her offspring and to take to it kindly and in a natural manner." CHAPTER XVI. Imperforate Anus. IMPEKFOKATK auus is not a very rare occurrence in new-born animals • It has been observed in Foals, Calves, Pigs, and Lambs. The latter appear to furnish the largeat number of cases. This condition is of coui-se very serious unless surgical aid is quickly afforded, and even then the young creatures f re not always saved. The meconium cannot be evacuated, nor yet the residue of the milk the animal may have ingested after birth ; whence results an accumu- lation of irritating matters in the intestines, which give rise to inflam- mation, and this quickly causes death. This occlusion or imperforation may exist in various degrees. There may be merely a membrane covering and occluding the anal openin<^; the borders of the anus may be adherent to a greater or less extent the rectum may be more or less absent or incomplete ; or it may open mto the genito-urinary passages instead of at the anus. Symptoms. When no fteces can be expelled, usually towards the second or third ctay alter birth, uneasiness and symptoms of acute colic are manifested- the animal does not suck, the abdomen becomes distended, expulsive ' Wochemchriftfiir T/iierheilbmk, 1869, p. 105. *1 M 4 DISEASES' AND ABNORMALITIES OF THE YOUNG ANIMAL. efforts and pawing are observed, yet nothing is passed. The animal snows signs of great pain and misery, and if help is not afforded it dies in agony. ^ In young female animals in which the rectum is absent, it often Happens that the mtestine ooens into the vagina, and the fjieces are expelled by that canal. Eainard has witnessed this malformation in several Jnlhes, and his attention was also drawn to four y^ung Pigs- male and females— in which the anus was absent. They were the litter ot one bow. It is therefore well to ascertain, in the case of female animals destitute of an anus, whether the meconium or faces pass by the vulva. ^ ^ Treatment. The symptoms lead the veterinary surgeon to examine the defecating organs, and to discover the character of the obstruction. If there is only a simple membrane occluding the anus, this projects like a large vesicle, owing to the pressure made upon it by the faices. This mem- brane, which is really the skin, has usually a deep red tint, and is soft and thin, offering but little resistance. The prominence it forms is quite soft and pits on pressure. In such a case all that has to be done is to incise the membrane—in a crucial manner, if deemed best. A long, narrow, sharp-pointed bistoury is the most suitable. After well ascertaining the entrance to the rectum, the skin is punctured, care being taken not to allow the knife to pass too deep ; a director may be employed to complete the incision, and to guard the intestine from Iu"'"'^^/u sooner is this incision made than the meconium escapes • then Che crucial division maybe made with a pair of sharp scissors! ihe index finger should be introduced as far as possible into the intes- tine, to make certain that all is right there. In order to prevent the opening closing by cica.trisation, a suppository or tent may be introduced into the rectum, and withdrawn every now and again in o-der to allow the faeces to be expelled— in jeccions assist- ing m the latter; or the angles of the divided skin may be snipped off by scissors so as to hinder their union. The lips of the wound are subsequently lubricated by a little carbolized oil or grease, and, provided inHammation does not set in, recovery is certain. When the prominence is not present, and yet there is complete occlu- sion, with all the above-mentiontd symptoms, the operation is more u i"i u r ^ perineal raphe is sought for, as on its course the anus should be found. This is carefully felt, when the prominence formed by the end of the intestine will be discovered. Then a short incision 18 made through the skin only, in the middle line ; the subcutaneous tissues are dissected away until the bulging of tiie intestine is reached • this is drawn outwards between the lips of the wound by forceps or a ligature, an opening is made into it, and the contents removed The margins of the opening are then secured to the borders of the external wound by some line sutures, and attention is paid to the parts durin" the healing process, in order to prevent the artificial anus becomino too contracted. ° When the rectum is absent to a more or less considerable extent (in some cases it is reduced to a mere fibrous cord^, tlu^n but littU> bp,n»>« of the operator may °vmbe^r„erallvmrM,T'''''''^' "'"?"■'''"=' '° "ireuinstanees ; but it di,r» »« tion is to apply alittl°e 1^70 bo^rir' d'ffiX 'sS Xir be" any tendency to re-adhesion. ' ^^^°^^^ *^ere be CHAPTER XX. Occlusion of the Auditory Canal. Occlusion of the auditory canal is much less mm thnn M.of ^t ,u eyelids, and when it exist's deafness is the conscouen^^^^^ dumbness. It is the latter condition which mostT'que^tly a tracts d aTnesT ' ^Thenl'smllf ' ^'^«°-7/hat the real and sl^Hou^dSI aeainess. ilien a small prominent tumour is detected in the nlace of the ear, or ^^•lIere he external auditory canal should be This tumour IS ra her soft and can be readily seLed by forceps, when it may be punctured with a bistoury or a lancet and a crucial inci on made through It or it may be resected by forceps and scalpel or scissors When the membrane forming the covering of the tumour is removed a quantity of grey cerumen is found obstructing the cana" th s caTbe extruded by pressure, injections of tepid water, or a smal c^op To hinder the closure of tlie canal, a little morsel of Hnt or lireowLp^^^^^ m the ear and retained there by a bandage round the head Widi the -Dog, which IS most frequently affected in this way, the bandage requires to be more carefully fixed tlian with other anima s, as it uses i s mws and does not rest until the covering is removed ^ timi •'' on!l '''''' ^'^ ^"^.