REESE LIBRARY 
 
 UNIVERSITY OF CALIFORNIA. | 
 
 \r PlOLOGt 
 C/i7S-S NO^ iBRARY 
 G 
 

A TEXT-BOOK 
 
 OP 
 
 Veterinary Obstetrics: 
 
 INCLUDING THE DISEASES AND ACCIDENTS INCIDENTAL TO 
 
 PREGNANCY, PARTURITION, AND EARLY AGE IN 
 
 THE DOMESTICATED ANIMALS 
 
 CUitl] vLttio i)unbrcb anb (ru3L-ntri-sii- iHlustnUions 
 
 GKORGE FLEMING, C.B., LL.D (Glas.), F.KC.V.S. 
 
 PHISCIPAI. VkTEHIXAKY SciUiEON OF THE HltlTISH AH.MY (ReTIIIED) 
 
 HUNOHAUY tOUEICN .MKMHEll Of THE ACAUEMIE HOYALE DE MEItECINE HEIXiigiTE: 
 
 rOKEION tMiKKESl'OXDINU MEMBER OE THE SOCIETE KOYALE DE MEDECIXE 
 
 PL'BLiyCE UE IIELGIQL'E; FOllEIGN ASSOCIATE OF THE SOCIETE CEXTHALE 
 
 VETEKINAIKE DE M^DECINE DE FRANCE; HONORARY FOREIUN MEMBER 
 
 OF THE SO<IETE XATIOXALE D'AQRICULTURK DE FRANCE; 
 
 HONORARY I.IKE MEMUbR OF THE ROYAL AORICULTURAI- 
 
 SOCIETY (IK ENGI.AXD, ETC. 
 
 SECOND EDITION, REVISED 
 
 V 
 
 Nkw York 
 
 WILLIAM li. JENKLNS 
 
 VETERINARY PUBLISHER AND BOOKSELLER 
 
 851 AND 853 Sixth Avenue 
 
 I'JOl 
 
r \ 
 
 (\ 
 
 "^ 
 
 \ 
 
 
 ^t^^^ 
 
ty 
 
 PREFATORY NOTK TO THE SECOND EDITION. 
 
 In preparing a second edition of this work, it has been subjected to 
 some alteration and considerable revision, in order to make it more 
 correct and, while introducing much new matter, to keep it within 
 reasonable dimensions. The illustrative cases given in the first edition 
 have been almost entirely omitted, and for several reasons, the chief of 
 which was that to I'etain them and add others that have since been 
 reported would greatly increase the bulk of the volume, while perhaps 
 contributing little to its usefulness. 
 
 It is scai'cely necessary to state that everything has been done to 
 make this edition as complete and acceptable as its predecessor ; the 
 best authorities on the different subjects included in tlie work have 
 been consulted and utilised in bringing the information up to date, and 
 more woodcuts have been added ; so that the book might continue to 
 be considered as at least equal to the best of those which have appeared 
 on this important branch of veterinary science. 
 
 GEORGE FLEMING. 
 
 HiGicF.K Lkigh, Combe Martin, North Dkvox, 
 Xovember, 1895. 
 
 9409G 
 
V 
 
 / 
 
 PvEFACi: TU THE FIRST EDITION. 
 
 Wmkn we consider the vast and yearly increasing amount of animal 
 wealth we possess, the great skill, attention, and expense bestowed on 
 the perfecting of the most important of the domesticated creatures, 
 which are daily becoming more essential factors in our progressive 
 civilization, it is somewhat remarkable, and rather discreditable, 
 though not altogether inexplicable, that nothing in the way of a work 
 devoted to the parturition of animals, and to the diseases and accidents 
 incidental to that period, has yet appeared in the English language. 
 For very many years the Anglo-Saxon race has devoted itself most 
 assiduously and praiseworthily, and with the greatest measure of 
 success, to the multiplication and full development of those (jualities 
 which more particularly enhance tlie value and utility of these animals. 
 This has entailed unwearied etYorts, the closest and shrewdest observa- 
 tion, and all the judgment and practical and scientific knowledge which 
 generations of men could afford. 
 
 It might therefore be considered that everything relating to the 
 reproduction and reai'ing of these creatures must, from a materialistic 
 point of view alone, be of great moment not only to breeders and stock- 
 raisers, but to the entire community. Great loss may be, and far too 
 often is, quickly sustained among animals during the pregnant or 
 parturient period, and this loss may not only prove very serious to 
 individuals, but make itself gravely felt by the general public. A 
 treatise which might aid, to however small an extent, in pointing out 
 how these losses may be averted or remedied, nmst surely, then, prove 
 a welcome boon to those who are engaged in breeding and raising 
 animals, as well as to all who are interested — and few are not — in their 
 nmltiplication and welfare. At the conunencement of this century a 
 book was i)ublished, entitled, " A Practical Treatise on the Parturition 
 of the Cow, or the Extraction of the Calf ; and also on the Diseases of 
 Neat Cattle in General." The author was Edward Skellet, " Professor 
 of that part of the Veterinary Art "; but that and otiier parts of this art 
 were certainly in a very crude, meagre, and elementary condition in the 
 days when Skellet ventured to touch upon them ; and yet his book may 
 be said to be the only attempt which has been made in this direction in 
 England. Papers on Obstetricy—soine of them of much value — have 
 appeared from time to time in professional journals ; but while in other 
 countries many treatises have been produced, no one in tliis country 
 has undertaken the task of supplying what has, for very many years, 
 been an urgent want — a text-book of Obstetricy worthy of modern 
 Veterinary Science. The necessity for such a guide has been felt more 
 particularly by the Veterinary practitioner at the commencement of his 
 career ; for only too frequently he has had to rely entirely upon his own 
 resources, and to painfully acqmre, at the expense of his employers, that 
 
vi PREFACE TO THE FIRST EDITION. 
 
 knowledge of the subject which was either very imperfectly or not at all 
 taught at the Veterinary Schools, and could not be found elsewhere. 
 To deliver one of the larger domesticated animals in a case of difficult 
 parturition requires special knowledge and aptitudes ; and even those 
 practitioners who are fortunate in possessing these will be the first to 
 confess that to attempt delivery in many cases is really a work of the 
 Danaides. 
 
 To the members of the Veterinary profession, therefore, no apology 
 can be necessary in offering for their acceptance the present book. 
 Eveiy endeavour has been made to make it a standard work, represen- 
 tative of the most advanced views relating to this department of 
 Veterinary Medicine. Animated by the desire to present my colleagues 
 in English-speaking countries with a text-book at least equal to the best 
 of the many which have been published on the Continent — a list of 
 which is appended — every likely source of information has been made 
 available, and no labour or pains have been spared to render my onerous 
 and very difficult task as complete and as useful as possible. A glance 
 at the references and illustrative cases will testify to the correctness of 
 this statement. 
 
 It has often been a matter for regret by the accoucheur of women, 
 that the parturient period of animals was one upon which they could 
 obtain but little, if any, information ; and its relations and importance 
 with regard to this and the puerperal period in the human species has 
 frequently been insisted upon. I trust that this cause for regret may be 
 at least partially removed, and that the text-book may prove of some 
 service to those medical men who are anxiously striving to advance 
 human obstetricy, and a knowledge of those pathological processes 
 around which there is still doubt and uncertainty. 
 
 My best thanks are due to Professor Saint-Cyr, of the Lyons Veteri- 
 nary School, for allowing me to use many of the drawings which illus- 
 trate his excellent treatise on the same subject, and to w^hich I have 
 often referred with much advantage. I am also greatly indebted to 
 Mr. W. A. Cartwa-ight, of Whitchurch, Salop, for his kindness in look- 
 ing over the proof-sheets containing the more practical portion of the 
 subject ; his long experience and skilful practice, combined with careful 
 reading and study, rendered his assistance particularly valuable in this 
 respect. 
 
 In this first attempt to deal with a very serious task, omissions and 
 defects will doubtless be discovered. But in the circumstances in which 
 I was placed they were unavoidable, and perhaps, after all, they will 
 not interfere with the utility of the work. Now that certain principles 
 in animal obstetrics have been laid down, and a commencement has 
 been made to establish the practice of the Veterinary Obstetrist on a 
 sound scientific basis, it is to be hoped that rapid progress will be made 
 in rendering it more perfect. Humanity is perhaps as deeply concerned 
 in this direction as in many others, and it must always be an important 
 object with the Veterinary Surgeon to spare animals pain, and to abridge 
 their sufferings as much as possible. 
 
 GEOEGE FLEMING, 
 Second Life Guards. 
 Regent s Park Barracks, 
 November, 1877. 
 
CHRONOLOGICAL LIST OF WORKS 
 
 OX VETERINARY OBSTETRICS PUBLISHED 
 
 UP TO THE PRESENT TIME. 
 
 Franxe. 
 
 Iiai7iarcl. Traite Complet de la Parturition des Femelles des Animaux 
 
 Domestiques. Paris, 1845. 
 Saint-Cyr. Traito d'Obstetrique Veterinaire. Paris, 1875. 
 Saint-Cyr and Violet. Second Edition of the above. Paris, 1888. 
 
 Germany. 
 
 Jorg. Anleitung zu einer Eationellen Geburtshiilfe der Landwirthschaft- 
 lichen Thiere. Leipsic, 1818. This is ahiiost a complete reproduc- 
 tion of the English work by Skellet, at least so far as the Plates are 
 concerned. 
 
 Binz. Theoretisch-praktische Geburtshiilfe filr die Haussaugethiere. 
 I^eiburg, 1830. 
 
 Gilnthcr. Handbuch der Praktischen Yeteriniirgeburtshiilfe, nebst 
 einem Anhange iiber die Wahl der Zuchtpferde. Hanover, 1830. 
 
 Thomas. Kenntnisse, Erfahrungen und Hulfsleistungen bei den Gebur- 
 ten der Pferde. Glogau, 1832. 
 
 Sey/lert. Die Geburtshiilfe bei den Kiihen, 1838. 
 
 ZHlcr. Kurzgefastzter, jedoch moglichst griindlicher Unterricht iiber 
 die Geburtshiilfe der Gniszeren Landwirthschaftlichen Ilausthiere. 
 Schleusingen, 1838. 
 
 Dietcrichs. Handbuch der Praktischen Geburtshiilfe bei den Groszeren 
 Hausthieren. Berlin, 18-15. 
 
 Jiaumeister-IiiicfT. Die Thieriirztliche Geburtshiilfe. Fifth edition, 
 Stuttgart, 1869 ; sixth edition, Berlin, 1878. 
 
 Ziirn. Handbuch der Tliieriirztlichen Geburtshiilfe. Leipsic, 1863. 
 
 Keh rcr. Beitriige zur vergleichenden und experimentellen Geburtskunde. 
 Giessen, 1864. 
 
 Thovias. Versuch einer Anweisung zur Geburtshiilfe der Pferde. Mar- 
 burg, 1866. 
 
 Harms. Lehrbuch der Thieriirztlichen Geburtshiilfe. Hanover, 1867 ; 
 second edition, 1884. 
 
 Franck. Handbuch der Thieriirztlichen Geburtshiilfe. Berlin, 1876; 
 second edition, edited by Ph. Goring, Berlin, 1887. 
 
 Belgium. 
 
 Dclwart. De la Parturition des Principales Femelles Domestiques. 
 
 Brussels, 1839. 
 Dencubounj. Traite Pratique d'Obstetrique Veterinaire. Brussels, 
 
 1880. 
 
viii LIST OF WORKS ON VETEniNARY OBSTETRICS. 
 
 Holland. 
 
 Eberkard and Guntlicr. Veiiiandeliug over het Verlossen der Koeyen. 
 Amsterdam, 1793. 
 
 Sweden. 
 
 Sjostedt. Handbok i Forlossnings Konsten for Veteriniirer och uppfo- 
 dare af Husdjur. Stockholm, 1875. 
 
 Austria. 
 
 Hcnkcl. Die Geburtshiilfe bei den Kiihen. Second edition, Vienna, 
 1840. 
 
 POL.AND. 
 
 Seifert and Tennchcr. Lehrbuch der Pferdeiirztlichen Geburtshiilfe. 
 
 Prague, 1820. 
 Kaldcrt. Praktische Anleitung zu einer naturgemjiszen Geburtshiilfe 
 
 der laudwirthschaftlichen Hausthiere. Prague, 1830. 
 
 Italy. 
 
 Gattaneo. Manuale di Obstetricia Yeterinaria. Milan, 1845. 
 LanziUofti-Buonsanti. Manuale di Obstetricia Veterinaria. Milan, 
 
 1871. 
 Boschetti and Bassi. Trattato di Ostetrica Veterinaria. Turin, 1889. 
 
 A translation of Fleming's Text-Book, with additional remarks by 
 
 Professor Bassi. 
 
 England. 
 
 Skellet. A Practical Treatise on the Parturition of the Cow, or the Ex- 
 traction of the Calf ; and also on the Diseases of Neat Cattle in 
 General. London, 1807. 
 
 Fleviing. Text-book of Veterinary Obstetrics : including the Diseases 
 and Accidents incidental to Pregnancy, Parturition, and Early Age 
 in the Domesticated Animals. First edition, London, 1878 ; second 
 edition, 1896. 
 
T A J! L E OV I L L U S T 11 A T 1 N S. 
 
 no. 
 
 1. Pelvis of the Mare ... - 
 
 2. Pelvis of the Cow - - - - 
 
 3. Pelvis of the Sheep - - - - 
 
 4. Lateral Ligaments of the Sacrum and Pelvis 
 0. Ligaments of the Lumbar Vertebra), Sacrum 
 
 and Pelvis, seen from below 
 G. Longitudinal Section of a Mare's Pelvis 
 
 7. Diagram of the Mare's Pelvic Axis - 
 
 8. Inlet of the Pelvis of the Mare : Wide Pelvis 
 
 9. Inlet of the Pelvis of the Mare : Narrow 
 
 Pelvis ----- 
 
 10. Longitudinal Section of the Cow's Pelvis - 
 
 11. Inlet of the Cow's Pelvis : Narrow Pelvis - 
 
 12. Inlet of the Cow's Pelvis : Wide Pelvis 
 
 13. Bones of Pelvis of Mare 
 
 14. Bones of Pelvis of Horsf 
 
 !.">. ^Tedian Section of the Pelvis of the Horse - 
 I t'l. Median Section of the Pelvis of the Mare - 
 17. The Generative Organs of the Mare in nitu 
 
 15. Section of Udder of Cow 
 
 19. Lobale of Mammffl - - - - 
 
 20. Section of the Cow's Teat - 
 
 21. Generative Organs of the Mare : isolated - 
 
 22. Nerves of Mare's Uterus 
 
 23. Utricular Gland of a Pregnant Goat 
 
 24. Utricular Gland of a Pregnant Cow 
 
 25. Horizontal Section of Uterine Glands 
 
 2t>. Uteru.", Oviducts, and Ovaria of the Sheep - 
 
 27. Ovary opened vertically - . . 
 
 28. Portion of the Ovary of a Pig 
 
 29. Graafian Vesicle in Mare's Ovary 
 
 30. Ovulam of the Mare 
 
 31. Formation of the Ovisac in the Bitch's Ovary 
 
 32. Graafian Vesicle and Ovum - 
 
 33. Escape of Ovum from Ovisac 
 
 34. Successive Stages in Formation of Corpus 
 
 Lnteum in Graafian Follicle of Sow - 
 3'). Impregnating Tube - - . - 
 
 
 
 
 I'Aor. 
 
 Bauinehler 
 
 and Riirjf 
 
 3 
 
 Ibid. 
 
 - 
 
 - 
 
 C) 
 
 Ibul 
 
 - 
 
 
 7 
 
 Leyh 
 
 - 
 
 
 8 
 
 Ibid. 
 
 - 
 
 . 
 
 10 
 
 Saiid-Cijr 
 
 - 
 
 - 
 
 13 
 
 Ibid. 
 
 - 
 
 - 
 
 14 
 
 Ibid. 
 
 
 - 
 
 l.'j 
 
 Ibid. 
 
 
 - 
 
 If, 
 
 Ibid. 
 
 - 
 
 
 17 
 
 Ibid. 
 
 - 
 
 - 
 
 18 
 
 Ibid. 
 
 - 
 
 - 
 
 18 
 
 Ibid. 
 
 
 - 
 
 20 
 
 Ibid. 
 
 
 
 20 
 
 Franrk 
 
 
 
 22 
 
 Ibid. 
 
 
 - 
 
 22 
 
 Sain(-C'i/r 
 
 - 
 
 - 
 
 28 
 
 Fninck 
 
 - 
 
 - 
 
 34 
 
 Virchow 
 
 - 
 
 - 
 
 35 
 
 Gnibiiurt 
 
 
 - 
 
 35 
 
 Chauvcav 
 
 - 
 
 - 
 
 37 
 
 Franch 
 
 
 - 
 
 42 
 
 Ibid. 
 
 - 
 
 - 
 
 43 
 
 Ibid. 
 
 - 
 
 - 
 
 43 
 
 Ibid. 
 
 - 
 
 - 
 
 44 
 
 Oiroi 
 
 
 
 4.') 
 
 y^tint-Ci/y 
 
 - 
 
 - 
 
 50 
 
 Ibid. 
 
 - 
 
 - 
 
 5(» 
 
 Franch 
 
 - 
 
 - 
 
 50 
 
 Ibid. 
 
 - 
 
 - 
 
 50 
 
 liisrhnf 
 
 - 
 
 - 
 
 52 
 
 Barry 
 
 - 
 
 
 53 
 
 Thomson 
 
 - 
 
 - 
 
 53 
 
 Pour he t 
 
 
 
 54 
 
 Luford 
 
 
 
 G7 
 
TABLE OF ILLUSTRATIONS. 
 
 36. Section of Impregnating Tube 
 
 37. Dilator of the Cervix 
 
 38. Ovum from Oviduct of Rabbit 
 
 39. A more advanced Ovum 
 
 40. Ovum from Uterine half of Oviduct 
 
 41. Ovum from Uterine end of Oviduct 
 
 42. Blastoderm and Primitive Trace 
 
 43. Ovum Twenty to Twentj-five Days Old 
 
 44. Ovum about a Month Old - 
 
 45. Chorion of Mare at Mid-term 
 
 46. Foetal Membranes of the Cow at Mid-term - 
 
 47. Foetal Membranes of the Goat at Full Time 
 
 48. Foetus and Foetal Membranes of Cat 
 
 49. Foetus of Mare and its Envelopes - 
 
 50. Plan of Foetal Envelopes in Mare - 
 
 51. Portion of Chorion with Placentulas : Cow- 
 
 52. Accessory Placentulse in a Cow's Uterus 
 
 53. Accessory Placentulte on the Cow's Uterus - 
 
 54. Foetal Portion of Placenta Prsevia - 
 
 55. Maternal and Foetal Cotyledons of the Cow 
 
 56. Cotyledon of a Cow's Uterus 
 
 57. Foetal Circulation in a Transition State 
 
 58. Foetal Circulation : Advanced Period 
 
 59. Male Foetus of the Mare 
 Genito-uriuary Organs of a Foetal Sheep - 
 Female Organs of a Foetal Deer 
 Female Foetus of the Cow - 
 
 63, Genital Organs of a Hermaphrodite Goat - 
 
 64. 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 Cyst or Mole : Human 
 Cow in the Act o£ Parturition : Standing 
 
 Position - . . . 
 
 Mare in the Act of Parturition : Recumbent 
 
 Position - - . _ 
 
 71. Normal Position of the Foetus in the Mare 
 
 at Parturition : First Stage 
 
 72. Normal Position of the Foetus in the Mare 
 
 at Parturition : Second Stage - 
 
 73. Normal Position of the Foetus in the Mare : 
 
 Third Stage - . - - 
 
 74. Diameters of the Pelvis 
 lb. Lumbo-sacral Position 
 
 76, Right Cephalo-ilial Position in the Dorso- 
 lumbar Presentation 
 
 60, 
 61, 
 62, 
 
 65, 
 
 66, 
 67. 
 68. 
 69. 
 
 70. 
 
 Ibid. 
 
 ■ 67 
 
 Ibid. 
 
 - 67 
 
 Bischoff 
 
 - 69 
 
 Ihkl. 
 
 - 69 
 
 Ibid. 
 
 - 70 
 
 Ihkl. 
 
 - 70 
 
 Saint-Cyr 
 
 - 71 
 
 Ihkl. 
 
 - 73 
 
 Ihkl. 
 
 - 74 
 
 Colin 
 
 - 75 
 
 Ibid. 
 
 - 76 
 
 Ibid. 
 
 - 77 
 
 Buffon 
 
 - 78 
 
 Chauveau 
 
 - 79 
 
 Saint- Cyr 
 
 - 82 
 
 Gurlt 
 
 - 87 
 
 Franch 
 
 - 88 
 
 Ibid. 
 
 - 88 
 
 Ibid. 
 
 - 89 
 
 Colin 
 
 - 90 
 
 Pettigreio 
 
 - 91 
 
 Saint- Cyr 
 
 - 104 
 
 Colin 
 
 - 106 
 
 Franch 
 
 - Ill 
 
 Midler 
 
 - 112 
 
 Ihkl. 
 
 - 114 
 
 Fr ancle 
 
 - 114 
 
 Leuchart 
 
 - 115 
 
 Franch 
 
 129 
 
 Thomson 
 
 - 133 
 
 Saint-Cyr 
 
 - 165 
 
 Zundel 
 
 - 178 
 
 Boivin 
 
 - 179 
 
 Original 
 
 - 236 
 
 Baumeister - 
 
 - 237 
 
 Franch 
 
 - 240 
 
 Ibid. 
 
 - 241 
 
 Saint-Cyr 
 
 - 243 
 
 Saint-Cyr 
 
 - 244 
 
 Ibid. 
 
 - 245 
 
 Franch 
 
 246 
 
TABLK OF ILLCSrJLlTIoXS. 
 
 77. Cephalo-sacral Position in the Dorso-lumbar 
 
 Presentation . - - - 
 
 78. Cei)halo-sacnil Position in the Dorso-lumbar 
 
 Presentation . - . - 
 
 7'.\ Left Cephahi-ilial Position in the Sterno- 
 abdominal Presentation 
 
 80. Mammarj' Gland during Lactation 
 
 81. Completely Deformed Pelvis : Mare 
 
 82. Pelvic Exostosis - . - - 
 
 83. Fracture of the Pelvis 
 
 84. Uterine Hernia : ^Lare 
 
 85. Uterine Hernia : Cow 
 
 86. Incomplete Torsion of the Uterus - 
 
 87. Multiple Torsion of the Uterus 
 
 88. Diagram of Uterine Torsion 
 
 89. Left Uterine Torsion 
 
 90. Right Uterine Torsion 
 
 91. Right Uterine Torsion : ^Iani[)ulation 
 
 92. Left Uterine Torsion : Manipulation 
 
 93. Left Uterine Torsion hi situ 
 
 94. Darreau's Retroversor 
 
 95. Barnes' Uterine Dilator 
 
 96. Skull of a Hydrocephalic Calf 
 
 97. Skull of a Hydrocephalic Calf 
 
 98. Skull of a Hydrocephalic Foal 
 
 99. Calf affected with Hydrocephalus - 
 
 100. Extraordinary Development of theCranium 
 
 of a Hydrocephalic Calf 
 li'l. Anasarcous Foetal Calf 
 IH-J. Anasarcous Fojtal Calf 
 l<t;5. Deformed Head and Xeck of a Foal 
 104. Ectromelian Monstrosity : Horse - 
 in.'). Ectromelian Monstrosity : (ioat - 
 I'M'). Symelian Monstrosity : Pig 
 107. Celosomian Monstrosity : Calf 
 ILH. Ectopia Cordis .... 
 
 In'.t. Pseudencephalian ^lonstrosity 
 lli>. Cyclopean Monstrosity : Ram 
 ill. Cyclopean Monstrosity : Ass 
 \\'2. Acephalian Monstrosity - . . 
 
 II.?. Schistocephalus Fissislabrus 
 1 14. Camylorrhacchis Contorta - 
 11"). Monomphalian Monstrosity 
 110. Skull of Syncephalian Monstrosity 
 
 117. Monocephalian ^lonstrosity 
 
 118. Sysomian Monstrosity 
 
 119. Monosomian Monstrosity : Calf 
 12i>. Polymelian Monstrosity : Calf 
 
 rJl. Double Parasitic Monstrosity : Cow 
 
 Saint -Ci/r 
 
 ■ 
 
 247 
 
 /hi,/. 
 
 - 
 
 248 
 
 FranrL 
 
 . 
 
 •248 
 
 Virchow 
 
 - 
 
 272 
 
 Saint- Ci/r 
 
 . 
 
 290 
 
 Ihid 
 
 - 
 
 291 
 
 Ibid. 
 
 . 
 
 292 
 
 Ibid. 
 
 - 
 
 298 
 
 Zundel 
 
 - 
 
 299 
 
 Ibid. 
 
 . 
 
 313 
 
 Gurlt 
 
 - 
 
 314 
 
 Saiiit-Cyr 
 
 - 
 
 322 
 
 G'lrlt 
 
 - 
 
 323 
 
 Ibid. 
 
 - 
 
 323 
 
 Saint-Cyr 
 
 - 
 
 324 
 
 Ibid. 
 
 - 
 
 324 
 
 Rosnif/nol 
 
 - 
 
 327 
 
 Dorreau 
 
 - 
 
 333 
 
 Origi)iol 
 
 - 
 
 359 
 
 S<iint-Ci/r 
 
 - 
 
 382 
 
 Ru eff" — lia u m eister - 
 
 383 
 
 Saint-Ciji' 
 
 - 
 
 383 
 
 Rueff—Bi 
 
 umeister - 
 
 384 
 
 (h-ifjinal 
 
 . 
 
 385 
 
 Fvanck 
 
 - 
 
 388 
 
 Ibid. 
 
 - 
 
 388 
 
 Ibid. 
 
 - 
 
 392 
 
 Zundel 
 
 - 
 
 402 
 
 Rufff — Buumeister - 
 
 4(12 
 
 Ibid. 
 
 - 
 
 403 
 
 Ibid. 
 
 - 
 
 403 
 
 Ilering 
 
 - 
 
 404 
 
 Ibid. 
 
 - 
 
 404 
 
 Ibid. 
 
 - 
 
 405 
 
 Gurlt 
 
 - 
 
 405 
 
 Ibid. 
 
 - 
 
 406 
 
 Rueff—Baumeister • 
 
 406 
 
 Ibid. 
 
 - 
 
 407 
 
 Ibid. 
 
 . 
 
 408 
 
 Franck 
 
 - 
 
 408 
 
 Ilurff— Buumeister - 
 
 409 
 
 Rurf-Bftu 
 
 nifister 
 
 41)9 
 
 Original 
 
 • 
 
 410 
 
 Rueff—Baumeister - 
 
 410 
 
 Zundel 
 
 . 
 
 411 
 
xii TABLE OF ILLUSTRATIONS. 
 
 FIG. 
 
 122. Sysomian Monstrosity - . . Saint-Cyr 
 
 123. Celosomian Monstrosity : Lamb - - Youatt 
 
 124. Twin Foetuses in Different Presentations - Saint-Cyr 
 
 125. Anterior Presentation : Deviation of the 
 
 Hind -limbs in the Pelvis - - Ihid. 
 
 126. Anterior Presentation : Hind-limb Devia- 
 
 tion - - . . . Franch 
 
 127. Anterior Presentation : Fore-limb crossed 
 
 over the Neck - - . - Saint-Cyr 
 
 128. Anterior Presentation : Fore-limbs flexed 
 
 at the Knees - - . . Ih'id. 
 
 129. Anterior Presentation : Extending the 
 
 Fore-limb .... Franck 
 
 130. Anterior Presentation : One Fore-limb 
 
 completely retained - - - Saint-Cyr 
 
 131. Anterior Presentation : Both Fore-limbs 
 
 completely retained - . . Ihid. 
 
 132. Anterior Presentation : Downward Devia- 
 
 tion of the Head - - - Ihid. 
 
 133. Anterior Presentation : Extreme Down- 
 
 ward Deviation of the Head - - Ihid. 
 
 134. Anterior Presentation : Lateral Deviation 
 
 of the Head towards the vShoulder - Ihid. 
 
 135. Anterior Presentation : Lateral Deviation 
 
 of the Head towards the Abdomen - Ibid. 
 
 136. Anterior Presentation : Deviation of the 
 
 Head Upwards and Backwards - Ihid. 
 
 137. Anterior Presentation : Deviation of the 
 
 Head Upwards and Laterally - - Ibid. 
 
 138. Lumbo-Sacral Position - - - Ibid. 
 
 139. Hock Presentation : Calf - - - Franch 
 
 140. Diagrams of the Hind-limbs in Hock Pre- 
 
 sentation - . . . Ihid. 
 
 141. Hock Presentation : Hock Corded - Saint-Cyr 
 
 142. Thigh and Croup Presentation - - Ihid. 
 
 143. Thigh and Croup Presentation : Thigh 
 
 Corded - ... - Ibid. 
 
 144. Thigh and Croup Presentation : Body 
 
 Corded ----- Franch 
 
 145. Transverse Presentation : Right Cephalo- 
 
 ilial Position — Side View - - Saint-Cyr 
 
 146. Transverse Presentation : Right Cephalo- 
 
 ilial Position — Upper View - - Franck 
 
 147. Transverse Presentation : Vertical or Ce- 
 
 phalo-sacral Position - - - Saint-Cyr 
 
 148. Sterno-abdominal Presentation, Head and 
 
 Feet Engaged : Foal - - - Franck 
 
 149. Sterno-abdominal Presentation, Head Re- 
 
 tained : Calf - - - - Saint-Cyr 
 
 PAGE 
 
 417 
 
 - 419 
 
 - 423 
 
 - 430 
 
 - 431 
 
 - 435 
 
 - 437 
 
 - 438 
 
 - 440 
 
 - 441 
 
 - 444 
 
 - 446 
 
 - 449 
 
 - 450 
 
 - 454 
 
 - 454 
 
 - 456 
 
 - 462 
 
 - 462 
 
 - 466 
 
 - 467 
 
 - 469 
 
 - 470 
 
 - 474 
 
 - 474 
 
 - 477 
 
 - 479 
 
 - 480 
 
TAliLK OF ILLUSTRATIOXS. 
 
 FIG. 
 
 150. Solid Repeller, with a Removable Spike - 
 
 151. Simple-joiated Repeller 
 
 152. Jointed Repeller : Open 
 
 153. Jointed Repeller : Closed - 
 
 154. Traction Cord and Band, and the Manner 
 
 of Applying tbem 
 
 155. Schaack's Traction Cord 
 
 156. Binz's Simple Head-collar - 
 
 157. RuefJ's Head-collar, No. 1 - 
 
 158. Rueffs Head-Collar, No. 2 - 
 151'. Binz's Forceps- band 
 
 1()0. Schaack's Forceps-halter 
 
 161. Manner of Placing Schaack's Halter 
 
 16-'. Schaack's Halter Placed on a Calf's Head - 
 
 103. Halter with a Single Traction Cord 
 
 104. Halter with Two Traction Cords - 
 
 1G5. Defays' Wire-extractor with the Torsion 
 Rods . - . - - 
 
 IGG. Defays' AVire Extractor Applied - 
 lf)7. Breulet's Tube and Noose - 
 1(")S. Breulefs Noose Fixed on the Foetus 
 1G1>. Cartwright's Porte-cord 
 
 170. Darreau's Porte-cord 
 
 171. Giinther's Curved Porte-cord and Blunt 
 
 Crotchet . . . . 
 
 172. Darreau's Curved Porte -cord 
 
 173. Darreau's Repeller . - - - 
 
 174. Binz's Porte-cord - . - - 
 17.'>. Short Blunt Crotchet 
 
 17t'). Blunt Finger Crotchet 
 
 177. Short Sharp Crotchet, with Broad or 
 
 Flanged Point - - - - 
 
 178. Short Sharp Crotchet, with Round Point - 
 
 179. Long Blunt Crotchet 
 
 180. Long Pointed Crotchet 
 
 181. Long Pointed Crotchet, Darreau's Pattern 
 
 182. Long Pointed Crotchet, Darreau's Pattern 
 
 183. Schaack's Crotchet - - - - 
 1S4. Simple Short Crotchet-forceps 
 
 1H5. Long Simple Crotchet-forceps 
 18G. Giinther's Long Crotchet-force p"* - 
 
 187. Jointed Crotchet-forceps - 
 
 188. Nelson's Blunt Crotchet- forceps - 
 
 189. Nelson's Serrated Crotchet-forceps 
 
 190. Tallich's Short Bent Crotchet-forcep.s 
 101. Andre's Crotchet-forceps - 
 
 192. Bitch Forceps .... 
 
 193. Weber's Forceps . - . . 
 
 194. Defays' Forceps .... 
 
 OrKjinal 
 IbUK 
 Rainard 
 Ibid. 
 
 Baumeister - 
 
 Saint-Cj/r 
 
 Bauineisler • 
 
 Rueff 
 
 Ibid. 
 
 Baitmeiiiter — Rueff 
 
 Saint- Cyr 
 
 Ibid. 
 
 Ibid. 
 
 Detroye 
 
 Ibid. 
 
 xui 
 
 PAfiK 
 
 489 
 489 
 489 
 489 
 
 500 
 500 
 502 
 502 
 502 
 503 
 504 
 504 
 505 
 506 
 50G 
 
 507 
 508 
 508 
 508 
 509 
 509 
 
 509 
 5U9 
 510 
 511 
 511 
 511 
 
 512 
 612 
 513 
 513 
 513 
 513 
 516 
 518 
 518 
 519 
 519 
 519 
 519 
 520 
 620 
 522 
 .522 
 522 
 
XIV 
 
 no. 
 
 195. 
 196, 
 197. 
 198. 
 199. 
 200. 
 201. 
 202. 
 203. 
 204. 
 205. 
 206. 
 207. 
 208. 
 209. 
 210. 
 211. 
 212. 
 213. 
 214. 
 216. 
 216. 
 217. 
 218. 
 219. 
 220. 
 221. 
 222. 
 223. 
 224. 
 
 225. 
 226. 
 
 TABLE OF ILLUSTRATIONS. 
 
 Diagram of the Pelvic Axis 
 Obstetric Pulleys - - . - 
 
 Baron's Obstetric Machine - 
 Straight Embryotom - - . 
 
 Curved Embryotom 
 
 Gunther's Embryotom : Improved Pattei-n 
 Colin's Scalpel Embryotom 
 Unsworth's Spring Embryotom 
 Gunther's Long-handled Embryotom 
 Cartwright's Subcutaneous Spatula 
 Carsten Harm's Spatula 
 Ungefrohrn's Spatula 
 
 Cartwright's Bone-chisel - . - 
 
 Cartwright's Bone-saw . - . 
 
 Swedish Chain-saw - - . - 
 
 Pad Pessary .... 
 
 Ring Pessary . . . . 
 
 Cup and Ball Pessary 
 Zundel's Labial Sutures 
 The Loop of Delwart's Truss 
 Delwart's Truss Applied 
 Renault's Truss . . . . 
 
 Leather Truss - - . . 
 
 Lund's Truss L-on - . - . 
 
 Lund's Truss Applied 
 Parturient Apoplexy : Cow 
 Teat-syphon .... 
 
 Ring Teat-syphon ... - 
 
 Liithi's Perforating Sound - - . 
 
 Armatage's Truss Applied for Umbilical 
 Hernia - - - . . 
 
 Umbilical Clam - - . . 
 
 Armatage's Iron Umbilical Clam - 
 
 Saint- Cyr 
 Ihkl. 
 Ibid. 
 Orifjmal 
 
 Saint-Cijv 
 
 Ihkl. 
 
 Ibkl. 
 
 Zunclel 
 
 Franclc 
 
 Saint- Cyr 
 
 Ibid. 
 
 Franch 
 
 Saint-Cyr 
 A rniatage 
 Original 
 
 Artiiatage 
 
 Ibid. 
 
 Ihkl. 
 
 PAGE 
 
 524 
 528 
 530 
 535 
 535 
 536 
 536 
 536 
 537 
 537 
 537 
 538 
 538 
 538 
 538 
 588 
 589 
 589 
 593 
 593 
 594 
 595 
 596 
 597 
 598 
 638 
 691 
 691 
 699 
 
 708 
 712 
 712 
 
TABLE OF CONTENTS. 
 
 Prefatory Note to Second Editiox - 
 
 PuKKAiK to First Edition - 
 
 Lisr ok Works on Veterinary C)i!stetkics 
 
 Imroduction 
 
 PAOE 
 
 ill 
 
 V 
 
 vii 
 XX xi 
 
 PAET FIRST. 
 
 EUTOKIA, OR TOKOLOGY. 
 
 BOOK I.— OBSTETRICAL ANATOMY - 
 CHAPTER I.— THE PELVIS 
 
 Section I. — Bones or the Pelvis 
 
 1. Os Innominatum 
 
 Ilium 
 
 Ischium 
 
 Pubis 
 
 2. Sacrum 
 
 3. Coccyx 
 Differences in the Bones of the Pelvis of other Animals than 
 
 the Mare 
 Coxo .... 
 Sheep and Goat 
 Bitch and Cat ■ 
 P\g .... 
 
 Section II.— Articulations or the Pelvis 
 
 1. Sacro-lumbar Articulation 
 
 2, 3. Sacroiliac Articulations 
 
 4. Ischio-pubic Symphysis - 
 
 5. Sacrococcygeal Articulations 
 Differences in the Pelvic Articulations of other Animal.' 
 
 than the ]Mare - 
 Cow ... - 
 
 Sheep and Goat 
 Bitch tnid Cat 
 
 Sacro-sciatic Ligament 
 Section III.— The Pelvis and its Cavity 
 Jfare .... 
 
 External Surface 
 
 Internal Surface 
 
 2 
 2 
 
 3 
 4 
 4 
 5 
 6 
 
 6 
 6 
 
 7 
 7 
 8 
 
 8 
 8 
 it 
 9 
 [) 
 
 IC 
 10 
 11 
 11 
 11 
 
 12 
 12 
 12 
 13 
 
TABLE OF CONTENTS. 
 
 PAGE 
 
 Anterior Opening or Inlet - - - 14 
 
 Posterior Opening or Outlet - - - 16 
 
 Differences in other Animals than the Mare - - 17 
 
 Coio - - - - - - 17 
 
 Sheep and Goat - - - - - 19 
 
 Pig 19 
 
 Bitch and Cat - - - - - 19 
 
 Differences in the Pelvis according to Sex - - 19 
 
 Section IY. — Capacity of the Pelvis, or Pelvimetry - 21 
 
 CHAPTER II.— FEMALE GENERATIVE ORGANS - 27 
 
 Section I. — External Organs of Generation - - 27 
 
 The Vulva - - - - - 27 
 
 Differences in other Animals than the Mare - - 30 
 
 Coio ■ - - - - - 30 
 
 Sheep ■ - - - - - 31 
 
 Pig - - - - - - 31 
 
 Bitch and Cat - - - - - 31 
 
 Section II. — The Mamm^ - - - - 32 
 
 Differences in other Animals than the Mare - - 34 
 
 Cow - - - - - - 34 
 
 Sheep and Goat - - - - - 35 
 
 Pig - - - - - - 36 
 
 Bitch - - - - - - 36 
 
 CHAPTER III.— INTERNAL ORGANS OF GENERATION 36 
 
 Section I. — The V..gina - - - - 36 
 
 Differences in other Animals than the Mare - - 38 
 
 Coio, Sheep, and Goat - - - - 38 
 
 Pig - - - - - - 38 
 
 Bitch and Cat - - - - - 39 
 
 Section II. — The Uterus - - - - 39 
 
 Differences in other Animals than the Mare - - 42 
 
 Coio - - - - - - 42 
 
 Sheep and Goat - - '- - - 46 
 
 Pig - - - - - - 46 
 
 Bitch and Cat - - - - - 46 
 
 Development - - - - - 46 
 
 Section III. — Fallopian Tubes, or Oviducts - - 47 
 
 Differences in other Animals than the Mare - - 48 
 
 Cow, Sheep, and Goat - - - - 48 
 
 Pig - - - - - - 48 
 
 Bitch - - ■ - - - 48 
 
 Section IV. — The Ovaries - - - - 48 
 
 Differences in other Animals than the Mare - - 51 
 
 Cow, Sheep, and Goat - - - - 51 
 
 Pig - - - - - - 51 
 
 Bitch and Cat - - - - - 51 
 
 Development - - - - - 51 
 
TABLE OF CONTENTS. xvii 
 
 BOOK I r.— OBSTETRICAL PHYSIOLOGY 
 KEPKODUCTION - 
 
 53 
 
 CHAPTER I.— GENERATION - - - 57 
 
 Section I. — Puhkrty - - - 57 
 
 Section II.— CEstrum or Menstruation - 5'J 
 
 Section III. — M.vti'r.xtion of the Graaki.vn Vesicles (J;-} 
 
 CUAPTER II.— FECUNDATION -04 
 
 CHAPTER III. -STERILITY - 65 
 
 CHAPTER lA'.-CHANGES IN THE OVUM - - 08 
 
 Section I. — Development of the Embryo - 71 
 
 Section II. — Api-endaoes of the Foctus - li) 
 
 Chorion - - - -lb 
 
 Differences in other Animals than the Mare - - 77 
 
 Ruminants - - 77 
 
 Pig - - - - 78 
 
 Bitch and Cat - - - ■ 78 
 
 Amnion - - - - 79 
 
 Liquor Amnii - - - - - 80 
 
 Differences in other Animals than the Mare - 81 
 
 Ruminants - - - - - 81 
 
 Pig ■ ■ - - - 81 
 
 Rilrh and Cat ■ - - - - 81 
 
 AUantois - - - - . - 81 
 
 Differences in other Animals than the Mare 84 
 
 RuininantH - - - . - 84 
 
 Pi;, ■ . . . - 84 
 
 Bitrh and Cat - - - - - 84 
 
 Umbilical Vesicle - - - - -84 
 
 Differences in other Animals than the Mare - 85 
 
 Rtimiiianl:( and Pif/ - - 85 
 
 The Placenta - 85 
 
 Differences in other Animals than the Mare - 86 
 
 Cow - -86 
 
 Sheej) and Goat - - . . . yo 
 
 Pig - - - - - 92 
 
 . Bitch and Cat ■ - 92 
 
 Functions - -93 
 
 Umbilical Cord .... ii;{ 
 
 Differences in other Animals than the Mare 94 
 
 Ruminants - - -94 
 
 Pig • ■ - - - - 95 
 
 Bitrh and Cat - ■ ■ ■ - 95 
 
 Section III. — Development of the F<etus - - 96 
 
 The Nervous System - -97 
 
 The Organs of Sense -98 
 
 The Skin and its Appendages - - - 100 
 
 The Locomotor}- Apparatus - . . . 101 
 
TABLE OF CONTEXTS. 
 
 PAGE 
 
 The Circulatory System . . . . 104 
 
 The Respiratory Apparatus . - . - 107 
 
 The Digestive Apparatus - - - - 108 
 
 The Genito-urinary Organs . - - - HO 
 
 Sectiox IV. — Periods of Development - - 115 
 
 Sectiox Y. — Physiological Phenomena in the Fcetus - 118 
 
 Nervous Functions ----- 119 
 
 Absorption . . . - . 120 
 
 Nutrition - - - - - - 121 
 
 Circulation . . . . - 122 
 
 Secretion ------ 124 
 
 Section YI. — "Weight and Dimensions of the Fcetus at 
 
 Birth - . . . . 125 
 
 CHAPTER v.— PREGNANCY - - - - 127 
 
 Section I. — Modifications in the Uterus during 
 
 Pregnancy - - - - - 128 
 
 Yolume - - - - - - 128 
 
 Structure - - - - - - 128 
 
 Sensibility . . . - . 131 
 
 Form - - - - - - 132 
 
 Situation ----- - 134 
 
 Direction ------ 134 
 
 Influence on and Alterations in the Position of Neighbour- 
 ing Organs - - - - - 135 
 
 Section II. — Position of the Fcetus in the Uterus - 137 
 
 Section III. — Signs of Pregnancy - - - 138 
 
 Rational Signs ----- 1.33 
 
 Material Signs - - - - - 140 
 
 Sensible Signs . . . - . 143 
 
 Section IY. — Duration of Pregnancy - - 148 
 
 Mare - - - - - - 149 
 
 Cow ------ 151 
 
 Sheep and Goat ----- 152 
 
 Pig - - - - - - 153 
 
 Bitch - - - - - - 153 
 
 Cat - - - - - - 153 
 
 Section Y. — Uniparous, Gemelliparous, and Multi- 
 
 PAROUS Pregnancy - - - - 153 
 
 Mare ------ 154 
 
 Cow ------ 155 
 
 Sheep ------ 158 
 
 Goat - - - - - - 160 
 
 Free-Martins - - - - - 161 
 
 Diagnosis of Multiple Pregnancy - - - 163 
 
 Position of the Foetuses in Multiple Pregnancy - - 164 
 
 CHAPTER YI.— HYGIENE OF PREGNANT ANIMALS - 166 
 
TABLE OF CONTENTS. 
 
 BOOK III.— PATHOLOGY OF PEEGNANCY - 
 
 CHAPTER I.— ANOMALIES IX PREGNANCY 
 Section I. — Supkuk(Ktath>n 
 Section IT.— Extka iTKiiixE Pkkcjnancv 
 
 Symptoms, Course, and Terminations - 
 
 Diagnosis and Treatment 
 Skction hi. — SiTiuors or Pseudo-pkeunancy - 
 
 Moles ..... 
 
 Uterine Cysts .... 
 
 Hydrops Uteri or Hydrometra 
 
 CHAPTER II.- DISEASES INCIDENTAL TO PREG 
 NANCY 
 
 Section I. — Inflcknce of Pre(;nancy on Ordinary 
 
 DlSE.\SES .... 
 
 Section II. — Diseases incidental to Pregnancy 
 Pica ..... 
 
 Rickets and Osteomalacia 
 
 Constipation .... 
 
 Vomiting . . - . - 
 
 Colic - . . - . 
 
 CEdema . . - - . 
 
 Hydramnios or Hydrops Amnii 
 
 Symptoms .... 
 
 Diagnosis 
 
 Results - 
 
 Etiology 
 
 Treatment 
 Paraplegia 
 
 Treatment 
 Cramp 
 Eclampsia - 
 Cerebral Congestion 
 Hysteria - 
 Amaurosis 
 Cough 
 
 Albuminuria' 
 Mammitis 
 Red Colostrum 
 
 CHAPTER III.— ACCIDENTS OF PREGNANCY 
 
 Ante-partum Prolapsus of the Vagina ■ 
 
 Treatment 
 Hernia of the Uterus (Hysterocele) 
 Ante-partum Rupture of the Uterus 
 
 Causes . - - - 
 
 Symptoms 
 
 Treatment 
 Metrorrhagia 
 
 XIX 
 
 I'AUK 
 
 KV.t 
 
 ir.o 
 nn 
 
 177 
 178 
 178 
 180 
 180 
 
 181 
 
 181 
 182 
 183 
 183 
 184 
 184 
 184 
 184 
 185 
 185 
 185 
 186 
 186 
 186 
 187 
 188 
 188 
 189 
 18'.t 
 189 
 190 
 190 
 190 
 190 
 190 
 
 I'.tl 
 I'.M 
 19-J 
 193 
 1'I4 
 196 
 196 
 196 
 197 
 
3CX TABLE OF CONTENTS. 
 
 PAGE 
 
 Abnormal Retention of the Foetus - - - 198 
 
 Symptoms and Terminations ... i99 
 
 Causes - - - - - - 202 
 
 Treatment - - - - - 202 
 
 Abortion - - - - - - 204 
 
 Sporadic Abortion .... 205 
 
 Causes - - - - - 205 
 
 Symptoms . . . . - 209 
 
 Results - - - - - 211 
 
 Pathological Anatomy - - - - 211 
 
 Diagnosis _ . . . - 212 
 
 Treatment . . - . . 214 
 
 Epizootic, Enzootic, or Infectious Abortion - - 216 
 
 Causes . . - . - 217 
 
 Symptoms ... - - 222 
 
 Pathological Anatomy - - - - 223 
 
 Treatment - - - - - 224 
 
 BOOK IV.— NOKMAL PARTUEITION - - - 227 
 
 CHAPTER I.— PHYSIOLOGY OF PARTURITION - 227 
 
 Section I. — Causes of Parturition - - - 228 
 
 Section II. — The Expelling Powers - - - 229 
 
 Section III. — Signs and Course of Parturition - 232 
 
 CHAPTER II.— PRESENTATIONS OF THE FOETUS AND 
 
 MECHANISM OF PARTURITION - - - 239 
 
 Section I.— Presentations . - - - 241 
 
 Section II. — Positions .... 242 
 
 Section- III. — Mechanism of Parturition - - 250 
 
 Mare - - - - - - 251 
 
 Coio - - - - - - 254 
 
 Other Animals ----- 255 
 
 CHAPTER III.— NECESSARY AID IN NORMAL PAR- 
 TURITION - - - - - 255 
 
 Section I. — Attention to the Mother - - 256 
 
 Section II. — Attention to the Offspring - - 265 
 
 CHAPTER IV.— SEQUELAE OF PARTURITION - - 268 
 
 Section I. — Functional Modifications - - 268 
 
 Section II. — Organic Modifications - - - 275 
 
 PART SECOIsrD. 
 
 DYSTOKIA. 
 
 General Considerations . - . - . 279 
 
 BOOK I— MATEBXAL DYSTOKIA - - - 289 
 
 CHAPTER I.— DYSTOKIA BY PELVIC CONSTRICTION 289 
 
 Complete Deformity of the Pelvis - - - 290 
 
 Exostoses ------ 291 
 
TABLE OF CONTENTS. xx\ 
 
 PAGR 
 
 Fractures ---... 291 
 
 Tumours in the Pelvic Cavity - - . 293 
 
 Indications for Surgical Treatment - - . 294 
 
 CHAPTER II.— DYSTOKIA EY DISPLACEMENT OR 
 
 CHANGED RELATIONS OF THE UTERUS - 297 
 
 Hernia of the Uterus — Hysterocele - - . 297 
 
 Origin and Symptoms in Uni parous Animals - - 298 
 
 Origin and Symptoms in Multiparous Animals- - 300 
 
 Pathological Anatomy - - . . 300 
 
 Diagnosis - - . . . 301 
 
 Indications . . . . . 303 
 
 Deviation of the Uterus .... 306 
 
 Diagnosis ..... 307 
 
 Complications - - . . . 308 
 
 Indications - - . . . 308 
 
 Torsion of the Uterus : Contorsio Uteri - . 309 
 
 History - - - . - 309 
 
 Nature and Frequency .... 312 
 
 Etiology - - - - - 316 
 
 Symptoms - - . . . 318 
 
 Diagnosis - . . . . 321 
 
 Prognosis ..... 326 
 
 Pathological Anatomy .... 326 
 
 Treatment - - - - - 328 
 
 Torsion of the I'terus in the Mare ... 340 
 
 Causes - - - - . - 341 
 
 Symptoms ..... 341 
 
 Prognosis and Treatment .... 342 
 
 Torsion of the Uterus in other Animals - - 343 
 
 CHAPTER III.— DYSTOKIA FROM MORBID ALTERA- 
 TIONS IN THE (lENERATIVK ORGANS . - 344 
 
 1. Utero-vaginal Tumours - . . . 344 
 
 Diagnosis ..... 346 
 
 Treatment - - - . . 346 
 
 Cancerous, Carcinomatous, or Sarcomatous Tumours . .347 
 Condylomatous, Papillomatous, and Lipomatous 
 
 Tumours - - - . . 348 
 
 Fibroid and Myomatous Tumours - - - 348 
 
 Thrombi or Ilacmatomata - - 349 
 
 Serous Cysts ..... 350 
 Hernia of the Bladder into the Vagina : Vaginal 
 
 Cystocele ..... 35 1 
 
 Treatment - . - . . 352 
 
 Tumours in the Vicinity of the Genital Organs - 353 
 
 2. Rigidity of the Cervix Uteri - - - 354 
 
 Symptoms ..... 354 
 
 Diagnosis ..... 356 
 
TABLE OF CONTENTS. 
 
 Prognosis 
 
 Treatment 
 Induration of the Cervix Uteri 
 
 Symptoms 
 
 Diagnosis . . - 
 
 Prognosis - . . 
 
 Pathological Anatomy - 
 
 Treatment - - - 
 
 Complete Obliteration of the Os Uteri 
 
 Causes 
 
 Symptoms 
 
 Results 
 
 Diagnosis . - - 
 
 Treatment 
 
 PAOE 
 
 - 356 
 
 - 356 
 
 - 361 
 
 - 362 
 
 - 363 
 
 - 363 
 
 - 364 
 
 - 364 
 
 - 365 
 
 - 365 
 
 - 366 
 
 - 366 
 
 - 366 
 
 - 366 
 
 CHAPTEE IV. — OTHER CAUSES OF MATERNAL 
 
 DYSTOKIA - - - - - 367 
 
 1. Anomalies in the Placenta . - - 367 
 
 Schirrous Chorion .... 367 
 
 2. Morbid Adhesion between the Foetus and Uterus - 368 
 
 3. Stricture or Occlusion of the Uterus by External Bands or 
 
 Membranes . - . - - 369 
 
 4. Persistent Hymen ----- 369 
 
 Treatment . . - . . 370 
 
 5. Vaginal and Vulvar Constriction, or Atresia - - 370 
 
 Treatment - - , _ . 371 
 
 BOOK II.— FCETAL DYSTOKIA - - - 372 
 
 GROUP I.— OBSTACLES INDEPENDENT OF PRESENTA- 
 TIONS AND POSITIONS - - - - 372 
 
 CHAPTER L— VARIOUS CAUSES - - - 373 
 
 The Umbilical Cord as an Obstacle - - - 373 
 
 Diagnosis ..... 374 
 
 Indications - - - . . 374 
 
 Excess in Volume of the Foetus - - - 374 
 
 Causes .----- 375 
 
 Diagnosis ..... 377 
 
 Prognosis ----- 378 
 
 Indications ..... 379 
 
 Excess in Growth of Hair .... 379 
 
 Anomalies in, and Diseases of, the Foetal Membranes - 380 
 
 Indications ..... 331 
 
 Abnormal Quantity of Placental Fluid - - . 381 
 
 CHAPTER IL— DISEASES OF THE FCETUS - . 381 
 
 Hydrocephalus . - . . . 381 
 
 Pathological Anatomy . - - . 382 
 
 Diagnosis ..... 386 
 
 Indications . . . - . .386 
 
 Ascites, Anasarca, and Hydrothorax - - - 387 
 
 \ 
 
TABLE OF CONTENTS. xxiii 
 
 I'AOK 
 
 Cause - - - - - 389 
 
 Diagnosis . . . . . 390 
 
 Indications ..... 390 
 
 Emphysema ..... sm 
 
 Indications - - - - - 3ltl 
 
 Polysarcia - - - - - 391 
 
 Indications ..... 392 
 
 Contractions ..... 392 
 
 Indications ..... 393 
 
 Tumours - - - - - 394 
 
 Indications . . . . . 394 
 
 Death - - - - - 394 
 
 CHAPTER III.— MONSTROSITIES - - 394 
 
 Classification ..... 395 
 
 Cl.\ss I. — Simple Monstrosities - - - 396 
 
 Order I. — Simple Monstrosities through Absence of 
 
 Parts - - - - - 396 
 
 Order II. — Simple Monstrosities through Smallness of 
 
 Parts ..... 306 
 
 Order III. — Simple Monstrosities through Abnormal 
 
 Division of the Body - - . . 397 
 
 Order IV. — Simple Monstrosities through Absence of the 
 
 Natural Division of Parts - - - 397 
 
 Order V. — Simple Monstrosities through Fusion or 
 
 Coalition of Organs .... 397 
 Order VI. — Simple Monstrosities through Abnormal Posi- 
 tion and Form of Parts - - - 397 
 Order VII. — Simple Monstrosities through Excess in 
 
 Formation . . . . . 398 
 
 Order VIII.— Hermaphrodites - - - 398 
 
 Cr.A?>! II. — Trkiu-k and Doi'ule Monstiukitiks - - 398 
 
 Order I. — Trigeminal ^lonstrosities - - - 398 
 
 Order II.— Monsters with Two Heads - - 399 
 
 Order III. — Double-headed Monstrosities, with the Trunk 
 
 "Wholly or Partially Double - - - 399 
 
 Order IV. — Monstrosities with a Single Head, but the 
 
 Trunk or Limbs more or less Completely Double - 399 
 Order V. — Monstrosities with a Single Head and Trunk. 
 
 and more than Four Limba - - - 400 
 
 Order VI. — Monstrosities with the Head, Trunk, and 
 
 Limbs more or less Completely Double - - 4(»U 
 
 Origin of Monstrosities, and the Lavs of Teratology - 411 
 
 Frequency of Monstrosities - - - 415 
 
 Distorted Monstrosities - - - 416 
 
 Cyclopean Monstrosity - - 416 
 
 Pseudencephalian Monstrosity - 416 
 
 Double-headed Monstrosities - - 417 
 
 Celosomian Monstrosities - - - 418 
 
 Diagnosis ..... 418 
 
dv TABLE OF COX TEXTS. 
 
 Prognosis - . . . - 
 
 Extraction ----- 
 Double and Triple Monstrosities - - - 
 
 Diagnosis - - - - . 
 
 Extraction - - . . . 
 
 CHAPTER IT.— DYSTOKIA FROM MULTIPARITY 
 
 Diagnosis ----- 
 Extraction . - . . . 
 
 GROUP II.— DYSTOKIA FROM MALPRESENTATION OR 
 MALPOSITION OF THE FCETUS 
 
 CHAPTER I. — DYSTOKIA DEPENDING 
 ANTERIOR PRESENTATION 
 
 OX THE 
 
 A. — Normal Anterior Presentation 
 Section I. — Dystokia from Abnormal Positions 
 
 Dorso-pubic Position - . . . 
 
 Dorso-supra-Cotyloidean Positions 
 Section II.— Dystokia due to the Hind-limbs 
 Extended Hind-limbs retained by their Stifles - 
 Hind-limbs flexed under the Body pass with it into the 
 Genital Canal - . . . 
 
 B. — Abnormal Anterior Presentatu)n - 
 
 Section I.— Dystokia due to the Fore-limbs - 
 One or Both Fore-limbs crossed over the Neck - 
 Fore-limbs incompletely 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 due to the Heah and Fohe 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 IL— DYSTOKIA IN THE POSTERIOR PRE- 
 SENTATION - - - - - 
 
 A. — Normal Posterior Presentation 
 Section I. — Dystokia from Abnormal Positions 
 
 Lumbo-pubic Position - - - . 
 
 Lumbo-supra-Cotyloidean Positions - 
 Section II. — Dystokia due to the Head or Fore-limbs - 
 
 Head and Contracted Neck - - - - 
 
 Fore-limbs . . . . . 
 
 I'AGK 
 
 419 
 419 
 420 
 420 
 421 
 
 421 
 423 
 
 424 
 
 42.-) 
 
 426 
 427 
 427 
 
 427 
 428 
 428 
 428 
 
 429 
 433 
 
 433 
 434 
 435 
 436 
 440 
 
 443 
 444 
 
 446 
 448 
 453 
 
 455 
 455 
 455 
 
 456 
 457 
 457 
 457 
 459 
 459 
 459 
 460 
 
TABLE OF CONTENTS. xxv 
 
 PAlIB 
 
 B.— Ahnokmai- Posterior Prksentations - - HJO 
 
 Hock Presentation .... 4(52 
 
 Thigh and Croup Presentation - - - 4»»7 
 
 CHAPTER III.— DYSTOKTA FRO^l TR.\XSVP:RSE PRK- 
 SENTATIONS - - - - - 472 
 
 Section I.— Dysiokia iku-mthe Durso-i-imhar Fuesenta- 
 
 TION - - - - - - 473 
 
 Cephalo-ilial Positions . . . . 473 
 
 Cephalo-sacral Position . - - . 477 
 Section II. — Dvstokia trom the Si ernd-ahdominai, 
 
 Prksknt.\tion - ... - 478 
 
 Cephalo-ilial Positions . . . . 478 
 
 Cephalo-sacral Position .... 478 
 
 BOOK III.— OBSTETRICAL OPERATIONS - - 483 
 
 CHAPTER I. — PRELIMINARY PRECAUTIONS AND 
 
 OPERATIONS - - - - - 484 
 
 CHAPTER II.— RECTIFICATION OF PRESENTATIONS 
 
 AND POSITIONS - - - - - 487 
 
 Retropulsion ..... 487 
 
 Rotation - - - - - 491 
 
 Version - - - - - - 4111 
 
 Extension and Flexion .... 4'.l3 
 
 CHAPTER III.— MECHANICAL MEANS FOR THE EX- 
 TRACTION OF THE FCETDS - - 4'.i8 
 Section I. — Cords ano Bands - - - 4it9 
 Halter, Head-cord, or Head-collar - .'>01 
 Section II. — Pass- or Porte-Cords - - OOS 
 Section III. — Crotchets or Hooks - - - -''H 
 Section IV.— Ckotciikt-Forceps and Forceps - - -''IT 
 
 CHAPTER IV. — THE EMPLOYMENT OF FORCE IN 
 
 DYSTOKIA .... - ;VJ3 
 
 Section I.— Diuechon ok Traction - - - i>'^4 
 
 Section II. — De(;ree of Traction - 524 
 Section III. — Mkans for dkvi-lopinc the Necessary 
 
 Force ...--- .'.28 
 Section IV. — Comparison hetween Manial andMecuani- 
 
 CAL Force ... - - .')31 
 
 CHAPTER v.— EMBRYOTOMY - - 532 
 
 Embryotomy Instruments - - - - 534 
 
 Preliminary Arrangements for Emhrvntomy - - 540 
 Craniotomy or Cephalotomy 
 Puncture of the Cranium - 
 Craniotomy 
 
 Decapitation and Decollation 
 Amputation of the Limbs 
 
 :.40 
 541 
 542 
 542 
 544 
 
 Amputation of the Fore-limbs - •'■*•'* 
 
xxvi TABLE OF COXTENTS. 
 
 Amputation of the Hind-limbs 
 Detruncation or Division of the Body of the Foetus 
 Evisceration . . . - . 
 
 Thoracic Evisceration - . . . 
 
 Abdominal Evisceration - - - - 
 
 CHAPTER YL— VAGINAL HYSTEROTOMY 
 
 CHAPTER YIL— GASTRO-HYSTEROTOMY OR C^SAR- 
 
 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 PARTUEITIOX 
 
 CHAPTER L— RETENTION OF THE FCETAL ENVE- 
 LOPES ---.-. 
 
 Symptoms and Terminations 
 
 Causes . . - - . 
 
 Treatment . . . . 
 
 CHAPTER IL— POST PARTUM HEMORRHAGE 
 
 Symptoms - . . . 
 
 Treatment - _ - . 
 
 CHAPTER III.— INVERSION OF THE UTERUS - 
 
 Symptoms . - . . 
 
 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 VI. — TRAUMATIC LESIONS OF THE 
 GENITAL AND NEIGHBOURING ORGANS 
 
 I. — Laceration and Rupture of tue Uterus - 
 
 Treatment - . - . . 
 
 Rupture of the Uterus after Parturition 
 II. — Laceration and Rupture of the Vagina - 
 Complications of Ruptured Vagina 
 III.— Thrombus of the Vagina and Vulva 
 IV. — Relaxation of the Pelvic Symphysis 
 
 PAGE 
 
 547 
 548 
 549 
 550 
 550 
 
 551 
 
 554 
 556 
 557 
 
 561 
 
 561 
 
 562 
 564 
 
 564 
 565 
 566 
 567 
 
 574 
 575 
 576 
 
 576 
 577 
 579 
 580 
 581 
 583 
 600 
 
 603 
 605 
 605 
 606 
 
 608 
 
 609 
 
 609 
 612 
 613 
 613 
 616 
 619 
 619 
 
TABLE OF CONTENTS. xxvii 
 
 I'AOE 
 
 V. — llllTlUE OF TIIK Rl.ADUKR - - - G20 
 
 VI. — Rupture of the Intestinks - - - G2() 
 
 VII. — RUITURE OF THE Dl.WllRAGM - - 620 
 
 VIII. — Rupture of the Ahdomixal Muscles - - G20 
 
 IX. — Rupture of the Sacro-sciatic Lkjament - (Vil 
 
 X. — Rupture of the Hkart - - - <i21 
 
 BOOK v.— PATHOLOGY OF rAKTUIilTJOX - - G22 
 
 CHAPTER I.— VAGINITIS .... (•,i>2 
 
 CHAPTER II.-LEUCORRHCEA - - - G24 
 CHAPTER III.— METRITIS, METRO-PERITOXITIS, AXI) 
 
 PARTURIENT FEVER .... 025 
 Symptoms .... 025 
 Terminations .... G2G 
 Pathological] Anatomy - - - G28 
 Causes - - - - - G31 
 Prognosis .... 034 
 Prophylaxis .... 634 
 Treatment .... G34 
 CHAPTER IV.— PARTURIENT OR PUERPERAL APO- 
 PLEXY. -PARTURIENT COLLAPSE - - G3G 
 Symptoms .... 037 
 Duration, Terminations, and Complications - G4(> 
 Prognosis - - - - 042 
 Causes . - - . . 043 
 Pathological Anat<'niy - - - G4t) 
 Nature - - - - - 047 
 Diagnosis .... 653 
 Prophylaxis .... 653 
 Curative Treatment - - - 654 
 
 CHAPTER v.— POST PARTUM PARALYSIS - - 65i) 
 
 Symptoms .... 651) 
 
 Diagnosis .... GGO 
 
 Pathology - - - 660 
 
 Prognosis .... 660 
 
 Treatment - - - - 601 
 
 CHAPTER VI.— ECLAMPSIA ... 6G1 
 
 Symptoms .... 6G2 
 
 Etiology and Pathology - - - Gt>5 
 
 Diagnosis .... GG7 
 
 Prognosis .... 667 
 
 Treatment .... 607 
 
 CHAPTER VIL— EPILEPSIA UTERINA. -MANIA PUER- 
 
 PERALIS ------ 6G8 
 
 Symptoms - - . . 668 
 
 Cause ..... 669 
 
 Treatment .... 661* 
 
U TABLE OF COXTENTS. 
 
 CHAPTER VIII.— PARTURIENT LAMIXITIS 
 
 Symptoms 
 Causes - 
 Treatment 
 
 CHAPTER IX— MAMMITIS OR MASTITIS 
 
 Pathological Congestion of the Mammag 
 
 Causes 
 
 Symptoms - - . 
 
 Treatment 
 Inflammation of the MammEe 
 
 Symptoms - - . 
 
 Course and Terminations 
 
 Pathological Anatomy 
 
 Causes 
 
 Complications - - - 
 
 Prognosis . . - 
 
 Treatment 
 
 CHAPTER X.-AGALACTIA - 
 
 CHAPTER XI.— INJURIES TO THE TEATS 
 
 Fissures - . . 
 
 Causes 
 
 Symptoms 
 
 Treatment ... 
 
 Obliteration of the Galactophorus Sinus 
 
 Symptoms 
 
 Treatment - _ . 
 Fistula of the Teat 
 
 PAGE 
 
 670 
 670 
 671 
 672 
 
 673 
 
 674 
 674 
 674 
 676 
 676 
 677 
 680 
 685 
 686 
 690 
 690 
 690 
 
 696 
 
 697 
 697 
 697 
 697 
 698 
 698 
 698 
 699 
 700 
 
 BOOK YI. — DISEASES AND ABNOKMALITIES OF 
 
 THE YOUNG ANIMAL - - - - 701 
 
 CHAPTER I.— ASPHYXIA OF THE NEW-BORN ANIMAL 701 
 
 CHAPTER 11.— UMBILICAL HAEMORRHAGE - - 702 
 
 Treatment .... 702 
 
 CHAPTER IIL— PERSISTENCE OF THE URACHUS - 703 
 
 Treatment , . - . 703 
 
 CHAPTER lY— UMBILICAL HERNIA - - - 704 
 
 Causes - - - . . 705 
 
 Pathological Anatomj' - - - 705 
 
 Symptoms . . _ . 706 
 
 Prognosis - . _ . 7O6 
 
 Diagnosis . _ . . 707 
 
 Treatment • - - - 707 
 
 CHAPTER v.— CEDEMA OF THE UMBILICUS - - 713 
 
 Treatment .... 714 
 
 CHAPTER VI.— INFLAMMATION OF THE UMBILICAL 
 
 CORD - - - - - - 714 
 
 Symptoms .... 714 
 
TAliLE OF CiiyTKNTS. xxix 
 
 I'AOE 
 
 Pathological Anatomy - - - TIT) 
 
 Causes - - - - 7ir» 
 
 Treatment - - - 717 
 
 CHAPTER VII.— ARTHRITIS - - - 718 
 
 Causes ... - - 719 
 
 Symptoms .... 722 
 
 Prognosis .... 724 
 
 Pathological Anatomy - - - 724 
 
 Treatment .... 727 
 
 CHAPTER VIIL— INDIGESTION - - - 729 
 
 Causes . - - - - 729 
 
 Symptoms .... 729 
 
 Treatment .... 730 
 
 CHAPTER IX.— GASTROINTESTINAL CATARRH - 730 
 
 Symptoms .... 7;5l 
 
 Etiology .... 7;u 
 
 Pathological Anatomy - - - 732 
 
 Prognosis .... 732 
 
 Treatment - - - - 732 
 
 CHAPTER X.— DYSENTERY OF YOUNG ANIMALS - 733 
 
 Symptoms .... 733 
 
 Pathological Anatomy - - - 735 
 
 Etiology ..... 736 
 
 Diagnosis .... 737 
 
 Prognosis .... 737 
 
 Treatment - - - - 737 
 
 CHAPTER XL— RETENTION OF MECONIUM.-CONSTI- 
 
 PATION ...... 739 
 
 Causes ..... 739 
 
 Symptoms .... 739 
 
 Treatment .... 739 
 
 CHAPTER XII.— ECLAMPSIA OF YOUNG ANIMALS - 740 
 
 Symptoms - - - - 740 
 Treatment - - - -741 
 
 CHAPTER XIIL— TETANUS AGNORUM - 741 
 
 Symptoms - ■ - -741 
 
 Etiology. - - 741 
 
 Pathology .... 741 
 
 Prognosis .... 741 
 
 Treatment .... 742 
 
 CHAPTER XIV.-CYANOSIS .... 742 
 
 CHAPTER XY.— SKIN DRYNESS OF THE NEW-BORN 
 
 ANIMAL ..---- 74:5 
 
 CHAPTER XVI.— IMPERFORATE ANUS - - 74:'. 
 
 Symptoms .... 74.» 
 
 Treatment - - - 744 
 
XXX TABLE OF COXTEXTS. 
 
 PAGE 
 
 CHAPTER XVII.— IMPERFORATE VULVA AND VAGINA 745 
 
 CHAPTER XVIII.— IMPERFORATE PREPUCE - - 746 
 
 CHAPTER XIX.— OCCLUSION OF THE EYELIDS - 74G 
 
 CHAPTER XX.— OCCLUSION OF THE AUDITORY CANAL 747 
 
 CHAPTER XXI.— TONGUE-TIE - - - 747 
 
 CHAPTER XXIL— CLEFT PALATE - - - 748 
 
 ADDENDUM.— Infectious Abortion - - - 749 
 
 INDEX - - - - - - 751 
 
TEXT-BOOK OF VETERINAliY OBSTETIilCS. 
 
 INTRODUCTION. 
 
 The generation and development of animated creatm-cs 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 eflorts, recourse must be had to artificial means, 
 and the resources of science and art are accordingly invoked. 
 
 The term " parturition" (from 2)arturio, 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 is that which is usually considered to be the most critical in the 
 existence of the young creature, and to most frequently demand atten- 
 tion in such valuable animals as the Mare, Cow, Sheep, liitch, etc. 
 
 The parturition of the domesticated animals, and the abnormal con- 
 ditions which may precede or follow that event, come within the province 
 of Veterinary -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 
 
xxxJi 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 ohstare, 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 ohstare, 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 dehvered of their 
 young in a standing than a recumbent position. 
 
 Instead of Obstetricy, the terms "Tokology" (tokos, a birth, from 
 TiKTeiv, to bring forth, and Adyos, 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 therefore deemed it advisable to retain the 
 better-known word. 
 
 The term "Obstetrics" is not, as has been already shown, Umited 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, 
 havinj^ 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 tlie 
 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 pelvic cavity — is 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 foi-mation of the foetus, 
 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 
 that of the final act which we have named " parturition." 
 
 The four chief functions of the generative system may be enumerated 
 as follows : menstruation or astncm, conception, gestation, and pi'^^^tiri- 
 tion, all of which are intimately related to and dependent upon each 
 other — a failure or defect in one disturbing their relationship, and lead- 
 ing 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- 
 ates with natural or spontaneous parturition, has been included under 
 the head of Eutokia (from «?, well, and toxos, birth). 
 
 The ditTiculties attending parturition, whether they depend upon the 
 mother or the fcctus, or upon both, with the means for overcoming 
 them, and the accidents which may complicate difiicult parturition, 
 come under the general designation of Dystokia (from 5i?, difficult, and 
 ro\o<i, 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 
 in this manual. 
 
 The maladies to which the parent is most exposed after parturition, 
 
xxxiv INTRODUCTION. 
 
 and their medical or surgical treatment, as well as the condition of the 
 young animal after birth and up to the time of weaning, also form a 
 portion of the veterinary obstetrist's study. 
 
 Such is the plan of the work : and I have only now to state that the 
 animals more particularly referred to are of the Horse, Ox, Dog, Pig, 
 Sheep, and Goat species ; the other creatures which man has domesti- 
 cated — such as the Elephant, Camel, Eabbit, and Cat — coming but 
 rarely within the observation of the veterinary practitioner. 
 
 It maybe remarked that pregnancy and parturition in the domesticated 
 animals differ in several important features from these processes in the 
 human species — the differences being mainly due to the dissimilarity in 
 their respective attitudes : the quadrupedal 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 Veterinary Obstetricy, other qualifica- 
 tions must be looked upon as essential. The practitioner must be pos- 
 sessed of great tact in manipulation, a certain amount 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 
 Veterinary Science from an economical point of view. The ever in- 
 creasing value of nearly all the 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 suffering — in all probability to preserve 
 their life — previous to, during, or subsequent to the occurrence of this 
 physiological act, is no less a duty than it should be a source of satisfac- 
 tion to the Veterinarian. 
 
PART FIRST. 
 
 EUTOKIA, OR TOKOLOGY. 
 
 Those divisions of Anatomy, Physiology, and Pathology which are 
 directly related to the processes of generation, gestation or pregnancy , 
 &nd 2^arti(rition, as well as that act itself, belong to tlie section of Obste- 
 trics to which the designation of EUTOKIA («?, ivell or favourable, and 
 Toxos, birth), or TOKOLOGY, has been given. We shall discuss each of 
 these subjects in the order in which they now stand, commencing with 
 the anatomij of the pelvis, and of the external and internal organs of 
 generation. 
 
 ^ 
 
 BOOK I. 
 
 OBSTETRICAL ANATOMY. 
 
 The female organs chiefly concerned in generation and parturition are 
 either entirely passive, or more or less active ; according as they are 
 composed of hard or bony, or soft parts. The i^elvis constitutes the first, 
 while the second are composed of the organs and structures contained 
 within it, or more or less directly attached to it. The pelvis also forms 
 the passage which the foetus has to pass through in order to reach the 
 external world in the act of parturition. 
 
 The soft organs are the vulva, vagina, uterus, ovaries, and manuiuB : 
 the latter furnish the young creature with its proper nourishment imme- 
 diately after birth. Of these soft organs, some are external, and others 
 are internal ; the first are the vulva and mammae, and the second are 
 the vagina, uterus, and ovaries. The vagina and the greater portion of 
 the unimpregnated uterus are contained in the cavity of the pelvis ; and 
 the ovaries, as well as the uterus during pregnancy, are lodged in the 
 abdomen. 
 
 Our study will commence with an examination of the pelvis in the 
 various domesticated animals, beginning with a description of the bones 
 of which it is composed ; then its ligaments ; and, lastly, this osseous 
 framework, which is of much importance, will be considered as a whole, 
 and from an obstetrical point of view. 
 
 Afterwards the external and internal organs of generation will be 
 described, and their differences noted in the various species. 
 
 The P]quine species will be taken as the type, and the differences in 
 the other species compared with it. 
 
 C II A 1^ T !•: K I . 
 The Pelvis. 
 
 The pelvis is the large, symmetrical, more or less horizontal, or horizon- 
 tally conoidal cavity or canal which continues the abdomen posteriorly, 
 and with which it communicates in front. It is formed of bony and 
 ligamentous walls, and contains, sustains, and protects a portion of the 
 
 1 
 
 / 
 
2 OBSTETRICAL ANATOMY. 
 
 genito-urinary apparatus, as well as the terminal portion of the ali- 
 mentary canal. It 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 mechanical 
 elements concerned in the act of parturition, and its form varies more 
 or less in different species ; though its direction is always rectilinear in 
 the domesticated animals, and not incurvated as in woman. 
 
 SECTION I.— BONES OF THE PELVIS. 
 
 The pelvis is composed of three principal bones — the two coxce 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 be subdivided, 
 but after a certain time they become consolidated. Each coxal bone, 
 for instance, is at an early stage of intra-uterine 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- 
 plementary 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 tuberosity. After birth, the three chief portions 
 of the coxae 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 innominatum 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 poi'tion, 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 acetabulum — 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 
 S2)ine, into which the sacro-sciatic 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 fora7nen ovale or sub-pubic opening or foramen. 
 
 The two coxae are united inferiorly in the median line, and posteriorly 
 by an articulation or solid suture — the symphysis pubis or ischio-pubic 
 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. 
 
THE I'KLl'lS. 
 
 S 
 
 Each coxa, as has been stated, is composed of three portions whicli 
 unite at the acetabuhnn ; and although consoHdated into one piece, yet 
 they are separately described as if distinct. The names of these divi- 
 sions are ilium, ischiian, a.nd jyu bis. 
 
 Ilium. — The ilium, hip, or liaunch hone (as ilium), frives its name to 
 the region it occupies. It is the largest of the three bones, as well as 
 being that which is most elevated. In shape it is irregularly triangular 
 and tlat, and is directed obliquely downwards, inwards, and backwards; 
 it has two faces, three borders, and three angles. Its cvteniai or superior 
 face, or dorsum, is marked by some muscular imprints, and is curved in 
 its widest part to form a concave space — the external iliac fossa, which 
 lodges the gluteal muscles. The internal or inferior face, or venter, 
 offers a smooth external portion — the iliac surface, into which is im- 
 planted the iliac psoas or iliacus muscle ; and an internal roughened, 
 
 Fig. 1. 
 
 Pelvis ok thk Mare 
 
 A, Ilium ; 13, I'ubia ; C, Ischium ; D, Foramen Ovale ; E, Tuberosity of the 
 Ischium ; F, Cotyloid Cavity. 
 
 ear-shaped, irregularly diarthrodial surface, most apparent from behind 
 --the auricular facet, for articulation with the sacrum. 
 
 The anterior border, or crest of the ilium, is slightly concave, and bears 
 a rugged lip for muscular insertion. The external border is thick and 
 roughened, and grooved for the passage of bloodvessels ; inforiorly it 
 has three nutrient foramina. The internal border is thin and concave, 
 especially in its posterior part, where it constitutes the (jreat sciatic 
 notch ; it affords attachment to the sacro-sciatic ligament. The spine 
 or ridge of the same name partly belongs to it. 
 
 The external angle, antcro-supcrior spinous jyrocess, or point of the hip, 
 is a wide, thick, and flattened portion, bearing four tuberosities afford- 
 ing attachments to muscles. The internal or antero-intcrnal angle or 
 supero-posterior spinous process, is a rough tuberosity curving upwards 
 and backwards to form an angle with the corresponding portion of the 
 opposite ilium — the sumtnit of the croup. The inferior, posterior or coty- 
 loid angle (concurring in the formation of the acetabulum), is very large 
 
4 OBSTETRICAL AX ATOMY. 
 
 and prismatic in shape. Posteriorly, it offers a concave articular sur- 
 face (acetabular), and above this cavity is the supra-cotyloid ridge or 
 crista ilii — an elongated eminence passing backwards, sharp at its 
 summit, smooth internally, and roughened externally, which is continu- 
 ous anteriorly with 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 the pelvic cavity 
 ■ — the linea ilio-pectinea. 
 
 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 sedentarum of man) is next in size to the 
 ilium, and the most 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 tivo faces, four borders, and 
 four angles. 
 
 The upi^er face is smooth and nearly flat, and forms part of the floor 
 of the pelvic cavity. The loiver 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 loostcrior border is straight and 
 directed obliquely forward and inward, composing, with the corre- 
 sponding border of the opposite bone, a large notch — ihejnibic or ischiatic 
 arch. Throughout its extent it exhibits a roughened depi'essed lip, 
 which projects on the lower face — this is the spine. The external border 
 is thick and concave, affords 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 ischio-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 
 {tuber ischii) — a thick, up-curved prismatic mass which is continued by 
 a prominent ridge elongated from before to behind, the thin margin 
 of which is curved outwards and downwards. The distance between 
 the external tuberosities of the two ischii gives the width of the ischial 
 arch, and allows an estimate to be formed of the transverse diameter 
 of the posterior opening of the pelvis. The postero-internal angle con- 
 stitutes, with 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 two faces, three borders, and three angles. 
 
 The upper face is concave and smooth, and concurs in forming the 
 floor of the pelvis. In the pelvis of many Mares it has a more or less 
 marked depression, apparently produced at the expense of the anterior 
 portion of the bone, which is thin ; while in the Horse it is generally 
 much thicker at this part, and instead of a depression the surface may 
 be plain or even convex. The loiver face is rough, and traversed on its 
 
THE I'KIA'IS. 6 
 
 whole length by a wide groove which reaches the bottom of the acetabu- 
 lum, and lodges the pubio-femoral ligament and a very large vein. 
 
 The anterior border is thin and uneven, and is curvetl like the arc of 
 a circle ; it concurs in forming the anterior circumference of the pelvis. 
 The posterior border is thick and concave, and in front circumscribes the 
 oval, sub-pubic, or obturator foramen. It is channelled, near the aceta- 
 bulum, by a fissure that passes obliquely downwards and inwards. The 
 internal border joins that of the opposite pubic bone in the middle line, 
 to form the anterior portion of the ischio-pubic or pelvic symphysis. 
 
 The external or cotyloid angle is the thickest, and constitutes the 
 largest portion of the roughened depi'essed surface at the bottom of 
 the acetabulum. The internal angle is united to the corresponding 
 angle of the opposite bone. The posterior angle is fused at an early 
 period with the antero-internal angle of the ischium, to form the inner 
 boundary of the obturator foramen. 
 
 The pubis does not alter much in form with age, but retains its 
 convex shape, while the part around the acetabulum is of considerable 
 thickness : a circumstance which tends to diminish the pelvic cavity to a 
 notable degree. During life, the pubic bones gradually lose their spongy 
 tissue, and to such an extent that in old age it has almost disappeared, 
 and the parts are translucid. 
 
 It may also be well to note that the compact tissue is most abundant 
 in the vicinity of the acetabulum, that cavity being the point where the 
 impulsive efforts communicated to the body by the posterior limbs are 
 concentrated ; at this part, also, ossification connncnces. 
 
 2. Sacru7H. 
 
 The sacrum (os basilare of man) may be said to terminate the vertebral 
 spine posteriorly, and results from the fusion of five vertebra) into a 
 single, voluminous, pyramidal or triangular mass. It encloses the 
 pelvic cavity above, and articulates in front with the last lumbar 
 vertebra, behind with the first coccygeal or tail-bone, and laterally with 
 the ossa innominata. It has an 2ipper and a lojccr face, tiro lateral 
 borders, a base or anterior extremit;/, summit or posterior cxtremiti/, and 
 central canal. 
 
 The upper face shows the supra-spinous processes or supra-sacral spine 
 (though the processes only meet at their base). On each side of this 
 spine is a channel in which are four openings — the supra-sacral foraminci, 
 which communicate with others on the inferior face. The lower face is 
 smooth, and slightly concave from before to behind ; this is the roof of 
 the pelvic cavity, and shows traces of its being composed of five bones, 
 as well as offers four foramina for the passage of the sub-sacral nerves. 
 
 The two lateral borders are thick and concave, and posteriorly show a 
 rugged lip. In front is an irregular oblique surface for articulation with 
 the ossa innominata ; this is divided into two portions, the lower of 
 which, slightly uneven and diarthrodial, is the auricular surface ; the 
 upper is for the insertion of the sacro-sciatic ligament. 
 
 The base, or anterior extremit;/, is articulated by a shghtly oval and 
 convex surface with the last lumbar vertebra, and forms with the spine 
 a salient angle looking down towards the abdominal cavity, named the 
 sacro-vertebral angle. Laterally, it is united to the two coxa, between 
 which it is fixed like a horizontal wedge. In front it shows the open- 
 ing of the spinal canal. 
 
6 OBSTETRICAL ANATOMY. 
 
 The summit or posterior extremity likewise offers the opening of the 
 spinal canal, and a surface for articulation with the first tail-bone. The 
 central canal is a continuation of that in the other vertebrae, for the 
 passage of the spinal cord. In this bone, however, instead of being 
 circular it is triangular, and diminishes in width posteriorly. 
 
 The position of the sacrum is more or less inclined downwards from 
 before to behind, according to the breed of the Mare. 
 
 3. Coccyx. 
 
 The coccygeal or tail bones are a series of small, cylindrical, or irregu- 
 larly prismatic pieces, from fifteen to eighteen in number, behind the 
 
 Fig. -1. 
 
 Pelvis ov the Cow. 
 
 A, Ilium ; B, Pubis ; C, Ischium ; D, Foramen Ovale ; E, Sciatic Spine ; F, 
 Cotyloid Cavity ; G, Tuberosity of the Ischium. 
 
 sacrum, the first three of which may be said to belong to the pelvis. 
 They form the base of the tail. 
 
 Differences in the Bones of the Pelvis of other Animals. 
 
 In all the domesticated animals the coxae are nearly horizontal, and 
 the ilium has a vertical direction. 
 
 Goio. 
 
 In the pelvis of the Cow, the space between the coxge is no greater 
 before than behind ; they are not so solid or voluminous, comparatively, 
 as in the Mare. This is more particularly the case with the ilium, the 
 iliac concavity of which is not so wide. It is more vertical than in the 
 Mare. The ischium, though thinner than in the Mare, has a much 
 wider surface, and is more curved from before to behind and from side 
 to side ; while the ischiatic spine, or supra-cotyloid crest, is very promi- 
 nent and thin. Three tuberosities are observed on the postero-external 
 angle. 
 
THE r ELVIS. 7 
 
 The pubis is wide and thin ; it has no channel on its inferior face, and 
 the upper face is very concave. The foramen ovale is large, and its 
 mar<^in thin. The symphysis is ossified earlier than in the Mare. 
 
 The sacrum is longer, and more curved and voluminous than that of 
 the Mare. The lateral borders are sharp and directed downwards. It 
 is composed of the same number of vertebras as in the Horse. The 
 articular surfaces for union with the coxic approach the vertical direc- 
 tion. 
 
 The coccygeal hones are stronger and more tuberous ; they are from 
 sixteen to twenty in number. 
 
 The pelvis of the Cow is therefore less developed than that of the 
 Mare, though it has more extensive bony walls ; it is also lighter and 
 less voluminous. We shall see that it likewise differs in its form and 
 direction, and that this has a notable influence in the mechanism of 
 parturition. 
 
 Fig. 3. 
 
 Pklvis ok thk Sheki". 
 
 A, Ilium ; B, Pubis ; C, I>schium : D, Foramen Ovale ; E, Cotyloid Cavity. 
 
 Slicep and Goat. 
 
 In the Sheep and Goat, the bones of the pelvis greatly resemble those 
 of the Cow. The ischium, instead of being curved in a longitudinal 
 direction, however, is nearly rectilinear, and the external iliac fossa is 
 divided into two portions by a small longitudinal crest. The pelvis, on 
 the whole, is more horizontal and longer than in the Cow. 
 
 Bitch ami Cat. 
 
 In the Bitch and Cat, the lateral diameter of the pelvis is greater 
 before than behind ; the ilimn is almost vertical, and its external face 
 is much depressed. The space which forms the pubic arch only occu- 
 pies the inner moiety of the posterior border of the ischium, which is 
 very broad ; between the arch and the ischial tuberosity is a roughened 
 lip, which is directed downwards. The sacrum is somewhat quad- 
 rangular ; it is composed of three bones, which are consolidated at an 
 early age, and the lateral surfaces for articulation with the ilium are 
 turned outwards and almost vertical. There are only tliree vertebral 
 
9 OBSTETRICAL ANATOMV. 
 
 foramina. The coccygeal bones are strong and tuberous, and the first 
 five or six are as perfect as the true vertebral bones. 
 
 Pig. 
 
 The pelvis of the Pig resembles that of the Sheep. The crest of the 
 iliiwi is convex, and there is no external protuberance on the symphysis 
 pubis. The jiubis is narrovs^; and the ischiuvi, instead of a crest, has a 
 tuberous prominence. The sacrum is formed by four vertebrae, w^hich 
 do not become fully consolidated for a long time, and it is sometimes 
 difficult to discover w^here the sacrum ends and the coccyx begins. The 
 spinous processes are absent ; and the neural arch being deficient on 
 each side, the spinal canal is open above. There is nothing particular 
 to note in the coccygeal bones. 
 
 SECTION II.— ARTICULATIONS OF THE PELVIS. 
 
 The bones of the pelvis are united by articulations and ligaments? 
 as well as fibrous bands, which are complementary. A knowledge of 
 these is of some importance to the obstetrist. The articulations are 
 
 Fig. A. 
 
 Lateral Ligaments of the Sacrum and Pelvis. 
 
 a, Superior Sacro-iliac Ligament ; h, Sacral Ligament ; c, Lateral Sacro-iliac 
 Ligament ; d, Sacro-sciatic Ligament ; e, Small Sciatic Notch ; /, Great 
 Sciatic Notch. 
 
 five in number : (1) the mcro-lumhar, (2, 3) the two sacro-iliac, (4) the 
 ischio-pubic symphysis, and (5) the sacro-coccygeal articulations. The 
 ilio-sacral and sacro-sciatic hgaments complete the subject of this 
 section. 
 
 1. Sacro-lumbar Articulation. 
 
 The sacro-lumbar articulation is formed between the anterior face or 
 base of the sacrum, and the last lumbar vertebra; the union takes 
 place by five articular surfaces and thick fibro-cartilages, and numerous 
 strong hgaments bind the two bones closely and very firmly together, 
 so as to allow only a very restricted amount of movement between them. 
 It would appear that these bones, though so hmited in their movements 
 on each other, yet are never anchylosed in old age nor yet by accident, 
 even if all the other vertebrye in this region should happen to be con- 
 solidated. 
 
riiK I'KLris. » 
 
 This arrangement is particularly remarkable in the Mare, on which it 
 confers great strength and solidity. It is not present in the Cow ; con- 
 sequently, that animal is liable to a kind of incomplete luxation, which 
 may at times become an obstacle in parturition. 
 
 We have already alluded to the salient angle formed by the union of 
 the last lumbar vertebra with the sacrum [sacro-vertebral aiujle), and 
 which looks downward into the abdominal cavity.^ 
 
 2, 3. Sacro-iliac Articulations. 
 
 The sacro-iliac articulation of each side establishes the union of the 
 posterior limbs with the spine, and is formed by the sacrum and ossa 
 ilii ; it belongs to tiie arthrodial class of joints. The two surfaces which 
 come into apposition have been already described, and it only now re- 
 mains to point out that the sacrum is fixed between the antero-superior 
 extremities of the ossa ilii like a horizontal wedge or the keystone of an 
 arch inverted ; the transverse diameter is greater below than above — 
 the pressure it has to resist being from below. The oblong roughened 
 surfaces on the sacrum and ilium have a layer of cartilage between 
 them to diminish shock and facilitate movement, which is further pro- 
 moted by each articulation being provided with a synovial membrane, 
 though the amount of synovia secreted is very trifling. The union of 
 the bones at this part is strengthened by three powerful ligaments : the 
 sacro-iliac — superior and inferior, and the sacro-iliac inopcr. There is 
 also the sacra-sciatic or sacro-iscJiiatic to be noticed hereafter. Though 
 the movements of this articulation are very limited, but still useful in 
 locomotion and parturition, yet it rarely, if ever, becomes consolidated. 
 The diarthrodial union between the bones appears to be chiefly, if not 
 exclusively, intended to obviate the fractures which must occur had 
 they been united in a more solid manner ; while the two articulations 
 being the centre towards which all the impulsive efforts of the posterior 
 extremities converge, a great degree of mobility would not be compatible 
 with their solidity. 
 
 4. Ischio-puhic Synipliysis. 
 
 The syviphrjsis pubis, as it is sometimes termed, is the amphiarthrosis 
 formed by the union, inferiorly, of the two ossa pubis and ischia. The 
 articulation is consolidated by means of a layer of fibro-cartilage between 
 the margin of these bones, which becomes ossified more or less com- 
 pletely and rapidly according to species ; and by a layer of white liga- 
 mentous fibres — short and compact — which pass across above and 
 below, the latter being the strongest. The movements of this articula- 
 tion are very limited, and depend solely upon the elasticity of the 
 interosseous cartilage ; they are abolished when ossification occurs. 
 This happens in the majority of horses before adult age ; though some- 
 times the posterior portion is cartilaginous after this period. 
 
 5. Sacro-coccygeal Articulations. 
 
 These resemble those of the vertebra} in general, there being a thick 
 disc of fibro-cartilage placed between each tail-bone, the first of which 
 
 ' This angle ia much more marked in wom.an, and 'n named the promontory ; it i« 
 immediately at the entrance to the pelvis, and for these reasons it is frequently a cause of 
 difficult parturition in her; while, from its less development and distance from the 
 pslvis, it offers no obstacle in animals. 
 
10 
 
 OBSTETRICAL ANA TOMY. 
 
 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 interfering 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 diminishes 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. 
 
 DiFFEKENCES IN THE PeLVIC AeTICULATIONS OF OTHER AnIMALS. 
 
 In all the domesticated animals other than the Equine species, the 
 sacrum is joined to the last lumbar vertebra by t^iree diarthrodial 
 surfaces only — the head of the body and two transverse inocesses ; these 
 latter on the vertebrae are not in immediate contact with the base of the 
 
 Fig. 5. 
 
 Ligaments of the Lumbar Vertebr.e, Sacrum and Pelvis, seen from below. 
 
 a, Intertransverse Ligament of the Lumbar Vertebrae ; b. Capsular Ligament of 
 the Spinous Process of the Fifth and Sixth Lumbar Vertebrje ; c, Capsular 
 Ligament of the Sacrum ; d, Inferior Sacro iliac Ligament ; e. Obturator 
 Ligament ; /, Transverse Ligament of the Ischio-pubic Symphysis. 
 
 sacrum, an interosseous ligament uniting them. Therefore it is that, 
 in the Coxv 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. 
 
 In the Cow the ischio-pubic symphysis is considerably longer than in 
 the Mare, not rectilinear, and much curved downwards in the middle ; 
 across this concavity on the floor of the pelvis, the foetus passes during 
 parturition. In the Cow ossification of the symphysis is less complete, 
 and does not take place until much later than in the Mare, though it 
 may in some instances be found entirely accomplished in old animals. 
 Ossification, according to Saint-Cyr, commences in the Cow at the 
 ischial arch, and proceeds forwards ; while in the Mare it begins at the 
 
77//; I'KJJ'JS. 11 
 
 pubis and extends backwards. The same authority remarks that this 
 symphysis in the Cow has often a sahentcrest projecting into the pelvic 
 cavity, which, if it does not offer a very considerable obstacle to the 
 passage of the feetus, may nevertlieless greatly fatigue tlie obstetrist 
 when his hand is engaged between it and the young creature, during the 
 straining of the mother. 
 
 Sheep and Goat. 
 
 In these animals the ischio-puhic symphysis is rectilinear ; the inter- 
 posed cartilage is not ossified until very late in life, and almost never in 
 those which have had many young. The same remarks are applicable 
 to this symphysis in the Pig. 
 
 Bitch and Cat. 
 
 The symphysis in the Bitch and Cat scarcely ever ossifies ; so that 
 these animals, when advanced in age, still have a notable degree of 
 mobility in this region, and the diameter of the pelvic cavity may be 
 proportionately increased. 
 
 Sacro-sciatic Ligament. 
 
 The sacro-sciatic ligament (Fig. 4, d) transforms the pelvic cavity into 
 a complete canal, by filling up the space on the side of the pelvis, 
 between the sacrum and coxai. It is a wide membranous expansion, 
 composed of white fibrous tissue — -the fibres crossing each other in 
 different directions, and sei-ves rather to enclose this portion of the 
 pelvic space than to maintain the solidity of the sacro-iliac articulation. 
 It is irregularly quadrilateral, its superior border being rectilinear, and 
 attached along the rough crest on the side of the sacrum, as well as to 
 the first two or three coccygeal bones. Its anterior border is irregular, 
 and not well defined, but it is inserted above into the base of the 
 sacrum, and below into the inner border of the ilium, circumscribing in 
 its middle the opening which has been named thegi'eat ischiatic notcli, 
 through which the gluteal vessels and nerves, as well as the sciatic 
 nerves, pass, and to the compression of which against the bones of the 
 pelvis during pregnancy may be due cramp of the posterior limbs, 
 or even more or less persistent paralysis ; the inferior border is attaclied 
 to the spine of the ischium, as well as to the ischiatic tuberosity, and 
 between these insertions, and immediately behind the cotyloid cavity, 
 it forms the small ischiatic notch, the opening through which the 
 obturator internus muscle passes ; while the j^osterior border, not well 
 limited, completes the posterior circumference of the pelvic cavity, and 
 divides into two layers, between which lies the semimembranosus 
 muscle, and above it is mixed up with the enveloping sheath of the tail 
 muscles and bones. 
 
 The inner face of this wide ligament is covered by peritoneum to the 
 extent of one-third in front ; and behind it is in direct relation with 
 various organs contained in the pelvic cavity, by means of an abundant 
 loosi- connective tissue. Its crtcrnal face is traversed by the sciatic 
 ner\-es and covered by muscles. 
 
 There are no notable differences in this ligament in the various 
 species of animals we are dealing with. 
 
12 OBSTETRICAL ANATOMY. 
 
 SECTION III.— THE PELVIS AND ITS CAVITY. 
 
 Having now studied the individual portions which compose the 
 pelvis, as well as the manner in which they are united, it remains to 
 consider this region in its entirety, and with regard to its general con- 
 formation, dimensions, axes, and other important features. This study 
 is of much moment from an obstetrical point of view, and for the full 
 comprehension of the mechanism of parturition. 
 
 The cavity of the pelvis is the space between the inlet and outlet. 
 In the human female it lodges nearly the whole of the uterus, and in 
 the early days of pregnancy the foetus also. This is not the case with 
 the domesticated animals, owing to their different attitude, until the 
 act of parturition carries the progeny there.^ With its two openings, 
 the pelvic cavity is capable of more or less increase in capacity in 
 every direction, through relaxation of the pubic and sacro-iliac articu- 
 lations and sacro-sciatic ligaments. The yielding of the latter is very 
 noticeable in the larger animals immediately before parturition, as well 
 as the elevation of the coccyx by the body of the foetus in its passage 
 outwards. It is also a fact of daily observation that the pelvis per- 
 manently widens in animals which have had young frequently ; this 
 accounts for the peculiar rocking gait they exhibit in progression, which, 
 in some of the domesticated creatures at least, is no doubt due to per- 
 sistent relaxation in the articulations above mentioned. 
 
 It may be again observed that the anterior margin of the floor of this 
 cavity is nearly straight, and its posterior border is deeply cut into by 
 the ischial arch, while the floor itself often offers some diversities. 
 For instance, it may be convex in front and concave behind, or vice 
 versa, the concavity being separated from the convexity by a transverse 
 ridge, which may also be represented by a series of small conical 
 eminences ; or the floor may be a smooth plane sloping upwards from 
 before to behind, with a kind of raised border surrounding the anterior 
 contour of the obturator foraiuen. 
 
 We will first notice the pelvis of the Mare, and proceed to compare 
 it with the other domesticated animals. 
 
 Mare. 
 
 Considered in a general manner, the pelvis of the Mare represents 
 a slightly cone-shaped bony cavity at the posterior part of the trunk, 
 completing or continuing the abdominal cavity ; the base of this conical 
 space, intersected obliquely downwards and backwards, is anterior : 
 its axis forms, with that of the abdomen, a very wide angle, the sinus 
 of which is inferior. The summit or narrowest part of the cavity is 
 posterior. With regard to conformation, it offers, for convenience of 
 description, an external and internal surface, and tico openings. 
 
 External Surface. — This surface may be considered as consisting 
 of four regions, j^lcines, or faces. The superior region or croup is the 
 narrowest, and is slightly oblique downwards and backwards, the 
 degree of obliquity varying not only in different breeds, but also in 
 different animals of the same breed and species. In the Mare it is 
 
 ^ Girard thought that, in the Bitch, one of the young in the body of the uterus might 
 occupy this space ; but Rainard could not verify this : all his examinations of prej^nant 
 animals which had died before bringing forth their young proved the body of the uterus 
 to be quite empty. 
 
THE I'KLriS. 
 
 13 
 
 indicated by the droop or slope of the croup, whicli is generally greater 
 than that of the Cow. It is more conspicuous in common than in 
 ^vell-bred horses, in which the croup is almost horizontal, and the tail 
 nearly on a level with its highest point. The width of this region also 
 varies not only with the height and volume of tlie animal's l)ody, hut 
 also according to breed— the draught or coarse-bred Horse having a 
 wider croup than the thorough-bred one. This region is constricted 
 from before to beliind, and shows, on the middle line, the spinous pro- 
 cesses of the sacrum and the first coccygeal vertebrte ; and on each 
 side the channels into which open the four sacral foramina. 
 
 The inferior region is nearly horizontal, and is slightly convex. 
 Formed by the pubic and ischial bones, it offers in the middle the 
 symphysis pubis, on each side the subpubic channels and the obturator 
 foramen, and outwardly the cotyloid cavities tlirough which the pelvis 
 rests on the posterior limbs. 
 
 Fig. 6. 
 
 LONCITl'DINAL SECTION OK A MaKK's PeLVIS 
 
 The lateral regions are more extensive than the others ; they are in- 
 clined downwards and inwards, and are wider before than behind. 
 On each are observed the crest of the ilium and tlie two anterior iliac 
 spines, the external iliac fossa, the great sciatic notch, the spine of 
 the ischium, the small sciatic notcli, and the tuberosity of the ischium. 
 
 The internal surface (Fig. 6), as has been already mentioned, is 
 formed partly of bony and partly of ligamentous walls, and circum- 
 scribes the pelvic cavity, which is a continuation of that of the abdomen, 
 and with which it communicates by a wide osseous circle — the anterior 
 opening or inlet of the pelvis. A transverse section of this canal shows 
 that it is oval-shaped, the largest portion being towards the pubis, and 
 the narrowest towards the sacrum. 
 
 The internal surface is more regular than the external, but it cannot 
 be divided into two portions like the liuman pelvis, the inner aspect 
 of the ilia not being excavated to form an anterior cavity. It may, 
 however, be considered as having /owr concave i)lanes, an anterior opening 
 or inlet, and a jwsterior opening or outlet. 
 
 The superior, sacral, or rectal plane, or roof of tlie p)clvis is formed 
 by the lower face of the sacrum, and is in contact ■with the rectum, 
 
14 
 
 OBSTETEIGAL ANA TOMY. 
 
 subsacral vessels, and sympathetic nerves. It is slightly concave 
 longitudinally. 
 
 The inferior plane, or floor of the pelvis, is constituted by the upper 
 surface of the pubic bones and ischia. It is rectilinear from before to 
 behind, and concave from side to side. The symphysis pubis occupies 
 the median line; 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. 
 On 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 them, and they are traversed from before to behind 
 
 rig. 7. 
 
 Diagram of the Mare's Pelvic Axis. 
 A, Inlet ; B, Outlet, 
 
 by the obturator vessels and nerves, and pierced by the gluteal and 
 ischio-muscular vessels and nerves, the internal pudic and the great 
 and small sciatic nerves. As has been stated, it is the compression of 
 these nerves by the uterus and its contents which causes the cramps 
 pregnant animals experience towards the termination of gestation. 
 The lateral planes are readily dilatable during parturition. 
 
 Anterior Opening or Inlet (Figs. 7, 8, 9). — This opening, which is 
 continuous with the abdominal cavity, and may also be designated the 
 brim, anterior circumfereyice, or abdominal ojjening of the pelvis, is nearly 
 circular, or shghtly oval, the widest part corresponding to the symphysis 
 pubis. It is a little obliquely inclined downwards and backwards, and 
 is limited above by the anterior border of the sacrum and its articula- 
 tions with the lumbar vertebra and ilia ; below, by the anterior border 
 of the pubic bones ; and on each side, by the ileo-pectineal ci-est and a 
 portion of the inner aspect of the ilia. Owing to this circumference 
 being entirely bony, and also to the solidity of the articulations between 
 the different bones, the inlet of the pelvis cannot be dilated to any 
 appreciable degree under the most violent efforts, even supposing the 
 
THK l- ELVIS. IS 
 
 sacro-iliac and ischio-pubic ligaments to become softened and relaxed 
 before pregnancy — a change which must be indeed rare in the Mare. 
 
 It is by the inlet that the fcetus enters the pelvic cavity, and a know- 
 ledge of its dimensions is therefore of much moment to the obstetrist. 
 These dimensions are ascertained by taking the diameter of the openiiif 
 at several points, but two diameters are generally recognised : a siipcro- 
 inferior and a transverse. The supcro-inferior, or sacro-pubic diameter 
 (Figs. 8, 9, a, 6), rather oblique, is the width between the sacro-vertebral 
 angle and the symphysis pubis. This is generally the 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 entei-s the 
 pelvis. It varies with the size of the Mare, but is usually between 
 eight and ten inches. The transverse or bis-iliac diameter is measured 
 from one ileo-pectineal crest to another, and is generally less than the 
 supero-inferior, though sometimes it may be equal, or even greater. It 
 is from seven to nine inches. 
 
 Fig. 8. 
 
 Ini.kt ok the Pklvis ok thk Mahk : WiDK Tklvis. 
 
 /), Supero-inferior, or S.icro-pubic Diameter ; c d, Superior Bis-iliac 
 Diameter ; e /, Inferior Bin-iliac Diameter ; e i, / /i, Ohlique, Ilio-sacrul, 
 or Sacroiliac Diameters ; J K, Middle Diameter. 
 
 It may be observed that Franck gives two oblique transverse diameters, 
 and Saiut-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 unfrequently 
 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-iliac diameters, a 
 superior and an inferior. The superior (Figs. H, 9, c, d) is about the 
 upper third of the pelvic cavity, and corresponds to the shoulder and 
 hip joints of the foetus when it is in the f/orso- and lumbo-sacral positions 
 — the most frequent; while the inferior {c, f) is drawn at the lower 
 fourth of the cavity, corresponding to the elbow and stifle joints of tin; 
 foetus. The upper diameter is sometimes less than the sacro-pubic (as 
 in Fig. 9) ; but more frequently it is equal, or even superior to it. Tlie 
 
16 
 
 OBSTETPdCAL ANATOMY. 
 
 inferior bis-iliac diameter sometimes slightly exceeds the sacro-pubic, 
 but generally it is less. The oblique, ilio-sacral, or sacro-iliac diameters 
 (Figs. 8, ^, e i, f h), pass from the articulations, the names of which 
 they bear, through the middle of the inlet, to the ilio-pectineal crest on 
 the opposite side — just about the centre of the cotyloid cavity. Their 
 length is between that of the sacro-pubic and superior bis-iliac diameters, 
 and they ai'e only important to note when the inlet approaches a circular 
 outline (Figs. 8, 12), as then the foetus may pass through the cavity with 
 its dorso-sternal diameter corresponding to one of them ; while in more 
 oval pelves it rotates slightly in its progress, its larger axis correspond- 
 ing more or less with that of the inlet— that is, to the dotted lines in 
 Figs. 9, 11. 
 
 PosTEBiOE Opening oe Outlet (Fig. 7, b). — This is also sometimes 
 named the pei-ineal circumference, or recto -^iretliral opening ; it includes 
 in its contour the rectum and vagina, and is related to the vulva and 
 
 Inlet of the Pelvis of the Mare : Narrow Pelvis. 
 
 h, Supero-inferior, or Sacro-pubic Diameter ; c d, Superior Bis-iliac 
 Diameter ; e /, Inferior Bis-iliac piameter ; e i, f h, Oblique, Ilio-sacral, 
 or Sacro-iliac Diameters. 
 
 anus, which are external to it. Owing to the horizontal direction of 
 the Mare's pelvis, this outlet is limited above by the apex of the sacrum 
 and the base of the coccyx ; below, by the ischial arch, formed by the 
 junction of the two ischia ; and, laterally, by the upper surface of the 
 ischia and posterior border of the sacro-sciatic ligaments. The opening 
 is oval. 
 
 The diameters are ordinai-ily much less than those of the inlet — per- 
 haps to the extent of one-fifth ; but this circumstance has rarely any 
 influence in parturition, as the opening is very dilatable, owing to the 
 relaxation that takes place in the sacro-sciatic ligaments during the later 
 months of pregnancy, and the great mobility of the sacrum and coccyx, 
 which allows the supero-inferior diameter to be increased considerably. 
 
 It may be noted that the pelvis of the female Ass differs but little 
 from that of the Mare, so far as shape is concerned, its inlet being 
 generally oval from above to below, the sacro-pubic diameter slightly 
 exceeding the transverse in measurement. 
 
THE VELVIH. 
 
 17 
 
 Differences in otheu Animals. 
 
 Coxc. 
 
 In the Cow the pelvis (Fig. 10) is longer than in the Mare, and less 
 vertical ; the ischio-pubic symphysis is also longer, and, instead of 
 being straight, is very curved, so that the floor of the pelvis is concave 
 in every direction. The ischial arch is more deeply cut at the sym- 
 physis, and the posterior borders of the ischia join at an acute angle or 
 V-shape, the opening being supero-posterior. The external border of 
 these bones is higher, and the sciatic spine or supra-cotyloid crest is 
 thinner and more elevated. So that, altogether, the bony parietes of 
 the Cow's pelvis are more extensive, comparatively speaking, than the 
 Mare's. The sacral surface is more concave, and the sacro-sciatic 
 ligaments longer, tliough narrower. 
 
 The pelvic cavity (Figs. 11, 12) of the Cow is also less wide, when 
 compared with its height. The diameters of the i/i/c^ — which is more 
 
 Fig. 10. 
 Lo.vciTfDiSAL Section ok tiik Cow'.s Pelvis. 
 
 oblique than in the Mare — are very unequal ; the difference between 
 the sacro-pubic and the transverse, according to Saint-Cyr, being one- 
 third (nine and six inches) ; while it is narrower at its lower part, and 
 not so markedly oval as in the Mare. Its sides are also nearly parallel 
 for some distance, so that its sacro-pubic diameter is greater than its 
 transverse ; the difference varying, according to Saint-Cyr's measure- 
 ments, in favour of the first from 3 centimetres (Fig. 12) to 104 centi- 
 metres (Fig. 11). 
 
 The dimensions of the outlet are not so reduced as in the Mare ; they 
 are more equal, and are about those of the transverse diameter of the 
 inlet. It therefore results that the pelvis of the Cow is more cylindrical 
 and less conical than that of the Mare ; but this feature does not render 
 parturition any easier, for tliougli the outlet is a little larger than in 
 the latter animal, yet this advantage is counterbalanced by the length 
 of the pelvic cavity, the greater extent of its bony walls, and the very 
 marked cun-ature of the symphysis. So it is that, while it rarely 
 happens that the Foal experiences any difficulty in passing through the 
 cavitv, once it has fairly cleared the inlet, in the Cow parturition takes 
 
 2 
 
18 
 
 OBSTETRICAL ANATOMY. 
 
 longer, and it is not at all infrequent for the Calf to become fixed in the 
 pelvis, there to remain unless removed by artificial means. 
 
 It is also to be noted that the floor of the pelvic cavity is on a much 
 
 Fig. 11. 
 
 Inlet op the Cow's Pelvis : Narkow Pelvis. 
 
 a b, Supero-inferior, or Sacro-pubic Diameter ; c d, Superior Bis-iliac 
 Diameter ; e f, Inferior Bis-iliac Diameter ; e i, / h, Oblique, 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 lovrer, and have a strong tendon fixed into the 
 
 Fig. 12. 
 Inlet op the Cow's Pelvis : Wide Pelvis. 
 a b, Supero-inferior, or Sacro-pubic Diameter ; c d, Superior Bis-iliac 
 Diameter ; e /, Inferior Bis-iliac Diameter ; e i, f h, Oblique, Ilio-sacral, 
 or Sacro-iliac Diameters ; J K, Middle Diameter. 
 
 pubic symphysis— the transverse ligament of Goubaux. Therefore 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 I' K LI' IS. I'J 
 
 Sheep and Goat. 
 
 With these animals the pelvis does not differ to any notable extent — 
 except, of course, in size — from that of the Cow. The syviplujiiis is 
 nearly rectilinear in its direction, and its ossification occurs at a very 
 much later period than in the Cow or Mare ; this allows the diameters 
 of the pelvic cavity to be increased during parturition, and accounts for 
 the rarity of ditVicult births in the Sheep and Goat. 
 
 Puj. 
 
 The general conformation of the pelvis in the Pig is not unlike that 
 of Ruminants, except that the sacro-vcrtchral angle, or ' promontory of 
 the sacrum,' is more salient, the canal longer, the ylane of its anterior 
 circumference more oblique, and the direction of the ischio-puhic sym- 
 physis perfectly rectilinear. The pelvic cavity is very large in proportion 
 to the size of the young at birth ; therefore it is that accidents are very 
 rare during the act of parturition. 
 
 BitcJt and Cat. 
 
 In these creatures the sacro-vertcbral angle is still more marked than 
 in the Pig, and diminishes the inlet of the pelvis to a notable extent ; 
 the direction of the symphysis is rectilinear, and the general outline of 
 the pelvic cavity is nearly cylindrical, though the inlet is larger below 
 than above. The ischiii7n, innnediately above the obturator foramen, 
 is wide and shallow, and rises abruptly to almost a right angle ; this is 
 the narrowest part of the canal, and liere it is that the passage of the 
 foetus is obstructed in small females wliich have been impregnated by 
 large dogs. It must be remarked, however, that the late, and often 
 incomplete, ossification of the symphysis allows a certain amount of 
 dilatation of tlie canal, and renders the passage of a comparatively large 
 foetus possible. 
 
 Differences in the Pelvis accokding to Sex. 
 
 There is a considerable difference in the size and conformation of the 
 male and female jjelvis in the domesticated animals, as might be 
 expected from the sexual functions being so diverse in the two creatures, 
 the female pelvis being larger in every sense, but more particularly in 
 its transverse diameter. These differences have only been carefully 
 studied in the Equine species, but they exist in a somewhat similar 
 degree in the pelvis of other species. 
 
 In the Mare, in addition to the pelvis being wider than that of the 
 Horse, the inlet is nmch larger, the ilio-pectineal crests are further 
 apart, and the distance between the lower face of the sacrum and the 
 anterior border of the pubis is much greater, the ilia and pubis being 
 broader and more concave. On the upper surface of the Mare's pelvis, 
 the sacro-sciatic notches are very deep ; the inner border of the ilium 
 forms a very concave line, and the ischiatic spines are widely separated. 
 The tioor of the pelvis is wide, and the bones composing it have a 
 tendency to assume the same horizontal direction. In the Horse, the 
 ischiatic border does not describe a regular curve ; it is composed of 
 two nearly straight portions, which unite where the neck of the ilium 
 begins. The supra-cotyloid crests are not much separated, and are 
 
20 
 
 OBSTETRICAL ANATOMY. 
 
 turned outwards, and the two portions of the floor of the canal are 
 directed very obliquely downwards and inwards. In the Mare the 
 ischial arch is wider than in the Horse, and forms a regular curve in 
 
 Fig. 1.3. 
 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. H. 
 Bones of Pelvis of Horse. 
 
 are also large and almost circular in the Mare, while they are small and 
 oval in the Horse ; the ischio-pubic symphysis is farther from the 
 cotyloid cavities in the former than in the latter. 
 
 The sacrum is also broader and longer in the Mare, and in the 
 
Till-: Ph'LI'IS. 
 
 21 
 
 majority of animals it is more concave from before to behind. The first 
 coccygeal vertehr* are larger and more flexible, and carried at a greater 
 elevation than in the Horse. 
 
 This ditierence of conformation in the pelvis of the Mare is adapted 
 to the passage of the foetus through the canal, and it causes the animal 
 to appear lower in the forehand than the Horse, in which the croup is 
 not so high. It is rare to find a -\Iare which has the croup so square as 
 the Stallion, the hind quarter of which is almost equal in depth, breadth, 
 and length. 
 
 The width of the pelvis of the Mare, as before observed, produces a 
 rocking motion during progression, and this is all the more mai'ked as 
 the animal has been fre(iuently bred from ; for the same reason the 
 speed is not so great, and it has been remarked that Mares which have 
 had several foals are not well adapted for the circus. 
 
 The diflerences in the pelvis of the Mare and the Horse are 
 sometimes noticeable at birth ; but they are generally most apparent 
 when the adult period has been reached, and the body has acquired its 
 definitive form. In both sexes, the supero-inferior diameter of the inlet 
 is greater than the transverse in early life. 
 
 Some idea of the difference in the dimensions of tlie pelvic cavity in 
 the Mare and Horse, may be obtained from the following measurements 
 of two animals about the same in size : 
 
 Mare 
 
 Horse 
 
 Vertical Diameters. 
 
 Horizontal Diameters. 
 
 Between the 
 
 Sacrum and 
 
 Pubis. 
 
 Between the 
 
 Sacrum and 
 
 Ischium. 
 
 Between the 
 Pectineal Ridges. 
 
 Betwoen the 
 Ischial Spines. 
 
 9 inches. 6^xi inches. 
 8 » 6fV „ 
 
 9^ inches. 
 8 „ 
 
 7i inches. 
 
 The differences in the pelvis in the two sexes are, perhaps, not 
 so marked in the smaller domesticated animals until the female has 
 brought forth young several times. 
 
 SECTION IV.— CAPACITY OF THE PELVIS, OR PELVIMETRY. 
 
 We have already casually alluded to the capacity of the pelvic cavity in 
 the largerdomesticated animals, and toitsdiameters; audit will be inferred 
 that these must vary with the different sizes existing in the Mare, Cow, 
 Pig, and Bitch ; though in others which are generally of uniform volume 
 — as the Sheep, Goat, Ass, and Cat — the pelvis does not offer much 
 diversity. In this respect the latter species resemble mankind, in the 
 female of which a difference in size does not make much difference in 
 pelvic dimensions — half an inch probably covering the variations. But 
 in the Mare or Cow, if we compare a small with a large animal, this 
 difference in diameters may extend to nearly two or three inches. 
 
 The subject oi pclvimetrn is very important to the accoucheur of the 
 human species, as the female pelvis is particularly liable to be deformed 
 or defective in its proportions. It is not nearly of so much moment to 
 the veterinary obstetrist, as the head of young animals generally 
 experiences no difficulty in passing through the pelvic cavity, except 
 
22 
 
 OBSTETRICAL ANATOMY. 
 
 sometimes in the Carnivora or in cases of hydrocepiialus ; and also 
 because the less value of animal life leads the operator, when in diffi- 
 culties, to sacrifice the foetus rather than endanger the existence or 
 value of the mother. 
 
 It is^ nevertheless, useful to know the diameters of the pelvis of dif- 
 ferent animals, in order not only to fully understand the mechanism of 
 parturition, but also with regard to the indications they may furnish in 
 many cases of dystokia. 
 
 We have shown that the pelvic canal in the large and small Herbivora 
 is somewhat of an oval shape, the narrowest part being above, and the 
 widest below ; and that in the Carnivora it is somewhat cylindrical. 
 This diffei'ence in outline is conformable with the shape of the foetal 
 thorax, which in the former is deeper than it is wide, particularly at 
 the period of birth. During parturition, the foetus of Herbivorous 
 animals is so placed, generally, that the withers and shoulders are 
 towards the roof or superior plane of the pelvis ; while the sternum and 
 
 iucee^ ^¥%«^ 
 
 Fig. 15. Fig. 16. 
 
 Median Section of the Pelvis of the Horse (Fig. 15) and Maee (Fig. 16). 
 
 1, Sacrum ; 2, Two first Coccygeal Vertebra ; 3, Two last Lumbar Vertebrae ; 
 4, Ischio-pubic Sj-mphysis ; a h, Axis of the Pelvic Cavity ; c d, Supero- 
 inferior Diameter of the Inlet ; e f, Supero-inferior Diameter of the Outlet ; 
 c g, Vertical Diameter of the Inlet ; i h, Vertical Diameter of the ]Mid- 
 pelvis ; kf, Vertical Diameter of the Outlet. 
 
 anterior limbs, which form a larger mass, rest on the floor or inferior 
 plane. The passage of the thorax of the foetus in these animals is, 
 apart from other causes, the chief difficulty in parturition. In the 
 human female, it is the head of the foetus. The thorax of the Carni- 
 vorous foetus is not nearly so deep, comparatively ; it is therefore better 
 adapted to pass through the nearly circular canal. 
 
 The term diameter, in obstetrics, is emploj^ed to designate the distance 
 between certain points in the pelvic cavity, and by which, practically, 
 we may compare the capacity of that space with the volume of the 
 largest part of the foetus that has to pass through it. 
 
 In the human species four diameters are usually given for the inlet 
 and outlet of the pelvis, and some veterinarians also furnish these 
 measurements. They are : (1) a vertical or sacro-pubic, from the sacro- 
 lumbar articulation to the ischio-pubic symphysis ; (2) a transverse, 
 passing between the most concave portion of the ilia ; and (3, 4) two 
 oblique, from the ilio-pectineal line of one side to the sacro-lumbar 
 articulation of the other. 
 
THE PELVIS. 28 
 
 Chauveau, in his measurements of the Horse's pelvis, gives these four 
 measurements for the inlet (mean vertical, 8^ inches ; transverse, 8A 
 inches; oblique, 8^ inches); but for the outlet only the vertical and 
 transverse (mean vertical, Oi inches ; transverse, 7 inches). Eainard, 
 for the inlet, j^ives three diameters ; (1) a supcro-inferior, from the sacro- 
 lumbar articulation to the anterior border of the ischio-pubic sympliysis; 
 (2) a tranavcrse, from the inner surface of the cotyloid angle on one side 
 to the same point on the opposite side ; (3) a vertical, from the middle 
 of the sacrum to the ischio-pubic symphysis in the larger animals, and 
 to the sacro-coccygeal articulation in the smaller. But for the outlet he 
 lias only two diameters: (1) a vertical, from the posterior part of the 
 ischio-pubic symphysis perpendicularly to the sacrum or its prolonga- 
 tion, the coccyx ; (2) a transverse, from one ischial tuberosity to the 
 other. 
 
 The most important diameter is certainly that between the middle of 
 the sacrum and the ischio-pubic symphysis in the larger animals, and 
 the sacro-coccygeal articulation and ischio-pubic symphysis in the 
 smaller creatures. For it must be remembered that the pelvis of the 
 domesticated animals oilers a very inclined plane, and if, placing it in 
 the position of the human pelvis, we draw a horizontal line from the 
 symphysis towards tlie spine, it will be found that this line does not 
 touch the sacro-lumbar articulation, but the middle of the sacrum in the 
 large, and the sacro-coccygeal articulation in the smaller animals. This 
 point is the nanrowest through which the fatus has to pass, and in 
 which it will meet most resistance ; for while the top of its shoulder is 
 towards the sacrum, its chest is resting on the pubis. So that it may 
 be said that this is really the first solid resistance to be overcome in 
 parturition. 
 
 Considering the variations in size in some species, it is not possible to 
 give general measurements for all ; but we may follow the example of 
 Eainard, and give average diameters for different-sized animals. These 
 are tabulated as follows; the last column, headed ' Symphysis,' gives 
 the length of the floor of the pelvis. 
 
24 
 
 OBSTETRICAL ANATOMY 
 
 Species. 
 
 Height. 
 
 OPENINGS. 
 
 Symphysis. 
 
 Inlet. 
 
 Outlet. 
 
 
 Diameters. Measures. 
 
 Diameters. 
 
 Measures. 
 
 Horse 
 
 15 hands 
 
 Supero-inferior 9i in. 
 Vertical 9:^ in. 
 Transverse 9^ to 9^ in. 
 
 Vertical 
 Transverse 
 
 6yV in. 
 74 in. 
 
 9 to 9i in. 
 
 14 hands 
 
 Supero-inferior 9^^ to 9i in. 
 Vertical SjV in. 
 Transverse S/jj to 9 in. 
 
 Vertical 
 Transverse 
 
 6 to 6^ in. 
 63^ to 7 in. 
 
 S^^in. 
 
 12 hands 
 
 Supero-inferior 8,% to S^'^^jin. 
 Vertical JtV in. 
 Transverse \ 7J to T^^ in. 
 
 Vertical 
 Transverse 
 
 4y3^to4yVin. 
 OyV to 5i in. 
 
 7^ to 7i 
 in. 
 
 Ass 
 
 Medium 
 size 
 
 Supero-inferior 1^-^ in. 
 Vertical 5y\ in. 
 Transverse 4j^ in. 
 
 Vertical 
 Transverse 
 
 4yV in. 
 3y^77 in. 
 
 Sf-iT in. 
 
 Cow 
 
 Medium 
 size 
 
 Supero-inferior SjV in. 
 Vertical Jro in. 
 Transverse 7iV in. 
 
 Vertical 
 Transverse 
 
 7t%- in. 
 7\ in. 
 
 4J^ in. 
 
 Sheep 
 
 Ordinary 
 size 
 
 Supero-inferior 4yi^ in. 
 Vertical 2i% in. 
 Transverse S^V in. 
 
 Vertical 
 Transverse 
 
 3| in. (varies) 
 2^4, in. 
 
 2 in. 
 
 Goat 
 
 Medium 
 size 
 
 Supero-inferior 4| in. 
 Vertical 2^ in. 
 Transverse 3^ in. 
 
 Vertical 
 Transverse 
 
 2|in. 
 2|in. 
 
 2|in. 
 4 in. 
 
 Pig 
 
 27i in. 
 Length 
 from 
 snout to 
 tail, 54| 
 in. 
 
 Supero-inferior 4 in. 
 Vertical 3x%^ in. 
 Transverse Sy^ in. 
 
 Vertical 
 Transverse 
 
 2Ain. 
 4 in. 
 
 Dog 
 
 Large 
 
 Supero-inferior 2^ in. 
 Vertical 2 in. 
 Transverse 2 in. 
 
 Vertical 
 Transverse 
 
 2iin. 
 2 in. 
 
 2 in. 
 
 Small 
 
 Supero-inferior 2 in. 
 Vertical ly'V in. 
 Transverse ly% to ly'V in. 
 
 Vertical 
 Transverse 
 
 2 in. 
 
 l{^ in. 
 
 IViT in. 
 
 Cat 
 
 Ordinary 
 size 
 
 Supero-inferior 2^ in. 
 Vertical i 2 in. 
 Transverse 1^^ in. 
 
 i 
 
 Vertical 
 : Tnuisverse 
 
 2\ in. 
 
 ly«(r in. 
 
 1 
 
 : ly«^ in. 
 
 Some veterinarians, however, as already stated, who have made this 
 subject an almost special study, only specify two diameters — -the supero- 
 inferior or sacro-puhic, and the transverse or bis-iliac. The following 
 are the measurements furnished by four of these authorities : 
 
77/ A- fKU'ls. 
 MARE. 
 
 B;mineiMtcr 
 Diuiiictont. and 
 Rncff. 
 
 Cftmten- 
 UanuH. 
 
 Arloing. 
 
 Snint- 
 Cyr. 
 
 UcinarkM. 
 
 iM.frr. InchoD. 
 
 Inches. 
 
 Iiichw. 
 
 Inches. 
 
 
 Supero-inferior Diameter 9 to 10 
 
 n 
 
 9 
 
 sr 
 
 •Theaverageof '2Sm^a- 
 surements of Mares 
 vary ill!,' from l.'M, to 
 161 hands in height.. 
 
 'Transverse Diameter 11 to ]2.\ 
 
 i 
 
 H 
 
 H 
 
 8A+ 
 
 fTbeaverage of ^Smea- 
 aurenienis as above. 
 
 1 OlTLET. 
 
 
 
 
 1 
 
 Supero-inferior Diameter 9 to 10 
 
 n 
 
 1 
 
 
 
 Transverse Diameter 9 
 
 H 
 
 n 
 
 
 
 COW. 
 
 I 
 
 Diixnicters. 
 
 Baumeistor 
 and 
 Reuff. 
 
 Cars ten- 
 Harms. 
 
 Arloing. 
 
 «^^*- ' Remarks. 
 
 Islet. 
 
 Inches. 
 
 Inches. 
 
 Inches. 
 
 Inches. 
 
 Supero-inferior Diameter 
 
 9 to 9i 
 
 8i 
 
 
 104* *The average of 5 mea- 
 surements of Cows of 
 different sizes and 
 breeds. 
 
 Transverse Diameter 
 
 6^ to 7? 
 
 7 
 
 — 
 
 7it flbid. 
 
 OlTLCT. 
 
 
 
 
 
 
 Supero-inferior Diameter 
 
 9 
 
 
 
 
 
 Transverse Diameter 
 
 9 
 
 6i 
 
 
 
 
 It will be seen from these measurements that no great practical utility 
 can be derived from pelvimetry, so far as averages are concerned ; as the 
 diameters of the pelvis must vaiy with the size and other peculiarities 
 in an animal's conformation ; so that we may have considerable differ- 
 ences. In the Mare alone, Saint-Cyr found a difference in the supero- 
 inferior diameter of 2V inches, and in the transverse diameter of 2.^ 
 inches. 
 
 With the view of determining the capacity of the pelvis of the living 
 animal at a given time, external pelvimetry has been resorted to. This 
 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 
 find out the first, a piece of wood is placed vertically against each 
 haunch, and the space between them is measured ; for the second, a 
 tape measures the distance between the ischial tuberosities ; and for 
 the third, a piece of wood is placed horizontally across the summit of 
 the croup, while 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 tuberosities ; while 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 OBHTETRICAL ANJT03IY. 
 
 attention to pelvimetry in animals, points out the means whereby the 
 diameters of the inlet may be attained. ^ 
 
 This method is, however, so complicated and unsatisfactory, that it 
 requires further elaboration before it can be recognised as useful and 
 reliable. 
 
 Saint-Cyr has endeavoured, in a somewhat similar manner, to arrive 
 at some criterion as to the diameters of the inlet of the pelvis — which 
 is, after all, the most important in parturition — in the living animal 
 For the sacro-jmhic diameter, he has taken for guide the height of the 
 Mare, supposing that the two should be nearly always constant in their 
 relations ; and to fix this relation, the diameter was measured in twenty- 
 eight animals of various sizes. Taking the average of these twenty-eight 
 measurements, and dividing it by the average of the heights, the quotient 
 obtained gave the co-efficient, by which it was necessary to multiply the 
 height of any Mare to find the sacro-pubic diameter of its pelvis. For 
 the transverse or bis-iliac diameter, the width of the croup measured 
 between the external angles of the ilia (taken by a tape), or between the 
 coxo- femoral articulations (taken by a large pair of compasses), was 
 adopted. But it was soon discovered that one and the same co-efficient 
 would not serve for all cases ; as in common-bred lymphatic horses, the 
 bones are large, the soft textures abundant, and the pelvic cavity less 
 than would be surmised from the width of the croup ; while in those 
 which are well-bred, the bones are smaller and denser, the soft tissues 
 more condensed, and the pelvic space large, comparatively speaking. 
 So that the co-efficient had to be less in the latter than the former. 
 
 The results of Saint-Cyr's measurements and calculations are fairly 
 reliable, and the external measurements do not differ very widely in 
 their indications from those furnished by actual measurement of the 
 pelvic cavity. 
 
 This method, however, even when accepted as perfectly reliable, only 
 furnishes us with the dimensions of the well-formed normal pelvis ; it 
 gives no information with regard to internal deformities, for the estima- 
 tion of which it is necessary to have recourse to ' direct exploration,' 
 either through the vagina or rectum, by which we may not only dis- 
 cover the character, but also, approximately, the extent of the deformity. 
 "Internal pelvimetry" may also be resorted to in this way; and in 
 practice, after a little experience, it will be found sufficiently simple and 
 trustworthy to be of much service. This internal measurement of the 
 pelvic cavity cannot be satisfactorily made by means of compasses or 
 other instruments in the living animal, as in w^oman ; but the hand may 
 be successfully employed in ascertaining the different diameters by 
 spans — as the thumb from the index to the middle finger, and even 
 widely spread to the little finger ; the distance between these being pre- 
 viously known, we may readily ascertain with sufficient accuracy the 
 diametrical capacity of the pelvis. 
 
 The axis of the jjelvis is the term given to an imaginary line drawn 
 through the pelvic canal from before to behind, at an equal distance 
 from the circumference. In the human pelvis there are ttoo axes — 
 those of the upper and lower outlet, and a knowledge of them is of 
 much importance in midwifery ; they form an obtuse angle with each 
 other, and, when combined with the inclination of the pelvis, w^e observe 
 that the direction the human foetus must take is somewhat tortuous or 
 
 1 The calculations and measurements are given in Saint-Cyr's " Traite d'Obstetrique 
 Veterinaire," second edition, p. 26. 
 
EXTEItS'AL nnCAXS tiF (!h:Xt:i!ATIi>X. 27 
 
 curved. In animals there is only one axis, and that is almost rectili- 
 near, the sacro-vertehral angle or " promontory" heint; comparatively 
 little developed, and the sacrum passinj^ almost in a direct line from the 
 vertebral colunm. This rectilinear direction of the pelvic axis is greatly 
 to the advantage of animals during parturition ; so that the axis of this 
 canal requires but little notice from the veterinary obstetrist, except) 
 when the passage is very constricted. 
 
 CHAPTEK II. 
 Female Generative Organs. 
 
 The genital onjans of the female are much more complicated than those 
 of the male, because of the far greater sliare they take in the process of 
 generation. They are usually described, according to their situation, 
 as external and iyiternal ; or from their function — as cojjulativc and 
 formative. 
 
 Proceeding from the exterior to the interior, these organs may be 
 enumerated as follows : the vulva and viamnue or mammary (jlanih, the 
 vagina, litems, Fallopian tubes, and ovaries. We will describe these in 
 the above-mentioned order, taking the Mare again as the type, and 
 indicating the diflferences in the other domesticated animals. 
 
 SECTION I.— EXTERNAL OIKJANS OF GENERATION. 
 ThK VlLVA. 
 
 The external orifice of the generative organs, the vulva, appears as a 
 vertically elongated slit, situated beneath the anus, between the 
 perineum and ischial arch and the posterior margin of the two hind 
 quarters. It jjresents two thick lijis or labia, and two covnnissures, 
 externally ; and internally it forms a cavity which is continuous with 
 that of the vagina, and extends beyond the meatus nrinarius. The 
 limit between the vulva and vagina is not perceptible in the adult, but 
 is always conspicuous iu the foetus. 
 
 Tlie lips {labiic vulv(C) are usually in contact, and they, with the 
 opening which separates them {rivue vulvcc), vary in si/.e according to 
 age and condition. They are slightly prominent and thick, being com- 
 posed of firm, fiexiblo, and elastic tissue, which is covered with a fine, 
 smooth, unctuous skin destitute of hair, but rich in pigment in the 
 majority of animals. Internally, they are covered by mucous mem- 
 brane, a continuation of that lining the vagina, and which is constantly 
 lubricated by a greasy mucus possessing a special odour, according to 
 the species of animal ; on the free border of the vulva this membrane 
 and the skin meet* 
 
 At the junction of the labia above and below are the coviviiss^tres, due 
 to this junction. The superior commissure is situated close to the anus, 
 from which it is only separated by a narrow space — the perincruvi. It 
 is very angular, and corresponds to the foiirchctte in woman. The 
 inferior commissure is obtuse, rounded and more voluminous; it lodges 
 
 ' The two lips coTTes|wind to the labia majora of wninaii : there are no labia minora 
 in aniniala 
 
28 
 
 OBSTETRICAL AXATOMY 
 
 the clitoris, and is situated immediately above the raphe. The cavity 
 of the vulva sometimes contains the hymen, which separates it from the 
 vagina at a certain period of life ; it also contains the meatus 2irinarius 
 and its valve, as well as the clitoris. 
 
 The structure of the vulva consists of the mucous viembrane lining its 
 interior, and which is covered by pavement epithelium ; an erectile 
 structure connected with it, named the vaginal bulb ; two constrictor 
 muscles; two muscular ligaments, fascice, etc. The mucous membrane 
 is continuous with that of the vagina and bladder ; it is usually of a 
 pink or rosy tint, but at the period of oestrum it has a bright-red hue. 
 Near the margin of the labia it frequently shows black pigmentary 
 patches, which give it a marbled appearance. It is provided with 
 
 Fig. 17. 
 
 The Generative Organs of the Mare in situ. 
 
 1, Body of the Uterus ; 2, 2, Cornua of the Uterus ; 3, Vagina ; 4, Bladder ; 
 5, Rectum ; 6, Sphincter of the Anus ; 7, Constrictor Mu-cle of the Vulva ; 
 8, Bulb of the Vagina; 9, Ovary and Fimbriated Body; 10, Fallopian 
 Tube ; 11, Kidney; 12, 12, Broad Ligament. 
 
 numerous mucous follicles and sebaceous glands ; the latter are chiefly 
 found near the free border, and particularly around the clitoris and the 
 space between it and the inferior commissure, where they aggregate to 
 form several small sinuses. This membrane is also furnished with 
 great numbers of papillae. The vaginal bulb is wholly composed of 
 erectile tissue with wide spaces, which constitutes the jjlexus retiformis. 
 This tissue passes from the base of the clitoris to the sides of the vulva, 
 where it terminates in a round, salient, or ring-like lobe. Covered by the 
 posterior constrictor of the vulva, this bulb communicates inferiorly with 
 the cavernous veins, and the afflux of blood into its meshes diminishes 
 the capacity of the vulva, thereby concurring to render the coaptation 
 of the copulatory organs more complete during coition. 
 
KXTKHXAL on<IANs of (lEXEItAriON. 29 
 
 The muscles of the vulva are constrictors — an anterior and posterior 
 — and are vohuitary. The anterior coustrictor is analoj^'ous 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 conmiencenient, its 
 extremities being continued by means of aponeurotic fascicuH as far as 
 the sides of the rectum, where they disappear. Posteriorly, this muscle 
 is confounded with the next to be described. The posleriur constrictor 
 {constrictor ciinm) 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-fibrous tissue, which is capable of contracting, and in the midst 
 of which are observed some isolated red nmscuhvr fasciculi — ^given off 
 from the principal nuiscle. 
 
 The posterior constrictor of the vulva is 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 the 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 elevate 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 vuiscuhir liijaments of the vulva in reality correspond to the 
 li(jamcntuin suspcnsorium of the penis in the 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 tine 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 
 cavernosuni of the male penis. From two to three inches in length, 
 this body commences by two roots attached to the iscliial arch, and 
 which are covered by a rudimentary ischio-cavernous nmsclc. After 
 being fixed to the ischial sympliysis, by means of a suspensory ligament 
 similar to that of the male, it passes backward and [)rojects into the 
 vulvar cavity, towards the inferior commissure, in which it is lodged. 
 Its free extremity is enveloped in a mucous cap — the prcpntium, which 
 is plicated in dit}erent 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 tlie clitoris 
 resembles that organ, having a fibrous framework, erectile tissue, 
 cavernous vessels or " plexus retiformis," and a pair of muscles — the 
 crcctorcs clitoridis. This organ is more especially the seat of venereal 
 
30 OBSTETRICAL ANATOMY. 
 
 excitation during coition. It is present in all the domestic female 
 animals, and is frequently erected while they are in " heat," as well as 
 in the act of copulation. It is abundantly supplied with nerves, which 
 endow it with most acute sensibility, and the mucous membrane 
 enveloping it is usually dark coloured or marbled, though in white 
 Mares it may be colourless. 
 
 The meatus urinarius is the orifice of the urethra, which is a very 
 short canal in the female. This canal passes immediately beneath the 
 anterior sphincter muscle of the vulva, and after a brief course (about 
 two inches) in the textures composing the floor of the vagina, opens 
 into the vulvar cavity at from four to six inches from its exterior. This 
 opening, which is on the floor of the cavity, is covered by a wide dupli- 
 cature of the lining membrane that acts as, and is designated, the valve 
 of the meatus or vagina (valvula vagince) ; its free border is turned 
 backwards, and it would thus appear to direct the urine towards the 
 external opening of the vulva, and prevent its reflux into the vagina. 
 Eainard states that this valve is more extensive as the vagina is narrow, 
 and consequently as the female is young ; it has been compared to the 
 hymen of woman. Brugnone was of opinion that it was attached to 
 the upper surface of the vagina by a small cord, and that it was the 
 rupture of this by the forced entrance of the penis which caused the 
 slight flow of blood from the vulva observed in Mares put to the horse 
 for the first time. This is no doubt the hymen to which he refers — a 
 membrane found generally in the i'illy, though not often in the Mare, 
 but which, when present, separates the vulvar from the vaginal cavity. 
 This membrane forms a circular partition, fixed by its circumference to 
 the vulvo- vaginal walls along with the valve of the meatus, and is 
 perforated by one or more openings, which are sometimes very small. 
 
 The existence of the hymen in animals has been denied, but that it is 
 present sometimes, though rarely, there can be no doubt, and, as in 
 woman, when imperforate it leads to retention of secretions. Not 
 infrequently old brood Mares show in this situation pediculated appen- 
 dices, which are the debris of this mucous septum. 
 
 The urethral orifice of the Mare is wider than that of the Horse, and 
 will readily admit a large catheter. In passing that instrument, it is 
 well to remember that the urethral canal curves forward and downward, 
 and that the valve must be raised either with the point of the instru- 
 ment or the finger before the passage can be entered. 
 
 In ordinary circumstances the vulva is retracted, and with Mares 
 which have foaled several times the labia usually exhibit as many 
 wrinkles or folds as parturition has been frequent. 
 
 During oestrum, but especially towards the termination of pregnancy, 
 the labia become tumified and soft, the inferior commissure descends, 
 the vulvar opening is enlarged, and from it is discharged a quantity of 
 tenacious stringy mucus. 
 
 Differences in the Vulva of other Animals. 
 
 Cow. 
 
 In the Cow the lips of the vulva are larger, softer, and thicker than 
 in the Mare, and the inferior commissure, angular and prolonged into a 
 curved peak, is furnished with a tuft of hair. The meatus urinarius is dis- 
 posed as in the Mare ; but in the interior of the urethral canal, fixed to its 
 
EXTER^TAL ORGAXS OF UEXEILI TlnX. 31 
 
 lower aspect, is a valve whose free margin is directed backwaz-ds ; this 
 valve surmounts a cul-de-sac about the third of an inch. This valve of 
 the canal must be remembered in passing the catheter into the bladder. 
 About an inch within the entrance of the vulva, and imbedded within 
 the substance of its lips, are the vulvo-va<ji)ial (jhoids {(/laiulnla vagince, 
 S. Duvcrncyi, S. Bartholini) — large almond-shaped bodies whose widest 
 exti'emity is directed upwards, and the narrow end, situated near the 
 clitoro-sciatic muscle, is prolonged into their excretory canals. These 
 are conglomerate glands, whose excretory ducts unite to form a kind of 
 sinus that at last opens into the vulva, about the third of an inch from 
 the labia. The clitoris is longer, and more tortuous and slender than in 
 the Mare, and contains a dense fibrous nucleus of a spiral shape. The 
 vaginal bulb is much more extensive than in the Mare, and is continued 
 to the clitoris, where it is covered by a thick muscle, which descends 
 from the extremity of the sacrum, and terminates on the clitoris. The 
 same changes occur in the vulva of the Cow as in the Mare during 
 oestrum, and towards the termination of pregnancy ; the mucous 
 secretion of the vagina is more abundant in the Cow, however, and 
 persists longer. 
 
 SJicep. 
 
 In the Sheep which has not copulated, a filamentary band, stretching 
 across the constriction between the uro-genital canal and the vagina, 
 represents the hipnen. The 2Ialpi(jhian canals open into that passage 
 near the constriction, and the crura of the clitoris are enfolded Isy 
 erector muscles ; while the clitoris itself protrudes immediately within 
 the peak of the vulva. 
 
 Pi'.h 
 In the Pig, the urctJira opens between two longitudinal ridges ; but 
 the surface of these and other similar prominences in the uro-genital 
 passage is interrupted by numerous fine, wavy, oblique furrows. There 
 is no vaginal valve, as in the other animals. The clitoris is comparatively 
 small, and the inferior commissure of the vulva is still moi-e acute and 
 pointed than in the Cow and Ruminants in general. Towards the 
 meatus are numerous fine points — the openings of glands analogous to 
 the prostates ; and on the sides of that orifice are two small fossaa 
 surrounded by a raised border. 
 
 Bitch and Cat. 
 
 In the Bitch the vulva is triangular, and the inferior commissure 
 acute. The clitoris is a small tubercle, and the uretlira opens between 
 a little transverse fold and the triangular flattened clitoris; beyond this 
 is a second transverse crescentic fold, with its concavity opposite that 
 of the preceding. In the Cat, a small cartilage or l;one exists in the 
 clitoris ; this is not found in any other of the domesticated animals. 
 
 The Peiunj:um is the name given to the space between the superior 
 commissure of the vulva and the lower margin of the anus. Its length 
 varies in different species, and in different-sized animals of the same 
 species ; but it is shorter in creatures which have produced young than 
 in those which have not. It is composed of various tissues — externally 
 is the smooth, tine, and very elastic skin, with the vertical prominent 
 line passing down its middle — the " raphe ;" beneath this are connective 
 
:32 OBSTETRICAL ANATOMY, 
 
 and adipose tissue, and fascia, with various muscles, bloodvessels, and 
 nerves. 
 
 The internal limits of the vulva are defined by the constriction or 
 ■bulb, which forms a marked prominence in early life, but tends to dis- 
 .appear in relaxed folds after the animal has brought forth young several 
 times. The dimensions of this aperture are rather adapted for the 
 passage of the foetus than the penis ; though its narrowness is some- 
 times an obstacle to delivery in a primipara. The limbs, body, or head 
 of the foetus are at times arrested at the superior or perineal com- 
 missure, which they so distend as to threaten laceration of that part. 
 In emaciated animals, and particularly Mares, the vulva is deeply 
 retracted above the ischia, and consequently disposes them to be injured 
 in this region during coitus, by the accidental introduction of the male 
 organ into the anus — the mechanical action of which damages, and may 
 even rupture, the rectum. Eainard alludes to several occurrences of 
 this kind, which terminated in the death of the Mares. 
 
 SECTION 11.— THE MAMM^. 
 
 The mamvice, or udders, may be said to be appendices to the external 
 organs of generation. They are the glands destined to secrete the fluid 
 — milk — which is to nourish the young animal for some time after birth. 
 In early life they are rudimentary, but become developed with age, and 
 attain their full dimensions when the female is capable of reproduction ; 
 and especially at the full period of gestation, when their function is 
 about to be carried on actively. After parturition their largest develop- 
 iment is reached, and when the young creature has completed its term 
 ■of sucking, they lose their activity and diminish considerably in size. 
 In the Mare they are two in number, placed beside each other in the 
 inguinal region, about nine inches in front of the vulva, where they 
 take the place of the scrotum in the male. Externally, they appear as 
 two hemispherical masses separated by a shallow furrow; each has in 
 its centre, on each side of the mesian line, a conical, slightly flattened 
 prolongation named the teat or niijple, which is perforated by several 
 orifices from which the milk escapes, and by which the young creature 
 obtains that fluid by suction. The two glands are retained in their 
 position by the fii:ie thin skin covering them, and which, destitute of 
 hair at the extremity of the teats, though elsewhere provided with a 
 soft short down, is smooth, pliable, and unctuous from the presence of 
 sebiparous follicles. At the base of the teat are a number of small 
 tubercles, which correspond to the areola of the nipple in woman ; these 
 ;are the glands. 
 
 The mammge are also attached to the abdominal tunic by means of 
 several wide, short, but elastic bands, which bear some analogy to the 
 suspensory ligaments of the prepuce in the male. 
 
 In STRUCTURE each udder oft'ers an envelope of yclloio elastic fibrous 
 tissue, glandular tissue, the simises or galactopUorous reservoirs, and the 
 lactiferous ducts, with excretory canals or onilk ducts. 
 
 The elastic envelope, joined at the mesian line with that of the oppo- 
 site udder, is strengthened by wide bands detached from the tunica 
 abdominalis ; it furnishes from its internal face numerous prolongations 
 which, crossing each other in the mass of the gland, form septa or parti- 
 tions that divide it into distinct lobes and lobules, which are in this way 
 
EXTERNAL OKGAXS OF GEXEILITIUX. 88 
 
 somewhat independent of each other ; so that one or more may be 
 diseased or deranged in function, without the otiiers being involved. 
 Externally, this envelope is closely adherent to tlie skin, through the 
 medium of a thin but dense layer of connective tissue. 
 
 The (jlctiuhdar tissue offers the same arrangement as other conglome- 
 rate glands, and is composed of acini or caical vesicles clustered, like 
 grapes on their stalk, around the tuhiili lactifcri, or ultimate terminations 
 of the excretory ducts. These, commencing by cul-de-sac extremities, 
 open into one another to form dilatations {ampnlUe), and finally con- 
 verge into a number of principal canals, which end in the galacto- 
 phorous sinuses (sinus lactei). The acini of the lobules, as well as the 
 ducts, are lined by polyhedral epithelium ; this becomes spherical and 
 infiltrated with fat during lactation. 
 
 The galactopliorous sinuses or reservoirs are situated slightly above 
 the base of the teat, and are generally two in number — one in front, 
 the other behind ; though there are sometimes three, and even four. 
 They nearly always comnmnicate with each other, and are prolonged 
 into the teat by a corresponding number of terminal and independent 
 excretory canals, whose orifices are always very narrow, and are seen 
 at the free extremity of that body, which is obtuse and rounded. 
 Collectively, these excretory canals are much wider at tiie base of the 
 teat than at the extremity ; the orifices are usually behind each other, 
 and are about a line apart ; and the canals and orifices are lined by 
 a fine membrane which is continuous with the skin, the latter being 
 closely adherent at this part. 
 
 The length of the teats varies with use ; the elastic or dartoid tissues 
 surrounding them, composed of non-striated circular and longitudinal 
 fibres, renders them capable of a kind of erection, under the influence 
 of stimuli. The extremity of the teat is well provided with this tissue, 
 which acts as a sphincter, and prevents the passive flow of the milk. 
 
 Connective tissue, bloodvessels, nei"ves, and absorbents complete the 
 organization of the mamma?. The arteries are given oft' from the 
 external pudic ; the veins are of two orders — deep, which follow the 
 arteries, and superficial. The nerves are derived from the renal or 
 mesenteric plexus. 
 
 As before mentioned, the mamma> undergo remarkable modifications 
 at the age of puberty and the termination of gestation ; and these 
 changes have reference not only to their volume and secretion, but also 
 to their minute structure. In the young or virgin Mare, they are hard, 
 and can scarcely be perceived ; and their dimensions are not nmch 
 increased in those which have had only one or two foals, though the 
 teats are usually larger than before ; but when they have borne several 
 foals, the mamnue continue somewhat enlarged and pendulous. When 
 gestation is not going on, the glandular cul-de-sacs are contracted and 
 wasted-looking; tlie lining membrane is shrivelled on itself, and covered 
 with only a polygonal epithelium. .\t the termination of gestation, 
 however, the mannna; assume the functions of the uterus to a certain 
 extent ; the vesicles become enlarged, and new ones are developed ; the 
 epithelium presents a spherical shape, is charged with fat granules, and 
 fills the acini ; the entire gland has become progressively, but greatly 
 increased in si>:e, and instead of being soft to the touch it now feels 
 firm. Shortly before parturition the secretion of milk commences, and 
 soon after that event the glandular cavities become fully distended, and 
 
 3 
 
34 
 
 OBSTETIUCAL AXA TOMY. 
 
 assume their maximum dimensions, which are maintained, with shght 
 variations, during the entire period of lactation. When this period is 
 terminated, the secretion gradually ceases, and the gland again assumes 
 its quiescent condition, and nearly its ordinary size.^ 
 
 DlFFEEENCES IX OTHEK AxiMALS. 
 
 Coic. 
 
 In the Cow the mammae are also inguinal as in the Mare, and each 
 lateral mass, although enveloped in a single fibrous capsule, is made up 
 of two quite distinct glands— or " quarters," as they are 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 mammae and four 
 teats. The glands are compacted into a roundish mass, which is more 
 
 Fig. 18. 
 
 .Section or Uddek of Cow. 
 
 a, Anterior Quarter ; h. Posterior Quarter ; g, Septum between the Quarters ; 
 c, c. Section of the Lactiferous Ducts ; (/, d. Lactiferous Sinus or Milk 
 Cistern ; e, e, Orifice of the Teat ; f, Large Lymph Gland in the Posterior 
 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 confluent 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 infrequently there are found behind the 
 foui 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. 
 
 1 Li the 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 i hvays present, however ; though they are so in the Ass, which has them largely 
 devel ped. 
 
KXTHIiXAL onnAXS OF (1K.\ KiLlTIoX. 
 
 35 
 
 The teats of the Cow are fjenerally from two and a half to three and 
 a half inches in length, and, as has been said, this lenj^'th varies accord- 
 in"^ as the animal has reared a large or small number of calves. The 
 two anterior are generally the longest, and the corresponding (juarters 
 furnish more milk than the others. The dartoid tissue around the free 
 extremity of the teat, acting as a sphincter, prevents the passive escape 
 of the milk from the orifices of the excretory ducts; for if a small cannula, 
 scarcely larger than one of these ducts, be inserted slightly beyond the 
 orifice, the secretion immediately Hows. And when the end of a teat 
 has been wounded, or when the elastic tissue of this part has been divided 
 in the performance of some operation, there is no longer any obstacle to 
 the emission of the milk. 
 
 The arteries that supply the mamm® of the Cow with blood are 
 derived from the external pudic. The branch of each side, on reaching 
 the lateral glands, divides into two principal trunks, one of which goes 
 to a corresponding quarter; that which is destined for the posterior 
 
 B 
 
 . o.;v 
 
 «• 
 
 Fifc-. 19. 
 
 A. Lob'ile of the Mainniie filled with Milk ; 
 r.. Milk Globules ; C, Colostrum : a. Cell 
 with a \'ir<ible Nucleus; /*, Cells fmrn 
 which the Nucleus has disappeared. 
 
 Fig. 20. 
 Skc-i'ion ok thk Cow's Te.\t. 
 o, ti. Principal Lactiferous Ducts ; 
 /;. Lactiferous Sinus ; r, r. Acini ; 
 (I, Klastic or iJartoid Tissue of 
 the Teat ; <\ Orifice of the Teat. 
 
 gland beuds at a right angle backwards, the branch for the anterior 
 quarter — the largest — descending perpendicularly, to become subdivided 
 into numerous ramuscles and terminal twigs. The veins and nerves 
 are derived as in the Mare. 
 
 In the Cow, the secretion of inilk can be excited and maintained by 
 regular " milking," the only suspension occurring before the birth of 
 another calf. 
 
 Sheep ami Goat. 
 
 In the Sheep and Goat there are only two mamnijc, as in the Mare 
 and Ass, though they are formed on the same plan as in the Cow. They 
 are also inguinal, somewhat hemispherical and voluminous, particularly 
 in the Goat, and each is provided with a single conical, well-detached 
 teat. The latter animal has sometimes, in addition, two posterior rudi- 
 mentary teats, and the galactophorous sinus of each ordinary teat is 
 very large, the walls of the teat being thin ; it is capable of containing, 
 in some instances, nearly three ounces of milk. 
 
36 OBSTETRICAL ANATOMY. 
 
 Pig. 
 
 In the Pig the mammae are ten or twelve in number, disposed by 
 pairs in two parallel rows extending from the inguinal region to beneath 
 the thorax, and distinguished as inguinal, abdominal, and thoracic 
 mammae. They have not, as in the larger animals, any sinuses, the 
 lactiferous canals of each teat joining directly to form a variable number 
 of excretory ducts, which open at the free extremity of the teat by 
 from five to ten orifices. The limits of each gland are denoted, extern- 
 ally, by a slight vertical depression, and a trilling convexity correspond- 
 ing to the teat. 
 
 The mammas of this animal are scarcely perceptible while they are 
 not active ; but during lactation they form two series of well-developed 
 eminences, divided on the middle line by a wide and deep furrow. 
 
 Bitch. 
 In the Bitch there are eight to ten mammae, arranged as in the Pig. 
 When the latter number is present they are disposed on each side as 
 two pectoral, two abdominal, and one inguinal. 
 
 The secretion of milk is a special function of the mammary glands, 
 and takes place in the caecal vesicles of the lobules. The fluid is con- 
 veyed from these into the lactiferous ducts and sinuses, where it is 
 stored until a certain period : this retention after a time distends the 
 glands very much, and puts the elastic envelope greatly on the stretch ; 
 while the teat also increases in size, length, and firmness. When this 
 distension becomes inordinate, it causes the animal uneasiness and 
 pain, and if not relieved by natural or artificial means it may occasion 
 mischief. In the majority of cases, the pressure of the envelope on the 
 contained fluid overcomes the resistance of the sphincter at the end of 
 the teat, and relief is afforded in this way. 
 
 CHAPTEE III. 
 Internal Organs of Generation. 
 
 The internal or formative organs of generation are contained within 
 the pelvis and abdomen, and comprise the vagina (which some writers 
 include with the external organs), uterus, Fallopian tubes, and ovaries. 
 
 SECTION I.— THE VAGINA. 
 The Vagina is a musculo-membranous canal of variable dimensions, 
 with thin walls ; it extends almost horizontally within the pelvic cavit}^ 
 from the vulva posteriorly to the uterus anteriorly, the cervix or neck 
 of which it embraces in a kind of semicircular ciil-de-sac. The rectum 
 lies above it, and the bladder below ; on each side are the ureters and 
 the walls of the pelvis, and posteriorly it is surrounded by adipose and 
 loose connective tissue. When distended it is cylindrical in form, but 
 usually its sides are in contact. Its length is variable, of course, but 
 in a full-sized Mare it is about a foot long. It is maintained in position 
 anteriorly by folds of peritoneum, which attach it to the rectum above 
 and to the bladder beneath, the attachment to the rectum being accom- 
 plished through the medium of the loose connective tissue referred to. 
 But this tissue, which also unites it to the bladder, is here close and 
 
INTERNAL ORGANS OF OENKllA TloN. 
 
 37 
 
 firm, and this fact may serve to explain why the rectum is so rarely 
 involved in displacements of the uterus, while the bladder is always 
 
 Fig. -1. 
 
 i;knkr.\tive Okgans ov the Mare: Isolated axi> Paktly Oi'Kxkd. 
 
 1, 1, OvaricH ; 2, 2, Fallo'.ian Tubes ; 3, Pavilion <>f tlie Tub*;, Kxternal Face ; 
 4, Ibid., Inner Face, showing the Opening in the Middle; .">, Ligament of 
 the Ovary ; 6, Intact Horn of the I'teruH ; 7, A Horn opened ; 8, Body of the 
 Uterus, Upper Face ; '.», Broad Liiraineut ; 10, Cervix, with its numerous 
 folds, or Palma plirala ; 11, Cnl-df-snc of the Vagina; 12, Interior of the 
 Vagina, «-ith it* Folds of M»icou« Membrane ; 1">, Urinary Meatus and its 
 Valve, 14 ; ir>, Mucou'f Fold, Ji Vestige of the Hj-men ; 16, Interior of the 
 Vulva; 17, Clitoris; 18, 18, Labia of the Vulva; H», Inferior Commissure 
 of the Vulva. 
 
 more or less so. Laterally, it is attached to the muscular and aponeu- 
 rotic structures in the cavity of the pelvis. Internally, it is lined by 
 a thin mucous membrane, which is always abundantly covered with 
 
38 OBSTETPJCAL ANATOMY. 
 
 mucus (in woman this mucus is acid, while that of the uterus is 
 alkaHne), and is disposed (in the Mare) in longitudinal rugie, which 
 are more conspicuous after several births. These rugae no doubt favour 
 the dilation of the canal during coitus or the passage of the foetus ; a 
 transverse ridge, already described as existing on the lower face of the 
 canal, covers the meatus. This membrane is continuous with that 
 of the vulva, and anteriorly, at the cul-de-sac, it is reflected over the 
 cervix of the uterus, which projects, like a cauliflower in shape, into 
 the cavity. It is provided with papillae, and covered with pavement 
 epithelium. It usually has a pale pink hue, but at the period of 
 oestrum its colour becomes heightened to a bright red, and its secretion 
 is considerably increased. 
 
 Externally, the vagina is invested by a muscular coat, which is 
 enveloped by an abundant layer of connective tissue, and traversed by 
 a large number of bloodvessels ; in front, how^ever, this tunic is invested 
 in peritoneal membrane, which is applied in a circular manner around 
 it, to pass over the uterus. 
 
 The vagina is supplied with blood by the internal pudic artery ; its 
 veins are disposed as an encircling plexus, and terminate in the satellite 
 trunk of the artery. The vagina serves for copulation and the passage 
 of the foetus. At the periods of oestrum and parturition, the mucous 
 secretion is more active than at other times. In youth it is contracted ; 
 after copulation its dimensions are increased, and these are greatest 
 during parturition. In old age it is much diminished; in the third or 
 fourth months of gestation in the larger animals, it becomes elongated 
 from displacement of the uterus, which is carried farther forward into 
 the abdominal cavity ; towards the termination of this process its 
 length diminishes as the uterus acquires increased volume, and to 
 such an extent does this occur, that at the commencement of parturi- 
 tion, if the foetus is large, and especially if there be two foetuses, the 
 posterior wall of that receptacle, pushed back into the pelvis, nearly or 
 entirely effaces the cavity of the vagina, and even in some instances 
 thrusts it between the labia of the vulva or beyond. 
 
 The vagina has been found partially divided into two canals by a 
 niedian, though incomplete, vertical septum, which was so short that 
 it could not be said to form a double vagina. 
 
 Differences. 
 Coiv, Sheep, and Goat. 
 In the Cow the canal is longer and wider than in the Mare ; the 
 mucous membrane of the vagina is thicker, is disposed in transverse 
 rugae as in the human species, and at each side of the passage for a 
 certain distance, between the mucous and muscular layers, there exists 
 a mucous canal that opens into the vulvar cavity, in front of, and at 
 the side of the meatus urinarius. 
 
 The uses of these canals, which are not present in the Sheep or Goat, 
 and rarely in the Mare, and which are usually known as the " canals of 
 Gaertner," are unknown. They pass backwards into the broad ligaments 
 of the uterus, and terminate in a cul-dc-sac. They probably have some 
 function during fa^tal life. 
 
 Puj. 
 
 In the Pig these canals are present ; the folds of mucous membrane 
 are longitudinal, and gradually subside towards the line of separation 
 
INTERNAL OKCANS <>F t! EXKliATION. 39 
 
 between the vagina and vulva. The vagina is from eight to nine inches 
 long. 
 
 Bitch and Cat. 
 
 There are no " GaDrtner's canals" in the Bitch or Cat. The vagina is 
 of comparatively great length, and has longitudinal ruga), which are 
 interrupted by transverse folds. In both animals the canal is wider 
 towards the vulva than towards the uterus, and its walls are rendered 
 very thick by white fibrous tissue, in addition to the non-striated 
 muscular fibres it contains. 
 
 SECTION II.— THE UTERUS. 
 
 The L'teuus, or womb (Figs. 17, 1 ; 21, 8), is an elongated musculo- 
 membranous sac which receives the ovum, and constitutes the recep- 
 tacle for the nutrition, development, and, finally, after a certain period, 
 the expulsion of the fcrtus. It is situated in the sublumbar region 
 of the abdomen, towards the inlet of the pelvic cavity, into which its 
 posterior extremity enters. This portion — the body — represents a simple 
 cylindrical reservoir, slightly flattened above and below, while the 
 anterior part is bifid ; the two divisions — the cornua or horns — curve 
 upwards and forwards. The body is situated horizontally beneath the 
 rectum, which is in contact with it after passing between the two 
 cornua ; on each side of its upper external face it receives the insertions 
 of wide ligaments ; and its sides and anterior face are in contact with 
 the intestines. Its lower surface is in contact with the bladder and the 
 pelvic curvature of the colon ; while its anterior extremity is continuous 
 with each of the cornua, and the posterior is separated from the vagina 
 by the constriction named the col, cervix, or neck of the uterus. The 
 cornua are cylindrical tubes, and, lodged among the intestines occupy- 
 ing this region, proceed at an angle from the body in an upward direc- 
 tion, describing two curves — an inferior, convex, which is free ; and a 
 superior, concave, to which the suspensory ligaments are attached. 
 Each horn has also a posterior extremity or base, a continuation of the 
 body of the uteinis ; and an anterior extremity or summit, rounded into 
 a cnl-de-sac, which is turned upwards, and has at the bottom a small 
 tubercle, the insertion of the oviduct. 
 
 Floating in the abdominal cavity, like the intestines, the uterus is 
 also attached, as they are, by two membranous bands which suspend 
 them from the sublumbar region, and are consequently designated the 
 broad or suspensory lit/aments of the uterus ; also, from the general 
 resemblance to the wings of a bat, the alca vespertilionis. These bands, 
 derived from the peritoneum of the abdomen, are lartjer in front than 
 behind, and in shape are irregularly triangular ; beliind, they are close 
 to each other, but in front diverge like the sides of the letter V, They 
 descend from the lower face of the lumbar region, and attach them- 
 selves, by their inferior border, to the sides of the upper surface of the 
 body and the smaller curvature of the cornua ; their anterior border 
 is free and sustains the oviducts and ovaries, the first being included 
 between the two layers of the ligament, while the ovary, placed within 
 it, also receives a layer detached froju the principal one, which with 
 it forms a little cup-shaped cavity. Another small, long, and narrow 
 band of peritoneum is observed external to the broad ligament ; this 
 can be traced posteriorly to the internal inguinal ring, and anteriorly 
 it presents a little enlarged appendix. Between the two layers com- 
 
40 OBSTETRICAL AXATOMY. 
 
 posing this band, is a thin muscle similar to the cremaster of the male 
 before the descent of the testicle into the scrotum ; this band is the 
 analogue of the round ligament in woman. The uterus is also main- 
 tained in position by the vagina posteriorly, and by the peritoneum, 
 which at this part forms four bands — the recto-uterine and vesico- 
 uterine. 
 
 The interior of the uterus is divided into three compartments, cor- 
 responding to its divisions into body and cornua. The cavity of the 
 body communicates with the vagina by a narrow canal which traverses 
 the constriction or cervix of the uterus, and is designated the canal of 
 the cervix. In all the domesticated animals, except the Rabbit, this 
 canal is prolonged into the anterior extremity of the vaginal cavity like 
 the end of a tap into a barrel ; forming a very marked protrusion — the 
 cervix. In this is the opening {orificiuyn uteri externum) leading from 
 the vagina to the body of the uterus — the os titeri or os tincce ; around 
 this aperture the utero-vaginal lining membrane is curiously arranged 
 in transverse rugae disposed in a circular manner, and which gives to 
 this prominent part the appeai'ance of a radiating flower. In woman 
 the rugae of the canal are differently disposed, and resemble the branches 
 from the stem of a tree ; consequently, they have been named the 
 arbor vitce uterina or imhna plicata. 
 
 The uterus is composed of three membranes — an external, or serous ; 
 Q, middle, ox nvuscular ; and an internal, or mucous tunic. The serous 
 or peritoneal membrane envelops all the organ, and is in reality only 
 an expansion of the broad ligaments, which are prolonged backwards 
 on the posterior extremity of the vagina, which they encircle and then 
 pass to the rectum and bladder, as well as to the lateral parietes of the 
 pelvis, constituting the four ligaments already referred to. Between 
 the two cornua this membrane forms a peculiar fraenum, which is very 
 developed in Solipeds. Owing to this arrangement, the cervix does not 
 receive any peritoneal covering. The muscular layer is composed of 
 longitudinal and circular fibres, analogous to those of the small in- 
 testines. At the insertions of the broad ligaments into the uterus, a 
 series of fasciculi are given off from this layer, which pass up between 
 the folds composing them, and have been found throughout their 
 extent, especially towards the ovaries. The fibres composing this coat 
 belong to the class of non-striated or involuntary muscles, being made 
 up of fusiform nucleated fibres lodged in a matrix of exceedingly 
 coherent granular matter. The appearance of this coat is different to 
 that of ordinary muscle, being much more dense and of a faint yellowish- 
 red hue, like the middle coat of arteries or the small intestines. The 
 superficial set of fibres are irregularly longitudinal in their direction, 
 and frequently interlace with each other ; the deep set are circular, 
 especially around the orifice of each oviduct and the os uteri, w^here 
 they are thick and close ; though even among these fibres irregular 
 fasciculi pass in different directions. Both layers are thicker in the 
 cornua than the body ; their obvious function is to diminish the volume 
 of the uterus during parturition. 
 
 At an early period of life these fibres are perceptible, but during gesta- 
 tion they are greatly increased, and present a manifest striation. Their 
 increase is doubtless to permit the necessary dilatation of the uterus, 
 without allowing its parietes to become too attenuated and feeble ; 
 though to some extent they do diminish in thickness, according to the 
 species. The inner set are loosely adherent to the lining or mucous 
 
INTERXAL OKGAXS OF GENERATION. II 
 
 membrane of the uterus. A rich venous network is lodged in the 
 muscular tunic of this organ. 
 
 The miicdus hiyer is a thin, dehcate, pulpy membrane, covered by 
 ciliated columnar epithelium in the body and cornua of the organ, 
 ordinary cylindrical squamous or stratified epithelium in the canal of 
 the cervix, like that of the intestines, and tessellated or squamous on 
 the rugae of the cervix. This ditlers from ordinary mucous mem- 
 brane in the presence of a very delicate sub-mucous connective tissue, 
 in which the utricular glands, blood and lymph vessels, as well as nei-ves 
 supplying the membrane, are situated ; for this reason it appears to 
 receive its vascular supply directly from the muscular coat, its vessels 
 being continuous with those of that layer. This difference is probably 
 related to its intermittent, though higher, organising function. 
 
 In the cervix, the basement membrane covers multitudes of villi, the 
 points of which in woman are nipple-shaped, with a depression in the 
 centre ; within the cervix tliese villi are very large, but in the body of 
 the organ there are none. The membrane here is remarkable for the 
 series of longitudinal rugic formed on it, and which are not effaced by 
 ordinary distention of the organ ; though they disappear during the 
 increase in size of its cavity in pregnancy. On these ruga^ and in the 
 fosste between them, particularly towards the cervix, are a great 
 number of simple mucous and special cylindrical glands. The first are 
 particularly abundant towards the cervix ; some here and there have 
 closed mouths, are enlarged, and form small vesicular prominences, 
 which have been named tlie "ova of Naboth " {ovtila NabotJii), from 
 tlieir supposed identity with the ovarian ova. 
 
 The cylindrical, uterine, or wtv'iculsLV glands (qlandiihe iitriculares), are 
 situated close to each other; they are sometimes bifurcated, frequently 
 spiral, and terminate in a cul-de-sac in the substance of the mucous 
 membrane, something like the agminate glands. In the Mare they are 
 long, slender, and tortuous, and divide repeatedly in the deeper part of 
 the mucosa, and in such a manner that numerous branching tubes are 
 connected with a single stem or gland-duct. They are lined by columnar 
 cells, which project vertically into the gland tube : these cells have a 
 ciliary movement. The utricular glands do not exist at birth, and it is 
 probable that they are only fully developed when sexual maturity is 
 reached. At certain periods, as during (tstrum, they throw out a large 
 quantity of very viscid, almost transparent, mucus. They are secreting 
 structures, and during gestation play a most important part, becoming 
 largely developed, and furnishing a thin, white, albuminous fluid, tlie 
 so-called " uterine milk.'' This secretion comes more particularly in 
 contact with the intervillous portions of the fcetal placenta, in which are 
 curious pockets that act as receptacles for this milk, which is absorbed 
 by the vessels on their walls. 
 
 The uterus is sujiplied with blood by the uterine and utcro-ovarian 
 arteries, which arise from the posterior aorta, and passing between the 
 layers of the broad ligament reach the uterus. The first divides into 
 two branches — an ovarian and a uterine ; the former is very flexuous and 
 goes to the ovary, while the second passes to the cornua of the uterus, 
 where its ultimate divisions anastomose with those of the proper uterine 
 artery. This vessel, on reaching the smaller curvature of the cornua, 
 also divides into two portions — an anterior, anastomosing its branches 
 with the utero-ovarian ; and a posterior, spreading over the body of the 
 organ and communicating with the artery of the vagina. The blood is 
 
42 
 
 OBSTETRICAL ANATOMY. 
 
 conveyed from the uterus by corresponding veins, which are more 
 numerous than the arteries, and are capable of great distention. Tliey 
 have no valves. In animals which have bred frequently, the vessels are 
 greatly enlarged and very fiexuous ; indeed, from an early period the 
 arteries are remarkable for their large size, their tortuous course, and 
 their frequent anastomoses ; while the considerable calibre of the veins 
 is as conspicuous as the complex networks they form. 
 
 The lymphatic vessels issuing from the organ are as remarkable for 
 their large size as for their number ; they all proceed towards the sub- 
 lumbar region. 
 
 The nerves are derived from the small mesenteric and pelvic plexuses. 
 
 rig. 22. 
 Nerves of Maee's Uterus. 
 a, Anterior Abdnmiual Ganglion ; b, Posterior Abdominal Ganglion ; c, A 
 Lumbar Ganglion of the Sympathetic Chain ; d', d. Anterior Hypogastric 
 Nerves ; e. Lymphatic Connection with the Right Pelvic Plexus : f, ;/, 
 Branches from the Third and Fourth Sacral Nerves to the Pelvic Plexus ; 
 1, Ovarian Artery ; 2, Uterine Artery ; 3, Uterine and Vesical Artery ; 
 4, Branch of the Internal Pudic Vein ; 5, Ovarian and Uterine Vein ; (3, Left 
 LTterine Cornu. 
 
 "When the gravid uterus increases in volume, it pushes the pelvic 
 flexure of the colon before it as it advances into the abdominal cavity, on 
 to the floor of which it gradually descends and rests until the termina- 
 tion of pregnancy. As has been mentioned, in this advance and descent 
 it carries with it the cervix and vagina, which is considerably length- 
 ened, the traction being extended even to the vulva, this appearing 
 to be buried between the ischiatic tuberosities toward the end of 
 
 pregnancy. 
 
 Differences. 
 Coic. 
 
 The uterus of the Cow, with regard to its general disposition in the 
 pelvic and abdominal cavities, does not offer any striking differences 
 
IXTKIiXAL oiiOAXS (>F (1 f^XRUArmx. 
 
 V?i 
 
 from that of the Mare, except that the body is short (its interior space 
 beinfT also much less than in the Mare's uterus), and it does not extend 
 so far into the latter cavity. If the uterus were perfectly horizontal, a 
 transverse line drawn across the abdomen, in front of the external aii^^e 
 of the ilium, would be exceeded to the extent of some one and a half to 
 two inches by the extremities of the cornua ; so that if the animal were 
 placed on its back, the uterus would only be found to reach to the 
 fourth or fifth lumbar vertebra. 
 
 With regard to shape, however, the uterus of this animal offers some 
 noteworthy features. For instance, the concave curvatures of the 
 cornua look downwards, whereas in the Mare they are in the opposite 
 direction ; though in both the broad ligaments are attached to tliis con- 
 cavity. The consequence is, that in the Cow, if the uterus be considered 
 as freely suspended in the cavity of the abdomen, the extremity of the 
 horn is twisted outwards and upwards ; while its base near the body of 
 
 Aj\)/H' 
 
 Fig. 23. 
 A, Utricular (!Iand of a i>regDant (loat. 
 
 Fig. 24. 
 B, Utricular Oland of a preLrnaiit Cnw. 
 
 the organ, although drawn in the same direction by the ligaments, yet 
 retains its position, being firmly maintained in it by the body of the 
 uterus, which also receives the insertion of the broad ligaments on its 
 loiccr plane. This insertion causes the uterus to project above them ; 
 while in the Mare, in which the ligaments are inserted at the upper part 
 of the body, the uterus projects below them. In tlie Cow these liga- 
 ments are very extensive, particularly at their anterior border, and 
 widely separated from one another in front near their lumbar attach- 
 ment, which is prolonged as far as the flank. The ligaments, taken as 
 a whole, may be compared to a triangular sheet, one angle of wiiich is 
 fixed to the floor of the pelvis, and the other two to the tuberosities of 
 the ilia ; on this sheet rests the body of the uterus and a portion of the 
 cornua. This peculiarity in the suspensory apparatus of the uterus of 
 the Cow explains the occurrence of torsion of the organ during preg- 
 nancy — an accident to which reference will be made hereafter. 
 
44 OBSTETFJCAL AX ATOMY. 
 
 The cornua are thin and tapering at their anterior extremity, and the 
 body is short and narrow ; while the interior of the uterus is not so 
 ample as in the Mare. Here it oii'ers a peculiarity which is not observed 
 in the latter animal, the Carnivora, or the Pig, in the presence of 
 rounded smooth prominences named caruncles or cotyledonal processes 
 {placenta uterince), which increase in number with the size of the 
 species. The maternal cotyledons are most numerous in the cornua, 
 and few and small in the body of the uterus : they are about the size of 
 a pea or haricot-bean, in calves : at a later period they have acquired 
 the dimensions of a button, and they increase largely and assume 
 variable shapes during gestation. In the Cow they are flat or slightly 
 convex on the top, but concave in the Sheep and Goat, and their 
 colour is usually pale ; after conception, however, they become red 
 from the afflux of blood to them. They are intended for the reception 
 of similar processes on one of the foetal membranes, the chorion, 
 and will be noticed more fully hereafter. It may be sufficient now to 
 mention that their number in the Calf sometimes amounts to thirty or 
 
 
 Fig. 25. 
 HoRizosT.\L Section of the Upper Surface of the Micous Membrane, 
 
 NEAR TO A COTTLEDON, OF THE UTERUS OF A NON-GRAVID COW : ^IaGNIFIED 
 
 ISO Diameters. 
 
 a, Section of a Utricular Gland, and a' its Proper Structure ; h, h. Mucous 
 Glands ; c, c, Adenoid Tissue. 
 
 forty ; and after parturition there have 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 the 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 uteri of the Cow is from 2| to 3^ inches in length ; it is 
 narrow, almost as firm as cartilage in texture, and irregular in shape ; 
 the mucous membrane is more finely plicated over it, around the os 
 tinea, than in the Mare. The fibres composing the cervix are divergent 
 and circular. At an early age this part is 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 
 
iNTEiiXAL (>i;i:axs of i!KXtn:ATi(>y. \:> 
 
 lips are composed of flattened, dense, transverse libres. The orifice, or 
 OS uteri, is either circular or elongated transversely, and corresponds 
 to the middle of the posterior part of the vaginal cavity. During 
 pregnancy the cervix is firm and tense, and appears to become shortened 
 in animals which have had young several times. The folds of nmcous 
 membrane which we have descril)L'd as existing in its anterior and 
 around tlie os, permit its dilatation during the passage of the fa-tus. A 
 knowledge of the presence of the two lips of tlie cervix, and also their 
 
 I'tkul-9, Ovhhcts, and Ovaria ok thk Shkki'. 
 
 a, Vagina ; h, Os Uteri ; r. Transverse Folds of Cervix I'teri ; </, Hody of 
 Utenus ; t, f. Caruncles or Cotyledonal Processes ; f, ConHiience of tho ('ormia ; 
 7, Intact Cornu ; h, h. Oviducts or Fallopian Tubes ; i, i, Finihriif ; /•, /', 
 Ovaries ; /. Koiind Ligament ; m. m, Broad Ligaments ; ii, n. Cotyledons. 
 
 position, is useful when explorations by hand are necessary in cases of 
 inversion of the uterus.' 
 
 The utricular glands are wider than in the Mare, and have lateral 
 diverticuli. 
 
 The muscular tunic altogether is thicker in the Cow than in the Mare ; 
 indeed, the walls of the uterus in this animal are more dense than in any 
 of the domesticated creatures, the muscles having a red tint, and being 
 continued well into the broad ligaments. 
 
 ' Profe.«.«or Violet found two distinct cervice.t in the ateius of a Cow, both projecting 
 into the vagina, but the canal in one of them was very fhort, and terminated in a 
 cul-dt-Mte. 
 
46 OBSTETRICAL AXATOMV. 
 
 SJieejJ 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 rugte 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 tinea. The cotyledons we have mentioned 
 already ; they are concave, or cupuliform, 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 rugte. The os uteri is marked by a series of 
 narrow, close-set, longitudinal laminye, 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 deeper 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 corjnis uteri. The interior of the 
 latter shows a few smooth longitudinal rugae, and the os uteri is a 
 smooth, thick, and even prominence, larger almost than the body of the 
 uterus, which is short. It projects very markedly into the vagina. The 
 utricular glands are pyrifomn ; the round ligaments escape from the 
 abdomen by the inguinal rings. 
 
 Development. 
 
 In the foetus and the adult animal which has not been fecundated, 
 the uterus is comparatively small, narrow, and insignificant ; 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 five-eighths. In the Lamb 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 removed without much risk. 
 
 During gestation the uterus acquires a great volume, and its 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 
 difl'erent animals. In those which are uniparous (one foetus), as the 
 Mare and Cow, they are short ; but in those which are multiparous 
 (more than one foetus)^ they are long in proportion to the number of 
 
 ^ In order to avoid confusion in the employment of terms, and also on the score of 
 convenience, it may be as well to ob-erve here that Kniparoax animals are those which 
 generally produce only one at a birth ; inultijiafoiis, those which bring forth more than 
 <iiie ; primip%rouA, those which produce young for the first time ; and pluri parous, 
 those which have bred more thaa once. 
 
IXTHllXAL onHAXS OF UKXEJlATKiX. 47 
 
 young they bear, while the body is diminished in length. In the uni- 
 parous animal the fa'tus is usually developed in the body of the uterus, 
 and its posterior extremities only are sometimes engaged in one of the 
 cornua ; but in the nuiltiparous females the cornua resemble the intes- 
 tines, and the young are developed in them, the body of the uterus 
 seldom containing any. In the Rabbit, indeed, .there is no corpus uteri, 
 the cornua opening independently and directly into the vagina. 
 
 After parturition tlie uterus gradually diminishes in size, and some of 
 its supplementary structures disappear ; but it never resumes its previous 
 volume. 
 
 The lujmncnts of the uterus suspend it loosely, yet securely in the 
 abdominal cavity ; and while allowing it a certain range of movement, 
 permit its full development during gestation. At this period they become 
 developed in a peculiar manner, and, as we have seen, between their 
 lamina; appears a layer of muscular fibres ; in the Cow these fibres are 
 arranged in fasciculi, one of which, larger than the others, extends from 
 the ovary to the cervix uteri. These ligaments would also appear to 
 stretch considerably in version or inversion of the uterus in Herbi- 
 vorous animals ; even in the Carnivora they accompany the uterus when 
 hernia takes place ; and in the torsions of this organ which sometimes 
 occur in Ruminants — when its upper face becomes the lower, or even 
 when it has made a complete turn upon itself — they encircle and strangle 
 the uterus at the cervix. 
 
 SKCTIOX III.- FALLOPIAN TUBES, OR OVIDUCTS. 
 
 The F.\LLOi'i.\N TUKES, or oviDfCTs, are two small, cylindrical, 
 tlexuous canals, about ten inches long, white in appearance, one of which 
 is lodged in each broad ligament, between its serous layers, and near its 
 anterior border. Each tube connnences at the extremity of the uterine 
 horn, at a small hard tubercle in its cul-de-sac {ostium uterinum). This 
 tubercle is its opening into the cornu, and from this it proceeds, more 
 or less tortuously, and increasing slightly in diameter, towards one of 
 the ovaries, upon which it terminates by a free, widened extremity 
 {ostiu7n ubdominale) in the ^x/rj7/o;i of the tube. The calibre of this 
 canal is small, and scarcely admits a thin straw at its middle portion, 
 and it is still smaller towards the uterine extremity ; as it approaches 
 the ovary, however, it increases in width until it ends in tlie pavilion. 
 The uterine extremity of the canal opens through the small liard tubercle 
 just referred to as existing at the cul-de-sac of the cornu. The ovarian 
 extremity oflfers, in all the mammalia, a peculiar disposition. It opens 
 into the peritoneal cavity of the abdomen (the only instance of a serous 
 cavity communicating with the exterior), near the ovarian fissure, in 
 the middle of the pavilion, which is also named the fimhrite tuharum, or 
 morsus diaboli, from its fringed or dentated border. This pavilion is 
 fixed to the external side of the ovary, and its inner surface is marked 
 by numerous narrow, close-set, minutely plicated lamintc, while its cir- 
 cumference is irregularly disposed into a number of unequal, fringe-like 
 prolongations (timbrice) which hang into the abdominal cavity. This 
 arrangement is interesting, from the fact that it gives us a unique ex- 
 ample of a breach of continuity between a gland (the ovary) and its 
 excretory canal (the tube). 
 
 Each tube is composed of three tunics : an external or serous, formed 
 by the broad ligament; a middle or muscular, coi^stituted by longitu- 
 dinal and circular non-striated fibres, continued from those of the 
 
48 OBSTETRICAL ANATOMY. 
 
 uterus, which are also disseminated in the pavihon and its fimbriae ; 
 and an internal or mucous, which exhibits longitudinal rugae in the 
 tube, and radiated in the pavilion ; this membrane is covered by 
 ciliated epithelium, and its villi are greatly enlarged after impregnation. 
 It ceases abruptly at the margin of the fimbriae, where it meets the 
 peritoneum. 
 
 The bloodvessels supplying the Fallopian tubes are derived from the 
 ovarian arteries, and their nerves are from the great sympathetic. 
 
 Their function is to convey the spermatozoa of the male to the ovary 
 in the first instance, and afterwards to transmit the impregnated ovum 
 to the uterus or its horn ; in this respect they are the excretory ducts 
 of the ovaries. When the Graafian vesicle of the ovary ruptures, the 
 fimbriae of the tube grasp the ovary, and receive the ovum, which they 
 carry to the ovarian extremity of the canal ; this act, together with the 
 application of the pavilion to the ovary, takes place either through the 
 contraction of the non-striated muscular fibres which this part contains, 
 or from the swelling of the bulb of the ovary. At times, however, the 
 act is not properly accomplished, and the fecundated ovum, instead of 
 passing into the uterine cavity, escapes the fimbriae and falls into the 
 abdomen, where it constitutes that most remarkable form of gestation 
 termed extra-uterine. 
 
 DiFFEKENCES. 
 
 CoiLi, Sheep, and Goat. 
 
 In the Cow, Sheep, and Goat, the fimbriated extremity of each tube 
 is expanded upon the outer margin of the ovarian capsule ; the inner 
 surface of the pavilion is beset with numerous fine oblique striae, and is 
 further increased by narrow folds or laminae converging toward the 
 contracted opening of the duct. The duct itself forms three or four 
 wavy folds, and is then continued along the walls of the wide ovarian 
 capsule to the extremity of the uterine horn, which makes an abrupt 
 curve to meet it. 
 
 Pig. 
 
 In the Pig the oviduct has few or no inflexions, but its length 
 is proportionately greater than in the other species. The paviUon 
 is wide and deep, and the margin of its abdominal opening is almost 
 even ; its inner surface is augmented by many loDg, narrow, and 
 highly vascular folds, which radiate from the commencement of the 
 contracted part of the tube upon the expanded pavilion. 
 
 Bitch. 
 
 In the Bitch the fimbriated commencement of the oviduct is attached 
 to the exterior boundary of the aperture, opposite the ovarium ; while 
 the tube itself, long and fine, passes in a wavy course round the 
 anterior aspect of the latter to the uterus. The length of the tube is 
 from two and a half to three and a half inches. 
 
 SECTION IV.— THE OVARIES. 
 
 The Ovaries {testes muliebres), the essential organs of generation in the 
 female, and analogous to the testes of the male, are two ovoid or elongate 
 reniform bodies, smaller than the latter, but of the same shape, and 
 situated in the abdominal cavity. They are loosely suspended in the 
 
IXTERXAL ana AN S OF GENERATIOX. 40 
 
 sublumbar region, behind the Fallopian tubes and the kidneys, among 
 the convolutions of the intestines, thouj^'h sometimes their position is 
 altered. In four instances in the Pig they have been found in the 
 perineal region, occupying small cavities analogous to the scrotum of 
 the male. ' Smooth externally, each ovary shows in the middle of its 
 upper portion a more or less oblique, but deep fissure, resembling the 
 hilus of the kidney, and which gives attachment to the pavilion of the 
 Fallopian tube. Each ovary is suspended at the anterior border of the 
 broad ligament, and is also sustained in situ by the vessels passing to 
 and from it, as well as by a small cord of non-striated muscular fibres 
 called the li(jamcnticm orarii, which connects it with the uterus. 
 
 The structure o( the ovary comprises a serous and fibrous membrane, 
 the proper tissue of the ovary, and the Graafian vesicles embedded in it. 
 The serous membrane is continuous with the broad ligaments — is, in 
 fact, a peritoneal tunic which entirely envelops it, adhering closely to 
 the covering beneatii. This is the tunica albu(ji)iea—& dense resisting 
 membrane similar to the structure enveloping the testicle, and sending 
 lamellar prolongations into the substance of the ovary. 
 
 The proper tissue or stroma of the ovary is solid and hard, and has a 
 speckled-grey tint. It is divided into two layers, which are distinct in 
 appearance and structure. The medullary layer is nearest the hilus, 
 and is somewhat red and spongy ; it is formed by the intercrossing of 
 connective tissue, non-striated muscular fibres, and by a large number 
 of vessels which radiate fi'om the centre towards the periphery of the 
 organ and nerves. The cortical layer has connective tissue for its basis ; 
 it is not very vascular, but it contains in its substance the Graafian 
 vesicles or follicles, and for this reason is named the oviijcnic layer. 
 
 These Graafian vesicles are generally in various stages of develop- 
 ment ; the smallest are situated beneath the tunica albuginea, and they 
 descend towards the deeper layer, increasing in volume as they do so. 
 When they have reached their period of full growth, they are filled with 
 a transparent, citron-coloured fluid, and the ovigenic layer being in- 
 capable of containing them, they form a more or less considerable 
 prominence on the sui-face of the ovary. A Graafian vesicle, when 
 perfect, is composed of an envelope and its contents. The envelope 
 comprises two tunics — a fibrous membrane (tunic of the ovisac), which 
 is continued externally with the stroma of the ovary, and internally is 
 rich in bloodvessels ; an inner (ovisac), formed by a smooth membrane 
 which derives its bloodvessels from the latter ; it is lined by an epithe- 
 lial or granular membrane (tunica i/ranulosa), composed of round or 
 polygonal granular cells. At the bottom of the vesicle this epithelium 
 forms an aggregation (the cumulus, or discus proliijcr), in the centre of 
 which exists the ovum or ovuluvi of mammalia. The contents of the 
 vesicle is a yellowish, transparent, albuminous mass, that becomes 
 reddened by an admixture of blood when the vesicle ruptures. 
 
 The ovulum, ovule, or ovum, is a small cell imbedded in the cumulus, 
 and surrounded by an amorphous, thick, white membrane, which has 
 been designated the zona pcllucida ; within this membrane is a granular 
 
 ' A remarkable, if not unique, cane of displacement of the ovarie* i<» recorded by 
 M, Dupmt, in the Journal df» Vitirinair>t <Ih .}fi'li for 1869. In four female I'ip«. 
 fifteen days old, beneath the vulva were observed two protulierances exactly like the 
 testicles of the male, and which, on examination after death, j>P>ved t^) be the ovarieo. 
 The other organs of generation were normal. The same Sow which produced them, had, 
 in a previous litter, brought forth two females with the ovaries similarly misplaced. 
 
 4 
 
50 
 
 OBSTETRICAL ANATOMY. 
 
 layer, the vitcllus or yolh, 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 the nucleus— the germinal vesicle, or 
 
 Fig. 27. 
 
 Ovary opened Vertically. 
 
 a, a, b, h, Graafian Vesicles at different 
 stages of development. 
 
 Fig. 28. 
 
 Portion of the Ovary of a Pig. 
 
 a, Point at which a ripe Vesicle is about 
 to escape ; b, Fissure by which an 
 Ovule has escaped. 
 
 vesicle of Purhinje, a most important portion of the ovum ; it has the 
 appearance of a very small clear ring, measuring about l-60th of a line 
 in diameter, and upon its surface is a dark spot, the inacnla germinativa. 
 This is always observed as a simple rounded body, measuring from 
 
 Fig. 29. 
 
 Graafian Vesicle in Make's Ovary. 
 
 a, Membrana Propria of the Graafian 
 Follicle ; b, Membrana Granulosa ; 
 b'. Discus Proligerus ; c, Ovum. 
 Magnified 5 Diameters. 
 
 Fig. 30. 
 
 OVULUM OF THE MaRE. 
 
 , Zona Pellucida ; b, Vitellus, con- 
 taining the Vesicula Germinativa ; 
 c, Cells of the Discus Proligerus. 
 
 l-200th to l-300th of a line in diameter ; it is rarely found double or 
 as an aggregate of granules, except in miniature ova. 
 
 The large flexuous arteries supplying the ovary are from the utero- 
 ovarian trunk; they spread over the spaces in the tunica albuginea, 
 before entering the hilus of the organ to be distributed in its interior. 
 
IMKRX.IL <>/:i;A.\S oF dEyKllATlnX. 61 
 
 The veins are extremely large, and form a very close plexus around the 
 f;land {bulb of the ovarij), emptying themselves into the vena cava near 
 the renal veins. The lymphatics pass to the suhlumbar ganglia, and 
 the nerves come from the small mesenteric plexus. 
 
 Differences. 
 
 Coxv, Sheep, and Chat. 
 
 In the Cow the ovaries are relatively smaller than in the Mare, but 
 their form and structure are the same. Each is lodged in a depression 
 or sacculus of the broad ligament, which is more or less deep, and the 
 Ciraafian vesicles are visible through the tunica albuginea. The same 
 arrangement is observable in the Sheep and Goat. 
 
 Pi'J- 
 In the Pig the ovaries are comparatively large, oblong bodies, with 
 an irregular, tuberculated, or lobulatcd aspect, due to the Graafian 
 vesicles, which, when well developed, project beyond the surface of the 
 organ, instead of remaining within it. When these ovisacs enlarge, 
 the stroma is scanty in proportion. Tiach ovary is enclosed within a 
 peritoneal sac, near tlie opening of which it has a pedunculate attach- 
 ment. The posterior wall of this sac, as we have seen, appears to be 
 formed l)y the wide and deep pavilion of the Fallopian tube. 
 
 Bitch and Cat. 
 There is nothing particular to indicate in the ovaria of the Bitch and 
 Cat, except that the ligaments suspending them to the spine are very 
 short, and they are contained in a fold of peritoneum. 
 
 Develoi'ment. 
 
 The development of the ovaria and the ova is very interesting. In 
 the Mare, the ovaria of the fa'tus are, when compared with the uterus, 
 of an immense size, and at six months are almost as large as in the 
 adult. In aged animals they become atrophied, and it is not unusual 
 in old Mares to find either one or both in an unhealthy condition. Not 
 infrequently they are hypertrophied, and their fibrous envelope and 
 stroma are much thickened. Sometimes the vesicles are greatly en- 
 larged, and converted into cysts which contain a limpid, sanguinolent, 
 or purulent fluid, secreted from their walls. Flandrin cites the case of 
 a ^lare, one of whose ovaria weighed 26k pounds, and measured 
 14i inches in its long, and 12 inches in its short diameter. The 
 texture of the ovaries is also liable to various abnormal alterations. 
 