^^^f' °"^ °"'y '^'°^1<^ ^« operated upon at a wh Ph fnn' '^' ^^''^^' '* IS better to wait until the slight inflammation The 141rtntt.°^"^"°" ^^'^^'^^' '^^^^-^ ^^^ °^^-- -^- -^-Soes So far as hearing is concerned, the result is often negative; indeed, Eanard confesses that, of the large number of Dogs he operated upon not one recovered its hearina. or t > CHAPTER XXT. Tongue-tie. Anothkk congenital defect of young animals is what is called "tongue- tie , It is most irequently observed in Calves.i and is similar to the oclaSrTn ial^e':'"' '^^ ^'^"'- ^''"'•''"'^''' J»"«. 1877) observed this condition on six 748 DISEASES AND ABNORMALITIES OF THE YOUNC ANIMAL. condition in children which goes by the same name— being characterized by the fnenuni Hnguue being too narrow from above to below, and too iniich prolonged forward, sometimes extending to the root of the lower incisor teeth. This anomaly greatly hinders the prehension of food and swallowing of fluids; the Calf, if drinking out of a bucket, vainly plunges its face into tlio fluid as far as the eyes. The teat is seized with difliculty, and the tongue is so limited in its movements that it cannot bo protruded to lick the nostrils, as is the custom with Bovine and some other creatures. The defect is often unperceived, and the young creature loses condition, becomes weak, and eventually suc- cumbs. The treatment is very simple. It consists merely in dividing the fronnum to such an extent that the organ may recover its liberty of movement. Iin nediately after the operation, the creature protrudes its tongue to lick the blood which escapes, and it can drink with ease. The wound heals in a few days witiiout any precautions. CHAPTER XXII. Cleft Palate. I CAN find no mention of this congenital defect in animals, though of its occurrence there can be no doubt; as some years ago I saw a thoroughbred Foal with a cleft palate at the Eltham Stud Stables. When it sucked or drank a large portion of the fluid escaped by the nostrils. The animal was not submitted to treatment, and I do not know what became of it. The fissure may have closed as the creature grew up. If the cleft remains permanent, operative treatment might be attempted. The procedure would, of course, depend upon the extent of the fissure and the species of animal to be operated upon. \ Va ANIMAL. ADDENDUM. Infectious Abortion. htaTsfof^rt^retn'^^^^^^^^^^^ fPo^'tant subject, among breeding stock, thlt'it Ss been'cts tod'nYc S^" foSr"'^^ information which has come to hand since tL If^l ^^^^"^^'^ dealing with it were printed off. ^^^""^^ (PP- 21G-22G) There can bo no doubt that in those instances in whinh ni .• occur on an extensive scale, so as to assume Tn nn,^- r ^'^9r*ion3 character, and to continue in certain W?^ff;L ^"^""^V^,-",' ^P^^ootic years, infection is the chief! if nrtron?y cause •Thr^^^^'^'"'^"*^ ^°^- supposed to operate in thei • productions nlr^lvn^f ^^'"''^' "'^^"y by weakening the constitution "^^ ^'*'°8 as pred.sposants. exSei^;:?:^sjs:g^^^^:rsiii'^^T r^^' '^^ be alluded to as l^^^n^ irVea ZSt^ t^^^^ and twenty days, by introducing into the vagSa ofnre^nant r" ' mucus from that of animals which had nboH-t-q n °^ P^^S°f"'> Cows Trinchera-^ L.s produced a va-ina catarrh and t htn • ""i^^^ ' -^^^"^ tiZt'^^^"^' by another which bad^likev4e'm^t%vrthX°LS: thS£eS.noJt,?C rtss-j::^s;i^f - or contagious, and that it may be transmitted either d"Sf or t£^^^^^^^^ he intervention of certain media-as infected urine. fSs or X, by at endants on the animals which have aborted, by the 'vetexWv obstetrist who has recently removed the placental membranes from an anunal that has aborted, or even by the male animal in fhpn^ f :ri'f""-n'^^''.^V'^ infecting agLt produts'reluf U ob tn no v./n^.i f'°"^^ the respiratory, digestive, or circulatory organs! not yet ascertained ; but there is every probability that it finds access to the interior of the uterus through the vagina andLrvix.L in pSen? fever, and developing in the fcctal envelopes, produces klteratbnstWp sufhcient to kill the foetus without affecting to any conSaWe exti? the health of the female. This occurs after each^ concS so tha repeated abortions eventually lead to sterility by causin. the Serine mucus to become _acid-a change which is fatal to^he sTennato^oa ' t.altier- is of opinion that though the disease chiefly aflects the Bolinn species, yet it is transmissible to other domestic\pecLs, and offers '_ Sachncn Jahresbericht, 1878. - La Clinica Veterinaria, 1888. ^ Journal dt Mcdtciuc Vctcrinaire de Lyons, 1890. 760 ADDENDUM. I It ) if some characters common to the pneumo-enteritis of the Pig (Swine plague) and Sheep (the pneumo-enteritis prevalent in the Alps). In a German periodical^ recently published, a summary of the views of forty-five Danish veterinary surgeons is given on this malady. It is concluded that there can be no doubt as to the infectious character of abortion, and that it can bo propagated from stable to stable, or cowshed to cowshed by infected animals — male or female ; immunity is acquired after two or three years, as the disease disappears of itself from an establishment if no new animals are introduced, though getting rid of those which abort and replacing them by others may continue the scourge for an indefinite period. When the herd is not renewed the prevalence of the malady decreases spontaneously, the abortions gradu- ally become fewer, and the accident only occurs towards the end of pregnancy, finally ceasing. The treatment found successful in combating the disease in Denmark consisted chiefly in rigorous disinfection of the stables or cowsheds twice a year, by cleansing them and washing with a 1 per cent, solution of chloride of lime ; though the stalls, walls, etc., were, when possible, washed once a week, and the drains flushed everyday. Animals about to abort were immediately isolated, and looked after by a special attendant who was not allowed to go among healthy pregnant animals. The foetal membranes were removed within twelve hours after abortion, and, together with the foetus, buried in lime ; while the genital cavity was repeatedly washed out 'v'th a 1 per cent, solution of creolin, or ^ per cent, of lysol, until all vaginal discharge had ceased. Cows which had aborted were not put to the Bull until two or three months had elapsed, so as to prevent extension of the infection, and afford a better chance for their becoming pregnant again. Even Cows and Heifers in infected places and apparently healthy, received a vaginal injection before copulation ; afterwards the parts about the tail and vulva were carefully washed every day with a mild disinfectant. The Bull employed in an infected locality was treated in a similar manner, the parts about the generative oi'gans being cleansed and disinfected before and after service. It is most important tliat animals from infected herds or studs be not introduced among healthy pregnant Cows or Mares, unless every precaution is taken against contamination ; and if these suspected animals are pregnant they should certainly be isolated until parturition is completed. With regard to the symptoms, there is not much to be added to what has been already stated. Abortion generally occurs in the Mare from the fourth to the ninth month of pregnancy, in the Cow from the third to the seventh month. Before it happens the vaginal mucous membrane is observed to bo reddened, and pimple-like elevations about the size of a millet-seed are often seen on its surface ; while there is a reddish- tinted discharge from the vagina, and the diminished yield of milk has the consistency of colostrum. In about three days after the appearance of the vaginal discharge abortion occurs, but the discharge frequently continues for a considerable time afterwards. ' Dciittichc Zdttichr'ift J'ilr Thicrmc Heine und Vcnjldchende Pathologic, xxi., 1S05. oi the Pig (Swino the Alps), mary of the views lis malady. It is ctious character of stahle, or cowshed munity is acquired 5 of itself from an 3ugh getting rid of may continue the s not renewed the le abortions gradu- )wards the end of isease in Denmark ibles or cowsheds . per cent, solution re, when possible, y. Animals about ifter by a special pregnant animals, airs after abortion, the genital cavity on of creolin, or i -sed. Cows which three months had ind afford a better )ws and Heifers in vaginal injection lil and vulva were 3tant. The Bull inilar manner, the disinfected before lerds or studs be ares, unless every [ these suspected d until parturition I be added to what in the Mare from ow from the third iiucous membrane 5 about the size of here is a reddish- . yield of milk has er the appearance charge frequently ■.thologh, xxi., ISOi). TKDEX. A. AitnoMiNAL evisceration, S.OO Abdominal fretation, 175 Abdominal muscleH, 'rupture of, 62] Abdominal taxis, 329 Abnormal anterior presentation, 433 posterior presentations, 4tJ0 (luantity of placental fluid, 381 retention of the fcutus, 1!»8 Abnormalities of the young animal 701 Abortion, 204 ' iirtiticial, 294, fjCl enzootic, 216, 749 epizootic, 216, 749 infectious, 216, 749 sporadic, 205 Accessory cotyledons, 87 Accidents after parturition, 564 of pregnancy, 191 After-pains, 268 Agalactia, 696 Aid after labour, 263 during labour, 256 Alae vespertilionis, 39 Albuminuria during pregnancy, 190 Alimentary canal of fietiis, lOa' appendages of, 109 Allantoic 'iquid, 83 Allan tois, 81 differences in other animals, 84 Amaurosis during pregnancy, 190 Amnion, 79 differences in other animals, 81 Amniotic acid, SO Amputation of the limbs, 544 of the fore limbs, 545 of the hind limbs, 547 of the uterus, 600 Anasarca of fn-tus, 387 Anatomy, obstetrical, 1 Anidian monsters, 178 Anomalies in pregnancy, 169 in the foetal membranes, 380 in the placenta, 367 in the umbilical cord, 373 Aute-^artum paresis, 187 p:oIai)sus of vagina, 191 rupture of the uterus, 194 Anus, imjierforate, 743 Apoplexy, parturient, 636 Appendages of the f,ntus 75 Arbor vitie uteriiia, 40 Area proligera, 71 vasculosum, 71 Arthritis, 718 Articulations of the pelviH, 8 Artificial abortion, 294, 56] passage for the frptus, 297 premature birth, 561 Ancites in foitus, 387 Ascitic hydronietra, 181 Asphyxia of the new-born animal, 701 Atreiiia of anus, 743 ' of OS uteri, 365 ' of vulva, 745 Attention to the mother during and after parturition, 256 to the offspring, 265 Auscultatiou of the uterus, 146 A.'cis of the pelvis, 26 Haij.ottkmknt, 146 jljindages or trusses, 594, 707 liludder, inversion of, 608 rupture of, 620 Blastotlenu, 70 Bones of tlie pelvis, 2 Broad ligaments of uterus, 39 Bulb of the ovary, 51 O.KSAUiAN section, 340, 554 Calving fever. 636 Canal of cervix uteri, 40 Cancerous tumours, 347 Cajiacity of pelvis, 21 Causes of parturition, 228 Cavity of pelvis, 12 Cephalo-ilial positions, 173, 478 -sacral position, 477, 481 Cephalotomy, 540 Cerebral congestion during pregnancy 189 Cervix uteii, 39, 44 "^ ^ & .i , cnniU of, 40 digital irritation of, 295 induration of, 361 rigidity of, 354 spaMu of, 351 structure of, 41, 44 752 INDEX. ] CliangeH in the ovum, OS Cliurda ilorwnliH, 71, 0(5 Chorial cotyleilons, 90 Chorion, lU tlitfertnces in other animftlg, 7" frondosum, 85 schirroua, 307 Cleft palate, 748 Clitoris, 29 Coccyx, 6 Colic, 181 Collapse, puerperal, 636 ColoHtrum, 271 Comparison between manual and mechani- cal force, 531 Complete deformity of the pelvis, 'igO Complications of ruptured vagina, 616 Condylomatous tumours, 348 Constipation in pregnant animals, 184 of young animals, 739 Constriction of vagina and vulva, 370 Contorsio uteri, 309, 341, 343 Contractions in foetus, 392 Cords and bands, 499 Comua of uterus, 39 Corpus luteum, r)3 Cotyledonous milk, 91 Cotyledons, foetal, 86 maternal, 90 Cough during pregnancy, 190 Cramp, 188 Craniotomy, 540, 542 Cresyl or cresol, 634 Crotchets, 511 Crotchet-forceps, 