 The Graafian vesicles are present in the ovary of the fcetus, but they 
 do not attain their full development mitil puberty ; neither are they all 
 present at birth, but are continually being developed beneath the tunica 
 albuginea. The first-formed elements in the fcttal ovary are cells and 
 cell-nuclei ; these next appear in somewhat circular groups, which are 
 more opaque than the other parts of the regularly uniform mass (Fig. 
 31, A). A kind of film soon condenses round these groups (B), and upon 
 the inner surface of this there is fixed an epithelial precipitate from the 
 fluid and granules of the interspaces of the contained primary cells. 
 Within the ovisac thus formed, a large nucleate cell becomes visible : 
 this is the commencement of the ovum (C, (j). As this expands, the 
 proportion of fluid to the formed particles increases, and the latter 
 
52 
 
 OBSTETRICAL ANATOMY 
 
 ^^2r^- 
 
 are attracted to the contiguous surfaces : some to that of the ovisac, 
 which thus becomes lined by a thicker layer of ceils ; others to the 
 ovum, accumulating round it. With the enlargement of the ovisac, the 
 stroma of the ovum condenses round its delicate membrane (Fig. 32, h), 
 to form what has been called the " theca folliculi " of Baer — the fibrous 
 
 tunic already noted ; this vascular 
 tunic (a), with the other (h), consti- 
 tuting the vesicle; while the stratum 
 of nucleate cells lining this double 
 covering is the membrana granulosa, 
 and those surrounding the ovum itself 
 form the ])roligcrous disc (e), the mass 
 of cells adhering thereto being the 
 cu7mihis. 
 
 The hyalinion, or proper tunic of the 
 ovum, thickens into the clear substance 
 improperly named the zona pelhicida 
 ( /'), which in reality is a bag. x\s the 
 cells and cell-nuclei of the ovum become 
 developed, they are pushed deeper into 
 the stroma by those of more recent 
 formation ; while, as the ovum ripens, 
 the cells immediately around it become 
 elongated and pyriform, the tapering 
 extremity being attached to the zona : 
 those of the cumulus diverge irregularly 
 into the fluid intervening between them 
 and the membrana granulosa of the 
 ovisac. What have been termed reti- 
 nacnlce (d) have been described by some 
 authorities ; they are four processes 
 formed by the cells of the cumulus, 
 and may be merely exceptional diver- 
 gences. 
 
 Until puberty there is no great ac- 
 tivity apparent in the vesicles ; but at 
 this time the ovary becomes more vas- 
 cular, and certain vesicles increase in 
 volume. At the period of "rut" or 
 " heat," one or more vesicles, accord- 
 ing to the species of animal, show 
 evidence of increased vascularity and 
 become distended ; the ovisac thins at 
 the most prominent part to which the 
 ovum tends, and blood is extravasated into it ; then, partly by absorp- 
 tion and partly by pressure, the coverings give way, the proligerous disc 
 and o^Tim escape outwards, and are either received into the Fallopian 
 tube for conveyance to the uterus, or, which is very rare, fall into the 
 cavity of the abdomen. 
 
 The size of the mature ovum in the Cow is -^Ijj, Pig -^Ijj, Cat ^i^, 
 
 Fig. 31. 
 
 FOBMATIOX OF THE OviSAC IN THE 
 
 Bitch's Ovaky. 
 
 Bitch 
 
 ie(T> 
 
 Rabbit 
 
 of an inch. 
 
 After the rupture of a Graafian vesicle and the escape of the ovum, the 
 cavity of the ovisac is filled with a clot of blood, while its walls are 
 thickened and altered in colour, being in most animals partially everted 
 
IXTHnXAL nnnAXS nf C t:.\ HIIAT K >\. 
 
 53 
 
 at the rupturetl orifice. In the Cow and Sheep the folUele has a brick- 
 red colour, and in the Pig it is yellowish-brown — it is then designated 
 in the human subject, from its colour, the corpus lutcum ; but gradually 
 the clot shrinks, loses its tint, and the cavity contracts ; at the same 
 time the walls are hypertrophied, and the tunica granulosa becomes 
 wrinkled and transformed into cylindrical epithelium. By the time the 
 
 Fig. 32. 
 Graafian Vesicle and Ovum. 
 
 succeeding ovisac with the ripening ovum has begun to protrude from 
 the surface of the ovary, the old ovisac has lost its colour, with much 
 of its dimensions, and fallen inwards ; the cylindrical epithelium becomes 
 infiltrated with fat and is gradually absorbed. This change, with col- 
 lapse of the wall, depresses the cicatrix of the aperture ; and these suc- 
 
 Fig. 33. 
 KscAPE OK Ovum kuom Ovisac. 
 
 cessive shrinkings and cicatrisations of the ruptured ovisacs give the 
 ovary a pitted and furrowed appearance in advanced life. 
 
 If the expelled ovum be not impregnated, the changes of the ovisac 
 into the yellow convolute cavity, then into the depressed stellate cicatrix, 
 occur somewhat rapidly ; but if impregnation takes place, the matura- 
 tion of successional ova is delayed, and the first change in the ruptured 
 ovisac goes on to a greater extent, the corpus lutcum not becoming 
 obliterated for a comparatively long time. In this period the inner coat, 
 or original ovisac, is much thickened by a larger de^wsit of yellow oil- 
 granules ; it becomes more deeply plicated, is impacted into a yellowish 
 
54 
 
 OBSTETRICAL AX A TOMY. 
 
 mass, and gains an adventitious white lining membrane, and it rarely 
 happens that the cavity is obliterated before full gestation. It is 
 then, in the human species, represented by a stellate hnear figure 
 surrounded by the corpus luteum, which is ultimately absorbed, but 
 usually not before some weeks after parturition. 
 
 It is this difference between the impregnated and unimpregnated 
 condition which enables us to distinguish, in these ruptured vesicles, 
 the true and false corpora lutea. 
 
 In the Mare the retrocession of the true corpus luteum is more rapid 
 than in the other domesticated animals, and it has not that deep yellow 
 colour observed in the Cow ; but it is of a darker, dull reddish-brown 
 
 Fig. 34. 
 
 Successive Stages in the roRiiATiox of the Corpus Ldteuii in the 
 Graafian Follicle of a Sow : Vertical Section. 
 
 a, Follicle immediately after the expulsion of the Ovum, its cavity being filled 
 with blood, and no ostensible increase of its epithelial lining having yet 
 taken place ; at 6 a thickening of this lining has become apparent ; at 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 e,f, <j, h, forms the Corpses lutevm, 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, hy post-mortem examination of Mares, 
 of the possibility of ova being thrown off 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 Cow there is usually only 
 one, in the Sheep and Goat one or two, in the Pig from four to a dozen, 
 and in the Bitch a variable number. 
 
ItKI'Unin'CTinX. 65 
 
 BOOK II. 
 
 OBSTETRICAL PHYSIOLOGY. 
 
 REPRODUCTION. 
 
 Having described the situation, structure, and peculiarities of the 
 external and internal orfj;ans of the female domesticated animals, we 
 have now to inquire into their functions. Some of these functions have 
 for their end the conception, development, and preservation of the young 
 animal for a certain period, until it can maintain a more or less inde- 
 pendent existence, when others of them are brought into play in order 
 to place it in direct 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 in favourable relations with each other. This pre- 
 liminary condition is indispensable, as the essential of reproduction is 
 the contact with, and action of the male fecundating fluid on, the ovum 
 of the female. Nature has ordained that this creative act should be 
 accomplished by engendering in these animals an instinctive, copulative, 
 and irresistible desire at a certain stage of existence ; which desire, 
 continuing only for a brief period, is renewed after particular intervals, 
 until the faculty of reproduction ultimately ceases. 
 
 The advent of the power of reproduction in the male and female sex 
 of animals is very unequal among the various species, and is generally 
 in relation to the duration of their existence — the creatures which are 
 short-lived being capable of bringing forth young at an earlier period of 
 life than those which enjoy a longer term. 
 
 The Elephant only brings forth one at birth, and this occurs but once 
 in three or four years ; while the descendants of the Kabbit in tlie same 
 space of time may be reckoned at more than a million. This great 
 disparity has nothing of chance or accident in it, but is in admirable 
 harmony witli the designs of Nature. The individuals of every species 
 produce, as has been justly remarked by Verheyen, a total number of 
 germs which amply covers the losses caused by death ; and the prema- 
 ture destruction of many of these germs is likewise a providential safe- 
 guard against their too numerous multiplication. 
 
 Two factors regulate fecundity ; these comprise the nutritive excess 
 which the maintenance of the individual renders disposable, and the 
 sum total of the materials necessary for the embryonic evolution ; but 
 tlie divergences of these two factors are as extensive as those of fecun- 
 dity itself. 
 
 If we take the weight of the foetus at birth as the equivalent to the 
 nutritive matter that the parent has endowed it with, and multi])ly this 
 weight by the number of young annually produced, we shall obtain the 
 total amount of the materials which have been derived from the 
 maternal organism. Theti weighing the mother, and comparing her 
 weight with that of the foetus, we shall arrive at tlie disposable nutritive 
 excess; and from this, according to Leuckart, be able to calculate the 
 fertility of a species. Although this calculation is only approximate, it 
 none the less demonstrates, in principle, the relations between fecundity 
 and the two before-mentioned factors. This is shown in the following 
 table, drawn up by Leuckart, with reference to the domesticated 
 animals. 
 
56 
 
 OBSTETRICAL PHYSIOLOGY. 
 
 Species. 
 
 Weight of 
 Body. 
 
 Annual 
 
 Number of 
 
 Young. 
 
 Weight of 
 
 each Young 
 
 Animal. 
 
 Annual nu- R^i^^^ion between 
 
 ce^l of the t'^«' 1*^^"^ ^^^S*^* °^ 
 Mof l„„i tlie Mother and that 
 Maternal , t.\. x- 
 
 Organism. , of the \oung. 
 
 Nutritive Matter' 
 
 yielded to the 
 
 Foetus. 
 
 Horse 
 
 Cow 
 
 Sheep 
 
 Pig 
 
 Dog 
 
 Fowl 
 
 Grammes. 
 
 325,000 
 
 175,000 
 
 50,000 
 
 90,000 
 
 22,000 
 
 0,900 
 
 1 
 
 2 
 
 20 
 
 18 
 
 100 
 
 Grammes. 
 
 50,000 
 35,000 
 4,500 
 2,400 
 0,440 
 0,044 
 
 Grammes. ] 
 
 25,000 100: 7,7 
 
 35,000 100 : 20,0 
 
 9,000 1 100: 18,0 
 
 48,000 ^ 100: 53,0 
 
 7,950 ' 100: 36,0 
 
 4,400 ■ 100: 500,0 
 
 Per cent, of the | 
 
 living Maternal 
 
 Weight. 
 
 14 
 
 20 
 
 9 
 
 3 
 
 •2 
 
 5 
 
 The nutritive reserve of the Horse, compared with that of the other 
 animals, is here seen to be very limited ; while, on the contrary, the 
 Fowl yields in reproductive material a sum equivalent to five times the 
 weight of its own body. When a balance is struck between the profits 
 and losses in the animal economy, it is found that the great difference 
 existing has its own reasonable explanation. The function which 
 makes the greatest demand upon the nutritive capital, is doubtless that 
 with which the muscles are charged, and their maintenance in power 
 exacts the heaviest compensation ; as they consume material in pi-opor- 
 tion to the weight of the body, and the energy, extent, and frequency 
 of the movements. In proportion as the height increases, the cubical 
 weight augments at the expense of the motive power ; while the latter, 
 equal to the square of the transverse section of the muscles, follows an 
 arithmetical, and not a geometrical, progression. 
 
 The nutritive maintenance, then, demands in an absolute manner an 
 expenditure much more considerable in the larger than the smaller 
 animals ; so that the 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 reproductive- 
 ness ; as is evidenced in the case of our domesticated animals, if com- 
 pared with the wild creatures of the same species ; and their fecundity 
 increases or declines as their food is plentiful and good, or scarce and 
 bad. But this influence of alimentation on fecundity, and the faculty 
 of living beings to maintain a nutritive reserve, has its limit ; for the 
 intestinal absorption goes on in direct proportion to the superficies of 
 the mucous membrane lining it, and this is definite. 
 
 The sum of materials necessary for embryonic evolution is also 
 founded on the nutritive reserve. In proportion as the organisation is 
 simplified and the various apparatus decrease in number, so does the 
 maturity of the embryo gain in precocity, and the nutritive matter serve 
 for a larger number of germs. Thus, as has been aptly said, what would 
 be required to maintain the single foetus of a large mammal, whose 
 organisation is complete at its birth, would suffice 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 the young 
 mammal derives its sustenance from the mammte of the mother, at 
 whose expense it continues, for a more or less protracted period, to live 
 as a parasite (as it really was in utero). With the higher animals, 
 
I'UiiKKTV. :•: 
 
 wliich give birth to an incomplete being, tliere is observed an increase 
 in fecundity : the Bitch only yields two per cent, of its weight, but the 
 Calf absorbs twenty per cent, of its parent's weight. 
 
 This unequal distribution of fecundity among the animal species is a 
 conservative element in the scheme of organic nature. The reproduc- 
 tivencss and the numerous chances of destruction surrounding the germs, 
 are compensated for in just proportion ; for out of many thousands 
 of ova furnished by the most prolific species, a comparatively limited 
 number only find all the conditions favourable for their development. 
 
 CHAPTER I. 
 
 Generation. 
 
 The processes by which generation is accomplished are four ; these ai'e 
 <x>pulation, fecundation, (jcstation, and jnirturition ; but it is only on tlie 
 attainment of a certain age — that of pid^crty — that these sexual acts are 
 in activity, and they continue so for a variable period, according to the 
 species. During this time, ova from the ovaries, fecundated by the 
 male seminal fluid, are received into the uterus, and remain there for a. 
 regulated period, until they have become transformed into young crea- 
 tures possessing certain physical attributes and resemblances to their 
 parents. This is the gestation period, and is followed by that of 
 jiarturition, when the young are born. 
 
 SECTION I.— PUBERTY. 
 
 The generative organs of the domesticated female animals are, like 
 those of the human female, only in a state of greatest activity during 
 the prime of life ; and the most notable characteristic of their functions, 
 as in woman, is their periodicity. These functions lie dormant from 
 birth until puberty, when, somewhat suddenly, certain very marked 
 modifications occur throughout the whole organism, but particularly in 
 the generative organs of the male and female animals. In the first the 
 testicles become more voluminous, and in some species they leave the 
 abdominal cavity to be lodged in the scrotum ; they also begin to secrete 
 an abundance of a special fluid — the "spermatic" or "seminal," in 
 ^vhich particles of a definite shape — spermatozoa — and endowed with 
 motion, appear. This fiuid is stored up in the vesicnUe seminalcs, 
 which, until this period, were small and wasted-looking. The organ for 
 the conveyance of this spermatic fluid to the female becomes more 
 developed, and is capable of complete and frequent erection. In the 
 female the mammie enlarge, the ovaries are more vascular and turgid- 
 looking than before, and the Graafian vesicles are more or less developed. 
 The periodic ovipont then begins to be carried on, with all tlie 
 distinctive peculiarities that attend it, and which it is to bear during 
 the prolific period of life. 
 
 The age at which animals arrive at pnhcrt]i or sexual maturity, is not 
 only dilTerent in different species, but is influenced to some extent by 
 the rapidity of their growth and the duration of their life. Domestica- 
 tion has more particularly brought about changes in this respect, and 
 by inducing a more rapid development of the organism, has hastened 
 the advent of this period. And it may be said that puberty is sooner 
 attained in the female than the male, and also that domesticity has 
 
VXS& i aK aJboos two OBOBths mhl i 
 
•n:. 
 
 
 3»: 
 
60 OBSTETRICAL PHYSIOLOGV. 
 
 In other animals this ejection sometimes consists of a viscid, red- 
 tinted, or sangtiinolent fluid. In all it has a special and powerful odour, 
 which attracts the males, and enables them to distinguish between the 
 females which are in " rut " or " heat," and those which are not, as well 
 as exciting in them the most ardent amatory desires. 
 
 The uterine mucous membrane is also very congested, and there is 
 poured out on its surface a fluid containing epithelial debris, mucus 
 corpuscles and blood globules. 
 
 The existence in the lower animals of what is analogous to the 
 menstrual discharge in the human female, has frequently been denied, 
 but without any reason or proof. A discharge of blood from the sexual 
 organs of woman announces the advent of puberty ; and its coincidence 
 with the maturity and escape of the ovarian o^nile, as well as its 
 periodical appearance until the termination of fertility, establishes 
 between this phenomenon and the "heat " or " rut" (cestrum) of animals 
 a very close analogy. And this analogy is rendered complete by the 
 fact that animals also at this period have more or less evident sanguine 
 emissions. Kahleis, Fuchs, Spinola, Numann, and others have observed 
 this in the Cow, and have also noted that the discharge occurs regularly 
 at intervals of nineteen or twenty days, when the animal is not giving 
 milk or in calf. The haemorrhagic flow appears two or three days after 
 the commencement of " rutting," and when this is most intense. The 
 amount of blood does not exceed one or two ounces, and the coagulated 
 clot remains in the vagina until it is expelled with the urine. There 
 can be no doubt as to its source. If, at the moment when traces of it 
 are perceived externally, the Cow is killed and the inner surface 
 of the uterus examined, blood will be seen exuding from the cotyledons. 
 And this phenomenon has been proved to extend bej'ond the Bovine 
 species, for it has been witnessed in the Mare, Bitch, Cat, Eabbit, etc.; 
 and in the red-coloured mucus of the vagina and uterus, multitudes of 
 blood-corpuscles have been found. 
 
 Not only is the existence of a menstrual discharge in animals a well- 
 ascertained fact, but the ill effects of its retention in cases of uterine 
 obstruction or occluded vagina, have been recorded as occurring in both 
 the Bovine and Equine species. 
 
 The cause of menstruation or periodical discharges of blood in female 
 animals, has received a satisfactory explanation from the researches of 
 Eouget, who has established the fact that the utero-ovarian artery, on 
 arriving at the body of the uterus, near the Fallopian tube, divides into 
 curs^ed or spiral bouquets of vessels which open into veins, like the 
 helicine arteries of the male cavernous sinus. Along the inferior border 
 of the ovarj", this artery forms a series of branches that wind and twist 
 exactly like the arterial ramifications at the root of the corpus cavern- 
 osuin, penetrating the stroma of the ovary, and giving rise to spiral con- 
 volutions. The venous system composes the uterine sinuses — contorted 
 venous canals not unfrequently spiral, like the arteries. 
 
 The uterus is, therefore, an erectile organ like the penis, and its 
 erection is connected with the periodic haemorrhage from its inner 
 surface. The venous sinuses in the meshes of the muscular tissue, 
 crossing each other at the hilus of the ovary, are partially compressed, and 
 
 twent3'-four years of age, which every three weeks had a sanguineous emission from the 
 vulva ; this discharge ceased towards the middle of pregnancy, but returned after 
 parturition. I have frequently witnessed the periodic discharge from Mares either 
 streaked with blood, or blood-tinted. 
 
a'STJ.-CM. 61 
 
 the immediate result is the distending and erection of the bulb of the ovary. 
 This modification in the ovarian circulation extends to tlie uterus, so 
 that both are in a state analogous to erection ; the prolonged tension is 
 communicated to the vessels and capillaries of the mucous niemhranc ; 
 the epithelium is shed, leaving the tunic of the capillaries exposed, and 
 this soon gives way, whence results the haemorrhage, which })crsists as 
 long as the erection and obstruction to the free How of blood tln-ou"li 
 the veins continues. This is the case in the human female, but it nmst 
 be admitted that, in several animals, the erectile formations are either 
 in a rudimentary condition or entirely absent. 
 
 In the Bitch the bulb of the ovary is moderately developed ; but the 
 arteries of the uterus, although contorted in a spiral form, are not such 
 avascular mass of vessels as to constitute a real erectile organ. In 
 Ruminants, small vascular masses or formations are observed near the 
 cotyledons, which may be taken to represent the spongy texture of the 
 human uterus. 
 
 That the menstrual flow is independent of the influence of the ovaries, 
 and even nearly all of the uterus and its ajjpendages, would appear to 
 be established by several important facts connected with the subject of 
 ovariotomy or "spaying." There is a tradition among those who 
 practise this operation on Sows, Bitches and Cats more particularly, 
 that it does not prevent their showing signs of oestrum unless they are 
 operated upon when pregnant ; this is more especially the case with 
 animals which have already produced young, but it is nevertheless the case 
 also sometimes with young animals which have never been bred from.' 
 
 With regard to the season at which this " heat" takes place, it has 
 been observed that it is usually the spring-time, when food becomes 
 plentiful, especially with Herbivorous animals. The Carnivora are in 
 heat during winter. The Mare is usually in heat from April to June, or 
 later. \Vith the Cow whose Calf is sold at from one to two months old, 
 with a view to utilising the milk, the season of course is varied, as care 
 is taken to induce conception again as soon as the lacteal secretion 
 begins to diminish ; but it has been observed that midsunnner is more 
 particularly the rutting period. And the " heat '' in Sheep, though 
 naturally present in September, is usually only shown during summer, 
 because the Ewes are kept apart from the Ram at the natural time, in 
 order that the Lambs may be born at a favourable season — the spring ; 
 and the period of suckling over (four or five weeks), they may be weaned 
 when the herbage is tender and nutritious. .\nd in other circum- 
 stances, particularly with animals bred for tlie butcher, tlie rut is 
 induced sooner by putting the Ewes in contact with the Kam at an 
 earlier period, so as to obtain two or three lambings in the year. 
 
 The Bitch is in heat from December to February, or in the autumn 
 and spring-time. 
 
 ' A strikinjf in.ttance of this h.oa been given recently by Barthelniy, in tlie Journal dc. 
 Medeciii'' I'etcrinaire, who a.-<.serta that the (pstnim or " nit '' can occur in Piijs after com- 
 plete removal of the ovaries. A professional spayer operated on thirty-ei^jht young Pigi 
 under sixty days old, yet these animals showed the symptoms of " rtit " at from three to 
 eight months, and monthly after that a^e, as thou^;h they had not l)een spayed. .\n action 
 was brought against him, after M. liarthelmy had given his opinion that the a-strum 
 indicated incomplete removal of the ovaries. The defendant declared that he had seen 
 ivstnim in pigs which had l>een properly si)aytd. The court ordered that five of the 
 Figs which showed all the phenomeii.'t of rrstruin to the greatest extent, shouM be killed 
 and examined by a competent veterin.iry surgeon. This was done, and it w.-vs found that 
 in each case the operation had been well performed — the ovaries, tubes, and almost the 
 entire cornua of the uterus having been removed. 
 
62 OBSTETRICAL FHYSIOLOGY. 
 
 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 
 a, 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 
 within the twelvemonth. 
 
 ThQ 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 the Horse every three or four weeks, and the 
 objective phenomena which announce it continue from two to four days. 
 In the Bitch they last for nine or ten days, and, as has been stated, 
 only ajjpear 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 Bitches 
 at the end of this interval — from the fortieth to the sixtieth day — there 
 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 animal also 
 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 mammae 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 Puppy, she will take to it as if it 
 were her own, and rear it most aflectionately. 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 tt'strum continues varies with species, and 
 particularly with regard to the age they attain ; but it always disappears 
 towards the decline of life. 
 
 Climate, inseparable from the conditions of alimentation, exercises a 
 
MATURATIOX OF THE <iRAAFIAX VESICLES. 63 
 
 marked influence on the "rut," in hastening its development and its 
 periodicity ; but the economical law to which it is subordinate does 
 not vary. With many species, the rut only appears once a year ; while 
 in others wliich are favourably placed with rof^ard to alimentation, it 
 persists in every season, or at least during a large part of the year. 
 Domesticity, iu assuring animals food and shelter, and removing them 
 from the risks and alternations of an erratic life, multiplies the periodical 
 returns of this condition. Fowls, Pigeons, etc., lay despite the rigours 
 of winter, and the domesticated mammals are in heat at short intervals. 
 
 Though, as a rule, oestrum does not appear until after parturition is 
 achieved, and lactation has nearly or quite ceased, yet it is not rare to 
 find some animals — as the Mare and Pig — manifest a desire for the male, 
 and even copulate ; and it is no less a fact that rutting and impregna- 
 tion may and does occur soon after parturition. The Cow, Ass, and 
 Sheep, and, it is believed, the Mare, will copulate with gi-eater certainty 
 of success on the ninth day after parturition than at any other time. 
 
 As has been just stated, various conditions intluence the appearance of 
 this state, and more or less change the period and the intervals of its 
 advent. Warmth, shelter from vicissitudes of weather, an abun- 
 dance of nourishment, especially that of a stimulating nature, and easy 
 labour, favour its more frequent and early appearance, and especially a 
 judicious bringing together of the male and female. It has also been 
 induced by the injection of certain substances into the vagina. 
 
 The persistence of this condition for longer than the natural period 
 is a symptom of uterine or ovarian derangement, and therefore un- 
 favourable. It renders Mares and Cows less serviceable, and even 
 dangerous, constituting the disturbance designated " nymphomania." 
 Repeated intercourse with the male will not allay the abnormal con- 
 dition, but frequently aggravates it. Such animals will not breed. 
 Ovariotomy is often practised for " nymphomania," and in the Cow the 
 operation is frequently followed by subsidence of the troublesome 
 symptoms for a time ; in the Mare it is much less successful. 
 
 SECTION III.— MATURATIOX OF THE (IKAAFIAN VESICLES. 
 
 The spontaneous and periodic ripening and dehiscence, or discharge, 
 of the ovarian vesicle that marks the period of cestrum in the domesti- 
 cated animals, though independent of fecundation, yet is doubtless 
 intended to conmience the act of generation. The peculiar condition 
 which accompanies the maturation of the ovum, the intense desire of 
 the female for the male, and the excitation produced in the latter at 
 this period, with its aptitude for procreation, conclusively demonstrates 
 this. At this time, as we have seen, particular changes occur in tlie 
 ovaries. A certain Ciraatian vesicle or vesicles, according to the species 
 and whether the animal is uniparous or multiparous, becomes more 
 voluminous than the others, raising the enveloping membrane of that 
 body, and makes a more or less salient projection on its surface, as is 
 witnessed in the ovary of the Pig. Around this vesicle the bloodvessels 
 enlarge, and the stroma is congested ; while in its interior an effusion 
 of blood takes place ; the capsule becomes greatly distended and injected, 
 and at a particular point gives way, leaving an irregular gap through 
 which the ovum (Fig. 28, a) escapes. In the Pig, during the evolution 
 of the vesicle, the corpus luteum is red, deep red, blue, or nearly black. 
 It is probable that the Graafian vesicles open at any part of the surface 
 
64 OBSTETRICAL PHYSIOLOGY. 
 
 of the ovary, in those animals in which the pavilion of the Fallopian 
 tube is large 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 oestrum, 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 ; while the Pig and 
 Carnivora having several at a birth, a corresponding number of vesicles 
 open, and their contents occupy' each cornu of the uterus. 
 
 The ovum liberated 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 known as fecundation, conception, or inipreg- 
 iiation, 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 motion. 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 coit^is 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 leaves the ovary, changes occur in it which may be 
 
STEIULITV. 65 
 
 noted here. The germinal spot, })reviously at the inner surface, passes 
 to the centre of the genninal vesicles ; and this, which was before at 
 the surface, goes to the centre of the yolk or vitellns ; while the mem- 
 brane investing the latter, from being thin, suddenly thickens. When 
 the ovum is discharged, the tunica (jraiiulosa and rctinacnla accompany 
 it through the small opening in the vesicle ; the whole being received 
 into the pavilion or infundibulum of the Fallopian tube, which at this 
 time is tirndy applied against the ovary. Arrived at this part, the 
 ovum is carried along by the slow vermicular motion or contraction 
 of the tube, as well as by the ciliary movement of the cells covering 
 the nmcous membrane lining this duct, until at last it reaches the 
 uterus. 
 
 CHAPTER III. 
 Sterility. 
 
 Hitherto we have been treating of fecundation as if it were always 
 a sure result of the coupling of the male and feniale sexes at a 
 certain period. Successful fecundation, however, is not always the case, 
 and in some species — particularly the Equine — sterility, temporary or 
 permanent, in the female is far from being uncommon, and is some- 
 times serious. Sterility, barrenness, or infecundity depends on numerous 
 causes, to some of which we must allude, as in distinguishing their 
 presence we may be able to remove or counteract them. 
 
 It is difhcult to ascertain the extent to which it prevails, especially in 
 the larger and more important animals. In the Stud Book, it is shown 
 that among thoroughbred Mares the percentage of those which carry 
 foal is 73"8G, and those which abort or are infecund 26"64. In the 
 studs of France the fruitful Mares are o9-o7, and the unfruitful ones 
 4043 per cent. The Due de Guiche gives 68 per cent, of fecund 
 Mares. At the haras of Pin, during a period of twenty years, there 
 was a percentage of 68- 27 fecund Mares, abortions 5-06, non-fecund 
 26G7 ; while at the Pompadour haras, where Oriental horses were 
 chieHy bred, the births in three years were 79'55, abortions 2*27, and 
 non-fecunds 2045. 
 
 In the Cow, the fecundations appear to average about 79 per cent. 
 
 With the Sheep, sterility or infecundity is not so common. RuefT, at 
 Hohenheim, found among 8,500 sheep, only 740, or 8 per cent., unfruitful. 
 
 Sterility may depend upon organic or pliysical causes, and may 
 amount to permanent impotence, more particularly when congenital 
 and located in the generative apparatus. Monstrosities, hermaphro- 
 dites, animals in which one or more important organs of the sexual 
 apparatus are absent, and hybrids, are generally permanently sterile.' 
 
 Prolonged continence and old age are not infrequent causes of in- 
 fecundity, as is witnessed in Mares which liave worked for many years 
 in towns, and then been transferred for breeding purposes. 
 
 Change of climate has in many cases a marked influence on fecundity 
 — sometimes putting it altogether in abeyance, and at others rendering 
 the animals infecund for only a longer or shorter period. It may also 
 be impaired, or suspended ten)porarily or permanently, by abuse of 
 the generative functions, bad hygiene, etc. 
 
 ' There are exceptions to this rule. Several well authenticated instancea are recorded 
 in which the suliped mule haa bred, as well aa other hybrids. 
 
 5 
 
66 OBSTETRICAL PHYSIOLOGY. 
 
 It may likewise be due, though temporarily, to premature or tardy 
 coition when the generative organs are not in a physiological 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 w^hich 
 are of an equable and gentle disposition. The latter are often impreg- 
 nated at one attempt ; and it has been observed that with 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, the 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 if 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 fix 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 sterilitj^ in the Mare and Cow from the 
 earliest times. This occlusion may be complete during coition, and 
 prove fatal to conception ; or it may be due merely to a spasmodic con- 
 dition of the muscles 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 necessarj'. 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 are to be gently insinuated by the same movement 
 into the os, and pushed on until the cavity of the uterus is reached. A 
 
STERILITY. 67 
 
 simple sound, the size of an ordinary catheter, well j^reased, may be 
 employed with the same object as the lingers, and appears to answer 
 (juite as well. Various instruments have been devised to dilate the 
 cervix, but nothing is equal to the lingers or the sound. The animal 
 may be put to the male on the same or the following day. This simple 
 operation for the cure of sterility has been very often practised, and is 
 well known to the Arabs of the Sahara, who treat their barren Mares in 
 this manner, and in the majority of cases with success. 
 
 In the United States of America, Lyford's method of ensuring fertility 
 when the cen'ix is at fault, has been extensively practised, with excellent 
 results. Use is made of what he terms irapregnators and dilators. The 
 former consist of a hollow tube or cone, composed of soft rubber of 
 suilicient thickness and tirnmess to retain its shape and resist the 
 pressure of the cen'ix. Somewhat constricted at the disc portion, in 
 order that it may be self-retaining (Fig. 35, a), the posterior surface of 
 the disc is somewhat concave, to admit the urethral sinus of the glans 
 penis ; while the canal in the body is sufficiently wide to allow the 
 semen an easy passage through the tube to the end {h) which projects 
 
 Fig. .Jo. Fig. 36. 
 
 ImI'REGNWTI.NG TlBH. SkcTIOS OI- ImPRKCNATINC TlBE. 
 
 a. Disc ; h, Bulb. a, Disc ; /<, F.ullj. 
 
 t^Tr— jf^- 
 
 -% =-^^ =^ 
 
 Fig. \M. 
 Dilator ok thk Cervix. 
 
 into the uterus. These imprcgnators are in three or four sizes, to 
 lit different-sized cervices ; and to render them less objectionable to the 
 Stallion and Marc, the disc (Fig. 3G, </), as well as the bulb {}>), is hollow 
 and very elastic, so that connection between male and female takes place 
 almost as if no foreign body intervened. The advantages claimed for 
 these articles are : close approximation to the normal condition of the 
 cen'ix during copulation, and so rendering the communication between 
 the cavity of the uterus complete, thus assuring easy access for the 
 semen ; they are easily inserted ; are ready for immediate use ; and they 
 are cheap and durable. The dilator (Fig. 37) greatly facilitates the 
 introduction of the tube, by dilating the os uteri and displacing any 
 obstruction that may exist, thus allowing the cervix to envelop the 
 impregnator easily and closely, as well as saving much time in inserting 
 it. This is accomplished by the left hand in the vagina placing the 
 tube — in which is the dilator — at the entrance to the os, while the right 
 hand makes the necessar}' pressure on the handle of the dilator to push 
 it into the canal ; the left hand retains it there until the dilator is with- 
 
68 OBSTETRICAL PHYSIOLOGY. 
 
 drawn. The Stallion is then allowed access to the Mare, and within 
 five minutes after copulation the tube is extracted by means of a tape 
 attached to it, the end of which has a ring, and hangs outside the 
 vulva. 
 
 Moderate rigidity of the cervix, which cannot be overcome by prompt 
 manipulation, may be combated by means of sponge tents introduced 
 into the os. These are made by soaking a sponge of the necessary size, 
 and to which a long string is securely tied, in a strong solution 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 the thread 
 is removed, and the sponge, being slightly smeared with grease or 
 glycerine, is passed into the os, where it is left to soften and expand, in 
 doing which it widens the canal. In some instances it may be neces- 
 sary to assist the dilatation by making some slight incisions through 
 the cervix. 
 
 In rare instances complete dilatation may require to be effected by 
 a cutting instrument, but this should never be resorted to until the 
 simpler and safer means have failed. 
 
 Disease of the mucous membranes, with altered secretions, must be 
 treated according to the indications. 
 
 CHAPTEK IV. 
 Changes in the Ovum. 
 
 During the progress of the ovum towards the uterus, and soon after its 
 reception into that cavity, some remarkable alterations occur. The 
 ovum has encountered the fructifying element of the male semen — the 
 spermatozoa ; at least, this has been established in the Rabbit, in whose 
 oviducal ovum they were found to have passed through the zona pelliicida, 
 though no opening has yet been discovered in that extremely fine 
 evanescent film. The germinal vesicle disappears, or has changed its 
 character, and a somewhat more opaque cmhrijonal cell succeeds, which 
 may be, or includes, a combination of the nuclear matter of the sperm- 
 cell with that 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 the course 
 of the 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 be retained there for a certain time previous to 
 perishing or being ejected, and that, should it meet the spermatic fluid, 
 impregnation will ensue and the usual results follow.^ But it is more 
 
 ^ It may be remarked that, with multiparous animals, the number of young in the 
 cornua are not in proportion to the corpora lutea of the same period. Franck mentions 
 an instance in which there were eleven corpora lutea and only five foetuses ; from which 
 it might be inferred that six ova had perished, or, if they had been impregnated, that 
 the fcBtuses must have died at a very early period, and been absorbed. It has also been 
 stated that an ovum from the right ovary (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 observed in woman, in the Bitch, the Guinea-pig, and also in the Sheep. 
 Kehrer, in the MonaUachrift filr iJeburtshnnde (vol. xxii., p. 225), 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 the uterine contractions. 
 
ril.iXdHS IX THE OITM. 
 
 69 
 
 likely that the initial changes are, in the majority of instances, accom- 
 plished in the tube. There, the ovum is bathed and moved about in 
 the clear fluid containing the spermatozoa, by the peristaltic action 
 of the walls of the duct, in order to enable the largest number of the 
 fertilising particles to obtain access to the yolk, and thus ensure 
 fecundity. 
 
 With the formation of the embryo-cell, the vitellus becomes separated 
 or retracted by fluid from the zona pellucida, and begins to rotate 
 therein ; while one or two minute granular or oil-like bodies may appear 
 in the surrounding fluid (Fig. 38). 
 
 A division or segvicntation of this primary embryo-cell into two portions 
 (Fig. 39), each provided with a nucleus, is the next step ; then there is 
 mutual repulsion of these secondary globes, and further cleavage of each 
 into two portions (Fig. 40), and these again into other binary divisions 
 (Fig. 41) of the germ yolk, through attraction round each cell of the 
 particles contiguous thereto, until the whole is worked up into a mass 
 of finely nucleated corpuscles — the ultimate segmentations of the 
 impregnated parent embryo-cell. Each of these corpuscles contains a 
 colourless pellucid nucleus, and each of these again a nucleolus. The 
 
 Fig. 38. 
 Ovum kkom OvmrrT nr Rabbit, 
 
 PKNETKATKD HY Si'KRMATOZOA IN 
 ITS VlTKLLINK LaVKR. 
 
 Fig. 39. 
 
 An Ovum more auvan<ei) in 
 THB OvinufT. 
 
 eight-fold cleavage of the yolk has been observed three days after 
 impregnation in the Rabbit, four days in the Guinea-pig, and ten days 
 in the Bitch ; and always in the ova found towards the uterine extremity 
 of the oviduct. In the latter animal the smooth surface of the zona 
 pellucida becomes irregularly flocculent, as if a granulo-mucous substance 
 had been deposited thereon ; in the Rabbit the ovum acquires a thick 
 adventitious layer of albumin before entering the uterus (Fig. 42, n) ; in 
 the Guinea-pig the zona continues smooth. After entering the uterus, 
 on the fourth day the zona becomes fainter, as the final segmentation 
 or rnulben-y state of the yolk is attained, and it disappears altogether 
 when the germ-mass is completed. The act of impregnation is thus 
 consummated, and a series of new changes begin, which are replete 
 with interest and importance. 
 
 When arrived in the uterus, a layer of very small vesicles makes its 
 appearance on the whole of the inner surface of the membrane now 
 investing the yolk. The viulbcrri/ structure then passes from the centre 
 to a certain part of that layer, the vessels of the latter coalescing with 
 those of the former, where the two sets are in contact, to form a mem- 
 brane — the future amnion ; while the interior of the mulbeny-like body 
 
70 
 
 OBSTMTHmAL PMrSI^M^iV, 
 
 is now seen to bo occupied by a large vesicle, coafeainiug 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 flUed with a colourless and pellucid fluid; this hollow and 
 spherical body seems to be the true germ. The vesicle oontaining it 
 disappears, and in its place is seen an elliptical depression, filled with a 
 clear fluid, 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 increases 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 — the 
 first of which 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. 
 Ovxm v«om the UTEBrerii: ealji' ov 
 
 OrtDUGT. 
 
 r ig. 41. 
 
 OvTM ritOM THE Ul'EEIXE BSD Off THE 
 OvLUrCT, WITH A>" AUPmOBtil 
 LATER OF ALBCMtS. 
 
 Though the foregoing changes in the impregnated ovum have been 
 chiefly observed in the Rabbit and Guiuea-pig, yet there can be little 
 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 is superadded to the zona pellucida before it enters the utems ; 
 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 proce^ 
 the zona thins away and fixially disappears, and a mass of albuminoiel 
 matter accumulates arouud the ovum, which affords material for imbibi- 
 tion. The germ-mass becomes fluid at the centre, and expands into a 
 hoEow sphere, the hollow wall of which ofl:ers two layers : both consist- 
 ing of coherent cells, and only differing, as just remarked, in the size 
 and proportion of the oil-globules. 
 
DKrEI.iiI'MKXr OF THE KMIinVO. 71 
 
 SECTION I.— DEVKLOPMENT OF THE EMBRYO. 
 
 The ovum having been lodged in the uterus, and the f/erm-mcmhraTie 
 or blastoderm having divided into two layers — an upper or seroics, and a 
 lower or mucous — and between which, at a later period, a vascular layer 
 is developed, another modification occurs by which the outline of the 
 embryo becomes evident. 
 
 In the centre of the blastoderm, where it is supposed to divide into 
 these layers, there is observed a clear space which has been designated 
 the area jtrolujera or pcllucula, in the centre of which, and in the trans- 
 verse axis of the vitellus, there is going on a multiplication of loosely 
 connected cells in a small rounded mass, which forms the rjerminative 
 area, primitive streak, or trace of Von Baer ; while around this another 
 space — the area vasculosa — is developed. The •' primitive streak " is 
 the centre where the blastoderm commences to be separated into the 
 external and internal layers ; the middle layer, which is to form the 
 foetal organs, not extending beyond the "germinative area" or "streak." 
 
 Fig. 42. 
 
 Blastodkbm and Pkimitivk Thack. 
 
 a. Vitelline Membrane with iti) <X)iiiiiiencing VilloBities ; h, External (or Serous) 
 Layer of the Bl*«t<xierui ; r. Internal (or Mucouh) Layer ; d, liody of the 
 Embryo ; //, b'. Earliest Cephalic and Caudal Elevation of the External 
 Layer. 
 
 By a proliferation of the elements of the outer and middle layers of 
 the blastoderm, the primitive trace increases in surface and thickness, 
 becoming clearly defined and prominent, in the form of a shield, and is 
 named the opaque area, which, when it grows transparent in its centre, 
 is named the transparent or pellucid area ; the clear spot, narrowing or 
 constricting in its middle part, is named the area vasculosa or einhnjonic. 
 In the middle of this embryonic area appears a dark line, or median 
 furrow, duo to changes occurring in the primitive streak ; and below it a 
 round cord — the chorda dorsalis — the axis of the future embryo, and 
 which is to develop the spine ; on each side of the streak is the lamina 
 dorsalis, and the portion of fluid separating them from the chorda dor- 
 salis is the future spinal cord and brain. The inner layer of the 
 blastoderm, at the points corresponding to the embryo, becomes doubled, 
 so as to form a new layer — the middle layer. The chorda dorsalis 
 
72 OBSTETRICAL PHYSIOLOGY. 
 
 thickens at the front part, to form the first appearance of the skull, and 
 the fluid between the dorsal laminae is in larger quantity, in corre- 
 spondence with it ; so that the central parts of the nervous system and 
 their coverings are laid down at the same time and grow simultane- 
 ously. The separation between the spinal cord and brain takes place 
 early, being coincident with a curving downwax'ds, towards the yolk, of 
 the anterior part of the laminae dorsalis, which defines the limit between 
 the skull and spine, brain and cord. 
 
 Next follows the closing of the dorsal laminae over the fluid which is 
 to constitute the brain and cord. Two other laminge 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 diiferent 
 direction, converging to meet heloic the axis, where they join, except 
 at the umbilicus. 
 
 After the rudiments of organic life have been commenced in the 
 central portion of the 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 the fold. The opening gradually 
 decreases until the opposing folds of membrane are in contact ; it then 
 disappears, leaving the fcetus surrounded by two membranes. The one 
 next the foetus is the amnion, and the other is gradually separated from 
 the amnion, and joins the serous lamina of the blastoderm, forming the 
 " false amnion " of Pander, or the " 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 vesicula 
 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 
 laminae towards the median line ; the brain and spinal marrow, which 
 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. 
 
 Towards 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 which 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 foetus, and what have been termed its 
 annexes, or enveloping membranes. The diiferent 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 vascular or germinative, 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 mucous or intestino- 
 glanclular, 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 intra-foetal and the 
 
I'EVKlJiVMEST <>F rilE KM /!/:)'<>. 
 
 73 
 
 extra-fcEtal parts. We shall examine the latter first ; merely noting, 
 in the meantime, that the intra-fcetal parts of the external or sensitive 
 layer of the blastoderm form the epidermis and its appendages — as the 
 hair, claws or hoofs, glands of the skin etc. — the central nervous 
 system, and the organs of sense — sucli as the retina and tlie labyrinth 
 of the ear ; while tlie extra-foctal parts it forms are due to its alteration 
 in shape. 
 
 The foetus, as we have seen, is a circular body applied against a 
 certain point of the blastoderm, whose outer layer is continuous, and 
 extends over the internal face of the chorion and the surface of the 
 embryo without any limit. But the inflection or bending of the latter 
 at its two extremities causes the external layer to become depressed, 
 and to constitute two folds ; one investing the head, the other the 
 opposite extremity of the body. The lateral parts of the embryo are 
 also inflected towards each other to form the thoracic-abdominal cavity. 
 
 
 r^. 
 
 tr-vj^ •. 
 
 Fig. 43. 
 
 OvcM Twenty to Twenty kive Days Old. 
 
 1, VUlositie.s of the Vitelline Membrane ; 2, External Layer of the Bla.stoilerni, 
 or .Second Chorion, with its Villosities ; 3, Uiiiliilical Vesicle, formed by 
 the Inner Layer <>f the Blastoderm ; 4, Vessels of the Umbilical Vesicle ; 
 5, Cephalic and Caudal Processes ; 6, Embryo ; 7, Allantoid Vesicle. 
 
 and it is thus enclosed in the serous layer, whose sides soon meet above 
 the back of the young creature, and a short pedicle — the superior 
 umbilicus — joins the two portions of the blastoderm. This pedicle soon 
 disappears, and the embryo is then enclosed in an independent sac — the 
 amnion already referred to. The sensitive layer is, tlicrcfore, decom- 
 posed into two sections : an internal, the amnion ; and an external, the 
 serous vesicle, which is applied against the inner face of the zona 
 pellucida, and concurs to form the cliorion. 
 
 The middle layer will be noticed hereafter, and we now go to the 
 internal layer. The intra-fcetal parts of this so-called " mucous layer " 
 form the epithelium of the intestines and the glands belonging thereto, 
 the respiratory apparatus, the kidneys, and the bladder. These organs 
 are developed at the same time as the extra-fcrtal parts. 
 ♦^ In curving in upon itself, the embryo encloses a portion of the internal 
 blastodermal layer, but the union between the free and the imprisoned 
 parts is at first largely maintained ; soon, however, it contracts, and in 
 
74 
 
 OBSTETRICAL PHYSIOLOGY. 
 
 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-fcetal portion ; and the 
 livihilical vesicle, vesicula alba, or extra-fcetal portion. These two 
 divisions communicate by the omplialo-mescnteric or vitelline duct. 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 
 alimentary 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 the umbilical vessels towards its borders. Becoming 
 
 Fig. 44. 
 
 Ovum about a Month Ou>. 
 
 1, Vitelline Membrane or Primitive Chorion, which has almost disappeared ; 
 •2, External Layer of the Blastoderm or Second Chorion ; 3, Allantois pene- 
 trating the Villosities ; 4, Umbilical Vesicle ; 5, Union of the Caudal and 
 Cephalic Processes, and Formation of the Cavity of the Amnion ; 6, Embryo ; 
 7, Allantois. 
 
 still more elongated, it passes through the umbilicus and spreads itself 
 over the inner face of the chorion, betw^een the latter and the amnion. 
 It is divided into two sacs by a constriction, the urachiis, at the 
 umbilical ring ; the inner sac is the smallest, and forms the bladder ; 
 while the external, the most voluminous, composes the ^jro^er 
 allantois. 
 
 We have now seen that the vitelline membrane, lined by the serous 
 vesicle, forms a complete shell around the ovum in process of develop- 
 ment ; and that the layers of the blastoderm eventually constitute three 
 membranous sacs, two of which envelop the embryo. These various 
 membranes constitute the " envelopes '' or " annexes " of the young 
 creature during utero-gestation, and in describing them it is usual to 
 include the " cord" composed of bloodvessels, as well as the capillary 
 ramifications which establish and maintain such important relations 
 between the mother and its offspring during this period. 
 
ArrEyn.tdKs of thk iw.tus. 
 
 SECTION II.— APPENDAGES OF THE F(ETUS. 
 
 The appendages or annexes, then, comprise the chorion, a membranous 
 envelope exactly adapted to the uterus ; the amnion, a second ovoid 
 sac included within the latter, and containing the fcetus ; the allantoic, 
 a n^embrane composed of two layers, wliich are spread over the external 
 face of the amnion and the inner surface of the chorion, and thus lines 
 the cavity formed by these two envelopes ; a small bladder of a pyri- 
 form shape, the umbilical vesicle ; the jylaccnta, a collection of vascular 
 tufts grafting the fcetus to the mother; and the umbilical cord, com- 
 posed of vessels that attach the foetus to the envelopes which contain it, 
 and which ultimately ramify in the placental tufts. We will describe each 
 of these in detail, as a correct knowledge of their anatomy is essential 
 to the comparative obstetrist. As before, we will take Solipeds as the 
 type of comparison. 
 
 Chokion. 
 
 The cJwrion, the outer envelope proper to the ovum, is found covering 
 it loosely at the earliest period of its existence, and corresponds to the 
 membrane lining the egg in oviparous animals. It is a vast mem- 
 
 Fig. 4r.. 
 
 Chobiox ok thk Mark .\t Mio-tkkm : Inklatkd. 
 
 A, Posterior portion occupying the Body of the Utenis ; V, Left Cornu plicated 
 and sacculated ; C, Right Cornu, longer than the left, and containing a 
 portion of the Fcetus. 
 
 branous sac, completely closed, and which, being moulded upon the 
 uterine cavity, resembles the uterus in form, having a body and two 
 cornua; the latter, however, are not co-extensive witli those of the 
 uterus. When the chorion is distended, its cornua show fine and deep 
 plica; or bulgings, like the caecum ; the cornua are always unequal in 
 size, that in which the fcetus is developed being of course the largest. 
 The external surface, otherwise smooth, is studded witii innumerable 
 small, red, short papilla? or " processes," which are formed by the 
 placental villous tufts. This papillary face adheres slightly to the 
 internal surface of the uterus, and between the two surfaces a trifling 
 quantity of brown or blood-coloured fluid is found. The inner face is 
 
76 
 
 OBSTETRICAL PHYSIOLOGY. 
 
 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 infundibulum 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. 46. 
 
 FcETAL Membranes of the Cow at Mid-term. 
 
 A, Uterus opened on its left side ; B, B, Cotyledons of the Uterus ; C, C, Placen- 
 tulse ; D, D, Allantois ; E, Vesicle of the Urachus ; 7, Amnion ; G, Um- 
 bilical Cord. 
 
 chorion may be divided into two laminae, the outer of which has been 
 called the cxochorion, and the inner the endochorion. 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 
 
APPENDAGES OF THE FtETrs. 
 
 77 
 
 arranirement closely resembles that of vegetables, each ceil containing 
 a distinct nucleus ; the villi have the same texture, but tlieir cells are 
 tilled with a granular matter. Tiie strength of the membrane is greatest 
 in the early ovum ; it is formed by the zona jicllucida, which is lined by 
 the external layer of the blastoderm. It is thought that the primitive 
 chorion disappears by resorption, and that this blastodermic layer 
 becomes the definitive chorion ; also that when the allantois lias spread 
 
 Fig. 47. 
 
 F(KTAL MrMBRANKS OK THK (Jo.AT AT Fri.I, Tl.MK: TwiNS. 
 
 A, Cervix of the I'teruM ; B, Ltft Cornu ; C, Kiirht Cornu ; J), Allantois of 
 one of the K.i'tuses ; K, Amni-.n „f ditto ; F, Portion of the I'terine Wall 
 left at the middle of its Body, where the Fa-tUHes come in contact ; G, I'nion 
 of the Two Chorions at the Cervix Uteri. 
 
 itself between the amnion and the external envelope, carrying outward 
 the umbilical vessels, this detinitive chorion becomes vascular, and 
 furnished with its numerous villosities. 
 
 Differences. 
 
 liuminants. 
 In Ruminants, the chorion corresponds to the internal face of the 
 uterus, whose form it repeats, and with whose surface it is more or less 
 
OBSTETRIC A L PHYSIOL OG Y. 
 
 in contact. The middle of its inner surface is united to the amnion 
 and the allantois by loose gelatinous connective tissue, so laminated 
 that it might be mistaken for different layers of membrane. It is only 
 covered by the allantois 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 w^hich effect a very important connection between 
 the latter and the chorion. These are the placentida, 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 
 sac. 
 
 Fig. 4S. 
 
 F(ETUS A.ND 1\KTAL MeMBR.\NES OF THE CaT. 
 
 a, a, Chorion ; h. Zonular Placenta ; (/, Umbilical Vesicle, with its Expansions, 
 f, between Amnion and Placenta, and g, its Pedicle of attachment to a loop 
 of small intestine ; li, Allantois ; Tc, Foetus. 
 
 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 
 i-elated 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 papillae ; so that placentation in this animal is dis- 
 seminated, though here and there, between the innumerable groups of 
 papilliB, are bare spots merely covered with epithelium, and there are 
 no papillae at its extremities. 
 
 Bitch and Cat. 
 In the Bitch and Cat, the arrangement of the chorion is similar to 
 that of the Pig ; it has no cornua, its extremities are obtuse, and its 
 
APPENDAGES OF THE FCETUS. 
 
 79 
 
 inner face is everywhere in contact with the allantois, though it does 
 not adhere closely to it. 
 
 Amnion. 
 
 The amnion is the second complete sac enveloping the fcutus. It 
 lloats freely in the chorial sac, to which it is only attached at a single 
 
 Tig. r.'. 
 
 FcKTl'S OK MaUK AM) ITS ExVKLOPES. 
 
 A, Chorial Sac ; C, Amnii)tic Sac withdrawn from the Allantoid Cavity, and 
 opened to expose the Fiutus ; 1), Infundilxiliun of the I'rachns ; V>, Allantoid 
 portion of the I'nibilical Cord : h, Portion of the Kxtcrnal Surface of the 
 Chorion destitute of Placental Villosities, and correnponding to the j)oint of 
 insertion of three pediculated llippomanes. 
 
 point, through the medium of the umbilical cord ; and it contains the 
 ftctus, which is fixed to its inner face by the same means. It is formed 
 by the external layer of the blastoderm. It envelops the embryo very 
 closely at an early period, and is continuous with the common integu- 
 ment of the foetus at the open abdominal parietes. At a later period it 
 
80 OBSTETRICAL PHYSIOLOGY. 
 
 is distended with 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 first 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 foetus. It exhales or secretes a fluid — the 
 liquor amnii — which bathes the foetus, and serves an important purpose 
 in intra-uterine life. 
 
 In the foetus, 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. Though 
 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 amniotic 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 extremities of the pouch, 
 corresponding to the posterior limbs of the foetus, is stretched into a 
 very short wide horn. 
 
 LiQUOK x\mnii. 
 
 The liquor amnii is an albuminous alkaline fluid contained in the 
 amniotic sac, in which the foetus 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 slightly 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 amniotic, 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 
 
APFEXDAdES OF THE F(ETUS. 81 
 
 that invests the young animal at birth, is due to the precipitation on its 
 skin of the mucus and yellow matter contained in this lluid. Hoppe- 
 Seyler gives its cliemical composition as water, holding in solution a 
 small quantity of casein, kreatin, lactic acid, grape-sugar, and saline 
 matter, and therefore resembling very dilute serum. 
 
 The «5t'5 of the //(/uor a??in»" are varied and important. It is not very 
 probable that it serves as nutriment for the fa'tus in the early period of 
 intra-uterine life ; though it has been found in the stomach of those 
 young animals which had been purposely fro/en in their membranes, and 
 then dissected ; portions of the hoof epithelium have also been dis- 
 covered in the fcctal stomach. It preserves an equable temperature for 
 the young creature; maintains the integrity of its exterior before the skin 
 is covered by the peculiar sebaceous coating ; favours its movements and 
 its development, by removing it from unequal pressure ; diminishes the 
 impression from sudden external movements and shocks, thus preserving 
 it from injury ; and allows it to obey the laws of gravitation. It also pro- 
 tects the mother from injury by the foetus, towards the termination of 
 gestation. During parturition, it protrudes the membranes ; is the primary 
 agent in dilating tlae os uteri ; shields tlie foetus from the direct action 
 of the uterine contractions, whose violence might compromise its 
 existence ; renders the dilatation of the os easy and prompt ; and, 
 finally, by lubricating the vagina, causes the passage of the fotus 
 through it to be more gentle and expeditious than it would otherwise 
 be. 
 
 Differences in the Amnion of other Animals. 
 
 Biiminants. 
 
 The amnion in Ruminants is similar to that of the Mare. It is eauly 
 separated into two layers, and shows on its inner surface, particularly 
 near where it invests the umbilical cord, a large number of whitr or 
 yellowish- white bodies. In the Cow these are sometimes elongated in 
 the form of papillae; at other times they exist in flattened, slightly 
 raised patches, about one-fourth of an inch long. Sometimes they are 
 single ; occasionally they are in clusters. They consist of large, flat, 
 nucleated cells, resembling a squamous epithelium ; it is concluded 
 that they are the seat of formation of a glycogenic material. Up to a 
 certain period of intra-uterine life they increase in size, and then 
 degenerate — their organization and development being in inverse relation 
 to the development of the liver, whose function they assume, with regard 
 to glycogenation. Externally the amnion is altogether in contact with 
 the allantois and chorion. 
 
 Puj. 
 
 It does not differ in the Pig. 
 
 Difch and Cat. 
 In the Bitch and Cat the amnion is entirely covered by the amniotic 
 layer of the allantois, to which it adheres in the same manner as in the 
 ^lare ; the two membranes are only separated by the umbilical vesicle, 
 and there is no trace of the pouch and vascular plexus seen in that 
 animal. In the amniotic liquid, crumbs of meconium are found towards 
 the end of gestation. 
 
 Allantois. 
 The allantois arises on the front part of the posterior extremity of the 
 mucous layer which is closing to form the intestine, as a growth of the 
 
 6 
 
82 
 
 OBSTETRICAL PHYSIOLOGY. 
 
 intestine, which proceeds very rapidly. It passes out where the ventral 
 laminae are still unclosed, in the region of the umbilicus, and reaches, 
 either mediately or immediately, the inner surface of the exochorion. 
 By the constriction of the umbilicus, it is separated into two portions 
 which communicate ; that within the body of the embryo is the saccu- 
 lated urinary bladder, with the uraclms 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- 
 cliorion. As a membrane it lines the 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 way it transforms the 
 chorionic sac into a kind of serous cavity, in which the amniotic sac is 
 enclosed like a viscus. 
 
 The inner, or amniotic layer, is so loosely united to the amnion, that 
 
 Fig. 50. 
 
 A, Foetus ; B, Cavity of the Amnion ; C, Cavity of the Allantois ; D, Um- 
 bilical Vesicle : 1, Chorion ; 2, Chorial Layer of the Allantois ; 3, Amniotic 
 Layer of the Allantois ; 4, Amnion ; 5, Urachus, the expansion of which 
 forms the Allantois ; 6, Pedicle of the Umbilical Vesicle. 
 
 a slight dissection or inflation will readily detach it. When inflation 
 is practised, the separated membrane presents a wavy appearance, from 
 the presence of numerous cellular attachments it has with the amnion ; 
 as the inflation is forced these bands tear with a noise like the crackling 
 of parchment, and with care the whole of the portion, which is equal in 
 extent to the amnion, may be removed. The chorial allantois adheres 
 much more firmly, and in some parts it can scarcely be dissected away. 
 Inflation, however, demonstrates its existence and continuity with that 
 on the amnion ; for if, after opening the allantoid sac by cutting through 
 the chorion and the layer covering it, we introduce a tube between the 
 two membranes — which 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 vrhere the vessels have almost 
 
Jf'I'/-:\f>.lf,'ES OF THE FCETCS. 83 
 
 become capillaries. If, instead of forcinfr the air towards the ramifica- 
 tions, it is sent in the contrary direction, it will be seen to pass to that 
 ])ortion of the membrane covering the umbilical cord, and insinuate 
 itself between the amnion and the layer of allantois enveloping it, thus 
 proving the continuity of the membrane. 
 
 As has been stated, the cavity of this sac is in communication with 
 the interior of the bladder by means of the nracJnis — a narrow canal in 
 the amniotic portion of the umbilical cord, and which widens at the 
 origin of the allantoidean portion, where its walls are continuous with 
 the amniotic layer of the membrane, as well as the chorial layer, after 
 being prolonged as a sheath around the cord. These arrangements 
 show the allantoid cavity to be a kind of urinary reservoir or dependency 
 of the bladder, the fundus of which is prolonged in an infundibular 
 manner as far as the umbilicus, to constitute the urachus, which follows 
 the umbilical vessels in the amniotic portion of the cord, and ends by 
 forming the allantoid cavity. 
 
 The structure of this membrane is slightly fibrous, with a layer of 
 epithelium ; it is thin and pellucid, and appears to be destitute of 
 vessels at a late period of fcetal life. It bears on its surface the umbilical 
 vessels, from the umbilicus to the chorion. 
 
 The allantois contains a fluid — the allantoic liquid — the quantity of 
 which, like that of the amnion, is greatest at an early period. It is 
 then colourless or slightly turbid ; but with the growth of the foetus it 
 gradually assumes a yellowish hue, until near parturition, when it is 
 brown. It presents somewhat the same physical properties as the 
 liquor amnii, and contains albumin, osmazone, a nitrogenous mucilagi- 
 nous matter insoluble in alcohol, a particular principle named allanto'inc, 
 which appears to be the urate of urea, with lactic acid, lactate of soda, 
 and phosphates of soda, lime, and magnesia. Allantoic acid is not 
 found in this fluid in Rolipeds. In addition to the large percentage of 
 water, there is a notable proportion of sugar at an early epoch of fcetal 
 life ; this, however, gradually and linally disappears towards the ter- 
 mination of gestation. 
 
 It is probable that before the fa-tal circulation is fully established, the 
 allantoid fluid serves to nourish the young creature, but that towards 
 the end of gestation it is a product of the urinary secretion of the foetus. 
 It is certain that as gestation approaches its termination, the renal 
 excretion of the young animal passes from the bladder along the 
 urachus, and deposits near the allantoic orifice of that tube a thick fluid 
 of a reddisli colour, and possessing a urinous odour ; it contains uro- 
 erithrin and hippuric acid. 
 
 The fluid contains, besides, whitish filaments, and small oval or 
 discoid masses of a brownish colour from the size of a pea to that of a 
 hen's egg, either floating about in the cavity or attached to the allantois 
 by a narrow pedicle. Sometimes they are very niimerous, and at other 
 times there is only one. From the fanciful notions attached to them in 
 ancient times, they were named the " hippomancs." Usually they have 
 the consistency and elasticity of gluten, are flattened, and are thinner 
 at the border than the centre. Those attached to tBe allantois are 
 generally pyriform, and their pedicle is narrower as they ai-e more 
 developed : proving that the loose bodies in the fluid were originally 
 appendages of the allantois. It is not improbable that they are inspis- 
 sated parts of the allantoic fluid which were originally deposited upon 
 the membrane. They contain much oxalate of lime. 
 
81 OBSTETRICAL PHYSIOLOGY. 
 
 Differences. 
 
 BiUminants. 
 
 In Ruminants the allantois is different to that of the Mare, being less 
 complex. It represents a very elongated cavity, the middle portion of 
 Mrhich is not extensive, and receives the insertion of the urachus ; while 
 its extremities, which are unequal, are 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 foetus, 
 even at birth, the allantois still communicates 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. 
 
 Laminated deposits, like the Jdppomanes, are found in the allantoic 
 fluid of Euminants, 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 it seems to pierce, while 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 
 cells, the size of lymph corpuscles, and quantities of granular particles 
 — being, in fact, histologically the same as the hij^j^onianes , 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 intestinalis, or vcsicida 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 with 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 portae. These are the two omphalo-mesenteric vessels. The 
 umbihcal vesicle in Solipeds is constantly present as a normal formation 
 in the earlier months of foetal development, being formed from the 
 extra-foetal 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 ultimately enclosed within the foetal abdomen. It is a. 
 
THH I'l.ACKXTA. Sf) 
 
 transitory organ, and in the last months of foetal 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, adhenng 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 foetus, 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 fcetus. 
 In some instances the chorion has been found perforated at its junction 
 with the umbilical vesicle, which was therefore in communication with 
 the cavity of the uterus. 
 
 Differences. 
 
 Ruminants and Pig. 
 In Ruminants and the Pig, the umbilical vesicle is longer than in 
 Solipeds ; it also bulges in the middle, and its ends terminate in a canal. 
 It is longest about the twenty-fifth day, and disappears very early ; no 
 traces of 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 ( ;/') comprised between the amnion, the inner layer of the allan- 
 tois (h), and the placenta (b) ; it is provided at its middle part with a 
 narrow pedicle (<j), which is prolonged into the umbilical cord and has 
 very vascular walls. 
 
 The Placenta. 
 
 The placenta varies extremely in different species. In Solipeds it is 
 constituted by a multitude of short villosities or filiform papilke, 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 verj- 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 uj) of a 
 principal arteriole and two veins, there being generally only a single, or at 
 most, a double, capillary loop. 
 
 The villosities of the fietal placenta, penetrating the newly-formed 
 crypts in the uterine mucous membrane, bring the capillary systems of 
 mother and fcetus into the closest relationship, only the very thin coats 
 of the vessels and the epithelium inter\-ening in the two circulations. 
 There is no fusion, vascular continuity, or direct communication 
 between the maternal and foetal 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 
 
86 OBSTETRICAL PHYSIOLOGY. 
 
 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 until the vascular intussusceptive 
 relations between 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. 
 Coic. 
 
 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 placentidc2, or " foetal 
 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 "placentse"; into these latter the foetal 
 processes are received. The maternal cotyledons are nothing more, as 
 has been stated, than appendages or thickened points of the mucous 
 membrane, whose utricular follicles, more numerous than elsewhere, 
 have become enormously 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 insufficient. ^ 
 They have been discovered in the foetus in process of formation, and 
 regularly disposed, beside the ordinary cotyledons. 
 
 Ghauveau's experiments have proved, that after all these placentulae 
 have been extirpated from the uterus of the px'egnant 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 
 has also stated that during pregnancy the number of cotyledons is 
 increased ; and Colin, in his Plii/siologie Comparec, 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 [harunkeln) on 
 the mucous membrane, and which had no corresponding relations with 
 the chorion. In one instance the ordinary cotyledons were entirely 
 
 ' In the Journal de Med. Veterinaire de Lyon, M. Strebel, of La Tour, Switzerland, 
 gives an instance in which there was absence of the uterine cotyledons in a Cow, and the 
 placenta was like that of the Mare. Conception took place, gestation went on favourably, 
 and parturition was normal. 
 
THK PLACENTA. 
 
 87 
 
 absent in an unimpregnated cornu, and in their stead were thousands 
 of the accessory processes grouped together in small clusters. The 
 whole of the lining 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 j^lacenta i^rcevia (Figs. 53, 54). Certainly, this kind of 
 •placenta prccvia in Cattle has not the disadvantages it offers in woman ; 
 for although a premature delivery may occur, a sufhciency of the 
 placenta always remains to maintain the nourishment of the foetus. 
 Serious hicmorrhage is likewise little to be apprehended in such cases ; 
 and even disconnection between the placenta foctalis and the placenta 
 uterina in the Cow causes no injury. This is not the case with the 
 human 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. 
 
 ToKTiON OK Chorion with Placentll.*: : Cow. 
 
 1, Chorion ; 2, Placentulae. 
 
 uterus of Cows which have been slaughtered and bled. Birnbaum 
 attributed these streaks to a plethora ex vacuo} 
 
 The accessory placentuko, 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 arranged in four 
 regular rows, in the gravid uterus, through the rapid increase of the 
 amnion towards the poles of the ovum, they lie somewhat closely to- 
 gether, and the accessory processes are placed between these rows in 
 an 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 
 their 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 
 resemble the ordinary cotyledons, their bloodvessels being arranged in 
 the same manner, while they are covered externally by a sheatli 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 oi-dinary coty- 
 ^ Untersuchungtn i'lf/er deu Ban dtr EihdiUe der Saugthiere, p. 90. 
 
OBSTETRICAL PHYSIOLOGY. 
 
 Fig. 52. 
 
 Accessory Placentul^ in a Cow's Uterus. 
 
 They appear like innumerable miniature cauliflowers growing from the surface 
 of the mucous membrane. 
 
 Fig. 53. 
 
 Accessory Placentul.e on the Cow's Uterus, constituting what is 
 KNOWN AS "Placenta Previa." 
 
 a, Internal Os ; b, h, Placentul^ ; c, c, Eadiating folds of Mucous Membrane, 
 from which the newly-formed Placentulte have sprung ; d, d, Two Normal 
 Placentae Uterinre ; e, e, Uterine Mucous Membrane. 
 
 I 
 
THE J'L.trEyTA. 
 
 89 
 
 leJons and the tinest caruncles. It may here be mentioned that the 
 ovum of the Cow in the first week of pregnancy is smooth. Franck 
 has never been able to discover the vascular semi-detached caruncles 
 which are afterwards developed through the prolonf:;ation of the blood- 
 vessels ; though they are found in the Canine species. He has, how- 
 ■ever, obsen'ed definitely-formed vascular chorion-cotyledons between 
 the fourth and sixth weeks of pregnancy. The interposed cotyledons 
 obsen'ed 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. 
 F(KTAi. Portion ok Placenta Pu.kvia. 
 n, n, Newly-fornifd F<ftal Placenti Pripvia, a Plactntule havintj been dcvc- 
 lopt-d on the Internal ()•»; f>, Blood-cli)t and portion of F<i'tal Membranes 
 which lay in thu t>3 ; r. Chorion. 
 
 mucosa by four digitations, fixing themselves in the so-called simple 
 follicles, according to Franck.^ 
 
 This excellent authority also points out, with regard to this circum- 
 stance, that in the vicinity of the uterine glands there are found small 
 follicles which are nearly always unobserved. The connection between 
 these chorial tufts and the uterine mucosa is extremely slight. 
 
 At a later period of pregnancy, there appear other caruncles in the 
 form of foetal tufts and cotyledons, which the previously developed and 
 prominent 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 
 ' DtiUjiche ZeUfchriJl j'tir Thiennediciii. 
 
90 OBSTETRICAL PHYSIOLOGY. 
 
 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 the corresponding uterine 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 
 
 Fig. 55. 
 
 Maternal and Fcetal CoxtLEDONS of the Cow. 
 
 A, Pedicle of the Maternal Cotyledon ; B, B, Maternal Cotyledon ; C, Fcetal 
 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 
 which they receive their bloodvessels, and their colour is nearly always 
 dark yellow ; altogether in shape, hue, and general appearance, they 
 are not unlike a morel mushroom. 
 
 The " foetal" or " chorial cotyledons " repeat the disposition of the 
 maternal cotyledons. They are bright-red concave patches, each 
 exactly fitting into the sinuses of the corresponding uterine processes, 
 with which they strikingly contrast in hue ; on their surface they offer 
 a multitude of long, conical, ramifying, or branched vilh, measuring 
 
THE PLACENTA. 
 
 91 
 
 from 4 to 6-lOths of an inch, \Yhich arc received into the depressions of 
 the maternal cotyledons. This ramifying or racemose disposition of the 
 chorial villi is peculiar 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, 
 To 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. ^ 
 
 COTTLKDON OK A Cow's UtERUS. 
 
 a a. Surface of F(ftal Chorion ; h h, lilood vessels of Fn^tal Chorion ; r r. Surface 
 of I'terine Mucous Membrane ; it d, Bloodvessels of ditto ; /, Secretion from 
 T'tricuKy (Jlands— Cotyledonous Milk— l>ftw.en Maternal and Futal Vessel.-, 
 and which is necessary to the Mutual Interchange of liases, and Nutrient, 
 Effete, and other Matters between Parent and Offspring. 
 
 The reticulated surface of the maternal cotyledons is homologous with 
 the decuhia scrotina of other mammals; but it possesses a flrmer texture, 
 and usually remains attached until the termination of gestation- -allow- 
 ing the fa-tal villi to be withdrawn from it at birth ; it is afterwards 
 
 ' We must not overlook the fact, that the txistence of the "uterine milk" in the 
 living pregnant animal has been denied by M. Colin (Trailv de Phi/Mioloi/if Comparce 
 rff.i Aiiiniaiix, 1872, vol. ii., p S70), who states that this fluid is simplv a product of 
 cadaveric decomposition, and is not found during life ; a.s he h.xs a«.sure<i himself in the 
 most evident manner, by opening the uterus of a pregnant Mare and Cow. It is not 
 found immediately after death, as he has demonstrated on many occasions in Cows an<l 
 Sheep slaughtered in the abattoirs at all j)eriods of gestation ; it is not even observed 
 after six, twelve, or twenty-four hours, or longer, when the surrounding temperature does 
 not favour decomposition. It is only when the placentie sp<>ntaneotisly separate, or are 
 disunited by slight traction, at a greater or le.ss time after death, accurdini; to circum- 
 stances, that the white or yellowisn-red coloured fluid appears between the chorion and 
 uterine mucous membrane. In proportiiui as decomposition has advanced, the fluid is 
 abundant. Colin therefore concludes that it is a product of softening and progressive 
 dissolution of the uterine mucous membrane and its cotyledons, as well as the placentse 
 themselves. 
 
•92 OBSTETRICAL PHYSIOLOGY. 
 
 shed or disappears in some obscure manner, and the caruncle again 
 assvimes 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 animals, 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 fcEtal 
 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. 
 
 Pig. 
 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 papillas being collected in small but 
 closely-grouped clusters. When uninjected 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 cori'esponding arrangement, and the arterial capillaries form a 
 fine network, the meshes receiving the villosities which carry the fcetal 
 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 foetal and maternal arterial capillaries. 
 The chorion is destitute of these papillae at its extremities, which are in 
 contact with the chorion of other foetuses in the uterus. 
 
 Bitcli 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 said 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 mucous 
 membrane in which these are situated, and w^hich 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 membrane in 
 Carnivora secretes a kind of plastic lymph, which forms this caducous 
 lining, or membrana decidua ; but it is only present at a certain period 
 ■ of fcEtal life, and forms the base of the uterine placenta. 
 
THE UMBILICAL CORD. 9S; 
 
 Functions. 
 
 The functions of the placenta are obvious : it is the nutrient and 
 respiratory apparatus durin<^ a portion of intra-uterine existence ; and 
 for the acconiphshment 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 oil' 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 suthcient 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 
 placenta?, 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 fa^tal envelopes. 
 
 It has, therefore, been thought useful to arrange the domesticated 
 animals 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 " localised." This arrangement and sub- 
 division may be expressed as follows : — 
 
 Single Placenta 
 
 Multiple Placenta 
 
 Diffused 
 Zonular 
 
 Horse. 
 Pig. 
 Dog. 
 Cat. 
 j Cow. 
 Localised • Sheep. 
 
 ( Goat. 
 
 U.MIilLICAL CouD. 
 
 The umbilical cord, funis, or navcl-strimj, is a collection of vessels 
 which form the means of connnunication 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 fuutus 
 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 allantoic 
 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 a.nd 
 a vein, which are embedded in embryonic connective tissue ( Whartonian 
 gelatine), ih^t make them appear more voluminous than they really are. 
 This " Gelatine 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|)ortion of the cord, where they give off some branches 
 
I 
 
 4fe 
 
 amumozii i 
 
 TTvrrtiiTfr- i_^. 
 
 nrrrm ir init 
 
 til r.cn tii'' . '>RTn;rnr gnn?- 
 
 SttL, vvilit i if^ TOniiL "Cite- b:k 
 
 332: 
 
 
 
 /FrftTfT ii fiin ^tv;^ imnlrr j^sffi: ir _ ^^iSTfe mic tTT^R^ siiol incL uri it vrr 
 
 i' --•;-- -^,- . — - T Mt*tT(nn i.ft, I — ^ i__ ' ~^ "-"^^jjg fTrmrrrT<r ffxnprryf^ tv. • ±^rip > 
 
 ■i' - TTEKr Tmrrn'riTTrff, - . uiT«r -chf umhwtCELi iTEtBH, 
 
 ix. . -lit rrrTHr - -HLTrtmg?^ CT 11- ;. -iri rrmTTHi," T^aill TvisH- il ZB 
 
 X* " -'"- 'lEL. mill tJE -Wi.iri rrtr - iTt^f- Itt^T -SHEaS mHCI (irwi.ri in?) 
 
 ■XT- ' -£!IH«. TJHrESb. ^ ^u ' mf XT "_ • 7irm n jtKPQSEBB 
 
 f ^"TTTOOt H; TIF- Tn-pc»'»-iTT' ■■ _ - - - - :j. xrmr rVt. TffifraLl 
 
 ( 
 
 X 
 
 it- 
 
 i- 
 
 1- 
 
 
 
 TT1 Tra^ ^JTTKII- 
 
 ':■ ■■ gufi iiff 
 JS y.i wTii.im.Tn r -cut "rnTtfrrff . ni -JirrF iiffliifitar. SCofi rm 
 
 - -.^ .' • - frmcbif IE Tie- 
 
 lacmHiii 
 
 . .T ■■• : \'. '■-■' - -^ iram ihw 
 
 'S^aiVu 
 
 

 Ib. :iift ?^ "imt aawaBsntasc it ititt •saad, is zbt^ smaat: jb ji 
 
 3r 
 
 T"-.-" -,i- r 'ij: r- ---^ ._i r* 'iiac Tffl 'isdnKt^: ~ -i.x- 
 
 rBsneir aanir. moo. ijireaar 
 
 — nunsffr 
 
 
 r^V-^MEtfas OK; JB 
 
 ""TEUXi. 
 
 
 
 - 31 TWO 
 
96 OBSTETRICAL PHYSIOLOGY. 
 
 not complete, and hernia of the intestines exists at birth, or even for 
 some time after 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 foetus — it has been held by some authorities that this is only acci- 
 dental, and depends on the movements of the foetus 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 improbable, however, that the twisting can be due to 
 muscular movements of the foetus ; as it is unlikely these should be 
 entirely, or even mostly, in one direction. It has 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 foetus or the 
 mother would be taken advantage of, the cord and foetus revolving 
 together until, with the growth of the latter, the friction of the amnion 
 puts an end to the rotation. It does not appear that any advantage 
 accrues to either foetus or mother from the torsion of the cord ; on the 
 contrary, it increases the resistance to the flow of blood, and also 
 augments rather than diminishes the danger of stoppage of the circula- 
 tion by accidental pressure. Examination of non-displaced foetuses 
 proves that it is far from being constant. 
 
 At birth, the umbilical cord is usually torn or gnawed through at a 
 short distance from the umbilicus of the foitus ; the remaining portion 
 dries up, dies, and falls off in a few days. 
 
 SECTION III.— DEVELOPMENT OF THE ECETUS. 
 
 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 teratology — 
 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 lanmice, which 
 are in xQ^Miy the j^roto-vertebra , or first rudiments of thevertebrge. Each of 
 these masses is perforated by a small opening, and is resolved into three 
 portions — the proto-vertebral cavity, the muscular lamina, situated above 
 the cavity, and the proto-vertebra placed below the cavity. The muscular 
 lamincB, 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-vertebrce, bend upwards and downwards 
 on each side, so as to enclose the proto-vertebral cavity or spinal canal. 
 
hEVELOVMKXr OF THE FaUCS. 97 
 
 and the dorsal cord ; the upper ring represents the rudiments of tlie 
 annular portion of the vertebrir, while the lower ring and the dorsal 
 cord constitute the vertebral bodies and the discs uniting them. 
 
 The lateral lamince arise from the portion of tlie middle layer of the 
 blastoderm placed on each side of the vertebral laminte. In the region 
 of the trunk tliese lamiuic are separated for a certain time fi-om the 
 latter; but in the cephalic region they are always adherent to them, 
 and at this part they are usually designated the cephalic lam'nue. The 
 'proper lateral lamime are divisible into two layers, external and internal, 
 united by a viiddlc layer ; they comprise between them a space which 
 becomes the plcuro-peritoneal cavitij, after the formation of which the 
 lateral are joined to the vertebral lamina. The internal or fihro-intes- 
 iinal layer envelops the deeper portion of the blastodermic layer or 
 intestinal furrow, the umbilical vesicle, and the allantois ; it constitutes 
 the tibrous and vascular parts of these membranes, and carries the ves- 
 sels to the inner face of the chorion. The external or cutaneous layer 
 is developed in two ways : above, it glides between the muscular laminie 
 and the fa^tal portion of the external layer of the blastoderm to form 
 the cutaneous envelope on the back ; below, it separates into two leaves 
 which receive between them the prolongations of the muscular lamiucC 
 destined to constitute the intercostal, abdominal, and other muscles of 
 this part of the body. Of these two secondary leaves, the external 
 forms the skin of the trunk, and the internal the parietal layer of the 
 peritoneum. The cutaneous lamin® also furnish an extra-foetal pro- 
 longation — the fibrous layer of the amnion. 
 
 The middle or mesenteric lamime join at the median line, and in their 
 substance are developed the Wolttian bodies, or antecedent deciduous 
 kidneys, and the principal vessels of the trunk. 
 
 The cephalic lamina:' always remain adherent to the vertebral laminae, 
 and are inflected inwards with them to form the anterior part of the 
 cephalo-intestinal cavity, which is divided into two compartments — the 
 pharyngeal and a'sophageal cavities. Tlie pharyngeal cavity opens 
 externally by the mouth, and is partly enclosed on the sides by the 
 pharyngeal arches. The a-sophageal cavity soon shows a diverticulum, 
 which is not long in communicating with the pleuro-peritoneal cavity, 
 and subsequently contains the heart ; it is therefore named the cardiac 
 cavity. The cephalic lamina} also form the derm of the cranium, and 
 the fibrous layer in which are developed some of the cranial boues. 
 
 The Nervous System. 
 
 The development of the nervous system comprises the growth of the 
 brain, spinal cord, and nerves. The initial steps in the development of 
 the brain and cord have been already indicated. At each extremity of 
 the medullary cavity, which is a modification of the median furrow, is a 
 slight bulging. From the posterior, or rhomboidal sinus, the sacro- 
 lumbar nerves are given off, while the anterior gives origin to the brain. 
 This anterior enlargement appears as tlirce successive dilatations named 
 the cerebral vesicles or cells, which are distinguished as anterior, middle, 
 and posterior. They are filled witli fluid, and the middle slightly sur- 
 mounts the other two, which gives the whole the figure of a small 
 triangular mass. The vesicles increase irregularly in volume, and their 
 walls, in developing, form the nervous tissue ; while their cavity persists 
 and becomes the space observed in each portion of the encephalon. The 
 anterior vesicle represents the cerebral hemispheres, the thalami optici 
 
 7 
 
98 OBSTETRICAL PHYSIOLOGY. 
 
 and the lateral ventricles. The middle vesicle forms the crura cerebri, 
 corpora quadrigcmina, and the aqueduct of Sylvius or middle ventricle. 
 The posterior vesicle gives rise to the medulla oblongata, p>ons varolii, 
 cerebellum, and fourth ventricle. The middle vesicle increases more 
 rapidly in volume at first 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 lucidem, and the convolutions are 
 apparent on their surface: while the corpora quad rig em i na emd crura 
 are well defined. At a later period the cerebellum is seen, as well as 
 the 2M US Varolii, corpora restiformia, and corpora pjiramidalia. 
 
 "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 middle of the sacrum in the Equine 
 foetus, but ascends higher in the other species. During this apparent 
 ascensional movement is developed the filum terminals, and the termi- 
 nating nerves of the cord (cauda 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 epithelium of the central canal ; and an 
 external, the grey substance of the cord. Gradually 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 well as the spinal 
 ganglia, which are developed at the expense of the proto-vertebrae ; the 
 superior roots are not distinguishable for some time after. The envelopes 
 of the nervous centres are furnished by the proto-vertebral laminae, 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 gangha are formed 
 separately in the proto- vertebras, 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 nei^ve tissue 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 
 primary ocular vesicles, traces of the ocular globes ; the hollow prolong- 
 ments form the optic nerves, and the vesicles furnish the choroid layer 
 and retina. The crystalline lens, vitreous body, cornea, and sclerotica 
 
DEVELOPMENT OF THE FCETUS. 99 
 
 are derived from the external blastodermic layer. The part of the 
 integument not required to forn: the lens constitutes the envelope of the 
 globe. The latter forms the sclerotica and cornea ; while the epiderm 
 furnishes the epithelium to the latter, which becomes distinct from the 
 sclerotica in about the fourth month. A slit occurs at the lower part of 
 the fibrous envelope of tlie globe ; this is related to the development of 
 the vitreous humour, a prolongation of the derm passing through this 
 slit and entering between the lens and the anterior wall of the secondary 
 ocular vesicle which appeared shortly before. There this prolongation 
 becomes developed and transformed into the vitreous humour, wliich at 
 cue period is surrounded by vessels, but shows none immediately before 
 birth. It exhibits in its centre a transverse canal, which lodges a 
 branch of the arteria centralis of the retina. 
 
 The optic nerve is developed in the pedicle connecting the ocular 
 vesicle with the anterior cerebral vesicle, and the rci'ina is formed by the 
 inner layer of the secondary ocular vesicle ; it extends to the lens in 
 changing its character in front. The choroid coat is constituted by the 
 posterior layer of the ocular vesicle ; it extends as far as the lens, and 
 is then inflected in front of that body to form the iris. The borders of 
 the pupil embrace the vascular envelope of the lens, and the anterior 
 face, as well as this pupil, is covered by a very vascular membrane, the 
 viemhrana i)upillaris ; behind it is the equally vascular covering, the 
 mcmhrana capsulo-pupillaris, that passes through the pupil to the lens to 
 envelop it in a kind of sac that disappears towards the end of gestation. 
 Previous to this time this aperture is very wide ; but as the iris is 
 developed the pupil contracts, and the vessels of the vascular or 
 pupillary membrane diminish in size and number, until at last only a 
 few are seen crossing the transparent membrane. 
 
 The protective and motor apparatus of the eye is gradually developed 
 around the globe. The eyelids are small cutaneous folds which are 
 formed in the first third of uterine life, and grow and unite by their 
 margins until a short time before or after birth, according to the species, 
 when they separate. They are maintained closed by a thin membrane, 
 which disappears in Solipeds, Ruminants, and the Pig, before birth ; but 
 in Carnivora it remains until some days (eight or ten) after that event. 
 So long as the lids are closed, the conjunctiva is only a sac comnmni- 
 cating with the lachrymal canal. The crystalline lens in the fcetus and 
 new-born animal distinctly shows the three septa peculiar to it ; three 
 diverge from each pole at angles of 120'. The lachrynial gland is an 
 appendage of the epithelial layer which is intruded above the globe ; 
 at first compact, it becomes gradually excavated into cavities, from 
 which arise the excretory ducts. 
 
 The auditory apparatus, consisting of the intei*nal ear, auditory nerve, 
 and middle ear, is developed separately. The labyrinth appears in the 
 form of a vesicle which is not in direct relation with the posterior cere- 
 bral cell, but is constituted by a depression of the epidermic layer — tbe 
 auditor]! fossa — that becomes more and more marked until it is finally 
 a closed cavity. At this time the wall of the labyrinth is only a simple 
 epithelial membrane ; but this is soon increased externally by a con- 
 nective membrane which vascularises it, and then gives rise to three 
 layers : an external, which adheres to the epithelium to form the mem- 
 brane of the labyrinth ; an external, that lines the labyrinthic cartilage; 
 and a middle, whose soft embryonic connective tissue disappears and is 
 replaced by a fluid, the perilymph. At the same time that these 
 
100 OBSTETRICAL PHYSIOLOGY. 
 
 changes of structure are taking place, the vesicular shape of the laby- 
 rinth is modified, and shows the cochlea, semicircular canals, utricuhis, 
 and saccuhis. 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 ^y??z_/;a?z?r?H, while the 
 inner cavity forms the middle car and Eustachian tube, and the external 
 portion the external auditory canal or meatus. The ossicula auditus are 
 at first cartilaginous, and appear towards the third month ; after which 
 thev gradually ossify, and have nearly assumed their definitive shape at 
 birth. 
 
 The concha is developed beneath the integument after the second 
 month. 
 
 The organs of smell begin by two depressions in the epidermic layer, 
 analogous to the crystalline lens and auditory fossettes. These two 
 olfactory fossa appear below the ocular vesicles, and, becoming deeper, 
 their depth is further increased by granulations which spring up on 
 their borders. Behind, they communicate with the pharynx, and the 
 formation of the palate separates them in front from the buccal cavity. 
 From this time the nasal fossae are constituted and completed by the 
 development of the bones of the face. The olfactory lobes and nerves 
 are at first tubular, and are related to the anterior cerebral vesicle. 
 In the young foetus the nostrils are formed by a collection of mucus 
 and epithelium ; they open towards the middle period of gestation. 
 
 T]ie Skin and its Appendages. 
 
 The skin and its appendages, which might be designated the tactile 
 apparatus, are developed by the epidermic and middle layer of the 
 blastoderm. The cutaneous laminae, by the modification of their ele- 
 ments, form the derm, in which vessels are readily seen after three 
 months. In the epiderm it is not long before the mucous and horny 
 layers can be distinguished ; in the first, pigment cells are observed at 
 the commencement of the fifth month in the lai'ger quadrupeds. The 
 epiderm is easily detached from the derm ; it forms a peculiar white, 
 completely-enveloping pellicle on the surface of the latter, apparently 
 separated from it by the growing hairs. Frequently we find the integu- 
 ment covered by a special coating that looks like varnish (the varnix 
 caseosa) ; this would appear to be intended to protect the epidermic 
 epithelium from the destructive solvent action of the alkaline amniotic 
 fluid. It is very abundant on the human foetus at all periods, but is 
 not found on that of animals so long as the skin is glabrous. As soon 
 as the hairs begin to appear, the epiderm is partially detached in the 
 form of the thin pellicle just alluded to, and the decomposition of which 
 gives rise to an appearance like varnish. It is best seen in the foetal 
 Pig, the hairs on the skin appearing all at once over the body ; in the 
 other domesticated animals they are only developed successively, and 
 consequently the shedding of the epiderm occurs partially and in 
 patches, which are insensibly confounded with the normal epidermic 
 layers. Microscopically, these flakes offer the same characters as 
 epidermis removed by a vesicant ; the points where the hairs have 
 passed appear as regular infundibuliform openings. When the fcEtus 
 increases in volume the epiderm desquamates, and the debris floats in 
 the amniotic fluid. 
 
DEVELOI'MEXT oh' THE FlETUS. 101 
 
 In the third month, the hairs are perceptible on the fcetus of the 
 Mare and Cow. Hair folhcles have been observed in embryos of the 
 Pig which did not measure more than two inches in length. They first 
 appear about the eyebrows, lips, and joints of the limbs, and the whole 
 of the body is covered at the sixth or seventh month ; they are usually 
 observed in the fa'tus of the Mare and Cow around the lips, towards 
 the eighteenth week of gestation. The hair may be shed and renewed 
 before birth, for it has been found in the amniotic fluid and in the 
 stomach of the fcctus. Each hair is developed in a prolongation of the 
 epidermic layer which is imbedded in the substance of the derm ; this 
 prolongation is constituted by a bottle-shaped mass of cells. In the 
 centre the cells are modified and heaped up, so as to form a small cone 
 whose base covers the growing papilla ; this cone elongates, until it 
 touches the superficies of the epidermis, when it becomes bent in the 
 effort to push itself through, but, finally, it issues beyond the surface, 
 where it may grow freely. 
 
 The sebaceous and pcrspiraiorji glands are developed in a similar 
 manner, at the middle period of uterine life. The horny productions, 
 such as the claws, lioo/s, enjots, and cJicsniits, are apparent at an early 
 stage. Towards the end of the second month there can be perceived in 
 the foetus of the Cow, at the extremity of each digit, a small, pale, and 
 transparent conical tubercle ; this is the rudiment of the claw. The 
 hoofs of Solipeds appear towards the twelfth week, and about the com- 
 mencement of the fourth month they are more developed ; their texture 
 has become firm and opaque, whereas before it was gelatinous and 
 transparent, and has assumed a fine yellow tint. They are always 
 soft, however, until birth, in order to guarantee the integrity of tlie 
 fa'tal envelopes. At mid-term, brown or black patches appear, if the 
 coronet is pi-ovided 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 
 fa^al 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 papilhc of the coronary cushion 
 and plantar surface of the foot of Solipeds and Ruminants, giving it that 
 fibrous appearance which is so striking during extra-uterine life. 
 
 The Loconwtorij Apparatus. 
 
 The development of bone, and with it the locomotory apparatus in 
 general, next demands our attention. Bone is developed in the blastema 
 or primitive basis — a transparent glairy mucous matter containing 
 numerous minute corpuscles. This progressively acquires increased 
 firmness, sometimes assuming a membranous or ligamentous condition, 
 usually of a gristly consistence before its conversion into bone. The 
 change into cartilage is denoted by the appearance of minute nucleated 
 
102 OBSTETRICAL PHYSIOLOGY. 
 
 cells, which increase in number and size, and are aggregated in rows, 
 with intercellular tracts where the ossification is about to begin. These 
 rows, in the cartilaginous basis of long bones, are vertical to its ends ; 
 in that of flat bones they are vertical to the margin. The cells furthest 
 from the seat of ossification are flattened and in close contact ; nearest 
 that seat they become enlarged and separated. The first appearance of 
 bone is that of minute granules in the intercellular tissue. Canals are 
 next formed in the bone, by absorption ; these ultimately receive blood- 
 vessels, and become the " vascular canals." The immediate nutrition 
 of bone is provided for by the production of minute "plasmatic canals," 
 " lacunae," or " bone-cells " from the vascular ones. Ossification begins 
 at the centre of round bones, and proceeds towards the surface ; in flat 
 bones it extends between two membranes, and from a central point 
 towards the periphery ; in short bones, towards the circumference; and 
 in long bones, from a central point or diapliysis, towards another 
 centre — the epiphysis, situated at each end. Particular parts or pro- 
 cesses are furnished with a separate centre of development, named the 
 aporihysis. Length occurs at the extremity of the diaphysis, and bulk 
 by deposition on the surface, the medullary canal of certain bones being 
 due to internal absorption. 
 
 The spina is the first portion of the skeleton observed in the embryo, 
 it being represented by the chorda dorsalis, which is composed of a mass 
 of cells in the interior of a transparent sheath. The proto-vertebraB 
 appear on each side of the cord, and ultimately enclose it and constitute 
 the spinal canal ; in this way results the external sheath of the cord, and 
 the superior uniting membrane. The vertebral stalk now exists as a 
 membranous axis, but not for long, as it becomes segmented in order 
 to form the vertebras, and these segments are gradually converted into 
 cartilage. Each persistent vertebra does not correspond to a proto- 
 vertebra, the latter dividing into two portions to constitute two 
 vertebrae. The body of the vertebra is developed more quickly than 
 the spinous portion ; at the end of the second month all tiie vertebral 
 bodies are cartilaginous, while the laminae are yet in a membranous 
 condition. In the third month ossification commences, and during this 
 process the dorsal cord disappears, except between the vertebrae, where 
 it is developed to form the intervertebral fibro-cartilage. 
 
 The /ace and cranium are formed by a membrane that envelops the 
 encephalon, and which is due to the proto-vertebral laminaB. This 
 cranial membrane becomes partly cartilaginous and partly fibrous, the 
 cartilage existing at the base of the cranium, and appearing to be a 
 prolongation of the bodies of the vertebrce : indeed, there is a resem- 
 blance between a vertebra and the cranium, in so far as the latter can 
 be resolved into four portions, each corresponding to a vertebra. This 
 cartilage is slowly transformed into bone ; while the fibrous part, 
 answering to the roof and sides of the skull, passes directly into the 
 osseous state. The bones of the face are formed by the j^haryngeal, 
 branchial, or visceral arches — a name given to four laminae which, 
 springing from the anterior extremity of the dorsal cord, curve down- 
 ward to meet those of the opposite side ; the spaces between them are 
 named the " pharyngeal clefts." The upper jaw, mouth, and nasal 
 cavities — composed by the nasal, maxillary, and palate bones— come 
 from the first pharyngeal arch ; while Meckel's cartilage, which passes 
 from the handle of the malleus towards the lower jaw, is also an ap- 
 pendage of it. This cartilage disappears about the sixth or seventh 
 
l>KrKI.(il'.\(KXT or THE FiLTl'S. 103 
 
 month. At tirst the mouth communicates with the nasal cavities ; the 
 palate is developed in two portions, which advance towards eacli other, 
 but remain for some time apart ; so that during this time the young 
 animal has a cleft palate.^ The second phai-yngeal arch forms the 
 stapes, the petrous portion of the temporal bone, the styloid arch and 
 the hyoid branch. The third originates the hyoid bone with its 
 cornua, while tiie fourth only constitutes the soft parts in this region of 
 the throat. 
 
 The thorax, consisting of the ribs and sternum, is an appendage of 
 the proto-vertebral lamiuio, 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 altogether, 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 vertebra}, 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 vertebrae, 
 and which is soon lost in the substance of the abdominal parietes ; in 
 Birds this body assumes large dimensions on the last cervical vertebrue. 
 
 The shape of the thorax differs with species, being round in some 
 and oval in others, but it is always less developed in the foetus than in 
 the young or adult animal. 
 
 The 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 either simple or divided, according to the foot of the species. 
 In these prolongations the cartilaginous segments are formed, which, 
 when ossified at a later period, constitute the bones of the limbs. 
 
 The muscles are divided into four groups, after their origin. They 
 are the vertebral juusclcs, which arise from the muscular laminae of 
 the proto-vertebrai ; the visceral 7nusclcs for the thoracic and abdominal 
 cavities, the neck and jaws, and having the same origin ; the cutancoics 
 muscles, which originate from the cutaneous lamina; of the middle layer 
 of the blastoderm ; and the muscles of the limbs, the development of 
 which is not fully understood. 
 
 It was believed at a certain period, that the muscular fibres are 
 formed by the joining together at their ends of several elongated cells. 
 It is now known that each fibre is constituted by a single cell which 
 extends in length, and whose nuclei are multiplied and placed at the 
 surface ; while the contents are transformed into a substance that pre- 
 sents all tlie characteristics of contractile tissue. The sarcolemma is 
 formed after the fibre, by a modification of the connective tissue sur- 
 rounding it. 
 
 The locomotory apparatus of the majority of the domesticated species 
 of animals is so developed at birth, that immediately after that event 
 the young creature can move with more or less alacrity. With the 
 
 ' This cleft condition of the palate would sometimes appear to persist after ffctal life. 
 In April, 1876, at the Middle Park Stud, in Kent, I saw a thoroughbred Foal with a 
 cleft palate. It was being s^uckled, and a portion of the milk, instead of passing down 
 the cpsophagiis, escaped from the nostrils. It was this unusual course of the milk which 
 led to the detection of the abnormality. 
 
104 
 
 OBSTETRICAL PHYSIOLOG Y 
 
 larger herbivorous quadrupeds, the Hmbs of the new-born animal are 
 long to enable it to reach the teat, as well as to enable it to escape by 
 flight should danger be apprehended. 
 
 The Circulatory System. 
 The development of the circulatory system is not apparent until some 
 days after the appearance of the embryo in the blastodermic layer, there 
 being no trace of vessels in the germinative space. It is not long, how- 
 
 m 71 
 
 Fig. 57. 
 
 FcETAL Circulation in a Transition State. 
 
 a, b, c', Circle or Envelope resulting from the Fusion of the Vitelline Membrane, 
 External Layer of the Blastodermic Vesicle, and the Transformation of the 
 Allantois ; c, The Diminishing Umbilical Vesicle ; d. Cephalic Portion of the 
 Embryo ; d', Caudal Portion ; e, Ventricle of the Heart ; /, Auricle of the 
 Heart ; i, Aorta, forming the Aortic Arches ; h, Trunk representing the 
 Thoracic Aorta ; g, Vessel which becomes the Anterior Vena Cava ; k, Vena 
 Azygos ; I, Confluents of the two Veins g and k ; m, Confluent of all the 
 Veins at their Entrance into the Auricle of the Heart ; n, Vessel resulting 
 from the Union of the Allantoid Veins p, p, and the Omphalo-Meseraic 
 Vein q ; o, Posterior Vena Cava ; p, p, Allantoid Veins ; q, Omphalo-Meseraic 
 or Umbilical Vesicle Vein ; r. Posterior or Abdominal Aorta ; s, s, Allantoid 
 Arteries ; t, Omphalo-Meseraic Artery. 
 
 ever, before the central organ of circulation and some vessels appear in 
 the middle layer, and canals also spread to the surface of the umbilical 
 vesicle. While the contents of the vitelline vesicle are being imbibed 
 by the embryo, the heart is in course of formation ; bloodvessels are 
 increasing and extending, the allantois is completed, and, finally, the 
 placental circulation is established and continues until birth. 
 
 The pleuro-peritoneal cavity in the embryo shows a diverticulum in 
 
DKl'KLnI'MKXT nF THE FCETUS. 10'. 
 
 front — the cardiac cavity, in the interior of wliich the heart is 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 relaxes alter- 
 nately, the movements being very slow, though they gradually become 
 accelerated. Towards the twelfth day the organ has the shape of a 
 cylindrical contractile 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 simjlc aorta, which in its turn divides into two branches 
 — the subrertebral or common aortie — which run parallel along the 
 lower surface of the embryo, giving off four or live branches, the 
 omphalo-meseraic arteries, which ramify in the germinative area and 
 end in a vein — the terminal sinus. From this ramification and sinus 
 arise two vessels, the omphalo-vicscraic veins, which return to the 
 posterior extremity of the heart. The circulation in the umbilical 
 vesicle is very ephemeral in several species, while it is as persistent in 
 others ; varying, of course, with the duration of the vesicle itself. 
 
 The heart, from being merely a cylindi"ical 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 points — one anterior and superior, at the origin of the aorta, 
 named the aortic bulb ; a middle one, the ventricular cavity ; and a 
 posterior, the auricular cavity. The constriction between the auricle 
 and ventricle is named Hallcr's passage {d&troit). 
 
 These two cavities are single only for a brief period ; the ventricular 
 first divides into two — a division marked externally by a fuiTOw which 
 is visible on the surface of the heart of a foetal 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 
 auricula-ventricular 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 ; 
 for the auricle becomes partitioned into two portions, and externally this 
 division is marked by anotlicr depression, corresponding to the septum 
 formed in the cavity. It is to be remarked, however, that the partition 
 remains incomplete during the wliole period of uterine life, being per- 
 forated by an opening — the Joranwn ovale or foramen of Botal. The 
 aortic bulb now contracts and forms two vessels — the aorta and pul- 
 monary artery. 
 
 The arteries are developed, partly at the expense of the primary 
 circulation, and partly 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, w-hich are placed within the other arches ; all 
 these, however, do not exist at the same time, some becoming atrophied 
 while the others are forming. For instance, the first two completely 
 disappear ; the third forms the carotids ; the fourth, the axillary artery 
 and the arch or cross of the aorta ; the fifth is atrophied on the right, 
 but on the left forms the pulmonary artery, the ductus arteriosus, and 
 the aorta. The latter is continued along the spine by the fusion of the 
 
106 
 
 OBSTETRIC J L PH 1 'SIOL 00 V, 
 
 two primitive aortae, 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 interior 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. 
 
 Fig. 58. 
 
 FcETAL Circulation : Advanced Period. 
 
 A, Placentulfe ; B', B', Umbilical Veins, with their Common Trunk, B ; D, Vena 
 Portse, and its Anastomosis, C ; E, Ductus Venosus ; F, Posterior Vena 
 Cava ; G, Right Ventricle of Heart ; H, Pulmonary Artery ; J, J, Aorta ; 
 I, Ductus Arteriosus ; K, Umbilical Arteries, with their Anastomosis at the 
 extremity of the ITmbilical Cord. 
 
 The umbilical veins are developed immediately after the formation of 
 the omphalo-meseraic veins, and join these ; as the ramifications of the 
 latter diminish in size the former increase rapidly, and when the liver is 
 formed around them they throw into it those branches which are the 
 rudiments of the hepatic plexus. Between the portal and hepatic 
 veins, the umbihcal vein communicates with the vena cava by the 
 ductus venos^Ls of Aranzi, which does not exist in the foetus of Solipeds 
 in the last month of gestation. The embryonic veins form four chief 
 trunks — two anterior, the anterior cardinal veins ; and two posterior, the 
 
DEVELOrMEXT OF THE FCETUS. 107 
 
 postcrior cardinal veins. The veins on each side unite in pairs to form 
 the ductus Cuvieri, which opens transversely into the omplialo-meseraic 
 trunk 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 
 cava. 
 
 The posterior vena cava appears in the liver about the fifth week ; it 
 receives the veins of the kidneys and the Woltlian bodies, and behind 
 it anastomoses with the cardinal veins. 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 caixlinal 
 veins for the two extremities — the anterior which enters the ductus 
 Cuvieri, and the posterior which constitutes the hypogastric and crural 
 veins. It therefore happens that the venous system of the foetus, which 
 was at first symmetrical, becomes asymmetrical in the adult animal. 
 
 As a result of these 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 foetus. This 
 fluid, carried by the arterial vessels, reaches tlie umbilical arteries, and 
 from them is distributed to the placenta. There it is respired, depurated, 
 or arterialised, 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 vcnosus, and is finally thrown into tlie 
 right auricle, then into the ventricle, whence it is expelled by a contrac- 
 tion of that cavity. Instead of entering the lungs, which do not act 
 during fcctal 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 veiiosus. The head and neck receive the purest 
 blood, a circumstance which probably explains the predominance in 
 size of the upper to the lower parts of the body of the fa^tus. 
 
 At birth, the conditions of existence being suddenly changed, very 
 marked modifications occur in the circulation. The lungs then become 
 tlie 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 flow of blood, and the 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. 
 This opening, however, not infrequently remains intact in young 
 animals ; though, as a rule, tliis does not greatly affect the circulation, 
 for when the heart contracts the auricles are isolated by the narrowing 
 of the orifice and the elevation of a valve. 
 
 The Bespirator;/ Apparatus. 
 
 There is an absence of unanimity as to the mode of development of 
 the respiratory apparatus, and particularly the lumjs. 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 OBSTETRICAL FHYSIOLOGY. 
 
 perforated with numerous ramifying cavities, that communicate with 
 the trachea ; while others describe tliem as commencing by a median 
 enlargement, which is hollow, and opens into the oesophagus. The 
 walls of the orifice of communication with the digestive passage become 
 considerably lengthened, and afterwards form the trachea and larynx ; 
 while the vesicle or enlargement representing the lungs divides into two 
 pyriform sacs, each of which is greatly subdivided to constitute the 
 pulmonary lobes, with their vesicles and infundibula. The trachea is 
 completed through the formation of the cartilaginous rings in the tube 
 that attaches the lungs to the oesophagus ; the larynx is developed in 
 the same manner, at the pharyngeal opening of the tube. This organ, 
 however, is not very distinguishable during foetal life, and only assumes 
 its definite form and volume at puberty. 
 
 Up to birth the placenta retains the function of the lungs, which, 
 though ready to act, only come into play when the creature is born. 
 Previous to this event they are of a dark-red colour, firm and compact, 
 heavier than water, and apparently destitute of alveoli ; though these 
 latter exist, but are filled with embryonic elements, and their walls are 
 in contact. A moderate insuffiation is sufficient to distend the air- 
 vesicles, when the lungs become crepitant and enlarged, have a rosy 
 colour and spongy appearance, float in water, and the air cannot be 
 completely expelled from them. The same change immediately occurs 
 in these organs when the young creature is born alive ; the external 
 atmosphere, acting upon the surface of its body, causes it to inspire 
 deeply, the chest dilates, the air rushes into the lungs, and respiration 
 commences only to cease with life. This alteration in the colour, 
 texture, and specific gravity of the lungs enables us to decide, in certain 
 cases, whether or not an animal has been born alive. 
 
 The thymus gland first appears towards the second month, as a 
 growth from the respiratory mucous membrane, near the larynx ; it then 
 descends gradually along the trachea until it reaches the thorax, where 
 it is situated between the layers of the anterior mediastinum. It 
 increases in size until birth, after which it remains stationary for a 
 short time ; then it gradually diminishes and disappears at a period 
 which varies according to species, and even individuals. Exceptionally 
 it has been found in Horses three years of age. It is a gland in struc- 
 ture, though it has no excretory canal. Its uses are unknown, but it 
 is surmised that it plays a part in the nutrition and haematosis of the 
 foetus and young animal. It may be that, like the spleen, it assists in 
 converting the white corpuscles of the blood into red corpuscles. 
 
 The Digestive Apixiratus. 
 
 The development of the digestive apparatus comprises the formation 
 of the alimentary canal and the organs attached thereto. The alimen- 
 tarij canal begins to appear after the first outlines of the nervous centres 
 and the vascular apparatus have been manifested. We have already 
 described the manner in which the intestinal cavity was formed from 
 the inner lamina of the blastoderm. This cavity, for convenience of 
 description, may be divided into three portions : the anterior intestine, 
 which originates the pharynx and oesophagus ; the middle intestine, 
 which becomes the stomach and intestines proper ; and the posterior 
 intestine, which constitutes the rectum. The chief, or middle intestine, 
 is at first a cylindrical uniform tube, the diameter of which is after- 
 
I'EVKLorMEXT cF THE FCETVS. 109 
 
 wards modilied to constitute the organs comprised between the oeso- 
 phagus and rectum. 
 
 The mouth begins by a depression or cul-dc-sac, whicli is limited by 
 the maxillary tubercles ; it increases as it dips towards the pharynx, 
 from which it is only separated at last by a thin membrane ; this is 
 eventually absorbed, and the moutli then communicates with the com- 
 mencement of the digestive canal. Towards the third montli the mouth 
 is confounded with the nasal fossa?, but after this the palatine bones 
 appear, and finally isolate the two cavities. 
 
 The tniujue is at first only a small protuberance from the maxillary 
 tubercles, but is completed by the addition of a little growth from the 
 second branchial arch. Its epithelium and glands are derived from the 
 external layer of the blastoderm ; they are apparent at the third or 
 fourth month. 
 
 The j)}ianjux a.ni cesojjluKj us lei\<;then and widen as the foetus grows ; 
 the latter at first communicates with the trachea, but it gradually 
 closes, and ends by separating entirely from that tube. 
 
 The stomach is formed by the dilatation of the anterior part of the 
 middle intestine. This dilatation is fusiform, its larger axis being 
 longitudinal ; but it soon curves on itself, and then this axis becomes 
 transversal. 
 
 In Ruminants the stomach is single when it first appears, though it is 
 not long before furrows are observed on its outer surface ; while inter- 
 nally the particular septa are seen as in adult life. In the fa'tus the 
 stomach is small, but its volume increases rapidly after birth, when the 
 animal commences to take solid food. During the sucking period in 
 Ruminants, there is a predominance of the fourth over the other gastric 
 compartments ; but as soon as the young animal begins to consume 
 fibrous aliment, the rumen increases rapidly, until it is by far the 
 largest cavity. 
 
 The intestines are at first of uniform calibre, thougli in a short time 
 it is easy to distinguish the different sections of which they are 
 ultimately composed. In hoofed animals the ciccum appears very early ; 
 it is situated near the omphalo-meseraic duct, which is detached from 
 the extremity of an intestinal loop that is drawn towards the umbilical 
 ring ; while the latter is becoming obliterated, this loop ascends in the 
 abdominal cavity. The intestines are quite smooth on their inner 
 surface during the first two months, and towards the third month show 
 the villi and glands of Lieberkiihn ; the Brunnerian glands and the 
 follicles are only seen later. 
 
 The rectum arises from the posterior intestine, and is developed like 
 the other portions. 
 
 With regard to the anus, there is observed towards the caudal 
 extremity of the foetus a depression analogous to the buccal cul-de-sac. 
 This becomes deeper, and joins the rectum and genitourinary organs ; 
 later, it separates from the last, and then belongs exclusively to the 
 alimentary canal. 
 
 The APrEND.KGKs OF THE .\LiMKNT.\uv cAN.\L are the salivary glands, 
 teeth, liver, pancreas, and spleen. The salivarri i/lands are developed 
 in a solid cellular tubercle, which is connected with the epithelium at the 
 upper part of the digestive apparatus. With the growth of this tubercle, 
 it is converted into a series of cavities having the form of glandular cj//s- 
 de-sac. The submaxillary gland appears first, and is entire in a foetus 
 of only twelve lines in length ; the parotid gland is the last formed. 
 
no OBSTETlih'AL niVSloLDdV. 
 
 The teeth are developed in the interior of a cavity called the " dental 
 follicle " or " sac," by means of the elements of three germs correspond- 
 ing to the anatomical constituents of the teeth — enamel, ivory, and 
 cementum. The follicle is an oval cavity whose wall comprises two 
 layers — an external tibrons sac, and an internal gelatinous lining, at the 
 bottom of which is the ivory pulp or ijcrni. This is a prominence 
 detached from the bottom of the sac, and has exactly the shape of the 
 tooth. It is composed of a mass of delicate cellular tissue provided 
 with vessels and nerves, and on the surface a layer of elongated cells. 
 At the sunnnit of the follicle, facing this pulp, is the enamel pulp, which 
 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 
 cylindrical cells connected with the buccal epithelium by the guberna- 
 cnlnin dentis. The cetncnt otyan manifestly exists in the Foal, being 
 found at the base of the ivory germ, though it disappears quickly after 
 having performed its function. It is unnecessary in this place to enter 
 into a consideration of the development of the teeth. 
 
 The lirer connnences to be formed at an early period in all animals, 
 appearing at the surface of the duodenum in the shape of one large 
 tubercle or two snuxll ones, according to the mnnber of lobes in the 
 organ of the adult. To these external tubercles, corresponding internal 
 ones arise from the intestinal epithelium ; the tirst 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 tills the abdominal cavity. At a later 
 date this increase is less nuirked, although when gestation is nearly 
 terminated the gland is proportionately more voluminous than in the 
 adult. 
 
 The pa}icrcas, like the salivary glands, is tirst seen as a solid cellular 
 tubercle, which is subsequently hollowed out by ramescent cavities. 
 
 The spleen is developed about the second month, on the great curva- 
 ture of the stomach ; it would appear to be formed at the 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 Genito-urinari/ Onjans. 
 
 The genito-urinary organs are related to each other in their develop- 
 ment, and have some parts in common. Immediately after the 
 formation of the intestines, these organs are anticipated by the Woljtfion 
 bodies or prifiiordial kidnei/s. These are glandular masses extending 
 in front, or one on each side, of the vertebras from the heart to the 
 pelvis. They are composed of small transversely disposed tubtili 
 filled with a white Huid, and opening into a common duct running 
 parallel to the spine, which again enters, inferiorly, that portion of the 
 allantois which becomes the bladder. The duct is formed before the 
 tubuli, and is one of the earliest developed structures in the embryo. 
 Placed behind the peritonetnn, the Woltlian bodies are attached by two 
 folds of serous membrane — one, the anterior, named the diapJiraijmatic 
 ligament of the Wo[rfla)t bodies; and the other, posterior, the lumbar 
 ligayncnt of the Wolffian bodies. These organs secrete at tirst a fluid 
 resembling wine, though their function is soon greatly modified, as they 
 are not long in becoming atrophied ; then a portion serves for the 
 
DEVELOPMEST OF THE EiETrs. 
 
 Ill 
 
 development of the genital organs, while another gives rise to organs 
 whose use is not exactly known — such as the Rosennuiller organ, whicii 
 is very developed in the Equine fcutus, and the canals of Gaertner visible 
 in the Cow. 
 
 With regard to the uhinaky oiuiANH, we have mentioned how the 
 allantois was derived from the terminal portion of the intestine ; it only 
 now remains to add that the uriiuin/ bladder is derived from the 
 abdominal portion of the allantois, which is merely a dilatation of that 
 sac. During fcetal life the bladder is extended, by the urachus, to the 
 umbilical ring ; but after birth this canal is obliterated, and the bladder 
 retires to the bottom of the pelvic cavity. 
 
 The kidjicys appear a long time after the Wolrtian bodies. They 
 
 Fig. 5 
 
 Male F(KTIs ok the Makk at Fivk and a Hai.k Munth.s : the Ahdomen 
 opened and te.st1cle.s expo.skh. 
 
 l,Thii;li8 ; 2, I'eniH— neither Scrotum nor Prepuce an; y«;t fonnwi ; 'i. IJIa/ifler, 
 with the two Umbilical ArterieH ; 1, Abdominal Parietes ; '>, Douglas' Fora- 
 men, with the two Afferent CanalM, h, //; 6, KidneyH ; 7, .Supra-renal Cap 
 Hule8 ; 8, Rectum ; 9, MeHorchJH or Spermatic Cord ; a, fTubernaculuni 
 Hunterii ; a', Internal Inguinal King ; b, b, Efferent Ductn ; <:, c, To*ticlejj ; 
 d, d, Pampinifurm Plexus. 
 
 show themselves in the form of two culs-dc-sac, constituted by tlie 
 upper wall of the small vesicle of the allantois. These small cavities 
 become ramified, and are ultimately replaced by solid tubercles, in 
 whose interior are developed the tubuli uriniferi and the Malpighian 
 tufts. According to some observers, the kidneys only subsequently 
 communicate with the ureters, which are developed separately in the 
 middle lamina of the blastoderm, and terminate in the pelvic portion 
 of the allantois. 
 
 The genital organs of the male a,nd female offer, at the commencement 
 of their development, the greatest analogies. For a certain time it is 
 impossible to distinguish the sexes ; so that some authorities propose 
 to term this the " indifferent " state of the genital organs. Afterwards 
 
112 
 
 OBSTETRICAL FHYHIOLOG Y, 
 
 the sexes become defined, and at this stage the organs may be studied 
 as internal and external. The indifferent stage begins about the sixth 
 week, when there appears on the lower face, and near the inner border 
 of the Wolffian body, a small white cord, which, in keeping this position, 
 increases in volume. This is the genital 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 cul-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 tubuU seminiferi. The head or globus 
 major of the epididymus, is formed by the middle portion of the Wolffian 
 body ; the tail or globus minor, the vas deferens, and the ejaculatory 
 
 Fig. 60. 
 
 Genito-ukinaey Organs of a Fcetal Sheep. 
 
 a, a. Rudimentary Kidneys ; h, Ureters ; c, c, Testes ; d, d, Wolttian Bodies ; 
 e, e. Excretory Ducts of Wolffian Bodies or Sperm Ducts ; g, Oviduct with 
 its openings /, /. 
 
 canal, are derived from the Wolffian duct. Lastly, the vesiculce semin- 
 ales and the commencement of the urethra are formed by the posterior 
 extremity of the ducts of Miiller, which joins the uro-genital sinus — the 
 very short canal communicating between the bladder and cloaca. The 
 developed testicle remains in the abdominal cavity, maintained there 
 by a peritoneal fold, the /j/z'ca gubernatrix ; or descends by the inguinal 
 canal into the scrotum. This descent is preceded by the appearance of 
 a preparatory structure — the gubernacidum testis — consisting of a central 
 axis of soft gelatinous substance containing many nucleated cells and 
 surrounded by fibrous tissue, which soon exhibits the striped character- 
 istics of voluntary muscle. Some of these fibres spring from the bottom 
 of the scrotum and traverse the abdominal ring, while others arise from 
 Poupart's ligament — the whole, enclosed by connective tissue and con- 
 nected by a fold of peritoneum to the psoas muscle, extending to the 
 testis. This gubernaculum, in shrinking or contracting, draws 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 gubernaculum. The iliac 
 
DEVELOPMEXT OF THE FCETUS. 113 
 
 and pubic portions of the muscular tissue now become the " cremaster" 
 muscle, while the sac of peritoneum carried down with the testicle 
 is converted, by obliteration of the neck, into the tunica vaginalis 
 testis. 
 
 In Solipeds tlie testicles do not usually descend into the scrotum until 
 six months after birth ; when one or both do not appear, as sometimes 
 happens in the male domesticated animals, and remain in the abdo- 
 minal cavity during life, the gubernaculum, or what corresponds to it, 
 is reduced to a small thin cord, without a trace of cavity, and showing 
 only some few pale fibres of the atrophied cremaster muscle. In the 
 Foal they are voluminous, and somewhat reddish in colour ; they are 
 occasionally found in the scrotum at birth ; but they soon ascend into 
 the abdomen, to redescend during the first year. With some animals, 
 however, as has been already mentioned — and far more frequently with 
 the Horse and Pig than any othei's — the testicles remain in the abdomen 
 during life, or only one descends to its natural situation. When they 
 remain in the abdominal cavity, the animal is said to be " anorchid " or 
 " cryptorchid ;" and it has been shown that, although such animals 
 have the sexual propensity well marked, yet they are unproductive ; 
 their semen does not contain any spermatozoa. 
 
 When one testicle has migrated to the scrotum, leaving one in the 
 abdomen, the Horse is " monorchid," and possesses the power of re- 
 production unimpaired. 
 
 In Ruminants the testicles are small, and are in the scrotum at birth, 
 where they remain. Sometimes there is a strange malposition of the 
 testicles, and especially in the Pig, they having been found beneath the 
 chin, in the flank, and elsewhere. 
 
 In the female, the ovary is derived from the genital gland, whose 
 anatomical elements are disposed so as to form the stroma. Graafian 
 follicles, and the ova. 
 
 In fcetal Solipeds the ovary is of an immense size, especially about 
 the middle of gestation, and its stroma is red and extremely soft. 
 In other animals, and particularly liuminants, this disproportion is not 
 observed. 
 
 The Fallopian tube and its pavilion are formed by the anterior portion 
 of Miiller's duct, the extremity of which presents a small linear orifice. 
 The uterus and vaijina arise from theposterior part of these ducts, whicli 
 approach each other, and finish by amalgamating posteriorly to form a 
 single canal. This fusion originates the vagina and body of the uterus, 
 the two diverging portions of the ducts comprised between the point of 
 union and the Fallopian tubes forming the uterine cornua. The uterus 
 and vagina are at first continuous and without any sign of demarcation, 
 but towards the sixth month the neck of the uterus begins to become 
 apparent. 
 
 The external organs of tlie female in their indifferent state demand 
 notice. The intestine terminates in the cloaca, a cavity into which not 
 only this tube but also the bladder enters, through the uro-genital sinus. 
 This arrangement ceases somewhat suddenly, by the development of a 
 transverse septum that divides the cavity into two portions — the anal 
 opening, and the uro-genital orifice. -Vt the lower end of the latter 
 appears the genital tubercle, the rudiment of the penis or clitoris, and 
 which is surrounded by cutaneous ridges — the genital folds. This 
 tubercle increases in size, and is traversed by a groove or fissure 
 
 8 
 
114 
 
 OBSTETRICAL PHYSIOLOGY. 
 
 passing from behind forward. Up to this time the sexes cannot be 
 distinguished. 
 
 The male sex is marked by the rapid development of the genital 
 
 Fig. 61. 
 
 Female Organs of a Fcetal Deek. 
 
 a, Uterus ; h, b, Coinua ; 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 forms 
 the urethra ; while the genital folds, meeting each other below the 
 penis, join to complete the scrotum. Owing to these changes, the 
 
 Fig. 62. 
 
 Female Fq^tus of the Cow (natural size). 
 
 1, Heart ; 2, Lungs ; 3, Diaphragm : 4, Kidney : a, Wolffian Body ; b, Ger- 
 minal Gland ; c, Wolffian Duct ; (/, Miillerlan Duct ; d', Uterus and Vagina ; 
 d", Abdominal Opening of the Oviduct ; f, Clitoris ; g, Round Ligament of 
 the Uterus. 
 
 digestive are separated from the urino-genital organs, and the urethral 
 canal is connected with the bladder and the excretory ducts of the 
 testicle. 
 
I)EF£LuJ'Mh'XT (>F THE FCETl'S. 
 
 115 
 
 The organs in the female also soon indicate the sex. The uro-genital 
 sinus forms the vulvar cavity or vestibule of the vagina, so marked in 
 the lower animals. The genital tuhercle becomes the clitoris — the 
 homologue of the penis. The cutaneous folds constitute the labia of the 
 vulva ; while the genital groove is closed at one part of its extent to 
 form the perinieum. The mavimce, appendages of the generative organs, 
 appear in the early months of uterine life, and the teats are perforated 
 very soon. They are also seen very distinctly in the male ftttus in the 
 early months. 
 
 In certain malformations of the generative organs, more or less of 
 
 Fig. 63. 
 
 (Jksital Obi;axs ok .k HRRUAPtiiiODiTB Goat, tmk Malk Pakts i'redomi.nati.vc. 
 
 a, a. Testes ; h, h. Combination of Epididymis with Abdominal Ends of 
 Miillfrian Duct.-* ; (/,'/, Vasa OeftTuntia ; e, Body of I'tenis and A'agina ; 
 /',/, I'terine Cornua ; <j, ij, Fallopian Tubes. 
 
 their primitive conditions are retained ; the most frequent of these 
 malformations is hermaphrodism. Examples of this are by no means 
 uncommon among the lower animals, and the annexed drawing gives a 
 good example of the organs of a hermaphrodite goat, with the male 
 parts predominating.^ 
 
 SECTION IV.— PERIOD.S OF KKVKLOPMENT. 
 
 Thus far we have traced the development of the young creature in 
 the uterus ; but as our description may appear a little confused from 
 our having described the growth of individual organs, rather than the 
 
 • For further details on the subject of embryology of these creatures, see my trans- 
 lation of "The Comjiarative Anatomy of the Domesticated Animals," by A. Cbauveau 
 and S. Arloing, second edition, London, 1691. 
 
116 OBSTETRICAL PHYSIOLOGY. 
 
 foetus as a whole, it may be advisable to adopt the plan of dividing this 
 bodily development into periods, which will also give an approximate 
 idea of its age. From conception to maturity, utero-gestation may 
 therefore be divided into seven periods or stages, as follows : — 
 
 First Period. — Towards the second week after conception, the ovum 
 or germ has passed from the ovary into the uterus ; it is then about a 
 line in diameter (one-twelfth of an inch). 
 
 Second Period. — In the third and fourth weeks of gestation in the 
 Mare, Eurainants, and Pig ; the third week in Carnivora ; there appear 
 the first traces of the embryo, and the head, body, and limbs can be 
 distinguished. Towards the twenty-eighth day, the embryo of the Mare 
 measures about six lines, and that of the Cow four lines ; that of the 
 Sheep at twenty-five days is four and a half lines ; and the Bitch at 
 eighteen days two lines. 
 
 Third Period. — This is from the fifth to the eighth week with the 
 Mare and Cow ; the fifth to the seventh with the Sheep and Goat ; and 
 the fourth to the sixth with the Pig. The embryo of the Mare has 
 acquired a length of rather more than 2 inches ; that of the Cow If 
 inch ; that of the Sheep and Goat 1| inch ; that of the Pig If inch ; 
 and that of the Bitch 11 to 12 lines. 
 
 Fourth Period. — This is from the ninth to the thirteenth week with 
 the Mare ; the ninth to the twelfth with the Cow ; the seventh to the 
 eighth and ninth with the Sheep and Goat ; the sixth to the eighth with 
 the Pig ; and the fifth week with Carnivora. The length of the foetus 
 of the Mare is 6 inches ; that of the Cow bh inches ; that of the small 
 Euminants 3J inches ; that of the Pig 3 inches ; and that of the Dog 
 2| inches. 
 
 Fifth Period. — This extends from the fourteenth to the twenty-second 
 week in the Mare ; the thirteenth to the twentieth in the Cow ; the 
 tenth to the thirteenth in the Sheep and Goat ; the eighth to the tentli 
 in the Pig ; and the sixth week in Carnivora. At this stage the foetus 
 of the Mare is about 13 inches long; that of the Cow 12 inches; that 
 of the Sheep and Goat 6 inches ; that of the Pig 5 inches ; and that of 
 the Bitch 3i inches. 
 
 Sixth Period. — From the twenty-third to the thirty-fourth week in the 
 Mare ; the twenty-first to the thirty-second in the Cow ; the thirteenth 
 to the eighteenth in the Sheep and Goat ; the eleventh to the fifteenth in 
 the Pig ; the seventh to the eighth in Carnivora. The foetus of the Mare 
 in this period has acquired a length of more than 2 feet ; that of the 
 Cow is about the same dimensions ; the foetus of the Sheep is more than 
 a foot ; that of the Pig about 7 inches ; and that of the Bitch 5 inches. 
 
 Seventli Period. — From the thirty-fifth to the forty-eighth week — up 
 to parturition, in the Mare ; the thirty-third to the fortieth in the Cow; 
 the nineteenth to the twenty-first in the Sheep and Goat ; the fifteenth 
 to the seventeenth in the Pig ; the ninth in the Bitch ; and the eighth 
 in the Cat. 
 
 A newly-born Foal measures about 3i feet long ; a Calf 2 feet ; a 
 Lamb 1^ foot ; a Pig about 9 or 10 inches ; a Puppy 6 to 8 inches ; 
 and a Kitten about 5 inches. 
 
 In this study of the evolution of the young animal in utero, one 
 cannot fail to be struck with the slowness with which development pro- 
 gresses for a certain period, and its rapidity afterwards. The slowness 
 in growth may be accounted for by the extreme minuteness of the ovum 
 
PERIODS OF DEFELOl'MKXT. 117 
 
 at the moment of impregnation, and its containing within itself alone 
 the elements upon which the primary steps of evokition depend, there 
 being at tirst no direct connection between the embryo and the uterine 
 vessels. The parts which in reality grow most rapidly in the early 
 period of gestation, are the enveloping membranes and the Uuids they 
 contain. In the Sheep, towards the end of the lirst quarter of gesta- 
 tion, the membranes alone weigh from live to nine times more than the 
 foetus ; while the allantoic and amniotic fluids are from eight to ten 
 times as heavy. These fluids increase in an absolute manner from the 
 commencement, until within perhaps a short time of parturition. Rapid 
 at first, towards the middle period their secretion abates, and then begins 
 the more active development of the fcrtus, with a relative diminution in 
 the proportion of the fluids ; until about the end of the fourth month 
 they only represent something like a third of its weight. In the Sheep 
 a few days after the fifth month, or about birth time, they are a sixth 
 of the weight of the young animal. 
 
 The development of the foetus is so tardy at first, that the fcetal 
 Lamb at the fortieth day has scarcely acquired the 300th part of the 
 weight it has at birth ; at two mouths it has only a 60th, but now it 
 grows more rapidly ; so that at the expiration of the fourth month it 
 has gained more than one-third of its total weight. 
 
 The inequality in the growth of the different organs is also very 
 notable ; those whose functions are most required, such as the nervous 
 centres, liver, etc., attaining considerable proportions very quickly. 
 The brain, for instance, soon acquires a marked predominance over the 
 other organs. In the fcctus of the Lamb at the lifty-seventh day, the 
 proportion of the entire brain to that of the body in weight is as 1 to 
 15; at the seventieth day it is as 1 to 55 ; and at birth as 1 to 65. At 
 mid-term with the Calf, its weight is to that of the body as 1 to 53, and 
 at birth as 1 to 120. 
 
 The spinal cord does not follow the same progression in growth. In 
 the Calf at mid-term it is only the 421st part of the weight of the foetus, 
 and at birth the -iTOth part. In the Lamb at birth, it is equal to the 
 3-iOth part of the body. 
 
 The heart, which appears so early, is more voluminous in the embryo 
 than towards the termination of gestation and after birth. The heart 
 of a Calf at mid-term equals 125tii of the weight of the body ; that of a 
 Lamb at birth the 120th ; in the adult liuU it is only the 264th part. 
 
 The hnujs have, relative to the total bulk of the fa'tus, a variable 
 weight according to age. In those of the Lamb at fifty-seven days, 
 they are equal to a 20th part of the weight ; in a Calf at mid-term, the 
 33rd; in another at eight months, the 34th ; and at birth, the 35th and 
 55th ; in a Foal a little more than eight and a half months, they were 
 the 33rd ; in Lambs and Goats at birth, they averaged from the 24th 
 to the 61st part of the whole weight. 
 
 The development of the thymus gland also varies considerably accord- 
 ing to age and species. In a Calf at mid-term, its weight was the 137th 
 part of the body; in another at seven months, it was the 197th ; in a 
 Foal at birth, the 200th ; in a Goat at the same period, the 130th ; and 
 in a Lamb eight days after birth, the 22Sth part. It is always propor- 
 tionally more voluminous in Ruminants than Solipeds, and in them and 
 the Pig it extends in front nearly to the larynx. In the Dog it does 
 not get beyond the anterior mediastinum, and is small, though more 
 persistent. It has in rare cases been found in Horses more than three 
 
118 
 
 OBSTETRIC A L PH YSIOL OQ Y 
 
 years old ; but, as a rule, in the adult animal it is only represented by 
 a small and variable quantity of adipose tissue. 
 
 The liver is extremely voluminous in the early period of embryonic 
 and fcBtal life, but decreases proportionately as gestation approaches 
 its close. In the foetus of a Lamb at the fifty-seventh day it has been 
 found equal to l-6th of the body in weight ; in Calves at mid-term and 
 birth to l-29th ; with the Foal at birth l-21st, and l-24:th in Lambs at 
 the same period. In the adult Horse it has been fomid to represent 
 l-75th of the total weight, and l-83rd in the Ox. 
 
 The intestines, during foetal life, do not grow in length so as to attain 
 the proportionate dimensions they offer in adult life. In an Equine 
 foetus of eight or nine months, the small intestines measured about 15 
 feet, the caecum 6^^ inches, and the large intestines Sh feet, or a, 
 total of about 20 feet — about l-5th of their length in after-life. Shortly 
 after birth they acquire l-3rd the length to which they attain when 
 fully developed. The Calf at mid-term has only 1-lOth the length of 
 the adult intestine — being only sixteen times the length of the body, 
 instead of twenty times. The Lamb and Kid at birth have l-3rd of 
 their intestines complete — their length is seventeen to eighteen times 
 the length of the body, instead of twenty-seven times in adult life. 
 
 The general proportions of the body, and especially those of the 
 skeleton, are not in foetal life what they are after birth. The bones 
 are, relatively to the other parts, more voluminous as a whole, and 
 notably at their extremities, than in the adult. The limbs in particu- 
 lar, and this more so in Solipeds and Euminants, have attained a length 
 which is not at all proportionate to that of these parts when their 
 growth is completed. And several bones of the limbs, such as the 
 radial, tibial, metacarpal, and metatarsal bones, are almost fully 
 developed in their dimensions at birth. The following interesting table 
 exhibits the comparative weight of the different bones in the Foal and 
 the adult Horse. 
 
 The weight is given in grammes (15-432 troy grains) : 
 
 
 i 
 
 d 
 
 
 "a 
 
 
 
 
 \^ 
 
 
 
 
 
 
 a 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 <o 
 
 •a 
 
 a> 
 
 >>^- 
 
 
 s 
 
 
 .J^ g. 'Si o 
 
 
 
 
 
 3 
 
 ?o 
 
 Species. 
 
 1 
 
 > 
 
 o 
 Q 
 
 s 
 
 n 
 
 a 
 
 §.2 
 1 
 
 5 
 
 CO 
 
 3 
 
 S 
 
 
 Carpu 
 
 Metacar 
 
 Digital Uc 
 Anteri 
 
 o 
 
 a 
 
 
 3 
 
 1 
 
 c3 
 
 51 
 1^ 
 
 
 grs. 
 
 grs. 
 
 grs. 
 
 grs. 
 
 grs. 
 
 grs. 
 
 grs. 
 
 grs. grs. grs. 
 
 grs. 
 
 grs. 
 
 grs. 
 
 grs. 
 
 grs. 
 
 grs. 
 
 Foal at Birth - 
 
 315 1 390 
 
 130 
 
 383 
 
 195 
 
 188 
 
 243 
 
 59 238 139 
 
 227 
 
 232 
 
 262 
 
 66 271 
 
 17 
 
 Foal at Birth - 
 
 370 
 
 350 
 
 135 
 
 2-26 
 
 190 
 
 205 
 
 250 
 
 40 240 131 
 
 245 
 
 254 
 
 280 
 
 62 
 
 275 
 
 173 
 
 Foal two days 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 old - - - 
 
 — 
 
 — 
 
 — 
 
 
 159 
 
 170 
 
 224 
 
 — 218 — 
 
 — 
 
 223 
 
 246 
 
 — 
 
 255 
 
 — 
 
 Adult Horse : 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 large size - 
 
 — 
 
 — 
 
 — 
 
 — 
 
 370 
 
 310 
 
 36 
 
 45 240 170 
 
 1 
 
 450 
 
 390 
 
 360 
 
 70 
 
 280 
 
 180 
 
 SECTION v.— PHYSIOLOGICAL PHENOMENA IN THE FCETUS. 
 
 With regard to the physiological phenomena which occur during 
 foetal life, we cannot presume to speak in detail in this place. It is, 
 however, interesting, and perhaps necessary, to allude briefly to several 
 of the most important, in order to complete this portion of our subject. 
 
PHYSIOLOGICAL rilEXtiMHXA IX TIfK FCETUS. llt> 
 
 Nervous Functions. 
 
 The developmeut of the tiervous functiojis is one of these phenomena 
 worthy of attention. It appears certain that the young creature is 
 formed and developed without the direct intervention of the nervous 
 intiuence of the parent, as there is no coniinunication between the 
 nerves of the uterus and the fcetal envelopes ; and it has not been 
 shown that there are nerves either in the latter, or yet in the umbilical 
 cord. The progressive animation of the new creature cannot, therefore, 
 be derived from immediate nervous propagation, or direct extension of 
 the nervous activity from the mother to its offspring ; and we must 
 look upon this animation as originating in the embryo, and becoming 
 developed under the influence of inappreciable causes. At the very 
 commencement of embryonic life, the nervous system, which, in extra- 
 uterine existence, holds under its control the organic functions, appears 
 now to have no possible influence on the phenomena that gradually 
 manifest themselves. The primary changes in the ovum occur before 
 the earliest traces of the nervous system are apparent ; and while its 
 rudiments are forming, those of other parts are also being developed. 
 Even when the nervous system has attained a somewhat considerable 
 growth, it does not appear to have assumed those controlling powers 
 with which it is so largely endowed at a subsequent period. 
 
 In the homogeneous plasma of the ovum, in the common blastema, 
 coincidently or successively, a multitude of diilerent parts are being 
 formed independently of each other, as if each contained within itself 
 the why and wherefore of its formation and ulterior perfecting. The 
 nervous system itself seems to be submitted to the same general laws, 
 and it does not appear to be dependent upon any other part, neither does 
 any part depend upon it ; even when it is fully formed, the phenomena 
 pertaining to growth are evidently effected without its stinmlating 
 intervention. Besides, it is well known that the monstrosities which 
 are sometimes seen destitute of brain and spinal cord, may yet reach 
 the end of their foetal development. True, certain facts have appeared 
 to demonstrate that the formation of parts is dependent on nervous 
 action. In certain monstrosities, organs have not become developed 
 when the nerves which should have been distributed to them were 
 absent ; in others, several organs have become fused together when 
 their nerves were similarly aggregated ; while an organ has been 
 divided into fractions corresponding to the accidental development of 
 its nerve. The muscles of the posterior part of the body of the fa'tus of 
 the Cow and Pig have been obsen-ed to be absent when the corre- 
 sponding portion of the spinal cord was, with its nerves, very imper- 
 fectly developed. But these facts do not prove that tlie absence of the 
 nerves was the cause of the non-development of the nmscles ; for in 
 such cases there is a correlation between the non-formation of the 
 nerve and the absence of the muscle; the same cause whicli has hindered 
 the formation of the one in a certain part of the body has also prevented 
 the growth of the other in that part. It is the same, to a certain point, 
 with the relative development of vessels and the increase of the parts to 
 which they are distributed. In the original homogeneous plasma, there 
 were developed the diverse elements of an organ at the same time as 
 its vessels, and the force which created the connective, nervous, and 
 muscular tissues, created also the elements of the vessels — ai'teries, 
 veins, and capillaries ; they are closely related to each other, and their 
 
120 OBSTETRICAL PHYSIOLOGY. 
 
 growth goes on concurrently. If the vessels do not carry a sufficient 
 supply of formative material, the development of the part is tardy or 
 ceases ; and, on the other hand, if the latter from some cause becomes 
 feeble and cannot assimilate this material, the vessels gradually cease 
 to carry it ; consequently, both become atrophied when they cease to 
 grow. 
 
 When the nervous system has arrived at a certain degree of develop- 
 ment, it begins to assume its functions ; though the first manifestations 
 of its activity are very obscure, and probably limited to mere tactile 
 impressions, evinced by movements more or less appreciable. It is 
 well known that in the pregnant Mare and Cow, after their ingestion 
 of a large quantity of cold water, the foetus, towards the end of the 
 second third of gestation, and more particularly in the later months, 
 executes movements which are at times so marked that they can be felt 
 if the hand is applied to the abdominal parietes, or even seen in the 
 region of the flank. It is very probable that these automatic or reflex 
 movements may produce torsion of the umbilical cord, and in this way 
 become a predisposing cause of abortion. Colin, having had occasion 
 to lay open the abdomen of a living pregnant Mare within two or three 
 months of parturition, saw the foetus, immediately after the incision in 
 the abdominal walls, jumping about in the uterus in a very lively 
 manner without any external stimulus being applied ; it moved the 
 whole of its body, or withdrew its legs or head when pinched through 
 the uterus and the envelopes. In a quarter of an hour after removal 
 from these and the mother, it no longer moved. The human foetus at 
 five months has been seen to flex and extend its limbs when removed 
 from the uterus. 
 
 Towards the termination of gestation, there can be no doubt that the 
 foetal movements are somewhat energetic, for at this period the foetus 
 changes its position preparatory to passing through the pelvis. Thus 
 the young Soliped, during the whole of its intra-uterine existence, lay 
 with its abdomen turned upwards and the posterior limbs lodged in 
 the largest of the two cornua ; but it now turns over on its belly, with 
 the legs downwards and the umbilical cord passing across one of its 
 sides. 
 
 The movements connected with deglutition also appear to be per- 
 formed at an early stage of development, for some of the hairs which 
 are so often observed in notable quantity floating in the amniotic fluid, 
 have been discovered in the foetal stomach. 
 
 Absorption. 
 
 The phenomena of absorption play a considerable part in the develop- 
 ment of the young animal. As soon as the microscopic ovule reaches 
 the uterus, its vitelline envelope or pellucid zone becomes studded with 
 delicate, hair-like prolongations — villosities without vessels — which, 
 steeped in the fluid thrown out on the uterine surface, transmit this to 
 the lamina of the blastoderm. At first this absorbent surface is very 
 small, and the growth of the embryo is consequently slow ; neverthe- 
 less, this trifling absorption is sufficient to increase the ovule to forty 
 or fifty times its original volume before the blastodermic laminae and the 
 germinative space are completed. 
 
 Later, when the umbilical vesicle is formed at the expense of the 
 vascular and mucous laminee, its vessels absorb the soluble matters that 
 are added to the mass of elements necessary for the growth of the 
 
PHYSIOLOGICAL 111 ES >>. MESA IS THK ElETIS. 121 
 
 embryo. And, finally, when the chorion is at last organised, and 
 furnished with its myriads of vascular papilhe in the form of dissemi- 
 nated or a^'glomerated placentuhv, absorption goes on with exaggerated 
 activity over the whole uterine surface and texture, in order to supply 
 all the nutrition required for the now rapid development of the foetus. 
 
 The nutritive elements are absorbed by the vessels of the placental 
 villosities, transformed into blood, and conveyed to the young creature 
 by the umbilical veins. This extra-fcetal absorption is supplemented by 
 that which is taking place in the fluid of the envelopes, and also in the 
 organs and tissues of the fa>tus itself. It is certain, however, that the 
 l)lacental absorption is by far the most important, and that the rapid 
 development of the fa^tus is mainly, if not altogether, due to the nutri- 
 tive elements obtained there ; while it is not improbable that the 
 amniotic fluid found in the stomach and intestines may act as a dilator 
 of these, modify the action of the bile accumulated in the latter, and 
 perhaps yield a small amount of nutriment ; though it must be'remem- 
 bered that it does contain much of the nutritious elements, and that 
 the fa?tus which is unprovided with a mouth, and therefore cannot 
 swallow, is nevertheless as well developed as one that does ingest this 
 fluid. 
 
 Nutrition. 
 
 It has been shown that the foetal vascular system is quite distinct 
 from that of the mother, the isolation of the two systems being complete, 
 and only brought into contact at the placenta or placentuhc. There the 
 maternal blood is conveyed by certain arteries into particular sinuses 
 or receptacles of the uterus containing the ultimate radicles of these 
 vessels, which emerge into veins ; while the foetal vessels, extremely 
 attenuated, dip down into these receptacles and are batlied in the 
 blood of the parent, as the "gills" or branchiic of aquatic creatures 
 are in the water in which they live. But the actual blood of parent 
 and offspring never meet : they are only brought into indirect contact; 
 and between them are the thin coats of vessels, basement membranes, 
 and cells. This indirect contact is sufficient to permit the venous fcctal 
 blood to become arterial, by enabling it to part with its carbonic acid, 
 and also to get rid of excrementitious matter derived from the different 
 processes connected with the growth of the foetus, and whose retention 
 in the blood of the young creature would doubtless be a source of injury 
 to it. This arrangement of the two systems of vessels also, as has just 
 been said, allows certain nutritious elements of the maternal blood — its 
 fluid portion only — to be taken up into the system of the fu-tus. In 
 this way, as has been pointed out, these vascular rootlets of the placenta 
 closely correspond to the villi of the mucous membrane of the intestines; 
 and the analogy is rendered more complete when we know that the 
 nutrient material is selected and prepb,red by two sets of cells, one of 
 which — the maternal — transmits it to the other — the fcttal — in the 
 same manner as the epithelial cells of the intestinal villi seem to take 
 up and prepare the nutrient matter that is destined to be again assimi- 
 lated by the cells which float in the circulating fluid. No other com- 
 munication between two vascular systems exists ; and the fact that the 
 blood corpuscles of each are different in size, conclusively demonstrates 
 that they must be distinct. Nevertheless, the special function of the 
 placenta, and the intimate relation existing, through it, between the 
 fluids of parent and ofl'spring, renders it evident that the maternal 
 
122 OBSTETRICAL PHYSIOLOGY. 
 
 blood may become impregnated with substances, or impressed with 
 attributes, which will affect the development or modify the constitution 
 of the foetus ; w^hile pernicious matters generated in the latter may prove 
 more or less noxious to the mother. 
 
 Circulation. 
 
 In order that the nutritive matters absorbed by the placental villi may 
 reach the foetus and be circulated in its body, it is necessary that a 
 determining and regulating power should be brought into play at an 
 early period in the existence of the foetus. This power appears with 
 the formation of the contractile organ which has been named the heart. 
 From the moment when this important organ appears in the form of a 
 cylindrical tube at the commencement of embryonic life, it dilates and 
 contracts alternately, first to receive the venous blood, and then to propel 
 it into the arteries. 
 
 The fluid w^hich is at first received and propelled by the heart is 
 transparent, colourless, and destitute of morphological elements, and 
 the organ itself exists in its most primitive form. As has been stated, 
 the situation of the heart and the course of the principal trunks of the 
 vascular area are early visible, and are marked by the peculiar dis- 
 position of the aggregations of cells from which these organs are to be 
 developed. It was shown that whilst the outer portions of these 
 aggregations were transformed into the u-alls of the respective cavities, 
 the inner portions appeared to deliquesce, and partly to remain as 
 isolated cells floating in the resulting fluid. These isolated cells are 
 supposed to be the first blood corpuscles. They are large, colourless, 
 vesicular, spherical cells, full of yellowish particles of a substance like 
 fatty matter. Many of these particles are quadrangular and flattened, 
 and have been called stearine-plates, though their composition is not 
 ascertained ; each cell has a central nucleus, which is not at first very 
 distinct, and the development of these embryo-cells into the complete 
 form of corpuscles is effected by the gradual clearing-up, as if by 
 division and liquefaction, of the contained particles, the acquirement of 
 blood colour and of the elliptical form, the flattening of the cell, and 
 the more prominent appearance of the nucleus. 
 
 In tracing the development of the red-corpuscles of the blood, it is 
 found that at first their nuclei have no envelope, but contain nucleoli ; 
 that they present all the characters of pale elementary cells, whilst 
 they are so numerous as to give the blood a whitish hue. When more 
 fully developed they acquire a cell and a reddish tint, and at a later 
 stage are circular, thick and disc-shaped, full-coloured, and about 
 l-2500th of an inch in diameter ; their nuclei are central, circular, very 
 little prominent on the surface of the cell, and apparently slightly 
 granular or tuberculated. 
 
 When the liver begins to be formed, the multiplication of blood-cells 
 in the entire mass of the blood ceases, and in a short time all trace of 
 the development of the red from the original colourless formative cells 
 is lost ; whilst, on the other hand, there takes place in the vessels of the 
 liver a new production of colourless nucleated cells, which are formed 
 around free nuclei, and which undergo a gradual change, by the pro- 
 duction of colouring matter in their interior, into red nucleated cells. 
 This new formation of blood corpuscles in the liver continues to take 
 place during the whole period of foetal life ; but whether these nucleated 
 cells themselves undergo transformation into the non-nucleated discs 
 
rHYSloLOmCAL I'HEXO.MKXA IX THE FlETI's. \2% 
 
 which constitute a gradually increasing proportion of the corpuscular 
 components of the blood during the latter period of embryonic life, or 
 whether these are formed only by the metamorphosis of lymph-cor- 
 puscles, has not yet been determined. 
 
 From the manner in whicli the circulation is carried on during firtal 
 life, and which has been adverted to, it is seen that the chief propelUng. 
 power is centred in the right side of the heart ; the force of tlie left 
 heart being mainly spent in elYecting a due supply of blood to the head 
 and upper extremities. And the structure of the heart proves this to 
 be the case, for the walls of the right ventricle have been found as 
 thick as those of the left ; while the walls of the right auricle are even 
 thicker and more muscular than those of the left auricle — a condition 
 which persists for a short time after birth. 
 
 The isolation that exists in the two circulatory systems might lead 
 to the inference that there was no relation between the contractions of 
 the heart in the foetus and those of the maternal organ, and experience 
 proves this to be the case. Naegele has noted that there is no relation 
 between the beats of the heart of the human fa^tus and those of its- 
 mother's heart. By auscultation he was able to distinguish the two 
 sounds of the fcjetal heart, and found it beat on an average 135 times 
 per minute — never more than 180, nor less than 90 ; and he remarked 
 that the beats were sensibly the same from four and a half months, when 
 they are first perceptible, until birth. And Hollmann, in resorting to 
 the same mode of investigation in Cows, ascertained that, in one which 
 was advanced eight and a half months in pregnancy, and whose pulse 
 was G4 per minute, the foetal beat was l^l ; in another Cow, but which 
 was ill, the pulse was from 70 to 112, while that of the foetus was 113 
 to 128. 
 
 Colin opened a living Mare which had been pregnant for )iine or ten 
 months, and a Cow whose gestation dated about three months. When 
 the uterus of the Mare was opened, and the contained envelopes incised 
 to extract the fa3tus, the latter moved actively and respired deeply, 
 though at rare intervals. The umbilical arteries and vein yielded some 
 blood, from the small punctures made through their walls ; the lirst 
 throbbed with a certain amount of force, and the pulsations were rapid. 
 When the cord was divided and tied, the foetus appeared to be dead : 
 there were no more spontaneous movements, and the respiration had 
 ceased. The thorax and the abdomen were now thrown open, and it 
 was observed that the heart contracted spontaneously and strongly, and 
 the pulsations of the aorta and umbilical arteries could be very distinctly 
 felt. At first the contractions of the auricles regularly alternated with 
 those of the ventricles, as in a normal condition ; but soon, as occurs in 
 expiring animals, the auricles contracted several times fur one contrac- 
 tion of the ventricles, as if it required several systoles of these to fill the 
 ventricular cavities. At each contraction the auricles diminished nmch 
 in volume, became nearly empty, and looked very pale, but assumed 
 their reddish-violet colour again during their diastole. At last tlie 
 rhythmical movements became altogether perverted ; the auricles and 
 ventricles contracted simultaneously and quickly, but more and more 
 feebly, and finally ceased altogether half an hour after the thorax had 
 been opened. The Cow in which the foetal circulation was studied had 
 its flank widely incised, and one of the cornua of the uterus withdrawn 
 through the opening. Some of the placentula) were removed with 
 difliculty from their cotyledons, and both bled a good deal When the 
 
124 OBSTETRICAL PHYSIOLOGY. 
 
 umbilical cord was exposed, the beating of its very tense arteries could 
 be distinctly felt ; and when compressed, these enlarged between the 
 foetus and the point where the pressure was applied. On removing the 
 foetus from the uterus, it did not make any perceptible movement, but 
 then it was only three or four months old. The thoi'ax having been 
 •opened, the action of the heart was observed to resemble that of the 
 •other foetus ; there were 31 pulsations in the first minute, IS in the 
 third, 11 in the fourth, and 21 in the fifth. The beats ceased in about 
 twenty-five minutes. In these two experiments, as well as in others 
 made on smaller animals, M. Colin found it impossible to perceive any 
 •difference in colour between the blood of the umbilical arteries and that 
 •of the veins, both fluids showing a tint intermediate to that of the 
 •arterial and venous blood of the adult. 
 
 Secretion. 
 
 With regard to secretion in the foetus, it is worthy of remark that 
 •several glandular structures at an early period and during foetal life ex- 
 hibit a remarkable degree of activity ; and more especially is this the 
 •case with those of the stomach and intestines, the liver, the mucous 
 membrane of the air-passages, and the kidneys. The glands of the 
 jiiouth and oesophagus only furnish the mucus that covers the mem- 
 brane lining these parts, but it is not long before the stomach is filled 
 with a white or colourless viscid fluid, in which is a large proportion of 
 ■epithelial cells and nuclei. Colin has found as much as 229 grammes 
 of this fluid in the stomach of a Foal at birth, from 150 to 180 in Lambs 
 at the same period, 200 to 300 in Calves towards the middle of gesta- 
 tion, and 500 to 600 in those at birth. It is neutral or slightly alkaline, 
 and contains, more especially in the foetuses of Solipeds and Kumin- 
 ants, a ver}- large proportion of sugar, with mucine and salts. This 
 fluid can scarcely, however, be looked upon as a gastric secretion, but 
 rather as a mixture of this with the amniotic liquid swallowed by the 
 foetus ; and it appears certain that, though the mucous glands are active, 
 yet those which elaborate the pepsine are inactive. The stomach 
 ■of a foetal Calf twenty weeks old, digested for eight days in milk at a 
 temperature of 20 degrees (Cent.), transformed that fluid into a gela- 
 tinous mass, but did not coagulate it. 
 
 The secretory function of the pancreas is so obscure, that it has not 
 yet been determined. 
 
 The biliary secretion soon appears, and is remarkably abundant. In 
 the foetus of the Cow at birth, a small quantity of clear bile having a 
 slight greenish tint is found in the gall-bladder; and at the fourth month 
 ■of gestation, the large intestines of this creature and the foetuses of 
 Solipeds are filled with meconium, which is recognisable through the 
 walls of the tube by its green hue. The foetal bile becomes thicker and 
 deeper-coloured as birth approaches ; it is insipid and alkaline. M. 
 Lassaigne analysed that of the foetus of a Cow six months old, and 
 found two colouring matters, mucus, the carbonate and chloride of 
 sodium and phosphate of lime, but no picromel. 
 
 Mixed with the fluids thrown out by the intestines and the other 
 matters entering them, it forms the meconium, which is composed, 
 a,ccording to Simon, of cholesterine 16,00 ; extractive matter and biliary 
 resin 10,40 ; caseous matter 34,00 ; picromel 6,00 ; green colouring 
 matter 4,00 ; and epithelium, mucus, albumin 26,00. This meconium 
 is scanty in the first periods of foetal life, and has been found to be 
 
WEIGHT AND DIMENSIONS OF THE FlETL'S AT BIRTH. Vlb 
 
 white in foetuses destitute of a liver, as well as in others whose intestine 
 was obliterated below the entrance of the biliary duct. It is very con- 
 sistent and plentiful in the intestines at birth, in those of a Foal whoso 
 stomach contained 2i29 grannnes weight of the white viscid fluid above 
 mentioned, there were found 216 grammes of greyish meconium in the 
 small intestines, and 559 of green in the large intestines. This product 
 is frequently expelled in certain quantities towai'ds the end of gestation, 
 and is found in the liquor anmii, winch owes its yellow colour to its 
 presence ; it is swallowed with this lluid, and is then observed in small 
 masses in the stomach. 
 
 The liver appears to bo engaged, during fu>tal life, in the depuration 
 of the blood, as appears from this accumulation of meconium, which is 
 chietly altered bile ; but at the same time, as has been stated, it is 
 serving as a blood-making organ, and this is probably its principal func- 
 tion before birth. 
 
 The secretion of urine is somewhat active during intra-uterine life,. 
 and appears to be el^ected by the Woltlian bodies before the kidneys 
 begin to act. It is not, however, until the end of gestation that a notable 
 quantity of urine is found in the bladder, and urea in the allantoic fluid 
 of the Cow. It is certain, however, that this fluid is not altogether the 
 urine of the fa^tus, as its proportion is relatively larger at an early 
 epoch of foetal life, and the connnunication between the bladder and 
 allantois is more limited towards parturition. 
 
 With regard to the function of the thyroid and thymus "glands," as 
 they have been termed, and the spleen and suprarenal capsules, during 
 fcetal life, there is but little positively known. It appears, however, to 
 be admitted that the ottice performed by tliese ductless or vascular 
 glands, is to restore to the circulating current any substances which 
 they may withdraw from it, and that their action is subsidiary to the 
 process of sanguification ; being exercised, perhaps, chiefly upon that 
 portion of the nutrient materials which did not pass through the 
 absorbent system when first introduced, but was taken up directly by 
 the bloodvessels. 
 
 SECTION VI.— WEIGHT AND DIMF.XSK )XS OF THE F(ETrS AT BIRTH. 
 
 The various phenomena coimected with development having been 
 completed, so far as uterine existence is concerned, it may be useful to 
 note wliat has been ascertained with regard to the icciyht and dtJiioi- 
 sious of the fa>tus at birth ; the latter being of much importance 
 from an obstetrical point of view, though it is a subject which has not 
 received all the attention it merits from veterinary obstetrists. 
 
 Weight. 
 
 With regard to weight, we find, as might be expected, that this 
 varies considerably, according to the size, breed, and condition of the 
 parents, and other circumstances which more or less influence growth. 
 
 For the Horse species, Boussingault estimated that Foals from parents 
 weighing from 400 to 500 kilogrammes, weighed at birth from 50 to 51 
 kilogrammes.^ Franck estimated that the Foal weighs 00685 the 
 weight of the mother before parturition. According to a table drawn 
 up by Saint-Cyr, it appears that a Foal at birth may vary in weight 
 between 31 and 55 kilogrammes, according to breed and individual 
 
 ' The kilogramme is equal to 2 205 pounds cvoirdupoii>. 
 
126 OBSTETEICAL 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 -jV^h to -^^th. of the weight of the Cow ; whereas 
 Eiedesel gives it as yV^h. 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 Lambs weighed at the Alfort pens, 
 is given by Magne as about 4 kilogrammes 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 
 2-6830, and the other 2-680 kilogrammes — the weight of the two being 
 ■5-310 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 well known that, in a general way, the fcetus is larger than the 
 pelvic opening through which it has to pass at birth, but 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 fcetus, 
 these being the dimensions which it is most important to compare with 
 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 stcrno-dorsal line to the vertical measurement taken from 
 the summit of the highest dorsal spines to the sternum, and hiscapulo- 
 liuineral line to the distance measured from one scapulo-humeral articu- 
 lation to the other ; while the bicoxo-fcmoral line is the measurement 
 •of the croup from one coxo-femoral articulation to the other. From the 
 measurements in the Horse species, we find that a Mare measuring a 
 trifle over fifteen hands in height, and whose pelvis was nearly nine- 
 teen inches in width, brought forth a Foal weighing slightly less than 
 thirty pounds, and whose sterno-dorsal measurement was nearly twelve 
 inches, biscapulo-humeral line 7| inches, and bicoxo-femoral line nearly 
 
PREOXAXry. 127 
 
 8 inches. The othei* measurements of Maros and Foals yielded similar 
 results, and give an idea of the expulsive ellbrts the uterus must make 
 to expel the fcetus. In the case tirst cited, it may be admitted that 
 the pelvis of the Mare had, approximately, the following dimensions : 
 inlet of the pelvis — sacro-pubic diameter, inches ; inlet of the pelvis 
 — bi-iliac diameter, 8^ inches. In comparing these dimensions with 
 those of the Foal to which it gave birth, it is obvious that the biscapulo- 
 humeral and bicoxo-femoral diameters of the latter could be easily 
 accommodated by the bi-iliac diameter of the mother, as they are less 
 by 1^ and ^ inch ; but it is not the same with regard to the sacro-pubic 
 diameter, which is less by nearly three inches than the sterno-dorsal 
 line of the fcietus. It is therefore evident that, in order to pass through 
 the pelvis, this line must be diminished at least by three inches. In 
 the second edition of his work, he gives the measurements of other 
 parts of the body of the fcttus, but their consideration leads to com- 
 plexity. In studying the table he has drawn up of these various 
 measurements in the Foal, he thinks an idea may be formed of the force 
 of the uterine contractions necessary to expel the foetus; and again 
 remarks that, even when the largest circumference of Foals only slightly 
 exceeds that of the pelvic inlet of the Mare, or is equal to it, a great 
 amount of accommodation must nevertheless take place in the thorax 
 of the young creature, as the sterno dorsal diameter is greater than the 
 sacro-pubic diameter of the mother. When gestation is prolonged the 
 fa'tus is still larger, and the difliculty in its expulsion is increased. 
 
 With regard to the Bovine species, nine Cows were tabulated. The 
 first, the smallest, was 11| hands high, and the width of the croup 18J 
 inches ; the weight of the fcetus was about sixty-two pounds, the 
 sterno-dorsal diameter 10.\ inches, the biscapulo-humeral G,',-, inches, 
 and the bicoxo-femoral 7i\ inches. Another Cow was l-2\ hands higli, 
 the width of croup IS^^ inches; the weight of the fa-tus was about 
 seventy-three pounds, the sterno-dorsal diameter 10^ inches, the 
 biscapulo-humeral G inches, and the bicoxo-femoral 8^'^ inches. With 
 a Cow 12? hands high, and croup 18 inches in width, which had 
 experienced a protracted accouchement in consequence of the size of 
 the calf, and which had aborted the previous year, the weight of 
 the fa-tus was sixty-six pounds, the sterno-dorsal diameter 15 inches, 
 the biscapulo-humeral 7^ inches, and the bicoxo-femoral 8^ inches. 
 The circumference of the chest of the Calf being so much greater than 
 the inlet of the Cow's pelvis, explains why it is tliat parturition in 
 this animal, even when normal, is longer than in the Mare. 
 
 With regard to the Ovine and Caprine species, the fa-tus is rela- 
 tively smaller in dimensions than the Calf ; while in animals which are 
 usually multiparous, the young are always less in circumference than 
 the pelvic inlet, though when it happens that they have only one foetus 
 this is often so increased in size that birth becomes very protracted, 
 and may even be impossible. 
 
 CHAPTER V. 
 Pregnancy. 
 
 Gkst.\tion, or i^rcgnancy, comprises the period during which the female 
 animal carries its young while this is undergoing development. Its 
 consideration is of much moment, and we will, with regard to it, study 
 
128 OBSTETRICAL PHYSIOLOGY. 
 
 it in this chapter from a normal or physiological point of view — noticing 
 the anatomical and functional alterations attending it, the mode of 
 recognising it, its duration in various species of animals, and the excep- 
 tional departures from the usual law with respect to the number of 
 young produced. 
 
 It has already been 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 ; while 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. 
 
 SECTION I.— MODIFICATIONS IX THE UTERUS DURING PREGNANCY. 
 
 With the development of the foetus, the uterus undergoes important 
 anatomical and physiological modifications ; while the system of the 
 mother also, as stated, participates more or less generally in the 
 phenomena which mark the period of gestation. The modifications 
 and phenomena are worthy of attentive notice, not only from the 
 importance they hold with regard to the reproduction of animals, but 
 also from the practical issues involved in the study. 
 
 The anatomical changes in the uterus are those relating to its volume, 
 structure, form, situation, and direction. 
 
 Voluvie. 
 
 With regard to volume, we have seen that during and after copulation 
 the uterus is congested, and that, when conception has taken place, the 
 thin pulpy secretion corresponding to the decidua of the human female 
 covers its internal surface. The vessels, distended with blood, gradu-. 
 ally enlarge to a great size — from the smallest to the largest forming 
 most intricate and beautiful plexuses on and in the texture of the organ. 
 The coats of the arteries are thickened to compensate for their disten- 
 sion, and the additional labour they have to perform ; while the veins 
 are still more enlarged in calibre. The lymphatics are likewise aug- 
 mented in number and dimensions ; and the nerves, w^hich were com- 
 paratively small in the unimpregnated state, enlarge and anastomose 
 so freely as to compose a network similar to that of the vessels — the 
 increase taking place in the nerve terminations, not in the nerve sub- 
 stance. 
 
 In uniparous animals in which the foetus is developed in one of the 
 cornua, this becomes greatly increased, and appears to be continuous 
 with the body of the uterus, the other horn looking like a mere appen- 
 dage projecting from its side ; but with multiparous females the'cornua 
 increase nearly alike in size, owing to their being each occupied by the 
 foetuses (Fig. 65). 
 
 Structure. 
 
 These changes add to the thickness and density of the uterus ; but 
 there are others still more remarkable. While the organ is increasing 
 in volume, becoming rounder, acquiring a greater capacity, and its 
 cervix widening, its proper structure is exaggerated to an extraordinary 
 degree. This exaggeration, however, does not occur equally through- 
 out ; it is most marked in the cornua of multiparous creatures at the 
 points where the young are fixed — in Euminant animals at the situa- 
 tion of the cotyledons, and in Solipeds at the part of the body of the 
 
MODIFICATloXS IX THE UTEJiL'S. 
 
 129 
 
 Uterus coiTcsponcling to the fa'tal i>laceuta. So that, at least in the 
 early months of pregnancy, it is thinnest towards the cervix. The 
 increased thickness of the organ, however, never equals that observed 
 in the human female, compared with which the walls of the uterus of 
 the domesticated animals are thin. 
 
 The firmness or density of the organ is always most conspicuous in 
 the cornua, and in the operation of "spaying," or castration of the 
 female, this serves as a useful guide in enabling the operator to distin- 
 guish between them and the intestines, which they so closely resemble 
 in appearance. 
 
 But during pregnancy this density seems to diminish as the organ 
 
 Fig. 64. 
 
 Vertical Section through a Portion ok thk Uterine Cotylkoon or a 
 Cow IN AN Eaui.t Stage of IMiegnancy. 
 
 o, Serous Membrane ; h. Section of Longitudinal Muscular Layer ; c, External, 
 and (•', Internal Layers of the Circular Muscle ; '/, SuWmucoxa, with Vessels ; 
 C, Adenoid Tis-un i,f the Cotyledon ; /' New Tissue of the Placenta Uterina ; 
 g. Section of the Mucous Lajer of the Cntyledon, with the Interspaces into 
 which the Fatal Cotyledons are inserted ; //, h, I'tricular tJlands piutsing 
 iinder the Side of the Cotyledon ; i, i. Large Cotyledonal Vessels ; k, Uterina 
 Mucosa ; /, /, Epitht-lial Layer of the Cotyledon. 
 
 becomes more vascular, and the cervix assumes a much softer condition 
 than usual. For instance, in the ftetal cornu of a Cow advanced three 
 months in pregnancy, the thickness of the wall was only 2*0 milli- 
 metres, while in the other horn it was 4 millimetres. In another 
 Cow at five months, it was 4 millimetres in the foetal horn and 5 
 millimetres in the vacant one. The mucosa is thicker, redder, more 
 pulpy and vascular, than before impregnation ; the longitudinal rugai it 
 then exhibited gradually disappear ; the epithelium covering it usually 
 loses its columnar form ; the utricular glands enlarge — they are longer 
 and their orifices wider, and their secretion, as well as that of the other 
 glands, is increased ; the interglandular tissue is largely and rapidly 
 augmented by multiplication of the ceils of the surface epithelium, and 
 
130 OBSTETRICAL PHYSIOLOGY. 
 
 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. 
 Rainard speaks of examining the uterus of several calves and lambs, 
 and finding only thirty or forty cotyledons ; while 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 hoi-n containing the foetus had forty-seven coty- 
 ledons and weighed 3,54 pounds ; while the other horn had only forty- 
 two placentae, 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 mucous membrane of the Mare, their 
 cavity being lined by 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 between the crypts, the size and areas of which correspond, 
 of course, to the size and arrangement of the foetal tufts. 
 
 Between the foetal and maternal placentae there is always a layer of 
 epithelial cells of varying thickness, which represents the viemhrana 
 decidua or serotina of woman. If not 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 foetal 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 sti-uctural 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 hyper trophied, the broad ligaments are increased in every direc- 
 tion, but especially in length, and muscular fibres are abundantly 
 developed between their layers, in order to give them sufiicient 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 muscular tunic. There appears to be a vast multipli- 
 cation of the fusiform nucleated fibres going on during pregnancy, as 
 
MUliIFICATKiXS IX THE rTKIU'S. l:Jl 
 
 wt'll as- an immense increase in the volume of those already existing'. 
 This tunic gi'adually becomes redder as well as thicker, and the muscular 
 fasciculi more distinct, and visibly more numerous ; its contractile 
 power also increases. The inner layer, composed of circular fibres, is 
 most conspicuous in the cornua of Carnivorous animals, and there tlii'y 
 contract in tlie interspaces between the younj^, so as to form well- 
 marked constrictions. The connective tissue which unites the muscular 
 fibres also increases during pregnancy, and becomes markedly fibrous. 
 
 Sensibility. 
 
 With the increase in volume, weight, and capacity, the uterus like- 
 wise acquires a higher degree of sensibility, doubtless from the develop- 
 ment of its nerves. So that between the cervix, the body, and the 
 cornua, there is established a sympathetic relation that is sometimes 
 not advantageous ; for irritation of the cervix, howsoever produced, 
 may bring on violent contractions of the whole organ, and lead to the 
 premature expulsion of the foetus. This expulsion, as is well known, 
 sometimes follows copulation ; though, as a rule, animals usually do 
 not seek to copulate during pregnancy if left to their own natural 
 instincts. It may also be a consequence of manipulation by the hand 
 of the explorer. 
 
 This contractility of the uterus is sometimes evidenced before par- 
 turition, when animals have been killed and quickly opened. Colin 
 has witnessed well-marked movements in the uterus of a Cat which 
 contained five young — three in one horn and two in the other ; these 
 contractions were most energetic at the constricted spaces between the 
 fa-tuses. The same talented veterinary physiologist has seen similar 
 phenomena in Sheep at different periods of gestation ; the cornua con- 
 tracted and dilated alternately, and approached or withdrew from each 
 other or the body of the uterus ; the movements persisting sometimes 
 for forty or fifty minutes after the animal's death. In a pregnant Cow 
 opened when alive, the same contractions were noted ; they became 
 more active and stronger under the influence of a slight irritation ; the 
 cornua changed their form in contracting; they shortened sensibly, 
 and became twisted on themselves at their anterior extremity. In a 
 Mare identical contractions were seen. 
 
 llaller had long ago remarked that, even in unimpregnated animals, 
 these uterine contractions were present—though they were most ener- 
 getic in the pregnant Bitches, Cats, and Rabbits he opened ; the move- 
 ment was spontaneous and peristaltic, like that of the intestines, and 
 it continued in the organ, even when it was removed from the body. 
 Those veterinarians who have had occasion to insert their hand into the 
 uterus of one of the larger animals, to adjust the fcctus or for any 
 other object, must have been astonished, and frequently embarrassed, 
 at the firmness with which the arm was grasped at the cer\-ix during 
 the expulsive efforts the creature made. 
 
 These uterine contractions are very powerful, and in all probability 
 their rliythm is analogous to that of the intestines — extending from the 
 extremity of the cornua towards the cenix in a peristaltic manner, 
 particularly in tiiose animals which, like the Bitch and Pig. have very 
 long cornua, with the young arranged one after another in them. 
 
 This increase in sensibility which the uterus acquires during gesta- 
 tion, must be considered as the organic cause of its contractions ; the 
 sensibility and contractility gradually diminish after parturition, during 
 
132 OBSTETRICAL PHYSIOLOGY. 
 
 which they reach their 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 which open on its internal 
 surface during the act, and thus prevents fatal haemorrhage. 
 
 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, the 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, the 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 the expenditure of its contractile power, 
 either through excessive distension, a delivery too prompt or too slow, 
 or general weakness of the maternal system. By 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 the 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 finger, 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 fojtus. The body becomes round, 
 and in the Carnivora, as already described, the cornua elongate and 
 show the alternate dilatations and constrictions due to the presence of 
 the young in their cavities. In the Mare, Cow, and Sheep, if there is 
 but one foetus, a single horn is enlarged — usually the right — to contain 
 the posterior limbs, while the other is relativelj" smaller and contracted, 
 and looks a mere appendage. When a Carnivorous animal contains 
 only one foetus, it is developed in the horn, 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 species each 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 
 may also be noted that, from being firm and dense at ordinary times, 
 its texture becomes gradually soft and elastic ; while it diminishes in 
 length, its projection into the vaginal cavity is lessened, and indeed at 
 a late period almost effaced, it appearing merely as a kind of ring. 
 
MOIJIFICATIOXS I.y THE UTERI'S. 
 
 133 
 
 separating the uterus from the vagina, and which is sometimes a httle 
 open. Not infrequently, if not always, the cavity of the cen'ix is lilled 
 with a plug of thick, adherent, glutinous matter, sometimes so abundant 
 that it also occupies the vagina, and forms an unpleasant obstacle to 
 
 Fig. 65. 
 
 The Gravid Uterus ok a Mcltiparocs anp Inipahous Animal. 
 
 A, Multipannis Uteni« : a, n'. Ovaries ; b, //, Fitnliriii' <>f Kallojiiftn Tubes, '', c'; 
 (i, d', Corniift <if I* terns — tliat on the left contains four EniliryoH, on the right 
 two, ono t)f which is exposed ; e. Body of Utcnis ; _/", Vagina ; f/, (j, Mesometry 
 <«r Ligament of Uterus. B, Uniparous I'terus : c, r'. Fallopian Tubes ; 
 e, Body of Iterus, coutaining early Uterine Ovum ; /, Vagina. C, Early 
 Uterine Ovum. 
 
 exploration, though it docs not interfere with parturition. We have 
 already alluded to the sensitiveness of the cervix. The cornua, also, in 
 becoming wider lose their inferior and posterior cur\-es. 
 
134 OBSTETRICAL PHYSIOLOGY. 
 
 Situation. 
 
 The uterus cannot change its form and volume without its situation 
 becoming altered. Before, and until a certain time after conception, 
 the body of the uterus is contained in the pelvis, but as it and the foetus 
 increase the position changes, and this also causes an alteration in the 
 situation of other organs. In the Mare the uterus gradually displaces 
 the pelvic flexure of the colon lodged in that cavity, and passes forward 
 below that viscus, towards and beyond the umbilicus, to rest on the 
 floor of the abdomen, in proximity to the diaphragm, stomach, and liver, 
 near the termination of pregnancy. In its development it is situated 
 chiefly in the middle line of the body, slightly inclining to the left, 
 because of the large mass of the colon occupying the right flank. 
 
 In Euminants, the uterus pushes the rumen and caecum out of the 
 pelvis, presses the mass of intestines to one side, and extends between 
 the right sac of the rumen and the abdominal walls. The presence of 
 the rumen in the left flank causes it to deviate somewhat to the right. 
 
 In mitltijjarous animals, in which the young are placed end to end in 
 the cornua, the latter rest on each side of the floor of the abdomen and 
 curve upwards ; in the Pig they incline somewhat to the right side, though 
 in all animals each cornu lies above its corresponding mammary line. 
 
 While these changes are taking place, the broad or lateral ligaments 
 are facilitating them by becoming unfolded and lengthened, and the 
 uterus in its increasing bulk extends backwards as well as forwards. 
 The cervix, firm and resisting, approaches the vulva, and to such a 
 degree sometimes that, in certain breeds of cattle — particularly those 
 which have the pelvis wide and inclined posteriorly, and bear large 
 calves — the posterior portion of the vagina appears between the labia 
 of the vulva a month or more before parturition, and especially w^hen 
 they lie down. 
 
 With other Cows, however, whose abdomen is very pendant, the 
 opposite occurs ; for the uterus, in passing forwards and downwards, 
 carries the anterior portion of the vagina behind it, and this cavity 
 becomes lengthened and constricted posteriorly, while the cervix is 
 shortened, and the vulva appears to be deeply buried between the 
 tuberosities of the ischium. 
 
 Directio)i. 
 
 With regard to the direction of the uterus, it is to be noted that its 
 horizontal position in the domesticated animals obviates those lateral 
 displacements which are so frequent in woman — its weight, and that 
 of its contents, maintaining it in an antero-posterior direction, and in a 
 line with the body of the animal. This direction rarely varies to any 
 appreciable degree, and it is only in a case of hernia at the flank, which 
 is very uncommon, that it inclines to one side. The only marked 
 inclination it assumes is forward and downward in Cows, whose 
 abdomen is very wide and pendulous. Otherwise, the uterus keeps its 
 normal direction. Eainard draws attention to a form of abdominal 
 hernia which gives the uterus a particular direction ; it is that which 
 takes place in the Mare or Cow, in the vicinity of the crural arch, when 
 the uterus, or one of its horns containing the foetus, descends behind 
 the corresponding mammary gland, or into the subcutaneous connective 
 tissue of the inguinal region, forming a large tumour in which the limbs 
 of the young animal can be felt. 
 
 Another change in the direction of the uterus, which it is most 
 
MODIFICATIONS jy THE (TEUrs. 135 
 
 important to consider in the larger animals, is the more or less com- 
 plete rotation or twisting on its axis of this organ — its upper face 
 becoming the lower, or again becoming superior after describing an 
 entire circle ; for this torsion occasions serious changes in the form of 
 the cervix and the direction of its cavity. The position of the cervix is 
 the inverse of that of the uterus, being always found on the 
 side opposite to that of the new direction of the organ itself; it is 
 directed upwards if the uterus is downwards, and if the latter twists to 
 the right or left the cervix goes to the left or right. Cases are men- 
 tioned in which torsion of tlie cervix itself has been found ; and though 
 it has been argued that the lateral ligaments would not permit this 
 malposition, yet there can be no doubt as to the fact. Lecoq of Bayeux, 
 cited by Raiuard, found in a Cow that had died through non-delivery, 
 the upper face of the uterus tui-ned towards the floor of the abdomen, 
 rotation having taken place from right to left ; the utero-vaginal 
 portion was twisted on itself, and the suspensory ligaments were 
 themselves twisted around this part. Numerous cases are recorded 
 which incontestably prove that, during pregnancy, the uterus performs a 
 half, or even a complete revolution on itself, producing torsion of the 
 cervix and the posterior part of the vagina, and consequent strangula- 
 tion of the organ near the neck, by the suspensory ligaments; so that 
 spontaneous delivery of the young animal by the natural passage is 
 impossible. 
 
 Influence on ami Alteration, in the Position of Neiijlibourimj Organs. 
 
 The alterations occurring in the uterus necessarily bring about others in 
 the neighbouring organs with which it lias mechanical relations. The 
 changed position of the organ in the abdominal cavity has been alluded 
 to In the Mare and Cow the horn in which the limbs of the fcctus is 
 lodged becomes extended and displaces the intestines, pushes the 
 stomach more to the left, rests on the liver, and is an obstacle to the 
 free movements of the diaphragm. The suspensory ligaments of the 
 uterus retain that organ and the cornua in situ ; but when they, in 
 the early stage of gestation, begin to extend forward, the vagina is 
 lengthened, until at a later period, when the size of the ftt'tus forces the 
 uterus backwards into the pelvic cavity, that canal is also pushed back 
 and forms a circular enlargement in the vulva. Its lining membrane, 
 owing to the compression and the increased circulation of blood through 
 it, assumes a violet or dark-brown tint, and appears to become thick- 
 ened, while it secretes a larger quantity of viscid mucus. 
 
 The pressure the gravid uterus exercises on the bloodvessels of the 
 hind limbs and the vulva and rectum, retards the venous and lym- 
 phatic circulation ; so that towards the end of gestation, and especially 
 in the Mare, there is often considerable adema of these parts. This 
 oedema is all the more marked, in the Cow as well as in the Mare, 
 when the compression is greatest at the posterior parts of the abdomen, 
 towards the commencement of the sapliena and mammary veins. 
 
 The anlema is always greatest in those cases, somewhat rare it is 
 true, in which there is a giving-way of the abdominal parietes near the 
 crural arch and above one of the mammic, when the uterus forms a 
 hernia beneath the skin ; then there is seen an enormous swelling at the 
 upper part of the limb. 
 
 The udder increases notably in volume, and it and the teats become 
 tense. In the Carnivora, the prominences of the mammaj, especially 
 
136 OBSTETRICAL I'HYHIDLOGY. 
 
 the ventral ones, are increased by two rows of elevations on each side 
 of the linea alba, which correspond to the portions of the cornna in 
 which the young are being developed, and where they form projections 
 on the wail of their sac. 
 
 The increase in volume and the various changes which the gravid 
 uterus undergoes, bring about alterations in, and frequently derange- 
 ment of, certain functions. Fortunately, however, these alterations are 
 slow and gradual ; so that the different organs concerned generally 
 adapt themselves to their changed condition without much inconveni- 
 ence. The animal becomes lazy and slower in movement, and is more 
 desirous of quiet and tranquillity as gestation advances. These indica- 
 tions are observed at an early period. At the same time the abdomen 
 enlarges and changes its shape : it becomes rounded, and projects 
 below and on each side beyond the crural region, while the flanks 
 become hollow, the croup and thighs wasted-looking, and the sacrum 
 and external tuberosities of the ilium more salient. 
 
 In the domesticated animals there are rarely observed those dis- 
 turbances in the digestive organs so marked at the commencement of 
 pregnancy in woman. On the contrary, immediately after conception, 
 possibly because the oestrum has disappeared, the appetite is increased, 
 digestion is usually easier, and all the formative phenomena seem to 
 acquire increased activity ; more use appears to be made of the food in 
 the economy, and there is a notable tendency to fatten. This tendency 
 has been taken advantage of by breeders and feeders of animals which 
 are destined more for food than reproduction ; and those intended for 
 slaughter are usually rendered pregnant, and fed until about the middle 
 period of gestation, when they have reached their most favourable 
 condition — as towards the last period this tendency vanishes, and 
 wasting is more apparent, due to the increased demands of the foetus 
 and the enlargement of the mammary glands. 
 
 In some cases, however, and particularly with the Cow, the appetite 
 becomes somewhat depraved, the animals eating soil, gnawing the 
 walls or woodwork of their stable, drinking foul water, etc., and very 
 exceptionally there may be vomiting. ^ 
 
 With the increased bulk of the uterus, as has been observed, the 
 abdominal and thoracic organs experience more or less the effects of 
 the compression it exercises on them. The diaphragm is pushed 
 forward, and diminishes the capacity of the thorax and the expansi- 
 bility of the lungs ; the ribs, encumbered by the w^eight of the foetus, 
 are raised with difficulty by the muscles of inspiration, so that respira- 
 tion is frequent and shallow, and the creature 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 
 the vagina, and indirectly on the neck of the bladder, causes attempts 
 at micturition to be more frequent ; while the compression on the 
 liver, vena portae and vena cava, explains the mechanical obstruction 
 to the circulation and subsequent cedema, particularly in the Mare. 
 
 In addition to all this, the blood is more or less modified. Its abso- 
 lute quantity is certainly not diminished ; on the contrary, it may be 
 increased to a certain extent ; but its corpuscles diminish in number in 
 a very perceptible manner, giving rise to a hydraemia more allied to 
 anaemia than anything else. 
 
 1 An instance of this very rare accident is given in the Etat Sanitaire des Animaux 
 Domestiques de Belgique for 1877, p. 65. 
 
POSITION OF Till-: FiKTI'S IX THE UTEltrs. 137 
 
 SECTION 11.— POSITION Ol' THK IdlTlS IN IHK UTERUS. 
 
 The position of the fa'tus in the uterine cavity is pretty well constant 
 in the same species ; and this position it retains more or less during 
 intra-uterine existence and until parturition occurs, when it is changed. 
 
 Brugnone, cited by Eainard and Saint-Cyr, writes : " If the uterus 
 of a Mare be opened longitudinally at the ninth or tenth month of 
 gestation, we find the fcetus with its head directed backwards, and bent 
 in such a way that its lower jaw touches the throat and its mouth the 
 breast. It forms an arc of a circle — the neck being in contact with the 
 sacrum, and the spine being bent round is turned towartls the right 
 or left side of the lower part of the abdomen. The limbs are Hexed, 
 the fore ones in such a manner that the knees reach the middle of the 
 head and tlie feet the umbihcus ; while the hind limbs are doubled 
 under the abdomen. The croup and haunches are at the bottom of the 
 uterus, in the vicinity of the stomach." The head may sometimes be 
 directed forwards. 
 
 Colin states that towards the termination of pregnancy, the foetus of 
 the Mare lies with the belly upwards, the hinder limbs in the longest of 
 the uterine cornua, and the anterior limbs and head directed towards 
 the cervix uteri. 
 
 In the Cow, according to Saint-Cyr, the uterus is curved downwards, 
 the superior convexity of the body being prolonged forward by the 
 cornu in which the fu'tus is partially developed. When the uterus is 
 opened, the ftctus is discovered with the head bent Imck, the body much 
 inclined and looking as if almost lying on one side, and pressing on 
 the empty cornu, which is considerably less developed than that of 
 the opposite side, and which is also lower. Otherwise, like the Foal, 
 the Calf is curved en arc, the head more or less near the sternum, and 
 the limbs flexed and close together (Fig. 46). 
 
 According to Colin, the belly of the fa'tus is downwards in Ruminants, 
 and towards the concavity of the cornu, the head being directed 
 backwards. 
 
 In multiparous animals, the fa'tuses are distributed in the two cornua, 
 one after the other, the head being usually turned toward the cervix 
 uteri, sometimes to the opposite side, and the abdomen lying towards 
 the concave portion of the cornua, wliere the broad ligaments are 
 attached and the vessels enter. In the Sow, however, it has been 
 noted that the young lie in a contrary direction ; the head, instead of 
 being presented to the cervix uteri, is turned towards the ovarian ex- 
 tremity of the cornu, though the abdomen and limbs always corre- 
 spond to the concave border of the horns, as it is there the placenta is 
 situated. 
 
 In forty-three Cows and Sheep, Colin found in twenty-five the foetus 
 in the right cornu, and in the left cornu in eighteen. At first sight it 
 might be supposed that the preference for the right cornu was due to 
 the impediment offered to development in the left by the large digestive 
 organs of these animals ; but this difference cannnt have any influence 
 on the function of the ovaries, the dehiscence of the Graafian vesicles 
 in the right being apparently more frequent than in the left. In mul- 
 tiparous animals, the foetuses are rarely equal in number in both cornua, 
 though neither of the latter has a constant advantage over the other in 
 this respect. 
 
 The position of the fcetus towards the termination of gestation may 
 
138 OBSTETIUCAL FHYHIOLOGY. 
 
 vary occasionally, and even frequently, owing to the active reflex move- 
 ments which it performs ; and to these energetic movements, it cannot 
 be doubted, are due the difficult presentations which the fojtus offers so 
 frequently (at least in some species) at birth. 
 
 SECTION III.— SIGNS OF PREGNANCY. 
 
 Having traced thus far the process of utero-gestation, we have now 
 to study the signs by which this process reveals itself. This study is 
 very important, in several respects, to the comparative pathologist, or 
 rather to the veterinary surgeon, whose science extends beyond patho- 
 logy, and who is frequently called upon to give an opinion as to whether 
 an animal is or is not pregnant. 
 
 The signs which announce pregnancy are numerous and varied, though 
 they are not all reliable, and several are very deceptive and not peculiar 
 to gestation. Indeed, it has frequently happened that animals whose 
 condition was not at all certain have brought forth young, and others 
 have done the same without giving rise to any suspicion that they were 
 pregnant ; though it must be remembered that at first there is nothing 
 present to guide one in forming an opinion as to the animal having 
 conceived. 
 
 Nevertheless, in order that a correct opinion may be arrived at, the 
 most equivocal signs must be taken into consideration, as well as those 
 which are, so to speak, unequivocal — indeed, they ought to receive, for 
 this very reason, more than ordinary attention ; as it is a matter of 
 much moment, and particularly in cases of jurisprudence, that the 
 veterinarian should be able to speak positively as to the existence or 
 absence of pregnancy. 
 
 The diagnosis of pregnancy is not always easy, and it is all the more 
 difficult as the stage is early. 
 
 In order to study the signs of pregnancy conveniently, it is usual to 
 divide them into two categories — the certain and the prohahle signs ; or 
 into three categories as follows: 1. The rational, physiological, or sub- 
 jective signs ; 2. The material ox objective signs; 3. The sensible signs 
 which are derived from observation and manipulation, in order to ascer- 
 tain the presence of the foetus. In this study, of course the larger 
 animals will be more particularly referred to, because of their relatively 
 higher value and importance, and their longer period of gestation ; and 
 also because the veterinary surgeon is most frequently consulted as to 
 their condition. 
 
 national Signs. 
 
 There are several rational signs due to the modifications broiight about 
 in the economy of the pregnant animal, and manifested by alterations 
 in temperament, character, and aptitudes. 
 
 The cessation of heat or rutting is, perhaps, the earliest subjective, 
 though it is certainly not the most cei'tain, sign of gestation, and may 
 even lead to mistakes. It is usually manifested soon after conception 
 has taken place (six or eight days), by a decrease in the venereal excite- 
 ment which marks the period of oestrum ; the animal, as has been men- 
 tioned, is comparatively tranquil and does not exhibit any desire for the 
 male, neither does she neigh, paw, or show the usual concomitant 
 symptoms of "heat." If the male approaches, the sexual desires are 
 not excited, and in refusing him the female may even resort to aggres- 
 
SI'.'XS OF VnEny.tXCY. 139 
 
 sive niovements. So that it has usually been held as a sign of concep- 
 tion, if the female refuses the male soon after copulation, and particularly 
 if a month or two has elapsed, and tiie Mare is in good condition and 
 well fed. But in some cases the symptoms of " heat " persist for some 
 time after coition, and the erethism of the generative organs is not 
 allayed, although in reality impregnation has taken place ; and in very 
 exceptional instances the " heat" will return after having disappeared 
 for a certain time. Some ]\Iares which have been pregnant for two or 
 thi'ee months, and especially those which have been put to the Stallion 
 early in the year, will e.xhibit indications of (i^strum when the weather 
 becomes warmer and the pastures afford more nutriment. When in 
 this state the female may again accept the male, and it may even 
 happen that a second fecundation takes place at this time — thus 
 occasioning those somewhat unusual conceptions which give rise to 
 superfa'tation ; though if pregnancy is somewhat advanced it is danger- 
 ous, and may occasion abortion. A story is told of a Mare in the 
 Saint-Leger stud, France, which, after being pregnant for some months, 
 yet showed symptoms of " heat." Louis XIV., who was more inclined 
 to favour the desix^es of the animal than to listen to the opinion of 
 Garsault, the famous equestrian of that period, ordered her to be put 
 to the Stallion. This was done, copulation took place, and the Mare 
 aborted. 
 
 Stallions exclusively employed for breeding, frequently refuse to 
 approach pregnant iMares in which the " heat" persists or reappears; 
 though this is not always the case, particularly with young Stallions. 
 
 In the Cow, as in the Mare, oestrum may continue or reappear after 
 fecundation ; though as a rule, I believe, the male refuses to copulate 
 again when the female is in this condition. " Very often," says 
 Grognier, " the Mare and Sheep, as well as the Cow, manifest signs of 
 'heat' ; but the Bull, better than the Stallion or Earn, knows the in- 
 dications of gestation, and abstains from having intercourse with Cows 
 which are in this state." M. Magne remarks that the Bull accustomed 
 to consort with pregnant Cows, smells at them as it does at others going 
 with it, but without being excited by their emanations. Exceptionally, 
 however, it must be noted that Cows have been known to manifest 
 a-strum regularly, and to receive the Bull, even a month before parturi- 
 tion. But these instances are very rare For cattle, therefore, it is an 
 almost certain sign of pregnancy when the Bull refuses a Cow, though 
 the latter may be in heat. 
 
 With Sheep a'strum may continue after fecundation, and the Ram 
 may copulate with them. 
 
 In general terms, then, it may be repeated that the cessation of 
 cestrum before its regular period, and soon after copulation, indicates 
 that conception has taken place ; that its persistence or reappearance 
 in the Mare and Sheep some time after the first copulation, does not 
 absolutely imply that impregnation has not occurred, even though the 
 male again consorts ; but if it frequently appears it is a presumption 
 that the female is not only not pregnant, but that fecundation is not 
 readily induced. 
 
 It has been generally observed that a change takes place in the char- 
 acter of the animal which has conceived, and this sometimes almost 
 immediately after conception ; the change being something analogous 
 to that produced after castration. Mares which were previously vicious, 
 
140 OBSTLTSICAL PIirSIOLOGr. 
 
 troublesome, or unsteady when in "heat/' are nearly always gentle and 
 tractable when in foal : the genital excitement which caused their 
 capriciousness or viciousness being allayed, they are no longer under its 
 induence. This change, when occurring after copulation, is a valuable 
 sign of successful impregnation ; and though it may sometimes fail, yet 
 whtn present it can scarcely lead to a mistake. If, on the contrary, 
 the animal has not been fecundated after one or more coverings, 
 if previously vicious its vices become exaggerated when 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 order 
 to get these animals in good condition for market, when they 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 
 in the Sheep and Pig at the last month, when the mammte 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 eating earth, drinking filthy water, Ucking walls, and 
 gnawing innutritions 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, trot, 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 fcetus 
 itself 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 speed 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. 
 
 2Iatenal Signs. 
 
 The material, physical, or objective signs are those depending upon 
 the change in volume of the abdomen and the mammc?, the appearance 
 of the milk in the latter, alterations in the composition of the urine, and 
 increase in iceight 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 fianks become hoUow, and the spine appears more concave in the 
 dorso-sacral region ; while the lateral portions of the croup sink so 
 much as to make the sacrum and haunches towards the root of the tail 
 look more salient. These phenomena are progressively developed as 
 gestation approaches its term, when they are very evident. In the 
 
SKINS OF I'RKGNA NC Y. HI 
 
 Mare thuy are irrej^ular in tlieir appearance, commencing three or four 
 months after conception, and do not possess the same value in every 
 instance ; for there are some animals in which the ahdomen is scarcely 
 at all unusually developed, and particularly the Mure — which is uni- 
 parous — until n(;ar parturition ; and others, generally those at j)asture, 
 or which have had a numher of fuals, that always have the helly coii- 
 siderahly developed and pendulous, and in which it is diflicult to per- 
 ceive any increase, even when they are in foal. 
 
 Jk'sides, some diseased conditions — as ovarian dropsy, uterine poly- 
 pus, hydrometra, ascites, impervious vagina, etc. — may give rise to 
 amplification of the abdomen ; and it must not be forgotten that Marcs 
 fed on poor fibrous forage not unfrequently have the belly enlarged. 
 So that of itself this is not at all a sure criterion of pregnancy. 
 
 Taken in connection with the other signs, however, the increase in 
 the abdomen — most marked towards its inferior third, and becoming 
 evident toward the fifth or sixth month of pregnancy — has a certain 
 value. It is most noticeable, perhaps, in looking at the animal from 
 behind ; though repeated examinations at various intervals may be 
 necessary to ensure certainty, and in important cases it may even bo 
 necessary to have recourse to measurement of the abdomen. 
 
 The cnlanjcvient of the mainvue is a sign which varies considerably in 
 different species, according to the condition of the females. In pri- 
 miparous animals, as the Mare and Cow, they begin to increase soon 
 after conception— towards the second or third month. The udder is 
 more prominent and firm to the touch, loses its wrinkles, and the teats 
 are more visible. This appearance is generally only ephemeral and 
 partially disappears, to reappear again more markedly after some 
 weeks ; then to subside and show itself several times during the period 
 of gestation. 
 
 Besides this mammary enlargement in the primipara, and which may 
 be accepted as a certain indication, these glands furnisli, towards the 
 last third of the period of gestation, a yellow, viscid, transparent liquid 
 — the colostrum— similar to white of egg, and wiiicli can be easily 
 extracted from the teats by milking. In those which have never con- 
 ceived, manipulation of the teat may furnish a drop or two of a watery- 
 like fluid, but in two or three months after fecundation it becomes 
 slightly increased in quantity, and is now viscid in consistency. It 
 gradually increases in quantity and quality, and about the period men- 
 tioned it has changed into colostrum. In the last weeks of })regnancy 
 this liquid sometimes Vjccome white and opaque, as well as less viscid, 
 and is then proper milk. When the animals have bred several times, 
 the increase in the size of the udder is only remarked in the last days 
 of gestation. In milch Cows, and particularly in those wliich are not 
 good " milkers," another sign is to be found in the diminution of 
 the lacteal secretion, and the shrinking of the gland some time after 
 conception — usually about the twentieth day. 
 
 In the pregnant Mare which still has a Foal running with her, the 
 secretion of milk also ceases some time before parturition ; and the 
 animal appears to be aware of this, for it weans the Foal generally 
 between the sixth and eighth month. 
 
 In the smaller animals the enlargement of the mamma; and the 
 appearance of the milk are usually remarked earlier, and more regularly, 
 than in the larger creatures. 
 