517 Cup-and-ball pessary, 589 Cyanosis, 742 D. Death of the fa>tus, 259, 394 Decapitation, 542 Decidua serotina, 91, 130 vera, 217 Decollation, 542 Detruncation, 548 Development of the circulatory system, 104 of the digestive apparatus, 108 of the embryo, 71 of the fojtus, 9() of the genito-urinary organs, 110 of the locomotory apparatus, 101 of the nervous system, 97 of the organs of sense, 98 of the ovaries, 51 of the respiratory apparatus, 107 of the skin and its appendages, 100 of the uterus, 46 periods of, 115 Deviation of the uterus, 306 Diagnosis of multiple pregnancy, 163 Diameters of pelvis, 15 Diaphragm, rupture of, 620 Differences in Fallopian tubes, 48 in pelvis according to sex, 19 in vulva of other animals, 29 Diffused placenta, 93 Digital irritation of the cervix uteri, 295 Dimensions of the f(etua at birth, 120 Diminution in the si/.e of the ftetus, 296 Diseases incidental to pregnancy, 181, 182 of the fuitus, 381 of the young animal, 701 Disproportion in size between male and female, 375 Distorted monstrosities, 416 Division of tln' body of the fcetus, 648 Dorso-pubio position, 427 Dorso-supra-cotyloidean ' isition, 428 Double monstrosities, 39; Ductus arteriosus, 107 Venn ' of Aranzi, 94, 95, 106 Duration ni pregnancy, 148 Dysenteria neonatorum, 733 Dysentery of young animals, 733 Dystokia, f(i'tal, 372 general considerations on, 279 maternal, 289 due to abnormal positions, 427, 457 anterior presentation, 426 displacement of the uterus, 297 dorso-lumbar presentation, 473 fore limbs, 433 head, 443 head and fore or hind limbs, 455, 459 hind limbs, 428 malpresentation of foetus, 424 morbid alterations in the genera- tive organs, 344 multiparity, 421 pelvic constriction, 289 posterior presentation, 456 sterno - abdominal presentation, 478 transverse presentations, 472 employment of force in, 523 E. Eclampsia, 681 during pregnancy, 189 in young animals, 740 Ectopia cordis, 403 Embryo, development of, 71 Embryotomy, 532 instruments, 534 preliminary arrangements for, 540 Emphysema of f(etus, 391 Employment of force in dystokia, 523 Endo-metritis, 625 septica, 629 Enlargement of the genital canal, 296 Enzootic abortion, 216 Epilepsia uterina, 668 Epispadias, 746 Epizootic abortion, 216 EstaWishing an artificial passage for the foetus, 297 Eutokia, definition of, 1 Evisceraticm, 049 abdominal, 550 thoracic, 550 Evolution in dystokia, 492 Excess in growth of hair of fcetus, 379 in volume of the fcetus, 374 Fi F, Fi Fj i'l Ft Fi Fii (ia (Ja Oe Ge :U8 at birth, 120 3 of the fffitus, 29d pregnancy, 181, 182 nal, 701 I between male and m, 416 f the f(£tu8, 548 427 in T'osition, 428 396 i, 91, 95, lOG ^ 148 1), 733 liraala, 733 iions on, 27!) positions, 427, 457 sntation, 426 of the uterus, 297 presentation, 473 33 i or hind limbs, 455, 28 ion of foetus, 424 ations in the genera- I, 344 121 ction, 289 lentation, 456 minal presentation, Bsentations, 472 rce in, 523 , 189 740 of, 71 ^ements for, 640 391 n dystokia, 523 nital canal, 29G cial passage for the 1 492 AT of foetus, 379 oetus, 374 Exomphalus, 704 Exostoses on pel vIh, 291 i^^xpelling powers in parturition 228 J^xpulHionofthef,..tuR,234 of the f„.tal membranes, 238 Ex onn.un and flexion in .leli very m External generative organs 27 Hurface of pelvis, 12 Extraction of f,„tu«, foreil,!,., 095 J.xtra-utenne pregnancy, 17:! r' E. i^ALLOpiAN lubes, 47 differences in, 48 Fecundation, 04 Female generative organs, 27 fibroid tumours, 348 Fimbriieof Fiillopiantube, 4 7 I insures in the teat-., 097 I'lHtiilaof the teat, 700 recto- vaginal, (i](i vosico-vi^inal, OlS Foetal cotyledons, 8ti, 90 dystokia, 372 envelopes, 75 puncture of. 29.") retention of, TifM membranes, anomalies in 380 disease in, .-^SO l'...tUH, abnormal retention of appendages artificial p.assage for, ''97 death of, 2.")9, ;;94 development of, 9G diminution in si"e of, 290 diseases of, 381 forcible extraction of •■'9-, medninical means for extraction of, periods . f development of H", physiok.gical phenomena in, l"l8 positions of, 242 presentations of, 241 weight and dimeusiona of ]•)-, ]'<.rce, comparison between manual and mechanical. 531 " employrnentof in dystokia, 5"3 means for developing .■)-'S Forceps, 517 f b, ~ lM>rcible extraction of fnetus, 295 fractures of pelvis, 291 Kree-martins, 161 Frequency of monstrosities 41--, iMmcdonal modifications after parturition, Functions of placenta, 93 Funic soufHe, 147 { Funis, 23 I ,, G. U.VLACTopHouou.s sinusts, 33 obliteration of, 698 (iastro-hysterotomy, 340, 554 (^a^tro-intestinal catarrh in you.,,- animals, f-elatine of Wharton, 93 (iemelliparoTm pregnancy, 153 ^^'n/-:x. 763 Oeneral care of offspring, 266 ''-•al considerations .\.rdingdystok.n, rauimiti8, 190, 073, 070 atrophy succeeding, 081 catarrhal, 077 during pregniuicy, 1 90 induration succeeding, 0S1 infectious, 078, 088 parenchymatous, 98 ^Vnencephaliaii monstrosities, 405 Anidian or zooniylian monstrosities, 406 Aschistoilactylus, 397 Atretocephalus, 397 Atretocornms, 397 Autositic, 401 Camylorrhacchis, 398 Camylorrhinus, 397 Celosomian monstrosities, 402, 418 Cephalotridymus, 398 Cormotridymus, 398 Cryptodiciymus, 400 Oyclocephaliaii monstro.iities, 405 Cyclopean monstrosities, 410 Cyclops or monophthalmus, 397 Dicephalus, 399 Dicranus, 39! i Diphallus, 398 Diprospus, 3!t9 Dipygus, 399 I'lctromelian, 402 Kmprosthomelophorus. 400 ]']pigastro(lidymus, 400 Ku8om])halian monstrosities, 407 Exeuceiihalian monstrosities, 404 (tastrodidynnis, 400 ( !astrr)-tlioraoodidynuis, 100 llclliiterics, 401 Hermaphrodites, 398 ITeteralian, 409 Heterocephalus, 3!t!i HeterodidjnuiH, 39!' Heterotaxies, 401 Heterotypian, 409 Ischiodidymus, 400 Megalocephalus, 3!I8 Megalomelus, 3!i5 Melotridymus, 3!t8 Monocejjhalian monstrosities, 400 Monocranus, 399 Monomplialiaii monstrosities, 407 Monophthalmus, 397 Monosoniian monstrosities, 40!' Nanocephalus, 39t) Nanocormus, 3!>0 Nanomelus, 390 Nanosomug, 390 ])iierperallH, 6!i-'t utorUH (luring preg- lilf) »Bitiei>, :}(»«, 4 Of. stroHitieH, 40;' *n iiKinMti'iwit.ics, 400 t? )8 sit'les, 402, 418 18 i I atr().'nij»lmI()-chr()U(KU(iy,„uH, .JOO Oiiiiilialiwitic, 401 ()|>iHth()iiifl()ph()niH, 400 ruruMJtia, 401 PurociiphaluM, IllMJ J'tTocDriiiUM, ,'i!Mi I'uroiiiuliM, .'t9(i I'fniHoniiiN, ;t!ttj I'leuroiniilopli.niiM, 400 l'i)I.v>,'n:itliiaii, 40!i l'i)lyiiu'liiiii, 4'0 IV'iulutici^ilmlian iiiiiiiKtrohitv, 401, 110 rHDudo-lioriniiphroditiiH, 398* l*yKa•_' SchiMt(JC(>iiiiim fiNsiHternaliM, 40;! SchistocorinuH reHexua, 40;i HchiHtoiiiulus, 397 .SchiHtoaoinuH, 397 Schistosomus coiitortus, 1 03 SoinatotridyimiH, ;i!i9 Syint4ian iiioiiHtroHitie.s, 402 Hyncophaliun iiioiiMtrdMitiet!, 407 Sysoiiiiaii uionHtroHitieH, 409 TutrachiiuH, 400 Tftrasculus, 400 Thoiacodidyiima, 400 Tri<,'oiiiinal nionstrositit's, 398 Morbid adho«i..n between f-.tua and ulenl^ Morsus diaboli, 47 Mother and progeny, supplementary obser- vations oil, ri(i2 .Mutations of tlie fd'tus, general, 493 partial, 19;i Multiparity, dystokia fnjuj, 421 Multiparous pregnancy, 153 diagnosis of, Iti;! positions of ffjtuses in, KM Multiple placenta, 93 Muscles of vulva, 29 Myomatous tumours, 348 N. N.VVKLOTUIN(!, 93 Necessary aid in normal parturition, \ih:> Aornial anterior presentation, 427 | posterior presentation, 4:^7 Normal parturition, 227 Nymphomania, C3 O. OiiLiTKUATioN of the galactophorous sinus 098 of the OS uteri, 36r> Obstacles independent of presentotions and positions, 372 Obstetrical anatomy, 1 operations in, 483 piiysiology of, ,5.") Occlusion ( 7fi6 of the eyelids, 746 of the uterus, 369 e auditory canal, 74/ Occlusion of the vagina, «18 •KJenuv during jirugnancy, 184 "f the umbilicuH, 713 ' ylcniatouH hydrometra, 181 O'.Htruin, 59 Offspring, attention to, 265 general care of, 266 Ouiphnioct'le, 704 ;: j in mare, 119 ; in pig, 153_ in sheep, 153 extra-uterine, 173 gemelliparous, 153 multiparous, 153 ; prolonued. 375 pseudo, 1 7 " signs of, lo-i of material, 1 It) cf rational, 138 of sensible, 143 spurious, 178 symptoms of, 170 terminations of, 170 treatment of. 177 uniparous, 153 I'legnant animals, diseases of, 181, 182 liygiene of, 106 Preliminary precautions and operations, 184 Prepuce, imperforate, 746 118 Presentations of the fcetus, 239, 241 Prolapsus of the bladder, 608 vagina, ante partum, 603 vesicaj, 608 Protracted labour, 258 Pseudo-pregnancy, 178 Puberty, 57 Pubis, 4 Puerperal collapse, 600, 636 Puncture of the cranium, 541 of the fojtal envelopes, 295 ( >UAl)iur.K.MKLLAK pregnancy, 156 <,|uintuple pregnancy, 157 R. Rectal exploration, 145 Recto-vaginal fistula, 616 Rectification of presentations and posi- tions, 487 Ri'd colo'itrum, 190 Reduced number of fd'tuses, 375 Relaxation of the pelvic symphysis, 619 Keproductinn, 55 Repulsion, 492 Retention, abnormal, of the ftetus, 198 of the ftetal envelopes, 564 of the meconium, 739 Retropulsion, 487 Rickets, 183 liigidity of the cervix uteri, 354 Rotation, -191 Rupture of abdominal muscles, 621 of bladder, 020 of diaphragm, 620 of heart, 621 of intestines, 020 of periiiieuni, 017 t'f sacro-sciatie liiianient, 021 of uterus, ante partum, l!>4 post partum, 609 of vagina, 613 of water-bag, 234 Rutting, 59 ill goitt, U>ii INDEX. 767 lit) 138 14:J 170 7 iseases of, 181, 182 i)ns and operations, -J 8 4 !, 74tj foetun, 2:i9, 241 JdtT, 608 'turn, 603 58 78 500, (536 liuiii, 541 ■elopes, 295 (I egnancy, 15(i V, 157 R. 145 I, 6113 esentatioiis and posi- fix'tuaes, 375 ilvic sympliysLs, 619 u, of the ftetus, 198 velopes, 564 in, 739 ix uteri, 354 luil inUBcles, 021 I 620 20 il7 li>iainent. 621 partuin, 194 nil, 609 234 hACHO cocc'YcjKAr, articulations, 9 biiero-iliac articulations, 9 Sacro-luinbar articulation, 8 Sacro-sciatic ligament, 11 rupture of, 621 Sacrum, 5 Sarcomatous tumours, 347 Hcliirrous chorion, 367 Wwiuehe of j arturition, 268 Serous cyst", 349 Sexual maturity, 57 Signs of pregnnrcy, 138 materia), 149 rational, 138, sensible, 143 Simple monstrosities, 396 Single placenta, 93 Sinus lactei, 33 Skin dryness of the new- born animal, 743 Spasm of the cervix uteri, 354 Sporadic abortion, 205 Spurious pregnancy, 178 Sterility, 65 Stricture of uterus, 369 Succus intestinalis, 84 Superfaetation, 169 Suspensory ligaments of uterus 39 Sutures, 591 Symphysis, pelvic, relaxation of, 619 Symphysiotomy, 561 Symphysis, ischiopubic, 4 T. Taxis, abdominal, 329 vaginal, 331 Teats, structure of, 33 fissures in, 697 fistulie in, 700 injuries to, 697 Teat syphon, 691 Teratology, laws of, 411 Testes muliebres, 40 Tetanus agiiorum, 741 Tetaniis neonatorum, 741 Thigh and croup presentation, 467 riioracic evisceration, 550 Thrombi or hiematomata, 349 Thrombus of the vagina, 619 of the vulva, 619 Tokology, definition of, 1 Tongue-tie, 747 Torsion of the uterus, 309 in the cow, 312 in the mare, 340 in other animals, 343 Traction, degree of, 524 directi(m i f 524 Traumatic lesions of genital and iieiL'h- bouruig organs, 609 Treble monstrosities, 398 Trusses, 594, 707 Tubal lactation, 174 Tubuli lactiferi, 33 Tumours in f.i^tus, 394 in pelvic cavity, 293 in vicinity of genital organs, 353 luinours, cancerous, 347 condylomatnus 348 fibroid, 348 lipomatous, 348 niyomatous, 348 papillomatous, ; 48 sarcomatous, 3i7 uterovaginal. 