 In animals which have borne young, similar changes to those 
 
142 OBSTETRICAL PHYSIOLOGY. 
 
 observed in primiparge take place, but the mammae may be later in 
 enlarging. 
 
 Though, in a natural state, the mammary glands are only intended 
 to furnish aliment to the young creature until it is sufficiently strong 
 and active to find its own food, when they suspend their function ; yet 
 domestication has greatly modified their secretory power in some 
 species — as with the Cow, Goat, and sometimes the Ass and Sheep — 
 and the secretion of milk becomes an almost permanent function. Not 
 only this, but at times the secretion, as observed in the unimpregnated 
 Bitch, is very anomalous and unnatural. In the non-pregnant female 
 of various species — not excepting the human species — the secretion may 
 appear naturally, or be induced by mulsion or frequently repeated 
 suction of the teats, even in very young creatures, a short time after birth ; 
 and what is more astonishing, male animals have in rare instances 
 assumed a function which is always looked upon as specially charac- 
 teristic of the female sex at the maternal period. So early as the days 
 of Aristotle — who mentions a he-goat which yielded milk — this strange 
 phenomenon has been at times observed ; and M. Lecoq testifies to 
 an Ox, in process of fattening, having the four rudimentary mammae 
 increased in volume and yielding milk which furnished cream, and 
 became casein when an acid was added to it. 
 
 Certain alterations in the composition of the urine have been re- 
 ported by M. Keiner of Giinsback, which, with other circumstances, 
 might, if found to be trustworthy, be valuable as an aid in the diagnosis 
 of pregnancy. He has discovered that the salts of lime in the urine 
 diminish in proportion as the foetus requires these for the formation of 
 its bones ; and his discovery has been tested by a chemist whose 
 analysis of this fluid, obtained from a pregnant Mare, shows that the 
 lime lessens very much as the time for parturition draws nig'.i. At the 
 fifth or sixth month it is diminished 55 per cent., and to 70 per cent, 
 from the sixth to the ninth month. 
 
 It has been proposed to weigh animals which are suspected to be 
 pregnant, at certain intervals ; an increase in weight being an evident 
 accompaniment of growth in the foetus. In this direction, Eueff has 
 recorded that Mares, towards the fourth or fifth month of pregnancy, 
 have shown an average increase in weight of more than eleven pounds 
 in eight days, and he particularly recommends this aid to diagnosis, 
 which appears to be most useful at mid-term. 
 
 It may be noted as an additional aid in diagnosis, that with the 
 progress of gestation the mucous membrane lining the vulva and 
 vagina becomes swollen, and assumes a red or bluish-i-ed hue, instead 
 of its usual pink colour ; and towards the termination of pregnancy, 
 the secretion of vaginal mucus, particularly in the Cow, is largely 
 increased. 
 
 All these numerous signs are by no means to be implicitly relied upon, 
 however, as they are not infallible in proving the existence of pregnancy 
 in every case ; some of them are only noticeable at a late period, while 
 others may be absent. It is necessary in taking them into considera- 
 tion, to distinguish those animals which are kept at pasture and destined 
 for breeding, from those which are kept in the stable and used for 
 various purposes. With the first, the cessation of oestrum and the 
 refusal of the male are almost certain indications of conception ; while, 
 with the latter, the same phenomena may be the result of fatigue or 
 bad food and mismanagement. 
 
SIGXS OF PREGXAXCV. U3 
 
 With regard to fattenintj, change of temper, etc., it is evident that 
 they may depend upon other causes than pregnancy ; and obesity 
 can only be very conspicuous in primiparous animals, or those which 
 are not rearing young ; for Glares or other creatures put to the male a 
 few days after parturition, are not likely to accumulate fat and rear 
 their progeny at the same time. When, however, all the above signs 
 are manifest in an animal, they establish a very strong presumption, 
 though not an absolute certainty, as to its condition. It is not until a 
 later period, when the abdomen begins to increase more rapidly in 
 volume, the animal becomes sluggish, and the mammio enlarge and 
 secrete the viscid fluid just described, that the existence of pregnancy 
 might safely be attirmed. 
 
 The chances of error in diagnosing pregnancy in the first half of the 
 period are numerous, and even up to a later stage — until parturition, in 
 fact — these indicative signs may be absent. I know of an instance in 
 which an unfortunate Mare was ridden to hounds until the day before 
 it gave birth to a dead foal, and perished. 
 
 Sensible Signs. 
 
 Wlien the contractility of the fa>tal muscles begins to be developed — 
 which is towards the fourth month in the larger animals — the young 
 creature can move, though the movements are too feeble to be recog- 
 nisable externally at an early period ; but later, towards the end of 
 pregnancy, they become vigorous and unmistakable. 
 
 To obviate as much as possible the risks of error in diagnosing 
 pregnancy, various expedients have been resorted to in order to 
 ascertain with certainty the presence of the foetus in the uterus, by 
 exciting these movements. Some of these are as barbarous as they are 
 stupid. One especially merits the strongest condemnation ; this is 
 pouring water into the ears of the Mare or Cow, under the supposition 
 that if the animal is not pregnant it will shake its whole body to get 
 rid of the fluid, but if pregnant that it will only shake the head and 
 ears. Another cruel and dangerous test is causing these animals, but 
 especially the Mare, to run very quickly for a certain time, and to give 
 them cold water to drink or oats to eat immediately afterwards, in 
 order to excite inordinate movements in the foetus. It will readily be 
 understood that these and other vicious practices are very likely to 
 produce abortion, and that they should therefore be discountenanced 
 and discontinued. The only useful and practicable means tliat can be 
 resorted to, are those which appeal to the senses of touch, sight, and 
 hearing. But it must be remarked that these have fewer oppi^rtunities 
 for their exercise, and are more limited in their application, in animals 
 than in woman. 
 
 Qn feeling or touching, watching the movements of the foetus as they 
 are manifested externally, and auscultation, we must mainly rely, and 
 these afford, with the other signs, the only conclusive evidence we can 
 obtain. 
 
 The indications obtainable by manual exploration are through the 
 abdominal, rectal, and vaginal touch. The feci of the abdomen does not 
 yield equally certain results in all the domesticated animals. In those 
 which are small, as tlie Bitcli and Cat, a little careful manipulation will 
 render the presence of the creatures in utcro very evident towards the 
 middle period of gestation : but in the larger animals — the Mare and 
 Ass on the one hand, and the Cow on the other — there exist con- 
 siderable differences, as pointed out by Trasbot. 
 
144 OBSTETRICAL PHYSIOLOGY. 
 
 In the Cow after the fifth or sixth month, the presence of the 
 foetus can be readily ascertained by this means; but in Sohpeds it is 
 not until the seventh or eighth 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. The examiner stands on the right side 
 of the Cow, the left of the Mare, with his back towards the animal's 
 head, and applies the palm of his right or left hand against the abdomen, 
 immediately below the flank, about eight or ten inches in front of 
 the stifle, and just above the udder, pressing moderately, the other 
 hand resting on the back. At this part of the abdomen a hard volu- 
 minous mass can be felt in the uterus, while the movements of the 
 foetas are perceptible as it stirs at irregular intervals, and causes the 
 jerks and shock of its displacements to be communica,ted to the walls 
 of the abdomen. These movements are strongest in the morning, and 
 are more distinct if the mother is eating or drinking, especially if the 
 water is cold, or immediately after feeding. Some old authorities 
 recommend that, to render the movements of the foetus more per- 
 ceptible, the Mare should be trotted, put in the stable and given 
 some food, and then, by placing the hand on the before-mentioned 
 region, the foal will be felt if it is there. The distention of the stomach 
 by food compresses the other abdominal organs, and especially the 
 uterus, and the inconvenient displacement excites the young creature to 
 movement. The ingestion of fluids does the same, and particularly if 
 they are cold ; for then they powerfully affect the foetus by the uncom- 
 fortable sensation they give rise to. Cold water thrown against the 
 belly, or the application of the cold wet hand, will produce a similar 
 effect. In the Cow, smart compression of the abdomen with the closed 
 fist at the part just indicated, so as to push the uterus upwards and 
 allow it to return with a little force, is also a good method of ascertain- 
 ing the presence of the foetus, and will prove successful when simple 
 application of the flat hand will fail. It is most likely to succeed 
 when there is not much food in the stomach and intestines, as the 
 uterus is then much easier displaced. When this compression has been 
 made with some energy, the uterus strikes the abdominal wall immedi- 
 ately afterwards, and then there can be perceived a firm voluminous 
 mass ; this is the uterus containing the foetus. 
 
 At a more advanced period, in the last two months, the movements of 
 the foetus can be easily remarked as it jumps about briskly, striking 
 the interior of the abdomen at brief intervals. This, and the other 
 signs appreciable at this time, leaves no doubt as to the existence of 
 pregnancy. The foetal movements are never more marked and pre- 
 cipitous than immediately before abortion, at a late period of gestation; 
 they are then energetic, and to all appearance convulsive. 
 
 With the smaller animals the same methods of exploration may be 
 resorted to, and with the same, or even more marked results. The 
 perceptible movements of the foetus of course settle the question as to 
 pregnancy and the vitality of the young creature ; but their absence is not 
 conclusive as to the contrary, for it has not infrequently happened that 
 the foetus remained insensible to this kind of excitation, and yet was 
 alive at birth. The tests should be applied more than once in these 
 doubtful cases. 
 
 It maybe noted that the "feel" of the abdomen distended by the 
 
/'A'AV/.vj.V'-)'. 145 
 
 xiterus is very ditferent when tlie distention is caused by fluid, Hatus, 
 etc. The uterine tumour is firm, liard, elastic, and defined, preserving 
 its form in all positions of the body ; whereas in ascites the swelling 
 is not defined, there is no repercussion on compression at the flank 
 of the Cow, the fluid obeys the laws of gravitation, and the abdomen 
 has not the same firm, elastic feel. Percussion will aid in distinguish- 
 ing between pregnancy and tympanitis. In certain diseased conditions 
 of the uterus, however, a diagnosis is very difficult, and the next means 
 of exploration will have, in some of these embarrassing cases, to be 
 adopted. 
 
 Rectal exploration, as well as that by the vagina, can only be success- 
 fully carried out in the larger animals, because of the small dimensions 
 of these ))assages in such creatures as the Bitch and Cat. The risks 
 attending this mode of examination liave been at times much exag- 
 gerated, and there is really but little danger to the animal so long as 
 reasonable precautions are taken not to produce injury ; the foetus has 
 even been pushed gently about in the uterus without any accident to it 
 or the parent. After the third month it will afi'ord an indication of 
 pregnancy. 
 
 To examine an animal per rectum it should be standing, and, if 
 dangerous or irritable, the twitch may be applied to the nose, or for 
 safety to the operator the hind limbs must be secured ; with the Cow, 
 the nose seized by one hand of an assistant and a horn by his other 
 hand, will be sufficient. The bowel should be emptied of the fccces it 
 may contain, so as to allow the oiled hand and arm of the explorer to 
 be introduced and freely moved about. When the abdomen is large 
 and pendulous, it is useful to place the animal hi^^her before than behind, 
 and to have the lower part of the belly raised by assistants on each 
 side, by means of a sheet or sack, or even their hands joined beneath, 
 so as to throw the uterus backwards and upwards ; though in the 
 majority of cases these measures are not necessary. The hand being 
 passed into the rectum to beyond the brim of the pubis, it is opened 
 iind the palm placed on the lower surface of the intestine and gently 
 ])ressed downward, towards the floor of the abdomen ; when there will 
 lae felt, if the animal is pregnant, a hard irregular mass, more or less 
 voluminous according to the stage of gestation, and capable of being 
 <]isplaced to a certain extent — even partially brought into the pelvis, if 
 parturition is near. In this case, the head or other parts of the foetus 
 can be distinguished through its envelopes and the uterine and rectal 
 walls. But if pregnancy is not so advanced — ^say only at the sixth 
 month, the fcetus cannot be so readily felt, and it may happen that at 
 this period it is situated low down in the abdomen, or well forward in 
 one of the horns of the uterus, and lying to one side of the mesial line 
 (nearly always to the right in the Cow) ; so that an inexperienced or 
 careless examiner might miss it altogether at the first exjiloration. 
 This error can be avoided by carefully moving the introduced hand to 
 the right and left as far as the intestine will permit, with the animal's 
 l)ody inclined backwards and the belly raised by assistants, as just 
 <lescribed. The ftt'tus should be excited to move, if possible, so as to 
 guarantee its presence. 
 
 The difficulties are greater if it is desired to know whether the fcetus 
 is alive or dead. Sometimes we may at once perceive the movements 
 of the young creature in the uterus ; but at other times it is motionless, 
 and cannot be made to exert itself except by moving and pushing it 
 
 10 
 
IK? (>/!sTi-rn:/(\i/. n/ys/DLixn'. 
 
 sovoval times. This, howevov, is not commeiulablo, unless performed 
 with the greatest gentleness and care ; and if tlune is nethiiig urgent, 
 it would be preferable to nuike an examination at another time, rather 
 than incur the dangerous results that might follow this numipulation. 
 
 The prominences of the fix^'tus might be mistaken for the hard nuisses 
 of faeces lodged in the intestines ; but a distinction can generally be 
 nuide by the rapidity with which these prominences appear and dis- 
 appear through the sudden movements of the young creature, com- 
 pared witli the slow, regular, peristaltic motion of the intestine and its 
 tivcal contents. 
 
 Vaijiital cxplonxtion, as mentioned, can only bo practised on the 
 larger animals. It is t\ot attemled witli any more danger than the 
 rectal examination ; but though it is of great value in wonum, especially 
 when ballottfiiu'iit^ is resorted to, yet it is not nearly so useful in 
 anin^als ; for in consequence of their horizontal position, this reper- 
 cussion is not possible. Neither is it so valuable as the exploration 
 per rectum. It is practised with the animal in the same position as for 
 the last-named examination, and the hand, well lubricated with soft 
 soap or, better still, with olive oil, is inserted into the vagina as far as 
 the cervix uteri. In the tirst months of gestation the uterus descends 
 into the abdomen ; consequently, the vagina is longer and more 
 inclined downwards in front : while the fcvtus is beyond reach of the 
 hand. Towards tlie fifth or sixth month, the uterus, in expanding in 
 every direction, approaches the vulva, and the canal of the vagina being- 
 shortened, it can be perceived in the pelvic cavity. The same manipu- 
 latory numanivres as were practised in the rt^ctum, amy be employed 
 in the vagina at this time, but the results are far from being so satis- 
 factory ; the vaginal examination should, therefore, never be preferred 
 to that by the rectum. 
 
 Ballottenient may be resorted to in the smaller animals, by placing 
 them in a vertical position ; but the other signs of pregnancy are usually 
 so manifest in them, that generally there is little ditVicultyin diagnosing 
 their condition. 
 
 Auscultation has not been much employed in the diagnosis of preg- 
 nancy in the lower animals, though its value in womau is inideuiable ; 
 as since its introduction by M. Mayor, of Cieneva, in 1818, its utility 
 has been frequently and successfully put to the test, not only to ascer- 
 tain whether there was a fa^tus, but also whether it was alive. In 
 woman, either the uncovered ear or the stethoscope is applied to the 
 abdomen ; the latter is generally preferred, as by it the sound is 
 limited, as well as defined. 
 
 The pulsation of the fa'taJ heart, or double hattement, consists of a 
 rapid succession of short, regular, double pidsations, dilTering from 
 those of the adult heart in rhythm and frequency ; the sound being like 
 the mutlled ticking of a watch, or tlie pulsations of the heart of a new- 
 
 ' The haUoffemfiit ov ropereiissiini to asoortain the prosonco of a. ftvtiis in woiuau, is 
 produced by the operator placing his patient in the upiiglit position, in- if in bed, raisiing 
 her shoiiUlers. The forefinger is then introduced into the vagina and placed on tlie 
 cervix uteri, while the other hand is employed to keep the uterine tumour steady ; then 
 suddenly but slightly jerking upwards the point of the intrmluced tinger, ft sensation is 
 experienced of something having receded from it, and whicti he will percei\e to fall 
 again on the point of his tinger in a moment or two. The jerk oi the tinger upon tlu- 
 iiead of the fa-tus causes it to float upwards a little in the liquor amnii, and its weight 
 makes it descend ag.iin. We have seen that a kind of external, or flank ballotlemettt, 
 can be practised in the Cow. 
 
I'UEQ NANCY. ,^7 
 
 born child. In addition to the sounds of tlie footal heart, there is also 
 
 he '; ;^u;r:-ft" f '""'^r' 't\^ ^^^^^^^ '^^ ^^-^^ ^^'-^^ pissin" rough 
 
 the greatly er.larged vessels of the uterus, particularly at the part to 
 which the placenta is attached ; it is an intermittent whirling' sound 
 eard at an early period of pregnancy, and usually regarded as one of 
 Its nost unequivocal signs. There is, in addition, the v>dli^^,a ^ the 
 
 Teftru "T;'"-^"''r^"'-^'^''"r^ •" ^^^^^'" ^-ourai/e ;o^;-:4 tf 
 
 the fa-tus It IS synchronous with the foetal pulsations. 
 
 m the larger animals, auscultation of tlie abdomen for the nurnose of 
 aiscovenng the existence of these sounds is very ofU-n unSessfuf 
 because of the intestinal walls, the rumblings and noises c7 the Tntes 
 tines, and those of the rumen in the Cow, the large "Entity of amniS 
 hnd the position of the fa.tus, etc., which entirely ^mask the W f of 
 the fo-tal heart ; so that it is seldom, if ever, resorted to. Lafosse and 
 resS 7"r' ^T '"T'"'^^ '^ ''' ^"^^ apparently with saisf actor 
 
 Dre^naL fhn, I V, /''^ distinctly in Cows which were six months 
 rauscul'taUon^ FM?' ° '""Ti}' '^"' ^^^^Y <^-rnn.t always be perceived 
 these fa tir he.;. iV '"""" ^'.'^^^•^^^"•^^"ti^^ns that he has offen heard 
 Cow bdn^^ "^''"'^ ^'•^^'" ^ '^ ':' i^^ P'^'- ^"'""te, those of the 
 
 the mothi^ ll i.''";^^^^^^ byth^ «tate of 
 
 inc mothei s health ; he acknowledges that they cannot be heard in 
 
 teTl^osco rii^'tr'"- ?r'T-'^ ^'^ ^"'^^ P^^^--«'- ^aale, utg t^ 
 frc r;3l "i ir '"'^'^' V^'^'. ''^"^^"' ^" ^'•^"^ ^"^ ^ ^'"J« a^>«ve the crural 
 
 hS week mi to r ""L"^'' ^u ^f ^'\^-^ '^" ^^^'^^^ ''^^^^ f''^"' ^^'^ ^wenty- 
 
 hlth %\eek up to two hours before birth ; though he was certain from 
 
 heir distinctness, that they might have been heard earlier in nm be 
 
 thc^y varied from 12G to 128 per minute, the mother's pulse being 6M 
 
 80^n1r''^an^d''7''h'' '"^ '''^'''' ^^'' "^^^ succeeded in detecting these 
 vr^rnlntV-il kTk "" Trf^ occasions practised auscultation on 
 pregnant Mares, but have failed to distinguish the fa-tal pulsations. 
 
 shouM nrrh/' "'' '"^f^f" V^>' as suggested by M. Trasbot, the uterus 
 
 or ra he, '.? r ^'''^.''^'•' '^^^^'"'^^^ ^^y ^ long special stethoscope 
 
 -or rathe. ' metroscope "-introduced by the vagina, its wide end 
 
 ^o^L L K . ^ surrounding the fa.tus being good conductors of 
 sound, the beats of its heart should be distinctly heard, if it is alive 
 IZ^W in f^"' -«°,- .1^20. and Verardini, fn 1871 have spoken 
 spS ^'^/r«-rai7nea^ auscultation in the human 
 
 ceived hr^ in th f" '^-'^/^r 'u' '^^'"« '^^ pregnancy, it will be per- 
 
 f^an sunoo^iHrn V^^ ^f "°^^ '^'' condition, there is but little more 
 henhvT.l 1 ^^,,^^''l^."«..t»'^ presun.ptions becoming stronger as 
 the phjMca and other indications are more marked. It is onlv how- 
 ever, towards the middle period, when all the rational and ;hv8?cal 
 
 ^^1^^""'' r' "'^" ^'" ^°^^'^^°" -^ ^'-* "^«-« has beenscer 
 alirm wkhr .?. ^.^'P^T'"''^ mana,-uvre8 above described, that we can 
 wLn ; 1 w u^"" '^^"*^^'' ""^ ^"■°"' ^^^ existence of pregnancy. And 
 
 ha th .'^^^ l'>-^"''' '° P"""""'^ ^' *^'« '*'^«^' '' '« ^^*» t'^ remember 
 hat this condition may exist without being accompanied by very 
 evident signs, and that a hasty conclusion must not be drawn When 
 for instance, some rational signs present give rise to the presumption 
 
148 OBSTETRICAL PHYSIOLOGY. 
 
 that an animal is pregnant, but no physical indication reveals this state, 
 the examinations must be repeated before a final decision is arrived at. 
 The 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 surrounded by great diffi- 
 culties, and a guarded opinion must therefore always be given. 
 
 SECTION rV'.— DURATION OF PREGNANX'Y. 
 
 The duration of pregtiancy 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 the doe 
 Eabbit, which carries its young only twenty-eight to thirty days, to the 
 female Elephant, 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 
 foetus, the duration of gestation is greater than in the case of a female. 
 It has even been remarked that the male parent may have an influence 
 in this direction. For instance, a Mare which has been put to a 
 thoroughbred 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 when 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 weU fed. 
 
 The differences in indi\'iduals of the same breed or species may be 
 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 o\'um to 
 pass through the Fallopian tube also varies in different animals. In 
 the Eabbit and Guinea-pig, for instance, it takes three days ; in Eumi- 
 nants from four to five days, and in the 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 
 fixed, though there are of course limits beyond which Nature, ever 
 provident and watchful for the preservation of species, cannot go without 
 ceasing to be natural. 
 
oriLirmx of rnEnNANcv. 149 
 
 Mare. 
 
 The usual period of gestation with the Mare is eleven inonths, though 
 it may vary between ten and twelve. 
 
 From the observations of Winter, Brugnone, Tessier, and Grille, made 
 on 2S4 Mares, it results that the shortest period of gestation was 307 
 days, and the longest 394 days — or a mean duration of 34() days. 
 
 (iayot, in 25 instances noted at the Haras of Pin, France, found the 
 average to be 343i days ; the shortest being 324 days, and the longest 
 3G7 days. 
 
 A writer in the Journal d'Econoutie riiralc hclge for 1829. cited by 
 Rainard, gives as the minimum 322 days, maximum 41!) days, the 
 average being 347 days. 
 
 Colin gives the average as 345 days, though birth may occur at 
 330th to 365th, and sometimes to the 380th day. 
 
 Dieterichs gives the shortest period as 307 to 317 days, and the 
 longest as 409 to 419 days— the average being 330 to 342 days. Bau- 
 meister and Rueff give a minimum of 330 days, or eleven months, the 
 maximum as 420 days, or fourteen months' — the average as 340 days, or 
 \\\ months. 
 
 A correspondent of the Field (May 2(jth, 1894) alludes to a Mare 
 which foaled twelve months and tvveuty-tive days after the last 
 senice. 
 
 With regard to the influence of breed on tlie duration of pregnancy, 
 we have the researches of Baumeister and Rueff ; from these it appears 
 that, witli pure-bred Persian mares, the gestation period was 341 days — 
 343 for male foals, and 338 for females ; in thoroughbred Arab Mares, the 
 average was 338 days — 339 for males and 337 for females ; in high- 
 bred Russian Mares, some of which belonged to the Orloff race, the 
 average duration was 341i days — 341 for males and 342 for females. 
 With Hnglish Mares, the'y found that in half-breds the average was 
 339^ days — 340 for males, and 339 for females. 
 
 Saint-Cyr, referring more particularly to Gayot's observations, ax-rives 
 at the following conclusions : 
 
 1. In the Mare, the normal duration of pregnancy may be fixed 
 between 340 to 350 days— this being tlie interval in wliich the majority 
 of Foals are born. 
 
 2. Some Foals may be born alive from the 300th to tlie 310th day, 
 but this is rare. 
 
 ' Hanion [H^cueil <I> Mt<l. VeUrinaln, lSt57) iilludes to thf ca«e of a Mare seven 
 yeara old, which went beyond her ordinary jwriod of pre^jnancy, only nianifeHtini; at the 
 usual time the customary signs of foalinij; though the.ie noon ctBHed, but recurred ajjain 
 in fifteen days, only to disappear in a short time. .\ft«?r this interval tlie animal 
 appeared t<i l»e quite well, feeding and working as Ixfore. At the sevcntt i-nth month 
 of pregnancy she was in the same condition : but on the fifteenth day of the eighteenth 
 month, she was sei/.ed with serious .■•ymptonis which continued during four days, when 
 death ensued. Hamon txaniined the body in th<- presence of many {)eople, who were 
 much interested in the case-, and discovered a Foal which weighed seventyhve kilogrammes, 
 and was as fat and fresh-looking as if it had been extracted at the normal jK-riod. The 
 tongue protruded from the mouth, the eyes were almost gone, the mu?<cles were well 
 developed but somewhat blo<xlle»s, and the position of the fnt\is was natural. The 
 lunbilical cord had the same asjn-ct as in ordinary ca-ses, but there was no bl<K>d in its 
 vt-isels, and it waa ruptured at five or six centimetres from the alxlominal walls. The 
 futal envelopes were hyi>ertr<>phied. their tot.il thickness being four to fiv.- centimetres ; 
 otherwise they were healthy. The rerrix uteri was of a great thickness and very rigid ; 
 when dilated it would only allow the passage of the fist. The litpior amnii wa« reddish 
 coloured. 
 
150 OBSTETRICAL FHYsRiLOGV. 
 
 3. Births are frequent between 325 and 340 days, 
 
 4. They are not rare from 350 to 365 days, but they are indeed so 
 after the latter period. 
 
 5. We may consider 300 to 400 days as the extreme limits within 
 which normal gestation occurs in the Mare ; below or beyond these it 
 ceases to be natural and really physiological. 
 
 6. According to the researches of M. Gayot, pregnancy is often a little 
 longer for a Colt than a Filly ; and though this conclusion is certainly 
 not founded on a sufficiently large number of observations, it neverthe- 
 less acquires a certain degree of probability from being in conformity 
 with what is observed in the Bovine species. 
 
 The average duration of pregnancy with thirty-three thoroughbred 
 Mares which foaled at the celebrated Middle Park Stud, Eltham, in 
 1876, T find on examination to be 335i days — the shortest periods being 
 316 days (one instance), and 318 days' (one instance) ; and the longest 
 354 days (one instance), and 348 days (one instance). Between the 
 320th and 330th days, there were only 5 instances ; between the 330th 
 and 340th days, there were 11 instances ; and between the 340th and 
 348th days there were 15 instances. Owing to some of the Mares 
 having been put to the Horse more than once, and in some cases at 
 intervals of several days, the averages may not be absolutely correct, as 
 the last coitus has been the one which is reckoned from!^ But with 
 one Mare (Entremet) put only once to the Stallion (Rosicrucian), the 
 period was 324 days ; with another (Hilda) put to the same Stallion, the 
 period was 332 days ; and with another (Imogene) and this StalHon, it 
 was 342 days. 
 
 With regard to sex, there were sixteen Colts and seventeen Fillies: the 
 average gestation period of the former was 336^ days, and the latter 
 334 days. The shortest periods (316 and 318 days") were with Fillies, and 
 the longest periods were also with Fillies (354 and 348 days). The ages of 
 the Mares ranged from five to nineteen years ; there being three at five, 
 two at six, three at seven, two at nine, two at ten, six at twelve, four at 
 fourteen, four at fifteen, two at sixteen, one at seventeen, one at 
 eighteen, and three at nineteen. In the first group, pregnancy averaged 
 340 days ; in the second 3501 days ; in the third 3281^' days ; in the 
 fourth 340i days ; in the fifth 336 days ; in the sixth 337V.r davs ; in the 
 seventh 336.i days ; in the eighth 333 days ; in the ninth 3401 days ; in 
 the tenth 324 days ; in the eleventh 330 ; in the twelfth 325. These 
 figures would go to prove that the period of gestation decreases with age ; 
 and indeed we find that the shortest pregnancies occurred in Mares 
 nineteen years old (316 and 318 days), and the longest in six and nine 
 years old Mares (354 and 348 days). 
 
 The animals were of course kept in the most favourable conditions 
 for breeding; and this, with their splendid qualities and precocity, 
 doubtless shortened the period of gestation, which is below the ordinary 
 average. 1 
 
 An extensive horse-breeder in Oregon, U.S.A., has been making some interesting 
 observations on the duration of pregnancy in jMares, as influenced by the season. He 
 writes : " On the 20th of .Tuly, 1879, I bred a Mare, and bhe foaled on the 30th of the 
 following May. The next spring I bred my Mares early, and they carried their Foals 
 about eleven and a half months. "The thought occurred to me then that Mares bred early 
 in spring carried their Foals longer than those bred later. For the next two seasons I 
 took charge of a band of Mares, and found that those bred in April carried their Foals 
 longer than those bred in Maj-, and that those bred in May went longer than those bred 
 in June and .Tuly. Since then I have had considerable bad luck with ujy Mares getting 
 
UriiATlUX OF riiKGXAXCy. IM 
 
 It is also generally admitted that pieginincy is of longer duration in 
 the Ass than the Ivjuine species — from 358 to 385 days. 
 
 In a stud-book kept in tliis country, a record is given of observations, 
 from which it appears that the shortest period of gestation in the Ass 
 in eight carefully-recorded entries was 3G5 days, and the longest 385 
 days, of which there were two cases. The mean period was 374 days. 
 The males and females were foreign. When the female Ass has been 
 covered by the horse Stallion, the period of gestation is not so long. 
 
 Coir. 
 
 It is commonly believed that the Cow is pregnant for the same length 
 of time as woman, and this is to a certain extent correct, so far as the 
 average period is concerned ; but there are variations which must be 
 taken into account, and which will be apparent if we look at the pub- 
 lished results of various observers. Of 1,062 observations made at the 
 .\gricultural School of Saulsaie, and by Blaine, Tessier, Grille, and 
 Fiirstenberg, we find that 15 were pregnant for less than 241 days, 52 
 from 241 to 270 days. 119 from 271 to 280 days, 544 from 271 to 300 
 days, 230 from 281 to 2'JO days, 70 from 290 to 300 days, and 32 beyond 
 301 days. So that it would appear that, with the Cow, parturition is 
 very rare before the 241st day ; not so rare after the 300th day ; some- 
 what common from the 240th to the 270th day ; and quite common 
 between the 280th and the 290th day ; the average duration of preg- 
 nancy being about 283 days. Colin gives an average of from 280 to 
 285 days, though birth may occur at the 250th to the 300th day, and 
 tven later. 
 
 Dieterichs gives the shortest period as from 210 to 226 days ; tlie 
 longest between 326 and 353 days — average, 286 days ; while Bau- 
 meister and MneW give the shortest they observed as 240 days, and the 
 longest 330 days — average, 285 days. The average of the Bernese 
 Simmenthaler breed at Hohenheim was 280^ days : male Calves 283 
 days, and cow Calves 278 days. 
 
 Earl Spencer has furnished notes of 764 observations, which would 
 go to prove that no Calf can be born alive before the 220th, nor after 
 the 313th day, and that it is impossible to rear those born before the 
 242nd day. Those births which occurred before the 260th day he con- 
 sidered as decidedly premature, while those which took place after 300 
 days were classed as irregular. In 314 instances, 310 calved after the 
 285th day, three went on to the 306tli day, and one to the .'^13th. The 
 average given is 284 to 285 days. Among the Calves born between the 
 290th and 300th day, there was a decided preponderance of males ; all 
 those produced after the 300th day were females. 
 
 with foal on the Range by scnih Horse-s, and have only kept the time of those that I 
 was certain of as to time of lireeding. The average number of dayii of ffestation for 
 nineteen Mare.s l)red in April is ;i4.S daya ; average for twenty-three MareH bred in May 
 is 34.'> days ; average for thirteen Marcs bred in June and July is '138 days ; longest time 
 of any Mare bred in April is .360 dayn, shortest time of any Mare bred in April in 
 332 days ; longest time of any Mare bred in May is :]60 Hays, shortest time of any Mare 
 bred in May is 323 days ; lonjjest time of any >Iare bred in .Tune and .Inly is 3.14 days, 
 shortest time of any ^Iare bred in June and July is 314 days. The la»t Mare referred to 
 was a virgin Mare, and very fat at the time of breeding, and continued so up to the time 
 of foaling. Mares here in Oregon usually get very poor during the winter months, but 
 have an abundance of n\itritious grass to run on during the spring and summer months. 
 It is my opinion that Mares which have an abundance of nutritious food for a time previous 
 to foaling, bring the futus to maturity sooner than they would were they kept on a small 
 amount of vers- innutritioua food." 
 
152 
 
 OBSTETRICAL PHYSIOLOa Y 
 
 In the American Journal of the Medical Sciences for 1845, the result of 
 observations on 62 Cows gives the longest period as 336 days, and the 
 shortest as 213 days : the average for the male Calves being 288 days, 
 and females 282 days. 
 
 An American breeder, in the Ne%c Live Stock Journal for July, 1882, 
 gives the following observations. Only Cows were noted which had a 
 single service, the Bull being kept isolated and no other Bulls accessible. 
 With an equal number of male and female Calves, the average with the 
 males was one day longer. 
 
 Cows. 
 
 x-« «f ^, X.O Shortest 
 >o. of days. Xo. of days. 
 
 Longest 
 No. of days. 
 
 15 in 1877 averaged 
 
 14 in 1878 „ 
 
 17 in 1879 „ 
 
 15 in 1880 „ 
 
 9 in 1881 „ 
 
 287 
 286 
 285 
 286 
 286 
 
 282 
 
 279 
 
 276 (twins) 
 
 280 
 
 282 
 
 296 
 292 
 295 
 291 
 292 
 
 Cattle-breeders, we believe, generally entertain the notion, notwith- 
 standing Earl Spencer's observations, that gestation is longer for a male 
 than a female Calf. 
 
 It would appear that precocity has a notable influence on the dura- 
 tion of pregnancy in the Cow, in the more improved breeds the period 
 being shortened ; though the Calves at birth are not so well developed 
 as those of the common breeds. 
 
 Sheep and Goat. 
 The Sheep and Goat go with young about five months. M. Magne 
 carefully noted the pregnancy of 429 Sheep at the Alfort Veterinary 
 School during a period of eight years, with the following result : 
 
 2 instances of 143 days 
 
 57 instances of 150 days 
 
 15 
 
 144 „ 
 
 49 
 
 
 151 „ 
 
 22 
 
 145 „ 
 
 23 
 
 
 152 „ 
 
 30 
 
 146 „ 
 
 1 13 
 
 
 153 „ 
 
 55 
 
 147 „ 
 
 1 7 
 
 
 154 „ 
 
 68 
 
 148 „ 
 
 7 
 
 
 155 „ 
 
 80 
 
 149 ., 
 
 3 
 
 
 156 „ 
 
 From this list we observe that the difference between the longest 
 and shortest period was only thirteen days, by far the largest number 
 of births occurring between the 147th and 151st days ; the shortest was 
 143 days and the longest 156 days. The average duration of pregnancy 
 was about 149 days. Gestation was longer with the female than the 
 male Lambs, and this Magne attempts to explain by the greater develop- 
 ment and weight of the former, which rendered parturition more diffi- 
 cult and slow. 
 
 Colin says the average period in the Sheep is 151 to 152 days, though 
 parturition may take place from the 145th to the 160th day. 
 
 Dieterichs gives the shortest period as 146 days, the longest 157 — 
 average 151 days ; and Baumeister and Eueff state the shortest period 
 in the Sheep and Goat as 135 days, the longest 160 — average, 144 days ; 
 the male Lambs requiring, as usual, the longest period. With regard to 
 
DURA Tl< >X <> F /'HKfLWA NOV. 1 f.-'i 
 
 breed, these authorities fouiul that the period of gestation in Merinos 
 averaged 150-3 days; while with Southdowns it was only WA-l days, 
 or six days loss. 
 
 In the Merinos, for the male Lamb the average period was \')\\ 
 days, female Lamb loO-li days, and twins 149-9 days ; and in the South- 
 downs, for the male Lamb 14-4 -7 days, female Lamb 144- 1, and twins 
 144 days. 
 
 Mayne asserts that the Goat goes a little longer than the Sheep — tlie 
 average being live months and some days ; another authority gives it 
 as 148 days. 
 
 Pig. 
 
 The Pig is usually pregnant four months, or according to some au- 
 thorities three months, three weeks, and three days. Baumeister and Kuetf 
 give the longest period as 130 days, the shortest 110 — average, 120 ; 
 while Dieterichs gives 109 days as the shortest and 133 as the longest 
 — average, 115 to IK) 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 : 
 
 2 instances 104 days. 
 
 10 
 
 
 110 to 115 days. 
 
 23 
 
 
 IKi to 120 days. 
 
 27 
 
 
 121 to 125 days. 
 
 o 
 
 
 i2G days. 
 
 1 
 
 
 127 days. 
 
 The average was, therefore, 119 days, the interval between the longest 
 and shortest periods being 23 days. 
 
 Bitch, 
 
 The Bitch goes with young about two months, or from 5H to 05 days ; 
 the average being 63 days or nine weeks. Baumeister and Rucff state 
 the shortest period to be 55 days, and the longest 70 — the average being 
 60 days. 
 
 Cat. 
 
 The Cat is pregnant from 50 to (JO, 62, or even 04 days, the average 
 being 55 days or eight weeks. 
 
 SECTION v.— GEMKLLI PAROUS AND MI'LTIPAROUS PREGNANCY. 
 
 Among the domestic animals there are species wliich are naturally 
 uniparous — produce only one at a birth ; and others which, in a normal 
 or physiological manner, bring forth two, three, or more at a time, and 
 are therefore designated (jemelli pi irons or mnltiparous, gestation being 
 known as double, triple, quadruple, etc. As examples of uniparous 
 animals, we may give the Mare, Ass, ('ow, Sheep and Goat ; while we 
 may cite the Pig, Bitch, and Cat as mnltiparous creatures. As multi- 
 parity is normal with the latter, we shall not specially refer to them, 
 but will allude to those creatures which, naturally uniparous, sometimes 
 bring forth more than one progeny at a time. 
 
 It is seldom that twins or triplets are produced by the larger 
 domesticated animals, and particularly by the Mare and Ass, though 
 instances are recorded of these ; while in the Cow, Sheep, and Goat 
 
154 OBSTETRICAL PHYSIOLOdY. 
 
 the occurrence of twins, triplets, or even more young creatures at a 
 birth, is not so rare. 
 
 The causes of muUiparity are not well ascertained. It may be due 
 to simultaneous ripening of two or more Graafian vesicles, which, 
 rupturing at the same time, allow the escape of the ova they contain, 
 and which may become impregnated at a single coitus. Or a Graafian 
 vesicle may contain two or more ova, as Bischoff has witnessed in 
 w^oman ; and these arriving together in the uterus, may be fecundated 
 at one time. Or it may even happen that the vitelline membrane con- 
 tains two yolks, as sometimes occurs in the fowl's egg ; and as the 
 vitelline mass is the essential part of the egg, it is evident that when 
 this contains two of these masses, they ought, if fecundated, to produce 
 two embryos. 
 
 In the first case, each foetus has ordinarily all its appendages dis- 
 tinct and completely independent ; or it may be that the two chorions 
 are fused together, in which circumstance the two foetuses will then 
 have a common envelope. In the second hypothesis, this fusion of 
 the chorions appears to be the rule, although the envelopes may also 
 be independent ; and in the third case — that of the two vitelluses 
 contained in the same vitelline membrane — not only the envelopes, but 
 also the foetuses may become united more or less closely, and thus give 
 rise to double monsters. 
 
 Finally, it is also possible that two ova may become^ detached from the 
 ovarian cluster, though not simultaneously, but successively ; and be 
 fecundated, one after another, at two consecutive copulations within a 
 brief period. Occurrences of this kind, by no means rare, have been 
 wrongly adduced as instances of superfoetation. 
 
 Mare. 
 
 Of all the domestic animals, the Mare is the one which least frequently 
 brings forth more than a single creature at a birth ; and Saint-Cyr has 
 only been able to collect fourteen instances, though we have been more 
 fortunate. Eueff admits that one case of gemellar gestation may occur 
 in this animal in every 250 normal cases, but that the young are nearly 
 always born dead or die soon after birth. In the register of a stud, only 
 one instance of twins was found in every 236f births. 
 
 Demoussy, cited by Saint-Cyr, observed an example of double gestation ; but the 
 Foals, though alive when born, perished soon after. Lemaltre gives a similar instance ; 
 only that one of the fcEtuses was expelled at four months, while the other was retained, 
 was foaled alive at the usual time, and survived. Trelut has seen a Mare which, at the 
 tenth month of pregnancy, cast two well-formed Foals. She had been put to the stallion 
 five times— on April 23, May 4, 16, and 25, and June 5 ; she aborted on March 15. Her 
 abdomen was enormously large, and some time before abortion she had received a kick in 
 the flank. 
 
 A fourth example of double gestation is related by Goux. The two Foals— a Colt and 
 a Filly — were alive when born, and continued to thrive. Saint-Cyr's father, an agricul- 
 turist, witnessed an analogous occurrence, the progeny also surviving ; and Saint-Cyr 
 himself saw a twin birth in a Mare, one of the Foals, which was born dead, weighing 
 25 kilogrammes ; the other, which lived, weighing nearly 2G kilogrammes. 
 
 In the Veterinarian are found a number of instances of twin Foals in this country. 
 Mr. Milliufjton (vol. iv., p. 424) gives three cases of this kind, the Foals being born alive. 
 In vol. ix. (p. 450) an account is given of a Mare which died of hydrops uteri, in which 
 were twin Foals ; in vol. xii. (p. 288) is another account of two born dead, and in vol. xvii. 
 (p. 177) a similar instance. 
 
 A most unusual case of twin-birth is related in the North British Afjricultiirist for 
 May 17, 1876 :— A Mare, the property of Mr. Chapman, farmer, Halnaby, gave birth to 
 
i}EMKi.i.ir.uiors .i.\/> MrLT/r.mors I'h'K'.-x.txcv. io5 
 
 a Colt and Filly foal on the 2n.l March, Isrf'. l><«tli livini,'. On tht- Itith March. IS/C, she- 
 brought forth two tilly Koals, thus giving birth to four Foals — one Colt and three Filliefi 
 — in less than thirteen months. 
 
 The /^V/(/ (May 10, Is?'?) reports a Mare in Devonshire, which produced twin Foals 
 three times within three years. The Mare went full tinii; in each instance, but only one 
 Foal (they were all Colts) lived for any length of time. According to the Liitrpool 
 Merrni-y (July 23, 18-1.")) a Mare at Abringhall, tifteen years old, brought forth /o«r Colts 
 in the space of fifteen months 1 
 
 Raabe, in 1S.')2, witnessed a triple birth in a five year-old ^[are ; the three Foals were 
 born alive, and were completely developed, but they soon died. 
 
 Two instiinces of triple birth are given by SaintCyr, the most rem.arkable being that 
 recorded by Paugoui'-. This occurred with a Mare which, put to the Horse only once, on 
 February 17, IS 13, aborted during the night of September '27-28, two Foals being found in 
 one chorion ; on the 2.'ith of the following February, it j>rodiiced a third Foal perfectly 
 formed, and which lived. In the second case, related by Devilliers, the Mare had been 
 put to the Stiillion several times in May, June, and July. On March 10 it produced 
 three properly-formed but dead Foals, one having ai)parently ceased to live some days 
 before. 
 
 In the Vffrn'nnrian for 1875 (p. 334) allusion is m.ade to an agricultural Mare in 
 Norfolk, eight years old, and not known to have been previously bred from, producing 
 three Foals at a birth. The first was dead, and appeared to have been so for several days. 
 The second was born alive immediately after the birth of the first, but only lived about 
 half an hour. The third was born dead seven hours after the second, but its condition 
 showed that at the time parturition commenced it was alive. The Foals were all of the 
 same colour — bay — and were perfectly formed. The Mare made a gootl recovery. In the 
 same journal for 1867 (p. .">95), Mr. Newman, of Ilavant, reports the birth of three fine, 
 well-develoj>ed Foals, two of which were born alive and lived. The Mare, of the cart- 
 breed, had gone the full i)eriod of pregnancy. 
 
 In tile Vtteriuary Journal for >Iarch, 1882, Mac^illivray reports the case of a Mare 
 twenty-one years old, which produced three Foals at a birth, one of which was dead. Two 
 years previously she had twin Foals. 
 
 The most numerous instances of twin or triple j^cstation in the >rarc 
 are, however, to he attrihuted to two successive fecundations, of which 
 Saint-Cyr has collected eight examples. In all of these, strange to say, 
 the Mares had been put to a Stallion of the Equine and Asinine species 
 in succession, and brought forth each a Foal and a Mule. In the majority 
 of these instances, the two fecundations were within a brief period — 
 the one succeeding the other immediately, or, at any rate, within the 
 same day; though in one instance there was an interval of fifteen days. 
 Which was the elder of the two Foals in tliese births — the one first born 
 or the one first conceived ? Though in the imman species such a ques- 
 tion might have some importance, with animals it has only a physio- 
 logical interest ; but the order in which they were born would, never- 
 theless, be the only rational assignment. 
 
 The female Ass more frequently brings forth twins than the Mare ; 
 but even in this animal such an occurrence is rare. In an average of 
 thirty she- Asses, kept for the production of milk by a man at Fa 
 Chapelle Saint-Denis, only four liad twins in a period of seventeen 
 years. 
 
 Cow. 
 
 Double and triple births are not so unusual in the Cow, the former 
 being far from uncommon. Indeed, it is so frequent in some breeds, 
 and with individuals, that it has been suggested to produce by selection 
 a breed of Cows which would habitually have twins ; while even quad- 
 ruple, quintuple, and more births have been recorded. 
 
 Mr. J. Macgillivray, of BanfiF, in an excellent little "Manual of Veterinary Science 
 and Practice," pxiblished in 1857, writes : — "A neighbour of mine, Mr. Peter Low, had 
 
156 OBSTETRICAL PHYSIOLOGY. 
 
 a Cow, a splendid animal, of the cross breed, which had twin Calves yearly for six suc- 
 cessive years. Two of her female progeny have had twin Calves repeatedly. Mr. Low 
 kept one of her male twins, a Bull ; to him two Cows have had tvdn calves, and there 
 are a number of Cows in calf to him just now. From this and other similar cases, I think 
 there is no doubt but, by proper selection and management, a race of twin-bearing cattle 
 might be established." And again he says : — " From a paper now lying before me. I shall 
 record what I believe to be a unique cae of a calf-producing Cow. I am indebted for 
 the particulars to Mr. James Stephen, Balfluig Cottage, Alford. ' Memorandum regai-d- 
 ing a small Cow of the black Polled breed, which belonged to the late Mr. Alexander 
 Stephen, Farmton, Alford : — 
 
 Year. Xumber of Calves at a birth. 
 
 1842 1— first Calf. 
 
 1843 ... ... ... 3 — came to maturity. 
 
 1843 ... ... ... 4 — one died ; seven in one year. 
 
 1844 ... ... ... 2 — came to maturity. 
 
 1845 ... ... ... 3 — came to maturity. 
 
 1846 ... ... ... 6 — died prematurely. 
 
 1847 ... ... ... 2 — came to maturity. 
 
 1848 4.'" 
 
 Eueff says that, with the Simmenthalei- breed of cattle at Hohen- 
 heim, during an interval of ten years, there were four per cent, twin 
 births. 
 
 Triple gestation is of course much more uncommon, but the instances 
 on record are numerous. 
 
 Dupuy mentions a very unusual instance of fecundity in a Cow which, at three birth.< 
 in successive years— 1817, 1818, and 1819— brought forth nine Calves, only two of which 
 were not reared by the mother ; these Calves afterwards had only one offspring at each 
 birth. Rainard speaks of one of his pupils delivering a Cow of three Calves in the 
 neighbourhood of Lyons ; and Roche-Lubin gives two similar instances. In one of these 
 the first two Calves were born alive and reared by their mother, but the third, which wa^i 
 in a bad position, was removed dead six days later. In the second instance, the Cow, 
 after producing a living and properly-developed Calf, continued to strain and make fruit- 
 less efforts to get rid of the other foetuses, until she died five days afterwards, when two 
 Calves attached to each other by the sternum were found in the uterus. Sperling records 
 the case of a Dutch Cow which produced three Calves ; the first was a male, the second 
 a heifer, and the third a heifer in a wrong position. In England Mr. Snowdon has seen 
 a Cow which brought forth a living Calf some hours after a dead one, and in a few minutes 
 an anidian monster. 
 
 In the Ip-'iwich Journal for October, 1875, mention is made of a Cow which produced 
 six Calves in twenty months, all living : first three fine Calves, then one, and again two. 
 
 The Liverpool Mercury (April 9, 1847) mentions a Cow which produced sixteen Calves 
 in eight years— two Calves at six births, three at one birth, and one at another birth. The 
 Mark Lane Express (May 11, 1852) alludes to a Cow which brought forth three Calves at 
 a birth — making eleven calves before she was seven years old. A similar instance is 
 reported in the Hartford Times of Connecticut for 1881. The Cow was a three-fourths 
 Durham. On April 16, 1877, she gave birth to twins, one male and one female ; 
 March 19, 1878, she gave birth to triplets, two male and one female, making five Calves 
 in eleven months and three days ; July 9, 1879, she gave birth to twins, both males ; 
 October 7, 1880, she gave birth to triplets, two males and one female, making ten Calves 
 in the three years five months and twenty-one days. The Calves were all of good size, 
 healthy and handsome, and were raised on the farm. 
 
 In 1888, a Cow at Braceborough, Stamford, gave birth to twins. Her former yearly 
 calvings were twins, a .single one, a single one, twins, triplets, and then the above- 
 mentioned twins. 
 
 The Chester Chronicle (February 18, 1865) reports the birth of three full-sized Calves 
 by a Cow, all of which did well ; and the Shrewsbury Chronicle (July 5, 1844) gives a 
 similar instance, but the Calves, born during the night, were found dead in the morning. 
 In the Eield for June 17, 1876, the birth of three Calves— a Bull and two Cows— i.s. 
 reported. They were alive and doing well. 
 
 Quadrigemellar gestation is also sometimes observed in the Cow. 
 
OEMELLIPARUUS A.\l> Mri/J'l r.inoUS rUE'iyjM'Y. 157 
 
 Rainard ^'ives two instances ; and Haiuon mentions a littli- lireton C<>\v which, in l.SfiS, 
 I«roductd four Calves -two male and two female, tin- last two dyinir soon after hirth. 
 (lellti jjive." a remarkable instance of a Cow which, in 1S37, had three Calves, in IS.'iS two, 
 in 183y two, in I^IO two, and in IMl four 1 One of the last was a heifer ; all were well 
 develoj)ed and successfully reared, and the last four, at five weeks old, weighed about 
 forty-five pounds each. 
 
 The Ji'ttue Wtaiitaire of Toulouse (February, 1876) gives a case of (|uadrigemellar 
 parturition in a Durham Cow, ai;;fd twenty-two montha, near Kochefort. Birth occurred 
 naturally in an hour ; two cow-cnlves were first born, then two males ; three did not live 
 l>eyond an hour, the other survived thirty-six hours. 
 
 In the Ettit Saiiilain of the Domestic Animals in Belgium for 1877 (p. 87) mention is 
 made of a Cow, seven months pregnant, which for eighteen days had fallen into such a 
 state of tlebility that she could not rise, and she hail also com[)letelv lost her appetite. 
 She was killed, and at the autopsy fourf<etuses were found. Thesn weighed re-pectively 
 10.]j, ll.\, I'J^, and 14 kilogrammes. Three were females. 
 
 An instance is given by Saint Cyr as occurring at Beaujeu in 1881. Tliis was a Cow 
 which had pnniuced one calf at each of three births, three Calves twice, and at last four 
 Calves ; all were strong and lively, and were reared. 
 
 The I'fli rinariitn (vol. xiii., p. ">7iM gives an account of a delivery, with assistance, of 
 four dead Calves. This journal also (vol. xiv., p. 1.".) records a case in which, with 
 assistance, a Cow was delivered of four Calves— two dead at birth and two alive, though 
 these soon expired. They were properly developed, and appeared to have been healthy 
 up to parturition ; they weighed, respectively, '25\, 24, 17f, and 17} lbs. From the 
 structure of the placenta, it was concluded that each fietus had been contained in a 
 t-eparate membrane and fluid. The birth was premature by two months and nine days. 
 In the same journal (vol. xvii., p. 421) another (piadruple birth is described ; the Calves 
 Were well developed and all born alive, though tliey soon after died. 
 
 According to the Che.idr Chronicle (March [>, 1 "< 17), a Cow brought forth three Calves, 
 and in three days a fourth. All died soon after. The Field (December 7, 1872) describes 
 the birth of four Calves by a Cow about four years old, and which had twins at a previous 
 calving. One Calf died, but the others did well. The Lirerpool Mtrriiry (March 28, 
 1S45) reports a Cow as having proluced four Calves — full-sized, but dead. Kddow's 
 ShreirMbuti/ Journal (July 29, 1846) alludes to a Cow which gave birth to four bull-calves, 
 three of which lived. 
 
 Mr. Cartwright, of Whitchurch, gives an instance of four Calves at a birth. The Cow 
 and Calves died soon after. 
 
 In the Field for March 29, 1879, mention is made of a shorthorn Cow which produced 
 four Calves at a birth — two male and two female —all alive, and five weeks old when 
 reported. She was six years old, and lost condition very consideralily for .'«ome time 
 before calving : she was almost ho{)ele3.sly weak for weeks after that event, but ultimately 
 did well. .\11 the C.ilves were white. 
 
 .\ farmer at Nttherseal, England, owned a Cow that gave birth to four Calves, two of 
 them bulls, all w ell developed. The next day one died, but the others lived and did well, 
 a.s did also their dam. 
 
 A Cow in Norfolk, eleven years old, was delivered of four full-grown Calves, but none 
 of them survived. 
 
 Quintuple pre^'nancy is, of course, more rare in tlie Cow. 
 
 In the (liornnlf di Vrte_riiiari<i for June. iS.'i.'i, Professor Lessona, of Turin, de«cril)e« 
 a (|uintuple l>irthin a Cow in Piedmont. The animal was twenty days frcmi its full time. 
 The abdomen was very voluminous, but Ix-yond the premature delivery there was nothing 
 unusual attending the liirth. The progeny consi?>te I of three females and two males, and 
 each weighed about 37 A psxinds. They were healthy ;iud fully developed ; but the 
 mother, either through her premature delivery or from age, was unable t<j suckle them, 
 and they were put to another Cow whose milk pmved unsuitable for them, as tliey had 
 sn attack of indigestion, and in about eight days after birth all were dead. Les.sona 
 thinks two were lodged in the same envelope in each horn, and that the fifth fietiH, with 
 a single placenta, <K;cupied the body of the uterus with iti proper envelopes. A singular 
 fact was their Ix-ing all presented for delivery in a normal jxisition — a very extraordinary 
 circumstance. The Cow had pro<luced twin Culves the preceding year. 
 
 Schumann, in 18.")4, rejKirts a quintuple birth — all males, and deafi -bom. RuefT records 
 another, in which all the Calves lived— and one which r>cciirred at Havingen, in a five- 
 year-old Cow. Baron also refers to a similar instance. Mr. 'iarrard, of Ticknall, how- 
 ever, has a more favourable report of a birtb of this kind. In 1854 a Cow gave birth to 
 
158 OBSTETRICAL I'HYSKJlJJdY. 
 
 five living healthy Calves, all of which were, when he wrote (a week after birth), alive 
 and vigorous, and likely to continue so. They were nearly all of one size, and larger 
 and stronger than could be supposed. Four were bull-calves. The Cow, by no means 
 a large one, was eleven years old and of a mongrel breed, and had never produced 
 more than one Calf at previous gestations. She did not manifest any unusual 
 symptoms of exhaustion ; the first four Calves presented naturally ; the fifth was a breech 
 presentation. 
 
 About sixteen years ago a Cow at Hohenniath, Bavaria, dropped five Calves, ranging 
 in weight from sixteen to twenty pounds. They were all of the same colour and all dead, 
 the dam dying soon after giving birth to them. 
 
 In 1S7S, Professor Freytag, of Halle University, saw a Cow at Zeit, Saxony, which 
 gave birth to four Calves in rapid succession, and very shortly afterwards dropped another. 
 Parturition proceeded normally, and the Cow did not appear to suffer more than usual ; 
 but the Calves, though well developed, were born dead. The case is recorded in the 
 Deutsche Landwirthschaftliche Pre-fxe for 1878. 
 
 But the most wonderful instance of fecundity yet mentioned is that of a Cow which was 
 seen by Ferrari, who reports the case in the Journal de Med. Veterinaire et dt Zoottchnii'^ 
 for 1883. She brought forth fourteen Calves at foxtr births. At her first delivery, in 
 1879, she had twins, which lived ; in 1880 she had five — two females and three males- 
 only two of which survived and were sold ; in 1881 there were four — two males and two 
 females — only two of which were alive ; at the fourth parturition, in 1882, .she gave 
 birth to two males and a female, one of the former dying, but the other two lived and 
 grew well. 
 
 Kurds speaks of a Cow which aborted seven fretuses ; while Kleinschmeid {ila<jazinfi'ir 
 ThitrlttUkundt, 1857) mentions having found fifteen embryos in the uterus of an animal 
 of this species ! 
 
 In the Veterinarian (vol. xxxii., p. 200), Mr. Forbes, of Keigate, mentions a Cow, six 
 years old, which at her third calving produced — three weeks premature — five Calves at a 
 birth — four males and one female. Three of the Cdlves died in a few hours, the fourth in 
 a day, and the fifth two days after they were born. 
 
 The Che-Hter Chronicle (February 11, 1854) reports a Cow, between ten and eleven 
 j-ears old, producing five Calves— four males and one female — all of which lived. The 
 Calves were nearly of the ordinary size, and were strong and livelj'. In Eddow's 
 Shrewahury Journal (September 9, 1874), mention is made of a Cow which had been 
 purchased as barren, but which in due course produced a dead Calf, on the following day 
 another, and so on until four were born. The Cow then died, and on being opened a fifth 
 Calf was found. Mr. Litt, of Shrewsbury, in the same journal gives the particulars of 
 the case of a Cow which died within a fortnight of calving, and on being opened no fewer 
 than five fully-developed Calves were found in the uterus. They were nearly uniform in 
 size, and, with the exception of one, which was rather emaciated, they were in a 
 remarkabh- well-nourished condition. They consi.sted of four females and a male, and 
 were very little smaller than ordinary Calves at birth, being about the usual size of 
 twins. !NIr. Litt was of opinion that, had they been born at the proper time, they would 
 have lived. The Cow had not thriven so well as its companions for some time, but up 
 to the morning of the day previous to decease, it appeared to be in perfect health. Death 
 was probably due to the excessive drain upon the animal's .system produced by so many 
 young. 
 
 Sliee'p. 
 
 With the Sheep, twins are a very common occurrence ; and it is a 
 saying that in a good flock there should be as many Lambs as Ewes, 
 the double births compensating 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 Cleves, every Sheep brings forth two or three Lambs twice 
 a year — five Sheep producing twenty-five Lambs in twelve months. 
 In French Flanders, according to Magne, who cites Corneille as his 
 authority, there is a very prolific breed of Sheep, each ordinarily pro- 
 ducing three, sometimes four, five, 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 were 22 double births ; and 
 
nKMKI.UI:ii:nls AM> .\fl/.T/J:i/:<>ts rniCHXASry yyj 
 
 ho mentions liaving seen a Sheep tliat was twenty years old, which had 
 bred every year. A Ewe at Hohenheim, in 1845, hroiif,'lit forth one 
 Lamb, the first ; m 184G two; in LS47 live; in 1848 four; 1841) three ; 
 1M50 two —in all seventeen Lambs at six births. Four of these were 
 males, and thirteen females. 
 
 In our own country such fecundity is not very uncoiimion. 
 
 For instaiicf, in the Cha»il>er of Aiirlntlliire. Joiinia/ for Maidi, 1>71, there is a 
 notice of extraordinary proliticacy related by Mr. An^nis, of Lowthorpe, Hull, who 
 saya : — " Last 3'ear i-ne of my E*es, of tl>e Jjincohi lireeti, broiiglit forth .six Lanilis, ail 
 living. I had great ditticulty in persuading my neighbours to believe this, although 
 the fact was tjuite elear and well attested. I gave her a private ear-mark, and last 
 Michjvelmas a separate red mark also. As we naw this spring that she was getting heavy, 
 we kept her ipiite separate from the rest of the Ewes, and last Thursday she produced 
 another six Lambs. Some of these will not survive, as they were a few days belore their 
 prop«'r time ; but all are complete and well fornn-d, and the ICwe is now suckling one 
 Lamb." " The especial wonder about this woolly mother," adds the editor of the journal, 
 "is tliat she belciMns to a breed in which it is rare for a l-'we to drop more than three 
 L«nib.s, while good luck among the Lincoln Hocks is 'one half pairs,' with occasionally a 
 three." 
 
 The Carmarlhi u Journal (March, 1844) alludes to foiir Ewes in that county, which in 
 one week yeaned fourteen Lambs ; one had five Lambs, and these all did well. The 
 Che.iler C/ironirle (May '2.'), 1867) mentions that a little Welsh Kwe at I'irkenhead had 
 two Lambs in the spring of ]S»;i ; in ISGfi three, all alive; Ibtiti, four, all living ; and in 
 1876 five, fiiur of which lived, and were in good health. Jidl's WkUij Mtssiuijer 
 (June "29, l'<14) sUites that a farmer in Kent had a Ewe which dropped the extranrdinary 
 number of six Lambs, four of which it reared, and the other two were brought up by 
 hand. The previous season the aanie Ewe produced four Lambs, all of which were 
 reared and turned out well. .According to tho C/iesfir C/ironiilc (Aprd 11, 1S68), a farmer 
 at Otlej-, Yorkshire, had a Ewe, five years old, which had produced fifteen Lambs. AVhen 
 one year old it had two, at two years four, at three \'ears two, at four years four, and at 
 five years three. The SaJo/nun (April li, l.'^7-) speaks of a Ewe at Wem, Salo]), which 
 gave birth at one time to five Lambs the previous year, and these were all reared, and in 
 thi^ year six were born, five of which lived. The Chfsfir Chronicle (April l!', 1873) 
 alludes ti> a Ewe which produced an annual average of three Ijambs for seven years ; the 
 animal itself was one of three. The Slirtwihitri/ C/irouicle (June "20, 1874) reportn that 
 a Shn>pshire Kwe lambed twice in six months, producing twins each time ; and the Fii-ld 
 (May \'l. 187-'5) gives an instance of a Ewe having five Lambs, one of which died in a few 
 days, but the others did well. The Oxirfslri/ AilrtrliMr (October 2, 1S72) instances a 
 Ewe which gave nine Lambs in two seasons — -three and six — all fine I^ambs, anil in perfect 
 health. And in the Cnmliridu newsj>aper for the same month, it is mentioned that 
 "Mr. .1. M. Harding, of the TownHill Farm, .Swansea, has just h>»<l an extraordinary 
 piece of goo<l luck in Innibing. From a small flock of seventeen Ewes, he has had no 
 le.«s than thirty-seven Lambs, all alive and doing well. Every Ewe has bnuight 'doubles,' 
 and three have brought ' triplets.' It i.s not only the numl»-r of I.,ambs, but they are all 
 strong and healthy. . . . There is no reiuson to doubt that the remainder of the flock 
 will be e<|ually prolific." 
 
 In the yo'.tiniiham Jnnrnnl for 18 UI, it is stated that a Ewe in that loeality brought 
 forth five Lambs .at a birth, all alive and likely to continue so. 
 
 Mr. Lite, already ((uoted, mentions the case of five Ewes which ha<l been attacked 
 with symptoms of brain disorder shortly before lambing, and soon died. Each, when 
 opened, was found to have four I>anil>s, making twenty in all. 
 
 The Lynn yl(/iy»7i.scr for February, 187"_', states that a Ewe in that locality lambed 
 on the 11th of that month, the Lamb living twenty-four hours; again on Junt' '28, and 
 on January 21, 1872, bringing fi>rth twin I^ambs on the last occasion. The Ewe thus 
 lambed three times in a year and ten days. 
 
 In 1875 Mr. Rol>ert P. Oreenhill, of Elmbridge, near Droitwich, wa.s in jx>sses.siiiii ,,f 
 a Ewe, seven years old, which had product-d no fewer than 20 Lnnd)s -a small flock. In 
 the first year she gave birth to 2 ; in the second, 1 ; third, •$ ; fourth, " ; fifth, 4 ; sixth, 4 ; 
 and seventh, 3. 
 
 And at Shafte.«bury, it is recorded in M.iy, 1876, that a farmer had some Ewes 
 fatting, and a neighbour's ram gf)t with them ; consequently, 13 of thtm jin>ved to be 
 j)r»gnant, and produced no le.ss than 31 Lambs, all born alive (a few dead since), ai 
 follows : — 
 
160 OBSTETRICAL PHYSIOLOGY. 
 
 1 single ... ... ... ... ... 1 
 
 8 twins ... ... ... ... ... 16 
 
 3 threes 9 
 
 1 five ... ... ... ... .. 5 
 
 13 ewes. 31 lambs. 
 
 The Field for March 29, 1S79, states that a Ewe at Adderstone Hall, Belford, 
 Northumberland, produced five Lambs, all of which were alive and thriving some time 
 afterwards. 
 
 The Live Stock Journal fur April, 1878, mentions that a Ewe at St. Mary's, Orton, 
 dropped six tine healthy Lambs— four males and two females ; two of these were 
 adopted by other Ewes, the others being suckled by the mother, an extraordinary-sized 
 Leicester. 
 
 The London Farmer tells of a Border-Leicester Ewe that produced six Lambs at a 
 birth, all living and doing well. Another Ewe, of mixed breed, had the same number at 
 Meldon Park, Morpeth — all living. This animal had produced twenty-eight Lambs in 
 six years — 4 in 1873, 4 in 1874, 4 in 1875, 4 in 1876, 6 in 1877, and 6 in 1878. 
 
 Other similar instances might be quoted. 
 
 It may be remarked, that extraordinary fecundity in Sheep is seldom 
 observed in the highest-bred races, which are usually uniparous ; it 
 appears to pertain more to the common breeds. Not only this, but 
 certain years are more remarkable than others for double, treble, and 
 quadruple births in this species. 
 
 Goat. 
 
 The Goat is generally 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. But usually 
 with three or four 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 these multiple 
 l)irths in animals ordinarily uniparous, are the result of one or successive 
 copulations. The majority of the authorities in such matters are 
 certainly of opinion that a single copulation will suffice to fecundate 
 several ova ; and they doubt if, after a fruitful copulation, it is possible 
 for the spermatozoa to reach the ovary, supposing a second ovum to be 
 developed, unless the second impregnation takes place very soon after 
 the first, and before the fertilised ovum has descended into the uterus. 
 The well-authenticated instances of superf station, though rare, never- 
 theless rather militate against this opinion ; and it would appear to be 
 impossible to explain why one animal among several hundreds, perhaps 
 thousands, should alone bring forth "doubles" or " triplets," while all 
 the others, placed in the same hygienic conditions, have only one 
 offspring. It is a fact, however, that with certain breeds of Sheep an 
 abundance of nourishment and plentiful years dispose to these multiple 
 births. 
 
 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 
 Cow twins in every ninety births. He considers it exceptional to have 
 multiple gestations in primipane, 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 the latter may be impreg- 
 
nEMELLIPAliUi-S AXI> .WrLTH:l/;nfs J'J:Jy;.\.l\r)\ 101 
 
 nated at a siii^'le copulation, unci brin-,' forth suvcral youn^'. yet, as a 
 rule, they are fecundated more than once, and in fact do not cease to 
 seek the male until after several copulations. And yet, even in these 
 creatures, there are instances of extraordinary fecundity often recorded. 
 With rej^ard to the Sow, for example, I have notes of a case in which 
 24 young were produced, but the mother died soon after ; another case 
 in which a Sow brought forth 48 in two succeeding litters — 22 in the 
 first and 21 in the second ; and another case of a Sow that had 21 
 living Pigs in a litter, she having tlien produced more than eighty young 
 in less than two years. Then with respect to the liitch, I have the 
 record of a St. Bernard's that gave birth to 17 Puppies in one litter, and 
 in the succeeding litter tliere were 23. 
 
 In these cases of multiple gestation in creatures naturally uniparous, 
 one of the fetuses occupies the ordinary situation of single gestation — ■ 
 the head towards the cervix uteri, the larger portion of the trunk in the 
 body of the uterus, and the hind (juarters and limbs in one of the coruua. 
 The second fo'tus occupies the whole of the other cornu ; with the head 
 turned back, or, as occurs not infrequently, in the opposite direction, 
 and so on. 
 
 The duration of gestation in these cases is generally shorter than that 
 of single pregnancy in the same animal, probably in consequence of the 
 unusual distention, as well as derangement of the principal functions in 
 the mother. The weight of the young, individually, is usually less than 
 the average ; but, collectively, it may be very much greater than that of 
 one young creature produced at a birth. Thus, in the quadruple birth 
 recorded by Magdinier each fcutus weighed ten to eleven kilogrammes; 
 in that by 13ouchard tliey only weighed from eight to nine kilogrammes; 
 in the quintuple birth descrilied by Cassina, each calf weighed seventeen 
 kilogrammes, or eighty-five for the entire birth— an enormous weight. 
 Lignatia, another Italian veterinary surgeon, mentions that in a double 
 birth in a Cow, one of the Calves which was born dead, though at full 
 time, weighed twenty kilogrammes ; and the other Calf, which was 
 alive, weighed forty-three. In the double birth observed at Saulsaie, in 
 which both Calves were born alive, one was twenty-eight kilogrammes 
 and the other thirty-one. 
 
 Free-martins. 
 
 A curious fact in connection with this subject in the Bovine species, 
 is that when the young are of both sexes, the female is in general 
 unproductive. John Hunter drew special attention to this subject/ 
 which has since received the notice of many veterinaiy surgeons and 
 agriculturists. Though the anomaly has been particularly remarked in 
 Bovine animals, yet some authorities assert that it also pertains to Soli- 
 peds, but it would seem that the Ovine species is exempt. Even of the 
 
 ' " It ia a fact known, and I believe almost universally underHtood, that when a Cow 
 brings forth two Cnlve-i, one of them a I'ull-calf and the other to appearance a Cow, that 
 the Cow-calf is unfit for propagation, but the I'.ull calf grows into a very pro]Hr Bull. 
 Such a Cow-calf is called in this country a Free-martin, and is commonly xs well known 
 amon|;r the farmers as either Cow or Bull. It ha« all the external marks of a Cowcalf 
 namely, the teats, and the external female parts, called by farmers the bearing. It does 
 not show the least inclination for the Bull, nor does the Bull ever take the least notice of 
 it. In form it very much resemblea the Ox or ipayed Heiftr, being considerably larger 
 than either the Bull or the Cow, having the h'>m4 very similar to the horni of an Ox. 
 The bellow of the Free martin is similar to that of an Ox. having more resemblance to 
 that of the Cow than that of the Bull." — Ob'iirvationj* on the Animal Economy. 
 
 11 
 
162 OBSTETRICAL PHYSIOLOGY. 
 
 human species, it has been asserted that twins are less prolific than 
 those born single at a birth, and their vitality is also diminished. 
 
 The fact that twin Calves are sometimes unfruitful is well known in 
 many countries, where the female Calf receives a particular designation : 
 as " Free-martin " in Britain ; in Holland, " Queenen "; in Germany, 
 " Zwitter," or "Zwilling"; in Swabia, " Z wicker "; in Piedmont, 
 " Mugne "; in France, "Loures," " Taures," etc. The old Eoman 
 agriculturists knew these animals as " Taurae." It is generally believed 
 that the defect is only present when both Calves are females, and 
 certainly it is very rare indeed that the male is infecund. Baumeister, 
 however, gives an instance in which a Bull — a twin — was put to a 
 hundred Cows, none of which produced a Calf. In Switzerland it is 
 the belief that when the Cow-calf is born first, it will not be sterile ; 
 and that when, on the contrary, the male is born before the female, it 
 will be unproductive. The female twin is generally a hermaphrodite, 
 and in form more of a male than a female ; the vulva is excessively 
 contracted, and the vagina a cul-de-sac. The mammae are also feebly 
 developed, sometimes appearing as a mere trifling fold of skin, at others 
 as a voluminous sack. The animal is usually long-legged, with 
 muscular hind quarters. Internally, in some instances, the uterus is 
 undeveloped ; in others the ovaries are absent, and instead of them there 
 are testicles. With others, again, there is no trace of a uterus, the 
 vagina ending in an infundibulum — a condition which is readily ascer- 
 tained in the living animal by introducing the finger. The clitoris is 
 sometimes enormously developed, and not unusually the urine is ex- 
 pelled powerfully backwards. Ordinarily, the "free-martin" evinces 
 sexual desire very rarely, if at all.^ 
 
 1 One of the recorded e.xaminations of these creatures is given in the (Esterreichische 
 Viertcljahre^fichrift for 1875 (p. 78), and was brought to the notice of the Gresnter 
 Land and Forest Society of Austria, the veterinary surgeon to which furnished the 
 anatomical details. The society purchased the Calf three and a half years previously, 
 and it had never exhibited any signs of sexual instinct during that period. It was 
 therefore killed. It was in good condition, and of the Miirzthaler breed. The head and 
 physiognomy had a most singular appearance, resembling that of a Monkey, though the 
 horns were strongly developed. The udder was little and hard, and the vulva small and 
 contracted, although normal ; on opening the labia no trace of a clitoris could be found. 
 The vagina was nine to ten centimetres in length, and instead of extending forward to 
 the cul-de-nac, which is often very dilated in Cows, it terminated abruptly in a funnel- 
 shaped aperture, and here the genital organs ended, for the cervix uteri was absent, as 
 was the uterus and Fallopian tubes, and it was only in the vicinity of the external angle 
 of the ilium that were found small ovaries closely and curiously enveloped in fat, so that 
 they could scarcely be recognised. The glands of Bartholin in the vagina were almost 
 as large as an egg, and were full of blood ; instead of the valve in the vagina there was 
 a small impermeable opening. On incising the mammte the gland substance was foimd 
 to be absent, and in its stead was fibrous and adipose tissue. In fine, this twin was 
 destitute of uterus and oviducts, and the vagina was short and constricted. 
 
 In the Q^titerreichisrhes Landivirthscha/tlkhe Worhcuhlatt for 1878, the observations 
 of Professor F. Mliller are published. These are based on the examination of three 
 twin Calves. The first was a female in an early stage of uterine development, and in it 
 he found testicles in conjunction with external feminine organs. The other two were 
 full-grown, sterile Cow-calves ; one was aged three years and two months, the other being 
 more than two years. In both cases the external pudenda were normal, the labia firm, 
 puffy, and well closed, and the clitoris not unduly prominent. The udder and the four 
 teats were small in development. Both animals had in some degree a male appearance 
 generally, and neither of them had ever been observed to be in " rut." Examination of the 
 internal genital apparatus revealed almost exactlj' the same state of affairs in each case. 
 The female generative organs were not fully developed in either. In both of them two 
 gland-like bodies connected with the sexual apparatus were present, viz., small bodies in 
 place of normal ovaries, and larger bodies further back in the neighbourhood of Giirtner's 
 duct. Whether these latter bodies, which Midler is inclined to consider remnants of 
 
<;EMEi.i.ii'Ai:i>rs a\i> MrLTiF.inors ri:t:i:.\A\rY. 103 
 
 Tilt' rule doeis not always hold ;^'oocl, howevt'r, as to the infecundity 
 of twill Calves, as many instances are on record in whicli they have 
 bred. For instance, in the Veterinarian (vol. ix., p. 22) there is an 
 authenticated case in which the female of a twin birth, when five 
 months old, became prej^nant, and in due course produced a Calf. The 
 next birth was twin Calves. And a few years ago, a Shorthorn ('ow 
 belonging to Mr. James Harrison, Water Stratford (1 rounds, near 
 Buckingham, dropped twin Calves- — a Bull and a Cow-calf. As the 
 Cow was well descended, Mi-. Harrison decided to keep both Calves for 
 breeding purposes, and tlie experiment was quite successful, for the 
 Heifer had a strong Cow-calf, and the Bull was the sire of three 
 Calves. 
 
 Diaijnuais of Multiple rrcijuancij. 
 
 The (liatjnosis of multiple pregnancy in animals ordinarily uniparous, 
 is not very certain. It is usual to say that the signs are only those in- 
 dicative of a single ftrtus, but exaggerated. The belly is more volumin- 
 ous than wlien there is but one, especially in the early months ; the 
 respiration is more than usually embarrassed; the animal lies frequently, 
 and soon moves lazily and heavily, while the posterior limbs become 
 ccdematous. These signs, it will be remarked, are obscure, as a lai'ge 
 Foal or Calf, or some morl)id condition, may occasion the disproportionate 
 size of the abdomen and alteration in breathing; so that at best they only 
 afford a vague presumption as to the condition of the mother. It is 
 also said that the belly is larger on the side on which it is usually least 
 enlarged — the left ; in others, both sides are enlarged at the same time, 
 and there the movements of the young are most evident. But tliissign, 
 in addition to being far from constant, depends upon the relative posi- 
 tion of the progeny ; as when there are two one may occupy the body, 
 the other the cornu, of the uterus. Neither does an examination per 
 rectum or vatjinani art'ord any certain indication of multiple gestation ; 
 as the number of young, supposing there are more than one, cannot be 
 sufficiently distinguished. 
 
 Auscultation, if it could be successfully applied to the larger animals 
 — which are usually uniparous — would doubtless greatly aid in diagnos- 
 ing whether a gestation was single or multiple. The distinct pulsation 
 of the foetal hearts, especially if at a distance from each other, and if 
 the number of pulsations were ditTt-rent in the respective situations, 
 should be conclusive proof of multiple pregnancy. It would, of course, 
 b<' important to note the different situations of the pulsations, as the 
 action of the fci-tal hearts might be at times synchronous. Care would 
 also have to be observed not to confound tlie beating of the maternal 
 heart with that of the fditus. 
 
 Wolffian bodi(«, are to be regarded aa rudiments of testicles cannot be determined, but 
 he admits that there is much in favour of such a view. The general re«tj!t of hii« 
 examination, which is in >;reat measure corroborative of former ((b^ervations, Mullcr 
 i,'i ves as follows : (1) From a practical point <»f view, female twin f'alves should never be 
 used for breeding purpo.ses, because they are generidly barren in consequence of mal- 
 flevelopment of the internal genital ori;ans. Kxceptinns to this rule are few and far 
 between : one such is recorded in Krarf't's JoHninl a<t having been noticed in 187.1. 
 (-) The cau?e of such sterility depends on an arrested development of the genital glands 
 in the earliest stage of their development from the Wolffian bodies, at which jKiriod the 
 sex is indifferent. The view that the incomplete female is really a m.ile not fully 
 developed, is not supported by the two cases under notice. Neither can it be assumed 
 with certainty that it is a hermaphrodite, although there are some grounds for justification 
 of the latter opinion. 
 
164 OBSTETBICAL PHYSIOLOGY. 
 
 Fosition of the Fcetiises in Multijjle Pregnancy. 
 
 The relative position of the young in the uterus in the cases already 
 briefly alluded to, is important to remember. With regard to each 
 other, it may be said that they 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 the other by " inclusion," as in 
 some of the monstrosities of which \Ye will speak hereafter. It may be 
 necessary, however, to state that the included foetus may be contained 
 in the abdominal cavity of the other individual, constituting deep and 
 ahdominal 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 placentae 
 are often confounded (in Ruminants), or united by a kind of membran- 
 ous connection, 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 Eainard ; but more commonly, 
 after the birth of the first foetus, the uterus contracts on itself, enclosing 
 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 foetus until the usual time expires. An 
 illustrative case is given in the Memoires de la Societe 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 foetus is retained and grows until 
 the normal time for delivery. 
 
 The foetus that has died during pregnancy may be kept in the uterus 
 for a long time, through close adhesions existing between that organ 
 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 retained 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 stronger vitality of the one which lives, and which, by attract- 
 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 foetal from the 
 
HKMKI.I.irAliors ASh Mf l.Tl I'.l i;i its l'i;h:ilXA\cy. 
 
 1 •;.' 
 
 maternal placenta, which, of course, causes an interruption to the cir- 
 culation of the younj^ animal, and a suspension of nourishment and 
 oxygenation of its blood. 
 
 In the second variety of gestation, in which the chorion is connnon 
 to the two f(rtuses, but which are yet separated by the amnion, there 
 is only one placenta ; the two having a circulation in common, tlu-ougli 
 their placenta* and the umbilical vessels connnunicating l)y their vascu- 
 lar ramifications. In this case the expulsion of one fcrtus necessarily 
 brings about that of the other. This also occurs when both are con- 
 tained in tile same envelopes. 
 
 I believe only two instances are on record of inclusion : that of the 
 first mentioned variety, in which one fcetus was found in the abdominal 
 
 Fig. ti6. 
 
 Twi.N pKKtiNANCY : CoW. 
 
 cavity of the other, Bartholin, the celebrated anatomist, at the com- 
 mencement of the seventeenth century described the case of a Mare 
 which brought forth a Mule, in the abdomen of which was found an- 
 other : and Gurlt' mentions an instance in which one fcrtus was 
 developed within the abdominal cavity of a Calf, and consisted of an 
 incomplete left hind leg, a membranous organ representing the uterus, 
 and the skin and some vessels. It may be remarked, however, that 
 Rainard witnessed an instance of this abdominal inclusion in a Goose. 
 The egg was double tlie ordinary size, and it had another inside of 
 about the ordinary dimensions ; each had a perfectly formed shell. - 
 The subcutaneous tumours of young animals, containing either a whole 
 foetus or portions of a pre-existing one, are connnon, 
 
 ' .\fagazin/iir rhifrheilhinde, 1860. p. 347. 
 
 • In the Vfhrinanj Journal for 1891 (p. 88), Mahon de«crib<'«< an iriHtanw of inclusion 
 in a male Hare. 
 
16i! OBfir ETHICAL PHYSIOLOGY. 
 
 CHAPTEE VI. 
 Hygiene of Pregnant Animals. 
 
 The hygienic measures to be observed in the management of animals 
 during gestation are, in general, those which should prevail always, 
 irrespective of this condition. But beside these there are a few par- 
 ticular precautions to be attended to, in order that this period may be 
 safely and successfully passed through, and these precautions are all 
 the more necessary as the period of birth approaches. Unlike the 
 human female, pregnant animals do not require those careful, numerous, 
 and minute attentions so essential to her health and the welfare of her 
 offspring ; indeed, too much nursing and pampering, by removing 
 animals further from their natural condition, are unnecessary, and 
 likely to do more harm than good. 
 
 When an animal is believed to have been fecundated, it should not 
 be allowed near the male again ; as in the artificial state in which 
 domesticated creatures are usually kept, attempts at coitus may do 
 harm ; though it must be confessed that among Cows the Bull often 
 remains in the same pasture with them, and they calve as regularly and 
 as safely as if they were not so exposed. 
 
 With those animals which are employed in labour — as the Mare, and 
 sometimes the Cow — it is well not to work them severely nor fatigue 
 them much, and particularly as pregnancy is advanced ; and, on the 
 other hand, absolute repose is pernicious. Exercise is most beneficial, 
 and the most difficult cases of parturition occur among animals to which 
 this is denied. The pregnant Mare will accomplish ordinary and accus- 
 tomed work, particularly if it be slow, without any harm, perhaps with 
 benefit, until the seventh, eighth, or ninth month, when more care 
 must be observed ; but moderate exercise should always be allowed up 
 to the period of parturition. Harness is preferable to saddle work for 
 pregnant Mares ; and fast trotting, galloping, jumping, travelling over 
 broken ground, or severe and sudden exertion, injuries, or shocks of 
 any kind, are to be avoided — in fact, extremes should be guarded 
 against. 
 
 If the animal must be employed for riding, the use of spurs should 
 be interdicted, because of the sudden contraction of the abdominal 
 muscles which their application induces, and which may lead to 
 abortion. 
 
 Should the animal not be usefully employed in this way, then it ought 
 to be regularly exercised in hand, or placed in a paddock provided with 
 shelter from inclement weather. 
 
 The Cow, if employed in labour, may be worked moderately until the 
 sixth or seventh month. If kept for milk production, the milking 
 should also cease about this period ; though with well-fed Cows it is 
 often prolonged until near parturition. Nevertheless, there can be no 
 doubt that this practice is prejudicial to the foetus, by arresting or 
 retarding its development, through diverting into the mammary glands 
 the materials which should be disposed of in the uterus. 
 
 Exercise at pasture is beneficial to all animals ; even the Pig and 
 Bitch are greatly benefited by movement. 
 
 The food of pregnant animals is an important consideration. 
 Creatures in this condition should be well fed, and especially if they 
 have to accomplish a certain amount of labour or yield milk. The 
 
IIVUlKXt: (>F I'ltECXAXT AXIMALS. 167 
 
 appetite is generally increased, and there is, as has heen already observe<l, 
 a tendency to fatten. This tendency should he somewhat guarded 
 against, as it may prove troublesome, particularly if it is allowed to pro- 
 ceed to an extreme degree ; when it may retard the development of thn 
 faHus, induce abortion, cause ditlicult parturition, or give rise to serious 
 after-consequences. This precaution is more to be observed in the 
 second than the first half of pregnancy, when the food should bu 
 plentiful, but not in excess, and llesh more abundant in the animal than 
 fat. The food should also be of good quality, very nutritious, easy of 
 digestion, and not likely to induce constipation. 
 
 Indigestion should be carefully guarded against, and unaccustomed, 
 hard, damp, bulky, fermentable, mouldy, or otherwise hurtfully altered 
 food, should be avoided, as it is likely to prove indigestible, occasion 
 tympanitis, and produce other injurious results. 
 
 Grazing on pastures is favourable to the pregnant condition of her- 
 bivorous animals, and especially if the land is not too broken, or sloping, 
 and the herbage is good ; as they take their own exercise, and breathe 
 a purer atmosphere than tliat of stables or sheds. But it must be re- 
 membered that they should, if possible, be protected from damp, fogs, 
 cold rain, stormy weather, etc. If the herbage is not sutViciently abun- 
 dant and nutritive, it should be supplemented by an additional allow- 
 ance of food. 
 
 In connection with food, it may be well to observe that, besides the 
 ordinary saline matters which it is beneficial to add to the ration, espe- 
 cially when it is prepared for the animals, in those regions where 
 inflammation of the joints of young creatures, and other morbid con- 
 ditions due to the deficiency of certain mineral constituents in the 
 economy are noted, it may be necessary to add these constituents to the 
 food of tlie pregnant animal. 
 
 The ])hosphates so necessary for the formation of certain tissues of 
 the body, for instance, may be deficient in the herbage ; and this may 
 be compensated for by giving, in addition to bran, meal, oil-cake, etc., 
 and even properly-prepared bone-dust. 
 
 The inttcr should be pure, and jjlentiful at all times ; as then the 
 animals will drink only moderate quantities, and when necessary. 
 
 .A. point to be particularly attended to, is not allowing pregnant 
 animals to drink very cold water, nor eat food at a low temperature. 
 We have seen that the fu-tus is extremely susceptible to the action of 
 cold, and abortion is by no means unusual tlirougli the operation of this 
 susceptibility. 
 
 Very cold water, fro/en food — such as i*oots, or herbage covered with 
 white or hoar frost — should therefore be withheld fron^. pregnant 
 animals, as they are likely to induce abortion, metritis, and other 
 serious accidents, either through their direct action upon the ftrtus, or 
 indirectly through the derangement they may set up in the digestive 
 apparatus. 
 
 ^\ ith regard to dwcUiwjti, the hygienic rules which should always be 
 observed in buildings in which animals are kept, ought to be rigorously 
 enforced with regard to those in which pregnant creatures are lodged. 
 Cleanliness is, above all things, necessary to be observed. Near foaling 
 time — three weeks or a month — the Mare should be kept apart in a 
 roomy loose-box, and when convenient, within sight of the other Horses 
 with which it has been accustomed to associate. The Cow is usually 
 allowed to remain in its ordinarv stall in the cow-shed ; but overcrowd- 
 
168 OBHTETRICAL PHYSIOLOGY. 
 
 ing and want of space should not be allowed, and every Cow, towards 
 the end of gestation, ought to have plenty of room in its stall, if a 
 separate box cannot be allotted. Stables, sheds, and loose-boxes should 
 have wide doors, to prevent injury to the females. With stalls, the 
 floor should slope very little indeed, from before to behind ; as if the 
 inclination 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 eversion of the uterus. The cow- shed ought to be kept very clean 
 and free from bad smells, and have plenty of fresh air. The stalls 
 should have plenty of litter, so as to prevent the Cows soiling them- 
 selves. Should a case of abortion occur in a stable or shed, among 
 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 
 be removed from the vicinity of other pregnant animals, and kept apart 
 from them so long as there is any vaginal discharge ; the same precau- 
 tions which must be adopted with regard to thorough disinfection and 
 cleansing, are likewise necessary here. It is not advisable to have 
 Cows bring forth among others whose period of gestation has not 
 arrived. 
 
 The cleanliness of the animals themselves 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 foetus. 
 
 Mental and physical tranquilUti/ are essential conditions of successful 
 gestation. Harsh or ci'uel 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- 
 tion. 
 
 With an irritable or timid primipara of the larger animals, it is well 
 to be gentle, and to accustom it to manipulation, particularly about the 
 udder, in order that it may the more readily allow its progeny to 
 approach it without danger. 
 
 Surgical operations, and medication in general, should be proscribed, 
 as they may be hurtful during this state, unless they are urgently 
 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 which 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 
 remedy than purgatives. Powerful narcotic, sedative, and other 
 medicinal agents, if they do not injure the mother, may imperil the 
 life of the foetus. 
 
 We have no sufficiently 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 foetus. 
 
Sf ■l'h:nF(KT. I Tins. 1 »J0 
 
 BOOK ill. 
 
 PATHOLOGY OF PHEGNAXC'Y. 
 
 The patholo(i!/ of prej,'nancy may be said to include those diseases and 
 accidents which constitute deviations from the regular or normal scries 
 of physiological phenomena ctiaractcristic of this condition. Tliese 
 deviations are somewhat numerous and various, and we will follow 
 Saint-C'yr in classing them under three distinct heads : anomalies, 
 diseases, and acvidents. They will be studied in this order. 
 
 CHAPTER I. 
 Anomalies in Pregnancy. 
 
 The anomalies occurring in gestation are super fietation, extra-uterine 
 jjregnanci/, and spurious pregnancy. 
 
 SECTION I.-SUPKRr«ETATIOX. 
 
 The term supcr/a'tation {fa'tus super firtuni — one fci'tus on another) 
 has been employed to designate these cases of conception in wliich an 
 animal, already pregnant, has been supposed to conceive a second time 
 before the termination of the primary gestation. In ordinary double or 
 triple gestation, the same copulation has produced the young at once ; 
 but in superfu'tation they are supposed to be formed at a more or less 
 wide interval of time, and of course by different copulations. 
 
 The belief in the possibility of such an occurrence in woman was 
 common among the old writers, and cases are adduced in support of 
 this view ; but its correctness has been nmch disputed by some recent 
 authorities. 
 
 Aristotle admitted the likelihood of superfcrtation taking place in 
 woman, because during pregnancy she was always with her imsband ; 
 but he denied its possibility in the Mare, although he was aware that 
 it might receive the male several times. In all probability, he imagined 
 that the instinct of the Mare would repel tlie Stallion after impregna- 
 tion. The naturalists and hippiatrists who succeeded him, have also 
 denied that such an abnormal occurrence could take place in the Mare ; 
 because, they declared, after conception the orifice of the uterus is 
 closed, so that the semen of the male cannot be introduced ; every 
 double birth, they also maintained, was due to two ova being impreg- 
 nated at the one copulation. 
 
 But numerous facts recorded by competent authorities would go to 
 prove that superfoetation is not only probable, but possible ; and that if, 
 generally, there is only one successful copulation possible, on the other 
 hand there are instances well vouched for, in which two successive 
 copulations have been followed by two independent impregnations. In 
 uniparous animals such cases have been frequently observed, the most 
 convincing of which is the production of a Mule-foal and a Horse-foal 
 by the same Mare at one birth. 
 
 An occurrence of this kind is mentionefJ in thi- Memoirf* dr VArnilfmif Boi/alr fjUn 
 i><-ifurf.f for 17o3 ; a Mare «t Ch;«tillon-«nr-.S«vr. >)ronght forth a H<>r^e and a Mule-foal. 
 
170 PATHOLOdY i>F PRFJJXAXCY. 
 
 Demoussy speaks of a M. Maillard, a wealthy farmer and breeder of horses, who had 
 occasion to observe a similar occurrence. 
 
 In the Journal Viterinaire Pratique for 1826, there is an account of a ^Slare which, 
 covered on the same day by a male Ass and Stallion, brought forth in eleven months a 
 well-formed, though weak, Mule-foal, and a full developed, but dead, Horse-foal. In the 
 same journal for 1836, there is another case of this kind recorded. A Mare had been 
 put to an Ass Stallion at St. Maixent, and was shut up in an enclosed space ; into this, 
 however, a Horse Stallion, two years old, broke, and covered this animal several times in 
 the course of the same day. The Mare obstinately refused to be covered when afterward* 
 put to the Horse, according to custom. At the usual period of parturition it produced 
 two Foals, one evidently belonging to the Equine species, and the other a well-characterized 
 Mule. These two young creatures, when three months old, were presented to M. de- 
 Vaublanc ; they were then being suckled by the Mare, and were in perfect health. The 
 fact was verified by the Mayor of the Commune, and communicated to the administration 
 of the Stallion depot of St. Maixent. 
 
 In Moll and Gayot's " Connaissance General du Cheval," Ayrault states that in Poitou, 
 France, a Mare was put to a Stallion Ass on March 7, ISoo, and on the 28th, being still 
 " in season," was put to a Horse. The following year, during the night of April 14-15, 
 this Mare produced a Colt-foal at eight o'clock, and a Filly-mule at eleven o'clock ; so 
 that the oldest foetus was born three hours after the youngest. 
 
 In the Journal dfs Veterinairts du Midi for 1859, Dr. Chabaud relates that in the 
 Commune of Verniolle (Ariege), a Mare was put to a Stallion Ass. As oestrum con- 
 tinued, it was put to a Stallion fifteen days afterwards. Nothing unusual occurred during 
 gestation, and when parturition took place, a fine healthy Foal was born, and after ten 
 minutes' straining, to the astonishment of the owner, a good well-formed Mule. The 
 Mare suckled the two, and they did well. 
 
 In the Journal des Vete'rinaires du Midi for 1864, M. Gilis gives a similar account of 
 a Mare that had been covered by a Stallion, then some minutes afterwards by an Ass, and 
 in twelve months had two Foals, perfect in their conformation — one, a Mule, died soon 
 after birth, and the other, a Horse-foal, did well. 
 
 Lanzillotti-Buonsanti mentions a Mare which, on March 28, 18.t1, was put to an 
 English Stallion, and on April 5 to a Barb ; on February 28. 1852, it produced two Foals, 
 each resembling one of the Stallions. Lessona speaks of a Mare which was put to a Horse 
 in 1852, and sixteen days afterwards to a Persian Stallion ; at eight months' pregnancy it 
 dropped a Horse-foal, and in two hours after a Mule-foal.' 
 
 In the Veterinarian (vol. xxx., p. 78), Mr. Evans refers to a Mare which was put- 
 three times to the Horse, about six weeks intervening between each time. Two months- 
 prior to the ordinary period of parturition from the last coitu?, two Foals were pro- 
 duced, one alive and full grown, the other so immature that it died immediately. 
 The same journal (vol. xxxix., p. 444) contains another instance, in which a Mare was- 
 put to a Cart-Horse on May 20, but showing symptoms of cestrum subsequently, was 
 again put to him on June 19. At the commencement of the following April two- 
 foetuses were born, each being in a different stage of development, and one of them 
 apparently a month older than the other. The same Mare had aborted the previous- 
 year. 
 
 In the Mimoires of the Veterinary Society of Calvados, vol. ii., M. Lemaitre 
 describes the case of a Alare which aborted on December 2, and in the following June 
 brought forth a Foal which continued to live. Trelut, in the Journal de>< Veterinaire-s- 
 du Midi for 1844, mentions a Mare, eleven years old, which was put to the Horse on 
 April 23, on the 4th, 6th, and 25th of May, and again on June 5, 1845. In December 
 this Mare received some kicks on the belly and flank iroai a Horse, but this did not impair 
 her health. On March 1 it slipped up, and on the 15th it aborted two Foals without 
 
 ^ All these instances are paralleled in the human female, by various authorities. 
 Buffon, quoted by Fodere and Churchill, mentions a woman at Charleston, South Caro- 
 lina, who, in 1714, was delivered of twins within a very short time of each other, the one 
 being blaok, the other white. On examination the woman confessed that on a certain 
 day, immediately after her husband had left her, a negro entered her room, and, by 
 threatening to murder her in case of refusal, obtained connection with her. Dr. Moseley 
 alludes to the case of a negro woman who brought forth two children at a birth, both of a 
 size, one of which was a negro and the other a mulatto. On being interrogated upon 
 the cause of their dissimilitude, she said she perfectly well knew the cause of it, which, 
 was that a white man belonging to the estate came to her hut one morning before she 
 was up, and she suffered his embraces almost instantly after her black husband had 
 quitted her. Similar illustrations are quoted by De Bouillon, Trotti, Guerarde, Delmas,. 
 Dunglison, and others. 
 
SUPEKFCETA Tl<>\. 1 7 r 
 
 suffering any ill effeoU. The first Kiml had the tongue protruding from the mouth, tht* 
 mucous meutbraneH were very pale, the liair of lx>dy and mane and tail were pre.sent, the 
 eyes were closed, the skin was colourless and lookiug as if macerated, and the hair was 
 easily removed ; the bloodvessels only contained a few dn)ps of pale blood ; aiul the 
 muscles, pale and Haccid, did not show any signs of deconii)osition. The second Foal 
 had the skin smooth and shining, but no trace of hair ; the eyes were open ; the mucous 
 membrane bright red ; the muscles tiini and red ; and the lieart and vessels tilled witli 
 red blood. 
 
 Cauzit, in the yoKnta/ dt Mr'd. Viteriimire de Lyon for 1859, gives an instance of 
 superfietation in a Mare, fecundation having occurred at an interval of eight days ; and 
 Chabaud, in the Journal tits \\t. tin Midi for IS")!', mentions another case, in which 
 fecundation must have occurred at fifteen days' interval. 
 
 An instance is reported from the United States of America. On tlie "iOth of February, 
 1876, a five-year-old Mare belonging to William Driesbach, of Sparta, N.Y., foaled a 
 dead Ci>lt, fully developed and otherwise promising in those points which go to make \\\y 
 a good Horse. The Mare appeared to be well, and tti the siirprise of her owner, on the 
 2nd of April following, six weeks after the birth of her Foal, gave birth to another Colt, 
 which was sound, healthy, well developed, and in all respects as promising a colt as could 
 be found in the State. 
 
 In the Joiirnal Vtltrinaire Pnttique for 1828, there is an instance given of what was 
 supposed to be superfietation. A fine-woolled Kwe, impregnated at the usual season in 
 1S"23, evinced in the following year, at the period of parturition, the ordinary signs of 
 giving birth ; but these subsided without any produce being born, and the animal ipiite 
 recovered. The foetus was in the abdomen, and could be easily felt. In 18'24, this Kwe 
 was again impregnated ; in the early days of March, 1S25, the niamnue contained milk, 
 and soon after the symptoms of parturition became manifest ; but, as before, they dis- 
 apjK'ared without any result. The animal then lost condition, became grailually weaker, 
 and was not long in succumbing. On opening it, a perfectly developed Lamb was found 
 in the right horn of the uterus, and in the left another well-formed fti-tus of the male sex 
 was discovered. The latter, with its envelopes, as well as the uterine cavity, were normal, 
 except that a jwrtion of the fluid had escaped and the f<etus was dead ; the cervix uteri, 
 however, was constricted by the presence of a newly-formed mass of matter, which was 
 so hard that it could scarcely be cut through — a circumstance that appeared to explain 
 the impossibility of delivery. 
 
 Hering {lieperf. t'iir T/iitr/itlUcnnth, .Tahrgang ix., p. 1) alludes to instances of super- 
 fietation in the Cow and Sheep. An Knglish breeder recently reported a remarkable case 
 of sujierfietation in the Cow, as follows : — " I have a Cow that on August !• last had a 
 Heifer Calf, apparently at full time ; indeed, so fine a one that I am rearing it. The Cow 
 niilktd well for about a month, and then suddenly lessened the i|uanlity, and shortly 
 c-ased to give any. On September 2*5 she took the Bull, and from that time I noticed 
 nothing unustial with her, though constantly seeing her, »intil December 24, when she 
 had another Calf, a Bull, strong and fullsi/.ed, and certainly not premat>ire. The ('alf is 
 ni'W alive and doing well, and the mother is giving as much milk as after any of her 
 previous calvinga. She was running with a Bull during la-st .March and until .•\i>iil 2.'>, 
 when the Bull was castrated, and she coidd not have had access to any other tintil 
 Septemlier 2'J, when she was seen to be in season and sent to a neiglibonr's Bull and 
 served. 
 
 From the facts already accumulated it may, then, he concluded that 
 superfcctation in the Mare may occur, and indeed has occurred, several 
 times. It has heen argued against these facts that suj)erfa'tation is 
 impossible, because a Mare that has once conceived would be exceed- 
 ingly liable to abortion if submitted to a second service ; but it is more 
 than doubtful that abortion should be the inevital)le consequence of re- 
 peated copulation ; and we have the human species to adduce in })roof 
 of the comparative innocuousness of sexual intercourse during pregnancy. 
 So far as researches have gone, however, it must be confessed that these 
 double conceptions have only occurred in uniparous animals by suc- 
 cessive copulations on the same day, or within a few days ; and we 
 are therefore without any indication that this could occur in them at 
 longer intervals. This, it will be evident, is no very strong proof 
 of superfcctation having taken place ; for in the case of the Mule and 
 Horse Foal, it only proves that a double conception may occur from 
 
172 rATHOLOGY OF PREGNANCY. 
 
 intercourse with two different animals within a very short period. If 
 a longer period — say three or four months — intervened, then super- 
 fcetation would be admissible, and would perhaps be undeniable, pro- 
 vided there was nothing abnormal in the uterus — such as a double 
 organ. 
 
 Rainard remarks that torsion of the neck of the uterus in the Cow, 
 though preventing the birth of the foetus, 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 very 
 doubtful, the animal, if not killed for consumption as food, is generally 
 left to the efforts of nature ; should the season be favourable it is 
 allowed to remain at pasture, and freqiaently after some suffering the 
 creature regains its condition, even becomes fat, and may then be 
 advantageously sold to the butcher. Towards the spring-time, such an 
 animal might conceive again without having been delivered of the first 
 foetus. 
 
 In multijyarons animals there can scarcely be a doubt that superfoeta- 
 tion may take place, and perhaps of all those which have been domesti- 
 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 from one 
 ovary in the corresponding horn, the other remaining open and un- 
 occupied. 
 
 In the Sow, many instances are published in favour of superfoetation. 
 One of these is given by Miiller, of Hildesheim, in 1887. Twenty-one 
 days after the birth of a litter of six Piglings, the mother Sow became 
 restless and irritable and refused to suckle them. Two days later, that 
 is twenty-three days after birth, a second litter of eleven, all well-formed 
 and healthy, appeared upon the scene. Five of the first and nine of the 
 second litter are still doing well. It is remarked that the mother had 
 access to the Boar for some weeks after the first impregnation, and the 
 authenticity of the account is stated to be beyond dispute. 
 
 In the Bitch, many observers have assured themselves that super- 
 foetation is by no means unfrequent. Rainard, Blaine, and others 
 speak of it. Blaine says, " I am disposed to think that Bitches are 
 capable of superfoetation ; that is, they conceive more than once. If 
 this is the case, a Bitch may copulate to-day, and become impregnated, 
 and in a day or two she may copulate again, and again become impreg- 
 nated. This is not frequent, I believe ; but it certainly does happen, or 
 we could not account for the different periods at which the progeny 
 sometimes appear. I have known a week, and in one case even ten 
 days, intervene between the puppings ; but one or two days is not at all 
 uncommon. As a still more convincing proof, the whelps often appear 
 of different kinds." 
 
 It must be remembered that the bitch remains in " heat " for three 
 or four days, and will seek for repeated intercourse with the male 
 during that period. It must, therefore, either be concluded that the 
 last intercourse was the successful one, or 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 superfoetation in the 
 
SUPKlihWrA TJo.y. 1 7 5 
 
 larger domesticated animals. The cases recorded have not been 
 sutliciently investigated to convince those who deny the likelihood of 
 two conceptions taking place after a certain interval ; and it must be 
 admitted that a true explanation of such a singular occurrence has not 
 yet been offered. A lapse of time occurring between the birth of two 
 animals is no strong proof of a second impregnation during conception ; 
 for, as we shall see hereafter, when twins are conceived from the same 
 intercourse, it may and does happen that one ovum does not attain 
 maturity so soon as the other, and is eitlier rejected or retained after a 
 more or less lengthened interval — a circumstance wliich might mislead. 
 And again, with regard to the size of twins, it is not at all unusual to 
 find one larger and more developed than the other, though both were 
 produced at the same period. Putting aside the question of superfuita- 
 tion in animals, the anatomical disposition of whose generative organs 
 evidently permits such an occurrence, a little consideration will show 
 tliat usually there are physical obstacles which would appear to offer an 
 insurmountable barrier to a second impregnation, after conception has 
 been achieved for a short time. Soon after that event has taken place, 
 the entrance to the ' uterus is closed by the shut sac enveloping the 
 embryo, and which adheres closely to the inner surface of the organ 
 throughout its entire extent — covering the orifices of the os uteri and 
 Fallopian tubes. In addition to tiiis, the canal of the cervix is during 
 gestation rendered still more impervious by the thick viscid mucus 
 secreted by its glands. Such being the case, it w'ill be obvious that a 
 second 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. For a second 
 impregnation to occur during conception, fecundation must take 
 place before this closing-up of the uterus and Fallopian tubes — an 
 interval too brief after the primary impregnation to make much 
 difference in the respective developments of the young animals. In 
 cases in which there is a double uterus, or in which conception occurs 
 in only one horn, superfcetation is possible, and one parturition may 
 not be followed by another for some consideral)le time. However this 
 may be, there are certain facts recorded whicli need explanation if super- 
 fcetation be not admitted as possible. 
 
 SECTION 11.— EXTRAUTERINE PKKCNANCV. 
 
 In studying the development and progress of the ovum, after its 
 escape from the ovary and impregnation by the spermatozoa of the male, 
 we saw that a peculiar arrangement existed in the presence of the 
 fringed border at the extremity of the Fallopian tube, which grasped 
 the ovum and permitted it to be conveyed into the canal on its way to 
 the uterus. From certain causes which are not yet clearly understood, 
 it sometimes chances that the ovum, instead of taking this its normal 
 course, either remains in the ovary, is arrested in its progress tlirough 
 the tube, or, escaping the fimbriated extremity of the latter, falls into 
 the peritoneal cavity, or glides between the folds of peritoneum con- 
 stituting the broad ligament, or between the serous and mucous mem- 
 brane of the uterus ; in all of which situations nature makes an effort to 
 afford space and nutrition for the embryo, and thus supply the place of 
 the uterus. This effort, however, as might be anticipated, is only par- 
 tially successful, and after attaining a more or less imperfect develop- 
 ment, the futus perishes from lack of nourishment. 
 
174 PATHOLOGY OF I'llEGNAXCY. 
 
 This abnormal deviation from ordinary gestation, happily very rare in 
 the domesticated animals, has received various names — such as Extra- 
 uterine ijregnancji, Exfcetation, Conceptio vitiosa, etc. The first is that 
 usually employed ; and the different varieties are commonly designated 
 from the situation the ovum occupies. Thus we have (1) Ovarian 
 fcetation , when the ovum is detained in the ovary ; (2) Ovario-tuhal, 
 when lodged partly in the Fallopian tube and partly in the ovary ;' (3) 
 Tubal, when the tube is the situation; (4) Interstitial, when the ovum 
 ■enters the parietes ol^ie uterus at the termination of the tube, but is 
 arrested between the uLres before it can reach the cavity of that organ ; 
 (5) Utero-tubal, a compound of the two, the ovum being partly in the tube 
 and partly in the uterus ; (6) Utero-tuho-ahdominal, when the foetus is in 
 the peritoneum, the umbilical cord passing through the tube to the 
 uterus ; (7) Tuho-ahdominal, when the foetal envelopes are fixed in the 
 tube, but the foetus is developed in the peritoneal cavity ; and (8) 
 Ventral or abdominal fo'tation, when the embryo is formed and develops 
 in the abdomen ; (9) Vaginal ffMation, when the ovum is implanted and 
 becomes developed in the vagina. 
 
 Extra-uterine pregnancy is extremely rare in the domesticated 
 animals, and appears to be much more so in them than in woman ; 
 several of the varieties just enumerated have never, to my knowledge, 
 been observed in them. This ma}' be fully accounted for by the 
 different arrangement of their generative apparatus, the much less 
 tendency of these to disease, functional disorder, or deformity, and also, 
 •doubtless, to their function being only that of reproduction. With 
 regard to anatomical arrangement as averting, to some extent at least, 
 this misplaced gestation, we may point out that of the Mare as typical 
 — though the same indication is applicable to the case of the other large 
 animals. In this creature, the escape of the ovum into the abdominal 
 cavity can only occur through some malformation or anomaly in the 
 -conformation of the fimbriated extremity of the tube, which, in the 
 normal condition, is applied to the base of the ovary, and envelops it 
 during the genital excitement. Neither is it likely that its course 
 through the cavity of the tube can be checked, as this is short and 
 ■direct ; and the comparative thinness of the uterine walls almost 
 precludes the probability of the ovum lodging itself in them. 
 
 Ovarian fcetation has very seldom been observed, so far as my re- 
 searches have led me ; though its occurrence in the domesticated 
 animals is far from being impossible. It has been divided into two 
 kinds — internal ovarian, when the embryo is developed in the Graafian 
 vesicle or interior of the ovary ; and external ovarian, when the ovum 
 has left the vesicle and grows beneath the envelope of the ovary. The 
 only instances on record are given by Rohlwes, Gurlt and Plot. The 
 first observed this rare form of gestation in a Mare which had been 
 pregnant twenty-one days. The ovary was greatly enlarged, and con- 
 tained a small embryo in a vesicle. Plot observed it in a Cow, and 
 also in three Sows. 
 
 Tubal fcetation, in which the embryo is developed in the Fallopian 
 tube, is also exceedingly rare, if the paucity of cases reported is any 
 criterion. Rohlwes mentions having found the bones of a foetus in the 
 left Fallopian tube ; and Carus says this form has been noted in the 
 Rabbit. Carsten Harms speaks of it as causing fatal internal haemor- 
 rhage, by rupture of the tube, through the incapacity of the latter to 
 -distend sufficiently for the development of the foetus. 
 
/•;.Y TKA ■ I ' TKI! I .\ K I 'I! KtlX.iyry, 17 ;-, 
 
 Interstitial fcetation is that form in wliicli the cmhryo is developed 
 between the nieinbranes foriniti}^ the walls of the uterus ; the muscular 
 fibres, at the point where this occurs, are separated, and the cyst con- 
 taining the embryo is situated between the serous and mucous mem- 
 brane. This variety has not been noted in the lower animals, I believe; 
 neither have the remaining forms, except the abdominal, some very rare 
 cases of which are on record. 
 
 Abdominal or ventral fwlation may present two varieties: the ovum 
 may graft itself, after escaping from the ovary, directly in the cavity of 
 the abdomen, and there be developed ; or it may be developed at some 
 other point — the ovary. Fallopian tube, etc., and fall into the abdomen 
 after rupture of the pouch which contained it. In the first instance it 
 is named jirimar;/, and in the other secundar// abdominal f'adation. 
 E.\tremely rare though both varieties are in animals, yet perhaps the 
 tirst variety is less frequent than the second. 
 
 Wojinal fa'tation has been recorded as occurring in animals, and the 
 size and conformation of the vagina lends itself to this kind of abnormal 
 pregnancy, which does not appear to be possible in woman. 
 
 Several instances of these different kinds of fcetation are to be found 
 in veterinary literature. 
 
 The length of time during which these extra-uterine foetuses may be 
 retained, varies according to circumstances. In the human species, a 
 case is recorded in which the fcetus remained in the abdomen for lifty- 
 six years ; and a great many instances are published in which retention 
 has continued from three months up to the last-named period. In 
 animals this retention of the misplaced fd-tus may also continue for a 
 long time ; and though death usually occurs if delivery is delayed much 
 beyond the usual period of pregnancy, yet development appears to pro- 
 gress in the ordinary manner, and subject to the laws of normal gesta- 
 tion. It is indeed astonishing to hnd the ovum fix itself, and become 
 developed into the embryo and f<etus, by drawing nourishment in the 
 strange situation in which it chances to fall — the placenta, cord, and 
 envelopes being present just as if it had found its way into the natural 
 receptacle. It does not appear to be (juite decided whether the ovum, 
 in primary abdominal f<etation, receives an additional covering ana- 
 logous to the decidua ; though it is very probable that it does, and that 
 this membrane may perform a similar otlice in the nutrition of the 
 fa'tus. The part of the abdominal or other surface to which the ovum 
 adheres, receives an increased vascular supply for the occasion, its 
 vicarious function being as actively carried on as if it were the lining 
 membrane of the uterus. 
 
 Not infrequently retention is brought to a termination by the death 
 of the parent, through the disordered state of health induced by the 
 living foetus, or through absorption of the septic matter it engenders, if 
 putrefaction sets in after its decease. On other occasions — and these 
 are comparatively not very unusual in the lower animals— an effort 
 is made by nature to get rid of what really in time becomes a foreign 
 body, by artificial openings. In these cases the fcntus may be passed 
 whole or by fragments through the al)dominal parietes, the intestines, 
 or the vagina — in almost every case the former, owing to tlie quadru- 
 pedal position of the domesticated animals. Several occurrences of this 
 kind are to be found in the literature of Veterinarv Science. 
 
176 PATHOlJinY OF PRE'iXAXrV. 
 
 Symptoms, Course, and Terminations. 
 
 The symptoms are generally those of conception and gestation. The 
 ovum grafts itself on some part with which it chances to be in contact ; 
 an embryo results, the placenta being attached to the neighbouring tex- 
 tures and developing with the increase of the young creature ; these 
 changes being accompanied by the ordinary external signs of uterine 
 pregnancy. In the majority of cases, when parturition should occur in 
 the usual course, the premonitory indications of that phenomenon are 
 very slight or altogether absent ; though the animal may now and then 
 make expulsive efforts, which continue perhaps for a few days, and 
 then subside gradually, or recur at intervals. In the most favourable 
 cases, when the foetus perishes, it becomes encysted and mummified ; 
 the fluids and soft parts are absorbed, and the remaining portions 
 become dry and parchment-like ; or the creature may undergo a process 
 of calcification by the deposition of carbonate and phosphate of lime in 
 its tissues, which preserve its shape, and convert it into a " lithopaedion " 
 or " osteopaedion." 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 gestation being only discovered by chance 
 when the animal dies from some disease which 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 are many that a fatal termination will be the 
 consequence of extra-uterine gestation. Expulsive efforts or other 
 causes, may lead to rupture of the cyst in which the foetus is contained; 
 and this, with the fluids and debris 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 foetus ; and if the mother does not at once succumb to 
 pyaemia or septik£emia, adhesions and communications are formed 
 between the kyst and neighbouring organs, and the remains of the 
 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. After the foreign matters 
 have been completely, or even only partially, eliminated in this way, 
 the fistulous openings by which they escaped cicatrise after a variable 
 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, septikaemia, or one of the many accidents which the presence of 
 such a body may produce. The course of external ovarian gestation, 
 which has been stated by Gurlt to occur in the domesticated animals, 
 appears to be as follows : the envelopes of the ovary rupture towards 
 the second or third month of the embryo's development, w^hen the latter 
 falls into the abdominal cavity, w^here 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 htemorrhage. 
 
EXTRAUTEIUXK PREGNANCY. 177 
 
 Diagnosis and Treatment. 
 
 There is absolutely nothing in the early, or even in the later stages of 
 extra-uterine pregnancy — especially ovarian and tubal — to indicate the 
 existence of any deviation from normal gestation : and when at length 
 the animal exhibits indications of approaching parturition, there may 
 be grave doubts as to the actual state of affairs, though the absence of 
 certain signs may give rise to suspicion. The animal is uneasy and 
 strains, yet the vulva is not enlarged, and the How of mucus observed 
 in the preliminary stage of ordinary parturition is not apparent. 
 Exploration of the cervix uteri by the vagina, will prove the absence of 
 induration or morbid tumefaction, as well as dilatation or contraction 
 of the OS, notwithstanding tlic length of time that has elapsed and the 
 expulsive efforts. Palpation and inspection of the abdomen may also 
 furnish certain information with regard to volume, and the situation of 
 the enlargement. Careful exploration of the abdominal cavity by the 
 rectum will be found advantageous in cases of abdominal gestation un- 
 complicated with uterine pregnancy. Not only can the condition of the 
 uterus be satisfactorily determined, but perhaps a tumour independent 
 of that organ may be discovered, in which a fa^tus, or parts of one, 
 can be felt. In such a case, efforts must be made to check the attempts 
 at parturition, though it must be confessed that they are not likely to 
 be successful. Sedatives, large doses of opium, chloral, hot water 
 applications to the abdomen, and other measures of this kind, are 
 indicated. If the diagnosis is well established, and the animal can be 
 utilized for food, it is generally better to have it destroyed if in fair 
 condition. In cases in which the period of parturition has passed, and 
 when the animal has been unwell for some time, exliibiting loss of 
 appetite, with marked depression, quickened pulse and increased tem- 
 perature, and nothing else to account for these symptoms, then we may 
 suspect the existence of extra-uterine gestation and putrefaction of the 
 fcetus. 
 
 In the smaller animals — such as the Sheep, Goat, Bitch, etc., 
 abdominal palpation can be readily resorted to, and often with most 
 satisfactory results. 
 
 When elimination of the fcrtus has commenced in any of the modes 
 just described, active interference may or may not be necessary, accord- 
 ing to circumstances. The fistulous openings which may be occasioned 
 by the eliminative process, must be dealt with as ordinary listuUc. 
 Should the foetus chance to be alive, it is scarcely possible that it can 
 be removed by operation without greatly endangering the life of the 
 mother. If in abdominal gestation a tumour, simulating an abscess, 
 fonns on any part of the abdomen, this may be carefully opened, and 
 the fcetus extracted with a successful result. The accessory treat- 
 ment, sucli as careful nursing and hygienic measures, must not be 
 neglected. 
 
 In vaginal pregnancy, there is of course an absence of the usual signs 
 of abdominal gestation, unless this is going on concurrently. The 
 animal shows symptoms which should lead to exploration of the vagina, 
 when the fcetal tumour will be encountered ; this will probably be 
 attached to the floor of the passage, from which it can easily be 
 removed. 
 
 12 
 
178 
 
 PATHOLOGY OF PREGNANCY. 
 
 SECTION III.— SPURIOUS OR PSEUDO-PREGNANCY. 
 
 Spurious pregnancy is a designation applied by veterinary obstetrists 
 to certain accidents, characterised by the development of special patho- 
 logical productions, which may probably be due to a previous conception, 
 and which more or less simulate normal pregnancy. Such cases are 
 far from common, and the principal of them are described as moles, 
 uterine cysts, and hydrometra or hydrops uteri.^ These we will allude 
 to. 
 
 Moles. 
 
 Moles, or more correctly speaking perhaps, anidian monsters, are more 
 or less voluminous fleshy masses constituted by a blighted embryo, the 
 
 membranes of which have continued to perform their function, and to 
 nourish the abnormal growth. They are, as a rule, met with only in 
 Euminants, and especially the Bovine species, though Eoell mentions 
 their occurrence in the Mare ; and in nearly every case they appear to 
 be one of twins, the development of which has been arrested at a certain 
 period. 
 
 The mole {viola cruenta) is more particularly characterised by the 
 persistence of an umbilical cord which, though degenerated, yet seems 
 in the majority of cases to maintain relations between the tumour and 
 
 1 I am not aware that the curious and obscure form of pseudo-pregnancy occurring in 
 woman, and designated pseudo-cyesi^ by the late Dr. Simpson, has ever been observed in. 
 animals. 
 
SPURIOUS OR PSEUDOPREGXANCV. 
 
 179 
 
 the uterus. With rej^ard to the tumour itself, it is generally easy to 
 distinguish the distorted remains of an embryo — sucli as skin, bones, 
 muscles, and even organs of sense in some cases. These anidian 
 monsters have not attracted much attention ; though several instances 
 of their occurrence are publishfd in veterinary literature. 
 
 Kainard and others mention having found fibrous moles {inula 
 
 Fig. Q^. 
 
 Hvi'ATui Cyst or Molk : Himan. 
 
 Thi- f'y'<t, which filled the I'UruM, has bten opened, and gives exit t<> a number 
 of Hydatid Veaiclef. The Section Hhown two Membranous Layers, the first 
 of which, a, a, a, is external, and is analogous to the Kpichorion or Decidua ; 
 while the second, h, h, h, is a fine transparent Membrane, apparently the 
 remains of the Chorion, r, r, r, flranular Vesicles ; */, >/, il. White ^'ef*^<»•ls, some 
 of which appear on the Surface as (Granulations, and others act as Pedicles to 
 the Globules at their extremity ; f , r, < , Oblong Vesicles which app»'ar to Ije 
 Constricted or Dilated Vesicles ; f,f,f. Budding Vesicles. 
 
 raceinosa) in the uterine comua of the Bitch, Pig, and some other mul- 
 tiparous animals during gestation, and most frequently in the last dilata- 
 tion of one horn, rarely in both ; sometimes they were between two of 
 the dilatations which contained living foetuses. Tliey are spheroidal, 
 soft, irregular in shape, and look like flesh ; they appear to be composed 
 of fibres running in every direction. In the dilatation of the horn con- 
 taining them, traces of a zonular uterine placenta have been obse^^•ed. 
 
180 PATHOLOGY OF PREGNANCY. 
 
 Rainard was of opinion that they were embryos whose development was 
 checked by disease. 
 
 Demoussy states that the presence of foetal 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 foetus. 
 
 Uterine Cysts. 
 
 Uterine cysts are pathological productions, somewhat analogous to 
 the vesicular degeneration 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 designated 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. 
 
 Eainard says : " "When this collection is forming, the abdomen 
 gradually enlarges as in ordinary gestation : the animal looks healthy, 
 and there is scarcely any difference 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 months 
 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 ordinary 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 foetus. Then, at a certain time, there appear the precursory indi- 
 cations of parturition or abortion : expulsive efforts— certainly less 
 energetic, painful, or prolonged, as a rule, than those of natural parturi- 
 tion, and rather resembling those of micturition or defecation. The 
 cervix uteri slowly enlarges, though the hand introduced into the 
 vagina discovers the os to be almost impervious, and neither foetus nor 
 
IXFLUEXCK OF PREGXAXCY oX dnDIXAin' DISEASES. 181 
 
 ineiiibranes can be felt ; when it is dilated, there is at once a gush of 
 tluid, the aspect and quality of which varies. It is often greyish- 
 coloured, thick, and more or less fa^tid ; though it may also be clear 
 and serous. Its evacuation may occur at very variable periods — as at 
 one hundred and eighty days, five and a half months, thirty-two weeks, 
 or forty-six weeks, after the supposed successful copulation, according 
 to the various writers who have described these cases. 
 
 There are two forms of hydrometra — (edematous lij/dronietra and 
 ascitic hifdrovu'tra. The former exists when the walls of the uterus are 
 infiltrated with serum, and may acquire a thickness of four or five 
 inches ; the latter is an accumulation of tluid in the cavity of the 
 uterus. Hydrometra luis been observed in the Mare, Cow, and Bitch ; 
 rarely in the Sheep. 
 
 Recovery has often followed the evacuation of the fluid, when it has 
 been in the uterine cavity ; in some cases the condition has become 
 so aggravated as to cause death, or necessitate the destruction of the 
 animal. 
 
 The diagnosis is arrived at by manual exploration, and by the absence 
 of some of the most characteristic indications of pregnancy. 
 
 When the condition is diagnosed, and there is reason for interference, 
 the indications for treatment are plain — carefully dilate the os, evacuate 
 the contents of the uterus, and inject astringent and antiseptic fluids 
 (as carbolic acid 1 to 20) at intervals into its cavity. Give gentle laxa- 
 tives frequently ; guard against distention of the bladder, from which 
 the urine may be removed by means of a catheter, if necessary ; and 
 give nourishing food, with tonics. 
 
 Cri AFTER II. 
 Diseases incidental to Pregnancy. 
 
 Owing to animals being kept in a more natural state, generally, than 
 the human species, when pregnant tliey are much less exposed to the 
 risks and inconveniences of that condition than woman. The difference 
 in the attitude of the body may also tend much to obviate those serious 
 accidents, and prevent those unpleasant consequences, which so often 
 attend gestation in the human female. 
 
 Nevertheless, notwithstanding this inmiunity, pregnancy in animals 
 brings about certain modifications in the organism which may some- 
 times call for serious notice, either when it leads to a morbid pre- 
 dis{X)sition, or in its influence on the progress of certain diseases already 
 existing at the time of conception, or which have developed during 
 pregnancy. There are also maladies whicli are peculiar to this condi- 
 tion, some of them of much importance. 
 
 SF.CTI(1N I.— INFLUENCE OF PREGNANCY UN ORDINARY DISEASE.S. 
 
 The influence of pregnancy on the course of the ordinary diseases of 
 animals has not yet been well ascertained, though it has been long 
 obsened that such an influence exists, and has often been productive 
 of marked effects. 
 
 .\nd these may have been due, directly or indirectly, in some cases at 
 least, to the condition of the blood in the female, the red globules of 
 
182 PATHOLOGY OF PREGXAXCV, 
 
 which are greatly dhninished, and the proportion of albumin is also 
 notably decreased, while the serum, on the contrary, is much above the 
 normal standard. The amount of fibrine likewise varies, though this 
 variation is neither so constant nor so uniform as in the other consti- 
 tuents ; but it generally increases towards the termination of pregnancy.^ 
 Owing to this decrease in the solid portion of the blood, and particu- 
 larly in the red globules, the pregnant female is more anaemic than 
 plethoric. It is none the less exposed to inflammatory attacks, how- 
 ever, owing to the excess of fibrine ; but, as Saint-Cyr justly remarks, 
 these phlegmasitE assume a particular physiognomy, and run a very 
 different course to those observed in ordinary conditions, and more 
 especially with I'egard to depletive measures, which have to be carefully 
 resorted to — or, we might say, abstained from. 
 
 The mechanical effects of the foetus, and the immense volume of the 
 uterus, must also produce disturbance of most essential functions, 
 and more especially those of the abdominal and thoracic organs. There- 
 fore it is, that during pregnancy such affections as indigestion, colic, 
 tympanitis, enteritis, or pneumonia, are so frequently followed by 
 abortion and slow convalescence, or death of the animal. 
 
 Chronic diseases have in general but little influence on gestation. It 
 has been imagined that " broken wind " in the Mare is much relieved 
 during pregnancy ; but some observations would go to prove that it 
 is rather aggravated — though the troublesome cough does not appear 
 to prevent the fcBtus reaching its full period. 
 
 Acute diseases are more serious, and especially those of an epizootic 
 kind, which often cause abortion or induce premature labour. Influenza 
 very often leads to abortion in Mares, and the contagious pleuro- 
 pneumonia of cattle has frequently the same result, death being more 
 frequent as pregnancy is well advanced. Sheep-pox is also more 
 serious and more often fatal in pregnant Sheep, and most frequently 
 followed b}^ abortion. 
 
 A number of observers— among them Saint-Cyr, Bouley, Eoll, Lafosse, 
 and Eeynal — have remarked that the cattle-plague does not appear to 
 have any very particular influence on gestation : and the same has been 
 said of eczema epizoutica (" foot-and-mouth disease "). But this Con- 
 tinental experience does not harmonise with that relating to these two 
 diseases in our own country. Abortion has been a notorious sequel of 
 both maladies, and more especially of " foot-and-mouth disease," in 
 which the losses from this cause have sometimes amounted to twenty, 
 thirty, fifty, and even more, per cent. 
 
 Painful and nervous diseases are also more serious during pregnancy 
 than at other times. It would, however, seem to be an error to attri- 
 bute the non-appearance of certain disorders during pregnancy to the 
 influence of this condition, as Spinola has done with regard to 
 rabies, etc. 
 
 SECTION II.— DISEASES INCIDENTAL TO PREGNANCY. 
 
 As has been already stated, the diseases peculiar to the pregnant 
 condition are fewer, not so frequent, and usually much less serious in 
 animals than in the human female. The chief maladies or morbid 
 
 ' In woman, it has been noted that the normal proportion of red globules is from 12fi 
 to 127 per 1,000, and that during pregnancy this proportion falls to 120, 115, 95, 90, and 
 even 87 per 1,000 of the total mass of the blood ; while the albumin descends from an 
 average of 70i to 69, •]*;, and 62 per 1,000. 
 
UISKASKH IXCIhKSTAL TO rRKGXAXCV. 183 
 
 ooiulitions which have been noted in animals are pica or mnlacia, 
 rickets and osteomalacia, coiistipation, vomitiny, colic, oidcvui, hydrops 
 amnii, paraplegia, cramp, eclampsia, cerebral congestion, atitaurosis, 
 cough, albuminuria, mammitis, and red colostrum,. 
 
 Pica. 
 
 We have ah-eady noted that the appetite of pregnant animals is some- 
 times depraved, and that they will ingest foreign matters — such as 
 plaster licked from the walls, wood gnawn from their stable-fittings, 
 eartli, etc. 
 
 When depending on derangement of the digestive functions — on a 
 neurosis of the stomach — this depraved appetite may be corrected by 
 the careful administration of tonics, antacids, and attention to the 
 quantity and quality of the food. The Herbivora should be allowed 
 conmion salt in their food, or to lick. 
 
 Rickets and Osteomalacia. 
 
 Disease of the bones, tending to softening or fragility, has been fre- 
 quently observed in pregnant animals, and especially those which are 
 young ; the two conditions being observed independently or coincident 
 in the same creature. There is considerable increase in the organic 
 matter of the bones, and a corresponding decrease in the inorganic 
 constituents, especially of calcium phosphate ; the long bones are more 
 particularly affected, thougli the whole skeleton may be involved. The 
 bones become softened, are often enlarged, and are friable and brittle; 
 so that in advanced cases fractures occur readily, while deformity is not 
 at all rare. The disease has been witnessed in an en/.oiitic form on the 
 Continent in large breeding establishments, among Mares and Cows ; 
 flocks of Sheep have also been artected, and it is not uncommon in 
 Bitches and Swine. It is generally due to the animals receiving insufli- 
 cient food, or eating that which is deficient in mineral matters — such as 
 lime and phosphorus — as well as in nitrogenous constituents. When 
 pregnant animals are not well fed, the fa3tus makes such demands upon 
 them for growth materials that they must suffer, and that speedily, in 
 their osseous structure. 
 
 The early symptoms are often those of pica, the animals instinctively 
 seeking for lime salts. But frequently the first indication of this condi- 
 tion is the occurrence of fracture of one of the limb or pelvic bones 
 from some slight cause — as getting up from the recumbent position, 
 slipping, or a blow. The pelvis appears to be very liable to such frac- 
 tures, though the long bones, ribs, scapula, and even the sternum, are 
 commonly damaged in this way. Sometimes, before these fractures 
 occur, the animals appear to be stifT, and walk as if suffering from 
 paresis or debility, and the joints begin to swell ; then the recumbent 
 position is assumed and maintained, unless strong persuasion is applied. 
 The condition is always more or less serious, though there may be difti- 
 culty in diagnosing it, unless careful examination and inquiry is made. 
 Prevention lies in giving pregnant animals good food, keeping them in 
 a healthy state, and not breeding from them when too young. The 
 curative treatment is simple, and is mainly centred in offering nutri- 
 tious food rich in lime salts — as crushed oats and beans for ^Fares, and 
 even for Bovines (which may have them scalded or boiled), with green 
 forage or good hay ; nerve tonics — as strychnine or nux vomica, and 
 preparations of calcium phosphate, may also be administered in serious 
 
134 PATHOLOGY OF PREGNANCY. 
 
 cases. For the smaller animals the same drugs may be prescribed, 
 with the addition of cod-liver oil, and milk-and-oatmeal porridge for 
 food. 
 
 Constipation. 
 
 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 
 suffer most frequently from constipation, Saint-Cyr recommends the 
 administration, every day for eight or ten days, of five to eight grammes 
 of white mustard ; but I have always found castor-oil, witli enemas 
 when the constipation was very obstinate, quite satisfactory. Castor 
 or linseed oil, or even boiled linseed, answers well for the larger animals. 
 
 Vomiting. 
 
 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 in the Belgian Etat Sanitaire des Aniniaux Domestiques for 
 1877. 
 
 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. 
 
 CEdenia. 
 
 The infiltration of serosity into the connective tissue of certain parts 
 of the body of pregnant animals — almost exclusively the Mare — is some- 
 what allied to the anasarca serosa of woman. The period at which it 
 is manifested depends much upon breed, conformation, and individual 
 temperament, as well as upon the season and hygienic conditions. With 
 common-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 
 is most marked in primiparas. It commences usually at the inferior 
 part of the hind limbs, gradually ascending to the hocks, or higher ; the 
 fore limbs are also attacked, though not so markedly ; and the swelling 
 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 foetus on the pelvi-crural vessels, as well as, perhaps, 
 to the anaemic condition of the system. The exemption of the Cow 
 from oedema 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 l'i:EQNANCY. 185 
 
 If it causes inconvenience, frictions witli soap or turpentine liniments, 
 bandaging, or even slight scarifications, may be employed ; but the 
 occasions for these must be very rare indeed. 
 
 ni/dranniios, or Hydrops Amnii. 
 When there is an unusual secretion of the amniotic and allantoic 
 fluids, it constitutes what has been termed " dropsy of the amnion " 
 {hydrops amnii or hydrainnios) ; though, as Saint-Cyr remarks, as there 
 may also be an increase of the allantoic fluid, it would be more exact 
 to designate it " dropsy of the fuetal envelopes." This condition, when 
 very marked, is serious for the mother as well as the foetus. A number 
 of cases have been recorded, and Saint-Cyr has enumerated sixteen, 
 thirteen of which occurred in the Bovine, two in the Equine, and one in 
 the Caprine species ; one has also been observed in the Bitch. Gierer, 
 who has published an interesting account of several cases, observes 
 that it is most frequently met with in poor, badly fed animals — and 
 particularly in Cows, in which improper hygiene has produced a morbid 
 excitement of the generative organs ; the result of which is that 
 exosmosis and endosmosis do not take place equally through the walls 
 of the placentae and placentulie. 
 
 Symptoms. — It is not until the fifth or sixth month of pregnancy, or 
 even later, that indications of this condition are evident. Then the 
 abdomen rapidly enlarges, especially to one side — generally the right ; 
 and fn a short time it has acquired a greater volume than it has towards 
 the end of gestation. At this period the health becomes deranged, and 
 colic, with or without tympanitis, is not unfrequent. General debility 
 is so marked that the animal can scarcely, if at all, stand ; the appetite 
 is lost, rumination is suspended, defecation and micturition are irregular, 
 cedematous swelling of the limbs and abdomen ensue, with dyspnoea, 
 which increases so quickly in intensity that asphyxia is often innninent. 
 The muscular parietes of the abdomen have in some cases been rup- 
 tured, and the entire mass of the uterus, with its contents, has formed 
 a subcutaneous liernia. The ordinary period of gestation may be com- 
 pleted ; or abortion may occur at the seventh or eighth month, when all 
 the indications of such an occurrence are present. The uterine contrac- 
 tions, owing to the relaxed condition of this organ, and its distended 
 and paralysed fibres, are weak, the pains feeble and unsustained, 
 the OS does not dilate, and the act of parturition is consequently 
 tedious. 
 
 Diagnosis.— The state of the abdomen miglit lead to the supposition 
 that the case was one of tympanitis or twin pregnancy, .\bdominal 
 percussion, and the " touch," as well as auscultation, should aid in 
 diagnosing this condition. Rectal examination will reveal the immense 
 size of the uterus, which forms a great globular mass in the abdominal 
 cavity, and almost completely fills the pelvis, though nothing of a fcrtus 
 can be detected ; while vaginal exploration discovers the cervix uteri 
 eff'aced, the os closed, and the posterior part of the uterus projecting 
 more or less into the vagina ; pressure on this prominent portion proves 
 that it contains fluid, though usually no fa-tus can be felt, as it is 
 beyond the touch, and almost lost in the small ocean of fluid surrounding 
 it. In rare cases the os is partially dilated, and the fcctal membranes 
 protruding more or less into the vagina ; usually, however, scarcely one 
 or two fingers can be introduced into it. 
 
186 PATHOLOGY OF FllEGXAXCY. 
 
 Eesults. — The occurrence of hydrops amnii is nearly always fatal to 
 the foetus. In none of the cases recorded was it alive ; in a certain 
 number it appeared to have lived up to the period of parturition or 
 abortion ; in others it had been arrested in its development, and was 
 dead for some time. In a Goat, the two foetuses were in a state of 
 general anasarca, being completely infiltrated. 
 
 The mother may or may not survive. Of the above cases four perished 
 from the disease ; one was killed as incurable ; another recovered after 
 a long time ; one was subsequently sold for food ; and seven or eight got 
 well so rapidly and completely as to be bred from again. The results 
 have, as a rule, been more favourable as assistance has been prompt 
 and early. 
 
 After death the uterus is found excessively dilated, its walls pale in 
 texture, with ecchymoses on its surface. The foetal membranes vary, 
 sometimes being thickened and dense, and at other times attenuated 
 and friable. The fluid has been found contained in alveoli or cells, 
 formed by the processes uniting the allantois to the amnion ; so that 
 the membranes might be torn in several places without all the fluid 
 escaping — in this respect resembling the vitreous humour of the eye. 
 The liquor is usually limpid and transparent, or of a pale citron colour, 
 with a slightly sweetish taste ; its quantity, as has been remarked, is 
 always considerable : as much as 50, 70, 100, 120, 150, and even 200 
 litres having been found. 
 
 The digestive organs are nearly empty, even in Bovines. 
 
 Etiology. — As in woman, so in animals, the etiology of this condi- 
 tion is not well understood ; but it would appear that it may be due to 
 several very diverse causes. Multiparae are much more frequently 
 affected than primiparae, and it nearly always occurs during the early 
 months of pregnancy ; the foetus is generally little developed, and in 
 the majority of instances is dead before it is expelled. It has been 
 supposed that obstruction to the foetal circulation, induced by torsion 
 of the umbilical cord, may act in producing it, or imperfection in 
 function of the heart or liver of the foetus ; the death of the foetus, de- 
 formities, monstrosities, twin pregnancies, ascites, and other causes 
 have been enumerated as concomitant or exciting causes. But until 
 we know how the amniotic and allantoic fluids are formed, and what 
 their normal quantity is, it is not probable much progress will be made 
 in elucidating the etiology of this pathological condition. 
 
 Treatment. — The chief indication is to evacuate at least a portion of 
 the fluid, by rupturing the membranes, as medical treatment has always 
 proved inefficacious. It must be remembered that the foetus is always 
 dead ; and even if alive, with the view of saving the life of the mother, 
 it should be sacrificed. Though opening the amniotic sac, and removing 
 a certain quantity of the liquor, need not necessarily compromise the 
 existence of the foetus ; as a case has been published by Lhomme^ 
 in which a portion of the foetal membranes, protruding beyond the 
 vulva, was excised without interfering with the ordinary progress of 
 gestation ; for when parturition occurred three months afterwards, a 
 well-formed Mule was born and continued to live. 
 
 The chances of success are greater as intervention takes place early, 
 and before the abdomen is excessively distended, the respiration not 
 seriously affected, and debility not great. 
 
 ' Journal de Vtttririairt du Midi, 1869. 
 
DISEASES ISClDKyTJL T<> rnEnX.i.MY, 187 
 
 The evacuation should be etTected through the vagina, though it has 
 been made through a puncture in the flank. If the fatal membranes 
 are in the vagina, they may be ruptured by the fingers there; if not, and 
 the OS is sufficiently dilated for the admission of the hand, they may be 
 ruptured in the uterus ; if it is closed it should be gently dilated, and 
 the envelopes punctured, if necessary, by means of a trocar and canuula. 
 As soon as the membranes are pierced, a gush of Huid takes place, the 
 abdomen diminishes in volume, the uterus becomes retracted, and in this 
 retraction the fct'tus and membranes are sometimes expelled. Sliould this 
 expulsion not take place soon, they must be removed in the ordinary way. 
 Afterwards, the animal is to be carefully attended to and generously fed. 
 
 Paraplegia. 
 
 What has been termed paralysis of the posterior extremities is not 
 rare in the Cow during gestation, especially when near parturition, and 
 often even when that act has commenced. Antc-partum paresis would 
 perhaps be .a better designation, as in the great majority of cases the 
 debility which compels the animal to remain in a recumbent position, 
 is merely the efi'ect of pregnancy and the increased weight the creature 
 is called upon to support. It has also been witnessed in the Sheep and 
 Goat, and, though very rarely, in tlie Mare. (Generally, however, it 
 appears six, eight, ten, or twenty days, rarely a month or two, previous 
 to parturition, and attacks animals in the most diverse hygienic con- 
 ditions — those which are well fed and tended, as well as those 
 which receive the opposite treatment. It is not rare to observe in 
 a cow-shed, two or three cases occurring a short distance from each 
 other, and even in a locality we may, in certain years, meet witli a 
 number of cases ; then several consecutive years may elapse without 
 any being noted, though it would be a manifest exaggeration to say that 
 it was eitlier an epizootic or enzootic malady. It must not be con- 
 founded with what has been termed " parturient fever," or " parturient 
 apoplexy," in which we have paralysis, but from wliich it differs greatly, 
 as the sympton)s and results will show. 
 
 The paralysis of gestation generally appears suddenly and without 
 any premonitory symptoms, manifesting itself with tiic same intensity 
 at the outset as at a later period ; though in rare cases the animal 
 shows a weakness and unsteadiness of the posterior part of the body 
 and hind limbs for a short time before it drops, and the end of the tail 
 is said to be remarkably flaccid. When paralysis has really set in, the 
 Cow is forced to lie, but it does not appear to suffer ; the position is 
 natural, the head carried as usual, the eye bright and clear, the muffle 
 damp and cool, and rumination in the majority of instances is not 
 suspended ; the pulse, res])iration, and appetite are unaltered, and 
 sensation does not seem to be impaired, even in the hind limbs — it may 
 be exalted. Constipation is frequently present. It is only when the 
 animal attempts to rise that its condition is evident , the fore limbs 
 and neck can be moved to accomplish this, but the hinder extremities 
 are powerless, or can only be raised to a slight extent ; though with 
 help it may be lifted up and can then stand, but unsteadily. 
 
 Ordinarily, the paralysis persists until parturition, when it disappears ; 
 though Saint-Cyr mentions an instance in which a Cow became para- 
 lysed twenty-eight days before that event, and lay on the litter for two 
 days after calving, without being able to move its hind extremities ; 
 but it arose spontaneously on the third day, and did well. The same 
 
1 88 PA THOLOG Y OF PIlEGNANCY. 
 
 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. 
 If the animal is old or debilitated there is less hope for recovery. "When 
 it can move the hind limbs after a day or two, and change its position 
 from one side to another, a favourable issue may be predicted. 
 
 The cause is somewhat obscure, but is supposed to be due to com- 
 pression, or rather straining, of the nerves and vessels of the posterior 
 extremities by the heavy uterus. In five or six cases there has been 
 found, on ])ostmortem 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 
 of the spinal cord are injected. From the rapidity with which recovery 
 generally takes place, it is obvious that the lesions cannot be serious in 
 many cases. Debility from insufficient 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 falling down and injuring 
 bones or muscles. 
 
 Treatment. — The first thing to be done is to ascertain, if possible, 
 upon what 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 if 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 
 of 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 applications 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 
 after parturition, then more energetic treatment may be adopted. In 
 these cases, the subcutaneous injection of strychnine is nearly always, 
 attended with success. 
 
 Crmnp. 
 
 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 — striking 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 
 flexure of 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 time the muscles of the leg are hard, tense, and painful to 
 manipulate, and the animal betrays the torture it experiences by its 
 
DISEASES INCIDEyrAL To I'llEOXAXCV. 189 
 
 expression and attitudes. This manifestation is increased if the Mare 
 is compelled to walk, its first steps being extremely dillicult ; while the 
 limb is maintained in a perfectly rigid condition, and the indications of 
 pain most marked. In a short time these symjjtoms disappear, and 
 movement is restored. The cramp may pass from one hind limb to 
 another alternately, and appears to be due to the compression exer- 
 cised on the sciatic nex've in its course over the sacro-sciatic ligament. 
 This cramp has much analogy, in its symptoms, to luxation of the 
 patella ; from this it may be distinguished, however, by the latter 
 occurring most frequently in young animals, by the displacement of the 
 patella, and by the total inability to flex the limb until the patella has 
 been replaced. 
 
 Cramp is of no moment, and can be relieved by walking the animal 
 for a few paces, or by smart friction. It disappears altogether after 
 parturition. 
 
 Eclampsia. 
 
 Saint-Cyr speaks of a report by Lafitte, in which three Bitches are 
 stated to have been affected with eclampsia during pregnancy. The 
 symptoms were acute clonic convulsions, which were at times remittent, 
 with unsteadiness of the limbs, but without total loss of sensibility, 
 hearing or vision. The successful treatment was milk diet, ten centi- 
 grammes of fucsine morning and evening in milk, and at the same 
 periods enemata of chloral hydrate. 
 
 Cerebral Cnnrjestion. 
 
 Saint-Cyr and Violet speak of cerebral congestion as one of the con- 
 comitants of pregnancy, and they, as well as some English and 
 foreign veterinary surgeons, consider it identical with the condition 
 known as " parturient apoplexy." But it would appear that this ante- 
 partum cerebral congestion is very rare, and is due to a plethoric condi- 
 tion and lack of exercise ; though, as has been observed, and as will be 
 again remarked, this and other affections of the nervous system some- 
 times witnessed during this period, may be due to uncmia and albumin- 
 uria, which are not unfrequently the cause of similar disturbances in 
 woman. 
 
 Reference to the symptoms and treatment of this brain congestion 
 will therefore be deferred until post- part tun congestioii or apoplexy is 
 dealt with. 
 
 7///.s7r /•/</. 
 
 This would appear to be a very infrequent concomitant of pregnancy, 
 as I can only find one instance recorded. 
 
 Olver ( Veterinary Journal, vol. vii., p. 36") dc-icnla's the cane of n thoroii^jhhred 
 Mare, four months pregii.int, which was suddenly attacked with trrt-at nervcuis excite- 
 ment, accompanied by profuse pi-rsjiiration, great difficulty in walking, straddlintr gait, 
 continual micturition, etc. The 8li^;htcst noise increased the excitement. There wa"* 
 great rigidity of the muscles, particularly those of the gluteal region, and at a later 
 period volition appeared to he. abolished, the limbs acting merely as mechanical 
 props ; the eyes were turned upwards as if in a trance, and the animal was quite blind ; 
 there was frequent neighing, and continual o]>ening and closing of the viilva, with 
 the expulsion of small qu.'intities of urine, and a highly congested condition of the 
 vaginal mticou.i membrane ; the pulse was eighty-two f)er minute, and the respirations 
 Were accelerated. There wa-s every symptom of nostrum. .\b there was difficulty in 
 swallowing, coniie wa-< injected subcutaneously, and with the most satisfactory effect. 
 Next day she was still perfectly blind, and even more nervous ; but she had gradually 
 recovered consciousness, and took a little f<K>d. The pulse in the evening was n'>rmal. 
 
190 PATHOLOGY OF PREGXANCY, 
 
 and the muscles had lost much of their rigidity, while the aervous excitement had sub- 
 sided ; there was, however, great thirst and obstinate constipation. The latter were 
 relieved by suitable remedies, but some days elapsed before vision was regained. She 
 did well subsequently, and proved to be in foal. 
 
 Amaurosis. 
 The only instances of amaurosis occurring in connection with preg- 
 nancy, are two given by Eiss.^ 
 
 A Mare, nine years old and in good condition, when advanced in pregnancy became 
 blind. On the eyes being examined by Riss, the humours and lens were found to be 
 quite healthy, but amaurosis was complete. A blister was applied to each cheek, and 
 other treatment adopted, but without success. The day following parturition, which 
 occurred about a month afterwards, vision was perfectly restored. 
 
 A seven -year- old Mare, when near parturition, and which had never exhibited any- 
 thing the matter with its eyes, suddenly became blind from amaurosis. Remembering 
 the other case, Riss abstained from treatment. The Mare foaled in thirteen or fourteen 
 days after loss of sight had been noted, and on the third day after this occurrence it was 
 able to see as well as ever. 
 
 CoUfjll. 
 
 We have mentioned hydramnios as a cause of disturbance in the 
 respiration, the obstacle to which is often a marked symptom of that 
 condition. But even without the existence of this kind of dropsy, the 
 breathing is not unfrequently 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. 
 
 Albumimiria. 
 The existence of albuminuria in pregnant women has long been 
 known, and Zundel gives it as one of the complications or accompani- 
 ments of gestation in animals ; though he does not look upon it as a 
 pathological condition. Others, on the contrary, think that this is a 
 matter well deserving further investigation; for as, as 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. 
 
 Mamviitis. 
 
 Mammitis is another very rare occurrence during pregnancy, and the 
 cases recorded by Saint-Cyr and Violet only number three — two Heifers 
 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, while 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 withdraw the fluid from the teats. One 
 Heifer went to the end of her pregnancy, but the other aborted some 
 weeks before. The Mare had already produced Foals, but the udder 
 had regained its natural size 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 may con- 
 ^ Recueil de Medecine Veterinaire, 1831. 
 
ACCIDEXTS OF r/!K';.\.l.\ry. 19! 
 
 tinue until after parturition. It docs not demand any attention, unless 
 the udder is very large and hard, when it would be beneficial to draw 
 the teats frequently. 
 
 CHAPTER III. 
 Accidents of Pregnancy. 
 
 Though a distinction between the diseases and accidents of pre^'nancy 
 cannot always be readily drawn, yet for convenience we follow Saint- 
 Cyr in allotting to a separate chapter those conditions or diseases which 
 may be due to accidental causes, operating either externally or inter- 
 nally. These are prolapsus of the vagina, henna of the uterus, rupture 
 of the uterus, metrorrhagia, abnormal retention of the fn'tn-o and abo7-- 
 tion. 
 
 Antk-i'Aktim Pholapsuk or thk Vagina. 
 
 Prolapsus vagiuie, or itivcrsio vagi)ue, has been observed, so far as 
 I can ascertain, most frequently in the Cow and Sheep ; rarely in the 
 Mare or Bitch. It consists in the protrusion, or i^ushing backwards, of 
 the vagina by the uterus and its contents during pregnancy, the tumour 
 it forms appearing between (inversio vagime incompleta), or external to 
 (invcrsio vagime completa), the labia of the vulva. It must not be con- 
 founded with post-partum prolapsus. This accident is peculiar to 
 pregnancy, and may occur in well-shaped Cows, but whose tissues, and 
 especially those of the genital organs, are soft and relaxed — animals of 
 a lymphatic temperament, good milkers, with a wide pelvis, and which 
 are fed on an abundance of bulky but innutritions food. Keeping such 
 Cows on a floor sloping too much to the rear, as well as falls, injuries 
 of different kinds, distention of the rumen, fatigue, etc., arc all likely to 
 lead to this accident in such animals, when pregnant. It is observed, 
 though very rarely, in primiparu', and occurs most frequently after the 
 third or fourth gestation, the period of its appearance during tliat state 
 varying ; in certain Cows manifesting itself so early as the fifth month 
 (though this is rare), and oftenest at the end of the seventh or eighth 
 month, and even so late as twenty or fifteen days before delivery. 
 
 The occurrence of the accident is made known by the appearance, at 
 the vulva, of a circular, bright-red tumour, depressed in the centre, and 
 of a variable but gradually increasing si/e as gestation advances, or the 
 exciting causes remain in operation — from the volume of a fist to that 
 of the head of a child or man, or even larger. At first it is only visible 
 when the animal is lying, and disappears when it gets up ; but when of 
 considerable volume it never entirely vanishes in the latter attitude, and 
 even when reduced by the hand the vulva renuiins larger than usual. 
 
 If existing for some time, however, in certain cases infiltration takes 
 place and inflammation may ensue, when a large ajid somewhat dense 
 tumour projects permanently outside the vulva, the circumference of 
 the latter constricting it and rendering matters worse. The colour now 
 becomes a darker red, and even dark brown ; the tumour may be 
 abraded on the surface from the rubbing of the tail and contact with 
 the faDces and urine, while at its upper part can be seen the neck of the 
 uterus. The animal does not seem to be incommoded, unless it be of an 
 irritable disposition, when straining Jiay take place, and this increasing 
 in intensity, the cervix, and even a portion of the body of the uterus, 
 
192 PATHOLOGY OF PREGNAXCY. 
 
 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 ijrolcqMiis uteri, and an examination of the 
 voluminous mass may lead to the detection of some portion of the foetus 
 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 occurrence as to cause excoriation and ulceration. 
 
 Tkeatment. — This prolapsus, in the majority of cases, does not appear 
 to cause the slightest inconvenience to the animal, and offers no 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 accomplished ; 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 rugae 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 gentle 
 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 been recommended, but 
 they are very rarely required. 
 
 In very exceptional instances, we may have not only complete pro- 
 lapsus vaginae, but also, as has been said, partial protrusion of the 
 uterus itself. Then the case is very serious, owing to the excessive 
 straining and the weight and bulk of the foetus, 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 tact. 
 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 
 ' Veterinary Journal, vol. i., p. 267. 
 
ACCIDENTS OF JPJiEGXJXCV. 103 
 
 in a forcible manner, as recommended by Saint-Cyr, by means of a stick 
 placed transversely, a man at each end, another pulling' out the tongue 
 and pinchin«; the septum of the nose. Attempts at reduction can only 
 be made in the intervals of strainim,', and during the straining all that 
 can be done is to resist further expulsion. Having returned the dis- 
 placed organs into the pelvis, the arm and list must follow them, and by 
 pressing on the cervix of the uterus so act on the mucous membrane of 
 the vagina as to leave no folds or ridges in it ; when the straining has 
 ceased, which usually occurs very soon, the arm may be withdrawn, 
 though the practitioner must be on the outlook for its recurrence, and 
 prepared to prevent another extrusion. This may be guarded against 
 by the use of a pessary consisting of a wooden rod from one to two feet 
 long, furnished with a head several inches in diameter and covered with 
 some soft material, or a ring fixed horizontally at the end sufficiently 
 wide to go over the cervix ; this end, well greased, is to be inserted in 
 the vagina in such a manner as to keep the uterus in the pelvic cavity, 
 the other end being fixed by a cord at each side to a girth round the 
 body or elsewhere. An ordinary quart bottle with a concave bottom 
 may be employed on an emergency, a round piece of wood driven into 
 the neck making it sufliciently long. So long as this pessary is worn — 
 and it may be allowed to remain in the genital canal for a considerable 
 period — the vagina should be syringed daily with warm water and a 
 mild astringent. Death is often the result of such an accident ; and 
 to prevent a fatal termination, it has been suggested that artificial 
 delivery should be effected without delay. Premature delivery has been 
 counselled in those cases in which the Cow continues to strain and evert 
 the vagina, notwithstanding bandages, sutures, and other means, and 
 when grave consequences are likely to follow ; more especially is this 
 advice to be adopted when pregnancy has reached the 2G0th day, and 
 the Calf is alive. Perforation of the membranes may be effected by the 
 fingers after they have dilated the os. There is no difficulty in parturi- 
 tion, as a rule ; but care is necessary for some days afterwards to 
 prevent inversion. 
 
 With ^leep, according to Cox, it is a common custom to return the 
 partially prolapsed vagina, and to tie the wool across the vulva ; on 
 other occasions a truss, similar to that used for cattle, is employed. 
 Both metiiods frequently fail, and in these cases nothing answers so 
 well as the ring-shaped pessary of a small size. 
 
 Hernia of the Utehus (IIystekocele). 
 
 Ilernia of the uterus is not uncommon in the domesticated animals, 
 and has been observed in the Mare, Cow, Sheep, Goat, and Bitch. In 
 the latter animal the organ is often displaced before conception, and 
 the fcctus is developed in the hernia ; but with the larger creatures the 
 empty uterus is too far removed from the abdominal parietes to escape 
 from the cavity ; and it is only when its volume is increased as gestation 
 advances, that it may form a hernia, should there exist an accidental 
 opening in the muscles wliich enclose the cavity. In the Bitch the 
 hernia may be inguinal ; in the other animals it is always accidental 
 and ventral, and usually towards the inferior part of the abdomen — on 
 the right or left side, or in the pubic region. 
 
 Its ordinary cause, when accidental, is due to the natural or spon- 
 taneous relaxation of the abdominal aponeuroses ; or to traumatism, as 
 
 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 mammae, 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, 
 if not impossible. In other cases this act may be accomplished without 
 difficulty or extraneous aid ; Cows which have been ruptured from the 
 perineum to the ribs have calved easily enough ; and 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 the uterine contents are expelled. 
 Should circumstances render it necessary, abortion may be artificially 
 induced, or hysterotomy may 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 this kind, and have heard of 
 another in which an operation was performed for the removal of the 
 tumour, in which two foetuses 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. 
 
 Ante-pabtum Euptuee op the Uterus. 
 
 Rupture 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 has been observed in the Cow, Sheep, Goat, 
 and Bitch ; it is not very common before gestation has terminated, and 
 the symptoms by which it can be diagnosed are not very reliable. 
 Spontaneous rupture of the uterus usually occurs at the anterior part of 
 the organ, between the two cornua, or even in the cornua themselves ; 
 the direction of the rupture generally depending on the direction of the 
 muscular fibres — being sometimes diagonal, at other times transversal, 
 and more rarely longitudinal. The size of the 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 
 
ACCIHEXTS OF PJ{KC!XJ.\'CV. 105 
 
 ost its contractility before death, and ininiediatoly after their produc- 
 tion ; when the organ has contracted after the accident, the extent of 
 the laceration is much diminished. The Hps of tlie wound are in some 
 cases thin and ragged, in others swollen and inflamed. The texture of 
 the uterus itself, in the vicinity of the rupture, may be quite healthy, or 
 it may be inflamed, softened, or gangrenous ; while the peritoneum is 
 normal or inflamed. The blood elTused into the abdominal cavity may 
 be in large quantity or scarcely noticeable, and it may or may not be 
 decomposed. 
 
 According as the tissue of the uterus is more or less completely torn, 
 the ruptures have been divided into those which are " complete" and 
 " incomplete." In the first, the cavity of the organ communicates 
 freely with that of the abdomen ; while in the second, the peritoneum, 
 or sometimes a portion of the muscular layer, is intact. 
 
 The foregoing remarks refer to longitudinal rupture of the uterus, but 
 Saint-Cyr alludes to w^hat the Italian veterinarians designate as semi- 
 mobile nterus, and which he believes to be allied to rupture. This is a 
 condition in which the uterus has been completely divided across, 
 either at the body or the cornua, and remains floating in the abdominal 
 cavity, being only suspended by the broad ligaments. The most 
 singular fact connected with these cases is, that although the uterus is 
 torn in this manner, its contents— the foetus and membranes — do not 
 escape ; the wound cicatrises, and the organ appears as a large cystoid 
 tumour. Ercolani, Veterinary Professor at the Bologna University, has 
 met with four instances of this extraordinary accident, the pathological 
 specimens being deposited in the museum of that institution. Their 
 history and description are as follows : 
 
 1. The utenis of a Cow which contained in one of tlie cornua a fa>tus beyond its term, 
 and in the other horn such a great ([uantity of mucus that, so far as volume is concerned, 
 it Would be difficult to say which cornu was the largest. This uterus is completely 
 divided at thect-rvix and Huats in the nl>dominal cavity, being attache<l only by the broad 
 li(;aments, which are thin and distended. The detached portion of the uterus has a 
 globular form, and its perfectly smooth surface is everywhere covered by peritoneum ; 
 where the separation has taken place, the organ is closed by tlie cicatricial union of the 
 border of the rupture. The mucous membrane in the left cornu of this portion is loose, 
 and nhows numerous radiating cicatrices ; the ftrtus in the right cornu is indurated, and 
 apjiears to have lived bej'ond the ordinary pt-riod of gestation, to judge by the hoofs, as 
 Weil aa by the teeth, which are cut. The nose did not correspond to the opening of the 
 cornu, as the head was doubled on the left side of the neck. The vertex and occiput were 
 turned tipwards, ami closed a vast circular opvning resulting from llie <lestruction of the 
 partition separating the two cornua. The head adhered to the entire border of this 
 opening — unequal and ragged as it must have been ; and all that portion which projects 
 int(» the left cornu presents a large toumire., where not only is the skin abtsent, but even the 
 p«;ri>j9teum itself. Lying flat on one of its sides and curled uj>, the limbs twined towards 
 the head, and the muffle placed between the thighs, the f<itu-t represents a kind of great 
 discoid IkkIv. 
 
 "2. Cornu of the utenu of a pregnant Cow, containing a completely develojjcd foetus, 
 markedly indurated. This cornu, j)erhaps ruptured during jiarlurition, is detached, and 
 hangs almoiit free in the ab<lomen ; while the rupture has cicatrised, and there is formed 
 a large kyst, evt-rywhere closed, ani> containing the fietus. The walls of the iiterus are 
 for the most part fibrous, and the fietal envelopes coriaceous. Like the precetling case, 
 this specimen w.-vs found in a Cow which had l>een slaughtered by the butcher ; the cornu 
 fell on the ground, after some few fibrous bands which attached it to the subdumbar 
 region had been cut through. 
 
 :{. The uterus of a Sheep arrived at the termination of pregnancy ; the organ ha.s been 
 torn in the vicinity of the vagina, anil remains free in the abiJominal cavity. In this 
 instance, also, the uterus forms a completely closed kyst, which contains a very much 
 indurated lamb. In d^-taching this organ, an irregular cicatrix is seen, which leads to the 
 supposition that the accident was due to torsion of the cervix. 
 
196 PATHOLOGY OF PREGNANCY. 
 
 4. Posterior portion of the body of a Guinea-pig, which shows the right cornu of the- 
 iiterus detached, and cicatrised where separation has occurred. This cornu, whicli was 
 half free, was tilled with fluid blood ; the distension caused by the blood has been so 
 great that the cornu is 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. Energetic 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 foetus may be expelled 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 ofl", 
 the external genitals resume their ordinary appearance, and every 
 indication of pregnancy disappears except the enlarged abdomen, on the 
 floor of which the foetus lies, and there it may become mummified, or 
 in the course of time be eliminated by an ulcerative process 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 must die. The 
 mother may thrive, especially if the 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 be 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 the foetus is alive, it may not be advisable 
 to kill the mother and preserve the young one. On the chance of the 
 mother surviving, attempts might be made to treat the 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 foetus. 
 With regard to the smaller animals, gastro-hysterotomy might be 
 practised with some chance of success in favourable cases. 
 
ACCIDEXTS OF rREONANCY. 197 
 
 Though the accident is generally of a most serious character, yet, 
 remembering that recovery does sometimes take place, there need not 
 be undue haste in destroying the animal. When the organ contracts 
 the dimensions of the rupture are reduced, and tears in the upper 
 portions are very much less serious than tliose in the lower surface, for 
 obvious reasons. 
 
 Metuoruhagia. 
 
 Accidental haemorrhage from the uterus during pregnancy, appears to 
 be somewhat rare in animals, judging from the paucity of instances 
 recorded. Carsten Harms* has observed this accident in cattle ; it was 
 accompanied by a small discharge of blood from the vagina, particularly 
 during micturition, and resulted in the death of the fcctus. Some 
 observers have not noticed this discharge ; the blood has always re- 
 mained in the uterus, where it has been sometimes found, as a clotted 
 mass, to the amount of more than four gallons. In the majority of 
 cases it would seem to be occasioned by a spontaneous separation — 
 more or less extensive — of the placental capillaries from the uterine 
 surface. Zundel has seen it occur in an animal which showed signs of 
 <:cstrum while pregnant. The following cases may, to some extent, 
 illustrate this accidental uterine haemorrhage. 
 
 1. Egli (Journal dest V^(erinaircs (hi Midi, IS.IO, p. 13."]) wxs called to see a Cow 
 which staggered about in walking, and did not eat. He found it lying, and had great 
 <litticulty in getting it up, when it kept alternately lifting the hind legs. The pulse 
 was slow and very weak, and the heart's beats were loud. There were no other 
 -symptoms. It was bled, but during the operation it staggered and trembled ; the bleed- 
 ing was stopped. It then lay down without appearing to suffer, and was dead in a few 
 minutes. At the autopsy the uterus was observed to be considerably distended and of 
 a violet colour, and an enormous (piantity of blood was effused between the muscular 
 and serous layers, so that the wall of the organ was about six inches thick ; there was no 
 «xtravasation, either in the abdomen or the cavity of the uterus. No cause was a-scribed 
 for the accident. 
 
 2. Zundel (Journal de Mt!il. Vet. de Lyon, 1861) describes the case of a Mare which 
 suddenly presented the following symptoms during pregnancy : Anxious countenance, 
 <lrooping head, rigidity of the loins, staggering gait andjaraencss of the left bind leg, as 
 if from a sprain ; the respiration 3<3 per minute, and pulse 60 and small. Treatment 
 was of no avail ; prostration gradually set in, the animal .-ippeared extremely anxious, 
 soon it could not stand, and when it fell, death ensued almost immediately without much 
 agony. There were never any symptoms of colic or discharge of blood per rulvam. Un 
 examination, a five-months-old ftetus was discovered in the right cornu,and the placenta 
 was detached nearly throughout. The left liom was the seat (»f sub-acute inflammation, 
 and its volume exceeded that of the right ; an enormous blood-clot, me.asuring about four 
 gallons, occupied ttiia horn and the body of the uterus. The bloodvessels were nearly 
 empty. Zundel asks whether the lamene.ss, which had already V)ecn noted as a symptom 
 of metrorrhagia by some (Jerman atithorities, may not be explained by the arrangement 
 of the lumbar jilexus, which send.s nerves to the limbs and the generative organs. 
 
 3. In a pregnant Mare, Schmidt (Aiuialrs lU Mid. Vit. di JirujrtJl) .i, 1862) witnessed 
 the following symptoms : Sudden inappetence ; he.ad low and "beneath the manger"; 
 reeling gait ; extreme feebleness, and hind limbs widely separated ; Ifwking first towards 
 one flank, then the other; pulse 110, regular but sinking; heart's beats <iuite audible, 
 and venous pulsation in neck ; mucous nicmbranes very pale, and the body temperature 
 low. Dark-coloured bloo«l flowed in a pasisive manner frtim the uterus. The Mare died 
 on the same day, and an autopsv revealed all the organs, except the ntenis, almost 
 bloodless ; that viscus was found to be considerably distended with blood — nearly two 
 pailsful — which w.vs partly coagulated. It contained, in afidition, a seven-months foetus 
 surrounded by the liquor amnii, and entirely separated from the uterine walls. 
 
 4. Macgiliivray (Vrferinary Journal, 1881, p. 177) waa asked to attend a Mare 
 more than nine months pregnant, because she was discharging mnch blood. Nothing 
 was done to check the flow, which was arterial blood, and continued rather more than a 
 
 ' Lthrburh dtr I'/iifrdrztlichen O'eburtJihiil/e, p. 60. 
 
198 PATHOLOGY OF PliEGXANCY. 
 
 day, when it entirely ceased. The Mare subsequently produced a strong healthy Foal 
 at the usual time. The author had no doubt that this was a case of jjlacenta j^rcwia, and 
 the result of some distention or looseness about the cervix or os uteri, whereby the parts 
 immediately within these became detached, and allowed a flow of arterial blood at that 
 point. 
 
 5. The same observer {Ibid.) saw a young Cow within a fortnight of second calving, 
 which for two days had been discharging large quantities of clotted blood. It began 
 with the escape of arterial blood, but changed to venous, and finally became mixed with 
 some of the uterine fluid. The Cow ultimately gave birth to a living Calf soon after, 
 and did well. There was an entire absence of labour pains up to a short time before 
 delivery, the os uteri being only partially dilated. The same animal had suffered from 
 severe post-paitum haemorrhage at her first calving the previous year. 
 
 6. Kotelmann records the case of a Mare, seven months pregnant, which suddenly lost 
 about half a pound of blood by the vagina ; this happened again during three or four 
 days, then the discharge changed to a yellow serum and ceased on the seventh day, when 
 the animal regained its health and brought forth a Foal in due course, but died after- 
 wards of paralysis. 
 
 7. Vogel speaks of a Mare which had four regular parturitions, and had reached the 
 thirty-seventh week of her fifth pregnancy, when, without any precursory symptoms, 
 thfre was an emission of blood from the vulva ; this could not be checked, though cold- 
 water compresses were applied to the loins for two hours. The blood continued to flow 
 until the vagina was plugged ; after some hours the plugging material was removed, 
 when it was found that the 03 uteri was dilated. The hemorrhage having recommenced, 
 it was deemed advisable to induce abortion. The membranes were therefore ruptured 
 and the fcetus extracted. But the Mare died immediately afterwards, and at the autopsy 
 a fibroid tumour was found in the uterus, the pedicle of which was two and a half inches 
 long, and near which the fcetal placenta had become adherent to the mucous membrane. 
 Vogel was of opinion that the hemorrhage was due to rupture of the placenta caused by 
 movements of the foetus. 
 
 8. Anacker refers to the case of a Cow which, when six months pregnant, exhibited 
 symptoms of severe colic, during which she emitted strange bellowings. Some days 
 afterwards a considerable quantity of blood was expelled from the vulva, and the follow- 
 ing day there was another quantity, blood only coming away by drops in the interval. 
 Being treated by bleeding and soothing medicines, and topical astringents, recovery took 
 place in four days. The Cow did not abort. 
 
 9. The same authority alludes to the case of another Cow which, in the sixth month of 
 pregnancy, after a severe attack of colic, discharged a large quantity of blood from the 
 vulva, without any lesion being detected in the vagina. The same treatment was pur- 
 sued, and the animal completely recovered. 
 
 10. Violet (SaintC}>r's Traite, p. 222) mentions the case of a Cat which had nearly 
 reached the time for parturition, when it fell from a height of about eighteen feet, expir- 
 ing soon afterwards. An autopsy was made immediately, and it was noted that the 
 uterus was deeply congested and full of dark blood, which had partially separated the 
 placentas, 
 
 11. The same authority alludes to another Cat, also pregnant, which died very sud- 
 denly, and the uterus of which showed the same appearances as in the above case. 
 
 When there is no escape of blood externally, the diagnosis of this 
 accident is most difficult ; but when the haemorrhage is apparent, then 
 topical remedies might be applied in severe cases, and if these are of no 
 avail, then artificial delivery should be attempted and the' same treat- 
 ment adopted as iox post-partum haemorrhage (wJtich see). 
 
 Abnormal Eetention of the Fcetus. 
 
 It was remarked, when speaking of the normal period of gestation, 
 that this varied within considerable limits, and that the foetus might 
 remain in the uterus for a comparatively long period beyond the 
 ordinary time, without any serious inconvenience to itself or its 
 bearer. 
 
 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 foetus were observed in the last 
 
ACCIDENTS OF PREONANCY. 199 
 
 century by BoutroUe,* Gervy,- and Iluzard, senior and junior; the latter 
 exhibited to the Society of the Facuhy of Medicine of Paris, in 1815, 
 the uterus of a Sheep containing a fcetus which had been there for 
 three years. Since that period the Hterature of the subject has become 
 very extensive, more than forty instances being recorded in Enghsh 
 veterinary journals alone. All the domesticated animals may suffer 
 from abnormal retention of the foetus, but the Cow appears to be far 
 more exposed to it than any other — the frequency in tins animal 
 being as twelve to one in the Mare, and ten to one in the Sheep. Of 
 the forty-eight instances recorded by Saint-Cyr, 35 occurred in the 
 Cow, 7 in the Ewe, 5 in the Mare, and only 1 in the Bitch. 
 
 SY.MrTOMS AND TERMINATIONS. — The symptoms at first are, of course, 
 those of pregnancy, until the period of normal parturition, or even 
 during pregnancy when abortion is about to take place. At this period 
 there are nearly all the signs of parturition : enlarged mamma3, swollen 
 vulva, pendulous abdomen, restlessness and anxiety. Then straining 
 begins, but the os uteri remains closed and no fcetus appears. This 
 condition may persist for only a brief period, and be so little marked as 
 to pass uuobsen'ed in some cases ; in others it may continue for two, 
 three, or four days, the expulsive efforts gradually diminishing in force 
 and frequency until they altogether disappear. The animal then re- 
 gains its ordinary state, and, if a Cow, the secretion of milk goes on as 
 if there were nothing the matter. Health may never be impaired from 
 this cause, and the condition of the animal may not be suspected until, 
 if a Cow or a Sheep, it has been fattened and slaughtered by the butcher 
 for food, when the fcxtus is discovered. It has been observed that oestrum 
 does not appear in such animals, as a rule. The exceptions are rare, 
 though Rossignol mentions a Cow which retained its fcutus for twenty- 
 seven months, yet gave an abundance of milk, often exhibited oestrum, 
 went to the Bull, and was at last killed because it became too fat ! 
 More cases of a similar kind are recorded. 
 
 In other instances, after the ordinary period of gestation has been ex- 
 ceeded by several months, signs of parturition are again manifested, 
 and delivery may then be safely accomplished, either witliout aid, which 
 is rare, or by careful manipulation ; the young animal may even be born 
 alive if too long a period has not intervened since the normal time of 
 delivery.-' Parturition in these cases is generally diflicult ; and the 
 
 ' Le Par/ait [iouvkr, 1776. He writes : " There are Cow« which are not ' open,' that 
 is to say, which have not sufficient pasHage for the Calf, which nm.iins in the Cow an<l 
 becomes dried up like a ball. The Cow does not die for all thin, if it is well cared for ; 
 but many perish when, instead of drying up, the fcetus becomes a mass of corruption. The 
 Cow which carries it--* dried up Calf in the uterui does not seek the Bull. ... It is neces 
 sary to take care of these Cows for ten months or a year, and to feed them well, especially 
 when the Calf dries, for they eat little and become extremely emaciated for fifteen days. 
 In about ten months or earlier, if ther« is any herbajje, these Cows are put out t<^i pasture, 
 and they fatten like others ; the butchers find the calf dried up in the Calf-bag." 
 
 '^ Iiuilruclions I'cUriuairf, vol. iv., p. '25tJ. 
 
 ' In the Xeicca.'^tle Jonnial for January 18, 1840, there is the description of a Calf 
 which wa« bom on the 306th day (fifty two weeks and one day). It waa alive when 
 dropped, but died soon after. It was of great size, though born without assistance ; it 
 was a male. 
 
 Strange to relate, in the Veterinarian for IS.'iO (p. 14S), a Mr. Tatam, of Homcastle, 
 records a caae of abnormal pregnancy in a Cow in his locality, in which not only was the 
 peri<xl the same (fifty two weeks and a day), but the Calf was a male, as extraordinary in 
 size, and excited a similar degree of wonder, as the above. Mr. Tatam saw the Calf ; 
 had he seen the other one ? 
 
200 PA T HO LOG Y OF PREGXA NCY. 
 
 favourable termination of such a condition is due to the membranes 
 of the foetus remaining intact, and the os sufficiently contracted and 
 close to exclude the atmosphere. Even under these circumstances, 
 the retention of the foetus may not have so fortunate an ending. 
 Very often, after fruitless straining, the animal continues unwell ; it 
 has little or no appetite, languishes, becomes feeble ; hectic fever 
 appears ; it falls into a state of marasmus, and dies after a more or 
 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 time obtaining access to the uterine cavity, the case is in 
 nearly every instance very serious. The foetus 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 straining ; 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 ; the secretion of milk is sus- 
 pended ; horribly foetid discharges are passed jjcr vaginam, containing 
 pus, broken-up decomposed tissues, and even bones of the foetus ; 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 foetus, and for a long time, with- 
 out any such serious result. Figuier removed from the uterus of a 
 Cow the entire skeleton of a foetus which had been there for more 
 than Jive 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 fifth month of 
 gestation, and the retention of the putrefied foetus for more than three 
 months afterwards, without any harm ensuing ; Gervy also removed the 
 head of a foetus which had lain in the uterus of a Cow for eighteen 
 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 foetus is very unusual indeed in this animal, the best recorded 
 instances being one by Hamon, in which death took place after seventeen 
 months' pregnancy ; and another by Hammond, when the same result 
 followed after twenty-two months. 
 
 The period during which a foetus may be retained in the uterus varies 
 from a few months to five years. 
 
 We have mentioned that, in these cases of retention, the foetus may 
 live for a certain time, provided the membranes are not ruptured when 
 the symptoms of parturition first manifest themselves ; it may even 
 continue to develop, as is evidenced by its size, its bony framework, 
 hoofs, teeth, etc., which often cause it to look like an animal that has 
 
 I have some instances of 300 days' pregnancy in Cows, the calves being born alive. 
 
 In the Mare, prolonged pregnancy is not nearly so frequent, though it sometimes 
 occurs, the foetus being retained a month, or even a little longer, without prejudice to the 
 Foal's existence. 
 
ACCIDENTS OF PREGNANCY. 201 
 
 been born for two, four, or six months. But in other cases there can 
 scarcely be a doubt that the fci'tus perishes when the first inelTectual 
 expulsive efforts are made by the mother, or even at a period anterior 
 to the ordinary occurrence of parturition, as is proved by the absence 
 of hair, and the small size and weight of the creature ; while, again, it 
 may live for some hours after rupture of the membranes, provided it 
 can breathe, or the placental connections are intact. 
 
 In all cases, as a rule, if the air does not obtain access to the uterine 
 cavity, putrefaction does not ensue ; and when the uterus is examined 
 after death, it is found to be closely contracted on its contents, its 
 raucous membrane healthy or slightly ecchymosed here and there, with 
 the cotyledons pale, wasted, and separated from the placentuliR. Some- 
 times between the inner surface of the uterus and the chorion there is 
 a gelatinous mass, which covers the ftt'tus and conceals the placental 
 cotyledons, these being decayed, spongy, and sometimes completely 
 destroyed. The liquor amnii has also been absorbed ; so that the 
 membranes ai-e in close contact with the foetus, and may even have 
 become adherent to it in places. The foetus itself is desiccated by 
 absorption, and its skin is hard and dry as if tanned, or it is wrinkled 
 and shrivelled ; while the flesh, if any remains, is either perfectly white, 
 or pale and faded-looking in colour, and emits a kind of rancid odour. 
 Other organs are pale and bloodless, and more or less undergoing fatty 
 degeneration. When the retention has continued for a long time, all 
 the soft textures may disappear, and nothing remain but the bones ; in 
 other instances the fcrtus and its membranes become the seat of calca- 
 reous infiltration, and constitute what has been termed a Uthop(edian. 
 
 It is sometimes extraordinary how perfectly a fcotus is protected from 
 decay in the uterus. For instance, in the Veterinary Journal (July, 
 1876), Mr. Taylor mentions one which had been retained for seven 
 months beyond the normal period ; and yet with the exception of 
 absorption of the eyes, it did not present indications of having passed 
 more than a few days in excess of the usual term in the uterus. 
 
 When the envelopes have been ruptured, however, and the liquor 
 amnii has escaped, we have a different pathological condition. Then, 
 through the partially dilated os the air has been admitted, and if imme- 
 diately before this the fcctus was alive, it may then die and rapidly 
 submit to the putrefactive process, its soft parts decomposing and 
 macerating, and forming a most foul-smelling mass ; so that when the 
 uterus is opened, we discover a gi-ey or greyish-red fluid emitting a 
 most disgusting odour, and containing portions of matter resembling 
 adipocere, and perhaps bones which may yet be covered by soft parts 
 and held together by ligaments, or entirely disunited and decaying. 
 The uterus itself shows evidence, in the majority of cases, of chronic 
 metritis ; sometimes abscesses have been formed in its texture, or it has 
 become adherent to other organs — as the intestine, or such tissues as 
 the abdominal walls — with which it has established fistulous communi- 
 cations, and through which portions or the whole of the fcctus may be 
 passed. 
 
 In the case of twins, it sometimes happens that one of them dies, and 
 this occasions symptoms of abortion ; but delivery of the dead foetus 
 cannot be effected, owing to the obstruction offered by the living one, 
 which is born at the usual time, the parent being in good health. But 
 days, weeks, or even months after, the remains of the dead foetus may 
 be passed, or have to be extracted from the uterus. 
 
202 PATHOLOGY OF PREGXANCY. 
 
 The foetus may also be retained in the vagina long after being passed 
 from the uterus, the os of which is closed ; but then it is of very small 
 size, and does not appear to cause serious inconvenience. 
 
 Causes. — Various causes have been assigned for the retention of the 
 foetus, several of which are no doubt quite sufficient to offer an obstacle 
 to normal parturition. Among these causes may be cited : a diminution 
 or loss of contractile power in the 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 ; malposition of the 
 foetus ; 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. 
 
 Tbeatment. — The treatment of foetal retention must greatly depend 
 upon circumstances. When the owner of an animal that has reached 
 the termination of pregnancy and begins to be in labour perceives that 
 the straining 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 attendance 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 he will ascertain, 
 in all probability, the character of the obstacle to parturition, and be in 
 a position to decide whether delay is necessary, or if he is to promote 
 immediate delivery. In some instances it will be difficult 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 sufficiently dilated or the foetal membranes are not ruptured ; 
 and they insist on this course even when there 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 foetus in 
 the uterus, even for a very long period, so long as the 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. 
 All that has to be done is to keep the animal very quiet — 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 the 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, which rendered spontaneous delivery 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. In 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 will 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 
 
ACCIDEXTS OF PREGXANCY. 'iQ'i 
 
 be resorted to at once, in the majority of cases, if not in all. Never- 
 theless, even here we tind excellent practitioners recommending absten- 
 tion, at least for some hours, according to circumstances. For instance, 
 Dupont,^ of Boi-deaux, a good authority, does not at all agree with 
 the generally received opinion that death of the fujtus nmst neces- 
 sarily immediately follow rupture of the membranes, as he has met 
 with many cases in which it has lived for a long interval — twenty-four 
 to thirty-six hours — after the escape of the liquor anuiii ; and he does 
 not hesitate to affirm that respiration commences with, and is con- 
 tinued after, the evacuation of this fluid, especially if the young 
 creature is in a natural position — tiie fore-limbs and nose in the os. 
 He will not say so much for all the positions of the foetus, though he 
 has effected delivery in them fifteen to twenty hours after escape of 
 the " waters," and the creature has respired and lived. He thinks that 
 the popular opinion is due to the fact, that the attention of the obstetrist 
 is solely directed to preserving the life of the mother, and that the fa'tus 
 is killed through the violent compression it sustains in a narrow pelvis, 
 from the powerful contractions of the uterus, without the intervention 
 of other causes. 
 
 When some time — days, for instance — has elapsed since this stage 
 in parturition was reached, and labour has completely subsided, the 
 case is ditlicult, and it will again depend upon circumstances whether 
 expectant or active treatment shall be adopted. An exploration should 
 certainly be made, and if it can be ascertained that the membranes are 
 not ruptured, while there is no straining and the condition of the 
 animal is satisfactory, then it will be advisable to wait until indications 
 of labour are once more manifested. If the state of the animal is not 
 80 favourable and delivery is decided upon, and should the os be imperme- 
 able, or not sufliciently dilated to allow the passage of the foetus, then 
 it must be opened either by careful manipulation, uterine douches, the 
 uterine dilating bag, or other modes which will be alluded to when 
 treating of dystokia. 
 
 When a long period has intervened, and the general and local dis- 
 turbance in tiie animal necessitate active interference on the part of 
 the veterinary obstetrist, then of course the first and most urgent indi- 
 cation is to remove the cause — the putrefying foetus — from the uterus. 
 When the os is not sufficiently open to admit the hand and the with- 
 drawal of the foetus, then the case is one of difficult labour, complicated 
 by the death of the fa-tus and its state of decomposition. If the os 
 should chance to be contracted, it must either be dilated by the means 
 we have named, or if these do not succeed (though they often do), then 
 the cer\ix must be incised. In very exceptional cases, gastro-hyster- 
 otoniy has to be performed if the foetus or its remains arc to be got rid 
 of ; and in some instances, owing to the emphysematous condition of 
 the fcetus, its shape or size, or deformity of the genital passages of the 
 mother, embryotomy is called for. 
 
 When the uterus is emptied of all the matters, solid and fluid, it 
 contains, it should be thoroughly cleansed by repeated injections or 
 washings with tepid water, and finally with someanti-putrescent fluid — 
 weak solutions of chloral, permanganate of potassium (Condy's fluid), or 
 of carbolic or salicylic acids. General treatment may also be necessar}*, 
 and this must be regulated according to the indications. In all the 
 manipulative operations subsequent to delivery, it will generally be 
 
 * Archive Vcterinaire, June, 1876. 
 
204 PATHOLOGY OF PREGNANCY. 
 
 found that care and patience, and, above all things, an absence of undue 
 haste, are commendable, and particularly with regard to the removal of 
 the membranes, especially in primiparae. The danger of septic infection 
 may be largely averted by intravaginal 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. 
 
 Abortion. 
 
 "When pregnancy is interrupted by the expulsion of the ovum, or of 
 the foetus at a stage when this has not attained sufficient development 
 to live external to its parent, abortion {loartus immaturus) is said to occur. 
 But when the foetus is expelled before the ordinary period of parturition, 
 yet with all its organs sufficiently perfected to enable it to exist for at 
 least some time in the external world, this is designated incmaturc birth 
 {partus ])rcEmaturus). In the first instance, the young creature is either 
 dead when expelled* from the 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 foetus is 
 expelled forty days before the normal period ; in the Bovine species, 
 thirty-five days ; in the Sheep and Goat, twenty days ; in the Pig, 
 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 
 foetus is expelled in the Mare before the 300th 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 foetuses almost as tenaciously ; but 
 the Sheep and Goat are rather liable to this accident. The Cow and 
 Mare, but more especially the former, most frequently lose their foetus. 
 In what proportion abortions occur is not ascertainable from any docu- 
 mentary evidence. For the Cow, Baumeister and Eueff state that in 
 France, in a dairy containing Durham Cows, and numbering 100 preg- 
 nancies, there were 17 abortions ; and at Hohenheim, from a register 
 kept for thirty years, it appears that one-fifth of the Cows aborted. 
 Among 5,864 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 much more frequent during the first than the 
 second half of pregnancy, and especially with the Mare. When this 
 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. The 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 epizootic. When cases 
 occur here and there on farms or breeding establishments over a 
 wide extent of country, without any relationship as to causation, they 
 
ACCIDEXTS OF PREGXAXCV. 205 
 
 are sporadic or accidental abortions ; and tliougli they must bo reckoned 
 as losses, yet they rarely attract much attention from the damage they 
 intlict, because of their isolated, and by no means unusual, occur- 
 rence. But when, on the contrary, the pregnant animals — say Cows, 
 Ewes, or Mares — on a farm, in a village, or over a large district or 
 country, abort in large numbers, and the mishap is evidently due to the 
 same cause or causes, then it is indeed a grave misfortune, as it entails 
 serious damage — present and prospective — to the interests of agricul- 
 ture and live stock. This is enzootic or epizootic abortion — -an occurrence, 
 unfortunately, far from uncommon, and the etiology of which has 
 Utracted the attention of the most distinguished European veterinarians 
 ior many years. 
 
 Sporadic Abortion. 
 
 Causes. — The assignable causes of sporadic abortion are very 
 numerous, but the way in which many of them operate in causing 
 separation' of the foetus from the mother is either unknown or little 
 understood. However, it is considered or presumed that they may act 
 either directly or indirectly, and produce their effects in an evident or 
 an obscure manner. They may be ranged as external or internal. 
 
 1. External Causes. — Atmospherical influences, bad weather, or 
 irregular seasons, have been cited as predisposing to or causing abor- 
 tion. There can be no doubt whatever that cold, and especially when 
 suddenly applied to the skin, may produce this result; and hence it is that 
 the abrupt setting in of cold weather is often marked by miscarriages 
 among animals exposed to it. Many observers have noted that the 
 continued and severe cold of winter is far less frequently productive of 
 abortions than when cold, wet, or frosty nights in autumn succeed line 
 warm days. Cold rain is sometimes very damaging in this respect. 
 
 With regard to food and ingesta in general, there can be no doubt 
 that here we often have an undoubted cause. Food of bad quality, 
 indigestible, or containing injurious ingredients, is well known to bo 
 dangerous. After unfavourable seasons, when forage has not been well 
 dried and made, abortions are far from uncommon. Indigestible food, 
 or that which has a tendency to collect or ferment in the stomach, may, 
 by exerting pressure on the uterus, produce this accident.' On the 
 other hand, too great an abundance of easily-digested and stimulating 
 food, by inducing plethora, and consequent congestion of the uterus 
 and loosening of the placentas, has been set down as another cause. 
 Frozen food or water, when taken in immoderate quantity, and espe- 
 cially if the digestive organs are nearly empty, as well as forage or 
 herbage covered with snow or fi-ost, are also injurious in this i-espect 
 to all the larger animals when pregnant, and abortion often follows 
 
 ' Delwart has given a good illustration of this. " For twenty years all the Cowa in a 
 herd of thirty aborted each year, and if by chance one Calf nached it.s term, it was so 
 puny and deformed that it died in a few days after birth. The cauHe of these alxirtions 
 appeared to me to lie in the too lirge >|uantity of ^jrains and balU of cereals with which 
 the animals were fed ; the nimen and Hecond compartment of the Htomacli formed a 
 compact mass which weighed on the fa>tus, prevented its development, ami ended by 
 killing it. These Cows were put under our care, and submitted to a different kind of 
 alimentation ; roots replaced the innutritions fixxl previously given, and which gave rise 
 to permanent indigestion. This regime was seconded by the administration of a decocti< n 
 '•f linseed, five or !«i.\ bucketfuls in the day, and a draught of a pound of sodium sulphate 
 to each Cow. . . . Success was complete ; the desttuctive scourge entirely disappeared, 
 and twenty- eight healthy Calves were born at the proper time." 
 
206 PATHOLOGY OF PREGNANCY 
 
 immediately.^ Filthy putrid water has also very frequently a perni- 
 cious influence on gestation. Some plants — such as the horse-tails 
 (Equisctacece), sedges (Gyperacece), 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 
 expulsion of the foetus more or less readily ; and toxical substances, 
 such as cantharides, which act upon the uterus, will do the same. 
 Purgatives, 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 more certain. Contusions to the 
 abdomen by kicks or falls, or squeezing through a narrow doorway or 
 passage, railway or steam-boat travelling, blows and shocks, keeping 
 the animals in stalls with very inclined floors, 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 miscarriage ; and 
 exploration per ■vaginam 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.^ 
 
 ^ Saint-Cyr mentions that Gelle has witnessed nearly one-fifth of a flock of Sheep 
 abort immediately after drinking from a pond, the ice on which had to be broken to 
 water them. Audoy reports an exactly similar occurrence ; and Delorme, who haw also 
 observed analogous accidents, adds that they are most likely to happen when the Sheep 
 have been deprived of water for several days. Huvellier mentions a rich grazier of 
 Merlerault who owned ten brood Mareg, one half of which aborted every year, because 
 they were sent three times a da}' to drink cold water. Often, after quenching their 
 thirst, they trembled, were seized with colic, and aborted. The regime was changed ; 
 the ISIares received water at morning and mid-day in the stable, a handfid 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 occux-ring to the Mares belonging to the Prince of Conde, and 
 from the same cause. 
 
 * The Veterinary Journal (vol. i., p. 422) alludes to an occurrence of this kind in 
 New Zealand in 1875. 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 cause of great loss when the rye became ergotised. The same journal (vol. ii. , 
 p. 51) contains an account of serious abortions among Mares in Germany, due to rust 
 {Trkhobasis rubigo) on the straw on which they were fed. In Animal Playiies (London, 
 1871) many interesting notices are given of similar occurrences. 
 
 Haselbach reports that in a cow-shed where maize infested with its parasitic fungus 
 (Utitila(/o mh'idi!>) was given to the cattle, eleven aborted within eight days. The food 
 was changed at once, and the other Cows escaped the accident. A certain quantity was 
 administered to two pregnant Bitches, and they both expelled their young. 
 
 With regard to the ergot of rye, its action as an ecbolic does not appear to be so 
 certain in Herbivorous as in Carnivorous animals, large quantities of it having been 
 given to pregnant Cows without abortion resulting. 
 
 ^ Professor Bonley performed the operation of castration on three pregnant Cows ; 
 they aborted in two days after, and one died. Nevertheless, Chanel has seen a cas- 
 trator operate on a Sow about two months pregnant. Three fcetuses, the size of the 
 middle fing-er, were removed, along with the portion of cortiu in which they were con- 
 tained. The poor beast lost much blood, and was very ill for six or seven days ; yet in 
 more than two months afterwards it brought forth five young Pigs, which it suckled. 
 
ALVIJJEiXTS OF PMEUXAXCY. 207 
 
 Carrying a rider, in the case of the Marc, and especially if spurs are 
 used, is attended with much risk. 
 
 Excitement, fear,^ sudden surprise, or anger, are also causes. Heavy 
 thunder has sometimes been serious in this way ; and the fear produced 
 hy Dogs leads sometimes to heavy losses among Sheep — foxhounds 
 running near or among pregnant Cattle or Sheep often cause consider- 
 able damage, especially among nervous animals. 
 
 Certain odours are said to cause abortion. 
 
 2. IntcrnalCauscs. — Badly-fed and neglected animals sometimes abort, 
 but not nearly so frequently, perhaps, as those in the opposite condition 
 and extremely fat. It is generally admitted that with some animals 
 there is a special predisposition to abort, and that a very trifling cause 
 — especially previous abortions — and sometimes no apprecial)le cause 
 at all, will induce this accident ; while other animals never lose their 
 fa?tus, though exposed to the influence of apparently most powerful 
 causes. This predisposition is not manifest externally, and sometimes 
 it disappears as age advances. 
 
 A more constant and potent cause, however, is to be found in the 
 presence of grave diseases, and especially those which affect the system 
 generally, producing more or less derangement of all the functions. 
 The various serious epizot'Jtic maladies, enteritis, and all those abdo- 
 minal disorders which give rise to restlessness, tympanitis, cough, as 
 well as those diseases which induce cough — as bronchitis, pneumonia, 
 asthma, etc. — pleurisy and other affections and injuiues accompanied 
 by great pain ; as well as nervous or convulsive derangements — such as 
 tetanus, epilepsy, vertigo, etc., are all set down as causes. 
 
 In acute febrile diseases of the mother, the foetus may perish from 
 the abnormal accumulation of heat ; or chronic or acute anaemia in the 
 female may prove fatal to the foetus, by causing asphyxia in it. 
 
 Certain virulent disorders affecting the female may likewise cause the 
 death and expulsion of the young creature ?» utcro — for example, foot- 
 and-mouth disease and tuberculosis. The foetus of a Cow affected with 
 contagious pleuro-pneumonia, has been found with its lungs affected in 
 a similar manner ;-' and to prove that the transmission of these diseases 
 can be effected in this way, Sheep which were in the uterus when their 
 dam was affected with variola (sheep-pox) were found to resist inocula- 
 tion with the virus of that very malignant malady.' 
 
 Violet baa even rt-moved t>ne of the ovaries from a Cow two months prr^natit without 
 abortion taking place or the animal suffHrini,' in health, and it would prolKibly have gone 
 the full time and reared its Calf if it had not been killed for food. 
 
 ' The Cat rarely aborts, and instances are on record in which they have fallen from a 
 considerable height without this accident occurring. Nevertheless, they are liable to 
 miscarry, and a friend who lives near Chatham had a favourite Cat heavyin Kitten, that 
 aborted immedi-itely afU-r being pursued by a strange Dog, which, however, did not 
 •eise it. The accident in this case was evidently due to fear. 
 