344 iumultuous labour, 257 Turning, 491 rr ^'• tMBiLiCAi. cord, 93 anomalies in, 373 differences in, 94 diinensirns of, 94 hiemorrhage from, 702 hernia of, 78-1 inflammation of, 714 obstacle to birth, 373 vein, 94 vesicle, 84 differences in, >', Umbilicus, ledema of, 713 Urachus, 83, 94 persistence of, 703 Uterine arteries, 41 c.vsts, 180 dilator, 359 inertia, 422 milk, 91 Utero-vaglnal tumourB, 344 Uterus, 39 amputation of, 600 deviations in. 306 differences in, 42 direction of, 134 form of, 39, 1 32 hernia of, 193 influence of on other organs, 135 inversion of, 576 laceration of, 609 modifications in, 12S occlusion of, 369 position of foutus in, 137 reduction of, 585 reposition of, 385 retention of, 588 rupture of, 609 • of ante partum, 613 of, during birth, 610 sensibility of, 131 situation of, 39, 134 structure of, 39, 128 torsion of, 309, 340, 343 volume of, 128 Utricular glands, 41 V. Vagina, 36 atresia of, 370 eomplieations in rupture of, 616 differences in, 38 imperforate, 745 inversion of, 603 laceration of, 613 occlusion of, 618 during pregnancy, I ^ f 768 Vagina, rupture of, iii'S throiiiliuH of, 61it Vaginal bulb, 28 constriction, 1570 cystocele, 3f>l exploration, 116 fietation, IT'i hysterotoTny, 5;")! irrij,'ation8, 295 taxis, Xil Vaginitis, 622 Valvula vaginie, 36f) Venereal iLvstnuii, filt Ventral fu'tation, 17;") Version, 491 Vertical diameter of pelvis, 15, 22, 26 Vesicle, umbilical, 81 INDEX. Vesico- vaginal fiHtuIie, (ilS AV'sicuIa alba, 81 Voiniling during pregnancy, 181 Vulva, 27 atresia of, 370 diffeiences in, 30 imperforate, 715 thrombus of, (519 Vulvar atresia, 370 W. Watkk-ha(i, rupture of, 234 Weight of foetus at birth, 125 Wharton's gelatine, 93 Whartonian jelly, 93 Z. /oNLi.AK placenta, 93 |iil THE KND. liaillUve, TimiaU it- to,- , -'() a,ul 21, Kiny miliuiii aired, Strand. REVISED AND ENLARGED CATALOGUE OF I Veterinary Books I AND WORKS TREATING ON Horses, Cattle, Sheep, Swine and Do gs ISSUED BY i I J. A. CARVETH & CO., PUBLISHERS AND IMPORTERS OF Veterinary and Medical Books, 413 Parliament St.. Toronto, Can. 1894. 14 15- 11 k 4. c s IV I il l x.i-ix.ixxp.p.Ms^;.^„p.ji,^„p^p,j^,^j„p^„.„j„.^_ I I If \ LIST OF TEXT BOOKS USED IN THE Ontario Veterinary College, TORONTO, CANADA. *Courtenay's Medicine and Surgery. *Dun's Materia Medica. Duncan's Entozoa of the Horse. Fleming's Operative Surgery. Fleming's Obstetrics. Fleming on Horse Shoeing. *Gould's Medical Dictionary. Gresswell's Equine Medicine. Gresswell's Hospital Equine Prescriber. -Green's Pathology. Hill's Bovine Medicine and Surgery. Hill, on the Dog. ■^King's Muscles of the Horse. Klein's Histology. Liautard's Operative Surgery. Liautard on Castration. M'Fadyean's Anatomy. Steel's Diseases of the Ox. -Strangeway's Anatomy. ^Smith's Physiology. ^"Williams' Medicine. ^^Williams' Surgery. The Books required for first term are marked PRICES GIVEN IN INDEX. Books will be sent Free of Postage upon receipt of Ptice. ■i<'*'.-mmm»mmM>'-xmmmimhmj^miiiii J. A. CARVETH & CO.'S Veterinary and Medical Catalogue, 1894. Agassi* and Gould. Outline OF Comparative Physiology " $i Allen's American Cattle. Their History, Breeding and Management. Ihis book will be considered indis- pensable by every breeder of live stock Kevisen edition. By Lewis F. Allen' Illustrated. Cloth, 12mo .' Amateur. "Horses." Their Rational Treatment and the Causes of their Premature Decay. By Amateur. . . . Anderson. "The Gallop." By Ldward L. Anderson. Illustrt ted with instantaneous photographs by John Annan. Small 4 to, boards ANDERSON -Vice in the Horse " and other papers on Horses and Biding By E. L. Anderson. Demy, 8vo, cloth Anderson. " On Horseback." An mstructive work on horsemanship. ay E. L. Anderson. 12mo, cloth ANDERSON - " How tc Ride and School a Horse." With a System of Horse Gymnastics. By Edward Li. Anderson. Cr. 8vo ANDERSON-" A System'of School Training for Horses." By Edward L. Anderson. Cr. 8vo Anderson -"Modern Horsemanship " A New Method of Teaching, Riding and Training, by Means of Pictures from Life. Fourth edition, revised and enlarged, with forty photogravure plates. By Edward L. Anderson.. Armatagre— " Every Man His Own Horse Doctor." Together with Blaine's Veterinary Art, and numer- ous recipes. A valuable and compre- hensive guide for both the prnfossional and general reader. By Prof. George Armatage, M.R.C.V.S. New Edition. One large octavo volume, 830 pages, half morocco ^^ Armatas^e. " Every Man His oVn Cattle Doctor." The Veterinary t-jf/o/ia-rf/rt.— Embracing all practi- 50 2 50 1 76 90 Cat!r/T*"°" ?l *^^ I^>««^«e8 of Cattle, Sheep and Swine. By Prof George Armatage, M.R.C.V.S.^ One arge octavo volume, 894 pages, with upwards of 350 practical il ustratffs mem'^HT^ °' '^•^^^- ^-^ S meni. Half morocco Armatage-" Cattle." Their Vari'e' ties and Management in Health and Disease By George Armatage, K.'ciy.;..^:!^."!'!^.'^^^^^^^^^^ Armatage -- " The Sheep."'- * ' ' I'ta Varieties and Management in Health and Disease. By George Armatage S'^-doth ..'';'' "lustrations. 1 75 1 50 90 1 00 «6 50 1 00 1 00 1 00 50 5 50 6 50 Armatage - " The Horse. " " ' Itg Varieties and Management in Health and Disease." By Genrap A7rr,T Armatage -"How to Feed the House, AVOID Disease and save M R r V <.^^ ^r^°^^' Armatage! Armatage--" The Horse-owner and ^tableman's Companion," or Hints on the Selection, Purchase, and General Management of the Horee By George Armatage. Third edition," revised, 16mo Armatage-" The Thermometer ' Is AN Aid to Diagnosis in Veterin- ary Medicine," By George Arma- tage, M.R^C.V.S. Second editS. revised and enlarged, 16mo .... n Rn Armatage -"The Veterinarian's rocKET Remembrancer," hein" con- cise directions for the 'treatment of urgent and rare cases. By Georce Armatage M.R.C.V.S. Revised edition, 32mo , „. Armsby-"A Manual o^cimE Feeding." Containing the Laws of Animal Nutrition. ByH.P.Armaby With plates. 12mo., cloth j 75 50 I J. A. Cabvbth & Co.'s Catalogue Hi y Art of Dispensing— A treatise on the methods and proceBses involved in conipoundiDg medical prescrip- tions. Cloth •! Ashby— " NoTEB ON Physiolooi " for the uae of students preparing for ex- amination. With 131 cDRravings. By Henry Ashby, M.D. 8vo., cloth. Ashmont— " Puinch-lkbokDog Train- ing." 12mo., cloth Ashmont— " Doos : Theik Manaoe- MENT AND TREATMENT IN DISEASE." 