 ' Barrier descril)es an abortion epizoilty among Cows, in which nearly nil the Calvea 
 were exjielled »live at the fifth tt> the seventh month, but died within eight days after- 
 wards. The principal symptoms were a more or less loud r;lle, the discharge of ruHty- 
 coloured mucus from the nostrils, .and constant loud bellowings. At the autoi)sies the 
 "lungs were tumefied, red, and fleshy, and the bron^;hi filled with the saffron-tinted fluid 
 that fl.iwed from the nostrils." 
 
 ' In I he human feniale, Klautsth remarks th.at pregnancy m.ay in such cases l)e brought 
 to an end either by the death of the fa>tus, or less frequently by premature uterine contrac- 
 tions. The foetus mny die owing to (1) deficiency of oxygen ; (2) alteration in temperature ; 
 or (3) direct transmission of the infection. These conditions may he combined. The 
 inconstancy of the transmission of the ii.fection the author would explain by the circum- 
 stance that it can only occur when the normal connection between the maternal and 
 
208 PATHOLOGY OF PREGNANCY. 
 
 Hydrocephalus, ascitis, anasarca, and chlorosis, may also lead to the 
 death of the foetus, which in nearly every case is not only the most 
 frequent predisposing cause of abortion, but is almost a certain deter- 
 mining cause of its expulsion, Hydramnios, and other morbid condi- 
 tions of the foetal membranes, or faulty formation or relations between 
 the placentae, are other causes ; and congenital malformations of the 
 foetus, malposition, or exaggerated volume are also mentioned. The 
 presence of several foetuses often leads to abortion in uniparous animals. 
 
 Disease of the uterus will, of course, be very likely to lead to the pre- 
 mature expulsion of the ovum or foetus. Metritis, abnormal conditions 
 of the mucous membrane, as well as new formations — such as fibroid 
 and carcinoma, and other alterations by which the enlargement of the 
 organ is hindered — as enormous tumours in the abdomen, ovarian 
 dropsy, etc. — will predispose to or excite abortion, as will also every 
 condition which leads to hyperaemia of this viscus. 
 
 Abortion has not unfrequently been ascribed to some defects or other 
 influences in the male, though in what these consist has not been 
 explicitly stated ; unless they are to be found in the debility arising 
 from too frequent usage, or other causes related to the animal's state 
 of health. There is strong and abundant evidence that a male en- 
 feebled by too much use, is very likely to be a cause of abortion in the 
 females to which he is put. This accident has also been said to 
 occur frequently when the male was larger and more powerful than 
 the female. 
 
 Various injuries to, and diseases of the foetus or its envelopes, may 
 lead to the same result. External violence may not only injure the 
 uterus itself, so as to produce abortion, but the foetus even may sustain 
 damage. Cauvet has remarked in a case of abortion in a Mare brought 
 about by kicks on the abdomen, that the foetal membranes exhibited 
 at the corresponding point an enormous ecchymosis, and behind 
 the shoulder of the foetus, which was in relation to this extravasation, 
 was a large brown-coloured exudation. Another observer has witnessed 
 an adhesion between the skin on the cranium of a foetus and the foetal 
 membranes, as well as depression of the cranial bones — all evidently 
 due to external violence. 
 
 The foetus may be poisoned by food or medicines which do not pro- 
 duce any appreciable effect on the parent. 
 
 fcEtal circulation is disturbed. Premature pains may be caused by (1) increased body 
 temperature ; (2) altered blood ; (3) changes in the uterine mucous membrane, as in 
 endometritis exanthematica ; or (4) toxins present in the blood. If the deficiency in 
 oxygen occurs rapidly, the foetus dies ; if more gradually, pains are induced. In typhoid 
 fever abortion occurs in more than half the cases, and the foetus is generally born dead, 
 the death being most often due to the transmitted infection. Cholera is not trans- 
 mitted to the fix'tus, the death beinij here dvie to the altered blood, to an endometriti.=, 
 to a diseased fcetal })lacenta, and to temperature variations. In measles the fretus rarely 
 dies. In severe malaria ihe ftjetus is more often born alive, but soon dies of malarial 
 cachexia. In pneumonia the death of the foetus is not uncommon, and is due to 
 asphyxia. Variola frequently kills the fcetus, yet many are born alive. As regards the 
 pains, the fcetus may be expelled in variola even during the suppurative stage ; in 
 malaria after the paroxysm ; in erysipelas most often when the eruption appears ; in 
 cholera during the transition stage ; in influenza soon after the onset of the febrile 
 symptoms, and in pneumonia on the third or fourth day. In typhoid fever the abortion 
 may be accompanied by much hiemorrhage, or strong contractions and little hismorrhage. 
 In cholera the htemorrhage is profuse, and the contractions violent. The foetus is mostly 
 much more threatened by the altered temperature, disturbed circulation, and patho- 
 logical changes in the endometrium, than by the transmission of the infection. — 
 Munchener Med. Wochenschrijt, December 26, 1894. 
 
ACCIDENTS OF PREGNAiWV 209 
 
 Symptoms. — The symptomatology of abortion is extremely varied, 
 being in some cases so trifling that, as already said, the accident may 
 be unperceived, so far as the female is concerned ; while in others the 
 symptoms indicate a very serious condition. This usually depends on 
 the period of pregnancy at which the accident occurs. 
 
 Generally, abortion takes place without any premonitory indications, 
 and the animal may be as well and lively as usual up to the moment 
 when the foetus is expelled; and' the expulsion itself is so sudden, so 
 prompt, and accomplished with so little visible effort or disturbance, 
 that the accident in most cases receives very little, if any notice. It 
 frequently occurs during the night, and wonder is often expressed at 
 finding in the morning the aborted fietus — generally contained in its 
 intact envelopes — lying behind an animal which, on the previous even- 
 ing, looked perfectly well, and even now is so cheerful and unaltered, 
 and its functions so unimpaired, that it can scarcely be believed that 
 it has been the subject of such a mishap. Even the sentiment of 
 maternity, which is so strongly developed in animals, as Saint-Cyr 
 justly remarks, is not awakened in favour of the expelled fcctus, and the 
 mother shows the utmost indifference to it, even treading on it as if it 
 were in no way related to her. 
 
 When this simple abortion has taken place during the day, it has 
 been noted that the flanks fall in a little, the abdomen descends, the 
 vulva and vagina slightly dilate, and there escapes from them a gluti- 
 nous, sometimes sanguinolent, fluid, with which the ftctus is passed 
 almost without effort. We have said that the ovum or foetus is 
 generally expelled in its intact membranes ; this more frequently 
 happens at an early stage of pregnancy. Sometimes, however, the 
 amnion ruptures at the commencement of abortion, and the embryo or 
 ftftus escapes with a small quantity of liquor amnii, the envelopes being 
 rejected soon after ; or in some instances they may be retained in the 
 utei-us, and thus constitute a source of danger, the animal not making 
 any effort to get rid of them. This complicated abortion occurs more 
 frequently at the later stages of pregnancy, and more resembles normal 
 birth than simple abortion, which is most frequently witnessed in the 
 first half of pregnancy. Nevertheless, we have the latter happen so 
 late sometimes as the seventh or eighth month in the larger animals. 
 It is observed more particularly in those which are debilitated from any 
 cause ; but, at the same time, animals which apjjear in the very best 
 health are often the subjects of simple abortion. 
 
 So little disturbance does this kind of abortion cause, that the animal 
 can be treated in eveiy way as if nothing had happened ; though it is 
 more judicious to give it a little extra care for some hours at least. 
 
 In what has been termed laborious, difficult, or complicated abortion, 
 which is often due to external causes, such as injuries, the precursory 
 symptoms are generally well marked, and vary somewhat, according as 
 the fnetus may be dead or alive. The animal suddenly appears dull and 
 peculiarly dejected ; or it is restless, uneasy, and continually moving 
 about ; if pregnancy is advanced and the fa-tus is alive and strong, its 
 movements are, on watching the abdomen attentively, perceived to be 
 frequent, violent, and disordered, but they soon become feeble and 
 infrequent, and cease altogether when the foetus has succumbed. The 
 appetite is lost, a plaintive neigh in the Mare, moan in the Cow, or 
 bleat in the Sheep, is emitted every now and again ; the pulse is quick, 
 small, and hard as in haemorrhage ; progression isdiflBcult and unsteady; 
 
 14 
 
210 PATHOLOGY OF I'EEGXAXCY. 
 
 the physiognomy is anxious, and respiration hurried. When the foetus 
 is ahve there is perhaps less prostration, and — more particularly with 
 the Mare — there appears to be much abdominal pain. The animal often 
 looks anxiously to%Yards the flanks, paws with its fore feet and stamps 
 with its hind ones, moves from side to side, perspires at the flank, 
 breast, and elsewhere, lies down and gets up again, whisks the tail 
 incessantly, and exhibits every indication of increasing restlessness. At 
 the same time the abdomen loses its round shape, and drops ; if the 
 animal is in milk, the mammtB become soft and diminish in size more 
 or less rapidly, while the secretion diminishes ; but if it is not yielding 
 milk, then, on the contrary, they enlarge and become turgid ; the vulva 
 is tumefied, and from it escapes a tenacious mucus, serous, or sero-san- 
 guinolent, and — if the fcetus is dead — more or less foetid fluid, according 
 to circumstances. Then follow symptoms analogous to those which 
 characterise normal parturition — the uterus begins to contract, and the 
 expiratory muscles act simultaneously with it ; the expulsive efforts, or 
 " labour pains," acting more or less energetically and continuously, 
 according to the suddenness of the abortion and the strength and 
 health of the animal. The first result of this straining is the evacua- 
 tion of the bladder and rectum ; the next is the dilatation of the os 
 uteri and protrusion of the membranes into the vagina, then through 
 the vulva, where they appear externally as the " water-bag"; this may 
 rupture and the liquor amnii escape, and the pains becoming more 
 powerful, the foetus is at last expelled either nude or covered by the 
 membranes. This act occupies a variable period — from a few to many 
 hours, according to the strength of the animal ; and it may even require 
 humah intervention to bring it to a successful termination. In other 
 instances, however, the foetus is not expelled immediately after it is 
 dead, but- after many of the premonitory symptoms just described have 
 been manifested ; with the cessation of the movements in the foetus the 
 animal regains its ordinary tranquillity, appetite, and liveliness, and all 
 the symptoms disappear for one or more days, when they again set in, 
 and the foetus may be rejected without any apparent effort, or after 
 much straining. 
 
 In the case of two or several foetuses, it may happen that the one or 
 two nearest the os are dead, and are expelled, the others being alive are 
 retained until pregnancy is complete ; or the contrary may occur, the 
 living foetuses being in proximity to the os, prevent ihe escape of the 
 dead ones, and these being kept in the uterus until delivery of the 
 others takes place, become mummified. 
 
 And in some cases of what might be termed " violent " or " acute 
 abortion," when it suddenly sets in, and nothing is prepared for its 
 being carried to a successful termination, either on the part of the 
 foetus or of the mother, the latter is exhausted by ineffectual efforts, 
 and soon passes into a critical condition. 
 
 Abortion differs from normal parturition chiefly in the state of the 
 cervix uteri. Towards the termination of pregnancy, this part of the 
 uterus becomes gradually shorteneol anol softer ; but in abortion we do 
 not have these progressive changes which are so favourable to the 
 passage of the foetus from the uterine cavity outwards. The cervix is 
 long and rigid as in the non-pregnant condition, and its dilatation is 
 therefore slower, more diflicult, and more incomplete than when gesta- 
 tion has reached its termination ; and especially as the muscular fibres 
 of the uterus have not acquired either their full development or contrac- 
 
ACCIDENTS OF rHKHXAXt'Y'. 211 
 
 tile force. To counterbalance this, there is the small size of the foetus, 
 which does not require so much space for its passa^'e as if it were full 
 grown ; so tliat the dilViculty in removing' it is less on this account, 
 though the other dilliculties the obstetrist has so often to encounter in 
 parturition may all be present. 
 
 Results. — Abortion is always a serious accident, if only from the 
 loss of the fcEtus. It is frequently complicated by haimorrhage, which 
 may primarily have been the cause of uterine action ; it may also result 
 in rupture of the organ, from the efforts the animal makes to overcome 
 the resistance oflered by the cervix ; indeed, we may have the usual 
 complications that attend parturition. But in many cases the com- 
 plications are few and trilling, the animals scarcely experiencing any 
 inconvenience, and retaining all their useful qualities unimpaired. 
 When the accident occurs in the Cow at an early period — before the 
 fifth month — the secretion of milk is generally interrupted, often for a 
 year, as the mamnuu have not had time to experience the reilex or sym- 
 pathetic influence which stimulates them into activity ; when, how- 
 ever, it takes place in the last half of pregnancy the seci'etion may be 
 established, though the yield is usually diminished, and the glands do 
 not furnish tiieir ordinary quantity until the next pregnancy. 
 
 Abortion may produce prolapsus of the uterus and vagina, and some- 
 times even of the rectum. 
 
 At an early period of pregnancy, as we have mentioned, when the 
 foetal and uterine attachments are not very close, the ovum or foetus 
 may be expelled with the w^iole of the membranes ; but as the process 
 has advanced this result is less probable, and particularly with the 
 Cow. The membranes are frequently retained, wholly or partially, 
 when the fcctus comes away ; and owing to the condition of the cervix 
 and its rapid contraction, they are included in the uterine cavity and 
 constitute wliat is termed " retention of the placenta'' — often a serious 
 complication of abortion in the Cow after the first third of pregnancy, 
 the membranes decomposing and giving rise to putrid infection and other 
 alarming pathological conditions. 
 
 In the simplest cases, oestrum appears in the C'ow in from one to two 
 weeks after the miscarriage, as after parturition, and conception may 
 occur then ; but not infrequently impregnation does not take place until 
 after several returns of this condition, and often a whole year elapses. 
 In other instances, oestrum does not appear until the full interval of 
 regular pregnancv has elapsed, and then the animal conceives almost as 
 readilv as before the niishap. Another very common result is a more 
 marked disturbance in the generative functions, in which there is a 
 tendency to abortion after every conception ; and with other animals 
 there remains an excitability of the generative organs, which is mani- 
 fested by an almost persistent state of oestrum, giving rise to nympho- 
 mania, accompanied by sterility. 
 
 Pathologic.\l Anatomy. — The lesions occasioned by abortion are 
 varied, according to circumstances. In the majority of cases, and 
 especially when pregnancy has been well advanced, the maternal organs 
 are in a similar condition to that observed after normal parturition. 
 The OS is dilated or closed, but in general the cervix is a little softer 
 than in the unimpregnated state. The uterus is more or less contracted 
 on itself and looks congested, its vessels being voluminous varicose. 
 
212 PATHOLOGY OF PREGNANCY. 
 
 and filled with blood ; its cavity contains a certain quantity of blood- 
 coloured mucus, and often all the characteristic indications of placental 
 retention and decomposition ; its mucous membrane is red and thick- 
 ened, and there may be traces of inflammation in it and the cotyledons, 
 as well as evidence of the cause which produced the accident, if due to 
 injury. 
 
 The appearance of the foetus varies also, according to the period 
 at which it is expelled, the cause or causes which led to its expulsion 
 or death, as well as the period of its decease. At p. 116 we have 
 enumerated everything known that is likely to lead to a knowledge of 
 its age. Whether it is expelled, or is found in the uterus on examining 
 the carcase of an animal that has died or been destroyed, the body of 
 the foetus may be in a more or less perfect state of preservation. If it 
 has perished recently, it is little if at all altered ; its skin is firm, white, 
 elastic, and even ; the mucous membranes are pale ; and its flesh white, 
 rather soft or firm, and odourless. But when death has taken place 
 some days previously, and the air has had access to the uterine cavity, 
 then there are indications of putrefaction — all the more marked as the 
 interval is prolonged since death occurred. The foetus is swollen, 
 infiltrated, and emphysematous, and exhales a putrescent odour, while 
 the hairs, and even the hoofs, are easily removed. "When the air has 
 not entered the uterus, the foetus may present a withered, wrinkled and 
 mummified appearance. If abortion has been due to hydramnois, then 
 the foetus is sodden and wasted. 
 
 The foetal envelopes have been found, in some instances, intensely 
 congested, and the fluids reddish tinted; in others the latter were turbid, 
 whitish, and not so fluid as usual ; while in others, again, the envelopes 
 were softened, fragile, and colourless. 
 
 Saint-Cyr draws attention to a fact which we have referred to on 
 several occasions, but which is worth alluding to again. It is that, as 
 a general rule, the death of a foetus brings about its expulsion in a short 
 time ; and not its own expulsion alone, but also, in multiparous animals, 
 that of all the uterus may contain. This rule, however, is far from 
 being absolute. We have already seen that a dead foetus may be 
 retained for a very long time ; and at the autopsy of such multiparous 
 creatures as the Bitch, Cat, and Sow, which have died or been killed 
 while pregnant, it is not rare to find, between two perfectly healthy and 
 well-developed foetuses, one which has been arrested in its growth, and 
 has evidently been dead for a long time, and yet its presence has occa- 
 sioned no disturbance. Besides, Bitches and Sows, and even the 
 uniparous Mare and Cow, at the usual period of parturition will bring 
 forth, along with well-developed and living young, one or more dead 
 foetuses whose general appearance testifies that they had ceased to live 
 for a long time. These facts prove that the diseased condition, or even 
 the death, of one or more of the foetuses in an animal does not always 
 prevent gestation from following its regular course. 
 
 Diagnosis. — The diagnosis of abortion, easy in some cases, is in 
 others difficult and complicated ; and as an error in distinguishing this 
 accident may result in serious consequences to the veterinary obstetrist, 
 no less than to the animals confided to his care, as Saint-Cyr properly 
 remarks, it is well that it should receive attention. This excellent 
 authority judiciously presents the problem in three difi'erent aspects : 
 1, Prognosticate a possible, but not yet imminent abortion ; 2. Distin- 
 
ACCIDENTS OF PliEGNANCY. 213 
 
 guish an abortion takiuf; place from other accidents or diseases with which 
 it might be confounded ; 3. Keoognise tliat an abortion has taken place. 
 
 1. Prognosticate an Abortion. — Suppose the owner of a pregnant 
 animal asks such a question as, " Will this creature carry its young the 
 full time?" this must be answered by another question, " What loads 
 you to think it will not ?" For there can be no doubt that, as has been 
 already asserted, there is a special predisposition in certain animals to 
 abort from the most trifling cause, and indeed without any evident 
 cause at all ; and yet they offer no visible indication of this tendency. 
 In this aspect of the question, it is always judicious to remember certain 
 maxims, the most important of which is that relating to several 
 previous miscarriages, before giving an opinion as to the probability of 
 such an accident ; and this opinion should be based on exact knowledge 
 of the causes capable of compromising the issue of pregnancy to which 
 the animal has been or is then exposed. The inquiry should be as com- 
 plete as possible, and then an opinion ought to be carefully given ; as 
 many of the causes of abortion are so very imperfectly known, and so 
 many circumstances may modify the predicted result, that in the 
 majority of cases it is only permissible to hazard presumptions which, 
 after all, are more or less uncertain. 
 
 2. Jiccotjnise an Actual Abortion. — Here we have to distinguish an 
 abortion in process of accomplishment ; and at first sight nothing 
 would appear more easy, and, in fact, nothing is so easy if time be 
 allowed until all the characteristic symptoms attending the expulsion 
 of the foetus are plainly developed. But when the obstetrist is con- 
 sulted at the commencement — during the premonitory period, it may 
 be very embarrassing to give a decided opinion. In many cases, in- 
 deed, impending abortion is only announced — even for some days — by 
 such vague signs as an indefinable malaise, a peculiar dulness, inappe- 
 tence, laziness, perhaps a little fever, with pawing now and again, 
 agitation of the tail, and symptoms which might be taken for those of 
 slight colic. Saint-Cyr has known many good practitioners deceived 
 by these signs, and who have diagnosed either indigestion, gastro- 
 enteritis, or some other malady which disappeared — after the expulsion 
 of the fcL'tus ! Such a mistake is unfortunate for the reputation of the 
 veterinarian, as well as for the owner of the animal, whose interests 
 suffer ; as if a miscarriage had been diagnosed in proper time it might 
 have been prevented, and pregnancy allowed to run its normal course. 
 
 To prevent such an error, it is well to know that a mistake is possible ; 
 80 that if called in to attend an animal offering some of the above- 
 enumerated symptoms, the first inquiry should be as to whether it is 
 pregnant ; then the external organs of generation — the vulva and 
 mammic — ought to be examined with the greatest care, and the actual 
 symptoms thoughtfully analysed. This being done, it will often be 
 found that this is a case of threatened abortion ; and tliat, when taken 
 in time, the accident can be averted by rational treatment. 
 
 3. Recognise that an Abortion has taken place. — It may happen that 
 information is required as to whether abortion has occurred in an 
 animal ; though this information is far less likely to be sought from the 
 veterinarian than from the human obstetrist. In the absence of the 
 foetus or its envelopes, such a question is not easily answered with 
 regard to animals ; and the difficulty is increased if the foetus is un- 
 developed, and a long interval has elapsed since the presumed date of 
 the suspected abortion. Saint-Cyr is of opinion that, as a rule, it is 
 
214 PATHOLOGY OF PREGNANCY. 
 
 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 v^'e 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, hard, 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 
 amnii ; 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 difficulty 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. 
 
 Treatment. — The treatment is preventive and remedial. With regard 
 to preventive treatment, this must mainly depend upon a knowledge of 
 the causes which produce abortion— which we have seen are numerous, 
 and care in avoiding or modifying these. This pei'tains 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 in-itation 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 ; guarding 
 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 mouth or by rectum ; and allowing only 
 gentle exercise towards the 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 fa3tus 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 the animal 
 in the most perfect quiet possible — alone in a darkened place, with 
 doors and windows closed, if convenient. The 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 
 enemata (not more than a wine-glassful at once), which he thinks pre- 
 ferable to draughts, but which may, nevertheless, be emploj^ed concur- 
 rently. Zundel prefers chloroform, which, he asserts, has yielded 
 extraordinary results in his hands in these cases, by suddenly arresting 
 
ACCIDENTS OF J'RJ-JaXAXCV. 215 
 
 the straining. Ho gives it in doses of about three drachms to the Cow, 
 in the form of draught in oil or mucilage, repeating them every hour. 
 Carsten Harms recommends camphor, or camphor and opium, and 
 Euefif assafci'tida. 
 
 Enemas are objectionable, as they have a tendency to increase the 
 straining. 
 
 The abdomen should be gently rubbed for some time, and the stall 
 well littered ; and if the animal will eat and drink, easily-digested food 
 in small quantity, and gruel, may be given until all danger has passed 
 — generally for 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 nmst 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 rupture of 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 uterus 
 can be reached, when the fatus 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 
 fcetus being smaller, the difficulties are less. 
 
 If it should happen that the cervix is contracted, and shows no sign 
 of yielding to gentle manipulation, then after a sufficient time has been 
 allowed measures 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. Cox 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 
 dry after the escape of the amniotic fluid ; and, internally, extract of 
 belladonna, chloral, or ether or alcoliol draughts should be administered, 
 particularly if the animal is exhausted. Gruel, beef-tea, milk, or otlier 
 strengthening fluids may likewise be required. The ergot of rye is of 
 little value in cases occurring in the larger animals, and its use is rarely 
 to be prescribed. 
 
 If the membranes come away with the fcetus, there is little more to 
 be done ; though in the contrary case, which is by no means infrequent 
 in abortion or premature birth, the membranes are strongly .adherent to 
 the uterine placentie, and their retention, particularly in Cattle, is often 
 troublesome. Some practitioners in these instances prefer to remove 
 them immediately and mechanically by the hand, carefully separating 
 the placentulai one after another ; and though this is easily enough 
 accomplished so long as the os is dilated — whic : it usually is for three 
 days after delivery — yet others are content with some simple precautions, 
 and prefer to wait. When they find the membranes firmly adherent, 
 and their separation from the uterus likely to be attended with incon- 
 
216 PATHOLOGY OF PREGNANCY. 
 
 venience, they only partially detach them, then collect and twist them 
 into a rope-like form, and leave this mass in the vagina ; so that should 
 the cervix contract, it may not be imprisoned in the uterus. Others tie 
 them together with a piece of tape, which is allowed to hang out of the 
 vagina. In a short time the placenta becomes loosened, and can then 
 be wholly removed. A few experienced obstetrists rely on internal 
 medication for the separation of the foetal placenta. Zundel, for 
 instance, has long and successfully administered powdered laurel berries 
 in an infusion of fennel, giving 1| ounces three times a day, with an 
 ounce of sodium bicarbonate in half a pint of fennel infusion. The 
 membranes always come away on the second or third day, particularly 
 if plenty of mucilaginous fluid has been given in the interval. Bychner 
 employs a decoction of the meal of linseed-cake in doses of about twelve 
 pints a day, when this result ensues about the ninth day. 
 
 An animal which has aborted requires attention after the delivery of 
 the foetus. It should be kept clean, fed on gruel and easily-digested 
 food, though not in excess, kept from draughts of air, particularly in 
 cold weather, and otherwise nursed for some days. The complications 
 which sometimes accompany this accident will be alluded to hereafter, 
 as they are usually those of ordinary parturition. The animal should 
 not be allowed to become impregnated at the next oestrum, nor yet 
 perhaps at the succeeding period. 
 
 Eelaxation of the genital passages in the Bitch generally follows 
 immersion in a warm bath (112° to 114° Fahr.) for a few minutes; it 
 must not be prolonged after the respiration becomes hurried or the 
 animal looks distressed ; and the creature should be well dried and 
 kept comfortable. 
 
 Epizootic, Enzootic, or Infectious Abortion. 
 
 "What has been named epizootic or enzootic abortion, but which we 
 have designated " infectious," differs in its etiology and some other 
 features from abortion occurring in isolated or sporadic cases, but more 
 particularly from its attacking all, or nearly all, the pregnant Cattle (for 
 it is more particularly observed in Cows, seldom in Sheep, and more 
 rarely among Mares) on a farm or pasture, in a village, over a wide 
 district, or even throughout an entire country, for perhaps a succession 
 of years — thus constituting itself a veritable scourge to agriculture ; and 
 more especially as it only too frequently appears to defy all precautions 
 to prevent its occurrence, and eludes the most careful search for its 
 exciting cause. 
 
 Epizootics of abortion have been recorded from the earliest times ;^ 
 but it was only towards the end of the last century, when Flandrin, 
 Barrier, Pele, and other French veterinary authorities undertook their 
 investigation, that we discover the damage they inflicted. The observers 
 in this century are very numerous, but space forbids our alluding to 
 them ; it may be sufficient to state that Continental authorities are 
 agreed as to the destructiveness of this accident or disease, and, until 
 recently, as to the obscurity which attends its development. For 
 instance, Heuze mentions that in the Nievre (France) in 1869, the loss to 
 certain agriculturists amounted to 30,000, 40,000. and even 50,000 francs ; 
 
 ^ Those occurring up to A.D. 800 are described in my work on Animal Plagues. We 
 need only allude in this place to the human "abortus epidemicus " of B.C. 278 ; to that 
 observed in Germany in 1777, in which Cows and Pigs were involved ; and that at 
 Chalons in 1784, in which nearly all the Cows and Mares aborted. 
 
ACCIDENTS OF P/iK'/XAXCV. 217 
 
 in South Germany, in 18ol-52, according to RuetT, it was very serious ; 
 Zundel mentions that it is frequent in North Germany ; and, according 
 to Harms, it is very prevalent in Hanover. 
 
 Indeed, there is scarcely a country in which there are competent 
 observers, that has not been reported as suiifering from visitations of 
 infectious or epizootic abortion. Some of these outbreaks have been 
 most destructive. In the United States of America, for example, it has 
 proved a veritable scourge in some of the horse-producing regions, where 
 it seems to have made its appearance in recent years. It is only since 
 186G that it has attracted attention in the Mississippi Valley, and 
 gradually increasing in severity, in 1889 and 1890 it caused great havoc 
 — the losses through Mares aborting amounting to as many as 75 per 
 cent, in some regions ; in others, one-half of the Mares aborted. The 
 Horse-breeding areas in Illinois and adjoining States suffered most. 
 In Kentucky in 1892, it was reported that 75 per cent, of the brood 
 Mares — trotting and thoroughbred — were either barren or had lost their 
 Foals that spring. Bourbon County sustained a loss equal to £10,000 
 by Mares slipping their Foals. Fayette County suffered an even greater 
 loss ; while Madison and other counties experienced the same misfor- 
 tune. In Montana it inflicted much damage in the Horse ranches in 
 1892, when it first appeared there. In 1891 the disease was observed 
 in South America — in the State of Buenos Ayres, Argentine Eepublic 
 — where the outbreak was described as the most extensive of any that 
 had hitherto been observed in any part of the world, and the epizooty 
 as entirely a novelty in that region. The losses were very great. In 
 Australia an outbreak of epizootic abortion in Cows was reported from 
 Warrnanibool, Victoria, in 1892. In 1889, Labat reports an outbreak 
 among Ewes in France.' 
 
 C.A.USES. — If we attempt to study the causes which have been alleged 
 as operating in the production of epi/.outic abortion, we are ballled 
 by conflicting statements and opinions. Many authorities have adduced 
 those causes which have been already enumerated as producing sporadic 
 or accidental abortion ; while others have taken into consideration other 
 influences which may give rise to the accident, as well as those which 
 may propagate the disorder. Among the latter is Zundel, who has made 
 a conscientious study of this important subject, and throws consider- 
 able light upon it. 
 
 With regard to general causes, it is remarked that the disease is most 
 frequent — enzootic — in wet years, as it was in South Germany in 1852, 
 when inundations were common (Rueff),and in Haute-Saone frequently 
 (Trelut), and in other countries ; then it is probably due to anaemia, as 
 well as to forage damaged by moisture, ergotized, or otherwise altered. 
 This adynamic condition of animals, brought about by the weather and 
 food, is, in the opinion of Zundel, particularly favourable for the multi- 
 phcation ot microphytes, micrococci, and bacteria in the genito-urinary 
 mucous membrane, and these have been spoken of as the principal local 
 cause of this kind of abortion. He also adds that it is possible that, 
 among the fungus or parasitic elements which infest forage in wet 
 seasons, there may be some which act, hke the ergot of rye, directly on 
 the uterus. But in addition to the influence of seasons, there has also 
 
 * For particulars of these outbreaks in North and South America, _Australia, and 
 France, see the Veteriiianj Journal, voU. xxviii., p. 402 ; xxxiv., pp. 275, 337 ; xxxv., 
 p. 332 ; xxxvi., p. 16. 
 
218 PATHOLOGY OF PREGNANCY. 
 
 been a supposed influence of locality — the disease fixing itself in par- 
 ticular places and sparing others. For instance, Heuze remarks that 
 in the department of the Nievre, France, abortions are very few in 
 the arrondissement of Clamecy, while in other arrondissements there is 
 scarcely a calf. 
 
 With regard to local conditions or causes, it is certain that the regime 
 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 age, 
 breed, or constitution. 
 
 Malarial poisoning is a cause of abortion in domestic animals as 
 well as in the human species ; and in the malarial districts in Africa, 
 Florida, and India, Weatherly asserts that the natives of these parts 
 are so well aware of this, that they send their Cattle and Sheep inland 
 to breed, only bringing them 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 the 
 herbage was free from this condition, and where the animals were 
 stabled. 
 
 Strebel, for instance, informs us that in 1878 and 1879-80, from 
 20 to 60 per cent, of the pregnant Cows in the Canton of Freiburg 
 aborted, though they were in very good cowsheds ; and Bruin 
 mentions that in November and December, 1884, and January, 1885, 
 60 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 mysterious, something inscrutable and baffling, to the 
 pathologist who sought to account for their appearance and extension. 
 
 So 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 observed 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 that 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, theaj 
 another, then a third, and so on, of the others have experienced the' 
 same misfortune, and the malady has persisted in the place for con- 
 1 BrltLsh Medical Journal, February 2, 1S95, p. 278. 
 
ACCIDEXTS OF PREGNANCY. 210 
 
 secutive years. It is not always the pregnant Cows next to the one 
 which has aborted that are first seized, but rather animals some 
 distance from it. 
 
 Again, when pregnant Cows which were living in a place where the 
 disease had not existed, have been introduced into a stable where it 
 prevails, those that are at the end of gestation calve regularly and 
 normally soon after arrival ; but if they are a certain time in the 
 infected stable before this period is reached, they abort like the others. 
 
 So that the presence of an infecting element, if not absolutely proved, 
 is at least admissible, after the very numerous observations of the most 
 competent veterinarians — especially of Uarreau. Cruzcl, Felizct, Bouley, 
 Lafosse, Nocard, and others, in France; and Rueff, Haubner, Franck, 
 Rolotf, and many more, in Germany. The insalubrity and bad hygiene 
 of cowsheds and stables appear to have no influence in the patho- 
 genesis of the accident, as it appears quite as severely and readily in 
 those which are well ventilated and cleansed as in those in the opposite 
 conditions ; in fact, nothing can so well explain the occurrence of par- 
 ticular outbreaks of epizootic or enzootic abortion as the presence of 
 a contagium or a miasmatic iufcctioii. 
 
 The existence of a contagium would appear to have been proved by the 
 result of an experiment performed by Franck, of the ^lunich Veterinary 
 School, some years ago. It had been established by microscopical investi- 
 gation, that on the lining membrane of the vagina and vulva, there is 
 constantly found — as on the buccal mucous membrane — a minute 
 fungus mixed with the mucus, in every respect similar to the Lcptothrix 
 biiccalis, which, according to Hallier, is only an allotropic condition 
 of the ordinary moulds — such as the Penicillium (jlaucum or Aspergillus 
 — being, in fact, a kind of bacillus. Towards the period of parturition 
 these bodies become extraordinarily abundant, and they appear to 
 concur in the decomposition of the fwtal membranes and their expul- 
 sion ; when the membranes are retained and putrefy in the uterus, 
 they are extremely numerous, as are the micrococci. Franck showed 
 that, by smearing the vaginal canal of a pregnant animal to a certain 
 depth with the matter from the expelled membranes of one which had 
 been delivered, abortion can be induced. 
 
 So that, as Zundel asserted, it is sufiicicnt to introduce into the 
 vagina micrococci or bacteria, which will multiply there, and, penetrat- 
 ing to the uterus, commence their work of decomposition, to produce 
 abortion. 
 
 Roloff had also ascertained that abortion is due to something which 
 finds admission to the uterus by the vagina ; that a certain amount 
 of redness and tumefaction of the lining membrane of the latter always 
 precedes this accident ; and that this virulifcrous or miasmatic matter 
 is found on the articles soiled by the delivery of a Cow which has 
 aborted, as well as in the drains of the stable, on the litter, etc. 
 
 Brauer inoculated Cows which were pregnant from five to seven 
 months with this infective material, and in twelve, fourteen, fifteen, 
 and twenty-one days after the operation they aborted. 
 
 It must be remarked, however, that such views were not accepted 
 for a considerable time by a large portion of the veterinary profession, 
 who endeavoured to explain the occurrence of this kind of abortion 
 by asserting that when one animal got rid of its fcctus prematurely 
 others did so through sympathy or imitation — a very old notion indeed, 
 and one which will not bear examination. Cows do not abort when 
 
220 PATHOLOGY OF PREGNANCY. 
 
 others calve beside them, and why should they do so when abortion 
 takes place ? Sympathy should be shown as much, if not more, in 
 the first instance as in the second. 
 
 Then, again, others attributed this kind of abortion to the fact of 
 pregnant Cows being brought into contact with putrescent materials or 
 odours, no matter what they were derived from ; this was another old 
 notion, and so firmly was it believed in by farmers, that, in order to 
 ensure their pregnant Cow against this accident, they 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 the 
 supposed sympathy ; as it frequently happens that Cows go their full 
 time amid foul odours, and it even happens that in a shed a Cow will 
 calve, and the placenta will be retained until it evolves an almost in- 
 supportable stench of putrescence, and yet other pregnant Cows will 
 remain unaffected ; while not unfrequently abortions occur in a large 
 cowshed in which cleanliness is well attended to, and no bad smell can 
 be perceived. 
 
 The evidence in favour of the presence of an infecting agent in these 
 outbreaks of abortion which cannot otherwise be explained, is strong 
 from a clinical point of view, and still stronger from an experimental 
 one ; for in addition to the investigations of the authorities already 
 named, we have those of Nocard, carried out ten years ago, which 
 should definitely settle the question, as they were almost exhaustive 
 on every point, while his experiments were conducted with that 
 scrupulous care which marks all his pathological inquiries. He ascer- 
 tained that there was nothing in the living animal to indicate that 
 this abortion was a general disease of the Cow ; as all the functions 
 are normally performed, the temperature does not rise above the 
 tenth of a degree ; the urine contains neither sugar nor albumin, aud 
 the blood, milk, and various tissues are unaltered. The histological 
 examination and cultivations of solids and fluids did not reveal the 
 presence of pathogenic organisms. He examined the bodies of Cows 
 which had just aborted, of those about to abort — especially primiparae, 
 and of those which had aborted the previous year and were afterwards 
 sterile. In Cows which had aborted but still retained the foetal 
 envelopes, he removed, with all due precautions, fibrinous muco- 
 purulent flakes of a bright yellow colour he found in the latter ; 
 difficulty was experienced in separating the maternal and foetal placentae, 
 and the placental villi were of a dirty white colour, looking as if in- 
 filtrated with pus or macerated ; around the base of the cotyledons 
 there was a great quantity of the same yellow flakes, similar to those 
 frequently recorded as passing from the vulva after abortion. The 
 cotyledons, after their placental covering was removed, were firm, 
 rosy, and penetrated by deep wide follicles ; pressure caused the 
 exudation of some drops of purulent-looking matter, softer than the 
 flakes. Scraping of the cut surface gave a milky juice, white and 
 homogeneous, analogous to cancer juice. He also obtained a quantity 
 of cotyledonary pulp, and this, with the other matters, he sowed in 
 broths and in peptone-gelatine tubes. When stained and examined 
 microscopically, the puriform matter was found to consist of a mass 
 of epithelial cells and leucocytes mixed up in a mucus and fibrinous 
 network, together with a number of micrococci — isolated, double, and 
 in short chains — consisting of three, four, and five cocci ; here and there 
 were also a few short thick bacilli, isolated or associated two by two. 
 
ACCIDENTS OF mKCXAXCV. 221 
 
 Til the cotyledonary juice these bacilli were found almost to the entire 
 exclusion of the niicrococci, and in the juice scraped from the mucous 
 surface these organisms existed in about equal numbers. After forty- 
 eight hours the sown tubes exliibited an abundant cultivation. Those 
 sown with the cotyledonary juice, cultivated in a state of purity, 
 showed the short, thick geminated bacillus just referred to ; while those 
 sown with purulent matter had, on the contrary, a mixed culture of 
 micrococci and bacilli, the former being most abundant. Tlie tubes 
 sown with blood and milk preserved their limpidity. 
 
 Similar results were obtained in all the experiments ; but in a Cow 
 which had aborted the previous year, and was afterwards "sterile, a 
 mixed variety of organisms was found, while the matter obtained by 
 scraping the uterine mucous membrane gave a slightly acid reaction that 
 was probably the cause of the animal being incapable of impregnation ; 
 as spermatozoa cannot retain their vitality in other than an alkaline 
 medium. 
 
 It was observed that Cows — primiparoe and pluripane — from a 
 district where this abortion did not exist, had no micro-organisms 
 between the uterine mucous membrane and the foetal envelopes. 
 
 In his obsen'ations on the Calves, Nocard found that neither the 
 blood, bile, pulp of the spleen, liver, kidneys, nor mesenteric glands, nor 
 yet the serum from the pericai'dium, pleura, or peritoneum, yielded 
 cultivations ; but from the fluid in the stomach and the intestines, as 
 well as the medulla oblongata, he obtained cultures of the same micro- 
 coccus that he had found in the liquor amnii and flaky muco-purulent 
 matter. 
 
 It was, of course, necessary in these investigations to select foetuses 
 which had been aborted dead, and had therefore never breathed ; for as 
 soon as respiration begins, micro-organisms are always found in the 
 alimentary canal of all animals. 
 
 From his inquiries, Nocard was of opinion that the peculiar bellow 
 of the Calf, like the altered voice of the rabid Dog, is due to cerebral 
 derangement, caused by the presence of these micrococci. He also 
 believed that many cases of death from diarrhea in newly-born Calves 
 are due to this cause ; he has examined the medulla oblongata of those 
 which succumbed, and found a microbe in all respects identical ; so 
 that he questions whether it is not one and the same disease, develop- 
 ing at different periods in the life of the young animal. The existence 
 of micro-organisms in the alimentary canal of aborted foetuses, previous 
 to expulsion from the uterus (though none are in the healthy fcetus 
 during intra-uterine life), was also demonstrated; thus showing the 
 microbic nature of this infectious abortion. 
 
 In the outbreak of infectious abortion among Mares in Montana, 
 United States, inoculation experiments were made with cultures from 
 the membranes and blood of an aborted foetus, and these were successful 
 not only in inducing abortion, but the Foal of one which lived for a 
 short time had disease of the knee and hock joints. 
 
 It has not yet been absolutely demonstrated how the infection is 
 conveyed to the uterus, but as the Cow is individually seldom affected, 
 it is extremely probable that the vaginal discharges, as well as the 
 foetus and its envelopes, contain the organisms which occasion the 
 accident, and that putrefaction does not destroy their vitality. It has 
 been remarked that, in general, the foetal membranes are liable to be 
 retained in Cows which abort, and that when not removed artificially 
 
222 PATHOLOGY OF PREGNANCY. 
 
 they only come away when decomposition sets in. The influence of 
 these putrefying membranes has been noted by several veterinarians — 
 Pele, Barrier, Cruzel, Bouley, Eychner, Haubner, and others — who 
 imagined that the putrescent emanations infected the economy of the 
 animals breathing them ; but Zundel thinks 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 suflicient 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 foetus 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, and rzcc 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 trifling 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 foetus ; 
 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. ^A'hen attempts are made to remove them by hand, 
 this is found much more difficult than after ordinary parturition ; owing 
 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 perishes, probably as a consequence of 
 this placental retention. If it recovers, oestrum appears unnaturally 
 frequent, though conception is infrequent and sterility common ; 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 course of a year. 
 
 The foetus is usually dead, though when it is expelled (in the Cow) 
 after the fifth 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 PllEGNAXCV. 223 
 
 a rattling noise when breathing, accompanied by the discharge of a 
 rusty-coloured mucilaginous lluid from the nostrils ; they are attacked 
 by diarrhaa ; they bellow continually, and are always emaciated and 
 flabby, the gums and palate being pale, and the umbilical vessels livid 
 and withered-looking. The dyspna^a and great weakness evinced by 
 them shows that they are not properly organised. Nocard believes that 
 such Calves die from the same cause as those which are aborted dead. 
 Those which are dead when expelled exhibit indications of having ceased 
 to live a short time previously. 
 
 As has been stated, all the animals on a pasture or in a shed where 
 the disease prevails, do not abort at the same time, but at intervals. 
 \Vhen one aborts, another — its neighbour perhaps — appears to prepare 
 for the event, which may occur in about eight days ; then some days 
 after this it is the turn of another, and so on until two-thirds, or perhaps 
 even all, of the pregnant Cows beyond three months' gestation have 
 aborted. 
 
 It has also been mentioned that it is only after being some time in 
 sheds in which the disease is present, that newly purchased pregnant 
 Cows are attacked ; those which have passed their eighth month and 
 are near calving escape abortion. 
 
 Darreau alludes to instances in wliich a pregnant Cow, leaving a 
 shed in which abortions prevailed, and transferred to another where the 
 accident had not been seen, would remain all right for some time, then 
 suddenly miscarry, and in the course of about fifteen days other abor- 
 tions would occur in this shed — testifying to the danger of keeping 
 pregnant Cows in contact with or in proximity to those which have 
 miscarried in this way. It has also been stated that an animal which 
 aborts either remains sterile, or has always a tendency to abort again. 
 But it has been obser\'ed that if Cows are well fed, the period that 
 elapses after each abortion is often longer ; so that if a Cow aborts the 
 first time at six months, it will do so again at the seventh month, and 
 the third time a little before the ninth month, reaching its full period in 
 three pregnancies. 
 
 The symptoms of infectious abortion in the Mare do not differ much 
 from those observed in the Cow. Very often nothing at all is noticed, 
 the animal appearing in as good health as usual ; in other instances 
 there is uneasiness, which might pass without attracting much atten- 
 tion. In the American outbreaks, very often the first indication 
 observ'ed was the return of oestrum in Mares supposed to be some 
 months pregnant ; and the animals being at pasture, the expelled 
 foetuses escaped detection, until in some of the Mares pregnancy had 
 considerably advanced, when the size of the abortions led to the dis- 
 covery that the disease was rife. The Foals that lived for a short time 
 had inflammation of the joints, which often ran on to suppuration, and 
 this was ascribed to the same organism which had caused the abortion. 
 
 Pathological An.\tomy. — The appearances observed in the uterus 
 and its contents in infectious abortion have already been briefly 
 alluded to when describing Nocard's investigations, and there is not 
 much to be added. The foetal envelopes are generally nmch altered in 
 Bovines — looking as if macerated, and covered with pus or lymph-like 
 flakes ; while the liquor amnii is turbid, and sometimes flocculent. The 
 mucous membrane of the uterus it often very congested. In America, 
 in the case of the Mares, the foetal membranes in one outbreak were 
 
224 PATHOLOGY OF PREGNANCY. 
 
 always found abnormal in appearance. In one instance the portion of 
 the envelopes in the cornua was undergoing decomposition, having a 
 deep-red, congested appearance, followed later by a leaden-gray hue, 
 and exhaling a very foetid odour. Patches of the membranes were 
 destroyed, and small quantities of a muco-purulent matter were found. 
 
 Treatment. — If the malady is suspected to be due to any one 
 particular cause, or if there exist predisposing causes, then the indica- 
 tions for the prevention or cure of this accident are obvious. The 
 atonic state which seems to favour the occurrence of infectious abortion 
 in or after certain rainy seasons, should be remedied by good food and 
 tonics — and especially preparations of iron. Tonics have been par- 
 ticularly serviceable when abortion was supposed to be due to ergotised 
 food ; though Zundel recommends the internal administration 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, by 
 subcutaneous injection in the neighbourhood of the flank, the dose 
 being two Pravaz syringefuls of a two per cent, solution.^ 
 
 If, however, we admit the most common and efficient 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 healtla — then the first and 
 fundamental indication is to remove or isolate the source of the 
 mischief. 
 
 When, therefore, abortion occurs, and there is reason to believe that 
 this accident is in its nature infectious, the foetus and all pertaining to 
 it should be removed as promptly and completely as possible from 
 the shed or place in which the animal is located. The Cow itself 
 should also be removed — or, better still, the other pregnant animals 
 in the same shed should be moved away to another building — and 
 either kept altogether isolated, or at least away from all other pregnant 
 cattle, with a special attendant employed to look after it ; this at- 
 tendant should not go near the unaffected pregnant cattle, and the 
 excreta from the Cow should also be carefully kept out of their Avay. 
 
 The shed in which the accident has occurred, and especially if it 
 contain more pregnant cattle, ought to be immediately cleared of 
 all manure and other matters of an objectionable kind, the drains 
 and the floor — particularly that of the stall which has been occupied 
 by the Cow — being thoroughly swilled with water, and sprinkled with 
 some good disinfectant ; the walls should also be lime-washed ; a 
 good layer of straw may then be laid down, and the cattle replaced. 
 
 The shed should be kept clean and well ventilated for a number of 
 days, and the drains well flushed and disinfected. 
 
 The animal which has aborted must also be at once attended to. If 
 
 1 Wochensrhri/t fiir 71iierheilhmde und Viehznchf, 1884, p. 429. The adminis- 
 tration of this medicament has quite recently been brought forward again, and its 
 successful employment is reported in the North British Agriculturist for January 19 of 
 the present year. In this case a valuable herd was so haunted with the abortion plague 
 that it was about to be destroyed. Crude carbolic acid, in quarter-ounce doses, was 
 dissolved in sufficient warm water to make a mash, then the bran was added. The dose 
 was increased gradually to half an ounce. The mashes were given three tiines a week. 
 
 It has also been recommended to give the acid (Calvert's No. 4) in quarter-ounce 
 doses, as above, carefully dissolved in one quart of warm, sweetened water, or in a bran 
 mash once or twice a week. 
 
 This medication might be combined with Nocard's external treatment, mentioned above. 
 
ACCIDENTS OF rREdXASCV. TlTt 
 
 the membranes have not been discharged — which is most frequently 
 the case — they sliould be removed as early as possible, and not allowed 
 to putrefy ; their removal should be effected by the hand, and a weak 
 solution of carbolic acid, corrosive sublimate, perman^'anati; of potas- 
 sium, or salicylic acid ought to be injected into the vagina and uterus, a 
 o per cent, solution of carbolic acid being employed to sponge about the 
 vulva, over the tail and down the back part of the thighs. The mem- 
 branes themselves must bo destroyed or buried, and the Cow should 
 not be allowed to go near others whicli are pregnant so long as there is 
 any discharge jD(;r vu'.vavi: for safety, the period of isolation should 
 extend at least to from eight to fifteen days. The animal may require 
 good nursing in the meantime ; and it should not be put to the male 
 until every trace of irritation in the generative organs has disappeared. 
 
 If Cows show any symptoms of impending abortion, they ought to be 
 promptly removed from the vicinity of others which are in calf. 
 
 When this accident continues in a stable or shed, Saint-Cyr thinks it 
 necessary to recommend disposal of all the Cows therein ; and before 
 introducing others into it, to thoroughly cleanse and disinfect it by 
 removing all excreta; renewing the soil or flooring, washing and scraping 
 the mangers, racks, and walls and woodwork, making more air-aper- 
 tures if necessary, and leaving it empty, with the doors and windows 
 open, for a month or six weeks. 
 
 In sheds where abortion among Cows is frequent, Nocard recom- 
 mends the following preventive measures : 1. Once a week the cow- 
 sheds are to be well cleansed, particularly behind the Cows, and then 
 sprinkled with a strong solution of sulphate of copper, or of carbolic acid 
 — one part to fifty of water. i2. The tail, anus, vulva, and thence down- 
 wards to the hoofs of the hind limbs of every Cow inhabiting these 
 infected sheds, to be sponged daily with the following preparation — 
 
 Distilled or rain water - - 2 gallons. 
 Hydrochloric acid - - - ~h ounces. 
 Corrosive sublimate - - 2i drachms. 
 
 These ingredients to be thoroughly mixed ; and as the preparation is 
 poisonous to man and beast, care must be taken. 
 
 This precautionary treatment, wherever adopted, has been found 
 successful — another proof of the infectious nature of this kind of abor- 
 tion ; though, as Nocard remarks, in some instances the accident does 
 not wholly cease during the first calving seasou, but it always does so 
 in the second season. 
 
 With regard to infectious abortion in the Mare, similar measures to 
 those recommended for this accident in the Bovine species should bo 
 enforced. In Montana, U.S.A., those prescribed wei'e as follows : 
 1. If the Mare aborted in an open paddock or pasture, the f(ctus and 
 ftrtal membranes were to be burned, and the animal taken to a stable 
 or small lot, where she could be easily treated. 2. If she was removed 
 to a stable, this had to be apart from any other stable containing 
 pregnant animals, and not on high gi-ound from which the urine would 
 run on to other parts frequented by pregnant Mares ; if removed to a 
 small lot, this had to be low, or situated so that the drainage from it 
 might not be a source of danger. 3. When Mares have aborted and 
 are not doing well, their external genitals should be thoroughly cleansed 
 with a solution of corrosive sublimate (1 to 1,000 of water) ; the tail 
 itself was to be thoroughly washed with the same, and, if in fly-time, 
 
 15 
 
226 PATHOLOGY OF PREUNAXCY. 
 
 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 w^as 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 precautions 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 foetus and membranes to be covered with lime and 
 then buried in an out-of-the-way place. 6. Every morning sponge the 
 vulva, anus, perinaeum, 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 these 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 animals, 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 whenever or wherever the 
 accident occurs — whether at pasture, in strawyard, 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 bury everything — foetus, 
 membranes, etc , as well as to destroy all traces of discharges. 
 
I'HYsiuLouy OF I'.urrrjuTiox. 227 
 
 BOOlv IV. 
 
 XUKMAl. PAKTUKITIUN. 
 
 Xoii.MAL, natural, physiological, or spontaneous parturition or birth, is 
 the expulsion of the fcctus from the uterus through the maternal 
 passages, by natural forces, when it is suf!iciently developed to live 
 external to its parent. This act is designated " foaling," when occurring 
 in the Mare, " calving " in the Cow, " lambing " in the Sheep, " pup- 
 ping " in the Bitch, etc. It receives the designation of "normal," 
 " natural," etc., when it is accomplished in a manner favourable to the 
 parent and offspring without extraneous assistance, and by natural 
 forces alone ; and " abnormal," " pathological," or " dillicult," when it 
 cannot be so accomplished, and when the aid of man is required to 
 relieve ilie parent and release the progeny. Though eminently a 
 physiological act, it is nevertheless one of the most difficult ; the 
 inter\'al between normal and pathological parturition is sometimes 
 extremely brief, the one being often transformed into the other in a 
 remarkably short time. It is also said to be " premature " when it 
 occurs before the usual period, and the young creature is bcrn in a 
 viable condition; while it is "prolonged" birth when pregnancy 
 extends beyond the ordinary term. We have already spoken of these 
 terms, and alluded to their diversity ; and we have only now to note 
 that these variations do not appear to have any influence on the physio- 
 logical act of parturition. 
 
 CHAPTER I. 
 Physiology of Parturition. 
 
 The act of parturition, notwithstanding its special object, is dis- 
 tinguished from all other physiological acts or functions by certain 
 peculiarities ; for while the latter are normally accompHshed without 
 disturbing in any way the well-being of the individual, parturiticm, on 
 the contrary, even when natural, is accompanied by pain, general dis- 
 turbance and uneasiness, and violent efforts. And during birth nature 
 does not appear to obey those in)nmtable laws so strictly as in the 
 accomplishment of other physiological acts, but makes frequent and 
 wide deviations ; though these do not often compromise the final result. 
 We never find two births exactly alike, but each otTers something pecu- 
 liar when attentively observed. We need only refer to the duration of 
 the act as a whole, as well as to each of its periods or stages. Some- 
 times it only occupies a few minutes, in other instances days are 
 required to complete it ; in some cases the first stage is long and the 
 second short, and in others it is the reverse. The " labour pains," or 
 utero-abdominal contractions, present as notable differences with regard 
 to intensity, duration, and frequency, as well as in the pain they cause 
 and the influence they exercise on the other parts of tlie body ; while 
 the amount of allantoid or amniotic fluid is as variable, though no ill 
 effects may result from this. And, finally, the foetus may present itself 
 for expulsion in a variety of positions, which, though they may not 
 impede birth, yet prove that parturition is an extremely variable act, 
 while its phenomena are highly complex. 
 
228 NORMAL PARTURITION. 
 
 SECTION I.— CAUSES OF PARTURITION. 
 
 Though parturition only occurs at the end of pregnancy, nevertheless 
 this act is being prepared for from an early period in the development 
 of the ovum, as we have shown when speaking of the anatomy and 
 physiology of the generative organs. During the evolution and deve- 
 lopment of the ovum, the uterus increases in a corresponding manner, and 
 its muscular structure is proportionately augmented. When, towards 
 the termination of gestation, the ovum has reached maturity, and the 
 organs necessary for the independent existence of the foetus 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 mammae, 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 volume 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 Schroeder 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 sufficient 
 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 becomes a new source of irritation to the uterine nerve-fibres. The 
 reflex action, in the form of labour-pains, becomes more and more 
 powerful, until these follow at last in rapid succession and 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 all 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 I [.—THE EXPELLING POWERS. 
 
 The expulsive force by which parturition is effected resides in the 
 unstriped muscular fibres of the uterus ; these cause the organ to con- 
 tract in a rhythmical and somewhat peristaltic manner, the contrac- 
 tions of the abdominal muscles and diaphragm being merely auxiliary. 
 The contractions of the uterus may take place although the organ 
 
THE EXI'ELLIXH I'OU'Kns IX I'AirrmiTlnX. 229 
 
 does not contain a foetus, and have been noted in extra-uterine 
 pregnancy, when they probably occur through sympathy. They have 
 been observed in the false gestation of the Bitch which has not really 
 conceived, but whose manimic enlarge, and which makes its bed and 
 exhibits other indications of approaching labour ; as well as in preg 
 nancies prolonged beyond their ordinary limit. 
 
 As the uterine contractions which lead to expulsion are usually 
 accompanied by a painful sensation (due to the pressure exercised on 
 the terminations of the nerves within the muscular fibres), they are in 
 common parlance designated "labour pains" {dolores ad j^arttun) ; 
 while the resistance they have to overcome is centred in the foetus and 
 its envelopes, as well as in the passages these have to traverse in order 
 to reach the external world. 
 
 Expulsion is not effected by one contraction, but by a series of con- 
 tractions ; between each of these there is an interval of apparent repose, 
 during which the organ seems to be gathering strength for a new effort. 
 As in almost all unstriped muscular fibres, the reflex action following 
 upon an irritation is slow and gradual, and, according to the degree 
 of irritation, of varying intensity and duration. At the commence- 
 ment, corresponding to the slight irritation, the contraction is feeble 
 and short, and the time required to obtain the necessary sum of the per- 
 sistent irritation for a new reflex action is comparatively long ; though 
 the uterine walls are not relaxed on their contents, but are maintained 
 in a certain state of contraction by the tonicity of their muscles. 
 
 When the pains are regular, there is also a certain gradation in each 
 individual contraction. Feeble at its commencement, it gradually 
 increases, the uterus becoming harder until the maximum of contraction 
 has been reached ; this persists for some time, and then as gradually 
 subsides. 
 
 As parturition progresses, and the separation between tlie uterus and 
 ftt'tus increases, the irritation becomes stronger, and the intervals 
 between the contractions shorter, while these latter augment progres- 
 sively in intensity and duration. The necessity for these intermissions, 
 particularly in the early stage of parturition, is obvious. They allow 
 the animal time to recover, to some extent, from the exhaustion they 
 occasion, and permit the genital passages to become gradually prepared 
 for the exit of the foetus through them ; while the latter can also 
 recover from the inconvenience it may suffer from the interruption 
 between it and the uterus during the pain, and especially towards the 
 termination of the act. 
 
 During each regular pain the whole of the uterus contracts, though 
 the fundus does so most energetically ; and the longitudinal fibres of the 
 organ are more particularly brought into play at the initial and middle 
 stage of parturition. The cornua likewise contract ; they are twisted 
 on themselves anteriorly, are shortened through the action of the longi- 
 tudinal fibres, and are brought nearer the body of the uterus, which is 
 also shortened ; and as this shortening is always taking place in the 
 direction of the cervix, it is here that the sum total of the expelling 
 force is centred ; and it is this force, commencing to operate at the 
 fundus of the organ, and exerted on the incompressible liquor amnii, 
 which gradually opens the os for the extrusion of the foetus. The 
 latter, with its envelopes, first acts as a stimulus to the uterus, but they 
 soon begin to play quite a mechanical part in the dilatation of the 
 already greatly shortened cer\-ix. The latter becomes thinner as the 
 
230 NORMAL PARTmiTIOX. 
 
 contractions force the bag of waters against it ; so that the os is gradu- 
 ally widened, and the cervix really becomes a part of the uterine cavity. 
 As soon as the os is slightly opened, the bag of waters enters it and acts 
 as a mechanical dilator ; then the lower parts of the fore limbs, 
 succeeded by the head of the foetus, are introduced, and from their 
 combined shape act like a wedge, until, by the eccentric pressure, the 
 chest is passed in, and the cervix being drawn over the presenting parts, 
 the OS is 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 Goat wheh the 
 uterus is pushed back, and its orifice is visible at the vulva. Irregu- 
 larity in the contractions, however, and particularly when they are 
 rendered so from a transverse position of the fcetus, delays the dilata- 
 tion, which is otherwise rapid according to their force and frequency. 
 At first the dilatation occurs very slowly, especially in primiparai ; and 
 when the foetus presents by the croup, or when the body of the uterus 
 inclines too much downwards, causing the cervix to bend up towards 
 the sacrum, it is also very tardy. As soon, however, as the mechanical 
 action of the water-bag and foetus 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 size, each having a foetus in the same 
 position as if 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, or even both, present posteriorly ; not infre- 
 quently the second makes a mal-presentation. When there are twins, 
 parturition is more difficult 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 
 reached, 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 are 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 
 is behind it, mechanically aiding in its expulsion. In the Mare, the 
 interval between the birth of twins is rarely more than ten minutes ; 
 with 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 ordinarily born before the other. When 
 the number of foetuses is greater, they are also expelled successively at 
 intervals of Pome hours. 
 
 In cases of superfoetation, if such an occurrence can take place in 
 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 foetus whose period for birth has arrived ; otherwise, the other 
 foetus would be expelled at the same time, and there would then be a 
 birth and an abortion. 
 
 With the small multiparous animals, in which the foetuses 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 
 
77/ /v HXl'i:LLISn POWERS IX I'lnTlTRITIOX. Ti\ 
 
 seKiiiont of one of the cornua nearest the cervix, then the next segment, 
 and so on until tlie one in proximity to tlie ovary is reached, so as to 
 j^'et rid of all successively — one cornu expelling a fcetus alternately with 
 the other ; the uterine contractions, although general, being most ener- 
 getic at the portions intermediate to the fcetuses. 
 
 The uterine contractions are very powerful, as anyone can testify 
 who has had occasion to introduce his hand into the uterus of one of the 
 larger animals during parturition ; and their force is not always related 
 to the general physical power of the animal — though they are always 
 m: ire energetic in the Mare than the Cow, as well as more continuous. 
 .\ )t iufrecjuently they are more powerful in weak-looking animals than 
 in those wliich are robust and vigorous ; and their energy depends 
 evidently upon the development of the muscular structure of the uterus, 
 and the potency of the sympathetic ganglia which stimulate it. Their 
 energy and frequency also often depend upon the duration of the 
 pains, and the existence of mechanical obstacles to the birth of the 
 fu'tus. 
 
 After the complete dilatation of the os, the third stage of delivery 
 begins, and the manner in which the uterus contracts is modified. 
 The resistance is no longer at the cei'vix, but in the uterus itself, being 
 due to the presence of the fcetus ; and now the circular as well as the 
 longitudinal fibres come into action simultaneously, in order to diminish 
 the uterine cavity and quite expel its contents. In this they are 
 greatly aided by the abdominal muscles and the diaphragm, which 
 until now could assist but little ; though the participation of these 
 does not appear to be absolutely indispensable, for birth may take 
 place without it. Nevertheless, it is a fact that, in diminishing the 
 abdominal cavity and pressing on its contents, these muscles concur 
 in pushing the fcetus in the direction in which least resistance is 
 offered — towards the pelvic cavity ; and as their contractions are 
 effective, so do those of the uterus, which are coincident with them, 
 become increased in power and frequency. The animal '* strains," as 
 in defecation or micturition, but with all its force ; and these throes, 
 which are involuntary to a great extent, and in which nearly all the 
 muscles of the trunk share, soon bring tlie act to a termination. 
 
 The fcetus itself has been sometimes regarded as the chief agent in 
 parturition, from the fact that this act is longer and more dilVicult 
 when the creature is dead, and that it has been expelled after the 
 mother has ceased to live. But it must be remembered that the move- 
 ments of the fcL'tus are very trifling, and of little importance when com- 
 pared with the resistance to be overcome at birth ; so that the young 
 creature must remain almost, if not quite, passive during the act. And 
 if this act is tardily accomplished when the fcetus is dead, the delay 
 may be due to the absence of stimulation or irritation in the organ, to 
 the uterus not having a fixed point to act upon, or perhaps even to a 
 local septosis or paralysis from the decomposition of the foetus. 
 
 With regard to expulsion of the futus after the death of the mother, 
 it must also be remembered that all the organs do not cease to live at 
 once, and that many continue to contract for some time after the 
 mother's heart has ceased to pulsate. Leroux has felt this organ con- 
 tracting a quarter of an hour after death, and after gastro-hysterotomy 
 on the dead human body it has been seen to contract as in the living 
 woman ; Haller has witnessed the contraction of the cornua of the 
 Cat's uterus, even when the organ was detached from the body ; and 
 
232 NORMAL PARTUEITIOX. 
 
 Colin states that he has observed the uterus of Sheep to contract for 
 forty and fifty minutes after death. 
 
 As we have said, the resistance which the expelling forces have to 
 overcome is constituted by the foetus and its membranes, and the 
 genital passages — the os uteri, vagina, vulva, as well as the pelvis and 
 soft parts covering and lining it. The fcetus participates in the resist- 
 ance by its volume, its form, its manner of presentation, its position, 
 the conformation and texture of the tissues which unite it to the 
 mother, etc. ; while the genital passages offer resistance from their 
 form, width, extensibility, and rigidity or softness. The faeces ac- 
 cumulated in the rectum, or urine in the bladder, sometimes increase 
 the resistance to be overcome. 
 
 In order that birth may be possible, the expelling force must be 
 greater than the resistance, and it is upon the relation between these 
 that the manner in which the fcetus is expelled will more particularly 
 depend, as well as the difficulty attending its expulsion and the time 
 required for the act of parturition. 
 
 We have only now to allude to the influence of the expelling force 
 on the foetal membranes. We have seen that these, which we may 
 now, with their contents, designate the " water bag," assist in dilating 
 the OS, and that the uterine contractions propel them further into the 
 vagina in the form of an elongated bladder partly filled with fluid. 
 This soon appears between the labia of the vulva as a round distended 
 tumour at the moment a pain occurs, but flaccid in the interval; and 
 not long afterwards as a somewhat voluminous pediculated tumour, to 
 which each pain adds a little more fluid, until at last the membranes 
 cannot resist the strain, and rupture ; when the allantoic, and then the 
 amniotic fluids escape from them, leaving a variable quantity in the 
 uterus ; some of this is discharged into the vagina at the termination 
 of each pain, and assists in lubrifying the mucous membrane and 
 aiding in the passage of the foetus. 
 
 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 
 that rupture is later in taking place, and it not unfrequently happens 
 that the Foal is born in them ; though the Calf, I believe, never is. 
 But thei'e are individual differences in this respect even, and in some 
 instances it will be found that rupture takes place at the commence- 
 ment of parturition, in others towards the end ; though when this 
 takes place late it is more favourable than when it occurs early, as the 
 amniotic fluid preserves the foetus from undue compression by the 
 uterus, while it powerfully aids in the progressive and regular dilata- 
 tion of the OS and vulva, and lubrifies the passages, thus diminishing 
 friction and protecting the maternal organs fri'in injury. When rupture 
 occurs too eai'ly, and before the foetus has been sufficiently expelled, 
 the parts become dry, and labour is always longer and more painful 
 and difficult for the mother, while it is often fatal to the foetus. 
 
 SECTION III.— SIGNS AND COURSE OF PARTURITION. 
 
 The physiological phenomena just alluded to, and by which the 
 foetus is born, are collectively designated as "labour." The entire 
 period of labour is, for facility of description and study, divided into a 
 certain number of stages or periods — usually three or four. These are : 
 
SIGXS AND COURSE OF PAnTClUTION. 23$ 
 
 1. Preliminari/ staijc ; 2. Dilatation of tlic os uteri; 3. Exptdsion of 
 thefntus; 4. Expulsion of tlic membranes. 
 
 1. Preliiniiiarif Stage. — Various precursory signs announce the 
 approaching termination of pregnancy and the advent of labour. 
 These may be observed some hours, sometimes even for days, before 
 that event occurs. 
 
 One of the most important signs is the enlargement and increased 
 sensibiUty of the mamma;, to which the excess of blood no longer 
 required in the uterus is directed. These glands become voluminous, 
 hard and tender ; and this phenomenon is more particularly remarkable 
 in those animals whose milk is not utilised after the young have been 
 weaned. The mammary glands then become soft, Haccid, and small, 
 and cease to secrete. In sucli animals as the Mare and VlwG, these 
 glands, ordinarily small and scarcely perceptible, before parturition 
 become so remarkably developed as to cause alarm in people who do 
 not understand the cause. With the Mare especially, the develop- 
 ment of the mammoD is sometimes so considerable, that the engorge- 
 ment extends along the inferior surface of the abdomen and simulates 
 oedema ; or it ascends between the thighs as high as the vulva as a 
 prominent ridge, while the skin in this region, if white, looks reddened. 
 At a later period, the teat yields a serous fluid on pressure, or this 
 constitutes a crust around it ; the fluid afterwards becomes somewhat 
 lactescent, and finally appears as the " colostrum " or first milk. 
 
 Another premonitory sign is the tumefaction of the vulva, increase of 
 the space between the labia, which become soft and flabby, while their 
 lining membrane is reddened, and a viscid glairy mucus covers it. This 
 mucus, derived from the va^'inal lining membrane, soon becomes so 
 abundant that it is discharged in long filamentous streams, particularly 
 in the Cow, and soils the tail and hocks ; it is destined to lubricate 
 the genital passages, and faciUtate the extrusion of tlie foetus. 
 
 With these changes the al)domen falls, or rather becomes more 
 pendent ; the croup looks hollow, as do the flanks, due to the relaxa- 
 tion of the broad ligaments. The spine, particularly in the lumbar 
 region, becomes more horizontal and rather inclines downwards, as if 
 yielding to tlie weight of the abdomen. The haunches appear to be 
 wider apart, and the gluteal muscles to subside, owing to the falling in 
 or modification of the sacro-sciatic, as well as the sub-sciatic, ligaments, 
 from serous infiltration. 
 
 The animal walks sluggishly and unwillingly, and if grazing witli 
 others does not appear to care about following tliem. Sometimes, as 
 has been mentioned, there is swelling of tlie limbs, particularly the hind 
 ones. 
 
 If very careful vaginal exploration be made at this time, it will bo 
 found that the cei-vix uteri has become a part of the uterine cavity and 
 is almost completely effaced, being reduced to merely a thin circular 
 ring ; its tissue is soft, and the os is slightly open in those animals 
 which have previously had young. 
 
 As parturition draws nearer, these phenomena are more marked. 
 The animal also begins to be restless, and continually agitated ; if feed- 
 ing, it stops for some moments, as if listening to some sound only 
 audible to itself, or as if experiencing some strange internal sensation 
 for the first time, and which may certainly be the preparatory or com- 
 mencing contractions of the uterus. Not unfrequently the animal lies 
 down and gets up again, as if suffering from colic. Some are quite 
 
234 NORMAL PAllTURITION. 
 
 mute, though anxious and uneasy ; while others, in addition to exliibit- 
 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 suiifering. 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 Kabbit — 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 : 
 pawing, 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 faeces 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 enlarged. Bach 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 fcetal membranes begin to be detached 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 
 of the foetus enter the os, and dilate it to its fullest extent, when the 
 cavity of the uterus forms a canal continuous with the vagina. 
 
 3. Expulsion of tlie Foetus. — The 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 under 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 
 muscles of the trunk, it brings such an amount of pressure to bear on 
 the foetus as to propel 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 foetus, nor yet an 
 easy birth. 
 
 The water-bag soon ruptures, and its contents partly escape — that 
 behind the thorax of the foetus being i-etained, and voided only in small 
 quantity as the uterus contracts. When 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 primiparae, though it is sometimes observed in 
 protracted labour, which is the most painful. In general, however, no 
 harm results from this premature rupture if parturition is not too long 
 
siGXS Axn corns E of r.i/rrrniT/o.v. 235 
 
 delayed ; indeed, in some cases it may be useful, as when the uterus is 
 over-distended with fluid — in hydramnios, for example — wlien its dis- 
 charj^e allows the or^an to contract more freely. In other instances the 
 membranes are remarkably strong and resisting', and withstand the con- 
 tractions for a long time after they have been extruded beyond the vulva ; 
 their artificial rupture may even be required. Sometimes they do not 
 rupture at all, and the fcttus is born in them, or even after them, as has 
 occurred in the Cow. The rupture usually occurs at the most dependent 
 part of the bag — at the uterine orifice, towards the os, or in front of it. 
 Then succeeds a brief interval of (juiet— the foetus being meanwhile 
 retained in the uterus — during which the organ is closely applied to the 
 body of the fii-tus. and is preparing itself for a final effort, which is soon 
 made. The contractions are most energetic and rapid, and every time 
 they are made the waters flow in small quantity, moistening and relax- 
 ing the parts ; the fcrtus passes on until the fore feet and muzzle, form- 
 ing a kind of cone, appear at the vulva, the orifice of which is opened 
 by them. When the head has cleared the vulva, there is usually a 
 short pause, as if to allow the tissues of this region to become accus- 
 tomed to the distention, and to prepare them for the still greater strain 
 which is yet to be imposed on them. The thorax and shoulders of the 
 fietus have now arrived at the inlet of the pelvis, and as they form the 
 deepest and most diflicult part of the young creature's body, the con- 
 tractions which ensue for its complete expulsion, though most powerful 
 and continuous, only impel it slowly towards the outlet, on arriving at 
 which a more energetic and painful effort than all the others pushes it 
 through. The act may now be said to have terminated ; as to expel 
 the croup requires only a few comparatively weak throes, and the weight 
 of the anterior part of the body of the foetus, hanging beyond the vulva, 
 greatly aids them. It is rare indeed that the croup offers a serious 
 obstacle to expulsion. 
 
 During this act the creature betrays evidence of pain, especially if it 
 be a primipara : and this is particularly marked when the head of the 
 f(rtus passes through the, as yet, incompletely dilated os, and still more 
 so when the chest and shoulders strain the textures of the vulva and 
 perinipum to the utmost. Then the pulse is hard and frequent, and the 
 skin hot — sometimes covered with perspiration — or the body is rigid. 
 The Hitch and Cat often utter a cry of pain as the head and chest pass 
 through the vulva. 
 
 After the young animal is expelled, the umbilical cord is torn, and 
 the liquor amnii remaining in the uterus escapes, accompanied or 
 followed by a little blood resulting from the sudden separation of the 
 placenta?. 
 
 The position assumed by animals during parturition is somewhat 
 variable. The larger animals which usually only bring forth one at a 
 birth, such as the Mare, Cow, and Sheep, ordinarily do so standing ; 
 and this position has the following advantage : The vertebro- sacral 
 angle is ettaced, and the obstacle that its projection might offer to the 
 passage of the foetus into the pelvis is diminished ; the auxiliary 
 muscles — abdorninal and diaphragmatic — can act more energetically ; 
 the young creature, being sustained by the umbilical cord when it has 
 cleared the vulva, glides gently on the half-flexed hocks of the parent, 
 and so reaches the ground without injury (Fig. (39). 
 
 Such an attitude, however, is far from being constant with these 
 
236 NORMAL PARTURITION. 
 
 animals ; and very often, especially with the Cow, they bring forth in a 
 reclining position — maintained from the very commencement of the act, 
 and only rising when birth is completed (Fig. 70). These cases, which 
 are quite natural, though debility may be present, offer nothing par- 
 ticular in the position of the female — it being merely that assumed on 
 ordinary occasions, though, of course, parturition is more difficult. 
 
 The animal rests on the sternum, the body inclined to the right or 
 left side, the fore limbs 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 
 hind feet, 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 THE Act of Parturition : Standing 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 effaced, and the young being spared the risk of falling ; in 
 addition, each foetus as it issues from the vulva is within reach of the 
 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, 
 in order to soothe it while another is born. It may be remarked that, 
 with the Sow, the young creature is expelled with such force from the 
 vulva that it often turns a somersault. It may also be observed that, 
 with the small multiparous animals the "water-bag" usually only 
 appeal's 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 accidental circumstances, individual peculiarities, and 
 species, but even in the same animal at different births. With the 
 
 1 
 
S/';\s JXD COURSE OF rARTunTTToy. 
 
 •J37 
 
 Mare it is usually brief, and is ordinarily accomplished in about ten 
 minutes, sometimes in live — tliouj^h it may extend to a quarter or half 
 an hour, rarely more. This rapidity appears to be due to the fact tliat 
 tlie placenta is detached from the uterus during the early pains, and 
 consequently the ftrtus cannot live long after this occurs — three hours 
 being supposed to be the limit — unless it can breathe by the lungs. 
 The duration in the Cow is, on the average, one to two hours ; though 
 it may only be a few minutes to half an hour, or be extended, without 
 injury to the Calf, to one or two days. With Cows at pasture or which 
 do no work, it is sometimes only fifteen minutes. With the Sheep the 
 period is also brief, being about fifteen minutes. If there are several 
 Lambs, there is usually an interval of fifteen minutes to two hours 
 between them — the second and succeeding births being always quicker 
 than the first. 
 
 With multiparous animals — Sow, Bitch, and Cat — there is ordinarily 
 a period of ten or fifteen minutes, and sometimes half an hour, an hour 
 
 Fig. 70. 
 M.MiK IS THK Act ok Parturition : Rkcimrest Po.sition. 
 
 or even more, between each birth. Not unfrequently the Sow will 
 bring forth ten young ones within the course of an hour. 
 
 We have mentioned that with those animals which are delivered in 
 a standing position, the umbilical cord is ruptured when the young 
 creature reaches the ground, and usually close to its abdomen. If the 
 mother is recumbent when the olVspring is born, the cord is torn as she 
 gets up, which is usually immediately after parturition. The circula- 
 tion in and by the cord being incomplete shortly before and during 
 labour, its texture appears to undergo a kind of softening that favours 
 rupture ; while owing to the vessels being reduced in size, and also the 
 way in which their rupture occurs, hjrmorrhage is trifling. Sometimes, 
 however, the cord is sutViciently strong and elastic to resist spontaneous 
 rupture, and the young creature is born with the membranes attached 
 to it by means of this bond of union. The mother then, by a remark- 
 able instinct, in cleansing the young creature with its tongue, gnaws 
 through the cord and sets free its progeny. The Mare and Cow have 
 been known to do this at times ; otherwise it is usual with the 
 Carnivora. 
 
 Whether the cord be ruptured spontaneously or gnawn through by 
 
238 NOIIMAL PARTURITION. 
 
 the parent, there is nothing to be feared from haemorrhage from either 
 the foetal or placental end ; for, contrary to what is observed in the 
 human species, the blood has very little tendency to flow from the 
 umbilical vessels, and the laceration and cold soon check any slight 
 escape. But it may sometimes happen that it is necessary to divide 
 the cord at a short distance from the 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 apprehend from 
 bleeding. Eainard, in thirty years' experience, and other authorities, 
 has never observed any harm to result ; and the cases in which there 
 was danger are certainly very few. Eainard quotes from Brugnone, 
 that Beranger of Carpi has seen Horse and Ass Foals perish from 
 haemorrhage, through the cord having been cut and no ligature applied; 
 and Peuch has 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 
 check this escape, and it was necessary to fix a compress, steeped in 
 perchloride of iron, along the course of the cord before the haemorrhage 
 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 umbilicus. 
 Whether 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 mem- 
 branes, which immediately after parturition protrude from the vagina. 
 
 4. Expulsion of the Membranes. — The expulsion of the foetal mem- 
 branes, or " afterbirth," as they are sometimes designated, may occur 
 at birth, immediately after, or be delayed for a variable period — this 
 depending not only upon accidental circumstances and individual 
 peculiarities, but also upon species, and, consequently, the placental 
 connections. 
 
 Immediately after the foetus is expelled, the uterus contracts and 
 retracts energetically on itself, and its internal capacity rapidly 
 diminishes ; consequently, the placental villosities are detached from 
 their alveoli, the uterine and chorionic surfaces become wider apart, 
 and the placenta is ultimately separated from the uterus. The same 
 contractions which loosened them are also instrumental in forcing the 
 membranes through the gaping flaccid os into the vagina; and the 
 auxiliary muscles, being again stimulated by their presence here, as 
 they were by the head of the foetus in the same passage, add their 
 powerful contractions ; so that these new pains, aided by the physical 
 weight of the extruded portion with its appended umbilical cord, soon 
 bring the whole mass away. The contractions of the vagina have 
 probably little, if anything, to do with this expulsion, which is rarely 
 followed by haemorrhage in animals ; though in woman, owing to the 
 inertia of the uterus, this accident is not at all uncommon. Sometimes 
 the expulsion of the membranes is expedited by the young creature as 
 it descends from the vulva. 
 
 With the Mare, owing to the disseminated placenta and the slight 
 adherence of the placental villi, the separation of the membranes takes 
 place rapidly ; indeed, the Foal is not infrequently born in the intact 
 envelopes. But generally only a few minutes elapse before the after- 
 birth is detached. Eetention of the placenta is therefore exceedingly 
 rare in the Mare, though it is very dangerous ; as in attempting to 
 remove it there is great risk of hajmorrhage. 
 
s/t.w's .tx/) vurnsE uf /•.urrrnjTiox. 2.Ji> 
 
 With the Cow, because of the multiple placentubri, the number of 
 which may be over a hundred, the adhesion between the uterus and 
 fa'tal membranes is very intimate ; while the small volume of the 
 cotyledons offers but little surface for the uterine contractions to act 
 upon. So that while it happens that tlie Calf is never born in its intact 
 envelopes, it is also the case that the afterbirth is only slowly and 
 tardily extruded — two, four, or more hours, or even days, being required ; 
 and, indeed, it is not at all rare for retention to occur in this animal, 
 and the envelopes require to be removed artificially. 
 
 Multiparous animals get rid of the envelopes as they expel the 
 fcjetuses, the birth of the first being followed in a very brief space by its 
 membranes ; after which comes the second fcetus, then its envelopes, 
 and so on ; so that only those of the last foetus may be retained — an 
 accident which sometimes occurs. In these animals, the membraues 
 appear to be expelled without any difficulty ; the Bitch, for instance, 
 runs into a corner, and assuming a position as if about to micturate, 
 expels the secundines of the last puppy, devours them, and returns to 
 the other puppies. 
 
 With animals usually uniparous, but which sometimes bring forth 
 two or more young, the envelopes of each foetus are expelled imme- 
 diately after it is born, so long as they do not offer an obstacle to the 
 passage of the next foetus ; so that in a double birth in the Cow or 
 Ewe, a foetus being lodged in each horn, the second may be born 
 without the envelopes of the first having been discharged. 
 
 We may here note the strange instinct which impels not only carni- 
 vorous and omnivorous, but also herbivorous animals — Bitch, Cat, Sow, 
 Cow, and even sometimes the Mare — to devour the membranes as 
 soon as they are expelled, if they are not quickly removed from beyond 
 their reach ; at times they even devour them as they are being 
 extruded, and the work of delivery is thus hastened. However un- 
 natural and disgusting this propensity may appear, and though the 
 cause for it is unknown, it does not occasion any visible inconvenience 
 to the animal 
 
 It has been already remarked, that when the young creature is 
 expelled in its intact envelopes, the mother, if at large, frees it from 
 them by gnawing them through ; more rarely does the progeny release 
 itself by its own efforts. If the mother should chance to be tied up, 
 as in a stall, assistance may be required to cut the umbilical cord and 
 extract the young animal from its imprisoning membranes, else it may 
 become asphyxiated. This peculiarity is most frequently observed in 
 the Mare, with which birth is always rapid, and the cliorion strong 
 and easily detached from the uterus. Rueff states that it is not unusual 
 in the Sow. 
 
 Cri.\PTER II. 
 Presentations of the Foetus and Mechanism of Parturition. 
 
 In addition to, and to a certain extent independent of, the physiological 
 phenomena of gestation and parturition, there are in the latter certain 
 l)hysical and mechanical acts which have been, as Saint-Cyr remarks, 
 liitherto very imperfectly studied in veterinary medicine, but the con- 
 
240 
 
 NORMAL PARTURITION. 
 
 sideration of which is, nevertheless, very important from a practical 
 point of view. 
 
 These acts are related to the manner in which the foetus presents at 
 the pelvic inlet for passage through the outlet, and the way in which 
 this passage is effected ; they belong, in fact, to the presentations and 
 positions of the foetus, and the mechanism of parturition. 
 
 The presentations and positions of the foetus during parturition, as 
 well as the mechanism of that act, are of much practical importance 
 to the veterinary obstetrist, and demand careful consideration. Allusion 
 has been repeatedly made to the position of the foetus in the uterus 
 during gestation, and to the fact that this position is changed as par- 
 turition draws near. 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 foetus to assume, towards 
 
 Fig. 71. 
 Normal Position of the ra:TDs in the Make at Parturition (First Stage). 
 
 the termination of pregnancy, the position most favourable for its exit 
 through the pelvic cavity ; though it is indeed very questionable whether 
 the instinctive faculties of the young creature are already sufficiently 
 developed to bring about this result, which may, after all, be due to 
 some reflex action. However this may be, it is certain that the foetus 
 is very far from being always in this favourable situation, and that the 
 resources of art are often needed to remedy the false positions the 
 young creature may have assumed at the termination of pregnancy. 
 
 In studying the various positions and attitudes the foetus assumes 
 at birth, and the consequent presentations it offers towards the anterior 
 opening of the pelvis, there are to be considered: (1) the region of its 
 body which is first presented to the pelvic inlet, and (2) the relations 
 of, or correspondence between, this region and the shape and dimen- 
 sions of the pelvic cavity itself. 
 
 The first has been designated the presentation, and the second the 
 position of the foetus ; and the inlet, instead of the outlet, of the pelvis 
 
PRESENTATIOXS OF THE FCETUS. 
 
 '241 
 
 is considored in this respect, because it is the most important in practice, 
 unil the position may be altered either spontaneously or artificially 
 iluring labour ; indeed, this alteration has often to be effected by the 
 obstetrist in order to render birth possible. 
 
 SECTION I.— rilESENTATlONS. 
 
 The presentation results from the part of the fa^tus which first offers 
 itself at the pelvic inlet — that re^'ion of the young creature which the 
 hand of the obstetrist immediately meets on being passed into the os, 
 and which is directly opposite the inlet. In this sense the head, fore 
 feet, hind feet, croup, etc., are said to be presented, according as one or 
 other of them first offers itself on exploration. 
 
 These presentations are extremely varied, as any part of the foetus 
 
 Fig. 72. 
 
 Normal Position oi- the Kams i.\ tub Make at rARTURiTiON (Second Stage). 
 
 a. Allantoic ; b. Amnion. 
 
 may occupy this situation ; though so far as description and compre- 
 hensibility are concerned, their study can be greatly simplified. As 
 Hainard says: "The futus, when covered by its envelopes, is oval 
 shaped, or like an olive which it is desired to pass down the neck of 
 a bottle, and which may be presented to this in three ways — either by 
 one of its two ends or by its middle." These ends are the anterior 
 part of the chest in front, and the croup behind ; and it is these parts 
 on which the classification of the presentations is based. This classi- 
 fication gives two lonfjitudinal, or an anterior and posterior presentation ; 
 and as the foetus may also offer itself across the long axis of the 
 uterine cavity, we have a transverse presentation, which may again be 
 dorso-linnbar or sterno-ahdominal, according to the side of the fcRtus 
 which presents. These four fundamental presentations are, therefore : 
 1. Anterior Presentation. — The chest of the foetus presents towards 
 
 16 
 
242 NORMAL PARTURITION. 
 
 the inlet, and is preceded, accompanied, or followed by the head and 
 fore limi)S : the situation and direction of which may vary without 
 altering the essential features of the presentation. 
 
 2. Posterior Presentation. — The croup or breech is facing the inlet, 
 and the presence or absence of the limbs there only constitutes a variety 
 of the presentation. 
 
 3. Dorso-lwnbar Presentation . — Any portion of the upper part of the 
 body opposite the inlet. Lecoq and Eainard admit presentations of 
 the withers, back, loins, shoulder or haunch, as distinct presentations ; 
 but I agree with Saint-Cyr in declaring the distinction to be practically 
 useless. On exploring the pelvic cavity, no matter what part of the 
 back is first touched, the hand always encounters the spine of the 
 foetus, 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. Sterno-abdominal 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, which is the 
 inferior part of the body — or sterno-abdominal region — hence the 
 designation. 
 
 These four principal presentations have been divided into natural or 
 normal, in which spontaneous or unaided birth is possible ; and into 
 connatural 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 difficult to 
 overcome, and requires the aid of art. In the anterior presentation. 
 the head passes before the body, but in the posterior presentation it 
 follows the body ; in the former presentation the extended fore limbs 
 accompany the head, as there is space for them, for the diameter of the 
 chest being 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 the 2)osterior j^resoitation 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 he simple, or more or less comj)! icated , 
 according to circumstances. 
 
 SECTION II.— POSITIONS. 
 
 The presentation being determined by the part of the foetus which 
 offers 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 foetus 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 
 the sternum to the pubis, or the reverse msij happen ; in another the 
 foetus may be lying on the right side, the sternum corresponding to^ 
 the right branch of the mother's ilium, and the withers to the left 
 ilium, or vice versa. So that here are four different positions in the 
 same presentation — the anterior; and it will readily be understood 
 that it should be the same, or nearly the same, for the other presenta- 
 tions. 
 
POSITIONS OF THE FOiTUS. 
 
 243 
 
 Tlie position has accordingly been defined to be the relation of a 
 determinate point on the surface of the foetus, to an equally determinate 
 point of the pelvic circumference. The poiuts, so far as tlie mother is 
 concerned, may be determined once for all, and they will always remain 
 the same for every presentation ; they may be, for instance, the sacral 
 region above, the pubic below, and tlie two ascending branches of the 
 ilium at the sides. If with the fcctus we select any region — say the 
 withers — and put this part in relation with any of these four points of 
 the pelvic circumference, we shall have four successive and easily 
 recognised positions. If, therefore, we first give the name of the region 
 in the ftctus, and next that of the pelvic circumference with which it is 
 in relation, we have a ready means of designating the positions — de- 
 
 Fig. 73. 
 
 Normal Position ok the Futis i.v thk Mark (Thiri) Sta(;k.). Dobso- 
 SACKAL Position. 
 
 scribing the fcetus to be in a vertebrosacral position, for instance, when 
 its vertebral region is in relation with the micrum of the mother. The. 
 fixed points may be invariable in the latter ; but they cannot be so with 
 the fcctus, as they will vary with each presentation. 
 
 With regard to the anterior and posterior presentations, Rainard has 
 selected the fixed points as follows in tlie loiujitudiual presentations : 
 for the first, he has taken the spinous processes of the dorsal vertebra; 
 in th(! region of the withers ; for the second, the lumbar vertebra\ 
 For the positions in the other two presentations, he has not been so 
 fortunate in a designation, in the opinion of Saint-Cyr, who has very 
 judiciously proposed others which are more explicit and comprehen- 
 sible. The latter gives the various positions which should be recognised 
 in each presentation, as follows : — 
 
 , A. Anterior Position. — The chest of the fatus is at the pelvic 
 inlet, and it is desired to make known what relation this part has to 
 
244 
 
 NOllMA L PA n TU HIT ION. 
 
 the pelvic circumference. The determinate point on the foetus is the 
 vertebrae of the withers ; and these may be in relation with the sacrum 
 above, the pubis below, the right ascending branch of the ilium on the 
 right side, and the left ditto on the left. From this we have four 
 positions, named by Saint-Cyr as follows : 
 
 1. Dorso-sacral Position (Vertehw-sacral Position of Eainard, Fig. 73). 
 — This is the most favourable and the most frequent of all, and is said 
 to be the only natural position. The vertebrae of the foetus correspond 
 to those of the mother, 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 the yirs^ anterior j^osition, while 
 its sterno-dorsal diameter corresponds to the sacro-pubic diameter of 
 the parent (Fig. 74 a b). 
 
 2. Dorso-intbic Position {Vertebro-pubic Position of Eainard). — This is 
 exactly the inverse of the first : the foetus lying on its back, its withers 
 
 Fig. 74. 
 
 Diameters of the Pelvis. 
 
 a b, Superoinferior, oi- Sscro-pubic Diameter ; c d, Superior Bis-iliac Diameter ; 
 ef. Inferior Biis-iliac Diameter; ei,J'h, Oblique, Ilio-sacral, or Sacro-iliac 
 Diameters ; J K, ISIiddle Diameter. 
 
 towards the pubis, and the sternum opposed to the sacrum of the female. 
 This is also named the second anterior position. 
 
 3. Bight Dorso-ilial Position (Bight Vertehro-ilial Position of Bainard). 
 — The foetus lies in the left flank, 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 foetus corresponds to the 
 bis-ihac diameter passing through the centre of the pelvis (Fig. l-i,j k). 
 tlie 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 flank of the mother. 
 
 4. Left Dorso-ilial Position {Left Vertebro-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 j^ositions. 
 They are less frequent, as primary positions, than the first two, and 
 
posiTioxs OF mi-: fu-jtus. 
 
 24 r. 
 
 are sometimes met with as secondary positions after the reduction of 
 a inal-presentatiou — cliielly the dorsal or ventral. 
 
 lu addition to these anterior positions, Saint-Cyr gives other four 
 intermediate ones whicli may be observed wlien the sterno-dorsal 
 diameter of the fa'tus corresponds to the oblique diameters of th(! 
 pelvis (Fig. 74, c i, f h). These are as follows : 
 
 o. Bight Dorso-ilio-sacral Position. — This is the intermediate posi- 
 tion between the dorso-sacral and right dorso-ilial, the withers being 
 in relation with the right ilio-sacral articulation. 
 
 G. Left Dorso-supra'Cotyloid Position. — This, again, is intermediate 
 between the dorso-pubic and left dorso-ilial position, and quite the 
 reverse of the preceding ; the withers are inclined downwards and to 
 
 Fig. 75. 
 
 LfMBO-SACRAL Po.smON. 
 
 the left, above the cotyloid cavity, while the sternum lies towards the 
 sacro-iliac articulation. 
 
 7. Lc/t Dorso-ilio-sacral Position. — Here the position is intermediate 
 between the dorso-sacral and left dorso-ilial. 
 
 8. Iii(iht Dorso-supra-cotyloid Position. — This is the reverse of the 
 preceding. 
 
 The dorso-sacral and the two dorso-ilio-sacral positions are quite 
 natural, as during parturition the curving of the body of the foetus 
 corresponds to that of the mother's body, while the superior diameters 
 of the tirst — the ccrvico-biscupulo-hnmeral and hicoxo-frmoral — which 
 are the greatest, are related to the superior bis-iliac diameter of the 
 pelvis. The two dorso snpra-cotyloid positions are, on the contrary, 
 reversed and abnormal, like the dorso-piibic, because the curved con- 
 dition of the body of the foetus is the reverse of that of the body of 
 the parent, as well as opposed to the direction of the axis of the pelvis ; 
 
246 
 
 NORMAL PARTURITION. 
 
 SO that the foetus experiences much difficulty in moving along. The 
 relations are still more reversed between the transverse diameters of 
 the foetus and those of the pelvis when the first correspond to the 
 inferior bis-iliac diameter of the mother. 
 
 Positions in the Posterior Presentation. — In this the croup or 
 breech first presents at the pelvic inlet. The lumbar region of the 
 foetus, which is the determinate point, may be directed towards the 
 sacrum, the pubis, or the right or left branch of the ilium of the 
 
 Fig. 76. 
 Right Cephalo-ilial Position in the Dorso-lumbar Presentation. 
 
 female towards the oblique diameters of the pelvic cavity. Hence we 
 have eight positions, as in the preceding presentation. These are : 
 
 1. Lumbosacral Position. — The foetus is in what some authorities 
 have called a " natural " position (Fig. 75), but which is asserted by 
 others to be unnatural. The loins are towards the sacrum of the 
 mother, the right coxo-femoral articulation towards the right ilium, 
 and the left articulation towards the left ilium. This is sometimes 
 named the first j^osterior position. 
 
 2. Luviho-jxuhic Position. — Some practitioners designate this the 
 posterior reversed position. The foetus is lying on its back, its croup 
 and loins corresponding to the pubis of the mother, while the limbs 
 
POSITIONS OF THE F(ETUS. 
 
 247 
 
 are towards the sacrum, aj^ainst which they are more or less pressed. 
 This is sometimes termetl tlio second posterior j)06ilion. 
 
 3. liiijht Lninho-Uial rosition. — The fa'tus is lyinj^on the right fhmk. 
 its croup and /<)/;/,s opposite the asceudinj^ branch of the right iHum of 
 the female, and the hmbs towards the left Hank of the mother, where 
 they must be sought for if they do not present in the pelvis. 
 
 4. Left Lumbo-ilial Position. — This is exactly the reverse of the 
 preceding position. 
 
 5. liiijht Lumho-ilio-sacral Position. — This is intermediate between 
 the lumbo-sacral and the right lumbo-ilial positions, the lumbar region 
 being towards the right ilio-sacral articulation. 
 
 6. Left Liimbo-supra'Coti/loid Position. — This is also intermediate 
 between the lumbo-pubic and left lumbo-ilial position, being the reverse 
 of the preceding, as the withers are at the other extremity of the same 
 obliiiue diameter. 
 
 Fig. 77. 
 Ceph.\lo-sacr.\i. Position in the I)on.so-i.uMB.\K Tkicskntation. 
 
 7. Left Lumho-ilio-siicral Position is intermediate between the lumbo- 
 sacral and left lumbo-ilial positions. 
 
 H. Jiight L umbo -supra -cotyloid Position is the opposite of the 
 ]M-eceding. 
 
 The lumbo-sacral and lumbo-ilio-sacral positions are the same as 
 their corresponding anterior positions, and therefore natural ; but the 
 lumbo-pubic and lumbn-supra-cotifloid are, on the contrary, the reverse 
 of these, and an- accordingly abnormal, while the luniho-ilial, like the 
 dorso-ilial, hold tln' middle place with regard to facilities and diOiculties 
 in parturition. 
 
 Positions in the Dokso-lumhau Pkesentation. — Here the fcctus 
 is presented across or trdn.srcrse, 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 the fatus 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 
 
 NORMA L PJ nTUniTIOX. 
 
 Fig. 78. 
 Cephalo-sacral Position in the Dorso-lujibar Presentation. 
 
 Fig. 79. 
 Left Cephalo-ilial Position in the Steeno-abdominal Presentation. 
 
rosiTioxs OF THE FO-yri's. 219 
 
 the abdomen of the mother, and the creature in the attitude of a Dog 
 sitting. 
 
 Tlie important consideration in tiiese three positions is related to 
 the situation or direction of the liead ; if this is known, it is easy to 
 infer that of the other parts of its body, and thus appreciate the in- 
 dications for delivery to bo followed in this presentation. According 
 to the direction of the head, the three following positions are described : 
 
 1. Right Ct'pluilo-ilial Position. — The fu'tus is on its right side, which 
 rests more or less directly on tlie abdominal walls of the mother, the 
 head in the right tlank, the croup towards the left Hank, the body more 
 or less curved, and the dorso- lumbar region towards the pelvis, in which 
 it presents (Figs. 70, 77). 
 
 2. Left Ccphalo-ilial Position. — This is the reverse of the preceding. 
 
 3. Ccphalo-sacral Position. — In this position the foetus presents by 
 the back, and in an almost vertical 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 Stkhno-ahdominal Pkkskntation. — In this trans- 
 verse presentation the foetus otTers the abdomen to the inlet of the ))elvis, 
 and on deep exploration the hand first meets this part, and perhai)s two 
 or more of the limbs, generally a hind and a fore one. The head may 
 be found (Fig. 79), or it maybe out of reach; or the head and limbs 
 may be doubled back, so that no part of the creature has entered the 
 vagina, though the sternum and other parts on the lower surface of the 
 body can be felt. 
 
 In this presentation there are three principal positions : — 
 
 1. Left Ccphalo-ilial Position. — The fa'tus lies on the right side, the 
 head towards the left ilium of the mother, and the croup to the right 
 ilium (Fig. 79). 
 
 2. liitjht Ccphalo-ilial Position. — This is the reverse of the preceding. 
 
 3. Cephalo-sacral Position. — In this position the fu-tus is vertical, the 
 croup being downward ; but the abdomen and sternum are towards the 
 pelvic inlet, all the limbs being directed towards tiie 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 these transverse positions are abnormal and dystokial. 
 
 SaintCyr, who has mainly followed Rainard in the definition of these 
 presentations and positions of the fa-tus, 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 diOiculties 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 dififerent presentations and positions : 
 
250 NORMAL PARTURITION. 
 
 /"Longitudinal 
 
 Ph 
 
 I'Dorso-sacral. 
 
 I Right Dorso-ilio-sacral. 
 /'Natural Positions -' Left Dorso-ilio-sacral. 
 I Right Dorsoilial. 
 
 Anterior J VLeft Dorso-ilial. 
 
 I r Right Dorso-supra-cotyloid. 
 
 ^Abnormal Positions^ Left Dorso-supra-cotyloid. 
 
 [ Dorso pubic. 
 
 ?Lumbo-sacral. 
 
 I Right Lumbo-ilio-sacral. 
 'Natural Positions -; Left Lumbo-ilio-sacral. 
 Right Lumbo-ilial. 
 
 /'Natural Positions -; J 
 
 ^PosteriorX vLeft Lumbo-ilial. 
 
 I i Right Lumbo-supra-cotylold. 
 
 lAbnormal Positions- Left Lumbo-supra-cotyloid. 
 I Lumbo-pubic. 
 [ Right Cephalo-ilial. 
 [ Dorso-lu7nhar — Abnormal Positions - Left Cephalo-ilial. 
 .Transversei ^ Cephalo sacral. 
 
 I r Right Cephalo-ilial. 
 
 yStcrno-abdominal — Abnormal Positions - Left Cephalo-ilial. 
 
 \ Cephalo-sacral. 
 
 The longitudinal presentations, with natural positions of the trunk of 
 the foetus, do not necessarily imply an easy birth, as, independently 
 of disproportion between the dimensions of the passage and those of the 
 foetus, there may be a misdirection of the head or Hrabs, which would 
 constitute dystokial presentations. 
 
 SECTION III.— MECHANISM OF PARTURITION. 
 
 Under normal conditions, it may be said that the pelvis itself does 
 not offer any obstacle to the passage of the fa3tus, and that it is the soft 
 parts alone which oppose its exit. 
 
 Of the different presentations enumerated, the anterior — in which the 
 fore feet, head, and chest present simultaneously-^is the only one we 
 may designate as " natural," especially with the larger animals and 
 primiparae. 
 
 Fromage de Feugre 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 
 fore limbs, head only, and hind limbs 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 in 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 difficult 
 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 foetus 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 primiparae) in which even slight traction is necessary. 
 
 We will follow Saint-Cja- in first studying the mechanism of parturi- 
 tion in this presentation, in which, of the eight positions pertaining to 
 it, the vertebrosacral is by far the most frequent and favourable. This 
 we will now notice. 
 
M ECU A MS. M or I'AirrriilTKiX. 251 
 
 Make. 
 Anterior Presentation. 
 
 1. Mechanism of Parturition in the Dorso-sacrai Positio)i. — In 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. Wlien perfectly natural, the head 
 and fore lej,'s first enter the inlet ; the head is extended, forehead look- 
 ing upwards to the sacrum, cliin towards the pul)is, nose forward, the 
 lower 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 dilViculty, as tlie pelvic diameter readily admits 
 them when the soft parts are sufficiently relaxed. With the chest, how- 
 ever, there is dilliculty, as its diameter is greater than that of the pelvis; 
 and the question is, therefore, how it is got through the canal. In 
 1870, Saint-Cyr saw four well-bred iiarness and saddle Mares give 
 birth to Foals at the Lyons Veterinary School. (Jestation had been 
 regular, and parturition, which was easy and favourable, did not exceed 
 tlie ordinary duration. In taking the diameters of the maternal pelvis 
 by the method already described, and those of the fcetus (dorso-sternal, 
 biscapulo-humcral, and bicoxo-femoral), it was found that in these four 
 instances the biscapulo humeral diameter — the largest in the chest — was 
 easily accommodated in the bis-iliac diameter of the female pelvis, which 
 was greater by i'2, 45, -48, and even 52 millimetres (from li to 2 inches) ; 
 while the sterno-dorsal diameter of the young creatures exceeded that 
 of the sacro-pubic region in the mothers by 2.S, 85, 87, 88 millimetres 
 (from 1 to S\ inches). This part of the body of the foetus 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 of the 
 lateral diameter of the pelvis, it will be found that the thorax and withers 
 of the fu'tus still notably exceed in size theoj)ening through which they 
 must pass. That they do pass through it, and with ease in the majority 
 of cases, without injury to the mother or the young creature, is a matter 
 of daily experience ; but the mechanism by which the reduction is 
 effected has been much discussed. 
 
 Lafosse endeavoured, in the last century, to describe it, and came to 
 the conclusion that the head once through the inlet, the shoulders of 
 the Foal, 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 
 sacnnn ; also that the spinous processes of the withers, wliieh are almost 
 cartilaginous, bend back on eacli other, and to right and left of the spine, 
 thus preventing too great compression of the chest. Altogether, he con- 
 cluded that the Foal in its passage becomes moulded in such a manner 
 that 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, the internal contour 
 of whicli it assumes. 
 
 Rainard, however, takes a slightly different view of this matter ; for 
 while admitting, with Lafosse, the inclination backward of the dorsal 
 spines as a tirst cause in diminishing the vertebro-sternal or perpendi- 
 cular diameter of the thorax, he cannot admit that the upper border of 
 the scapuUr lie against the neck, but states that theshoulders, on arriv- 
 
252 NORMAL P ART U HIT ION. 
 
 ing at the pelvic entrance, come in contact with the ascending branches 
 of the ihum, and are thrown back somewhat, leaving 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 Eainard 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 this not only 
 diminishes the chest in a vertical, but also in a horizontal direction, 
 as is witnessed in studying the mechanism of respiration in the 
 living animal, in which, during 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 being 
 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 a moderate amount of pressure, pro- 
 vided it is not too long continued, may be borne with comparative 
 impunity. 
 
 In the larger animals, the pelvis cannot undergo any sensible in- 
 crease in size during the passage of the deepest portion of the foetal 
 body through the inlet, which is, in the Mare, an absolute inextensible 
 bony girdle. Lafosse has sawn through the pubes of Mares about to 
 foal, 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 
 foetus which has to accommodate itself to this part of the passage at 
 this stage of delivery. 
 
 When, however, it has passed through the inlet, extensibility of the 
 maternal tissues can, and does, take place, and permits an enlargement 
 of the canal. The wide sacro-sciatic ligaments which enclose the pelvis 
 laterally, are softened and more elastic during birth ; the sacro-iliac 
 and sacro-lumbar articulations are increased in mobility ; and even the 
 posterior part of the ischio-pubic symphysis may become slightly 
 relaxed. So that when once approaching the outlet the progress of 
 birth is more rapid, and this progress may be aided if, as is pointed 
 out by Lafosse, the tail of the mother is well elevated. 
 
 A slight check to expulsion is observed when the croup arrives 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, 
 more particularly if the croup is largely developed, which is the case in 
 some Foals. One haunch may pass into the inlet before the other, how- 
 ever, and thus facilitate the passage. 
 
 2. Mechanism of Parturition in the Dorso-ilio-sacral Positi())}s. — 
 These positions are two in number and symmetrical, and probably are 
 frequent at the commencement of birth in the anterior presentation, 
 when the width of the pelvis exceeds its depth — the oblique diameters 
 being then greater than the vertical — so that the foetal 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- 
 
MKCIIAXISM OF I'AUTilUTKiX. 2h',\ 
 
 j^reater than its width this rotation is effected spontaneously at the 
 commencement of birtli. So that these oblique positions are as favour- 
 able as the dorso-sacral position. 
 
 3. Mechanism of Parturition in the Domo-Uial Positions. — These 
 lateral positions — also two in number and symmetrical — are, accord- 
 inf^ to Saint-Cyr, rarely primary, but, as Kainard remarks, are some- 
 times found as sccondar;/ j>ositions, due to the reduction of some 
 mal-presentations. The latter authority asserts that spontaneous birth 
 is impossible in these positions, because the chest of the fa;tu8 
 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 
 is alicays more dillicult, 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 fa-tus, here also we 
 find the two salient parts of the latter — the sternum and dorsal spines 
 jamming against the tw^o resisting parts of tlie ])elvic circumference — 
 the ascending branch of each ilium, and it will he readily seen that in 
 some cases tliese will prove an insurmountable obstacle. Nevertheless, 
 as a general rule, this obstacle may be easily turned, if the pelvis is 
 sutliciently wide, by merely causing the body of the fcetus to rotate in 
 such a manner that its greatest diameter will be brought opposite the 
 oblique diameter of the inlet, which extends from the ilio-pectineal 
 ridge to the sacro-iliac articulation on the opposite side. Then its 
 <;ntrance 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 it oblique or dorso-sacral, 
 and if the ftetus is not large the croup will probably follow without 
 (lifliculty. If, however, the fa-tus is large, it should be placed in the 
 <lorso-ilial 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 of 
 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. — Of the 
 positions in which we may have a breech or posterior presentation, 
 only one is compatible with spontaneous delivery— the lumho-sacral ; 
 though even this is denied by other authorities. Tiie fu'tus 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 fcetus is a rounded voluminous mass which does 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 against the sacro-vertebral angle ; while the stifles, which 
 are salient, press against the edge of the pubis, and the hip-joints 
 
254 NORMAL PARTURITION. 
 
 against the branches of the ilium. Entrance into the inlet must there- 
 fore be slow, difficult, and painful for the mother, and when this 
 first obstacle is overcome and the croup is in the pelvic cavity, the chest 
 has to follow, and to submit to the same compression at the inlet as in 
 the anterior presentation. But this part of the fcetus is much less 
 favourably disposed for such a reduction of dimensions in this position ; 
 as the resistance offered by the walls of the maternal pelvis has a ten- 
 dency to erect the dorsal spines, and to carry the ribs and sternum 
 forward — all this going to increase the diameter of the fcetus in every 
 direction. It is only, then, by direct compression or squeezing, that 
 the necessary diminution in the diameters of the young creature can be 
 effected, and not by a kind of physiological decrease, as in the anterior 
 pi'esentation. 
 
 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 
 this position, even when 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 foetus present one 
 after the other at the inlet ; so that a slight 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 Partiirition 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 difficulty 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- 
 iliac 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 tban that of the Foal, owing to the greater length of the 
 maternal pubic symphysis, and the more considerable extent of the 
 pelvic walls, as well as the peculiar curve in the floor 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-Cjr in these observations measured the thorax after the birth of the young 
 creatures, and when the lungs had become expanded. He does not appear to have made 
 any allowance for this expansion, which of course makes a difference in the size of the 
 thorax after biith. 
 
 - The fact that parturition is more quickly pei formed in the Mare than any other 
 quadruped was well known to Aristotle : Equa, omnium qiiadrupedem, J'acilllme, parit. 
 
.VAVAW^JA'l' All) IX Xol.M.lL rAnTHUTloX. 25^ 
 
 tliose in the Mare with a narrow pelvis, to wliich that of the Cow bears 
 considerable resemblance. 
 
 The same may he said of the positions in the tostkiuok i'uksknta- 
 riON. In the lumbo-sacral })osition, tlie stiHes of the Calf, beinj^ more 
 oblique than those of the Foal, are not so liable to be held by the 
 anterior border of the pubis, while another advanta^'e is to be found in 
 the smaller disproportion between the lengtli of femurs of the (!alf and 
 the sacro-pubic diameter of the Clow ; so that tlie Calf is more fre- 
 (juently born alive in this position than the Foal, wliile the Cow is more 
 rarely subject to injury, though extraneous aid may be necessary at 
 times. 
 
 Other Animals. 
 
 With regard to the smaller female animals, the same remarks are 
 applicable to presentations and positions, as in the case of the Mare 
 and Cow, and mors especially with reference to tlie Sheep and Goat. 
 In these latter, when there is only one foetus, birth is etTected by 
 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 Bitch and Cat. 
 
 It may be noted that with the common-bred Bitch, which has a more 
 or less elongated muzzle, when fecundated by a Dog of the same con- 
 formation and size, and which in due course brings forth from five ti> 
 eight young, there is usually no difliculty in delivery. The conical 
 form of the muzzle of the puppies, and the softness of their tissues, 
 permits their entering the inlet in this presentation, and passing easily 
 through it under the influence of the uterine and abdominal contrac- 
 tions. But when the Bitch is of small size, and is fecundated by a 
 young, vigorous, and larger Dog, and especially if the muzzle of either 
 or both parents is short, then the head of the puppies is usually large 
 and round, with the forehead higli, and the presentation offers grave, 
 and frequently insurmountable dilViculties. This is more especially the 
 case if the puppies are few in number, when they are usually larger. 
 This will be alluded to again when we come to treat of dillicult parturi- 
 tion. 
 
 It may also be observed that in the Anterior Presentation, the foro 
 limbs of the ftetus — contrary to what takes place in the ^lare and Cow 
 — do not accompany the head, but are placed alongside the chest, owing 
 to this disproportionate size of the head, which is as voluniinous^if 
 not more so — than the chest in some instances ; but then the latter, 
 even with the legs alongside it, is easily reducible, while the head 
 is very slightly so. 
 
 The Posterior Presentation is frequent in Carnivorous animals, but 
 birth is efifected under the same conditions as in the other species. 
 
 CHAPTER III. 
 Necessary Aid in Normal Parturition. 
 
 Although, as a rule, j)arturition is generally ellected in animals in 
 what we have designated a "spontaneous ' manner (without the inter- 
 vention of man), and without danger or prejudice to the mother or ofT- 
 spring ; and although these do not require that luinute and scrupuloua 
 
256 NORMAL PARTURITION. 
 
 attention bestowed on woman and infant, even when birth has been 
 easy ; yet, from the nature of this act and the unfavourable conse- 
 quences which are sometimes noted, certain precautions should be 
 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 carrying out 
 to competent persons selected by the owner ; as it is seldom that the 
 veterinarian is called in unless something serious has occurred. The 
 mother as well as the offspring require watching, and more or less 
 nursing. 
 
 SECTION I.— ATTENTION TO THE MOTHER. 
 
 "With the 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 be adopted. With the Mare and Cow particularly, this function 
 is accompanied by 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 is in a place by itself, or which' is 
 .at liberty in a pasture or meadow. Therefore, the Tvlare about to foal 
 should be allowed a roomy loose-box, well supplied with soft litter ; 
 and the Cow should, if possible, be similarly provided. If either 
 animal must be kept tied, then the fastening should be of such a kind 
 that it can readily be undone when required. The Sow should have a 
 separate sty, and even the Sheep may need a separate allotment. If 
 kept in a dwelling, the temperature should be comfortable and the 
 ventilation good. 
 
 A. DuEiNG Labour. — When parturition commences, 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 primiparas, 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 
 jji'otracted parturition, they being only modifications of natural labour ; 
 the difficult cases coming under the head of dystokia 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 himself 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 
 
XECfSS.inr AH) IX X>>J;MAL rAltTCHITloX. 257 
 
 for the expulsion of the latter. The labour-pains should be normal, 
 and the act should neither be hurried nor abrupt, nor yet too slow ; and 
 the mother should not exhibit any constitutional weakness or physical 
 debihty. In addition, the foetus should be normal, as well as its mem- 
 branes ; and the genital passages of the motlier ought to be in a 
 properly formed and healthy condition. The foetus should be alive and 
 natural in form and size, particularly with regard to the volume of the 
 head and thorax ; and it ought to be in such a position that it can be 
 expelled without assistance. The fojtal envelopes should possess a 
 certain degree of tliickness and resistance, so that they may not rupture 
 too soon, nor yet resist the action of the uterus too long. The pelvis of 
 the mother should have a convenient shape and capacity ; the genital 
 passages soft and elastic ; the os, vagina, and vulva properly formed 
 and extensible ; and the other pelvic organs in a normal state. 
 
 If the act of parturition is not sufficiently advanced, and the soft 
 parts through which the foetus has to pass are not enough dilated, time 
 ought to be allowed for this to take place. As a rule, there should be no 
 hurry to interfere with the progress of the case, as a somewhat long 
 period is often required for preparation ; and if this is accelerated by 
 the intervention of art, accidents are more likely to occur than if the 
 labour had been long and protracted. 
 
 Vitulary or parturient collapse has been remarked as more connnon 
 in Cows which have calved quickly or abruptly ; and in such instances 
 it has also been noticed that the uterine contractions do not sufficiently 
 detach the fa^tal membranes. 
 
 In parturition, there is as much wisdom shown in remaining a spec- 
 tator sometimes, as in interfering at other times when circumstances 
 require it. It is only when obstacles, insurmountable by the natural 
 efforts of the animal, offer themselves that aid nmst be rendered. So 
 long as the course of parturition remains normal, nothing should be 
 done, under ordinary circumstances. 
 
 With the Mare, however, delay should not be pushed too far, as the 
 fcetal placenta is very easily detached from the uterine surface, and the 
 fa'tus may perish of asphyxia or inanition. 
 
 The intelligent owner of, or attendant on, an animal which is about 
 to bring fortli, should be able to ascertain the position of the fcetus, and 
 decide as to whether parturition may terminate in a natural manner, 
 or if the existing obstacles are easy to overcome. If they are not, he 
 certainly should not venture to attempt delivering the animal himself, 
 or to pull about the mother or fcetus ; as this may only tend to aggra- 
 vate the accident, and render relief more diilicult. The veterinary 
 surgeon should be sent for, as his knowledge and practised manipula- 
 tive skill will, in the majority of cases, bring the most comphcated 
 labour to a prompt and happy termination — preserving the mother, and 
 often the progeny. 
 
 This appeal to the veterinarian is not always made, however, until 
 great damage has been done by the owner, his servants and neighbours, 
 or the empiric, and the loss of valuable time caused ; then he is sent 
 for, but now the case may be one of extreme difficulty or hopelessness, 
 from exhaustion or injury. 
 
 We shall only notice in this place what has been designated abrupt, 
 tumultuous, disordered, or false labour {partus pracipitatus), and pro- 
 tracted labour, both due to anomalies in the expelling forces. 
 
 1. Tumultuous Labour. — In this kind of labour the act of parturition 
 
 17 
 
258 XOIUIAL PAETUPJIIOX. 
 
 is irregular and precipitate ; and though the pains are excessive and 
 frequent, yet no progress appears to be made, the parts not being pre- 
 pared, 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 foetus 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 observed in young, well-fed, vigorous, irritable animals, 
 and especially primiparae, 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, how- 
 ever, the pains are violent, and the agitation great and persistent, 
 other measures must be resorted to. Some authorities recommend 
 bleeding, but this should, if possible, be dispensed w^th. Blankets 
 steeped in hot \vater 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 raising the animal's hind 
 quarters ; and at other times, when the cervix is in a state of spasm, 
 relief is soon obtained by applying a little extract of belladonna to it. 
 With small animals, a few drops of laudanum, either in draught or 
 enema, and a warm bath, 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 Labour. — Pi'otracted labour, due solely to the inability 
 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 
 have ruptured, the waters have entirely escaped, and the uterus, in a 
 state of general tonic contraction — tetanus uteri — is closely applied to 
 the foetus, but makes no effort to expel it. This usually, if not 
 always, happens when the foetus 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 frequently old 
 animals, w^hich 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 Mare and Cow are : comparatively shallow and 
 repeated inspirations, feeble and unfrequent straining, weak pulse, 
 restlessness and symptoms of suffering, extremely slow progress in 
 birth, — parturition in the Cow being extended to twenty-four, and even 
 forty-eight hours, though the foetus may be in a good position, of ordi- 
 
XECEss.UiV A III i.\ .\i>i:Mji, r.urri i:iTwx. 2r.9 
 
 nary size, and the passaj;e clear. If the hand is introduced hito the 
 va-^ina, it will he discovered that the uterine contractions are weak. 
 
 There is no ur^'ent dan<;er to the mother in this condition ; though 
 the life of the fcitus is often imperilled, as the placenta may he de- 
 tached more or less from the uterus, und this may lead to fatal 
 consequences. 
 
 An examination is of course necessary, in order to ascertain whether 
 there is any ohstacle to parturition. Should such not be found, then 
 stimulants may be given ; such ecbolics as rue, satt'ron, savine, and 
 particularly ergot of rye, have been recommended by various writers. 
 These may be useful, but it will generally be found that active inter- 
 vention is preferable, and more especially as there is little, if anything, 
 to prevent the fcitus being easily reached ; for should the os be in- 
 sutliciently dilated, it may readily be made wide enough for the hand 
 to pass into the uterus. Moderate and judicious traction on the 
 parts which present, when the mother makes expulsive efforts, will 
 bring the futus into the pelvic cavity and through the vulva. 
 
 De.\th of the FtETUs. — When parturition is retarded, it is often a 
 question whetlier the foetus is dead or alive, and to answer it correctly 
 is sometimes dilVicult. Auscultation in the larger animals cannot, as 
 it may in the human species, furnish any certain evidence in this re- 
 spect. The fcDtor of the liquor amnii has been held to prove the death 
 of the fcctus ; but though it is a good sign, yet it is not infallible. 
 When decomposition has, however, well advanced, and the foetus is 
 emphysematous and its hair easily removed, then there can be no 
 doubt as to its being dead. The coldness of the parts external to the 
 vulva of the mother, when well marked, is also a si.i;n of death. Of 
 course, so long as the foetus displays active movements, it is alive : 
 but tlie absence of these is not an absolute proof that it no longer 
 lives ; for sometimes when it is partly in the pelvis and the waters 
 have escaped, so that the uterus encloses it firmly, though still living 
 it remains passive, and cannot be stimulated to movement. Should 
 the presentation be anterior, then passing the fingers into its mouth 
 and titillating the tongue will prove a test of its vitality, as the jaws 
 and tongue are almost certain to move if it lives ; but the absence 
 of movement will not be decisive, though it will constitute very probable 
 evidence of death. If the umbilical cord can be reached and seized 
 between the thumb and index finger, slight compression will discover 
 whether or not the arteries pulsate. The absence of pulsation afTords 
 a strong, but not in every case a sure, presumption that the fcctus is 
 dead. 
 
 Gelle, many years ago, gave an empirical test which, he asserted, 
 was constantly successful; though it is ditVicult to say why it should 
 be. This method consists in passing a blanket or sheet under the belly 
 ut the Cow, and lifting it up by assistants at each side. If the fcetus 
 is not dead, the Cow exhibits dislike of the pressure ; but if dead, then 
 it rests on the sheet. 
 
 Another authority states that, with the Mare, the expulsive efforts 
 cease for the time being as soon as the Foal is dead, and if it has not 
 entered the pelvic inlet ; if it has passed into this, the pains continue as 
 usual. 
 
 In the Cow the fcetus may be alive though the labour-pains have 
 ceased for some hours, or only occur at long intervals. With the 
 
260 NORMAL PARTURITION. 
 
 Bitch, it has been remarked that when the pains are weak, the first 
 puppy that presents is usually dead. 
 
 The causes of death of the foetus during parturition are not numerous, 
 and may be enumerated as follows: — 1. Knots on the umbilical cord, 
 which, though not unfrequent in the human foetus, appear to be very 
 rare in animals ; 2. Twists of the cord around the body, neck, or limbs 
 of the foetus, and which may be sufficiently tight to interrupt the circu- 
 lation in the umbilical vessels ; 3. Prolonged compression of the umhilical 
 cord, due to the foetus remaining a long time in the passage, whereby 
 the circulation of blood is checked ; 4. Premature rupture 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, moi-e or less com- 
 plete and extensive, between the uterus and foetal envelopes, by which 
 the vital connection between the mother and foetus is interrupted, 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 foetal 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 to 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 the rule. So 
 common is this experience, that a very distinguished French veterinary 
 surgeon — Donnarieix — 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 — after the commencement of labour. 
 The explanation he gives, and which we think is correct, is based on 
 the manner in which the foetal placenta is inserted into the uterus. In 
 the Cow, the placentulse, 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 everywhere distributed over the chorion, adheres but feebly to 
 the uterine mucous membrane, and gives way as soon as labour com- 
 mences, so that foetal asphyxia is imminent if birth be not prompt. 
 There are 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 underwent this straining without 
 injury. 
 
 The foetus may also perish when it is in a wrong position, or 
 is of unusual size, 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 diffi- 
 culties of parturition, because it does not then stimulate the contrac- 
 tions of the uterus, and its flaccid tissues do not afford that resistance 
 to the uterine muscles which they do when it is alive. But Saint-Cyr 
 
XECEssAnv .-iff) r.y \(>/:.\f.iL pahtl'ritiox. 261 
 
 denies that tlie death of the foetus renders parturition slower or more 
 dillicult ; tliough he admits that if, at the commencement of tliis act, 
 there may chance to be any trifling irregularities in presentation or 
 position, tiiese may be recti^ed to a certain extent by the automatic or 
 more or less instinctive movements of the living fcetus. Jle concludes 
 that though the death of the foetus has certainly a great importance, so 
 far as the interests of the breeder are involved, as well as with regard 
 to obstetrical operations in ditiicult cases ; yet it has little or none 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 water-bag, and when to 
 use traction on the fa'tus. This custom will be followed, and these 
 points noticed. 
 
 liupture of the Water-bag. — This sliould not be artificially ruptured 
 too early ; indeed, in the Cow it should never, as a rule, be opened 
 artificially, 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 
 adhesion to the uterus, render this non-interference all the more 
 necessary. 
 
 With the Mare, however, matters are different. In this animal the 
 fcetal membranes are thick, firm, and feebly adherent to the uterus; 
 so that the Foal is sometimes born completely enveloped in them. It 
 is, therefore, well to incise them when the water-bag appears as a large 
 tumour beyond the vulva ; until this happens nothing should be done, 
 unless the os is completely dilated, and the head and feet of the fcrtus 
 are well in it. The membranes may be torn by the fingers, or cut by 
 scissors or a knife, care being taken not to injure the Foal. 
 
 When the water-bag is ruptured too early, the uterus contracts on 
 the foetus, as has been said, and becomes moulded on it ; this is opposed 
 to birth. Besides, the genital passage becomes dry and adherent, and 
 this is an additional obstacle. To remedy 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, wliich may 
 be introduced by a funnel, the Cow's hind quarters being slightly 
 raised. 
 
 Traction of the Fir t us. —V^'hcxi the membranes arc once ruptured, the 
 natural expulsion of the foetus should be waited for. In some instances, 
 however, this expulsion may be conveniently assisted by judicious 
 traction on the fa;tus. If it is in the dor.'in-.sacral position, gentle 
 traction may be made on the pastern of each fore leg when these and 
 the head have cleared the vulva, 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 
 ftctus to follow tlie curve of the pelvis ; inclining the traction a little to 
 the right and left, will also aid in passing the shoulders and afterwards 
 the haunches. The head and neck, wlien they are clear of the vulva, 
 should be supported. If the fa-tus is in the dorso-ilio-sacral position, 
 the 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 are yet in the 
 vagina, and brought gently outside the vulva along with the head, 
 
■262 XOILVAL PAKTrillTlUX. 
 
 when traction may be employed. This should at first be made 
 upwards, so as to clear the withers from the brim of the pelvis, against 
 which they sometimes jam. \Yhen this is effected, the same proce- 
 dure as in the other case is to be adopted. 
 
 In the dorso-ilial positions, it is alwaj's useful, when they are recog- 
 nised in time, and before the chest has entered the pelvis, or even when 
 it is in the vagina, to attempt to modify them by converting them into 
 one of the preceding positions, and particularly the dorso-sacral, or 
 dorso-ilio-sacral — though this modification requu'es the manipulative 
 skill of an experienced veterinary sui-geon. If the foetus is already in 
 the canal, delivery must be attempted according to the principles 
 already indicated : directing the feet towards the centre of the passage 
 and outside the vulva, and by seizing the fore-arms using them to turn 
 the withers towards the sacrum of the mother, then employing moderate 
 traction on the limbs. 
 
 If the foetus presents posteriorly, in the hiinho - sacral position, 
 with the croup towards the maternal sacrum, the only way in which 
 birth can be effected 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 the hocks, which are deeper 
 situated, are flexed in the opposite direction, and are distinguished 
 by their broad flat sides and the blunt point of the calcis, which points 
 in a contrary direction to the flexure of the joint. In this position, the 
 two limbs are to be seized at the pastern, and traction exercised at first 
 slightly upwards, in order to carry the stifles over the brim of the 
 pubis, which sometimes checks them ; then downwards, to bring the 
 croup below the sacrum ; and lastly, an alternate movement from right 
 to left and left to right, to free the haunches, one after the other. It is 
 well to see that the tail of the foetus is in a right direction before traction 
 has been much practised. 
 
 In the lumho-ilio-sacral and luviho-illal positions, the foetal croup 
 passes along easily when the pelvis is deeper than it is wide — as in the 
 Cow, for instance. The limbs onty 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 chest to corre- 
 spond with the vertical diameter of the inlet. If the Mare has a wide 
 pelvis, it would be preferable to place the foetus in the lumbo-sacral 
 position. 
 
 We may remark, however, with regard to gemellar parturition, that this 
 kind of pregnancy is not usually recognised in uniparous animals until 
 birth takes place. The escape of only a small quantity of liquor amnii, 
 and the small size of the creature first delivered, when compared with the 
 size of the mother's abdomen, are not infallible indications that more 
 young will be produced. Soon, however, another water-bag appears, 
 and another foetus presents at the vulva. Not unfrequently, when the 
 position of the two foetuses is natural, they present one after the other 
 successively, and without any assistance being required. This is the 
 case more particularly with the Sheep and Goat — animals which so 
 often produce twins. But sometimes, and especially with the larger 
 animals, the two foetuses present themselves simultaneously at the 
 pelvic inlet, and neither can pass through. In such a case, which it 
 must be confessed is rare, it is necessarj- to push back the one least 
 favourably presenting, and to keep it away until the fore limbs of the 
 other are engaged in the passage. If the two foetuses chance to be in 
 
NECESSARY AID IX XORMAL PAIITURITIOX. 263 
 
 an unfavourable position, the anterior extremities of one should be 
 sou^lit for (recognised by the knees, and to a certain extent by the 
 pasterns), or the hind limbs (recognised by the pasterns and hocks) if 
 they are convenient for the purpose, and traction exercised as in the 
 case of a single fojtus, and according to the directions given above, 
 taking care to keep the other fietus out of the way. Should it not be 
 possible to extract this fcctus, it may be that certain parts of tlae other 
 stop its progress, or that the expulsive forces are expended on the latter, 
 although it is farthest from the os. It is tlien necessary to push back 
 and turn the former, and endeavour to extract it by the extremity 
 opposite to tliat which was first tried. But if the fore limbs have been 
 got into the passage, as well as the head, the position need not be 
 changed, the procedure being then the same as for a fuetus dispropor- 
 tionately large. 
 
 Another remark is with reference to the operator. In exploring tlie 
 genital passages, gentleness and tact should be scrupulously observed, 
 and the hand and arm ought to be well oiled, the nails of the lingers being 
 cut at least moderately short. It requires some experience to be able to 
 ascertain, by the sense of touch, what parts of the foitus present, and 
 those which are an obstacle to birth ; as well as knowledge to guide 
 one in placing the parts in a favourable position, and particularly in 
 one whieli approaches what we have designated the "natural" presenta- 
 tion. The time chosen for exploration should be tlie interval between 
 the labour pains, and care must be taken not to rupture the membranes, 
 if they are still intact. The exploration may be made while the 
 animal is standing or lying ; both positions have certain advantages, 
 though the lirst is generally preferable, and is certainly less fatiguing. 
 
 It must not be forgotten that, when traction is required, this should 
 be slow and moderate, and only applied when the animal itself makes 
 expulsive elTorts. In many cases tiie resistance to be overcome is often 
 very slightly superior to the forces exerted by the parturient animal. 
 Violent and" sudden traction is to be deprecated, as it may inflict serious 
 injury, while doing little, if anything, in aiding delivery ; and even 
 should this be etTected, it must be remembered that the contractile 
 power of the uterus is deranged when the contents of the organ are 
 attempted to be suddenly and forcibly removed. The simplest and 
 safest traction is that made by the hands of the operator — for both 
 hands may, in some cases, be introduced into the vagina. Should he 
 not have suQicient strength or purchase, an assistant may clasp him 
 around tlie chest and pull at and with him— gradually and steadily 
 during the throes. But we shall recur to this subject again. 
 
 B. Aftku I.Anoru. — The attention to be paid to the mother after 
 parturition will ditTer not only according to the species to which it 
 belongs, but also according to its temperament, strength, and the kind 
 of labour which it has undergone. When this has been natural, and the 
 animal is vigorous and not much fatigued, simple hygienic measures are 
 all that is necessary. It should be kept comfortable, with plenty of pure 
 air, but away from draughts. If it has been perspiring, the body, and par- 
 ticularly the belly, should be well wisped if it is a large animal ; indeed 
 this friction is always to be recommended, as it often allays the restless- 
 ness which sometimes persists after delivery ; it also regulates the circu- 
 lation, and appears to hasten the retraction of the uterus. It may be 
 necessary to cover the body with a blanket, as the animal is very sus- 
 
264 NORMAL PARTURITIOX. 
 
 ceptible to cold at this period. A gallon or so of nourishing, tepid gruel, 
 or even soup, may be given ; after which the diet should be moderate 
 and easily digested. Clean dry litter should be plentifully supplied, and 
 the animal left alone for half an hour or so, after which it may be 
 visited, offered more gruel, and the offspring assisted to the teat, if it 
 has not already found it. From three to eight, or even fifteen days' r€st 
 should be allowed, according to circumstances, and in order to permit 
 lactation to be fully established, and the animal quite recovered. 
 
 When parturition has been protracted, and the animal has suffered 
 much, and especially if the generative organs have been bruised and 
 lacerated, nursing should be continued longer, and greater precautions 
 adopted. Every care ought to be taken to prevent metritis or metro- 
 peritonitis ; and with this object in view tepid vaginal injections, to 
 which may be added a little permanganate of potassium or chloral, may 
 be employed : warm cloths being applied to the loins, the animal allowed 
 light diet, with small doses of sulphate of magnesia, and kept clean in 
 a good stable, and in a pure atmosphere. 
 
 When the animals are old, weak, or exhausted by protracted labour, 
 or if there has been hgemorrhage, stimulants should be administered, 
 and strengthening food allowed. Sometimes the debility is so extreme 
 that the animal scarcely gives any indication of life. There is then all 
 the more need for careful nursing and quietude. Friction to the surface 
 of the body, clothing, and a good bed are particularly necessary ; and as 
 lactation is established with difficulty in these cases, this must be 
 attended to. It must be borne in mind that cold and damp are danger- 
 ous immediately, and indeed for some time after, parturition. There- 
 fore, when turned out to pasture care should be taken to afford protec- 
 tion in bad weather, and damp cold localities should be avoided. 
 
 With regard to Ewes, if the weather is mild and the situation 
 favourable, protection is not required ; but if cold w^inds and wet pre- 
 vail, then shelter is necessary. When more than one Lamb is likely 
 to be produced, the first should be kept warm and receive a little Cow's 
 milk diluted with water, until the Ewe has finished lambing. Twin 
 Lambs may easily be reared by a strong mother, if supplied with a 
 sufficiency of suitable food ; but, as a rule, if there are more than two, 
 they should be put to another Ewe or reared artificially. In order to 
 overcome the repugnance so often manifested by the Ewe to a strange 
 Lamb, if its own has died, the foster-Lamb may be rubbed with the 
 skin of the dead creature, or the two may be placed together during 
 the night, or even put into a dark shed along with a Dog, which will 
 induce the Ewe to protect and take to the Lamb. 
 
 The Goat is more exposed to long and difficult parturition than the 
 Sheep, and not unfrequently requires assistance. The same care is 
 necessary as for the Sheep. 
 
 The Sow generally suffers from weakness and prostration after 
 parturition, and requires plenty of nourishing and easily-digested food. 
 When this is given there is less likelihood of the animal devouring 
 its young, and all the more so if it is not irritated by the presence of 
 people. 
 
 The Bitch should not be allow^ed to rear too many Puppies, and 
 w^armth, a dry abode, and good food must not be withheld. The Bitch 
 does i:iot readily take to strange puppies ; sprinkling these with some of 
 its milk has been sometimes successful. Constipation is not unfrequent 
 after parturition, and this may be removed by castor-oil or manna. 
 
XECESSAIIV All I l.\ .\ni;.\iAI. /'.Um'/.'/Tloy. 265 
 
 SECTION 11. — ATTENTION TO THE OFFSPRING. 
 
 No special rules can be laid down for the management of new-born 
 animals, as this nmst vary more or less according to tlie species. How- 
 ever, there are some general rules which it may be well to observe, and 
 these we will refer to. 
 
 With regard to the Foal or other creature which may be born in the 
 fa^tal membranes, it is evident that it nmst be freed from them imme- 
 diately, or it will perish from suffocation ; for having no longer any 
 conmiunication with the mother by means of the umbilical cord, the 
 blood cannot be oxygenated. If the umbilical cord is not ruptured, it 
 may be double-ligatured about two inches from the umbilicus, and then 
 divided between the ligatures ; or it may be severed by scraping it 
 through with a jagged knife. 
 
 Immediately after delivery, and having removed the nmcus which 
 sometimes clogs the mouth and nostrils and hinders respiration, the 
 young animal should be examined to ascertain whether it be strong or 
 weak, whether all the natural apertures exist — such as the eyes, mouth, 
 anus, vulva, urethra — and if any of them chance to be absent, to make 
 artificial ones soon, if possible, by a kind oi puncture, enlarging after- 
 wards by the knife and sound, and preventing union by pledgets of 
 lint, etc. 
 
 Suspended Animation. — Whenever 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 lungs, 
 through the nostrils. 
 
 The establishment of respiration is a purely reflex act. The foetus, 
 hitherto maintained at a certain and always uniform degree of warmth 
 in its liquid bed in the uterus, is suddenly usliered into the cold and 
 dry air of tlie outer world ; and this transition operates chiefly on the 
 skin, producing a peculiar impression— such as we ourselves experience 
 in being suddenly immersed in cold water ; this impression is at once 
 transmitted to the cerebro-spinal centre, whence the reflex influence of 
 the spinal cord is called into play, and the respiratory nmscles are 
 excited to movement by the centrifugal nerves issuing therefrom. All 
 these muscles contract simultaneously, the chest is dilated, and the air 
 rushes into the air-passages and lungs, distending the air-cells in the 
 latter, and instituting the process of respiration, which is only to cease 
 with the death of the creature. This rellex act may also be produced 
 by pressure on the umbilical cord, or anything which hinders the oxy- 
 genation of the blood in the fcctus ; hence it has been inferred that the 
 excess of carbonic acid in the circulating fluid acts as a stimulus to the 
 medulla oblongata. 
 
 It sometimes happens that the young creature is in a state of syncope 
 when born, or very soon after, and gives no sign of life. Observers 
 have distinguished syncope from weakness, in which the animal is cold 
 and does not breathe, the mucous membranes being pale and the body 
 flaccid ; and syncope from plethora or cyanosis, when the mucous 
 membranes are of a livid blue tint, the lips and tongue swollen, and 
 the eyes injected. 
 
 In the first form, resuscitation is to be attempted by pouring cold 
 water on the head, beating the body with a cloth dipped in cold water 
 — particularly about the face and chest — dry-rubbing the limbs, titil- 
 lating the nostrils with a feather, pulling tobacco-smoke into them, 
 
266 NORMAL PARTURITION. 
 
 imitating the respiratory movements, as in a case of asphyxia, and in- 
 flating the lungs by means of a pair of bellows, acting through the 
 nostrils. So long as the heart pulsates there is a probability of restora- 
 tion to life. 
 
 In the second form, allowing a little blood to flow from the umbilical 
 cord, and even cutting this or fomenting it w^th hot water to induce 
 hcemorrhage, is very useful, in conjunction with cold water to the head 
 and cold water enemas. But, as a rule, death is always imminent in 
 these cases of syncope. 
 
 Genebal Care. — With the larger animals, the newly-born creature 
 should be placed before the mother, if it is not near her ; and it gene- 
 rally follows that she instinctively licks off the viscid matter which 
 30vers its skin ; and in doing this the cutaneous circulation is excited, 
 and, by sympathy, the other organs of the young animal. Conse- 
 quently, it becomes revived, soon endeavours to get up, and though it 
 may fall several times, yet it generally quickly succeeds in maintaining 
 itself on its limbs, and instinctively seeks the maternal teat. It is very 
 rare that the mother does not voluntarily, and at once, commence to 
 cleanse its progeny ; nevertheless, there are exceptions, chiefly among 
 the primiparffi, and especially when the labour has been long and 
 painful. But it will generally be found that sprinkling the young 
 animal with a little flour, bran, or salt will excite the attention of the 
 mother and induce the cleaning process. Should it not do so, then the 
 creature must be well dried and rubbed with a sponge, hay-wisp, or a 
 cloth, and kept warm. This is more particularly necessary when the 
 mother is indifi^erent to it, which sometimes happens with primiparae 
 when people are present. Indeed, some Mares become quite savage 
 after parturition, and will not allow their Foal to come near them, and 
 will even kill it ; though this most frequently happens when they are 
 tormented by spectators. Other Mares, vicious before parturition, 
 sometimes become remarkably quiet when they have a Foal by their 
 side. When they exhibit any aversion to their progeny, it is well to 
 leave them quietly together for some time. 
 
 If the Foal or Calf is weak, and cannot reach the teat within half an 
 hour or so after birth (for in uniparous animals the mamniEe are 
 inguinal, so that the young are always suckled in a standing posture), 
 it will be found necessary to assist it by bringing it to the mother, and 
 applying the teat to its mouth, at the same time caressing and soothing 
 the parent if disinclined to it by temper or by painfulness of the udder. 
 This coaxing and handling should be performed by someone accus- 
 tomed to the animal. It may be necessary to have a second person 
 at hand to hold the Mare by the head or to lift up its fore foot. 
 
 Sometimes from weakness or inexperience of the Foal, and temper 
 of the Mare, the former runs the risk of perishing from starvation. 
 The Mare should be safely secured, and two persons ought then to 
 push and support the yotmg animal behind by joining a hand of 
 each, while the other hands are employed in directing it towards the 
 teat, which it should be allowed to use for two or three minutes. 
 After one or two attempts of this kind, the Foal begins to find its way 
 to the udder by itself, while the Mare becomes reconciled to it. When 
 the Foal exhibits great debility, it may be preferable to feed it for a day 
 or two with the milk of the Mare, which has been drawn by hand. 
 
 With the Cow, these difficulties are seldom present, and if an animal 
 
XhVEss.u:}' AiJ> ix .\i'I:m.\l j'.t/rnj:/TJ'>.\. -j.;? 
 
 will not take to its Calf this is geiu'ially transferred to another Cow, 
 or it may be artitjcially reared. The Foal may even be reared in this 
 manner, thou^'h not so easily as the Calf. The milk of the Cow or 
 Goat will sulfice, and there is generally little dilliculty in teaching it 
 to drink it by at lirst pouring a little into its mouth while the finger 
 is inserted therein ; or a piece of cloth steeped in milk, or even a bottle 
 and tube, may be used. 
 
 Calves are often harshly treated after birth ; they are not allowed 
 to suck, even for a number of days, for fear of damaging the Cow, but 
 are kept apart and fed on drawn milk. Calves intended for slaughter 
 may be artificially fed, and especially if nutritive substances are added 
 to the milk ; but for those intended to be reared, it is a mistake to 
 separate them from the Cow during the early days of their existence. 
 
 Lambs, when able to stand, and if they do not readily find their 
 way to the teat, should have a little milk from it pressed into their 
 mouth. With twin Lambs, if the Ewe is in good condition, the udder 
 well tilled, and the weather and pasture favourable, both may be 
 suckled ; in the opposite conditions it may be necessary to remove one. 
 If the Ewe does not yield sullicient milk, this may be largely remedied 
 by giving a liberal supply of good food. 
 
 Multiparous animals, such as the Bitch and Sow, usually lie when 
 suckling their young; so that there is seldom any dilliculty with them. 
 The only care generally required in the case of young Pigs, is to prevent 
 their being crushed by the Sow in the act of lying down or moving. 
 If the litter is large, plenty of good food is necessary. 
 
 It is well to remember that if a Sow has more young in the litter 
 than teats, unless watched the weakest will die of starvation. Each 
 young Pig has its own particular teat, to which it is persistently 
 attached ; and if the creature is ill and does not suck, or if there is 
 not a claimant for the teat, the gland there will cease secreting milk. 
 The pectoral teats and glands are the largest and most active, and the 
 weakest of the litter should be put to them. In general, a Sow should 
 not be allowed to rear more than ten in a litter. Cleanliness and 
 warmth are required for young Pigs. 
 
 Puppies do not require any special care beyond a warm, clean, and 
 dry abode. 
 
 After the first milk has been taken, there is usually an abundant 
 evacuation of black resinous matter — meconium — from the intestines 
 of the young animal, caused by the ' colostrum,' as this milk is named ; 
 and it is well to notice if this evacuation occurs, as when it does not, 
 serious constipation may ensue. With new-born animals which, for 
 some reason or another, are deprived of this colostrum, a nuld laxative 
 — such as castor-oil, or honey or liquorice powder and water— should 
 be administered to obviate this condition. 
 
 At birth the feet of hoofed animals are covered with a soft yellow 
 horn, which in some countries it is the custom to remove, from a 
 belief that this removal hardens the succeeding horn. It is unneces- 
 sary' to state that this is a popular fallacy, and that it is really injurious 
 to deprive the foot of this temporary protection. 
 
 The young, with their parents, should be kept apart from others — 
 for some time at least, and especially the Equine species; and it nmst 
 not be forgotten that a mild dry temperature is most favourable for all 
 young creatures. 
 
 Gentle exercise is as necessary for the Foal and Calf, as it is for their 
 
268 XORMAL FARTUPJTIOX. 
 
 parents, a few days after birth. Therefore it is that a meadow is 
 preferable to a stable, as, in addition to the more favom-able natui^e of 
 the food, sufficient exercise is afforded. Indeed, with the Mare light 
 and regular work may be imposed a short time after foaling, and with 
 much benefit to it and the Foal. The latter will follow its dam, pro- 
 vided the pace is not too fast, and a halt be frequently allowed for it 
 to get to the teat. It is astonishing sometimes to observe how well 
 Foals travel soon after birth, even over bad roads and during inclement 
 weather, and for great distances, provided the journey is short each 
 day. Huzard has seen Buffalo Calves, born during the night, follow 
 their mother next day, and make a daily journey of six or eight leagues 
 without appearing fatigued. 
 
 It is not rare to find newly-born animals, particularly when parturi- 
 tion has been laborious, injured more or less, from the manipulation 
 of the obstetrist during birth, the lesions being more or less serious. 
 The most frequent injuries are those due to obstetrical instruments 
 and appliances. The wounds may be dressed with cold water, with 
 slightly alcoholised water, or some dilute tincture — such as that of 
 arnica ; but salts of lead, or other poisonous salts, should not be em- 
 ployed. Abrasions, which are generally superficial, may be treated 
 with glj'cerine and water, to which a very little carbolic acid has been 
 added ; or by lard, or any mucilaginous substance. Sprains should 
 have cold water irrigation if possible, refrigerant lotions, or friction 
 with soap liniment. Wounds and lacerations, if very severe, must have 
 appropriate surgical treatment. 
 
 CHAPTEE IV. 
 Sequelae of Parturition. 
 
 We have stated that gestation and parturition are physiological pro- 
 cesses, and we may now add to these the puerperal state. But though 
 in one respect eminently physiological, the puerperal condition is 
 marked by special features, which distinguish it from other physio- 
 logical states, and which, occurring under other circumstances, would 
 be more allied to pathological changes. We refer now more par- 
 ticularly to the functional and organic alterations which take place 
 after delivery. True, we do not have in animals such important, nor 
 so many, sequelae as are noted in women at this period, some of which 
 are really pathological. Nevertheless, we have certain phenomena 
 occurring during the return of the economy and the generative organs 
 to the condition they wei'e in previous to pregnancy, which are not 
 only very characteristic, but are worthy of serious attention. These 
 phenomena have been divided into functional and organic. 
 
 SECTIOX I.— FUNCTIONAL MODIFICATIONS. 
 
 The functional modifications include the after-pains, lochia, milk- 
 fever, and lactation. 
 
 1. After-pains. — These are the painful sensations in the abdomen, 
 indications of which are frequently observed in animals, and which 
 persist after the expulsion of the foetus and the secundines. They are 
 due to the contractions of the uterus, that go on for some time, and 
 
SKijrKL.K i>F r.inTI/KITIoX. 215!) 
 
 eventually reduce the organ to its ordinary volume and so diminish 
 its cavity. After an easy labour, there are generally few or no 
 symptoms of these pains ; and when they are present the only indi- 
 cations are whisking of the tail, at which time the walls of the abdon)eu 
 appear to be harder. They seldom continue longer than twelve or 
 twenty-four hours in these cases, and do not require special treatment. 
 In other cases, however, and particularly when birth has been very 
 sudden and rapid, they persist longer and are more severe. The animal 
 paws and exhibits suttering ; it also stretches as if trying to micturate, 
 arches the back, contracts the abdominal muscles, and strains. The 
 access of these attacks is not regular ; and when they are frequent, 
 severe, and continue beyond twenty-four hours, we may apprehend the 
 retention of a portion of the foetal membranes in the uterus, or com- 
 mencing inversion of that organ. This will necessitate an exploration, 
 in order to discover the cause ; which, when ascertained, should receive 
 appropriate treatment, to be hereafter described. 
 
 2. Lochia. — The term lochia has been given to the sanguinolent, sero- 
 sanguinolent, muco-purulent, and, finally, mucus evacuations from the 
 vagina occurring after parturition, and generally persisting until the 
 uterus has regained its ante-pregnant condition. The existence of this 
 evacuation, so marked in woman, has often been denied in animals ; 
 but there can be no doubt whatever as to the fact of its presence. It 
 has been witnessed by several veterinarians in the Mare, Cow, Sheep, 
 and Bitch, and we have noted it repeatedly in the Sow and Cat. But 
 it is considerably less in these animals than in woman, and does not 
 flow continuously as in her, but at irregular peinods ; the discharge 
 accumulates in the uterus, and only escapes when the animal undergoes 
 exertion, and in defecation or micturition. In the Cat, however, we 
 have witnessed this discharge — very "flight — flowing constantly for four 
 days after parturition ; and with the Bitch we have a sanguinolent, 
 then a mucus discharge persisting almost continuously for several days 
 subsequent to that event. 
 
 In the larger animals, this discharge can be seen about the inferior 
 commissure of the vulva ; it sometimes accumulates about the thighs 
 and tail in flakes and patches, as well as on the litter ; and when the 
 animal has been lying it forms small pools on tlie ground. 
 
 When we remember that the uterus has for a long period nourished 
 one or more fcctuses, we can scarcely wonder that it cannot all at once 
 cease its secretory function, and that its mucous membrane should con- 
 tinue in a hypera3mic condition until the lacteal secretion in the 
 mammic 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 from 
 traumatic causes ; neither does it have a bad odour, unless the uterus or 
 vagina is the seat of some pathological process, or a portion of the 
 placenta is retained. According to some authorities, the average dura- 
 tion of the discharge is from two to three weeks ; but Saint-Cyr believes 
 that when it is prolonged beyond five to eight days, it is no longer a phy- 
 siological, but a pathological process. This is about the period which is 
 necessary, in the larger animals, for the return of the vulva to its 
 normal dimensions and ordinary form. - ^ 
 
 f\ 
 
270 NOIIMAL FAETURITIOX. 
 
 Of the importance of the lochia there can be no doubt. By them the 
 uterus is reheved from its physiological hypertrophied condition, aiid of 
 the excitement of which it was the seat during pregnancy and parturi- 
 tion. But it cannot have the same importance as in woman, in whom 
 the lining membrane of the uterus is thrown off after every delivery, 
 and renewed. It is not so with animals, as we shall see hereafter. 
 
 One or two veterinary authorities have attached so much importance 
 to the lochia in animals, that to their suspension or suppression they 
 attribute such serious results as sanguine plethora, articular rheumatism 
 in the Cow, laminitis in the Mare, metro-vaginitis, cystitis, nephritis, 
 peritonitis, mammitis, inflammation of the intestines or spinal cord, 
 coryza, vitulary collapse, etc. But there is evidently exaggeration in 
 this ; and we are inclined to think that, at the most, the untimely 
 cessation of this discharge can only cause, as has been stated, dulness, 
 indifference of the mother to its progeny and surroundings, inappetence, 
 suppression of milk, slight fever, with dry erect coat, and constipation. 
 
 To avoid this untimely cessation of the lochia, it has been recom- 
 mended that, with the larger animals, before and after parturition the 
 food should be sound and nutritive, but moderate in quantity, and such 
 as will not predispose to plethora or congestion ; not to travel or fatigue 
 animals towards the end of pregnancy ; to shelter them at this period ; 
 not to hurry labour, and only to render assistance when necessary ; and 
 after delivery to attend to the removal of the secundines, which are 
 sometimes retained in the Cow for an abnormal period, but should not 
 be allowed to remain longer than four or five days. 
 
 3. MiLK-FEVEE. — In woman the establishing of the lacteal secretion 
 after delivery — generally forty-eight hours — is usually accompanied by 
 a general febrile condition, in which this fluid changes from colostrum 
 to ordinary milk. This is the so-called " milk-fever," a pathological 
 condition said by some authorities to be present in animals, and denied 
 by others. The latter assert that, when parturition has been quite 
 normal, there is only observed a little dulness, lassitude, the pulse 
 fuller and quicker than usual, and less appetite for the first day — all 
 consequences of the suffering undergone dux'ing even the easiest partu- 
 rition. In a day or two, however, all this has disappeared, except 
 perhaps a little weakness, which soon vanishes also. But when par- 
 turition has not been altogether natural, and complications arise, then 
 there may certainly be fever, though this has nothing to do with the 
 change of the colostrum to milk — a gradual process ; indeed, when 
 traumatic fever sets in this secretion is diminished or suspended. 
 
 Saint-Cyr is disposed to deny the existence of this so-called " milk 
 fever" in animals, and he quotes eminent accoucheurs, who are inclined 
 to doubt the existence of this fever in woman as related to the lacteal 
 secretion, but as due rather to traumatism from injury to the genital 
 organs during child-birtli. His own observations on Cows are cer- 
 tainly not favourable to the existence of a fully developed fever in 
 these animals ; and even among those who believe in it, there are many 
 who admit that it is scarcely peixeptible. 
 
 Rainard, for instance, accounts for its being so little marked in 
 animals, by observing that in woman the uterus receives its blood from 
 the abdominal (inferior) aorta, but the mammas from the pectoral (or 
 anterior) aorta ; while in animals the uterus and mammae are supplied 
 by the posterior aorta. In w^oman, when lactation is established, there 
 
sEvUKL.K "/•• I'AirrrinTiox. 
 
 271 
 
 is an alteration in the circulation, and consequently a -general dis- 
 turbance which has been hitherto desij^'nated " intlainniatory " or 
 " an^iotenic fever"; but in animals this change in the circulation does 
 not occur. Therefore, this " angiotenic fever " should not be present. 
 
 4. Lact.\tion. — Before parturition, preparation for the secretion of 
 milk is already being made in the mammary glands, and immediately 
 preceding that event a thin serous or milky fluid can often be expressed 
 from the teat ; while immediately after delivery, the a'dematous tume- 
 faction which had been observed in these glands for some time begins 
 to disappear as they increase in voluiiie, become firmer, tenser, and 
 more sensitive, and receive a larger quantity of l)lood. Tlien their 
 activity is suddenly brought into full operation, and their secretion 
 reaches its maximum. At the same time this fluid is modified in quality 
 in a notable but gradual manner, so that it is very dilTerent tliree or 
 four days after parturition from what it was on the first or second day 
 — being colostrum at the early period, and milk subsequently. 
 
 Colostrmn. — The first milk, or "colostrum," secreted after deliveiy 
 is a viscid, dirty-white, or yellowish fluid, sweet, though unpleasant to 
 the taste, and of a greater density than that of ordinary milk, being in 
 the Cow 1-Oo6. When allowed to stand for some time it has a thick 
 layer of tough cream ; it coagulates at a comparatively low temperature 
 into a semi-solid mass. It is very rich in solid elements, these varying 
 according to individuals, and even breeds. The fat globules are present 
 only in comparatively large number, and are less in size than in milk 
 at a later period ; but there are numerous colostrum corpuscles — bodies 
 of a large size, spherical or ovoid in shape— often agglomerated in 
 masses by a tenacious viscid matter, and among them many leucocytes 
 endowed with movement, as well as pus cells. 
 
 The colostrum corpuscles appear to be only leucocytes or epithelium 
 from the walls of the milk ducts, and undergoing degeneration. 
 Boussingault gives its composition in the Cow as follows : — 
 Water .... 75-8 
 
 Albumin and casein - - 150 
 
 Butter - - - - 2-6 
 
 Milk-sugar - - - - 3 "6 
 
 Salts - - - - 3 
 
 But a more recent analysis by Chapelle, shows it to be composed of : 
 Albumin - - - - 15-997 
 
 Casein . . - - 2552 
 
 Butter ... - 5-390 
 
 Lactose ... - 1-361 
 
 Salts ... - 5-300 
 
 Water - - - - G9-700 
 
 Dumas gives the colostrum of various animals as below : — 
 
 
 Cow, 
 
 Aas. 
 
 Goat. 
 
 Water 
 
 803-3 
 
 828-4 
 
 641-0 
 
 Fat 
 
 26-0 
 
 5-6 
 
 52 
 
 Albninin 
 
 150-7 
 
 llfiO 
 
 2450 
 
 ' Mucus 
 
 20 
 
 7-0 
 
 30 
 
 Sugar .. 
 
 traces 
 
 430 
 
 .32-0 
 
272 NORMAL PARTURITION. 
 
 It is admitted that milk is due to a fatty degeneration of the 
 epithelial cells of the gland follicles, in which they are greatly multiplied 
 and developed during lactation. These cells rupture, and nothing 
 remains but the fat globules of the 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 pregnant, the milk again 
 loses its casein, and becomes very albuminous; consequently, coagulable 
 by heat. Its sugar also 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. 
 
 Milk. — Towards the fifth or sixth day, or even longer, after par- 
 
 B 
 r9:}oy. 
 
 r 
 
 Fig. 80. 
 
 Mammary Gland during Lactation. 
 
 A, Lobule of the Mammary Gland filled with Cells ; B, Milk or Fat Globules ; 
 C, Colostrum, a, Cell filled with Fat 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 animal 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 circumstances •} 
 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, climate, state of 
 health, etc. In Herbivorous animals it is generally alkaline ; in Car- 
 nivorous, acid. 
 
 1 Cow's milk of good quality, 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, 
 
SEQUELAE OF PAnTUUITlUX. 
 
 273 
 
 Vernois and Becqucrel give a comparative table of the composition of 
 the milk of various animals, as below : 
 
 
 
 Cow. 
 
 Goat. 
 
 Sheep. 1 Camol. 
 
 Maro. 1 Abs. 
 
 Sow. 
 
 Bitch. 
 
 Specific Gravity - 
 
 103-2 tw 
 
 1033-38 io:w -53 iaio-9s 
 
 
 1 
 1033-74 1034-57 — 
 
 10-11-62 
 
 ■Weight of Water- 
 
 88'JOS 
 
 804 00 844 -JO 
 
 83-2-3-2 
 
 
 iK)4-30 800-1-2 854-90: 772-08 
 
 Wei;;lit of Solid 
 
 
 1 
 
 
 
 
 I'lirts 
 
 110 -o-i 
 
 135-94, 155 10 
 
 107-68 
 
 134-00 
 
 95-70 109 -881 145-10 227-92 
 
 Fat - 
 
 •26-66 
 
 36121 56-87 
 
 51-31 
 
 36-00 
 
 24-36 18-531 19 50 87-95 
 
 Casein ami Extrac- 
 
 
 
 
 
 
 
 tive Matters - 
 
 39 24 
 
 65 15 55 14 
 
 69-78 
 
 40-00 
 
 33-35 
 
 35-65 84-50 116 88 
 
 Milk-snjrar - 
 
 43-64 
 
 38 03' 36-91 
 
 39-43 
 
 58 00 
 
 32-76 
 
 50-46' 30-30 15-29 
 
 1 Salts (by iucinera- 
 
 
 
 
 
 
 , 
 
 tioii) - 
 
 1-38 
 
 604, 6-18 
 
 ,16 
 
 — 
 
 5-23 
 
 5-24| 10-90 7-80 
 
 Doycre furnishes us with another interesting analysis, which we 
 cannot omit publishing here : 
 
 Constituents. 
 
 Wom.in. 
 
 Cow. 
 
 Goat. 
 
 Sheep. 
 
 Llama. 
 
 Ass. 
 
 Marc. 
 
 Water 
 
 87-38 
 
 87-60 
 
 87-30 
 
 81-60 
 
 86-60 
 
 89-63 
 
 91-37 
 
 Fat - 
 
 3-80 
 
 2-20 
 
 4-40 
 
 7-50 
 
 310 
 
 1-50 
 
 0-55 
 
 Casein 
 
 0-34 
 
 3-00 
 
 3-50 
 
 4-00 
 
 3-00 
 
 0-60 
 
 0-78 
 
 Albumin - 
 
 1-30 
 
 1-20 
 
 1-35 
 
 1-70 
 
 0-90 
 
 1-35 
 
 1-40 
 
 Sugar 
 
 7-00 
 
 4-70 
 
 3-10 
 
 4-30 
 
 5-60 
 
 6-40 
 
 5-50 
 
 Salts - 
 
 0-18 
 
 0-70 
 
 0-35 
 
 0-90 
 
 0-80 
 
 0-32 
 
 0-40 
 
 The salts contained in the milk vary with the character of the food, 
 and also according to the time that has elapsed since parturition ; this 
 fluid being particularly rich in inorganic elements during the first third 
 of the period of lactation. According to the analyses of Haidlen and 
 Furstenberg, there are in it 1,000 parts of ash ; -iTo phosphate of lime, 
 magnesia, iron, etc. ; 219 carbonate of lime and salts, which are more 
 especially combined with the casein ; 343 of sodium salts, with traces 
 of sulphur and tluonde of calcium. Milk also contains such gases as 
 carbonic acid, oxygen, and nitrogen, in solution. 
 
 In the Cow the flow of milk becomes very plentiful in about a week 
 after calving, but after a month or so it gi-adually diminishes in quantity 
 for about ten montlis, when the animal, as a rule, " runs dry." In the 
 first and second months after calving, when tlie yield is abundant, it is 
 generally more watery than after the fourth or fifth month ; and the 
 furtlier the diminution in quantity proceeds the better it becomes in 
 quality, other circumstances being equal. 
 
 It will be seen from the above table, that the milk of the Cow closely 
 approaches that of woman, and this accounts for the readiness with 
 which it can be substituted for the latter without injury to the child. 
 It is, when compared with that of Solipeds, more rich is casein and fat. 
 The milk of the Goat is the most nutritive, and contains more casein ; 
 but it is viscid and has a peculiar odour, something like that of the 
 cutaneous transpiration of this animal, and particularly during the 
 rutting season ; this odour is not so powerful in white Goats, nor in 
 those without horns, if they are properly kept. The milk of the Sheep 
 contains more fat than that of the Cow and Goat, while the casein is in 
 larger quantity, but is also viscid. It has less water than that of the 
 
 18 
 
274 
 
 XOBMAL PABTUFJTIOX. 
 
 Cow, and altogether is particularly rich, esjoecially soon after lambing. 
 This is well seen in the subjoined analysis, and it will explain the diffi- 
 culty which is experienced in bringing up a Lamb when the Ewe has 
 died soon after parturition : 
 
 Ewe's Milk I Ewe's Milk 
 
 Three Weeks | Six Weeks 
 
 after Lambing. . after Lambing. 
 
 Water 
 
 Fat - 
 
 Casein 
 
 Milk-sugar - 
 
 Mineral Matters (Ash) 
 
 75-00 
 
 12-78 
 
 6-58 
 
 4-66 
 
 •70 
 •67 
 
 •44 
 •00 
 •19 
 
 100^00 
 
 10000 
 
 The milk of the Mare apx3ears to contain the largest proportion of 
 water and the smallest quantity of fat, the milk of the Ass coming next 
 to it in these constituents. This contains little casein, scarcely any fat, 
 and a small quantity of ash. On the other hand, it is comparatively 
 rich in milk-sugar, which is, according to Voelcker, a very digestible 
 material and a good aperient, particularly for children. But of all 
 animals, the Carnivora have the richest milk ; the casein and fat being 
 particularly abundant, and no other food will at all compare with 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 difficulty of bringing up a Puppy by hand. No kind of food is 
 sufficiently concentrated adequately to provide for the nourishment of 
 a Puppy, strong beef-tea being perhaps the best substitute for that 
 purpose. The milk of Carnivorous animals has another peculiarity, in 
 the very small proportion or entire absence of milk-sugar. This sub- 
 stance is very abundant in the milk of Herbivorous animals ; and when 
 Carnivorous creatures 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 entirely on flesh, 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 
 
 Goat Camel Mare 
 
 Milk is a typical food, and when healthy and in sufficient quantity, 
 contains all the constituents for the maintenance and growth of the 
 young creature." This is particularly noted immediately after birth, 
 
 ^ According to a French medical journal, Montbrun-les-Bains, in the Drome, is cele- 
 brated for nurses, who continue to give the breast for two j-ears and more. When one 
 of these women loses her nursling, she takes a puppy-dog instead, which then becomes 
 one of the family. But it has been observed that all these dogs become affected with 
 rickets, and this has led a medical man to conclude that woman's milk is deficient in 
 some principle contained in dog's mik, and that consequen' ■ "he latter might be a cure 
 for rickets. An observation published by him would seem to confirm this view. 
 
 - The mammary secretion may be present in animals without their being in the preg- 
 nant or parturient state, or ever having been so. We have already alluded to Bitches 
 yielding milk without having Puppies. Rabbits have done the same without having 
 been fecinidated, and have reared the young of other Rabbits ; Bitches have done the 
 same. Virgin or barren Ewes have also yielded milk, as have likewise Mares — Mule 
 and Horse — and Fillies. 
 
sEijuL.E iiy I'Anrrniriox. j;.') 
 
 and before it he,c;ins to seek for other food. It is at this period, also, 
 that growth is most rapid ; and it has been observed that Puppies 
 double their initial weight in six days only. Colin has stated that, in 
 thirty days, ten Puppies — reduced to nine on the twenty-lifth day — 
 living on the milk of the mother alone, except for the last ten days, 
 showed a total increase of 3o^ lbs., the entire weight having been 
 trebled since birth. A similar increase maybe observed in other young 
 creatures while being suckled. When, from some cause or another, the 
 progeny cannot obtain milk sufficient in quantity or proper in quality, 
 it is necessary that this be remedied. A Calf can be readily artifici- 
 ally reared in an ordinary establishment, if it has had one or two days' 
 colostrum ; or a substitute for the mother in another Cow may be pro- 
 cured. It is not so witli the Foal, which is much more dilVicult to rear, 
 and another Mare, even if procured, will not always readily play the 
 part of nurse. Nevertheless, many animals can be reared by judicious 
 and patient management, and if artificial food must be resorted to, this 
 should come as near as possible, in chemical composition, to that 
 furnished by Nature. 
 
 In some instances, the mammary secretion may become a source of 
 embarrassment, or even of danger, when it is too abundant or is not 
 withdrawn when secreted. This happens more particularly with the 
 Bitch, Cat, Mare, or other animal which is suddenly deprived of its 
 young by death, or for special reasons ; and the retention of the milk is 
 often a cause of discomfort and disturbance, culminating not unfre- 
 quently in inflammation of the gland. In such cases the milk should 
 be withdrawn until its secretion is diminished or altogether ceases, the 
 diet limited and modified, and mild diuretics or purgatives may be 
 administered to hasten this end. Camphor, in small and frequent 
 doses, has been recommended with this object, as well as an effusion of 
 walnut-leaves and powdered white agaric. 
 
 Whatever general treatment may be adopted in such instances, local 
 treatment must not be overlooked ; and in addition to removing as 
 much of the contents of the mammary glands as possible, these may be 
 kept healthy, or cured when congested or inflamed, by suitable treat- 
 ment. Soothing liniments or embrocation should be timeously applied 
 by friction to the skin covering them. 
 
 SECTION II.— ORGANIC MODIFIC.VTIONS. 
 
 Gestation and parturition being completed, it is necessary that the 
 genital organs should return to their non-puerperal state. Indeed, this 
 return to their ordinary physiological condition is commenced in the 
 uterus even during labour, and remarkable modifications occur more 
 particularly in the uterus and its membranes then, and for some time 
 afterwards' These changes are connected with the diminution of the 
 uterus in volume, alterations in its mucous membrane, and the reform- 
 ing of its cei-vix. 
 
 The powerful contractions of the uterus during parturition, iudul)it- 
 ably tend to use up the contents of the cells of the non striped muscular 
 fibre composing its middle coat ; the simultaneous compression of the 
 capillaries and afferent vessels preventing the expended protoplasm 
 from being replaced. After the expulsion of the ftetus and its mem- 
 branes, this wasting or degeneration of these fibres continues: the 
 uterus still contracting at inten-als, and producing those sensations 
 
276 NOBMAL PAIITUIUTIOX. 
 
 known as "after-pains" — the contractions being slow, gradual, and 
 continuous, and lasting until the whole of its inner 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 diminishing in force as this change goes on ; 
 and this change is essentially related to the 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. They 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. 
 
 This 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, immediately 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 w'ill be found reduced to a twelfth or thirteenth of its weight 
 at parturition. 
 
 At the same time, the mucous 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 physiology of pregnancy, we described the manner in 
 ■which this membrane became enormously thickened, either wholly or 
 partially, to constitute a most important glandular and vascular 
 structure for the development of the young creature. But after 
 parturition, fatty degeneration attacks this structure and completely 
 destroys it in Solipeds and Euminants, and this destruction takes 
 place in a remarkably 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 foetal placenta — 
 the decidua vera — is completely detached 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 shines through it. 
 The uterus soon retracts and the placental wounds diminish in 
 size, becoming covered with granulations like other wounds. In a 
 Bitch which 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, 
 and having the mucous membrane very smooth, slightly thickened 
 and pigmented, and which, being found in all the pluriparous Bitches 
 and Cats examined, were believed to be old placentular cicatrices. 
 
 In Euminants 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 even appear to subside altogether, or to be 
 
SEQEL.E OF I'Airrri'JTloX. -211 
 
 reduced to exceedingly small porportions. With Solipeds and the 
 Sow, which have a diffused placenta, the follicles which received the 
 placental papilhr of the chorion also disappear ; and the membrane, 
 greatly thinned, assumes its ordinary ridged appearance, though the 
 ridges or folds are larger and more numerous than before conception. 
 In a Mare killed eighteen or twenty hours after parturition, lircolani 
 found the maternal portion of the placenta reduced to one-half its 
 thickness ; its colour, instead of being a dull red, had become yellowish ; 
 the follicles, from being one to two millimetres in length, were reduced 
 to one and half a millimetre, and the capillary network around them 
 was no longer visible 
 
 The evacuation of the detached elements is accompanied by an 
 apparently large mucous secretion, which, often sanguinolent, con- 
 stitutes what we have described as the " lochia." 
 
 Finally, a new epithelium is formed in the place of that which has 
 been shed, and the uterine interior presents the appearance it had 
 before impregnation. According to Friedlander, the formation of the 
 new mucous membrane takes place in the following manner : All that 
 has remained behind of the cellular layer richly infiltrated with blood, 
 as well as the upper portions of the glandular layer, gradually exfoliates 
 and is discharged in the lochia. The flatly compressed glandular tubes 
 situated close to the muscular coat are opened up, and their cylindrical 
 epithelium forms the new mucous epithelium of the internal surface 
 of the uterus. The connective tissue situated between the tubular 
 glands accordingly proliferates, and becomes reorganised. In con- 
 sequence of the increase in thickness of the mucous membrane, the 
 previous shallow depressions of the epithelium are deepened, and in 
 that way the uterine glands are also reformed in the new mucous 
 membrane. 
 
 Coincidently with this return to small proportions, the uterine cervix 
 also regains its former shape. During the passage of the fcitus, in 
 process of dilatation the os and vagina form a continuous canal without 
 any interruption, and the cervix is effaced. Immediately after the 
 ftt'tus has passed througli, however, the latter reappears, the os is 
 closed, and the uterus and vagina are again separated by the sphincter- 
 like ring which the uterine neck exhibits in the cavity of the latter. 
 The cervix is at this 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 doing so it elongates 
 towards the vagina, into which it projects, until it has regained its 
 natural form and consistence ; though it is always shorter and less 
 regular in shape, particularly at the os, in animals which have had 
 several young, than in tho'^'^ which have never been pregnant. The 
 uterus itself does not completely assume the dimensions it had in non- 
 pregnant animals, but is always larger after it has contained one or 
 more foetuses. 
 
 It may be noted that the broad ligaments of the utenis become 
 shortened after parturition, and consequently raise the organ towards 
 the lumbar region, and in the direction of the pelvis ; while their 
 muscular fasciculi undergo fatty degeneration and absorption. 
 
 Such are the organic modifications the genital organs undergo after 
 labour, when everjthing occurs regularly. But it sometimes happens 
 that the muscular layer of the uterus appears to be stnick with 
 paralysis soon, or even immediately after birth ; so that it remains 
 
278 NORMAL PARTURITION. 
 
 distended, and its cavity is so large that the arm can easily be intro- 
 duced into it. This inertia is not so much to be dreaded in animals 
 as in woman, though it is often troublesome and sometimes serious in 
 them. The cUbris of the decidua vera, and other effete matters, ac- 
 cumulate in its cavity, and the os being always more or less patent, 
 the air obtains admission, putrefaction commences, and grave results 
 may follow. An exploration will discover a variable quantity of sanious, 
 and more or less foul-smelling, matter in the cavity of the organ ; and 
 until this is removed, and the organ made to contract on itself, danger 
 may be apprehended. 
 
 The gradual and steady involution of the uterus is therefore of much 
 importance after expulsion of the foetus. 
 
I'AJiT SI-COXJ). 
 DYSTOKIA. 
 
 GENERAL CONSIDERATIONS. 
 
 In studyiiij^ the physiology of parturition, we saw that a favourahle 
 termination of hxhour clepended on two factors, one of which was a 
 proper degree of activity of the expelhng powers, and the other a 
 normal condition of the obstacles to be overcome by these powers. 
 When tliese are out of proportion to each other, then we have dilVicult 
 parturition, or Dystoki.v (oi's, difficult ; tokos, birth). Diflicult par- 
 turition may be due to too feeble pains, or to an obstacle which the 
 unaided efforts of the animal cannot surmount except after an unusual 
 period of labour, or not at all. 
 
 We have already alluded to the nature of and variations in the 
 expelling forces, and also to the causes of protracted labour. We have 
 now to treat of the ditliculties attending parturition, with their con- 
 sequences — proximate or remote, and the means to be adopted for 
 overcoming, preventing, or remedying these. This involves a study of 
 the necessary obstetrical operations, the accidents attending or follow- 
 ing parturition, and the diseased conditions more or less related to the 
 puerperal state — all of which may be included under the head of 
 " pathology of parturition." 
 
 The dilliculties attending parturition depend upon the resistance 
 opposed to tlie expelling powers, and this is determined by the relation 
 of the object to be expelled — the presenting part of the foetus, to the 
 maternal genital passages. Consequently, an exaggerated resistance 
 may be due to abnormal conditions of the parturient passages, or to 
 some unnatural condition of the young animal. In the first we have 
 MatcriKil Dystokia, and in the second Fcital Dijslohia. These necessitate 
 particular operations, some of which demand much study, address, and 
 manipulative power on the part of the obstetrist. In addition, we have 
 dangerous accidents sometimes occurring during parturition, which, if 
 they do not happen to interfere with the mechanism of that act, may 
 nevertheless recjuire the highest degree of surgical skill to remedy. 
 And, linally, there are the maladies which accompany the parturient 
 state, some of them being serious, and needing great clinical and 
 therapeutical knowledge for their successful treatment. 
 
 These dilliculties, accidents, and diseases do not occur with the same 
 gravity, nor with the same frequency, in all the domesticated animals ; 
 indeed, with regard to the latter, some species appear to be altogether 
 exempt from at least one or more of them. 
 
 Cases of dystokia are much more frequent in the Bovine species than 
 in any other ;' and least so, perhaps, in the Equine species. These two 
 
 ' The Camel — and particul.irly the Bactrlan varii'ty which i.s characteristic of Mongolia 
 — apjifars generally to re<iiiire aiiiiiatance during parturition. At least we may infer this 
 from the statement of Colonel Prejevalsky, who, in speaking of the Mon;;olian Camel, 
 says : — "The males Injcome vicious during the rutting season, which is in February, and 
 they will then fight with one another, and sometimes attack mankind. The interference 
 of man is needed to bring the sexes together. The period of gestation is thirteen months, 
 at the expiration of which the dam gi%e3 birth to one, or, as an exception, to two P'oals. 
 
280 DYSTOKIA. 
 
 species are those which the obstetrist is generally called upon to attend 
 during protracted or difficult parturition ; and every practitioner who 
 has had any experience in this matter, will testify that for one case in 
 the Mare or other animal there will be at least ten in the Cow. Two 
 Danish veterinarians, Nielsen and Tallich, have estimated, that while 
 they have had ten cases in the Mare, the first has had 190, and the 
 second 159 in the Cow ; and yet these writers practised in a district 
 where more Horses than Cows were reared. 
 
 We have already said that the Mare is, of all quadrupeds, the one 
 which brings forth its young most easily — a fact noted by Aristotle. 
 But this remark only applies to normal parturition in that animal ; in 
 abnormal cases there is, as a rule, more urgency and danger than in 
 the Cow, as well as more difficulty in affording relief. Indeed, a very 
 able veterinarian, Donnarieix, who has had an extensive experience in 
 obstetricy, declares that obstetrical operations in the Mare are a labour 
 of Hercules ; while in the Cow they are, comparatively, child's play. 
 This experience will not quite accord with that of every practitioner ; 
 as in both animals difficulties in parturition will be sometimes 
 encountered, which baffle the skill of the most competent obstetrist, 
 and often prove insurmountable. One of these difficulties in the Mare 
 is related to the difference in the vitality of the Foal and Calf when 
 parturition has commenced — a difference which we have before pointed 
 out as due to the particular arrangement of the maternal and foetal 
 placentae in each species, and which it is of great importance to 
 remember in choosing the means to be employed in overcoming obstacles 
 to parturition in either the Mare or Cow. The following comparison 
 has been drawn by Donnarieix, between parturition in the Mare and 
 Cow, and fairly accounts for the differences in each animal : — 
 
 Mare. Cow. 
 
 1. Delivery is often followed by 1. Delivery always terminates 
 insuccess. favourably. 
 
 2. A wound inflicted on the 2. A wound of these organs 
 genital organs is generally fatal. rarely causes death. 
 
 3. Inversion of the uterus is 3. Inversion of the uterus is 
 nearly always irremediable. often curable. 
 
 4. Mares nearly always succumb 4. This accident is not generally 
 to penetrating wounds of the abdo- fatal in Cows. 
 
 men during parturition. 
 
 5. Delivery of the most simple 5. Delivery, even in the most 
 kind is occasionally followed by complicated cases, generally proves 
 bad results. In abnormal and comparatively easy, and obste- 
 laborious parturitions not unfre- trical operations successful, 
 quently Mare and Foal succumb. 
 
 6. Difficult parturition proves a 6. Such parturitions are not of 
 Herculean task to the operator. much account to a practitioner 
 
 skilled in the necessary operations. 
 
 Human assistance is also required at the time of parturition. The new-born Camel is the 
 most helpless creature imaginable ; it must be lifted by hand and placed under the 
 mother's teats ; but as soon as it can walk, it follows her about everywhere, and the 
 latter is so attached to her offspring, that she cannot bear to be separated from it. The 
 female Camel is granted its liberty for a whole year after parturition ; so that it only 
 foals every other year." — Mojigolia, the Tangut Country, and the Solitudes of Northern 
 Tibet, voL i., p. 124. London, 1876. 
 
(7KX/:/!,l L < •nXSlDEHA T/i>Xs: 
 
 281 
 
 Cow — con tin ued. 
 
 7. Under the same circumstances 
 the calf may live four or five days 
 /;/ ntcro, as life is maintained by 
 the placental connections. These 
 ditferences are oxjilaincd by the 
 mechanism of fatal life in the two 
 species of animals, as well as by 
 the anatomy of the uterus and 
 fcetal membranes. 
 
 8. The neck of the fcetus being 
 shorter and thicker, the head is 
 less twisted, and the operator can 
 with <,'reater ease bring it back 
 into its normal position. In addi- 
 tion, there are teeth in the lower 
 jaw, the neck of which is narrow ; 
 so that the slipknot does not leave 
 it, and straightening of the head 
 and neck becomes an easier affair. 
 
 yiMiK^con fill ued. 
 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. 
 
 8. The neck of the Foal being 
 very long, the head is usually 
 found deeply buried in the Hank 
 whenever it is turned backwards. 
 The operator has very great ditli- 
 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. 
 
 0. 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 fo'tal 
 membranes to manipulation, when 
 made to ascertain either the posi- 
 tion of the foetus or for correcting 
 the position, together with the 
 stniggles and violence of the Mare, 
 which now and then drops as if 
 dead, are all difticulties to be over- 
 come. 
 
 Presentations which, in the Cow — owing to its phlegmatic tempera- 
 ment, intenals of quietude, and more gentle and tractable nature — arc 
 common, and as a rule adjustable, are yet most diflicult in the Mare, 
 and if not quickly attended to, rapidly lead to a fatal termination. 
 With regard to diflicult parturition in the other domesticated animals, 
 the Goat 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 th? (loat the act is sometimes 
 very prolonged, though on account of the multiple placenta) the fa'tus 
 may live as long as in the Cow. With the Ewe the same occurrence 
 is observed, but in 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. 
 
282 BYSTOKIA. 
 
 the hand into the genital passages. It is rare indeed that the ob- 
 stetrist is required to attend upon the healthy Sow, this animal 
 appearing to be almost exempt from difficulties in parturition. In 
 cases of rachitism, however, there is sometimes so much deformity of 
 the pelvis, that aid is required. Notwithstanding the narrowness of 
 the passages, the hand or fingers may be passed into them. 
 
 Cases of dystokia ai'e not infrequent in the Bitch, and particularly 
 if it is of small size, or belongs to a breed with a large round head and 
 short nose. Numbers of Bitches perish every year from non-delivery 
 of their Puppies ; these latter may also succumb before the decease of 
 their parent, as it often happens that the death of one entails destruc- 
 tion on the others. Cats are sometimes subjects of difficult parturition, 
 and from the same causes as Bitches. 
 
 A very great disadvantage under which the veterinary obstetrist 
 labours in cases of dystokia, is the late period at which his services are 
 generally called into request, and often after serious, and even irre- 
 parable, injury has been done by unskilful hands ; and this in instances 
 in which a little scientific manipulation and some surgical knowledge 
 would have, perhaps, made all right and safe in a few minutes. Saint- 
 Cyr justly says, in commenting on some remarks made with regard to 
 the services a veterinary surgeon may render in difficult partmntion, 
 that these can be beneficial only on the absolute condition that he is 
 present in good time. Called upon too late, when the " waters " have 
 escaped for a long period, and the neighbouring empiric has exhausted 
 his science, aggravated a bad presentation, irritated the generative 
 organs by manipulations, tractions, and violent means ; then all the 
 ability of the most experienced practitioner may be useless. He will 
 find the passages dry, burning, swollen by inflammation, the fcetus 
 more or less advanced into the pelvic cavity, where it is, it may be said, 
 "wedged," or like a nail driven into wood ; with the uterus spasmodi- 
 cally contracted on itself, and so closely applied to the body of the 
 foetus that it is almost impossible to pass the hand between them. 
 How is it possible to manipulate in such a place — how change the 
 vicious position of a foetus which the greatest efforts cannot make 
 advance or retire ? How can a sharp instrument be carried into the 
 uterine cavity and used with safety, when the hand alone can scarcely 
 be made to enter it ? 
 
 It is in these circumstances that a practical knowledge of obstetricy 
 is most valuable, and renders he who possesses it a very great acquisi- 
 tion to an agricultural or pastoral district. And this knowledge may 
 be said to be special ; for obstetricy is not like the other branches of 
 veterinary surgery, in forming a portion of every veterinarian's practice. 
 On the contrary, it is rarely practised in towns or cities, but is almost 
 exclusively limited to animal-rearing localities ; there alone is to be 
 found the school in which the practitioner may be initiated into all the 
 difficulties of this complex art, and the best and readiest means of sur- 
 mounting them. And it must be confessed that the practice of this art 
 is not particularly alluring, and is attended with many more incon- 
 veniences, hardships, and difficulties than fall to the lot of the human 
 obstetrist : indeed, we know of no more arduous and anxious occupa- 
 tion than that of the country practitioner in a cattle-breeding district, 
 and he requires physical endowments which are certainly not needed 
 by the attendant on woman. 
 
 Veterinary accouchments are generally difficult and perplexing, as 
 
aKXElHL rOXSIDEn.iriOXS. 283 
 
 well as fatif^^uing. Lon^ and powerful arms are necessary, as well 
 as much address in usin;^ them and the linj^ers ; bodily activity is 
 above all essential, in order to go about an animal, to place one's self 
 in the most favourable position for exploring and operating, and to 
 avoid injury from the creature. The veterinary obstetrist should also 
 be gifted with presence of mind, coolness, and fertility of resource ; so 
 as to take into consideration all the circumstances of the case, devise 
 his method of procedure, and carry it out promptly. 
 
 The conditions under which the veterinarian has to perform his task 
 are not favourable or encouraging. It is anything but easy to practise 
 the necessary manipulations in the larger animals — such as the Mare 
 or Cow — in such a great cavity as the abdomen, and in the uterus 
 which lies deep in it, and contains a voluminous fcetus. In practising 
 these manipulations, the operator has to contend with the struggles 
 and disordered movements of the animal, which sometimes, in the 
 midst of its sufferings, does not hesitate to use its feet, horns, or teeth 
 as weapons of offence, or to crush its medical attendant against the 
 adjacent wall. In addition, the violent contractions of the uterus, and 
 especially of the cervix, fatigue the operator extremely. Sometimes 
 these manipulations have to be continued for hours, until the various 
 obstacles to delivery arc successively overcome, or the creature is 
 doomed to perish. 
 
 Add to this, that Cows and ^Nlares during i)arturition often inhabit 
 close, foul stables, with an almost poisonous atmosphere, destitute of 
 light, and perhaps also cold and damp. Here the veterinarian must do 
 his duty — cold, wet, and dirty, exposed to draughts and every kind of 
 discomfort. Most frequently, too. he is left to his own resources; for 
 it is rare that intelligent and obedient assistants can be found in such 
 places. And all this after driving long distances, often at night and in 
 bad weather. How different to the accoucheur of woman ! 
 
 All the inconveniences, risks, and hardships of the veterinary obstet- 
 rist do not end here. After manipulations, sometimes long continued, in 
 a uterus containing infective matter resulting from retention of a dead 
 foetus, or foetal membranes in process of decomposition, he is exposed to 
 the most serious septic diseases, and may even lose his life. A cutaneous 
 eruption, indeed, often appears on the arms of the operator, merely 
 through having manipulated for some time in genital organs, the mucous 
 membrane of whicii was only irritated and inflamed, or simply swollen 
 and bruised — no putrefaction or suppuration being present. Most 
 frequently the disease is only local, and is sometimes a simple, limited, 
 erythematous redness which disappears in twenty-four hours ; at other 
 times it is a trifling eczema without pustules, but with intense itching ; 
 frequently it is a pustular, sometimes confluent, ecthyma, the crusts 
 on which are occasionally not detaciied for months ; in other cases 
 there arc furuncles, abscesses on the arm, or even over the body. In 
 the majority of cases, the atTection is accompanied by fever, anorexia, 
 great uneasiness, and pains so acute that sleep is impossible ; there 
 niay also be tumefaction of the axillary glands. The course of the 
 disease is generally irregular, relapses are common, and it is a long time 
 before its effects pass off. Death sometimes occurs, and amputation of 
 a portion of the arm has been necessary. ^ Such are the difficulties and 
 risks of the veterinary accoucheur. We will now refer more particularly 
 to his line of conduct in practice. 
 
 ^ I'et^rinar;/ Journal, vol. ii., p. 21 S. 
 
284 DYSTOKIA. 
 
 Proprietors of animals should, in their own interests, suffer no delay 
 to occur in sending for the veterinary surgeon as soon as they perceive 
 that parturition is not progressing regularly ; and they should carefully 
 abstain from any violent handling of, or traction on, the foetus which 
 might render irremediable a difficulty often easy to surmount at the 
 commencement, by anyone sufficiently acquainted with obstetrics. 
 
 On his part, the veterinarian should not lose time in giving his 
 services ; as every minute's delay may render the case more difficult, 
 and tend to compromise the life of not only the young animal, but also 
 that of the mother, as well as the interests of the owner and his own 
 reputation. It is essential that he should be provided with certain 
 instruments, as obstetrical operations are partly performed by means of 
 these, as well as by the unarmed hand, which is, after all, the most 
 perfect instrument, and should always be preferred to instruments when 
 possible. Some operations, however, can only be undertaken with 
 instruments, and it is therefore necessary that the obstetrist be pro- 
 vided with at least those which are most useful and indispensable : such 
 as one or two knives, cords, hooks, Schaack's head-collar or some other 
 pattern, etc., and these should be so portable as to be carried in a 
 leather or canvas bag, or a small box. 
 
 On reaching the patient, all information concerning it should be 
 gathered at once and an examination immediately made into its condition. 
 The period when labour commenced ; if the " water-bag " has ruptured, 
 and when ; if the animal has gone its full time, or exceeded it ; if it is a 
 primipara, or, if not, if its previous parturitions were favourable — all 
 these and other useful points in its history should be obtained. 
 
 The examination should comprise : the general appearance of the 
 animal ; whether weak or strong ; the character of the j)ulse ; and the 
 nature, frequency, and intensity of the expulsive efforts ; as well as the 
 condition of the mammae, and external genital organs. After this, if 
 further examination is necessary, direct exploration of the internal 
 genital organs should be made. We have already described the mode 
 of procedure to be adopted in this exploration ; but because of its im- 
 portance, we will again notice it. 
 
 If possible, the Mare and Cow should be examined in a standing 
 attitude, as this is the best. If, however, the animal is lying, and from 
 exhaustion or paralysis it cannot get up, then of course the examination 
 must be made in this position ; indeed, it may be advantageous to 
 examine in both positions. 
 
 When standing, it should be approached gently and coaxingly, and 
 rigorous restraint is seldom necessary ; for the pains of labour usually 
 render the most vicious animals tractable. With the Mare it generally 
 suffices to have one of the fore-feet held up by an assistant, while the 
 examination is made ; if young and dangerous, it may be necessary to 
 employ a side-line on a hind pastern, or hobbles on both hind pasterns, 
 and perhaps a twitch on the nose. With the Cow, a strong man hold- 
 ing the animal's head is sufficient to make it stand quiet. 
 
 Lateral movements may be prevented by placing the animal against 
 a wall or partition on one side, and a powerful man at the other side ; 
 or a man at each side. The operator must be on his guard against the 
 animal suddenly dropping, which would expose him to serious injury. 
 When the floor inclines from the tail towards the head of the animal it 
 is most favourable for an exploration, as the mass of intestines is thrown 
 forward against the diaphragm ; so that they do not press on the uterus. 
 
 I 
 
HEXEJLiL CoySIDEHATWXS. 285 
 
 which is then more free and better adapted for niancmvivs in its 
 interior. 
 
 When the operator has to explore in the lyin<; position, he liiuls it 
 much more fati^'uin;^ and dillicult, as he has then to kneel, and to 
 acconnnodate himself to the animal. In the decubitus, it is still more 
 necessary that the croup shoidd be higher than the front part of the 
 body, in order to get the digestive organs out of the way ; the lateral 
 pressure of the viscera should also be diminished by having the spine 
 higher than the limbs ; and it must be borne in mind that the more an 
 animal is raised above the ground when it is lying, the easier is the 
 manipulation. For the same reason, the smaller animals should be 
 raised as high as the operator's hand : the Sheep, Sow, and Goat on 
 several bundles of straw ; the Bitch and Cat on a table covered with 
 straw or a cloth. The two latter animals must be so seciu'ed that they 
 will not bite or scratch the operator. 
 
 To compel a Cow to get up, Schaack recounnends that a small Dog 
 be introduced into the stable, and made to bark at and excite the 
 animal 
 
 The coat must be removed, and the shirt-sleeve rolled as high as the 
 shoulder ; indeed, with large animals, when there is a likelihood of much 
 manipulation bein^ required with the cavity of the uterus, it has been 
 recommended to remove the shirt and underclothing from the arm and 
 shoulder altogether. 
 
 My friend, Mr. Cartwright, of Whitchui'ch, employed a large, thick, 
 and long woollen sleeveless vest that buttoned close up around the neck ; 
 this is very suitable for such cases, as it not only admits of the shirt 
 being removed, but besides keeping the operator's clothes clean, it 
 prevents him catching cold. Other operators wear a long gown, like a 
 dissecting-room gown. 
 
 The back of the hand and arm should be well smeared with oil, 
 grease, or even 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. It is 
 scarcely necessary to add that rings should not be worn on the fingers. 
 The right hand is usually introduced, but it is well to be able to use 
 both hands — certain manipulations being more easily executed with 
 the left than the right hand ; and, besides, in protracted operations 
 one hand relieves the other. 
 
 Before commencing the examination of the genital passages, it is 
 well to empty the rectum, and if possible the bladder. While emptying 
 the former viscus, useful information may be 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 the 
 vagina at a moment when the animal is not straining — the outer margin 
 (little finger) being downwards, thumb towards the rectum, and pushed 
 gently inwards by a slight rotatory movement ; but the advance of the 
 hand must be momentarily checked if the straining is at all severe, or 
 until the animal, if irritable, has become reconciled to it. When once 
 through the vulva, more room is found in the vagina, and the hand 
 and fore-arm can then penetrate with ease as far as the cervix uteri. 
 
 The object of exploration being to ascertain, in the first place, the 
 condition of the genital passages, as well as the state of the pelvic 
 cavity in general, the operator has to satisfy himself whether the vagina 
 
286 DYSTOKIA. 
 
 is empty, or if it already contains some portion of the foetus or its 
 membranes, and what these are ; if there is any normal condition or 
 contraction of 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 size from exostoses, frac- 
 tures, or other causes. 
 
 The state of the soft parts will likewise engage his attention, and he 
 must learn whether the vulvo-uterine canal is dry, or contains suffi- 
 cient mucus to facilitate manipulation or delivery, 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 the vagina, or if it is completely 
 effaced ; whether the uterus has descended on the floor of the abdomen, 
 or is yet in its ordinary position ; whether the 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 morbid degeneration, and if it lies in the 
 axis of the vagina or deviates therefrom, or is more or less twisted. 
 Passing the hand into the uterine cavity, if necessary and possible, 
 and with all care and gentleness, the explorer will meet with the 
 " water-bag," if it is not already ruptured, and the foetus, if he has not 
 already encountered it ; at the same time the ene^'gy and frequency of 
 the labour pains can be ascertained. If the membranes are ruptured, 
 the hand must be passed into them in order to discover the situation of 
 the foetus — the kind of presentation and position, the manner in which 
 the limbs are disposed, and any complications which may be present. 
 If the membranes are not ruptured, and it is deemed necessary to open 
 them — which not unfrequently happens when an exploi'ation has to be 
 made, and labour is advanced, the pains being well marked, the os 
 dilated, and the water-bag in the vagina — the hand may be passed 
 between them and the uterus, the palm being towards the foetus ; or it 
 may not be required to pass so deeply. 
 
 When the membranes are tense, pressure against them with the end 
 of the index-finger during a throe is usually sufficient to open them : if, 
 however, they are flaccid, a portion is seized between the thumb and 
 middle finger and torn by their nails, or by the nail of the first finger 
 against that of the thumb. Sometimes the fingers alone are not 
 sufficient, as when the envelopes contain but little fluid ; then a pair 
 of scissors, a small trocar, or even an ordinary pen, will effect this 
 object. 
 
 In examining for presentation and position, each region of the body 
 of the foetus should be familiar to the touch, as it can be distinguished 
 by its own proper characters. Under ordinaiy circumstances, the hand 
 of the operator first meets with the limbs of the foetus ; if they are the 
 anterior limbs, and the plantar surface of the feet is turned downwards, 
 then the foetus 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 limbs, then it is in the vertebro-pubic 
 position. To distinguish the fore from the hind limb, the shape of the 
 joints and their mode of flexion must be taken into account — the fetlock 
 and knee of the former bend in the same direction, while in the latter 
 the fetlock and hock flex in opposite directions ; the knee, in addition, 
 is large, round, and rather flattened in front, while the hock is flattened 
 
GEN ERA L COXSIDKIL / TK >\S. 287 
 
 on each side, and offers the calcis as an unmistakable f;uide. Thei-e is 
 also a diflerence in the shape of the feet. 
 
 The explorer should take time to assure himself of the real state of 
 atTairs, and conduct his examination with all the care, attention, and 
 ^'entleness possible. The ftrtus may present in a variety of positions, 
 in which hind and fore limbs may offer first, either alone or together ; 
 and in the case of twins or monstrosities, the limbs of ditTeront crea- 
 tures may be encountered at the same time. If the presentation is 
 anterior, the head will be met with, and this is distinguished by the 
 presence of the mouth, eyes, and ears ; if it is a posterior presentation, 
 then we have the rounded croup, tail, hocks, and external genital 
 organs. In other presentations, the neck is recognised by the mane, if 
 it be a Foal, in addition to its shape, whether Foal or Calf ; the 
 shoulders by the acromion processes and withers ; the chest, by the 
 ribs and intercostal spaces ; and so on. In addition to all this, the 
 obstetrist should judge at the same time of the volume of the foetus, 
 and its proportions. This is particularly necessary in the case of mon- 
 strosities ; and in some instances it is most dillicult to decide what the 
 hand may alight upon in such an examination. Kopp alludes to the 
 case of a Mare which he examined during parturition, when he found a 
 foetus affected with hydrocephalus to such a degree, that for a long time 
 he thought the head was the thorax. 
 
 It cannot be too strongly impressed upon the minds of those who 
 are commencing obstetric practice, that such an exauiination should 
 be so complete as to furnish all the requirements of a sound diagnosis, 
 on which the indications for affording assistance can b- readily based ; 
 and this exploration can only be said to be complete when the obstetrist 
 is as well acquainted with the position of the ftotus and the obstacles 
 to its birth, as if he had scrutinized the whole 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 delivery — either natural or artificial — so that this may be 
 effected with certainty and rapidity. 
 
 These measures being decided upon, a methodical jn-ocedure is as 
 necessary in carrying them out, as in exploring the vagina and uterus. 
 The required assistants should be selected, and to each should bo 
 allotted his share in the operation, in which he ought to be instructed 
 briefly and clearly ; the instruments, cords, and other apparatus ought 
 next to be placed m readiness ; and then the task may be begun. 
 When this is once commenced, it should be conducted with prudence, 
 and yet with decision, all irrational and unnecessary manci-uvres being 
 avoided ; while every precaution being at the same time observed, tliere 
 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 that his task is 
 to remove or overcome everything whicli suspends, hinders, or inter- 
 feres with the natural course of parturition, and to bring this as near 
 as possible to a normal termination. He should understand and appre- 
 ciate the part Nature plays in this act ; only seeking to second her 
 efforts so long as she is competent to attain the desired end, by remov- 
 ing any obstacles in the way. When Nature's efforts cease to be effec- 
 tive, tliey should be imitated as closely as possible ; and no more ought 
 to be attempted than Nature herself would have accomplished under 
 
288 DY ST OKI A. 
 
 more favourable circumstances. Art should never undertake what 
 Nature can effect ; 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 
 delay, so as to spare the animal pain and exhaustion. Sometimes par- 
 turition is difficult because of the insufficiency of the expelling forces, 
 as we have already noticed, and this may be remedied by hygienic and 
 therapeutic means ; but more frequently, while the expulsive efforts are 
 normal, there is undue resistance. To increase the expelling forces in 
 the latter instances would evidently be unwarrantable and injurious, 
 and we must attack the resistance by various means, according to its 
 character. Obstacles in the genital passages must be overcome either 
 by altering the position of the foetus hy manipulation, in changing the 
 position of the mother, or by other means ; and it often happens that 
 we must combine extraneous force with the expulsive efforts of the 
 mother, in order to extract the foetus artificially. At other times the 
 size of the fcetus must be reduced by embryotomy, and in extreme cases 
 an artificial passage has to be made for it by hysterotomy ; though 
 these dangerous operations may be occasionally averted by causing 
 artificial abortion, at a period when the foetus is sufficiently small to be 
 safely expelled through a contracted pelvis. 
 
 There is no occasion, in veterinary obstetrics, to hesitate in sacrific- 
 ing the life of the foetus in serious cases ; and in this respect the 
 practitioner is in a different position to the accoucheur of woman-kind. 
 With animals there is only a material loss to be looked at, and the 
 foetus must always be greatly inferior in value to the mother ; therefore, 
 in order to save the latter, it is more profitable to sacrifice the former. 
 
 Such are the general principles w^hich we believe to be applicable to 
 all cases of dystokia. These cases are numerous and various — more 
 varied even in animals than in woman ; and in order to study them 
 beneficially, it is advisable to classify them in a methodical manner. 
 We will follow Saint-Cyr in arranging and studying them in the order 
 given below. 
 
 Synoptic Table of the Causes ob' Dystokia in the Principal 
 Domesticated Animals. 
 
 (Pelvic Constriction. 
 Displacement and altered relations of the Uterus. 
 Morbid alterations of the Maternal Organs. 
 Umbilical Cord. 
 
 TExcess in Volume ^ 
 
 Independent of Excess in Growth of Hair 
 
 the Presenta--! Diseases Vof the Fcetus. 
 
 tions, by : Monstrosities I 
 
 Iroetal ...\ iMultiparity j 
 
 ■n J i. I Anterior. 
 
 Dependent on ,, , . 
 . V, -r, . Posterior, 
 
 the Presenta- i-^ , , 
 tions • Dorso-lumbar. 
 
 ISterno-abdominal. 
 
 Dystokia 
 
PVsroKIA FROM rELVlC UOA.STRJrTJoX. 28» 
 
 BOOK I. 
 
 MATERNAL DYSTOKIA. 
 
 TnK pathology of parturition, as has been mentioned, includes disturb- 
 ances produced by excessive or tumultuous pains and too feeble pains, 
 and derangement caused by too great an obstacle to birth. We have 
 sufticiently described the first ; and we have now to deal with the 
 second, in so far as the mother is concerned. The maternal obstacles 
 to parturition are related to the too great resistance offered by the 
 parturient passages, either in their hard or soft parts. These obstacles 
 have been grouped in the preceding table under the heading of j^clvic con- 
 strictio)i, displacement or change in relations of the uterus, and morbid 
 alterations of tlie maternal organs. 
 
 CHAPTER I. 
 
 Dystokia from Pelvic Constriction. 
 
 DvbTOKiA from constriction of the pelvis is sometimes observed in 
 animals ;' though less frequently, perhaps, than in woman, in whom 
 constitutional causes and the different position (vertical) of tliis region, 
 operate largely in producing diminished dimensions of its cavity. Any 
 alteration 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 generally reduced 
 in all its dimensions is sometimes noticed in the lai'ge, as well as tlie 
 small domesticated animals. 
 
 On the Continent of Europe, this has been observed miOre particularly 
 among some of the small common breeds of Cattle — such as tlie 
 liretonnc, and certain of the grey Swiss breeds, as the Fribourgeoise. 
 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, which 
 have a sharp croup. There is often a relative narrowness of tlie pelvis 
 in animals of small size that have been put to larger males. This has 
 been witnessed in the Mare and Bitch ; and as the young are propor- 
 tionately larger than the pelvis can accommodate in parturition, we 
 have here a cause of dystokia. 
 
 An abnormal inclination of the pelvis has been supposed by some 
 writers to exercise an unfavourable inlluence on parturition, but this 
 has been denied by others. Provided the other conditions of normal 
 parturition are present, no ditViculty should be experienced in delivery ; 
 but if, added to this state, there is a narrow pelvis, then obstetrical 
 operations would certainly be rendered more serious. 
 
 Deformities which occasion irregular constriction of the pelvic cavity 
 
 ' A naturally wide polvis — <>r r.ither an excea« in width--observfd more particularly 
 in aninialK of a Ijinphatic temperament, and especially in Cows, al'-ni; with an extra- 
 ordinary -supplenesis and laxity of the soft parts in thi.s region, h.'us the inconvenience «>f 
 renderini; i)4irturition tmi ea-^y, it would .ipjiear. For this facility is supposed, and not 
 without re;i'<on, to bring about such complic.iti<ms as inversion of the vagina and uterus, 
 placenta) retention, and even predispose*, according to some authorities, to Titulary 
 apoplexy in the Cow, and metritis in the other animals. 
 
 19 
 
290 
 
 3fA TERNAL D YSTOKIA. 
 
 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 foetus. These cases, however, are somewhat rare ; they 
 are generally found to be due to complete deformity of the pelvis, 
 exostoses, fractures, or tumours. 
 
 Complete Deformity 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 
 School, there is the pelvis of a Mare and another of a Female-Ass, which 
 
 Fig. 81. 
 Completely Defoejied Pelvis : Mare. 
 
 present a very remarkable degree of general constriction, and which 
 must have offered a very serious obstacle to parturition if the animals 
 had ever been pregnant. That of the ]\Iare (Fig. 81) is singularly 
 depressed on both sides, the ischia, and especially the pubis, being 
 atrophied with respect to size. The oval foramina and cotyloid 
 cavities are close together, the floor of the pelvis is extremely con- 
 tracted and angular, and the pubic arch is hypertrophied. In this 
 specimen there is a very notable diminution in the different diameters 
 of the pelvic cavity ; the supero-inferior, instead of being about Qh inches 
 is only about 6, and the bis-iliac diameter is but 4J, instead of being 
 7J to 8 inches. 
 
 The diagnosis of this deformity ought not to be difficult, especially 
 when it is so marked as in this instance. Vaginal exploration should 
 soon discover it, and the diminution in size may be approximately 
 determined by spreading the fingers, and in this way measuring the 
 
DYSTOKIA FIKHI fELl'IC CONSTRICTION. 291 
 
 two diameters. The dia^'nosis may not be so easy, however, when the 
 canal is partly or wholly occupied by the fcetus. 
 
 Another kind of deformity described by several authorities, consists 
 in a depression of the sacrum (lordosis), which is recognised externally 
 by an abrupt hollow existing towards the posterior third of the croup. 
 By rectal exploration the sacrum is found to constitute a projection 
 in the roof of the pelvis, at the lower face of the bone, and this 
 diminishes the supero-inferior diameter of the cavity to an extent 
 corresponding to the protuberance. 
 
 Exostoses. 
 
 Exostoses on the pelvic bones, and particularly when they project 
 into the pelvic cavity or encroach on its openings, may become a 
 more or less serious obstacle to the passage of the fuetus (Fig. 82). 
 
 ffe= 
 
 .^ 
 
 Pelvic Exostosls. 
 
 Favre, of Geneva, states that bony tumours situated beneath the 
 croup, at the inner and upper surface of the pelvis, render parturition 
 ditBcult, even if they are not large and near the root of the tail. lie 
 atlds that such cases are not rare in old Mares. 
 
 Fractures. 
 
 Like the exostoses, more or less completely consolidated fractures 
 of the sacrum or coxa;, which have been united by an irregular callus, 
 may, for the same reason, prove an obstacle to birth. As animals 
 suffering from a fracture of any of the bones of this region are often 
 destroyed, laborious parturition from such a deformity is not so frequent 
 as from some other causes ; nevertheless, it does occur now and again. 
 
 It must be remembered that fractures of the pelvic bones are some- 
 what frequent in animals, and may occur at any part. The most 
 common seat of fracture is perhaps the external angle of the ilium ; 
 
292 
 
 MATERNAL JDV^^TOAIA. 
 
 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 coxse has been 
 observed in two cases by Lafosse ; in one case by Crepin, and in 
 another by Philippe. 
 
 D'Arboval has witnessed a fracture of the pubis in a Dog ; and 
 Carsten Harms alludes to fractures of the ischium occurring in the 
 Mare and Cow. The latter authority has likewise found the two iliums 
 of a Goat united at their posterior angle by a mass of bone 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 fracture of the 
 ossa innominata, the solution of continuity involving all the border of 
 the foramina ovale in the pelvis of a Mare ; the second is a fracture of 
 the left ilium near its neck, and extending to the cotyloid cavity, also 
 
 Fig. S3. 
 Fkactuke of the Pelvis. 
 
 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 ihum of a Mare ; 
 the tenth is an oblique fracture of the neck 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 Patologica Comparata 
 della R. University di Bologna. Memoria I. Bologna, 1867, p. 38 : — Fratture della- 
 Pelvi. 
 
JiYSTOKIA Fi:OM I'ELl'IC CONSTRICTION. IW 
 
 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 
 also a pelvis in wliich the pubic portion of the symphysis has sustained 
 a comminuted fracture. 
 
 Much will depend, of course, upon the nature and the scat 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 nmch external deformity, no gi^eat effect can be produced on 
 the act of parturition, as this part has notliing 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 
 (Kig. <s3). Many cases are on record of ditticulty 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 be 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. 
 Tl>e previous history of the animal may also aid in confirming the 
 diagnosis. 
 
 Fractures of the pelvis may also take place durin</ parturition, and 
 RuetT mentions two instances 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 breeding animals. 
 
 TUMDUiiS IN THK PkLVIC C.WITY. 
 
 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 ditliculty in parturition. But that form 
 of melanosis which appears in grey animals, and particularly manifests 
 itself in the form of tumours at the root of the tail, around the anus, 
 and in the connective tissue of the pelvis, should oflfer the most frequent 
 obstacle to delivery. 
 
294 MATERNAL DYSTOKIA. 
 
 A case has occurred in my own experience, in which an aged Mare, nearly white, 
 belonging to a friend, was, on my recommendation, taken by a farmer, who attempted 
 to breed from it ; but at the termination of pregnancy, and during parturition, it died 
 without giving birth to the Foal. 
 
 When opened, it was found that delivery could not take place owing to great masses 
 of melanotic deposit in the pelvic cavity. When given to the farmer there were only a 
 few small nodular masses observed about the tail and vulva. 
 
 Leconte [Mem. de la Societi Centrale de Med. VeUrinaire, vol. v., p. 180) was con- 
 sulted with regard to a Mare, about twelve years old and about five months pregnant, 
 which bad such a large melanotic deposit around the anus that defecation was impossible 
 without assistance. Rectal exploration discovered a very voluminous tumour situated 
 at the left side of the pelvis, in the centre of which a slight fluctuation could be per- 
 ceived. With a view to accelerate the maturation of the tumour, vesicatory agents were 
 applied to the left flank and croup; five days later the tumour was larger and more 
 fluctuating, and it was punctured, when about two pints of a dark, purulent, but almost 
 odourless fluid escaped. On the hand being introduced into the softening mass, a 
 portion was found about the size of two fists, and partially detached ; this was removed, 
 and weighed nearly seven pounds. In twelve days the wound had cicatrised ; and in 
 five and a half months, gestation being nearly completed, another melanotic tumour, 
 situated somewhat deeply towards the right side of the pelvic cavity, was also removed. 
 Cicatrisation took place rapidly, and delivery occurred without any difficulty. 
 
 Cases have been recorded in which a large quantity of hardened fwces in the rectum 
 was a cause of dystokia. 
 
 Indications for Surgical Treatment. 
 
 The surgical treatment of those cases in which dystokia is due to 
 any of the causes just enumerated, will greatly depend upon circum- 
 stances, not onl}' with regard to the kind of treatment, 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, 
 or if 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 sufficiently early 
 period. But if 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 cavity, 
 and the kind of obstacle which causes the diminished space. The 
 indications are : to forcibly extract the foetus through the narrowed 
 2}assage ; to widen the i^assage ; to diminish the size of the fcet^is ; or to 
 make an artificial ^oassage. But as artificial abortion may be necessary 
 during pregnancy, should the veterinarian be consulted, and from 
 examination be led to conclude that parturition will be dangerous or 
 impossible, we shall include this as one of the indications, and com- 
 mence with it. 
 
 1. Artificial Aboetion. — Artificial abortion may be 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 successful with the Mare than the Cow, because of the greater 
 excitability 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 domesticated animals, each being attended with success, and 
 each offering special advantages in particular cases. These are : irrita- 
 
DYSTOKIA FROM PELVIC CONSTRICTION. 29r. 
 
 tion of the cervix uteri by the hand; puncture of the envelopes; and 
 caginal irriijations. 
 
 Dujital Irritation of the Cervix Uteri. — Tliis is accomplished in the 
 following manner : The hand is introduced into the vagina, and first 
 one finger, then two are insinuated into the os by a semi rotatory 
 movement, and finally the whole hand is inserted, as the part dilates. 
 If the operation is repeated several times, labour pains soon ensue. As 
 the manual exertion is rather fatiguing, the sponge tent, elastic bags, 
 or other dilators of the os uteri may be employed. A better and more 
 successful mode is the introduction of a long elastic catheter, strong 
 pieces of catgut, or even a quill, between the fcctal membranes and the 
 uterus. Labour may be promoted by passing the hand through the 
 OS, and separating the membranes from the uterus. 
 
 This procedure is to be recommended for Mares, the uterus of which 
 is so irritable that abortion sometirnes takes place after manipulations 
 in the rectum for some time. In ordinary cases, the expulsion of the 
 foetus occurs in from six to twelve hours. It is not applicable to Cattle, 
 Harms having once manipulated a Cow in this manner for a whole 
 night without producing any result ; neither is it to be recommended 
 for smaller animals. 
 
 Puncture of the FuHal Envelopes. — The envelopes are punctured by 
 pushing a long, and more or less pointed, sound through the os uteri, 
 into the " water-bag"; the liquor amnii soon escapes, and the uterine 
 contractions begin. P^xpulsion of the fa-tus follows in from twelve to 
 forty-eight hours. This method is particularly etficacious with Cattle. 
 
 Vaginal Irrigations. — Irrigation of the vagina with cold water (oi- 
 water at a temperature of about 90° Fahr.), made by means of a syringe 
 or injection-tube, and continued for a quarter of an hour every three 
 hours, will induce labour pains about the fourth injection, and effect 
 the expulsion of the foetus towards the second, third, or fourth day. 
 This method is more particularly adapted for the smaller animals ; 
 though it will also succeed with the larger. The only danger to be 
 apprehended from it is an attack of metro-peritonitis. 
 
 2. Forcible Extraction. — The first impulse which presents itself 
 when the foetus meets with any obstacle to its passage through the 
 pelvis, is to " force it through "; and it is this impulse which is carried 
 into execution by unscientific people. Too frequently, however, it 
 happens that by this procedure some portion of the foetus is so tightly 
 wedged in the pelvis that no amount of force is capable of moving it 
 farther, and renders absolutely impossible those other operations whicli 
 might be the means of saving at least the mother or ofi'spring, or 
 perhaps both. For this reason it is, that the owner of an animal in 
 this condition should not himself, nor sutler others to, pull at the fatus. 
 or attempt any similar mancjcuvre, until the arrival of the veterinarian. 
 And the latter has a difVicult task before him in solving the problem as 
 to whether he ought to extract the foetus forcibly, or resort immediately 
 to the other measures prescribed. This will render a careful examina- 
 tion necessary, in order to ascertain the nature, seat, and degree of 
 constriction. 
 
 The animal is making excessive, nay violent efforts, and the foetus 
 may be in a 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 
 
296 MATERNAL DYSTOKIA. 
 
 falls, utterly prostrated by its efforts. As the uterine contractions gene- 
 rally increase in violence in the presence of obstacles to birth, there is 
 the gravest danger to mother and offspring. 
 
 In such a case, the veterinarian, having introduced his hand into the 
 pelvis in the ordinary way, endeavours to discover if the obstacle is 
 there. With this object in view, he closes his hand to try if he can 
 move his shut fist about in every direction, and with ease. Then stretch- 
 ing out the thumb, he can approximately 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 foetus 
 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 foetus cannot be brought through. 
 
 Saint-Cyr has calculated that the closed hand of an adult man repre- 
 sents an irregular mass measuring between three and four and a half 
 inches in diameter; but the head of a Calf, in its supero-inferior diameter, 
 measures from seven to ten inches, and four to five inches in transverse 
 diameter. It is therefore obvious that the head of a Calf could not pass 
 through an aperture in which the hand cannot move freely ; and much 
 less the chest of a Foal, which is at least twelve to thirteen inches in 
 depth. 
 
 It is also necessary to take into consideration the cause of dystokia. 
 If this is due to a complete deformity of the pelvis, then the case is 
 serious, and there is little hope of traction alone overcoming the difti- 
 culty. If it is due to a tumour, and localised, then it must be ascertained 
 if this is of a bony character, arising from an exostosis or fracture ; or 
 if it is movable and independent. If the latter, the case is not so 
 serious, and especially if the tumour is connected with the sacro-sciatic 
 ligament ; as it may be pushed out of the way of the foetus, and birth 
 take place. 
 
 As Saint-Cyr insists, all these considerations should be weighed before 
 deciding to terminate parturition by mechanical traction ; for if the im- 
 possibility 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. 
 
 If extraction of the entire foetus is discovered to be practicable and 
 the position is favourable, then there should not be much difficulty in 
 effecting delivery, which may be achieved as in ordinary circumstances. 
 It will be much facilitated, should the foetus and the passage be dry and 
 tenacious, if these are lubricated with oil or soapy fluid. 
 
 If, however, the foetus has become wedged in the passage and cannot 
 be pulled through, it may 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. 
 
 3. Enlargement of the Passage. — 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 dehvery. 
 
 4. Diminution of the Size of the Fcetus. — With the domestic 
 animals, as we have repeatedly said, thex-e are no moral considerations 
 to oppose us when it comes to a question of sacrificing the foetus to save 
 the life of the parent. And with the Mare there should be no hesitation 
 in this direction, when a careful examination has proved delivery of the 
 
DYSTOKIA F/:ti.]f l>lsl'LA<'h:.\i EST i>F Tllh: CTERUS. -I'M 
 
 living or entire fct'tus to he impossible, particularly when we remember 
 that the young creature soon perishes. 
 
 With the Cow, however, the case is somewhat dillVreiit, as when 
 delivery is unsuccessful this animal may be killed and utilised as food. 
 Kmbryotomy is, nevertheless, often resorted to before the case is con- 
 sidered hopeless ; and not at all infrequently with good results, so far 
 as the Cow is concerned. 
 
 We shall treat of embryotomy hereafter ; but it may be useful to 
 mention here that, in an anterior presentation, removal of one or both 
 of the fore limbs at the scapula of the fditus, will often allow the remain- 
 ing portions to be removed by traction. With a posterior presentation, 
 excision of one hind leg is frequently suflicient to permit the body of the 
 fcttus to be drawn through the passage. 
 
 o. Establish .\n Artifici.vl Pass.\ge ioh thk Fcetus. — When all 
 the preceding means have been recognised as impracticable or too 
 dangerous, there yet remains another which, though it may place the 
 life of the mother in great jeopardy, and should be considered only as 
 a last and a most serious expedient, may be I'esorted to : this is the 
 Cifsarian section, or gastro-hysterotomy — an operation to be described 
 hereafter. It may only be noted in this place, that a formidable opera- 
 tion, such as this is, should be resorted to early, and before the female is 
 much exhausted by inellicacious manipulations and impotent labour 
 pains. 
 
 CHAPTER II. 
 
 Dystokia from Displacement or Changed Relations of the 
 
 Uterus. 
 
 Delivkry may be rendered dillicult by displacement or altered relations 
 of the organ containing the foetus — the uterus, either from hernia of 
 that organ through a natural or accidental opening in the abdominal 
 parietes ; from deviations in its direction, whereby the os is no longer 
 in the axis of the pelvis; or torsion of the organ, due to its having made a 
 revolution or become twisted on its own axis — a singular displacement 
 that well merits attention. 
 
 Hernia of the Utekis — Hysterocele. 
 
 Every kind of ventral hernia may be viewed as more or less tending 
 to dystokia, from the important 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 exists, this is likely 
 to be increased during labour, and may complicate delivery. But the 
 case is generally all the more serious if the displaced organ is the gravid 
 uterus itself. 
 
 Hernia of the uterus is certainly not a vet}' common accident; never- 
 theless, it is far from being rare, if we are to judge by the instances 
 recorded in veterinary literature, and it has been observed in the Mare, 
 Cow, Sheep, Sow, Goat, and Bitch— in all the more important domesti- 
 cated animals, in fact, and has often proved a very serious obstacle to 
 parturition. 
 
298 
 
 MATERXAL DYSTOKLA. 
 
 Origin and Symptoms in Uniparous Animals. 
 
 The symptoms and other features of this accident rather differ [in 
 uniparous and multiparous animals. In such uniparous creatures as 
 the Mare and Cow, hernia of the uterus is generally not observed until 
 pregnancy is pretty well advanced— towards the eighth or ninth month, 
 or even later in the Mare, and the seventh or eighth month in the Cow. 
 This delay is evidently due to the circumstance that, in the non-preg- 
 nant animal, the uterus is small, and clnpoly fixed by its ligaments to 
 the sub-lumbar region; so that if Lhcro is a lircaeh in the abdominal 
 walls, it is either the intestine or omentum which pa-ses through it. 
 When, however, pregnancy is advanced, the groat size of the organ, 
 
 Fig. 84. 
 
 Uterine Hernia : Mare. 
 
 A, B, Hernial Tumour ; C, Teat carried down bj' the Tumour. 
 
 together with its weight, brings it in contact with the parietes of the 
 peritoneal cavity, and if there happens to be a weak part or a rupture, 
 no matter how slight, the heavy uterus gradually forces itself through, 
 and may in time escape altogether from the abdomen, along with other 
 viscera. 
 
 It would seem that laceration of the abdominal walls may occur in 
 other ways than through external traumatic influences, or any appre- 
 ciable occasional cause ; and it would also appear that, in some animals, 
 there is a kind of predisposing relaxation or softening of the abdominal 
 muscles, which leads to their being unable to support the gradually 
 increasing strain thrown upon them by the heavy uterus, and its often- 
 times very lively and energetic inmate. The muscles are stretched 
 
DYSTOKIA FlinM lilSl'LACKMEXT I'F THE I'TKIU'S. 
 
 l>i»!) 
 
 and attenuated, their fibres are separated and some of them rupture, 
 and in this way is formed a rent which gradually enlarges from the 
 increasing pressure. Then a tumour appears externally and towards 
 the lower part of the abdomen, though always a little to one side — 
 usually the left in the ^lare, the right in the Cow, and not infrequently 
 in front of the pulns, in the mammary region. This tumour, when first 
 noticed, is about the size of a child's head, and not clearly defined ; but 
 it rapidly enlarges, and in a few days may acquire prodigious dimen- 
 sions — descending as low as the hocks, or even nearly to the ground, 
 pushing the mamnue to one side or carrying them with it, extending 
 as high as the vulva and almost as far forward as the sternum, giving 
 to the abdomen a singular appearance (Fig. 84). 
 
 These extraordinary herniao are most frequently witnessed in Cows 
 (Fig. 85), though several veterinarians — among others, Lecoq, Binz, 
 Leconte, Serres, Lafosse — have seen them in Mares. In very many 
 
 Fig. 85. 
 Uterine Hebnia : Cow. 
 
 instances they are due to violent efforts, kicks, blows, and other external 
 injuries. 
 
 When the hernia is recent, and especially if it occurs in the mammary 
 region, it is generally surrounded by a considerable ocdematous swell- 
 ing. This swelling disappears after parturition, though the hernial 
 tumour itself does not diminish in volume, the digestive organs having 
 occupied the space previously held by the fu?tus. Then the animal has 
 a still more singular appearance, perhaps ; for owing to this emptying 
 of the abdominal cavity, the belly is wonderfully retracted and the 
 flanks are so drawn together that the fingers may be made almost to 
 touch througli them on each side. 
 
 Before parturition, palpation of the tumour enables the foetus to be 
 distinguished — the head, limbs, and body being felt, while its movements 
 are perceptible by the eye or hand. 
 
 As a rule, and contrary to what might be surmised, this uterine hernia 
 does not appear to cause any loss of condition or inconvenience except 
 in progression, which it interferes with, and causes the animal to move 
 
300 MATERNAL DY ST OK I A. 
 
 with the hind legs wide apart. Aptitude for labour is also somewhat 
 impaired, as may be imagined. 
 
 Origin and Symptoms in Mnltiparous Animals. 
 
 As has been mentioned, uterine hernia is observed in multiparous 
 animals, but its manner of production would appear to be different 
 to what it is in uniparous creatures, this taking place in the interval 
 between gestations. The length and mobility of the cornua in such 
 an animal as the Bitch, together with their close proximity to the 
 abdominal walls, sufficiently explain how they may pass into an 
 opening in these walls. There is formed, at first, a small tumour the 
 size of a pigeon's or hen's egg ; this tumour is soft, indolent, more 
 or less easily reduced, and attracting perhaps little or no attention 
 while the animal is unimpregnated, it remains stationary. After 
 impregnation, however, it daily acquires larger dimensions ; one or 
 more ova have descended into the hernied portion, localised them- 
 selves there, and become developed into foetuses without the Bitch 
 showing much, if any disturbance. 
 
 The usual seat of the hernia is in the mammary region, to the right 
 or left of the linea alba, though it may be also inguinal, or even vulvar. 
 
 An example of inguinal uterine hernia will be given hereafter ; we 
 will now briefly allude to a case of vulvar uterine hernia described by 
 Eainard. In this instance the uterus, which had been apparently 
 carried through the inguinal ring, was pushed backwards through the 
 connective tissue, and appeared as a tumour at the vulva. The owner 
 of the animal, not knowing what the swelling contained, opened it by 
 means of a penknife ; in this way there was formed a fistulous wound, 
 from which a viscid fluid escaped. Eainard incised this fistula, and 
 found beneath the skin a second membrane having some analogy to 
 it, and which afterwards proved to be the uterus ; to the inner face of 
 this there adhered a reddish-brown vascular network, which was 
 the placenta, and which was easily detached by the finger ; within it 
 appeared a transparent bladder — the amnion — already slightly perfor- 
 ated, and looking like the envelope of a cyst. Having opened this, 
 there escaped a quantity of fluid, and a foetus apparently three or four 
 weeks old. The Bitch died next day. 
 
 When the hernia occurs in the abdominal region, it usually appears 
 as an indolent tumour, the skin covering it being destitute of redness, 
 and not attenuated in any way ; the tumour itself is soft and fluctuating 
 at different points where the liquor amnii is, but firm and resisting at 
 others where the foetus chances to be. 
 
 It may be noted here, that there may be other herniae of the uterus 
 besides ventral. For instance, Gelle describes a case of hernia of one of 
 the uterine cornua which contained a Calf, and which had passed 
 through a rent in the mesentery. And Eainard has observed several 
 cases of this kind in the Bitch. 
 
 Pathological Anatomy. 
 
 The pathological anatomy of uterine hernia is not without interest 
 to the obstetrist ; and as it has been studied in animals which had 
 died during attempts at parturition, or were slaughtered after that act, 
 the evidence is as plentiful as it is reliable. 
 
DYSTOKIA Fi;OM DISPLACEMLWT OF THE UTERUS. 301 
 
 The chief and essential lesion is, of course, to be found in the 
 abdominal parietes. The fleshy or tendinous fibres of the oblique 
 muscles may be merely separated, especially at the commencement ; 
 though most frequently some of them are ruptured. The great rectus 
 muscle always shows a solution of continuity, the rupture being 
 sometimes as clean and sharp as if it had been made by a knife ; 
 though at other times it is irregular and lacerated. In every case 
 there results a variable-sized opening, more or less circular, oval, or 
 triangular, its larger diameter corresponding to the axis of the animal's 
 body ; Eodet has seen an opening of this kind measure nearly twenty 
 inches. 
 
 The seat of the rupture varies ; sometimes the rectus nmsclc is per- 
 forated at its pubic insertion, as Favre has seen it ; in other cases it is 
 elsewhere, but in every instance it is inferior — posterior to the umbilicus, 
 ;ind to the right or left of the linea alba. The latter structure is at 
 lirst never involved ; but when the hernia increases largely in size, it 
 may in its turn give way ; so long as it I'emains intact it forms a kind 
 of cord extending from the pubis to the sternum, and by partially 
 dividing the tumour, gives it a bilobular appearance. 
 
 In a few cases the tunica ahdominalis resists the strain imposed on it, 
 being only extended, and in this way the hernia has another covering 
 in addition to the skin ; but in many instances it tears, like the muscles. 
 Delplancjue has shown that the peritoneum may escape rupture, stretch 
 and, accompanying the descending viscera, constitute a serous tunic to 
 the hernia ; most frequently, however, it gives way, the uterus passes 
 through it, and then there is no hernial sac. 
 
 In a recent hernia, the connective tissue surrounding it is greatly 
 ecchymosed and infiltrated, and the muscular fibres broken up and 
 separated ; the tendinous fibres are also disassociated and torn, and 
 numerous red and partly decolorised blood-clots lie among their inter- 
 stices. At a later period no extravasated blood is found between the 
 skin and the uterus, but the parts are uniformly red ; and, later still, 
 attempts at repair are evidenced by cicatrisation of the borders of the 
 inapture, which have then a rounded, thickened, and fibro-tendinous 
 aspect, and are dense and resisting. The connective tissue beneath the 
 skin is condensed into a kind of smooth membrane, continuous with 
 the margin of the rent, and forms a second tunic to tiie hernia. 
 
 Before parturition the hernia is occui)ied exclusively, or nearly so, by 
 tin- gravid uterus, which is wlioUy or in part lodged in tliis accidental 
 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 the Cow, and the colon and 
 small intestine with the Mare — find their way into the pouch; Rodet 
 has even found the uterus and the entire intestinal mass included in it. 
 
 Diagnosism 
 
 The diagnosis 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 usually 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 fcctus can be detected. 
 
802 MATERNAL DYSTOKIA. 
 
 It will also be discovered that the tumour does not adhere to the 
 abdominal parietes, and that it may be reduced by taxis. 
 
 But 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 is 
 which prevents delivery. In such a case vaginal exploration must 
 be resorted to ; by it we may learn that the os is not dilated from 
 one of several causes to be hereafter discussed ; or the non-dilatation 
 may be due to the uterine contractions not pressing the foBtal mass 
 directly against the cervix, in consequence of the altered direction of 
 the uterus, or the margin of the hernial opening strangulating the foetus 
 and hindering its advance. These obstacles must be combated by 
 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 whole length 
 of the arm is inserted ; in which case, if the animal is standing, the 
 abdomen may be raised by means of a sheet or blanket, so as to bring 
 the foetus within reach. If the animal is recumbent and cannot rise, 
 then it should be placed on its back and secured in that position, the 
 croup being raised by bundles of straw. The tumour may then be ex- 
 amined by external palpation, as well as by rectal and vaginal explora- 
 tion, and the position of the foetus determined. 
 
 As a rule, the position is never quite normal. In the most favour- 
 able cases, the head is found to be directed backwards and near 
 to the pubis — sometimes partly in the pelvis, with the face upwards 
 and slightly forwards ; the fore feet being more or less doubled back 
 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 dog. 
 
 The state of the borders of the hernial orifice should be carefully 
 ascertained, and their rigidity and tension, together with the degree 
 of constriction they exercise on the body of the foetus, noted. This 
 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. 
 
 With the Bitch uterine hernia is frequently most difficult to diagnose, 
 and errors are far from infrequent ; the most common mistake is fixing 
 on the tumour as a cancerous mass. But mammary tumours are very 
 different to that of hernia ; they are generally nodulated, very hard, and 
 the skin is closely adherent to them ; whereas the uterine hernia has 
 not the fluctuation of a cyst or abscess, neither has it the resistance of 
 a carcinoma, fibroma, or adenoma, while the skin covering it is smooth, 
 supple, perfectly natural, without ulceration, discoloration, and other 
 signs which mark the presence of mammary enlargements. The 
 uterine tumour can also be reduced by taxis or manipulation, while the 
 fissure in the abdominal wall can be felt. This, together with the fact 
 that it is only developed rapidly after impregnation, and without any 
 local or general inflammatory symptoms, or disturbance of the general 
 health, should settle the question. 
 
 However, should any doubt yet remain, or if it is desired to ascertain 
 the exact state of affairs, a more careful examination will be necessary, 
 it being always borne in mind that this hernia in the Bitch appears in 
 different regions. Vaginal 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. 303 
 
 An external examination must, therefore, be relied upon, and this is 
 easier and more certain than with the larger creatures. By it the size 
 of the abdomiual rent will be ascertained, and also whether the foetus 
 can bo passed through it into the abdomen ; though this is rarely 
 possible, owing to the hernia occurring when the uterus was empty, 
 and when it could pass through an opening which would not bo sulli- 
 cient for a fcetus when fully developed. 
 
 All manipulatory operations on the Bitch should be practised with as 
 much tact and gcntleuess as possible, as the young are readily killed, 
 while the female itself is very liable to metritis. 
 
 Indications. 
 
 Animals suffering from uterine hernia sometimes bring forth their 
 young spontaneously, and without any bad results to themselves or 
 their progeny ; thus proving that the uterine contractions alone will 
 expel the fcetus, and that the aid of the abdominal muscles is not 
 absolutely necessary. More especially is this the case with the 
 larger animals. Leconte mentions a ]Mare whose career he traced for 
 five years, and which, notwithstanding the existence of this condition, 
 brought forth four living foals — three without assistance, the fourth 
 being in a wrong position. Cows which had most alarming hernias 
 have even brought forth twin Calves spontaneously. 
 
 But, as a rule, with these larger uniparous animals parturition is 
 always more protracted and dillicult than in ordinary circumstances, 
 and the assistance of the veterinary obstetrist is needed to effect 
 delivery; and this, after all, is in some instances impossible, and the 
 mother and offspring are lost. This is more particularly the case with 
 multiparous animals, and especially the Bitch, in which it is generally 
 all but impossible to reduce the hernia or remove the foetuses by the 
 natural passage. Roll has, nevertheless, described the case of a Bitch 
 suffering from uterine hernia, which brought forth its progeny in a 
 natural manner ; and Prange, in 1844, published the liistory of another 
 Bitch that, unaided, gave birth to three Puppies which liad been lodged 
 in a hernia of this kind. A case occurred in my own experience of a small 
 terrier Bitch, which, when I saw her, had what the owner and others 
 thought was a very large mammary tumour. Soon after she brought 
 forth two Puppies — one dead, the other, the largest, alive — and without 
 help, when the supposed tumour completely disappeared. Sheather^ 
 describes a case of this kind, in which five Puppies were expelled 
 without assistance. 
 
 When there are several fcctuses, some of them may be contained in 
 a non-hcrniaod cornu, and so can readily be born ; while tliose in the 
 extruded horn may experience ditliculty, and if the hernial sac is con- 
 stricted at its neck birth may be impossible. So that if the Bitch lives 
 and no operation is performed, the imprisoned fretuses may be ulti- 
 mately expelled by a process of ulceration of the abdominal walls. 
 
 At a meeting; of the Medicftl Society of Strasburp, M. Kopp {OazeUe Midicale dt 
 Sfrwihourf), 1875) exhibited the uterus and it« apjHindages bt'lunpinj,' to a Ritch upon 
 which he had operated in order t<> extract .a firtus which was loflt'ed in onu of the uterine 
 cornua. The animal had been restlesA for nome twenty-four hours, when Kopp was 
 called in to examine it. He found every indication of approaching ))arturition ; but 
 notwithstanding this, and the C"n»iderable volume of the abdomen, the oa titeri was 
 almost closed — a circumstance which decided him to wait. During the night the Bitch 
 
 > Vthriiiary Journal, 1887, p. 234. 
 
304 MATERXAL DYSTOKIA. 
 
 gave birth to a dead Puppy, and on the foUowinsf day the dinsinished distention of the 
 abdomen enabled him to discover, beneath the skin, the presence of three fnetuses. On 
 inquiry, he ascertained that for some time the animal had been sufiFering from an 
 inguinal hernia on the left side, and this information led him to adopt active measures. 
 The skin was incised over the isolated hernial sac, as far as the inguinal c^nal ; then, 
 after largely opening the tumour, as well as the uterine cornu it cuntained, he was able 
 to remove the three dead foetuses and their membranes. The prolapsed uterine portion, 
 having been carefully cleansed, was closed by suture and returned to the abdominal 
 cavity, and a strong ligature placed round the sac. The inguinal canal had been widely 
 incised ; but notwithstanding this, the reduction of the uterus and its appendages offered 
 somo difficulties, in consequence of the great mass of fat in and upon the broad ligaments 
 surrounding them. Evei'ything appeared to be going on favourably until the ninth day, 
 when the animal suddenly succumbed. Death was attributed to purulent absorption, 
 produced through the agency of a small abscess on the broad ligament, which had been 
 abraded during the operation of reduction. There were no traces of metro-peritonitis, and 
 the wound in the uterus, as well as in that portion of the sac which had been ligatured, 
 was cicatrising most satisfactorily. According to Kopp, this was an instance of intra- and 
 extra-abdominal pi'egnancy at the same time ; and in proof of this, he pointed to the 
 narrowness of the inguinal canal, aiid the presence of the uterine hernia previous to 
 impregnation. 
 
 Three of the foetuses were developed in the cornual hernia, and the fourth in the bod)' 
 of the uterus. 
 
 Chanel reports that a Sow brought forth young after a portion of one 
 of the uterine cornua containing two foetuses, and which had been 
 hernied, was amputated. 
 
 Notwithstanding these instances, however, the assistance of the 
 obstetrist is necessary to effect dehvery, for which a careful examina- 
 tion, as in diagnosis, will indicate the means. 
 
 Previous to parturition the hernia should be supported, when pos- 
 sible, by a truss or retaining bandage, and care should be taken to 
 prevent over-exertion or straining. 
 
 With the larger animals, delivery by the natural passage is, of course, 
 the chief object to be attained. In certain cases, the simplest measure, 
 and which is sometimes all that is necessary, is to elevate the hernia 
 by means of a sheet or blanket passed under it, and raised by an assis- 
 tant at each side of the animal. Manipulation ^^er vaginam may 
 supplement this support, and in the majority of such cases may even be 
 absolutely necessary to complete delivery. 
 
 In other instances, however, the foetus cannot be removed from the 
 hernial sac without placing the female in a recumbent posture. Either 
 lateral or dorsal decubitus may be resorted to, according to circum- 
 stances, but the preference is usually given to the latter position ; 
 though when lateral decubitus is tried, the animal should be placed on 
 the side opposite to that in w^hich the hernia exists. 
 
 In the dorsal position, the weight of the foetus and uterus is removed 
 from the floor of the abdomen ; consequently, the abdominal muscles 
 are relaxed, and the borders of the hernial opening are not so tense ; 
 while the uterus and its contents, by their own weight, have a tendency 
 to escape from the hernia and fall into the abdomen ; at the same time 
 the foetus is more accessible to the hand of the obstetrist. 
 
 Should the os be contracted, it must be dilated by the hand; if the 
 membranes are intact, they are to be ruptured ; should the foetus make 
 an unfavourable presentation, which is not very frequent in these cases, 
 this can be rectified ; and if the creature is dead, which is nearly always 
 the case when assistance has not been rendered sufficiently early, and 
 the membranes are ruptured, it can be all the more easily removed. 
 
 When the foetus presents anteriorly and the head can be seized, this 
 

 DYHTUKLl nv DISPLACEMENT. 305 
 
 should be brought into the pelvic inlet, and cords attached to the lower 
 jaw, or Schaack's head-collar forceps (to bo hereafter described) may be 
 employed ; then having secured the head, the fore limbs are sought for, 
 and brought into the passage one after the other, where they are also 
 secured by cords around the pasterns. Sometimes these limbs cannot 
 be found, owing to their being bent back against the body of the foetus, 
 and this will certainly render delivery more ditlicult. 
 
 Should the fn'tus present posteriorly, the case is more unfavouraljle ; 
 though if the hind limbs can be found and brought into the vagina, 
 delivery may soon be effected if there are no other complications. 
 
 Cords being fastened to the pasterns, sulVicient and well-directed 
 traction should be employed on them, the hand of the operator remain- 
 ing in the pelvis if necessary, in order to guide the passage of the foetus. 
 Saint-Cyr suggests that an intelligent assistant may at the same time 
 bo directed to make methodical pressure on the hernia, in order to com- 
 plete its reduction, which is effected when the contents of the sac are 
 returned to the abdomen. 
 
 At times this reduction is easy, and at other times it is extremely 
 dirticult. In the latter instances, all the more care is necessary that the 
 external manipulations are not too forcible, if it is desired to have a 
 living foetus. Should the resistance prove greater than the means which 
 may safely be employed to overcome it, then a surgical operation must 
 be determined on. When the muscles of the abdomen prove an obstacle 
 to the escape of the fcetus from the hernial sac, and produce a kind of 
 strangulation, an incision may be made through them in the most con- 
 venient part, as in the operation for strangulated hernia of the intestine. 
 
 In other cases the Cajsarian operation may have to be resorted to, 
 and speedily, if the mother or progeny, or even both are to be saved. 
 Recourse to this formidable measure will only be had in particular 
 instances : as when the mother or fcetus is valuable, and other means 
 have failed or are not likely to succeed. 
 
 And in uterine hernia this operation is undertaken in far more 
 favourable conditions than in some other circumstances which necessi- 
 tate its adoption. In this accident only the skin, and perhaps also 
 occasionally the tunica abdominalis, has to be cut through to expose 
 the uterus, which has not to be sought for among the mass of intestines 
 and laboriously withdrawn from their midst ; indeed, it generally 
 occupies the whole of the hernial tumour, and so closely, that there is 
 no danger of the intestines escaping during the operation. .\ simple 
 incision — no larger than is necessary — through the organ, a larger one 
 through the fa'tal membranes, and the prompt extraction of the foetus 
 therefrom, pretty nearly complete the task. 
 
 If the Ctcsarian operation is timeously resorted to, the chances are 
 greatly in favour of delivering a living ftetus ; with the Cow a living 
 and perfectly viable Calf is almost certain to be obtained, even a long 
 time after labour has commenced and the " water- bag " has rup- 
 tured. And even with the Mare it is not at all impossible to rescue 
 a living Foal, if the operation is resorted to before rupture of the mem- 
 branes. 
 
 The chances in favour of the mother are, of course, fewer than with 
 the fcetus ; for under the most favourable conditions, after removal of 
 the progeny, there will still remain the great hernial sac, which it will 
 be most ditttcult to keep the intestines from occupying, and still more 
 difficult to cure in a radical manner — judicious trussing and bandaging 
 
 20 
 
306 MATERNAL DYSTOKIA. 
 
 being nearly all that can be done to palliate the effects of the acci- 
 dent. 
 
 All 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 
 liernia 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 w^hich 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 
 is 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 in 
 favour of the Ceesarian 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 Ceesarian operation in another place. 
 
 Deviation of the Utekus. 
 
 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 the 
 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 ofler 
 
DEVIATION OF THE UTERUS. ;J07 
 
 serious obstacles to delivery. With quadrupeds, however, in which 
 the uterus is horizontal, the veterinary obstetrist has but to deal with 
 one kind of deviation of the uterus, the only one possible — that of 
 inferior obliquiti/, which appears to be extremely rare, and corresponds 
 to antevei'sion in the human female. 
 
 Accordinj^ to some authorities, who have more particularly studied it, 
 this change in position may, in certain circumstances, become a very 
 serious cause of dystokia. 
 
 The accident has, up to the present time, only been observed in the 
 Cow ; and this circumstance is believed to be explained by an interesting 
 feature in the anatomy of tliis animal, which has been brought under 
 notice by Professor Goubaux, of the Alfort Veterinax-y School. 
 
 It would appear that in Bovines, as noted at p. 18, the abdominal 
 nuiscles are not attached to the anterior border of the pubis as in 
 Solipeds, but are inserted into a thick ligament found at the external 
 and inferior part of the pubic bones, and which strengthens the 
 symphysis pubis. It consequently happens that, at this border of these 
 bones, the floor of the abdomen is on a lower plane than that of the 
 pelvic cavity ; so that there is a kind of step between the two cavities, 
 the height of which varies in different animals, but has been found to 
 be as much as three, four, and even live inches. Dissection has demon- 
 strated that the peritoneum lining the lower surface of the abdominal 
 cavity, on arriving at the pubis ascends this step, in covering it like a 
 carpet, to line the upper surface of the pubic bones and tlie anterior 
 part of the pelvic cavity. 
 
 From this anatomical peculiarity, it may happen that the fundus of 
 the gravid uterus, instead of being directed forward, will incline directly 
 downwards and lie on this pelvic step, not passing beyond the umbilicus, 
 behind which it may even rest sometimes. At the same time, and as 
 a consequence of this arrangement, the other end — the cervix — is tilted 
 upwards in the direction of the sacro-vertebral angle, and it may even 
 compress the rectum against that part. It will be obvious that, through 
 this great deviation in the direction of the cervix, the os no longer cor- 
 responds to the axis of the vagina, the canal following, of course, the 
 same oblique ascending line as the cervix. Such an alteration in the 
 position of the uterus entails a similar change in the attitude of the 
 f(rtu3, which, instead of being placed almost horizontally, is now more 
 or less vertical — the head towards the sacrum, and the buttocks resting 
 on the pubic step. 
 
 During parturition we may easily understand how affairs are 
 changed with regard to the performance of this act. The uterine 
 contractions are no longer directed towards the cer\'ix ; the os only 
 dilates slowly or not at all, according to the degree of uterine obliquity; 
 the animal is exhausted with ineffectual attempts to expel the ftptus ; 
 and if assistance is not rendered, it may succumb without being 
 delivered, or the uterus may rupture. If the position of the ftrtus is 
 abnormal, then the case is still worse, so far as artificial delivery is 
 concerned. Garreau has observed that labour may be suspended alto- 
 gether ; the foetus dies, becomes mummified, and is retained for perhaps 
 a very long time. 
 
 Diagnosis. 
 
 The diagnosis of this deviation does not appear to be attended with 
 much difficulty. The long duration of labour, and the inutility of the 
 
308 MATERNAL DYSTOKIA. 
 
 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. Eaising 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 
 remained for three 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 Caesarian section, and with perfect success ; as the Cow 
 quite recovered, and w^as 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 blood, 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 simple ; 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 
 soon take place ; then the foetus, pushed towards the vagina, instead of 
 against the sacrum, will enter the passage, from which a little judicious 
 
TOIiSION OF THE UTERUS. 30» 
 
 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 luere 
 decubitus. This, in pushing upwards the fundus of the uterus, brings 
 down the cervix to its normal position by an easily understood tilting 
 movement. Scliaack has noticed tliis to happen in two instances. 
 
 In such cases, says Kainard, if the animal persists in standing, it 
 may sutlice 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 diilicult cases, however, these measures will not be sutlicient, 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 fcctus, 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. Tlie weight of the fa-tus 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 
 obliquity 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. 
 
 TOHSION OF THE UtERUS : CONTOKSIO 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 fre<juently observed. The accident is rare 
 in the Mare ; it has bet'ii observed in the Slieep and (loat, as well as 
 in the Cat ; but though in the Sow and Hitch the uterine cornua may 
 become displaced and twisted on each other, and even become hernied 
 by the broad ligaments, 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 
 
310 MATERXAL DYSTOKIA. 
 
 to be of recent discovery ; for though it was clearly and explicitly in- 
 dicated in the last century by Boutrolle [Parfait Boiivier, second edition, 
 1766), yet it was not until after much observation and discussion in 
 this century that such a condition was proved to be possible. Boutrolle 
 wrote : " If it is possible to pass two or three fingers into the os {yelVere), 
 the hand and arm may be forced through ; but if, on the contrary, a 
 finger cannot be passed into it, and the opening is found to be turning, 
 it is a sign that the os is twisted — that it has made a half-turn on itself 
 — and it is impossible to enter it." 
 
 Though Veterinary Science had gained a sound footing in France 
 soon after the publication of Boutrolle's "Perfect Cowherd," yet its 
 students do not appear to have paid any heed to the amateur's descrip- 
 tion of the spiral twist of the cervix uteri, the difficulty in penetrating 
 the 05, and the impossibility of birth taking place through it. In- 
 difference or incredulity may have prevailed ; and it was not until 
 painful experience had awakened attention to the existence of the 
 accident, that the veterinarians of this century began to notice it. 
 
 Nevertheless, in France, Boutrolle's "Cowherd" appears to have 
 been carefully read and usefully studied by those for whom it was 
 written — the country-folks or cowmen, or he may have gained his 
 knowledge from these; for, according to Saint -Cyr, one of their 
 great problems in cases of difficult parturition — a problem not con- 
 fined to the cowherds of France— was to discover if the calving Cow 
 was not " barree " (obstructed), if it had not the torche, veliere, or 
 portiere torse, torle, or tordue (cervix twisted), terms employed accord- 
 ing to the localities and dialects, and which signify what Boutrolle 
 has distinctly described. 
 
 At the commencement of this century, however, we are informed by 
 Rainard that Maurin of Cantal, and Yieillard of Brioude, two of his 
 pupils, had witnessed this form of dystokia. 
 
 In France, other veterinary observers afterwards published similar 
 cases, the first in order being Lecoq, of Bayeux, w^ho in 1837 had 
 occasion to note this accident. In a Memoire sur le part lahoricux,^ 
 he expresses his surprise at the silence prevailing among veter- 
 inary authorities with regard to this condition, which was met with 
 from time to time, and was well enough known to breeders. In 
 describing the symptoms he had noted, Lecoq says : " The hand 
 having been introduced into the vagina, and pushed as far as the neck 
 of the uterus, encountered a kind of valve obstructing the entrance to 
 the latter. I was beyond the part I had taken for a valve, and had 
 got into a narrow canal whicJi Jiad the form of a scrcic [ayant la forme 
 d'une vis). The Cow died on the following day without having been 
 delivered, and at the autopsy it was found that the uterus was com- 
 pletely turned upside-down — the superior face having become the 
 inferior — and that this version had taken place from right to left." 
 
 The first Continental veterinarian who observed — or rather, who 
 described — a complete rotation of the uterus (the previous cases recorded 
 were only those of haK-rotation) was Eichner, a professor at the Berne 
 (Switzerland) Veterinary School, who, in his " Systematic Treatise on 
 the Diseases of the Bovine Species " (published in 1810), mentions it, 
 and advises rolling the body of the Cow as a means of remedying the 
 accident. In 1842, Blickenstorfer, professor at the Zurich Veterinary 
 School, also wrote a memoir on it. The first in France to direct special 
 
 ' Comptes Rtndus de la Sociefe Vittrhiairt du Calvudof< tt de la Mavche, 1838. 
 
TORSIOX OF THE UTERUS. 811 
 
 attention to it, was Mazure, whose description is one of the best we 
 possess. It is published in the same periodical which contains Lecoq's 
 account. From liis narrative, it appears that he was consulted by one 
 of his colleagues with regard to a Cow, the cervix of whose uterus was 
 so twisted that a linger could not enter the os. Ma/.ure gave an 
 unfavourable prognosis ; but, notwithstanding, it was attempted to 
 reduce the torsion by making an opening in the right Hank in order to 
 reach the uterus. The attempt failed, though it demonstrated that 
 there was a quantity of fcetid serosity and fibrinous flakes in the peri- 
 toneal cavity ; that the uterus had a rupture in its left posterior border, 
 the rent being rounded in form and having a diameter of from twenty 
 to twenty-four centimetres ; and that the fcctus was dead, as had been 
 suspected. 
 
 .\s nothing more could be done with the Cow, it was destroyed, and 
 it was then discovered that the uterus had made a complete revolution 
 on its axis ; while towards the part adjoining the cervix, there were 
 found live spiral twists, two of which, more voluminous than the others, 
 were of a greyish colour and hard in texture. Throughout the whole 
 extent of these twists in the uterus, the connective tissue, infiltrated 
 with serosity, formed a swelling which rendered the dilatation of the 
 posterior part, and the passage of the Calf through it, most difficult. 
 The foetus was perfectly developed and intact, and did not appear to 
 have been dead more than two or three days. 
 
 Another Norman veterinax-ian, Pouchy, described four cases about 
 the same period. These Cows merely suffered from loss of appetite, 
 great distention of the abdomen, unhealthy-looking coat, a foetid and 
 sanguinolent vaginal discharge, and suppression of milk, for six to 
 eight weeks ; when submitted to treatment, and turned out to pasture, 
 they recovered sufliciently to become fit for the butcher. 
 
 In Cerniany, about the same time, according to Dieterich, torsion of 
 the uterus had been the subject of investigation and treatment by 
 Schmidt of Bavaria, Vix of (iiessen, Fricke of Hanover, and Irminger. 
 Fricke cured a case by fastening the feet together, two by two, and roll- 
 ing the animal in a contrary direction to that in which the uterus was 
 twisted. 
 
 In Britain, in the same year that Reichner described the accident 
 in Switzerland (1H40), Mr. Carlisle, of Wigton, under the head of 
 " ('asarian Operation "' describes an undoubted case of torsion. The 
 circumstance which rendered the operation necessary, was a severe 
 injury the animal had received two days previously, since when it 
 had manifested symptoms of parturition ; but though several attempts 
 had been made to extract the fo-tus, delivery could not be accomplished 
 minnij to the uterus being tu-isted Caesarian section having delivered 
 the Calf and its membranes, the Cow only lived a short time. The 
 uterus was found to be " completely rotated, even to the termination of 
 tlie vagina." 
 
 After this period, torsion of the uterus attracted a large share of 
 attention among the most accomplished Continental veterinarians, and 
 particularly after the observations published by Denoc, in France, in 
 184j. It formed the subject of animated and interesting discussions at 
 the Belgian Sociote de Medicine, the Societe Central de Med. Veterin- 
 aire of Paris in 1853 and ISGO, the Veterinary Society of Wurtemberg 
 in IH.54, and that of Denmark in 1855 ; and memoirs on it have been 
 ' I'tterinarian. vol. xiii., p. 407. 
 
312 MATERNAL DYSTOKIA. 
 
 published by Bordonnat, Eossignol, Gaven, Bouley, Canu, Lemaire, 
 Cliambon, Goubaux, Chauveau, Weber, Liautard, Dagoureau, Lessona, 
 Ollivero, Ercolani, Lafosse, Chuchu, Goron, Obig, Heu, Eocco, ]\Iarlot, 
 Gourcy, Coquet, and many other foreign veterinarians ; while it is 
 alluded to with more or less detail in the treatises of Eainard, Bau- 
 meister and Eueff, Ziirn, Harms, Lanzillotti-Buonsanti, Cruzel, Saint- 
 Cyr, etc. 
 
 In this country it did not receive much attention for some years, if 
 we are to judge from the paucity of allusions to it ; though there can be 
 no doubt that the accident frequently occurred. But in recent years 
 many cases have been described by "Cartwright (^A^hitchurch), Woods 
 (Wigan), Bennet, Cox, Eussell, Macgilli\Tay, Cunningham, and others. 
 Their observations refer to torsion of the uterus in the Cow. 
 
 With the Mare, in which the accident is nearly always fatal, it has 
 been witnessed by Belhomme, Elsen, Delwart, Hamon, Noll, Devaux, 
 Canu, Leconte, Schmidt, Miinich, Anderson, and Cox. 
 
 It has been observed in the Ewe by Lewis, in the Bitch by Macgilli- 
 vray, and in the Cat by Yivier. 
 
 Nature, and Frequency. 
 
 Before proceeding to describe the symptoms and other features of 
 this curious accident, it may be well to inquire into its nature and 
 frequency. 
 
 As the designation indicates, the accident consists in a rotation of the 
 uterus on its axis, by which its upper surface may successively become 
 lateral and inferior ; and lateral on the opposite side and superior, when 
 the revolution is complete. This revolution may take place in two 
 opposite directions ; the upper face may at first be left lateral or right 
 lateral— -the first constituting left torsion, the second right torsion. 
 
 Torsion may be incomplete or complete. There may be quarter-torsion, 
 half-torsion, three-quarter torsion, or complete torsion, according to the 
 degi-ee of rotation the uterus has experienced. In those instances in 
 ■which the organ has made two complete turns, we have a double 
 torsion. 
 
 The consequences of this rotation are easily seen. The vagina and 
 its prolongation — the cervix uteri — because of their attachments, 
 cannot follow the uterus, and therefore become twisted in a cord-like 
 manner ; whence arises stricture of the os — the constriction being all 
 the greater as the rotation is comj)lete — and utter impossibihty to 
 effect delivery of the foetus unless the uterus is replaced in its normal 
 position, or its contents are removed otherwise than through the os. 
 
 Incomplete torsion is by far the most frequent form encountered in 
 practice. It is often so slight that it might rather be classed among 
 the deviations of the uterus already alluded to. For instance, very 
 frequently there is only a trifling displacement of the cornu containing 
 the foetus, and this may carry the uterus with it, giving rise to a condi- 
 tion which bears a certain analogy to the uterine obliquity met with in 
 woman, in which the organ is inclined laterally. Schaack, Eainard, 
 Weiss, and Zundel have often noted these cases in animals ; and the 
 latter states that they occur in greatest proportion among the larger 
 lymphatic Cows. In other instances, the torsion consists of a quarter 
 or half-turn, the upper face of the uterus having become lateral or 
 inferior; sometimes the gravid cornu occupies the inferior region of the 
 
TORSIOX OF THE UTKltUS. 313 
 
 abdomen ; and at other times, making a wider rotation, it is lodged in 
 the opposit*! flank. 
 
 There are scarcely any moans in practice by wiiich we can estimate, 
 with mathematical exactness, tlie degree of torsion the uterus has 
 undergone ; as what we have designated a quarter-turn or revolution 
 only signifies that the organ has made a rotation of 90°, while the 
 half-turn is scarcely ISO . Nevertheless, an approximation is all that 
 can be looked for, and, indeed, is all that is necessary. 
 
 As we have already mentioned, Mazure, in 1H42, had a case 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 quad- 
 ruple twists have been described ; because there have been found two, 
 three, or more spiral ridges or doubles close together, hard, and resisting. 
 
 Fig. .s.l. 
 
 Incomilktk ToHaiON ok thk Utkuls. 
 
 1, Body of the Uterus; 2, 3, 4, Spiral Twists directed from left to right; 
 5, Cervix Uteri and \'af{ina ; 6, Susin-nsory Liffainent ; 7, Pelvis. 
 
 and usually parallel to each other. But these multiple plies are only 
 what a somewhat long and supple cylinder makes when it is twisted. 
 
 To account for these multiple plic<r, 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 faHus, may be enclosed in the middle of a handker- 
 chief — the utems — 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. 
 
314 
 
 MA TERN A L D YS TOKIA . 
 
 Notwithstanding this illusion, however, it is certain that double and 
 even multiple torsion of the uterus may exist ; but then the body of the 
 organ and the vagina are close twisted like a cord. This multiple 
 torsion is discovered on making the autopsy of an animal which has 
 died or been killed because of non-delivery. In such a case, it requires 
 two or more turns of the uterus to bring it to its normal position. Such 
 a complicated condition would appear, however, to be very rare. 
 
 An important question is that relating to the possibility of such an 
 accident occurring to an organ like this, which is attached to the pelvis 
 by its continuation — the vagina — suspended to the vertebrae in the 
 lumbar region by broad ligaments, and maintained in situ, in addition, 
 
 Fig. 87. 
 
 MvLTu^LE Torsion ov thk Uterus. 
 
 1, Body of the Uterus ; 2, 2, 2, Torsion, involving the Body of the Organ 
 3, Rectum ; 4, Bladder ; 5, Vagina ; 6, Symphysis Pubis. 
 
 by the neighbouring viscera, and more especially by the rumen in the 
 Cow — the animal in which uterine torsion is observed by far the most 
 frequently. 
 
 This question can be answered by a reference to what we have stated 
 with regard to the anatomy of this portion of the generative apparatus, 
 at pp. 39, 43, and 46. We have seen that, in the Cow, the concave 
 curvatures of the uterine cornua look downwards, and that it is to these 
 concavities the broad ligaments are attached ; so that if the uterus be 
 considered as freely suspended in the abdomen, the extremity of each 
 cornu is turned outwards and upwards, while its base, near the body of 
 tlie organ, although drawn in the same direction by the ligaments, yet 
 
TOnsmx OF TIIK UTHnrr.^, 315 
 
 retains its position, being firmly maintained in it by tlio body of tho 
 uterus, whicb also receives the insertion of the broad lij^aments on its 
 lower face. This insertion causes tlie uterus to project above the 
 lif^amonts, which are very broad, particularly at their anterior border, 
 and widely separated from one another in front, near their lumbar 
 attachment. The li^'aments suspend the uterus loosely in the abdomen, 
 and allow it to become fully developed during pregnancy. At this 
 period, too, they become greatly increased in substance and length. As 
 gestation advances, nearly the whole of the great size of the uterus is 
 due to the development of the one horn in which the fd-tus is situated ; 
 and as the other horn retains its normal size, the twisting of this around 
 its ligament, and consequent torsion of the cervix, can be readily under- 
 stood. 
 
 Such is the explanation of the accident given by Chauveau ; but 
 Goubaux does not quite assent to it. According to him, it is not 
 because one horn of the uterus is developed more than another, neither 
 is it owing to one of the broad ligaments being longer than its fellow ; 
 it is in consequence of the development of the cornua during gestation, 
 and their projecting greatly beyond their means of attachment or sus- 
 pension, the broad ligaments being thrown altogether back. During 
 Sregnancy the cornua are considerably lengthened, while the ligaments 
 o not increase in breadth, their points of attachment to the inner face 
 of the tlank or the ilium reniaining invariably the same. This projec- 
 tion of the gravid cornu beyond the broad ligament supporting it — and 
 which may be as much as nearly two feet — must render the production 
 of the torsion remarkably easy. We have shown that the uterus is sus- 
 pended in its ligaments as in a hammock, and if these ligaments increased 
 in width as the gravid organ is developed in size, so as not to bo over- 
 lapped by the cornua, then it might to a certain extent roll about in 
 the hammock, but could not twist around it. pjven if the uterus were 
 suspended at the extremity of the ligaments, as in the Mare, it would 
 be far less liable to torsion, and would swing in the abdomen like a kind 
 of pendulum. 
 
 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 
 face and concave border of the cornua, and a large proportion of the 
 weight being situated high above and in front of tliese ligaments — all 
 this makes us comprehend how a shock of any kind may throw tho 
 organ otT its hanmiock, and produce incomplete, or even complete, 
 torsion in the pregnant Cow without rupturing the hammock itself. 
 
 RuetY and Ercolani have witnessed cases in whicli the torsion was 
 confined to the gravid cornu ; and Stocktleth mentions its occurrence in 
 the body of the uterus, in front of the cervix. Most frequently, how- 
 ever, it involves tlie vagina, as well as the cervix and body of the 
 organ. 
 
 In certain cases alluded to by Zundel, the accident has been accom- 
 panied by rupture of tlie ligaments ; and instances are recorded by 
 Dense and Albrecht in which the rupture has extended to the uterus 
 itself. Rueff alludes to a case in which the foetus had even escaped into 
 the abdominal cavity from a uterus thus ruptured, and, developing in 
 the peritoneal sac, constituted an extra-uterine pregnancy. 
 
 With regard to the direction of the torsion, several authorities have 
 maintained that it takes place from left to right. Others, however, 
 have found it to be in the contrary direction, and there appears to be no 
 
316 MATERNAL DYSTOKIA. 
 
 reason why it should occur in one way more than another, as the foetus 
 is developed in either cornu irrespectively. Eeynal, however, believes 
 that the obliquity of the inner face of the rumen might dispose the 
 uterus to torsion towards the right. Chauveau is, we think, justified in 
 asserting that torsion always takes place inwards and upwards — the 
 foetus slipping off its hammock causes this to swing round either to the 
 right or left. 
 
 The relative infrequency of this occurrence in the other domesticated 
 animals, is undoubtedly owing to the different arrangement of the 
 uterus and its suspensory ligaments. 
 
 With regard to the frequency of the accident, this depends upon 
 several circumstances, the chief of which, perhaps, are related to the 
 nature of the country in which the animals are reared, as well as to the 
 manner of rearing them. This will explain, partly or wholly, why 
 veterinarians in one locality are familiar wdth the accident, while others 
 with as extensive experience never witness it. 
 
 Leconte states that he has observed it about a dozen times, in 
 between three and four hundred cases of difficult parturition. Lemaire 
 has met with it seven times in four years ; and Eocco speaks of having 
 witnessed about thirty cases of uterine torsion during forty years' 
 practice. 
 
 Etiology. 
 
 Torsion of the uterus ordinarily occurs towards the termination of 
 pregnancy — about the eighth or ninth month, and its causes appear to 
 be very diverse, if we are to accept the numerous opinions which have 
 been offered on this point. 
 
 The cause which, of all others, appears to operate most frequently in 
 producing this condition, is a slip or fall, and particularly od the hind 
 quarters — croup or hocks. 
 
 For this reason, uterine torsion is oftenest witnessed among Cows at 
 liberty in pastoral countries where the ground is broken, intersected, or 
 hilly. Therefore it is, also, that the accident is not at all uncommon in 
 Switzerland and the hilly parts of South Germany ; while it is almost 
 unknown on the plains, and is very rare indeed among Cows kept in 
 sheds. 
 
 Sometimes the Cow has slipped upon its hind-quarters and tumbled 
 over, through coming in contact with another. Mai'lot and Liautard 
 have seen it arise from a horn thrust in the flank by a companion Cow, the 
 blow throwing the foetus and the uterus round to the opposite side. It 
 has occurred in a Cow which was often butting with others. Chambon 
 has noted it in a Cow w4iich was in the habit of rolling like a horse ; 
 Dagoureau reports it occurring in a pregnant Cow which leapt on others 
 like a Bull, and Liautard in another that used to get its fore feet in the 
 manger. Eocco states that it is produced in shoeing at the forge, w^hen 
 pregnant Cows are either thrown down or put in the travis to he shod ; 
 and Eueff mentions a case in which it happened through casting a Cow 
 for the purpose of performing an operation on it. In other instances it 
 has been ascribed to falling when jumping a ditch, or slipping up wben 
 descending a steep hill. 
 
 Eeynal, Mignon, Chambon, Weber, and others, appear to consider 
 meteorism as one of the most certain and most frequent causes of 
 uterine torsion, through the displacement of the viscera which the dis- 
 tension occasions. Either the expansion of the rumen induces unusual 
 
TOKSIOy OF THE UTKRUS. .117 
 
 and inordinate movements on the part of tlae fcutus ; or it acts din-ctly 
 on the uterus, and produces displacement of the or^an tlu'ougb tho 
 changes in situation and relations imposed on the other abdominal 
 organs. Mr. Cartwriglit, of Whitchurch, was of opinion that great dis- 
 tension of the stomach may, oitlier of itself, or especially in connection 
 with a fall, cause the uterus to be forced on one side, or twisted. 
 
 Other authorities, among whom we find Ercolani, attiibute the acci- 
 dent to severe toil when Cows are worked — as in draught ; others, to 
 deformity or malposition of the fu'tus ; and others, again, think it may 
 be mainly, if not exclusively, due to the spontaneous and energetic 
 movements of the fuitus in utcro, towards the termination of pregnancy. 
 It is well known that these movements are sometimes very lively and 
 powerful, and especially when induced by sudden jerks or blows 
 intlicted 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 the fcetus executes in order to get rid of uncomfort- 
 able sensations or avoid unpleasant positions, gives rise to those various 
 attitudes and mal-presentations which so frecjuently render birth dilVi- 
 cult, if not impossible ; and their occurrence may also explain how the 
 young creature may be the means of causing the cornu in which it is 
 contained, to roll and twist around the vacant cornu on the opposite 
 side. 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 
 (juarter or half revolutions — which are, after all, most frequent — may 
 occur without the active intervention of the fcetus, 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 the foetus, and may follow its movements moru readily. 
 
 Chambon and other veterinarians are of opinion that the irregular 
 and often violent movements whicli 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, 
 when he made a first exploration 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 the 
 inten-al. 
 
 Other authorities have supposed the accident to be occasioned by 
 premature straining in parturition, before the os is sufliciently 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 roUing themselves alternately from 
 right to left when they are lying. On the 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 
 Bovine species. Sternal or abdominal rolling could scarcely produce 
 displacement of the uterus. 
 
 Ruptme of one or both of the broad ligaments has been indicated by 
 
318 MATERNAL UYSTOKIA. 
 
 Leconte as always present in torsion ; but this is an error, as such a 
 lesion is found to be exceedingly rare after death. But rupture of 
 either or both of these important suspensory bands may take place 
 when pregnancy has well advanced, and there is a severe strain upon 
 them. Then it can be readily understood how the uterus, rolling about 
 among the digestive viscera and mainly retained b)^ the cervix and 
 vagina, may twist and twine on itself, and thus effectually occlude the 
 
 OS. 
 
 Torsion of the uterus has been witnessed by Pouchy, subsequent to a 
 birth in \vhich there was eversion of the vagina and uterus. 
 
 In all likehhood, the stretching of the broad hgaments, through 
 repeated pregnancies, predisposes to it ; though this cannot be the sole 
 cause, as torsion is often met with in primiparae. 
 
 Displacement of the uterus by the pressure of a diseased kidney has 
 been recorded by Eueff. The kidney was of great size, and weighed 
 more than thirty-three pounds. 
 
 Sijmptoms. 
 
 "We have stated that this accident always takes place towards the 
 termination of pregnancy- — from the eighth to the ninth month. But 
 Wegerer, Benzie, and other veterinarians, assert that they have 
 witnessed it so early as the fifth month. Without disputing the 
 correctness of their observations, it must be admitted that, during the 
 early periods of gestation, the means by which the uterus is retained in 
 its situation are sufficiently powerful to prevent any displacement of 
 this kind ; and that it can only be at a late period, when the foetus is 
 fully developed, and, with its membranes, has attained its maximum 
 size and weight — so far as uterine life is concerned, that such an occur- 
 rence is likely. And the existence of torsion is generally only dis- 
 covered when the time for the expulsion of the foetus has arrived ; 
 though it has been said that parturition takes place earlier when torsion 
 is present. 
 
 As a rule there is no particular indication of inconvenience or suffer- 
 ing at the moment when torsion of the uterus has taken place, if it has 
 occurred before parturition ; and it would appear that gestation may go 
 on to its termination without any appreciable symptoms being noted, or 
 anything like functional disturbance observed. 
 
 JEven in the initial stage of parturition, when enlargement of the 
 iidder, sinking of the croup, swelling and dilatation of the vulva, etc., 
 have become manifest, there is no sign w^hich can be relied upon to 
 prove the existence of torsion. Only in some instances it has been 
 remarked that the tumefaction of the vulva is not so great as in ordinary 
 cases, and that it remains dry, and appears to be buried more deeply 
 between the ischial tuberosities. 
 
 Occasionally some difficulty in micturition is observed before partu- 
 rition, should torsion have occurred — the urine escaping only in small 
 quantity at a time ; or there may be total suppression. This interfer- 
 ence with the discharge of the urine is due to the compression the 
 bladder experiences from one of the twists in the uterus. 
 
 The fii'st labour pains, which soon appear, are usually feeble, and are 
 separated by a comparatively long interval of quiet, during which the 
 animal appears to be nothing amiss. Nevertheless, as time goes on, 
 symptoms of colic are evinced now and again, and though the labour 
 
roiisiox ay the i'tkrus. .{19 
 
 pains succeed each other more rapiilly, and become more energetic, yet 
 birth does not seem to advance ; the "water-bag " does not show itself, 
 and nothing appears externally. This condition niay persist for six, 
 twelve, twenty-four, and even forty-eight hours ; when, if not before, 
 the veterinarian is perhaps requested to attend. 
 
 In other instances, however, the symptoms are more marked and 
 severe during this lirst period. The animal ap[)ears to suffer from the 
 pain of intense uterine and abdominal spasms, marked by violent strain- 
 ing, which comes on at longer or shorter intervals ; it moves about 
 anxiously ; paws energetically now and again ; attempts to lie down ; 
 rests on its chest or sits like a dog on its hind-quarters ; springs up 
 suddenly, and often with a bound. The pulse is quickened, the skin 
 becomes alternately hot and cold, moist and dry ; and the expulsive 
 efforts, though so violent, are of course futile. 
 
 In many instances, after a period varying from twelve to forty-eight 
 hours, these symptoms may disappear, and the animal seems to have 
 recovered, for the time at least, its ordinary health. To such an extent 
 does this occur, that it might be believed the period of ))irth had not 
 arrived, and that the symptoms were only those of " false pains." 
 
 In the course of from one to six days, howevei", this normal quietude 
 is interrupted by the recurrence of the labour pains, and in so urgent a 
 form that there can no longer be any doubt as to real attempts at 
 delivery. But still the efforts are not succeeded by any tangible 
 evidence that birth is making progress. As some obstacle to the expul- 
 sion of the ftetus now evidently intervenes, a manual examination will 
 probably be made by the veterinarian, if he has chanced to be called in, 
 and after he has heard the history of the case and noted the general 
 symptoms. 
 
 The oiled hand, on being introduced into the vagina, meets at first 
 with no obstacle in that canal ; but on advancing into it, the fingers 
 soon encounter one or more folds or ruga^ which render the passage 
 more and more constricted towards the cervix uteri. Towards the 
 termination of the vagina, the fingers reach a kind of citl-dc-sac, formed 
 by the mucous folds, which at this part converge in a spiral manner, 
 their direction being either to the right or left. .Mthough at first 
 there appears to be no passage, yet it will be found that by turning 
 the hand in the same spiral direction as the cavity winds, or rather the 
 rugie incline, the fingers will be able to penetrate to a certain depth ; 
 and if one of the most prominent ridges be followed in this way, it will 
 be discovered that it has a corkscrew-like course. 
 
 This is the pathognomonic or distinctive symptom of torsion of the 
 uterus, and it is not found in simple deviation or obliquity of the organ. 
 In the latter condition there is no spiral twisting or rug;e, but merely a 
 fold of mucous membrane passing from behind forward, in an oblique 
 manner ; while tiie hand can be i)assed with little ditliculty to the 
 cervix, the os of which is usually found dilated. It is only this 
 fold of membrane, in uterine deviation, which prevents the passage 
 of the fcEtus througli the os, by hindering uniform pressure on the 
 cervix. 
 
 The kind of spiral infundibulum into which the hand penetrates in 
 torsion of the uterus, varies in dimensions according to the amount of 
 torsion. In the quarter-turn or revolution, it may be possible to get 
 the hand into the constriction, though with difficulty, and to reach so 
 far as to touch the neck of the uterus, which may be more or less 
 
320 MATERNAL DYSTOKIA. 
 
 dilated, and allow the position of the fcetus to be ascertained. In 
 accomplishing this manoeuvre, the fingers 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-like manner. If the torsion is to the left, this ring inclines to the 
 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 the direction of the torsion, and the uterus is carried towards 
 the left iiank. 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 rings — 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 character of this twist hereafter. 
 
 In the complete turn, the occlusion is such that only one finger can 
 penetrate to a very slight depth in the spiral stricture, and the direction 
 of the rugae is very baffling, 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 foetal membranes, as well as the footus, are intact, and 
 particularly in the half and complete degrees of torsion. In the quarter 
 revolution, the membranes are sometimes ruptured and the waters 
 discharged for a considerable period. 
 
 The foetus is usually alive soon after the first labour pains ; but it 
 quickly perishes, and its death is almost certain to have taken place 
 within forty-eight hours after parturition has commenced. The period 
 of its decease, however, will greatly depend on the intensity of the 
 " pains." 
 
 The position of the foetus 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 foetus should be brought into its normal position. Some- 
 times when the twist is slight and the passage sufficiently large, the 
 foetus 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 foetus 
 can generally be found higher in it, towards the flank, on the right or left 
 side. This change in the position of the foetus may also be recognised 
 by exploration ])er rectum, which may also possibly allow the torsion of 
 the uterus to be distinguished, as well as its direction. The uterus can be 
 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 
 
TOIiSWX OF THE L'TEIIUS. -Vn 
 
 can be perceived. It may be noted, also, that occasionally the rectum 
 itself is displaced ami drawn towards the entangled uterus. 
 
 If tlie animal is not relieved, the symptoms above indicated persist 
 with variable intensity, according to circumstances. The straining and 
 attempts at spontaneous delivery continue either feebly, and with long 
 intervals between, or they are violent and almost incessant. The animal 
 soon ceases to eat and ruminate ; it becomes dull and dispirited ; fever 
 sets in, and the pulse and respiration are hurried ; rigors and grinding 
 of the teeth are remarked from time to time ; the lacteal secretion which 
 had commenced is now suspended ; the mammai become soft and 
 small ; the eyes sink in their orbit ; and extreme prostration ensues. 
 The creature, unable to get up, constantly lies ; the pulse becomes im- 
 perceptible, while the heart's beats are loud and tumultuous ; and death 
 generally occurs from the tliird to the tenth day after the eai-liest symp 
 toms were exhibited. 
 
 Many authorities are of opinion that death is the only result that can 
 he looked for when assistance is not rendered, and the animal is accord- 
 ingly left to its fate ; and, contrary to what Kainard has stated, they do 
 not admit that the fa>tus may become mummified in the uterus and the 
 Cow live and thrive. But we have the evidence of the old French 
 authority, Boutrelle, as \vell as that of Ercolani, Lessona, Rocco, (iurlt, 
 Liautard, Pouchy (already quoted), and others, that this happy termina- 
 tion is quite possible ; and indisputable cases are recorded of Cows with 
 unreduced uterine torsions, which have perfectly recovered and fattened, 
 and in the uterus of which, after slaughter, the desiccated or mummified 
 fcEtus has been found. 
 
 But yet these must be looked upon as exceptional cases ; and while 
 they only prove that spontaneous recovery is possible, it must be 
 admitted that, in the great majority of instances, death is not long in 
 appearing in torsion of the uterus, if the organ is not restored to its 
 normal position. 
 
 Diagnosis. 
 The diagnosis of this accident, and the direction and extent of the 
 torsion, are of great importance from an obstetrical point of view. We 
 will therefore consider (1) The presence of torsion ; (2) The direction of 
 the torsion ; and (3) The degree of torsion. 
 
 1. The Presence of Torsion. — To recognise the existence of torsion of 
 the uterus is not attended with much difficulty ; and in describing the 
 symptoms we have, to a certain extent, shown the manner in which the 
 accident manifests itself to tiie obstetrist. 
 
 It has been stated that, when the hand is introduced into the vagina 
 of an animal the subject of this displacement, it is soon discovered that 
 there is something in the way, and this appears to be a narrowing of 
 the passage. Passing on, the constriction seems to be increasing, until 
 at the end of the canal there is only a very small opening, into which 
 the lingers may pass with difliculty ; when inserted there, it is found 
 that they cannot be pushed straight forward, but have a tendency to 
 deviate to the right or left, and finally to assume a spiral course. 
 
 We have also stated that this peculiarity in the constriction is 
 markedly characteristic and distinctive of uterine torsion, and this 
 statement holds good in the large majority of cases; so that it is scarcely 
 possible to make a mistake. 
 
 21 
 
322 
 
 3IATERNAL DYSTOKIA. 
 
 In very exceptional instances, however, the torsion may have occurred 
 in front of the cervix — in the body of the uterus ; and then the cervix 
 may be easily reached, while the os may even be penetrated, without 
 discovering any indications of the accident. Such occurrences have 
 been recorded by Stockfleth, Ercolani, and Eueff ; and these excellent 
 authorities have also witnessed the torsion limited to the cornu contain- 
 ing the foetus. Here we have neither the constriction of the vagina, 
 nor the spiral involutions of its lining membrane, to guide us to a con- 
 clusion, and we must mainly rely on rectal exploration. 
 
 Fortunately, such cases are all but unknown in practice, and prob- 
 ably in ninety-nine per cent, it will be found that the twisting has taken 
 place at the cervix, when we have the infallible distinctive sign — the 
 spiral rugae in the vagina. 
 
 2. The Direction of the Torsion. — It has been demonstrated that the 
 uterus may revolve on itself in two different directions, and that in 
 
 A B 
 
 Fig. 88. 
 A, Cord twisted to the Right ; B, Cord twisted to the Left. 
 
 order to make a complete revolution, its upper face may become right 
 lateral, then inferior, then left lateral, and again superior; or if it re- 
 volves in the opposite direction, it will become successively left lateral, 
 inferior, right lateral, and once more superior. 
 
 We have casually indicated how the direction of the twist may be 
 discovered when it has not made a complete revolution. But the 
 manner of discovering to which side the gravid uterus has inclined, 
 has been one of the most debatable in the history of this accident, 
 and has occasioned much controversy and the most contradictory in- 
 terpretations ; up to the present time, in fact, the problem has not 
 met with a satisfactory solution. The confusion prevailing with re- 
 gard to what appears such a simple matter, is well exemplified in the 
 discussion which took place in 1860, at a meeting of the Central Veter- 
 inary Medical Society of Paris, at which the most opposite notions were 
 promulgated. And yet, next to assuring one's self that torsion does 
 exist, the ascertaining of the direction it follows is of supreme impor- 
 
TORSION OF THE f'TEKUS. 
 
 321? 
 
 tance, as on this alone depends our bein^' able to rectify the malposition 
 of the or^'an without delay. The disputation appears to have arisen 
 solely from a confusion of terms — from neglecting to define what was 
 meant by torsion from left to riglit, or right to left ; and Haint-Cyr 
 praiseworthily endeavours, and with success, to settle the question by 
 repairing the omission. 
 
 " When," ho says, "in its revolution the left cornu of the uterus 
 passes above the riijht cornu, the upper face of the organ becomes 
 successively riijht lateral, then inferior, then left lateral, and again 
 superior — thus constituting a complete revolution ; tiio torsion is tlien 
 from left to rujht, or simply right torsion." 
 
 LEfT Utekise TOBSIOS. 
 
 1 , Body of the Uterus ; 2, Cervix 
 Uteri twiate*! to the left ; 3, 
 Rectum ; 4, Bladder ; 5, Sym- 
 physis. 
 
 yig. 90. 
 
 Right Uterine Torsion. 
 
 1, Body of the Uterus ; 2, 2, 2, Torsion 
 of the Cervix Uteri to the right, iii- 
 volvinv; the Body of the Organ ; ."'>, 
 Rectum ; 4, Bladder ; 5, Vagina ; (>, 
 Symphysis. 
 
 The reverse movement constitutes torsion /rom right to left, or, better, 
 left torsion. 
 
 In other words, the passing of the left cornu over the right produces 
 right torsion; that of the right over the left cornu, left torsion. 
 
 Hence we have the simple and easily remembered and understood 
 terms of right torsion and left torsion, which are synonymous with 
 torsion from left to right and torsion from right to left. 
 
 This being decided upon, the next question is how to distinguish, 
 from a purely objective point of view, a right from a left torsion; and 
 
S24 
 
 MATERNAL DYSTOKIA. 
 
 this also, it appears, has been a source of difficulty and debate, from 
 neglecting to define terms. Saint-Cyr again has come to the rescue, 
 and his efforts to put the matter in a clear light must be looked on as 
 eminently satisfactory. 
 
 Glancing at Fig. 88, we see two pieces of cord, the strands of which 
 exactly, but more clearly, represent the spiral plicaB of the twisted 
 vagina or cervix uteri. It will be observed from the course of the 
 strands, that the pieces are twined in opposite directions : cord A being 
 
 
 Fig. 91. 
 
 Right Uterine Torsion : 
 Manipulation. 
 
 Fig. 92. 
 
 Left Uterine Torsion 
 Manipulation. 
 
 twined to the right, and cord B to the left. This disposition of the 
 strands of a rope being generally recognised as exact in the technical 
 language of mechanics, as well as in speaking of the spiral inclination 
 of the thread of a screw, the same application of the terms should hold 
 good in such a mechanical deviation of the uterus as that now under 
 consideration. 
 
 These different torsions can be imitated by the handkerchief, as has 
 just been pointed out ; and they are well represented in Figs. 86 (left 
 torsion), 89 (left torsion), 90 (right multiple torsion), and 93 (left tor- 
 sion), which illustrate simple and multiple, as well as right and left 
 torsion. 
 
TORSIOy OF THE UTERUS. 325 
 
 This being fully uudorstooj, it now remains to demonstrate how tlie 
 different torsions may be distinguislied in the living animal, by vaginal 
 exploration. In doing so, we will follow the remarkably lucid directions 
 furnished by Saint-Cyr, to guide practitioners in forming a diagnosis. 
 
 Supposing the riijht hand introduced in a state of pronation (palm 
 downwards) into the vagina of a Cow supposed to be suffering from 
 uterine torsion, it is evident that, in order to follow the direction of the 
 spiral folds met with, it must execute a kind of rotary or screw-like 
 movement on the wrist. If this movement is such that the cubital 
 border of the hand, to the rirjlit at first (Fig. 91, position A), becomes 
 inferior (little linger downwards — position 13), then internal, so as to 
 arrive at a state of supination (palm upwards — position C), then the 
 torsion is to the riijht. 
 
 On the contrary, if the hand, in following the spiral folds in the 
 vaginal canal, rotates in the opposite direction, of course tJie torsion is 
 to the left. For instance, as in the other case, the hand is introduced 
 in a state of pronation (Fig. 92, position A), but instead of the thumb 
 turning upwards and round to the right, it inclines downward to the 
 left ^position B), the little finger ascending until it is uppermost, and 
 the palm of the hand is turned outwards (position C). 
 
 This is a very simple matter, apparently ; and yet in practice it may 
 be very important. It may be sufficient, then, if the fact is impressed 
 upon the young obstetrist, that when the palm of the hand turns to the 
 left, or inwards, the torsion is to the right ; and when it inclines out- 
 wards, or to the right, then the twist is to the left. 
 
 ■i. The Degree of TorsioJi. — To ascertain the degree of torsion is more 
 diflicult than to discover its existence or direction ; though every 
 endeavour should be made to satisfy one's self in this respect, as the 
 " detorsion " will be easy as the torsion is slight, and vice versd. 
 
 It has been stated that it may exist as a quarter, half, throe-quarter, 
 or a complete revolution ; and that it may even extend to a double, 
 treble, or quadruple twist. But it must be always doubtful whether we 
 can diagnose with certainty these different degrees of torsion which may 
 be met with in obstetrical practice. 
 
 It is evident, however, that the greater the amount of torsion, so the 
 more will the vagina be constricted, and penetration by the hand 
 rendered difficult. We have already, in treating of the symptoms, 
 drawn attention to the condition of the vagina and cervix uteri in the 
 more simple cases. When, for instance, the hand can be passed 
 without very much trouble as far as tlie cervix, and the os can be 
 penetrated to such a depth that some parts of the fcctus are felt, then 
 it may be presumed that the organ has only made about one-fourth of a 
 revolution on itself. If the passage is more constricted, the spiral folds 
 closer together, and the cervix can be reached with much difficulty — 
 perhaps only one or two fingers entering the os — we may expect that 
 the uterus has made a half or three-quarter revolution. 
 
 But if the vagina is completely occluded not far from the vulva, the 
 fingers being only able to pass into the funnel-shaped infundibulum for 
 a very short distance, and cannot reach the cervix, then there may be 
 one or more complete twists. The spiral folds will also be close and 
 numerous, and for this reason their direction will be all the more diffi- 
 cult to ascertain. 
 
326 MATEEXAL DYSTOKIA. 
 
 Prognosis. 
 
 With the Cow, torsion of the uterus must be looked upon as a serious 
 accident ; for except in a few exceptional cases, when assistance is not 
 rendered the foetus and mother have always perished. Nevertheless, 
 notwithstanding its grave character, modern veterinary science does 
 not consider it beyond remedy ; and its records show that, by judicious 
 intervention, mother and offspring may often be saved. 
 
 But in order to attain this happy result, a careful diagnosis must not 
 only be made, and the direction and extent (if possible) of the torsion 
 clearly ascertained, but the proper mode of restoring the uterus to its 
 normal position must also be observed and skilfully carried out. 
 
 A cautious opinion must always be given, but its favourableness will 
 of course depend upon the brief duration of the parturient symptoms, 
 the degree of torsion, the condition of the animal, and whether it has 
 been subjected to unskilful manipulation before the veterinarian has 
 been called in. 
 
 Pathological Anatomy. 
 
 When the animal has been subjected to manipulatory manoeuvres to 
 effect delivery, or when it has been permitted to live many hours after 
 signs of parturition have appeared, the first important alteration noted 
 on opening the abdomen is that due to peritonitis. There is a quan- 
 tity of blood-tinted serum effused into the peritoneal sac, in which float 
 shreds of fibrin ; and the lining membrane is reddened, deeply injected 
 with blood in parts, and particularly those which have been in contact 
 with the uterus ; not uufrequently there is a fibrinous exudate on its 
 surface, and this may cause adhesion between it and different organs. 
 
 On removing the intestines and the floor of the pelvis, the uterus and 
 vagina are exposed, and the torsion is visible. This appears as a large, 
 hard cord, composed apparently of a number of spiral strands of unequal 
 size, the closest twined of w^hich are in the middle of the strangulation ; 
 this cord — formed by the termination of the vagina and the cervix and 
 body of the uterus — opens out its strands as it recedes from the densely- 
 twined portion towards the fundus of the uterus on one side, and to the 
 vagina on the other (Fig. 93). 
 
 The broad ligaments are sometimes compressed between the spiral 
 folds, which they concur to form, and with which they are so intimately 
 connected that very often they cannot be recognised until the uterus 
 has been untwisted. In other instances, they merely envelop the twist 
 in crossing it ; so that the extent of the torsion cannot be seen until 
 the ligaments are detached from the ilium on each side. 
 
 Earely, as we have remarked, are these ligaments ruptured ; and 
 though some veterinary authorities have maintained that torsion is 
 impossible w^ithout one or both being torn, yet this lesion is seldom 
 witnessed. In the large majority of cases, they are tense and greatly 
 stretched, tightly compressing the cervix and rendering occlusion of the 
 OS all the more rigid ; but when the uterus is reinstated in its natural 
 relations, they are found to be intact. 
 
 If the uterus be seized at its fundus and turned in a direction con- 
 trary to that of the torsion, the strands of tbe latter gradually open, 
 widen, and are effaced ; while the strangulation disappears, the cervix 
 comes into view, and the vagina assumes its normal length and w^idth, 
 as well as its almost cylindrical form. 
 
 So that the hand introduced into the vagina, ^;cr vulvam, no longer 
 
TORSION OF THE UTERUS. 
 
 327 
 
 encountei-s the spiral plicaj met with in the animal wliilo alive ; hut 
 passes through the canal, and even into the uterus, without hindrance. 
 The numher of turns necessary to accomplish this will indicate the 
 amount of torsion which had taken place. Most frequently only half a 
 turn is necessary, showing that the uterus had made half a revolution 
 on its axis — the upper surface having become the lower. Sometimes 
 the quarter of a turn will sutlice to adjust it ; while in other instances 
 a complete turn, or even two, three, or four turns in the opposite dix-ec- 
 tion to the torsion, may be needed before the obstruction disappears ; 
 though it is very doubtful if more than two complete twists or turns are 
 ever really made. 
 
 Fig. 93. 
 
 Left Uterine Tor.sion in ■<itit. 
 
 1, Body of the Uterus ; 2, Twisted crnlx iiteri ; .'!, Vagin.a ; I, L< ft K.'\lloi)ian 
 
 Ligament. 
 
 At times the uterus and vagina exhibit signs of inflammation, par- 
 ticularly towards the strangulation, and the indications of acute metro- 
 peritonitis are frequently most marked. In exceptional instances we 
 may have gangrene of the uterus, probably due to obstruction of the 
 bloodvessels implicated in the torsion. 
 
 As a complication, a more or less extensive rupture, complete or 
 incomplete, of the uterus may exist — possibly having been ])roduced by 
 the severe uterine contractions during the life of the animal. This 
 rupture, implicating the walls of the organ, is most frequently met with 
 in its body, in the vicinity of the twisted portion, or at the junction of 
 the gravid cornu with the uterus. The foetus has been at times found 
 partly fixed in the fissure. 
 
328 MATERNAL DYSTOKIA. 
 
 "With regard to the foetus itself, its condition varies with the length 
 of time %Yhich has elapsed since it perished, and also whether or not 
 the external air has had access to it. In some instances, even when it 
 has been dead for a long time, it will be fomid in a state of perfect pre- 
 servation ; in others it is in an advanced stage of putrefaction, the hair 
 and hoofs coming off readily, and the body swollen and emphysematous, 
 while the odour emitted is disgustingly powerful and foetid. 
 
 In rare cases the foetus is mummified, and this may even occur when 
 it has attained its full development. 
 
 Such is an outline of the pathological anatomy of this accident. 
 Numerous illustrations of the various lesions met with after death 
 might be furnished, but the above description applies to all. 
 
 Treatment. 
 
 The successful treatment of torsion of the uterus had, to the great 
 majority — indeed, to all — of the veterinary obstetrists of not long ago, 
 evidently appeared hopeless ; consequently, the animal suffering from 
 this accident was either left to die without succour, or was consigned 
 to the butcher if its carcase could be utilised for food. In some few 
 instances, the animal has recovered from the effects of the torsion, and 
 without reposition of the organ having been effected. After fruitless 
 efforts, the labour pains subside, the foetus dies and becomes mummified; 
 the Cow is in an ailing condition, perhaps, for some time, but rallies, 
 and may even regain its former condition, not unfrequently even yielding 
 a certain quantity of milk. 
 
 In other cases the Cow becomes emaciated and miserable-looking, 
 gives no milk, and generally succumbs, after a variable period, to chronic 
 peritonitis. But in far more instances serious illness ensues at the very 
 commencement, and we have metritis and peritonitis, gangrene of the 
 uterus, putrefaction of the foetus, septicaemia, paraplegia, or other grave 
 conditions which quickly terminate life. 
 
 In British veterinary literature successful attempts at delivery have 
 been recorded. 
 
 On the Continent, although many cures have been published, yet they 
 only date from a comparatively recent day. Nevertheless, according to 
 Eainard,! Vieillard long ago (1823) succeeded in one instance in saving a 
 Cow and Calf, through having recourse to vaginal hysterotomy. In this 
 case there was inversion of the uterus, the cervix of which w^as extruded 
 beyond the vagina, and showed three markedly-salient spiral rings. He 
 experienced much difliculty in making convenient openings ; the exten- 
 sive incisions he was compelled to make, in order to remove the foetus, 
 became lacerations, and there was serious hiemorrhage. Yet the animal 
 made a good recovery. This formidable operation has not found an imi- 
 tator, and should not require one — except, perhaps, in a similar case, when 
 there is eversion of the vagina, so that the parts to be incised are visible. 
 
 The principal — indeed, the sole — indication for the relief of this 
 accident is to untioist the uterus ; in doing this the cervix and os are 
 restored to their normal condition, and the vagina rendered patent, 
 while the uterus itself assumes its ordinary relations. 
 
 Various methods — all of which have been attended with more or less 
 success in practice — have been devised to accomphsh this object. 
 
 They are (1) Abdominal taxis ; (2) Vagi^ial hysterotomy ; (3) Vaginal 
 
 1 Op. cit., vol. i., p. 240. 
 
TORSION OF THE UTKRi'S. 329 
 
 taxis; {^) Denoc s procedure ; (5) Darrcau's procedure; {G) liOtatioii uf 
 the Coiv's body: and (7) Gastro-hysterotomy, or Ccesarian section. 
 
 1. Abdominal Taxis. — The idea of opening the abdomen and thrust- 
 in^' the hands and arms into its cavity, in order to search for the twisted 
 uterus, then to untwist it directly by turning it on its axis in a contrary 
 direction to the torsion, in order to dehver the animal by the natural 
 passages, is at tirst sight an eminently rational and practical procedure, 
 and one which, occurring independently to several minds, has been 
 resorted to by a number of veterinary obstetrists. 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. Among these 
 may be cited the great weight of the gravid uterus — from 112 to 180 
 pounds — its immense size, its convex, smooth, and slippery surface ; 
 the limited space there is in the abdominal cavity for manipulation ; 
 and the obstacles the other viscera otl'er to version manceuvres. 
 
 " Nothing," says ^lazure, after repeatedly trying this method, 
 " appears more simple to the mind than to seize with the hand one of 
 the sides of the uterus, and to swing it round, and especially as it is 
 restoring the organ to its natural position. Yet no one whom I know 
 is competent to perform this simple movement." 
 
 " My confrere and I tried to swing round the uterus," writes Gosselin, 
 " but it was in vain ; all our efforts could not even cause it to change 
 its place." 
 
 Bouley attempted this method in 1853, but did not succeed. After 
 failing in other manceuvres to effect the detorsion of the uterus, in 
 despair he made a large incision in the right flank, in order to try if he 
 could not, by direct taxis on the organ itself, restore it to its ordinary 
 condition. But he was disappointed : for the uterus, enormously dis- 
 tended, so completely tilled the abdominal cavity that the hand could 
 scarcely be introduced between it and the walls of the abdomen ; while 
 the surface of the uterus was so smooth that the operator's fingers could 
 not cling to it. 
 
 Notwithstanding, this operation — which, from having been performed 
 in the region of the flank, has received the designation of "laparotomy" 
 (from \a-dpa, flank or /o/;is, and TijLruv, to cut) — has been practised 
 with variable success in Germany by Fausel (1849),' Epple (1852), 
 Kohler (1853), Diccas (1867), Lechleuthner (1868), Obich (1869), 
 Heichlinger (1869), etc. ; in France by Darreau, Garreau, and others ; 
 in Italy by Santoni and Rocco ; and in Denmark by Stockfleth. 
 
 We have said that the success attending laparotomy has been variable. 
 This is exemplified in Obich's experience.-' This veterinarian had three 
 
 ' It is worthy of note that the idea of resorting to laparotomy occurred t<j an excellent 
 veterinary practitioner in Scotland, perhaps lonir befort- it did to Fansel, though for lack 
 of Mpjxirtunity it waa not carried into effect. Mr. Cartwright, of Whitchurch, writing in 
 1s.jO, " On Torsion of the irterus in the Cow" ( I'f.lerinartHii, vol. xxiii., p. 248), and it» 
 treatment, and proposing to try rolling th> .ininial, adds : "HI did not succeed in this 
 way, I should proceed according to a suggestion given nie by Mr. .lohn Steel, of Biggar, 
 Lanarkshire — viz., to make an incision between the ilium and the ribs on the right side, 
 »nd try to untwist it (the uterus). If I succeeded, I shoidd sew up the wound and allow 
 the labour to take its natural course ; but if not, I am not aware that there is any other 
 means but that of performing the Ctesarian oj>»ration. Mr. Steel, .ilthough he ha.s not 
 yet h!»d an opportunity of testing its practicability, deserves the thanks of the profession 
 for such a suggestion, and it is one which I think verj- likely to succeed. At any rate, 
 if it does not, we can but perform the Cssarian operation." 
 
 ' Woe fume h rij't Jiir ThierhtUkunde, 1869. 
 
330 MATERNAL DYSTOKIA. 
 
 cases of uterine torsion, in which he resorted to this operation to replace 
 the organ. Two of the cases were attended with complete success ; but 
 in the third the uterus was of such an extraordinary size and weight, that 
 he failed to restore it to its natural position. He proposed in future to 
 facilitate the operation by using a looped cord with which to raise the 
 organ. 
 
 Heichlinger operated successfully on a Cow in the same manner, but 
 the animal afterwards perished through gangrene of the uterus. 
 
 It must be admitted that the operation has not been performed 
 sufiiciently often, and then sometimes in very unfavourable circum- 
 stances, to enable us to draw any satisfactory conclusions as to its 
 value. Darreau, who has been fortunate in some of his attempts, 
 writes: "Direct taxis by an opening made in the flank has had some 
 advantages ; I have even thought for a moment after my first success 
 that it would be the only means I should resort to for the future. But 
 unfortunately, new cases upset my predictions, and compelled me to 
 seek for more efficacious means." And Fausel admits that the con- 
 siderable weight of the uterus may sometimes prove an insurmountable 
 obstacle. 
 
 The dangers attending the operation, even if reposition of the uterus 
 be effected, are as great as its difficulties. Several good authorities have 
 therefore recommended its abandonment, or at least its being adopted 
 only in very exceptional circumstances. Franck, however, shows that 
 it is far from being unsuccessful — the uterus having been untwisted in 
 thirteen out of fifteen cases, nine of the thirteen animals recovering, the 
 other four being operated upon too late. 
 
 Oj^eration. — Different operators have different modes of operating. 
 Some prefer the animal in a standing position ; others throw it down. 
 One selects the left flank ; another, and perhaps with more reason, in- 
 cises the right flank. Saint-Cyr recommends the standing position, 
 with the hind quarters slightly raised. The right hind leg is pulled back 
 by a rope held by an assistant, to prevent the operator being kicked ; 
 while the head is tied short. An intelligent assistant introduces his 
 arm into the vagina, in order to follow and announce the results of the 
 untwisting. The operator then makes an incision in the right flank, 
 not too high, and from six to eight inches long, which should be sufficient 
 to allow the arm to be easily introduced. This incision should be 
 oblique— downwards and forwards — and skin, muscles (following the 
 fibres) and peritoneum are to be carefully cut through. The hand, 
 damped with warm water, is passed into the abdomen, above the uterus 
 if the tzvist is to the left, but below it if it is to the right ; then attempts 
 are made to put the organ in place by pressing and pushing it ; if any 
 part of the foetus can be seized, the labour is lessened, and wearing a 
 cloth glove, or wrapping the hand in a piece of thin cloth, will facilitate 
 holding. The task is also lessened in having the abdomen raised by a 
 sheet placed under it, and held by men on each side ; or a man on hands 
 and knees under the abdomen is even more advantageous, as he can raise 
 any part required by means of his back or loins. 
 
 Having effected detorsion, the wound is closed by suture, and anti- 
 septic dressings are placed over it, these being retained by a wide band- 
 age round the body. The wound quickly heals if peritonitis had not 
 set in before the operation was begun. 
 
 According to Obich, within eight days the wound will have healed by 
 first intention. 
 
TORSION OF THE CTEKCS. 3M 
 
 2. Vaginal Hystekotomy. — Vieillard, so long ago as 1823, removed 
 the fu'tus from a twisted uterus by means of vaginal section. In INOO 
 Ercolani proposed riKjiiuil lii/sterotomif, the opening being made through 
 the upper wall of the vagina, for the reposition of the twisted uterus. 
 The operation is of the same kind, and is conducted in a similar manner, 
 as that for the castration of Cows, introduced by Charlier ; except that, 
 instead of the ovaries being seized, the uterus is grasped through tlie 
 wound, and attempts iiuide to untwist it. Huetf speaks in favour of the 
 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 
 the torsion be very trifling ; in which case a simpler operation might 
 
 'succeed. 
 
 If attempted, not much risk nu\y be apprehended from incising the 
 vagina, as it has generally been found to be attended with little danger, 
 and cicatrisation soon takes place. 
 
 3. Vaginal Taxis. — All sanguinary and serious operations for the cure 
 of uterine torsion — like the two preceding — should be avoided, if 
 possible, until the simpler means which modern veterinary science has 
 indicated are tried. We allude more particularly to version, which 
 rarely fails to ])ring the case to a satisfactory termination. That is, of 
 course, on the assumption that this is resorted to sufliciently early ; for 
 it must be i-emembered tliat nothing is gained by delay in this accident, 
 and if relief is to be afforded it must be rendered promptly, and as soon 
 as the existence of displacement is fairly established. When delay has 
 been allowed to take place, more or less serious consequences must 
 ensue to either the fcetus or the maternal organs, or to both. 
 
 In certain cases of very incomplete torsion — quarter rotation of the 
 uterus, for instance — and when there is sufficient space in the vagina 
 for the hand to pass through the obstacle and into the os or uterus, 
 detorsion has been accomplished by seizing the most suitable parts of 
 the fcetus and exercising direct traction on it. Instances of success by 
 adopting this course have been furnished by Chambon, Cann, Gaven, 
 Darreau, and others. 
 
 The mode of procedure maybe as follows: — After ascertaining the 
 direction of the torsion, the arm is to be introduced into tlie uterus as 
 deeply as possible ; if the fastal membranes are yet intact, they must be 
 largely ruptured, and the most convenient parts of the fcjctus sought for. 
 In this respect it will be found that every part of the young animal does 
 not offer the same advantages to the operator, for reposition of the 
 uterus. The head is too large, and does not afford sufficient hold for 
 the hand ; the pasterns and knees are too much removed from the 
 body and too round ; but the hocks and elbows are, of all parts perhaps, 
 those best adapted for this kind of manipulation. If one of them can 
 be reached, it should be firmly grasped, and endeavours made by it to 
 raise the body of the fa?tus, at tlie same time giving it a turning move- 
 ment contraiy to that which would be given to the uterus in order to 
 untwist it. 
 
 Supposing, for example, that the torsion is to the right, and that the 
 fcetus, offering an interior presentation, is, from the fact of the quarter 
 revolution of the organ, in the right dorso-ilial position ; then the object 
 must be to place it in the dorso-sacral position. 
 
332 MATERXAL DYSTOKIA. 
 
 To effect this, the right hand, in a state of supination (knuckles down- 
 wards, palm upwards), must be introduced beneath the foetus, and, if 
 possible, the left fore limb seized by the elbow ; then the operator, 
 turning his arm round, raises the body of the creature, at the same time 
 turning 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. 
 
 Sometimes when the foetus is alive, at the moment this manoeuvre is 
 being executed it makes a movement which greatly assists the efforts of 
 the operator. 
 
 If the dimensions of the vagina admit of it, the limbs of the foetus may 
 be drawn into the pelvis, and even as far as the vulva ; and while the 
 operator is acting as described on the upper part of one of the legs, an 
 assistant presses on the free portion, and by thus aiding in the version 
 considerably facilitates the task. 
 
 By this procedure several obstetrists have been successful in readjust- 
 ing the uterus, through the medium of the foetus — the adjustment being 
 ascertained by the disappearance of the spiral mucous folds from the 
 vagina, and the patency of the canal. 
 
 Nevertheless, it has been remarked that this operation is not so easy 
 as one would be inclined to imagine without testing it in practice. It 
 requires much force to raise and turn the foetus in this way ; and the 
 constricted vagina and powerful uterine contractions are formidable 
 obstacles to the exercise of that force. 
 
 Some veterinarians, as Meyer and Losner, have succeeded in adjust- 
 ing a slightly twisted uterus by introducing the hands into the vagina, 
 and aided by assistants, who manipulated either with their hands or by 
 means of boards or sheets applied underneath the abdomen, so as to 
 set the organ straight. Of course, such attempts must be greatly pro- 
 moted if the foetus can be reached and used as an instrument in the 
 manner just alluded to. 
 
 4. Dexoc's Procedure. — Denoc appears to have been the first 
 veterinarian who attempted reduction of this torsion by the simple 
 means stated above, but applied in such a manner as to merit the 
 designation of "original." His procedure marked a great step in 
 advance, so far as veterinary obstetrics are concerned. 
 
 In 1845 he describes the case of a Cow^ unable to calve, but whose os 
 uteri was sufficiently dilated to allow him to pass his hand into the 
 uterus, where the foetus lay in a good position, but from which it could 
 not be expelled, owing to a wide membranous fold extending from the 
 cervix to the fundus of the organ. 
 
 His manner of getting rid of the torsion consisted in suspending the 
 animal by a very narrow sack passed under its chest ; and two pulleys 
 having been fixed in the wall on the right side — one corresponding to 
 the fore limbs, the other to the hind ones — the fore legs were tied by a 
 cord which passed through the corresponding pulley, while the hind 
 ones were also secured by another cord running through the posterior 
 pulley. Five men were posted to the distal end of each of these cords, 
 and directed to pull. When this was done, the suspended Cow was 
 swung into a dorsal position. Then two strong men, placed on the left 
 side, were directed to push the animal's body to the right — a movement 
 which caused it suddenly to rotate. 
 
 An exploration with the hand led to the discovery that the uterus 
 ^ Recueil de Mt'decine Velerinaire, 1845, p. 69. 
 
TOUSluX OF THE UTERUS. 
 
 333 
 
 liad changed its place, but that tliere was either a double torsion, or 
 the inversion of the animal had only incompletely turned the uterus, as 
 the duplicaturo was still present at the cervix. 
 
 < Another pull was given at the cords, and the previous manoeuvre 
 repeated, and this time with good elYect, as it was found that the 
 nl)structing fold had now vanished, and the uterus was in its ordinary 
 position. 
 
 • The Cow was then left alone, to await the result of its own expulsive 
 t tTorts; but nothing having transpired after about an hour, a dose of 
 ( igot of rye was administered. Another hour had not elapsed when 
 parturition was accomplished without the slightest dilliculty, two 
 Calves being born. 
 
 (j (j u 
 
 a^ 4k 
 
 ,- J 
 
 Fig. 94. 
 Darreau's Retroversor. 
 
 5. D.\RREAu's Procedure. — Denoc's method does not appear to have 
 been much practised, either because it was lost sight of, or was only 
 adapted for cases of very slight torsion ; and in view of the great dilli- 
 culty generally experienced in vaginal taxis — which is, after all, the 
 most reasonable, least dangerous, and perhaps the most convenient of 
 all methods — several devices have been brought forward to render it 
 more easy and effective. Of these none deserves more notice than that 
 of Darreau, which was brought before the Central Veterinary Medical 
 Society of Paris in 1852. The improvement in vaginal taxis for tliis 
 accident mainly consists in the employment of what has been desig- 
 nated a " uterine retroversor " {utcrin ritrovcrseur) — an appliance which 
 would appear to be very ingenious, if complicated. And, besides, it is 
 only of service in those cases in which the hand can be introduced in 
 the uterus and the feet of the fa'tus seized — a state of affairs, unfor- 
 
•3U MATERNAL DYSTOKIA. 
 
 tunately, not always — nor indeed very often — present in torsion of this 
 viscus. Liautard and some others, however, while admitting that the 
 apparatus is not very easily applied, yet testify to its utility. 
 
 The apparatus is composed of three rods (x\, A', A" ; Fig. 94) ; of a 
 winch (B) ; of a screw, with a movable screw-nut (D), pierced by three 
 holes ; and, finally, three cords (E, E', E") with a loop (F). The end 
 of each rod (G), a little thickened, has a longitudinal hole (H) ; the 
 other extremity (I) has a hole punched through it, and a shoulder (K). 
 This end of the thi'ee rods is inserted into the three holes of the winch. 
 
 The apparatus is put together for use in the following manner : — The 
 cords are fastened by their loop (F) to the tw^o pasterns and the lower 
 jaw of the foetus, and serve as points of attachment as well as con- 
 ductors to the rods. With this object the obstetrist passes them, one 
 by one, through the hole (H) in each rod ; then, by one hand, he seizes 
 the extremity (I), and with the second hand the other end (G) ; direct- 
 ing the latter towards the part of the foetus to be pulled at, 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 screw (C) 
 is pushed through the middle hole, and the cords are passed through 
 the holes in the nut (D) of the screw (C), by means of which they are 
 made as tight as may be necessary. 
 
 The apparatus may be used either while the Cow is standing or lying 
 on its back. By turning the handle of the winch in a contrary direction 
 to the torsion, counter- torsion is at once effected without difficulty, and 
 without causing the animal any fatigue. If the resistance is at all 
 great, the operator entrusts the instrument to the assistant, passes his 
 hand into the uterus, presses on the head of the Calf, and in this way aids 
 the action of the retroversor. Parturition then takes place naturally. 
 
 6. EoTATioN OF THE Cow's BoDY. — The methods of Denoc and 
 Darreau are likely to be useful only in cases in which the uterus is 
 slightly twisted ; 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 little danger, and hitherto has yielded such favourable 
 results, that it is certainly to be preferred, unless vaginal taxis can be 
 resorted to with every chance of speedy success. This method consists 
 in rolling the animal affected with uterine torsion, in such a manner 
 that the twist which forms an obstacle to parturition is effaced, and 
 the genital passages are open for the passage of the foetus. 
 
 This method has been in vogue for a long time, and its introduction 
 is due, according to Dieterichs, of the Berlin Veterinary School, to 
 Fricke, a Hanoverian veterinary surgeon. At least this would appear 
 to be the fact from what Dieterichs has stated with regard to Denoc's 
 procedure in 1845,^ when he says that not only had Schmidt, Vix, 
 Irminger, and Schenker — all German veterinarians — mentioned the 
 occurrence of torsion of the uterus ; but that Fricke, in addition, cured 
 a Cow of the accident by tying its feet, two and two, then rolling it, 
 taking care to move it in a contrary direction to that in which the 
 torsion had been produced. 
 
 Strebel, howevei% asserts that Eichner of Berne recommended 
 
 rolling before either German or French veterinary surgeons did — the 
 
 move to be made in a direction the opposite of the uterine twist, the 
 
 Cow's body to be higher behind than before. However this may be, 
 
 ^- Becueil de Mcdecine Veterinaire, 1845. 
 
TOnSIOX OF TIIK UTERUS. 335 
 
 German, French, Belgian, Swiss, and Italian veterinary obstetrists have 
 practised this method of reduction in a very large number of instances, 
 and altogether with most gratifying results. And veterinary surgeons 
 in this country have also found the method very satisfactory. As with 
 Denoc's rotation method, this is a version of the uterus, and not of the 
 fa'tus. 
 
 Tlie manner of rolling the animal varies somewhat with difl'erent 
 authorities, but in principle all are agreed. The first step, after ascer- 
 taining the existence and the direction of the displacement, is to empty 
 the udder of its milk as completely as possible, so as to prevent the 
 gland being injured during the operation. 
 
 \Vlnle this is being done, a sutViciently roomy place should be got 
 ready, and the floor covered with a thick layer of straw or moss litter ; 
 on this the Cow is thrown on the proper side, and witli all possible 
 care, the feet being fastened together. The hand and arm are then to 
 be introduced as far into the vagina as its condition will permit. 
 Should the os be accessible, and dilated, some part of the fa?tus must be 
 secured, and more especially a limb ; this must be firmly maintained in 
 one position. If the fa?tU3 cannot be reached, then nothing remains 
 but to make the wall of the vagina the point of resistance until a better 
 can be made available. 
 
 The assistants are then to pull at the ropes which secure the feet of 
 the Cow, so as to bring the animal on its back ; then gently, and with- 
 out jerking, allow it to fall on the opposite side. This being done, the 
 animal is raised on its chest, by the shoulder and quarter, and turned 
 over on the side on which it was thrown. In this way it will have 
 made a complete rotation. 
 
 While the assistants are rolling the Cow, the operator, with his hand 
 in the vagina or uterus, as the case may be, endeavours, by pressing in 
 the opposite direction, to keep the organ fixed aud to prevent its follow- 
 ing the movement the body is undergoing. 
 
 If the operation is well conducted, and the body of the Cow moved in 
 the proper direction, the obstetrist will lind, as rotation is carried on, 
 that the genital passage is becoming wider and the obstacle disappear- 
 ing, until, the spiral rings having become efi'aced, the hand can reach 
 the cenix and penetrate the uterus if the os is relaxed. Generally a 
 gush of the liquor amnii from the organ announces the termination of 
 the operation. 
 
 If, however, the hand is more strongly compressed by the spiral folds 
 as the animal is turned on its axis, and the vaginal canal is diminishing 
 in length, it is a proof that rotation is elTected in the wrong direction. 
 This is remedied, of course, by reversing the movement. 
 
 Sometimes it is sufficient to make the animal execute a complete turn 
 to bring the uterus into its usual position. More fretjuently, however, 
 this rotation only relaxes the constriction and does not entirely efface 
 the rings ; so that it is necessary to continue the turning— always in 
 the same direction — until the desired result has been obtained. Then 
 parturition can be completed in the ordinary way. 
 
 It will be seen from this description that the method consists simply 
 in rolling the Cow as one would roll a barrel ; and the only point now 
 to be discussed is the direction in which it should be rolled. 
 
 This point, strange to say, has given rise to as warm and unsatis- 
 factory discussions as some of the other points to which reference has 
 already been made. Some authorities have declared that, to achieve 
 
336 MATERNAL LYSIOKIA. 
 
 the reduction of the torsion, the Cow must be rolled in the same direc- 
 tion as it ; others assert that the rolling 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 the discussion was probably largely due 
 to the manner in which each disputant looked at the question — 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 right side, while a seventh 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 the 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 baftiing the spiral 
 curving of the vaginal rugae 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 direction, 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 confusion 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 riglit 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 rolling it on its hack 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 cases the result is the 
 same : the animal lying at first on the right side, finds itself at last ou 
 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 commence 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 Cow 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." 
 
TORSIOX OF THE VrEUrs. 337 
 
 The contrary expression of course means a precisely contrary move- 
 ment : left side, back, right side, sternum, left side. 
 
 From all this it must be admitted that, in order to effect detorsion 
 of the uterus, the Cow should be rolled in the same direction the uterus 
 followed during torsion ; and it is also clear that the uterus does not 
 participate to the same extent as the body of the animal in the rotatory 
 movement to which the latter has been subjected. 
 
 Supposing, as Saint-Cyr has done, that the torsion has been recog- 
 nised as left, and as is depicted in Fig. 93 (p. 327). 
 
 In such a case the animal would be cast on its left side, and turned 
 successively on its back, right side, sternum, and left side — it icould he 
 rolled, in fact, from left to right. 
 
 If one complete rotation does not sufBce, then the movement must 
 be continued in the same direction until the hand can freely pass to 
 the cervix and into the uterus. 
 
 The soundness of these views of our estimable colleague is amply 
 verified in the very numerous cases of torsion of the uterus which have 
 been published during the last thirty years on the Continent, and par- 
 ticularly in France, of which he gives a few examples. All the facts 
 collected by him are unanimous in justifying the acceptance of the 
 precept which he has formulated in the following brief and distinct 
 manner, for application in these often-times diHicult cases : Torsion to 
 the left — lay the animal on the left side and roll it to the left. Torsion 
 to the right — lay the animal on the right side and roll it to the right. Or 
 the same precept might be formulated in this way: In torsion from rigJit 
 to left roll the Coic from left to right ; and vice versd. 
 
 Though this precept appears contradictory to what has been recom- 
 mended above — in order to reduce the torsion, make the body of the 
 animal execute an equal degree of movement, and in the same direc- 
 tion, as that executed by the uterus ; yet the contradiction is only 
 apparent, not real. In fact, in this manoeuvre the movement of rotation 
 does not really commence at the moment when the Cow, lying on its 
 side, is turned on its back; but rather at the time when it is thrown on 
 its side from the standing posture. If it is thrown on the left side for a 
 left torsion, it really falls from right to left — or in the same direction as 
 the uterine twist. 
 
 Since the publication of these valuable remarks, further confirmation 
 of their exactness has been afforded by various papers published in 
 different veterinary- periodicals. 
 
 There is not much to add with regard to this " rotation " treatment 
 of torsion. We have recommended that if the animal can be moved 
 from its stall, and time permit, it should be thrown down on litter in a 
 roomy place ; all the limbs may be tied together at once ; or first the 
 two fore and then the two hind legs, these being fastened together 
 afterwards, but not allowed to cross. For an ordinary-sized Cow five 
 assistants are necessary ; one of these is to be placed at the animal's 
 head to hold it, and make it follow the movements of the body ; the 
 second should keep the limbs as close to the belly as possible, when the 
 Cow is rolled over on them. It is verj- important during the operation 
 that the hocks be kept flexed as much as possible, in order to prevent 
 the udder being damaged, and also to avoid muscular injuries to the 
 upper part of the hind limbs. The other three assistants should lift 
 and roll the Cow, and aid the second in pulling at the hind legs when 
 the animal is being placed on its back. We have already described 
 
 22 
 
338 MATERNAL DYSTOKIA. 
 
 how, and explained why, rotation should be made either in one direction 
 or the other. 
 
 The operator need not endeavour to render the uterus perfectly im- 
 movable during the rolling, as it turns a good deal with the body of the 
 animal, 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 half or even quarter torsion requires for its reduction at 
 least a complete revolution of the body. It often needs a number 
 of turns to reduce the torsion, but generally two, three, or four are 
 sufficient. 
 
 There is, therefore, no pressing necessity for maintaining the uterus 
 absolutely fixed while the Cow is being rolled ; indeed, as a rule it is 
 no easy matter to keep it at all near the desired position, there being a 
 great difficulty to find a part to cling to. The hand should rather be 
 employed in discovering the effects of the version, and finding when the 
 genital passage is patent. 
 
 Violet attributed his insuccess in some instances to the want of 
 resistance he could oppose to the turning round of the uterus as the 
 Cow was rolled, when he held the feet of the foetus. He therefore tied 
 the two pasterns of the latter together, after he had brought them out of 
 the vagina, giving the cords to assistants wherewith to exercise gentle 
 traction. A thin piece of wood was passed between the legs of the 
 foetus, which served as a lever by which the creature was made to aid 
 in reducing the torsion, the Cow being rolled half round, rarely 
 altogether round, whenever moderate resistance was experienced. In 
 this way the spiral constriction was made to disappear and the genital 
 canal opened, without injury to Cow or Calf. 
 
 It is always a very great advantage in an incomplete twist to pull the 
 foetus into it as much as possible, as its body can then be made a lever 
 in the way suggested by Violet. 
 
 An important precaution in this operation has been notified by some 
 practitioners ; and that is to roll the Cow on a slightly inclined floor, 
 if possible. It may be observed, however, that while Wegerer and 
 others recommend that the hind quarters of the animal should be the 
 highest, Chambon and Liaufcard maintain that they ought to be lower 
 than the rest of the body. And we can scarcely be in doubt as to the 
 correctness of the latter opinion ; for in the position indicated, the 
 uterus falls towards the pelvic cavity, and this favours relaxation of 
 the torsion, and the more easy introduction of the hand through the 
 obstacle in the vagina, if it is desired to attempt to fix the organ by 
 the hand while rolling is taking place. 
 
 Wegerer 's position — the hind quarters raised — is nevertheless to 
 be preferred if it is sought to fix the uterus by its own weight, when 
 the hand cannot be passed into the vagina, or cannot act advantageously 
 there. 
 
 As in the majority of cases there is only incomplete torsion, and all 
 that has to be done is simply to replace the foetus, or rather the uterus, 
 on its bed or hammock, reposition can sometimes be effected by merely 
 I'olling the animal on its back. 
 
 In some instances, when slow steady rolling will not suffice, a quick 
 or jerking roll may be successful ; in other instances it has been 
 found advantageous to place the animal on its back, and roll it from 
 side to side. 
 
 Wegerer, Sacchero, Eueff, and some others have combined rolling 
 
TO n^ I ox OF THE UTElirs. 339 
 
 with abcloininal manipulation and compression, so as to fix the fcetua 
 and uterus, or to push them in the desired direction for effecting 
 detorsion ; at the same time rotation is practised according to the 
 directions laid down. 
 
 Numerous practitioners are content to roll the Cow without attempt- 
 ing to fix or manipulate the vagina or uterus, and many successful 
 cases are recorded by them. 
 
 But tliis success appears to have been obtained at the expense of the 
 Cow or its ftctus, as the rotation had to be carried on for a longer time 
 than if the organ had been fixed ; several turns may be necessary where 
 one would suffice with the hand in the vagina. 
 
 If detorsion does not take place so soon as anticipated, there is no 
 reason to despair. If the direction of the twist has been exactly made 
 out, the rotation may be continued. Weber, Wannovius, and Fischer 
 mention instances in which the Cow has been rolled from fifteen to 
 twenty turns before success crowned their efforts. It is even men- 
 tioned that the rolling in some cases has occupied an hour or more. 
 Weber writes : — " The Cow is often rolled for more than an hour. 
 The operation is laborious, sometimes painful, to the operator ; it 
 demands an expenditure of strength which the most vigorous can 
 scarcely boast of, and requires much amour-propre to undertake it. 
 The efforts required to complete it are so great, that often when a 
 successful result has been obtained the operator is out of breath and 
 exhausted." 
 
 Happily, these extreme and baffling cases are rare, and they have 
 generally been observed with Cows in which the foetus was dead. It is 
 a common remark that reposition is easier when the fujtus is alive than 
 when it is dead. 
 
 Unfortunately, cases will be met with in which replacement of the 
 uterus, and, consequently, delivery of the foetus, is impossible by this 
 method of rotation, and these are more particularly cases of multiple 
 torsion. Rueff says that they are sometimes accompanied by decom- 
 position of the foetus, when the gases which are developed in the uterus 
 inflate the organ, and prevent its being untwi-sted. In other instances 
 there is plastic adhesion Ijetween the spiral folds, or between the uterus 
 and other abdominal viscera, or even the parietes of the abdomen. 
 
 When the uterus, by its exaggerated volume, appears to offer an in- 
 surmountable obstacle to reposition, it has been recommended to 
 puncture it through the vagina, and allow a quantity of its contained 
 fluid to escape, so as to reduce it to manageable dimensions, when the 
 other measures can be resumed. 
 
 It is also advisable, in all cases of torsion, to empty the digestive 
 organs as much as possible, by an active purgative. 
 
 It has often been predicted that the rotation procedure may give rise 
 to serious accidents — such as volvulus of the intestines, hernitc, etc. 
 But we cannot find any notice of such accidents having occurred. 
 
 If the diagnosis is correct, the nature and direction of the torsion well 
 ascertained, the animal not too much exhausted, and the parts in- 
 volved not seriously injured, a successful result may be anticipated in 
 the large majority of cases, when the treatment above indicated is 
 carried out. 
 
 When the uterus is placed in its normal position, the genital passages 
 patent and in a proper state for delivery, the Cow not much exhausted, 
 and the fcetus in a good attitude for birth, time may be allowed for 
 
340 MATEIIXAL DYSTOKIA. 
 
 Nature to effect the expulsion of the young creature. Bh^th 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 to 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 slight symptoms of indisposi- 
 tion the Cow at first exhibits, the owner does not send for the veterin- 
 arian until too late to save the fcetus, 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 its 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 the 
 abdomen and loins. Ergot 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 foetus 
 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 unlikely 
 to follow. The genital canal should be lubricated with glycerine, and 
 injections of tepid water may 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 compHcations must be treated according to their indications. 
 
 7. Gastko-hysterotojiy, oe C^saeian 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. 
 
 Eocco^ has twice successfully performed the Caesarian 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 livecl, but the Cow died two days afterwards. 
 
 We shall describe the operation hereafter. 
 
 Torsion of the Uteeus in the Maee. 
 
 Torsion of the uterus in the Mare is a rare accident. This is doubt- 
 less owing to the direction of the uterine cornua, and the manner in 
 
 ^ II Medico Veterinaria, 1863. 
 
 - Becueil de Medecine Veterinaire, ISoS. 
 
TORSIOX OF THE UTEin'S. 841 
 
 which the broad ligaments are attached to them, which renders rotation 
 of the organ very dilVicult, unless there is some anatomical anomaly in 
 the parts. 
 
 The possibility of 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 181G, Belhomme- in 
 1850, Elson and Dehvart-' in 1852, Hamon^ in 18G0, Anderson-' in 1860, 
 Canu'' in 1861, Schmidt' in 1863, Gierer'^ in 1863, Jansen» in 186(5, 
 Coxi« in 1875 and 1877, Rollsi' in 1878, Deneubourg'- in 1880, Oreste'^ 
 in 1881, and Miinich^^ in 1892. There can scarcely be a doubt that it 
 is much more frequent than is suspected, through its not being recog- 
 nised, and Saiut-Cyr has given some instances which go to prove the 
 truth of this statement. 
 
 Causes. 
 
 The causes of uterine torsion in the Mare are not well ascertained. It 
 is not improbable that some of the causes which produce it in the Cow 
 will also be effective, in certain cii'cumstances, in the Mare. 
 
 Wolff mentions that he has witnessed it in a Mare which had 
 suffered from attacks of colic four days previously, and when so affected 
 had thrown itself down and rolled violently. In Cox's case, a few weeks 
 before parturition the Mare had an attack of colic, and rolled over 
 several times. 
 
 The accident has only been seen in Mares whose period of pregnancy 
 had nearly terminated. In Elsen's case the Mare had been ten months 
 pregnant ; in Ilamon's case the ordinary period had expired ; and the 
 Mare which was attended by Schmidt was within a few days of foaling. 
 
 Sympto7ns. 
 
 The general symptoms appear to be similar to those observed in the 
 Cow. In the majority of instances the animals appeared to be affected 
 with severe colic, and attempts at micturition were frequent. The local 
 symptoms, however, differ somewhat, the torsion being generally more 
 forward in the body of the uterus ; so that the spiral vaginal folds are 
 often not so distinct, and, from Goubaux's experiments, may even not 
 be felt at all. 
 
 Rectal exploration is recommended by Saint-Cyr in these cases, the 
 torsion being felt as a thick, short and hard cord. Schmidt easily intro- 
 duced his hand into the rectum as far as the abdominal margin of the 
 pubis, and there he felt under his hand an obstacle which prevented 
 further progress, as only three fingers could be introduced beyond this. 
 The body under his hand was hard, resisting, and immovable ; whereas 
 the contents of the colon were soft and easily indented by the fingers. 
 
 ' Journal flfs Vehriiiairpn <lu Mi<li, 1846, pp. 337, 343. 
 - Proce^- Verbaiix de la Soc. l'tt<riji(i.ircj< de I' Yoinf, 1850. 
 ^ Annak'* <lc Mt'il. I'tft'rinairv dt Bruuelleit, 1852, p. 452. 
 
 * Rfcueil de Mai. V.l.rinaire, 1860, p. 612. 
 
 * Veterinarian, l><«iO, p. 317. 
 
 " Rt-rutilde Med. Viiirinaire, 1861, p. 186, 
 
 " Ibid., 1864, pp. 290, 714. 
 
 " Magazin Von Gurlt uiul liertwuj, p. 322. 
 
 » Ibid. 
 
 '* Veterinary Journal, vol. i., p. 264 ; vol. iv., p. 28. 
 
 " Ibid., vol. vii., p. 11. 
 
 '- Traite Pratique d'tJbxtelrique V^t^rinaire. 
 
 " Berue V^t'rinaire, 1881, p. 43. 
 
 " Wochenschri/t/iir ThitrhtUkunde, 1892. 
 
342 3TATERXAL DYSTOKIA. 
 
 The posterior portion of the floating colon, as in this instance, may 
 be obstructed in the Mare by the twist formed by the uterus and the 
 broad ligaments, and this obstruction will, of course, prevent expulsion 
 of the fteces. 
 
 Prognosis and Treatment. 
 
 This accident must be considered much more serious in the Mare than 
 in the Cow, for some of the reasons already alluded to as influencing 
 parturition and its results in these animals. A large majority of the 
 cases terminate fatally ; of seven alluded to by Franck five perished, 
 and a similar mortality attended those I have investigated. The fcetus 
 is nearly always dead. 
 
 The treatment must, of course, be similar. Belhomme succeeded, by 
 powerful traction, and without previous reduction of the twisted uterus, 
 in extracting a dead Foal in what he describes as a case of " demi- 
 torsion." It is probable that the torsion could not have been so 
 great, for when it exists to this degree delivery by traction is impos- 
 sible. 
 
 Elsen and Delwart succeeded in reducing the torsion in their case, 
 by rolling the Mare in the manner we have recommended to be adopted 
 with the Cow. In this instance, however, everything was against the 
 success of the operation, for the foetus had already been two months 
 beyond its time in the uterus; it was dead and in a state of putrefaction, 
 and had to be removed piecemeal. The Mare died from septic infection 
 eleven days after the operation. 
 
 In Canu's interesting case the result was favourable. The mare had 
 been endeavouring to foal, it would appear, for ten days, and was 
 evidently about to succumb. Canu, recognising torsion of the uterus, 
 was proceeding to open it by force, when the animal fell with great 
 violence, and the shock her body received had the unlooked-for result 
 of completely untwisting the organ; so that parturition, though difficult, 
 became possible. The Foal was dead, as might have been predicted ; 
 but the Mare was saved, and continued to recover sufficiently to be put 
 to light work, when, on the thirtieth day after the operation, it was 
 attacked with metrorrhagia which nearly proved fatal. It eventually 
 got well. 
 
 Deneubourg's case was similar to Canu's, and a living Foal was 
 eventually extracted, but it died in a few hours ; the Mare recovered. 
 
 In Oreste's case the foetus was putrefied, and the Mare succumbed to 
 septic metritis before reposition of the uterus could be attempted. 
 
 Hamon, in France, and Schmidt, in Germany, endeavoured to effect 
 reduction of the torsion in their cases by rolling the Mares first in one 
 direction, then in the other ; but without success, as both animals died 
 without being delivered. 
 
 Gierer observed two cases of complete torsion in Mares, in both of 
 which the accident was complicated by a large rupture at the base of 
 the uterus, through which the foetus had escaped into the abdominal 
 cavity. 
 
 Cox found the head and fore legs of the foetus protruding through 
 the inferior wall of the uterus. Exploration discovered the vaginal 
 passage beyond these parts, but it suddenly terminated ; though a 
 small rugose opening, barely admitting two fingers, was found. The 
 Mare died in two hours ; and on examination there was noted a double 
 twist of the cervix uteri, with rupture of the uterus and vagina. 
 
Toiisiox OF THE riKiirs. 343 
 
 The most recent cases recorded are two by Munich. ' In the first 
 the Mare had been showing symptoms of cohc for some days, and a 
 vaginal exploration discovered left-sided torsion of the uterus ; there 
 was a very foul odour. As the Mare was dying nothing was attempted. 
 Death was due to septic metro-peritonitis. In the second case the 
 Mare was lying down and straining violently. An examination proved 
 it to be another instance of complete left-sided torsion, which required 
 eight turns-over of the Mare to adjust ; a very small Foal was extracted, 
 but the straining continuing, the presence of another fo'tus was sus- 
 pected, and Miinich was making another exploration of the uterus, 
 when suddenly a mass of the small intestine escaped i)cr vulvavi, 
 through a tear in the upper portion of the uterus, near the pelvic inlet, 
 and at the point where he had felt the strongest tension before com- 
 mencing to untwist the organ. The Mare was destroyed, and the Toal 
 died in twelve hours. 
 
 Torsion of the Uterus in other Animals. 
 
 We need scarcely allude to this accident in the other animals men- 
 tioned as liable to the accident, as it is almost impossible to diagnose 
 its existence, owing to their small size. Besides, it appears to be 
 extremely rare in them. 
 
 In multiparous animals the foetuses develop simultaneously in both 
 cornua, which, increasing in volume, yet remain independent ; so that 
 torsion may occur at or near the cervix and occlude both cornua, or 
 it may take place at any part of one cornu. In such a case, when partu- 
 rition occurs, none of the fcctuses can be expelled, or those in the non- 
 twisted cornu may be born with difficulty, and even one or more of those 
 in the twisted horn if the twist happened some distance from its base ; 
 the foetuses beyond the stricture are, of course, retained and soon perish, 
 as does the parent in the majority of cases — and generally rapidly, 
 from strangulation of the viscus. Sometimes the severe straining 
 causes extrusion of the unconstricted cornu. 
 
 When the practitioner is called in time, detorsion may be attempted 
 by external manipulation through the abdominal walls, or even through 
 the vagina, if the animal be sufficiently large. By rolling it quickly 
 several turns and suddenly stopping, Saint-Cyr thinks detorsion might 
 be effected ; he also recommends trying brief suspension by the hind 
 legs and tlien rolling. But the difTiculty is to know in which direction 
 to roll the body. As a last resource gastrotomy or laparotomy may be 
 resorted to. 
 
 One instance in the Eice is recorded by Lewis,- which he put right 
 by rolling the animal over five times without withdrawing his hand 
 from the vagina, and exercising slight pressure with the point of one 
 finger against the os uteri ; with each turn of the animal the canal 
 perceptibly dilated. 
 
 Saint-Cyr^ records an instance in a four-year-old Sore, which, arrived 
 at the full period of gestation, began to strain very violently ; this con- 
 tinued for four hours, when suddenly a large mass protruded from the 
 vulva, and the animal soon died. The mass was found to be one of the 
 uterine cornua, having an extensive tear with lacerated and ecchymosed 
 
 > Wochenttchri/t fur ThierhtUhmde, 1892. 
 ' Veterinary Journal, 1886, p. 319. 
 3 Op. cit., p. 496. 
 
344 MATERXAL DYSTOKIA. 
 
 borders. The other cornu was in the abdomen, and contained two 
 voluminous foetuses, the expulsion of which was hindered by a half- 
 twist at its base near the pelvic inlet — the torsion being from left to 
 right. 
 
 Macgillivrayi alludes to a case in a small terrier Bitch, which he put 
 under chloroform and secured the Puppies one by one by means 
 of Breulet's apparatus ; one of these and the parent survived. 
 
 Guillebeau- had also a case of a Bitch which expelled two decom- 
 posed Puppies after a dose of ergotine, but after suffering for ten days 
 she died. The left cornu was found to be strangulated by having 
 become twisted completely round, involving the broad ligament as well. 
 Beyond this twist were two emphysematous foetuses ; and behind it 
 the uterus was much atrophied and its canal entirely obliterated ; so 
 that it would have been impossible to extract the foetuses by this 
 way. . ^. 
 
 Vivier^ and Violet'* each give an instance of this accident in the 
 pregnant Cat, death resulting in both cases. 
 
 CHAPTEE III. 
 Dystokia from Morbid Alterations in the Generative Organs. 
 
 roLLOwiNG the arrangement adopted by Saint-Cyr, we will in this 
 chapter study the obstacles to parturition which are due to (1) Tumours 
 developed in, or in the vicinity of, the genital organs of the female ; (2) 
 Hernia of the bladder ; (3) Bigidity of the cervix uteri ; (4) Morbid de- 
 generations of the cervix uteri ; and (5) Obliteration of the os uteri. 
 
 1. Utero-Vaginal Tumours. 
 
 The tumours met with in the vagina and uterus differ much with 
 regard to their nature, origin, structure, and influence on the act of 
 parturition. Sometimes they are contained in the interior of the genital 
 organs — in the uterus or its cornua or cervix, and on the walls of the 
 vagina, as well as on the labia of the vulva ; at other times they have 
 their seat in the neighbouring parts or organs — in the bladder, rectum, 
 or pelvic connective tissue. They may be constituted by degeneration 
 or displacement of these parts, or by heteroplastic products developed 
 there. 
 
 Their volume, form, and consistence are very diverse ; and they may 
 either adhere closely or loosely to the adjacent parts, being fixed in the 
 one case and movable in the other. Some are attached or implanted 
 by wide bases, others are pediculated or retained by a more or less 
 narrow pedicle. 
 
 Tumours of the soft parturient passages are rather rare in the 
 domesticated animals, and their occurrence has been frequently brought 
 under observation. The first instance is probably that recorded by 
 Jeani'oy, in 1828.^ Since that period a number of cases have been 
 
 ^ Veterinary Journal, 1888, p. 153. 
 
 " Archives Viterinai^-e, 1882, p. 361. 
 
 3 Had., 1876, p. 424. 
 
 * Saint-Cyr's Traite Obstetrique V4teri7iaire, p. 497. 
 
 •' Becneil de Med. Veterinaire, 1828, p. 639. 
 
Mnlilllli ALTEnATIoXS IX THE HKXKHATII'H nRtiJXS. 345 
 
 recorded by veterinarians in this and other countries, and some of these 
 are very interesting. 
 
 With regard to parturition, these tumours may be considered in a 
 general mamier according to their (I) Scat ; (2) Mode of attachment ; 
 and (3) Consistence. 
 
 1. Seat. — Tlie situation of genital tumours — whether in the vagina, 
 on the cervix uteri, in the os uteri, body of the uterus, or cornua — will 
 make a very great difference in the act of parturition. 
 
 Those tumours which are developed in the uterine cornua may, by 
 altering the structure of the walls of the uterus, hinder the amplilica- 
 tion of the organ, impair the nutrition of the foetus, and even cause it 
 to be expelled prematurely. If, however, they do not interfere with 
 the regular course of gestation, birth may take place in a natural 
 manner and without interruption. If the foetus is situated behind the 
 tumour, towards the body of the uterus, of course it meets with no 
 obstruction in its passage outwards ; and if it should happen that 
 labour is longer and more dillicult than usual, this can only be attri- 
 buted to the alteration the pathological production has effected in the 
 muscular structure of the uterus, and which may produce a diminution 
 in its contractile or expelling power. 
 
 When, however, the tumour is between the ftotus and the genital 
 passages, the case is much more serious. If it is fixed directly on the 
 cen'ix, it may prevent dilatation of the os to the necessary extent, or 
 perhaps altogether. W^hen it is situated in front of the cervix, 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 
 o-^, occupy it to a greater or less extent, and render the exit of the 
 1 tus impossible, unless the tumour is moved out of the way. If the 
 lumour 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 fa'tus. 
 
 2. Mode of Attachment . — The manner in which tlie tumours are 
 attached to the membranes from which they arise, has some influence 
 on their action as obstacles to birth. They have either a wide base of 
 attachment, or they are sessile or pediculated. 
 
 Those tumours which have a very wide base are generally of a malig- 
 nant character ; and though they may prove very serious, so far as the 
 female is concerned, yet they do not often prove a cause of dillicult 
 parturition, provided they are not situated in the vagina or on the 
 cervix. Animals so affected do not generally breed, though they may 
 regularly exhibit a'Strum ; if, however, they should ciiance to conceive, 
 and pregnancy has terminated, with these exceptions parturition may 
 not be delayed in its course. 
 
 The circumscribed sessile tumours are generally more serious than 
 those which are pediculated ; as the latter may be more or less 
 easily displaced when they are in the way, and delivery rendered as 
 easy as usual. Or if the pediculated tumours cannot be temporarily 
 removed from the path of the fcetus, they may easily be altogether 
 got rid of by a simple operation, particularly if their base is very 
 attenuated. 
 
 3. Consistence. — The hardness or softness of the tumours has an 
 important bearing on their obstructiveness. Such tumours as the 
 fibroids are so dense and inelastic, that the strongest compression will 
 -oarcely diminish their volume or alter their shape,;i^vl^le othe^Sc:- 
 
 /9^^ OF -h; ■ r \ 
 
 i UNIVEr.3ITY ) 
 
346 MATERXAL DYSTOKIA. 
 
 such as the condylomata or papillomata — readily change their form 
 and dimensions when submitted to pressure. 
 
 We will allude to each of these morbid productions more fully 
 hereafter. 
 
 Diagnosis. 
 
 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 
 during pregnancy ; and he may, consequently, be prepared beforehand 
 to overcome the difficulties which will present themselves at a later 
 period. But w^ith 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 difficult birth, that he is called upon to 
 give an opinion. 
 
 But as some compensation for this disadvantage, in animals direct 
 exploration is easier than in w^oman ; while the entire hand can be 
 introduced into the genital passages of the larger creatures with facility, 
 and every part be explored ; so that if the period is late for acquiring in- 
 formation 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 fcetus which 
 is covered by or denuded of its membranes ; as well as discover the 
 exact seat, volume, consistence, and mode of attachment, besides some- 
 thing of the nature, of such pathological productions as are now being 
 considered. 
 
 Treatment. 
 
 The indications for the treatment of these obstacles to birth 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 foetus 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 passage, 
 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 brought 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 
 
MonniD ALTER ATIOXH IX THE GEXERATIVE ORGAXS. 347 
 
 most expeditious, is not always the best ; as there may ensue internal 
 lucmorrliage, ^vhich will be all tlie more troublesome as htemostatic 
 agents are diOicult 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. 
 
 Kemoval by means of the ocraseur is preferable to all others when 
 possible. It is no more difficult than simple excision, and so far as 
 htcmorrhage is concerned, it is as safe as the ligature, while the conse- 
 ([uences are much more trifling. 
 
 When the base of the 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 ucraseur, it may be 
 torn off or removed by the finger-nail. 
 
 The most difficult tumours for treatment are those wliich are hard 
 :'.nd 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 
 remove them by means of the scalpel or bistoury. If the subsequent 
 (L'dema of the labia has not disappeared when parturition commences, 
 and if it hinders exploration by the hand, or the expulsion of thefcctus, 
 it may be combated ])y scarifications. These, however, should only be 
 Miade 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 recourse to embryotomy or 
 Cffisarian section — this decision being arrived 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. 
 
 CANCEROUS, CARCINOMATOUS, 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 published 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 has produced contraction of the os, and necessitated 
 'perative interference in order to effect delivery ; and one or two instances 
 are 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 hccmorrhage they occasioned. 
 
 When the cancer is situated at the cervix, and the os cannot be 
 
348 MATERNAL DYSTOKIA. 
 
 dilated by the foetus, then treatment must be directed to effect sufficient 
 dilatation for its passage through the canal. In nearly every instance 
 this must be accomplished by free incision of the cervix. 
 
 CONDYLOMATOUS, PAPILLOilATOUS, AND LIPOMATOUS TUMOURS. 
 
 These tumours are met with most frequently in the generative organs 
 of the Cow and Bitch, and particularly in the vagiiaa. They seldom 
 prove a serious obstacle to the passage of the fcetus. 
 
 They first appear as soft, fungoid, cauliflower-like vegetations, which 
 bleed from the slightest contact, and are readily crushed or deformed. 
 In the Bitch 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 in the vagina 
 of the Bitch ; and in two instances observed by Oreste and Falconio, 
 one tumour was the size of a filbert, the other of a large walnut. 
 
 The general indications for treatment are applicable to these growths, 
 though they seldom, if ever, prove an obstacle to birth. 
 
 FIBKOID AND MYOMATOUS TUMOUES. 
 
 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 lying between them, and are cemented into a solid mass by an 
 inter-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. The 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 
 Ercolani in 1855 ; cartilaginous transformation of the structure has 
 even been detected. 
 
 The fibroids are developed from the submucous or subserous connec- 
 tive tissue, or from the muscular texture of the uterine parietes. When 
 the latter, the tumour is rarely pediculated, but nearly always remains 
 sessile. The uterine 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 School contains the uterus of a Cow, one of the cornua of which 
 is occupied by a myomatous tumour springing from the muscular layer 
 of the part, and as large as a man's head. 
 
 Sometimes the pediculated fibroids of the uterus, in consequence of 
 
MUllBIl) ALTKllATinXS IX THE CEXERATIVE OUHAXS. 319 
 
 the elongation of their pedicle, extend beyond the os into the va^'ina, 
 and even in some instances pass through the latter and the vulva, and 
 remain suspended between the thighs. A case of this kind has been 
 observed by Granaveri and studied by Ercolani.^ 
 
 As we have observed, tlie 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 ])lace ; though 
 in some instances, when this occurs, absorption follows. During labour 
 they may predispose to ruptui-e of the uterus, from the alteration they 
 have produced in the texture of the organ. 
 
 Submucous or subperitoneal fibroids, 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 foetus, and be mistaken for 
 ^ome 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 
 iud flattened for the fcetus to pass over them. If they have an 
 I longated pedicle attached to some part which is easily displaced, they 
 may be pushed beyond the vulva by the foetus, or the pedicle may be 
 ruptured by the latter, and the parturient passage thus left un- 
 obstructed. 
 
 The recognition of these tumours is not very diflicult when they are 
 within reach of the hand. To prevent their being mistaken, during 
 manual exploration, for some part of an ordinary or deformed fcetus, 
 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 fa^tus. 
 
 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, as in so many others, 
 it sometimes effects surprising results. If they are pediculated and can 
 be reached, they may be incised, ligatured, or removed by the ocraseur ; 
 should the base not be attainable, or very extensive, they may be 
 partially extirpated. 
 
 If, after parturition, there appears anything like serious hemorrhage 
 due to this extirpation, this may be suppressed by plugging with lint or 
 line tow, which may be steeped in perchloride of iron. 
 
 THROMBI OR H^MATOMATA. 
 
 Thrombus or ha-matoma of the vagina or \ailva, usually appears most 
 frequently after delivery. Pfirter, however, has recorded the case of a 
 Mare in which a large blood tumour, or hoematoma, 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 the 
 
 * OrtMc and Falconio. Studii suUe Xeoplasie a Massa distinta degli Animali Domestici, 
 p. 58. 
 
350 MATERNAL DYSTOKIA. 
 
 vagina and vulva, the infiltration of blood extending to the perinoeum. 
 This tumefaction proved an obstacle to parturition ; so that it was 
 necessary to open it freely, and take away the clots of blood which had 
 formed. The htemorrhage which ensued was checked by the injection 
 of a solution of perchloride of iron. 
 
 Saake has observed these blood-cysts most frequently in Swine ; death 
 from ha3morrhage has sometimes resulted from their rupture. 
 
 The application of ice or cold water, or perchloride ofiron, or even the 
 actual cautery, and plugging the vaginal canal, will generally arrest the 
 bleeding. 
 
 SEROUS CYSTS. 
 
 Kopp, Hering, Ayrault, Lafosse, Liautard, Miiller, and others, have 
 observed serous cysts on the vaginal mucous membrane, and even in the 
 uterus, of the Mare and Cow. 
 
 The vaginal cysts are of variable size, but most frequently as large 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- 
 stances appear between the labia of the vulva when the animal is re- 
 clining, but disappear again into the vagina when the standing posture 
 is assumed ; though occasionally they are so large that they cannot 
 return without assistance. 
 
 The cyst is smooth and transparent, and contains a clear limpid 
 serosity, in which albuminous flakes are often observed. 
 
 Not infrequently the glands of Bartholin in the vagina of the Cow 
 are greatly distended with mucus, serum, or even pus, as a result of 
 inflammation. 
 
 Such cysts are not likely to retard parturition, and if they should, 
 their treatment is very simple ; as a lancet puncture sufiices to 
 evacuate the fluid they contain, and the walls readily adhere and 
 cicatrise. 
 
 Hering has seen them occupy the vagina and extend into the uterus ; 
 and in the latter organ their presence may be more serious than when 
 they are limited to the vagina. They may prove troublesome obstacles 
 to delivery, as well as dangerous to the animal in whose uterus they have 
 formed. 
 
 When the cyst is attached to the cervix or its neighbourhood, it may 
 pass into the os and obstruct it, and thus prevent the foetus passing 
 through. "When very large it may so closely simulate the " water-bag," 
 as to be mistaken for it— though the mistake need not lead to grave 
 results ; indeed, if ruptured the cyst immediately collapses, and can no 
 longer prove a iDarrier to the expulsion of the foetus. If the cyst is 
 situated towards the os, and if puncturing it be deemed inadvisable, 
 pushing it beyond the pelvic inlet out of the track of the foetus will be 
 sufficient 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 recom- 
 mended be adopted ; but a careful examination should always be made 
 before any active interference is attempted, and this examination will 
 obviate such an error. 
 
 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 it 
 
MonniD ALTKnATIOX.'i IX rilK h'KXKILlTll'E OWIJXS. 351 
 
 will lead to the same lamentable results, in all probability, as in 
 inversion. 
 
 HEHNIA OF THE HLADDER INTO THE VAGINA : VAGINAL CYSTOCELE. 
 
 Dystokia from the existence of a va<^inal cystocele is a somewhat 
 rare accident, and only a few instances are recorded as having been 
 observed in the Mare and Cow during parturition. 
 
 Inversion of this viscus may occur in two ways : — 1. When empty, it 
 may, by spasmodic contraction of its walls, evert itself — the mucous 
 membrane becoming external and the peritoneal coat internal — and thus 
 turned outside-in, it may pass through the meatus urinarius into the 
 vagina ; 2. It may, without being everted, escape into the vagina by an 
 c>ld or recent fissure in the floor of the passage. Most of the cases 
 occur during parturition, and when the animal is straining violently, 
 whereby a portion of the contents of the abdomen and uterus are pressed 
 against the bladder, and may thus produce its inversion. It is not at 
 all improbable that the viscus may, in consequence of the pressure it 
 ccasionally receives, be in a spasmodic state, or the cervix may be 
 lilated and relaxed at times (Cartwright). 
 
 In the Mare and Cow the urethra is short, straight, and wide ; and 
 this no doubt renders the bladder liable to inversion. Zundel states 
 that it may, during parturition, acquire such dimensions from retention 
 of urine that it will entirely fill the vagina, and protrude externally 
 during the expulsive efforts of the animal. 
 
 However this may be, it is certain that the cystocele will present a 
 different appearance in the vagina according as its peritoneal or mucous 
 membrane is visible : i.e., everted or non-everted. 
 
 In the first case we 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 lower wall of the vagina attentively, the meatus 
 urinarius cannot be found, but on the soft pulpy surface of the tumour 
 will be obsen'ed two small openings — the aperturss of the ureters — from 
 which a fluid continually escapes, and which may be recognised by its 
 odour as urine ; this fluid may even be thrown out with a certain degree 
 of force during the labour pains. These characters should be suflicient 
 to indicate the nature of the obstacle. 
 
 In the second variety, the bladder escapes through a rent in the wall 
 of the vagina, and this rent may only involve the muscular layer — tlie 
 vaginal mucous membrane remaining intact ; or, whicli is more frequent, 
 the muscular and mucous tissues may be ruptured. In either case 
 there is found in the vagina a round, smootli, and fluctuating tumour, 
 attached to the floor of the canal by a pedicle more or less wide, and 
 beneath which the 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 tlie dis- 
 placed bladder, the fundus of which is towards the vulva and the neck 
 directed forwards — its position being the reverse of normal ; the fundus, 
 by pressing on the urethra — which is doubled on itself — prevents the 
 urine from escaping, and we have in this way a rapidly increasing 
 vaginal tumour. In a case recorded by Violet,' the tumour had 
 acquii-ed, within eight hours, a diameter of from eight to ten inches. 
 Such a tumour must, therefore, constitute a more or less serious obstacle 
 to parturition. 
 
 ' Rtcutil dt Mill. Veterinaire de Lyon, 1S62, p. .371. 
 
352 MATERXAL DYSTOKIA. 
 
 "We have pointed out the necessity for a careful examination of the 
 tumoui", in order to avoid making a mistake, as the cystocele resembles 
 other tumours, and especially the cysts we have already described, or 
 even the " water-bag," and an error in diagnosis may lead to grave 
 consequences. Such an error is recorded by Chariot, ^ who, being called 
 upon to attend a Cow which had been attempting to calve for three 
 days, found on separating the labia of the vulva a whitish, tense, and 
 fluctuating tumour. Thinking that this was only the " water-bag," he 
 punctured it, when the colour and odour of the fluid which escaped 
 quickly undeceived him. When the bladder had collapsed, he then 
 recognised the tear in the vagina through which the viscus had passed. 
 The Cow being in a dying condition and the foetus still alive. Chariot 
 had recourse to the Caesarian section ; the Calf was saved, but the 
 mother died. 
 
 As the diagnosis of this accident is of so much importance, we will 
 notice the symptoms in greater detail. 
 
 Protruding through the opening of the vulva, or immediately within 
 the labia, will be discovered a tumour of a pyriform shape, and varying 
 in size and colour according to the duration of the accident. Sometimes 
 this tumour will be seen hanging from within the vagina by a kind of 
 pedicle, for at least eight or nine inches, and will contain two or three 
 pints of fluid. At times the protruded part will be nothing more than a 
 thickening of the bladder, produced by strangulation and inflammation ; 
 and it will be changed from its normal colour to that of an inflamed 
 surface, or, if it has been hernied for some time, to a darker hue. Some- 
 times it will become gangrenous and slough ; at other times its surface 
 appears rugged and plicated, and on occasions a large quantity of blood 
 has exuded from its surface. Should there exist any doubts as to the 
 nature of the tumour, the meatus urinarius must be looked for ; if that 
 cannot be discovered, then the greatest circumspection should be exer- 
 cised. The attachment and situation of the protrusion should be noted, 
 and also whether it is continuous with the vagina. The nipple-shaped 
 prominences which mark the openings of the ureters into the bladder 
 should likewise be looked for, as their presence will at once denote the 
 case as inversion of this viscus, as will also the escape of urine from 
 them. 
 
 Treatment. 
 
 The chief indication in vaginal cystocele is reduction or reposition of 
 the displaced viscus. This, however, is not always, if ever, an easy task. 
 In a case of simple hernia, the bladder is soon distended by the urine, 
 and owing to the increase in size, it cannot be returned by the opening 
 through which it passed when it was empty. Compression of its walls 
 will not suffice in the majority of cases to evacuate its contents, because, 
 as has been shown, the weight of the organ lies upon the doubled 
 urethra. To empty the bladder a catheter must be employed ; the 
 shoot of an elder-tree deprived of its pith has been successfully used for 
 this purpose on an emergency. Once emptied, the bladder readily 
 resumes its normal situation. 
 
 Puncture of the organ has been practised when catheterism was not 
 tried ; a fine trocar being inserted obliquely into the upper part of the 
 viscus — which was now of course the inferior part — so as to make it 
 
 ^ Joiu-nal Pratique de Med. Vtterinaire, 1826, p. 165. 
 
MORBID ALT Kll AT IONS IX THE GENERATIVE OROANH. 353 
 
 pass for a certain distance between the membranes before entering the 
 cavity of the sac, in this way imitating the entrance of the ureters. The 
 operation was completely successful, as the bladder 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- 
 ing of the parietes of the bladder and sphincter has taken place, we 
 most probably will 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 pessary or catheter, so as fairly to force it 
 mto its natural situation. If there should be violent straining at the 
 moment we are employing the staxis, we had better desist for a time 
 until we have abstracted four or live quarts of blood, or give a dose of 
 opium in solution, to allay any irritation or spasm. But if we cannot 
 succeed in this way, I think a far more preferable plan will be to get a 
 stick with a round blunt point that will pass through the sphincter, and 
 force it against the base of the protruded fundus. A very excellent 
 instrument would be a female catheter, such 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 ; though, of 
 course, we must be cautious in our pressure." 
 
 Sometimes it is no sooner returned than it is again everted, and this 
 repeatedly. In such cases pencilling around the meatus with nitrate of 
 silver, dashing cold water on the vulva, and walking the animal quickly 
 about, have caused its retention. 
 
 Should the distended cystocele be immediately in the track of the 
 foetus, and the expulsion of the latter urgent, if the bladder cannot be 
 returned before birth it must at least be emptied, to allow the young 
 creature to get through the vagina. As the latter passes over it, the 
 viscus should be protected from injury by the fingers. 
 
 We will return to a consideration of this condition when treating of 
 the accidents occurring as a sequel of parturition. 
 
 TUMOUKS IN THE VICINITY OF THE GENITAL ORGANS. 
 
 Tumours in the bladder, when of large size — as polypi, steatomatous 
 growths, etc., as well as calcareous concretions, may hinder parturition, 
 or even render it impossible, j-^ven an excessively distended bladder 
 may ofifer an obstacle to the accomplishment of this act, either in 
 checking the advance of the foetus, or by sympathetically disturbing the 
 uterine contractions. 
 
 The indications here are obvious. 
 
 Tumours of various kinds may be developed in the connective tissue 
 of the pelvic organs, and especially between the vagina and rectum, and 
 more or less obstruct labour. Ovarian tumours may also prove trouble- 
 some, as may likewise multiple abscesses and cysts in the neighbour- 
 hood of the genital passages. In some cases these may be successfully 
 punctured ; in others extirpation may be possible ; while in others, 
 again, the obstetrist can only choose between embryotomy and the 
 Caesarian section. 
 
 Distention of the rectum from an accumulation of faeces may prove a 
 cause of dystokia — particularly in the Mare ; but this should be easily 
 
 23 
 
354 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 Utebi. 
 
 Rigidity 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 dilated by 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 this 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 absence 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 ; whei-eas, when there 
 is spasm, it has usually been observed that there are inordinate and 
 disordered contractions 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, there 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 tumultuous or irregular parturition, or "false labour" 
 (metrijjercinesis , 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 they offer, the os remains closed and labour cannot advance. This 
 is, we think, the true explanation of this condition. 
 
 SijmiAoms. 
 
 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 
 
Mnnmi) ALTERATIOXS IX THE GENEKATIVK ORHAXS. 355 
 
 rally and assume its ordinax-y appearance— constituting a case of " missed 
 birth. "1 
 
 In other instances, the creature manifests an unusual amount of ex- 
 citement at first ; there is agitation, strainin-,', and symptoms of colicky 
 pains ; the abdomen is frequently looketl at by the aniinal, whicli lies 
 down but soon gets up again ; the pulse is full, strong, and frequent ; 
 the conjunctivie are injected ; the skin is hot ; fajces and urine are 
 passed at frecjuent intervals ; there is thirst and anorexia ; and some- 
 times durhig the throes the vagina is protruded beyond the vulva, and 
 appears as a large red mass. 
 
 A vaginal exploration is necessary, in order to learn the cause of 
 obstruction. This should be carefully and gently made — the latter 
 precaution being most important to observe during the throes. It may 
 be necessary, if the mucous membrane is dry, to inject some emollient 
 fluid into the vagina, or introduce it by a sponge. 
 
 When the hand is passed through the vagina, the os will be found 
 more or less contracted, so that scarcely one or two fingers can be in- 
 troduced into it, owing to the spasmodic resistance it offers, while the 
 cervix preserves its elongated shape. 
 
 In the Cow, the cervix and vagina are frequently filled with a 
 tenacious gluey matter, which sticks to the fingers like bird-lime, and 
 by fixing together the margin and walls of the os doubtless increases 
 the resistance the canal offers to dilatation. 
 
 If the finger can be introduced into the os, it will be found that there 
 is neither deformity nor morbid induration, and that the constriction is 
 due to the fibres of the cervix alone. 
 
 It has been pointed out that, contrary to what is stated above, the 
 cervix uteri is sometimes completely effaced ; tiie bottom of the vagina 
 being occupied by a kind of smooth-surfaced ball, in the centre of which 
 is a narrow opening, and through which the fcetus can be felt. The 
 convex body is the posterior segment of the uterus which, pressed by 
 the head or some other part of the f(i.'tus, is pushed into the vagina ; 
 while the small aperture is the os — partially effaced and undilated. 
 This trace of the os, instead of being in the centre, is at times more or 
 less to one side, and occasionally it can only be found with much 
 difficulty. 
 
 \Vhat seems to establish the spasmodic nature of the affection, is the 
 fact that in many cases, in the intervals of the " pains," the cervix feels 
 soft, and the os becomes dilated sulliciently to permit of the introduc- 
 tion of one or more fingers, or even of one or two limbs of the fcetus. 
 But the moment attempts are made to dilate it, the cervix again 
 becomes rigid, and this condition is greatly exaggerated when the next 
 pain comes on. 
 
 ' We may here call attention to certain HigOH presented by Cows, ;in<l which have 
 been dLScribed by Biot ( I'trtuil ilc Mid. Vctrritiaire, lS7t3, p. 1007) as essentially pathog- 
 nomonic of uterine disturlmnce in these aniinals, and for this reason have been specially 
 designated as uterine. These signs, upon which hv pl.ice^ the >,'re.'itest diagnostic value, 
 •re observed when the sick Cow is approached or touched in any way. The animal then 
 "suddenly elongates the neck, extends the head, yawns, protrudes tlie tongue, and emits 
 •t the s.-vme time a kind of dull moan, but which is rather a powerful expiration than a 
 real moan." When these signs are present, biot asserts that the cor/m d/lit — the dis- 
 torbance — is in the uterus, and never elsewhere. Laborious or protracted parturition, 
 iinalpositions of the fcetus or monstrous conformation, occlusion or induration of the 
 oervix uteri, hydramnios, t«irsion of the utenjs ; and after parturition, inversion of the 
 iVteras, retention of the placenta, and vitulary apoplexy with or without paralysis ; — all 
 Uiese may give rise t<i the manifestation of this singular phenomenon, which he has never 
 witnessed in any other affection — not even in chronic diseases of the uterus. 
 
356 MATERNAL DYSTOKIA. 
 
 Diagnosis. 
 
 From the symptoms enumerated, there should not be much doubt or 
 delay in diagnosing this cause of dystokia. As in so many other 
 instances, 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- 
 tion of 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 rarely 
 so prolonged. 
 
 But, as a rule, it 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. 
 The 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 foetus 
 cannot be 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 equally 
 guarded against. 
 
 Treatment. 
 
 As this condition of the cervix uteri is, at the commencement, of no 
 great importance, and 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 delay in birth ; then he ought 
 to wait, while being prepared at the same time for any emergency. 
 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 appears to be unduly prolonged without any 
 progress being made in parturition, and if the " pains " are energetic, 
 while the animal's condition is not so satisfactory, then intervention 
 may be counselled. But this intervention should be of the simplest 
 
MORBID ALTERATWXS IN THE aEXEItATIl'E ORGAXS. 357 
 
 and luiklest character, and in the majority of cases it will be attended 
 with entire success. Injections per rectum or vaginani, of emollient or 
 oily fluids, to which tincture 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 
 and applied over the loins of the larger animals, or warm-water baths 
 for the smaller ones ; and, in certain cases, the administration of 
 draughts containing some soothing medicament — such as chloral, 
 chloroform, or opium ; — these are the means to be adopted. 
 
 Bleeding has been advocated by some authorities — particularly on 
 the Continent ; but unless something very unusual in the general con- 
 dition of the animal demands it, the abstraction of blood is of very 
 questionable value. 
 
 Opium is of much service, from the influence it possesses in con- 
 trolling the uterine spasms ; it is therefore to be recommended when 
 the " pains " are severe and frequent. It may be given in large doses, 
 both in draught and enema, and frequently. 
 
 Chloral hydrate and chloroform, particularly the former, are of great 
 utility, and possess advantages over opium as soothing agents. 
 
 For a very long time, belladonna has enjoyed the reputation — and 
 apparently with justice — of being one of the best agents for combating 
 spasm of the cervix uteri, and permitting dilatation of the os. Occa- 
 sionally its efficacy has been contested, but the great balance of evidence 
 is in its favour, and its employment is almost a matter of course with 
 every veterinary obstetrist. It is generally applied in the form of 
 extract around the cen'ix, about a drachm or so being required for one 
 application — it is rare that a second application is needed. Time should 
 be allowed for its action. For the Bitch one-fourth or one-fifth of the 
 dose is sufficient. 
 
 If cocaine were not so expensive it would also prove most useful in 
 such cases, especially in the smaller animals, as a solution of it acts so 
 promptly and eifectively. 
 
 Sometimes it is attempted to dilate the os uteri by manipulation — 
 the fingers and iiand being the dilators ; but this means should not be 
 adopted until milder measures have failed, and until time and patience 
 have been exhausted over them. The hand and fingers well oiled, or 
 smeared with extract of belladonna, should be introduced in the form 
 of a cone, towards the os ; if they cannot be passed into the canal in 
 this shape, then the insertion of one finger may be attempted, followed 
 by a second, and so on until the band has been pushed through. 
 
 Very frequently this cannot be accomplished at the first trial, nor yet 
 at the second ; but with patience and judgment it rarely fails, and if 
 conducted with the care and gentleness which all operations of this 
 kind should receive, such manipulation may be attempted without the 
 least danger at inter\'als of a few hours, until crowned with success. 
 The condition of the os should be ascertained, after a certain period 
 has elapsed since the last attempt, every precaution being adopted to 
 prevent injury ; and an entrance to it ought only to be effected when 
 the resistance has greatly diminished, and can easily be overcome. 
 
 Mechanical dilatation of the os by means of the sponge tent has been 
 much, and most successfully, employed in human obsteti-ics for a long 
 time, and the method has recently been greatly simplified and perfected 
 by Sims, Joulin and others. It is perfectly applicable to animals. The 
 tent can perhaps be purchased at any druggist's, but if not it is easily 
 
358 MATERNAL DYSTOKIA. 
 
 made. Joulin makes those he uses in the following manner : — From a 
 somewhat fine and dry sponge of inferior quality, he cuts two long 
 conical pieces, one about three and a quarter mches in length, about an 
 inch wide at the base, and one-third of an inch at the apex ; the other five 
 or six inches in length, two and a half inches at the base, and one-third 
 of an inch at the apex. Of course they would require to be larger for 
 animals. 
 
 These cones are then prepared for use by wrapping them closely 
 round in twine, the circles of which should be so near each other as not 
 to leave ridges on the sponge. By this pressure the tents become 
 extremely compact, and look like a thick bougie. 
 
 When required for use, the twine is removed — this should not be 
 done until the tent has been prepared for at least two or three hours, 
 when it will have acquired sufficient rigidity. A piece of cord should 
 be attached to its base, so as to allow it to be w^ithdrawn when inserted 
 in the os ; but before this insertion takes place, the apex must be 
 covered with a little lard, cerate, or extract of belladonna. The sponge 
 is passed into the os as far as possible, either by the fingers or forceps, 
 and until the base of the tent is close to the margin of that opening. 
 The narrow and slightly flexible apex of the tent allows of its passage 
 through the os into the uterine cavity ; but in order to be successful the 
 operation must be quickly performed, otherwise the sponge rapidly 
 absorbs mucus and loses its rigidity. 
 
 No plugging or other means are necessary to retain the tent, as the 
 portion which projects into the uterus quickly increases in size from the 
 absorption of moisture ; so that, after a few minutes, a certain amount 
 of force is necessary to withdraw it therefrom by means of the cord. 
 
 The sponge-tent acts in several ways, and simultaneously : 1. It 
 detaches the membranes, and this is often sufficient to induce labour ; 
 2. It acts as a foreign body in irritating the posterior segment of the 
 uterus, which reacts by contracting ; 3. It dilates the inner opening of 
 the OS ; 4. It also dilates the entire length of the os, by swelling through 
 imbibition of the uterine mucus. 
 
 To obviate the risk of softening before it is inserted into the os, Joulin 
 prepares the tent in the following manner. Instead of wrapping it 
 round with twine while it is in a dry state, he saturates the sponge in a 
 solution of gum arabic, and then having rolled the twine round it, 
 leaves it to dry for some days. After this treatment it preserves a cer- 
 tain degree of suppleness, but may remain for a minute or two in 
 contact with mucus before imbibing it. 
 
 Barnes' procedure for the dilatation of the os uteri in woman, has 
 also proved of great service in human obstetrics ; but to our knowledge 
 it has only once been tried with animals, though there is no reason why 
 it should not be successfully employed, not only in producing abortion 
 in those cases to which we have pi'eviously alluded, but also in the 
 morbid condition now under consideration. 
 
 This procedure consists in dilating the os by means of fiddle-shaped 
 india-rubber bags, which, for women, are of three different sizes ; but 
 the very largest of them would probably be required as the smallest size 
 that could advantageously be used for the Cow or Mare.^ 
 
 The bag (Fig. 95), in an empty condition, is introduced into the os by 
 means of a whalebone sound or director, which fits into a small pocket 
 
 ^ These bags are made by Weiss and Son, surgical instniment makers. Strand, 
 London. When ordered, the animal for which they are to be used should be mentioned. 
 
MORBID ALTKIiATIOXS IX THE UEXERATIVE ORir'AXS. 359 
 
 at the side ; it is pushed through the canal until the pocket end projects 
 into the uterus ; then water is steadily injected into it by means of the 
 tube attached to the other end. When lilled with water the bag 
 remains in the os, in consequence of the middle portion being narrower 
 than the two ends. 
 
 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 lingers. 
 
 A simpler contrivance than that of Barnes, and which will perhaps 
 be found useful on similar occasions, is that designed by Schnakenburg, 
 and named the " Sphenosiphon." It is merely the bladder of an animal 
 tied to a syringe, and which, when water is injected into it, mechani- 
 cally dilates the cers'ix. 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 foetal membranes 
 and liquor amnii. 
 
 Fig. 95. 
 Bau.nks' Uterine Dilator. 
 
 Another means which has been successfully employed in such cases, 
 as it is simple and without danger, and at the same time efifective in 
 producing premature artificial delivery in woman, is the uterine douche 
 introduced into obstetrical practice in 1848, by Kiwisch of Dresden. 
 This is generally known as the " ascending uterine douche," and con- 
 sists of a jet of water at a certain temperature directed against the 
 posterior uterine segment for some minutes, and repeated, if necessary, 
 at intervals of two or three hours. It is often resorted to in woman to 
 favour the dilatation of an cntirehj closed os, and to prepare it for the 
 application of another method, which may be either Barnes' or Schna- 
 kenburg's. 
 
 This method might be adapted to animals in the following manner. 
 The apparatus may consist merely of a bucket, or barrel with one end 
 out, such as may be found in almost every stable or cow-shed, and a 
 long piece of indiarubber tubing about half-an-inch in diameter, which 
 can be procured easily and cheaply. To one end of this tubing is fitted 
 the pipe of an ordinary sjTinge — either enema or garden ; the other end 
 is immersed in the barrel or pail, which should be filled with tepid 
 water at a temperature of about 10-i' Fahr., and placed sufliciently high 
 to yield a pretty strong jet. 
 
360 MATEEXAL DY ST OKI A 
 
 In order to set the water flowing, the tube must be exhausted of air 
 by suction with the mouth, and the end provided with the syringe pipe 
 carried into the vagina and directed towards the cervix uteri. Each 
 douche should continue for about ten or fifteen minutes, or longer ; 
 and it may be repeated every two or three hours, or even at shorter 
 intervals, according to circumstances, until the desired effect has been 
 produced. 
 
 Cazeaux speaks highly of this method of dilating the cervix in 
 woman, and for the following reasons : 
 
 1. The uterine douche prepares the act of premature birth with the 
 greatest possible gentleness, by means of the softening and the necessary 
 dilatation of the inferior segment of the uterus. 
 
 2. By this means all preparatory treatment is needless. 
 
 3. This procedure is easily employed, and not at all disagreeable to 
 the woman, as the injection of warm water does not produce any 
 discomfort. 
 
 4. It does not require much time. 
 
 5. Its action can be graduated at the will of the obstetrist, who may, 
 according to requirements, increase or diminish the duration of the 
 douche and the temperature of the water, as well as vary the parts of 
 the cervix on which he directs it. 
 
 6. Finally, it can never occasion lesions of the genital organs, nor 
 yet injure the foetal membranes or the foetus. 
 
 This uterine douche is well worthy of notice, and though there are 
 only, so far as we can ascertain, three cases on record in which it has 
 been tried with animals, yet as these were most successfully treated 
 by it, it may be assumed that it will be found a most valuable means 
 of not only dilating the os uteri, but also of controlling the action, or 
 relieving certain morbid conditions, of the uterus itself. 
 
 Eougher treatment for the dilatation of the cervix than that which 
 has been described, is sometimes resorted to, either through impatience, 
 ignorance, or in cases which demand prompt action ; as the other 
 measures require a certain amount of time, from the slowness of their 
 operation — though perhaps this is rather an advantage than otherwise. 
 
 Forcible dilatation of the os uteri has been practised in human 
 obstetrics, and special instruments have been devised with this object. 
 Such dilators have been constructed by Osiander, Busch, Mende, and 
 Krause, but they have not been much used, as milder measures are 
 preferable. The same remark is applicable to veterinary obstetricy, 
 in which there is only too often a tendency to imagine that because 
 the patient is an animal, so all the more force and brusqueness can be 
 resorted to. 
 
 Forcible dilatation of the cervix, which 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 disadvantages. In these 
 cases, every other known means had failed ; so Oschner procured a pair 
 of large fire-tongs used by blacksmiths, and wrapping their jaws round 
 with tow which was smeared with grease, he introduced them, closed, 
 through the os ; then an assistant gradually opened the shanks or 
 handles of the tongs, and so produced the desired widening of the 
 passage. The inflammation set up by this manoeuvre was dissipated 
 by the employment of soothing remedies, after fifteen days' treatment. 
 
 It is obvious that such a mode of dilatation should not be practised. 
 
MORIill) JLTA'j;.tTlOXS IX T/fK C KXi:UATirE OIKiAXS. 361 
 
 unless there is something most unusual in the case ; as it is a most 
 painful operation, and likely to produce contusions and lacerations of 
 the cervix, which may require much time and attention to repair. 
 
 Incision of the cervix {vaijinal Jii/stcrotoviy) is another operation 
 which can scarcely ever be required for rigidity or spasm of tliis part, 
 and ought to bo reserved for more serious conditions. At any rate, it 
 should not be practised until the other measures we have eimmerated 
 have been fairly tried, as it is an operation not without rislt of ill 
 consequences. 
 
 In some cases, in which the spasmodic action of the uterus is 
 irregular, and leads to occlusion of the os, it might be advisable to 
 resort to anaesthesia, produced by the inhalation of ether or chloroform. 
 Of course the anaesthesia should not be pushed to complete insensibility, 
 but be limited to semi-consciousness or " obstetrical anaesthesia." This 
 is more particularly to be recommended for the smaller animals. 
 
 In the majority of cases, when the rigidity has been dispelled or the 
 spasm relaxed, birth will take place without further assistance being 
 required ; though it may be well that the obstetrist assure himself 
 that the foetus is in a favourable position for delivery. If there appears 
 to be atony of the uterus or the mother is exhausted, or if the fu'tus 
 is dead or in a faulty position, then it will be necessary to afford aid in 
 parturition by adjustment and traction. 
 
 In very many instances, it must be remembered, this rigid condition 
 of the cervix is due to malpresentation or malposition of the foetus in 
 the uterus ; and even when the os has been sufliciently relaxed, the 
 young creature cannot pass through until it has been properly placed, 
 and not unfrequently aided through the genital canal. 
 
 3. Indiuation of the Cervix Uteri. 
 
 Induration of the cervix is the term applied to this part when its 
 texture is altered in any way — whether the alteration be librous, sarco- 
 matous, or cancerous — so that its elasticity being destroyed, and its 
 structure inextensible, it offers an obstacle to parturition. 
 
 This alteration, or " scirrhus," as it has sometimes been designated, 
 is not at all infrequent ; but it has been observed, it appears, nearly 
 always in the Cow, and would seem to be almost, if not quite, peculiar 
 to that animal.' The reason for this partiality has been variously 
 accounted for, but probably Bouley, in an unpublished note to Saint- 
 Cyr, has afforded the most satisfactory explanation. He remarks that 
 " irritation produces in the Bovine species phenomena of induration 
 much more durable than in any other species ; in proof of this, witness 
 tlie plastic engorgements — so adverse to suppuration, and so slow to 
 disappear — which are caused by a seton introduced beneath the skin 
 of an Ox ; witness, also, the enormous swellings obsei^ved as a con- 
 sequence of inoculation for pleuro-jineumonia (Bovine), and those in- 
 durated tumours vulgai"ly designated osteo-sarconuitous, so frequent on 
 
 ' I can only find one case mentioned as occurring in any other animal, and that 
 happened in a Ewe. It is reported by Shentone ( Veterinarian, vol. xxix., p. 36), who 
 says thiit the creature had been in lal>>ur since the previous night, but i>ad made no 
 progrei*s, and was very much exhausted. "It w.as a c.%se of scirrhous os uteri. I told 
 him (the owner) I would <livide the stricture as the only means of saving her, but in her 
 case it was almost a 'forlorn hope.' However. I did divide it, cutting in two placet", 
 parallel to each other, and with a g.iod deal of ditficidty extracted a large Lamb that had, 
 from its appearance, been dead fur some time." The Ewe recovered. 
 
362 MATERXAL DY,STOKIA. 
 
 the maxilla, and which repeated irritation caused by the prick of a 
 needle are sufficient to produce. This seems to be a general organic 
 fact, of which induration of the cervix uteri is only a particular instance." 
 
 This induration must not be confounded w^ith the dense, fibrous, 
 though normal, consistence of the cervix of the Cow's uterus, which, 
 there can be no doubt, has often been mistaken for a diseased condition, 
 and particularly when in a rigid or spasmodic state. The distinction 
 between what we may term the functional derangement and the jja;J/io- 
 logical 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. 
 
 In some cases, perhaps, 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 
 more frequent in old animals, or those which have already been bred 
 from, than in those which are young or are pregnant for the first time, 
 though these do not appear to be exempt. 
 
 Eancon assured Eainard that morbid induration of this part was wit- 
 nessed more frequently in the ancient Briangonnais, where he practised 
 for thirty-six years, than in other regions of France. "We are not aware 
 whether the influence of breed or locality has been observed to influence 
 its prevalence in other countries. 
 
 Sy7n2:)to7ns. 
 
 Owing to the situation of the cervix, and the nature of the tissues 
 entering into its composition, as well as to the slowness with which 
 the pathological alterations take place, this condition may be in exist- 
 ence for a long time without any appreciable change being observable 
 in the animal's health. Therefore it is that Cows which are so affected 
 do not exhibit anything during the whole period of pregnancy, which 
 might lead a person to suspect the existence of uterine disease. 
 
 In some cases, however, towards the termination of pregnancy there 
 has been remarked a listlessness or gradually increasing debility, which 
 has been so great at last that the animal assumed the recumbent posi- 
 tion, and could not get up without assistance. This general weakness 
 has been mistaken for paraplegia, though it has sometimes been supposed 
 to be due to lumbago ; though it may have been merely a symptom of 
 generalised cancerous infection, the part itself being the seat of cancer. 
 
 But in the great majority of cases, the existence of induration is not 
 suspected until parturition sets in, when the labour pains, which may 
 continue for a long time, attract more than ordinary attention, as birth 
 does not take place. And not infrequently during the pains, and more 
 especially when the animal is lying, a livid, irregular-shaped, and nodu- 
 lated kind of tumour appears between the labia of the vulva ; this is the 
 undilated cervix uteri. 
 
 In other instances, however, nothing is observable externally, and a 
 vaginal exploration is necessary. The cervix is then discovered to be 
 more or less dense without being much increased in size, or it may 
 protrude into the vagina, and form a voluminous, irregular, nodulated 
 tumour which in some cases feels as hard as wood, and in others has a 
 rugged, soft, and ulcerated surface. Some veterinary obstetrists have 
 described transverse rugas, composed of a solid, unyielding, fibro-carti- 
 laginous material, in the os. 
 
MO null) ALTHlLiriOys IX THE nHXKIlATll'E VHnAXS. 303 
 
 The OS is not always easily fouiul, and it is sometimes so contracted 
 that one finger cannot be introduced into it ; at other times it is not so 
 constricted, and the ftotus may be felt through it. But in every case it 
 is irregular and deformed, deviated from its usual direction, and its 
 walls greatly thickened, perliaps corrugated. Its degree of hardness 
 and thickness will indicate whether, and to what extent, it can he 
 dilated ; and this condition may not only involve the whole of the 
 cervix, hut also the walls of the uterus itself, as well as those of the 
 vagina. 
 
 When the cervix is ulcerated, the hand will be found covered with 
 blood after the examination. 
 
 Diagnosis. 
 
 The diagnosis of this condition must be left, to a large extent, to the 
 tactile impressions derived from a vaginal exploration. In some cases 
 an ocular inspection of the cervix may be possible, and the previous 
 history of the case may also be useful in this direction. 
 
 Proijnosis. 
 
 The influence of the induration on the act of parturition will depend 
 upon the degree and extent of the alteration in the cervix. If this is 
 not very serious, and does not implicate the organ very much, and par- 
 ticularly if the induration is localized in some unimportant part, par- 
 turition, though protracted, may nevertheless be accomplished without 
 assistance. Often, however, the results are troublesome ; one of these 
 is laceration of the cervix, from its unequal dilatation. 
 
 Though there is a great difference, pathologically speaking, between 
 the various alterations — for example, between simple fibrous trans- 
 formation and cancerous degeneration — yet it is admitted that the most 
 benignant alteration is infinitely more serious, from an obstetrical point 
 of view, than simple rigidity of the cervix, either in its immediate or 
 remote results. This Saint-Cyr has proved to be the case in nineteen 
 recorded observations. Of these, seven were more or less unfortunate in 
 their results ; in three instances the mother and fti^tus succumbed ; in 
 other three the mother died, but the progeny was saved ; and in the 
 seventli, the Calf died, but the Cow lived. This is a very high rate of 
 mortality, and yet Saint-Cyr is not quite certain that in these nineteen 
 observations there were not some which were rather cases of simple 
 rigidity than induration of the cervix. For as Rainard remarks— and 
 the remark would also apply to the observations recorded in English 
 veterinary literature — it is not always easy, for lack of sufticient details, 
 to discern clearly to which category belongs such or such an obsei"va- 
 tion given by writers under the title of " indurated cen'ix," " schirrous 
 cen-ix," " stricture of the os uteri," etc. 
 
 In arriving at a prognosis in a case of this description, the immediate 
 results are not alone to be taken into consideration ; as pregnancy and 
 the manipulatory operations necessary to effect delivery— which is 
 always tedious and difficult — give to morbid alterations of these parts — 
 even when quite benignant in their nature — an exceptional gravity ; so 
 that many animals, even after a comparatively easy delivery, succumb 
 soon afterwards to the diseased condition. The uterus may be ruptured 
 through the efforts at delivery. 
 
364 MATERNAL DYSTOKIA. 
 
 Pathological Anatomy. 
 
 The lesions found after death are generally alluded to as "fibrous 
 degeneration," " scirrhus," or " cancer " of the cervix ; and it is usually 
 mentioned that this part was " hard and like cartilage," " creaking under 
 the knife like cutting an unripe apple or turnip " ; or that there was 
 " schirrus " or " cancer," " nodular and hard like cartilage.'' 
 
 Macgillivray states that when the contraction of the os uteri is the 
 result of prior disease, it will generally be found of a hard fibroid nature ; 
 while, on the other hand, where the contracted parts are soft and very 
 much thickened, acute disease will commonly be found accompanying 
 the stricture. " In hard stricture, the transverse rugae or folds appear 
 generally to be transformed into a compact, unyielding fibro-cartilaginous 
 material ; in one very serious case I found six of these hardened unyield- 
 ing transverse rugae or folds between the os tincce and os internum. In 
 soft stricture, without any actual disease being present, the contraction 
 is generally confined to the os and the vaginal portion of the cervix 
 uteri. In cases of complicated stricture, or, in other words, stricture 
 accompanied by some active disease, it will often be found that the 
 stricture is merely the concomitant eilect of the disease, and such 
 causative disease will almost invariably prove to be either ulcerative, 
 schirrous, really cancerous, or fungous in its nature. . . . Deposits of a 
 fibrinous nature are only too common in patients of rheumatic constitu- 
 tion." 
 
 Treatment. 
 
 The condition of the cervix uteri being ascertained, there should be 
 no delay in resorting to active measures, as it is impossible for delivery 
 to be effected, in the great majority of cases, without such interfei-ence. 
 Here the necessity for a correct diagnosis is, as we have already urged, 
 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 animal ; whereas, in induration these 
 measures would be ineffective, and valuable time must be lost in trying 
 them. 
 
 Delivery, in induration of the cervix, must be effected by one of two 
 serious operations. This must be eitlier vagiiial-hystcrotomy or (jastro- 
 liysterotomy. We shall again allude to and describe these, in speaking 
 of obstetrical operations. 
 
 It may only be necessary in this place to say that vaginal hysterotomy 
 — by which is meant incising the cervix, either completely or partially, 
 in one or more places — does not offer any very dangerous consequences 
 when the textures are healthy ; though when they are much degenerated, 
 the operation may be followed by troublesome, if not fatal results. 
 Nevertheless, dilating the cervix by incision is rarely so serious for the 
 mother as the Caesarian section ; though the foetus may incur more risk, 
 as, after the cervix has been relaxed, it is often a tedious and difficult 
 operation to effect delivery, and strong traction may even be necessary. 
 As this measure offers a chance of saving both mother and foetus, it 
 should, as a rule, be preferred to gastro-hysterotomy ; and this prefer- 
 ence is still further warranted by the fact that the life of the mother is 
 of more value than that of the foetus, and if one must be sacrificed it 
 should be the latter. Should the foetus happen to be dead, then there 
 is an additional motive in preferring incision of the cervix. 
 
MUllBID ALTKIIATIUXS IX THE (JEXERATIl'E OliGAXS. 365 
 
 When the os has been considered sufliciently dilated for the intro- 
 duction of the hand and arm into the uterus, then the foitus should be 
 placed in position for extraction — the most favourable bein^', of course, 
 the vertebro-sacral, with the head and fore-limbs towards the os. 
 Should it be found impossible to engage these in the passage, tlien 
 more incisions may be made in the cervix, and this can be done with- 
 out displacing the foetus. 
 
 It is well to remember that it is very much better to dilate the os by 
 incision than by laceration, through unduly forcing the foetus into it. 
 At the same time, judicious traction should be made during the maternal 
 eflbrts. 
 
 Aubry, Van Dam, and some others, have witnessed fatal haemorrhage 
 resulting from the incisions ; while metro-peritonitis has also been 
 reported as an equally unfortunate sequel. 
 
 But these cases are exceptional. Those veterinary obstetrists in this 
 country and on the Continent who have had most experience in the 
 operation, are unanimous in asserting that, provided certain pre- 
 cautions are adopted in making the incisions, no such results are likely 
 to follow. 
 
 Donnarieix states that, in thirty years, he has performed vaginal 
 hysterotomy in sixty cases of schirrus and other kinds of induration 
 of the cervix leading to occlusion of the os uteri, and of these only one 
 (Jied, though the cause of death was not ascertained. Recovery is the 
 rule and death the exception. 
 
 Of course, recovery must always be doubtful if the disease of the 
 cervix is of a malignant nature, as the operation and the irritation caused 
 by the extraction of the foetus will, in all probability, hasten its progress. 
 
 In some rare instances it may be advisable to have recourse to the 
 Caesarian section at once. When, for example, labour has been severe 
 and prolonged — when some days have elapsed since parturition com- 
 menced, and the veterinary surgeon is not sent for until amateurs have 
 exhausted their efforts and the animal is sinking; or when, from a 
 vaginal exploration, it is ascertained that uterine or vaginal disease is 
 so extensive and advanced that the mother cannot live much longer, 
 and the foetus is alive ; then this formidable operation should be adopted 
 without delay. 
 
 4. Complete Ohliteuation (Atresia) of the Os Uteri. 
 
 Congenital atresia of the os uteri may at once be admitted as an 
 impossibility in obstetrics, as if this canal is completely closed impreg- 
 nation cannot take place. But between fecundation and parturition 
 certain alterations may occur which, by leading to more or less persis- 
 tent closure of this passage, will prove an obstacle to birth. These 
 alterations may indeed exist at the period of fecundation, but then the 
 uterine opening must be only partially closed ; and, in fact, at parturi- 
 tion the OS may be superficially and partially, as well as completely, 
 occluded. This condition has been observed in the Mare, Cow, and 
 Sheep. 
 
 Causes. 
 
 The occlusion may be due to agglutination of the walls of the os, 
 the formation of fibrinous membranes or bands, the development of 
 cicatricial tissue from wounds or injuries sustained in previous preg- 
 nancies, etc. 
 
366 MATERNAL LYSTOKIA. 
 
 Symptoms. 
 
 These are, of course, the usual external symptoms of retarded 
 parturition. Internally, the hand, on being introduced into the vagina 
 and pushed towards the cervix, comes in contact v^ith a round, 
 smooth, and tense, but fluctuating tumour at a variable distance from 
 the vulva, or even between its labia ; the foetus can be felt through this 
 tumour, and this might lead to the supposition that this is the " water- 
 bag." But 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 foetal 
 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 
 neither 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 as the fluids surrounding it become absorbed, 
 and the parent does not appear at all amiss, its condition being per- 
 haps only accidentally discovered, either when it dies or is killed long 
 afterwards, or when the remains of the foetus 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 tincae should be the guide 
 in diagnosis. 
 
 Treatment. 
 
 As in induration of the cervix, so in atresia; delivery must be effected 
 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 suffice, 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 through 
 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 
 hereafter 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, 
 Hubert recommends a convex bistoury, the blade of which is covered 
 
OTHER CAUSES OF MATERXAL I'YsToKIA. 3r>7 
 
 to ^Yithill 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 uterus 
 are to be carefully incised to a small extent — layer after layer, until 
 the escape of the liquor amnii announces that the fd'tal membranes are 
 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 
 foetus is to be extracted. 
 
 Hubert has performed this opei-ation 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. 
 
 CHAPTER lY. 
 Other Causes of Maternal Dystokia. 
 
 There 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) Anomalies of the placenta; (2) Morbid adhesion heticecn the 
 fa:tus and uterus; (3) Stricture of the uterus by external bands; 
 (4) Persistent hymen ; (5) Vatjinal and vulvar atresia. 
 
 1. Anomalies in the Placenta, 
 
 We are but little acquainted with the morbid alterations of the 
 fcetal membranes of animals, and of those changes which lead to their 
 more or less permanent adhesion to the foetus and the uterus. 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 of difHicult or impossible birth. 
 
 It is very probable that animals are less subject to disease of the 
 uterus and the placental membranes than the human species, and tliis 
 would account to a certain extent for the absence of notice of such 
 occurrences. Nevertheless, 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 myxomata 
 of that membrane, in addition to new formations of the placenta, as 
 well as placentitis, 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,^ 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 were, in a leather bag, no part of the creature being 
 distinguishable. This is probably the condition known in woman as 
 7nyxo)na fibrosum placcntiv. 
 
 The labour pains are seldom violent, though the foetal membranes 
 
 ' Veterinary Journal, 1877, p. 105. 
 
368 MATERNAL DYSTOKIA. 
 
 (water-bag) cannot be expelled into the vagina, even v\^hen the os uteri 
 offers no obstacle. 
 
 An early examination is necessary, as the foetus soon perishes. An 
 incision must be made through the chorion, and the foetus extracted. 
 
 2. Morbid Adhesion between the Fcetus and Uterus. 
 
 Adhesion between the uterus and its contents may be due to in- 
 flammation of a portion of the mucous membrane, to hyperplasia of 
 the chorion, or to disease of the ovum or placenta, by which the two 
 latter are brought into direct contact with the interior of the organ. 
 Or it may be owing to a deficient quantity of liquor amnii when the 
 foetus begins to be formed ; for if the amnion, in the course of its 
 development, is not separated from the growing foetus by a sufficient 
 quantity of fluid, connection between them is almost certain to be 
 established either in isolated spots (Simonart's "bands"), or over a 
 wide surface. Adhesion between the amnion, chorion, and lining 
 membrane of the uterus, is then not only possible but probable, and 
 in this way the foetus is brought into a solid union with the maternal 
 organ. It can readily be understood that such an occurrence will 
 prove a very serious obstacle to birth, and greatly endanger the life of 
 the mother. 
 
 Eainard^ furnishes us with two observations, a writer in the 
 Veterinary Journal (" Nemo ")- with another, and Naylor^ with two. 
 
 Eainard justly remarks that veterinary surgeons should be aware 
 of the possibility of such adhesions, either with the placenta or the 
 envelopes, and, through them, with the 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 foetus, 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 adhesions are situated 
 towards the fundus of the organ — its most distant part, and where the 
 hand cannot reach, then there will be difficulty ; but this must be 
 overcome by raising the uterus and throwing it backwards, by elevating 
 the front part of the animal's body, and lifting the abdomen by means 
 of a plank, blanket, or sack. 
 