12nio., cloth Attfleld — " Chemistry : General, Medical and Pharmaceutical." By John Attfield, M.A., Ph.D., F.I.C., F.R.C.S. 12mo., cloth BAOH — " How TO Judge a Horse." A concise treatise as to its Qualities and Soundness ; including Bits and Bitting, Saddles and Saddling, Stable Drainage, Driving one Horse, a Pair, Four-in-Hand, or Tandem ; and ex- tracts from Rarej's and Rockwell's Methods of Training Young and Obstuiate Horses. By Captain F. W. Bach. 12mo., cloth, fully illus- trated BaliOU— " A Compend of Equine Ana- tomy AND Physiology." By W. R. Ballou, M.D. With 29 graphic illus- trations. 16mo Interleaved BANHAIVI — "Taiiles of Veterin- ary PoSOLOGY AND THERAPEUTICS," with weight, measures, etc., for the use of students and practitioners. By George A. Banham, F.R.C.V.S. These tables are intended as an aid to the memory for the dose and pharmacopu^ial preparation of drugs used in Veterinary practice. 12mo., cloth Battersby— "The Bridle Bits." A valuable little work on Horseman- ship. By Col. J. C. Battersby. 12rao., cloth BAUOHER— " New Method of Horse- manship." Including the Breaking and Training of Horses Beale— "How to Work with the Microscope." A complete Manual of Microscopical Manipulation, con- taining a fall description of many new processes of investigation, with directions for examining objects under the highest powers, and for taking photographs of microscopic objects. By Lionel S. Beale. Illustrated. 8vo., eloth Beasley — " Druooists' General Re- ceipt Book." Comprising a copious Veterinary Formulary; Recipes in Patent and Proprietary Medicines, Druggists' Nostrums, etc. ; Perfumery and Cosmetics ; Beverages, Dietetic Articles and Condiments; Trade 00 1 50 60 2 00 2 75 and Re- »2 25 2 50 1 00 1 25 2 00 1 50 1 00 1 00 1 00 7 50 Chemicals, Scientifio Processes, an Appendix of useful tables, vised. Cloth Bentley— " A Text-Book of Organic Matkkia Medica." 8vo BiilinKS— " The Relation of Animal Diseases to the Public Health, and THEIR Prevention." By F. S. Cil- ings. Svo., cloth 4 00 BourKuignon— "On the Cattle Plague ; ou Contagious Typhus in Honr-ir" CiTTLK • ITS History, Of P-.scription and Treat- ML. H. Bourii;uignon, M.D. 12m^ , til - British Htiarmaco^voeia. Cloth BRUCE- " Materia Medica." A Text liook of Materia Medica and Thera- peutics. By J. Mitchell Bruce, M.D., FRCP. , 12mo., cloth Burdett-CouttS— "TheBrookfield Stud." With Colored Illustrations from Oil Paintings and Drawings of Typical Horses and Mares of the differ- ent Breeds. Containing Detailed In- formation as to the Old English Breeds of Hackneys, Cleveland Bays, Yorkshire Coach Horses, Thorough- breds, and Ponies. Their Origin, Families, and History, and How to Breed Them. With special reference to Harness Horses and Hacks. Cloth , 4to Burgess— "American Kennel and Sporting Field." By Arnold Bur- gess. Containing descriptions of the Setter and Pointer, with directions fcr breeding and treatment. Svo .... Bussigny— " Handbook fcr Horse- women." By H. L. de Buseigny. 16mo., cloth CADIOT — " Roaring in Horses." Its Pathology and Treatment. This work represents the latest develop- ment in operative methods for the alleviation of roaring. Each step is most clearly defined by excellent full- page illustrations. By P. J. Cadiot, Professor at the Veterinary School, Alfort. Trans, from the original, by Thos. J. Watt Dollar, M.R.C.V.S , G. B.,Lec. Vet. Med. and Surg.. H. A. S.S. Cloth ilO Carpenter—" Zoology." By W. B. Carpenter. Revised edition, by W. S. Dallas, F.L.S. With General In- dex. Illustrated. 2 vols, each. .. . 2 0(1 Carpenter—" Animal Physiology." By Dr. W. B. Carpenier. 12mo., cloth CHAUVEAU — " The Comparative Anatomy of the Domesticated Animal." By A. Chauveau. Professor at Lyons Veterinary School, France. New edition, translated, enlarged and entirely revised. By George Flem- 2 00 2 00 50 1 Vbtbrinary and Medical Books tifio ProoeBBCB, and useful tables. Re- »2 25 T-BooK OF Organic " 8vo 2 50 .ELATION OF AnIMAL PuDLic Health, and N." By F. S. Bil- 4 00 " On the Cattle TAdlOUS TyI'HCB in p • ITS History, ption and Treat- Bourii;uignon, M.D. 1 25 ico^oeia. Cloth 2 00 aMedica." a Text Medica and Thera- itchell Bruce, M.D., , cloth 1 50 I — "The Brookfield :olored Illustrations igs and Drawings of fid M ares of the differ ■ ataining Detailed In- 5 the Old English leys, Cleveland Bays, 1 Horses, Thorough- nies. Their Origin, listory, and How to Vith special reference es and Hacks. Cloth , 2 00 sicAN Kennel and )." By Arnold Bur- ng descriptions of the nter, vith directions ■ treatment. 8vo.,.. 2 00 NDBOOK FOR HoBBE- H. L. de Bussigny. 'lO -ARiNG IN Horses." nd Treatment. This 3 the latest develop- tive methods for the oaring. Each step is fined by excellent full- ns. By P. J. Cadiot, le Veterinary School, from the original, by Dollar, M.R.C.V.S , Med. and Surg.. H. A. '.10 (looLooY." By W. B. jvised edition, by W. .a. With General In- ed. 2 vols., each 2 00 Animal Physiology." J, Carpenier. 12mo., 1 75 " The Comparative THE DoMESTICATEli A. Chauveau, Professor rinary School, France, anslated, enlarged and ;d. By George Flem- »7 00 1 25 7 00 2 50 op THE Feet and Horses." q 25 1 00 1 75 2 00 75 ing,F.RC.V.8.,8vo., cloih, with 585 Illustrations Chawner— " Diseases of the Horse AND How to Treat Them " By Robert Chawner. 12mo., cloth 11- lustrnted Chetwynd— " Racing Reminiscences AND Exi'ERIENCES OF THE TuRF " By Sir G. Chetwynd. 2 volumes, 8vo., cloth CLARKE— "Horses' Teeth." Treatise on their Anatomy, Pathology, Den- tistry Ac. Revised and enlarged. ^y .W- H^ Clarke 12 mo., cloth. Revised edition, 1893 CLARKE-" Chart Teeth of Fossil Clarke — ''The People's Horse, Cattle, Sheep and Swine Doctor " Elited by William H. Clarke. Cloth Clater's " Every Man His Own Far- rier."— The Causes, Symptoms and Cure of Diseases of Horses and Dogs. By Edward Mayhew, Cloth Clater's " Every Man His Own Cattle Doctor." By Francis Clater. New edition. Revised by Edward May- hew. I2mo.. cloth CLEAVELAND—"PiioNonNciNQ Medi- cal Lexicon." Pocket edition. Cloth Coburn— "Swine Husbandry." Man- ual for the Rearing, Breeding and Management of Swine. By F D Coburn. Cloth ; illustrated. ....'...' l 75 Cooley — " Cyclop.edia of Practical Rkceipts and Collateral Informa- tion IN THE Arts, Manufactures Professions and Trades," including Medicine, Pharmacy and Domestic Economy. Designed as a Compre- hensive Supplement to the Pharma- copeia, and General Book of Refer- ence for the Manufacturer, Trades- man, Amateurand Heads of Families. Sixth edition. Two volumes. Svo illustrated. Price ' ecu RTN EY-" Manual of" ' VeterV- n.^ry Medicine and Surgery," By .. V. S. Crown, COX- Disease embrace _^^ have been observed, suclTas in chok- ing: the disorders and accidents occuring to the stomach and intes- tines ; affection of the brain ; and some special forms of lameness, etc. By J. Roalfe Cox, F B.C. VS. Svo , «lorh, i'ullv illustrated CuiTiberlancl-"THE Guinea Pia for I'ooi. I Captlk Doctok." Also how to Develop Speed in Horses and how beat to Breed andTame them. From the works of the most cele- brated European, Amcricanand Can- adian veterinary authorities. By E. King Dodds. lUustratc.l 550 pages. . 2 50 Does of Great Britain, Amer- ica and other Countries- Compiled from Stonehenge and other standard writers. 12mo., cloth ... . 200 Driving; — By the Duke of Beaufort and other authorities. Crown 8vo , cloth $3 50; half blue morocco, gilt top . . 5 00 Du Hays& Weld— "Thk Pkuchkkdn House." In America, by Col. M. C. Weld. In France, by Charles Du Hays. Cloth, 12mo 50 DUN — "VETERiNAnv Meiiicines, theiu Actions am> Uses." By Finlay Dun, V.S. New Revised English edition (almost entirely rewritten) 6vo., cloth 3 00 Sheep ' 4 00 Duncan — " Intkhnai. Pahasitesofthk House" (Entozoa). By J. T. Dun- can, M.D., CM., V.S. Illustrated. Cloth 1 00 Duncan— "Thi: House." 12mo., cloth 75 Dwyer— " Seats and Saddles." Bits and Bitting, Draught and Harness, and the Prevention and Cure of Res- tiveness in Horses. By Francis Dwyer. 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(living an account of the Origin, Improvement and Characteristics of the Breed. By James Macdonaid and James Sinclair. Illu Btrated. 500 pages 5 00 MAQNER— " AiiT of Taminu anh Enu- ( AiiNi. iMi; HoiiHF ' By D. Magner. Thin is a great book, the result of years of lal)or and research by the author, who hasuparcd no expense in its publication. In addition to the chapters on the education of tho horse, there are others on the Feeding, Stabling, Shoeing, with directions for practical treatment for Sickness, liamcness, etc. Upwards of 1,000 pages, illustrated with 000 engrav- ingH. 8vo., cloth J5 00 MAQNER — " VETEItlNAltV Di.vohams." (1) Tho Structure of Horse'a Foot (in colors). The Structure of Horse's Foot (EtfectHof Bad Treatment of the Feet). Mounted and Varnished. 2 00 (2) The Shoeing of the Horse. The Education of the Horse. Mounted and Varniehod 2 00 Manningf- "Ii.i.rsTiiATKii Stock Doc I'OK AND Live Stock Encyci.oi'.f.dia." Cloth, 8vo 1 25 Martin ■— " Hoo Raisino and PoiiK Making." By Ilufus I?. Martin. Paper, 12mo 10 Martin— "The Family Horse. ' With illustrations concerning his care, stabling and feeding 12 mo., cloth 1 00 Martin— " Fences, Gvths, Buidoks." 301) illustrations 1 25 Martin— " Farm Ai'I'lianies " (Useful and Labor-saving). Nearly 250 il- lustrations. Cloth 1 25 Martin — "Farm Conveniences." 212 illustrations 1 75 Martin — " Cattle, thkib Vauioub BiiKF.DS, Man.\," the Dog. By (t. B Taylor. Cloth 75 Tanner — " The Am'hamet of thf. PiiiNCiPLKs OF A(U(i(;i;i,TUKF,." By Professor Henry Tanner, F.C.S 20 Tanner — " Jack's Education ; or How He Learned Fanning. By Professor Tanner, F.C.S. 2nd edition 125 Tanner—" Elioikntahy Lkssons in ruK SciKNci-; of AcuicrLTUUAL Puac- tick." By Professor Tanner, F.C.S. 2nd edition 1 25 Tanner--"TiiK Piuncipu-.s of AoiiicuL- TiiiK." By Professor Tanner, F.C.S. 35 Tanner — "Fihst Puinciplf.s of Aohi- cuLTUUE." 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Liautard, V S 12mo. cloth, illustrated .. 1 00 1 00 1 60 2 00 I Veterinary Journals. THE JOURNAL OF COMPARATIVE PATHOLOGY AND THERAPEUTICS. A new Veterinary Journal, idited by J. M'Fadyean, M.B., CM., B.Sc, F.R.S.E., Royal Veterinary College, London. Each number consists of about 100 pages royal 8vo., and contains: (1) Original articles by the most eminent British Veterinarians relating to Anatomy, Pathology, Medi- cine, Surgery or Hygiene. (2) Translations of important articles from current Continenl.d Veterinarian Literature. (8) A Synopsis of the most recent Discoveries and Advances in the domain of the Medical Sciences. (4) Woodcuts and lithographs where necessary to illustrate the text. The first part was issued on 31st March, 1888. Published quarterly, $8 per annum ; single copies, 75c. VETERINARY JOURNAL AND ANNALS OF COMPARATIVE PATH- OLOGY. Edited by Dr. George Fleming. A monthly journal devoted to the interests of Veterinarians. Subscriptions, per annum, $5 ; single copies, 50c. THE JOURNAL OF COMPARATIVE MEDICINE AND VETERINARY ARCHIVES. Edited by W. A. Conklin, Ph.D., D.V.S., and Rush Bhippen Huidekoper, M.D., Veterinarian (Alfort), published monthly, per annum, $3 ; single copies. 80o. AMERICAN VETERINARY REVIEW. Edited by A. Liautard, M.D., V.M., Foreign Corresponding Member of the Central Society of Veterinary Medicine, Paris, Honorary Fellow of the Royal College of Veterinary Surgeons, England. Published monthly. Per annum, $8; single copies, 25c. The above journals will be sent free of postage to any address upon receipt ( f price. Subscriptions are, in every case, payable in advance. Address all com- munications to J. A. CARVETH & CO., Veterinapy Publishers, 413 Parliament St., Toronta, Canada. als. THERAPEUTICS. M.B., CM., B.Sc, number oonsistB of Qal articles by the ', Pathology, Medi- rtant articles from ^nopsis of the most e Medical Sciences, rate the text. The I quarterly, $8 per >AEATIVE PATH- ;hly journal devoted annum, $5 ; single ND VETERINARY D.V.S., and Rush >li8hed monthly, per A. LlAUTARD, M.D., Jociety of Veterinary liege of Veterinary ^nnum, $8 ; single I > any address upon Address all com- CO., I tada.