 Most frequently the adhesions can be broken up by the fingers ; but 
 if they are too strong, then a bistoury or other convenient instrument 
 will have to be employed. Their incision must be carefully made, and 
 the " crutch" or " repeller " (to be hereafter described) will be useful 
 in keeping the foetus away from the part where the separation is being 
 effected. The cutting should be done gradually and steadily, the point 
 of the instrument being kept at an equal distance between the foetus 
 and the mucous surface of the uterus. 
 
 In alluding to these internal adhesions, it may be observed that 
 some very rare cases are recorded, in which parturition was opposed 
 by external adhesions between the peritoneal covering of the uterus and 
 the sac of a hernia, or neighbouring viscera. 
 
 ^ Traite Complet de la Parturition, vol. i. , p. 461. 
 - Veterinary Journal, vol. iii., p. 262. 
 3 Veter'inarian, vol. xxiii., p. 324. 
 
OTHER CAUSES OF MATEJLXJL JJYSTOKIA. ^69 
 
 3. Stkictuke ok Occlusion of the Uterus by External Bands 
 
 OR Mkmhuanes. 
 
 A number of writers, especially in foreign periodicals, have described 
 the pi'esence of bands or membranes external to the uterus — either in 
 the peritoneal cavity or vagina — obstructing the passage of the ftctus 
 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 in the vagina, their division is the principal object, 
 after which, if no other obstacle is present, delivery can take place. 
 When, however, the uterus is constricted by an external abdominal 
 band — though this condition will be ditlicult to diagnose — then probably 
 no course can promise anything like a successful result except the 
 Ciesarian section. 
 
 4. Persistent 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 
 looks like, while it acts as, a valve {valvula vaijiiue) to that opening. 
 This membrane, which stretches across the passage and separates the 
 vulvar from the vaginal canal, is the analogue of the hymen of woman; 
 and, as in her, it may persist after the impregnation of piimiparas — 
 having escaped rupture during coitus — and becoming abnormally rigid, 
 may prove an impediment to birth in some instances, though it must 
 be confessed they appear to be exceedingly rare. 
 
 This cause of dystokia should be very much less frequently met with 
 in the Equine 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.^ 
 With the Bovine, Caprine, Ovine, and Porcine species, however, the 
 case is different, as the penis, from its volume and shape, is far less 
 likely 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 primipane. 
 
 It is just possible that in many animals of these species, the hymen 
 may be more or less intact until parturition sets in, when the foetus, in 
 its passage through the vagina, ruptures and effaces it without much 
 delay resulting, or any other cause which might attract attention. 
 
 But in others — few though they be — the membrane would appear to 
 
 ^ The hymen appears to be only exceptionally present io the Mare, though it is an 
 error to assume tli.'it it is always absent. Not only is it sometimes to be found, and 
 occasionally of large size and extr.iordinary tenacity, t)ut it may even become a source of 
 trouble in uniniprejjnated Mares. Of this we have an example by Mr. Thomson, of 
 Belch ( yeleriiiarian, vol. vii., p. 147). That veterinarian was called to see a young 
 Mare, said t<"i have inversion of the bladder. On his arrival, he saw protruding from 
 the vulva a membranous sac containing about a quart of Huid in its cavity. An exami- 
 nation proved the s.ac to be a simple membrane, extremely vascular and miich inflamed. 
 It was easily pushed hack into the vaginal cavity, wh^re it was found to be attached to 
 the posterior part of the urethra and all around the vaginal canal, so that the paHsage to 
 the OS uteri w.-va completely obstructed ; the membrane could not be pushed so far 
 forward as the cervix. On removing the hand, it again protruded whenever the Mare 
 made an effort. 
 
 In another instance — a year and a half old Filly — Mr. Thomson observed an intact 
 hymen — but there was a small opening in it — immediately behind the urethra. 
 
 24 
 
370 MATERNAL DYSTOKIA. 
 
 offer a rather serious amount of resistance to the expulsion of the young 
 creature, and demands the services of the obstetrist. 
 The cases recorded are exceedingly few. 
 
 Treatment. 
 
 The indications for treatment, when the hymen is present and an 
 obstacle to birth, are obvious : divide it at once. This division may be 
 made in the middle of the membrane, and does not demand any parti- 
 cular care or surgical knowledge ; though it is well to make a close 
 examination before the incision is made, in order to avoid making a 
 mistake should the membrane appear as a tumour. 
 
 5. Vaginal and Vulvae Constriction or Atresia. 
 
 Stenosis and atresia of the vulva and vagina have not infrequently 
 been recorded as either delaying, or altogether preventing, parturition 
 in animals, according as the obstruction was incomplete or complete. 
 
 This condition may exist previous to impregnation, but to such an 
 extent as to offer no obstacle whatever to that act ; or it may become 
 developed in the interval between impregnation and parturition. Of 
 course, if atresia is complete, and of such a character that the spermatic 
 particles cannot pass into the os uteri, impregnation will not take 
 place, and the animal remains sterile. 
 
 The condition may, therefore, be congenital or acquired. Incomplete 
 congenital stenosis of these passages is not at all uncommon in young 
 animals, in which the vulva and vagina are often so constricted and 
 inelastic, that during copulation they are injured, and this injury tends 
 still more to diminish their calibre and dilatability during pregnancy. 
 Congenital stenosis to a very abnormal degree may sometimes exist, 
 however, without any apparent traumatic influence. 
 I Acquired stenosis or atresia is generally the result of certain diseases 
 or injuries, such as inflammation, suppuration, ulceration, and lacera- 
 tion, often due to difficult parturition. These may lead to hypertrophy 
 and density of the tissues, hard resisting cicatrices, solid adhesions, 
 or partial or complete obliteration. 
 
 Malposition of the vulva may also lead to atresia. I witnessed a 
 case of this kind in an Arab Mare of high pedigree in Syria. The vulva 
 was partly below the ischial arch. 
 
 In primiparae, cases of abortion, in which birth occurs in a hurried 
 manner, as well as when the water-bag is ruptured too soon, or in those 
 breech presentations in which the hind legs are bent forward and only 
 the hocks ofier — in all these the narrowness of the vulva and vagina, 
 from lack of preparation, is often an obstacle to parturition, their 
 tissues being "hard." 
 
 But with patience and warm emollient injections, as well as careftil 
 and gradual manual dilatation, this obstacle may be overcome. When 
 birth is taking place too hurriedly, Eainard recommends closing the 
 animal's nostrils and opening its mouth, pulling out its tongue and 
 pressing on the loins to prevent its arching the back and straining. It 
 is very rare that the resistance is serious, and in the great majority of 
 cases birth occurs spontaneously, or with trifling assistance. 
 
 Some authorities, however, have met with instances in which it was 
 necessary to dilate the vulvar orifice by incision, in order to prevent this 
 part being lacerated, and to spare the animal pain and subsequent 
 deterioration. 
 
OTHER CAUSES OF MATERNAL DYSTOKIA. 371 
 
 When the dystokia is due to disease or a traumatic cause, birth is 
 more ditVicult ; and this difliculty is increased as the pathological altera- 
 tion is extensive. 
 
 Treatment. 
 
 Tlie treatment of stenosis of the vulva and vagina must be, of course, 
 surgical, and will vary according to the cause producing the constric- 
 tion. But it will chiefly consist in incisions carried to a depth and 
 extent commensurate with the exigencies of each case, and modified 
 according to the anatomy of the part which forms the seat of stricture. 
 It will be found that lateral incisions are, when they can possibly be 
 practised, preferable to those made either superiorly or inferiorly, as 
 they are less lil<ely to be followed by inconvenient alterations and un- 
 favourable consequences ; while, with regard to the vulva, the textures 
 at the sides of that orifice have more vitality, and therefore cicatrise 
 more rapidly than at the superior commissure. 
 
372 FCETAL DYSTOKIA. 
 
 BOOK 11. 
 
 FCETAL DYSTOKIA. 
 
 Though the obstacles to parturition offered by the maternal organs are 
 somewhat considerable in number, yet it is found in practice that those 
 due to the foetus are far more frequently met with, and are much more 
 numerous ; though all of them may not constitute real or serious 
 obstacles, some being easily removed or overcome, when birth takes 
 place without any difficulty. 
 
 The obstacles which the foetus may offer to birth are, for convenience 
 of study, divided into two natural groups, according as they result from 
 some physical condition of the young creature itself, or from the more 
 or less irregular manner in which it is presented at the pelvic inlet. 
 Each of these groups, again, it is needless to add, embraces a certain 
 number of varieties of obstacles ; but though grouped and classified in 
 this way, it must be remembered that difficult parturition due to the 
 foetus may not be owing exclusively to any one of these obstacles in 
 every case, but in some instances may result from a combination of two 
 or more of them 
 
 This combination, however, does not preclude us from studying them 
 separately ; indeed, their separate consideration is absolutely necessary, 
 as it is only by analysing them that we can realize their influence in hin- 
 dering birth, either when alone or combined. 
 
 As will be seen from the following synoptic table, the obstacles in the 
 first group are very numerous and varied, and require careful considera- 
 tion from the obstetrist — opening, as they do, a wide field for investiga- 
 tion and reflection, as well as practical deduction ; and none the less 
 so with those of the second group, to be dealt with hereafter. 
 
 Synoptic Table of Fcetal Dtstokias independent ob' Pbesentations 
 AND Positions. 
 
 ( Umbilical Cord. 
 Excess in Volume. 
 Excess in Growth of Hair. 
 Anomalies and Diseases of Membranes. 
 Abnormal Quantity of Placental Fluid. 
 
 'Hydrocephalus. 
 Ascites, Anasarca, and 
 Hydrothorax. 
 Diseases ■^ Emphysema. 
 Polysarcia. 
 Contractions. 
 Tumours. 
 
 Monstrosities. 
 ^Multiparity. 
 
 Dystokia from 
 
 GROUP I. 
 
 OBSTACLES INDEPENDENT OP PKESENTATIONS AND POSITIONS. 
 
 In this group, the maternal organs of generation and those parts imme- 
 diately concerned in parturition may be perfectly healthy, and the foetus 
 itself may be in a favourable position for expulsion ; yet birth is either 
 protracted or rendered impossible without assistance, because of the 
 umbilical cord, the excessive volume of the foetus, excess in growth of 
 
THE LMlilLICAL CORD AS AN OL'STACLE TO BIRTH. 37'5 
 
 hair, anomalies in or diseases of its enveloping membranes, an abnormal 
 quantity of placental fluid, anomalies in the umbilical cord, disease 
 or malformation of the young creature, or a plurality of foetuses in 
 animals ordinarily uniparous. 
 
 CHAPTER I. 
 
 Various Extraordinary Causes. 
 
 The Umiulical. Cohu as an Obstacle to Birth. 
 
 Akomalies in the umbilical cord are not a very common cause of 
 dystokia. 
 
 The cord may be unusually short ; but this deficiency does not appear 
 to operate prejudicially in parturition, as the natural twist in it admits 
 of its elongation to a certain extent, while during the act of expulsion 
 the walls of the body of the uterus approach the cervix as the fcctus 
 advances into the vagina. Even if the coi'd happened to be too short, 
 it is questionable whether it would constitute a serious obstacle to birth, 
 as it would most probably either rupture or the placenta would separate 
 from the uterus. 
 
 If by chance the foetus should not be expelled until it was discovered 
 that the cord was insufficiently long, this might easily be cut in the 
 vagina, as far as possible from the foetus, the ends being compressed by 
 the fingers and ligatured after deliver)'. 
 
 In the domestic animals the cord is never so long as to occasion 
 what has been designated in human obstetrics prolajjsus of the cord, i.e., 
 its descent into the os, vagina, or outside the vulva, after rupture of the 
 membranes, and alongside the presenting part of the child — an accident 
 attended sometimes with great danger to the latter, from compression 
 of the funis. 
 
 The comparatively short coi'd of the domestic animals also exempts 
 them to some extent from another frequent cause of difficult labour met 
 with in woman — -the coil'nvj of tlic funis around some part or parts of 
 the foetus. Nevertheless, this coiling has been obsers-ed in animals — 
 more often, perhaps, with the Mare than the Cow. Havon, Dclwart, 
 Hurtrel D'Arboval, Rueflf, and Sacchers have seen the cord coiled around 
 the neck, and more especially when the foetus was in a wrong position — 
 head bent towards the flanks, near the cord. Gaven has found it round 
 the loins ; and numerous observers have noted it encircling one or 
 more of the limbs. Remondeau found Hie cord round both hocks of 
 the fcctus in an Ass ; this formed a serious obstacle to birth, and em- 
 bryotomy had to be resorted to before delivery was effected. Daubenton 
 had remarked the frequency of leg coils in Sheep. 
 
 Coiling of the funis around any part of the foetus is not in itself a 
 common cause of dystokia, although it may render delivery protracted 
 and fatiguing. It is more likely to induce asphyxia in the young crea- 
 ture, from the stretching and diminished calibre of the bloodvessels 
 composing it, and consequent check to the flow of blood. 
 
 Rainard is of opinion that the obstacle to parturition from coiling is 
 less serious in the Mare and Carnivorous animals than other creatures, 
 because of the readiness with which the placenta is detached in them. 
 
374 F(ETAL DYSTOKIA. 
 
 The dangers of strangulation are also much less when the foetus 
 presents anteriorly ; when the presentation is posterior, there is risk of 
 suffocation, because it is difficult to ascertain the situation of the cord 
 in order to divide it ; and the uterine contractions, as well as the arti- 
 ficial traction, tend to tighten the funis around the neck. 
 
 In the human species, it has often been remarked that children are 
 sometimes born with their limbs deficient, and the spontaneous amputa- 
 tion has been attributed to the constriction produced by this coiling or 
 twisting of the umbilical cord around the part, during the development 
 of the foetus. Vrolig, Hillairet, and Goubaux have recorded similar 
 mutilations in animals. 
 
 Diagnosis. 
 
 There are so many causes of dystokia, that it is often a puzzhng 
 matter to ascertain that which is really in operation in some instances, 
 and this is one of them. When nothing can be discovered as likely 
 to hinder birth — neither narrowness of the passages, excessive size 
 of the foetus, malpresentation, or other obstacle — a careful examination 
 should be made of the umbilical cord, in order to ascertain whether 
 it is relaxed or tight, or encircling any part of the body. If it is 
 relaxed, then the obstacle must be sought in something else ; but if it 
 is in a state of tension, and especially if round the neck or limbs, then 
 to it may be ascribed the dystokia. 
 
 Indications. 
 
 When coiling of the funis is ascertained to be the cause of difficult 
 parturition, the indications are to uncoil it ; or if this cannot be effected, 
 then it must be divided either by the fingers, scissors, or a probe- 
 pointed bistoury — hastening delivery as much as possible afterwards. 
 There is not much to be feared from haemorrhage after section of the 
 vessels, as they seldom bleed. 
 
 But to avert danger from haemorrhage or asphyxia, delivery must be 
 delayed as little as possible. A ligature around the cord before birth will 
 certainly produce asphyxia very promptly. In order to prevent both of 
 these occurrences — asphyxia and haemorrhage — Saint-Cyr proposes to 
 pass a string around the umbilical cord, leaving its two ends outside the 
 vulva ; these are passed through the two holes at the end of a porte-cord, 
 one of them being fastened with a knot there, while the other is carried 
 through the ring at the handle. When the umbilical cord is about to be 
 cut, this instrument is pushed into the uterus close to the body of the 
 foetus, and the line being pulled tight, the vessel is divided on the 
 placental side. This checks haemorrhage, and delivery can be effected 
 without much, if any, hindrance from the porte-cord, which can be 
 held by an assistant, the string being tied firmly round the handle, if 
 need be. 
 
 Excess in Volume of the Fcetus. 
 
 Excess in volume of the foetus, due to normal or abnormal development 
 of either the whole or only part of its body, is far from constituting an 
 unfrequent cause of dystokia in the domestic animals — rendering 
 spontaneous birth more or less difficult or altogether impossible, not- 
 withstanding the healthy condition of the maternal organs, the regu- 
 
EXCESS IN VOLUME OF THE FCETUS. 375 
 
 larity and energy of the uterine contractions, and the favourable position 
 of the foetus. 
 
 Causes. 
 
 Several causes may be in operation to lead to excessive development 
 of the foetus — either wholly or partially. Among these we may cite the 
 following as the principal : 
 
 Prolonged Gestation. — It has been shown that the fcctus may be 
 retained without injury for several wrecks beyond the period usually 
 allotted for its expulsion, and there can be little doubt that during this 
 interval its development is continued. This extra-development being 
 unprovided for in the dimensions of the genital passages of the mother, 
 leads of course to protracted or difficult parturition. 
 
 There are instances recorded of the foetus of the Cow and Mare 
 weighing 117, 165, and 189 pounds. It may therefore be readily 
 understood that the greatly exaggerated volume which this weight 
 represents, must meet with much resistance in passing through a canal 
 that, in ordinary circumstances, gives exit to a foetus weighing from 
 56 to 80 pounds. 
 
 lieduced Number of Fivtuses. — With multiparous animals, when the 
 number of foetuses is smaller than usual — as with the Bitch which has 
 only one or two, instead of five or six — the excess of nutriment they 
 receive often increases their bulk to an abnormal degree ; and as almost 
 every breeder of dogs knows, this frequently leads to serious results in 
 parturition. 
 
 Disproportion in Size between the Male and Female. — There can bo 
 no doubt that a disproportion in size between the male and female, in 
 many instances, exerts a marked influence in this direction. More 
 especially is this the case in crossing with different breeds, or in attempt- 
 ing to breed from too young females. 
 
 Delorme, quoted by Rainard (vol. i., p. 474), says that he has known 
 a certain number of Camargue Ewes die every year through non- 
 delivery, they having been put to Dishley Rams, which were much larger 
 than the native Sheep. 
 
 The case of small Bitches crossed by large Dogs is familiar to all 
 dog-breeders. There appears, indeed, to be a natural tendency in some 
 small-sized Bitches to seek intercourse with Dogs much larger than 
 themselves, and this preference not infrequently leads to fatal conse- 
 quences in parturition. 
 
 But in many instances dystokia is due to exaggerated development 
 of some particular region of the fa-tus, and more especially of the 
 head — a peculiarity derived from crossing, or breeding from a male 
 possessing this character. Indeed, some authorities deny that cross- 
 ing small female animals with males which are generally larger, is 
 likely to prove a source of difficult parturition, provided there is nothing 
 unusual in the proportion of any region of the latter. It is pointed out 
 that, in the human species, small women are very often married to very 
 large men, and yet their accouchements are more or less easy. It has 
 also been remarked that Melingie, in order to form the breed of Sheep 
 known in France as the Charmoise, coupled the small Bcrrichonne Sheep 
 with the great New Kent Earns ; and yet in two thousand births only 
 one was diffictdt. 
 
 A German veterinary surgeon, Nathusius, mentioned by Rueff and 
 Baumeister, asserts that in the cross between the small Merino Sheep 
 
376 FCETAL DYSTOKIA. 
 
 with the huge EngHsh Earns, he has observed fewer difficult births 
 than in flocks composed solely of Merinos. And Saint-Cyr states that 
 he has often seen little "Bressanne" Mares, which were put to big 
 Percheron or Anglo-Norman Stallions, foal without difficulty at the 
 ordinary period. We might also adduce the small female Ass coupled 
 with the Horse-Stallion, and which rarely suffers during birth. Abor- 
 tion or premature birth may be more frequently the consequence of 
 such " mesalliances." 
 
 Though certain facts could be opposed to the above conclusions, yet 
 it must be admitted that the uniformly exaggerated development of the 
 foetus is not a very common cause of dystokia, and is, as a rule, only 
 so when the pelvis of the female is smaller than usual. So that we 
 must look rather to special conformation than exaggerated develop- 
 ment. And so far as conformation is concerned, we find that excessive 
 development of the croup, chest, or head have the principal influence. 
 
 With regard to the head, it is indisputable that of the three regions 
 this most frequently proves an obstacle to parturition. In the Bitch this 
 is most particularly remarked. But it is also noted in other animals. 
 
 Price, in his book on Sheep, mentions that a grazier in Appledore 
 employed Leicester Eams for several years, and obtained a breed with 
 very small heads and " kindly disposition "; but he did not approve of 
 them, because they were not sufficiently large, and did not fetch a good 
 price in the market. He therefore, in the summer of 1804, hired some 
 large Kentish Eams, in order to give size to his flock. In the following 
 lambing season, he lost twelve Ewes, from the immense size of the 
 lambs' heads, and he was obliged to "draw" (extract artificially) 
 nearly all his Ewe lambs. In 1806 he had the same difficulty, and 
 lost nine Ewes in a flock of two hundred and fifty, from this cause. 
 
 Mr. Cartwright (Whitchurch) casually states that he has frequently 
 known of some Bulls "getting Calves with very large heads, and 
 causing great difficulty in calving; and the owners, finding what trouble 
 there was at calving-time, and the danger of losing their Cows, have 
 sold them, and obtained others whose breed have not this objection." 
 
 Euelf and Baumeister,i in alluding to this subject, remark that in the 
 Bovine species it is nearly always the head which forms the chief 
 obstacle to birth ; and they refer for proof of this statement to the 
 small native Cows of Wurtemberg, which, when crossed by the original 
 Simmenthalern Bull, have often difficult labour, as the latter breed has 
 often a large head. 
 
 And Schaack writes to Saint-Cyr, stating that for thirty years the 
 Cows in the district of Lyons were all put to a Bull remarkable for its 
 massive framework. The head especially was very developed, and as 
 the animal transmitted this conformation to nearly the whole of its 
 progeny, the size of the head of the foetus very often rendered parturi- 
 tion difficult. 
 
 Breeding from immature undeveloped animals is almost certain to 
 produce laborious births ; and the reason for this is not difficult to find : 
 the genital canal, and particularly the pelvis, is not sufficiently de- 
 veloped for the passage of the foetus. A very striking instance of this, 
 as well as of very remarkable precocity in the Bovine species, is given 
 by Mr. Barker.2 
 
 Influence of Food. — There is no convincing proof before us that the 
 
 ^ Op. cit., p. 247. 
 
 ^ Veterinary Journal, vol. iii., p. 336. 
 
EXCESS IX VOLUME Of THE EO-JTCS. 377 
 
 manner of feeding or kind of food has much influence on pregnant 
 animals, so far as excessive volume of the fa3tus, and consequent difli- 
 cult parturition, is concerned. 
 
 Cox' says: "The size of the fo-tus depends considerably upon the 
 condition of the parent and the kind of food given to it. Fat animals, 
 and those emaciated from the continuous use of food of a ])oor nature 
 or insutVicient in quantity, bring forth a small foetus. Where the de- 
 bility is the result of pregnancy, and food has been given of a nutritious 
 character and in suthciency during that period, the fcEtus will be dis- 
 proportionately large, the extra nutriment having been diverted to its 
 growth. Green food, or ' depasturing,' causes the foetus to grow rapidly 
 and attain a gi-eat size ; but Nature compensates for this by giving with 
 such diet greater relaxation of the tissues of the dam, and an increase 
 of the placental fluids to lubricate and assist at delivery." 
 
 Diagnosis. 
 
 The diagnosis of excessive volume of the foetus is difficult, and can 
 only be established, as a rule, at parturition ; for we do not possess 
 any certain means of appreciating the dimensions of the fa'tus in iitcro 
 before its enveloping membranes have ruptured and the os is dilated. 
 An unusual size of the maternal abdomen towards the termination of 
 pregnancy, is an uncertain and very often a deceptive sign. 
 
 Nasse, a German veterinarian, imagined that 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-lifths dui'ing this period, the normal in- 
 crease being only one-third. But it is evident that an inordinate in- 
 crease in weight may be due to other causes than the foetus or fa}tuse3 
 — such as an unusual number of these, an excess of amniotic or allan- 
 toic fluid, gi-eater obesity of the Bitch, etc. Otherwise, if this test 
 could be applied to the 13itch with practical results, the conclusions 
 derived from it could not be made applicable to the other animals. 
 
 The only circumstance which might give rise to suspicion, is the pro- 
 longation of pregnancy beyond its ordinary period; though this suspicion, 
 as we have seen, will not always, nor yet very often, be confirmed. 
 
 It is only, then, at partm-ition that this obstacle on the part of the 
 foetus can be ascertained. If at this time, in spite of energetic and 
 sustained uterine contractions", labour is protracted and does not 
 advance, and if on exploration the pelvis and genital organs are found 
 to be well formed and normal, the os dilated, the foetus in a favourable 
 position and not malformed, it may be suspected that the obstacle to 
 birth is dependent on the large size of the latter. A closer examination 
 will probably confirm this suspicion. 
 
 With the Bitch, the principal obstacle, as has been already said, is 
 generally the head of the Puppy, which, when it is large, is lodged at 
 the entrance to the pelvic inlet, where it can be touched j^cf vaginani. 
 
 The common-bred Bitch, with muzzle more or less elongated, when 
 fecundated by a male of the same size and conformation, and bringing 
 forth from five to eight young, has usually no difficulty in pupping. 
 The tapering or conical form of the muzzle of the Puppies allows it to 
 enter the passage and pass easily through, under the influence of the 
 uterine and abdominal contractions. But when the Bitch is of small 
 size, and has been impregnated by a larger and young vigorous Dog, 
 ' Vft'^rinary Journal vol. i. , p. 265. 
 
378 FCETAL DYSTOKIA. 
 
 and especially if the muzzle of either or both of the parents is short 
 and the cranium brachycephalic — as in the King Charles Spaniels, 
 Pugs, and Bull-dogs — parturition is oftentimes extremely difficult, as 
 the forehead in these breeds is very large 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 the Coio, the head of the Calf may also be the chief impediment, 
 and provided the young creature is otherwise in .a favourable position, 
 the muffle may pass through the inlet, but the remainder of the head 
 remains fixed like a wedge in the long and almost undilatable bony 
 canal. The head is often so firmly wedged at this part that it can 
 scarcely, even with much force, be advanced or pushed forward, and 
 this "wedging" is always one of the most serious difficulties which 
 the obstetrist has to overcome. 
 
 With the Mare, the head of the Foal is smaller, longer, and more 
 tapering than that of the Calf, and meets with much less resistance in 
 passing through the comparatively short and wide canal. But as 
 Saint-Cyr points out, and as w^e have previously shown, in the Equine 
 and Bovine species the young creature finds more difficulty when the 
 anterior part of its body — chest and shoulders — begins to enter this 
 part ; and from their respective dimensions it is evident that, even 
 under ordinary conditions, the anterior region of the foetal trunk must 
 submit to a certain degree of diminution in order to pass the pelvic 
 inlet of the mother. 
 
 The limits within which this diminution is compatible 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 the young creature may be so exaggerated that sufficient 
 reduction cannot be effected to allow of its being born. 
 
 In some cases the head is so large that it can scarcely pass through 
 the pelvis of the mother ; but it is generally the thorax that forms the 
 greatest obstacle — especially in the Cow, and if it is to get 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 difficulty 
 may even be serious. 
 
 Prognosis. 
 
 In such cases as those we are now studying, in which birth is 
 delayed through undue development of the foetus, it generally happens 
 that the membranes have ruptured and the liquor amnii has 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 these are energetic, so does 
 it the more rapidly succumb. The mother, in turn, becomes exhausted 
 through unavailing 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 
 foetus, 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. 
 
KXOE^'S AV GPJJU'TII OF HAIR. 379 
 
 Indications. 
 
 The indications for the treatment of these cases arc similar to 
 those given for constricted or contracted pelvis: (1) Extraction of the 
 ftt'tus entire by manipulation; (2) Removal by embryotomy. 
 
 1. Extraction of the Fcvttts entire. — If the "waters" have escaped 
 for any length of time and the parts are dry and viscid, warm emollient 
 fluids — as linseed-tea— should be injected into the vagina, and if neces- 
 sary the portions of the foetus presenting may be lubricated with 
 glycerine, oil, unsalted lard, or any other lubricant. The hand should 
 then adjust the foetus, 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 be hereafter described, being employed as 
 occasion demands. 
 
 The degree of traction will depend upon the amount of resistance to 
 be overcome, it being carefully borne in mind that a medium degree of 
 force well directed is often more effective than severe traction mis- 
 directed and inopportune. 
 
 For this reason it is that a careful adjustment of the foetus should 
 be made before any force is resorted to, the " wedged " portions being 
 " eased" and well smeared. It not unfrequently happens that a very 
 trifling displacement of the foetus will allow it to pass gradually through 
 the pelvic canal, and lead to the successful termination of a case which 
 otherwise many would consider impossible to deliver. 
 
 2. Embryotomy. — When forcible extraction is deemed impossible, or 
 dangerous for the mother, and when the latter has ceased to aid in 
 expelling the foetus, then the only alternative is embryotomy, which, 
 entailing as it does the destruction of the progeny, yet affords 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 
 large head, this must be removed by decapitation ; then if the thorax 
 be 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- 
 after described, it must be crushed in every direction by forceps ; then, 
 if extraction cannot be effected, the Ciesarian section is the last resource. 
 
 Excess in Guowth of IIaijj, 
 
 The only instance of this cause of dystokia I can find is that recorded 
 by Eberhardt,' of Fulda, who found a Cow unable to calve, and on 
 examination discovered the fa-tus 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 
 of the vagina, and so great was it that the fu'tus could not be moved. 
 Having secured the fore-limbs and head by cords, Ebcrhardt smeared 
 his 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. 
 
 > Deutsche ZeiUchnflfur Thiermedicin und VergleichemU PcUhologie, 1877, p. 299. 
 
380 FCETAL DYSTOKIA. 
 
 Anomalies in, and Disease of, the Fcetal Membranes. 
 
 It is very rare indeed, so far as published observations are evidence, 
 that anomalies in, or disease of, the foetal membranes prove an obstacle 
 to birth. That they may sometimes do so, however, is evident from 
 what we have previously described. As Franck justly remarks, it is 
 not unlikely that the retention of the foetal membranes after birth is 
 due, in many cases, to inflammation of the placenta {i)lacsntitis). A 
 not unfrequent condition of the membranes is congestion of, or extra- 
 vasation into, the placenta, rupture of the capillaries [capillary 
 aiJoplexy), and haemorrhage between the placenta materna and placenta 
 uterina. Partial separation of the two placentaB is also not very un- 
 common in the Mare ; and metrorrhagia may be due, at times, to 
 2:)laccnta pravia. Such haemorrhage, when it occurs in the uterus (see 
 Fig. 53, p. 88), and the blood mixes with the uterine milk, gives rise 
 to a chocolate-coloured fluid between that organ and the foetal mem- 
 branes ; and in the asphyxia and intra-uterine respiration (pulmonary) 
 of the foetus, this reddish-coloured fluid is often present in the lungs. 
 
 Hartmann alludes to a case in which the chorion papillae 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 be surmised 
 that many abortions or foetal deaths are due to disease of the ]Dlacentae. 
 
 The foetal membranes may be too thick and resisting, or too thin 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 foetus may even be expelled in them. Such 
 tenacious membranes may, to a certain extent, 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 sufficient length of time, and therefore rupture before 
 the OS is sufficiently dilated. The consequent escape of the " waters " 
 will render labour longer and more difficult. The utero-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. 368 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 foetus only, as a cause of difficult labour. 
 
 These adhesions are generally of the nature of fibrinous bands passing 
 between the membranes, or from the surface of the young creature'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. 
 
 Eainard- 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 .Taliresbericht, 1861, p. 53. 
 - Op. cit., vol. i., p. 492. 
 
DISEASES OF THE F(ETUS. 381 
 
 the Cow some time previously, and, becoming fixed to the membranes, 
 formed an obstacle to birth. 
 
 Vincent describes a very interesting case, in which the skin covering 
 the joints of the first and second phalanges of the right fore-leg of the 
 fcctus had contracted close and strong adhesions with the envelopes, 
 and these with the uterine mucous membrane. These adhesions 
 opposed a serious obstacle to birth, which could not be accomplished 
 until they were broken up by the fingers. 
 
 Adhesion of the membranes 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. 
 
 Difficulty 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. 
 
 Abnormal 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 difficult, 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 liquor amnii, 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. 
 
 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 dillicult parturition. 
 These conditions may produce hydrocephalus, ascites and anasarca, 
 emphysema, polysarcia, muscular contractions, and tumours of various 
 kinds. 
 
 Hydrocephalus. 
 
 As the term implies, " hydrocephalus " signifies dropsy of the brain, 
 the dropsy being constituted by the accumulation of a more or less con- 
 
382 FiETAL DYSTOKIA. 
 
 siderable quantity of fluid in the cranium of the foetus, 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, through the accumulation of fluid in their 
 interior. 
 
 Pathological Anatomy. 
 
 This diseased condition is recognised by a more or less exaggerated 
 development or volume of the cranium, the vault of which has been 
 elevated and distended by the fluid collected in the brain ventricles. 
 
 In some cases the distention has been so slight that 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. 
 The hydrocephalic tumour varies in shape as well as in volume. It is 
 sometimes quite globular, and protrudes so high and so much over the 
 
 rig. 96. 
 Skull or a Hydrocephalic Calf : the Cranial Bones are partially 
 
 DESTROYED AND DEFECTIVE. 
 
 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 unfrequently 
 the diameter of such a tumour in the Calf measures more than a foot. 
 The tumour is soft and depressible in parts, hard 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 be 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 them vast fontanellge occupied 
 only by a thin translucid membrane — the dura 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 
 
H YDKOCEI'HA L I 'S. 
 
 883 
 
 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. 
 
 Fig. 97. 
 Skull or a Hydbockphalic Calk : the Roof oi- thk Cranium i.v abse.vt. 
 
 The tumour is always entirely covered by intact, though sometimes 
 Tery 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 really 
 so (Fig. 96). 
 
 Fig. 98. 
 
 Skull of a HrnRotErHALic Foal: the Cranial K<x)f i.i DEKicreNT 
 AT THK Sides. 
 
 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 the Foal and Calf. Eainard estimated the quantity of 
 fluid that had been contained in the skull of a Calf sent to him, at two 
 
384 
 
 F(ETAL 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 litres (about eight imperial pints). 
 
 Fig. 98 represents a Foal's skull, now in the museum of the Lyons 
 Veterinary 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 contain about twelve litres 
 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. Olver^ 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 
 
 Fig. 99. 
 Calf affected with Hydeockphalus : its Skull is kepresknted 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 fourteen 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. 
 " GiornaJt di Veteriaaria, 1873. 
 
msEASES i>F TlIK FiETL'S. 3S5 
 
 This accumulation of Huid takes place in the ventricles of the brain, 
 as has been ascertained from dissection by liainard, 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 
 thin 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. 
 
 Thou^'h this alteration, or rather destruction, of the brain is of so 
 serious a character, and thougii it must have be^'un at an early period 
 of uterine life, yet it does not appear to liave much influence on the 
 development of the fa'tus ; as tliis 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 hydrocephalic 
 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 
 
 Fig. 100. 
 
 EXTILVOKDINAKY DEVKLOPMKNT OK THK Ck.\MIM OK \ HyDKOCEPH.M.K' CaLF. 
 
 birth, and they may survive even longer if the dropsy is not very ex- 
 tensive. 
 
 \n the most favourable cases, nevertheless, there is little profit to be 
 expected 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 
 upon, the young creature becomes completely unconscious and lies in 
 convulsions. 
 
 Ver)- few cases of recovery, even in the mildest form of the malady, 
 are recorded. 
 
 The obstacle this congenital condition of the fcctus presents during 
 birth, must, of course, depend upon the volume of the cranial tumour. 
 The birth of a hydrocephalic fcetus often takes place spontaneously, 
 though perhaps only after much straining. If the cranium is not very 
 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 eves. When extremely 
 
 25 
 
386 FCETAL DY ST OKI A. 
 
 large, the cranium may offer an invincible obstacle to spontaneous 
 delivery, notwithstanding the most powerful labour pains. 
 
 And, iDesides, the mechanism of parturition in such cases varies with 
 the presentation — anterior or posterior. The head of the hydrocephalic 
 foetus 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 
 OS uteri. The head certainly commences the 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 vagina, the cervix uteri is 
 found to be contracted on the nose or jaws of the foetus ; and the delay 
 in further expulsion depends upon the size of the cranium, the pro- 
 trusion of the uterus into the pelvic cavity, and the exhaustion of the 
 organ by futile contractions. 
 
 In the posterior presentation, 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 foetus we have also a 
 malposition to complicate matters. 
 
 Diagnosis. 
 
 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 foetus, then it 
 is sometimes more difficult 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 difficulty is discovered and the cause sought for. 
 
 In such a case manual exploration is necessary, and this should be 
 effected, if possible, by passing the hand between the foetus and the 
 wall of the vagina. This is difficult if the body is still in the passage, 
 and it may be requisite to have recourse to traction to withdraw 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. 
 
 Indications. 
 
 The indications for treatment in cases of dystokia from hydrocephalus 
 alone, without reference to such a complication as malposition 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 
 
/J/\/;./.vA'.s- nf THE FCETOs. 387 
 
 Foals and Calves whose cnuiiuins were of large size and full of fluid, 
 have been delivered by this means, some of them alive, and in the pos- 
 terior as well as the anterior presentation. In such a case, supposing the 
 fore-feet present, these should be secured by cords, the ends of which 
 may be given to an assistant ; tiien the hand should be introduced into 
 the vagina, and if necessary the os should be dilated sulliciently to allow 
 of another cord being fastened on the upper, or, perhaps better, the 
 lower jaw, which is often wider. Traction can then be made during the 
 throes of the mother. 
 
 When, however, traction will not etl'ect delivery because of the size 
 of the head, and the mother is becoming exhausted, the cranium must 
 be punctured — an easy operation when the presentation is anterior, but 
 more ditVicult when it is posterior. 
 
 The puncture may be made by means of a bistoury, a scalpel or 
 ordinary knife, or, which is preferable, a somewhat large trocar and 
 cannula, curved if possible. The most fluctuating part of the tumour 
 should be penetrated, and the fluid having escajDed, the cranial parietes 
 collapse, or give way to pressure ; the head is thus greatly reduced in 
 size, and delivery can be completed. 
 
 Rainard recommends the puncture to be made on the side of the 
 cranium ; and should it be necessary to still further reduce the size of 
 this part by bone-forceps or other means, the side will be found most 
 suitable. In the posterior presentation, the back of the head may be 
 punctured, and the weight of the young creature's body, hanging 
 beyond the vulva, will sulliciently steady the head for tliis purpose ; 
 but in the anterior presentation, traction sliould be made by means of 
 the cords while tlie cranium is being opened. 
 
 Rainard informs us that C'onte, being called to assist a ^lare in foal- 
 ing, found a posterior presentation, and luiving diagnosed hydrocephalus, 
 he was able by version to convert it into an anterior presentation, when 
 the head was easily punctured. 
 
 Embryotomy has been recommended in such cases ; but beyond 
 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 tlie foetus. 
 Indeed, it will be found that, in ordinary cases, patience and judicious 
 manipulation will often enable the obstetrist to dispense with cranio- 
 tomy. 
 
 Ascites, Anasarca, and Hydrothorax. 
 
 "Ascites" (fluid in the abdominal cavity) and "Anasarca" (fluid 
 beneath tlie skin), either partial or complete, do not appear to be such 
 frequent diseases of the fcjctus as hydrocephalus, the cases recorded 
 being comparatively few. 
 
 Anasarca has been observed in the Foal, Calf, and Kid, and ascites 
 chiefly in the Calf. These pathological conditions have generally been 
 confounded. 
 
 With regard to ascites, it appears that in all the recorded observa- 
 tions, thefu'tus was in what we have designated the " natural presenta- 
 tion and position " ; though in some cases these were complicated — 
 the head being turned back on the left side or all the limbs presented 
 with the head. 
 
 Sometimes the fcetus has ceased to live before the full period of preg- 
 
388 
 
 FCETAL DYSTOKIA. 
 
 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. 
 
 AXASAECOUS FcETAL CaLF. 
 
 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 Calf. 
 
 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 
 ^ Rainard, op. cit., p. 476. 
 
■ DISEASES OF THE FCETUS. 381> 
 
 the abdomen of the Cows was so developed, that their owners thouj^ht 
 they were bearing' twin Calves. 
 
 Quetier has published details of analof^ous cases of general infiltration, 
 ill which the fa-tus was at least twice its natural size. 
 
 This condition has been witnessed in the fa3tus of the Mare by Pauli' 
 and Lehnhardc,'-' and by Ilerran'- in the Goat. The latter authority 
 made an autopsy of a Goat which had died from injuries intlicted on 
 its head, and found in it twin fcetuses, 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 hydricmia ; 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 fcetal 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 {Wasscrkdlbcr) 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 w'ith 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 difiiculty met with during delivery in these cases will 
 depend upon the quantity of fluid effused into the abdominal cavity, 
 chest, or sujjerticial 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 fa'tus : " 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 
 once 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 fa3tus 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 
 
 ' (iiirlt tintl Hertwig's Magazin, vol. viii. 
 
 - It'ifl., vol. ix. 
 
 ^ Journal di Vt'ft'rinnire du ^fidi, 1864. 
 
 * Handbuch dcr ThitriirzfUrhen Gcliurlshiilfe, p. 429. 
 
 * Traite T/tt'orcli'pte et Pratique de VArt dfn Arcouchem€nt!>, p. 659. 
 ^ Rainard, op. cit., p. 485. 
 
590 FCETAL DYSTOKIA. 
 
 was in the act of parturition. The foetus was in the natural position, 
 and the head and fore-limbs were external to the vulva. Strong 
 traction was employed to extract it, during which the abdomen 
 ruptured, and it was estimated that more than twenty litres of fluid 
 escaped. The Cow was in great danger for a month afterwards. 
 
 Diagnosis. 
 
 The nature of the obstacle can only be ascertained by vaginal or 
 uterine exploration, though an examination per rectum may assist in 
 leading to a correct diagnosis. 
 
 In vaginal exploration the great size of the abdomen in ascites, the 
 distention of its parietes, and the fluctuation on pressure, should reveal 
 the state of affairs. Not unfrequently, however, the body of the foetus 
 so completely blocks up the passage that it is impossible to pass the 
 hand, and it may be necessary to remove the protruding limbs by 
 embryotomy in order to diminish its volume. Hesitation in resorting 
 to this operation is usually unjustifiable, as the foetus is nearly always 
 dead, and if alive it cannot exist after birth. 
 
 It has been recommended, in addition, to remove the two first ribs 
 or divide them, in order to allow the hand to explore the interior of 
 the foetus. If the obstacle is due to ascites, the convex condition of 
 the diaphragm, and the fluctuation of the fluid on the abdominal side 
 of it, will be remarked. 
 
 When the dystokia is owing to anasarca, this will be distinguished 
 by the general roundness of the surface of the body, owing to the 
 presence of the subcutaneous fluid — which effaces all the prominences, 
 and to the oedematous sensation communicated to the fingers by 
 pressure. 
 
 Indications. 
 
 When the condition of the foetus is once ascertained, the principal 
 indication, if delivery by traction cannot be effected, is to diminish its 
 volume by producing the evacuation of the fluid which distends it, as 
 promptly and effectually as possible. 
 
 In ascites, puncture of the abdomen through the parietes of that 
 cavity, if they can be reached, or puncturing the diaphragm through 
 the chest, if they cannot, must be practised. In the first, a bistoury 
 or anjr kind of convenient knife, or a trocar, will suffice ; in the second, 
 a long trocar or long-bladed knife, wrapped round with tow to near the 
 point, will answer the same purpose ; or if the hand can be introduced 
 into the thorax, the fingers alone will rupture the diaphragm. As the 
 fluid escapes, the abdomen collapses, and delivery is then easy. 
 
 When anasarca is present, the fluid must be got rid of by deep 
 incisions through the skin wherever the hand can reach. The 
 mechanical extraction of the foetus should then be easy. In a case 
 reported by Anacker,i however, the foetus was so large that it had to 
 be removed by gastro-hysterotomy. 
 
 An extremely rare cause of dystokia is due to congenital occlusion of 
 the urachus, which leads to great accumulation of urine in the bladder, 
 and consequent distention of the abdomen. A very good example is 
 given in the yearly report of the Veterinary School of Hanover for 1872. 
 
 This condition will be diagnosed in the same way as ascites, and the 
 same indications for extraction of the foetus are to be observed. 
 ^ Der Thierarzt, 1868, p. 85. 
 
DISEASES OF THE FCETVS. 3SU 
 
 EmI'HYSKMA. 
 
 Emphysema of the foetus is sometimes found to be a cause of dystokia. 
 Leconte mentions that he lias met witli a case in which a living fcotus 
 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 fa»tus has perished in the uterus. It sometimes 
 happens that during parturition the " water-hag " is ruptured before 
 the young creature has made sulVicient progress, or it may be in a bad 
 position. Tiie 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 whicli tlie fa'tus 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 crejiitates 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 fcetal membranes, and particularly 
 in the anmion. 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 
 flame 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 dimness 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 fa>tus 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 nmst be corrected. 
 
 Should mechanical extraction fail, then embryotomy must be prac- 
 tised. After the foetus has been removed, thorough cleansing of the 
 uterus will be necessary. 
 
 In these cases, the practitioner should take every precaution against 
 danger to himself, as serious, even fatal, consequences have resulted 
 from putrid infection. Tlie hand and arm should be well smeared with 
 lard, and thorough ablution ought to be practised immediately after the 
 operation is over. 
 
 POLVS.VUtl.V. 
 
 German authors only, so far as I can ascertain, make mention of 
 this condition, in which there are abnormal accumulations of adipose 
 ' OxornaU di Vtterinaria Pracdca, 1859. 
 
392 
 
 F(ETAL DYSTOKIA. 
 
 matter in the subcutaneous connective tissue ; so that at birth these fat 
 deposits often cause the Calf to weigh more than a hundredweight. Such 
 foetuses are designated in Germany " lard Calves " {Speck-kdlber). - 
 
 Indications. 
 
 The indications for the extraction of these lardaceous Calves are, as 
 might be presumed, tlie same as those for over-developed foetuses in 
 general. 
 
 CONTEACTIONS, 
 
 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 
 
 Fig. 103. 
 
 Deformed Head and Neck of a Foal, due to Contraction and Pkes.sure in 
 
 THE Uterus. 
 
 deform the part they are attached to, and prevent its assuming its 
 natural position. 
 
 This state of contraction and rigidity only takes place slowly and 
 progressively, and it chiefly, though not exclusively, affects the muscles 
 of the neck and fore-limbs, giving these a vicious direction which it is 
 very difficult to change, and whicli at parturition may become a rather 
 troublesome cause of dystokia. 
 
 The causes of these deviations, which bring about actual alterations 
 in 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 them- 
 selves. Eainard 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 
 
JUSK.tSKS nj- Tilt: F'KTrs. 3!t3 
 
 matters, the residue of fibrous provender. He also considered it 
 possible that it might be of a convulsive kind, owing to disease of the 
 nerve centres. 
 
 When the neck is affected, it is bent round to the side, the nose 
 being buried in the Hank, or even resting on the hind quarters of the 
 faHus ; and so rigidly is it curved, that not only does it resist all 
 attempts to straighten it in the uterus, but even when extracted and 
 the foetus is dead, tlie neck cannot be made to assume a rectilinear 
 direction. 
 
 The period of gestation at which this deviation occurs is, of course, 
 dinicult to arrive at ; but Kainard and Saint-C'yr are of opinion that it 
 takes place early, as the bones of the head and neck are more or less 
 deformed in some cases (Fig. 103), the head being more especially dis- 
 torted and curved laterally, and moulded, so to speak, to tlie parts on 
 which it has rested during intra-uterine existence. 
 
 This distortion appears to be more frequent in Solipeds, the neck of 
 which is longer than that of Ruminants or other domestic animals ; 
 and according to French writers, it appears to be more common in 
 some localities than others, and to be frequent in certain years — par- 
 ticularly in those of scarcity or bad forage. Houssard reported that 
 in Franche-Comte he had seen the majority of brood Mares abort near 
 tlie termination of pregnancy, or experience great difficulty in foaling, 
 from this abnormal distortion of the neck. Courjon, another veterinary 
 surgeon practising at Mey/.ieux, Isere, has remarked on the frequency 
 of this accident under the influence, it was presumed, of the same 
 causes. Schaack informed Saint-Cyr, that in his long experience he 
 had met with several cases of this kind, one of which was in a Calf 
 that lived, notwithstanding the deformity. 
 
 Contraction of the limbs also appears to be more frequent in Foals 
 than Calves, and varies in degree : from slight bending at the knees — 
 which generally more or less disappears after birth, and as the animal 
 acquires strength — to extreme flexion ; so that ligaments must be 
 ruptured, and perhaps bones broken, before the distortion can be cor- 
 rected. The accident is alluded to by Favre,' Gaven,-' Lemaire, ' Verct,* 
 and Cartwright.^ 
 
 Indications. 
 
 The indications for delivery are the same as those which will be 
 given for extraction of the fcctus in malposition of the limbs and 
 head. 
 
 Not infrequently recourse must be had to embryotomy ; and tlie 
 limbs more particularly require attention in this operation, as l)y divid- 
 ing the muscles, tendons, or ligaments of those which are contracted, 
 they may be straightened and delivery effected. A careful examination 
 should be made of the presenting limbs in all cases in which they are 
 found to be flexed, in order to discover whether the joints are movable ; 
 and gi-eat care ought to be exercised in using traction before they are 
 straightened or removed by the knife ; as rupture of the uterus, or 
 severe laceration of the other soft parts, may be the result. 
 
 ' La V^lifrinaire Campagnard, p. 290. 
 
 - JouriuU d* Mil/. I'r'frinnirf, 1850, p. 201. 
 
 * Jfi-cueil (if Mill. Velirinaire, 1856, p. 444. 
 
 * Ihid., 1837, p. 289. 
 
 •• 77(6 Vtttriuarinn, vol. xvi., p. 4S7 ; vol. x.x., p. ZQ^. 
 
394 F(ETAL DY ST OKI A. 
 
 Tumours. 
 
 Tumours of various kinds, situated either externally or internally, 
 may prove an obstacle to birth ; though the cases recorded are very 
 few. Some of the former are cj'sts which, in some instances, may be 
 looked upon as due to a second undeveloped ovum which has grafted 
 itself on the foetus (Fig. 121). Hygromata are not very uncommon, and 
 some of these are often ruptured during birth. Sometimes the tumours 
 are fibro-adipose ; in other instances they have been distended cavities — 
 as the guttural pouches ; and even scrofulous tumours have been 
 described. 
 
 Indications. 
 
 The indications will depend upon circumstances. Puncturing the 
 tumour if it contains fluid, removing it if it be accessible and solid, and 
 embryotomy if neither of these operations is likely to be successful, are 
 the only measures which can be recommended. 
 
 Death. 
 
 Many practitioners are of opinion that the death of the foetus renders 
 parturition difficult. In certain circumstances it may do so, but, as a 
 rule, provided the creature is in a proper position and perfectly developed, 
 its death has but little influence on this act. We have already alluded 
 to the death of the foetus at p. 259. 
 
 CHAPTEE III. 
 Monstrosities. 
 
 The designation " Monster," " Monstrosity," or Lusus Natures (French, 
 Monstre, Monstruosite ; German, Missgeburt ; Italian, Mostro ; Spanish, 
 MonstriLo), is generally applied to a creatui'e which exhibits some vice 
 in conformation — some remarkable anomaly or organic deviation in form 
 or structure, or both, in one or more parts of its body. 
 
 Monstrosities have been conveniently divided into two kinds — those 
 which are anatomically so, and those which are so by reason of their 
 vicious conformation. The first present no modifications externally, and 
 there is no disturbance of function, but merely a change in the number 
 or position of certain organs — a change only discoverable by post- 
 viortem examination. The second includes those defects or deformities 
 which more or less seriously impair the value of the young creature, 
 either by destroying the symmetry of its shape, or rendering it more or 
 less useless by the absence or incompleteness of certain organs. 
 
 The term " monstrosity," however, is usually reserved for a creature 
 which presents the most serious kind of organic alterations, and which 
 involve one or more organs — external or internal — these being modified 
 in form, structure, and relations. In this class we may have a de- 
 ficiency in one or more limbs, head, part of the head or trunk, or fusion 
 more or less incomplete of two or more individuals, etc. 
 
 It must be admitted, however, that the limits between these groups 
 of anomalies or organic deviations are not well defined, and that they 
 merge into each other imperceptibly ; so that it is not always possible 
 to say where the one class ends and the other begins, and we can only 
 fix upon the types of each of these artificial groups. 
 
MOXii TJiOSl TIKS. :5i>r. 
 
 In ancient times the appearance of monstrosities were ascribed to the 
 influence of enraj^ed j:jods, and they were regarded with fear or horror ; 
 or they were looked upon as prodigies or freaks of Nature, and 
 described as marvels or curiosities. 
 
 Indeed, it was not until the end of the last and commencement of 
 this century that they began to be studied in a scientific spirit, and 
 their anomalies shown to be only simple modifications or irregularities 
 in the development of organs. Haller and Meckel commenced this new 
 era, but it was not until the philosophical study of this subject had 
 been pursued by Etienne and Isidore Geoffroy Saint-IIilaire, that the 
 science of Teratologji was founded on a true basis. Then it was clearly 
 demonstrated that monstrosities themselves do not escape the general 
 laws of organisation, but own their sway and prove their universality, 
 and that Nature, in its widest divergencies, never ceases to be faithful 
 to the decrees which the Creator imposed upon it at the commence- 
 ment. 
 
 In 1827, E. G. Saint-Hilaire proposed a scientific classification of 
 monstrosities — those beings which had hitherto been looked upon as 
 combinations of different characters or individuals ; and on this basis 
 was raised the science of Teratology by his son Isidore. The labours 
 of these men have been largely su])i)lemented by the researches of such 
 authorities as Meckel, Gurlt, Otto, Jiischoff, Leyh, ]Martin-Saint-Ange, 
 Forster, Dareste, Panum, Lombardini, and others. Tbe labours of 
 these investigators are unknown to English veterinary literature — 
 indeed, the entire subject is nowhere mentioned } it will, therefore, be 
 our duty to notice it somewhat fully, not only from its novelty in this 
 respect, but also from its importance in a physiological and obstet- 
 rical point of view. 
 
 Classification, 
 
 Various classifications of monstrosities have been proposed at diiTerent 
 times by investigators, who generally based tlieir classification either 
 on the notions they entertained as to the mode of formation of these 
 creatures, or on some physical peculiarity presented in their organisa- 
 tion. ButTon divided them into three classes — 1, monstrosities by 
 excess; 2, monstrosities by defect ; 3, monstrosities by irregularity in 
 structure or situation of parts. To these classes Meckel added a fourth, 
 which included tlie herma))hrodites. Martin-Saint-Ange divided tliem 
 into: 1, monsters by excess, comprising the union of several fcetuses — 
 double monsters, in fact ; '2, monsters by excess of growth ; 3, monsters 
 by absence of one or more parts ; 1, monsters by general defect, as 
 dwarfs : 5, hermaphrodite monsters. 
 
 The two classifications which have generally been adopted by Conti- 
 nental veterinarians are those of Gurlt and GeolTroy Saint-Hilaire : that 
 of the former — the eminent Berlin veterinai-y professor — being preferred 
 by the Germans, Italians, Dutch, and Danish, and that of the latter by 
 the French. 
 
 Gurlt's classification and nomenclature are good and explicit, and in 
 some respects to be preferred to Saint-IIilaire's ; wliile tliose of the 
 latter offer advantages which might lead us to give them the prefer- 
 ence, apart from the fact that it is they on which the science was 
 based. 
 
 ' A monstrosity is generally only alluded to &» such, or a-* a Luxtu Xalnra ; a scientific 
 classification has not been attempted in this country. 
 
396 F(ETAL BFSTOKIJ. 
 
 Guiiti arranges monstrosities into two classes — Simple and Covi- 
 poiuid. The first comprises eight orders, twenty-six genera, and 
 seventy-three species ; the second includes six orders, twenty-six 
 genera, and fifty-nine species. 
 
 As some veterinarians may prefer Gurlt's classification to that of 
 Saint-Hilaire, and particularly for its practical utility, we give it here : 
 
 CLASS I. 
 
 SIMPLE MONSTROSITIES. 
 
 This class is occupied with a single individual, and refers to an 
 absence of or addition to parts, exaggeration of them, or alteration in 
 their form or position. It comprises 8 Oedees, 26 Geneea, and 73 
 Species. 
 
 OEDER I. — Simple Monsteosities theough Absence of Paets : — 
 
 1. Amoephus. — Absence of conformation ; 1 species : A. globosus. 
 
 2. AcEPHALus. — Headless ; 2 species : A. unipes, A. hipes. 
 
 3. Peeocephalus. — Head defective ; 7 species ; P. j^seudocephalus 
 (apparently without a head), P. aprosopus (head without a face), 
 P. microcephalus (small head), P. agnatkiis (head without a jaw). 
 Varieties : a, P. cKjnathus hjpostomus (mouth a longitudinal fissure 
 beneath the ordinary situation) : h, P. agnathus microstomus (small 
 mouth) : c, P. agnathus astomus (without a mouth), P. bracJu/rhynchus 
 (short face or nose), P. anomatus (without eyes), P. aotus (without ears). 
 
 4. Peeoso:\ius. — The whole of the body defective; 4 species: P. 
 liemiccplialicus (body defective and head absent), P. horridus (horrid 
 deformity), P. elumbis (loins absent), P. pscudoscelus (body defective, 
 with posterior limbs incomplete). 
 
 5. Peeocoemus. — Trunk defective ; 3 species : P. oligospond^jlus 
 (defective vertebrae), P. ecaudatus (without tail), P. anacdoca (without 
 external generative organs). 
 
 6. Peeomelus. — Limbs defective ; 6 species : P. apus (vrithout 
 limbs), P. acliirus (without anterior limbs), P. monocliirus (with only 
 one anterior limb), P. ascehis (without posterior limbs), P. monocelus 
 (with only one posterior limb), F. micromclus (liinhs shortened); with 
 the varieties, P. micromclus microchirus (anterior limb short), P. micro- 
 mclus microscclus (posterior limb short). 
 
 ORDER II, — Simple Monsteosities theough Smallness of 
 Paets: — 
 
 7. Nanosomus. — Limbs and trunk small — dwarf; 2 species: N. 
 pygmaus (short and low, but without disproportion of parts), N. caticeps 
 (cat-faced dwarf). 
 
 8. Nanocephalus. — Small head ; 8 species : N.micromatus (eyes too 
 small), N. brachyotus (ears too short), N. bracliygnotus (lower jaw too 
 short). 
 
 9. Nanocoemus. — Short trunk ; 2 species : N. rectus (vertebral 
 column straight, but very short), N. curvatus (vertebral column short, 
 and curved to one side.) 
 
 10. Nanomelus. — Limbs short ; 5 species : K. brevipcs (all the limbs 
 
 1 Pathologische Avatomie, Berlin, 1883. Article: " Missbildungen." Also Ueber 
 Thierische jMissijebiirten, Berlin, 1877. 
 
.VOXSTEOSI TIHS. 897 
 
 short), N. brachychirus (anterior limbs too short), N. cavipylochirus 
 (anterior limbs short and crooked), iV. chiroptcrus (anterior limbs short, 
 with cutaneous folds resembling wings), N. cowpylosceius (posterior 
 limbs short and crooked). 
 
 ORDER III. — Simple Monstkositiks through Aunokmal Division 
 OF THK Body : — 
 
 11. ScHisTOCKTHALUs. — DivisioH of the head ; 5 species : S. hcmi- 
 cephalus (cleft in the middle); with the varieties : a, S. hcmiccphalus 
 partialis, or hydrenccphalocclc (partial hernia of the brain, with liydro- 
 cephalus) ; b, S. hcviiccphalns totalis (absence cf all the cranium) ; 
 <;, S. hcmiceplialns complicatus (cleft cranium, face defective) ; S. bifidns 
 (face divided), ^'. fissipalatinus or rictus liqnmis (cleft palate), S. fissi- 
 labrus or labium Icporinum (cleft or hare lip), S. mcgalostomus (wide 
 mouth). 
 
 12. ScHisTOCORMUs. — Divided trunk; G species: S. fissicoll is {neck 
 cleft), S. fissistcrnalis (sternum divided), .S. schistcpiqastrico-sternalis 
 (division of the sternum and anterior portion of the abdomen), S. cxom- 
 phalus (divided umbilicus), S. fissiventralis (the whole of the abdomen 
 divided), S. fissispinalis or spina bifida (division of the spinal column). 
 
 13. ScHisTosoMUs. — Division of the head and trunk; 3 species: .S'. 
 rctlcxus (division of the body and iiivei'sion of the spinal column), S. 
 contortus (division of the body and torsion of the vertebral column), 
 S. microchirus (division of the body and anterior limbs shortened). 
 
 14. Schistomelus. — Cleft limbs ; 2 species : S. fissimanus (division 
 of the anterior limbs), .S'. fissungulus (division of the phalanges). 
 
 ORDER IV. — Simple Monstkositiks thuouchi Absence of the 
 Natuiul Division of Pauts : — 
 
 15. Atretocephalus. — Absence of openings in the head ; 1 species : 
 A. astomus (mouth absent). 
 
 16. Atretocoumus. — Absence of the natural apertures in the body ; 
 2 species : .-1. aproctus (anus absent), A. anurcthra (uretlira absent). 
 
 17. Aschistodactyhs. — Phalanges undivided ; 1 species : .1. solid- 
 Htojnlus (absence of division of the phalanges and claws in those animals 
 which usually have them divided). 
 
 ORDER V. — Simple Monstrosities throucih Fusion or Coali- 
 tion OF OudANS : — 
 
 IH. Cyclops or Monophthalmus. — One eye in the middle of the 
 face, and a proboscis in addition ; 3 species : C. mcgalostomus (large 
 mouth), of which there are two varieties ; a, C. mcgalostomics rhyn- 
 chfenus (large mouth and probosyi^ ; b, C. vicgalostomus arhynchus 
 (largo mouth, but no proboscis) AC. prostotuus (irregular mouth), in 
 which are two varieties : a, C. prostomus arhynchus (irregular mouth 
 and no nose) ; b, C. prostomus rhynch<pnus (irregular mouth and nose) ; 
 C. astomus (without mouth), with two varieties : a, C. astomus arhytv- 
 chus (mouth and nose absent) ; b, C. astomus rhynchanus (proboscis 
 present, but mouth absent). 
 
 ORDER VI. — Simple Monstrosities through Abnormal Position 
 AND Form of Parts : — 
 
 19. Campylorrhinus. — Curvature of the nose ; 1 species ; C. lateralis 
 (lateral curvature of the nose). 
 
398 FCETAL LYSTOKIA. 
 
 20. Camyloerhacchis. — Curvature of the vertebral column ; 2 
 species : C. scoliosa (lateral curvature of the spine), C. contorta (torsion 
 of the spine). 
 
 OEDEE VII. — Simple Monstrosities through Excess in Forma- 
 tion : — 
 
 21. Megalocephalus. — Head abnormally large ; 2 species : M. 
 hydrencc]_)halas (with hydrocephalus), M. polycerus (head with large 
 horns). 
 
 22. DiPHALLus. — Double penis ; 1 species : D. imperfectus (double 
 penis, incomplete). 
 
 23. Megalomelus. — Limbs with supernumerary parts ; 1 species : 
 M. ■perissodactylus (with supernumerary digits). 
 
 OEDEE VIII. — Hermaphrodites : — 
 
 24. Heemaphroditus. — Double sex, with predominance of organs 
 belonging to one sex ; 2 species : H. lateralis (genital organs to one 
 side), in which there are two varieties : a, H. lateralis masculinus (with 
 predominance of the male organs) ; b, H. lateralis femininus (with pre- y 
 dominance of the female organs) ; H. transversalis (the external genera- 'J 
 tive organs belonging to one sex, and the internal to the opposite sex), 
 including two varieties : a, H. transversalis masculinus (external genital 
 organs male, internal female) ; b, H. transversalis femininus (external 
 genital organs feminine, internal male — often imperfect). 
 
 25. PsEUDO - hermaphroditus. — False hermaphrodites ; 4 species : 
 P. megalomastJius (male with large mammge), P. microphallus (penis un- 
 usually small), P. hypospadiatus (with the urethra divided inferiorly), 
 P. femininus (false feminine hermaphrodite). 
 
 26. Androgynus. — Double hermaphrodites, the male and female 
 organs existing in a single individual, one sex being incomplete and the 
 other predominating ; 2 species : A. masculinus (the external organs are 
 masculine, with a small penis, the internal organs being male and 
 female — though the one set is more complete than the other), A. femi- 
 ninus (the external organs are feminine, with abnormally large clitoris, 
 the internal being male and female, with predominance of the one over 
 the other). 
 
 CLASS 11. 
 
 TREBLE AND 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 Orders, 26 Genera, and 59 Species. 
 
 OEDEE I. — Trigeminal Monstrosities, in which are united one 
 
 OR MORE PARTS OR ORGANS OF THREE INDIVIDUALS : 
 
 1. Cephalotridymus. — Three heads united to a single trunk ; 
 1 species : G. unicorporeus (with a single body). 
 
 2. CoRBiOTRiDYMUS. — Posterior part of the trunk triplicate, with more 
 than four limbs ; 1 species : G. tricaudatus (three croups with three tails, 
 but only one anus and four posterior limbs). 
 
 3. Meloteidymus. — Posterior part of the body double, and more than 
 eight limbs ; 1 species : M. dccapus (ten limbs of unequal length). 
 
MONSTROSITIES. ;J99 
 
 4. SoMATOTRiDYMUS. — Triple body ; 1 species : .S". slenialia (three 
 chests united). 
 
 ORDER II. — MoNSTiiUs with Two nE.\Ds — Cephaluilidi/ini: — 
 
 5. Diruosopus. — Double face ; 3 species : D. scjunctus (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 monostomus 
 (a mouth in one face only); c, D. distoma hemicephalicus (without a 
 cranium); D. conjunctns (two faces united,) has two varieties : a,D.con- 
 junctus distomus (double mouths); b, D. conjunctns monostomus (with 
 one mouth). 
 
 6. MoNoc'KANLS. — Single crauiuui ; 4 species: iV. 7;ieso{7na/«s (the lower 
 jaw included in or united to the other from the commencement of the 
 branches), M. di'/natus (lower jaw double), M. hcteroprosopus (diverse 
 faces), M. bimandibularis (upper jaw double). 
 
 7. Hetekocei'halus. — Double heads, one of which is complete, the 
 other very incomplete ; 2 species : //. interpositus (between the two 
 branches of the lower jaw of the complete head is interposed the lower 
 jaw of the incomplete one), //, 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 TUUNK 
 
 WHOLLY OK I'AKTIALLY DoUBLE : — 
 
 8. DicEi'HALUs.— Two separate heads; 7 species: D. biatlanticus 
 (double head and two atlases), D. suhbicollis (double head with appar- 
 ently two necks), I), bicollis (double head and two necks), with two 
 varieties : D. bicollis omoceplialus (both heads alike), D. bicollis hetcro- 
 cephalus (one head perfect, the other imperfect) ; D. subbidorsiialis 
 (double head, with apparently a double back), D. bidorsualis (double 
 head with double back), J), bilumbis (double head and double loins), 
 D. bispinalis (double head and vertebral column), has two varieties : a, 
 D. bispinalis quadrupcs (with four limbs); b,D. bispinalis acliirus (with- 
 out anterior limbs). 
 
 9. DicHANUs. — Double cranium ; 1 species : D. bisjyinalis (cranium and 
 vertebral colunm double). 
 
 ORDER IV. — Monstrosities with a Single Head, hut the 
 Trunk or Limhs more or less completely Douhle — 
 
 Cormo-nielodidi/mi : — 
 
 10. DiPYGUs. — Double croups ; 3 species : D. bidorsualis (double croup 
 and back), D. subbidorsualis (double croup, with half the back doubled), 
 D. bilutnbis (croup and loins doubled;, containing two varieties: a, i). 
 bilumbus teleoccplialus (with head regular) ; b, D. bilumbis cacoccpJialus 
 (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 attached to some part of its fellow ; 3 species : II. octipcs 
 (with eight feet), containing two varieties : a, II. octipcs cmprosthochiro- 
 pliorus {the anterior limbs of the parasitic twin situated in front) ; b, II. 
 octipcs plcurochirophorus (the anterior limbs of the parasitic twin situ- 
 ated at the side) ; //. tctrasulus (with four posterior extremities), also 
 containing two varieties : a, II. tctrasulus monopygus (with one croup) ; 
 
400 FCETAL DY ST OKI A. 
 
 b, H. tetrasulns dipygus (with a double croup) ; H. triscekis (with three 
 posterior Hmbs). 
 
 OEDEE V. — Monstrosities w^th a Single Head and Tkunk, and 
 MOKE THAN FouB LiMBS — Melocliclymi: — 
 
 12. — Opisthomelophokus. — An animal regularly formed, but which 
 bears on its back or croup a supernumerary limb or limbs ; 3 species : 
 O. trichirus (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. trichims (with an 
 anterior limb on the thorax), E. tetrachirus (with two anterior limbs on 
 the neck), E. triscchis (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. octipes (with four limbs on the side), 
 P. tetracliirus (with two anterior limbs on the side), P. trichirus (with 
 an anterior supernumerary limb), P. triscclus (with a posterior super- 
 numerary limb). 
 
 OEDEE VI. — Monstrosities with the Head, Trunk, and Limbs 
 MORE OR less COMPLETELY DouBLE — Somatodiclymi :— 
 
 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. quadriauritus 
 monoprosopus (with a perfect face) ; b, 0. quadriauritus aprosopus (face 
 absent) ; 0. biauritus (eight limbs and two ears), 0. synapheocephahis 
 (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- 
 cephalus (four posterior limbs, and heads united), T. bifacialis (four 
 posterior limbs, and the two faces separate). 
 
 18. Gastkodidymus. — Twins united at the abdomen ; 3 species : 
 G. quadrupes (twins united at the abdomen, and furnished with four 
 limbs), G. tetrachirus (with four anterior limbs), G. octipes (with eight 
 hmbs). 
 
 19. Gastro-Thoracodidymus. — Twins united at the thorax and abdo- 
 men ; 1 species : G. thoracodidymus octipes (with eight limbs). 
 
 20. Epigastkodidymus.- — Twins united at the thorax and epigastrium ; 
 1 species : G. octipes (wdth eight limbs). 
 
 21. Thoracodidymus. — Twins united at the thorax; 1 species: 
 T. octipes (with eight limbs). 
 
 22. Schelodidymus. — Twins united at the posterior extremities ; 
 1 species : S. hcptamelus (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 uaited at the pelvis; 1 species: /. ex- 
 avielus (with six limbs, four anterior and two posterior). 
 
 24. Omphalo-Chronodidymus. — Twins united at the umbilicus and 
 the head ; 1 species : 0. disomatus (the bodies separate). 
 
MONSTROSITIES. 401 
 
 25. Pygodidymus. — Twins united at the croup ; 1 species : P. averstin 
 (bodies united at the ischia and sometimes at the buttock, and in 
 opposite directions). 
 
 26. CuYi'TODiuYMUs. — Inclusiou of one twin within the other ; 
 2 species: C. abdoininalis (twin included in the abdomen), C. snhcutaiicus 
 (incomplete fix'tus included beneath the skin of the complete one). 
 
 Such is the classification adopted by Gurlt, and it will be seen that 
 it is very complete, while the nomenclature scarcely leaves anything to 
 be desired. Nevertheless, as Saint-IIilaire's classification and nomen- 
 clature are also employed, and are in some respects advantageous to 
 know, we will now allude to them, though not in such detail as we 
 have done those of Gurlt, following the summary given by Zundel. 
 Saint -Hilaire separates monstrosities from vices of conformation, 
 which he distinguishes as Ilcinitcrics, or simple and trifling organic 
 anomalies, and Ilctcrotiuies, or mere changes in the situation of organs, 
 and nearly always without alteration in relative position and connec- 
 tions. For the llcnnapJirodisms — due 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 
 hermaphrodism, female hcrmaphrodism, and neutral hermaphrodism ; 
 mixed ; complex — masculine or feminine ; and bi-sexual — perfect or 
 imperfect. The monstrosities — properly so called — exhibiting anomalies 
 which are more or less serious, either because of the injurious intiuence 
 they exercise on the functions of the individual, or the vicious con- 
 formation they give rise to — are divided into two classes : Simple 
 Monstrosities and Composite, Double, or Triple Monstrosities. 
 
 The first class comprises three orders: 1. Autositic Monstrosities 
 (avTO'i, self, cr/to5, nourisliment) — whose organs are capable of maintain- 
 ing them for a variable period after birth. Only one or more regions 
 of the body are involved, the majority being little, if at all, ditlerent 
 from the normal standard ; the circulatory apparatus is always more 
 or less complete, particularly the heart ; the lungs, nearly all the 
 digestive viscera, and at least a portion of the head, are present ; and 
 all the anatomical and physiological characters are manifested exter- 
 nally by the general conformation, which, in the greater part of the 
 body, remains symmetrical and almost normal. 2. Omphalositic 
 Monstrosities (d/x<^aAos, u)nhilicus, and ytros-, noiirislnnent) — those whicli 
 live imperfectly, being maintained by the nourishment derived from 
 the mother through the umbilical cord, and dying as soon as the cord 
 is ruptured. These omphalositcs are deficient in a large number of 
 organs, and those which are present are generally very imperfect ; 
 externally all the regions appear to be anomalous, and the symmetry 
 is imperfect, or even effaced. 3. Parasitic Monstrosities — the most im- 
 perfect of all, and generally inert, irregular masses, composed of bones, 
 adipose tissue, etc., destitute of umbilical cord, and attached to the 
 generative apparatus of the mother, at whose expense they maintain 
 an obscure parasitic existence, by means of a vascular pedicle. 
 
 The double monstrosities are divided into autositarian and double 
 parasitic. The first are composed of two individuals more or less 
 intimately united, and somewhat equal in development ; this equality 
 indicating that they both have been equally nourished, and that their 
 
 functions have been alike complete. The second are composed of two 
 
 26 
 
402 FCETAL DY ST OKI A. 
 
 distinct individuals, very unequal in development, the smallest being 
 the most imperfect ; testifying that it, Hke 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-Hilaire, like those of Gurlt, contains 
 several families, subdivided again into genera and species, according 
 
 Fig. 104. 
 
 EcTROMELiAN MONSTROSITY (Saint-Hilaiee) ; Nanomclus Campylochirus (Gurlt;i : 
 
 Horse. 
 
 to their affinities, and which include all the monstrosities he had met 
 with. With regard to these families, it may be mentioned that among 
 the single autositic monstrosities, there are the ectromelians {ixTpdm, 
 to make abort, yueAos, 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 M0NSTRO8ITY (Saint-Hilaire) ; Xanomelus Ccunpylochirus (Gurlt) 
 
 Goat. 
 
 The Symclian Monstrosities (o-vu, with, /xeAo§, 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 (x^/A?/, hernia, i7i7)jia,bocly), more frequent, 
 perhaps, than any others, are those which Gurlt places in his third 
 Order — Schistocorvms, and are chiefly characterized by the absence, 
 more or less complete, of the abdominal parietes, and the abrupt 
 
MONSTJlUaiTIES. 
 
 403 
 
 curvature of the spine backwards, downwards, or to one side ; so that 
 the pelvis and posterior limbs are directed forwards, to one side, or 
 over the back, while the abdominal cavity bein^ open, allows its viscera 
 to Hoat about unprotected. There are many degrees of this deformity. 
 Sometimes tlie abdominal cavity is open, the thorax being undeformed 
 and closed in posteriorly by the diaphragm, and the ribs attached to 
 the sternum (Schistoconniis fissicentralis, Gurlt, Fig. 107). Sometimes 
 the posterior end of the spine is curved forward to the middle of the 
 
 Fig. 106. 
 Sv>iELi.\.v Mo.NsTKOsrrv (SAiNT-HiL.vntK) ; Perosomits jiiendotceluti (iiiiu.T) : Vig. 
 
 back (ScJiistoconmis rcflcxus, Gurlt) ; the ribs follow in the same 
 direction, but instead of bending downwards to enclose the chest, they 
 spring upwards towards the dorsal spines ; the sternum is absent or 
 divided throughout its length {Schistocormus Jisslstcrnalis, Gurlt, 
 Fig. 107), with evisceration of thoracic organs — most fre(]uently the 
 heart {Ectopia cordis, Fig. 108) ; the diaphragm )s not present, the 
 
 Fig. 107. 
 Ci L3bOMi.vN MoNSTRasiTY (.*^.\int-Hil.\irk) ; Schiitocormiis JUfivfnfralijt (Gurlt) : Calk. 
 
 chest is as widely open as the abdomen, and the viscera of both 
 cavities are external to the body (.S. Schistcpigastrico-steritalis). At 
 other times the spine is twisted, and the body and head divided 
 {Schistosotnus contortiis) ; or other deformities of a similar kind, and 
 more or less complex, may be found. The skin follows the displace- 
 ment of the various regions — the external surface being generally in 
 contact — while the lining membrane of the chest or abdomen, or both, 
 becomes external ; sometimes to such an extent is this inversion of the 
 
404 
 
 FCETAL DYSTOKIA. 
 
 body carried, that it is turned, as it were, outside in ; tlie skin forming 
 a kind of internal sac — the hair to the interior — and containing the 
 head and limbs of the foetus. With such a deformity, of course other 
 serious malformations or displacements co-exist : distorted pelvis, 
 wasted or undeveloped limbs, atresia of the anus, more or less complete 
 absence of the generative organs, etc. 
 
 Fig. 108. 
 Ectopia Cordln : Schistocoi mus Jissisternalh. 
 
 This kind of monstrosity will have to be specially noticed hereafter, 
 the eventration of the viscera of the foetus often considerably baffling 
 the obstetrist ; while the frequent distortion of the spine and limbs 
 renders delivery very difficult. 
 
 Fig. 109. 
 PsEUDENCEPHALiAN MONSTROSITY ; Ptrocephalws pseuclccephaUis (Guult). 
 
 The Exenccphalian monstrosities, belonging to Gurlt's third Order in 
 the first Class, are those which have the brain defective, deformed, and 
 external to the cranial cavity — itself more or less imperfect. 
 
 The Pseiidencephaliau monstrosities belong to the third Order of 
 Gurlt's first Class, the encephalon being absent and replaced by a 
 variable-sized bright red tumour, composed of a multitude of small 
 
 tr: 
 
MOXSTKOSiriKS. 
 
 405 
 
 bloodvessels ; this tumour rests on the base of the cranium, the roof 
 of which is absent (Fij^. 109). 
 
 The Ancnccphalian 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. 
 
 
 rig. 110. 
 
 Cyclopean Moxstuosity : R.am. 
 
 The CycZocc^j/irtZwin monstrosities (xi'x^o?) circle, Ke<l>dk), head) — Order 
 five, Class first of Gurlt — are characterised by the approximation, or 
 more or less complete fusion of the eyes into one organ, with absence, 
 displacement, or deformity of the nose and mouth ; but the ears are 
 
 rig. 111. 
 
 CicLOPEA.v Monstrosity ; Cyclops megaloMomtu archynchiut (Gurlt) : A.ss. 
 
 usually in their natural position, or perhaps are lower than usual. Not 
 unfrequently the nose is absent and the mouth greatly enlarged, while 
 the fusion of the eyes may not be complete (Figs. 110, 111). 
 
 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). 
 
406 
 
 FCE TAL D YSTOKIA 
 
 The Anidian or zoomylian monstrosities, we have ah'eady described 
 at p.;_i78 ; so we need not again refer to them. 
 
 Pig. 112. 
 AcEPHALiAN Monstrosity ; A. perosomus hemicephalicus (Gurlt) 
 
 "V 
 
 Fig. 113. 
 Schistocephalus Jissislabr7is or labium leporhium (Hare-lip). 
 
 The Schistocephalian monstrosities (Gurlt) have the head or face 
 cleft : most frequently the face, the division being sometimes limited to 
 the nose and upper lip. 
 
MoXSTJiOS/TIES. 
 
 407 
 
 Those monstrosities which are characterised by the al)iioriiial situa- 
 tion and form of dilTerent parts — and wliich are inckided in Class 
 first, Order six, of Clurlt — are not exceedingly rare, and in some 
 instances are probably due to muscular contraction, or malposition 
 for some time in the uterus (Fif^. 114). 
 
 Saint-Hilaire divides the double monstrosities into two orders : Aiitu- 
 sitaric and Pdrasilic ; the former beinj^ constituted by individuals more 
 or less intimately united and somewhat ecjually developed, each con- 
 curring to the mutual existence : while the second is made up of those 
 monstrosities which, though united, have one being more or less com- 
 plete — being reduced in fact to a linil), jaw, or other fragment of a body 
 implanted or subsisting on an individual which is fully developed. 
 These are included in Gurlt's second Class. 
 
 In the autositaric order we have the Eusomphalian and Monomphalian 
 monstrosities : these have the common character of two heads and four 
 
 Fig. 114. 
 CamylorrhnrrhU contortn. 
 
 pairs of limbs ; the first have, however, a distinct umbilical cord to 
 each of the united fcrtuses ; while in the other — the Monomphalian — 
 there is only a single umbilical cord and umbilicus. 
 
 The Eusoniphalian monstrosity consists, then, of two pretty equally 
 developed fcrtuses, each with its own umbilical cord, the two being 
 usually joined together by some soft part at any region of the body ; 
 so that they may be separated by a surgical operation without the 
 existence of either beinu' compromised. This is included in the third 
 Order of Gurlt's second Class. 
 
 With the Monomphalian monstrosity, on the contrary, there being 
 only one umbilicus and one cord, the foetuses are joined at the ventral 
 surface, and have usually several organs in common — notably the liver, 
 to which the umbilical vein passes (Fig. 115). 
 
 The Si/nccphalian monstrosities have two bodies either completely 
 separated, or only divided above the umbilicus, and surmounted by a 
 
408 
 
 FCETAL DYSTOKIA. 
 
 more or less incomplete double head : the two heads being fused, as it 
 were, into one {Dicephalus lieteroccphalus of Gurlt — Fig. 116). 
 
 Fig. 115. 
 MoNOMPHALiAN MONSTROSITY : Cephalo-cormodidijmua (Guklt). 
 
 Fig. 116. 
 Skull of Syncephaliax Monstrosity. 
 
 The Monocephalian monstrosities, as the name implies, differ from 
 
MOXSTJiOSJTIh'S. 
 
 409 
 
 the last in havinf^ only one head, but a double body, the separation of 
 the two usually takinj,' place below the umbilicus (Fi^'. 117). 
 
 The Si/soniiaii monstrosities (Fij;. US) have two heads on apparently 
 a single body, though a closer investigation will prove tliat 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, 
 though 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 suthced for two pair of lungs, one pair of which, however, 
 were onlv rudimentarv. The two livers were combined into one, and 
 
 Fig. 117. 
 
 MO.NOCErH.\LIAN- MoX- 
 
 .sTROsiTT: Corvw-Mf- 
 lo'lidymi (Gcrlt). 
 
 Fig. 118. 
 
 Syhcmian Mon.strohity : Dicephalus 
 bicollis (UURLT). 
 
 in 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 reality, only a single body, 
 the duplicity generally commencing towards the neck, in the cervical 
 region, not un frequently at the atlas, and sometimes as far as the facial 
 region ^Fig. 119). 
 
 Among the double parasitic monstrosities, we may mention Saint- 
 Hilaire's Hcterotn plans, in which the smallest of the foetuses is attached 
 to the anterior part of the body of the other, at or near the umbilicus ; 
 the Hctcralians, in 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 umbiUcus ; the Pob/f/nathiayis, in which the 
 parasite is reduced to the mere fragments of a fcrtus — the jaws and 
 some cephalic remains adhering to the jaws of the other fcetus. All 
 
410 
 
 FCETAL LYSTUKIA. 
 
 these are included in Guiit's classification, which we would advise the 
 veterinary obstetrist, as a rule, to employ. 
 
 The Polymelian (/xeAo?, limh) monstrosities — Gurlt's Melodidymi — 
 comprise those creatures which are so frequently exhibited in public, 
 and in which there is only a single body and head, but supernumerary 
 
 Fig. 119. 
 MoNOSOMiAN Monstrosity; Dicephahts bi-atlanticui (Guklt) : Calk. 
 
 limbs. These limbs may vary in number, and be attached to various 
 parts of the complete foetus ; there may also be present, in addition to 
 the supernumerary members, an unformed kind of tumour resting on 
 the back or shoulders, which in one case has been recognised to be 
 
 Fig. 120. 
 Polymelian Monstrosity ; Emprosthromelophorus (Guklt) : Calk. 
 
 composed of the heart and lungs of a second foetus (Fig. 121). In 
 other instances, the tumour is alone observed, without the additional 
 limbs. ^ 
 
 ^ It is not improbable that the " Nadeah " bullock of India is an animal with a 
 parasitic monstrosity attached to it. A Bull of this kind has been described, by an 
 amateur, as having "an excrescence of skin, covered with white hair, hanging from the 
 top of the hump, about seven inches long and of a soft nature, in appearance resembling 
 
MoXSTlioSlTIEs. 
 
 411 
 
 The Eiulociimian monstrosities are those double foetuses of which 
 one, or part of one, is inchuled within the other. They are the Crypto - 
 didiimi of Gurlt's second Class. 
 
 Oriijin of Monstrosities, and the Laws of Teratology . 
 
 The causes which operate in the production of what we have 
 designated " monstrosities " appear to be numerous. 
 
 Putting to one side, as unworthy of notice, the superstitious ideas 
 which long prevailed with regard to the formation of these monstrosi- 
 ties — because they can all be explained by the laws of teratology — we 
 come to the period when Regis started the hypothesis that the germs 
 of these must have been originally produced with those of normal 
 beings, and that they were developed in i\\e ordinary course of genera- 
 tion. This hypothesis, or something like it, was accepted by.Winslow, 
 Duvernoy, Haller, and others, up to the time of Meckel. Geoffroy 
 
 .^^^'# 
 
 Fig. 121. 
 DoiitLE I'AR.v.'siTic Monstrosity; Polyintlian notome/utt : Cow. 
 
 Saint-Hilaire, however, successfully combated it, and demonstrated 
 that these anomalies in organization are not primary, but accidental ; 
 that embryos which, had they been placed in ordinary circumstances, 
 would have been developed in a normal manner, and had, in fact, 
 
 a child's stocking, dangling fn^ni side to side a.^ the animal moved, but in no wuy 
 unsightly or repulsive to IcmjIc at." 
 
 Such aninuals are worshipped, :ind not put to any work ; they are usually exhibited 
 covered with .1 kind <>f earth coloured cloth trimmed with cowrie-shells, and the owners 
 derive a livelihood by exhibiting them. The " fakeers " or holy mendicants usually 
 obtain {xis.session of them. The.se double or pohmelian monstrositie.s receive their 8acre<l 
 designation from the i^txl Mahadeo, who is bilieved b\- the Hindoos to have ridden upon 
 a bull called "Nadeah," which was capable of changing its 8ha]>e, and producing a-s many 
 legs or horns for otfen.sive or defensive purposes as it might find necessary. Thus it 
 happens that any animal with unnatural or extraordinary marks is supposed t<> hav«' 
 some affinity to the great " Nadeah ' of Mahadeo, the founder «f Hindoo teratology. 
 
412 F(ETAL DYSTOKIA. 
 
 begun to be so developed, only became a,nomalous and monstrous 
 because their development was disturbed. Therefore these anomalies 
 did not exist previous to impregnation, but were the result of some per- 
 turbation occurring during the development of the embryos, which were 
 at first perfectly normal. 
 
 The opinion which at present prevails with respect to these malforma- 
 tions, is to the effect that the embryo or foetus has been submitted to 
 some kind of alteration in utero, and that this has been produced during 
 the interval between conception and birth. It is a matter of ordinary 
 observation that sometimes a fall, blow, sudden fright, or a powerful 
 mental impression will, in woman, disturb the ordinary course of preg- 
 nancy, and give rise to more or less unusual symptoms, and even prema- 
 ture birth of an imperfect foetus. It has been attempted to explain the 
 action of these influences, by supposing that the sudden physical or 
 mental shock produces an abrupt contraction of the vascular system 
 and, coincidentally, of the uterus ; so that the foetal membranes are 
 thus all at once constricted and slightly lacerated. Consequently, a 
 part of the liquor amnii escapes (as has been frequently observed), and 
 this is succeeded by adhesion of the margin of the laceration in the 
 membranes to the corresponding part of the body of the embryo ; 
 thus are formed those layers or bands which, whether temporary or 
 permanent, disturb more or less the development of the young creature, 
 either by preventing organs from occupying their natural cavities, 
 hindering the union or fusion of parts, or opposing or delaying the 
 formation of those which should afterwards appear. That this opinion 
 is not improbable may be at once conceded, when we remember that 
 during the early stages of development the ovum is little more than a 
 semi-fluid mass, and that its constituent parts are extremely impres- 
 sionable. 
 
 But the formation of monstrosities is more particularly due to what 
 has been designated the theory of retardation or arrested develojmient ; the 
 deviations from the normal standard being the effect of disturbance and 
 arrested supply of nutriment during the period of intra-uterine growth. 
 G. Saint-Hilaire has proved experimentally, by means of eggs artificially 
 hatched, that the production of monstrosities is due to the interruption 
 or accidental suspension of development which had commenced in a 
 regular manner ; while Meckel has shown the striking analogy there 
 exists between many anomalies and various transitory conditions of 
 embryonic organization. 
 
 It has been well remarked that the majority of the malformations 
 due to defect in the higher animals represent, in a more or less perfect 
 manner, the normal conformation of the inferior classes. For instance, 
 the imperfection or absence of limbs is the natural condition of fishes 
 and some reptiles ; the heart is not present in zoophytes ; when it has 
 but one cavity in the higher mammalia, it only resembles the single 
 heart of crustaceae; and when the auricular septum of the heart remains 
 patent, it is like the reptilian heart. All this is explained by the fact 
 that the embryo of the domesticated animals, in arriving at its ultimate 
 development, appears to pass through all the degrees of organization 
 which mark the different types in the zoological series. And by means 
 of the knowledge we possess of the organization of these types, we are 
 sometimes able to say when a particular monstrosity began to deviate 
 from the normal condition, the nature of the deviation, and its cause. 
 
 An excess of general development is less frequent than the opposite 
 
MONS THOSITIES. 1 1 :j 
 
 condition, and partial excess of an organ or region is not infrequent; while 
 excess of parts is far from rare, and may be noted in the vasculai' 
 system, in internal organs, and externally ; more particularly is it 
 remarked in the extremities, when we iiave in some species "polydactyl- 
 ism," and in others " hyperdactylism." It is often observed that an 
 excess in development in one part coincides with defective development 
 in another, as if the balance in formative organization must be main- 
 tained throughout the body. 
 
 With regard to double monstrosities — the result of two fcetuses bein^ 
 accidentally joined together, and fused, as it were, into each other — G. 
 Saint- Ililaire proposed a special law which he designated the laio of 
 similar union or of mutual affinitij. The result of this law is the pro- 
 duction of symmetrical development in a double monster in as perfect 
 a manner as in a single and normal individual ; the two creatures 
 which, by their union, form either a partial or complete double mon- 
 strosity, are always joined by the homologous faces of their bodies — 
 side to side, front to front, or back to back. And not only are they 
 united by their homologous surfaces externally, but internally they are 
 allied by homologous organs : each part or viscus of one corresponding 
 to a similar part or viscus of the other ; so that each vessel, nerve, or 
 muscle on the plane of union of one, notwithstanding the apparent com- 
 plexity, is joined to the corresponding vessel, nerve, or nmscle of the 
 other : just as the two moieties of a single and central organ, originally 
 distinct and lateral, become naturally fused together at a certain period, 
 and in obedience to the laws controlling their formation and develop- 
 ment. A double monster is, therefore, only a being composed of four more 
 or less complete moieties instead of two, as in the single individual. 
 
 "With regard to more complex monstrosities, we lind that, instead of 
 two moieties, as in the normal condition of an individual, or the four 
 moieties as in the double monstrosity, we may have six, eight, or even 
 more ; but yet the law of similar union prevails, and the moieties com- 
 bine in twos. Therefore it is that a triple monstrosity is only a double 
 monstrosity doubled, and a quadruple one a triple nionstrosity doubled 
 also — all the phenomena of the compound monstrosity being accounted 
 for on the same general principle. 
 
 The formation of double monstrosities has given rise to some dis- 
 cussion, and at present there are two chief theories which are worthy 
 of notice. According to one of these, there have been originally two 
 ova, which may have been derived from one or from two Graafian 
 vesicles or follicles rupturing at the same, or nearly the same time, and, 
 passing down the oviduct together, towards the cornu, becoming fused by 
 pressure in their passage. The other theory supposes the existence of 
 only one ovum, by whose division or cleavage the double monstrosity is 
 formed. 
 
 The first view is that which has found most favour, though recently 
 it has been considered as quite exploded by Dittmer,' who is in- 
 clined to adopt the latter theory, and believes that the double monster 
 is only an instance of bilateral symmetry carried too far. According 
 to him, in the primitive germ of the normal embryo a longitudinal 
 gi-oove is formed, which afterwards represents the middle line, the two 
 lateral parts developing symmetrically. But if this groove is too deep 
 at one or both ends, the two halves will there be separated ; and the 
 separated extremities have the power of producing the wanting lateral 
 * Rtichert and Du Bois-Rct/mond's Archiv, 1875. 
 
414 FCETAL DYSTOKIA. 
 
 half of each. The separation of the two halves may occur at one 
 extremity or at both, and it may extend to any depth. According to 
 these differences, we should have the various forms of double monster — 
 from such creatures as the Siamese twins to cases of a small super- 
 numerary leg. There may even be a further stage of this process. One 
 of the separated halves may present a similar exaggeration of bilateral 
 symmetry, if it again separate into two halves like the original germ. 
 
 Thus may be explained monsters with three heads or three tails. 
 
 Some objections might be raised to this theory, but this is not the 
 place to enter upon their discussion. "We may, however, point out 
 that it will scarcely apply to included monstrosities, in which we have 
 one creature, more or less perfectly developed, contained within 
 another. We can scarcely doubt of the -existence of two ova, the 
 included one being the oldest, and that this inclusion has probably been 
 effected at a very early period of germ development. 
 
 To return, however, to the long-accepted theory. If wx descend 
 from the complex phenomena of double monsters to single ones, and 
 from these to simple anomalies, we find again that every anomalous 
 union between organs takes place by homologous parts. What have 
 been designated " Symelian " monstrosities are characterized by the 
 fusion of their more or less atrophied abdominal limbs ; in the " Cyclo- 
 cephalian " monsters the eyes are more or less fused into one organ of 
 vision ; while with the " Otocephalians " tbe ears themselves are 
 joined, and often intimately confounded. The union of the kidneys, 
 testicles, cerebral hemispheres, and other double organs, is often 
 observed in creatures otherwise normal in conformation ; and all these 
 anomalies occur under the reign of the same law — that of " similar 
 union " — which for organs, as for entire individuals, operates on homo- 
 logous parts. 
 
 With regard to the remote or proximate causes which lead to the 
 production of monstrosities, it is very probable that the most pi'ominent 
 are irregularity or inequality in the nutrition of the foetus, physical 
 injury, undue pressure, alterations in the membranes, or diseased 
 conditions of the young creature. G. Saint-Hilaire and Valentine, by 
 disturbing the development of the embryo of the fowl during the early 
 stage of incubation of eggs — through shaking, jarring, and pressing 
 them, perforating the shell, or covering it with wax — could almost 
 create monstrosities at will. And an accident during gestation — a 
 blow, a fall, a displacement of the uterus — will produce the same 
 results in animals. Lafosse observes that it is perhaps because of 
 the pressure to which the foetus of Euminants is exposed, owing to 
 the accumulation and fermentation of food in the rumen, that must 
 be attributed the greater frequency of anomalies in the species of this 
 order than in the other domesticated animals. The quantity and 
 quality of the food, as well as the work to which the mother is sub- 
 jected, have an undoubted influence on the nutrition of the embryo. 
 
 A circumstance which appears to have some influence in the pro- 
 duction of anomalies in animals, is the great disparity in size between 
 the male and female. Lafosse endeavours to prove this by showing 
 that the frequency of certain vices of conformation — such as hypo- 
 spadias, umbilical hernia, want of proportion between the jaws, etc. — 
 is most notable in the mule. 
 
 We are also convinced that excessive consanguinity (breeding "in 
 and in ") likewise leads to the frequent production of monstrosities ; 
 we have witnessed some startling instances in the Cow and Pig. 
 
MOySTROSITIES. \ 1 5 
 
 Weakness of the procreativc powers may also tend to the development 
 of monsters. 
 
 A too small uterus may likewise act mechanically in distorting the 
 foetus ; while the health or disease of the organ, or of the foetal mem- 
 branes, must exert a powerful influence on its development and con- 
 formation. It is not improbable that tlie Celosomian monstrosity 
 {Schistosomiis rcjlcxiis), observed only in the Bovine species, is due to 
 the form of, or pressure in, the uterus ; and to the same cause may also 
 be ascribed the greater frequency of double and triple monstrosities in 
 this species than in any other. 
 
 The amputation of limbs, or portions of them, may be due to the 
 action of the umbilical cord, which, in the Mare at least, is perhaps 
 sutticiently long for this purpose. 
 
 Hereditary influence is here undeniable. In the human species it 
 has often been remarked, and scarcely less frequently in animals. 
 Hornless Cattle, double-headed Puppies, tail-less Cats, and other 
 anomalies, are commonly reproduced. Franck' mentions the case of 
 a Mare which constantly had Foals whose lower jaw was so short that 
 they could not suck ; consequently they died. Gurlt alludes to a 
 Bitch which brought forth four litters of Puppies ; the first litter con- 
 sisted of six, two of which were minus their fore-feet and were hare- 
 lipped ; there were five in the second litter, four of which were 
 monstrosities ; in the third litter there was the same number, and the 
 fifth Puppy, which was otherwise normal, had a hump in the middle 
 of its back ; four Puppies were produced in tlie fourth litter, three of 
 which were anomalous. 
 
 A psychical or mental influence has often been invoked to account for 
 certain monstrosities, and the vulgar opinion since Old Testament 
 times is certainly entirely in favour of its existence ; but, on the other 
 hand, it has often been denied. While there can be no doubt that the 
 popular mind has greatly exaggerated this influence, yet it would 
 appear from the interesting observations collected by Trehonnais, as 
 well as the curious instances recorded by Buhler, Weber, Herbst, 
 Bagge, Kueff. and others — and which we regret we have not space to 
 quote — that it does operate to some extent in animals ; fear especially, 
 as has been already said, will react on the embryo or fu'tus. 
 
 Disease of the fu'tus itself, or maladies transmitted from the mother, 
 may play an active part in the production of anomalies and mon- 
 strosities. 
 
 Frequency of Monstrosities. 
 Monstrosities are far from being rare in the domesticated animals, 
 but they do not occur with the same frequency in all the species. 
 Gurlt- tabulates 740, which shows the proportion furnished by the 
 different animals. This is as follows : — 
 
 Ass - - - - 3 
 
 Mule .... 3 
 Goat - - - - 24 
 
 Mare - - - - 56 
 
 Cat - - - - 71 
 
 Bitch - - - - 78 
 
 Sow - - - - 87 
 
 Ewe - - - - 179 
 
 Cow .... 239 
 
 ' Ilandfmch iltr Ihitrarztlichtn Oehurtnliulfe, p. 434. 
 - Pathol. Anatomie, vol. ii., p. 5. 
 
416 FCETAL DYSTOKIA. 
 
 Baumeister and Eueff mention that in the King of Wurtemberg's 
 private stud, of 2,340 Foals produced there were only nine mon- 
 strosities, or one abnormal to 260 normal Foals. In the Hohenheim 
 dairies, among the Cows the monstrosities were only one-half per cent. 
 (1 per 200) ; Swine came next in frequency, then Goats and Sheep. 
 Among the latter there was only one monster in 768 Lambs. 
 
 Saint-Cyr collected 71 instances (not including hydrocephalic or 
 synocephalic monsters), which were apportioned in the following 
 manner : — 
 
 Calves 45 
 
 Lambs and Kids - - - 16 
 
 Pigs 4 
 
 Kittens . . - . . 4 
 
 Puppy 1 
 
 Foal 1 
 
 Though monstrosities are not rare in animals, yet all do not give rise 
 to difficult parturition ; for in some cases the deformity does not inter- 
 fere at all with birth ; in others in which the deformity is of such a 
 nature as would impede delivery, birth often occurs prematurely when 
 the foetus or foetuses are small and soft ; while even when fully 
 developed, double and triple monstrosities have been occasionally born 
 without assistance. 
 
 Nevertheless, there is ample proof that triple, double, and even single 
 monstrosities, often require to be removed artificially, and may be 
 productive of serious consequences to the mother. These we will now 
 allude to. 
 
 Distorted Monstrosities. 
 
 The distorted monstrosities which Gurlt has designated Camylor- 
 rhacchis contorta, and which are characterised by abnormal situation and 
 form of different parts (Fig. 114), may occasionally, from their crooked 
 shape, prove a source of difficulty during birth. The distortion may be 
 due either to muscular contraction in the foetus, or to extraneous uterine 
 pressure, and if we glance at the figure which illustrates one variety of 
 this malformation at p. 407, w^e will readily perceive that the obstetrist 
 may indeed have a serious task before him if he is required to remove 
 such a misshapen foetus. The remarks we have made with regai'd to 
 dystokia from muscular contraction are applicable to this form of 
 monstrosity ; and in the majority of instances it will be found that 
 embryotomy, or even the Caesarian section, must be resorted to. 
 
 Cyclopean Monstrosity. 
 
 A Cyclopean monstrosity would not, so far as the visual deformity is 
 concerned, give any trouble to the obstetrist ; but in conjunction with 
 this condition we not unfrequently find other anomalies existing, which 
 have to be considered. 
 
 Pseudencephalian Monstrosity. 
 
 The head of the foetus may prove a cause of protracted or difficult 
 parturition, as we have seen when treating of hydrocephalus as a source 
 of dystokia, as well as in other kinds of anomalies when it is either 
 greatly deformed or double. We are cognisant of only one instance in 
 
MoxsrnosiTiEs. 417 
 
 which a pseudenceplialian monstrosity {Perocephalus pseiidocephalns , 
 Gurlt) gave rise to dilliculty iu birth. 
 
 Double-headed (Monosomian and Sysomian) Monstrosities. 
 
 The occurrence of double-headed monstrosities is more common, 
 perhaps, than any other anomaly ; they are observed more particularly 
 in Ruminants, though instances are recorded of their appearing in the 
 Pig, and even in the Cat species. 
 
 We have collected reports of some three dozen cases, the large majority 
 of which refer to this anomaly in the Calf, and not one to the Equine or 
 Asinine species. Only two of these cases appear in English literature. 
 We have alreadv shown, in classification of monstrosities, the kind 
 
 Fig. 122. 
 Sy30mi.\n Mo.vstrosity : Dicephalus bkollis (Gublt). 
 
 and degree of division there exists between the heads, and we have 
 only now to deal with this anomaly from an obstetrical point of view. 
 
 It may bo obsened that many of these creatures have been born 
 alive, and have continued to live for some time. Canu mentions a 
 double-headed Calf which survived its birth fifty days, and Bert gives 
 a good description of another which he examined when it was fifteen 
 months old ; but in the latter instance the anomaly was limited to the 
 lower part of the head, the jaws only giving evidence of duplicity. 
 
 The existence of this anomaly renders birth more or less difiicult, or 
 even impossible, according to the size of the heads, their point of junc- 
 tion — whether at the face or cranium, or towards tlie neck, and also 
 according as the presentation of the fcttus is anterior or posterior. In 
 very many of the cases recorded, the mother died or had to be killed, 
 while in others birth occurred without assistance and with but little 
 
 27 
 
418 FCETAL DYSTOKIA. 
 
 difficulty — rather a matter for wonder, considering the width of two 
 foetal heads joined towards the upper part of the neck. In this respect 
 the Monosomian iiiust prove more troublesome sometimes than the 
 Sysomian monster. In the majority of cases the presentation is 
 anterior. 
 
 An examination will reveal the existence of this condition, when the 
 obstetrist will adopt the measures necessary for extraction. In very 
 many of the cases embryotomy will have to be resorted to, or even the 
 Caesarian section. Decapitation of one or both heads may sometimes 
 suffice. In other cases judicious manipulation and well-timed traction 
 will effect delivery. When the heads are united at the cranium (as in 
 Figs. 116 and 119), and it is impossible to decapitate, the obstetrical 
 saw, chisel, or bone forceps may be usefully employed to disunite them 
 at their junction. 
 
 With double necks, amputation of one head and neck should be 
 effected as low down as possible. 
 
 Celosomian Monstrosities. 
 
 Those creatures which are more or less destitute of abdominal and 
 thoracic parietes, and otherwise deformed in various degrees, would 
 appear to be somewhat frequently met with by the veterinary obstetrist. 
 The above designation for them will be recognised as that bestowed by 
 G. Saint-Hilaire, the name proposed by Gurlt being Scliistosoinus reflexiis 
 or contorUis (Fig. 107). They also are found more often in the Cow 
 than in other animals, the Sheep being next in order of frequency. 
 Of seventy-one monstrosities referred to by Saint-Cyr, twenty-three 
 belonged to this order, and of these twenty-one were Calves, and only 
 one Lamb and one Kid. Our own figures place the proportion of Calves 
 much higher. 
 
 Perhaps this relative frequency is at least partly due to the fact, that 
 the singularity of the malformation is so striking that observers are 
 more ready to publish cases of this kind ; while parturition being always 
 more or less laborious, empirics who may chance to be called in cannot 
 understand the anomaly, and the veterinary surgeon has at last to be 
 sent for. 
 
 Diagnosis. 
 
 The diagnosis of this malformation is not difficult to the practised 
 obstetrist. If the foetal intestines are apparent at the genital orifice of 
 the mother, their small size indicates at once that they are those of the 
 foetus ; while an exploration of the vagina and uterus will discover the 
 distorted body, with the viscera unprotected and floating freely about. 
 When nothing is visible externally, of course the diagnosis is more 
 difficult ; and this difficulty is increased with certain presentations and 
 positions of the foetus. When, for instance, this is anterior, and the 
 spine is greatly distorted, the hand will first meet the head, and around 
 it all the feet (Fig. 123) ; it will be in vain for the obstetrist to attempt 
 to separate these and push back the posterior limbs in order to put the 
 foetus in a good position, as the rigidity of the crooked spine prevents 
 this being accomplished. In other cases the presentation may be 
 abdominal or posterior, and then the hand encounters a confused, soft, 
 floating mass of viscera, the nature of which is not easily ascertained. 
 However, the feel of the intestines should lead to a suspicion of the case, 
 while the twisted spine, deformed pelvis, and general distortion ought 
 
MONSTROSITIES. 
 
 419 
 
 to lead to a correct diagnosis. In some cases the exposed heart can be 
 seized by the hand, and if the fcctus is ahve the contractions of this 
 organ will be distinctly perceptible. 
 
 Prognosis. 
 
 The prognosis in these cases of dystokia will greatly depend upon 
 the distortion and size of the fcctus, as well as upon its position. In 
 thirty -nine observations collected by Franck, twenty-eight — or 72 
 per cent. — of these monstrosities were born without injury to the 
 mother, and a number of them without assistance ; the remaining eleven 
 Cows had to be slaughtered. In thirty-two instances, twenty-eight — or 
 93 per cent. — of the foetuses presented by the abdomen ; only four cases 
 — 13 per cent. — presented anteriorly, with the head and all the feet 
 towards the genital canal. The latter were the most serious, as in three 
 of them the Cows died. Of the twenty-eight abdominal or visceral 
 presentations, twenty-three births took place without permanent injury 
 to the mothers, the other five being killed. One was delivered by the 
 CsBsarian section. In some of the cases in which birth occurred with- 
 out assistance, the young creature was born alive. 
 
 Fig. vii. 
 Cklosomian Mo.nstuosity : L.\mb. 
 
 1, Hind Foot ; 2, Fore Feet ; 3, Tail ; 4, Tongue : 5, f:il>ow of Left Fore 
 Limb ; 6, Stifle ; 7, Kibs everted ; 8, Viscera. 
 
 Extraction. 
 
 .\s we have seen, the prognosis in the large majority of cases is 
 favourable, and particularly when the presentation is abdominal. Here 
 careful manipulation will elTect delivery, and often the only mutilation 
 necessary is the removal of the ftctal viscera. These being got rid of, 
 hand or cord traction made on the most convenient parts, or the inser- 
 tion of a hook behind the spine into the pelvis or any other likely and 
 accessible part, with gradual pulling will effect delivery; if not, the 
 vertebrtD should be divided. 
 
 But when the head and all the feet present, then the case is much 
 more serious. If the fcctus is only moderately developed, even in this 
 position it has been removed by traction. But in nearly all these cases 
 embryotomy must be adopted. Some practitioners have succeeded in 
 extracting the Calf by cording the head and fore-limbs, and pulling at 
 these, while the hind-limbs were being pushed forwards into the uterus, 
 and so dislocating the spine and straightening the body. If the spine 
 does not give way, it may be cut or sawn through. 
 
420 FCETAL DYSTOKIA. 
 
 In removing the body of the foetus by instalments, the limbs are 
 amputated one after the other, according to the rules to be prescribed 
 for this operation ; and it may be necessary to excise two, three, or 
 all of the legs, and even the head of the foetus, before delivery can be 
 completed. 
 
 DoubijE and Tkiple Monstrosities. 
 
 We have already alluded to monstrosities which have the head 
 double ; we now^ come to the consideration of those which have the body 
 more or less double, or even triple, and which have been designated by 
 G. Saint-Hilaire Eusomphalian, Monoinpkalian, and Monocejjhalian, 
 according to the degree of separation of the bodies, and whether two 
 are united to a single head — the double-headed creatures being desig- 
 nated Synceplialian. 
 
 From an obstetrical point of view, there is little need to distinguish 
 between the Eusomphalian and Monomphalian monstrosities ; for, as 
 already explained, they consist of two distinct foetuses joined together 
 at some part of their body, the character distinguishing them being the 
 presence of a double or single umbilical cord (see Figs. 115, 117, 118, 
 119). 
 
 The occurrence of such monstrosities is generally, though not 
 always, serious, so far as birth is concerned ; they are met with in all 
 the domesticated animals, but perhaps most frequently in the Bovine 
 and Ovine species. Several instances are mentioned in w^hich birth 
 has taken place wathout difficulty, and the young creatures have lived. 
 Holzner of Erding, quoted by Franck, states that a double Lamb, with 
 eight feet, double abdomen, and single breast, neck, and head, was born 
 without assistance. But in other cases, unless relief is afforded the 
 gravest results are certain to ensue. 
 
 Saint-Cyr alludes to three instances in w^hich embryotomy had to be 
 practised, and in two of these the mother succumbed ; the third, how- 
 ever — a Mare — recovered. 
 
 Diagnosis. 
 
 The diagnosis of these monstrosities is often very difficult, as they 
 may be mistaken for ordinary twins. Franck has drawn attention 
 to the circumstance that there is very frequently a difference in the 
 presentation of the merely double-headed foetus and the double foetus, 
 particularly the double croup ; the first being mostly in the anterior 
 presentation, the latter in the posterior. 
 
 In the case of the double fcetus, its presence may be suspected 
 when one cannot be moved without moving the other ; w^hen one is 
 brought into a good position with regard to passing through the pelvic 
 inlet, and it cannot be advanced beyond a certain point, though the 
 passage appears to be sufliciently wnde to permit easy delivery, because 
 the other lies across the inlet ; when the hand is passed between the 
 two foetuses and is stopped at the point where the skin is carried 
 between them at their junction ; and w^hen they are united by homolo- 
 gous parts, as already explained. With regard to the latter, we may 
 be positive. If, for instance, two foetuses lie together at the inlet in the 
 same presentation — anterior or posterior — there is nothing to be inferred 
 from this as to their being monstrosities or merely twins, as the pre- 
 sentation may be the same for these latter ; but if one is in the anterior 
 
MONS TROSI TIES. <*21 
 
 and the other in the posterior presentation, then we may bo certain that 
 they are not united. Heterologous parts do not unite. 
 
 The diagnosis in the case of Monocephahan monstrosities is com- 
 paratively easy when the head presents. But much care and attention 
 are necessary in forming a diagnosis in such cases, and the examination 
 of the bodies should lead, if possible, to an exact notion of their condition. 
 
 Extraction. 
 
 In some cases, though they are very rare, extraction may be possible 
 by manipulation and judicious traction ; but as a rule, embryotomy, or 
 even the Cicsarian section, has to be practised. If it were possil)le to 
 separate the two individuals by excising the parts which unite them, 
 then birth would probably be as easy as with twins ; but it can rarely 
 be practicable, for the simple reason that the point of union is gener- 
 ally beyond reach : it is too extensive to be cut through, or the junction 
 is of an osseous character. Nevertheless, cases may occur in which 
 the knife and the obstetrical saw or bone forceps may be most effectively 
 employed in accomplisliing disunion. 
 
 Wlien the monstrosity is in the anterior presentation, should it prove 
 to be double-headed, then it will be found advisable to remove one of 
 the heads as low down the neck as possible ; after this is done, removal 
 of two or more of the anterior limbs by subcutaneous section, will often 
 diminish the diameter of the body to such an extent that traction on 
 the head and x-emaining skin of the limbs will sometimes effect delivery. 
 If not, then eventration of the thorax and abdomen will be necessary. 
 When the two croups cannot be made to pass through the pelvis together, 
 it will be imperative to divide each across, as far back as possible, 
 extract the anterior halves, push the posterior into the uterus, turn 
 them, and deliver them as in the posterior presentation. Sometimes 
 excision of one or more of the hind limbs, in order to diminish the 
 volume of the double croup, will be necessary before the operation can 
 be completed. With Monocephalic monstrosities, of course the head 
 and neck are not interfered with, only the body and limbs requiring 
 attention. 
 
 When the presentation is posterior, the procedure must be carried 
 out in a similar manner ; but in all cases the task is a long and 
 fatiguing one, and the tax upon the endurance and sensibility of the 
 mother is heavy indeed. 
 
 ('II.\PT1:R IV. 
 
 Dystokia from Multiparity. 
 
 At p. 164 allusion was made to the relative position of the young in 
 multiple pregnancy, and at p. 262 we described the manner in which 
 twin births take place. We need not again refer to these, but we must 
 notice those cases — rare, it is true — in which difficulties are encountered 
 from pathological conditions in twin parturition. As has been shown, 
 in ordinary cases one foetus occupies the body of the uterus, the other 
 one of the cornua, or both may be in thecornua ; and both may present 
 either anteriorly (Fig. 47), posteriorly, or one in the first and the other 
 in the second presentation (Fig. 66). One alone must pass through the 
 genital canal, then the other, as there is not space for both at once ; 
 
422 F(ETAL BYSTOKIA. 
 
 and birth is usually quite as easy as if there were only one foetus. 
 Indeed, it is sometimes easier, from the fact that parturition either 
 occurs before the full period of gestation has expired, and the progeny 
 are therefore not so largely developed ; or if the usual term has been 
 reached, it nearly always happens that the twins are smaller than in 
 uniparous births. When the most advanced foetus is expelled, a variable 
 period elapses before the birth of the second takes place. During this 
 interval the uterus is accommodating itself to its altered conditions, 
 and preparing for the expulsion of the remaining foetus ; while the 
 parent remains restless, pays little, if any, attention to the young 
 creature already born, and manifests a particular anxiety, which is an 
 almost certain indication that parturition is not completed. When the 
 uterus has got rid of its occupants, the mother then turns its attention 
 to the offspring. 
 
 This is the ordinary course of affairs ; but it is not always so fortunate. 
 In some instances, after the expulsion of the first foetus the uterus is 
 seized with a kind of inertia, and labour may be suspended for hours, 
 even for days, and sometimes more than a week.^ During this suspen- 
 sion the parent at times gives indications of uneasiness by pawing, 
 looking at the sides now and then, straining at intervals perhaps, and 
 not infrequently exhibiting symptoms of colic, while the milk retains 
 all the characters of colostrum until the other foetus is born. 
 
 Eetention of the second foetus after a certain time is fatal to its exist- 
 ence ; even in animals with a multiple placenta — such as the Cow, 
 whose foetus retains its vitality much longer than that of those whose 
 placenta is single, like the Mare — the retained foetus has never, accord- 
 ing to Saint-Cyr, been known to exist forty-eight hours after the birth 
 of the first. 
 
 This suspension of labour in twin birth, and which is not at all infre- 
 
 ^ This uterine inertia, scarcely noticed by veterinary writers as occurring in mul- 
 tiparous animals, we have often observed. One of these cases may be alluded to. A 
 medium-sized Bull-terrier Bitch, belonging to a brother officer, required my assistance 
 the previous year, through being unable to pup. The animal had been in labour for some 
 time, and the head of a Puppy was in the vagina. This was easily removed by an instru- 
 ment hereafter to be described, as was another which we contrived to seize immediately 
 afterwards. These were all that the uterus contained, and they certainly were not too 
 large for the genital passage ; the uterus could not expel them. 
 
 Some time afterwards, this officer, who had in the meantime removed to Portsmouth, 
 wrote to inform me that the Bitch was again pregnant, and owing to my having made him 
 acquainted with its uterine peculiarity, he was anxious to know what he should do when 
 its time was due for pupping. Recommending certain hygienic precautions, I advised 
 that nothing special should be attempted unless birth was delayed, as on the previous 
 occasion ; then a dose of tincture of ergot of rye wa-< to be administered, followed by 
 another if necessary. Subsequently, I had a letter stating that on the Thursday night 
 the Bitch had four small Pups, but there was no sign of milk. A dose of castor oil was 
 given, as symptoms of constipation were exhibited (due, in all probability, to fa;tal 
 retention) ; the following day the animal was in pain, "and as she was strong and well 
 in herself, I did not like to give the ergot of rye yet. However, on Saturday morning 
 she became very ill. and was scarcely able to stand up, and yet there was no milk. So 
 about ten o'clock, I gave her a drachm of tincture of ergot of rye (our prescription), and 
 about five p.m. she passed a dead pup, followed shortly hy five life ones. She is now 
 (Tuesday) all right, but all the live puppies died, save two." 
 
 This case is interesting, as showing the tendency in some animals to uterine inertia ; 
 as testifying to the great value of ergot of rye — at least, with the Carnivora — its ecbolic 
 action on animals being denied by many veterinarians ; as proving that the death of one 
 f cetus i7i utero does not always imperil the existence of the others ; and as demonstrating 
 that, contrary to what occurs in the Mare and Cow, foetuses will exist in the uterus of 
 the Bitch for forty-eight hours after the expulsion of others, without succumbing, even 
 when one of their number is dead. 
 
DYSTOKIA FROM MULTIPAniTV 
 
 423 
 
 quent, is ordinarily due to malposition of the second footus ; and this 
 cause of dystokia is one which nearly always demands the attention of 
 the veterinary obstetrist. 
 
 This malposition of the single foetus will be noticed presently ; we 
 have now to consider diiVicult birth due to multiparity. Dystokia from 
 this cause always happens when the two fcetuses are about the same 
 distance from the os uteri, and both present together at the pelvic 
 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 dilliculty in birth — a ditliculty which 
 varies according to the relative situation of the two foetuses to each 
 other. 
 
 The fcetuses may be so situated that when the hand is introduced 
 into the vagina or os, it will either encounter the head of one ftt'tus 
 
 Fig. 124. 
 Twin ForrusEs, in Dikkerkxt Puesestatioxs, passino into the (Jenital Canal. 
 
 with the fore-limbs of the other ; four anterior or posterior limbsj two 
 hind and two fore limbs (Fig. 124) ; two, four, or six feet ; a headland 
 a tail, etc. 
 
 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 FCETAL DYSTONIA. 
 
 the parts which present, those which belong to each foetus. This can 
 only be done by a most careful manipulation, and even then at times 
 the obstetrist will find himself embarrassed. For instance, when the 
 fore-feet of one foetus present along with the head of the other, the 
 operator may be led to believe that there is only one animal to extract ; 
 and as the position is seemingly favourable, and the difficulty only due 
 to excessive size of the foetus, powerful traction is resorted to for its 
 removal. This, however, fails to effect its object ; and when another 
 exploration is made, it is discovered that the attempt has so fixed the 
 foetal parts in the pelvis, that the most energetic and skilful manipula- 
 tion will scarcely move them in order to alter their position. 
 
 In other instances, we find the limbs of the foetuses so interlocked 
 {locked fcetiises) tbat they are with the greatest difficulty disengaged. 
 
 Extraction. 
 
 It is evident that, if delivery is to be effected, one foetus must be 
 extracted at a time. They must, therefore, be disengaged, and one 
 pushed forward into the uterus, while the other is carried towards the 
 vulva. When the latter has been born, then the second, if in a wrong 
 position, must be adjusted and removed. 
 
 This is easily written ; those who have had to carry it out in practice 
 are alone competent to say how difficult it is to execute in the majority 
 of cases. It must be remembered that, as in nearly every other case, 
 the veterinary obstetrist is only called in when the foetuses have been 
 for some time wedged in the pelvic entrance by the uterine contractions, 
 and most likely also by the injudicious manipulations of amateurs or 
 empirics. If he had the advantage of attending the animal before 
 matters had proceeded so far, and the foetuses were still in the abdomen, 
 then the difficulties would be greatly diminished. 
 
 Eecognising the presence of twins, he w^ould select that which is in 
 the most favourable position, cord the head and fore-limbs, or the hind- 
 limbs if they presented; place them in a good direction for extraction, 
 and by the aid of assistants draw it towards the outlet, while the other 
 foetus was pushed deeper into the uterus. When the first foetus is well 
 into the passage, and the other behind and clear of it, the operation 
 may be said to be completed. It may be noted, however, that owing 
 to the obstacle offered by the first foetus, the one remaining in the 
 uterus is very often in a wrong position, and the uterus contracting 
 upon it after removal of the other, may fix it in that position, and thus 
 necessitate adjustment and other assistance being rendered.^ 
 
 ^ It is often astonishing how multiparous animals bring forth their young under extra- 
 ordinary circumstances. Cases are on record of Cats having Kittens attached to each 
 other in such an unusual manner that the space allowed each for birth seemed too 
 limited to permit this to take place. Morot alludes to six Kittens, for instance, which were 
 born alive, and all of which were joined by the end of their umbilical cords, owing, it was 
 surmised, to the placenta, chorion, amnion, and allantois being single. 
 
.VA/J'/:k'SKXT.lT/itX on MA/J'OSITW.V OF THE FiETU^. 42.') 
 
 GROUP II. 
 
 DYSTOKIA FROM MALPRESKXTATION OR MAr.roSITIOX OK THK 
 
 Fa<:Tus. 
 
 Though the impediments to birth in the human female are not infre- 
 quently due to the fcutus being in sucli a position that it cannot pass 
 through the pelvic canal, yet it is very questionable whether, in animals, 
 this cause of dystokia is not much more common, much more com- 
 plicated, and very much more dillicult to be rectified. In woman the 
 ditiiculty in this case chiefly occurs when the axis of the foetus does 
 not coincide with that of the uterus — when, for instance, the head or 
 the breech cannot pass through the pelvic inlet, and the presentation 
 is more or less oblique or transverse. It is exceedingly rare "indeed 
 that the neck or limbs offer an obstacle to birth. 
 
 With the Calf and Foal the case is very different. These creatures 
 have the neck and limbs long and very flexible, and even the body 
 itself is comparatively long and readily curved in any direction. The 
 consequence is that the limbs or neck may be bent under, to one side, 
 or above the trunk ; while the latter may be flexed in such a manner 
 AS to become quite distorted. 
 
 The Cow is the animal of all others which suffers most frequently 
 from dirticult parturition, and several of the causes which give rise to 
 this dirticulty are not met with in the females of other species ; this is 
 no doubt chiefly owing to the fact that, among uniparous creatures, this 
 has proportionately the narrowest pelvis, and therefore deviations of 
 the head and limbs, or any unusual presentation or position of the 
 body, which would be of little moment in the case of Solipeds, lead to 
 trouble. As for multiparous animals, the young are generally so small 
 when compared with the genital canal, that they can generally pass 
 through it in presentations and positions which would be most difficult, 
 if not impossible, in Solipeds, and more so in Bovines. 
 
 For these reasons, we have a great number of more or less com- 
 plicated malprcsentations and positions, wliich give rise to varying 
 degrees of dystokia, some of them of a very formidable kind. 
 
 It will therefore be readily understood that, even when the axis of 
 the young creature's body coincides with that of the uterus and pelvic 
 canal, and the latter is normal in dimensions, birtli may not be possible 
 without assistance ; and this establishes a wide difference between the 
 obstetrics of the human, and the Equine and Bovine species. Added 
 to this, the veterinary surgeon has the difliculties before mentioned to 
 contend with — powerful and often irritable animals ; a long genital 
 canal and deep uterus ; uterine contractions so energetic that they 
 fatigue and paralyse the hand and arm ; the disadvantages of position 
 in the parturient animal ; the late period at which professional assist- 
 ance is sought for ; and the damage that may have been inflicted by 
 amateurs and empirics. 
 
 Considering the frequency of the causes of dystokia, and their often- 
 times serious character, they deserve the most careful study in order 
 that they may be successfully overcome. 
 
 The following synoptical table shows the various causes of fcetal 
 •dystokia dependent on abnormal presentations and positions : 
 
426 
 
 FCETAL DYSTOKIA. 
 
 rXATCRAI. 
 
 
 Obstacles due to the 
 Hind-Limbs 
 
 Causes which may be 
 met with in all^ 
 Positions ... 
 
 Obstacles due to the 
 Head 
 
 rDorso-pubic. 
 Abnormal Positions - Dorso-supra-cotyloidean (right or 
 [ left). 
 /The hind -limbs are extended and 
 
 retained at the stifles. 
 - The hind-limbs are flexed beneath 
 
 the body and enter the pelvis 
 
 with it. 
 TThe limbs are on the neck. 
 
 Obstacles due to the '^\^ ^V^}"' ^^ i°,^°."^Ple*ely ^^- 
 T' J • , -, tended in the pelvis. 
 
 The limbs are flexed at the knees. 
 
 The limbs are completely retained. 
 
 The head is flexed downwards. 
 
 The head is flexed beneath the 
 
 chest. 
 
 The head is turned to one side of 
 
 body. 
 
 The head is extended on the back. 
 
 /The head is retained with one or 
 
 Combined Obstacles both fore-limbs. 
 
 due to the Head -| The head is retained, or one of the 
 
 and Limbs ... I fore or hind limbs has entered 
 
 ' the pelvis. 
 
 fLumbo-pubic. 
 
 Abnormal Positions -] Lumho-(*upra - cotyloidean (right 
 
 y and left). 
 
 ^, . 1 J i. iv /The neck is contracted. 
 Obstacles due to the mu r v u ^ ai, 
 
 I The fore - limbs are under the 
 
 j chest, and enter the pelvis with 
 •• I it. 
 
 / The limbs are incompletely ex- 
 Causes to be met with f Obstacles due to the tended in the genital canal. 
 in ALL Positions ...\ Hind-Limbs ... The limbs are flexed at the hocks. 
 
 I, The limbs are completely retained. 
 (dorso tt-mear positions/^^P^*^°"^^^*^ ("S^t and left). 
 TRANSVERSE ' ^^^^° ' ^^ ^'^^^ position s ^ Cephalo-sacral. 
 PRESENTATION. " Sterno - abdominal Posi- / CephaloUial (right and left). 
 [ TiONS ... ... ...\Cephalo-sacral. 
 
 P-( 
 
 f^- 
 
 Natural 
 
 Head 
 Limbs 
 
 Fore- 
 
 CHAPTEE 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 foetus are 
 numerous and varied. In each of the presentations there may be 
 difficulties, 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 limbs, 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. 
 
 Eainard, looking at the subject from an obstetrical point of view, 
 considered the head and hmbs of the foetus 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 
 the anterior position, may cause the most varied complications, one or 
 more of which may be found in the same animal, and even compli- 
 
DYSTOKIA FROM ABNORMAL POSITION.^'. 427 
 
 eating each other. Thus, with a vicious position of the head we may 
 have a wrong direction of the fore, and perhaps also of the hind, hinbs. 
 But as the double or triple complications are ditVicult to describe, and 
 as the practical value of the descriptions might consequently suffer, it 
 is deemed the best course to study each complication 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, less 
 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. Normal Anterior Presentation. 
 
 In this presentation the extended head and the outstretched fore- 
 limbs are towards the genital canal. 
 
 SECTION I.— DYSTOKIA FROM ABNORMAL POSITIONS. 
 
 Here we have three abnormal or reversed positions — a dorso-puhic, and 
 two durso-supra-colyloidean. 
 
 Dorso-Pubic Position. 
 
 This position is difficult when the depth of the fcetal chest exceeds 
 the vertical diameter of the pelvic inlet of the mother — a circumstance 
 more frequent, evidently, in the Cow than the Mare — being, 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 lies 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 position by the fore-feet being upwards, and the fetlocks bending in 
 the same direction as the knees ; while if the head is within ruach, the 
 nose and lower jaw can be distinguished. 
 
 To rectify this position, rotation of the ftetus must be practised. 
 The lower jaw and fore-feet 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 ))ring the 
 head and feet into the pelvis, the hand guiding them into the canal in 
 the first position, when delivery can be effected. 
 
 ' Zippelius, ((unted by Franck, in 108 cases of dystokia found them to be due to the 
 several causes in the following proportions : 
 
 Abortions ... ... ... ... ... ... ... ... 31 
 
 Occlusion of the os uteri ... ... ... ... ... ... 30 
 
 Torsion of the uterus .. ... ... ... ... ... ... 10 
 
 Lateral inclination of the head and neck of the foetus ... ... 16 
 
 Lateral inclination of thf hrad and n>i.<Klirection of the fore-limbe 4 
 
 Head and neck under the fore-limbs ... ... ... ... 3 
 
 Head bent up on the back ... ... ... ... ... 2 
 
 Torsion of the uterus with posterior presentation ... ... ... 1 
 
 Posterior presentation with misdirection of the hind-feet ... ... 2 
 
 Limb over neck ... ... ... ... ... ... ... 1 
 
 Lumbo-pubic position ... ... ... ... ... ... ... 3 
 
 Posterior and tran.sverse presentation ... ... ... ... 1 
 
 Rachitis affecting the pelvis of Cow and Calf ... ... ... 1 
 
 Hydrops amnii ... ... ... ... ... ... ... ... 1 
 
 Mummification of the foetus ... ... ... ... ... 2 
 
428 FCETAL DYSTOKIA. 
 
 In the Mare and other animals there is more room for the passage 
 of the foetus in this position, and with the first-named deHvery may be 
 accompHshed in some cases by guiding the limbs through the genital 
 canal, so as to prevent injury to its walls. 
 
 Dorso-supra-Cotyloidcan 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 effected in the same manner as in the pre- 
 ceding position. 
 
 SECTION II.— DYSTOKIA 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 when 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 foetus 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-Limhs 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 foetus being in a state 
 of extreme abduction ; but more careful study has shown it to occur 
 when these limbs 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 foetus 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 
 the hand, but the almost complete expulsion of the foetus 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 
 delivery. 
 
 Indications. — When both stifles are together they form too large a 
 mass to pass through the genital canal, and must therefore be brought 
 into the inlet separately — one after the other. With this object in 
 
DYSTOKIA UUE TO THE IIIXDLIMBS. 429 
 
 view, Saiut-Cyr recommends very oblique traction on the fcutus — 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 mucli pulled at, as when such has been the 
 case the stifles are firmly and immovably wedj,'ed in the inlet. Then it is 
 necessary to push the fu'tus forward into the uterus, if this be possible, 
 or at least one of the stifles, and if this be effected, then have recourse 
 to oblique 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 fcetus. This can be accomplished by passing 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 foetus 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- 
 pleted. 
 
 When it happens that unskilful people have been exercising great 
 force before the arrival of the practitioner, and the hind-limbs are so 
 firmly fixed that it is impossible to move them, then embryotomy nmst 
 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 Ilind-Limhs, flexed wider the Body, pass tvitJi it into the Genital 
 
 Canal. 
 
 This malpresentation, known to the German veterinary obstetrists 
 as the " vertical -abdominal " or "dog-sitting position" (Bauch- 
 Vcrtikallaije, Hunde-Sitziije Lar/c), is not very common, and is one of 
 the most formidable, perhaps, which can be encountered. First 
 described by Canu in 1837,' it has been alluded to by a numl)er 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 
 foetus 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 the compression the fu'tus then experiences causes it to 
 struggle with the posterior limbs to free itself from the discomfort. 
 
 As in the preceding deviation, nothing is at first known of the 
 existence of the displacement. Paiturition commences and appears to 
 be going on favourably ; the foetus, 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 
 ' RecufU dt if'decint VtUrinaire, 1837, p. -145. 
 
430 
 
 FCETAL DYSTOKIA. 
 
 beyond the inlet, and as far as, or even external to, the vulva — some- 
 times the head, fore-limbs, neck, and even half of the body hanging 
 outside the vagina. But further progress is checked, and neither the 
 most energetic straining on the part of the animal, nor the most violent 
 traction by those persons who may be with it, can advance the foetus 
 beyond this point. 
 
 The obstetrist has great difficulty in ascertaining the cause of delay 
 in birth — the difficulty varying, and depending upon the volume of the 
 foetus, and whether its body more or less completely fills the pelvic 
 canal. The hand can generally only be introduced after much trouble 
 and tact into the passage, and having got to a certain distance it 
 encounters either under the body or head (Fig. 126), to one side of the 
 neck or head, or even projecting upwards above the head (Fig. 125), 
 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 other parts 
 
 Fig. 125. 
 Deviation of the Hind-Limbs in the Pelvis in the Anterior Presentation. 
 
 of the limbs being in the uterus (Fig. 126) ; in other cases the hocks 
 may be in the inlet, or even well through the passage — depending upon 
 the size of the foetus and the capacity of the maternal pelvis ; more 
 rarely the stifles have cleared the inlet, and the hind-feet are at the 
 vulva. The more advanced the hind-limbs are the more are they flexed, 
 and so the more is the body of the foetus bent on itself, until it is like a 
 dog in a sitting posture. It is needless to remark that unless the foetus 
 is exceptionally small in proportion to the pelvic capacity, it cannot be 
 extracted in this position, when the hind-limbs, and especially the 
 stifles and hocks, add so largely to the volume of the body ; traction 
 will probably kill the creature, and in all likelihood injure the mother. 
 Some cases are recorded in which delivery was effected, however, but 
 then circumstances were favourable, both as to time and the position 
 of the foetus. The greatest care is therefore necessary, in order to 
 ascertain the exact state of afl'airs ; indeed, in all cases of dystokia it 
 cannot be too often impressed on the mind of the young practitioner, 
 that a careful examination is absolutely essential before attempting 
 
DYSTOKIA DUE TO THE HIXDLIMHS. 
 
 431 
 
 extraction. In this particular fonn of dystokia, the life of the mother 
 may be preserved by timely and rational intervention ; while violent and 
 improper interference, even iit the earliest period, may be followed by 
 serious, if not fatal, consequences. 
 
 The distinction between this form of dystokia and tlie last is, accord- 
 ing to Saint-Cyr, not ditlicult. When the fcctus is expelled as far as 
 the loins, then it is the stifles whicli arc the cause of obstruction ; but 
 when only the anterior part of the thorax appears at the vulva, we may 
 be certain it is not these articulations. When the feet are not visible, 
 then a manual exploration is necessary. 
 
 With regard to preserving the foetus, the prognosis must generally be 
 unfavourable. The Foal is, in nearly every case, certain to perish at an 
 early period, from compression of its body or the umbilical cord ; and 
 though the Calf is more tenacious of life, and may continue to exist for 
 
 Trrrrrm 
 
 Fig. 126. 
 HiND-LiMn Dkviation : .Vstehior Preskntation. 
 
 some time, yet in the majority of cases it succumbs, or it has to bo 
 sacrificed to save the mother, which, if the practitioner can render aid 
 sufficiently early, may survive. 
 
 Indications. — In nearly every case the preservation of the mother is 
 the first object to be attained, the life of the foetus — if it be living when 
 the veterinary surgeon is called in — being quite a secondary considera- 
 tion ; though it must be admitted that if he is present when it is still 
 vigorous and not much engaged in the pelvic cavity, there is no reason 
 why it should not be extracted alive. The indication is, of course, to 
 rectify the deviation of the hind-limbs ; and if the fatus is not too far 
 advanced in the genital canal, this maybe accomplished by pushing it, if 
 need be, towards the uterus, and introducing the hand between it and the 
 wall of the vagina (often a most difficult matter), to carry the hind-feet 
 back — one after another — into the uterine cavity, either by the hand or 
 
432 POSTAL DY8T0KIA. 
 
 with the aid of the repeller ; then the head and fore-limbs being in a 
 good position, birth can readily be effected. In this manner Carsten 
 Harms has extracted a Foal. But in carrying the limbs into the uterus, 
 care must be taken to lift the feet off the floor of the pelvis, one after 
 the other, by flexing the hock and holding the hoof in the hand while it 
 is carried beyond the inlet. "When the front part of the foetus has not 
 advanced far into the pelvis, and the deviation has been ascertained in 
 good time, the anterior presentation has sometimes .been successfully 
 converted into a posterior one, so that birth could take place. 
 
 But such cases are rarely met with in practice ; and, as a rule, the 
 veterinary obstetrist finds that parturition has made much progress, the 
 foetus being fixed in the genital canal and occupying its entire diameter, 
 and its hind-limbs well forward under the body, each labour-pain 
 wedging it more firmly; and the case is perhaps complicated and 
 aggravated by the indiscreet manipulation of amateurs. In such cir- 
 cumstances, it is needless attempting to push the foetus towards the 
 uterus, neither can the hind-limbs be thrust into the uterine cavity ; as 
 no sooner are they carried from under the body for ever so short a dis- 
 tance, than a succeeding pain brings them into their former position. 
 Indeed, it is sometimes most difiicult to reach the hind-limbs to apply 
 cords to them, and so by straightening to bring them parallel to the 
 body. In some cases it has been possible to effect delivery by cord- 
 ing the hind-limbs if they are not advanced very far, and then imlling 
 llicm upwards until the feet reach below the wings of the atlas, but not 
 beyond ; traction now being made simultaneously on all the limbs and 
 the head, the foetus may be extracted. With one hind-limb engaged, 
 the same procedure can be adopted. In a case of this description in 
 the Mare, Obichi succeeded in extracting the Foal by cording the hind- 
 feet (which were under the body), and pulling at them as well as the 
 head and fore-feet. 
 
 Donnarieix recommends pulling the posterior limbs forward beneath 
 the body, the contents of the abdomen and chest having been previously 
 removed to facilitate the operation ; then cording the hind-pasterns, to 
 draw first one, then the other, towards the vulva. He admits, however, 
 that this is difficult, and one of his cases treated in this way occupied 
 four hours ; he was even compelled to excise one of the limbs at the 
 hock, before he could straighten it. The Mare, however, lived. 
 
 Canu, in 1837, gives another method in which embryotomy may be 
 carried out. The illustrative case was that of a Mare, the Foal — which 
 was dead — being born as far as the half of the chest. As it was not 
 possible to push it back, the body of the young creature was divided as 
 near the hind-quarters as possible, by making an incision from the 
 sternum to the spine, behind the last rib on each side ; then the abdo- 
 men was emptied of its contents, and the spine cut through between the 
 last dorsal and first lumbar vertebra, the amputation being facilitated 
 by an assistant holding the lips of the vulva as far apart as possible. 
 The Mare, which was very exhausted, did not offer much opposition 
 when the croup was pushed into the uterus, and the hind-limbs being 
 corded, version was easy, and the operation soon finished. The Mare 
 was at work within twenty days afterwards. 
 
 Canu's method of extraction has often been practised, both in the 
 Mare and Cow, by veterinary sui'geons ; and it has been proved to be 
 both rational and successful — so far as the mother is concerned- Iii 
 ^ Wochtnsch.rift fiir Thierheilkuv.de luid Viehr.ucht. 
 
DYSTOKIA DUE TO THE FORELIMHS. 433 
 
 practising it, the following directions have been given, and their obser- 
 vance is important : 
 
 1. Find the hind-limbs and secure them by cords around tlie pasterns ; 
 2. Cord the head and fore-limbs, and pull these out as far as possible 
 beyond the vulva ; 8. Remove the abdominal viscera, and divide the 
 spine as near the lumbar region as possible, taking the precaution to 
 leave a good piece of skin attached to the loins, so as to cover the 
 exposed bones and prevent the maternal organs being injured during 
 the subsequent steps in extraction ; 4. Obtain a solid bearing on the 
 divided spine, either with the hand or the repeller, and push steadily 
 and firmly against it so as to direct it into the uterus, when the cords 
 on the hind-pasterns being pulled by assistants, guided by the hand of 
 the operator, the remains of the fci'tus can be removed. This part of 
 the operation is the most difficult and fatiguing for the obstetrist, as 
 well as the most dangerous for the mother, and requires both strength 
 and dexterity to push back the loins and pelvis of the foetus while 
 advancing the hind-limbs, thighs, and croup towards the outlet ; 5. 
 Nothing now has to be done but to exercise moderate traction, and ter- 
 minate, in the lumbo-pubic position of the posterior presentation, a 
 birth commenced in the dorso-sacral position of the anterior presenta- 
 tion. 
 
 Dietrich recommends eventeration of the fa-tus, removal of one of 
 the hind-limbs, and the adjustment of the hinder parts through the 
 abdominal opening ; if 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 
 may be tried, the fore-legs and head being corded, and the misplaced 
 hind-limb finally extended backwards in the uterus. If this cannot 
 be accomplished, the hind-leg must be drawn forward and amputated 
 at the hock or beyond, and the thigh then carefully pushed towards 
 the uterus. 
 
 Removal of the abdominal viscera favours these manoeuvres. 
 
 When this malpresentation occurs in the Sheep or Goat, embryotomy 
 will generally be necessary, as there is not suflicient room to attempt 
 delivery in any other way. 
 
 B. AUNOHMAL AnTERIOH PRESENTATION. 
 
 In dystokia accompanying the anterior presentation, the obstacle 
 may be due to the fore-limbs or head, or to both, as well as to 
 the hind-limbs ; and it may be met with in any position the foetus can 
 occupy in this presentation, though it is most frequent in the dorso- 
 sacral position, which we will commence with. 
 
 SECTION I.— DYSTOKIA Dl'E TO THE FORE-LIMBS. 
 
 In the anterior presentation, and what we have designated the 
 " normal position," the two fore-limbs of the foetus are extended in 
 front towards the pelvic inlet, the head being also extended and resting 
 either upon or between the legs, the distal extremities of which extend 
 beyond its nose — the whole forming a wedge-shaped mass. Con- 
 sequently, the fore-feet should be the first parts to pass through the 
 
 28 
 
434 FCETAL DYSTOKIA. 
 
 genital canal ; and if only one appears along with the head, or if 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 
 directions they may assume are generally four : 1. They may he in- 
 completely extended in the loelvis ; 2. They may be crossed over the neck; 
 3. They may he hent at the knees ; 4. They may he extended covipletely 
 under the fcet^is. 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 involved ; if the latter, then the 
 direction may be the same or different. 
 
 The cause of misdirection of the limbs is not well ascertained. In 
 many cases it may be due to insufficient dilatation of the os uteri, 
 which hinders their 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. The misdirection may also primarily occur during intra-uterine 
 existence, and before parturition sets in, and particularly if the foetus 
 dies before birth, when its position is not the same as at that period. 
 There can be no doubt, however, that the accident generally happens 
 during parturition. 
 
 One or Both Fore-Limbs crossed over the Neck. 
 
 This complication is not very uncommon in the Mare, but is less 
 frequent in the Cow ; it usually occurs when the foetus is in the dorso- 
 sacral position. One or both limbs may be carried over the neck, but 
 it is generally only one. 
 
 It is undoubtedly, in many instances, an obstacle to parturition, as 
 the shoulders are no longer lodged in the hollow space at each side of 
 the neck, but are fixed at the side of the chest, the transverse diameter 
 of which they increase. The obstacle is still greater if one or both of 
 the limbs should chance to cross towards the summit of the head. At 
 all times the complication is more serious if the labour pains are 
 violent and irregular — as they generally are in the Mare when there is 
 any impediment to birth ; then there only too frequently results lacera- 
 tion of the roof of the vagina, perforation of the rectum, rupture of the 
 perinseum, etc. In the most favourable cases, labour is protracted and 
 more severe, and contusions of the genital canal are almost unavoidable. 
 In some cases birth may, and does, take place without assistance. 
 Eainard alludes to the case of an Ass in which spontaneous delivery 
 occurred, notwithstanding the existence of this complication. 
 
 The obstacle is discovered by exploring the genital canal, when the 
 hand will encounter in the vagina the head of the foetus and one limb 
 in the usual situation (if only one be misplaced), and the other limb 
 feeling as if shorter, higher up, and crossing the neck towards the 
 fetlock-joint. This is the usual state of affairs. 
 
 Indications. — When only one limb is crossed, reduction is not difficult, 
 and may be effected in the pelvis. The leg is seized a little above the 
 fetlock, raised, drawn to its proper side, and extended in the genital 
 canal. Delivery may then take place without help, or gentle traction 
 on the head and limbs may be necessary. 
 
 "When both fore-limbs are crossed, and the foetus is not too far 
 advanced in the pelvis, cords should be fixed to the pasterns, and the 
 
DYSTOKIA DfE T" TIIK FoRKLIMliS. 
 
 435 
 
 trunk pushed into the uterus ; assistants then pull moderately at the 
 cords, 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 faHus 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 incompletchj extended. 
 
 This accident would appear to be most frequent in the Cow, and is 
 due to the legs not advancing with the head in the ordinary way, after 
 
 Fig. 127. 
 Anterior Pi'.e.><entation : Fork-Limb crossed ovku the Nkck.' 
 
 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 fa-tus is in the vertebro- 
 sacral position, and should not be considered serious if the case has 
 not been tampered with. Its occun-ence 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 thia fi^ire the anterior limbs, especially the right one, are inaccurately drawn bv 
 the artist. They are too long, and the right leg should be shown as crossing the neck at 
 the fetlock joint. 
 
436 FCETAL DYSTOKIA. 
 
 difficulty in releasing them. In any case, the lower jaw and feet should 
 be corded ; this being done, the chest is pushed forward into the 
 uterus, when the upper parts of the limbs accompany it. The hand 
 can now fully extend the legs and bring them into the vagina along 
 with 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 generally 
 foimd in the Mare and Cow ; when it occurs in the Sheep and Goat it is 
 rarely of any importance, as delivery can usually take place without 
 assistance ; in the young of Carnivora, the metacarpal bones are too 
 short to offer 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 may be flexed, and the comphcation is not unusually 
 accompanied by a misdirection of the head ; hence, there are several 
 varieties of the complication, the most important being those due to the 
 general position of the foetus. It may occur in three positions — the 
 dorso-sacral, dorso-pubic, and dorso-ilial. 
 
 Dorso-Sacral Position of the Foetus. — If at the moment when the 
 limbs of the foetus enter the pelvic inlet, they are not quite extended 
 and the feet are slightly 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 head enters the inlet, and as it pro- 
 ceeds the limbs become flexed, the knees are bent and advance with it, 
 but the metacarpals and phalanges are directed backwards beneath the 
 forearms, and the hmbs thus doubled are applied against the neck. We 
 have therefore the head, fore-arms, and metacarpals in one mass, 
 entering or being propelled into the limited space afiorded by the inex- 
 tensible pelvic circle, and, according to circumstances, the hand of the 
 obstetrist will meet with these parts in varying relative positions, 
 depending on the stage of labour. When parturition has only recently 
 commenced, the head has entered, or is about to enter, the inlet, and 
 the limbs placed beneath it are still somewhat free in the uterine cavity, 
 while the foetus itself is not immovably fixed if the waters have not long 
 escaped. But when labour has been progressing for some time, the 
 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 
 jieck — the knees towards the head, the feet at the elbows. 
 
 With the smaller Euminants, as already remarked, birth may 
 take place spontaneously even now, as they often have more than 
 one fcetus, and these comparatively small, compared with the pelvic 
 diameter; while the bones are elastic and yielding. But with such 
 animals as the Cow and Mare the foetus is nearly always single and 
 voluminous, and its skeleton is rigid and unaccommodating, and can 
 only undergo a very small reduction in size during its passage through 
 the pelvis. 
 
 Therefore it is that, in the larger domesticated animals, such a devia- 
 tion of the limbs 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 ItlK Tn THE FnllKlAMliS. 
 
 437 
 
 the latter against the thorax, and prevent their being lo(l{::;ed in the 
 depression at the base of the neck — thus augnientin<^ 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 tliat only one limb is tlexed 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, extentl the fore-arm of each on the arm, and ex- 
 tend them in the pelvic cavity, as in normal parturition. 
 
 These indications are not so ditticult to carry out when the obstetrist 
 is called in sutliciently 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. 
 .A.NTEBIOR Presentation, Dorso-Sacral Position : FoiiKLisiits klexku at the Knee.s. 
 
 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 fcctus, the fore-arm is seized in the middle, the radial border of 
 the hand being upwards, the cubital downwards ; then bending the hand. 
 
^>Mk«%/ / th« k9%m Mi^ IhnMl 
 
 M, or 
 w.^ fool lo 
 thr b&od. 
 
 o ovikl. Md i( 
 u^bOT hmb^ if tJso 
 
 tuuUUUKMI. 
 :b« PMltra vim And 
 
 'W, 
 
 CO p<M.' 
 
 -*nn oi 
 
 rif, Lai 
 
 nu Fobs Lan. 
 
 hnntiy mar the oelvui \: be easily arece^srhle the method by pn>- 
 nrr« aztuiB; : is cha e gcoerklly 
 
 ■nf»«f T ^..•. ^rt r^ ^w . , bat in the 
 
 -■:i eiLsy HT-t^iigh when the 
 
 tit when it is eompietely 
 
 Retropolson m*y be 
 
 •< ocly poawble when 
 
 ag oat tfast :: :s 
 
 ace for 
 
 xi.': 3iw»c ..x.. c X i.r: 
 
 4S fior nmc tune, the " w&ten " hsve 
 
 iflypraipfled eowarda the ▼oIt^ th« 
 
 .ppiied dosciy to the 
 
 ^ attonpti at retro 
 
 «- 
 
 « 
 

 V Ij-. 
 
 luii-; 
 
 iorv . 
 aT»pi 
 
 •rrfl in r-- 
 
 -Mi, ittrf 
 
 Life tiin^T 
 
 J- ' 
 
 iuu;£^ 
 
 art recDTtKJL TTitt iffitm & 
 TiRjBfinK a' ine mist, or js hj 
 imt ioK-iimjK occinrr -tot mi 
 
 11 TIl?^ T(i- 
 
 nxotiarr, ::fl 
 
 xnv,-ar» iiK Titerc-Tt^rrrKK „_-_-- — -_ _ — 
 
 nufc-crnei istmctiuL finouii- 'tiieESioEe tk 3sat ^axaooit ^aartj. aaaui-a 
 
 ^'"-? — presanttoi. 
 
 nicrre drfiicutT aa.aa&.'g:' tmnv titt imima^:aE! igraaaE vgTRTOU 
 
 iu/,: or JMti JHnrra^Jual ^josiumi of ^im 3Jtaat^ — ~ 
 
 xioi c tiK I:.. . '-^BEB :qd '-JK* 3Bee. sat " "" "~ -^^ -- 
 
440 
 
 FCETAL DYSTOKIA. 
 
 of the foetus, in order to bring it into a more favourable position — the 
 dorso-sacral, if possible — before proceeding to the adjustment of the 
 other leg, which is to be effected in the manner already indicated. 
 
 One or Both Fore-Limhs completely retained. 
 
 The complete retention of one or both fore-limbs of the foetus in the 
 uterine cavity is often met with in the domesticated animals, but 
 perhaps more frequently in the Mare than the Cow or other creature. 
 It is always a serious cause of dystokia, and may occur in either of 
 the four anterior positions, though it is usually observed in the dorso- 
 sacral position. It is, no doubt, produced during birth, and in the 
 
 Fig. 130. 
 Anterior Presentation, Dorso-Sacral Position : One Fore-Limb completely 
 
 same manner as knee flexion ; its more frequent occurrence with the 
 Foal than the Calf is, in all probability, due to the former having longer 
 limbs than the latter. Under exceptionally favourable circumstances, 
 as Franck remarks, the Foal or Calf may be born with the fore-limbs 
 under the chest and abdomen, and without injury to the mother or 
 offspring. This is much more likely to occur when the foetus is small, 
 the maternal pelvis roomy, and only one limb misplaced. 
 
 But when the foetus is large and the pelvis narrow, then birth, 
 especially of the Foal, is impossible. Not only this, but unless ex- 
 traction is soon accomplished, the foetus runs great risk of dying from 
 asphyxia — indeed, the Foal is nearly always delivered dead in this com- 
 plication ; so that death of the foetus may be said to be the rule in 
 
DYSTOKIA DUE TO THE FoUELIMm^. 
 
 441 
 
 shoulder presentations. With the smaller Ruminants, owing to the 
 formation of the pelvis, birth is not often impeded. With the Sow 
 and Garni vora — 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 
 foetus, after what has been said with regard to the relative dimensions 
 of the young creature and the pelvis of the mother. The shoulder or 
 shoulders, and the muscles in this region, are the cause of dystokia — 
 more especially the flexor brachii, which constitutes a thick and some- 
 what tendinous elastic mass between the scapula and upper end of the 
 fore-arm. This muscular mass forms a very prominent obstacle on 
 
 Fig. 131. 
 
 A.STBBIOB PRtSKSTATION, D0R80-SaCR.\L PoSITIO.V : BoTH FoEK-LlMUa OOMPLKTKLY 
 
 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 fcetus, 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. 130). If 
 both limbs 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 
 
442 FCETAL DYBTOKIA. 
 
 head of the foetus is propelled outwards, but as soon as this ceases it 
 recedes again, as if thrown back by a spring. 
 
 With small-sized Cows, the hand introduced deeply into the uterus 
 may find the extremity of the fore-limb ; but in large Cows, and in the 
 Mare, particularly if the abdomen be pendulous, this is rarely, if ever, 
 the case ; indeed, sometimes the limbs can only be reached with the 
 greatest difficulty, though there is generally no trouble in introducing 
 the arm. When the limbs can be 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 
 abdomen (Fig. 131) ; or closely applied against the walls 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 
 violent means, but then these are the resort of brute force, and not of 
 humane and intelligent device, and nearly always entail the death of 
 the mother. With the smaller animals, when this complication is a 
 cause of dystokia, delivery can generally be effected by simple measures 
 and gentle force. 
 
 Indications. — The indications are to reach the limb or limbs with 
 the hand — resorting to retropulsion if necessary, to gradually raise and 
 bring them forward, joint by joint, into the pelvis, and then to extract 
 the foetus by judicious traction. These indications are not attended 
 with difficulty in those cases in which the head is yet in the abdomen, 
 or only at the pelvic inlet, and are easier carried out in the Cow than 
 the Mare. The method of rectifying the direction of the limbs will be 
 referred to hereafter. 
 
 It sometimes happens, especially with the Mare, and with Heifers 
 which have been rudely manipulated before the arrival of the veterinary 
 surgeon, that the foetus is so engaged in the genital canal that retropul- 
 sion is impossible. In such circumstances some authorities have re- 
 commended forced extraction, traction being exerted on the head of 
 the foetus either by assistants or mechanical means ; others have 
 advised decapitation — skinning the head and removing it at the first 
 or second cervical vertebra, taking care that the ends of the bones 
 are covered by the skin of the skull, to prevent laceration ; then 
 retropulsion is possible, the limbs can be extended, and extraction may 
 be effected. 
 
 With regard to forced extraction, there can be no doubt that if both 
 fore-limbs are retained, the life of the foetus is endangered, and that of 
 the mother also ; though it may be successfully practised with the 
 Sheep, Goat, and other small animals. When only one limb is retained 
 in the Mare or Cow, forced extraction may, nevertheless, succeed ; and 
 Eueff, Harms, Darreau, and other practitioners, have proved that it is 
 possible, traction being employed on the head and normally-presented 
 leg. Amputation of the head will not always prove advantageous 
 in retropulsion ; indeed, it will often be found that it is a dis- 
 advantage. 
 
 The most rational and hopeful operation is detaching the shoulder from 
 the trunk ; or the flexor brachialis muscle may be cut through by means 
 of the curved finger-knife (to be hereafter described) in its thickest part at 
 the shoulder-joint, or above the elbow-joint. Then extraction may be 
 
DYSTOKIA DUE T<> THE HEAD. 443 
 
 afjain attempted. If the fcetus does not come away, evisceration 
 of the chest and abdomen may be practised. Should dehvery be still 
 impossible (which is unlikely), the limb must be detached at the 
 shoulder and tlie 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. 
 
 SECTION II.— DYSTOKIA DUE TO THE HEAD. 
 
 Obstacles to parturition from a wrong direction of the head are 
 <iuite 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 
 ftt-tus the head can be carried back much farther — even as far as the 
 riank, 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 manoeuvres in this animal are 
 much more difficult 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 sulliciently 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 was made to dystokia from excess in volume of the head of the fa-tus 
 (p. 374), Cv lin, of Wassy, has puhliwhed an instnictive jiaper on the subject (Journal dt 
 Mid. Veterinnire tt df Zooftc/iuii, Nov., 1876, p. 5".i0), which deserves notice here. 
 Observing that in very bony Cows the size of the Calf's head is often an obstacle to par- 
 turition — especially in primiparre and in the jHra.t.iii/iif breed of cattle — while it is rare 
 in improved breeds, in which the head i.s small, he describes the nature of the obstacle, 
 and remarks that, if traction is ventured u]>on to extract the fatus, it must be very 
 violent, and therefore likely to j)roduce serious, if not irreparable injury. To avert this, 
 he insists <>n putting Schaack's head-collar on the fotus, or a cord placed l)ehin(l the ears, 
 then each side looj)ed roimd the lower jaw, to answer the same ptirpose. The head being 
 thus secured, the protruding limbs are pushed forward into the uterus, after a cord has 
 been fixed U> each p.'istem. If the genital j)assage is dry, oil is jilentifully injected into 
 it Traction being then exerted on the head, this readily clears the inlet of the maternal 
 pelvis, its fiiniensions being no longer increa-ned by the addition of the limbs ; it is drawn 
 well into the j>elvic cavity, and then the fore-limbs are easily brought through the inlet, 
 now only occupied by the neck of the fcttus. The head and feet are afterwards simul- 
 taneousl}- 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 ca-ses, he has been succes-sful in delivering the Calf without 
 resorting to embryotomy. Success is always certain, pronded incomjH't'-nt persons have 
 not previously rendered it imjwssible. He recommends the same procedure in spasm of 
 the cervix uteri, after reduction of torsion of the uterus, and in fcetal hydrocephalus. In 
 the latter, puncture of the cranium is easier if the fore-limbe have been previously 
 poshed into the utems. 
 
444 
 
 FCE TA L D YS TOKIA . 
 
 and are of the nature of deformity of the neck or head, or both ; we 
 have alluded to them when treating of " Contractions," at p. 392. 
 
 It will readily be understood why misdirection of the head should 
 prove a serious obstacle to delivery, when we remember the part the 
 nose and cranium play in dilating the os and genital canal, and how 
 largely this voluminous region must add to the bulk of the neck, and 
 render expulsion impossible. 
 
 Deviations of the head may be met with in the four principal positions 
 of the anterior presentation ; and they may occur alone, or be com- 
 plicated with misdirection of the fore-limbs. These will not again be 
 referred to, but the head will be studied in three different deviations 
 from the normal direction : 1. Doivmvard deviation, the nose being 
 
 ■^-#^ 
 
 Fi?. 132. 
 
 Anterior Presextation, Dorso-S.vcral Position : Downward Deviation of the 
 
 Head. 
 
 towards the trachea, and the " poll " or upper ridge of the neck present- 
 ing ; 2. Bent under the body, the neck being flexed ; 3. Lateral devia- 
 tion to the right or left side, the head being carried towards the shoulder 
 or flank of that side, the side of the neck presenting ; 4. Upicard devia- 
 tion, the head being bent upwards and backwards in the direction of 
 the withers, or twisted to the right or left side of the chest, with the 
 throat — either straight or twisted — presenting. 
 
 Doivmvard Deviation. 
 
 This is usually the deviation of the head met with in hydrocephalus, 
 though it is not very uncommon when the cranium is normal and the 
 foetus well formed. It is usually met with in the dorso-sacral position, 
 though it is not infrequent in the dorso-pubic ; it perhaps occurs oftenest 
 in the Cow, 
 
 The cause is usually ascribed to premature rupture of the foetal 
 membranes, the deviation occurring when the foetus is entering the 
 pelvis. If the head is not exactly in the axis of the inlet, but inclines 
 a little downwards and is at the same slightly flexed, the nose comes 
 in contact with the brim of the pubis, and is retained there ; while the 
 
DYSTOKIA ]>VE To THE HEAD. 445 
 
 uterine contractions, pushing on the body, propel the fore-hmbs, if they 
 are in a favourable direction, into the genital canal. Thus it will be 
 understood that, if the expulsive efforts continue, the head becomes 
 more and more tlexcd as the fietal mass is carried towards the vulva (as 
 is delineated in the shaded and unshaded fcetuses in Fig. 132), until, 
 from vortical 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 flexed, and as laliour goes on the 
 head is retained, as well as the cervical portion of the former ; so that 
 when the obstetrist 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 presentation {unshaded fcetus in Fig. 132). 
 
 The diagnosis of this deviation is not ditlicult. When the anterior 
 limbs are in a proper direction, the feet and upper part of them are 
 readily found, and their inclination should be noted ; but in a slight 
 complication the whole of the head cannot be discovered — only the ears, 
 eyes, nape of the neck, and the forelock and mane if a Foal. With the 
 Calf, 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. 
 
 Indications. — There is no difViculty 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 glide the hand 
 along the floor of the vagina into the uterus, pass it between the maternal 
 pubis and the forehead of the foetus, 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. 
 W'ith the Calf, whose muffle is wider and cannot be so readily received 
 into the palm of the hand, it is better to introduce the lingers into its 
 mouth, using them like a blunt hook, or to seize the nose l)y 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 unskilful 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 etTected by passing the running noose of a cord 
 round the nose or the upper jaw of the fa^tus, 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. 
 
 .\nd 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 fcctus 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 
 being applied, the Foal was expelled with its head in this position, but 
 without injuring the perinicum of the mother. The latter soon recovered, 
 
446 
 
 FCETAL DYSTOKIA. 
 
 but the Foal, as is usual in such cases in the Equine species, was 
 dead. 
 
 In this degree of deviation, as well as in the others, great assistance 
 will be afforded by raising the hinder parts of the mother to the extent 
 of one, two, or more feet. Lecoq, Eueff, and others have recommended 
 placing the animal on its back. It is perhaps better, however, to 
 elevate the hind-quarters, and resort to retropulsion either by the 
 hand or the crutch ; then, after injecting warm water or oleaginous 
 fluids, to either extend the head or to attempt forced extraction. The 
 blunt hooks fixed firmly in the orbits of the foetus, will be found most 
 useful in the latter operation. 
 
 In the dorso-pubic position, propulsion is necessary to adjust the 
 
 Fig. 133. 
 Antekior Presentation : Extreme Downward Deviation of the Head. 
 
 body for extraction ; the head being pushed into the uterus, efforts must 
 be made to place the foetus in the dorso-sacral position, which, being 
 accomplished, renders delivery possible. 
 
 The same procedure is necessary with the Sheep and Goat ; while 
 with the Bitch and Cat delivery must be effected by means of forceps. 
 
 Head bent 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 manner to the 
 preceding — the foetus in the anterior presentation advances to the inlet 
 with the neck flexed, and, consequently, 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 lower 
 
nVSToKIA Dl'K TO THK UKAD. \\1 
 
 and more under the neck until it gets beneath the chest, and even tlie 
 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 Uoor 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 amatem-s, 
 and the uterus closely applied to the body of the foetus, the case is 
 most ditticult ; as then manipulation and retropulsion cannot effect 
 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 delivery almost impossible, 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 fcetus — 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 its 
 back ; indeed, the success which has attended this change of attitude in 
 80 many recorded instances, should induce the obstetrist to adopt it 
 without much delay. Very often the altered position of the mother at 
 once disengages the head of the fcetus 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 effected, 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 fcetus is dead, which is nearly always the case 
 in the Mare. The head maybe 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 the neck is begun. This gives more room for manipulating 
 the body and etlecting 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 pull it so as to bring the head 
 nearer the inlet, where it may be possible to turn it into the genital 
 canal, or at least to amputate it more easily. 
 
448 FCETAL DYSTOKIA. 
 
 Lateral Deviation to the Right or Left. 
 
 The lateral deviation of the head to the right or left side of the body, 
 whereby the left or right 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 frequent deviations, 
 Saake observing it in 394- per cent, of his cases of dystokia ; it occurs 
 much more often in the Mare than the Covp or other animals. With 
 regard to its origin, as well as to its adjustment, a wide distinction 
 must be drawn between it as it exists in the Foal and other young 
 creatures. 
 
 The cause of lateral deviation of the head is not well ascertained in 
 all cases. It is not improbable that, in very many instances, it is due 
 to precipitate or tumultuous birth, when the os is either imperfectly or 
 not at all dilated. In such circumstances, the uterine contractions 
 propel the head of the foetus, otherwise in a good direction, towards the 
 pelvis ; but as the os is not open, and as the impelling force continues, 
 the body pushes the nose against either the pelvis or the occluded os, 
 and it turns to one side ; then the deviation becomes increased with 
 every contraction. Premature rupture of the fcBtal membranes and 
 escape of the " waters," spasm of the cervix uteri, torsion of the uterus, 
 and other anomalous conditions, may all more or less occasion it. As 
 with the downward deviation, if the nose is not in the axis of the 
 pelvis, or indeed of the os — even though the latter is partially dilated, 
 misdirection may occur, and all the more rapidly should the fore-limbs 
 chance to pass into the vagina. 
 
 The accident appears to be most frequent with primiparae. In 108 
 cases of lateral deviation of the head, Saake found 84 — or 78 per cent. 
 — in animals pregnant for the first time. The remainder were noted in 
 animals which had previously bred, but in which labour was protracted 
 through imperfect or tardy dilatation of the os. 
 
 This deviation is more serious when the foetus is dead than when it 
 is alive ; and when the deviation is only slight, the head fitting into the 
 concavity on the side of the neck, birth may even -though indeed rarely 
 — occur without assistance, particularly with the Foal, which has a 
 longer and thinner head than the Calf. Some authorities have remarked 
 that the deviation is more frequently to the right than the left side, 
 and others the contrary. 
 
 In some instances there can scarcely 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 foetus. In many Foals at 
 birth the neck cannot be straightened, and the head is distorted from 
 being pressed against the neck or side of the body (Fig. 103) — bones, 
 muscles, and ligaments being involved. We have referred to these in 
 describing " Contractions " of the foetus as a cause of dystokia. 
 
 It is not difficult, as a rule, to distinguish the existence of lateral 
 deviation. Usually both fore-feet are in the genital canal, but birth 
 does not progress. But an important fact to remember is that one limb 
 — that belonging to the side to which the head is bent — seems to be 
 shorter, or less advanced, than the other. The hand, on being passed 
 beyond these towards the inlet, comes in contact with a convex mass, 
 more or less occupying the whole of it, and rendering access to the uterine 
 cavity difficult. Patient exploration, however, discovers this to be the 
 bent neck ; and if it be a Calf, owing to the shortness of this part, the 
 
DVSTOKIA DUE TO THE IIEAIK 
 
 419 
 
 head is soon found, and recognised by the ears, eyes, and often the 
 muffle turned towards the shoulder (Fig. 13-i) — with this Bovine foetus, 
 in fact, the greater part of the head in the majority of cases lies against 
 the shoulder. 
 
 With the Foal, it is only too often otlierwise. The much longer 
 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 altdomen, or even the Hank or croup, where it cannot be 
 reached. This ditliculty is greatly increased if the abdomen of the 
 mother is very pendulous. Occasionally this is also the case with the 
 Cow, though it is i-are that in this animal the ears, or even the eyes, 
 cannot be reached by a fairly long arm (Fig. 13o). If the animal, be it 
 Mare or Cow, chances to be lying, and the deviation is only to the 
 
 Fig. 134. 
 
 ANTKHIOR PBE3EXTATIOX, DoRSO-SaCK.VL POSITION: LaTEKAL DEVIATION OK THK 
 
 Head towakds the Shoulder. 
 
 shoulder, it is most difficult to reach 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 right. 
 
 The head may be raised as high as the back, or lie as low as the under 
 part of the chest or abdomen. The fcetus is usually in the first (or 
 dorso - sacral) position, though the deviation may also occur in the 
 second (dorso-pubic) or third (dorso-ilial) positions ; in the latter posi- 
 tion the neck may be bent upwards — the head towards the maternal 
 sacrum, or doicnnards — the head resting on the floor of the uterus. 
 
 This complication is not only a very frequent, but, as has been said, 
 a very serious one for the obstetrist, and it may be truthfully asserted 
 that birth is not possible without his assistance ; indeed, it has been 
 well remarked that " it taxes all his strength, patience, and ingenuity." 
 
 29 
 
450 
 
 F(ETAL DYSTOKIA. 
 
 With the Calf, the neck of which is comparatively short, the head is 
 in most cases no farther back than the shoulder, though it may be as 
 high as the withers or as low as the sternum. It is, therefore, possible 
 to reach it ; and though its relatively large size is a great obstacle to 
 reduction, yet in the majority of instances this adjustment can be 
 accomplished, and especially if the young creature is alive, as its spon- 
 taneous movements aid the operation ; for this and other reasons 
 ah'eady alluded to, the Calf is more frequently extracted alive than the 
 Foal. 
 
 As a rule, reduction of the displacement is indispensable in delivery, 
 the head and neck, or shoulder, forming too voluminous a mass to pass 
 through the pelvic canal ; though rare instances are recorded in which 
 birth took place with the neck bent. 
 
 Anterior Peesentation 
 
 Fig. 135. 
 
 Lateral Deviation of the Head towards the 
 Abdomen. 
 
 With the Foal the head may also not go beyond the region of the 
 shoulder, and the case is then generally not so serious as with the 
 Calf, the head being smaller and the displacement more easily reduced. 
 But, as has been pointed out, owing to the long and flexible neck of 
 this creature, the head is most frequently deeper in the uterine cavity — 
 towards the side of the chest, abdomen, flank, or even the croup. 
 Here the hand cannot reach it, and reduction is nearly always impos- 
 sible ; besides, the foetus succumbs soon after the commencement of 
 the labour-pains — death being due in many, if not in all, cases to pre- 
 mature separation of the maternal and foetal placentae. However, 
 owing to the thinner and more flexible neck and the smaller head, 
 when the latter was lodged in the flank the foetus has been delivered 
 by energetic traction. 
 
DYSTOKIA DUE TO TUE HEAD. 451 
 
 Indications. — The principal indication in this deviation is, of course, 
 to get hold of the head, if possible, adjust and bring it into a favour- 
 able position in the genital canal, and then etVect delivery. This is on 
 the supposition that the head is accessible ; but when such is not the 
 case, then it is dillicult, if not impossible, to straighten the neck, and 
 especially if the curvature is due to contraction. When we come to 
 treat of obstetrical operations, reference will be made to this straighten- 
 ing of the neck. 
 
 When it is found impossible, or not advisable, to attempt adjustment 
 of the head and neck, then recourse must be had to forced extraction 
 or cmhriiotomii. 
 
 With regard to forced extraction in the Cow, though instances are 
 recorded in which it has been successfully practised, yet it should 
 never be resorted to by the humane pi-actitioner.i The gi*eat length 
 and essentially bony structure of the Cow's pelvis, and the large 
 volume and shape of the Calf's head, prove such an obstacle to forced 
 extraction in this lateral deviation, that, if persisted in, it will not only 
 cause the death of the mother, in all probability, but also that of the 
 foetus, unless it is unusually small and the pelvis of the Cow very 
 wide. In fact, those who have attempted it testify to its barbarity 
 and fatality. 
 
 With the Mare, the case is somewhat different. When the head of 
 the Foal is deeply buried towards its flank or croup, i-eduction is most 
 difficult, and requires long and laborious manipulations, which so irritate 
 the organs and exhaust the strength of the mother, that death not 
 infrequently results. In most cases, too, the obstetrist is called in 
 when the Foal is dead, so that there is no necessity for scruples with 
 regard to it. On the other hand, as we have previously said, the long, 
 thin, and flexible neck and narrow and tapering head readily allow 
 the latter to become embedded in the flank, and thus to offer much less 
 resistance than with the Calf ; while the wider pelvis of the Mare 
 offers further facilities. Numerous instances are given in which forcible 
 extraction of the Foal with the head so deviated, has been attended 
 with complete success — Darreau had eight out of ten cases — and with- 
 out much suffering on the part of the Mare. Indeed, so successful and 
 prompt is it, that Donnarieix, who has devoted much attention to this 
 procedure, says it should, as a rule, be adopted in these cases, as it is 
 not possible to restore the head to its normal position ; delivery by 
 vigorous traction is, if not easy, at least most frequently followed by 
 success. 
 
 Donnarieix operates as follows : The Mare is thrown down near the 
 stable door, the thighs pi'opped against the threshold, and a breeching 
 and side-line, fixed to the wall or held by assistants, may be employed 
 to keep the animal in position. Each fore-limb of the foetus is corded 
 at the pasterns, the cords being confided to assistants, the number of 
 which will vary according to the amount of resistance — four at least 
 are necessary, and sometimes six or eight. On the word being given, 
 these men pull slowly, steadily and gradually, without jerking, but 
 
 ' Franck (op. cit., p. 373) gives an instance in which two empirics attempted to 
 deliver a Cow that could not calve. They mistook this deviation for a breech presenta- 
 tion, as they could not find the head, and they thought the fore-feet in the vagina were 
 hind ones. They c<insequently, other means failing, set about extracting the Calf by 
 force, and eight men pulled at the cords attached to the feet ; the young creature was 
 removed, but it was dead. The Cow was unable to get up for eight days, but eventually 
 recovered. 
 
452 FCETAL DYSTOKIA. 
 
 Strongly and equally on both cords. The Foal enters the inlet, but it 
 often happens that, at a given moment, it stops there, owing to the 
 uterus forming a double or ring at this part and opposing progression. 
 Traction must then cease, but the fcetus is to be held firmly in the posi- 
 tion to which it has been advanced ; the hand is to be introduced 
 between the latter and the uterus — the back of the hand to the foetus, 
 palm to the mucous membrane — the fold sought for, and dispersed by 
 raising the back of the hand. Then the tractions are to be renewed, 
 and in the course of fifteen, ten, or even fewer minutes, the Foal is 
 extracted. It is well to empty the rectum before commencing 
 extraction. 
 
 When practised with care and discretion, this forced removal of the 
 Foal may certainly be commended, especially if it is of small size 
 and the Mare is not exhausted ; but when 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 already 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 abdominal muscles, through the powerful traction resorted to. 
 
 With regard to embryotomy, this must be looked upon as preferable 
 to forced extraction — even in the Mare, but particularly in the Cow ; 
 nevertheless, it must always be considered as an extreme measure. 
 The operation will be described hereafter, but we may note in this 
 place that the head or presenting limbs, or even both, may be re- 
 moved. Decollation is, however, a most difficult business when the 
 head cannot be reached ; if it is accessible the operation can scarcely be 
 necessary. The limbs should be removed subcutaneously, the most 
 advanced being first excised, and with the shoulder if possible. Not 
 infrequently removal of one limb will be sufficient to allow the foetus 
 to be adjusted — especially in the Mare ; or it may permit forced extrac- 
 tion, without adjustment, to be easily accomplished. 
 
 With the Calf, both limbs have usually to be removed. In this opera- 
 tion, the long sharp crotchet will be of service. 
 
 The parturient animal in which this head-deviation of the foetus 
 occurs, has sometimes a very pendulous abdomen, and manipulation is 
 greatly retarded by this conformation. Placing it on its back will 
 generally give greater facilities for obstetrical operations of this kind. 
 
 Lateral deviation of the head is usually encountered when the foetus 
 is in the first, or dorso-sacral, position. It may nevertheless be met 
 with, though rarely, in the dorso-pubic position, or in the right or left 
 dorso-ilial position, which is still more rare. 
 
 These positions, however, do not modify the indications for extraction 
 to any considerable extent, except that in the last, after correcting the 
 deviation of the head, rotation should be practised, and the foetus placed 
 in the dorso-sacral position, if possible, before delivery is attempted. 
 When the head is doubled beneath the body of the foetus in these lateral 
 positions, it will be found most advantageous, in order to reach it, to 
 throw the mother down on the side that will ensure the head of the 
 young creature being uppermost. Version may be advisable in some of 
 these positions. 
 
 1 Gurlt and Hertwig's Magazin Jili- Thurhtilkunde, 1S51, p. 269. 
 
DYSTOKIA DUE TO THE HEAD. 453 
 
 This lateral deviation of the head is liable to be complicated by mis- 
 direction of one or both of the foro-linibs, which may be Hexed at the 
 knee, entirely retained, or crossed on the sternum. Such a complica- 
 tion of course greatly adds to the gravity of the case, and renders it 
 much more formidable. 
 
 Here it will be necessary to adjust the limbs before interfering with 
 the head ; though the latter, if it can be reached, and there is any benefit 
 to be derived from doing so, should be secured by either a head-collar, 
 or a cord round the neck or jaw. The feet should always be secured by 
 cords, so that if it is requisite to push them into the uterus, they may 
 readily be withdrawn again. 
 
 In one instance of this kind,^ the sacro-sciatic ligament of a Cow was 
 divided, and the dead faHus removed through the opening. There was 
 very little hicmorrhage, and the Cow soon recovered. 
 
 With the smaller animals — such as the Sheep and Goat — this devia- 
 tion must be remedied by forced extraction with the short blunt hook or 
 finger-hook, the fore-limbs of the foetus being manipulated so as to push 
 away the unencumbered shoulder into the uterus, and bring forward 
 that round which the neck bends. The smallness of the genital passages 
 in these creatures is an obstacle to manipulation, but an intelligent boy 
 with a small hand may be of much sei^vice when acting under the direc- 
 tion of the obstetrist. 
 
 With the Bitch and Sow these deviations are extremely rare. When 
 they do occur it will be found that forceps will generally effect forced 
 extraction ; or a piece of strong catgut, or brass or copper wire, may be 
 passed round the bend of the neck. Traction on this will either re- 
 move the fa^tus, or by cutting through the neck permit it to be ex- 
 tracted by the forceps hereafter to be described. Placing the Bitch in 
 a warm bath for a few minutes, and then laying it on the side opposite 
 to that to which the head of the puppy is inclined, will be found 
 advantageous. 
 
 Deviation Upicanl and Backward. 
 
 The deviation of the head more or less upward and backward — the 
 inferior borders of the lower jaw being vertical or turned towards the 
 maternal sacrum — appears to be an extremely rare complication, and is 
 chiefly met with in tlie Mare, in which it has led to rupture of the 
 uterus and rectum, and delivery by the latter. 
 
 The cause is probably the same as in the other deviations of this 
 region. 
 
 On exploration, if the foetus is in the dorso-sacral position, the fore- 
 limbs may be found more or less advanced in the vagina, and beyond 
 them, at the inlet, the hand meets the sternum, while above it is the 
 front part of tlie neck, with the trachea leading upwards to the head, 
 which may be bent more or less back on the withers or loins (Fig. 136), 
 or inclined to one or other side of the fatus, the lower jaw always 
 facing the lumbo-sacral region of the mother, or twisted slightly round 
 (Fig. 137). 
 
 Indications. — Retropulsion is the first indication, and this alone will 
 often bring the head into its normal position ; it should be practised on 
 the sternum. Should the head not drop down to the pelvic inlet, then, 
 
 ' Velerinarian, vol. xxx., p. 20, 
 
454 
 
 F(ETAL DYSTOKIA. 
 
 still continuing the retropulsion, the hand may be introduced, the lower 
 jaw seized and brought towards the os, in carrying it downwards and 
 a little to one side if necessary, by a slightly screwing motion, k cord 
 
 rig. 136. 
 
 Anterior Presentation, Dorso-Sacral Position : Deviation of the Head Upwards 
 
 AND Backwards. 
 
 on the lower jaw, or around the head, may be useful if it can be 
 applied. Eueff recommends compression in the rectum, previously 
 
 Fig. 137. 
 Anterior Presentation Deviation of the Head Upwards and Laterally. 
 
 emptied, by the hand of an assistant, while the operator manipulates 
 in the uterus. If the animal is lying, it must be made to stand. 
 
 When this deviation has been found in the Cow, placing the animal 
 on its back has been found of great service in rectifying the displace- 
 ment. 
 
DYSTOKIA DUE To TIIK UKAD AXD FORE OK IIIXIJ LIMBS. 455 
 
 Embryotomy is rarely necessary. 
 
 In the smaller animals— at least in the Bitch — delivery has been 
 etlected without reduction of the deviation. 
 
 SECTION III.— DYSTOKIA DUE TO THE HEAD AND FOIiE OlC HIND 
 
 LIMBS. 
 
 Saint-Cyr speaks of complicated cases of dystokia in the anterior pre- 
 sentation, due to the head and fore or hind limbs, which are sometimes 
 met with, and the principal of which are the following. 
 
 Ilead retained, and xcith it One or Both of the Fore-Limbs. 
 
 No matter what the abnormal direction and position of the head and 
 neck may be, the ditliculty may be complicated — and very frequently is 
 — by retention of one of the fore-limbs, which may be either Hexed at 
 the knee or detained in the abdominal cavity ; the detention of both 
 fore-limbs, though very rare, yet is not impossible. 
 
 In such a case the deviated parts are successively rectified, usually 
 commencing with the limbs, as their presence in the genital canal does 
 not interfere with the manipulation of the head ; but it sometimes 
 happens that it is more advantageous to begin with the head — for 
 instance, when it is much forward in the uterus. But it is really of no 
 great moment which part is first dealt with, so long as the precaution is 
 taken first to cord those which are deviated. How they are to be 
 rectified will be explained presently — but it may be remarked that such 
 rectifications succeed most frequently in the Cow, from which the Calf 
 may be extracted alive ; but the fcctus of the Mare usually dies so soon 
 that there is no time for their adoption, so that — putting forced extrac- 
 tion aside as dangerous — version should be tried if circumstances will 
 admit, before resorting to embryotomy. 
 
 Head or One of the Fore-Legs retained^ and One or Both of tJie 
 Hind-Legs in the Genital Canal. 
 
 It may happen that one or more of the anterior parts of the body are 
 retained, and yet one or both of the hind-legs enter the genital canal, 
 this depending upon the manner in which the fcctus originally presented 
 itself — the presentation being generally sterno-abdominal, with either 
 hind or fore limbs, or both, in the inlet, and a change occurring in the 
 position subsequently. 
 
 When a fore-limb is retained and a hind one is in the passage, the 
 former may be bent at the knee or be under the chest. If possible, it 
 should be straightened and brought into the passage, and the hind- 
 limb also pulled towards the head of the futus, the foot as high as the 
 ear, and traction made on the head and feet. If delivery cannot be 
 accomplished, then propulsion may be attempted, and, if successful, the 
 position rectified — though this attempt is likely to prove futile. Then 
 it will be necessary to remove one of the fore-limbs at the scapula, or 
 cut through the trunk of the fuitus. 
 
 When the head is retained and one of the hind-legs has entered the 
 genital canal, in the dorso sacral position, an endeavour should be made 
 to push the hind-leg into the uterus, and even the head may be 
 pushed forward. But if for certain reasons this cannot be done, it may 
 be advisable to proceed to embryotomy — removing both fore-limbs 
 entirely, which will then admit of retropulsion of the trunk and adjust- 
 ment of the head and neck. 
 
456 
 
 F(ETAL BYHTOKIA. 
 
 There are other complications of a similar kind in this presentation, to 
 remedy which the practitioner must exercise his judgment by resorting 
 to rectification of the misplaced parts, so as to effect delivery in the 
 anterior presentation ; to version, so as to bring about a posterior pre- 
 sentation and then deliver ; or to embryotomy, in order to reduce 
 the size of the foetus, and thus have more room for manipulation and 
 removal of the body. 
 
 CHAPTEE II. 
 Dystokia in the Posterior Presentation. 
 
 Though parturition may take place spontaneously and terminate 
 favourably w^hen the foetus presents posteriorly and in a normal posi- 
 tion, yet as in the anterior presentation so in this — the presentation 
 
 Fig. 138. 
 Lumbo-Sacral Positiox. 
 
 may be natural but the position abnormal ; or, though both be normal, 
 yet delivery may be interfered with by deviation of some part- such as 
 the fore-limbs or head. Not only may this be the case, but the pre- 
 sentation itself may be unnatural. 
 
 Several authorities alluded to by Saint-Cyr mention deviation of the 
 tail of the foetus as ofi'ering an obstacle to birth in this presentation, 
 lumbo-pubic position ; and it is admitted that such may be the case if 
 that organ gets below the thin margin of the pubis, and becomes bent 
 down towards the croup ; but this should be easily remedied. 
 
 When treating of the mechanism of parturition (p. 250), it was 
 
DVSroKIA FROM Jj:yn/:MJL POSITIONS. 457 
 
 remarked that of the positions in the breech or posterior presentation, 
 only one is compatible with spontaneous and natural delivery — the 
 lumbosacral ; but this is only possible when the hind-limbs are fully 
 extended backwards, and are the first to enter tlie genital canal, so as 
 to gi-adually dilate the channel for the passa^'e of the voluminous and 
 rounded croup. Birth in this position, and without assistance, is more 
 frequent in the Bovine than the Equine species, and the youn<^ creature 
 is nearly always born alive. With the Mare, parturition is always 
 longer and more laborious, and the Foal quickly perishes after rupture of 
 the membranes. It therefore results that, even when the latter is in 
 the lumbo-sacral position, and everything is favourable, delivery should 
 be hastened if it is desired to preserve the life of the young creature. 
 
 The other three posterior positions — lumbo-pubic and right and left 
 lumbo supra-cotyloidean — are unnatural, and demand the intervention 
 of the obstetrist. 
 
 Besides, these positions, as well as the lumbo-sacral, may be compli- 
 cated by a vicious direction of the limbs or neck, which may lead to 
 as great, if less varied ditliculties, as those encountered in the anterior 
 presentation. 
 
 A. NOKM.\L PoSTEltlOK PRESENTATION. 
 
 We have just referred to this presentation and described what it 
 implies. 
 
 SECTION I.— DYSTOKIA FROM ABNORMAL POSITIONS. 
 
 As has been mentioned, these are three in number— the lumbo-picbic 
 and two lumbo-sitpra-cotyloidcaii positions. 
 
 Lwnbo-jncbic Position. 
 
 In this, the posterior reversed position, the foetus is lying on its back, 
 its croup and loins towards the tioor of the abdomen or the pubis of 
 the mother, with its feet and belly towards the sacrum. 
 
 As a consequence, the hind-limbs, which soonest enter the pelvis, are 
 inclined upwards and backwards into the genital canal, and are there- 
 fore the parts that first meet the hand in exploration. Saint-Cyr points 
 OQt what might be a cause of error in this exploration, in the following 
 terms: " As the anterior face of the hoof or claws is directed upwards 
 and the plantar surface (sole) downwards, the explorer might be 
 inchned to think that it was an anterior vertehro-sacral presentation ; 
 but in pushing the exploration further, and following the cannon-bone 
 with the hand, the hock is met with — recognisable by its jlatimss on 
 each side, the point of the calcis downwards, the hend being upwards in 
 the same direction as the wall of the hoof ; whereas the bend of the 
 knee is in the same direction as the sole of the foot. Beyond the hock 
 the hand also comes in contact with the croup and the tail, lying 
 towards the maternal pubis." 
 
 The obstacle to birth lies chiefly in the thighs and buttocks, while 
 the hind-feet project against the mother's sacrum, and, in addition to 
 increasing the resistance, threaten to lacerate the organs interposed 
 between them — the vagina or rectum, or both — and that bony mass. 
 Besides this, the body of the fcetus itself forms a curve exactly the 
 
458 FCETAL DYSTOKIA. 
 
 reverse of that of the pelvis ; so that it cannot readily accommodate 
 itself to the bony canal through which it should pass. From all 
 these causes, this position is not only unfavourable to birth, and must 
 be remedied, but it may also lead to serious accidents. 
 
 The position appears to be more frequently met with in the Mare 
 than the Cow, Donnarieix having witnessed it at least a score of times 
 in the first-named animal. This authority, however, is of opinion that 
 it is altogether a secondary position ; the foetus at the commencement 
 being in a normal position (lumbo-sacral), and still alive, is retained at 
 the pelvic inlet by its croup, and soon dies ; then obeying the laws of 
 gravity, at a moment when the uterus is relaxed, it turns upside down. 
 And he gives what he considers a proof, in the fact that breeders, in 
 consequence of what he was always telling them — to the effect that in the 
 posterior presentation the Foal does not live for longer than half an hour 
 — -were always successful in bringing the young creature forth alive 
 when they at once resorted to traction in such cases, all informing him 
 that the croup was above and the belly beloio ; while in all the instances 
 in which he had to interfere, the belly was uppermost and the bach doivn- 
 wards. In the latter cases Donnarieix never found the Foal living. 
 
 Saint- Cyr, however, thinks this explanation is not quite satisfactory, 
 that the opinion is too absolute, and that in the Mare, as well as in the 
 Cow, the lumbo-pubic position of the foetus may very well be pjrimary. 
 Donnarieix himself admits as much, from a case recorded by Eochard, 
 in which a living Foal was extracted— an extremely rare event in the 
 Equine species. 
 
 Indications. — The majority of authorities recommend that rotation 
 of the foetus should be practised in this position, so as to convert it 
 into a luvibo-ilial or even a himbo-sacral position ; while others, and 
 notably the French veterinary obstetrists, do not think of changing the 
 position, but readily effect delivery when other causes of dystokia do 
 not complicate it — indeed, they look upon these cases as the easiest 
 to remedy, and rarely requiring more than a quarter of an hour. 
 
 "With the Cow, however, and especially if the Calf is of large size, 
 version is necessary before delivery can be effected ; and this may be 
 also required with the Mare, though the comparatively larger pelvis of 
 this animal may permit delivery without changing the position. In 
 attempting this, the most important matter for attention is the direction 
 of the hind-feet during delivery ; these should be carefully guided 
 through the genital canal until they are external to the vulva, so as 
 to avoid those lacerations and ruptures which are only too readily 
 produced. 
 
 In order to accomplish delivery, the pastern of each hind-limb should 
 be corded ; then the hand must be passed along the flexor tendons 
 until the point of the hock is reached, this part usually jamming 
 against the brim of the pubis ; the hock is now raised, and at the same 
 time the corresponding cord is pulled gently backward and slightly 
 downward, so as to bring the calcis into the vagina ; this operation is 
 to be repeated on the other limb, and then both feet are to be directed 
 by the hand through the canal. This being accomphshed, the cords 
 should then be pulled upwards, so as to raise the croup and facilitate 
 its entrance into the inlet ; after which steady traction, proportioned to 
 the amount of resistance, must be employed during the labour-pains 
 until the young creature is completely extracted. 
 
JjysTiiKLi IHE To TllK IIK.U) (ill I-'ollKLlMHS. 469 
 
 L iimbo-supra-Co ty lo Ulean Pos it io7is . 
 
 These positions — ri-^ht and left — are so like the corrcsponclinf:; posi- 
 tions in the anterior presentation, that the same remarks are applicable 
 to them. When simple, the hind-limbs — perfectly extended — first enter 
 the ^'enital canal. Such positions are very rare, and they do not offer 
 anything very noteworthy ; they are recognised in the same way as the 
 lumbo-pubic position, and the indications are the same. As a rule, 
 parturition is easier in these positions than in the lumbo-pubic, as only 
 one haunch is jammed against the brim of the pubis ; the other, being 
 in contact with the mother's sacrum, can enter the inlet without much 
 dirticulty. Judicious traction on the hind-pasterns is all that is needed 
 after the position has been rectified. 
 
 The same observations apply to the lumho-ilial positions, which are 
 sometimes, though rarely, met with, and are a cause of dilViculty. 
 
 SECTION II.— DYSTOKIA Dl'K TO THE HEAD OR FORE-LIMBS. 
 
 Obstacles occasioned by the head and fore-limbs in this presentation 
 are less frequent, and not so serious as in the anterior presentation when 
 the hind-legs enter the genital canal. The 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 faxed, 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 the 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 
 difficulty, 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 fa-tus 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-Umbs should be 
 
460 FCETAL DYSTOKIA. 
 
 corded, placed straight in the genital passage, and traction made on 
 them by the cords and the hand ; if there is difficulty in moving the 
 foetus, traction should be made on one side, then on the other, by which 
 means progress will be made, and delivery ultimately completed. 
 
 Fore-Limhs. 
 
 In the posterior presentation it may happen that the fore-limbs olTer 
 an obstacle to birth, by entering the inlet along with the chest of the 
 foetus. Donnarieix alludes to this accident in a presentation which 
 he designates as mixed, and characterised by the entrance into the os 
 of the four legs at the same time ; this may occur in the anterior pre- 
 sentation, when the hind extremities are flexed beneath the abdomen 
 and jammed in the pelvis, as well as when these are the first to enter 
 the OS. Other authorities also speak of this accident, which is not 
 frequent. Sometimes the two hind-limbs and a fore one are found in 
 the passage. It is probable that the presentation is secondary, and 
 probably it was originally sterno-abdominal, with the feet engaged in 
 the canal. 
 
 The hind-legs are found in the passage, perhaps projecting from the 
 vulva, one or both of the fore ones being in the vagina, and probably 
 towards the maternal sacrum ; while the body of the foetus may be 
 parallel to that of the mother, but more frequently it is oblique. 
 
 Indications. — According to Donnarieix, retropulsion is impracticable 
 in the Mare in this difficulty, as the limbs are jammed against the 
 maternal pubis, ihums, or sacrum, and traction will lead to rupture of 
 the uterus. He therefore advises amputation of the fore-limb or limbs 
 at the humero-radial joint, after they have been withdrawn to near the 
 vulva ; he has always been successful in his cases by such treatment. 
 With the Cow, however, he admits that the fore-limbs may be pushed 
 forward into the uterus, and delivery then effected. 
 
 Dieterich and Darreau advise retropulsion of the fore-limb or limbs 
 by means of the repeller. 
 
 Amputation of these limbs being a long and troublesome operation, 
 Donnarieix's advice should not be followed until other measures have 
 been tried. These should be : propelling the fore-limbs into the uterus, 
 and if this cannot be effected, pushing the upper joints beyond the 
 inlet. Canu recommends cording the hind extremities, grasping the 
 fore ones above the knee and carrying them into the uterus, while the 
 assistants pull the cords. If these attempts fail, then the fore-legs can 
 be drawn as near the vulva as possible, and amputated either at the 
 shoulder or scapula. 
 
 B. Abnormal Posterior Presentations. 
 
 The abnormal posterior presentations are chiefly due to deviation in 
 the direction of the hind-limbs, and this is, in many instances, a very 
 serious complication. Instead of being extended backwards into the 
 passage, one or both may be bent at the fetlocks or the hocks — the leg 
 against the thigh, these joints presenting ; or they may be carried 
 straight forward under the body, the buttocks alone resting against the 
 inlet. So that, instead of a wedge-shaped mass offering its thinnest 
 portion to gradually dilate the genital canal, the foetus presents a large 
 rounded mass — the croup and thighs — which is not at all adapted for 
 
ABXOUMAL POSTERIOR PRESEXTATIOXS. 4G1 
 
 effecting a passage through the Hinited space. When to tliis bulk is 
 ailded tlu' Hexed portion of the hnibs, it will be seen that this cause of 
 dystokia, generally most formidable in all cases, must be more so with 
 primiparip, and especially if some time has been allowed to elapse since 
 the commencement of parturition, if the " waters " have esca])ed, and 
 if amateurs and empirics have been interfering. With I'egard to this 
 interference, however, it must be admitted that it is less to be dreaded 
 in this presentation than perhaps in any other ; incompetent people are, 
 fortunately, at a loss how to act, as there is nothing to lay hold of, and 
 the nature of the malposition or the manner of remedying it is obscure, 
 perhaps unknown to them. 
 
 In the diverse complicated positions of the posterior limbs in this 
 presentation, it may be remarked that they are more frequent and 
 difficult in the Mare than in the Cow — the increased difficulty being 
 doubtless due to the gi'eater length of the limbs in the Foal than the 
 Calf. 
 
 The malposition of the hind-limbs may be of three kinds : 1. Limbs 
 incompletely extended in the genital canal ; 2. Flexed hocks, the 
 doubled limbs engaged more or less deeply in the passage ; 3. Ilind- 
 limbs completely retained in the uterus, and applied more or less closely 
 against the abdomen of the fujtus, the back part of the thighs and the 
 croup presenting at the inlet. 
 
 We have mentioned that one or both limbs may be in a vicious posi- 
 tion ; even when the two are misdirected they may not be in the same 
 deviation — one leg being perhaps Hexed at the hock and the other ex- 
 tended forward towards the chest, one Hexed at the fetlock while the 
 other is bent at the hock, etc. 
 
 This presentation is somewhat rare, and though differing little from 
 the natural one, yet frequently leads to death of the Foal, as birth 
 cannot take place without assistance ; though the Calf, having more 
 vital tenacity, can live longer, and therefore has more chance of being 
 born alive, even if help be not afforded for some time. It is generally 
 due to the prominent stiHes being arrested at the inlet by the thin 
 margin of the pubis in the Mare, or the inclined plane this part forms 
 in the Cow. When the hind-limbs become fixed the body of the fa'tus 
 continues to pass outwards, so that the fenuu-s become more vertical, 
 and this causes the croup to be raised against the lumbar region, and 
 finally to be jammed there. The accident is much less frequent in the 
 Cow than the Mare, probably because of the sloping border of the 
 pubis. 
 
 Exploration discovers the soles of the hind-feet uppermost, with the 
 shank incompletely extended on the tibia, which again is partially 
 Hexed on the femur ; the stiHes are also found pressing against the 
 margin of the pubis, while beyond this the croup is jammed upon the 
 sublumbar arch. 
 
 Indications. — These are : push the croup forward in the uterus during 
 the inten-als between the pains, while traction is made on the cords 
 which have been attached to the 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 Cow — the 
 foetus should be pushed forwards, its hind-legs extended, and the 
 creature placed in the lumbo-sacral position, when delivery can be 
 completed. 
 
462 
 
 FOETAL DYSTOKIA. 
 Hock Peesentation. 
 
 The mechanism of hock presentations is supposed to be as 
 follows: — The foetus, in the posterior presentation, lumbo-sacral 
 position, and impelled by the uterine contractions towards the cervix. 
 
 Fig. 139. 
 Hock Presentation : Calf. 
 
 reaches the inlet with the hind-limbs not quite extended, nor the axis 
 of the young creature quite coinciding, perhaps, with that of the passage. 
 Consequently, the legs come in contact with the pelvic brim below by 
 
 Fig. 140. 
 Diagrams of the Hind-Limbs in Hock Presentation. 
 
 the posterior surface of the shank, while the croup encounters the 
 sacro-vertebral angle above. 
 
 The labour-pains continuing, the croup has a tendency to descend, 
 and, with the points of the hocks, to advance through the os: the latter 
 
ABNORMAL POSTERIOR PRESENTATIONS. 1(53 
 
 joints become <;raclually tloxed until at last the cannon-bones press 
 against the thighs, and the doubled legs and croup, jannned in the 
 inlet, form far too large 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 the direction of the femur 
 (a b) is much more oblique than in figure B, which shows the limb 
 extended, and that bone {a b') in its usual position. The consequence, 
 in figure A, is apparent in the elevation of the stifle to the middle 
 horizontal line, and tlie inclusion of the hock and greater portion of the 
 metatarsal bone in the line below, which only touches the stifle {a b', 
 figure B). 
 
 The mechanism is quite the same in the lumbo-pubic and lumbo- 
 ilial positions, the parts of the pelvic brim against which the croup and 
 limbs impinge being alone ditierent. 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 
 — neither with respect to the mechanism, nature of the complication, 
 nor measures to be adopted. 
 
 In hock presentation, the point of the 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 
 foetus 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 birth, as the phalanges of the 
 hind-limbs, which, owing to the extreme flexion of the hocks, are flexed 
 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. — The difliculties vary according to circumstances. With 
 the larger animals at their 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 fcEtus can be, and often is, extracted in this mal- 
 position. 
 
 The indication is, therefore, with the Mare or Cow, to give the hind- 
 limbs a favourable direction, by extending tliem in the genital canal ; 
 and this is more easily accomplished in the Cow than the Mare, owing 
 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 be effected in the Cow by nmtation of the fcetus, but 
 that this is impossible with the Mare, unless a particular operation — 
 to be noticed immediately — is adopted. Saint-Cyr, however, has. with 
 more or less trouble, and the Mares not straining severely, succeeded on 
 four or five occasions, when the Foal made a hock presentation, in ex- 
 tending the limbs in the genital canal, and effected delivery without 
 resorting to this operation. He points out, nevertheless, that the Foal 
 dies very quickly in this position, while very often the Calf is extracted 
 alive, even after long and laborious manipulations. Other writers 
 corroborate Saint-Cyrs opinion with regard to deUvery. 
 
464 F(ETAL DYSTOKIA. 
 
 The method of adjusting the hind-limbs is as follows : 
 
 1. Push tJie foetus 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 difficulty is greatly increased 
 in 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 sufiicient 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, — the 
 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 deliver)^ 
 This fortunate movement, however, must be extremely rare. 
 
 2. When the body of the foetus has been pushed sufliciently far from 
 the pubis to allow the limbs to be seized, the hand may then fasten a 
 cord on each 'pastern (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 which is most convenient is first extended. Some obstetrists 
 begin by seizing the hock, the fingers in front and below the joint, the 
 palm and thumb on the calcis and shank ; the lower part of the limb is 
 then drawn backwards, while the thigh is pushed forward, and by a turn 
 of the wrist the leg is carried through the inlet and straightened. The 
 same procedure is carried out with the other. 
 
 Other practitioners endeavour to flex 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 cannon-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 
 
ABXORMAL POSTERIOR PRESENTATIONS. 465 
 
 as near the buttock as he can ; this elevates the foot and brings it 
 nearer. As the hibour-pains usually push the foetus too near the pubis, 
 it must be thrust forward again by acting more particularly on the 
 point of the hock, using it as a kind of propeller. When sullicient space 
 has been gained, the hand descends along the cannon bone and grasps 
 the front of the foot — the thumb and index-finger meeting round the 
 coronet, so that the toe is in the palm of the hand ; in this way the 
 pastern and fetlock are forcibly flexed, 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, it sometimes 
 happens that, owing to the length of the limbs, the calcis presses against 
 the sacrum of the mother while the foot jams on the pubis. 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 assistant pulls at the cord witli 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. 
 
 Cartwright mentions that, in those cases in which the limb cannot be 
 sufliciently 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 
 there can be no objection to this section ; if alive, it will require con- 
 sideration. 
 
 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 fci'tus 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 be 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 Mare, when the 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, then, 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. 
 Extraction of the fcetus has been effected after amputation in the three 
 regions, but preference is generally given to division at the hock. This 
 is effected by drawing the joint as far into the 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 better, but this requires much force. 
 The joint is then disarticulated, and the separated portion of the hmb 
 withdrawn from the passage. The other leg being served in the same 
 way, deliveiy can be completed in the ordinary manner — the obstacle 
 being now removed. 
 
 " Now and then," as Cartwright remarks, " we are not able to bring 
 the legs straight into the passage, but have to get away the fa'tus by 
 means of cords around the hock or hocks, with one or both of the legs 
 doubled forward against the thigh. In these cases it will be advisable to 
 
 30 
 
466 
 
 FCETAL DYSTOKIA. 
 
 divide the tendons (gastrocnemii) at the back of the legs, just above the 
 point of the os calcis, and also the flexor tendons belovy the hocks, by 
 which means the flexion at the hock-joints will be more perfect, and the 
 leg and thigh approximate better. After we have done this, we may 
 pull at the cords around the hocks pretty freely ; but we must not omit 
 forcing the 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,! have known the 
 foetus to come away in a breech presentation, without the legs being 
 straightened at the stifles ; but it is bad practice. In some cases we 
 may remove the leg-bone, by sawing it through, close up to the hock, 
 and afterwards passing a cord above the os calcis to pull at, and then 
 pushing the breech forward." 
 
 Fig. 141. 
 Hock Presextatiox : Hock corded. 
 
 "With the Coic, the Calf is very frequently alive, and an important con- 
 sideration is how to deliver it in this condition. Shovild it be impossible 
 to effect retropulsion, forced extraction in this malposition should be 
 attempted ; it has often proved successful, and particularly when only 
 one limb was retained. 
 
 To effect forced extraction with one limb alone flexed, the leg extended 
 in the vagina should be corded at the pastern, or above the hock if this 
 can be reached. A cord is then to be passed around the bent hock by 
 means of the porte-cord, and traction exercised during the labour- 
 pains. 
 
 When both legs are flexed at the hocks, a cord must be passed round 
 each, as in Fig. 111. The necessary force can then be exercised. 
 
 Should forced extraction not succeed, the limbs may be amputated at 
 the hocks, as with tbe Mare. 
 
ABNOIiMAL roSTERIOR PRESENTATIONS. 
 
 4(57 
 
 It is well, in this malposition, when the himl-liinbs have been either 
 removed or adjusted, to ascertain the direction of the tail ; as it is some- 
 times thrown back over the croup (as in Fig. Ill), and may thus increase 
 the dirticulty to be surmounted. It may readily be brought back to its 
 natural position by passing the hand from the root to its extremity, 
 and bringing it into the vagina by witlidrawing the arm. In some 
 instances rctropulsion maybe necessary before the tail can be adjusted. 
 
 This hock presentation may occur in other than tlie lumbo-sacral posi- 
 tion, and it certainly has been observed in the lumbo-ilial. The croup 
 does not enter the inlet, but presses against it; so that, especially with 
 the Cow, the foetus can be pushed forward, the limbs extended, and 
 through them the position changed to lumbo-sacraL With the Mare, 
 however, the violent straining may prevent this measure being carried out 
 
 Fig. 142. 
 TmcH ANi> Crocp Pre.sentatio\. 
 
 until the fcetus is dead, when it may be removed by drawing the hocks 
 into the vagina, dividing the gastrocnemii tendons, pushing the body 
 into the uterus, rotating it into the lumbo-sacral position, and extract- 
 ing it. 
 
 With the Sheep and Goat the same procedure is applicable, but the 
 Bitch generally does not experience any difficulty in expelling the foetus 
 in this malpresentation. 
 
 Thigh and Ckoup Pkesentation. 
 
 The cause of this malposition is the same as that operating in hock 
 presentation ; the deviation is not at all unusual in Mares or Cows with 
 a very pendulous abdomen. The hind-legs are flexed more or less under 
 the body. 
 
 When the thighs and croup alone present at the inlet, the joints of 
 
468 FCETAL DYSTOKIA. 
 
 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 fcEtus — -as the hocks — jams against the pelvic 
 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 the 
 trunk is firmly fixed between the sacrum and pubis of the mother 
 (Fig. 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 may be in the lumbo-pubic, or right 
 or left lumbo-ilial positions. 
 
 Indications. — 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 either 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 foetus likewise makes the malpresentatiou 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 birth may be effected by the combined efforts of 
 the mother and the obstetrist. But this indication is often most diffi- 
 cult to fulfil ; though in some instances, and even with the Mare, it is 
 possible when labour is not too far advanced, and when the 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 and 
 brought into the vagina. 
 
 Pushing the foetus as far into the abdomen as possible, one of the limbs 
 is seized above the hock, and the thigh and leg flexed as completely 
 as circumstances will permit, by lifting that joint towards the mother's 
 sacrum. Still pushing the foetus ofi" by means of the repeller, the 
 hand is passed down to the hoof 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. Then the foot is 
 
ABNORMAL POSTERIOR PRESEXTATJONS. 
 
 469 
 
 brought into the passage by flexing all the joints on each other. Again 
 pushing the fcetus forward, the same nianci-uvre is repeated with the 
 other hinb, 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 diflicult 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 difliculty is surmounted by passing a blunt hook round 
 them, or a cord as in Fig. 141, the two ends of this outside the vulva 
 being twisted and drawn upwards and outwards by an assistant ; wliile 
 the operator, pushing at the croup, throws the body of the fci'tus 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 
 
 Fig. 113. 
 Thii;h .\Nn Ckovp Prksextatio.v : Thigh conoKn. 
 
 croup is firmly wedged in the pelvic canal and the thighs have cleared 
 the inlet, it is only too often impossible to effect retropulsion. Conse- 
 quently, there are but two courses open — extraction of the foetus 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 motlier on the back or side 
 may eftect a change for the better in the position of the foetus ; or if 
 standing or lying, then raising the hindquarters as high as may be 
 without injury should be tried. 
 
 These faihng, then Lecoq's method may be resorted to. This con- 
 sists in passing the hand, furnished with a cord, between the wall of 
 the pelvis and the body of the foetus 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 
 
470 FCETAL DYSTOKIA. 
 
 the vagina. In this way the thigh is encircled by a loop, as in Fig. 143. 
 The other thigh may be secured in the same way by another cord, and 
 this part of the operation will perhaps be much facilitated by using the 
 long bent porte-cord (Fig. 171). 
 
 Saint-Cyr states that one thigh corded may be 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 joined together outside, assistants, under 
 the direction of the operator, pull with the necessary amount of force ; 
 while the hand of the operator assists in the vagina, either in guiding 
 the foetus, seizing on and pulling at any part that may offer, or smooth- 
 ing down the folds of the mucous membrane in the canal which might 
 otherwise increase the obstacles. The foetus has been extracted alive 
 by this procedure. 
 
 Saake's method^ is somewhat similar, except that there is only one 
 cord, and that encircles the body instead of the thigh. 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 flank of one side ; then the other 
 end is also brought out in front of the other flank. Both ends are 
 carried to the top of the back, the plain end is passed through the 
 
 Fig. 144. 
 Thigh and Croup Presentation : Body corded. 
 
 ring (Fig. 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 by Saake. 
 
 Deneubourg makes use of the tail of the foetus for traction. 
 
 There can be 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 do better." In those instances 
 which are attended by success, it will generally be found, however, 
 either that the foetus is small or the pelvis large and well formed. 
 
 Some 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. 
 
ABNORMAL POSTERIOR PRESEXTATIOXS. 471 
 
 body. Notwithstanding this diminution in the volume of the foetus, 
 deUvery was still impossible ; the other limb was torn away in a similar 
 manner, after which a crotchet was lixed in each cotyloid cavity, and 
 the fu?tus was then easily extracted. In addition to the malpresenta- 
 tion, the young creature was atTected with hydrocephalus. 
 
 The use of sharj) crotchets in such cases is always attended with 
 risk ; should they slip during traction, or not be carefully implanted in 
 the fa>tus, 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 foetus is largely in- 
 cised, and the hand, armed with a crotchet, is passed into the pelvis 
 by this opening, the crotchet 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. By this method, a more solid 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 foetus. 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." 
 
 RuetT proposes to detach the coxte from the sacrum, by operating in 
 the pelvis of the fa-tus, and afterwards to extract the hind-limbs thus 
 separated from the trunk. Others recommend symphyseotomy — an 
 operation to be described hereafter. 
 
 When the ftetus 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 
 mancDuvres has to be adopted. Retropulsion 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-limbs of the foetus must be disarticulated at 
 the hocks, or higher. 
 
 In all manoeuvres of this kind, great care must be exercised in pre- 
 venting injur}' 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 Caesarian section may also, in extreme cases, be resorted to with 
 the Bitch and Sow. 
 
472 FCETAL DYSTOKIA. 
 
 CHAPTEE III. 
 Dystokia from Transverse Presentations. 
 
 The foetus is said to be in a transverse position, when the hand of the 
 obstetrist, instead of meeting with the anterior or posterior part of the 
 body, comes in contact with the trunk, either at the shoulders, withers, 
 sides, flanks, haunches, loins, back, sternum or belly, or (which is per- 
 haps most frequent) all of the limbs collected together. The foetus, 
 instead of having its greater axis parallel to the pelvis of the mother, 
 has it transverse, or more or less perpendicular to the antero-posterior 
 diameter of the pelvic canal. 
 
 The possibility of the foetus assuming a transverse position in the 
 uterus has been denied on various occasions by Goubaux, who bases 
 his objections on anatorao-physiological reasoning ; contending that the 
 uterus cannot contain the young creature when so placed, if the various 
 dimensions of the latter be compared with those of the gravid organ. 
 In the first place, however, it must be remembered that the uterus is 
 not an unalterably-shaped body with rigid walls, but a membranous 
 sac whose parietes are soft and yielding ; and that its form may vary 
 with the displacement of its contents — in a word, that its transverse 
 diameter may be increased at the expense of its length. Besides, the 
 foetus itself is not a compact unyielding mass, but is so flexible that it 
 may assume the most varied attitudes and shapes. 
 
 But the strongest proofs in favour of the possibility of such presen- 
 tations are furnished by obstetrical experience — the facts published by 
 a host of observers entirely demolishing the antagonistic theoretical 
 notions. It may be noted, however, that though the presentations are 
 justly designated transverse, yet the body of the foetus is generally a 
 little oblique in one direction or the other. 
 
 Though the transverse vertical or horizontal presentations are not 
 altogether rare, yet they are much less common than the longitudinal 
 presentations, and especially the anterior presentation. They do not 
 appear to be primary, and they are more frequent in the Mare than the 
 Cow — perhaps because of the more energetic contractions of the uterus 
 in the former animal not allowing natural adjustment of the foetus, 
 should the latter not be exactly in a favourable position when labour 
 commences. "When the liquor amnii escapes prematurely, the deviation 
 is still more likely to occur, and particularly if the os is not sufficiently 
 dilated. Torsion of the uterus ; spasm of the cervix ; violent straining 
 and disordered movements of the mother ; deviation of some parts of 
 the foetus — -especially of the head; hydrocephalus, monosomianism, 
 etc., have all been noted at times as a cause of transverse presenta- 
 tions. Deformed head may also lead to this presentation, especially if 
 it is distorted, as in Fig. 103. 
 
 These presentations are essentially dystokial ; as it is evident that 
 the foetus, if of normal size, cannot pass crossways or sideways through 
 the pelvic canal, which barely affords space for its passage longitudin- 
 ally. Birth, therefore, cannot take place without assistance ; version 
 must be practised in order to change the presentation, and one or other 
 of the extremities of the oval mass which the body of the foetus repre- 
 sents must be brought towards the inlet. The malpresentatiou, through 
 hindering birth greatly, endangers the life of the young creature, and 
 especially if it be a Foal. 
 
DYSTOk'/A FnoM THE DORSO-LUMnAH rilKSHXTATlOX. 473 
 
 As mentionccl at p. 247, the transverse presentations of the body 
 may be Hniited to two kinds — the dorso-lumbar, in which some part 
 of the back presents at the inlet ; and the stcrno-abdominal , in which 
 the lower part of the body (belly) oilers. 
 
 The foetus may either be Jiorizontal or vertical ; when the former, it 
 may be direct or oblique in direction — i.e., placed perpendicularly or 
 obliquely, with regard to the axis of the mother's body. Saint-Cyr 
 remarks that the first is the most serious, because the extremities of 
 the ovoid fu'tal mass are equally distant from the inlet ; with respect 
 to the other intermediate presentations between the 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 genital canal, so that version is less ditlicult. The oblique presen- 
 tations are almost the only ones compatible with the vertical position 
 of the fa'tus. 
 
 The direct horizontal presentations may be often suspected from the 
 appearance of the mother, the abdomen showing great enlargement 
 laterally ; not unfrequently the movements of the fcctus can be seen on 
 both sides — on the right as well as on the left. 
 
 SKCTION I.— DYSTOKIA FROM THK DORSO-LUMBAR 
 PRKSENTATIDN. 
 
 This presentation is somewhat rare ; the body of the foetus is curved 
 and the limbs ai*e directed forwards. When it is lying horizontally, 
 the fore part may occupy the right or left side of the mother ; hence 
 Saint-Cyr distinguishes them as right or left cephalo-ilial positions — 
 though this does not imply that the fa'tal head is necessarily in con- 
 tact with the ilium, for it may be turned round to one side or bent 
 downwards. 
 
 When the futus is vertical the head is usually uppermost, the hind- 
 quarters being inferior, as in Fig. 147 — Saint-Cyr's ccphnlo-sncral 
 position ; 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 ccphalo-abdominal position. 
 
 Cephalo-Ilial Positions. 
 
 To diagnose this cause of dystokia — or back presentation^ — is not 
 always easy. Labour has been going on for some time, the " waters " 
 have escaped, and though the straining may be very energetic — even 
 violent — yet nothing is seen of the fcutus. When the hand is intro- 
 duced into the genital canal, in order to discover the situation of the 
 fcetus and the nature of the obstacle which hinders l;irth, it encounters 
 at first a more or less rounded surface, which does not offer any special 
 character by which it might be recognised. The hand is then passed 
 deeper into the uterine cavity, and turned in every direction over the 
 body of the fa>tus (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 be learned. 
 
 By this methodical exploration, the obstetrist recognises that the 
 body of the foetus 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 
 
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 loithers 
 
 Fig. 145. 
 Transverse Presentation : Kight Cephalo-Ilial Position — Side View. 
 
 are recognised by the prominences which the spinous processes form at 
 this part ; the thin wedge-shaped outline of the part ; and the hair of 
 
 Fig. 146. 
 Transverse Presentation : Right Cephalo-Ilial Position — Upper View. 
 
 the mane, w^hich, in the Foal, ends here. The lumbar region may be 
 distinguished by the large and almost level surface it offers ; the pro- 
 jecting external and internal angles of the coxae in its vicinity ; the 
 
DYsroKIA FRO.U THE DORSO- LUMBAR PREflEXTATIOX. 475 
 
 hollow of the flank leading to the thigh and stille. The dorsal region, 
 or back, is discovered by the arches of the ribs springing from each 
 side, with the intercostal spaces. 
 
 Having diagnosed the presentation, the 2J0S it ion must now be deter- 
 mined, and this is done by ascertaining the direction in whicli the head 
 lies. With regard to this, we pointed out at p. 2-i9 that there were 
 three positions of the fcetus : The cephalo-ilial positions, two in 
 number, in one of which the fcetus has tlie head directed towards the 
 Ti(jht flank of the mother {riijht cephalo-ilial position), and in the other 
 towards the left flank {left ccphaloilial position), the head and feet 
 occupying the uterine cornua ; while in the ccphalo-sacral position, the 
 fa'tus looks as if seated on the udder 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 fcetus 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 and judgment 
 of the obstetrist to rectify. The gravity of the case will, however, 
 much depend upon the period when the veterinary surgeon is called in, 
 and the condition of the parturient animal. When sufticiently early 
 in his attendance, however, a favourable result may often, if not always, 
 be anticipated : the mother m.ay be saved, and frequently the oifspring 
 — particularly in the Covr and Goat. 
 
 This favourable issue is due to the fact that the presentation does 
 not admit of 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 fci'tus in the pelvic canal — so common in 
 the defective anterior or posterior presentations. 
 
 With the Mare, however, tlie case is always more serious, because of 
 the energetic contractions which — unless they can be controlled early 
 in parturition by partial amcsthesia or other means — ofl'er a formidable 
 obstacle to mutation of the 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 that tlie foetus is like a cork which 
 has fallen into a bottle, and which can only be extracted by one end or 
 the other. 
 
 Certainly the presentation ofTers serious difficulties, from the fact 
 that there is nothing about the foetus to lay hold of advantageously, or 
 to which cords can be attached. In the majority of instances, a long 
 interval has elapsed since parturition began ; tlie " waters " have 
 escaped, the genital canal is swollen and congested from the attempts 
 of amateurs at delivery, the interior of the uterus is dry and adhesive, 
 the organ lies as close to the fa^tus as a glove does to the hand, and 
 the parent is exhausted with unavailing straining, and perhaps mal- 
 treatment — though the most trifling 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 ? This must be version. The 
 presentation must be converted into an anterior or posterior one, and 
 
476 FCETAL DYSTOKIA. 
 
 this at the expense of much patience, fatigue, and skill. But in what 
 direction is version to be practised ? Eainard lays it down, as a rule, 
 that the extremities of the foetus which are nearest the pelvis are those 
 which should be brought into the inlet ; and that if both ends of the 
 foetus are at about an equal distance from it, the anterior should be 
 chosen, because it is the easiest for delivery. This rule, however, has 
 not been recognised by the majority of the best authorities. On the 
 contrary, experience and theory have demonstrated that in the majority 
 of cases pelvic version is the most advantageous ; inasmuch as, when 
 this has been effected, there are only the hind-limbs of the young 
 creature to deal with, whereas in anterior version there is the head in 
 addition to the fore-legs, and this may offer difficulties which have not 
 to be encountered in the posterior presentation — more especially if 
 there is anything abnormal in the condition of the head. Not unfre- 
 quently, and particularly when the foetus is yet alive and vigorous, a 
 kind of spontaneous change is effected in an unexpected direction ; for 
 it has been found that, in acting on the croup of the foetus, 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 the loins being under the hand, the withers and upper part of the 
 neck are encountered, and delivery can be readily accomplished. 
 
 But this spontaneous mutation cannot take place if the foetus is- 
 torpid or dead, and then version becomes imperative. Before this is 
 attempted, the intrauterine injection of emollient fluids should be 
 practised ; this is most essential if the waters have escaped for some 
 time. Then retropulsion must be had recourse to. The foetus must not 
 be pushed directly forward into the uterus, but rather obliquely, and in 
 a direction the opposite to that of the part we wish to bring before the 
 inlet. The hand or repeller must be used for this purpose, and in 
 proportion to the difficulty of effecting it, so must the intra-uterine in- 
 jections be frequent. 
 
 The retropulsion and injection, together with the uterine contractions, 
 have the effect, in many cases, of making the body of the foetus glide 
 around the inner surface of the uterus, until a convenient part presents. 
 Then the limbs and head — if they are required, 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 may be resorted 
 to, in order to convert the vertebro-ilial position into the vertebro-sacral 
 or vertebro-pubic. Delivery is completed by moderate traction. 
 
 The manipulations will, of course, vary with circumstances ; but it 
 will generally be found that, in all cases, raising the hind-quarters of the 
 mother will render them much easier of accomplishment. 
 
 When these manoeuvres have failed, embryotomy must be practised. 
 The intestines and other organs can be extracted by an incision in the 
 flank ; the vertebrae may be divided at the presenting part, and the 
 entire body cut through at this division ; then each half can be extracted 
 in the best and easiest manner possible. 
 
 The same indications are applicable to this kind of dystokia in the 
 Ewe and Goat ; though if version be impossible and embryotomy not 
 practicable, the Caesarian operation may be successful. In the Bitch 
 and Cat, when other measures fail, the latter operation may be attempted 
 with some prospect of a favourable result ; though version by means of 
 forceps or external abdominal manipulation is often effected. 
 
DYSTOKIA FROM THE DORSO-LUMBAR PRESENTATION. 
 
 477 
 
 Cephalo-Sacral Position. 
 
 As has been mentioned, in this position the anterior portion of the 
 body is higher than the posterior, and the head may be either turned 
 to one side or bent downwards. This accident is more rare than the 
 preceding. On exploration the back is discovered to be more or less 
 vertical, instead of horizontal, as in the cephalo-ilial positions ; though 
 it is seldom directly in front of the inlet, for one end or other of the 
 body is generally nearest it — sometimes it is the posterior, when the 
 presentation somewhat resembles the lumbo-sacral (Fig. 147) ; at other 
 times it is the anterior, when it is like the dorso-pubic. It therefore 
 happens that the hand will meet with the anterior part of the croup 
 and may feel the base of the tail in the first case, and in the other it 
 encounters the back, withers, and base of the neck. 
 
 Fig. 147. 
 Transverse Pre.sent.\tion : Verticvl or Ceimialo-Sacrai, Position. 
 
 This position is not so diflicult to deal with as the horizontal lumbo- 
 sacral, as it approaches the longitudinal presentations. 
 
 Indications. — An endeavour must be made to bring one of the ends of 
 the body of the foetus to the inlet — that which is nearest this opening. 
 Ketropulsion is therefore necessary, pressure being made on tlie end 
 farthest from the inlet. If the mother is placed in the dorsal position 
 and the posterior parts of the fa^tus manipulated through the abdominal 
 walls, the task of the operator will be facilitated. When tlie posterior 
 parts of the fcetus are nearest the inlet, an assistant should push against 
 its lumbar region, so as to bring the buttocks and thighs in front of the 
 opening, while the operator with his hand on the repeller pushes the 
 dorsal region forwards. 
 
 When the anterior part of the body is nearest the inlet — the mother 
 being in the dorsal position — the assistant pushes the hind-quarters 
 forwards and downwards, while the operator endeavours to bring the 
 neck towards him, using the crotchet if need be. The object is, of 
 
478 FCETAL DYSTOKIA. 
 
 course, to bring the foetus into the posterior lumbo-sacral position, with 
 the Hmbs 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-abdominal position (vertical dorso-lumbar pre- 
 sentation), though such is possible. The head of the foetus 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.— DYSTOKIA FROM THE STERNO-ABDOMINAL 
 PRESENTATION. 
 
 The sterno-abdominal presentation is a rather common one, particu- 
 larly in the Mare. The foetus 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 discovei'ing 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 cephalo-ilial, 
 in which the foetus is lying on its left side, the head directed towards 
 the right flank of the mother ; and a left ceplialo-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. 
 
 Cephalo-Ilial Positions. 
 
 In these positions the foetus 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 enter 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 canal 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, 
 t-^o — a hind and fore — are at the right side and two at the left, though 
 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-ilial position. In some instances only one limb 
 
DYSTOKJA FROM THE STERNO-ABDOMIXAL PRESENT A TIOX. »79 
 
 appears ; it may be there are two — either anterior or posterior, or one of 
 each; or three — a fore and two hind, or two fore and one hind. In 
 otlier 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 fcetus ; 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-Abdominal Pbksentatiox, Head and Fket encagkd : Foal. 
 
 uterus as far as possible, can touch nothing, even with the tips of the 
 fingers, except the belly or sternum of the fcetus ; 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 discovered of the 
 position, owing to the foetus being curved and the limbs and neck bent 
 in 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 fa?tus being also shorter, the latter is nearer the inlet, and 
 thei'efore more accessible to the hand. 
 
 It is generally admitted that this presentation is one of the most 
 diflicult and serious the obstetrist can meet with ; though when the 
 limbs can be seized it is not, as a rule, so troublesome as the dorso- 
 lumbar presentation. In order to effect deliver)-, 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- 
 
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 foetus 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, the skill of the obstetrist is 
 most severely taxed, and all the more if much time has elapsed since 
 parturition commenced and amateurs have been at work. 
 
 Indications. — It has just been remarked that posterior version is most 
 
 Fig. 149. 
 
 Sterno-Abdominal Peesentation, Hind Limbs most advanced, Head ketained: 
 
 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 repeller be employed. If they cannot be 
 pushed into the uterus, then they must be amputated at the knee, 
 elbow, or shoulder, and the fore-part of the foetus thrust forward while 
 traction is made on the hind limbs ; gradually these approach the 
 vulva and pass through it, the hind-quarters follow — the body being 
 
DVSTOKIA Fli'i'M THE STEKXO-ABDOMJXAL I'llESEXTATIVX. IM 
 
 very often in the lurabo-ilial position, when it can now be changed 
 into the lumbo-sacral. In order to prevent the hind-quarters jamming 
 against the maternal ihum, the traction on the hind-hmbs should he 
 oblique — from right to left or left to right, according to the position of 
 the fa^tus — when bringing it into the inlet. 
 
 When the liind-quarters are too distant to he brought first iiuo the 
 inlet, then anterior version should be tried. The hind-legs are pushed 
 into the uterus — though the fojtus may be delivered witla one, or even 
 both of these, Hexed 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 order to distinguish the parts to which they are attached. 
 Then, while traction is made on the head and fore-limbs, 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 foetus has the limbs 
 doubled against the body, and can only be touched with the tips of the 
 fingers, the hind quarters of the mother should be lowered by placing 
 her on a sloping Hoor — on the back if necessary ; an assistant then 
 manipulates the ftt>tus 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 effect 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 delivery, when its 
 mucous membrane forms folds or bands towards the os, which prevent 
 access to its interior, and imprison the limbs of the fcetus. Through 
 these the hand must pass, and in trying to smooth or lay them down 
 the legs must be freed. 
 
 CEPn.\LO-SACR.\L 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 
 number occurred in Mares. The fa'tus 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 sides. 
 All the limbs are usually in the genital canal, and they may extend to 
 or beyond the vulva, the soles of the hoofs being inclined downwarels, 
 though it may happen that only two or three are visible. When all 
 protrude eciually, 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 foetus nearly always succumbs in this 
 position, though the mother may be saved. 
 
 Indications. — Here again version must be resorted to, and this should 
 be posterior when all the limbs, or only the hind ones, protrude ; 
 the fore-limbs must be entirely, or tto 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 deliver}-. 
 
 31 
 
482 FCETAL BY ST OKI A. 
 
 Should the fore-limbs be most advanced, anterior version must be 
 attempted — this will bring the fcetus into the dorso-sacral position ; 
 but it is a troublesome operation, and necessitates retropulsion of the 
 hind-limbs, or their removal wholly or partially, as well as straighten- 
 ing the head and neck. If neither of these measures appears advisable, 
 the fore-limbs may be 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-ahdominal position — vertical sterno-abdominal presentation 
 — has been described, but it must be 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. The limbs are more or less accessible to the 
 operator, and therefore the mode of extraction is obvious after what 
 has been said of the other presentations. 
 
 ■Jt. 
 
OBSTETRICAL OPERATIONS. 483 
 
 BOOK III. 
 
 OBSTETKICAL OPEKATIONS. 
 
 In the various malpresentations and malpositions, as well as for the 
 other causes of dystokia already enumerated, the indications for recti- 
 fication and extraction were alluded to and described at sullicient 
 length, and the nieans to be adopted for carrying them out were like- 
 wise mentioned. It was shown that, in many cases, it is sufficient to 
 correct the abnormal presentation or position, and rectify the deviation 
 of limbs, neck, or liead, to effect delivery in the ordinary manner by 
 means of the hand alone. For, as has well been said, the practised 
 hand is the best and most perfect of all instruments, and it can effect 
 in obstetrical operations what no instrument is competent to achieve. 
 Therefore it is that an operator with a long and powerful arm, and a 
 small hand with strong fingers, possesses many advantages as an 
 obstetrist, and is in a better position to afford relief than one with a 
 short arm and large hand — especially in the correction of those devia- 
 tions which are so frequent, and oftentimes so baffling. 
 
 Extraction by the hand alone may be effected in many cases of 
 difficult parturition, when these rectifications have been made ; though 
 even then it is essential that the os uteri be fully dilated, the vagina 
 and vulva dilatable, and sutliciently prepared to allow the young 
 creature to pass througli ; it is likewise necessary that such a relation- 
 ship in proportions should exist between the volume of the fcetus and 
 the capacity of the pelvis, that extraction can be accomplished without 
 much difficulty. Finally, it is particularly desirable that the uterus 
 retain its contractile power, and that its regular contractions should 
 second the efforts of the operator. 
 
 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, 
 in order to overcome the dilficulties, recourse must bo had to various 
 surgical instruments and appliances, and there must be performed, 
 either on the mother or fcetus, more or less complicated and serious 
 •operations which demand strength, expertness, and an accurate know- 
 ledge of anatomy and physiology, and even of meciianics, in addition 
 to a thorough acijuaintance with surgical pathology. Some of the 
 obstetrical operations have been alluded to ; but it is necessary to study 
 them as a whole, in order to master their special features, and par- 
 ticularly the manner in which they are to be performed, as upon the 
 exactness of our knowledge with regard to them will generally depend 
 their successful results. 
 
 These operations have for their object either to supplement the 
 forces of Nature, which are insufficient to secure the birth of the young 
 creature ; to rectify its presentation or position ; to diminish its size 
 when it is cither too large, too deformed, or too deviated or distorted, 
 to pass through the maternal passages ; to enlarge the latter, or to 
 extract the foetus by an artificial passage when these last do not admit 
 of extraction. This leads to a consideration of : (1) Preliminary 
 precautions and operations ; (2) Rectification of presentations and posi- 
 tions of the fcetus ; (3) Mechanical means for the extraction of the fcetus ; 
 (4) Embryotomy ; (5) Vaginal hysterotomy ; (6) Ccesarian section ; 
 
484 OBSTETRICAL OPERATIONS. 
 
 (7) Symjjhysiotomy ; (8) Artificial premature hirtli ; (9) Siqjplementary 
 observations regarding another and progeny. In several of these the 
 obstetrist 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 this, but far too frequently the veterinary surgeon is not 
 called in sufficiently 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. 
 
 CHAPTEB I. 
 Preliminary Precautions and Operations. 
 
 A FEW observations may be made on certain precautions and opei'ations 
 which have to be attended to before any active measures are adopted 
 in cases of dystokia. And first as to the animal which 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 manipulation 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 
 one 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 
 
rKKLlMlXAnV rnECAUTIOXS AX1> OPEliATlOXS. 485 
 
 recumbent, and must kneel, or even 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 <^reatly 
 hinders manipulation and interferes with delivery. To obviate this, 
 the animal ou^'ht 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 have the front-part of the body raised by litter, so as to 
 bring the foetus 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 which 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 fttitus. 
 
 Cases are met with now and again in which it is desirable to place 
 the animal in the recumbent position, and then the gi'eatest 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 
 hind-quarters 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 lies 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 Cats 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 tlie animal before connnencing 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 sutVice 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 be 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 
 operations the one reheves the other. The fingers are brought together 
 
486 OBSTETRICAL OPERATIONS. 
 
 in cone-shape, and pushed into the vulva gently, then into the vagina, 
 with a slight rotatory motion, while the animal is not straining; should 
 it strain, 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 the state of 
 affairs — the condition of the genital canal and the presentation and 
 position of the foetus, if the membranes are ruptured, as they nearly 
 always are — and allows a diagnosis to be formed, from which indica- 
 tions for treatment can be arrived at. 
 
 It should not be necessary to add that all this procedure — much of 
 which has also to be 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 " linseed jelly," mixed with 
 some oil — olive to be 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 sufficiency — 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 some time, as this tends 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 chloroform 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 POSITIONS. 487 
 
 indeed, is not desirable ; for partial unconsciousness will allay the 
 excitement 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 be laid at the bottom of a nose-bag put on the head. 
 The antf sthetic should be inhaled until the introduction of the hand 
 into the vagina or uterus no longer excites the severe straining. Partial 
 narcosis might also be tried in some dillicult cases of parturition in the 
 Cow, but then it must be 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 
 effect a change in the position of the fcjctus. 
 
 CHAPTER II. 
 
 Rectification of Presentations and Positions of the Foetus. 
 
 Wh have seen how numerous and varied are the presentations and 
 positions of the foetus, 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 the hand into the genital canal, and 
 operate directly on the foitus. 
 
 The pi-incipal of these mutation movements are four in number : 
 lictropulsion, 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 tlie 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 fcctus must 
 be movable in the uterus — a circumstance not always noted, as the 
 organ is often contracted closely on the fcctus when the liquor amnii 
 has escaped, or the fa-tus itself may be fixed in the genital canaL 
 And, finally, the fcctal 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. 
 
 Retrgpulsion. 
 
 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 position can be corrected it is nearly 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 
 
488 OBSTETRICAL OPERATIONS. 
 
 when the foetus is in a good position, to enable the obstetrist to attach 
 cords to the limbs or some part of the head or body. 
 
 In the anterior presentation, for instance, the fore-limbs have often 
 to be pushed forward from the pelvic cavity, in order that the operator's 
 arm may find room to search for and seize the head ; or the latter has 
 to be pushed into the uterus to allow the limbs to be felt for; and 
 even in this presentation retropulsion of the hinder limbs may be 
 necessary. This procedure may also have to be adopted in the posterior 
 presentation when these limbs are flexed in the uterus, and the body 
 has to be pressed forward as far as possible, so that they may be 
 extended and brought into the pelvic inlet ; while it is also advantageous 
 in transverse presentations when version has to be attempted. 
 
 This retropulsion is sometimes easy, at other times it is most difficult 
 and laborious, and in certain cases it may even be altogether im- 
 possible. 
 
 The most favourable attitude for performing this operation, in the 
 larger animals at least, is undoubtedly the standing one ; but the body 
 of the animal should not be perfectly horizontal, for a great advantage 
 will be derived by raising the hind-quarters to a considerable degree, 
 as we thereby throw the uterus and its contents forward, and away 
 from the pelvic inlet. This elevation may be effected by straw or litter 
 placed under the animal's hind-feet. In order to obtain this inclina- 
 tion promptly, the Cow may be made to kneel, two assistants keeping 
 the fore-limbs flexed, while other two maintain the hind-quarters in an 
 upright position. 
 
 When the animal is recumbent and cannot be induced to rise, there 
 is little, if anything, to be gained by raising and supporting it by means 
 of slings or other appliances ; as the pressure which these produce on 
 the abdomen opposes the manoeuvres we have mentioned. Not un- 
 frequently the sight of a strange dog, as has been mentioned, will cause 
 the animal to get up. 
 
 When, however, the Mare or Cow is exhausted, and it would be 
 injudicious or impossible to make it stand, then manipulation must be 
 attempted in the recumbent posture. When this is decided upon, in 
 the great majority of cases it will be found that a considerable advan- 
 tage will be obtained by placing the animal on its back, propping it up 
 in this position with trusses of straw placed on each side, and raising 
 the croup by introducing another truss beneath the hind-quarters. 
 
 With regard to the smaller animals, such as the Bitch, they can be 
 placed on their back on a table, and an assistant will raise the pelvis 
 as high as may be deemed necessary. Eetropulsion of the foetus may 
 be effected with the hand in the large animals, the operator supporting 
 himself firmly on his legs ; but the arm must be strong, and very often 
 it has to be engaged in the genital canal as high as the shoulder. It 
 may sometimes happen that both hands have to be employed as 
 repellers, and the body of the operator pushed forward by assistants. 
 
 Seeing the difficulties attending this operation, and finding that the 
 hand and arm are not always sufficient, Continental veterinarians have 
 for a long time resorted to a "crutch" or " repeller " (French, 
 repoussoir ; German, Geburtskrilcke), in conjunction with the hand. 
 
 This instrument is of iron, and is between two and three feet in 
 length; it has a handle at one end, and a concave transverse piece, 
 like the head of a crutch, at the other. This piece may be either solid 
 or jointed (Figs. 150, 151, 152, 153). Provided the latter is sufficiently 
 
RECTIFICATION OF PRESEXTATIOXS AND POSITIONS. 
 
 489 
 
 strong at the joints, it possesses advantages over the solid instrument, 
 the principal of which is its easier introduction into the vagina and 
 uterus. The crutch end being carefully carried by one hand through 
 
 Fig. 150. 
 SoLin Rkpeller, 
 
 WITH A ReMOV- 
 
 ABLK Spike. 
 
 SlMPI,E-.TOINTEn 
 
 Kepeller. 
 
 Fig. 152. 
 
 JOINTKI) RepELLEB 
 
 Open. 
 
 Fig. ir..3. 
 
 .TniNTEI> Rei'eller: 
 Closbd. 
 
 the genital canal, towards the foetus, is applied to the most convenient 
 part of the latter ; while the handle is seized in the other hand, and 
 propulsion effected either by this hand, the breast of the operator, or 
 by an assistant. 
 
490 OBSTETRICAL OPERATIONS. 
 
 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 foetus 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. Brunet 
 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 surfaces 
 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 
 increases 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 PRESEXTATIONS A XI) POSIT 10 XS. 491 
 
 intervals between the "pains"; thouf^li during these the expulsive 
 eflbrts should be resisted, so that what lias 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 foetus 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. 
 
 K0T.4.TION. 
 
 " Rotation " of the fcetus 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 fcetus in hand to the right or left, as may be. If the young ci-eature 
 is alive, this mana'uvre is much more easily executed than when it is 
 dead, as it seconds the effort. Boutrolle advises that the abdomen of 
 the mother be raised 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. Kainard recommends, when the limbs are in the pelvis, to 
 tie them together, draw them beyond the \Tilva, 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 vertebro-sacral position. 
 
 This modification need not always be so complete, and it fre- 
 ijuently suffices to convert a lateral position into an oblique one, by 
 making the dorso-sternal diameter of the fcetus 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 
 a change of presentation, or, in other words, bringing towards the inlet 
 a part of the fcetus other than that which presented spontaneously, and 
 thus correcting a faulty presentation. 
 
492 OBSTETRICAL OPERATIOXS. 
 
 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 of version : one which has for its object 
 the movement of the head of the foetus towards the pelvic inlet — 
 anterior or cephalic version ; and the other the posterior part of the 
 body to the same opening — posterior or pelvic version, corresponding to 
 the piodalic 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 : 
 Bepulsion 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. 
 
 Bepulsion.— The, hand — usually the right — being introduced 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. — When 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 foetus becomes lengthened, as it were, and unfolded, and 
 when its larger diameter is brought into the axis of the pelvis the 
 manoeuvre is completed. 
 
 Version 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 turning, and all 
 vicious positions of the foetus, 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 
 
KECriFICAriOX OF rilESKXTATIoys AM) POSIT lOXS. 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 fa'tus may be somewhat 
 inclined to the right or left, the uterine contractions are sulhcient to 
 eftect adjustment, gradual and well-directed traction being alone re- 
 quired from the operator. 
 
 Extension .\nd Flexion. 
 
 Independently of the ijeneral 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 i^artial mutations — as in the adjustment 
 of one or more of the limbs, 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 
 manoeuvres a rudimentary knowledge of mechanics will be of gi'eat 
 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 manoeuvres, 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 fcctus is in the anterior presentation and 
 dorso-sacral position, with the head bent round towards tlie left Hank, 
 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 limlis, when the 
 weight of the fa'tus 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 
 fcctus is inclined from right to left, so that the right side being raised, 
 the limb can be taken from under it. The body is turned in the way 
 indicated for rotation. 
 
 We 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-quarters, either by placing litter under 
 the hind-feet, or causing the animal, if a Cow, to kneel on its knees. 
 And we have also remarked that it is not always possible to obtain the 
 
494 OBSTETRICAL OPERATIONS. 
 
 desired attitude, but that these mancBUvres 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 the necessaiy 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 agents, 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 Neck. — 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 sideways 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 
 ^ Vettrinarian, vol. xxxiv., p. 260. 
 
ItECTIFlL'ATluX OF VJIESEXTATIOXS AND I'oslTloXS. 495 
 
 gives to ail assistant, while he presses the neck forwards and to one 
 side, raising the nose by means of the cord and hand when there is 
 sulVicient 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. ^Vhen, 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 atlair ; 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 fojtus — paralyse the arm, whicli 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 l)y 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. Pulling 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. 
 
 Whcyi the head is bent npicards ami backwards — 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 body 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 tlie 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 effected by seizing 
 the lower part of the head, raising it upwards and bringing it round to 
 the 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 
 
496 OBSTETRICAL OPERATIONS. 
 
 brought straight by first cording the fore-limbs, then reaching the neck 
 of the lower jaw over the shoulder, and cording that also — retropulsion 
 and manipulation, with traction in the intervals of the straining, will 
 effect the rest. The case is very different, however, when the head is 
 carried as far back as the flank or hind-quarter, and especially if the 
 uterus is retracted on the foetus, and the interior is dry and adhesive. 
 In the Mare this is always a most formidable affair to deal with. Here 
 the mucilaginous and emollient injections are indispensable, and should 
 be at once resorted to. Then the fore-limbs must be corded, and 
 pushed into the uterus if they are in the way (using Darreau's porte- 
 cord if necessary), the 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 the 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 the 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 foetus ; this end he passed down- 
 wards, seized it at the lower side of the neck, and 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 the 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 on the breast or one of the 
 shoulders of the foetus, and while he pushed it towards the fundus of 
 the 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 porte-cord might also be used to 
 pass the cord if the hand could not be extended sufficiently far (see 
 Binz's porte-cord). 
 
 Extension of the Limbs. — The limbs are not unfrequently a cause of 
 difficulty in parturition, and have to be adjusted before delivery can be 
 
nECTIFICATIOX OF rj^KSKXTATIOXS JXJ> msiTfnys 497 
 
 ^^^^^^Lt:^:-:^:^^,^^^^ ^^ -. difficult m 
 
 leg being longer consequence of the different segments of the 
 
 ^^^'^e^::^.n^j::^X:l^^^^ the g^ital canal or 
 
 the uterus before they can be extendoi „^? . be pushed forward into 
 cord the lower ia^^orTead nrpv ' V ' -'^^ 
 
 the fore-arm^s brou?4t infol 'V,^^' ^^"^5 attempted^ Then 
 
 before, the shlnk is leLd Id smarUv :\^'."t"' '■' ^^^^^ °°^ «° 
 being adducted and the knee "^.X^.^^^^^^^^^ T ^'Z ^'' J°"^^ ^°^ 
 the pastern is opposite the inloJ fh! i "PJ^'^^ ^"^ outwards, so that 
 and hoof, which^fs elVi ^he mhn the"n.S "'" ?'f''^ '° *^^ ^^^^^°^k 
 the lower part of the li nb i. n ' -5 P^^tern-joints are well Hexed. 
 
 whole extended ?Le ^^th hr^xff flpl'^'f f,''"^ ^"^ '^^ 
 
 necessary, as they are shorter than H 0= ?°.u^ S^^ pbalanges is not so 
 immediatdy extended but thp )?^ f . °/.l^^ ^°^^' ''^"^^ ^hey may be 
 pre..n. lacey.r^flhe'^e^Jl^al tt^^^^^^^^^ ^^ ^^^ ^anJl to 
 
 held1s°ttn Ct;ht1rthe\'nltir"^ "^^''/^ !' '^^ ^^ ^-^^' -^^ the 
 ance of the hand ° "'^'^ ^^ ^'^°' °^ ^^^ ^^^'^ and the guid- 
 
 tiof/"f"\t"Ss1"ec:ion"ot"' ^'-^'^'^^ ^^^^^ «^ ^^e condi- 
 limbs corded ar'h;Zers or sS^^ ^"^^ "^"^' be made, the 
 
 cords while the operatoi raisp.fhA ' ^ ^n assistant pull on these 
 same time pushin' the^ orwarL .?• ''^''''^^ T^ outwards, at the 
 with attempts to brin'the nh« 1 ' '. manipulation is alternated 
 straightening theni th^re at thrf^ '°'.^ '^' '"^^^ ^^ '^^ ^^^"^1' and 
 n^ucousmembraneVomdimlg^'byrLo^' -"^^^'"°" ^'^ "^^'^'^^^ 
 
 firsV"ire:':Sd1ly Set'f^'^^r/' ^'^'^f ^^^ ^°--- i^ - 
 uterus ; if the fore arm rnn^hl 7^f^- '^'^^'^' ^^^ f'^^dus of the 
 
 knee upwards! rnd-pTo5kLln^^^^^ V ^''''?' ^° ^' '^ ^ring the 
 lower part of the imb can be^ex p d'^^^^ ^°T ^°'"'"enced^the 
 
 arm cannot be firn I seized so as o 1 '" • *^^^.^^"al. But if the fore- 
 passed between the le' and thl K 'i ^' -^f ^'^'^^tion. a cord must be 
 
 the side-the two ends be n' twi.f/r^f T^ '^.' l''""'^ ^^°"^1^^^ »^ack on 
 while the loop around the or! n °"V''^" ?^ ^'^'^ by an assistant, 
 possible by the hand TlL h; ' '' ^'°"^'^' ^' ""^^' '° ^*^« ^"^^^ as 
 arepushed^orwa^i-pJe sSrfonS^ part of the leg and the body 
 assiLnt puUs stead l/oTthecod\P°;;;^ '^""^^?^^' 7^'^'^ '^' 
 
 cavity, when the limb is extended in h "''^ '' '" '^^ P^'^''^ 
 
 p. 438). extended m the manner just described (see 
 
 3eque„ce of their heater ShaLLr ^°''' "'"" ""' ^"'f' i" '=°'>- 
 than the fore-h,ubf while th!.,n'„ .7 T P™P°rtionately longer 
 
 interdependeVt thai one caJnoTK^?'' m "^^Pr'^'P''l Joints are°so 
 
 ""tii^fr '' ""'""°- -^"3-e an rb^ru?' "^^ °"'"^' 
 
 oons^t'ethXt/rro'"a«: "{":;'»'"'" '" "-.^la-.it is generally 
 nearly aUvaysV^lh^^r^ Ta^- Crin'^r^r tJ^'I 
 
498 OBSTETRICAL OPERATIONS. 
 
 Mare pain and exhaustion, to divide the gastrocnemii tendons, and so 
 straighten the limbs. 
 
 "With the Cow the case is not so serious, and the Calf may be de- 
 livered alive. Eetropulsion of the hind-quarters and hocks is absolutely 
 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 foetus has been removed some distance from the brim of 
 the pelvis. Eaising 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 kept 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. 
 
 Wlien the hind-limhs are retained in the viatcrnal ahdominal 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 foetus 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 diflicult 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, seizing 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 difficult 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. 
 
 CHAPTEE III. 
 
 Mechanical Means for the Extraction of the Foetus. 
 
 Mechanical means for the extraction of the foetus are required when 
 the expulsive efforts of the parent, and perhaps the hand of the obste- 
 trist, are insufficient to produce delivery. These means are employed 
 to efi'ect 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 hands, 
 halters, crotchets or hooks, a.ndi 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. 
 
MECHANICAL EXTRACTION OF THE FQ-TUS. 499 
 
 SECTION I. -CORDS AND BANDS 
 
 forceps are to ti,. Imumn p"etiZer Thfy Ce'l" ddltif ,"'T 
 vantage l,hat they are readily procurable are che", ver?'!n 
 and can be eiiiploved wbere and wl„.„ J J" cneap, veiy p.irtable, 
 
 or put out of the way. as the cords will Xavs bHn' ft. f r"""!,' 
 
 They are used with the view of applying trictinn fo f].o f <- ^ 
 
 they can be attached to the head,Tod>li nbs or t^U I ^'' ""'f 
 circunistanppQ TI10 i;,>,k„ '^'-'^v.. iimos, 01 tail, accordui" to 
 
 t s ttVaiT ri tttS-!?;iti:tr-T;fe :/:£ 
 
 fhVbodTo :f°"">' "T^^"'" "^""S'' ■' '= =' .«ost-i,„portant ?e„io ™ 
 
 isSPIiiili 
 
 a?d'i7re™ovtl "'"'' '° ^"'^ °' "''' ''«'>'■ ^""^ "'» '° sbre^'olslinlTo 
 
 orll'^r&^ugt't;^^^ 
 
 from a quarter to half-an-inch or moro thir>k A / ^ i ' l^ " ^°P^' 
 
 l.»p or ,ron ri„«. by whicht forZnlt. n'oo e ?K^ "'5^^ \\l ^ 
 bon,e practitioners recommend strands of ManHla hemp and in mr'' 
 t.cular mstances, as when a somewhat ri^id loon is rmnbwl t ' 
 
 Uther obstetrists prefer a leather band "cnip. 
 
 to ptenrtm'^n^r £s°^il'iTa^\i;V''r^°''^^^ ',° '" "'^^ 
 hardness thinners, and strands, riL-^liaiTorruf B°„uhis!aceidt't 
 need not be much feared, and the durability, convenience and other 
 advantages possessed by the cords, are K.-eati; in the r favou TiZ 
 
 o^atyK^^^^^^^^ 
 
 un^ a^np pe^to^-r omfd feL^tb^^ O^^ 
 
500 
 
 OBSTETRICAL OPERATIONS. 
 
 When running knots or loops are made, these should be so tied that 
 there is no chance of their becoming untied through slipping, when they 
 come in contact with lubricating fluids and are strained. 
 
 Whatever is used for this purpose should be very pliable, and yet 
 sufficiently strong to withstand energetic pulling. A very good pattern 
 of cord is that used by Schaack (Fig. 155). 
 
 This is merely a cord with a running noose at one end, and a small 
 piece of round wood at the other, to give the assistant a better hold, 
 and enable him to use more force. 
 
 When cords are employed on the limbs, they are generally applied to 
 the pasterns of the Foal, as these parts are most accessible, and afford 
 the most secure hold. They can also be apphed above the knees and 
 hocks, when it is necessary to amputate the limbs at these joints. The 
 head may be secured around the lower jaw, but it is sometimes better 
 
 Fig. 154. 
 
 Traction Coed and Band, and the 
 Manner of applying theji. 
 
 Fig. 155. 
 Schaack's Traction Cord. 
 
 to pass the noose into the mouth and around the top of the head, like 
 a gag-rope. 
 
 When the cords are to be applied to the limbs, either of two modes 
 can be resorted to with this object. If the limb is bent, it must be ex- 
 tended and brought opposite the inlet, or into the genital canal, as the 
 case may be. Then Eainard recommends that the fingers be gathered 
 together and slightly bent, so as to form a kind of cone, on which the 
 running noose of the cord — sufficiently wide to pass over the foot of 
 the foetus— is placed, as in Fig. 154. The noose is kept in its place on 
 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 be got forward again. The hand 
 and cord being oiled, are introduced into 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 
 
MECHAXICAL EXTRACTIOX OF THE FCETUS. f.Ol 
 
 a f:cntle pull of the cord, which can then be tightened and given to an 
 assistant. 
 
 The other method, which is Schaak's, and by some obstetrists con- 
 sidered preferable to that just described, consists in placing the middle 
 of the noose on the dorsal aspect of the ends of the two middle fingers, 
 the finger on each side holding it against these, while the thumb keeps 
 it in the palm of the hand (Fig. 161). The left hand maintains the 
 cord sufficiently tense to assist in keeping the noose on the hand ; and 
 if the part of the cord which runs through the loop is placed towards 
 the thumb, the latter can readily increase the size of the noose. The 
 hand is passed into the vagina sideways, the little finger downwards, 
 and when the foot is reached, the thumb and index-finger are placed 
 within the noose, which they enlarge in separating from each other, 
 while the remaining fingers, flexing on the hand, are passed around the 
 foot, and cause the noose to glide over the hoof on to the pastern. The 
 fingers now press on the loop, while the 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, the looped cord may be employed ; though a long cord, doubled, 
 will be found to answer very well. This is passed round the flexure, 
 the 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. 
 
 The lower jaw is "corded" in a similar manner; the mouth of the 
 foetus being opened, the noose is passed around the neck of the jaw, 
 and the knot or loop placed beneath the chin. 
 
 In embr^'otomy cords render good service, as they can be attached 
 to any part within reach ; after decapitation of the fd'tus, for instance, 
 a cord passed through a thick fold of the 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 be em- 
 ployed, it will be found convenient to have knots at intervals, to pre- 
 vent the hands of the assistants slipping. 
 
 Jlaltcr, Head-Cord, or Ilcad-Collar. 
 
 In addition to the limbs and other parts, we have stated that the 
 traction-cord can often be 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 the interdental space, or " neck " of the 
 lower jaw, is the most convenient for the attachment of the cord ; but 
 nevertheless it will be found in practice that this does not afiford 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 the traction 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 this part throws the head too much upwards. Should the head 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 
 
502 
 
 OBSTETRICAL OPERATIONS. 
 
 bead 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 foetus, 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. Rueff's Head-Collar. 
 
 No. 1. 
 
 Fig. 158. 
 
 Rueff's Head-Collar. 
 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 which was passed 
 behind the ears, while the inferior part with 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 different-sized heads 
 (Fig. 156). It is made from a long piece of cord with a loop or eyelet 
 at one end, and at a certain distance from this — from fourteen to six- 
 teen inches — a second loop. The other end of the cord is passed 
 through the first loop, so as to make a noose which goes round the 
 neck of the foetus ; 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 held at its 
 upper part by the index-finger and thumb, passed into the genital canal 
 
Mi:CHAMVAL KXTUAi'TKiX OF THE I'OiTUS. 
 
 503 
 
 or uterus, where it is placed on the head of the fcxitus and the sides 
 appHed to the cheeks ; the lower portion, which was open, is now closed 
 by running; the end of the cord throu<,'h the second loop, by which the 
 head is tirinly secured, as in the figure (loG). 
 
 Instead of having the first loop at the end of the cord, Bautneister 
 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" {Zamjctihand). 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 foetus 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 loop. In this 
 
 Fig. 159. 
 BiNz's Forceps-Band. 
 
 way the head is firmly held, and powerful and direct traction can be 
 made on the 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 1S48, introduced another kind of head apparatus, which 
 he designated a "sliding head-stall" {U'ticre d. coulant), but which is 
 perhaps better known in France as a " forceps halter " (licol-forccps), by 
 reason of its shape and use. It is composed of two doubled cords, one 
 of which (Fig. 100, 1, I) 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 si/e 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 m 
 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, runs 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 fcetus. One 
 side of the loop is fixed in the runner, by rings of waxed pack-thread 
 
504 
 
 OBSTETRICAL OPERATIOXS. 
 
 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 nose-hand (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 
 
 IM 
 
 Fig. 160. Fig. 161. 
 
 Schaack's Forceps-Halter. Manner of placing 
 
 Schaack's 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 parts of the Halter. 
 
 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 being between the middle 
 and index-finger, the fixed side between the ring and little finger 
 (Fig. 161). The apparatus is at first held by the index and middle 
 fingers against the other fingers, as well as by the thumb, which keeps 
 both cords in the palm of the hand ; and finally by the left hand, 
 
MECIIAMCAL EXTRACT ION OF THE FCETUS. 
 
 505 
 
 which, di-awinjj; lij^htly on the three cords, keeps them sufTiciently tij^ht. 
 The runner should be at the wrist, the button of the nose-loop towards 
 the hand. 
 
 The apparatus being so disposed, the hand is introduced sideways 
 (little linger downwards) into the vagina, until it arrives at the head of 
 the f(ctus ; then the nose of the latter is passed into the head-stall loop, 
 which is pushed forward by one side of the face — say the right — towards 
 the neck and over the ear ; the other half being now carried on the 
 opposite side towards the left ear, and then the runner is seized below 
 the jaw. In tliis way the hand has passed round the length of the 
 head-stall from its fixed to its movable part — the latter readily allowing 
 the loop to enlarge and pass over the salient portions of the head, the 
 loop being nevertheless kept sufliciently tense by the right hand pushing 
 the runner up towards the throat ; while the left hand, pulling at the 
 movable cord — recognised by the knot at its end — tightens it as much 
 as may be necessary. The nose-loop is placed by introducing the 
 
 Fig. 1G2. 
 
 ScH.\ACK's H.\I.TKK TLACKIi ON A CaLK'S HeAD, THE RlGHT FoRK-PaSTKRN 
 liEIXf; ALSO CORDED. 
 
 index-finger of the right hand under the button, and drawing the loop 
 through the runner to a suflicient length, the left hand keeping the 
 other two cords tight ; the end of the nose is passed into the loop, which 
 is lifted as high as need be. This done, the right hand is withdrawn 
 from the uterus and vagina, along, while keeping tight, the three cords. 
 These are tied together in a knot outside the vulva, and the head is thus 
 securely and solidly fixed. 
 
 Saint-Cyr and others highly recommend this apparatus, which in its 
 modified form difl'ers but little from tliat described by Binz some years 
 previously. He remarks that its extreme simplicity, its trifling cost, 
 the facility with which it can be placed after a little practice, its 
 solidity — which enables it to withstand any amount of traction — and its 
 absolute innocuousness, all combine to render it one of the best and 
 most precious instruments required in veterinary obstetricy. In the 
 first place, when it is properly applied it cannot slip, and all the amount 
 of force necessary under the circumstances may be employed without 
 
506 OBSTETRICAL OPERATIONS. 
 
 fear ; next, being formed of small and flexible cords, which are well 
 oiled before use, it cannot injm-e the maternal organs in any way ; 
 thirdly, from the manner in which it acts on the neck, the lower jaw, 
 and the face, and the impossibility of its becoming tighter when once 
 it is fixed, it is absolutely inoffensive, so far as the foetus is concerned ; 
 and, finally, owing to the nose-loop, it always keeps the head in a good 
 direction, prevents it from deviating, and compels it to follow the 
 course most favourable for its extraction : in the words of Schaack him- 
 self, " Without exaggeration, the forceps of the accoucheurs could not 
 answer better for the human foetus." As an agent of prehension and 
 traction — but particularly the latter, Saint-Cyr asserts that he does not 
 know of anything superior to this apparatus. 
 
 Shaack's halter is more especially applicable to the Bovine foetus, 
 the head of which is so much larger and squarer than that of Solipeds, 
 
 Fig. 163. Fig. 164. 
 
 Haltek with a Single Traction Halter with Two Traction 
 
 Cord. Cokds. 
 
 a. Check-knot ; h, Running Knot or a, b, Two ends of the Cord ; r, 
 
 Loop. Check-knot on the a portion ; d, Run- 
 
 ning Knot or Loop on the b portion. 
 
 and sometimes requires very energetic pulling to remove it from the 
 pelvis. 
 
 It is not always an easy task, however, to place anything like a 
 formed halter over the head, especially if this is in the genital canal ; so 
 that it has been found more convenient to make the halter on the 
 head. Detroye^ takes a cord about ten feet long, in the middle of 
 which he makes a simple knot — a check-knot ; this is passed by the 
 hand or porte-cord around the neck behind the head, and the knot 
 withdrawn to the vulva ; a loop or running-knot is made on the cord 
 at a certain distance from the check-knot, and the shorter portion of 
 the cord is passed through it, the loop being tightened and run up 
 until it is close to the knot (Fig. 164). The length of cord between the 
 two knots should be sufficient to encircle the upper part of the neck, 
 and form a kind of halter without the nose portion ; the loop may be 
 made previously, when it is possible to make it glide on the head, 
 
 ^ Recueil de Medecine Vetdrinalre, 1889, p. 309. 
 
MECHANICAL EXTRACTIOX OF THE FCETf'S. 
 
 607 
 
 After drawing the portion with the check-knot on it sufliciontly tight 
 to place the head-piece in its proper situation, the same portion should 
 be passed or hitched round the lower end of the head; 
 the knots ought to lie between the branches of the lower 
 jaw. If it is desired to have only one traction cord, the 
 running-knot or loop should be made at one end, and the 
 check-knot a calculated distance from it (Fig. 1G3). 
 
 This forms a very simple and solid apparatus for 
 exercising any amount of traction on the head, without 
 much risk of danger to the fcctus. 
 
 A still simpler method is passing the middle of a ten 
 or twelve foot cord behind the ears of the foetus, carrying 
 the sides down behind the lower jaw, and then twisting 
 them outside the vulva until the two ends form one 
 portion between the branches of the jaw. This, how- 
 ever, has rather a tendency in some cases to tilt the nose 
 too much upwards. 
 
 With the smaller animals, cords cannot be passed 
 around the head of the fa3tus in the same manner as 
 in the Mare or Cow, because of the want of space ; and 
 on the same grounds forceps are objectionable. For 
 anatomical reasons, it is essential that the traction force 
 should be applied behind the head, as if the sum of the 
 expulsive efforts were directed there. With this object, 
 Defays devised an apparatus which fulfils this indication, 
 and is very simple and easily applied. It consists merely 
 of two very pliable copper or brass wires — twisted picture- 
 frame wire I have found to answer admirably — about 
 sixteen inches in length, and looped in the middle, so as 
 to be applied to the fcctus in the following manner : The 
 first finger of the left hand being passed into the vagina, 
 -erves to guide one of the loops towards the summit of 
 and behind the foetal head ; and it then conducts the 
 loop of the other wire beneath the head behind the jaw. 
 This done, the two wires on each side are twisted by a 
 little machine (Fig. IGo) composed of a thin iron rod in a 
 handle, the other end of which is thickened and pierced 
 by holes running nearly parallel to the stalk. Into these 
 holes the two wires of one side are passed ; the machine 
 on each side is pulled up as close as possible to the head 
 of the fcotus, and then, each being turned round three or 
 four times, the neck is enclosed in a kind of noose or 
 collar formed by the two wires (Fig. 166). 
 
 The rods are now withdrawn from the latter, and the 
 foetus can be extracted by exercising traction on the ends 
 of the four wires outside the vulva. By this contrivance, 
 delivery is effected without injury to the Bitch, and, 
 unless it is much decomposed, without separating the with the Tob- 
 head of the foetus. «'on Rons. 
 
 We have tried Defays' apparatus, and can speak highly of it ; not 
 infrequently we have succeeded in extracting the Puppy alive, and 
 when the use of forceps would have been impossible. 
 
 A much simpler, readier, and perhaps more successful apparatus (so 
 
 Fig. ifi.'i. 
 
 r)Er.\Ts' WlRK 
 
 Extra rroR 
 
508 
 
 OBSTETRIC A L OPERA TIONS. 
 
 far as our experience enables us to speak), is that devised by Breulet, 
 of Marche, Belgium, which meets every requirement in the accouche- 
 ment of small Bitches, and might be successfully employed v^ith Sows, 
 Ewes, and Goats. This apparatus is the same in principle as Defays' 
 
 Fig. 166. 
 Defays' Wire Extractor applied. 
 
 wire extractor, but there is only one wire. The principal part of the 
 invention is a noose-tube, consisting of a tubular piece of round wood, 
 from four to six inches 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. 167). 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 Foetus. 
 
 the occiput of the Puppy ; then the two ends of the wire are passed 
 through the tube, and this is pushed into the vagina under the chin of 
 the foetus ; the operator now tightens and secures the wire, by giving 
 it a turn round the first finger of his right hand, placing his thumb at 
 the end of the tube (Fig. 168). A little traction then extracts the 
 foetus, and without doing it or the Bitch [the least damage. I have 
 
MECUAXICAL EXTRACTION OF THE FCETl'S. 
 
 509 
 
 employed this instrument in canine obstetricy, and my success has 
 always been complete, even with the tiniest toy terriers. When sought 
 for in time, I have generally managed, expeditiously and easily, to 
 extract the Puppies alive. 
 
 It will be seen that the noose is not unlike the " iillet " used in 
 human obstetrics. 
 
 Fig. 169. 
 
 CAK-nVKIGHT's 
 POBTK-COKD. 
 
 Fig. 170. 
 
 Daubeai'h 
 PobteCoku. 
 
 FiK- 171. 
 
 GCNTHKU's ClRVKD 
 
 porte-cori) a.vd 
 Blunt Cuotchet, 
 armko with a 
 Cord and Rin*;. 
 
 i 
 
 Fig. 172. 
 
 |I).\hukau'h 
 Curved 1'oute-Cord. 
 
 t 
 
 SECTION II.— PASS- OR PORTE-CORUS. 
 
 When treating of certain presentations, it was remarked that though 
 the use of cords is urgently indicated in some cases, the arm is not 
 
510 
 
 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 manipulating accessible j)arts 
 which it is desirable to secure by these means. In such circumstances 
 the porte-cord, or pass-cord — which has been sometimes referred to — 
 is of great service. The instrument is of two shapes, straight and 
 curved. 
 
 The straight porte-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 limbs. For instance, in the 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 sufficient 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 
 same manner to the other fore-limb, so that each instru- 
 ment becomes a solid fixture to the leg, and is confided 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, ti-action is made on the hind-limbs, 
 the repellers being still employed to overcome the resistance 
 of the foetus and follow its movements. 
 
 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 sufficiently to answer 
 the purpose in the case of flexed 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. 
 
 Tyvaert^ has for a long time made profitable use of a simple porta- 
 ^ Annaks de Medicine Veterinaire, 1876, p. 320. 
 
 Fig. 173. 
 
 Dareead's 
 Repeller. 
 
MECHAXICAL EXTRACTIOX OF THE F(ETUS. 
 
 511 
 
 cord. This is composed of a somewhat short piece of iron wire, about 
 
 the thickness of a goose-quill, and bent a little round, the length and 
 
 curve varying with the part to be secured. One end is turned to form 
 
 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, serv'ing to 
 
 form 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 fa'tus, while its shortness 
 allows it to be easily manipulated in the uterus. It 
 is from twelve to sixteen inches long, and made of 
 wood or iron ; at the bent end is an opening through 
 which the cord passes. The instrument (named a 
 Gcburtssunile by the Germans) is passed to the 
 middle 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- 
 strument is then withdrawn, and the part is ready to be pulled at by 
 the cord left encircling it. 
 
 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 ring — no 
 noose — at the end of the cord ; the curved portion is pushed around 
 the part to be secured, and the hand, leaving it, is passed to the oppo- 
 site side of the part, where it searches for the loop or ring, which, when 
 found, is drawn into the genital canal. The instrument is then with- 
 drawn, the cord remaining around the part ; the free end of the cord is 
 passed through the loop or ring, and being pulled at, the limb, neck, 
 body, or whatever it may be, is secured in the noose so formed, and 
 traction can in this way be directly exerted upon it. 
 
 Fig. 17). 
 Binz's Pobtk-Cord. 
 
 SECTION III.— CROTCHETS OR HOOKS. 
 
 Obstetrical crotchets or hooks are iron or steel instruments of variable 
 dimensions, more or less curved at one end — which is blunt, sharp, or 
 
 Fig. 175. 
 Short Blckt Crotchet. 
 
 Fig. 170. 
 Blcxt Fikoeb Crotchet. 
 
 pointed — the other end having a ring (Fig. 176) or eyelet (Fig, 175) if 
 short, a handle if long. The latter is from thirty to thirty-six inches 
 
512 OBtiTETllICAL OPEIIATIONS. 
 
 in length (including the handle), and acts directly on the foetus without 
 any other appliance intervening ; while the short hooks have cords 
 attached to them, or they may fit on the finger of the operator by means 
 of a ring. Some sharp crotchets are jointed at the end curve, so as to 
 permit them to be more readily and safely introduced into the genital 
 passage by bringing the sharp point near the stalk, the curve being 
 restored by a spring when the fcetus is reached. But the advantages 
 of the jointed hooks are very few, while their strength is impaired and 
 their expense increased. In using the long or short pointed crotchets, 
 risk of injury to the maternal organs may be obviated, if the hand is 
 not found sufficient to guard the instrument during its introduction, by 
 fixing the point in a piece of cork or soft wood, to w^hich a long piece 
 of twine is attached ; when the crotchet is required to be implanted in 
 the foetus, this shield may be removed from the point, and withdrawn 
 from the genital organs by pulling at the end of the twine outside the 
 vulva. 
 
 Blunt and sharp crotchets are much employed in veterinary obstetrics, 
 and are very valuable. The blunt crotchets are more particularly 
 resorted to when the foetus is alive, and it is hoped to extract it before 
 it is dead ; they are most serviceable in correcting deviations of the 
 head or limbs, and the long crotchet is especially useful in finding and 
 
 Fig. 177. Fig. 178. 
 
 Short Sharp Crotchet, Short Sharp Crotchet, 
 
 WITH Broad or Flakged Point. with Eocnd Point. 
 
 straightening 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 delivering the Sow, Sheep, Goat, Bitch, or 
 Cat. 
 
 Giinther's long porte-cord (Fig. 171) can be most effectively used as a 
 blunt crotchet and at the same time as a carrier of the cord. A German 
 long blunt crotchet has a concealed sharp blade in the concavity of the 
 curve ; by means of a spring in the hanclle 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 suffi- 
 cient hold of the fcetus, 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. 
 
MECHANICAL EXTRACTION OF THE FCETUS. 
 
 518 
 
 So it is that the point should not bo turned round in a semicircular 
 manner, but rather at an acute angle, as in Figs. 181, 182. 
 
 There is rather a diversity of opinion with regard to the preference 
 to be accorded to the crotchets ; some practitioners preferring the short 
 ones, as they can be readily carried into the uterus guarded by the hand 
 and moved about there, so as to be implanted 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 
 
 <f^ 
 
 <f\ 
 
 fn 
 
 H A 
 
 Fig. 179. 
 
 Long Blunt 
 Cbotchet. 
 
 Fig. 180. 
 Long Pointeh 
 
 CllOTtHET. 
 
 Fig. 181. 
 
 Fig. 182. 
 
 Long Pointed Crotchets, 
 Darreau'.s Pattern. 
 
 long rigid crotchet, which they aflirm is more easily placed — one hand 
 guiding the point through the passage, the other hand acting on the 
 handle. 
 
 These preferences depend very much upon whether the operator is 
 more practised in the use of one or other of the crotchets, and also, 
 doubtless, upon circumstances peculiar to each case requiring the em- 
 ployment of such instruments. Both long and short crotchets are 
 most useful, and the obstetrist should have several of each, of various 
 
 33 
 
514 OBSTETRICAL OPEEATIOSS. 
 
 forms and dimensions, so as to be able to select that which is best 
 adapted to meet the requirements of particular cases. 
 
 It must be observed, also, that many practitioners are not in favour 
 of crotchets, and decry their use. But there is something unreason- 
 able in this, and the experience of almost every day goes to prove that 
 these instruments afford a simple and ready means of getting hold of 
 the foetus in regions of its body which the hand 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 effect of the uterine con- 
 tractions on the hand and arm of the operator. They can also be 
 profitably 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 mutations which are necessary in order to bring par- 
 ticular parts of the 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 have certain 
 disadvantages which must 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 the 
 contractions of this organ may paralyse the hand which carries the in- 
 strument and cause it to escape, or its point to wound either 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 which they are implanted are not very firm or 
 resisting, so that only a moderate degree of traction can be expected 
 from them, and which is often insufficient to overcome the resistance that 
 prevents the birth of the foetus. In such a case, if, through forgetful- 
 ness or maladroitness of the operator, the tissues suddenly give way 
 and the crotchet slips into the maternal organs, serious, if not fatal, 
 injuries may be inflicted ; or the hand or arm of the operator may be 
 the part to suffer. 
 
 These are undoubtedly disadvantages of a weighty 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 advai:itages 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 cases where the head of the foetus is back," Cartwright says, 
 " I am very partial to using the long sharp-pointed hook in the orbit ; 
 even if the head is at the extreme distance, with care we can insert it in 
 the orbit and get the head in the passage. Of course, it requires great 
 
MECHANICAL EXTRACTION OF THE FCETUS. 515 
 
 care in watching that the hook does not break loose and do mischief. 
 I have found that Nve may pull by the hook in the orhit witli great force, 
 without tearing the skin of the Calf, providtd the latter is not in a de- 
 composed state. From my experience, 1 can speak highly of the hooks; 
 indeed, you cannot get the head up without them sometimes." And in 
 embryotomy they may be most usefully resorted to for many purposes. 
 Reference will now be briefly made to the parts of the fcL'tus upon 
 which the crotchets can be most effectively employed, and the manner 
 of employing them. 
 
 Pauts into which the Crotchets may be implanted. — The parts 
 into which the crotchets may be implanted are numerous, but those 
 which are selected by the obstetrist will not only depend upon the 
 luiture of the malpresentation or malposition, but alsoupon the simplest 
 indications for the adjustment of these. ^Vhen the desirable part has 
 been reached, the point of the crotchet is inserted in such a way that 
 the instrument is directed towards the source of traction — the assistant. 
 When blunt crotchets are employed, except in cavities, it will be ucces- 
 aai'y to make an incision through the skin before they can be inserted. 
 Cartwright states that sometimes the sharp crotchets cannot be used 
 without making these preliminary incisions ; but then the instruments 
 must be rather blunt. The best parts for implantation are (1) the 
 muscular tissues, (2) the head, (3) the spine, and (4) the jiel vis. 
 
 1. The Muscular 2'issues. — These tissues are not advantageous for the 
 employment of the crotchets, for although they are easily inserted, they 
 are as easily torn out. Nevertheless, these instruments, when lixed in 
 certain muscular regions, such as the croup, thighs, loins, and neck — 
 more especially the latter, may render useful service in rectifying devia- 
 tions, as the skin offers a good amount of resistance. But, from the 
 fragile and yielding nature of the textures, it must be borne in mind 
 that the hand of the obstetrist should never leave the crotchet while 
 traction is made on it, and that its position in them must be most 
 attentively noted, in order to guard against accidents arising from its 
 tearing away. 
 
 2. The Head. — The head offers many good points for implanting the 
 crotchets — such as the symphysis of the lower jaw, the palate, and tlie 
 orbit ; as well as the ear and angle of the inferior maxilla, on particular 
 occasions. 
 
 It must be observed, however, that all these points are not of equal 
 value. The 7naxillar>/ si/ynphi/sis is convenient, but not very firm ; 
 moderately strong traction will rupture it, and damage may then occur. 
 Still, there are times and occasions when this part may be advan- 
 tageously seized by the crotchet, which may be inserted in two ways : 
 the point of the instrument may be passed from below the chin into the 
 mouth, or from the cavity of the latter through the mucous membrane 
 beneath the tongue, to below the chin. The first is generally preferable. 
 When traction begins, the operator must be on the look-out for tearing 
 away of the two branches of the jaw. 
 
 The orbital cavity is the best part of the head for a solid hold. Some 
 authorities have expressed doubts as to the propriety of fixing a 
 crotchet in the ocular cavity of a living fcc-tus, from a belief that the 
 eyeball must be damaged, and Rainard goes so far as to advise that it 
 should only be done when the creature is dead ; though he adds that, 
 if there is no other means of remedying a deviation of the head in the 
 
516 
 
 OBSTETRICAL OPEIIATIONS. 
 
 ^ 
 
 living Calf, it is well to attempt it, " as it is better to have 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 foetus 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 (the small- 
 ness of the pelvis not allowing any other means to be 
 employed) — describes his manner of operating as follows : 
 " The crotchet I use," says he, " is a solid (or long) one ; 
 the point is blunt and slightly flattened (Fig. 183). When 
 it is desired to pull at the head of the foetal Goat or Lamb, 
 the left hand at first seizes the nose, and the 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 cheek. In this way I can pull with 
 the two hands on both orbits, so as to keep the nose in a 
 good direction." He 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 
 means has answered very well. And Cartv/right states 
 that "it is astonishing how wounds heal up in the cheek 
 where hooks have been in the orbit. I have 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 the 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 foetus is alive, the blunt instrument must be first tried, 
 the sharp-pointed one being kept in reserve until this has failed ; or it 
 may be used at first when the young creature is dead. 
 
 ^he, joalatine arch afi'ords 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 
 foetus, and over the tongue until it gets beyond the palate, when it is 
 turned point upwards 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 — particularly 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 difficult or imperfect for a short time after birth. 
 
 Of course, the head must be in a good position either in the inlet or 
 in the genital canal before the crotchet can be placed behind the 
 palate. Traction must also be moderate and steady, and the usual pre- 
 cautions observed. 
 
 3. The Spine. — When embryotomy is practised, or the foetus is dead^ 
 the bodies of the vertebrse or their transverse processes, or the ribs. 
 
 Fig. 183. 
 
 Schaack's 
 Crotchet. 
 
MECHANICAL EXTRACTION OF THE F(ETUS. r,17 
 
 afiforJ excellent hold for hooks, thouj^h caro must be observed in placing 
 them securely, and guarding them when they are beinj; pulled at. 
 
 4. The Pelris.— 'In posterior presentations, when cords cannot be 
 employed to tlie hind-limbs, the loins, or the croup, or when they have 
 not surticient power, then crotchets must be resorted to ; and with this 
 view the fct'tal pelvis offers several very advantageous points. After 
 removal of one or both hind-limbs, the cotijloid cavities, by their depth 
 and the hardness of their walls, are admirably adapted for receiving 
 the hooks and withstanding energetic pulling. If both limbs arc 
 amputated from the hip-joints, then a hook may be placed in (sach 
 cavity ; if ablation of only one limb has been effected, then one hook 
 will be most useful. 
 
 1\\e pubic arch and the oval foramina of the pelvis are likewise well 
 suited for crotchet traction in the posterior presentation, when the 
 fo-tus is dead. In some cases the shari)-pointed crotchet may be passed 
 directly 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 
 of the sacrum, or the shaft of the ilium ; care being taken that the 
 l)oint does not pass through the skin. Or the crotchet may be passed 
 from without inwards — the safest method — after the pelvic bones have 
 been denuded as much as possible of their soft tissues. This is, 
 perhaps, the most practicable method, if the hind-limbs have been 
 already removed. But if they have not, then all the soft tissues of the 
 foetus— from the root of the tail to the ischial arch— should be largely 
 incised, and the hand passed through the incision into the pelvis, to 
 remove the viscera. The crotchet is then pushed into it, and planted 
 either on the brim of the pubis or in the oval foramen. 
 
 SECTION IV.— CROTCHET-FORCEPS AND FORCEPS. 
 
 The introduction of forceps into human obstetricy marked a new era 
 in the accoucheur's art, and has been productive of the greatest benefit 
 in difficult cases of parturition in women. But they have not yielded 
 much service to the veterinary obstetrist, except with the smaller 
 animals; notwithstanding that llurtrel 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 that 
 their use is perhaps the best means of completing parturition when it 
 cannot be terminated naturally, etc. Attempts have been made at 
 various times to introduce them into general use for the larger 
 domesticated animals, and various models — more or less modifications 
 of the human 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 order ; they are united at the middle by a 
 fixed or sliding joint, and one end — the " bow," or widest part — which 
 is intended to grasp the foetus, is fenestrated, or perforated by a wide 
 opening ; at the other end is the handle. 
 
 The reason why forceps have never come into general use in veterinary 
 obstetrical operations — except with the smaller animals — is not so much 
 from a prejudice against novelties and innovations, as because they 
 are really not adapted for this kind of practice, unless in a very 
 
518 
 
 OBSTETRICAL OPERATIOXS. 
 
 modified form, to be presently noticed. Eainard^ remarks : " Medical 
 men will be astonished that I have not mentioned the forceps, from 
 which 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. 1S4. 
 Simple Short Crotchet-Forceps. 
 
 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. 
 
 Fig. 185. 
 Long Simple Crotchet-Forceps. 
 
 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 much advantage in certain 
 cases. 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 hooks can be inserted near, but opposite to, each 
 other, on each side of the spine, pelvis, head, flanks, etc., the cord, 
 
 1 0;j. cit., vol. ii., p. 98. 
 
MECHANICAL EXTRACTION UF THE FiETUS. 
 
 '.19 
 
 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 
 
 r;\c|E 
 
 Fig. iSti. 
 GC.nthkr's Long Crotchkt-Fobcbps. 
 
 Fig. 187. 
 Jointed Cbotchkt-Forckps. 
 
 to answer the same purpose, and which has what is considered an 
 advantage — a series of notches on each side towards the traction-rope, 
 on which runs a clip that binds them together, and prevents their flying 
 outwards while the assistants are pulling (Fig. 18G). The two crotchets 
 A B, C D are brought together at A C by the cord E, which passes 
 
 Fig. 188. 
 Nelson's Blunt Crotchkt-Forckps. 
 
 Fig. 189. 
 Nklson's Skbratki) Crotchkt-Fgrckpb. 
 
 through their eyelets ; d is the clip on the ratchet c c ; f J\ the curve of 
 the crotchets ; and g g, 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 hes in a slight notch on the opposite one, to render their 
 introduction into the uterus more safe, and also to prevent accidents. 
 
520 
 
 OBHTETRWAL OPERA TIONS. 
 
 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 in 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 Talhch's short instru- 
 
 Fig. 190. 
 Tallich's Short Bent Crotchet-Forceps. 
 
 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. 
 
 Another instrument of this description has been devised by a Belgian 
 veterinary surgeon, Andre, which he designates a pince-forceps or 
 accroche-fcBtus. This is not unlike the instrument fixed in the nose of 
 
 Fig. 191. 
 Andre's Crotchet-Forceps. 
 
 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 eyelet of each passes a strong cord, the two 
 ends of which soon unite into a single piece (Fig. 191). When 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 
 
MECHAXICAL KXTHAi'T/oX OF THE FlETVS. 521 
 
 are fixed on the part to be drawn iit, by first pullinj^, outside the vulva, 
 at the strhi^' which opens them, pushing,' the points a^^ainst or over the 
 part ; then, wlien this is betwemi the points, drawing at thi^- single cord 
 which closes them. This is acknowledged to be rather an instrument 
 for holding or fixing a certain region, and not for exercising tractile 
 force upon. Andre has often applied it successfully to the lower and 
 upper jaw, or to the ear, to bring the head into a good position ; to the 
 tcmlo Achillis in order to raise a hind-limb, which the hand alone could 
 not do ; to the fore-limbs, etc. 
 
 With regard to the smaller animals, such as the Bitch, Sow, Sheep, 
 or Goat, in them we may often use the crotchet, small ordinary forceps, 
 or a small-sized model of the human forceps, with advantage. Various 
 patterns are in use, some of them fenestrated, others not ; some I'esemble 
 polypus-forceps, while otliers again are grooved, serrated, or toothed at 
 the ends of the blades. An essential which should not be lost sight of 
 in tlie forceps for such small animals as the Bitch or Cat, is that the 
 blades should be sufliciently long to seize not only the head, but much, 
 if not all of the body of the'fa;tus. If they are short in the blades, tliey 
 cannot be made to grasp sufficient of the fa'tus to remove it ; while the 
 joint being close to the vulva, or even within the vagina, is likely to 
 pinch the mucous membrane and cause the mother considerable pain. 
 
 A useful instrument is a small and slightly modified form of the 
 human forceps for Bitches ; there is a spring between the branches of 
 the handle (Fig. 192). 
 
 Weber has proposed a forceps for these small animals, and it has 
 been preferred by some authorities to the ordinary model. It is a 
 modification of one for a long time employed by Lel)lanc, which again 
 was fashioned after an instrument designed by Hunter. This is com- 
 posed of an iron stalk about ten inches in length, with a wooden handle 
 at one end, and two blades or bows at the other. On this stalk glides 
 a long enveloping metal tube, which, near the handle, has a wide ferule 
 or shield that allows it to be pushed along by the thumb of the hand 
 holding the instrument, and thus to bring the blades tog(rther. A nut 
 or female screw, running on a screwed portion of the stalk near the 
 handle, is intended to assist the pressure of the thumb, when this is in- 
 sufficient (Fig. 193). A finger of the other hand introduced into the 
 vagina, guides the instrument, and allows the part of the fcctus to be 
 seized to be reach(,'d by the ojjcrator, either with the view of extracting 
 the young creature or changing its position, according to indications. 
 
 But, it must be observed, it is very difiicult to a})ply an instrument 
 of the shape of those employed in human practice ; it ought to be some- 
 thing like that described by Palfin. It is most diffiicult, Defays truly 
 says, to apply an instrument in shape like the accoucheur's ordinary 
 forceps, owing to the neck of the ftetus in Carnivora being so thick, and 
 the difference in volume between it and the head far less than in the 
 human foetus. So that, when the forceps is used, the bow of the blades 
 presses on the neck, slips under the throat, and the head escapes from 
 them. To remedy this imperfection, he has made forceps with the ex- 
 tremity of the blades notched or hollowed out (Fig. 194), while the end 
 of one of the branches has a piece of metal with a slot in it attached 
 by a hinge, and which is intended to hold the blades together when the 
 fa^tus is seized. 
 
 Though this forceps has sometimes proved of service, yet cases occur 
 in which it is not so useful. 
 
522 
 
 OBSTETRICAL OPERATIONS. 
 
 When the Bitch is large, or of moderate size, forceps may be em- 
 ployed with advantage, though they must be of various dimensions. 
 
 Fig. 192. 
 Bitch Forceps. 
 
 Fig. 193. Fig. 194. 
 
 Webek's Forceps. Defats' Forceps. 
 
 But when the animal is very small, as is usually the case in difficult 
 parturition in this species, the space occupied by the bows of the forceps 
 — if they are ever so thin — so increases the volume of the mass which 
 
THE EMPLOYMEXT OF FORCE IN DYSTOKIA. r)*23 
 
 has to pass through the pelvic canal that this instrument cannot be 
 used. 
 
 As was pointed out when studyinj^ the anatomy of this region, thii 
 pelvis is cylindrical in Carnivora, and if we suppose its diameter to be 
 three inches, and that of the head of the foetus a trille less, it will be 
 seen tliat birth must necessarily be ditlicult ; and this dithculty will be 
 increased if the vaf^ina is narrow and ri^id. When the forceps is used, 
 the ditliculty is further exaggerated ; for wlien tlie blades are passed on 
 the head, the fcvtus is then augmented in size by a quantity equal to 
 their breadth multiplied by their thickness — the whole constituting a 
 mass greater than the pelvic cavity will permit to pass through it ; so 
 that delivery becomes impossible. Forceps, therefore, in small Bitches 
 increase the ditliculties of parturition, and these difliculties are all the 
 more embarrassing as the animal is diminutive. Recourse to this in- 
 strument is consequently contra-indicated, and if delivery is to be effected, 
 a means must be substituted which presents less inconvenience. As a 
 rule, the loss of one or two Puppies is not a matter of much moment, 
 the principal object being to save the mother by bringing tlie act of 
 parturition to a prompt termination. Therefore it is that Defays' or 
 Breulet's apphances (p. 507) are to be preferred in nearly all cases. 
 
 C PI AFTER IV. 
 The Employment of Force in Dystokia. 
 
 In connection with obstetrical operations, a rather important question 
 to be considered is the employment of force in the artificial extraction 
 of the fa3tus. For, 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, if not horrified, at hearing of the amount of pulling 
 which the fcetus has to undergo and the parent sustain, before delivery 
 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 
 regard to it are not yet sutliciently ascertained, and differences of opinion 
 exist with regard to them, yet it is a subject well deserving the attention 
 of the obstetrist, and especially the junior practitioner. 
 
 The indications for forced extraction have been given in preceding 
 chapters ; they are chiefly to l)e found in tlie smallness or deformity of 
 the maternal genital canal ; excessive development of the fcntus — wholly 
 or partially, or distortion ; malposition of parts wliich cannot be 
 remedied ; or morbid conditions that hinder birth. Forced extraction 
 is usually preferable to embryotomy and Caesarian section in those 
 cases in wliich the passage of the fcetus — whether alive or dead — appears 
 to be possible without serious injury to the mother ; and because of the 
 greater width of the pelvis of the Mare, it is more likely to be successful 
 in that animal than in the Cow. 
 
 The direction, intcnsitif, and nature or means of developing tlie force 
 to be cniploj/ed, have first to be considered, after which it will be 
 desirable to compare manual with nicclianical force, and point out their 
 respective advantages and disadvantages from an obstetrical point of 
 view. 
 
524 
 
 OBSTETRICAL OPERA TIOXS. 
 
 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 difficult, as well as a very important problem to solve. This 
 difficulty 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 foetus 
 must pass through it by always offering its gi-eatest 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 line, 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 difficulty in the question is to determine, 
 in a rigorous manner, the direction in which to exercise traction with 
 
 Fig. 195. 
 Diagram of the Pelvic Axis. 
 
 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 hne passing from the centre of the 
 anterior circumference to the centre of the 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, offers no serious difficulty. At 
 p. 261 it was shown that this direction can vary, and may be modified 
 according to the presentation — and more particularly the position — of 
 the foetus, and also according to the period of labour. 
 
 SECTION II.— DEGREE OF TRACTION. 
 
 When passing through the pelvic cavity, the foetus undergoes a certain 
 amount of compression, proportionate to the uterine contractions or the 
 
THE EMl'Li>y.ME.\T OF FOIiCE IX I>YSToKIA. 525 
 
 external traction which determines its progression outwards ; at the 
 same time, tliis compression produces a kind of reaction in the body of 
 the fcL'tus, 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 fcetus, without 
 injuring either the latter or the parent. In veterinary obstetrics we have 
 no lixed data to rely upon ; but the experiments of Joulin, Delore, and 
 PouUet, alluded to by Saint-Cyr, may ailord some idea of the resistance 
 oflered 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 fa'tus — 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 G3o 
 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 compromised if the 
 degree of 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 fcjutus. But tliis does not 
 take place with the ordinary forceps, which, even in the hands of the 
 most expert accoucheur, 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, without the 
 dynamometer showing anything more than a relatively feeble degree of 
 traction. 
 
 Otherwise, it is not only the bones which have to be considered, but 
 also the soft parts, which, pressed between the fa'tal head and the hard 
 pelvic circumference, may be bruised, crushed, 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 sustaius a pressure of 1,H0() grannnes, 
 even in the most favourable conditions ; though it may be as much as 
 six kilogranmies or more, according to circumstances. 
 
 These obser\ations, though doubtless valuable and significant for the 
 accoucheur of woman, are only very indirectly applicable to veterinary 
 obstetricy. Without taking into account the strength of the pelvic 
 osseous girdle, so much greater in the Mare and Cow than in won)an, 
 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 obstetrist. But tlic veterinarian 
 is in possession of means of traction which give him a great advantage 
 in 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 forceps. 
 
 In woman, as with animals, the foetus, in passing through the pelvic 
 
526 OBSTETRICAL OPERATIONS. 
 
 cavity is pressed upon by its walls, and in turn it presses upon them, 
 in the manner of a wedge which tends to tear them asunder. But there 
 is a great difference in woman and animals. On the one hand, it is a 
 hard, bony, and little reducible region — the head — which presses against 
 the pelvic walls, to which it transmits, almost undiminished, 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 much 
 in the latter case — that of animals — the eccentric pressure produced by 
 the passage of the foetus 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 foetal 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 foetus — each 
 square centimetre of the surface of the pelvis in contact with it should 
 support a pressure of about 500 grammes ; in less favourable conditions 
 it may even be much more. 
 
 From some measurements made by Saint-Cyr, the pelvis of the Mare 
 and Cow, which is nearly cylindrical, may be reckoned at 1,600 square 
 centimetres (248 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 foetus transmits to the walls of the genital canal, 
 to which it is very closely applied during its passage outwards. If, then, 
 it be admitted that the total of this eccentric pressure amount to about 
 one-half the tractile force expended on the foetus, it will be easy to find, 
 by a simple calculation, the pressure on each square inch. Supposing 
 the traction to be equal to 1,540 pounds — the estimated strength of 
 seven or eight men pulling with all their force at the cords — the 
 pressure on each square inch would be about 7f ounces ; or one-half that 
 exerted on the same extent of surface with a tractile force of 132 pounds, 
 in woman ! 
 
 Saint-Cyr does not pretend that these calculations give a rigorously 
 exact measure of what really takes place during parturition ; but he 
 believes they may assist, up to a certain point, in explaining certain facts 
 in comparative obstetrics which otherwise would remain obscure — how, 
 for instance, natural birth, which is always so painful in woman, 
 is comparatively painless in the lai'ger 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 surgeon's 
 patients. 
 
 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 be employed without danger; and on this point the opinions of the 
 best authorities are widely divergent. Some declare for moderate 
 traction — tv>'o, three, or four men at the most, pulling simultaneously 
 at the cords with all their force, are, in their opinion, quite sufficient 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 
 energetic traction, and are not afraid of employing the combined strength 
 of six, eight, or ten strong men ; being convinced that the parent suffers 
 
THE EMPLOYMENT OF FOIiCE LV DYsTnKIA. 527 
 
 more from protracted labour than from powerful traction — and not 
 infrequently their success justities their boldness. 
 
 Donnarieix admits that three assistants are usually suflicient with the 
 Cow — one at the head, another at the tail, and tlie third to aid the 
 operator ; while ten are needed for the Mare — one at the head, another 
 holdinf^ the rope which confines the limbs of the animal and prevents its 
 doing damage, a third to hold the tail, a fourth to assist the operator, 
 and the other five or six to pull at the foetus when necessary. Zundel, 
 however, is of opinion that these numbers are somewhat exaggerated ; 
 very often more than three assistants are required for the Cow, and if 
 more than six are needed for the Mare it is better to have recourse to 
 mechanical means ; as too many assistants hamper the operator, and are 
 often in each other's way, while tlieir united strength cannot be usefully 
 applied. 
 
 The assistants should be strong, and have had some experience in 
 handling animals ; some of them maintain the creature in a favourable 
 position, while the others aid the attempts at extraction, under the 
 orders of the operator. Precautions should be adopted to prevent 
 accidents — especially to the assistants — from the struggles or defensive 
 movements of the animal ; and if the traction is severe, the latter 
 should be supported against it by assistants pressing on the but- 
 tocks, by holding a rope or band against these — or even by placing the 
 hind-quarters against the half-door of the stable. The tractile efforts 
 should be made simultaneously without jerking, in a continued and 
 energetic manner, and always in the direction of the axis of the pelvis 
 — in a straight line behind the animal. The direction of the traction 
 may, however, be a little downward in the anterior presentation, 
 lumbo-sacral position, until the withers have passed through the inlet ; 
 as by this means the top of the withers is depressed, and this part 
 enters the pelvis before the sternum. The operator stands behind the 
 mother, his hands on the sides of the vulva, which he depresses with 
 the cubital border of one hand, while with the back of it he separates 
 the lips, and prevents their being abraded by the cords. It is better 
 to engage only one shoulder of the foetus at a time, if possible ; and 
 when the sternum and one shoulder have been carried into the passage, 
 then the other shoulder is brought forward by directing the assistants 
 to pull a trifle towards the opposite side. By acting in this way with 
 care, and by slow though continued efforts while the parent is straining, 
 delivery will be effected, if this be possible by traction. The operator 
 must not act hurriedly or brusquely, and his hand should carefully 
 attend the advance of the foetus : facilitating its passage, and aiding 
 the progress of the haunches by passing his open hand between them 
 and the maternal pelvis. 
 
 In the posterior presentation, when at least one assistant must be 
 told off to each cord, the traction should be moderate, or even gentle 
 at first, until the operator's hand has adjusted the fa-tus as much as 
 possible. In addition, the latter, besides directing his assistants, must 
 frequently himself guide the traction by the disengaged hand, and 
 personally exert himself in the extraction of the young creature — 
 separating the lips of the vulva, and pressing them towards the pelvis 
 when they are pushed outwards by the advancing foetus ; lubricating 
 the latter and the genital canal when necessary, etc. 
 
 With the smaller animals the operator himself applies the needed 
 force, though an assistant is usually necessary to hold the creature. 
 
528 
 
 OBS TETRICA L OPERA TIOAS. 
 
 Generally, very little traction can be made because of the danger of 
 tearing the foetus in pieces, and what is employed should be gentle and 
 sustained ; indeed, the foetus should be held steady, traction only 
 made during the expulsive efforts of the mother, and then lightly and 
 steadily. 
 
 SECTION III.— MEANS FOR DEVELOPING THE NECESSARY FORCE. 
 
 Hitherto the employment of human or manual force in the extraction 
 of the foetus has only been considered, and this, of course, is that which 
 is generally resorted to at first. But it is not the only force that may 
 be employed, and especially if it is desirable to exercise very powerful 
 traction. It is true that empirics and amateurs have often adopted 
 the barbarous expedient of attaching the cords fixed on the foetus to a 
 Horse or Ox, and by making the latter exert its strength, to tear the 
 young creature through the maternal passage. Eainard mentions that 
 in the Camargue, those who have the charge of droves of Mares, not 
 having the services of a veterinary surgeon, yoke another Mare to the 
 cords they fasten on the foetus, and deliver the parturient animal in 
 
 Fig. 196. 
 Obstetric Pulleys. 
 
 this cruel fashion. Being destitute of anatomical knowledge, they act 
 blindly ; and not understanding how to adjust a malposition, the Foal 
 is nearly always extracted dead, and only too frequently the mother 
 perishes. 
 
 With the object of extracting the foetus by force when manual 
 traction is not suificient, the ivmdlass, capstan, wheel, cart, and pulleys, 
 have frequently been used, and with great benefit. Many veterinarians 
 consider the employment of machines as barbarous as Ox or Horse 
 traction, but this opinion is scarcely just. They say such machines 
 are blind instruments which cannot be directed at will, and they prefer 
 increasing the number of men indefinitely rather than resort to them. 
 
 But many of the most intelligent and experienced veterinary 
 obstetrists speak of the great utility of these machines ; and some of 
 them state that whenever the combined strength of six men is not 
 sufficient to extract the foetus from the larger animals, they do not 
 hesitate to employ one of these articles. Not only can a greater tractile 
 force be developed by them, but this force may be diminished or in- 
 creased at will, and as gradually as circumstances may require. In 
 this direction, though the windlass, capstan, or wheel may be utilised, 
 
Tin: EMPLOYMKXT (>F FORCE IX DVSTOKIA. 529 
 
 yet for convenience in application, portability, and steady graduated 
 traction, nothing can approach the light obstetric pulley, the manner 
 of using which is shown in the annexed drawing (Fig. 19G). 
 
 When very powerful traction is required, whether manual or machine, 
 there is the risk — particularly if the animal is standing — of dragging 
 it backwards until it falls, or doing it some injury utdess the precaution 
 is adopted of lixing it in some way. It is obvious that there is great 
 danger — indeed cruelty — in attaching it merely by the head or neck, 
 and allowing this to bear all the strain. It is necessary to render the 
 creature immovable by passing cords, bands, or a sack behind the thighs 
 and above the hocks, bringing the ends towards the animal's shoulders, 
 and maintaining them there either by assistants, or by attaching them to 
 the manger or any other part sufliciently strong. A wooden bar placed 
 behind the thighs and secured to the stall-posts, is also serviceable ; as 
 is likewise an ordinai'y harness breeching, the front parts being secured 
 to rings in the wall or manger. In some cases, vigorous assistants, by 
 placing their back against the haunches of the animal, will offer 
 sullicient resistance to its displacement. Many practitioners prefer 
 throwing the animal down, if it is standing, in order to avoid the 
 dangers of being dragged ; Schaack even asserts that the body when 
 lying on the ground increases the expulsive efforts, and keeps the ftt'tus 
 in the plane of the pelvis. Donnarieix is not afraid of seeing the animal 
 dragged a little, and recommends that the traction should not cease in 
 consequence. Nevertheless, during decubitus the operator is more 
 quickly fatigued, besides being restrained in his movements ; the neces- 
 sary manu'uvres are more difficult to perform, and the weight of the 
 foetus is often an additional obstacle. And even when the creature is 
 lying, if the traction is very strong, it is often necessary to prevent the 
 body being drawn backwards. 
 
 All these inconveniences being recognised by Baron, in 1858 he in- 
 troduced an obstetrical machine in the form of an apparatus for pro- 
 ducing sustained traction {apparcil a traction soutenuc) in the extraction 
 of the fcctus. This apparatus presses against the hind-quarters of the 
 parturient animal, and owing to its construction it can not only develop 
 a very energetic extractive force in the gentlest and most inoffensive 
 way possible, but itself produces the counter-extension in an exactly 
 proportionate degree. 
 
 The principal parts of the machine are : a kind of horse-collar 
 (Fig. 197, A) with three stalks (B, C, D) intermediate between this 
 collar and a broad, fixed, female screw (E), which receives a movable 
 screw rod (II) that bears a revolving hook and chain (K) at one end ; 
 the other end of the chain has also a hook to which the cord or cords 
 fixed on the fa-tus are attached. The collar is made of several pieces 
 of light wood superposed, and bound together by an iron band applied 
 to its posterior surface. This band is perforated by three screwed 
 holes placed in a triangular position, and which receive the iron stalks. 
 The anterior face of the collar is so fashioned as to fit closely on the 
 liind parts of the animal, the space for the passage of the fatus being 
 about twenty inches in diameter. The intermediate stalks (B, C, D) 
 serve to transmit to the collar the pressure exercised by the female 
 screw ; they are about forty inches long, and each is composed of 
 two pieces, one of these being hollow (4, o, 6), the other solid (1, 2, 3) : 
 consequently, one fits into the other, and the end opposite the collar 
 enters one of the openings in the flange of the female screw (10) ; a 
 
 34 
 
530 
 
 OBSTETRICAL OPERATIONS. 
 
 small thumb-screw (7, 8, 9) secm-es the two portions of the stalk. 
 The female screw is of iron or copper, the flange being of wood, and 
 its circumference provided with two handles to hold it firmly when the 
 machine is in use. The male screw (H) is of iron, and screwed to the 
 right ; one extremity articulates with the turning-hook (I) ; it is 
 screwed in the contrary direction to the principal portion, so as not to 
 become unscrewed during the operation ; the other end has a four- 
 branched windlass which can be removed at will. 
 
 To use the machine, the animal is made to lie ; the cords are 
 attached to the foetus in the usual manner ; the windlass handle is put 
 on its place ; the screwed stalk (H) is introduced into the female screw 
 to about as far as J ; the collar is applied to the animal's croup, and 
 the three long stalks are fixed — one end in the collar, the other in the 
 
 Fig. 197. 
 Baron's Obstetric Machine. 
 
 flange. An assistant keeps the machine in equilibrium by placing one 
 of his hands on one of the forked handles of the flange, while the other 
 handle rests firmly on the ground. Another assistant, the coi-d attached 
 to the foetus being fixed in the hook at the end of the chain (K), slowly 
 turns the windlass in such a direction as will bring the extremity of the 
 stalk (I) towards the flange, while the operator superintends the extrac- 
 tion. It will thus be seen that a strong traction is exerted on the foetus, 
 while a proportionate pressure is transmitted to the croup of the parent 
 through the three long rods — the machine producing extension and 
 counter-extension at the same time, while it also allows a sustained 
 traction to be obtained — without jerks or checks, and as powerful as 
 may be desired. 
 
 This machine has been well tested in France, and received the highest 
 praise. 
 
THE EMJ'Loy.VEXT OF FOIiCE IX DYSToKIJ. .'31 
 
 SECTION IV.— COMPARISON BKTWEKN MANUAL AND MKC'IIANICAL 
 
 FORCE. 
 
 The employment of machines which multiply force for the artiticiul 
 extraction of the foetus, can be traced to a somewhat distant period ; 
 and the use of the windlass, the wheel, and the cart by rude empirics is 
 of ancient date. 
 
 Resorted to by ignorant people destitute of that knowledge which 
 alone can ensure safety and success, these appliances must have been 
 productive of great injury and loss. It was probably from witnessing 
 these results that the early French veterinarians were almost unanimous 
 in their condemnation of their use, and designated them as " cruel " 
 and " murderous." " It is cruel," says Fromage de Feugre, " to tie a 
 cord to a Calf, and to pull at it by the windlass or capstan, or by horses 
 attached to it. It is umch better, the Cow being tied by its liorns, to 
 make men pull at the cord, so that force may be emploj-ed with more 
 precaution and management." And Hurtrel d'Arboval remarks: " There 
 are people who would go so far as to pull at the cord whicli is attached 
 to the Foal or the Calf by the windlass, the capstan, or pulleys ; this 
 procedure is not only cruel, but its violence usually kills the fu.'tus, and 
 often causes lacerations, serious injury, and displacement of the uterus." 
 Other writers have written in equally strong terms against the use of 
 traction machines, and in favour of manual force — which, they argue, is 
 an intelligent force that may be graduated at will, and its direction 
 modified according to circumstances, so as always to act in the most 
 favourable way — i.e., in the axis of the pelvis. 
 
 Nevertheless, since 1S38, when Lecoq spoke in favour of mechanical 
 appliances, many of the most experienced practitioners have expressed 
 themselves in their favour. " I propose the pulley," says Lecoq, 
 " because it affords much more gentle and steady traction than that 
 obtained by strength of arm. . . . This opinion is shared by the majority 
 of the veterinary surgeons in our part of the world." " The employ- 
 ment of the pulley," writes Darreau in l8o2, " gives a more regular 
 and sustained traction than that of assistants, no matter how vigor- 
 ous and intelligent these may be ; in turning it slowly, we obtain a 
 gradual and continuous traction ; the shoulders and the body of the 
 f(jtus are elongated, the sides are flattened by the pressure, and delivery 
 is effected in the majority of cases without an accident. . . . By this pro- 
 cedure, we succeed in eight cases out of ten." Ayrault writes ■} "I 
 have decided to employ a means which I have often very severely 
 qualified when in the hands of empirics, and which can be only barbar- 
 ous and brutal by reason of the ignorance of those who apply it : I 
 spt>ak of the windlass, and wheel and axle. ... It is now amply demon- 
 strated to me that this obstetrical means, so little enticing at first sight, 
 is the first among all the means for producing traction which the veter- 
 inary surgeon has at his disposal — provided always that he watches its 
 operation with much attention ... so that no part of the foetus wedges 
 against the sides of the pelvis ; for the windlass does not know of any 
 obstacle which it cannot overcome." And Gan-eau,- commenting on 
 Baron's obstetric machine just described, reports, " From what lias 
 been said, it results from an examination of every part of this apparatus 
 that it is simple, and works well and easily ; that its power is at least 
 
 ' Rfcuf'd (h M^decine VeUriiuiire, 1857. 
 
 - Report a la Socieie CentraU de Afidfcine Veltrinaire, 1858. 
 
532 OBSTETRICAL OPERATIONS. 
 
 equal to that of the pulleys, windlass, or capstan ; that its action is 
 based on mechanical laws ; that the traction it produces is so gentle, 
 slow, and regular, that it is without danger for the mother ; that its 
 employment altogether leaves behind all the other means used for the 
 production of the necessary counter-extension in fcetal extraction ; that 
 the collar transmits, in a regular manner, and to the whole of the 
 inferior and posterior parts of the maternal pelvis, the pressure it 
 receives from the female screw ; that this pressure, disseminated over 
 the entire hind-quarters of the female, is proportionately less severe and 
 painful during traction of a given intensity. ' 
 
 Many more references could be given to other very competent 
 authorities in favour of mechanical over manual traction ; but the evi- 
 dence may be summed up by stating that mechanical traction is prefer- 
 able to that produced by manual power, inasmuch as it is slower, 
 more regular, its action is more sustained, and it is more powerful and 
 efficacious, without imposing increased strain on the parent or foetus. 
 Manual traction is unsteady and jerking, especially when several men 
 are pulling ; all the men do not pull alike, or at the same time ; there- 
 fore even during traction, however steady it may aim to be, the strain 
 varies, as men soon become fatigued; whereas the machine can maintain 
 the traction for any length of time without increasing or diminishing it. 
 
 One of the objections urged against machine traction is that its direc- 
 tion cannot be so easily varied upwards, downwards, or to one side or 
 the other, as manual traction. But this is a very trifling objection, 
 and it may be nearly, if not altogether, overcome by making assistants 
 press against the cord or cords, so as to give these the necessary 
 direction. 
 
 "When powerful traction is required, whether it be manual or 
 mechanical, great attention is necessary in guiding the foetus through 
 the genital canal, so as to prevent injury to the parent. The traction 
 should cease in the intervals between the labour-pains, and the efforts 
 ought not to be continuous ; the animal should be allowed intervals of 
 rest, and time be given for the genital canal to dilate and adapt itself 
 to the passage of the foetus. Severe and injudicious traction may be 
 productive of the n:iost serious results. Even when the operation is 
 nearly terminated, care will be requisite in order to prevent inversion of 
 the uterus. Tliis accident may be obviated by careful manipulation, 
 and abundant injection of emollient fluids. 
 
 CHAPTEE V. 
 Embryotomy. 
 
 Embryotomv, or emhri/ulcia, is the name given to every operation which 
 has for its object the reduction in volume of the foetus at parturition, by 
 mutilating or dividing it ; so as to allow it to be extracted by portions 
 when it cannot be delivered whole. It is a generic term for a number 
 of operations very different in their character, and performed on the 
 foetus either while it is wholly retained in the uterus, or more or less 
 engaged in the genital passage. 
 
 The operations may be practised on various parts of the young 
 creature — head, limbs, or body — and they facilitate the removal of one 
 
EMBRYOTOMY. 533 
 
 or more parts, so that the remainder can bo removed from tlie uterine 
 cavity. Of course, the life of the fcctus, if it be aUve, is sacrificed in 
 every case ; and this sacrifice is only made to prevent a j,'reater loss — 
 the death of the parent. But in resorting to embryotomy, the veteri- 
 nary obstetrist is not hampered by those grave considerations which, 
 from a legal, moral, and religious point of view, have so long embar- 
 rassed the action of the accoucheur of woman. 
 
 The question with the veterinary surgeon, should the foetus be living, 
 is as to the respective value of parent and offspring, and which of these 
 should be preserved in the interest of the owner. 
 
 In nearly every instance the response is entirely in favour of the 
 parent, this being of most commercial value ; and this fact, together 
 with the absence of legal and moi'al objections, will account for embry- 
 otomy being much more frequently practised in vetci'inary than in 
 human obstetrics. Nevertheless, the destruction of the living foetus in 
 the case of the domesticated animals should not be lightly entertained ; 
 it is the duty of the veterinarian, in the interest of his client, to preserve 
 the life of the young creature, as well as that of the parent, by every 
 means in his power ; and it is not until these means have been fairly 
 tried, or are deemed insufficient after due deliberation and without 
 trial, that the necessary mutilation should be undertaken. And it 
 must not be forgotten that embryotomy is not always without danger 
 for the parent ; on the contrary, it is nearly always serious, and its 
 consequences have often to be dreaded, while to the operator it is in the 
 great majority of cases a heavy and fatiguing task. 
 
 When the fa-tus is alive, then, it is only the most urgent necessity 
 that should impel the obstetrist to resort to embryotomy ; though 
 when the creature is dead there is no need for hesitation, and the 
 operation may be undertaken at once, if the operator is satisfied that 
 extraction cannot be effected otherwise. 
 
 The conditions which generally require recourse to embryotomy have 
 been indicated. They are: dcfonnitics of the maternal pelvis — either 
 congenital or acquired, constitutional or accidental — which prevent ex- 
 traction of the intact ftt'tus, this condition being, however, very rare in 
 animals; hyslcroccle ; (Uaproportion hctu-ecn the size of the fa: t us and the 
 fjenital canal ; certain kinds of vtonstrositi/ ; T^a.rt\cu\iir malprcsentatio7is 
 and malpositions of limbs or body, as well as irreducible distortions of 
 the foetus ; death of the frtus, when its retention in the uterus has given 
 rise to intense emphysema which hinders delivery ; certain diseases of 
 the foetus, as hydrocephalus, ascitis, (rdoma, etc. Indeed, embryotomy 
 is indicated in every case when parturition cannot be accomplished by 
 the other measures already mentioned, without seriously compromising 
 the life or future usefulness of the parent. 
 
 It has been stated that division of the foetus is very often a heavy and 
 fatiguing task ; and it may now be remarked that, however easy it may 
 be to lay down rules and give directions as to how the operation should 
 be conducted, only those who have had experience of it can testify that 
 it is much easier to write and to speak than to act, and that some of the 
 mancpuvres so complacently recommended by those who have but little 
 knowledge of the practical part of veterinary obstetrics, cannot be carried 
 out. 
 
 The fact that only one hand can be employed in the uterus, that this 
 organ is applied close to the fcctus when the " waters" have escaped 
 for some time, that the membranes are adhesive and cling to the 
 
534 OBSTETRIOAL OPERATIONS. 
 
 fingers, and that the flaccid tissues of the young creatures ghde away 
 from the cutting instrument — as they can only be rendered tense in 
 certain circumstances by the cords or crotchets — all this testifies that, 
 combined with the straining of the mother, the removal of the foetus by 
 instalments in the larger animals imposes a severe strain on the veter- 
 inary surgeon's physical and mental powers. 
 
 It must be stated that embryotomy cannot be restricted to definite 
 rules which shall be applicable to every case ; the operation must vary 
 according to circumstances, and these are often of the most diverse 
 kind. In very many instances, before the veterinarian is called in rude 
 and misguided hands have greatly complicated the case, and caused so 
 much injury and swelling to the maternal organs that the difficulties are 
 increased manifold. 
 
 But, as in everything else, there is a right way and a wrong way of 
 operating — apart from the collateral difficulties of the operation ; and 
 though no fixed rules can be laid down for every case which requires 
 embryotomy, yet there are directions, based on the results of practical 
 experience, which afford a general and trustworthy summary of the 
 most important points to be observed — by the young practitioner more 
 particularly. These directions will now be alluded to, in treating of the 
 incision, excision, or ablation of those parts of the foetus which are 
 selected for operation — these being the head, limbs, and body. But the 
 instruments in actual use, or which are recommended for performing 
 embryotomy, must first be noticed. 
 
 Embnjotovuj Instruments. 
 
 The performance of embryotomy necessitates the use of surgical 
 appliances for the division, puncture, or removal of certain parts ; and 
 as these operations have to be effected either in the genital canal or in the 
 cavity of the uterus, the manipulation of cutting instruments in such a 
 confined space by one hand, under all the disadvantages of distance from 
 the operator, the struggles and paralysing straining of the mother, and 
 without the aid of vision to guide and direct, renders the task peculiarly 
 difficult and dangerous. These diificulties and dangers have stimulated 
 the inventive faculties of veterinarians for a long time, in devising 
 instruments by which they might operate quickly and safely, and so 
 obviate fatigue and danger to themselves, and exhaustion and risk to 
 the parturient animal. 
 
 It is needless to remark that many of these instruments have never 
 come into general use, either because they did not fulfil the require- 
 ments claimed for them, or because they were too complicated or ex- 
 pensive. Sometimes, also, prejudice rather conflicts with the introduc- 
 tion of any novelty in this direction ; while long experience often enables 
 the practitioner to achieve the desired end with instruments which 
 would be useless, if not dangerous, in the hand of a less expert 
 obstetrist. 
 
 So it is that, for nearly all cutting operations, an ordinary pocket- 
 knife or bistoury is sometimes the only instrument employed ; the 
 operator being satisfied if the spring is sufficiently strong to prevent 
 the blade shutting up in the handle when it is used in the uterus. 
 Eainard preferred an ordinary knife with a blunt point and a convex 
 cutting edge ; others use a bistoury cache. Even small pocket-knives 
 of various sizes are utilised for this purpose, and one of Mr. Cartwright's 
 embryotomy knives is not unlike a gardener's large pruning-knife. In 
 
KMi:i:Y(iT(i}[y. r.35 
 
 the use and preference for knives, much must depend upon custom and 
 the expertness of the operator. 
 
 Nevertheless, convenience, safety, and the absence of long experience, 
 demand that proper instruments be devised for this operation. One of 
 the earliest to introduce a convenient and etlicient embryotom was 
 (liinther, who, in his work, published in 1830, figures an instrument 
 which is fixed on the finger by a ring ; the cutting edge of the blade — 
 which is about two inches long — being somewhat concave. This em- 
 bryotom lias been slightly modified in various ways by dill'erent practi- 
 tioners — sometimes having two narrow rings, so as to grasp more of the 
 finger ; at other times having, in addition, a small button on the back 
 of the blade for the finger to press upon; while the blade itself has been 
 made more cun'ed, straighter, longer, or like the blade of a fieam. 
 This instrument is the prototype of the ring scalpel invented by Dr. 
 Simpson, of St. Andrews, for opening the head of the human fcctus. 
 Two of these embryotoms which have been used in this country, are 
 shown in the annexed figures (198, 199). An improvement in this 
 instrument is having a hole at the opposite end of the blade (Fig. 199), 
 through which a piece of cord or tape can be passed and tied round 
 the wrist, to prevent the knife slipping from the finger and falling 
 into the cavity of the uterus. Indeed, this is a wise precaution with all 
 
 Fig. 198. Fig. \W. 
 
 Straight Embbvotom. Cikvkd Embuyotom. 
 
 the short instruments introduced into the genital organs, as the contrac- 
 tions of the uterus, struggles of the animal, and the position of the 
 hand, as well as the slipperiness caused by the presence of mucus, etc., 
 only too often render the hold of the instrument very insecure. The 
 middle finger of the operating hand is passed through the ring and the 
 other fingers enclose the blade, which is in this way safely conveyed to 
 the part of the foetus which is to be incised. The finger-knife is the 
 most useful instrument in embryotomy. 
 
 Giinther also at that time introduced another form of embryotom. 
 which has likewise continued in use, and has been more or less altered 
 or improved in shape. Tliis consists of a blade that can be made to 
 slide out and in a handle, by the thumb of the hand holding it. It can 
 therefore be introduced into or withdrawn from the genital passage 
 without risk of injury to the maternal organs. The annexed figure 
 (200) exhibits an improved model of Giinther's second embryotom ; the 
 original pattern had double cutting edges. It may be remarked that 
 Zundel and Saint-Cyr give Thibeaudeau the credit of inventing this 
 sliding bistoury ; but the instrument was only described by the latter 
 in 1831 ; 'whereas an exactly similar knife is figured in Giinther's work,^ 
 published at Hanover in 1830. 
 
 ' Recufil dfi Mtdtrinc Ve'ttrinaire, 1831, p. I.'i2. 
 
 ■■' fjf.hrbuch der Praktitchtn Veterinar-Geburtshiil/e, Hanover, 1S30. 
 
536 
 
 OBSTETRICAL OPERA TIOXS. 
 
 Another kind of embryotom is one not unlike an ordinary large 
 scalpel, on one side of which glides a blade-guard that can also be moved 
 backwards or forwards by the thumb of the hand that holds it. This is 
 a very convenient knife (Fig. 201) ; there is also a similar embryotom, 
 projected from the handle by pressure of the finger on a button when 
 the incision is to be made, and which is perhaps preferable to any 
 
 Fig. 200. 
 Guxther's Embryotom : Improved Pattern. 
 
 others. Unsworth's embryotom (Fig. 202) is somewhat similar, the 
 blade being projected from the side of the handle by means of a spring 
 pressed upon by the finger. 
 
 Embryotoms have also been proposed by Brogniez, Hubert, Contamin, 
 Obermayer, and others, but they all are more or less imitations of the 
 foregoing models. 
 
 Fig. 201. 
 Colin's Scalpel Embryotom. 
 
 Giinther figures an embryotom fixed on a handle, and which may be 
 of any convenient length — about thirty inches is recommended (Fig. 203); 
 the blade is semicircular, the concave border and point being very 
 sharp. This instrument is extolled for it usefulness in cutting through 
 the muscles subcutaneously, and especially in separating the limbs from 
 the trunk. The same authority gives the figure of a " Scheerenmesser,'' 
 
 Fig. 202. 
 Unsworth's Spring Embryotom. 
 
 or " secator,'' as it has been termed. This is an instrument about 
 thirty-six inches in length, composed of two branches, held together 
 by two short sheaths, through which the one glides on the other. Each 
 of the branches has a blade placed at a right angle to the stalk ; these 
 blades are opposite each other, the opposing edges being sharp, and 
 they are brought in contact by a rachet arrangement and screw moved 
 
EMliRYoToMY 
 
 :.37 
 
 by a handle at the other extremity. This instrument is very powerful, 
 and can divide bones as well as soft tissues. 
 
 Subcutaneous embryotomy is at times very necessaxy, but after the 
 skin has been incised great dilhculty is often experienced in separating 
 it from the textures beneath, by tearing through the connective tissue. 
 This is found to be the case more particularly in amputating the 
 shoulder, when the lingers become fatigued in trying to pass them 
 beneatli the skin. To facilitate this part of the operation, dillerent- 
 
 Fig. 203. 
 
 GI'NTHKR's LoNT.-H.VXDLEI) 
 
 Embryotom. 
 
 Fig. 204. 
 
 Cabtwright'.s ScnCLT.\NKOCS 
 Spatcla. 
 
 i 
 
 Fig. 205. 
 
 Car-stks Harm's 
 Spatcla. 
 
 shaped spatulas have been devised, which do the work of the fingers in 
 liberating the skin from the parts it covers. One of these spatulas has 
 been used by Cartwright ; it is merely a thin but rigid blade of iron, 
 about seven inches long and one or one and a quarter inch wide, the 
 edges being smooth and rounded, and one end fixed in a wooden handle 
 (Fig. 204). 
 
 Carsten Harms employs a double spatula about three feet in length ; 
 the blade at each end is about an inch wide and two inches long, the 
 
)38 
 
 OBSTETFJCAL OPERATIONS. 
 
 intermediate portion being simply a round rod about half an inch thick ; 
 one end is a little bent to one side (Fig. 205). This instrument can 
 be used with both hands, and is more firmly held than a one-hand 
 spatula. 
 
 Ungefrohrn proposes another, but somewhat differently-shaped 
 
 u 
 
 Fig. 206. 
 
 Ungkfrohrx's 
 Spatula. 
 
 Fig. 207. 
 
 Cartwright's 
 Bone-chisel. 
 
 Fig. 208. 
 
 Cartwright's 
 Bone-saw. 
 
 Fig. 209. 
 
 Swedish 
 Chain-saw. 
 
 spatula. This measures about twenty-five inches, the stalk being about 
 three-eighths of an inch thick, and the blade two inches long and some- 
 what crescent-shaped ; the convex border is most useful in raising the 
 skin, particularly in parts where the connective tissue is close and 
 resisting. The blade must be pretty strong and slightly convex on one 
 
/■:M/!/:yi>T(>My. 53t> 
 
 side, concave on the other. The other end has a wide eyelet as a 
 handle (Fig. -206). 
 
 The section of hones, though not often necessary, is nevertheless 
 sometimes required to be made, and it is found to be no easy matter — 
 with the larger bones especially. For this purpose chisels, saws, and 
 forceps have been proposed and employed. Cartwright has a model of 
 an instrument for slitting up the skin of a limb, which 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 half inch broad ; only the 
 middle portion at the end is sharp, the two corners, which project a 
 little, being blunt and rounded, as are also the sides (Fig. 207). 
 
 Margrafl's " Stemmeisen," 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 into which the chisel 
 is fixed, as in the ordinary carpenter's chisel. The cutting end of the 
 instrument is carried l)y the right 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 vertebra? when the head of the fcetus had to be 
 bisected, dividing the liead, 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 be of little value. Cartwright's saw is 
 figured liere (Fig. 208). The stalk (of iron) is sixteen inclies in length, 
 the saw four inches long, and the handle six inches. The saw-blade 
 should be 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 progiess. 
 
 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, 
 and they could be made sufliciently strong in jaws and handles to cut 
 through the largest bones. A screw at the end of the handles would 
 * Handbok i FOrlo^ninfji Komten Jor och upp/iidare af Hundjur. 
 
540 OBSTETRICAL OPEEATIONS. 
 
 bring these together with sufficient force 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 veterinary obstetrist. 
 Besides, it must be confessed that too little attention has been devoted 
 to the perfecting of those already in use, or to devising others more 
 simple and efticient to supplant them. There is here a wide field still 
 open for those who desire to cultivate a most important department of 
 veterinary surgery. 
 
 Instruments necessary for particular operations will be referred to as 
 these are described. 
 
 Preliminary Arrangements 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 ; he may even have attempted 
 everything possible in the way of extraction and failed. Being satisfied 
 that nothing remains 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 
 have 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. 
 
 Ckaniotomy or Cephalotomy, 
 
 Every operation which has for its object the diminution in size of the 
 cranium, when that part offers an obstacle to the passage of the foetus, 
 is designated by these names. Hydrocephalus is the condition which 
 most frequently calls for the operation in the larger animals ; though 
 certain malformations and monstrosities, and even an exaggerated 
 volume of the head of the foetus in the Bitch or Cat, may also re- 
 quire it. 
 
 Craniotomy comprises several distinct operations, which may be 
 performed independently or simultaneously. These are simple pnncturej 
 incision, or crushing of the cranial parietes {Ceplialotripsy). 
 
EMBRYOTOMY. 541 
 
 Puncture of the Cranium. 
 
 In order to allow the escape of fluid from tlie cranium — as in hydro- 
 cephalus — and thus permit the birth of the foetus, a simple puncture is 
 often all that is necessary. The lluid having escaped, the thin fra<,Mle 
 bones of the cranium readily collapse from the pressure they undergo in 
 the pelvic cavity ; so that the head and body can be 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 etYected by using a head-stall, Schaack's head-stall forceps, or 
 even a cord on the lower jaw : exercising suflicient traction on the cord 
 to prevent the head from slipping from under the hand of the obstetrist 
 during the operation. 
 
 The head may be punctured by a scalpel, straight bistoury, finger- 
 knife, or even the finger in certain cases. If a long-bladed instrument 
 is used, there is sometimes a good deal of risk, so far as the maternal 
 organs are concerned ; ic 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 shax'p. It is introduced safely into the 
 genital canal by drawing the point sulViciently far back into the cannula 
 to be entirely concealed. This end is then seized between the lingers 
 and thumb in such a way that the index-finger extends a little beyond 
 the extremity of the 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 dilVicult, 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 foetus. Having an-ived 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 hand, the trocar is withdrawn ))y 
 the right, and the fluid escapes. The instrument should be sutViciently 
 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 
 fcctus occupying the passage, it is extremely difficult to pass the hand 
 armed with the trocar so far as the head. Nevertheless, it may bo accom- 
 plished in many cases by patience and tact. There is no reason why the 
 trocar and cannula should not be passed through the mouth of the fcrtus 
 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 OBSTETPJCAL OPERATIOXS. 
 
 Craniotomy. 
 
 Craniotomii 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 facilitate 
 its performance ; but very few of them have been utilised in veterinary 
 obstetrics, and indeed for the larger domesticated animals they are of 
 no use. A simple straight or curved bistoury, Giiuther'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 cephalotrihc 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 d'Arboval recommends that craniotomy be performed with a 
 convex probe-pointed bistoury (sharp on the convex border), the middle 
 of the cranium being incised ; then the fingers compress the bones, and 
 so effect delivery. 
 
 Eainard advises 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 pulling 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 — 
 nionosomian or sysomian — is presented, and in certain irreducible mal- 
 positions of the head or limbs — especially in Heifers, wliun the head of 
 the Calf is in the genital canal, and can neither be advanced nor pushed 
 into the uterus. 
 
 The operation is more or less ditVicult, 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 situation it is not an 
 obstacle to birth, and its removal deprives the operator of a most 
 powerful means of exercising traction on the parts wliich 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 
 mancDUvres 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 cording 
 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 tlie 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 
 vertebric, and nothing more remains to be done than 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 foetus 
 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 tiirough the skin across the 
 forehead, in front of the ears, and to separate it by means of the fingers 
 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 sliould now be 
 placed on the bodies of the vertebra?, or even on the ribs if they can be 
 reached ; as the limbs do not offer sufJicient resistance when they alone 
 are pulled at, neither do they bring the body fairly into the passage. 
 
544 OBSTETFJCAL OPERATIONS. 
 
 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 vertebras, 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 w^hen 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 foetal 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 foetus and what to the mother, and has scarcely 
 strength to divide the tissues, which are all the more difficult to cut by 
 reason of their softness. It will readily be understood how such an 
 operation must be difficult for the operator and dangerous for 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 foetus 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 vertebrae on that side, then on the other ; 
 then sawing or chiselling through the bones, and afterwards using the 
 crotchets carefully. 
 
 Amputation of the Limbs. 
 
 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 manoeuvres 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 remove 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 manauvres fail, by the loss 
 of the limbs we are deprived of a powerful means of traction when we 
 are compelled, as a last resource, to adopt forced extraction. Besides, 
 
EMIinVuTitMY. 545 
 
 it must not be fortjotten that eiubryotomy 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 fu'tus 
 which he wished to remove, either by meclianical or manual power, 
 until it was torn off by brute-force. Fromage de Fcugri"- 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 tliat 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 dilliculty. 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,^ 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 tliick 
 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 Giinthei-'s work in 18130, and also by the 
 publication of the procedure of Huvellier- in the same year ; while the 
 jiarent 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. 
 
 Ampiitatioyi 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 then keeps the labia wide apart, in order to allow the operator 
 more room. A circular incision is made above the fetlock — or, better 
 still, the knee, taking 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 one, extending higher up as the leg 
 becomes elongated by the traction. 
 
 Some practitioners make this incision on the inner aspect of the limb, 
 
 > A Prnctiral Treadle on the Parturition of the Coir. London, 1807. 
 - Htcueil dt Jlakcine Vet(rinairc, l:?30, p. 449. 
 
 35 
 
546 OBSTETRICAL OPERATIOXH. 
 
 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 away at the wrong 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 foetus, 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 the requirements of the case. 
 
 Some practitioners operate in a somewhat different manner to the 
 foregoing. Lecoq, for instance, commences 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 fcjetus 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 pastei'n 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 the 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." 
 
KMBllVoTuMY. 547 
 
 Meyer recoiiimeiuls 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 nmscles uniting the limb to the 
 chest as possible, and also to apply counter-extension by means of the 
 arm or crutch placed a;^'ainst the chest or opposite shoulder of tlie futus ; 
 this also spares the mother much of the pain and exhaustion attending 
 extraction. 
 
 Amputation of tlie 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 logs are an obstacle rather from their lengtli than their 
 volume. This happens, as has been described, in the abdominal pre- 
 sentation of the fcctus, when the limbs so often render version dillicult 
 — all of them being perhaps in the genital canal, frona 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 be 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 throu^'h the skin at 
 this part ; traction is again applied, tlie nmscles tear, and gradually the 
 joint is reached. Tlie 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-limbs of the foetus is 
 very rarely indeed required, though, if necessary, it can be effected. 
 The same remark applies to the Bitch and Cat. 
 
 Amputation of the Hind-Limbs. 
 
 When the fcctus makes a posterior presentation, and a hind-limb 
 appears at the vulva, it may be necessary to amputate this limb ; or 
 with the hind-limbs Hexed at the hocks, and so firmly wedged in the 
 canal that they cannot be extended backwards, nor yet sufliciently bent 
 to permit delivery — which is far from being rare in the Mare — these 
 joints are disarticulated. 
 
 In the latter case, it is accomplished 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. 171 and 517 must be adopted. 
 The following procedure has also been recommended : A long incision is 
 
548 OBSTETRICAL OPERATIONS. 
 
 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 foetus 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 wudth 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. K 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 
 muscles 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 emphysema {plijjsovietra). 
 
 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 strong 
 traction exerted on them, so as to expose as much of the body of the 
 
KMliJiViiToMV. 549 
 
 younf( 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 vertebra,* 
 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 wiiere 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 supertluous 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 
 mancruvres. 
 
 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 I'etropulsion ; and sometimes 
 when one limb has been found, there is much difficulty in discovei'ing 
 the other. In such a case, ami 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 ftetus 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 iiorizontal 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 vertebrie ; then the knife is passed into tlie body between the last 
 rib and ilium, and the Hank cut through, another incision upwards 
 reaching the under side of the vertebraj — 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 vertebrjE 
 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 crotciiet 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 vertebra?. 
 
 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. 
 
 EviSCER.\TI0N, 
 
 When it is desired to reduce the volume of the thorax or abdomen, 
 or both, the organs they contain aie removed. This procedure is 
 
550 OBSTETRICAL OPERATIOXS. 
 
 generally adopted when, after removal of one or more of the limbs, the 
 body of the foetus still remains fixed in the genital canal — as in sterno- 
 abdominal and sterno-lumbar presentations ; by it we obtain a con- 
 siderable diminution in the dimensions of the body, more room for 
 manipulation and version, and perhaps, next to the removal of the limbs, 
 it is the most useful operation in embryotomy. 
 
 As we have said, evisceration of either of the cavities may be practised, 
 according to circumstances. We shall, therefore, describe the mode of 
 reducing the volume of both — thorax and abdomen. 
 
 Thoracic Evisceration. 
 
 This operation is sometimes practised in the anterior presentation 
 when the thorax of the foetus is too large, and may be performed inde- 
 pendently of abdominal evisceration. The chest is emptied of its con- 
 tents first, when the anterior part of the foetus is in the passage. The 
 head and limbs should be corded — if one of the latter is removed all the 
 better ; if not, the cords should be pulled well upwards, in order to 
 make more room between them. Should the head be an obstacle to the 
 performance of the operation, it may be amputated ; but if it is back in 
 the uterus, then it may be left there. A strong scalpel with a long 
 handle, the fingei--scalpel, or either of the two embryotoms shown in 
 Figs. 200, 201, is the best instrument. It is passed carefully into the 
 vagina until the hand reaches the breast of the foetus, when the blade 
 is thrust deeply into the chest, between the two first ribs, and as close 
 to the spine as possible, cutting down towards the sternum and upwards 
 to the vertebrae. 
 
 The knife is now dispensed with, and the hand being re-introduced, 
 the fingers are pushed into the chest and the two first ribs removed, 
 thereby allowing sufficient room for the whole hand to enter the cavity. 
 The lungs and heart are torn away from beneath the spine, and, with 
 the thymus gland, removed from the uterus. The chest collapses a 
 good deal, but if the foetus cannot yet be extracted, the hand may be 
 pushed through the diaphragm, and the contents of the abdomen carried 
 away through the chest. 
 
 Some operators, instead of opening the thorax in front, incise from 
 two to five of the ribs close to the sternum, and pass the hand into the 
 chest by the aperture so made. Others divide the ribs on both sides, 
 and remove the sternum as well as the viscera. It will often be found 
 that the contents of the chest and abdomen can be removed without 
 cutting the ribs. 
 
 Abdominal Evisceration. 
 
 Evisceration of the abdomen may be effected, as just stated, through 
 the thorax, by tearing away the diaphragm. 
 
 But in the posterior or adominal presentations, and indeed in any 
 presentation or position in which this region is accessible to the hand, 
 eventration can be performed. Nevertheless, it is not always easy ; on 
 the conti'ary, it is sometimes most difficult and dangerous. 
 
 Either of the embryotoms used for evisceration of the chest may be 
 employed for the abdomen. 
 
 The edge of the instrument is applied to the wall of the cavity, which 
 is incised by drawing the hand towards the operator. Then the whole 
 of the viscera are torn away, and, if need be, that of the chest also, 
 through the diaphragm 
 
/ 'Ad ISA A // }'.s TEKO TOM Y 
 
 CHAPTER VI. 
 
 Vaginal Hysterotomy. 
 
 At p. Sf)! reference was made to induration of the cei'vix uteri as a cause 
 of dystokia, and tlie indications for overcominf^ 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 fa'tus, 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 
 neck of the uterus in such a manner and to such an extent, that it will 
 allow the fcctus 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 cen-ix — 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- 
 Hnger 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 instnmient — 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 vagina 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 the 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 suflficient ; 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 cer\-ix 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 fcetus, fluids and discharges will escape into the abdo- 
 minal cavity, and give rise to peritonitis. There is less danger in 
 incising the upper part of the cervix, as the rectum is not so near ; 
 nevertheless, in induration there may be adhesions between them, and 
 an accident is therefore possible — though it must be rare. 
 
 So that, if only two incisions are required, it is advisable to make 
 one on each side of the cervix ; and if four are necessary, to have them 
 at each comer. 
 
552 OBSTETRICAL OPERATIONS. 
 
 Horsburgi recommends, if atresia is complete, to pass the finger or 
 a blunt instrument into the os, then introduce a stout, sharp-pointed, 
 curved bistoury about four inches long — dividing the stricture laterally 
 by two incisions — always drawing the bistoury towards the operator ; 
 after which he is to introduce both hands, with the palms towards each 
 other, and press them apart. " He will find the part immediately 
 dilate to the proper size, and labour may go on naturally ; or he may 
 then proceed to extract the Calf if labour has been protracted." 
 
 The object in making the incisions only to a comparatively slight 
 depth, and not through the entire thickness of the os, is to prevent 
 extensive lacerations of the organ during the passage of the foetus. It 
 will generally be found that these partial incisions will, with a little 
 patience, admit the hand ; this being passed into the uterus, seizes the 
 presenting part of the young creature, places it in a favourable position 
 if necessary, and then begins to draw it gently into the os. 
 
 Sometimes with primiparaB in good health and strong, delivery is 
 afterwards effected spontaneously, and this is the most favourable 
 result ; but in the majority of cases labour has been going on for a long 
 time — perhaps two days or more, the parent is exhausted, and the 
 uterine contractions are either suspended, or so feeble, as to preclude all 
 hope of their expelling the foetus. The head and fore-feet must then be 
 corded, and delivery accomphshed in the ordinary way. 
 
 It is well to remember, however, that the traction resorted to must 
 be judiciously employed. It should be moderate, gradual, and sustained, 
 in order to allow the tissues of the cervix time to accommodate themselves 
 to the eccentric pressure imposed on them by the advancing foetus. To 
 act otherwise is to incur the grave risk of lacerating the uterus beyond the 
 possibility of repair, and is quite as reprehensible as making deep 
 incisions. 
 
 "With regard to the consequences of vaginal hysterotomy, it must be 
 admitted that it is not without danger, and that death not infrequently 
 results. There are no reliable statistics to serve as a guide in estimating 
 the amount of success or non-success following its performance, as not 
 all— or perhaps not many — of the cases are published. Saint-Cyr has 
 collected forty cases — all published in France and Belgium since the 
 commencement of the century, and an analysis of these gives the follow- 
 ing results : 
 
 Mother and progeny saved in 14 instances. 
 
 Mother saved — fate of the progeny not mentioned — in 9 
 Mother alone saved in - - - - - - 5 
 
 Progeny saved, mother died, in - - - - - 6 
 
 Mother succumbed — fate of progeny not mentioned — in 5 
 Mother and progeny perished in . . . - 1 
 
 So that of 40 Cows operated upon, 28 survived, and twelve — or 30 
 per cent. — succumbed ; while, with regard to the progeny, 14 Calves 
 were delivered alive and continued to live, and 6 were dead ; nothing is 
 said as to the other 14. 
 
 In other words, of 80 lives more or less compromised, 18 at least — or 
 
 22i per cent. — were not saved by the operation. But Saint-Cyr is 
 
 inclined to think that if all the successful cases have been published, 
 
 there is reason to believe that all the unsuccessful ones have not ; and 
 
 ^ Veterinarian, vol. xviii., p. 215. 
 
r.i'UXAi. nvsTEiiitToMY. r.r.3 
 
 he is apparently confiriiuHl in this view by Bugniet,' who writes : 
 " Distinguished veterinarians have published very interesting observa- 
 tions on this important question in obstetrics ; but I am bound to say 
 that these experienced practitioners have been more fortunate than 
 myself, for I have had notliing but misfortune, and in the interest of 
 science I do not hesitate to say so." Bugniet, after describing three 
 eases in which he operated, and in which death of the mother followed, 
 as evidence that his procedure was not at fault, remarks : " Neverthe- 
 less, I acted with extreme prudence ; when the incisions were made, I 
 pi'oceeded to complete delivery with great care and deliberation. Incision, 
 dilatation, birth, removal of the placenta — all conducted with knowledge 
 and circumspection ; and yet this did not prevent a fatal issue." But in 
 opposition to this experience, there is that of other practitioners who 
 liave had a fair — indeed, a large — share of success. Donnarieix,'- for 
 instance, commenting on Bugniet's report, blames the latter for adopt- 
 ing e.ipcctant instead of active treatment, and asserts that he has taken 
 the exception for the rule. From his own experience, extending over 
 thirty years, during which he had performed vaginal hysterotomy in 
 sixty cases with only one death (the cause of which was not apparent), 
 he concludes (1) that incision of the cei-vix uteri is generally curable, 
 and (2) that palliative measures are more injurious than beneficial, when 
 their uselessness is demonstrated. 
 
 There is no doubt that, in the majority of instances and in the hands 
 of careful obstetrists, vaginal hysterotomy will be successful, and prove 
 a useful operation. 
 
 As a rule, for a period of eight or ten days after the operation, 
 there is a muco-purulent discharge from the vulva ; but the Cow eats, 
 ruminates, gives the usual quantity of milk, and does not appear to be 
 any more inconvenienced than after normal parturition. 
 
 The unfavourable results, however, nmst not be overlooked. Serious 
 injury to the neighbouring organs by the knife, or by the extension of 
 the laceration, is within the range of possibility. \Vhen the cervix is 
 completely divided, either by incision or by subsequent laceration 
 during the passage of the foetus, there may be intense peritonitis arising 
 from escape of the liquor amnii or other fluids into the abdomen, and 
 speedy death. Or excessive hicmorrhage may lead to serious con- 
 sequences. 
 
 in every case, of course, there must be more or less bleeding from the 
 incisions ; but, as a rule, this is of no importance, and it ceases after a 
 time. In less frequeiit cases, however, it persists, and either brings on 
 great debility, or, if excessive, leads to a rapidly fatal termination. 
 This result is most to be apprehended when the cervix is greatly 
 degenerated, and its tissues extremely vascular — as in carcinoma and 
 sarconia. It may also occur from rupture of bloodvessels, in lacera- 
 tion of the cervix or body of the uterus, during the passage of the Calf 
 through the incised os. 
 
 When serious hiemorrhage occurs, cloths or sponges steeped in cold 
 water, astringent lotions and styptics — as the perchloride of iron — must 
 be applied as close to the part as possible ; while cold water irrigation 
 should be maintained on the loins. 
 
 Another result is metritis, or metro-vaginitis, which is rapidly fatal, 
 and in which we find the usual local lesions on making an autopsy. 
 
 ^ Rerutil (U Miilecine Veliriiiaire, 1873. 
 ' Op. ci(., 1674, p. 511. 
 
^>^>'^ OBSTETRICAL OFERATIONS. 
 
 SepticaRmia is also to be apprehended ; and to prevent it, it is well to 
 remove every source of putridity, or anything likely to become putrid, 
 and to use plentifully a weak solution of carlDolic acid (1 to 100) or the 
 permanganate of potass in the interior of the uterus, and particularly 
 about the incisions in the cervix — even for some days after the opera- 
 tion. 
 
 CHAPTEE VII. 
 Gastro-Hysterotomy, or Caesarian Section.^ 
 
 Gastro-hysterotomy, Ca'sarian section, or ahdommal hysterotomy, is 
 an operation which has for its object the removal of the foetus or foetuses 
 from the uterus of the parent — when they cannot be delivered ^jer vias 
 naturales — by making an opening in that organ through the abdominal 
 walls, and thereby extracting them. 
 
 This is a formidable and a serious operation, whether it is practised on 
 the human female or on animals. In the obstetricy of woman, it has been 
 resorted to from a very early period ; the Greeks knew it as va-reporoiJ-oroKn] 
 or efifSpioeXKr], though it is supposed that they only performed it after the 
 mother was dead, and to save the child. Persons thus born were 
 sacred to Apollo, and ^sculapius was designated the son of that god, 
 because it was believed he had been delivered by gastro-hysterotomy. 
 Some strange notion appears to have been attached to this method of 
 delivery, as among these old-world people the person who had been 
 born by means of the operation was esteemed remarkable and fortunate. 
 Hence Claudius Ctesar, Scipio Africanus, Cteso Fabius, Julius Caesar, 
 and other more or less illustrious personages of old Rome, received the 
 surname of " Cffisones " from being extracted by abdominal incision 
 from their mother's womb: "Quia caeso matris uteru in lucem pro- 
 discunt." At a later period these persons were designated " Caesares," 
 — a noble title ; though, as has been demonstrated, it is a mistake to 
 assert that it owes its origin to Julius Caesar- — this being merely his 
 patronym. 
 
 Since these early times, abdominal hysterotomy has been often 
 practised on woman ; but when it was first attempted on animals is not 
 quite certain. Haller was led to believe that the Greek veterinarians — 
 Apsyrtus and Hierocles — knew and performed the operation on the 
 domesticated animals ; but this has been shown to be a mistake. 
 Until we arrive at the time of Bourgelat — the illustrious founder of 
 veterinary schools, in the latter half of the last century, we appear to 
 have no evidence that such an operation was ever proposed for animals. 
 And even Bourgelat- only suggests it in cases in which the dam is 
 attacked by a dangerous disease when the period of gestation has nearly 
 or quite expired, and its life may be beneficially sacrificed in favour of 
 its progeny, which is to be quickly removed from the uterus. In 1781, 
 Brugnone-"^ intimates that this operation may be performed on Mares 
 and other animals which could not bring forth ; but, hke Bourgelat, he 
 does not state whether he ever practised it. 
 
 It was not apparently until 1813, that Morange, and in 1816 Goheir'* 
 
 ' It has been suggested that the term "laparotomy," or " laparo-hysterotomy," would 
 be a better term for this operation. 
 
 - Traite de la Conformation Exterieure du Cheval, 1768. 
 
 ^ Trattato delta RazrA di Cavalli, p. 406. 
 
 ■* Memoires siir la Chirnrgie et la Medfcine Veterinaire, vol. ii., p. 40. 
 
dASTROHYSTEnuTDM V. :.:..'. 
 
 attempted it on the X\v\x\^ animal, though unsuccessfully. Moranf:;e 
 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, Rohlwes^ 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 
 ftt'tus had been often extracted in this way and the mother did not 
 succumb. 
 
 Gastro-hysterotomy has been practised both on the large and small 
 <lomesticated animals, but perhaps with most success on the latter. In 
 4S cases of this operation, Franck finds that 25 — or 52 per cent. — had a 
 fatal termination. Saint-Cyr, from a smaller number makes the mortality 
 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 ; G 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 G5 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 S 
 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 cases 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 Calves 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 parturition, 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 obser^-ations on the Bitch, found 
 that three minutes after death the fa-tus began to show symptoms of 
 asphyxia, and in thirty-six minutes it was dead. In pregnant Cows 
 and Sheep which were slaughtered, the fa'tus moved about in a very 
 lively manner for eight to ten minutes, but death ensued soon after. 
 
 Sauer observed an unusual instance of fcetal vitality in a Bitch which 
 
 1 D<M Ganze der Thierhfillunde, 1822, p. 143. 
 
556 OBSTETIUCAL OPERATIOXS. 
 
 could not be delivered, and was poisoned by cyanide of potassium. 
 Eight minutes after death the fcetuses were observed to move in the 
 abdomen, and this and the uterus being opened, they were extracted 
 alive. 
 
 After fifteen minutes, Franck has found in slaughtered Sheep that 
 the foetus was usually asphyxiated ; and he concludes that during the 
 first eight minutes after the death of the parent, the foetus 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 
 in 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 mortality 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 foetus 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 Bitch, 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 
 that there is no great reason otherwise why death should be a frequent 
 result of the operation, w4ien we consider the hundreds of similar 
 operations performed in the study of embryology, by Bischofi' and others, 
 on Bitches, Guinea-pigs, and Rabbits, the majority of which did not 
 have a fatal termination. He also alludes to the success of Nature's 
 Caesarian section, when we have mummification and maceration of the 
 foetus, consequent on occlusion of the os uteri, and the remains of the 
 creature find their way out 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 foetus being alive — 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, 
 instead of incurring the risk of losing both — the progeny being the most 
 valuable. The operation is therefore likely to be 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 foetation, certain cases of uterine torsion irredu- 
 
<:a s tj:o- n i 's rEiioTuMY'. 667 
 
 cible by the methods Wf have described. Atresia of tlie os sliould be 
 more advrtnta<;eously overcome by vaj^nnal hysterotomy, unless the 
 owner is desirous of savin<; the fietus aud sacrihcin^' the mother. 
 
 The operation is also intlicated when an animal, near tlie 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 fix'tus 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 nmch 
 more valuable than the parent. 
 
 Witli the Bitch and Sow, there is much more prospect of a favourable 
 result from the operation ; and as dithcult parturition in tliem 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 
 l)ractising 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 ftetus 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 gi-eat extent of the wound, as well as the opening of 
 the peritoneum, the hicmorrhage, and the escape of blood or liquor 
 anmii 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 tlie 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 
 
558 OBSTETRICAL OPERATIONS. 
 
 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 inflicted 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 himself of the advantages of 
 anaesthesia, 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 
 effect. 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 common 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 sutfice. 
 
 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 riciht 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 mammas 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 
 
O ASTRO NVSTEJiOK >M J '. 559 
 
 should be carefully thrown, placed on its back, and tliere 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 foot-and-a-half in lenj^'th — 
 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 fix'tus 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 live 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 Hainard points out that notliing is 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 sutlices for the Bitch or Sow. 
 
 If the aninuil 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, t!ie 
 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 oblicjue 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 apprehendetl. 
 
 The length of the wound will, of course, depend upon the si/e 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 tlirough until tlie 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- 
 
560 OBSTETRICAL OPEEATIONS. 
 
 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 foetal 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 foBtal 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 abdomen, 
 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 wall 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 w^ith 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 linca 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 sloppj' 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 
 multiparas the cornu containing the young is drawn partially outside 
 
SYMI'IlVSlitTiiMV. 561 
 
 tlie wouiul, opeiicil, and each faHus 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. 
 
 CH.\PTER VIII. 
 Symphysiotomy. 
 
 Sv.Mi'HVSiOTOMv, 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 cavity 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 intinitesimal, 
 and therefore can have but little influence on the progress of the foetus. 
 And when we remember that in woman the mortality is more than 
 ^•^2 per cent., while among those which survive many ai'e permanently 
 disabled, and those which recover often require months before conva- 
 lescence is established, 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 suflicient 
 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 difli- 
 culties occurring in pregnancy and parturition in animals, artificial 
 labour might be induced — /.<'., birth ctTected when the fa;tus 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 foetus — absolute or relative ; 
 protracted gestation ; serious paraplegia ; eclampsia ; cerebral conges- 
 tion ; ante-parturient exhaustion from the presence of too many fa'tuses; 
 prolapsus of the vagina and uterus ; transverse presentations, etc. 
 
 This measure is often resorted to in the human female, and with 
 gi-eat 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 which 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 
 
562 OBSTETRICAL OPERATIOXH. 
 
 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 Mare 20 to 40 days 
 before that period ; from the Cow 15 to 30 days ; and from the Bitch 
 10 to 15 days. 
 
 Opekation. — 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. "1 
 
 In the smaller animals the sponge tent, a long probe, or uterine 
 douches, will suffice. 
 
 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 w'ill 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 rallied 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 (Annales de Medecine Veterinaire, 1877, p. 156) was called to see a Mare, 
 eleven months pregnant and verj' heavj-, which could not be got up, and had been lying 
 so long that her sides were contused. He had her placed on an inclined plane, with the 
 front of the body higher than the hind-quarters. Then by means of a finger, and after- 
 wards by the whole hand, he succeeded in dilating the os, 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. 
 
i-Alih: OF MnTlli:i: AM) J'A'nt; /:\y. 563 
 
 the first consideration. The body ought to be rubbed and dried, and 
 covered \vith warm clothing ; stimulants must be given, as well as warm 
 gruel 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 (i to 5 grammes in alcoholic 
 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 must 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 pei-manganate 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 centigrannnes 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 bi-ain, 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 tongiie, which is turgid and projects from the mouth. When 
 extracted, the creature can scarcely breathe because of the tumefied 
 ton^nie, and asphyxia is imminent. Scarifications of the organ, or 
 leeches applied to it, with turpentine or mustard nabbed on the limbs, 
 soon bring relief. 
 
564 ACCIUEKTS AFTER PAliTURITIOX. 
 
 BOOK IV. 
 
 ACCIDENTS AFTEE PAETURITION. 
 
 The accidents occurring subsequently to parturition are rather diverse, 
 and not infrequently complicate the difficulties already alluded to as 
 hindering natural birth. 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 during 
 the puerperal period ; though the distinction between them and the 
 former is not always easy to establish. 
 
 Some of the complications 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) Betentionof tJie fci'tal envelopes in the uterus, 
 and its consequences ; (2) Post j^di'tum hcemorrhage 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 or neigh- 
 bouring 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. 
 
 CHAPTEE I. 
 Retention of the Fcetal Envelopes. 
 
 The retention of the foetal envelopes, placenta, "secundines," or "after- 
 birth," beyond a certain time after the expulsion of the fostus 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 usually 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 foetus 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 placentae 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 accident 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 placentae — the cotyledonal arrangement being 
 evidently opposed to ready separation. 
 
 But if the Cow is the animal of all others 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- 
 
i:t:TH.\TlUX ny THE FdlTAI. KXrh'/.n/'h'S. 565 
 
 tinue to ruminate and give milk as if there were nothiu},' 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 fcetid sanious fluid escapes from the vulva. 
 
 Si/7n2)toin^ 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 fdtal 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 fyeces 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 nuxss 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 mnnarius is pressed upon, and micturition is rendered diffi- 
 cult. There may also be symptoms of abdominal pain — whisking the 
 tail, stamping with the feet, and nuiking 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"; tiiat is, if expulsion does not ensue in the 
 first twenty-four hours, it should take j)lace 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 elTected tliere 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 impregnated with discharges. 
 
 The odour is most repulsive, and a sanious brown-tinted discharge, 
 composed of debris of the membranes and secretions from the irritated 
 mucous lining of the genital canal, fiow 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 
 
566 ACCIDENTS AFTER FARTURITION. 
 
 then horribly foetid. The hand, on being passed into the vagina, is 
 covered with the fluid, and it may encounter shreds of the placenta. 
 
 In such cases the health of the animal often suffers ; there is dulness, 
 prostration, diminution in the secretion of milk, decreased appetite, 
 respiration perhaps quickened, temperature increased, and other indica- 
 tions of illness. 
 
 The complications from placental retention are somewhat numerous. 
 Contact with the decomposing membranes may so irritate the interior 
 of the uterus as to occasion metritis, or even metro-peritonitis — a con- 
 dition which is always serious, and often fatal. There is also risk of 
 septicaemia ; and even under the most favourable circumstances there 
 sometimes remains a local irritation — a chronic vaginitis or metritis 
 that leads to leucorrhoea. 
 
 Some authorities have observed trismus, tetanus, metastatic arthritis, 
 and chest affections, as seqiidcn of placental retention. 
 
 There is no danger when the retention has only lasted for two or 
 three days, particularly if a large portion of the membranes protrudes 
 beyond the vulva, and it has a fresh tint. Attention is necessary, how- 
 ever, when the placenta begins to putrefy, and a fetid discharge com- 
 mences from the vulva ; though even so late as fifteen days after 
 parturition the membranes may be expelled spontaneously, without any 
 injury occurring from the prolonged retention. But the case is serious 
 when the animal begins to show symptoms of general illness, and par- 
 ticularly if no portion of the placenta can be seen or the os be occluded. 
 Plastic 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 
 emaciated, loses its appetite and ceases to yield milk, until at length it 
 falls into a state of marasmus, and perishes from septica3mia. Or in 
 more rapid cases, with these general symptoms the lining membrane of 
 the vagina is of a deep-red colour and intensely hot, a fetid sanguineo- 
 purulent discharge escapes from the vulva ; there are tremblings over 
 the whole body, hurried respiration, intense fever, and all the other 
 signs of metritis. 
 
 Though retention is not, in the majority of cases in the Cow, a very 
 serious affair, yet it should be attended to even in this animal. With 
 other creatures it is much more to be dreaded, as they incur greater 
 risks from prolonged retention. 
 
 Saint-Cyr mentions the case of a fine Mare which died in less than 
 eight days from metritis, due to the foetal membranes being retained ; 
 though the cause was not ascertained in time. 
 
 Causes. 
 
 Eetention occurs most frequently in cases of abortion, or when birth 
 takes place some days before the proper time. It has been remarked 
 that a Cow which retained its placenta unusually long after the birth 
 of its first Calf, will do so at every succeeding parturition. A pro- 
 tracted and laborious birth is also said by some authorities to favour 
 retention, while others declare that the converse is true. The accident 
 is stated to be more frequent with old Cows, and especially when these 
 are employed in draught — as in France and other countries. Abnormal 
 adhesion between the maternal and foetal placentae would, of course, be 
 a sure cause of prolonged retention, and we have given instances of 
 
RET EXT mx OF THE J'WTJL EXVELOPES. 567 
 
 such adhesion ; indeed, every obstetrist knows that at times there is 
 much difficulty in disuniting the cotyledons in the uterus. 
 
 When the cervix uteri contracts rapidly after delivery, and the os is 
 consetjuently iirmly 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 Germany, which 
 attributes this Zuriickhleihen der Nachcychurt, 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 Baumoister, milking too soon, 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. 
 
 Treat rnent. 
 
 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 fcttal 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 fcetus 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 dilTerence 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 ACCIDENT a AFTER PARTURITION. 
 
 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 been pointed out, that 
 the weight of the pendulous portion causes inconvenience in micturition; 
 while it fatigues and pains the animal by dragging on the uterus, and 
 induces expulsive, but futile 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 the loop as soon 
 as possible, in order to prevent accidents. 
 
 It has also been remarked that, even when birth has been easy and 
 favourable, primiparaj are often irritable and impatient, the presence 
 of the secundines 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 foetal 
 placentae, 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 placentae to soften and 
 the adhesions between them to diminish, though the opportunity for 
 complete detachment must not be overlooked. 
 
 When nothing whatever 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 hanging 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 emmenagogues — 
 such as rue, savin, laurel, stramonium, carbonate of potass, etc. — have 
 been for a long time credited with the power of hastening the 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 
 authorities. 
 
 Zundel, for instance, extols laurel berries, and gives the following 
 recipe : 
 
 Laurel berries ----- 120 grammes. 
 
 Aniseed ------ 60 „ 
 
 Bicarbonate of soda - - - 120 ,, 
 
 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- 
 
80 
 
 litlTKXTlnX itF THE FiKT.II. KM' Kl.orES. 569 
 
 ceeding in GO per cent, of his cases of retention. Ilering and Stock- 
 tleth also speak highly in its favour, and assert tliat it is always 
 successful, provided tliere is no mechanical obstacle to exjnilsion. 
 Baunieister and Kuefl" recommend potass carbonate in the dose of 
 4o grammes daily, at three times, in an infusion of chamomile or 
 savin. Hummer prescribes 90 gramme doses for three consecutive days, 
 and Ilertwig, Lund, and others also prescribe it with the same object. 
 Hering gives the following formula : 
 
 Carbonate of potass - - - - 15 grammes. 
 Savin leaves - - - - - 30 ,, 
 
 These are infused in 500 grammes of water, filtered, 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 tincture is given by Tabourin as follows : 
 
 Powdered savin . . - . 050 grammes. 
 
 Treacle 190 
 
 Powdered cumin - - - - 125 ,, 
 
 Essence of rue '1 . . 
 • aa 
 ,, ,, savui I 
 
 Alcohol ------ 2 kilogrannnes. 
 
 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 grammes of ergot of rye and 20 grammes of powdered 
 savin, made into a decoction in a litre and a half of water. Delwart, 
 Kainard, and Schrader recommend ergot of r}'e, and Ungefrohrn stra- 
 monium seeds (30 grammes in two litres of water), which he believes 
 to be specific in their action ; he advises that linseed decoction be given 
 in the intervals, as it acts as a diuretic, and Rychner asserts that tiiis 
 simple medication is particularly useful when the fu-tal 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. l^xtract of ergot of rye, 1 to 3 grammes, dissolved in 
 glycerine and spirits of wine (15 grammes of each), has been used 
 for injection. 
 
 Though medication lias been so highly vaunted by some authorities, 
 yet some others have not mucli 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 France the farmers attach a sabot filled with gravel 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 
 
570 ACCIDENTS AFTER PARTURITION. 
 
 is visible. This is seized either by the hands, or by means 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 good 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 day, 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 haemorrhage. About the third day is generally a favourable 
 period, as the cervix is still sufficiently relaxed to pass the hand through 
 the OS into the uterus: while disintegration between the foetal and 
 
JiETKXTIOX OF TIIK FU-ITAL EM'KLoI'KS. 571 
 
 maternal placenttc has advanced sufficiently to permit the hand to com- 
 plete the disunion without need for violence. It sometimes happens, 
 however, that extraction can be elTected 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 tiiis canal, then the operation is not so dilVicult, 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 mucous 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 maternal— 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, efTecting 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 cornu in which the 
 hind-limbs of the Calf were lodged, because of the insufficient length 
 
572 ACCWEXTS AFTER PAIiTCrJTIOX. 
 
 of the arm. Moderate traction, however, on the part just detached 
 will bring the others nearer, and facilitate 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 five 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 the 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 dow^n 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 beyond, the os. Eelief 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 sometimes, and all the more serious 
 if a number of the cotyledons is involved. This injury may lead, in 
 addition to haemorrhage, 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 placentae, have been torn away by 
 ignorant empirics, 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 must 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 placentae 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 efforts, 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 be assured that the whole of the foetal envelopes has 
 been removed from the uterus, it is well to make an examination of 
 them. Knowing their 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- 
 
RETEyrioX i>r tIIK /WT.IL H.WHI.nl'KS. [.78 
 
 pleasant-smelling liquid, which is derived from the fu'tal fluids, the 
 blood that has escaped from the umbilical cord, and tlie partly- 
 decomposed envelopes. As its retention is likely to do liarm, par- 
 ticularly if there is any wound or abrasion of the mucous membrane, 
 as nmch 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 fme, in 
 order to calm its restlessness and to allay the straining, if it is still 
 present ; keejjing 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 tlireatens ; 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, or 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 lead 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 ACCIUEXTS AFTER PARTUFJTIOX. 
 
 as soon as possible after the uterus has been emptied ; for this purpose 
 nothing is better than carbohsed soap. On the shghtest sensation of 
 uneasiness in the arm, advice should be taken with regard to it, as an 
 attack of Ecthyma joarturitionis is often a 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 injections of solution of cresyl, carbolic acid (2 per cent.), 
 boric acid, corrosive sublimate (1 to 2,000), etc., is regularly practised 
 by some veterinary surgeons. The interior of the uterus is first vrashed 
 out with warm water 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 b}^ 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. 
 
 CHAPTEE 11. 
 Post Partum Haemorrhage. 
 
 H^MOBEHAGE from the uterus or " flooding," after abortion or the 
 birth of the foetus at the ordinary term — an accident so frequent and 
 alarming in 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 ijlacenta fctnlis ; as well as to the absence of 
 those immense vascular lacunas 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 j^Ta'via in them,^ and which is a somewhat 
 common cause of hemorrhage 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 foetal 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. 
 
 1 Franck [Handhnch de ThieriirztUchen GehnrtshidJle,&nA Zeitschriftfiir Ilticrmedkin) 
 has clearly demonstrated the occurrence of placenta prajvia in animals. At pp. 87, 88, 
 reference has been made to it, and cases of it are frequently mentioned in veterinary 
 literature. 
 
POST I'Airn'M H.KMOnilllAGK. 575 
 
 In what Cox has designated " pre-placental presentation,"' we may 
 have hiDinorfhage 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 \vhen the usual period of parturition has been 
 exceeded, and the " water-bag" has been presented and ruptured, tlie 
 entire ^/(ictw;/a /«7a//s coming away before the f(etus itself. '^ in some 
 cases, a considerable portion of the membranes envelop the fore- 
 parts of the foetus, and occasionally to such an extent as to retard 
 delivery ; this may be shredded off and removed without risk, but it 
 will be found that the posterior portion remains attached. Tiie 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 fatus, it is found that hfemorrhage 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 post part utn hicniorrhage ; 
 and, according to Schrader, this atony of the organ is especially 
 observed after a rapid emptying of its cavity, whetiier 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 
 ha}morrhage 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, however, are rarely caused by real connec- 
 tive-tissue bands, may also give rise to profuse haemorrhage, as the 
 separated places in the vicinity of the adlaesious can only imperfectly 
 contract. 
 
 Symptoms. 
 
 The symptoms of p)osL partum iKemorrhage are not well marked 
 unless the bleeding is visible, though they are those of profuse h;emor- 
 rhage in general. There is the quick, weak, running-down pulse, which 
 becomes imperceptible as death approaches, and the tiirobbing, 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 difficulty 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 hiemorrhage is due to traumatic influences. 
 When the hicmorrhage per vnlvavi 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. 
 
 * VtUrivary Journal, March, 1S77, p. 178. 
 
576 ACCIDENTS AFTER PARTURITION. 
 
 Treatvient. 
 
 The essential indication in the treatment, is to suppress the haemor- 
 rhage as speedily as possible ; the next, to sustain the vital powers of 
 the animal. 
 
 If the fcetal 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 must be pushed into the uterus and gently moved about, in 
 order to excite contraction, if the organ is flaccid and uncontracted. 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 morphia, 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. 
 
 CHAPTEK III. 
 
 Inversion of the Uterus. 
 
 Inversion, procidence, prolapse of the uterus, or vagiiio-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 [complete 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 
 
IXrSRSIOX OF THE UTERI'S. r.77 
 
 only incompletely so, then they remain cylindrical at their lower end, at 
 the centre of the cylinder being a depression or cuccal 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 simple when the 
 viscus is intact, uninjured, and not accompanied by the extrusion or 
 displacement of any other organ. ^Vhen it is wounded or torn, or when 
 there is accompanying hernia or protrusion of other viscera, then it is 
 complicated. 
 
 As we have said. Ruminants are most liable to this accident : the 
 (/Ow 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 invei'sion of the vagina, for which it 
 might be mistaken. In uniparous animals the whole of the organ is 
 usually inverted ; while in multiparous creatures, generally little more 
 than the portion which contained the foetuses is involved. 
 
 Tlie 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, Yegetius, alludes to 
 it, and recommends the employment of an inflated pig's bladder as a 
 good pessary. 
 
 Syviptoms. 
 
 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 fa^tus was lodged. Under the 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 the 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 weigiit carries 
 it downwards, and renders the prolapsus complete — the lining or mucous 
 membrane having become external. 
 
 W^hen inversion is complete, the uterus has the form of an enormous 
 pear or calabash-shaped tumour hanging between the posterior limbs 
 — the wider and rounded portion being inferior, and sometimes ex- 
 tending as low as the hocks, the narrow extremity or pedicle being at 
 the vulva, in the interior of which, and between the labia and the 
 tumour, is a more or less deep and circular cul-de-sac, according as the 
 prolapsus has involved a certain extent of the vagina. 
 
 That the surface of the tumour is composed of the uterine mucous 
 membrane, is easily apparent from its softness and colour — which is 
 
 37 
 
578 ACCIDENTS AFTER PARTUPJTIOX. 
 
 sometimes a bright red, at other times somewhat violet or brown, 
 according as it is much injected with venous blood, irritated by the 
 external air, or by the litter, faeces, etc., with which it has come in 
 contact, and which may be adhering to it. With the Mare and Sow, 
 the uterine placental villi, and the innumerable depressions for the 
 reception of those of the foetal placenta, can be recognised ; in the 
 Cow, Sheep, and Goat, there are the deep-red, isolated, fungiform 
 eminences or cotyledons, and in the Bitch and Cat the wide dark- 
 brown zone. Sometimes with the Cow — more rarely with the Mare — 
 there are portions of chorion still attached to the placental surface of 
 the uterus ; and nearly always there are seen excoriations, more or 
 less extensive ecchymoses, and even gangrenous patches, on the mem- 
 brane — indications of the injury the organ has sustained, either during 
 or after parturition. This mucous surface is not so sensitive as might 
 be imagined ; it is more or less hot, and bleeds at the slightest touch, 
 though the haemorrhage may not be profuse ; at one side or the other 
 may be noticed a kind of depression — the opening to the cornu which 
 is not yet inverted. 
 
 The longer the period which has elapsed since inversion occurred, 
 so the larger is the tumour. This increase is due to the violent ex- 
 pulsive efforts of the animal, as well as to the increase in weight of the 
 organ, in consequence of the congestion and infiltration which have 
 taken place in its textures ; constricted — even strangulated — at its 
 upper part, the circulation is maintained with great difficulty, and the 
 capillaries become gorged with blood. The walls lose their elasticity, 
 become thickened, dense, and darker tinted, until, from its increased 
 volume and altered aspect, the organ can scarcely be recognised ; while 
 its reposition is rendered extremely difficult, if not impossible. 
 
 In consequence of the excessive hypersemia, ulceration and gangrene 
 usually supervene ; these are serious lesions, and may induce a fatal 
 termination. 
 
 Such a grave accident as this is, in which there is extensive 
 displacement, with severe straining at the suspensory ligaments of 
 the uterus, and sometimes their rupture ; the irritation and perhaps 
 abrasions or wounds of the mucous membrane ; the tension on the 
 vagina, and the compression of various parts or organs — all this might 
 be expected to produce general disturbance. And such is the case. 
 From the very commencement, and even before anything is apparent 
 at the vulva, the animal is uneasy and anxious-looking ; it paws with 
 the fore or stamps with the hind feet ; switches the tail as if driving 
 off insects ; lies down and gets up frequently, finding no ease in either 
 attitude ; and strains more or less energeticallj^ at closer or wider 
 intervals, thus adding to the extruded mass. Not infrequently the 
 Mare kicks at the prolapsed uterus, or endeavours to attack it with its 
 teeth. 
 
 At first there is no perceptible fever, and the animal, in the intervals 
 of straining, attentive to what is going on around, is solicitous about 
 its progeny, and may even eat. This state is not of long duration, 
 however ; for soon after inversion is complete, indications of fever 
 become manifest — quickened pulse and respiration, elevated tempera- 
 ture, and an expression of anxiety and pain. The straining is more 
 frequent and energetic, and soon exhausts the animal ; and the pros- 
 tration, together wnth the great weight of the pendent uterus, compels 
 it to assume and maintain the recumbent posture, in spite of attempts 
 
JXrEJiSIDX OF THE UTERUS. 579 
 
 to make it get up. The organ assumes a gangrenous or intensely 
 inflamed appearance, and the animal soon succumbs, either from the 
 nervous prostration resulting from its sufferings, or from the condition 
 of the uterus. 
 
 In woman, sudden inversion of the uterus always leads immediately 
 to great general disturbance — the heart's action is deranged, and 
 syncope, convulsions, vomiting, etc., may sometimes be caused by the 
 sudden change in the position of the uterus. More frequently those 
 symptoms depend upon acute cerebral aniemia, to which the sudden 
 emptying of the contents of the uterus already predisposes, but which 
 must be still greater when not only these contents but the whole oi-gan 
 itself passes out of the abdominal cavity. The blood then rushes into 
 the vessels of this cavity, which are suddenly under a greatly diminished 
 pressure, and the cerebral aniemia that ensues is due to the scanty 
 supply which the upper half of the trunk now receives. 
 
 A similar condition is sometimes — though rarely — observed in 
 animals, and particularly in the Mare. 
 
 Complications. 
 
 One of the ordinary complications of this accident, is the adherence 
 of the fcetal placenta to the uterine surface ; though this is much more 
 frequent with animals which have a nmltiple placenta — Cow, Sheep, 
 and Goat, than with the Mare, Ass, Sow, Carnivorous animals, or the 
 Rabbit. 
 
 The inversion of the uterus — when complete — also brings about dis- 
 placement of the vagina ; the deeper portion of this part is found 
 folded on the neighbouring surface of the cervix ; the bladder and 
 inferior wall of the rectum are also drawn into the middle of the 
 pelvic canal, and occupy the place the uterus has quitted ; the meatus 
 urinariiis is doubled on itself, and so compressed that no urine can 
 pass through it ; while the ureters continuing to carry that fluid to 
 the bladder, this reservoir soon becomes greatly distended, without 
 relief being possible. Hence results another source of suffering, and 
 another cause of exhausting efforts added to those occasioned by the 
 prolapsed uterus. In certain cases there may also exist prolapsus of 
 the rectum, and displacement, or even inversion, of the bladder. 
 
 The uterus may also be wounded or torn, either from bad manage- 
 ment during parturition, or from injudicious attempts at reposition ; 
 or the injury may be due to Rats, Cats, Dogs, or Pigs gnawing at the 
 bleeding mass ; sometimes it is the creature itself, or a neighbouring 
 animal which inflicts the damage. 
 
 Contact with the air, and particularly with foreign bodies, induces 
 inflammation, which frequently runs to on gangrene, and this to dissolu- 
 tion. Gangrene readily occurs in the Sheep. Sometimes perforation 
 ^f th*^ vagina or uterus, arising at times from sloughing of a gangrenous 
 patch, has caused fatal peritonitis ; in other cases pelvic abscesses have 
 formed. 
 
 After reduction has been effected, metritis and metro-peritonitis may 
 appear ; this is not at all unlikely in the Mare. Lafosse mentions 
 paraplegia also as a complication ; this may be a consequence of 
 gangrene and septic infection. 
 
 An exceptional complication is hernia of the intestines, through a 
 rupture in the uterus. It may be noted that in prolapsus uteri in the 
 Mare, it has happened that the colon has followed the fundus of the 
 
580 ACCIDENTS AFTER PAIITUFJTIOX. 
 
 organ, and become invaginated in the inverted sac. Funk also men- 
 tions the case of a Bitch in which one of the cornua became inverted, 
 and prevented the expulsion of the remaining fcetuses fi'om the other 
 cornu ; this necessitated the performance of the Cgesarian section. 
 
 Ayrault has, on three occasions, encountered an unusual complication 
 after reduction of the prolapsed organ, in the form of severe lameness, 
 with knuckling over of the two hind-fetlock joints, but without any 
 articular swelling. This complication disappeared as the animals 
 recovered from the effects of inversion. 
 
 Frofjnosis. 
 
 There can scarcely be any doubt that, if no assistance is rendered to 
 an animal suffering from prolapsus uteri, death must ensue, and more 
 or less speedily ; as gangi'ene is inevitable, while spontaneous reduction 
 is impossible. 
 
 In some instances death occurs in less than twenty-four hours, but 
 most frequently the animal may live from three to five days — very 
 rarely longer. Sabini,^ an Italian veterinarian, cites a case in which 
 treatment was not adopted until the seventh day ; but this is an alto- 
 gether exceptional instance. 
 
 Inversion of the uterus is generally fatal when owners of animals 
 have neglected to procure assistance until too late, or who employ 
 ignorant people to attempt reduction. If attended to sufficiently early 
 by those who are competent, the number of recoveries is considerable, 
 and perhaps in no other pathological condition is the utility and power 
 of art, when invoked at the proper time, better demonstrated. 
 
 The prognosis is not equally favourable, however, in all the domesti- 
 cated animals ; and between the Mare and Cow, for instance, the 
 difference is considerable. 
 
 With regard to the latter animal, Deneubourg, who has often had to 
 treat this accident, never lost one of his patients. In 100 cases, 
 Donnarieix has only had 3 deaths. Moens, in 27 cases, has not had a 
 fatal termination. Guillaume, cited by Gelle, lost 3 cases out of 42 ; 
 Loyer of Nemours, 9 out of 27 ; and Mazure, Holland, 1 in 4. 
 
 "With regard to the Mare, Donnarieix had 8 cases, and all perished ; 
 Cruzel had 3, and they also succumbed ; Schaack only saved 1 
 of 2. 
 
 In 268 cases of prolapsus uteri in the Cow, collected by Saint-CjT, 
 there were 35 deaths — or a mortality of 12 per cent. For the Mare 
 he only found 25 cases, and of these 17 were fatal — a mortality of 
 68 per cent. 
 
 A number of authorities quoted by Zundel- give the percentage of 
 recoveries in the Cow as 97, and in the Mare as 50. 
 
 It would, therefore, appear, and it is no doubt true, that this acci- 
 dent is much more fatal in the Mare than in the Cow. 
 
 Inversion in the Sow is nearly always fatal, and often within twenty- 
 four hours, unless amputation of the uterus is resorted to ; but the 
 Bitch will live, in very rare cases, for two, three, or four days with the 
 uterus prolapsed. 
 
 It has often been stated that inversion of the uterus leads to infe- 
 cundity ; but though it may do so in some instances, yet this cannot be 
 
 1 Journal des Vet6r%naires du Midi, 1869, p. 175. 
 
 * Dictionnaire de Med., de Chirurg. et d' Hygiene F^terinaires, vol. iii., Art. "Uterus. 
 
j\rj-:j:sj(L\ of the urEiius. 58i 
 
 accepted as a rule. Numerous cases are on record, and particularly 
 for the Cow and Bitch, in which fecundation has taken place after this 
 accident. 
 
 Though inversion is likely to recur after another birth, or even during 
 a succeeding pregnancy, it is not invariably so ; though to avert it cure 
 may be necessary. 
 
 Causes. 
 
 Inversion of the uterus generally occurs immediately after parturition, 
 and is most frequent in the Cow, whose uterine ligaments are so exten 
 sive and extensible. It usually occurs within two or three days, rarely 
 later. 
 
 With multiparous animals, in which each uterine cornu forms a kind 
 of independent uterus, one of these may alone be inverted, the foetus 
 contained in the other cornu being retained there for some time — 
 though not without danger to its existence, should the period be much 
 prolonged. 
 
 With uniparous animals, however, this does not take place, as the 
 uterus cannot become inverted without the fcetus being expelled. 
 Nevertheless, Aubry* has published a very curious observation regard- 
 ing a Cow, aflected with prolapse of the vagina during pregnancy, and 
 which had complete inversion of the left cornu at the end of that 
 period : but the Calf, lodged in the right cornu, and which was alive 
 and well developed, was retained there for two entire days. It was 
 then necessary to interfere and eflfect delivery, which was followed by 
 total inversion of the organ. This incident, which appears to be 
 unique, does not, however, preclude acceptance of the general rule, 
 that inversion of the uterus is absolutely incompatible with the pro- 
 longation of gestation. 
 
 In order that this inversion can take place, it is essential that the os 
 uteri be more or less dilated ; consequently, the accident is only observed 
 in breeding animals, and either during or soon after parturition or abor- 
 tion. 
 
 In order that it can occur, a certain degree of relaxation of the sub- 
 lumbar uterine ligaments must be present ; there must also be some 
 cause of irritation in operation after the expulsion of the fcetus, sufti- 
 cient to excite the contraction of the muscles of the uterus and lead to 
 inversion— though it is often dillicult to ascertain what this cause 
 may be. 
 
 In very many instances pregnancy has gone on to its full term, the 
 animal is strong and healthy, birth natural and easy, and tliere is 
 nothing to indicate the advent of such an accident- when, suddenly, 
 after a few expulsive efiforts, the uterus is ejected in an inverted state. 
 
 It has been attempted to explain the occurrence of the accident in 
 such cases, by alluding to the lymphatic temperament of the animals, 
 and their consequent laxity of tissue ; and it is often the case that 
 Cows which are " soft," and kept on food that is better suited for the 
 production of milk than flesh, are the most frequent subjects of inver- 
 sion — this sometimes occurring after each birth, though parturition was 
 perfectly normal. 
 
 Inversion of the vagina during pregnancy h-^.s also been mentioned 
 as the cause of inversion of the uterus ; and it may be so in some 
 instances, but it certainly is not so in all. Indeed, excellent authori- 
 > RtcutUdt Midecint VeUrinaire, 1859, p. 731. 
 
582 ACCIDENTS AFTER PARTURITION. 
 
 ties maintain that there is no proof that this accident is more frequent 
 in animals suffering from inversion of the vagina than those which are 
 not. And it is to be remembered, as already stated, that the os must 
 be more or less dilated and dilatable for inversion of the uterus to 
 occur — a condition which does not always, nor yet frequently, co-exist 
 with vaginal inversion. The latter, indeed, is far from rare in non- 
 pregnant animals, and in those which have never been pregnant ; and 
 it is not at all uncommon in those which are advanced in pregnancy, and 
 yet do not suffer afterwards from this uterine displacement. 
 
 Difficult and laborious parturition, when much manipulation and 
 jnergetic traction on the foetus have taken place, has likewise been 
 acknowledged as a cause of uterine inversion ; and it is certain that the 
 efforts to remove a fa3tus which, whether from malposition, deviation of 
 parts, excess of volume, etc., cannot be expelled in a natural manner, 
 are somewhat frequently followed by this accident. But on the other 
 hand, how often does it happen that the most vigorous — even painful 
 and violent — traction, and long and complicated manoeuvres, are not 
 succeeded by inversion ; while, on the contrary, the easiest and most 
 rapid birth sometimes is. 
 
 The retention of the foetal placenta beyond the ordinary period, must 
 also be taken into account as one of the exciting causes ; as it then acts 
 as a foreign body, irritates the interior of the uterus, and so by a reflex 
 influence induces contraction of its muscular layer — this giving rise to 
 invagination of the extremity of one of the cornua, which is supposed 
 to be the commencement of inversion. 
 
 It is also extremely probable that injudicious traction on the foetal 
 membranes may, for mechanical and physiological reasons, bring about 
 this result in a flaccid and dilated uterus, when the cervix is also re- 
 laxed. More especially is this likely to happen if the placenta is 
 adlierent towards the fundus of the organ, or in one of the cornua. 
 
 Much mystery appears to have attached to this inversion of the 
 uterus, and though various causes have been assigned as operating in 
 its production, yet as these are not present in every case, it has been 
 admitted that a particular predisposition must have existed. 
 
 It is evident that several causes may be invoked to account for the 
 accident. A flaccid, non-contracted uterus after birth, with a weak 
 cervix and dilated os, and relaxed broad ligaments, may be looked upon 
 as a predisposing condition ; and this is most likely to be present in 
 lymphatic animals, or those suffering from atony brought about by 
 debility from disease, bad or insufficient food, exposure to weather, etc. 
 When such a condition is present, it is easy to understand why inver- 
 sion may occur from abdominal pressure on the cornua or fundus of the 
 organ, or from external mechanical force ; and we can also comprehend 
 why an antiperistaltic movement of one of the cornua, or a portion 
 of it — just as happens in intussusception of the intestines — may take 
 place sometimes immediately after birth, and before the cervix has had 
 time to contract. Any trifling irritation may lead to this wrong move- 
 ment, and once commenced it is far more likely to continue than to 
 cease — as in the case of the intestines, when one portion becomes in- 
 vaginated within another. 
 
 We believe this will be found to be the correct opinion. 
 
IXrEJiSIOX OF THE UTERUS. 583 
 
 Treatvient. 
 
 Whatever may be the cause of inversion of the uterus, the obstetrist 
 must lose no time in remedying the accident ; as when interference is 
 not prompt, a fatal termination, or, at the very least, serious conse- 
 quences, will rapidly follow. 
 
 In treating it, several important indications ai'e to be observed, but 
 they may be classed as : (1) the immediate or preliminary measures 
 which the local symptoms demand, {'2) the reduction or reposition of tlie 
 uterus, (3) the retention of the organ, (i) the after treatment ; should re- 
 position be impossible or contra-indicated, then recourse must be had 
 to (5) amputation of the uterus. 
 
 Pkeliminauy Measures. — The preliminary measures consist in com- 
 bating the local and general symptoms. 
 
 The animal is sometimes standing, sometimes lying down. If the 
 latter, it must be got up ; as the standing attitude is by far the best for 
 reducing the inversion, there being more space in the abdomen when 
 its walls are not compressed by the ground, and the obstetrist can 
 operate more easily and quickly, while the downward inclination of the 
 lower surface of the pelvis and abdomen is favourable for reduction and 
 retention. If the animal is not very feverish, but only debilitated, and 
 there is otherwise no great urgency in the case, a strong diffusible 
 stinmlant may be administered, with the view to enabling it to get up. 
 It may also be induced to rise by bringing a dog before it ; or it may 
 be aided by a sack or sheet passed under the chest. 
 
 If it cannot be made to get up, or is unable to stand when raised, 
 reposition must be effected while it is lying — fatiguing, and often trouble- 
 some as the operation then is. This fatigue and ditViculty may be 
 somewhat diminished in raising the hind-quarters of the animal as nmch 
 as possible, by nieans of bundles of straw placed under them, — all the 
 litter being removed from beneath the abdomen, so as to relieve its 
 contained viscera from pressure as much as possible. Cosse, Tyvaert, 
 Ilaubner, Anderson, and others advise placing the animal on its back, 
 with the croup so raised ; while Viborg, Fiissler, Bettinger, Obermayer, 
 Ilering, Merkt, Adam, and several other obstetrists recommend raising 
 or suspending it by the hind-limbs, over a beam — a procedure which, 
 they assert, is most advantageous when reposition is possible or advis- 
 able. But, as has just been said, the recumbent position with the 
 larger animals is always to be avoided when possible, and every means 
 should be tried to make them stand. With the smaller animals — as 
 the Sheep, Goat, Sow, Bitch, or Cat — it is convenient to place them on 
 a bench or table, and lying either on the side or back, with the hind- 
 quarters well raised. 
 
 If the accident is recent— an hour or two, or even a little longer— the 
 uterus may be returned at once ; but should a longer inters'al have 
 elapsed, it is well to ascertain the condition of the rectum and bladder, 
 and to empty them if necessary ; though it must be confessed that it is 
 often a most difficult task to accomplish evacuation of the bladder. It 
 may be done, however, by causing assistants to raise the uterus, then 
 seeking for the meatus urinarius on its lower surface, near the vulva, 
 and introducing one or two fingers into that canal, or a catheter through 
 it into the bladder. 
 
 Should the foetal membranes still be adherent to the uterine surface 
 
584 ACCIDENTS AFTER PARTURITION. 
 
 — wholly or partially — they must be carefully removed without injuring 
 the cotyledons, enucleation being effected in the manner already 
 described. If properly performed, this removal should not cause any 
 haemorrhage ; and if any pulpy gangrenous cotyledons are found, it is 
 better to remove them at once with scissors than leave them to be 
 eliminated in the ordinary way ; though if they show any vitality at all 
 they need not be interfered with. Torn or gangrenous portions of 
 mucous membrane are also to be excised in the same manner. 
 
 This done, the uterus should be cleansed from matters adhering to its 
 surface- — such as litter, mud, dirt, filth or blood; this may be effected 
 by means of a fine soft sponge or cloth, the fluid employed being either 
 cold or tepid water, milk and water, some astringent or soothing lotion, 
 if there is much tumefaction or irritation, or a stimulating fluid— as the 
 dilute tincture of opium — if the organ is much bruised and congested. 
 Some practitioners immerse the entire uterus in a bucket containing 
 either of these fluids ; and some particularly prefer cold water, allowing 
 the organ to remain in it for as long as five or ten minutes. By this 
 means it is freed from extraneous matters and cleansed ; while the con- 
 gestion is allayed and the mass considerably reduced in size.^ Meyer, 
 Pfirter, and others state that this immersion in cold water has an 
 astonishing effect, and greatly facilitates reposition. Schnee even recom- 
 mends the application of ice, which, he asserts, not only diminishes the 
 volume of the protruded organ, but allays its irritability and contractions. 
 When attempting to reduce the cornu or uterus, he holds a piece of ice 
 in the hand he applies to the part. 
 
 If from long inversion and consequent congestion, infiltration or 
 inflammation, the volume of the uterus is so increased that it appears 
 impossible to return it, scarifications may be made on its surface ; these 
 often lead to a notable decrease in its size, and reduction may then be 
 effected. If it is determined to scarify the organ, the greatest circum- 
 spection should be observed in making the incisions ; they must be quite 
 superficial, and only a few at a time. Should the haemorrhage prove 
 excessive — which it sometimes does when the scarifications are deep 
 and numerous — then styptics must be applied. 
 
 When the organ is so increased in size that it cannot be returned, it 
 is well to ascertain whether this is not due chiefly to the intestines 
 having entered the pelvic cavity and filled the space in the inverted 
 uterus. If this be the case, they must be removed from it before reduc- 
 tion is attempted. 
 
 Coculet's- method of reducing the size of the congested uterus has 
 been successfully employed on many occasions. A dry and clean 
 piece of linen, about a yard in length, and twenty-eight to thirty 
 inches wide, is passed beneath the inverted uterus, and close up to the 
 vulva ; its lower border is then lifted over the organ, one of the ends 
 folded over it, and the other end over this, so as to envelop the entire 
 uterus — the four corners of the wrapper being uppermost. Tepid 
 water is now kept incessantly applied to this cloth, which is gradually 
 
 ^ A little care on the part of owners of animals would often prove of great advantage 
 in averting serious consequences in such an accident as inversion of the uterus, befoie 
 the arrival of the veterinary surgeon. This care should be mainly directed to keeping 
 the animal in a standing attitude, and preventing the uterus from being soiled, bruised 
 or torn, as well as swollen. The organ may readily and easily be preserved from injury 
 by receiving it on a sheet or large cloth, or. better still, a basket or tray, and keeping 
 it well raised until professional assistance arrives, 
 
 2 Journal des Veterinaires du Midi, 1862. 
 
INVERSION OF THE UTERUS. 585 
 
 tightened 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 be 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 witli 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. 
 
 Keduction ou Reposition. — "When inversion of the uterus is incom- 
 plete — a very rare occurrence — and the organ has not passed beyond 
 the vagina, reduction is comparatively easy. It is sulhcient, with the 
 larger animals, to introduce the closed list 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 necessai'y. 
 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 tlie 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. I'incliing the nose and loins will be 
 found ver}' efTective in this respect, and if a Cow, a Dog may be intro- 
 duced in front of it. Should the animal be much exiiaustcd or un- 
 steady, two additional assistants may be required to stand at each 
 side. 
 
 The utems 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 much 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 comers 
 
586 ACCIDENTS AFTER PARTURITION. 
 
 of each end of the cloth on which the uterus is placed, should be tied 
 round the neck of the assistants, so that their hands may also be free 
 to aid the operator in his manoeuvres : though the device must, one 
 would imagine, have more disadvantages than conveniences. 
 
 When the animal strains very severely and continuously — as some- 
 times happens during reposition — it is useful to constrain the chest 
 as much as possible by a girth, so as to prevent its expansion. It 
 may even be necessary to give a strong anodyne draught of chloral or 
 opium, or a dose of alcohol sufficient to produce semi-narcosis. Indeed, 
 with the Mare, in serious cases it is most advantageous to administer 
 chloroform or ether, in order to produce general anaesthesia before 
 attempting to handle the uterus. 
 
 For effecting reposition, two methods are recommended, and these we 
 will now notice — merely observing that, whichever be adopted, the 
 operator always places himself directly behind the animal, with the 
 inverted organ immediately before him. 
 
 First Method.— \i the inverted tumour formed by the uterus is not 
 very voluminous, and if by the application of cold water to it — should 
 it be tumefied — it 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 fist against the central part of the tumour ; and in some 
 instances, if it is well directed, and the inversion not serious, the organ 
 may be returned to the pelvic cavity by one push, while another will 
 carry it into the abdomen. 
 
 Eainard and other practitioners approve of this method, and describe 
 it somewhat in detail. The operator is to seek for the largest cornu — 
 that which contained the foetus — seize it by the fundus, and reduce this 
 by pushing it inwards, as we would the finger of a glove which has 
 been turned outside in — continuing the reduction by successive portions 
 until the pedicle of the tumour is reached, when more serious resistance 
 is encountered from the os uteri. This being overcome, the body of the 
 uterus is next replaced, either by the fist pressing against the widest 
 part, or by using a pessary. The pressure is to be directed straight 
 forward, through the vulva and pelvic canal, upwards and inwards. 
 
 Great care is necessary in exerting the pressure, which should not 
 be applied while the animal is straining. During expulsive efforts the 
 operator must be content to wait, merely keeping the parts where he 
 has carried them, until the straining has ceased. The pressure must be 
 steady and well directed, so as not to bruise or lacerate the uterus. 
 "When a portion is got within the vulva, it is held there by one hand, 
 while the other manipulates the next part to be returned. Eeduction 
 must be effected progressively, so that the organ may be completely 
 replaced ; if it is not, then re-inversion is certain to occur. 
 
 Some 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 chest 
 or abdomen of the operator, whose hands are thus at liberty to direct 
 the viscus into the vulva and vagina. 
 
 Second MetJiod. — If the uterine tumour is voluminous, and hangs 
 heavily as low as the hocks, then the first method is dangerous, if not 
 impracticable, and must not be attempted. The best method now un- 
 doubtedly is to return, first, tJie jJarts of the organ nearest the vulva, and 
 not act directly on tbe fundus of the uterus until the greater portion 
 has been replaced in the pelvis. 
 
IM'EJiSIOX OF THE CTEIU'S. 587 
 
 In ortler to accomplish this, the assistants on each side of the croup 
 raise the uterus in the manner ah-eady 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 necessai-y 
 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 termination of reduc- 
 tion, the organ itself returns to its normal position, and often quite 
 suddenly, as if it had been thrown forward ))y 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 
 efifected, 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 commencing invag- 
 ination — is encountered, they must be gently smoothed down or adjusted 
 — not forgetting, should the cornua be involved, the very dissimilar 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 
 made 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 bo 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 witli 
 a handle, or retroverter, may be used to complete the operation. Frick,* 
 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 tilled. This fluid acts in a mechanical manner, forcing 
 the uterus to distend and assume its ordinary form. It has been 
 ' Schicfizer Archii:, vol. xii., p. '249. 
 
588 ACCIDENTS AFTER PAUTUrJTIOX. 
 
 suggested that this distention plan should also be adopted for the larger 
 animals. 
 
 It should be observed that reduction has been effected in large and 
 small animals by elevating the hind-quarters until they are almost 
 vertical, the weight of the uterus, with careful manipulation on the part 
 of the operator, carrying it down to its normal situation. 
 
 Eetention of the Utekus. — Eeduction of the inverted uterus having 
 been accomplished, and everything done to remove the slightest traces 
 of invagination, the animal — unless serious injury has been inflicted on 
 the organ — immediately begins to look easier and happier, and the inex- 
 perienced would suppose that there was no further occasion for inter- 
 ference. The experienced obstetrist, however, is well aware that certain 
 precautions must be adopted against a possible recurrence of the accident. 
 True, 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 
 for retaining the uterus in its place until all risk of another inversion 
 has passed away. These devices consist of pessaries, sutures, and 
 handaaes. 
 
 Fig. 210. 
 Pad Pessary. 
 
 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 displacement of the uterus after its reduction. There are 
 several described and used by veterinary obstetrists. 
 
 The 2^(1 i)essary (Fig. 210) is a round piece of wood, from twenty to 
 twenty-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 
 rags, covered by a piece of soft cloth or oiled silk, and firmly tied to the 
 stalk by a piece of twine fixed in 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 jjessary (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 
 
IXrEliSlOX OF THE i'TEJtrs. 
 
 r.89 
 
 stem about twenty inches long, cleft in two as far as the middle, where 
 it is tied by a piece of twine or wire. Tiie ends of the two branches 
 (A A) are tiriuly tenoned in the mortises of the ring ; and tiie 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 (O O), in whicli are fastened the cords or straps destined 
 to tix the apparatus. 
 
 When rciiuired 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. 
 
 Fig. 211. 
 Ring Pessaut. 
 
 Fig. 212. 
 Cip-anhBam. rK.s.sAnv. 
 
 This part is well oiled, and being passed through tlie vagina, is so placed 
 against the uterus that the cemx will be in tlie middle of the ring, which 
 should make pressure on the cul de 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-ball pcssari/ (Fig. 212), invented or first described by 
 Chabert, is not unlike 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. 
 
 union to the end. On this screwed portion moves a transverse piece 
 (C C), by its middle opening or female screw (E) ; this piece has open- 
 ings (G G) at its extremities which receive straps or cords. 
 
 To use it, the ring and the three branches are dipped in melted wax, 
 then cooled, and again and again dipped and cooled, until the instru- 
 ment has acquired a sufficient volume, and the middle of the ring is 
 reduced to about one and a half inches. This prevents its injuring the 
 genital organs, when it is applied exactly in the same manner as the 
 preceding pessary — the cervix uteri being in the centre of the ring. 
 
 A rondelle i^essary has been devised by Leblanc, and Eainard has 
 invented a pessary (similar to Fig. 210) for small animals. 
 
 A bottle pessary has frequently done good service, when nothing more 
 suitable w^as at hand. An ordinary glass bottle, with a deep concave 
 and smooth bottom, has a long piece of wood fixed in the neck, and 
 can thus be made to act like the other pessaries ; but its weight is 
 objectionable, and there is also the danger of its breaking. 
 
 A very ancient pessary — employed even by the Greeks of an early 
 period — and one which has been most usefully resorted to by Tolney, 
 Laubender, Willburg, and others, is the bladder of the Pig or Ox. 
 When required for use, the bladder is steeped in warm water, then a 
 long wooden tube, or a piece of india-rubber tubing, is fastened to the 
 neck of it ; the bladder is introduced into the uterus and inflated, when 
 the tube is closed. Eainard recommends that it be only placed in the 
 vagina ; but the majority of obstetrists prefer it in the uterus. It has 
 been allowed to remain there as long as ten to fourteen days. 
 
 For valuable animals, it has been suggested that Gariel's air pessary 
 might be employed. This acts on the same principle as the bladder ; 
 in fact, it is an india-rubber bladder inflated by means of a long tube 
 with a stop-cock. This tube may be in connection wnth another bag 
 and stop- cock, the former being already filled with air, which can be 
 transferred to the other bag when it is placed in the vagina or uterus. 
 
 The smaller animals rarely require pessaries of this description ; 
 though there is no reason why, if necessary, modifications of the three 
 first, on a proportionately small scale, might not be employed. The 
 ring might be made of india-rubber, or cork. For the Bitch more 
 particularly, the cuvette pessary has been recommended and used. 
 This is an imitation of that employed for woman, and is merely an 
 oval, circular, or oblong piece, made of gum, india-rubber, gutta-percha, 
 or ivory, one to two inches in diameter, and having a hole in the 
 middle. When required to be introduced, this pessary is well oiled ; 
 the narrow end is passed edgeways into the vulva, and the piece is 
 pushed beyond the bulb of the vagina. Then, by means of the index- 
 finger, it is placed vertically, the hole in the middle allowing the finger 
 to fix it in the centre of the vulva, its two ends being retained by the 
 branches of the ilium, or at least in front of the ischium and the bulb. 
 
 A spring or elastic pessary, such as is now frequently employed for 
 woman, and which can be more easily introduced into the vagina, might 
 be useful with the smaller domesticated animals. 
 
 Salt, of Birmii:igham, has introduced into human gynaecology a new 
 flexible annular pessary, which might be advantageously employed by 
 the veterinarian for small animals. It consists of a watch-spring coiled 
 spirally, with the extremities left free, and encased in caoutchouc ; it 
 collapses for introduction, and when in situ it expands to the circular 
 
/M'J-JnSIOX OF TUB UTERUS. r.91 
 
 form, or such other shape as may best accommodate its contact with 
 surrounding parts. 
 
 The value of pessaries in inversion of the uterus in animals has 
 been a good deal discussed. We are not aware that they have been 
 much, if at all, employed in this country ; and in Germany they do not 
 appear to have obtained much favour ; while in France, though they 
 have often been resorted to, yet tlieir use has been only limited, as their 
 practical utility has been questioned by many excellent obstetrists. 
 
 It has been pointed out that if they can be supported without incon- 
 venience by some phlegmatic unimpressionable animals, more frequently 
 they irritate the organs in the pelvis, cause straining and uneasiness, 
 and produce those relapses which their application was intended to 
 avert. Therefore it is that, nowadays, they are not made available to 
 anything like the extent they were a few years ago. 
 
 Saint-Cyr admits that if, in some exceptional case, it is necessary to 
 employ a pessary, the Piifs bladder deserves the preference for the 
 larger animals. It is found nearly everywhere, requires no other pre- 
 paration than merely softening its texture by pouring some tepid water 
 into it, whilst its outer surface can be well oiled. It is easily placed 
 where desired, even in the uterus ; its soft, flexible walls cannot bruise 
 or excoriate ; and, by inflation, it can be distended to the size necessary 
 for each particular case. 
 
 Sutures. — The suture is generally preferred to the pessary, as being 
 simpler, more easily applied, and having fewer inconveniences than 
 the latter. Being inserted outside the genital organs, they do not 
 irritate those which are most concerned in inversion, neither do they 
 provoke expulsive etTorts on the part of the animal. 
 
 The sutures may be of hemp, silk, or metal ; and they may be passed 
 dii-ectly through the lips of the vulva, or include the skin towards the 
 point of the hip, on each side. The first may be named the labial 
 suture, the second, the Jiip suture. 
 
 The labial suture may be " interrupted," or " quilled," and is made 
 according to the principles of surgery. A saddler's large needle, or a 
 sacking-needle with a handle at one end and an eye near the point, is 
 the most useful. Through the eye is passed a piece of whipcord, two 
 or three strands of woll-waxed thread, or a piece of cotton or silk tape, 
 or moderately thick carbolised catgut. The needle is passed through 
 one lip of the vulva— say the right — from the outside, and near tlic 
 up})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, sutVicient 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 lt»ft 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 necessarj', a third 
 suture, directly transverse, may be placed between these. 
 
 It is more convenient and painless to pass the needle first through 
 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 
 
592 ACCILEXTS AFTER PAETUBITIOX. 
 
 cases, and with advantage. The needle — either the above or a small 
 seton needle — is 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 hip. The next suture is a trifle lower, 
 and the others below this : 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 maybe drawn 
 more or less tightly, and they may 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 suture. 
 This may be of lead, or iron wire softened. The needle is like that 
 used for the other 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, w^hile 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 being 
 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 through 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 the space occupied by the sutures ; each piece 
 is passed into each eyelet of the upper suture, and firmly crossed and 
 twisted as far as the two points of the suture ; the same is done with 
 the second and the third suture — 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 ; bub 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 vulva, 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 
 
J.VrBIiSKLV OF THE irEiius. 
 
 :i93 
 
 no respect prevent the inversion of the organ internally, but merely 
 hinder its escaping beyond the vulva ; and as their utility depends not 
 only upon the material of which they are composed, Imt also upon the 
 
 I 
 
 
 4 
 
 
 Fig. 213. 
 Zcnoel's Labial Sdturks. 
 
 integrity or power of resistance of the textures through which 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 Dklwabt's Turss. 
 
 It must not be forgotten, too, that even under the most favoui-able 
 ■circumstances, these sutures, both during their insertion and their 
 maintenance, are a source of uneasiness and pain to the animal. 
 
 38 
 
594 
 
 ACCIDEXTS AFTEB PARTUPJTIOX. 
 
 Bandages or Trusses. — To dispense with the inconveniences of the 
 pessary and suture, the bandage or truss has been proposed and exten- 
 sively employed ; and in the great majority of cases of uterine inversion, 
 it should be adopted in preference to the other methods of retention. 
 
 The 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 ex- 
 trusion of the uterus without interfering with defecation or micturition. 
 
 There are several kinds of truss in use, and these vary somewhat in 
 their details, though in principle they are the same. Some of them are 
 fixed around the shoulders and neck, others round the chest only, and 
 others, again, round both regions — most frequently to a collar or surcingle. 
 Allusion will be made to those which are recognised as most valuable. 
 
 Fig. 215. 
 Delwart's Truss applied. 
 
 Two of the most useful and readily-made trusses are composed of 
 light rope or thick cord — something like a clothes-line. One of these 
 is termed " Delwart's Truss," and is formed by cords united by a loop 
 in their middle, in such a manner that an oval space (a, Fig. 214) 
 sufficient to admit the vulva, and compress it laterally, is formed — the 
 inferior commissure being left free, to allow the escape of urine, and 
 uterine discharges, should there be any. The two portions of one of 
 the cords {b b) passing over the back, are secured to a collar or band 
 round the neck or chest ; while those of the other cord (c c) pass between 
 the thighs, and are tied to the lower part of the collar or surcingle, in 
 the manner depicted in Fig. 215. The loop may be wrapped in tow or 
 cloth, to prevent chafing to the parts under the tail. 
 
 Another rope truss, described by Eenault,^ is perhaps more simple, 
 yet quite as, if not more, effective than the preceding. This is com- 
 ^ Maison Rustique du XIX. Siecle, vol. ii., p. 286. 
 
ixi'Kh's/ttx oh' THE iTHnrs. :>\^'> 
 
 posed of a leather strap wliich buckles round the neck, and a rope from 
 twenty-four to tiiirty feet long — the thickness of the little linger, or a 
 triHe 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 aj>ply the bandage, the neck-strap or collar is first to be 
 put on ; the cord is then to be doubled in eijual 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 left passing to the right and the right to the 
 left. Each side is carried through the collar, and back over the front 
 of the shoulder, at the top of wliich both are tied in a simple knot, so 
 
 -i\ Z-^*?^^^ 
 
 Fig. 216. 
 Rknaults Truss. 
 
 as to be easily untied when required. At ten or twelve inches from 
 this, a firmer knot is tied, then several otliers 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 sinqjle 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.' 
 
 ' Hcir^burgh ( Veterinnrimu vol. xiv., p. 490) descrilxjs ft similar tru.ns, which he appliwl 
 t<> a Mare that had inverted the utenw three days after foaling. Giving the animal 
 some extract of hyoscvanius and gnm (pii, dissolved in a pint of warm water, to allay the 
 straining, aa soon as thi.n dose began to operate he reduced the organ. This waa done by 
 securing the animal, sponging over the uterus with a little vinegar and wat«-r, and 
 "taking hold of a clean t<iwel in the left hand, doubled, and the comers of the towel 
 
596 ACCIDEXTS AFTER PAETURITION. 
 
 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. 
 The 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 doubled 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 
 the fundus of the uterus, with the assistance of the right hand in bearing it up by a 
 moderate degree of force, and returned it to its place, slowly withdrawing the hand, and 
 leaving the towel for a few minutes. I next proceeded to remove the towel, by intro- 
 ducing the hand, greased for the purpose, into the vagina, taking it by the corners, 
 turning it several times round, and at the same time bringintr it out slowly. After 
 which I introduced the arm to the full length, in order to ascertain whether it was in 
 its proper position, using a little force on the further end, in order to stretch it. I then 
 withdrew the arm, and proceeded to apply the uecessarj' bandages. First, a strong girth 
 or surcingle was buckled tightly round the abdomen, to prevent the muscles acting with 
 such force as again to expel the uterus. This is essentially necessary. I then took a 
 small rope, or narrow web (the one used on this occasion was a cavesson for breaking 
 horses in the menarje), forming an eye (loop) in the middle, to be passed over the neck, 
 as if for casting. I then passed the ends between the fore-legs and along the belly — one 
 on each side of the udder, up between the hind-legs — tying a single knot exactly at the 
 inferior part of the vulva. Another was placed superior to the anus, carrying the ends 
 up on each side the tail, fixing them securely and tightly to the loop round the neck, and 
 on each side of the withers."' This truss was a perfect success, and could be dispensed 
 with in three days. Horsburgh condemns sutures passed through the labia pudendi. 
 
jxi'i-jjisioy <>F THE rrKurs. r.07 
 
 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 
 strapri, though in such a way as not to interfere with micturition or de- 
 fecation. 
 
 Various other trusses for the Mare or Cow have been proposed by 
 veteriiKiry 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 elliciency. 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. 
 LcNn's TRDS.S Iron. 
 
 base of the triangle, which fits 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 appUed to the smaller creatures, with the exception perhaps of 
 
598 
 
 ACCIDENTS AFTER PARTVPdTION. 
 
 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 
 Bitch. For small animals Eainard recommends a bandage made by 
 folding a piece of strong cloth in a triangular manner. The base of 
 this triangle lies over the loins, is carried down the flanks to beneath 
 the 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 hind-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, 
 fastening 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 applied. 
 
 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 the 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 and Lund. 
 
 If reposition of the uterus is properly effected and the truss well 
 
/.V/'A'A'.s/o.V OF THE ITERI'S. 599 
 
 applied, there is little reason to apprehend a recurrence of the 
 accident. 
 
 Aktku Tkeatment. — 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 tlie 
 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 tiie 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 the diet, particularly with Rumi- 
 nants, from their tendency to tympanitis and constipation. Indeed, 
 tympanitis may be sometimes considered 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 l)e 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 tickle it should be tempted by choice portions of diet; 
 though the quantity nmst not be large at any time until all danger is 
 past. 
 
 If there is apprehension of inflammatory complications, such as 
 metritis or peritonitis, emollient 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 tliere 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 bladder 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 suthce 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- 
 rhcca 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. With 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,' who witnessed it in three cases. This was great lameness 
 • RecutU de Midecxnt VcUrinaire, 1S57, p. 72.3. 
 
600 ACCIDENTS AFTER PARTURITION. 
 
 in the limbs, without swelling of the joints, but with marked knuckling 
 over of the hind-pasterns. It disappeared spontaneously as the patients 
 recovered from the other effects of the inversion. 
 
 Abiputation of the Uterus — Meteotomy. — Though it should be 
 recognised as a rule that, provided there is no serious complication 
 and the obstetrist is called in good time, with patience and skill 
 reposition of the inverted uterus is possible, yet cases will occur in 
 which the operator is baffled in his attempts at reduction, or when, at 
 the first glance or after an examination, he has to recognise this as 
 impossible or useless. " Since I have been in practice," says Schaack, 
 " I have been often called upon to remedy this kind of displacement, 
 and from what I have seen I am led to believe that the impossibility 
 of reduction is not so much due to the difficulties in the cases them- 
 selves, as to the hurtful manoeuvres which have been performed. 
 Nevertheless, it must be acknowledged that the development of the 
 hernia and the rigidity of the tissues are sometimes so great that it 
 requires a certain amount of confidence in one's self not to be dis- 
 concerted nor afraid. ... To be successful it is necessary to insist — 
 to insist in spite of everything — on applying one's self to seize each 
 alternative point of relaxation ; to engage, bit by bit, the displaced organ 
 in the vulva, in commencing with that which is nearest this opening, 
 then successively all the remainder." 
 
 This advice is judicious and sound ; but, as has been said, in certain 
 cases the extruded organ is so injured, either by the unskilful attempts 
 of ignorant men to return it, or from other causes, that it would be 
 certain death to the animal to replace it in the abdomen. We refer 
 now to extensive lacerations and bruises, or when the organ has 
 become softened and gangrenous ; and lacerations and ruptures are 
 always more serious, it must be remembered, in the lower than the 
 upper wall of the uterus. 
 
 In other cases, when reduction has not been complete, and one horn 
 remains more or less invaginated, or the body of the organ is not well 
 adjusted, inversion will again and again occur in spite of all attempts 
 at retention ; and this only too frequently leads to such grave injury 
 that there is no hope of the organ regaining its normal condition, even 
 should reposition be at last successful. Indeed, its walls are so 
 softened and friable that they cannot withstand the least pressure, 
 but tear whenever an attempt is made to carry the uterus into the 
 vulva. 
 
 With certain animals, too ■ — as Swine — reposition is extremely 
 difficult, particularly when one or both cornua are inverted ; as the 
 smallness of the organ, as well as the narrowness of the pelvis, is a 
 great obstacle to manipulation. 
 
 In such exceptional circumstances complete extirpation of the uterus 
 {Metrotomji) has been recommended and practised. 
 
 It is now many years since the operation was introduced into 
 veterinary surgery, as Binz states that it was performed by Jenne, a 
 German veterinarian in Forchheim, in 1802. 
 
 Though the operation is apparently a most formidable and painful 
 one, and only to be ventured upon as a last resource, yet, on the whole, 
 it is tolerably successful. Of thirty cases collected by Saint-Cyr, no 
 fewer than twenty-three recovered from the operation. Franck refers 
 to thirty cases, eighteen of which recovered, and four (two Cows and 
 two Goats) were killed, though not, it would appear, on account of 
 
ixvEiismx of THE rr Kill's. goi 
 
 the operation. Of these thirty cases only one was a Mare ; 17 were 
 Cows ; 3 Goats ; 4 Sows ; 1 ]"^we ; 2 Bitches ; and '1 Cats. He remarks 
 that, of the unfortunate cases, there were prohably some which died 
 from other causes than the amputation ; while others evidently perished 
 from septic infection. Recoveries have taken place after the Caesarian 
 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 a'Strum — 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. 
 
 Openitioii. — Various modes of operating have been practised and 
 recommended. With the larger animals, the hind-limbs 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 liijatior in ma.s.s. 
 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 firmly tightened by pulling at each end, so 
 as to completely intercept the circulation in the organ. This done, the 
 cord is tied in a knot. 
 
 Though this method has been mucli employed, and with a fair amount 
 of success, yet it has been condennied by some good authorities, on the 
 plea that it is dangerous to tie such a voluminous mass ; as all tlie parts 
 cannot be sufViciently 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 douhle lifjatitrc. 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 (irmly tied round the right half of the pedicle, the other round the 
 left, so as to include the whole in two separate ligatures. 
 
 Claverie' reports a serious hannorrhage from the employment 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 actual cautery to the cut surface. It is possible that the 
 needle wounded some large vessel, which, of course, would not be in- 
 cluded in either of the Ugatures. 
 
 ' Journal dfs V'^iUrinaires du Midi, 1860, p. r-35. 
 
602 ArcIDEXTS AFTER PARTI'RITIOX. 
 
 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 clavis, 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 htemorrhage 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 hemor- 
 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. 
 
 Trasbot^ brings under notice the use of the ecrascnr in amputating 
 the uterus. The case to which he refers was not successful ; but it is 
 probable that this result was due to the imperfect or improper manner 
 in which the instrument was used. 
 
 With the ecraseur, 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 ligature (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 suggested that Esmarch's method of amputation by 
 clastic compression of the 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 Socie'te Centrale de Medecine Vtttrinaire, 1870. 
 
iNVERsmx OF Till-: iTi-:i:us. eos 
 
 advantage in sending back into the circulation of the animal the larger 
 part, or even the whole of the blood contained in the or^'an, before 
 separating this from the body, and, in addition, perfonning a bloodless 
 operation. Coculet's method of reducing the volume of tlie inverted 
 uterus by compression, has been already alluded to, and is the same 
 in principle. Ksmarch'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. 
 
 W'iien the uterus has been cut away, the portion of vagina or cei-vix 
 remaining should be returned as far as possible into the genital canal, 
 and if there is any hirmorrhage injections of cold water will probably 
 check it. Cicatrisation generally occurs within fourteen days. If 
 ablation of the uterus is not effected immediately after constriction of 
 the pedicle, but allowed to take place spontaneously, mortification and 
 sloughing 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 Hexed 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 witli its progeny. Tiiis 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 Cow — a portion 
 of intestine had become prolapsed witji the uterus, the interior of the 
 sack of which it occupied ; another similar occurrence was noticed in a 
 Bitch. Franck insists on this complication being always looked for in 
 the Mare, and he recommends that this animal be either narcotised 
 by morphia or chloroform, so as to get rid of the violent straining to 
 which it yields itself. 
 
 An exploratory incision may then be made in the l)ody of the uterus, 
 and if any intestine is found in its interior, this must be returned to 
 the abdomen before amputation is ventured upon. 
 
 CHAPTHli IV. 
 Inversion of the Vagina Inversio Vaginae. 
 
 IsiBRStos, procidencc, 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 
 
 ' JtectuU de Midtclne Vairinairt, 1866, p. 115. 
 
604 ACCIDENTS AFTER PARTURITION. 
 
 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 difficult and protracted, owing to a disproportion 
 between the size of the foetus and the passage through which it passes, 
 and especially when force has been necessary to extract it, and the ex- 
 pulsive efforts 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 foetus through the 
 di'y, 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, oi 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 canal 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 differentiates it from simple prolapse due to relaxa- 
 tion of the connective tissue, w^hich 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 foetus 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. 
 
 x\s 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. 
 
JM'KJ^SP'.y I IF THE I'AHiyj. 606 
 
 Siimptoins. 
 
 Of course, the chief symptom of this accident is the presence of a 
 tumour protruding from between the labia of tlie vulva, and which may 
 hang for some distance below that opening. In tills respect it resembles 
 inversion of the uterus, though the dilTerence 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 nmcus or a fibrinous exudate ; in other cases 
 it is inrtamed, excoriated by the tail or litter, and covered with foreign 
 matters. There are no traces of cotyledons or placental follicles. 
 On the under surface of the tumour is obsenx'd 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 tlie tinger between 
 the tumour and the vulva, there is found a depression, or ctil-de-sac, 
 formed by its direct continuity with the vulvar nmcous 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 ditViculty 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 effusion 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 siiould sulhciently 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 insuHicient examination 
 have been mistaken for inversion. Inversion of tlie 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 afifaira 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 
 
606 ACCIDENTS AFTER PARTURITIOX. 
 
 this condition for months without showing much apparent inconvenience. 
 This is the kind of inversion that is liable to recur ; reposition may be 
 readily effected, but no sooner is it accomplished 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, 
 fffices, and litter, in addition to friction from the tail and other objects, 
 as well as the attacks of flies, etc., becomes irritated, excoriated, abraded, 
 and indurated, while it is greatly thickened from exudation ; a more or 
 less foetid muco-purulent secretion covers its surface ; cicatrisation of 
 the torn submucous connective tissue ensues ; new adhesions are 
 formed which fix the part in its abnormal situation, and offer what is 
 sometimes an insurmountable obstacle, if not to reduction, at least to 
 retention, after that has been effected. If assistance is not afforded, the 
 animal gradually loses condition and becomes emaciated ; hectic fever 
 sets in, 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. 
 
 Treatment. 
 
 The more speedily treatment is resorted to after inversion has 
 occurred, the more easily is reduction effected and likely to prove per- 
 manent, while the risks from injury are greatly diminished. 
 
 The treatment is somewhat similar to that recommended for inversion of 
 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 gradually 
 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 reduction 
 has 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 towards 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 inversion. 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 hand or a soft damp cloth. 
 If, after reduction, the straining continues, it may be inferred that the 
 mucous membrane is irritated by the existence of wrinkles or folds on 
 its surface. The hand must then be introduced again into the vagina, 
 and the ridges effaced either by passing the hand over them, so as to 
 carry the membrane onwards, or by gentle pressure entirely obliterating 
 them. 
 
 If the membrane is irritated and inflamed, 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 foetal membranes are still in the uterus, some obstetrists 
 recommend that they should be removed before reduction of the inver- 
 sion is attempted ; but others 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 
 
iM'h'JiSKKV of Tilt: r.iinxA. tior 
 
 must be removed, as their presence is certain to cause expulsive efforts 
 which will inevitably lead to protrusion of the vagina again. 
 
 For retention of the reduced part, sutures are often preferred : they 
 are passed through the labia of the vulva. Harms and Schleg' employ 
 ritKjclns 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 the other end is a kind of button raised on the surface. The 
 point is passed through the labia, and the band bent round so as to 
 meet and button at the ends. This ring has been worn, according to 
 Schleg. from a few days to more than live months. Other sutures have 
 been described ; but they are all on the same principle as Zundel's 
 already mentioned (I'Mg. 213). 
 
 In some cases one of the trusses alluded to for inversion of the uterus 
 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 nmcli 
 lacerated, and abnormal adhesions have taken place, then a recurrence 
 of the inversion is to be apprehended. This recurrence is, of course, 
 most likely to take place in chronic inversion, and all the skill and 
 patience of the veterinary surgeon will be required in dealing with such 
 a case. At times the accident has proved so troublesome, and retention 
 has so batiled every attempt after reduction was effected, that amputa- 
 tion of the protruded portion has been practised, and with success. 
 
 Rainard appears to have been the first to venture on this bold measure, 
 and he practised the 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 lU'ine, 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 
 Bitch was allowed to run at large, the only attention it received being 
 the injection of emollient Huids into the vagina, and a smaller allowance 
 of food. The pain was much less in intensity and duration than in the 
 first case, and the tumour came away in five or six days, when recovery 
 took place. Kainard. however, advises immediate excision of the 
 portion of the mass beyond the ligatures, when these have been drawn 
 tight. 
 
 Daprey operated on a two-year-old Filly in a somewhat different 
 manner. Inversion of the vagina had been present for fifteen days, and 
 the tumour was as large as a man's head ; it was cold, of a dark-brown 
 colour, and the animal was greatly agitated and fevcrisli. As gangrene 
 was apprehended, it was decided to remove the whole mass. This was 
 done by practising a kind of saddler's stitch around it, by means of two 
 needles armed with a waxed thread ; and when sewn round, the two 
 ends of the ligature were drawn so tight as to raise the enclosed sides 
 of the tumour into plaits like the mouth of a tied sack ; they were then 
 firmly joined. The Filly was kept standing with the hinder part of the 
 body raised, and the tumour was dressed with chlorinated water and 
 vinegar. Between the seventh and eighth days the mass came awav ; 
 the discharge diminished in quantity and fcetidness, and on the tenth 
 day the animal was nearly well. 
 
 Bernard, of the Toulouse Veterinary School, operated upon a female 
 ' Magaziii/iir Thierheiihunde unci Viehzucht, 1869, p. 13. 
 
608 ACCWEXTS AFTER PAETUFJTIOX. 
 
 Ass, which had the vagina inverted for more than a month, and every 
 means of retention had failed. Amputation was practised, by a circular 
 incision around the base of the tumour. At the first cut of the bistoury, 
 it was observed that the mucous membrane was very much thickened, 
 and easily detached from the 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 five inches. This 
 was done, and the hemorrhage was inconsiderable ; but it persisted so 
 long afterwards that 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 thick but dilatable ring, about the middle of the vagina, was 
 found, through which first one finger, then two and three, could be 
 passed. Beyond this ring the canal was normal in width. 
 
 There can be no doubt, then, that the inverted vagina may be ampu- 
 tated without much risk, when reduction is impossible or incomplete ; 
 but whether an animal which has undergone this operation can be 
 utilised for breeding purposes afterwards, we have no evidence to prove. 
 It is possible that the cicatricial tissue uniting the wound may be suffi- 
 ciently yielding to allow of gradual dilatation by manual or mechanical 
 means, and thus not offer much impediment to impregnation or parturi- 
 tion. 
 
 CHAPTEE 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 the 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 the 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 the 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 the 
 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 the 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 
 inverted, 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 
 
 1 Canstatt's Jahresberichf, 1859. 
 -' Archives Veterinaire, 1877, p. 801. 
 
INVEKSION OF THE JiLADDER. 600 
 
 sufHciently down, so that wo may be able to inspect the parts. Where 
 they enter, the inner membrane (now the ureter) will have a soft and 
 jelly-like protuberant appearance, in the middle of which will he detected 
 two very small openings of a nipple-like shape. To be certain that we 
 have hit upon them, we may introduce a probe, and pass it down 
 towards the suspended fundus. Havinj]; discovered the orifice of the 
 ureters, and passed a ligature around the neck of the bladder below 
 them, we have nothing more 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. We should also, after having applied the ligature, 
 puncture the distended fundus ; since its great weight may cause 
 dragging and inflammation about its cervix, or may force the ligature 
 over the mouth of the uterus, which would occasion the death of the 
 animal. After the separation has taken place, the remaining portion 
 will contract within the vagina, and the cavity will be closed by the 
 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 
 place. 
 
 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. 
 
 CHAPTER VI. 
 Traumatic Lesions of the Genital and. Neighbouring Organs. 
 
 1'jITHER 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 rupture of the uterus; 2. Laceration and 
 rupture of tlic vagina; 3. Thrombus of the vulva and vagina; 4. Relaxa- 
 tion of the j)clvic symphysis ; 5. Jiupturc of the bladder; 6. liupturc of the 
 intestines; 7. Rupture of tlic diaphragm; 8. Rupture of the abdominal 
 viusclcs; 9. Rupture of the sacra-sciatic ligament: 10. Rupture of the 
 lieart. 
 
 I. — L.VCKKATIGN .\ND RlI'TUUE OF THE UtkRUS. 
 
 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 — when the organ is 
 only partially torn or lacerated, or complete — 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 fa?tus has been removed from the uterus — when it 
 is generally a complication of inversion of this organ. Ante partum 
 
 39 
 
.610 ACCIDENTS AFTER PARTURITION. 
 
 rupture has been already fully alluded to at p. 194, and we have now to 
 study its occurrence during and after birth. 
 
 Bujjture during Birth. — Eupture of the uterus 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 them, and it has been affirmed 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 ; though 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 when 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 foetus ; 
 inflammatory softening of some portions of the parenchyma during 
 pregnancy ; or thinning of the wall at some part by pressui-e. 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 by the fully dilated chest. 
 
 In such cases the rent may be so great that the foetus 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 ma}' be extracted 
 therefrom with more or less difficulty per vias nahirales ; 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 effecting 
 the extraction of the foetus. 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 may 
 be during life, after death it usually appears much smaller, because of 
 the contraction of the muscular tissue. 
 
TRAUMATIC LESIONS OF THE (I EXIT A L ORGANS, ETC. 611 
 
 In all these cases, when the organ romanis in situ, the diagnosis is 
 ditticult, and generally it is only on post mortcin. examination that the 
 lesion is discovered. The moment of its occurrence may ho inferred 
 when a crotchet suddenly loses its hold, or the feet of the fa-tus pene- 
 trate the uterine walls. 
 
 Certain clinical symptoms are often ohservcd during life, which, if they 
 were constant, niiglit lead to a suspicion of the existence of rupture. 
 Thus, the expulsive efforts are very energetic and regular up to a 
 certain period, when all at once they cease ; the animal hegins to 
 manifest symptoms of abdominal pain — lying down and getting up, 
 stamping and pawing, looking towards its flanks, moving about uneasily, 
 moaning, bellowing, neighing, or even screaming, when the rupture 
 occurs. It has been stated that the Cow opens its mouth and protrudes 
 the tongue, extends 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 Ufe. 
 
 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 visit in inversion of the organ. The pulse soon becomes 
 feeble if there is much luemorrhage, and exhaustion quickly supervenes. 
 If 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 lloor of tlie organ is involved ; if 
 the OS remains closed, so as to prevent the admission of air, the prog- 
 nosis is still more favourable, though this can rarely be the case. 
 
 The chief complications are lnemorrJioijc, hernia of the intcsti)ics, and 
 peritonitis. 
 
 Death from direct luemorrhage is less frequent than might be antici- 
 pated, knowing the great vascularity of the uterus at parturition. This 
 infrequency is explained by the fact that bleeding from such a lacera- 
 tion is less profuse than from an incised wound of tlie same dimensions. 
 Nearly always, too, the foetus is partially 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 luemorrhage is so great that a 
 fatal termination soon takes place, witli all the symptoms ah'eady 
 described at p. oTo. 
 
 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. \Vhen primary, it is due 
 to the escape of blood, the fcetal fluids or envelopes, or the foetus itself. 
 
612 ACCIDENTS AFTER PARTURITION. 
 
 When secondary 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 foetus 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 w^ill 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 intestines, 
 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 must 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 be 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 
 
 cavit}', delivery i^e?- vias naturales is then impossible, and the Ctesarian 
 
 'section must be resorted to ; unless it be decided to allow the animal 
 
THAl'MATIC LESIDXS OF THE (IKXITAL OliUAXS, ETC 6i:{ 
 
 to take its chance, and get rid of the foetus as in extra-uterine footation, 
 shoulil 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 fujtus 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 rent 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 autiiorities have 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 supertluous. 
 
 Beyond the measures for reduction of the inversion, and the necessary 
 antiseptic after-treatment, little more has to be observed. \Vhen 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 
 the organ. This may be accomplished in the manner already indicated. 
 
 II. — Laceration and Rupture of the Vagina. 
 
 Lacerations 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. TriHing laceration of 
 the vagina and vulva is often observed in primiparu-, or those animals 
 in which the soft parturient passages are narrow or rigid^ 
 
 The injury may be either sj)0)itniieons 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, the 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 lesion occurs in what we may call a "spontaneous manner," 
 it happens either that the vagina is lacerated along with the uterus, 
 
614 ACCIDENTS AFTER PARTURITION. 
 
 during natural labour and from continuity of texture ; or when the os is 
 amply dilated, but the vagina is overstretched by the foetus. 
 
 In some instances such an accident as rupture of the vagina may be 
 secondary — 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 perforation 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 towai'ds 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 about 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 alw^ays transversal, 
 and, as has been before stated, the vagina may be 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 foetus, and the energetic and rapid 
 contractions of the uterus, as well as the greater susceptibility of this 
 animal to morbid influences — such as septicaemia. Nevertheless, in all 
 animals these injuries are notoriously serious, and if tlie 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. Eainard 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 foetus, 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 tlae 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 much more accessible 
 to the eye and hand ; though in some cases it is difficult to ai'rive at an 
 exact knowledge of the situation or extent of the injury. 
 
 With regard to j^^'ognosis, this will much depend upon circumstances 
 and the complications met with. Sometimes a naere abrasion of the 
 mucous membrane which produces a raw surface, or a laceration extend- 
 ing to the submucous connective tissue, may lead to septic infection. 
 This is particularly to be apprehended should the fcetus or membranes 
 have undergone decomposition, or any putrid matter — as the lochia — 
 
THAi'MATIC LESIONS OF THK HEXITAL (>/i(;.L\S, ETC. t)15 
 
 been allowed to remain in the genital canal, especially during hot 
 weather. Wounds or lacerations of the tloor of the vagina are generally 
 more serious than those on the roof or sides, for the reasons mentioned 
 with regard to rupture of the uterus. And even wounds, or rupture of 
 the sides or roof of the caiuil, are much more serious than the incisions 
 made through its walls in ovariotomy, owing to the presence during 
 parturition and the puerperal state of fluids which may quickly become, 
 or are already, putrescent. 
 
 Hiemonhiujc is generally not so much to be dreaded as in lacerations 
 of the uterus ; though occasionally it may be so serious as to endanger 
 the life of the animal. 
 
 Hernia of the intestine occurs when perforation of the vaginal wall 
 near the cervix is complete, and the peritoneal cavity is opened. This 
 is a serious complication, as is also licniia 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 the 
 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 linger proves that the canal runs in an oblique direction, and does 
 not communicate with the bladder or rectum. It contains a quantity 
 of thick yellow pus which flows intermittently from the vulva, and might 
 lead to tlie supposition that the case was one of vaginal catarrh. 
 Cagny, who gives this description, says 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 an antiseptic dressing until cicatrization was well 
 advanced. 
 
 Peritonitis and pelvic 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 fistulic, or even of wide-spread 
 destruction of the soft parts in the i)('lvic cavity, which sooner or later 
 induces a fatal termination. Should this not occur, and some of the 
 neighbouring organs have been injured at the same time as the vagina, 
 then there may be such important damage intlicted as to render the 
 animal nearly valueless. Some of these injuries will be alluded to 
 presently. 
 
 The si/mpt&ins of injury to the vagina and neighbouring organs will, 
 of course, vary with their nature and extent. 
 
 Much constitutional disturbance is generally only manifested 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 ; hut if they extend deeply into the con- 
 nective tissue, then acute fever, infiltration, and other grave symptoms 
 may supervene. 
 
616 ACCIDENTS AFTER PAIiTUBITION. 
 
 "With regard to treatment, this also must depend upon circumstances. 
 
 When rupture of the vagina is recognised during parturition, delivery 
 should be effected as speedily as possible, and with every care, in order 
 to prevent the laceration extending and the foetus passing into it. If, 
 unfortunately, some part of the latter has lodged in the rent, it must be 
 removed therefrom with the utmost precaution, so as not to injure other 
 viscera. The foetal membranes should also be extracted as soon as 
 possible. If there is haemorrhage from the vagina, this may be sup- 
 pressed by ice or injections of cold water if the rent is superior or 
 lateral ; if it is inferior, then a sponge or a cloth soaked in cold water, 
 in which is a small proportion of iron perchloride, should be placed in 
 the canal. Should there be hernia of the bladder or intestines, these 
 must be replaced at once. 
 
 In all cases of wounds, abrasions, or rupture of the vagina, every pre- 
 caution should be observed with a view to the prevention of septic 
 infection. With this object the greatest cleanliness must be observed, 
 all decomposing matters, or those likely to decompose, should, if 
 possible, be scrupulously removed, and injections or " swabbings " of 
 weak solutions of carbolic acid or other antiseptics, practised. If there 
 is much danger of haemorrhage, a suitable tampon of lint or fine tow, 
 saturated in one of these fluids, may be allowed to remain in the vagina 
 for some time. 
 
 Complications of Buptured Vagina. 
 
 We have mentioned some serious complications of ruptured vagina, 
 in which adjacent organs and tissues were involved. These are chiefly 
 the rectum, bladder, and perinaeum, one or more of which may be per- 
 forated and torn, along with the vagina. These ruptures vary in 
 extent and gravity, and while some are necessarily fatal, others are not 
 so ; but they may lead to serious deformity and inconvenience, such as 
 accompany chronic fistulge in important regions. They are recto-vaginal 
 fistula, rupticrc of the jjerz^c^zn?;, vesico-vaginal fistula, and occlusion of 
 the vagina. 
 
 Eecto- Vaginal Fistula. — Injuries to the rectum are generally pro- 
 duced through the wall of the vagina, during the passage of the foetus. 
 When the salient parts of the latter, and more especially the feet, are 
 misdirected and pressed up towards the sacrum of the mother, and if 
 the rectum chances to be distended with fteces, not only will the vagina, 
 but this viscus also may be perforated, and some portion of the foetus 
 soon appears at the anus. If this accident is discovered in time, it may 
 be possible to push back the parts thus misplaced into their natural 
 channel, and complete delivery by the vagina ; but notwithstanding 
 this happy termination, the communication between the vagina and 
 rectum very often remains permanent, and a recto-vaginal fistula is 
 established. 
 
 The treatment of these cases is not always satisfactory, so far as a 
 perfect cure is concerned. Sutures have sometimes been employed to 
 close the wound in the rectum, when accessible. But this surgical 
 operation can rarely be resorted to, and all that may be done is to keep 
 the lacerated parts clean, by frequent injections j;er vaginam and rectum, 
 prevent constipation, and treat the injury on ordinary principles — not 
 forgetting the free employment of antiseptics. 
 
 If sutures are employed to close the fistula, they may be supported by 
 a pessary or tampon placed in the vagina, beneath the fistula. 
 
TlLil'MATIC LKSIDXS nF TllK HKSITAL i >/;'.-. I \S, KTC. 617 
 
 When the hnibs or other parts of the fcetus protrude through the 
 anus, it is nearly always advisable to amputate them, in order to move 
 the body more easily in the vaj^'ina, and with less risk of further injury to 
 the parent. Once in the {genital canal, then the firtus can be extracted 
 in the ordinary manner. Opiates should be largely administered. 
 
 Ri TTfUK OK THE Pkkin.ki M. — Laceratiou of the vagina is not at all 
 infrequently complicated with more or less extensive rupture of the 
 perin;eum, and occasionally rupture of the vagina, rectum, and perineum 
 may be met with in the same animal. Sometimes it is only the /o/nc/«'/<e 
 and superior commissure of the vulva which are involved; in others the 
 entire extent of the perina^um 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 ftetus, 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 etTorts are continued, the sphincter and 
 all the tissues between it and the vulva are greatly stretched and 
 strained until they tear. Then the fcetus is finally expelled — sometimes 
 dead, at other tinies alive — and there remain immense 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 periniEum ; 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 perina^um, extending sometimes to 
 neighbouring tissues and organs, sets in. If the tear involves the anus 
 and its sphincter, there will be involuntary escape of ficcal 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, fistulas 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 hiemorrhage, styptics must be employed ; if the bleeding is slight, 
 cold may check it ; but if severe, iron perchloride must be used. 
 
 The lacerated margins, if much torn, nmst be freed from shreds which 
 are likely to lose, or have already lost, their vitality. They must then 
 be brought together by sutures — either of metal, carbolised silk, or 
 
618 ACCIDENTS AFTER 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 faeces 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 Fistula. — 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 cellulitis 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, 
 Ij and if it remains for any length of time in the passage the distention 
 
 I weakens the vitality of the soft tissues ; so that the compression to 
 
 which they are submitted between the foetus and the floor of the pelvis 
 will produce mortification, which may extend to the neck of the bladder. 
 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 symptoms need not be specified. The chief is incontinence of 
 urine. When this fluid is observed to be constantly dribbling from the 
 vulva after parturition, the existence of the accident may be suspected, 
 and an examination j;cr vaginam will confirm the suspicion. 
 
 Treatment must be mainly palliative. 
 
 I 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 
 jL be more or less complete, and its seat at any part of the canal, but 
 
 I 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 by employing a vaginal dilator. 
 
T/iAI'MAT/f Lh'smxs of THE HKSITAL nl'jlASS, KTV. 619 
 
 III. — Thuomhus of the Vagina and Vl'lva. 
 
 Thrombus or lui'matoma of the vagina and vulva, is sometimes 
 obsei-ved 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 durinj:^ laborious parturition. 
 
 In such cases, when the fcvtus 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 appeai-s 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 carl)olic acid, jiermanganate 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 haMnorrhage from the incisions prove troublesome, styptics 
 — such as dilute iron perchloride — and tampooning the vagina, may 
 be had recourse to. 
 
 IV. — Rklaxation 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 
 
 ' Reaifil de Malerinf Vitcriimirr., 1863, p. 106. 
 •* VtUrinarian, vol. xi.x., p. 386. 
 
620 ACCIDEXTS AFTER I'ARTURITION. 
 
 accident, which is increased by pregnancy, and the volume and malpre- 
 sentation of the foetus no doubt lead to its occurrence when parturition 
 takes place. The sacro-iliac articulations may also participate in this 
 relaxation, the symptoms of which are deformity of the pelvis, and 
 altered movement of the hind-limbs. 
 
 The animal lies almost continually, and rises with great difficulty. 
 When up, it can scarcely move, and the hind-quarters sway from side 
 to side — the ilium of either side rising or falling as the corresponding 
 limb sustains or is relieved from weight. The hand, passed into the 
 rectum, will cause pain if pressure is made on the sacro-iliac articulation. 
 The internal angle of the iliums projects much beyond the spines of the 
 sacrum, and when the animal walks movement. can be detected between 
 the pubic bones. 
 
 The condition is considered incurable. 
 
 V. — EUPTURE OF THE BlADDEE. 
 
 Eupture of the bladder alone, during parturition, would appear to be 
 an unusual accident, from the 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 foetus during expulsion may rupture this viscus, and particularly 
 if the rectum above is also full of fajces, 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 inflammation. Death is 
 inevitable. 
 
 VI. — ^EUPTUEE 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 animal throwing itself down violently, under 
 the sam^e 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 
 Mai-e, has also occurred during parturition, due probably to severe 
 expulsive efibrts. 
 
 VII. — Eupture of the Diaphragm. 
 
 Eupture 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. 
 
TRAUMATIC LESIOys OF THE <;HMTAL OllUAXS, ETC. O'Jl 
 
 \'III. — Rupture of thk Audominal Muscles, 
 
 At page 293, when treating of " Hernia of the Uterus " during preg- 
 nancy, it was explained under what conditions, and tlie manner in whicli 
 rupture of the abdominal muscles occurs. The accident can scarcely be 
 designated as one consecutive to parturition ; but its treatment may 
 nevertheless engage the attention of the veterinary surgeon, after the 
 uterus has been emptied of its contents. In the same section allusion 
 was made to the appropriate measures. 
 
 IX. — Rupture ok the Sacro-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 malprcsentation. 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 the chest ; the 
 young creature was dead. Embryotomy was resorted to, and one limb 
 was about to be removed, when the uterus suddenly contracted with 
 great violence, and half expelled the foal ; traction then removed it. 
 " All attempts to get the tilly up were ineffectual, and an examination 
 showed that a rupture of the sacro-sciatic Ugament on the right side, 
 with other lesions, had taken place." Stimulants and laxatives were 
 administered, and a mustard plaster applied to the loins. "In two days 
 she was on her legs, and tottering about the yard. Sufllice 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. .\t the necropsy a 
 transverse rupture, two centimetres long, was discovered in the right 
 ventricle of the heart.- 
 
 ' Veterinarian, vol. xxxiii., p. 321. 
 
 • M&moirte dt la SociiU Centralt tlr Mrilrriw I'ttiriimire, vol. v. 
 
622 PATHOLOGY OF PARTURITION. 
 
 BOOK V. 
 
 PATHOLOGY OF PARTUEITION. 
 
 Under the head of Pathology of Parturition, it is intended to include 
 those diseases which accompany or follow this act, and are more or less 
 related to it. Some of these maladies are of great pathological interest 
 and practical importance, and deserve the closest study. The parturient 
 or, if the term might be employed, puerperal period, is a very remark- 
 able and critical one in the life of the female animal, and it becomes all 
 the more so as the creature is submitted to the influences of domestica- 
 tion, and rendered 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 foetus, and when 
 birth takes place this is retained until the lacteal secretion has been 
 fully established. Consequent upon this reflux, there is established a 
 kind of 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 
 of 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 as exact 
 definition 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 been recognised as one well worthy of consideration in 
 veterinary pathology ; and the closer its effects are studied, so the more 
 inclined 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- 
 corrlicea ; 3. Metritis, Metro-peritonitis, a,\idi Parturient Fever; 4. Par- 
 turient Aiooplexy ; 5. Post piartum Paraplegia; 6. Parturient Eclampsia ; 
 7. Epilepsia Uterina or Mania Pucrperalis ; 8. Parturient Laminitis ; 
 9. Mammitis; 10. Agalactia; 11. Injuries to the Teats ; Diverse Injuries. 
 
 CHAPTER I. 
 
 Vaginitis. 
 
 Inflammation of the vagina may exist independently, but it is generally 
 an accompaniment of inflammation of the uterus, or "metritis," which, 
 being the more serious evil, masks this malady. When occurring after 
 parturition it is generally due to protracted and laborious delivery, 
 
I'AaiMTlS. (;2.3 
 
 which necessitates manipulatory eiforts, the use of instruments, etc., 
 the passage of a very vohuninous ftetus, the pressure of a pessary, or 
 any other cause that may lead to irritation, bruising, or wounding of 
 the mucous membrane. In very exceptional instances, the inllanunation 
 may be indirectly due to the action of cold on the skin, or the ingestion 
 of very cold water — though this is more likely to induce metritis or 
 metro-vaginitis. 
 
 The inriammation may lead to, or be complicated with, ulceration, 
 gangrene, or mortification to a greater or less extent. 
 
 The labia of the vulva and the lining membrane of the vagina are 
 more or less swollen, tlie latter being of a deep or bright red, brown, or 
 livid hue ; there may be also patclies of congestion and eccliymoses, 
 with wounds or abrasions, and in rare cases phlyctiena; may be observed 
 on the surface of the membrane. The temperature of the canal is also 
 gi-eatly increased, while its walls are dry and often adhesive. Micturi- 
 tion is generally painful and dillicult, constipation is often present, and 
 there is sometimes nmch itching in the region of the vulva, which is 
 indicated by the continued attempts the animal makes to rub the part. 
 If the inflammation is severe and extensive, fever will be present. 
 
 When the intlanmiation has existed for one or two days, the mucus 
 secreted by the membrane is gi'eatly increased in quantity ; it is at first 
 a serous limpid fluid, sometimes streaked with blood ; then it gradually 
 becomes thicker and sero- or muco-purulent, soiling the tail and the 
 thighs and hocks, and sometimes becoming so acrid as to cause removal 
 of the hair and excoriation of the skin. 
 
 Simple vaginitis, of itself, is not a serious affection, and the inflamma- 
 tion often subsides spontaneously in the course of a few days, or rapidly 
 yields to treatment. In some instances, however, it assumes a trouble- 
 some, if not a grave character. When gangrene ensues, there may 
 be also infective inflammation in tlie surrounding parts, and large por- 
 tions of the membrane, or even the skin of the labia, may slough, while 
 the discharge is sanious and foetid. Baumeister describes a diphtheritic 
 form of vaginitis which he observed in a Cow that had calved a few 
 days before, and which died on the third day. At the autopsy, the 
 vagina, as well as the uterus, was found full of pseudo-membranous 
 productions. Another Cow which stood beside this one, and which 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 treatment of simple vaginitis does not merit much consideration. 
 Cleanliness, attention to diet, and injections of cold or tepid water, or 
 mild astringents, into the vagina, generally succeed in subduing the 
 inflammation ; but if the injections induce straining they siiould only be 
 administered in small quantity, and in combination with anodynes. 
 When, however, there is any tendency to acute inflammation and gan- 
 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, being 
 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. 
 
624 PATHOLOGY OF PARTURITION. 
 
 CHAPTEE II. 
 
 Leucorrhoea. 
 
 When inflammation of the vagina, and perhaps also of tlie 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, vrefind mucus corpuscles, an abun- 
 dance of epithelial cells, probably some pus corpuscles, and at times 
 micrococci and infusoria, particularly the Trichomonas vaginalis, 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 bad 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 
 afi"ected ; if it does occur, the chances are that the full period of preg- 
 nancy will not be reached. 
 
 ^Yhen 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 rnore 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 
 warm water, which ought to be injected until it flows out quite clear. A 
 solution of carbolic acid or cresyl in v;'arm 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 in 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. 
 
METRITIS, METRO-PERITONITIS, AND PARTURIENT FEVER. 625 
 
 CHAPTER III. 
 
 Metritis, Metro-Peritonitis, and Parturient Fever. 
 
 Inflammation of the uterus [Metritis) may be limited to one or more of 
 the internal layers of the organ {Kiulo-metritis), or it may extend to its 
 outer covering — the peritoneum {l[ctro-2)crito)iitis), and produce certain 
 signs ; while the introduction of septic matters into the blood, which is 
 very often a result of this inflammation, will give rise to symptoms 
 of septictcmia. The latter complication, from the febrile indications 
 which accompany it, is appropriately distinguished by the name of 
 "Parturient Fever" — a designation applied wi'ongly to another and 
 very different malady of this period — Parturient apoplexy or Puerperal 
 collapse — and which will be studied hereafter. 
 
 It is true that we may have metritis and metro-peritonitis without 
 septicnemia — at least to any very marked degree ; but the symptoms of 
 fever which accompany the former are generally more or less apparent, 
 and it is often difficult to discover when septic infection has taken place 
 — the high temperature and greatly accelerated circulation being the 
 first notable symptoms observed, and they often appear at an early stage 
 of metritis. And septic infection may take place without metritis, when 
 putrid matter obtains admission to the circulating fluids through a 
 lesion in the uterus or vagina. 
 
 Inflammation of the uterus and Se2)tic(cmia pucrpcralis occur in all 
 the domesticated animals. The latter would appear to be very frequent 
 in the Bitch ; but the Mare, Cow, Sheep, Goat, and Sow are liable to 
 septic infection, either as a result of metritis, or the introduction of 
 putrefying matter into the blood through an abrasion or wound. 
 
 The inflammation, as well as the infection, varies in intensity from 
 acute and sub-acute, to chronic. 
 
 Symptoms. 
 
 Inflammation of the uterus and parturient septicasmia may ensue very 
 soon after delivery — rarely before the second day with the Cow, and 
 seldom beyond the eighth day. With the Mare and Bitch, according to 
 Franck, the development of these conditions may be later. Immediately 
 after parturition the animal may appear to have quite recovered from 
 the efiects of that act — yields milk, takes care of its progeny, and there 
 is nothing to indicate the existence of disturbance. The temperature in 
 the rectum is normal, except in those cases — far from rare — in which 
 birth has been diflicult, and the genital canal has been roughly treated 
 and injured; t^lien the rectal temperature may be higher. In simple 
 metritis there is tumefaction of the vulva, with boat and redness of the 
 vagina, fever, straining, difficulty in micturition, diminution or sujipres- 
 sion of the milk secretion, inappetence and dulness. With, and often 
 without, treatment this condition passes ofif in a few days. In traumatic 
 metritis the same symptoms are observable, but soon there are well- 
 marked rigors and horripilation ; if a Cow, rumination is suspended ; 
 in the Cow and Mare the pulse becomes small, hard and quick ; the 
 secretion of milk is stopped, and the udder diminishes in size and 
 is flaccid ; the temperature rises rapidly, and the respiration is hurried 
 and shallow ; the mouth is hot and pasty, and the visible mucous mem- 
 branes injected ; while the horns and ears are veiy warm. 
 
 The animal grinds its teeth, and betrays the existence of colicky pains 
 
 40 
 
626 PATHOLOGY OF PARTURITION. 
 
 by lying clown and getting up, stamping, striking at the belly and turning 
 the head towards the flanks, 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 
 not lie down, 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 
 which are separated — and the discharge therefrom of a fluid at first 
 serous, and either transparent or having a yellow, chocolate, or reddish 
 tinge ; then it 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. 
 Eectal exploration generally discovers the uterus larger than natural, 
 and more or less distended by gas. 
 
 Defsecation is painful, and the faeces 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 Kuminants 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 metro-peritonitis there always occurs — and sometimes very rapidly 
 — an effusion of serum into the abdominal cavity. When this is in great 
 quantity, the 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, contrasting markedly with the tympanitic 
 resonance of the upper regions ; while 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 septicaemia, 
 is generally very rapid, and may not occupy more than a few days — 
 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 fa?tal 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 more than 
 one-half of the number of animals attacked. 
 
 Though so serious, however, in those animals which are about to 
 recover convalescence ensues very rapidly, especially with the Cow. A 
 few hours often suffice to bring alDout such a change for the better, that 
 one could scarcely believe it unless he saw it, and it might excite a doubt 
 
METFdTIS, METRO-PERITONITIS, AND PARTURIENT FEVER. 6l.'7 
 
 as to whether metritis had really been present. In the evening the 
 animal is left in an almost hopeless condition, and next morning it is 
 standing, the eye limpid, the physiognomy bright and cheerful, and it 
 caresses the offspring which previously was unheeded or repelled. The 
 animal has not recovered, however, but it is out of danger, and with a 
 few days' care it may be on the way to convalescence. The decrease 
 in rectal temperature is always a favourable sign. 
 
 But, as has been said, death is the most frequent termination ; and 
 this may occur in two, four, or six days from the commencement of the 
 malady — rarely later. Then all the symptoms become aggravated. The 
 tumefaction of the genital organs increases, and extends to the mamm^ 
 and hind-limbs ; the vulva is covered with ecchymosed patches and is 
 cold ; the vaginal discharge is ichorous and brown in colour, and emits 
 a most ftt'tid odour ; the temperature suddenly falls ; the surface of the 
 body is covered by a cold glutinous perspiration — especially in the Mare 
 — and the animal expires either in a state of profound coma, or in con- 
 vulsions. 
 
 In such cases death may be due to the violence of the inflammation 
 and its extension to the peritoneum, gangrene of the uterus, or to 
 septic infection by absorption of the putrid matters in its cavity, and 
 general poisoning therefrom.^ 
 
 More frequently than rapid recovery, the malady passes into a 
 chronic state. Then the more acute symptoms gradually diminish, 
 the appetite returns, and the animal does not exhibit much suffering. 
 But convalescence is not established — the mammaa remain flaccid, and 
 the secretion of milk is either very scanty or altogether suppressed ; 
 the sweUing disappears from the vulva, but the discharge therefrom 
 persists or is increased in quantity. This discharge is either of a white 
 glairy character — leucorrhcjua ; grayish and grumous, resembling clotted 
 milk ; or red, brown, or sanguinolent. It is always more or less mal- 
 odorous, and sometimes extremely foitid ; more particularly is this the 
 case when, as often happens with the Cow, the discharge is mixed 
 with, or derived from the retention in the uterus of the foetal envelopes, 
 or even the fa'tus itself. In some instances, the croupous exudates 
 which have been formed on the mucous membrane become broken up, 
 and are cast off with the discharges. Franck states that, in one case, 
 a large croupous or false membrane, which had covered the greater 
 part of the interior of the utei-ua, was shed in this way. 
 
 In other instances the cervix uteri contracts, though the mucous 
 membrane is still inflamed ; consequently, the muco-purulent secretions 
 are retained for some time, and the discharge from the vulva ceases. 
 But when the organ becomes distended, it contracts, or it is pressed 
 upon when the animal lies down, or during micturition or defecation ; 
 
 ' Franck mentions that in three instances the dise-ose manifested itself on the d.iy 
 after an ea--y jiarturitii>n, and it liad become so .severe that on the Rrcon<l daj' it was 
 necessary to slauuhter the animals. On the inner surface of the vulvar labia — which 
 was of a dark-red hue — were one to three parturient ulcers, and in a few hours there had 
 occurred an enormous tumefaction of the labia, which extended to the pelvic connective 
 tissue and as low .is the b'Kks, while the dependent parts of the body were al^o involved. 
 Deep scarifications — which caused no pain — were useless, and were not followed by 
 bleeding. On examination of the bodies after death, thrombi were discovered in the 
 uterine and ovarian veins. In these cases the infection seemed to have been derived 
 from an adjoining Cow, which retained the placenta. 
 
 Meyer refers to a ca^e of this kind, in which death ensued during the evening of the 
 day on which the disease manifested itself. He found a large blood-clot in the uterus, 
 and ecchymoses on the intestines. 
 
628 PATHOLOGY OF PARTURITION. 
 
 then the os is forced partially open, and the accumulated fluid escapes 
 in great abundance. Gohier, Chouard, and other veterinary writers, 
 give instances of this singular form of chronic metritis ; they have seen 
 Mares which every forty days, every month, or at shorter intervals, 
 expelled fourteen, sixteen, and even as much as twenty pints of pus, 
 after exhibiting symptoms of colic, followed by more or less marked 
 expulsive efforts. 
 
 The animal soon loses condition ; the appetite is irregular, the skin 
 is unhealthy-looking and clings to the bones ; and though debility is 
 present, oestrum may occur far more frequently than in health, yet 
 fecundation is not possible. Marasmus sets in, with febrile attacks 
 at intervals — pyaemic fever ; and though recovery is still possible, by 
 skilful treatment and long-continued nursing, yet death is only too 
 often the sequel. 
 
 Even when recovery appears to be progressing favourably, relapses 
 may occur, sometimes through the breaking up and diffusion of venous 
 thrombi, which give rise to a pyaemic process, as in the case recorded 
 by Contamine. On the morning after an easy parturition, the after- 
 birth having also been expelled, the Cow began to tremble very much ; 
 the udder was small and flaccid, the back arched, the appetite gone ; 
 there was anxiety, with colicky pains, constipation, and pressure in 
 the right flank caused pain ; the labia of the vulva were apart, swollen, 
 and of a dark-red colour. In three days the animal was much better ; 
 but after three weeks there was a relapse. Petechiae formed on the 
 conjunctivas, the hind-limbs became swollen, bleeding ensued from the 
 skin and nostrils, and there was cough. The Cow finally recovered. 
 
 Occasionally during the subacute or chronic stages of metritis, 
 metastatic formations occur in the lungs, liver, joints, and other parts ; 
 not infrequently there are caseous deposits in the uterus, which may 
 attain such a thickness in its walls as to simulate pregnancy. 
 
 Pathological Anatomy. 
 
 In those cases in which death has taken place and an examination 
 of the body been made, the local and essential lesions are found in the 
 genital organs and peritoneum, and when puerperal septicemia has 
 been present there are indications of general infection of the body. 
 Decomposition sets in early, the tissues are dark-green and foetid, and 
 meteorism is most marked. 
 
 In simple endo-metritis such pronounced and general lesions are not 
 found, nor is the peritoneum involved. In the more acute cases, and 
 particularly those in which there has been septic infection, puerperal 
 ulcers of a dirty greenish hue are generally met with in the vagina, 
 often in the vicinity of the meatus urinarius, and about the labia of 
 the vulva. The mucous membrane is of a dull dai'k-red hue, and 
 swollen in patches by diphtheritic infiltration, or covered in parts by 
 croupous exudates. The bladder may also be implicated, though not 
 to such a serious extent, and especially if the catheter has been em- 
 ployed. In the cavity of the uterus is constantly found a quantity of 
 chocolate-coloured or grayish fluid, composed of efl'used blood, remains 
 of fcetal envelopes, and the secretions of the mucous membranes — all 
 in a more or less advanced state of decomposition, and emitting the 
 most repulsive odour. This fluid contains quantities of epithelial and 
 round cells, fat globules, and septic bacteria. The quantity of fluid 
 
METRITIS, METRO-PERITONITIS, AND PARTl'lUKXT F El' Eli. 629 
 
 varies considerably, according to circumstances — amounting sometimes 
 to many gallons. 
 
 The uterus itself is never contracted as in the normal condition, and 
 it is often two or three times larger than it ought to be. 
 
 The walls of the organ are thickened, friable, softened, intensely red, 
 and infiltrated with sanguinolent serosity, inflammatory products, and 
 pus globules. The mucous membrane is thickened, of a dirty-brown 
 or dark-green tint, livid, softened, ecchymosed in places, and covered 
 here and there with diphtheritic or fibrinous exudates and blood-clots, 
 the latter being chielly found — in the Cow — at the base of the coty- 
 ledons, which are, with the exudates and clots, in process of putre- 
 faction, and are gray, pulpy, and almost detached. Sometimes portions 
 of decomposed fcctal membranes yet remain attached to the cotyledons ; 
 and there are here and there gangrenous eschars, in the form of green 
 or grayish spongy masses of a diphtheritic nature, which are in process 
 of softening and dissolution. In all these alterations — which are 
 usually very notable in the cornu that contained the foetus — there are 
 the characteristic features of Endometritis scptica. 
 
 It is seldom indeed that the puerpei'al or septic inflammation is 
 limited to the mucous membrane. Nearly always it extends to the 
 submucous connective tissue (Metritis jyf'lcgmonosa), which is infiltrated 
 with an a^dematous transudation ; or it becomes the seat of acute 
 inflammatory (t-dema, in which the tissue swells, becomes tumid, and 
 its interstices tilled with fluid, small cells, and a gelatinous, semi-solid 
 material The muscular tissue is swollen and softened, and a dark 
 fluid flows from it. 
 
 The subperitoneal connective tissue of the uterus may suffer in like 
 manner, and undergo necrotic softening and putrefaction ; while the 
 serous membrane itself becomes inflamed (Metro-peritonitis). 
 
 When this takes place, the abdominal cavity contains a quantity of 
 reddish, turbid, sanious serosity, in which are flakes of lymph. The 
 lining membrane of this cavity, and especially that covering the uterus, 
 is highly inflamed, and its surface is covered with pseudo-membranous 
 layers of fibrin ; while adhesion may have taken place between the 
 different organs it covers. In some cases the inflammation of the peri- 
 toneum is not so difluse, and is more or less limited to the uterus and 
 organs immediately adjacent. 
 
 In other cases, again, the phlegmonous inflammation extends to the 
 pelvic connective tissue (raranictritis), and then there is diffuse acute 
 cedeina, inflltration with pus, or even abscesses. 
 
 Indeed, in the uterine connective tissue there may be, in different 
 parts, active cell proliferation and abscesses, and if the animal chances 
 to live beyond a certain period, these terminate in caseous inspissation, 
 or even perforation into the abdominal cavity. 
 
 A very important pathological lesion, and one which is not infre- 
 quently noted in parametritis, is thrombosis of the veins and lymphatics. 
 Thrombosis of the uterine veins has been observed in animals — solid, 
 white, or yellowish thrombi adiiering to the internal surface of the 
 vessels, and extending towards the larger venous trunks — even as far 
 as the posterior vena cava. Sometimes the breaking-up of these 
 thrombi causes relapse, and embolic pyaemia of the \un<j,s or neighbour- 
 ing organs. When septic infection does not occur, bruising of the soft 
 parts during diflicult parturition may give rise to thrombosis of the 
 veins, with secondary pyaemia. This may explain the occurrence of 
 
630 PATHOLOGY 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 be due to the direct 
 influence of the infecting matter, but more frequently it is caused by 
 the inflammation of the connective tissue around the vessel. The pro- 
 ducts 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 vpith pus [Purulent lymphangitis), 
 and the neighbouring glands are swollen andsoftened. This thrombosis 
 of the lymphatics has been considered a favourable circumstance, since 
 the 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- 
 sidered 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 
 efl'erent 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 dirfectly connected by means of this tissue — such as the 
 ovaries. The peritonitis may extend through the diaphragm to 
 the pleurae, or the inflammation in both membranes may be due to 
 ichorrhsemia. 
 
 In those eases in which 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- 
 static abscesses in such parenchymatous organs as the lungs, liver, 
 spleen, kidneys, etc. 
 
 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 
 dark-coloured and non-coagulable, ecchymoses are found in various 
 organs and tissues, and there is a marked tendency to rapid putrefac- 
 tion. The elementary structures of organs show the commencement 
 of an acute inflammatory process — the fine granular infiltration 
 or "cloudy swelling," fatty degeneration, or even disintegration of 
 cells. 
 
 It has been already stated that there is nothing exceptional in par- 
 turient fever, and so far as its pathological anatomy is concerned, the 
 same alterations are observed in non-parturient subjects. Parturition 
 only predisposes the animal 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 
 of the uterus at this time are in a favourable condition for the reception 
 and action of this septic material. In animals which have succumbed 
 
METRITIS, METROPEIIITONITIS, AXD PARTURIENT FEVER. 631 
 
 after the operation of ovariotomy, similar pathological alterations arc 
 found. 
 
 With regard to chronic metritis, various changes have been observed. 
 In some cases the uterus has contained a considerable quantity of fetid 
 pus, or muco-pui-ulent 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 vaginal mucous membrane is also infiltrated and indurated in some 
 cases. 
 
 Causes. 
 
 The predisposing 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 ai'tificial 
 removal of the fojtus 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 or lacerated in 
 returning it, is another cause. Ketention of the foetus or foetal 
 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, absoi-ption 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 cen'ix 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 
 
632 PATHOLOGY OF PARTURITION. 
 
 material. Infection less frequently takes place from the interior of 
 the uterus under normal conditions, as injury is not so likely to occur 
 there from the passage of the foetus. Exceptionally, it may take place 
 in the uterus through the cotyledons, when some of these are torn 
 during the separation of the foetal membranes. 
 
 As has been mentioned, the parturient period is eminently favourable 
 for the absorption of septic matters ; as the mucous membrane of the 
 genital canal is exceptionally vascular, and the bloodvessels and 
 lymphatics are greatly developed. 
 
 Auto-infection occurs generally when there is a fresh wound, and 
 when the foetus is dead, and, still retained in the uterus, has become 
 decomposed through the access of air; or from retention and putre- 
 faction of the envelopes. The ichorous putrefaction of wounds, or 
 new growths in the uterus or vagina, may also lead to septic in- 
 fection. ^ 
 
 Embryotomy, when the foetus is decomposing, is a dangerous 
 operation if a wound chances to be inflicted during its performance. 
 It is the same with the removal of the foetal envelopes. - 
 
 With the Mare, removal of the foetal membranes does not appear to 
 be dangerous, and their retention is not usually followed by infection, 
 for it is not until the second or third day after parturition that their 
 decomposition usually commences ; so that if small injuries have been 
 produced during birth, it is most likely that they will be suppurating 
 or granulating by that time, and thus be proof against the passage of 
 putrid matter. If, however, a fresh wound is made, or the granula- 
 tions are injured by mechanical means, then removal of the putrid 
 envelopes is full of risk. Foelen mentions that a Cow had a wound 
 on the vulva, and this was infected by putrid membranes ; on the 
 fourth day after, the animal died with all the symptoms of parturient 
 septicaemia. 
 
 External infection does not appear to be so frequent as auto-infection 
 among animals. It takes place when septic materials are brought to 
 
 ^ Franck gives the following illustrations, which could be easily and largely sup- 
 plemented : 
 
 1. The fcEtus of a Heifer was dead in the uterus, and much distended with gas. 
 Embryotomy had to be resorted to in order to extract it ; and this was accomplished, 
 apparently, without causing any noticeable injury to the vagina. On the third day 
 septicaemia became manifest, and the animal had to be killed. 
 
 2. A Cow gave birth to a Calf in a normal manner ; but the hoof of the young 
 creature on its passage through the vagina made a small wound. Twenty four hours 
 afterwards a second Calf in a state of putrefaction was removed by manual force, but 
 without injuring the Cow. In two days the latter was attacked with puerperal fever, 
 and was killed. 
 
 3. Mombrini removed a dead Calf from the uterus by embryotomy. Septic inflam- 
 mation of the uterus and peritoneum set in, and the Cow died on the seventh day. 
 
 4. It is well known that Bitches which retain the foetus in the genital canal for 
 any length of time (eighteen hours or thereabouts), frequently perish from SeptiJccemia 
 pue7-peralis. This appears to be due to the fact that the puppy so retained quickly dies : 
 owing to the shortness of the umbilical cord, the early separation of the placenta, and 
 birth taking place in the amnion. The young creature also speedily putrefies, and the 
 large raw surface formed by the maternal placenta is a ready inlet for the direct in- 
 troduction of the septic material into the blood. Speedy death of the Bitch is the 
 consequence. 
 
 - A Cow retained the fcetal envelopes for five days after parturition, when they were 
 removed. The operator had evidently wounded a cotyledon or the uterine mucous 
 membrane in doing so, as his hand was stained with blood. In three days the animal 
 was affected with parturient fever and died. No injury to the uterus could be detected 
 on post-mortem examination. 
 
.^[ETRITIS, .\fETROPERITOXITIS, AM> I'ARTUPdEXT FEVER. 633 
 
 the recent wounds or lacerations of the genital organs by any means — 
 as directly by the hand, instruments, sponges, straw, etc., or indirectly 
 through the atmosphere, when the septic micro-organisms are sus- 
 pended therein — the so-called miasmatic infection. There is a close 
 relationship between abortion and parturient fever — a Cow suffering 
 from the latter being undoubtedly dangerous in a stable or pasture 
 where there are a number of pregnant cattle ; while a case of abortion 
 or placental retention occurring in a stable, might be considered nearly 
 as serious among parturient Cows. 
 
 A retained and decomposed placenta is undoubtedly a fertile source 
 of parturient fever. Franck refers to three instances, in which the 
 Cows calved in a normal manner and the fcctal membranes came away 
 in four hours after ; but a trifling wound existed in the mucous mem- 
 brane, at the entrance to the vagina. In two or three days afterwards 
 these animals showed very acute symptoms of parturient fever. They 
 stood near another Cow whose uterus contained a decomposing placenta. 
 The emanations from the vulva or discharges of this animal had, there 
 can scai-cely be a doubt, infected the three ; or the soiled straw may 
 have been the means of conveying the septic matter to the vulvar 
 wounds ; the tail of the Cow may even have been an active agent in 
 throwing the vaginal discharges about, as it is generally much soiled 
 by them. 
 
 External infection may 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 
 foetus ; and the operator himself may be the means of infecting. An 
 instance of this kind is related as occurring in Switzerland, during 
 1861-63 ; in a large cowshed containing about 200 head of cattle, 
 suddenly a number died of parturient fever, though they had no 
 difficulty 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 
 animal, cleaned it, etc., in assisting the others during parturition, had 
 conveyed the infection to them. And it is quite possible that many 
 serious and wide-spread outbreaks of parturient fever in cattle are 
 due to an obstetrist who has been engaged in removing a dead fcx'tus 
 or a retained placenta. The same cause may be in operation among 
 Ewes 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 scpticiis 
 ])ucrperalis of Arloing?) being the active agents in engendering the 
 disease. 
 
 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 
 other cases, when only a small 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. 
 
634 PATHOLOGY OF PAETUPJTIOX. 
 
 Indeed, we may have simple metritis -without much constitutional 
 disturbance. 
 
 Prognosis. 
 
 The prognosis of parturient fever must be, in the majority of cases, 
 unfavourable, as the veterinary surgeon is only too frequently not called 
 in until too late. When infection is but slight, or when the local 
 inflammation is not very severe, then careful treatment may restore the 
 patient to health. It must not be forgotten, however, that what 
 appears at first a mild form of metritis, may become a very grave attack 
 of this fever. 
 
 Prophylaxis. 
 
 From what we have said with regard to the causes of parturient 
 fever 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 
 unfortunately inflicted, cleanliness and careful dressing with some such 
 antiseptic as carbolic acid, should be enforced. This is especially 
 necessary when extraction of a dead foetus or retained placenta takes 
 place. 
 
 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 they 
 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 foetus or fcEtal membranes, is also dangerous among them. The 
 same remark applies to animals — such as Ewes and Cows — at pasture. 
 The soiled ground should be most carefully disinfected with lime, when 
 possible, and pregnant or parturient animals kept away from it. 
 
 Trcatvient. 
 
 Metritis, metro-peritonitis, and parturient fever being gi'ave 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 foetus 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 sublimate, 1 to 2,000 — 3,000. The first thing to be attended 
 to in treatment is the condition of the uterus, and the removal of any 
 infective 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 carboUc acid and olive 
 oil (1 to 10), applied by means of a brush or feather ; or salicylic acid 
 1 part, spirits of wine 20 parts, warm water 24 parts. 
 
 After the interior of the uterus has been cleansed by injections of 
 
 1 Cresol, cresj'l, or cresylic acid, which enters largely into the composition of Jeje's 
 Fluid, has been extolled as an excellent antiseptic, and is preferred by many Continental 
 veterinarians to corrosive sublimate and carbolic acid. It is not poisonous, like these, 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 
 reasons. 
 
METiiiris, METRn-rEiiiTuyrns, AM) PAirrrniEXT fkvki:. 035 
 
 warm water, an injection of carbolic acid solution (1 to 20 — 50) boro- 
 glycerine (1 to 20—40 of water), or the above solution of corrosive 
 sublimate, should be made every day, and the wounds, if accessible, 
 dressed at the same time. Permanganate of potash (1 to .00 of water) 
 may be employed to inject into the genital canal, when the disease is 
 less acute. 
 
 All tluids injected should be warm — 80° to 100' Fahr. ; and solution 
 of opium or extract of belladonna may be advantageously employed in 
 the uterine injections, to allay pain and straining. 
 
 The external treatment must be hot fomentations, cataplasma, or 
 counter-irritation to the surface of the abdomen — or all three combined. 
 The 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 no specific remedy with which to neutralize the action of the 
 septic matters in the blood and tissues. The sulpliites 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 lai'ge 
 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 liave been poisoned by this matter, 
 often recover after profuse and fcctid 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 ammoniac 
 (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 with the 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 scquche of the disease treated according to their indications. 
 
636 PATHOLOGY OF PAETUPJTIOX. 
 
 Peritonitis may be combated by the exhibition of large and frequent 
 doses of calomel Van den Eide and Clement were successful in treat- 
 ing serious cases of metro-peritonitis by administering calomel, and 
 applying mercurial ointment to the abdomen. 
 
 When the pain is very severe, mustard may be applied to the surface 
 of the abdomen, and, in the case of small animals, linseed-meal poultices 
 on which laudanum has been sprinkled ; while subcutaneous injections 
 of morphia may be freely resorted to. When great exhaustion or 
 collapse is present, large and frequent draughts, containing diffusible 
 stimulants, must be administered, with nutritious gruel. To the smaller 
 animals milk or beef-tea may be given. 
 
 In the chronic form of metritis, the same treatment may be adopted, 
 so far as the genital canal is concerned ; and if there is vaginal dis- 
 charge, the treatment recommended for leucorrhoea will be suitable. If 
 the uterus is not contracted, this may be promoted by the exhibition of 
 preparations of ergot of rye. 
 
 In handhug animals suffering from parturient fever, or in examining 
 the carcases of those which have died, the veterinary surgeon should be 
 on his guard against inoculation. More particulai'ly is this necessary 
 when exploring the genital canal of the living animal, or removing a 
 putrescent foetus or foetal envelopes. The arm and hand should then be 
 well smeared with oil or lard, and thoroughly cleaned with carbolic acid 
 soap when the operation is completed. 
 
 CHAPTEE IT. 
 Parturient or Puerperal Apoplexy or Collapse. 
 
 Peehaps no disease affecting animals has received a greater amount of 
 attention, or given rise to more widely divergent opinions as to its 
 nature, than the malady to which, chiefly for convenience, we have 
 given the designation of parturient apoplexy or puerperal collapse. 
 Veterinary literature, since the commencement of the century, teems 
 with descriptions and discussions relative to the disease, and the most 
 eminent veterinary pathologists still appear to be far from unanimous 
 as to its nature. The great number of names given to it — some of which 
 either indicate the opinions prevalent with regard to its pathology or 
 causes, or point to prominent symptoms — are evidence of the un- 
 certainty which has prevailed, and now prevails, with regard to it. For 
 instance, it has been designated puerperal fever, nervous ov paralytic form 
 of puerperal fever, milk-fever, puerperal apoplexy, paraplegia, puerperal 
 collapse, vitulary fever, vitulary apoiilexy, vitulary paralysis, processus 
 puerperal, puerperal typhus, calf fever, dropping after calving, eclampsia 
 puerperalis, etc. 
 
 In France it is usually designated " Vitulary Fever," while in 
 Germany it is commonly known as " Calving Fever." In England it 
 is usually designated "Parturient Apoplexy," "Puerperal Fever," 
 " Milk Fever," etc. 
 
 The malady appears to have been known from an early period, but 
 the first exact description of the symptoms we can find is that given by 
 Skellett,^ who names it " Milk Fever, or Dropping after Calving "3 in the 
 
 ^ Practical Treatise on the Parturition of the Coiv. London, 1S07. 
 
PARTURIENT APOPLEXY— PUERPERAL COLLAPSE. 637 
 
 following year it is alluded to by Jorj;,! who evidently knew Skellett's 
 work, as the latter's plates are copied. Some years after tliis period 
 the disease began to attract much attention, as with improvement 
 in the breeding of Cattle it gradually became more prevalent, until now 
 the literature of the subject is very extensive. 
 
 Without entering at this moment into a discussion as to the nature 
 of the disease, it may be suHicient to say that it is a very serious and 
 acute affection, almost special to Cows in the parturient state — and 
 particularly those of the improved Milch breeds, in which it is frequent; 
 that its invasion is sudden and its course rapid ; and that it is character- 
 ized by loss of consciousness and paralysis, seldom by convulsions. It 
 is extremely fatal, death ensuing in a very short time ; or if recovery 
 takes place, this is sometimes nearly as rapid as the attack was sudden. 
 It has been confounded with parturient fever, or considered to be only a 
 nervous or paralytic form of that malady ; while Franck, who appears 
 to have studied it very carefully, is of opinion that it is identical with 
 the eclampsia of the human female, and considers that "puerperal 
 eclampsia " {Eklampsic in Folgc dcr Geburt) is the best designation for 
 it. He asserts that to look upon it as a " fever" is a mistake, as a high 
 temperature — the sure sign of such a condition — is not pi-esent ; while 
 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. 
 
 Symptovis. 
 
 The disease sets in suddenly after calving, and without any premoni- 
 tory symptoms. It may attack the Cow so early as twelve or 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 offered all the symptoms 
 of the disease seven weeks after calving. 
 
 In some instances, before the symptoms commence, the lacteal secre- 
 tion is either diminislied 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 
 faeces are hurriedly expelled, and the animal becomes indifferent to its 
 Calf. There is often a shivering fit, but this is not followed by 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 longer stand, 
 and it either lies down, or falls on the floor of the stall. There it 
 may remain tranquil, merely moaning or bellowing, or striking with 
 its feet at the belly as if affected with colic, and making convulsive 
 ^ Anltitung zur Ehier Raiionelien OeburUhiilfe, etc., /ur Thierdrzte. 
 
638 
 
 PATHOLOGY OF PARTURITION. 
 
 movements. Other signs of congestion of the brain may be more or less 
 marked ; the ears and horns may be warmer than natural, and in 
 addition to the 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 
 time 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. 
 
 
 
 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 afforded, 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 per 
 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. 
 
PARTURIENT APOPLEXY'— PUERPERAL COLLAPSE. 639 
 
 The respirations may be increased to eighty or ninety per minute, 
 and this occurs more particularly when tliere is pneumonia, duo to the 
 passage of foreign matters into the bronchi — an accident frequently 
 noted in this disease. When the coma and paralysis are very marked, 
 the respirations are often slow and deep — from eight to live in the 
 minute, sighing or stertorous — indicating paralysis of the soft palate ; 
 at other times it is calm and regular. All these variations may be ob- 
 served in the same animal — the hurried, stertorous breathing succeeding 
 the quiet and deep respirations in a very abrupt manner. As the pulse 
 increases in frequency the breathing sometimes becomes slower. 
 
 The temperature of the body is not increased, as a rule ; on the 
 contrary, it is very often below the normal standard when coma sets 
 in — Harms and Adams have found it as low as 35' Cent. (95' Fahr,). 
 According to Thomassen,^ it may be 102-2^ to 103° Fahr. at the com- 
 mencement, and in a few hours fall to 100', or even 9G\ to rise again 
 when there is improvement. Cases have been reported in which it 
 was as low as 89"6' and 90', and in the latter it ascended in three 
 hours to 100', the animal recovering. It is possible that, in the cases 
 in which these very low temperatures were noted, the anal sphincter 
 has been relaxed, so that the air passing into the rectum would make 
 it cooler. The extremities are generally icy cold, and the surface heat 
 of the trunk is irregularly distributed. 
 
 The nmcous membrane of the mouth is pale, and saliva accumulates 
 about or flows continually from it (hence the disease is soinetimes 
 designated Ahtropfeln aus dcm Manic by the Germans). Food and 
 water are refused, and, indeed, at an early period there appears to be 
 paralysis of the pharynx and oosojihagus, and if care is not taken the 
 solids or fluids attempted to be administered may And tlicir way into 
 the air-passages, and if they do not quickly produce asphyxia, they 
 will probably give rise to pneumonia. When fluids are administered, 
 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 
 pneumogastric 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 secretion of milk may be diminished or suspended, and some- 
 times very suddenly, even before the voluntary muscles are paralysed ; 
 in other instances it may be unintemipted. 
 
 W' hen the animal is about to recover, these symptoms 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 
 ^ Reaitil dt Midtcine Veteritiaire, 1889, p. 491. 
 
640 PATHOLOGY OF PARTURITION. 
 
 tongue is moved about ; the head is raised ; attempts are made to get 
 up ; it elevates the fore-part of the body, and after some struggles 
 finally gets on its hind-legs and stands. The first favourable indications 
 are elevation of temperature and resumption of the intestinal peristalsis. 
 The latter is assured vs^hen the rectum is found to be filled with ftBces, 
 after 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 commencing to ruminate ; its calf is caressed ; urine and fseces 
 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, 
 v^hich 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 collapsus — 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 
 imperceptible ; the breathing is puffing, 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 
 from 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 
 of death. 
 
 Dtiration, Terminations, and Complications. 
 
 The duration of the disease is very brief. There are instances on 
 record in 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 
 days. 
 
 If there are no complications, the terminations are death or recovery. 
 The chief complications are broncho -pneumonia, milk -metastasis, 
 amaurosis, temporary or permanent paralysis (sometimes in the form 
 of monoplegias), 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 
 medicine — 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 pai^turient malady. Indeed, the animal may perish 
 from suffocation alone when the quantity of matter that passes through 
 the larynx is considerable. And not infrequently, when the creature 
 has lingered for a few days and is then killed, the existence of pneu- 
 monia from this cause will be discovered on making an examination 
 
PARTURIENT APOPLEXY— PUERPERAL COLLAPSE. G41 
 
 of the boily. Ailani^ believes that ten per cent, of the Cows which 
 recover from parturient collapse eventually die of pneumonia, due to 
 extraneous matters introduced during the paralysed condition of the 
 pharynx. Sometimes the animal appears to be almost recovered from 
 the attack of parturient apoplexy, when symptoms of lung congestion 
 or intiammatiou are suddenly developed, and death soon occurs. 
 Paralysis of the a>sophagus, which may persist for some days after 
 recovery, has in some cases been the cause of death from choking. 
 
 Another complication of parturient apoplexy, is the so-called milk- 
 metastasis which does not appear to have been noted in this country, 
 but which is alluded to by Violet in France, Bentele, Born, and Franck 
 in Germany, and AUemani in Italy. Occasionally there is observed 
 after an attack of the disease, a white, milky-looking emulsion similar 
 to chyle, expelled as urine, or as a discharge from the nostrils ; and at 
 one time it was imagined that this was the milk which, instead of 
 being got rid of by the mammie, was absorbed or retained in the blood, 
 acted upon the nervous centres, and was then expelled in this vicarious 
 manner. 
 
 Though no analyses appear to have been made of this fluid, Franck 
 is of opinion that the fluid is only the normal secretions mixed with 
 lymph. The milk-metastasis theory is untenable, as it is quite opposed 
 to what we know of the lacteal secretion, especially during this disease.'-' 
 
 With regard to parah/sis, this is not evident until the animal recovers 
 consciousness, and begins to look bright and anxious for food, when it 
 is found that it cannot be made to rise. The paralysis may affect 
 various parts, but it is usually limited to one limb, to the two hind- 
 limbs (parapkiiia), or to one side of the body {hemiplegia). Saake says 
 he has sometimes seen instances in which the fore-limbs were paralysed, 
 while the posterior ones could be moved freely. In certain cases the 
 paralysis of limbs is accompanied by muscular atrophy. 
 
 Amaurosis is readily discovered from the animal being blind. It is 
 generally persistent. Breulet, Gabler, Dommelen and Festal have 
 recorded instances. 
 
 Gangrene of certain parts — feet and teats — is often met with in some 
 parts of Holland. The Cow will have recovered from an attack of 
 parturient collapse from ten to fifteen days, when a fcetid fluid is found 
 exuding from between the claws and around the coronets of the hind- 
 feet ; soon a line of demarcation forms about the middle of the shanks, 
 and this is quickly followed by complete sphacelus of the extremities. 
 
 * Worhen-^rhrijl fiir T/iier/ieilhinilf, 1S70-71. 
 
 - I5entele ( Wochenarhrift fur ThierUtilkundc, IS.')?, p. 145) states that a Cow attacked 
 by calvingfever, lay for sixty hours in a state of lethargy. The urine, which was passed 
 six hours afterwards, waa milk (?) with clots — as if boiled — in it. The animal recovered 
 from the attack, but some weeks later it had to be killed in con8c<{Uence of diseased lungs 
 — proK-ibly pm-nmonia from extraneous m.itters. 
 
 Born (Anacker's I hifrnrzt, 1871, ]). 270) relates a case in which milk flowed from the 
 nostrils of % Cow that was affected with calving-fever. 
 
 Allemani (// Moliro Vftf.rinar'ta, 1870, p. 289) tells us of a Cow-proprietor who 
 believed one of his CoW'* pa-nsed milk instead of urine. The supposed milk — which w.is 
 of a yellowish- white clour — contained epithelium from the bladder, a large (piantity of 
 epithelium from the kidney, lymph-corpuscles, and albumin. After some days this 
 condition disappeared. The fluid did not coagulate spontaneously. 
 
 Violet (Saint-Cyr"s TraiU d'Obsttfnque Vileriiiaire, p. 1072) found a similar condition 
 of the urine. This came away through the catheter with much force, and it was so 
 white that the attendants thought it was milk. It was also foamy and effervescent, like 
 champagne or bottled beer. The animal recovered, but the urine was slightly effervtscent 
 for some days. 
 
 41 
 
642 PATHOLOGY OF PARTURITION. 
 
 The animals are slaughtered. From time to time in the same country, 
 dry gangrene of the teats is reported as a sequel of collapse. 
 
 Stoellings 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 limb 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, Franck states that 294 either died or 
 were 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 recover. 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 critermm," says Lanzillotti-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 lead 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- 
 priety of utilising the flesh in this manner, there have been difierent 
 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 feve?- — 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 
 
PAUTriUKXT APnl'LEXY—rrEIU'EnAL COLLAl'SE. 013 
 
 hours after calving, then it nearly always terminates in death. It is the 
 same when the attack is very sudden and severe ; when there is marked 
 coma, rapid and general loss of heat, great distension of the rumen 
 (which may speedily cause asphyxia), violent convulsions, deep mucous 
 niU\s in the trachea and bronchi, lustreless eyes — insensible to light or 
 touch ; paralysis of the digestive organs — indicated by meteorismus, 
 torpidity of the bowels, so that the rectum remains empty when it has 
 been evacuated ; as well as paralysis of the pharynx and cisophagus — 
 shown by inability to swallow; suspended lacteal secretion, relaxed 
 sphincters, putling breathing by the mouth, pendulous lower jaw, and 
 total suppression of milk. 
 
 The favourable indications are maintenance of the normal tempera- 
 ture in body and limbs, or the slightest elevation when this is low ; natural 
 tint of the mucous membranes; expulsion of the urine either spontane- 
 ously or when the linger is introduced into the urethra ; and, according 
 to Schaack, " a mode of respiration in which the animal retains its 
 breath for an instant, then allows the air to escape by a long and slightly 
 plaintive expiration." 
 
 It is likewise a very favourable sign when the faeces are passed. A 
 return to consciousness is also, of course, a happy omen, and particularly 
 if the animal attempts to rise, desires food or drink, and the lacteal 
 secretion begins to reappear. 
 
 In some cases, however, there appears to be slight recovery, and yet 
 fatal relapse takes place. The pulse will also aid in forming an opinion 
 as to the probable termination of the malady. 
 
 The longer the disease continues, so the more hope there is of re- 
 covery ; though there is all the more danger of pneumonia from extrane- 
 ous matters in the bronchi, if the coma or the paralysis of the muscles 
 of deglutition lasts for some days. Weigand says that when an animal 
 continues lying for six to eight days, unless it can eat and drink, it 
 should be killed. 
 
 Causes. 
 
 The unanimous opinion with regard to this disease is that it is peculiar 
 to the puerperal condition, and that it has a close relation to the state 
 of the Cow previous to parturition, and to a more or less marked breed or 
 individual predisposition. So far as breed is concerned, it is a fact that 
 the Cows most liable to be attacked are those in which the secretion of 
 milk is abundant — "deep milkers" — and which are in a more or lees 
 plethoric condition. \Vith the perfecting of Cows for the production of 
 milk, this disease has become vastly more prevalent. Numerous 
 observers testify to this fact. " Since in Algau," writes Bentele, " the 
 Cow has been so largely utilised for the production of cheese — converted 
 into a milk machine, in fact — the previously unknown calving-fever has 
 appeared." 
 
 So it is, that in countries or districts where Bovines arc reared more 
 for their Hesh than their milk, parturient 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 breeds of milch Cows, and the 
 malady has extended with the extension of these breeds. For instance, 
 in North Ilolland it appears to have been completely unknown forty years 
 ago ; but when attempts were made to improve the milking qualities of 
 the Cows by importing numbers from South Holland — where they are 
 " deep milkers," and where the disease is very frequent — then it showed 
 
6ii PATHOLOGY OF PAETURITION. 
 
 itself, much to the 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, 
 while in others it is quite frequent. 
 
 With regard to individual predisi^osition, there can be no doubt that 
 even in these predisposed breeds there are animals which suffer from 
 parturient apoplexy more than others ; and instances are reported of 
 Cows being attacked after several consecutive births. 
 
 Plethora, no doubt, exercises a great influ-ence in the production of 
 the disease ; for it is chiefly among well-fed Cows — particularly those 
 kept for milk in the vicinity of large towns, which seldom or never leave 
 their stable, and are abundantly nourished immediately before calving 
 — that parturient apoplexy prevails most seriously and extensively. 
 Even among Cows at pasture, when the herbage is luxuriant, the 
 disease 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 
 fed during a long winter, are abundantly supplied 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 (Ehenish 
 Prussia), and that the majority were Cows which, bought lean in 
 Holland, some time before parturition, 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 
 have made similar observations. It has also been remarked that a 
 uniform, 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. 
 
 The risk is all the greater if the secretion of milk has been suspended 
 for 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. 
 Thus it is, that while the disease is prevalent in the cowsheds of towns, 
 or in 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 developvient of lactation, has also a powerful 
 influence. When the secretory function has reached a certain point, 
 the Cow 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 
 lactiferous 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 fourth, 16 after the fifth, 2 after the 
 
 1 Maqazin fiir Tlderhtillcunde und Viehzucht, 1855. 
 
 - Ibid. 
 
 ^ Veterinarian, 1851. 
 
PARTURIENT APOPLEXY— PUERrERAL COLLAPSE. G45 
 
 sixth, 3 after the eighth. After the third Calf, or even previous to its 
 birth, dairy-keepers are averse to purchasing the bettor-bred milch Cows, 
 
 Temperature 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, nmst favour congestion of these organs. 
 Therefore it is that currents of cold air, lying on cold ground, and cold 
 fluids ingested innnediately after parturition, have been looked upon as 
 powerful occasional causes. Sanson thinks that the sudden expulsion 
 of the blood so abundantly contained in the uterine mucous membrane 
 and cotyledons — and which should bo only slowly diffused — forces that 
 fluid into the neighbouring vessels, and surcharges them beyond measure; 
 while Ayrault 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 w^eather. 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 develop- 
 ment on a peculiar condition or epizootic constitution of the atmosphere, 
 but in what this consists no one has attempted to explain. K()hne 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 the puerperal fever of woman to the parturient processes in 
 the Cow, but of this there is little evidence indeed ; wliile others, as 
 already mentioned, imagine that it is merely a nervous form of parturient 
 fever, and due to blood-poisoning. 
 
 Giinther, very many years ago, and a few others more recently, fancied 
 it was produced by a moral infiiiencc — the removal of the Calf soon after 
 birth, which distressed the Cow. But it was forgotten that tlie malady 
 sometimes occurs when the Calf is with the Cow, and sucking ; and 
 that other creatures in which the moral faculties are more highly 
 developed, and which exhibit great anxiety and distress on being 
 deprived of their progeny, do not suffer from parturient apoplexy. 
 Besides, the disease is no more prevalent in those countries or districts 
 where the Calves are taken away from the Cows at an early period, 
 than where they arc allowed to remain with them. 
 
 Others also have attributed the occurrence of the disorder to mental 
 excitement during the act of parturition ; but surely this excitement 
 must be greater with the first Calf or with the second — when the 
 disease seldom appears — than with the third, fourth, or fifth Calf, when 
 it is so frequent. Not only this, but it is a notorious fact that parturient 
 
■646 PATHOLOGY OF PARTURITIOX. 
 
 apoplexy, in. almost every case, follows an easy and rapid expulsion of 
 the foetus without assistance, and ejection of the foetal membranes at the 
 ordinary time. Indeed, parturition is generally wonderfully easy and 
 the opposite of abnormal. So much is this the case, that Kohne boldly 
 asserts that a difficult or protracted delivery is never followed by this 
 disease ; and another authority (Banderschieren) is no less positive in 
 declaring that if a Cow has a difficult calving, or if the placenta is re- 
 tained, there is little reason to apprehend an attack of the disease. But 
 this statement is not absolutely correct. 
 
 The more rapidly the uterus contracts and resumes its normal size, 
 so the more danger there is of parturient apoplexy ; while the longer it 
 remains relaxed or the membranes are retained in it, so the chances 
 are diminished. In the examination of the bodies of Cows which have 
 died, the uterus is generally found very firmly contracted. Before the 
 expulsion of the foetal membranes, the disease is exceptionally rare. In 
 a very few cases, the attack has commenced during parturition, and in 
 still fewer before birth, when the lacteal secretion had not appeared. 
 
 Constipation and gastric repletion have been held by one or two 
 writers to be causes, and others attribute it to over-repletion immediately 
 before parturition. 
 
 These are the chief causes which have been given as operating in 
 the production of this grave affectiota ; and it will be seen that they 
 are sufficiently numerous and diversified to prove that the nature of 
 the disease is obscure — so far at least as its etiology is concerned. 
 The chief points to be remembered may be stated as follows : parturient 
 apoplexy, as a rule, attacks Cows within one to five days after parturi- 
 tion, and especially when that act has been easy, prompt, and natural ; 
 the animals which are affected are those of the higher breeds, good 
 milkers, in a state of plethora, and pluriparse ; one attack predisposes 
 to another. This leads to a consideration of the iMthological anatomy 
 and nature of the malady. 
 
 Pathological Anatomy. 
 
 Notwithstanding the numerous, characteristic, and striking symp- 
 toms which mark this disease, the post mortem appearances, no matter 
 whether the animal has been killed or allowed to die, are for the most 
 part of a somewhat varied character. In the majority of the descrip- 
 tions there is much confusion, the lesions of parturient fever being 
 mistaken for those of parturient apoplexy, and vice versa, just as the 
 two diseases are confounded with each other. In this malady the 
 generative organs are usually little changed ; the uterus may be con- 
 gested — which it always is immediately after parturition, or it may 
 even be paler than usual ; but it is generally firmly contracted. 
 
 The digestive organs are also usually normal, or their bloodvessels 
 are much distended — perhaps due to paralysis of the vaso-motor system 
 of nerves. The rumen is distended with gas in many cases, and the 
 third compartment of the stomach is often filled with hard dry food 
 between its leaves, while the intestines contain somewhat hardened 
 faeces. The gall-bladder is sometimes much distended. The lungs 
 are normal, perhaps slightly emphysematous ; at other times they are 
 congested, or in different stages of pneumonia if foreign matters have 
 obtained access to the air-passages. The examination of the brain 
 has not yielded very satisfactory or constant results. Some authorities 
 have not discovered any pathological lesions worthy of note, either in 
 
PARTURIENT APOPLEXY— PUERPERAL COLLAPSE. 647 
 
 the brain or spinal cord, or their envelopes ; while others have found 
 well-marked and important lesions. These varied from venous con- 
 gestion to oedema, ana)mia, and exudation. Violet, in addition to 
 finding' a (juantity of foul-smellin;^' reddish lluid in the uterus (which 
 was not intlamed), observed congestion of the pia mater with very dark 
 blood ; there was also congestion of the vessels in the brain tissue, and 
 a long clot in the great vena Galcni. 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 Binx has observed sanguineous extravasation and 
 gelatinous matter 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 oljlongata, 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 uerves has been 
 involved. 
 
 Nahire. 
 
 With regard to the nature or efTicient cause of the disease, thei-e has 
 been a great diversity of opinion, and even now the most eminent 
 veterinary authorities are not 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 imi)action of the digestive organs 
 with hard dry food. But such impaction nuiy 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 live heads : 1. Ilyperaimia of the nerve-centres ; 
 2. Anirmia of the nerve-centres ; 3. Derangement or paralysis of the 
 nerv'e-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. HVPER.EMIA OF THE Nerve-Centres. — Sincc 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 nen-e-centres. Festal found blood-clots beneath the 
 
648 PATHOLOGY OF PARTURITION. 
 
 cerebral arachnoid membrane, which he attributed to hyperaemia. In 
 1853, Noquet attributed the congestion of the trisplanchnic nerves and 
 cerebro-spinal nervous system which he constantly found, to plethora, 
 engorgement of the stomach, and intensity of the milk-fever. 
 
 For Sanson,! the collapsus of parturition is the consequence of a 
 sudden disturbance in the physiological condition of the uterus after 
 parturition, consisting in the abrupt removal of blood which congested 
 the organ at that time ; as during gestation a large portion of that 
 fluid is diverted towards the pelvic region, where the uterus is lodged. 
 After parturition the mucous membrane and cotyledons of the organ 
 have lost their function, and the enormous quantity of blood they con- 
 tained is suddenly thrown into the circulation, surcharges the neigh- 
 bouring vessels beyond measure, and produces collapse ; this diversion 
 of the blood is greatly favoured by cutaneous chills. In proof of this, 
 at the autopsies he made, Sanson affirms that the mucous membrane 
 and cotyledons were always found bloodless, and of a pale-yellow 
 colour. 
 
 This theory has much analogy to that of Franck, which will be 
 alluded to presently. In 1858, Ayrault believed that the cerebro- 
 spinal congestion was brought about by the direct action of cold on 
 the uterus, from which the blood was repelled. Felizet, in 1866, 
 advanced the theory that this congestion was the moral result of 
 removing the Calf from the Cow immediately after parturition. Pro- 
 fessor Violet is satisfied that an easy birth suddenly diminishes the 
 intra-abdominal blood - pressure, which aifects the heart so much 
 during pregnancy, and to which it and other organs have to accom- 
 modate themselves. Birth taking place rapidly, the heart continues 
 to act in a fashion to which the bloodvessels, particularly the capillaries, 
 are not accustomed, so that they gradually become distended, and 
 finally congested ; hence ruptures and haemorrhages may occur, and a 
 fatal termination. Others — among them Deneubourg — trace the com- 
 mencement of the disease to milk-fever, the intensity of which, 
 originated by a rapid and easy delivery, is in proportion to the develop- 
 ment and secretory power of the mammae. The resulting disturbance 
 is spread over the entire economy, and favoured by the repletion of 
 the stomach and the pre-existing plethora — suddenly increased by the 
 mass of blood which goes to the uterus during pregnancy — as well as 
 by the state of the nervous system in general which the pains of labour 
 have induced, excites grave disturbance in the important functions of 
 digestion, circulation and innervation. Hence arise disorders as much 
 more sudden and serious as the repletion of the stomach and the 
 plethora are great ; the blood is rich and plastic, and the irritability 
 of the nervous system — especially the ganglionic — is excited. Con- 
 sequently, there is a general functional disturbance resulting from the 
 "congesting" action of all the cerebro-spinal and trisplanchnic or 
 ganglionic nerves. 
 
 Some have considered the disease to be essentially an encephalitis, 
 myelitis, meningo- cephalitis, or a cerebral or medullary apoplexy, 
 according to the character or seat of the lesions found after death. 
 But some of these opinions are opposed by the fact that many of the 
 lesions on which they are based are seldom observed, and that the 
 recovery of affected Cows is often very rapid. 
 
 1 Journal de Veterinaii-es du Midi, 1854. 
 
PJin-nUEXT AFOI'LEXy—Pi'EUPKlLiL VOLLAl'.sE. 619 
 
 Professor Trasbot asserts that the disease is the result of spinal con- 
 gestion, with consecutive paralysis. 
 
 In England the opinion has long prevailed that puerperal collapse 
 is the consequence of cerebral con^'estion, generally terminating in 
 hieniorrhage, and that the peculiar distribution of the cerebral blood- 
 vessels in the Cow predispose to this accident. It may be noted that 
 a similar arrangement of these vessels is present in the Pig, and that, 
 according to some German veterinarians a disease very like the puerperal 
 collapse of the Cow is observed in Sows after parturition in North 
 Germany ; but Thoraassen^ points out an important difference, inas- 
 much as in the Sows the paralysis is not complete, there is intense 
 fever, and the animals generally recover. 
 
 2. Anj::mia of the Nekve-Centres. — Many years ago, Haubner 
 came to the conclusion that puerperal collapse was due to cerebral 
 anirmia resulting from an ex vacuo hyperucmia of the abdominal organs, 
 as Cows of a certain age were predisposed to this congestion from want 
 of contractile power in their abdominal parietes. Werner and Prehr 
 were also of opinion that cerebral aniomia was owing to abdominal 
 congestion. Billings- supposed that an exaggerated sensibility of the 
 uterine nerves, induced, in a reflex manner, spasm of the arterioles of 
 the brain and kidneys, and so caused auicmia of these organs. Franck 
 believed the condition to be owing to secondary anaemia succeeding 
 congestion of the brain, occurring in Cows which had an easy and 
 rapid delivery. The sudden contraction of the uterus and its diminished 
 capacity brought about by the post ixirtum pains, causes great disturb- 
 ance in the blood circulation. The organ receives much less blood, and 
 this, in ordinary cases, is compensated for by the increased aOlux to 
 the mamniic and the skin ; but a chill to the latter may upset this 
 physiological compensation, and tlie repelled blood is diverted else- 
 where ; if this be to the brain, then there is cerebral congestion and 
 consequent oedema, resulting in aniumia by compression of the blood- 
 vessels. There is a predisposition to serous effusions in animals after 
 parturition, because of the hydricmic condition of their blood, and 
 especially when there is passive congestion of the kidneys and albu- 
 minuria towards the termination of pregnancy. Tlio great frequency 
 of cerebral hyperiemia in the Cow, was regarded by Franck as a con- 
 sequence of the division of the internal carotid into a number of small 
 vessels before it enters the cranial cavity, as well as the formation of 
 the rctc viirahilc from a common branch that gives off the cerebral 
 arteries. 
 
 This theory is adopted by Goring, who edits the second edition of 
 Franck's work on " Veterinary Obstetrics," and is accepted by many 
 practitioners. 
 
 Werner's'' 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 — 
 manifested by the general depression, loss of sensation, inactivity of the 
 spinal cord in the dorsal region, suspended digestion, quickened" action 
 of the heart and slowing of the respiration. Too rapid evacuation of 
 the contents of the uterus causes descent of the abdominal viscera, 
 ^ Reriidl dc Mt'lecine Veierinaire, 18S0, p. 784. 
 - American Journal ot' Comparative Medicine, 1584. 
 ^ Wochenschrijtfur Thierheilkunde und I'iehzucht, 1868, p. 363. 
 
650 PATHOLOGY OF PARTURITION. 
 
 dilatation of the posterior aorta, and slowing of the circulation. The 
 primary cause of all this is bad management of the Cows, and pressure 
 of the foetus on the stomach and intestines, diaphragm, vena cava, and 
 posterior aorta. 
 
 3. Derangement or Paralysis op the Nerve-Centres. — Many- 
 high authorities — among them Kohne, Binz, Carsten-Harms, Wan- 
 novius, Busch, Bull, Bychner, Baumeister-Bueff, 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, the spinal cord and brain during the course of the disease. The 
 following 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 consequently 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, and 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 the collapse is a kind of leucocytha^mia, 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 mortevi features 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 Abnormal in the Blood, which 
 
 LEADS TO THE DEVELOPMENT OF THE SyMPTOMS AND LeSIONS OBSERVED. 
 
 — It has long been a popular notion in several countries that puerperal 
 apoplexy is caused by the absorption of the milk into the blood circula- 
 tion ; hence the designation of "milk-fever" given to the disease in 
 England, France, Germany, 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 foetus, 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 more or less intense morbid disturbance, 
 due more especially to the presence in the blood of a product foreign to 
 its normal composition. Without commenting at any length on this 
 theory, it may be sufficient to mention that in some cases of parturient 
 apoplexy the function of the mammary glands is not suspended; though 
 
rAIiTUniEXT ArorLKXV—PUEni'ERAL COLL APSE. G51 
 
 the theory would seem to receive some support from the fact, that when 
 the milk is abundantly secreted the animal usually recovers rapidly. 
 
 Carsten- Harms considered it an airiemia, air havin<^ 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. 
 
 Stocktleth, Lanzillotti-Buonsanti, Zundel, Raynaud, and others, have 
 maintained the hypothesis that the absorption of septic matters formed 
 in the uterus from the locliia, blood-clots or tissue debris, 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 indigestion ; 
 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, SchmidtMiUheim published a theory with regard to the 
 genesis of the disease, which has since been adopted by some veterinary 
 notabilities. According to this authority, it is of toxic origin, and is 
 analogous to the condition observed in j^lan, and known as Botulism, 
 due to the ingestion of sausages and llesh in which a ptomaine or 
 leucomaine has been developed. These animal alkaloids produce 
 paralysis of the tongue, palate, pharnyx, larynx, oesophagus, 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, chiefly because the 
 progeny is small, and in which the 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 that the great ditTerence 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 period, 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 products of this 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 primarily as nerve excitants, and, 
 secondai'ily, as nerve depressants. Still further to confirm this hypo- 
 thesis, the striking analogy between puerperal collapse and haimoglo- 
 binuria in the Horse is adduced ; and the fact that both diseases can 
 frequently be arrested or their violence ameliorated in the early stages 
 
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 haemoglobinuria 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 paralysis 
 {Walley). 
 
 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 
 as food. Such is not the case, however, as all experience, experimental 
 and other, goes to 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 
 for 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 what 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 foetus 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 all 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. ^ 
 
 Predisposed as is the Cow by artificial management, 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. 
 
PARTURIENT APOI'LEXy— PUERPERAL COLLAPSE. 653 
 
 secretion for construction does not take place, are chiefly located in the 
 nervous system, and especially in the brain. Conj^estion of the cere- 
 bral vessels at first, which may speedily lead to effusion of serum or 
 hicmorrhage, 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 e.xpeoted, be 
 witnessed in other animals in which distension of that cavity during 
 pregnancy is quite as exaggerated as in iiovines. Besides, there is no 
 evidence that vascular engorgement of the abdominal organs is a con- 
 stant feature in necropsies of Cows which have succumbed to the disease; 
 neither is auicmia of the bi-ain always, or even 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. 
 
 DiofjHosis. 
 
 Puerperal collapse has been confounded with parturient fever and 
 metritis, jjoA'^ ;;a?7»»i 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 jiost 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 inability 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 conies to bo 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 
 
€54 PA THOL OG Y OF PARTURITIOX. 
 
 reason to lay great stress on preventive 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. 
 The 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 the Cow in as natural and free a condition as possible, with all 
 the functions of secretion and excretion in full jDlay, 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 others, again, speak favourably of milk- 
 ing the Cow by hand a few days before calving, and thrice instead of 
 twice a day for a short time after that event, if the Calf is removed or 
 cannot abstract sufficient milk. This they more particularly insist upon 
 doing if the udder is largely developed or distended. 
 
 As Cows which have had difficulty 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, such 
 as mustard, should be immediately applied to the loins or hind-quarters 
 of those which have calved easily and are likely to become affected. 
 
 x\s 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 
 op].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 adopting 
 active measures, the attendant has waited for the curative effects of 
 nature — usually decided about the second or third day, only attempt- 
 ing to combat certain morbid conditions w'hich 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 shall 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 the ■position 
 of the affected animal, and we cannot do this in better terms than those 
 
PARTURIENT APOPLEXY— PUERPERAL COLLAPSE. 655 
 
 of Williams } " If the Cow is already down when lirst seen by the 
 practitioner, his first care must be to see that she is made to lie as near 
 the natural position — on the sternum — as possible ; and this he will do 
 by liaving her packed up at the side by bundles of straw, or, what is 
 better, sacks tilled with straw, tirmly wedged under the quarter and 
 shoulder, the head at the same time being properly propped by the 
 same means, and care being taken at all times that the Cow is prevented 
 from injuring her head by striking it against hard bodies." It may be 
 added that some practitioners are particularly careful to have the head 
 well raised above the other parts of the body, especially when the 
 animal is comatose ; and this is sometimes effected by means of a halter 
 on the head, or a rope round tlie base of the horns, the other end being 
 passed over a beam in the stable. This elevation of the head prevents 
 increased congestion of the brain, and facilitates the return of blood 
 from that organ. 
 
 It is often beneficial to alter the position at intervals — every two or 
 three hours ; and Williams recommends that the mammary gland 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 prostrate and in a state of coma, if the pulse be not excessively 
 weak and the heart's action almost fluttering, 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 in tone. The opening into the jugular is to be a 
 large one, in order that the blood may How freely to relieve the conges- 
 tion — to check, if possible, a further extravasation of blood or effusion 
 of serum, and to divert its active flow into the head; but it must not be 
 carried out so as to debilitate the heart's action. When the pulse 
 becomes fuller and stronger, the bleeding is to be stopped ; from three 
 to five quarts will generally be sufficient." 
 
 Theoretically, venesection is to be commended. If the theory be 
 accepted that the condition is due tohypera^mia — audit has been shown 
 that this opinion has a better foundation tlian 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 quality is 
 gi-eatly deteriorated by the abstraction of blood. A short time after 
 venesection, we shall expect to find the former blood-pressure in the 
 arterial system, but the blood far more watery than jireviously. 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 danger 
 of the disease will be increased. 
 
 Williams 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 flows the tone of the 
 
 pulse will improve ; for the weakness of the pulsation, the want of 
 
 * Principles and Practice of Veterinary Medicine, p. 418. 
 
656 PATHOLOGY OF PARTURITION. 
 
 impulse, and debility of the heart's action, are results of brain-pressure. 
 If, however, the surface of the body be cold, if the animal be tympanitic, 
 the heart's action fluttering, and the 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 due 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 may seem — is in an anaemic 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 stimulants." 
 
 If abstraction 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 
 recommended to open the mammary or other superficial veins. 
 
 A principal indication in the treatment of the disease, viewing it in 
 the light we have done, is to favour the cutaneous circulation and stimu- 
 late the shin 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 be stimulated with strong ammonia liniment. Some 
 authorities recommend 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 mustard 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 greatly augmented by covering the body with 
 a wet sheet, and above this 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 the collapse. 
 
 But it must be i-emarked that this hydropathic treatment has proved 
 a great success in the hands of some practitioners, who were unsuccess- 
 ful with other methods. Hartenstein and Mauri, ^ 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. When 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 
 medicine — 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 tijmjxinitis which is so often present as 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 
 ^ Revut Vetermaire, June, 1889. 
 
i^uiTrniKxr ArcrLKXY—rrKni'KHAL ci'Lljj'sk. nr.: 
 
 most effective and rapid in their action when given in the fluid form, if 
 the animal can swallow. If it cannot, then they may be administered 
 by means of the stomach-pump or proban^', or even in bolus. \Villiams 
 reconnnends giving carbonate of ammonia in bolus ; the hand, being well 
 oiled, is to be pushed as far as possible into the pharynx, when the dose 
 " will slowly gravitate into the rumen." Should the medicine not act 
 promptly, or the tympanitis be so great that suffocation is to be appre- 
 hended, then the rumen ought to be punctured without delay. This 
 may be effected by the ordinary trocar and cannula, the latter being 
 allowed to remain in the rumen for some time. It may be closed by a 
 cork, which is to be withdrawn when the gas accumulates. If care is 
 exercised, fluid medicaments may be introduced into the stomach through 
 the cannula. 
 
 Even when the tympanitis is not extreme, but the animal is comatose 
 and there is gastric regurgitation, it will be advisable to puncture the 
 rumen ; as by this means the entrance of food into the trachea may be 
 prevented, by allowing the gases to escape through the cannula, instead 
 of by the oesophagus. 
 
 Enemas are as essential as counter-irritation. The rectum should 
 first be emptied manually, and then either enemas of warm water, or 
 those of a stinmlant or laxative nature, administered. By the rectum 
 enemas of linseed-oil, common salt, sulphate of soda or magnesia, aloes, 
 tobacco, oil of turpentine, camphor, etc., have been administered. The 
 rectum forms a safe and convenient channel for the introduction of 
 medicines, and especially those intended to act upon the torpid digestive 
 organs, when the animal can no longer swallow. Powdered camphor in 
 small quantities has even been introduced into the rectum to stimulate 
 the intestines, when drugs exhibited by the mouth have failed to etTect 
 this. Knemas may be given as frequently as necessary without danger to 
 the animal, and with ease — advantages not available by mouth adminis- 
 tration. 
 
 The urine should be frequently removed from the bladder, either by 
 pressure on the viscus through the rectum, the introduction of the 
 catheter or nozzle of the ordinary injection syringe into the urethra, or 
 even by passing the finger into that canal. 
 
 As has been mentioned, the milk should be often removed, and the 
 udder completely emptied. Even when there is no milk, the teats should 
 be well and repeatedly stripped. 
 
 runjativcs are in nearly every case necessary (though some authori- 
 ties deny this), and they should be active, and given in larger doses 
 than in ordinary circumstances; constipation being a constant and 
 serious symptom, while action of the bowels may be considered a most 
 favourable sign. The most common are sulphate of magnesia or soda, 
 aloes, chloride of sodium, cream of tartar, linseed-oil, castor-oil, tartar 
 emetic, ipecacuanha, croton-oil, etc. 
 
 In the great majority of instances these agents are not given alone, 
 but in combination with other substances. 
 
 A very favourite compound in Germany is that mentioned by Kohne, 
 the composition of which is as follows : 
 
 Nux vomica - - - - 8^ drams. 
 Tartar emetic - ... 2 ounces. 
 Sulphate of soda - - - l.S ,, 
 
 Common salt - - - - 4^ ,, 
 
 42 
 
658 PATHOLOGY OF PARTUEITIOX. 
 
 These are boiled together for about a quarter of an hour in four pints of 
 water, and one-fourth given every hour or every two hours. 
 
 Harms places great confidence in tartar emetic. He 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 much as two ounces in fourteen hours. In thirty-seven 
 cases of the disease, only two died. 
 
 When it is desired to increase 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 extol nux vomica in tolerably large doses, to aid 
 in rousing the action of the intestines. 
 
 Stim2ilants — a,s ammonia — are often administered, and in conjunc- 
 tion with bleeding they may prove of the greatest service at the com- 
 mencement of the 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 commended. 
 
 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 much resorted to, and some of the reports as to their 
 eifects are in their favour. Strychnine has been administered in this 
 way, also veratrine and eserine, and their utility has doubtless been 
 due to their action on the bloodvessels, more especially the arteries and 
 capillaries. 
 
 When recovei'y commences, small doses of stimulants may be bene- 
 ficial if there is much debility, and the animal can swallow readily. But 
 in the administration of fluids when the animal is comatose or degluti- 
 tion is impeded, the greatest care is necessary to prevent their entering 
 the trachea — an accident which might prove fatal. To test whether 
 the animal can swallow, a little cold water may be poured into the 
 mouth from a bottle. If swallowing is difficult, then the only safe 
 mode of administration is by the stomach-pump or probang, or directly 
 into the rumen by the trocar and cannula. Large quantities of fluids 
 are objectionable, and the amount in any single dose should not exceed 
 a pint. 
 
 It must also be remembered that, if it is probable the animal will not 
 recover, but will be killed and its flesh consumed as food, drugs of a 
 poisonous kind, or likely to flavour the meat, should not be given. 
 Many cases are recorded in which people 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 remained 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 the 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 
 
POST PARTUM PAUALYSIS. 659 
 
 according' to circumstances ; and paralysis will be best combated by 
 stimulation to the loins, and the subcutaneous injection of strychnine, 
 with diuretics and purgatives. 
 
 Easily digested food in small quantities should alone be allowed 
 immediately after recovery, and the animal must not be given any 
 indigestible food, nor be permitted to eat hay or litter. 
 
 To prevent injuxy to the surface of the body, it is well to change the 
 position of the animal two or three times a day, if soft litter — such as 
 peat moss — cannot be procured. In turning from one side to another, 
 the movement should be on the under part of the trunk after the limbs 
 have been doubled under the body — not on the back ; and care should 
 be taken that tympanitis is not interfering with the respiration. 
 
 In some cases there remains a certain degree of paresis or inertia, 
 after the more urgent symptoms have disappeared — indeed, when the 
 animal looks bright and well, so that it will not or cannot rise. This 
 condition has been combated successfully and promptly by the adminis- 
 tration of an enema containing a quantity (10 to 15 ounces) of oil of 
 turpentine. 
 
 It is judicious not to breed from a Cow which has suffered from par- 
 turient collapse, unless every precaution is taken towards the next 
 calving period. 
 
 CHAPTEK V. 
 
 Post Partum Paralysis. 
 
 In treating of the diseases peculiar to pregnancy, allusion was made to 
 paraplegia (p. 187) as one of these. Paralysis of the hind-quarters is 
 more frequent previous to birth than after that event, and is generally 
 observed in the Cow. After birth, paralysis is comparatively rare, and 
 may affect nearly the whole of the body, or both or only one of the 
 hind-limbs. Tlie Cow is also the animal which oftenest exhibits i)ost 
 partnvi paralysis. The affection may be due to parturient apoplexy or 
 collapse— as already noticed ; it may also be a result of metritis ; or it 
 may follow ditVicult parturition, and especially after the birth of a large 
 Calf, or if the latter has been in a wrong position. Franck has often 
 witnessed its occurrence after delivery, when the uterus has been half 
 twisted. Williams gives an instance in which paralysis appeared to be 
 due to mental disturbance ! 
 
 Sjpnptonis. 
 
 The symptoms are similar to those of ante partum paralysis. 
 The animal continues to lie, and one or both hind-limbs may be 
 moved in a convulsive, irregular manner, or they are completely in- 
 capable of movement. In the majority of cases, however, the animal is 
 able to turn itself over at intervals from side to side — particularly during 
 the night. Sometimes only one leg is paralysed. Apparent paralysis 
 is at times observed in Cows, which persist in lying after parturition, 
 and though they can move their limbs readily, yet they will not attempt 
 to get up ; their appetite is unimpaired, they exhibit no symptoms of 
 disease or suffering, but yield plenty of milk, and the excretions are 
 normal. 
 
 This condition may continue for weeks or months, and often animals 
 have to be killed in consequence of it. 
 
660 PATHOLOGY OF PARTURITION. 
 
 Diagnosis. 
 
 There should be no difficulty in diagnosing this condition from puer- 
 peral collapse, metritis, or other affection incidental to parturition. If 
 the paraplegia does not appear until a short 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 
 mammitis ; in that case there is not only the loss of power, but also 
 diminished sensation in the hind-limbs. But if due to a sprain of the 
 back from slipping, then sensation is not impaired, and pain may be 
 indicated on pressure of the part injured. 
 
 When due to fracture of the pelvis, crepitation may be heard on 
 movement, or an examination per rectum will detect the damage ; or if 
 there is dislocation of the hip-joints the accident will be manifest on 
 moving 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. 
 
 Pathology. 
 
 Little is known as to the nature of 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 efi'usion. 
 
 It can easily be understood how paralysis is induced in parturient 
 apoplexy. Williams states that it is due to inflammation and red 
 softening of the spinal cord in the lumbar region. 
 
 Prognosis. 
 
 The prognosis must necessarily depend upon the diagnosis. The 
 paraplegia, real or simulated, is due to various causes, and therefore 
 the likelihood of recovery must be based upen 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 haemorrhage 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. 
 
 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 limbs for a considerable period. 
 
POST PARTUM PARALYSIS. 601 
 
 Treatment. 
 
 Treatment must also depend upon the diagnosis. When the para- 
 plegia is due to congestion of the spinal cord, cold water may be applied 
 to the loins continuously by means of rugs kept saturated, or at fre- 
 ijuent intervals by a large syringe or garden hose. After a few days, 
 blisters, or even the actual cautery, should be applied to the loins, and 
 the subcutaneous injection of strychnia resorted to. The condition of 
 the bowels and bladder must be attended to ; the former being regulated 
 by feeding, and if necessary by laxatives, the latter by diuretics. 
 Electricity may be useful in some cases, and particularly when only one 
 limb is involved. 
 
 In all cases, the state of the uterus should be ascertained, and if it 
 is unsatisfactory, then remedial measures should be adopted with regard 
 to it. 
 
 When the animal cannot turn itself, this must be done by its 
 attendants ; and if it is a valuable one, and the paralysis is likely to 
 continue for some time, slinging for a short period every day may be 
 tried. 
 
 When due to other causes, the treatment must be adapted to the 
 circumstances of the case ; with Cows, however, unless there are special 
 reasons to the contrary, and if they are in good condition, it is often 
 advisable to have them killed for food. 
 
 CHAPTER VI. 
 Eclampsia. 
 
 Thkre can be no doubt that tlie malady described in this work as 
 parturient apoplexy or puerperal collapse, has often been confounded 
 with the disease known in woman as "eclampsia," and which is also 
 witnessed, with some slight ditTerences, in animals. For it seems to 
 be now admitted that the eclampsia of woman and the malady of the 
 Cow are nearly, if not altogether, identical ; and the same or similar 
 causes may be 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- 
 \'ul3ions are generally present, and, indeed, maybe regarded as a constant 
 symptom. 
 
 The symptomatology of the disease in the human female and in 
 animals differs in some particulars, owing no doubt to differences in 
 organization. In woman there are premonitory signs — such as uneasi- 
 ness, headache, nausea, twitch ings, 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 
 rapidly replaced by tonic contraction of all the extensor muscles either 
 of the trunk or limbs. The respiration is stertorous or suspended ; the 
 pulse — at first full andstrong— isso weak that it is scarcely perceptible; 
 the tongue is protruded from the mouth, and often bitten ; foam appears 
 between the lips, and unconsciousness is complete. The attack may last 
 for 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 they shake the whole 
 
662 PATHOLOGY OF PARTURITION. 
 
 body. The respiration gradually returns to its normal state, and the 
 pulse resumes its natural rhythm ; the jerking of the limbs and body 
 subsides, perspiration appears, and in from one to five minutes all is 
 tranquil ; the comatose condition which supervenes varies in duration, 
 but the patient awakes greatly exhausted, and complaining of pain in 
 the limbs. (Edema of the face and limbs has been observed. Exception- 
 ally, there is only one attack ; generally there are several, which may 
 succeed each other quickly, when the patient may remain comatose 
 between the pauses, and at the height of an attack death may take place 
 from oedema of the lungs or apoplexy. In favourable cases the intervals 
 become longer, the attacks themselves more imperfect and shorter, until 
 they finally cease. The malady is considered very serious when it occurs 
 during pregnancy, and it has been estimated that one case occurred in 
 every 350 cases of labour. 
 
 It will be seen presently how far these symptoms in woman correspond 
 to and differ from those observed in animals. 
 
 The disease affects the Cow, Goat, Bitch, and perhaps the Sow. It 
 has been studied by a considerable number of observers on the European 
 Continent, and in this country cases of it have been reported, chiefly by 
 Storrar, Eolls, and Clark. I have only seen one case of it, the animal 
 being a Bitch suckling too many Puppies. 
 
 Syvij)ioms. 
 
 In the Cow the disease occurs at all ages, and may appear occasionally 
 before parturition, but is most frequently observed after that event, and 
 soon ; though it may be delayed so long as the twenty-sixth day. 
 PrimiparaB often suffer, and it is said to be most frequently witnessed in 
 Cows in poor condition. It is not always recurrent at subsequent 
 pregnancies, in this respect diilering from the affection in woman, in 
 which it is also more commonly seen before parturition. When it 
 attacks the Cow ante partum, it is believed to be usually about mid-term, 
 and convalescence and recovery may follow without labour being 
 induced. 
 
 The symptoms are not so urgent as in woman, and the disease is far 
 less fatal — though during the attack consciousness is abolished, as in 
 her, in at least the great majority of cases. 
 
 In the cases reported by Clark, ^ the attack was usually sudden, and 
 without warning, though the Cows had not been altogether well for a 
 day or two previously — this period probably corresponding with that of 
 the preliminary malaise experienced by woman. The symptoms were : 
 " foaming at the mouth, champing of the jaws, prominent staring eyes, 
 excited expression, head very often turned to the side ; sometimes lick- 
 ing at the fore-leg, stall, or some imaginary object. Some Cows I have 
 heard bellow, others do not do so ; there was twitching of the body and 
 limbs (clonic spasm), difficulty in respiration according to intensity of the 
 attack. The convulsions generally last two or three hours, and in the 
 majority of cases do not reach the stage of coma, although I have had 
 cases which have done so." 
 
 In a somewhat typical case described by Professor Mauri,- the Cow was four years 
 old, and a jjriniipara, which had cahed, the placenta being expelled two hours after- 
 wards. On the following morning the animal was seized with tremblings, refused all 
 food, manifested breathlessness, and looked anxious. On being led to the pasture, it was 
 
 1 Journal of Comparative Patholofjy and Thtrapentics, 1893, p. 28. 
 - Revue Vtltrinaire, 1876, p. t>5. 
 
ECLA.MI'Sr.L 668 
 
 perceived that it was weak in the hind-quarters, and in the short distance it had tn travel 
 it fell se\eral times. It was put in a shed with a northern exposure, and its Calf being 
 broujjht, it remained completely indifferent to it. At two o'clock ic fell, and Mauri was 
 sent fur. He found it lying extende<l on the right side, the respiration appeared to be 
 entirely diaphragmatic, and it was rlitticiilt to perceive the movements of the Hanks ; 
 the pulse was imperceptible, but the heart's beats were strong. The tongue iuing out of 
 the mouth, and the air expelled carried a large (juantity of foamy saliva with it. The 
 senses appeared to be completely abolished, and the eyeballs — turned trreatly upwards — 
 Kxiked fixed in a remarkable manner. The limbs were rigidly extended, and they, with 
 the trunk, jerked in such a violent manner, that the whole body was shaken without 
 being displaced. The udder was not Haccid, and milk of a good (piality was readily 
 obtained Irom it. 
 
 Mauri thought it was a case of parturient collapse, and ordered the necessary treat- 
 ment. After six o'clock in the evening, while jireparations were being made to carry 
 out his prescriptions, the Cow got up and stumbled towards the side f)f the hhed where 
 its Calf wa.s standing. During the night it ate and ruminated. Next morning at eight 
 o'clock there was another attack. The premonitory symptoms lasted for about half an 
 hour, and the animal lay until half-p;xst nine. At midday it did not present any signs 
 of disease. It had no more attacks, but the owner, apprehensive of future danger, sold 
 it two months afterwards, and Mauri lost sight of it. 
 
 Calmettes' mentions that a four-yearold Cow gave birth to a Calf during the night in 
 quite a natural manner, and during the following day it ate and ruminated as usual. 
 Tov.ards six o'clock in the evening it suddenly commenced to tremble and stagger in its 
 hind liudw, so that it could only walk with the greate-t ditticulty. At seven o'clock 
 Calmettes noted that the hind-iiuarters were veiy feeble ; the general sensibility 
 appeared to be increased, and pressure on the dorsodumbar region cau.^^ed much pain ; 
 the skin was very hot, an<l the respiration deep and hurried ; the pulse was strong and 
 ([uick, the mucous membranes somewliat red<lentd, and the muffle damp. Counter- 
 imtiints were applied to the hind-ipiarters, and draughts and emollient enemas adminis- 
 tered. At one o'clock in the morning he was again called. The animal had fallen on 
 its side ; the general .sensibility was diminished, and the skin wjus very cold. From 
 time to time it was remarked that all the extensor muscles of the limbs were convulsed, 
 which threw the latter into rigid extension ; though, when seized by the hand^, they 
 could be Hexed and moved alx)ut. The sensorial functions were completely abolished, 
 and the skin could be pricked or incised without inducing the least movement ; the eye, 
 which wa.s generally fixed, pirouetted in its orbit from time to time, while it could dis- 
 tinguish nothing, and could be touched without betraying any sensation ; there was also 
 loss of hearing. At this time the respiration was about normal — eighteen to twenty 
 respirations in the nnnute ; the pulse was small and imperceptible ; the heart's beats 
 strong ; the mucous membrane rather pale than red, and the muHle dry. During 
 expiration there was a labial xoiijih, and an abundance of foamy ealiva escaped from the 
 mouth. The animal remained in this condition for six hours. 
 
 Towards .seven o'clock next morning, when al)out to send for a butcher, the limbs 
 becauje rigid and were seized with convulsions, which extended to the entire body. .iVs 
 if by enchantment, the animal placed itself on its sternum, rai.-ed its head to the normal 
 position, and Hnally got up, though with diHiculty. It had been in a somewhat de«>p 
 coma for about an hour. 
 
 In the evening it had u second attack, there being ceneral agitation, with hurried 
 respiration and weakness of the hind-quarters. Soon it fell, had numerous convidsions, 
 and manifested the same general insensibilitv it dispUyed in the morning. This con- 
 tinned for only three hours. Next morning it ajijieared to be quite recovered. 
 
 Fifteen months previously, and eight days after parturition, this C'ow had another 
 attack when returning fn)m pasture ; bein^' suddenly seized with tremblings, it stag- 
 gered and fell. In half an hour afterwards it was conqiletely insensible, an'i sensa- 
 tioidess ; the respiration was almost normal, the pulse iinjxjrceptibl-, though the 
 contractions of the lieart were powerful, and all the symptoms already enumerated were 
 pres.Mit, but became more rapidly developed. The convulsions continued for two and a 
 half hours. 
 
 Lafitte- makes mention of a Cow that calved in the most favourable manner, and four 
 hours afterwards became agitated and restless : soon afterwards, there were con vuNions of 
 the muscles of the trunk and limbs, anil so much weakness set in that the animal could not 
 stand. The t«mgue was often projected from the mouth and foam flowed therefrom : 
 the Cow could hear and see during the attack. The pidse was intermitt>nt, and the 
 respiration moderately increased. In about ten hours it arose and gradually recovered. 
 Two days after, it had another and a final attack, which lasted for three hours. 
 
 Revue Vitirinuirt, 1876, p. 67. • Ibid., p. 70. 
 
664 PATHOLOGY OF PARTURITIOX. 
 
 Tlie same writer alludes to another Cow, which, a few hours after calving, was seized 
 with persistent convulsions and great general weakness, which rendered standing im- 
 possible—presenting, in fact, all the symptoms of the previous case. This attack con- 
 tinued for three hours, and another followed on the same day. Then an interval of a 
 day elapsed, when the fits succeeded each other so frequently, and with so much 
 intensity, that the animal died from asphyxia. 
 
 These cases afford an illustration of the usual symptoms observed in 
 this disease as affecting the Cow. The urine appears to have been 
 examined in only one instance, and then albumin was present during 
 the crisis, which lasted for three days ; but it was not found when con- 
 valescence had set in. 
 
 In the Goat only one case has been reported — that by Lafitte.^ The 
 animal had been affected with metro-peritonitis following parturition, 
 and for which it had been appropriately treated. Two days subse- 
 quently it appeared to be agitated and restless ; all the muscles, and 
 particularly those of the jaws, were convulsed ; the eyes rolled about ; 
 there was abundant salivation, etc., and the creature could not stand. 
 There was only one attack, which lasted for several hours. 
 
 The disease has been observed most frequently in the Bitch. 
 
 Hertwig,- who was the first to describe the malady as it affects the 
 Bitch, and Zundel,'^ give a similar account of the symptoms in that 
 animal. The latter had never witnessed premonitory signs of the 
 disease, though Hertwig had. He says that with Bitches which are 
 suclvhng, and particularly those kept in the house and well fed, it is 
 not rare to observe a state of tetanic rigidity and incomplete paralysis, 
 with the following symptoms : The animal suddenly commences to be 
 uneasy and anxious ; the ej^es are haggard, sometimes the nose is a little 
 hot ; the respiration is very short and quick, though pressure on the 
 chest or abdomen does not cause any pain. In a short time — about a 
 quarter of an hour after the difficulty in respiration was observed — the 
 animal cannot stand, but falls on its side, and lies with the limbs 
 extended : even when raised it cannot stand. The breathing becomes 
 still quicker — from 60 to 100 per minute ; while the pulse is 100, 
 small, hard, and irregular. Consciousness appears to be retained, but 
 the animal refuses food and drink, and the alvine and urinary excretions 
 are suppressed. The mammary glands are greatly engorged, hot, and 
 abundantly provided with milk, the quality of which does not appear to 
 be altered or injurious to the young, which usually continue to suck as 
 before. This state continues for forty-eight hours, wlien death generally 
 occurs from apoplexy and paralysis ; though by proper treatment the 
 disease may always be quickly cured. Zundel's description is almost 
 the same, except that he says there are tonic convulsions, with clonic 
 spasms extending rapidly to the whole of the body ; sometimes there is 
 trismus, with grinding of the teeth ; constantly there is a white foam at 
 the mouth and muscular tremblings of the jaws ; the breathing is 
 stertorous, and sensibiUty much diminished. There are cases in which 
 the eclampsia appears to be merely partial, affecting only the hind- 
 limbs, for instance, and the animal sits, the head being unaffected, and 
 whines. The disease is continuous and without intermissions, the 
 attacks lasting for one or two days. If no relief is afforded, the creature 
 dies from total paralysis, due to congestion of the meninges of the brain, 
 or from asphyxia after a spasm of the glottis. 
 
 ^ Revue Vettrinaire, 1876, p. 71. - Kranhhdlen dtr Hunde, 1853. 
 
 ■^ Dictiounaire de Med. de Chir. et d'Hyjiene Vetirinaires ; article ' Eclampsie. ' 
 
ECLAMrsIA. «>"•• 
 
 Mauri, in giving a similar description of the syaiptonis in the several 
 cases he observed, lays stress on the dillicult respiration, which is very 
 quick, irregular, noisy, and spasmodic, the ribs being fixed in their 
 movements, as in the horse affected with tetanus. The eyes were 
 deviated to the left in one of his cases, and the limbs were convulsed 
 as if the animal were receiving a succession of electric shocks. 
 
 There may be only one attack, lasting for a more or less considerable 
 period, or there may be several following each other at longer or shorter 
 intervals. Lafitte saw a Bitch which had given birth to two Puppies, 
 two days previously, and which it was suckling ; it had an attack of 
 eclampsia that continued for a day, another of shorter duration on the 
 following day, and a last and slight one the next day. The Bitch re- 
 covered, but' some days afterwards the Puppies had a similar convulsive 
 seizure, less intense, and shorter in duration. One had three attacks 
 on the first and second days, and died ; the other had only two in one 
 day, and survived. 
 
 The same authority mentions a Bitch that, four days after parturition, 
 had clonic convulsions of all the muscles, especially those of the jaws ; 
 there was much salivation, respiration was ditticult, etc. There were 
 no convulsions during the night, but on the following morning another 
 attack set in, which continued until the evening, when the animal died. 
 
 In some cases, as nmny as six attacks have been noted in the course 
 of a day. 
 
 With regard to the Sow, there is some doubt whether the disease 
 described as puerperal collapse is not eclampsia. Certainly there are 
 indications which belong to both diseases, but the probabilities are that 
 it is the latter ; though it has been classed by Franck with the first- 
 named, which he also erroneously designated eclampsia. It has been 
 observed and reported upon by EUenberger, Wostendorf and Seiler in 
 North Germany. 
 
 In the cases EUenberger^ had an opportunity of seeing, the animals 
 were attacked from three to five days after easy parturition. The 
 appetite was partially or totally lost, the young were neglected, and the 
 animal seldom moved about ; soon it persisted in lying, and there was 
 suppression of fteces and urine, with diminution or cessation of milk 
 secretion. The animal lay on its side, the eyes closed, and the body 
 temperature low ; at times there were feeble convulsions. The respira- 
 tion was irregular, deep-drawn, and moaning ; the pulse 80 to 90 per 
 minute ; and there was great loss of sensibility. Nothing was observed 
 about the generative organs. After twenty-four to thirty-six hours 
 improvement took place, ficces were voided, and the animal began to 
 pay attention to surrounding objects ; the temperature rose; the pulse 
 and breathing became normal; the appetite and milk secretion returned; 
 and in from three to five days recovery was complete. All the Sows 
 survived the attack. In one case reported by Seiler,- the symptoms 
 were more of a convulsive or epileptic nature. 
 
 Etiology and rathology. 
 
 With regard to the etiology of the affection in woman, opinions differ 
 
 widely, and they are not less conflicting with regard to animals. The 
 
 points of similarity in the disease affecting woman and the animals 
 
 enumerated will have been noticed. It occurs in the Cow and Bitch 
 
 ' Maijaiin for Thkrheilktinile und I'iehzucht, 1860. 
 - Canstatt's Jahreshtricht, 1862, p. 48. 
 
666 PATHOLOGY OF PARTURITION. 
 
 during pregnancy and within a variable period after parturition, and in 
 primiparae as well as in pluriparse. The symptoms are very analogous, 
 though consciousness does not appear to be so often in abeyance in 
 animals as in woman. Albuminuria certainly would appear to mark a 
 distinction, but this condition also has been noted in some animals, 
 while it is not a constant symptom in woman ; besides, the urine of 
 affected animals ha« only been casually tested, and the presence of 
 albumin in it may be as frequent in them as in the human female. 
 The difference in symptoms may be due more to the higher organisa- 
 tion of woman and the circumstances in which she is placed, than to 
 any divergence in the pathology of the malady, in the three or four 
 species in which it manifests itself. 
 
 Scanzoni, Dubois, and some others, believed the disease to be a 
 neurosis due to reflex irritation of the spinal nervous system. Playfair^ 
 quotes a number of medical authorities to show that its etiology in 
 woman is very doubtful, though the coincident existence of albuminuria 
 seems to prove its dependence on the retention of the elements of urine 
 in the blood. But this theory has been controverted by the fact that a 
 large proportion of women had albuminuria before and during pregnancy, 
 and yet had no eclampsia ; and also that albuminuria followed the con- 
 vulsions and did not precede them, rendering it probable that this was 
 induced by the same cause that gave rise to the nervous symptoms. 
 
 Traube and Eosenstein ascribed the occurrence of eclampsia to acute 
 cerebral anaemia, due to changes occurring in the blood during 
 pregnancy. 
 
 Another authority (McDonald) imagined it is caused by irritation 
 of the vaso- motor centre, as the result of an anaemic condition of the blood 
 produced by the retention of effete matters which the kidneys had failed 
 to remove ; and Haultain- considered it to be due primarily to renal 
 insufficiency ; this gives rise to fits, from a poisoned state of the blood 
 causing general extreme arterial tension through contraction of the 
 peripheral arterioles. 
 
 With regard to the etiology and pathology of the disorder in animals, 
 Hertwig, speaking of the Bitch, thought the disease might be caused 
 by chills, the loss of offspring, and consequent stagnation of milk, and 
 mental emotion. Zundel asserted that it only occurred in Bitches 
 while suckling, and only in those of the smaller breeds had he observed 
 it, these having been well fed and being rather plethoric. Mauri also, and 
 others, think plethora a favourable condition for the development of 
 eclampsia, as they never observed it in lean animals ; but in Cows those 
 in poor condition appear to be as liable to it as highly-fed ones. Clark 
 firmly believes that the primary cause, especially in post partum cases, 
 is reflex irritation of the uterine nerve-centres, basing this belief on his 
 observation that the attacks in the Cow occur most frequently from the 
 eighth to the twelfth day after calving, this being the period at which 
 the " second cleansing " appears. In all his cases the weather was un- 
 favourable, being cold and stormy, with east and north-east winds ; and 
 this, in his estimation, was a potent factoi' — causing chill, which, acting 
 directly on the nerve-centres of the uterus, produces reflex irritation of 
 the spinal system, which again induces albuminuria. 
 
 In the only case I met with in the Bitch, I was inchned to attribute 
 the attack to excessive lactation, the progeny being too numerous. 
 
 ^ Srkvce of Midwifery. 
 
 - Edtnburijh Afali.idl Jonnia/. 
 
ECLA.VI'SfA. 667 
 
 As in parturient collapse, the changes found after death are far from 
 being constant in the human female. Dupaul found cerebral congestion 
 in very many of the women wlio had died suddenly from an attack, and 
 Stoltz states he noted this condition in all his autopsies ; but McDonald 
 discovered only congestion of the meninges, extreme anajmia of the 
 cerebro-spinal centres, and no evidence of oedema. 
 
 Diag)iosis. 
 
 After the description given of the symptoms, a diagnosis of the malady 
 should not be ditlicult. The history of the case, and the pregnant or 
 parturient condition of the animal, should be of service in distinguishing 
 the malady from epilepsy. Eclampsia in Cows might be mistaken for 
 parturient collapse, but it should be remembered that the latter generally 
 occurs at and after the third calving, rarely indeed during pregnancy, 
 and usually within two days after parturition ; that it is most common 
 in fat or plethoric animals ; that the animal always falls down ; that 
 though there may be excitement and struggling, there are no convulsions, 
 and coma rapidly ensues. 
 
 Prognosis. 
 
 According to some authorities, eclampsia in animals is a veiy benig- 
 nant disease, but others assert that when treatment is not adopted — 
 in the case of Bitches at least — death is the ordinary termination. 
 With the Cow it is not a serious malady. Saint-Cyr gives three deaths 
 in eleven cases, some of which had not been medically treated. Clark 
 had only two fatal cases during twenty-five years' practice, and these 
 were not treated. So that the prognosis should not be unfavourable if 
 proper treatment is timeously adopted. There do not appear to be any 
 notable sequela?, as a rule, though Clark mentions a case in which the 
 animal, a Cow, lay for a month after the convulsions disappeared, and 
 became permanently blind. 
 
 Treat7nc7it. 
 
 Hertwig reconnnends the abstraction of blood from the jugular, the 
 quantity varying with the size and condition of the animals ; and he 
 asserts that frequently all the symptoms diminish considerably, or even 
 disappear, while the blood is flowing. After the bleeding, he administers 
 a spoonful of tea every four or six hours, with small doses of nitrate of 
 potass. If the bowels are constipated, an enema is to be given. Zundel 
 has been particularly successful with the syrup of chloroform, which, in 
 small and frequent doses, keeps the animal in a state of semi-anuisthesia ; 
 the cure being terminated by a dose of laxative medicine and one or two 
 enemas. The syrup of ether produces the same effect as the chloroform, 
 though less quickly and surely. 
 
 Bromide of camphor has been favourably spoken of, as has chloral 
 given by the mouth and in enema. Clark lauds belladonna as almost a 
 specific, in doses of from two to three drachms, repeated in two or three 
 hours, if necessary ; he finds the glycerol of belladonna (equal parts of 
 glycerine and belladonna) a most convenient preparation, as it is easily 
 dispensed and readily miscible with water. He believes bleeding may 
 be of service in the more urgent cases when belladonna fails to arrest 
 the attack, though he is not much in favour of it. 
 
668 PATHOLOGY OF PARTURITION. 
 
 CHAPTEE VII. 
 Epilepsia Uterina.— Mania Puerperalis. 
 
 A PECULIAR nervous affection, to which the designation of " Epilepsia 
 Uterina '' has been given by Storrar,^ might be classed with the disease 
 which, in the previous chapter, has been named "Eclampsia," did it 
 not differ somewhat from it, and rather resemble epilepsy, or what 
 Harms has called " Mania puerperalis." Until its exact pathology 
 is better defined, it will be convenient to retain Storrar's designation. 
 
 ?iym]}toms. 
 
 The disease appears to affect the Cow only," and is marked by great 
 agitation, sometimes fury. We cannot do better than give the symptoms 
 in two cases, and then refer to Storrar's and Harms' evidence. 
 
 Rolls- was sent for in great haste to see a Cow, five years old, which had calved a 
 fortniijht previously, and had eaten the placenta. For two days before he was called in 
 the animal had not been well, and its Calf had been removed the previous night. It had 
 a wild, excited expression ; eyes staring ; ears warm ; pulse full, rather strong and 
 quick ; jaws continually moving, as if in the act of biting ; foaming at the mouth ; the 
 under part of the tongue purple and livid-looking. The movement of the jaws could 
 not be stopped by holding them together, and when the animal was left to itself it was 
 continually biting at its fore-legs, though without making a wound ; when interrupted 
 it gnawed the manger, woodwork of the ttall, or anything presented to it. If hay was 
 offered it would seize it, masticate it with the continuous and violent movement referred 
 to, and swallow it. It took some bran mash and chilled water, and though it partook of 
 nothing else, it looked full, and there was the peculiar sour odour often met with in Cows 
 suffering gastric derangement, and especially when it occurs soon after parturition. 
 Blood was abstracted, and belladonna and linseed-oil administered. In about three hours 
 afterwards, the convulsive movements ceased and the Cow appeared to be much better. 
 Next day the excited expression was still apparent. Under further treatment it 
 recovered. 
 
 Thirteen months afterwards it calved again, and when a fortnight old the Calf was 
 removed from it. Next morning it was found to be suffering from a similar attack, 
 the jaws moving in the same convulsive manner, but not so violently. Rolls noted 
 that the Cow looked wild and excited ; the pupils of the eyes were normal ; ears warm ; 
 pulse eighty per minute, and full and strong ; foaming at the mouth ; under part of 
 tongue livid ; grinding the teeth occasionally ; the fore-legs were wet and covered with 
 saliva, from gnawing them. The animal was again bled and had opiates, and recovery 
 soon took place. 
 
 Robellet'* gives a similar instance, in which the symptoms closely resembled those of 
 rabies. The Cow — four years old — calved four days previously, parturition being normal. 
 On the day on which Robellet was sent for, it had refused to eat at pasture, left its com- 
 panions, and constantly licked its fore-legs. In the evening it was restless, and bit 
 everj'thing about it. Robellet found that it had bitten the manger, rack, and food, 
 allowing the latter to fall from its mouth without masticating it ; it also seized its breast 
 and forelegs, but without breaking the skin. The pulse was full and sixty per minute ; 
 the eyes, unnaturally open, were red, fixed, and haggard, and the pupils dilated ; the 
 buccal mucous membrane was slightly inflamed, and a frothy saliva surrounded the 
 borders of the lips ; the respiration was normal. At times the Cow stretched out its 
 fore-limbs, bellowed, pawed the ground with the fore-feet, and seemed to defy an in- 
 visible enemy. The handle of a stable-fork being presented, the animal seized it in a 
 frantic manner and bit it, shaking the head violently. 
 
 These s3'mptoms gave rise to the suspicion of rabies ; but no evidence as to inocula- 
 tion could be obtained. The Cow was separated from the others, secured by a double 
 chain, and an ounce and a half of chloral administered in two doses in tea — a quarter 
 of an hour between each dose. Several minutes after the second dose, the Cow, which 
 had continued to show the same symptoms, hung its head, and, without staggering, fell 
 
 ^ Veterinary Journal, vol. iv., p. 53. 
 
 ^ Ibid., vol. ii., p. 17. 
 
 * Recueil de Medecine Vtterinaire, 187-1. 
 
KI'ILKI'SIA UTKUIXA. 669 
 
 like an inert mass on the tiround, then rose at once of itx own accorii. Ten ininuteH 
 afterwiinU the eanie (K;currence was again noted — the Cow once more falling and jumping 
 up ; it remained in the excited condition already desciibed. Next day all the alarming 
 syniptoms had subsided ; there was no fever or excitement — nothing except slight weak- 
 ness and prostration. It had fallen a third time on the previous day, then became 
 drowsy, and remaintd lying for about three hours ; after which it arose, apparently (piite 
 well. 
 
 liobellet's father had seen two similar cases. 
 
 Storrar relates tliat, in one of his cases, so savagely did the Cow bite 
 the timber forming the front of its stall, that with one desperate effort 
 it broke all the incisor teeth except one, entirely out of its jaw, and 
 fractured the alveolar processes. Another Cow, some years before, so 
 severely injured the lower jaw that the incisors could not be employed 
 for some time ; though the molars could be used when the food was 
 placed in the mouth. 
 
 Giinther' and Landel- have observed similar cases. They describe 
 the animals as extremely excited and violent, biting everything around 
 them — even people — climbing into the manger, running against the 
 wall, roused to fits of fury at the slightest noise, foaming at the mouth, 
 and sometimes tossing the head and bellowing. The pulse is hard and 
 quick, but the heart's action is weak. 
 
 Cause. 
 
 Rolls thought that, in the case he describes, depriving the animal of 
 its Calf was the cause of the attack ; Harms ascribes the symptoms to 
 chills, which produce brain congestion ; while Storrar looks upon the 
 malady as epileptic, dyspeptic, and uterine. "The animal affected has 
 calved some few days previously — say from four to fourteen, or even 
 more days ; she has been heartily eating iier food ; giving milk very 
 largely, or, more correctly, her milk has been remarkably rich, and 
 throwing up, when left for a time, a very heavy layer of cream ; and the 
 usual uterine lochial discharge has been suppressed. Or the case might 
 be thus stated : An excessive drain upon the system by the mammary 
 glands, causing, perhaps, the suppression of the uterine cleansing, with 
 the peculiar smell about the animal, and more marked in her milk, 
 which is referred to by Mr. Rolls, followed by a more or less severely 
 developed attack of indigestion. These causes act upon the nervous 
 centres, so as to produce the extraordinary excitement which has been 
 described. The dyspeptic signs are the more prominently shown ^such 
 as a desire to eat anything unclean in jjreference to good food, or coarse 
 straw in preference to roots or hay. The bowels beconie torpid, and 
 the supply of milk nearly ceases." 
 
 It is scarcely possible to believe that this condition is due to psychical 
 inrtuences, and it might more correctly be attributed to cerebral irrita- 
 tion from some physical cause^either indigestion, constipation, or 
 deranged circulation in the brain, and related to the parturient state. 
 
 Treatment. 
 
 If indigestion or constipation is present, purgatives should be admini- 
 stered, with stimulant or tonic medicines, according to the indications. 
 When there is much fury or excitement, narcotics in large doses may 
 be given — the best, perhaps, being chloral hydrate. Belladonna might 
 also be very serviceable. Great attention must be paid to the diet. 
 
 ' Gthurlxhiilje, p. H.t. 
 
 - Reptrtorlnm dtr Thitrheilkumlt, vol. viii. 
 
670 PATHOLOGY OF PARTURITION. 
 
 Giinther abstracted blood in large quantity, and gave extract of stramo- 
 nium. He also, on the supposition that the brain was congested, 
 applied strong stimulants to the back of the head and to the spine. 
 
 CHAPTEE YIII. 
 
 Parturient Laminitis. 
 
 With the Mare,^ a few days after foaling or abortion, there has been 
 sometimes observed an attack of congestion or inflammation of the feet, 
 which closely simulated the painful and serious malady known as 
 " Laminitis," and appeared to be related to the parturient state. The 
 disease does not seem to be very common ; though Obich- asserts that 
 it and metritis are the most frequent sequelae of parturition in the Mare. 
 It appears to have been first described by Tisserant^ in 1846 ; since then 
 it has been alluded to by Gloag and Smith^ in England; Fabry, Guilmot, 
 Lecouturier, Windelinck, and Deneubourg ^ in Belgium; Obich'^ in 
 Germany ; and Ayrault" and others in France. It has been observed 
 also as a complication of ruptured vagina. 
 
 Symptoms. 
 
 The symptoms of the disease are those of laminitis occurring under 
 ordinary conditions. They are suddenly manifested on the second or 
 third day after foaling or abortion, more rarely on the fourth day, and 
 very seldom later. In a small number of cases, inflammation of the 
 feet has been noticed either during or immediately after parturition. 
 Exceptionally, it has taken place within twenty-four hours after the 
 contents of the uterus have been expelled. As a rule, there has been 
 nothing remarkable in the case — birth having taken place naturally ; 
 sometimes, however, parturition may have been difficult. 
 
 The attack is either sudden, or only very indefinite premonitory indi- 
 cations are present. The animal becomes unusually restless, and moves 
 
 ' It would appear that Bovine animals are liable to a foot inflammation after parturi- 
 tion, as well as Glares. Roloff {]\Iittheiiu»gen aus de7- Thierai'ztUclien Praais in Preus- 
 zischen Staate, I860, 1866, p. 154) observed a peculiar inflammation of the feet of Cow.«, 
 supervening on parturition. Some days after that event, the skin between the claws 
 was observed to be reddened, swollen, and moist, and gradually the inflammation 
 extended to the coronet and heels (Ballen) ; the skin became more tumefied and dense, 
 and immediately above the claws was uniformly thick and red. In some cases absce.sses 
 formed at the coronet, the horn became separated, and finally the whole claw was shed. 
 The inflammation extended to above and behind the fetlock, and the pain was so great 
 that the animals ate but little, and consequently they soon lost condition. The hind- 
 limbs were most frequently attacked, first one, then the other, one being always more 
 affected than the other. The Cows had onl}' calved a short time previously. Roloff 
 supposed that the disease was due to contact of the skin about the hind-feet, with some 
 substance which had escaptd from the vulva after calving. He therefore insisted on 
 the utmost cleanliness being observed ; had the stalls cleaned out and sprinkled with 
 chloride of lime every daj', the hind-feet damped with chlorine water, particularly 
 between the claws, and afterwards sit eared with oil. By these measures the extension 
 of the disease was at once checked. 
 
 - Wochtnschrift fiir Thitrheilknnde, 1869, p. 105. 
 
 ^ Journal des Veterinairex du Midi, vol. ix., p. 347. 
 
 ■* Veterinarian, 1851, pp. 14, 258. 
 
 5 Annahs de Medecine Veterinaire, 1860, 1861, 1868. 
 
 '' Op. cit. 
 
 " liecueil de Midecine Veterinaire, 1866. 
 
I'AirrrniHXT lamimtis. 67i 
 
 its limbs — the fore ones especially — continually, wliile it exhibits si^'ns of 
 sutYering. There is fever, quick and hard pulse, hurried respiration, and 
 all the other signs of this most distressing foot-inflammation, the most 
 marked of which at this time is the disregard of the progeny. In other 
 cases the attack is more gradual ; there is loss of appetite, great thirst, 
 depression, hurried respiration, full, hard, and quick i)ulse, constipation, 
 etc. — premonitory symptoms which may continue for two, three, or four 
 days. The fore or hind feet may be affected. Tisserant and Guilmot 
 say the former, Deneubourg the latter ; though in some instances all the 
 feet may be involved. The position of the animal, if standing, indicates 
 the feet affected, and they are found to be extremely hot, the plantar 
 arteries throbbing, and percussion of the hoof causes intense pain. 
 During the inflanmiatitm the Mare evinces the greatest agony. If all 
 the feet are implicated, standing may be impossible; the expression is 
 anxious and pinched ; the respiration is hurried, jerking, and plaintive, 
 and the nostrils widely dilated ; the skin is usually covered with per- 
 spiration, and the production of milk is completely checked. Indeed, 
 the rapid disappearance of this secretion has attracted the attention of 
 nearly every observer. In the evening perhaps, there will be an abun- 
 dant supply of milk, and in the morning mulsion or suction will only 
 obtain a few drops of a transparent or reddish tluid, though the mamma3 
 may look as full and as well developed as usual. This suppression of its 
 supply of food is soon testified to by the Foal, which betrays its sensa- 
 tions of hunger by becoming less timid, and making itself familiar with 
 those around it. 
 
 The duration of the disease is from four to eight days; Franck says 
 from eight to fourteen days. The symptoms are certainly most intense 
 between the fourth and eighth day. The termination is generally 
 recovery, if proper treatment has been adopted ; though in some cases 
 the malady assumes a chronic form, with the accompanying deformity 
 and disorganisation of the feet. In rare instances, death may ensue 
 from nervous exhaustion caused by the excessive pain; or the intlamma- 
 tiun may run on to suppuration, and a fatal result arise from pyjcmia, 
 with purulent deposits in the lungs, brain, or other organs. 
 
 A favourable or unfavourable prognosis may, according to Guilmot, 
 be gained from the lacteal secretion. If this returns in tlie course of a 
 few days, it is a good sign. 
 
 Causes. 
 
 The cause or causes of parturient laminitis ai-e imperfectly known. 
 The prcdisposinij cause is generally recognised to be the parturient state, 
 though there is a wide divergence of opinion as to the way in which the 
 disease originates. Tisserant believed that it is due to a disturbance in 
 the functional equilibrium existing between the various organs. After 
 parturition, and particularly after abortion, there is manifestly a dis- 
 turbance of this kind ; there is, as Kainard correctly states, a general 
 superabundance of blood, and consequently a tendency to disease until 
 the equilibrium between production and consumption is restored. 
 Guilmot thinks that the space left by the fcctus must necessarily bring 
 about a series of exceptional phenomena, whose point of departure is 
 perhaps the superfluous supply of blood thrown into the circulation 
 after parturition. Deneubourg sees in this disease and parturient 
 collapse of the Cow, two different " modes of expression " of the same 
 disease ; and while recognising the justness of the expression employed 
 by the old hippiatrists, that " the fever has fallen into the feet," he is 
 
672 PATHOLOGY OF PAETUEITIOX. 
 
 inclined to think that the morbid localisation is due to sudden suppres- 
 sion of the lochia. " The larger animals," he writes, "are not exempt 
 after parturition from the depuratory process which takes place on the 
 internal surface of the woman's uterus after delivery, and known as the 
 lochia ; and its abrupt suppression gives rise to a disturbance — a fever, 
 which physicians designate ' puerperal fever,' and veterinary surgeons 
 ' vitulary fever.' The disease proper to the Cow is, in our opinion, 
 simple vitulary fever, which, in concentrating itself on the tendinous, 
 articular, and perhaps muscular tissues, may become a rheumatismal 
 vitulary fever. That of the Mare, until now unrecognised, is evidently 
 due to the same cause ; we cannot deny it a certain analogy with the 
 vitulary fevers which are witnessed m the -Cow, and we propose to 
 designate it by the name of vitulary laviinitis, to distinguish it from 
 essential laminitis." 
 
 Bouley was of opinion that parturient laminitis may be allied to that 
 other form which so commonly succeeds intestinal congestions from 
 accidental causes, or from drastic purgatives ; and that both varieties 
 may well be the result of a momentary paralysis of the vaso-motor 
 nerves of the keratogenous apparatus of the foot, under the influence of 
 a profoundly depressing action. 
 
 The occasional causes are quite as obscure. Tisserant asserts that 
 none of the ordinary causes of laminitis are special in their operation 
 here ; while Deneubourg adds that it attacks INIares without distinction 
 as to age, constitution, condition, or hygienic circumstances. Guilmot, 
 however, remarks that Mares which are submitted to moderate work, 
 and which receive an allowance of food in proportion thereto, are not 
 attacked ; while those which are fed on oats have always been the 
 subjects affected, so far as he has been able to observe. 
 
 There is the same diversity of opinion with regard to the influence of 
 parturition in the production of parturient laminitis. Tisserant has 
 noticed it occurring, in the great majority of cases, in Mares which had 
 aborted at a somewhat advanced period of gestation, or whose delivery 
 had been laborious or very difficult, from the wrong position of the 
 foetus or from some maternal obstacle. Deneubourg, on the contrary, 
 has observed it following parturition effected in the most favourable 
 conditions, as well as after abortion or difficult labour ; with Mares 
 which had expelled the foetal membranes, as well as with those which 
 retained them ; but never after a laborious parturition which required 
 manoeuvres more or less protracted and painful ; though he adds that 
 his brother had witnessed a case following laborious and artificial 
 delivery. It may be noted that Gloag^ gives an instance in which it 
 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 laminitis are usually applicable. In the majority of cases 
 the treatment need not, and should not, be heroic. If the fever runs 
 high, sedatives — as the tincture of aconite — should be given ; and it 
 may even be necessary to administer narcotics — as chloral or opium — 
 if the pain is very great. Some authorities recommend the abstraction 
 of blood, either generally or locally ; but many are averse to this 
 treatment. 
 
 •• Veterinarian, 1851, p. 14. 
 
I'ARrrniKXT lamlxitis. firs 
 
 The inflamed feet should he treated with the greatest care, and for 
 subduing' the inflainination nothing' can equal cold applications — either 
 cold water, cold poultices, or even ice. Continuous irri'^ation is to be 
 preferred, the water being applied by means of india-rubber tubing, 
 wliich carries the fluid direct from the water-tap to the foot. The latter 
 is thickly covered with pieces of thick flannel or tow, so as to diffuse 
 the water around it. The shoes should be previously removed, and the 
 wall of the hoof lowered, so as to allow the sole and frog to sustain as 
 much of the weight as possible. It is a good plan to litter the animal 
 on saw-dust or peat-moss. 
 
 Warm applications should never, on any account, be employed for 
 the feet. 
 
 When suppuration is apprehended or has set in, or even when the 
 eftusion or exudation is serious, an outlet may be made between the 
 sole and the wall, towards the toe of the hoof, for the escape of the 
 fluid. Astringent and antiseptic lotions or foot-baths may be useful. 
 .\t the commencement of the disease, and sometimes at a later period, 
 when it threatens to become chronic, stimulating applications — even 
 blisters — may be applied with advantage to the limbs above the 
 fetlocks. 
 
 The diet should be light, and limited to mashes, grass, a small quantity 
 of good hay, and nitrated water or gruel as drink. The body should be 
 comfortably, if not warmly, clothed, and friction to the skin is often 
 beneficial. 
 
 The Foal should be allowed to remain with the Mare, as its frequent 
 sucking is likely to hasten the return of the milk, which is, as has been 
 already remarked, a most favourable sign. 
 
 If constipation is present, laxatives should be administered, and 
 emollient enemas are then, as well as at other times, most useful. 
 
 CH.VPTER TX 
 Mammitis or Mastitis. 
 
 In treating of pregnancy, allusion was made to the function of the 
 mamma>, and it was pointed out that this function — except in rare 
 cases, when it may be independent of pregnancy or the parturient 
 period, and even manifest itself in the male sex — is, in manunals, peculiar 
 to the period of parturition and rearing of the young. Some time before 
 the progeny is born, the mamma; begin to enlarge ; they become 
 pendulous and their density increases, while they are more vascular; if 
 not marked bv dark pigment, their colour is observed to have changed, 
 and the teats are considerably developed. So that at parturition the 
 glands have attained dimensions and ofTer appearances very dift'erent to 
 those exhibited a short time previously; while the fluid— the milk — 
 provided by Nature for the sustenance of the young creature after birth, 
 is secreted in more or less considerable quantity — generally in propor- 
 tion to the development of the mamma\ 
 
 With the exception of some species — such as the Cow and Goat, 
 sometimes the Ewe and Ass (and also the Mare among the Khirgiz), in 
 which the secretion is maintained artificially for some time beyond its 
 natural duration, and, with the former animal especially, almost per- 
 manentlv — the function is essentiallv intermittent : being most active 
 
 43 
 
674 PATHOLOGY OF PARTURITION. 
 
 during the parturient or puerperal period, and ceasing when the progeny 
 no longer requires milk. It is during this period that the activity of the 
 mammae exercises so much influence on the health of parent and off- 
 spring, and it is also at this time that these glands are most liable to 
 derangements which are more or less serious. Even 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. 
 But 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 
 with olive-oil, or fomenting it with decoction of marsh-mallows. This 
 might be termed the normal or 'physiological engorgement of the mammae ; 
 but there is also a ijatliological 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 the commencement of inflam- 
 mation of these glands. 
 
 Pathological Congestion of the Mamm^. 
 
 Hyperaemia or congestion of the mammae is not very uncommon, and 
 all female animals are liable to it ; though it is most frequently observed 
 in the Cow, Mare, Ewe, and Bitch, in degrees varying rather with the 
 causes which determine than the phenomena that accompany it. 
 
 Causes. 
 
 Congestion of the mammae is due to various causes : among which 
 may be cited injuries, exposure to cold air or water, or over-repletion — 
 the stings of insects have also been blamed. There is generally a 
 sympathetic excitement existing at this time, either 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 milked at the proper time. The tendency 
 of the mammae 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 become 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. 
 
 Symptoms. 
 When the congestion is due to accumulation of milk, the symptoms 
 are, of course, only gradually developed ; but if arising from injury, then 
 they may appear suddenly, a certain part becoming all at once swollen, 
 hard, and tense, but without altogether losing its softness and elasticity. 
 There is neither redness nor great sensibility ; the swelling is not 
 oedematous, and does not "pit"; there is but little fever, and the appe- 
 tite is not much affected. 
 
MA MM IT IS on MASTITIS. 675 
 
 An important consideration in these affections of the mammtr, is that 
 relating to their anatomy. As was shown at pp. 32-3o, in the Mare, 
 Ewe, and Goat, they are formed of two perfectly distinct glands placed 
 together in the inguinal region ; while in the Cow they are composed of 
 at least four glands or "quarters" in close contact, and apparently form- 
 ing one mass in the prepubic region ; and in the Sow, 13itch, and Cat, 
 they are numerous and distinct from each other, and extend from the 
 inguinal to tlie thoracic region. When we know that all the glands 
 may become congested or inflamed, or only one — or even only a certain 
 number of acini in each gland — we see at once that morbid conditions 
 may give rise to very diverse symptoms, due to these anatomical 
 peculiarities. 
 
 With the Cow, congestion may therefore be limited to one gland or 
 " quarter "; though at the commencement the whole udder may be 
 swollen, and localisation only occur at a later period. The same is 
 obsen-ed with the Bitch and all the other animals with numerous 
 mammye : there is always at first general engorgement, before it is 
 finally localised. The tumefaction partakes somewhat of oedema, from 
 its readiness to pit on pressure, and there is often a doughy swelling 
 around the udder, which, in some instances, extends to the other parts 
 of the abdomen. The latter symptom is most noticeable in Mares, in 
 which, in the course of a few days, the mammary swelling altogether 
 disappears, leaving only an cedematous tumour towards the umbilicus. 
 
 The secretion of milk is diminished ; at first it may be normal in con- 
 sistence, and exceptionally it may offer streaks of blood, which give it 
 more or less of a rose tint. When this condition continues, however, 
 its degree of fluidity is changed, and it becomes lumpy and clotted, 
 being partially coagulated in the lactiferous sinuses and canals, and the 
 coagula of casein are evacuated at the same time as the other portions 
 of the milk, which is sometimes nothing but pure viscid, yellowish 
 serum, having a sweet taste; sometimes these coagula — round or 
 cylindrical masses — obstruct the canals, and prevent the escape of the 
 milk. Fiirstenberg states that he has sometimes found casts of epithe- 
 lial cells in them, and that about the third or fourth day tlicre are 
 globules of colostrum. This alteration in the milk may be limited to 
 that from the affected gland or quarter ; in the others the secretion may 
 be healthy, though less abundant. 
 
 This condition most frequently terminates by resolution, and very 
 often without treatment — the tumefaction disappearing in a very brief 
 time, or in the course of four to eight days ; though the milk may 
 remain less plentiful for some time, and up to the eighth or twelfth day 
 may still contain colostrum corpuscles. In other cases, the quantity of 
 milk remains less than usual ; and when relief is not afforded, we may 
 have inflammation supervening, and the formation of one or more 
 abscesses. 
 
 In the great majority of cases, it is probable that this condition 
 commences in, or is limited to, the parenchyma of the gland, which 
 receives an inordinate supply of blood. This leads to a congested con- 
 dition, and consequent diminished lacteal secretion, with serous infiltra- 
 tion into the interlobular connective tissue. According to Fiirstenberg,^ 
 the milk contains more particularly the solid elements of this fluid, and 
 also the epithelium yet undergoing that change which should be com- 
 pleted in the acini. 
 
 ' Milchdriisen der Kiihe. 
 
676 PATHOLOGY OF FAETURITIOK. 
 
 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 oedema (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 the gl&nd (Entzilndung 
 der Ueberzilge des Enters und des Zellgeicehes). 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 high 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 much inflamed, as in the erysipelatous form, Franck 
 thinks it probable that a special cause — a kind of infection of the skin 
 — is in operation. 
 
 Treatment. 
 
 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 relief, and aid in dispersing the tumefaction. 
 
 When mammitis is apprehended, Ziindel highly recommends in- 
 unction with camphorated pomade, which, he 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 hniment of 
 carbolic acid (one part) and olive-oil (thirty to forty parts). 
 
 Inflammation of the Mamm^. 
 
 All the domestic animals are liable to inflammation of the mammae; 
 and it is somewhat frequent after parturition, though it also appears 
 after abortion. The Cow is oftenest attacked, and from the importance 
 of the lacteal secretion in this animal 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 
 
MAMMITIS on MA a Tins. 67^ 
 
 Goat and Sheep, and is still more rare in the Mare. It is seldom 
 witnessed in the Bitch, Sow, or Cat ; though when it does occur in the 
 foinner, it is liable to lead to the formation of neoplasms of different 
 characters in the glands. 
 
 Various kinds of inriamniation of the mammary glands have been 
 described — such as superficial or subcutaneous, and deej) ; acute and 
 chronic, acticc and ^^tiisa-c or latent, and a rheumatisiiial form ; while 
 Saiut-Cyr gives a catarrhal, a i)}ilc(jmonous, and a parcnchijmatous 
 mamniitis. 
 
 The catarrJial form is — so far as its symptoms are concerned — allied 
 to that which we have described as due to congestion, and consists in 
 an inflammation of the mucous membrane lining the teats and lactiferous 
 sinuses. This inflammation is generally caused by the retention of 
 millc in the gland ; this fluid becomes altered and coagulated, and the 
 clots irritate tlie membrane and inflame it, the inflammation extending 
 to the acini after a time. In the Cow the inflammation usually com- 
 mences in one quarter or gland, and may remain limited to it ; or it 
 may extend to the other quarter of the same side, and even to one or 
 both of the opposite side — though this is rare — by an extension of the 
 morbid process from the acini to the interstitial and interglandular 
 connective tissue. When more than one quarter is involved, then the 
 disease in each varies in intensity. 
 
 When limited to the mucous membrane, the inflammation induces a 
 kind of catarrh or special galactorrhcea which, according to Gerlach, is 
 not at all uncommon, and accounts for the serous or watery milk some- 
 times given by Cows ; and the same agency may lead to the spontaneous 
 coagulation of the milk, without any acidity being present. 
 
 Sijmjjtonis. 
 
 The animal does not at first appear to be much affected, and the 
 swollen gland or glands are evidently not very painful, the pain being 
 probably of a dull character. The skin is tense and shining, though 
 perhaps not reddened ; the teat is greatly enlarged, hard, and some- 
 what sensitive to manipulation. The swelling is rather ^edematous 
 superficially, but when deeper the tissue of the gland is found to be 
 somewhat harder, and towards the teat rather lumpy, from the presence 
 of coagula of casein. 
 
 By mulsion, a rose or i-ed-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, though for 
 more days it may contain numerous colostrum and pus globules. If 
 neglected, however, or mismanaged in treatment, the 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, all emitting a highly ammoniacal odour. 
 
 This catarrhal condition may continue for a considerable time, and it 
 may happen that the matter contained in the sinuses and ducts, be- 
 coming inspissated, escapes from the teat with difiiculty, or not at all ; 
 so that, in accmnulating in these cavities, it forms deposits — half milk, 
 
678 PATHOLOGY OF PARTURITION. 
 
 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 
 means of the lancet, these "lacteal abscesses" discharge a large quantity 
 of foetid mattei". Then the general phenomena disappear, the tumefac- 
 tion and sensibility diminish, the suppuration — though it may persist 
 for some time — gradually decreases, and the normal secretion of milk is 
 finally established. In other instances, all the symptoms disappear 
 except the clotted character of the milk, and the 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. Tbey 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; but they always constitute 
 a more or less serious obstacle to the flow 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 difficult, and in all 
 cases they may give rise to extreme distention of the gland, and lead to 
 the formation of abscesses or parenchymatous inflammation. 
 
 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 Cow has been located in a stable 
 where the disease prevails, a quarter of the 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 ; finally, it becomes serous, flaky, of a 
 yellowish 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 the animal does not seem to be afl'ected, though 
 it appears to be more difficult to fatten. So long as the disease is 
 limited to one quarter of the 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 'plilecjmonous ma^nmitis described by Saint-Cyr, is always more 
 serious than the catarrhal form. It commences with several generally 
 very well-marked febrile 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 authorities, 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 general febrile reaction at the very commencement of 
 phlegmonous mammitis. 
 
 In a very brief period the udder acquires a considerable, sometimes a 
 great volume — in the Cow, often reacliing as low as the hocks, or even 
 ^ Archives Vtttrinaire, 1884. 
 
MAM Mir IS on MASTITIS. 679 
 
 lower; the swelling is a?deniatous, " pitting" deeply on pressure; but 
 it is hot, intlammatory, very painful, and extends beyond the gland — 
 at times towards the vulva and umbilicus or sternum with the Mare 
 and Ewe. Beneath the ojdematory tumefaction the gland texture can 
 be 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. Progression, 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, especially on the 
 affected side of the gland. The creature, for the same x-eason, seldom 
 if ever lies down ; when it does so, it is on the side on which the gland 
 is least affected. There is often much restlessness and anxiety, and 
 the Mare may show symptoms of colic. The seci-etion of milk suddenly 
 ceases, and pressure on the teat only causes a small quantity of 
 reddish-coloured grumous fluid to How. 
 
 All these symptoms may become aggravated in four, six, or eight 
 days, when the malady may terminate by resolution, suppuration, gan- 
 grene, or induration, according to circumstances. 
 
 Parenchi/inatoits via77nnitis, or inflammation of the proper glandular 
 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 suffering, though not 
 of a very acute kind ; the pulse is full and quick, respiration 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 mutHe hot and dry ; there are rigors, and muscular twitchings 
 or tremblings, particularly towards the shoulders and Hanks. The 
 conjunctivae are injected, the skin more sensitive than usual, and the 
 Cow manifests pain when the 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 tlie 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 ctdematous, 
 as in the 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 
 mannnio ; 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 mammo! in the Mare. 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 dimmished 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 
 
•680 PATHOLOGY OF PARTURITION. 
 
 character ; at other times it is putrescent and foetid. Microscopically, 
 it is found to be composed of particles of solidified casein, a few fat 
 globules, epithelium from the milk vesicles and ducts, but more espe- 
 cially pus and red blood-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 
 in this fluid. Chemically, it contains little casein, milk, sugar, or fat, 
 but much v^ater and albumin. 
 
 The progress of the disease is very rapid — more so than in either of 
 the other forms ; in twenty-four, thirty-six, or forty-eight hours — some- 
 times even in less than the first-named period — the disease has reached 
 its greatest intensity. The attack is generally very sudden — the animal 
 being apparently quite well when left for the night, and perhaps pre- 
 senting all the symptoms described when seen again next morning. 
 When it has reached its culminating point, it may remain stationary 
 for two, three, or four days before passing to one of its ordinary termi- 
 nations. Towards the third or fourth day the vicinity of the gland 
 becomes oedematous, and this oedema may extend to beneath the chest 
 and as high as the vulva — in the Mare, to the inside of the thighs and 
 •down the hind-legs. 
 
 Course and Terminations. 
 
 The course and terminations of mammitis are matters of much im- 
 portance. It rapidly passes through its different phases until the 
 fourth, rarely until the sixth day, when it terminates either by resolu- 
 tion — which seldom indeed occurs without prompt treatment ; atrophy ; 
 induration ; snpijuration ; gangrene; or even the death of the animal. 
 
 Eesolution is, of course, by far the most favourable termination. In 
 the parenchymatous form it can rarely be rendered complete, even by 
 the most rational and vigorous treatment, after the second or third 
 day ; in the phlegmonous form it may occur so late as the fourth to the 
 sixth day, but seldom after the eighth. It is marked by a gradual 
 diminution in the intensity of the symptoms — general and local, and 
 particularly in the pain, which first disappears, then the tumefaction 
 and induration. 
 
 Saint- Cyr lays much stress on the decrease in density, with regard 
 to prognosis. If it persists beyond the time stated above — if after 
 forty-eight hours in parenchymatous mammitis, or six days in the 
 phlegmonous form, the gland has not, to any marked extent, lost some- 
 thing of its woody hardness, there is great reason to fear that resolution 
 will not be complete, and that some portions will remain indurated, or 
 that the mass will become either partially or totally atrophied. 
 
 Though the subsidence of the fever and decrease of the swelling are 
 in themselves favourable signs, yet they may be deceptive with regard 
 to thorough resolution ; and it must be recognised as more favourable 
 when the tissue of the gland resumes its softness and suppleness, rather 
 than when the swelling subsides rapidly and the hardness remains but 
 little altered. 
 
 It is scarcely necessary to mention that the return of the normal 
 secretion to the affected gland is a most favourable sign, though this 
 does not occur very rapidly. For several days^ — from ten to twenty, or 
 even more — the fluid obtained from the teat of the affected quarter re- 
 mains watery, or rather serous and curdled ; it contains numerous colo- 
 strum cells, and is more albuminous than caseous — coagulating readily 
 
MA MM IT IS nil MASTITIS. 681 
 
 by heat, and having little cream or sugar. But it gradually recovers 
 its usual composition and increases in quantity, imtil at last, in amount 
 and quality, it does not differ from that furnished by the other quarters 
 of the mamniic. It sometimes happens, however, that with regard to 
 the lacteal secretion, though the gland regains its normal si/e and soft- 
 ness, it does not acquire its full functional activity until the next 
 pregnancy and tiie 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. 
 
 Atrophji 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 
 connective tissue or the inflammatory 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 mammic 
 become deformed and asymmetrical ; the teat retracts and assumes an 
 abnormal direction, and little, 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 
 mammic 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 suffers less 
 pain, the appetite returns, as well as rumination, if any oedema was 
 present it has disappeared, but yet the gland does not regain its 
 healthy character. The inflammation 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-de6ned, and rounded 
 masses which have an almost stony hardness, and are apparently 
 adherent 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 ; though for a long time the local temperatiire 
 is higher than usual, and the animal evinces uneasiness when it lies 
 down. The induration of the swollen gland, often visible externally, 
 
682 PATHOLOGY OF PARTURITION. . 
 
 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 few coagula of casein, epithelium casts, and sometimes even 
 veritable diphtheritic false membranes. In such a case, all the parts 
 of 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 mammse 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 mammae of this animal, but a 
 consideration of which cannot be entered upon here. 
 
 Supintration — by 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 skin, and between it and the tunic of yellow fibrous tissue 
 covering 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 the 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 circumscribed. 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 
 febrile symptoms diminish, and the general condition improves ; the 
 swelling in the gland subsides, along with the pain ; pus escapes 
 from the opening for two or three weeks, and finally ceases, the 
 wound becoming cicatrised. Recovery is now complete, and nothing 
 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 that between the mammae and the 
 abdomen. Here the pus is deep-seated, and it burrows or spreads 
 wherever 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 
 of the gland ; while in some cases it may cause death from the 
 violence of the inflammation and intensity of the pain, or through 
 exhaustion from the long-continued aud profuse suppuration. 
 
 When 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 of the tissues, which resist distention, the pain pro- 
 duced by the inflammation is most acute and distracting; while the 
 
MAMMITIS OR MASTITIS. 683 
 
 process of suppuration destroys a greater or less number of the acini, 
 and the pus — deep-seated — is long before it reaches the surface of the 
 gland, causing great havoc in doing so. Sometimes the interstitial 
 abscess opens into a milk sinus, and partly escapes by the teat during 
 milking. The pus is then mixed with the serum of the milk, and perhaps 
 there are clots of casein and shreds of glandular tissue, the fluid having 
 a highly amraoniacal odour. The pain is less, but docs not cease, 
 and it is generally necessary to make an external opening for the 
 readier and more complete evacuation of the matter. There is 
 generally much destruction of tissue, and cicatrisation is diflicult and 
 tedious, particularly when there are lacteal fistulae. Not infrequently 
 the abscesses are multiple, and in some instances there are as many 
 as there are intlamed lobules. In other cases one abscess succeeds 
 another, owing to the presence of dead tissue in the mass of the gland. 
 
 Even when the abscess opens externally, and the other quarters 
 yield milk, the pus is, of course, liable to pass into that lluid, and to 
 render it most objectionable as food. So that during the whole of the 
 suppurative period, tlie 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. 
 
 Filrstenberg has drawn attention to a cold abscess, often observed in 
 the udder of Cows more particularly, and due to the spontaneous 
 softening of a chronic tumour or induration — the softening being the 
 result of fatty degeneration. The tumour loses its hardness, and the 
 softening 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 escaping ; or it may evacuate 
 its contents into one of the milk sinuses. 
 
 The secretory function of one or more quarters of the mammae 
 may be quite destroyed — a serious result witli valuable Milch Cows. 
 
 (jaii-jrcnc of the whole or a portion of the udder, is not an un- 
 usual termination of mammitis, and is, of course, tlie most serious 
 one, except the death of the annual. It may be limited or ditTused. 
 The first frecjuently 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 mammii; by the pus burrowing around it, and thus 
 cutting off 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 is found lying on the ground among the feet of the animal. 
 In this way Nature gets rid of tlie diseased portion, and recovery be- 
 comes possible. The gangrene is generally limited by a dense band 
 of fibrous tissue. In many cases surgical interference is necessary 
 when the mammae mortify; and when this 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 diffuse, gangrene of the mamma; 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 
 
684 PATHOLOGY OF PARTURITION. 
 
 looks prostrated ; 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 perinasum. At first 
 oedematous, 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 commencement 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 
 mammte; the temperature is elevated; attempts to milk, which cause the 
 utmost distress, only result in obtaining a few drops of reddish or semi- 
 purulent fluid 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 conjunctivae 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 tremblings ; 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 liable 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 
 literature, and particularly those given by Toggia, Yvart, D'Arboval, 
 Eoche-Lubin, Lafosse, Nocard, and others. That recorded by Yvart, as 
 occurring in the Alfort flock in 1833, is interesting. Kotelmanni gives 
 a very good description of the disease, as he observed it. In 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 {milcliicasser) dropped from the 
 teat, and when the latter was squeezed curdled milk, or milk in firm 
 clots about the size of a jpea, 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 
 difficult, the hind-leg tow^ards the inflamed side of the udder being most 
 slowly and cautiously extended, as if lame ; when both mammae were 
 afiected, 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 
 1 ZeitschriJ't fiir die P. Thierheilkunde von Nehd und Vix, 1836, p. 423. 
 
MAMMITIS on MASTITIS. 685 
 
 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. 
 If, in the first twelve hours, the malady did not yield to antiphlogistic 
 treatment, the skin covering the part and tlie hard gland, hitherto hot, 
 became cold, painless to the touch, and assumed a dark-blue, glazed 
 appearance. Then an u'dematous 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 a^dema was a sure sign that gangrene had commenced in 
 the mass of the diseased gland, and the sanious Huid which could be 
 drawn fron; 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 oedema extending tliere- 
 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 sutliciently 
 empty the udder, and which were well fed. 
 
 Kotelmann believed that this insufficient evacuation of the manmia?, 
 mechanical injury to the teat, etc., was the cause. 
 
 Pathological Anatomi/. 
 
 In the majority of instances, the interlobular connective tissue is the 
 principal seat of the inflammation, 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 marania^ ; 
 though the inflammation of the proper gland-tissue will bring about 
 the same results. Retention 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 fistula) 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 
 
686 PATHOLOGY OF FARTURITIOX. 
 
 an inflammation of the acini, but also of the intervening connective 
 tissue, involving the lymphatic system ; consequently, there is reason to 
 suspect the disease to be infectious. 
 
 When circumscribed gangrene has occurred, and elimination of the 
 diseased part is accomplished, the dead mass may weigh as much as 
 five or six pounds in the Cow ; it is somewhat regularly oval, but 
 rather flattened and discoid in the Mare ; the colour is a light or pale 
 yellow, and in consistence it is pulpy but not elastic, and the finger 
 cannot be easily passed into its substance ; traces of its lobulated 
 structure can still be perceived, and if a section be made of it, all the 
 characters of the mammary gland can be 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 distended or choked with coagulated milk, pus and serum, the 
 whole forming a diversely-coloured fluid. In the veins are sometimes 
 blood-clots, variable in colour and consistency ; gas and foetid fluids 
 escape from the tissue on section ; and the oedema is found to be due 
 to infiltrations of yellow serum in which are brown and greenish streaks. 
 This fluid, examined microscopically, has much the appearance of that 
 found in animals which have died from septicaemia. Shreds of necrotic 
 tissue are also met with. 
 
 Causes. 
 
 Mammitis appears to be due to the most diverse causes. Among the 
 principal predisposing causes, the first is lactation — the disease appear- 
 ing immediately before or soon after parturition ; and the animals whose 
 mammae are most active at this period, are those most frequently 
 attacked. In the great majority of cases in the Cow — in which animal 
 it is most serious — it follows within 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 afi'ected at any time ; yet the lacta- 
 tion period — that when the mammse are at the height of their function, is 
 the time when this inflammation is generally met with. With those 
 animals whose milk is only utilised to rear their progeny, sudden 
 separation from their young without any precautions is often noted as 
 an exciting or predisposing cause. The great activity of these glands 
 in the Cow, and the long time during which this activity is maintained, 
 is, there can be no doubt, one of the chief reasons why this animal 
 so often suffers from this affection. 
 
 Mechanical causes may produce this inflammation — such as con- 
 tusions, wounds,^ injuries in milking- or sucking, blows from the head 
 of the young creature, etc. Parenchymatous inflammation of the gland 
 may also be due, according to Franck, to a deep purulent wound in 
 
 ^ Gotze (Sachs. Jahreshericht, 1867, p. 92), quoted by Franck, mentions an instance in 
 which the posterior part of the udder of a Cow became inflamed, and soon there was a 
 severe attack of mammitis. When the animal was killed, a large abscess was found in 
 the gland, and in it were two common pins which Gotze thought might have ptnetrated 
 there from the rumen. 
 
 - In those countries where the milk of Ewes is utilised, like that of Cows, in the pro- 
 duction of cheese — as at Roquefort, where cheese bearing this name is largelj* manufac- 
 tured — mammitis appears to be very frequent, and has been attributed very often to the 
 rough handling the teats and udder receive in milking. 
 
 Rnche-Lubin says that he has often witnessed shepherds acting so violently in milking, 
 that the Ewes could scarcely breathe, staggered in their hind-limbs, and sometimes fell 
 from the pain and shock. 
 
MAMMITIS on MASTITIS. (587 
 
 the canal of the teat, especially that produced in dilating this channel, 
 or in the removal of papillomatous tumours from this part.' 
 
 In these cases infection may occur from the wound itself, or through 
 micro-organisms passing into the canals from without. In support of 
 the latter view, wliich will be referred to again, we may mention that 
 Viseur has attributed catarrh of the membrane lining the milk-ducts 
 and sinuses to the too frequent employnient of the teat-tube or syphon ; 
 this more or less paralyses the sphincter of the teat, and through the 
 relaxed aperture the air, charged with germs, irritates and inflames the 
 membrane. 
 
 " Overstocking " of the udder with milk has generally been considered 
 a very likely cause in the production of inflammation. The sudden 
 removal of the young, imperfect milking, etc., have also been blamed. 
 Franck, however, appears to doubt the influence of mammary disten- 
 tion, and some observations and experiments would tend to prove that 
 this does not always cause inflammation. For instance, Cows which 
 had suff^ered from mammitis, and had temporarily lost the function of 
 one or two quarters of the mammui, were found at the next lactation 
 period to have recovered the secretory power of these glands, but the 
 excretory canal in the teat was obliterated. Consequently, great dis- 
 tention occurred, and this was not relieved by an artificial opening. 
 Nevertheless, no inflammation ensued ; after the third day there was 
 a marked diminution in the turgescence of the quarters, and in about 
 eight days they had resumed their normal volume. And Kehrer has 
 experimentally shown that extreme distention may not cause inflamma- 
 tion, by closing two teats of a pregnant Bitch with collodion, and so 
 securely that at birth the Puppies could not remove it. The corre- 
 sponding glands were much distended with milk, but no inflammatory 
 action was set up. 
 
 The influence of cold and wet, and especially the former — particularly 
 when animals rest with the udder on the ground — has also been ascribed 
 as a cause of mammary inflammation, but probably there is some 
 exaggeration in this ; as Cows which are seldom housed sufTer less, 
 perhaps, from this malady than those kept in warm cowsheds. Cold 
 winds or draughts in cowsheds have been especially alluded to as 
 operating powerfully in its production ; and though these and lying on 
 cold ground do not produce the disorder so frequently as is imagined, 
 yet there can be no doubt that while the udder is very active, and it is in 
 a state of almost constant hypera?mia, it will be more susceptil)le to 
 alternations of temperature, particularly if the animal is rendered deli- 
 cate by high feeding and an artificial existence. 
 
 Certain atmospherical conditions — as electrical storms — have been 
 supposed to exert some influence also ; and extensive outbreaks of 
 mammitis have certainly been observed to coincide with these disturb- 
 ances — the udder being attacked with a kind of phlegmonous erysipelas. 
 
 ' Noquet (Recueil lie M^il. Vittrhiaire, IS.'d) ftllndos to a Cow in which, in conBe- 
 qnence of mainmitJ!*, for six months the two j.)o»torior quarters of the iKidnr lost their 
 p<)wer of secretin^ milk. It afterwards c ilved, and the siniineH of these <|iiarterR were 
 tilled with milk, but none could escaj^x.', owing to the teat canals l)eing closed. By means 
 of a knittini;-needle, artificial pasiaces were made, but these became deep purulent 
 fissures. When Noquet first saw the Cow, three quarters of the mammte were enormously 
 swollen and gangrenous. Deep scarifications were made, and repeated dressings ap[>lied ; 
 while camphorated draughts wtre administered internallj-. The three quarters were 
 destroyed, leaving only the left anterior quarter. Half a year afterwards all had cica- 
 trised, and there remained only a fistula. The animal waa in good condition, and was 
 therefore slaughtered. 
 
688 PATHOLOGY OF rARTURITION. 
 
 Faulty hygiene has been looked upon as aiding in the development of 
 mammitis ; filthy and badly ventilated dwellings being greatly blamed 
 as tending to generate a miasma, which exerts a special influence on the 
 udder. 
 
 Plethora has been imagined to be, if not an exciting, at least a pre- 
 disposing cause, and so has hot weather. Bardy gives a description of 
 an epizooty of mammitis which was said to be due to the Cows con- 
 suming ranunculaceous plants, which were very abundant in the fields 
 where the animals grazed. The people in the locality assured him 
 that this always occurred when these plants were most plentiful in 
 certain years. 
 
 Mammitis sometimes complicates or accompanies vaginitis, metritis, 
 peritonitis, etc., according to some authorities. 
 
 There is much reason to believe that a particular form of mammitis 
 is due to a putrid or septic infection, and Franck is one of the strongest 
 supporters of this view. Indeed, he asserts that the majority of cases 
 of mammitis are of septic origin ; and he has experimentally proved the 
 correctness of his statement. For instance, he has repeatedly injected 
 into the teats of healthy Cows, pus from the udder of those affected 
 with mammitis, or fluid from putrid flesh, as well as putrid blood, and 
 within twenty-four hours an acute inflammation of the corresponding 
 quarters has been observed. This inflammation occurred in Cows whose 
 udder was in active function, as well as those which were " dry." The 
 uninjured epithelium of the milk sinuses and vesicles is, therefore, not 
 protective of the gland like the pavement epithelium of the vagina ; for 
 it has been shown that when putrid flesh or blood-fluid was injected 
 into the uninjured vagina of Ewes and Cows, no inflammation was 
 set up.i 
 
 ' One of Franck's experiments is instructive. A Cow which gave only a small quantity 
 of milk, had, on February 26, 1875, a quantity of fresh pus from the" udder of another 
 Cow suffering from mammitis, and diluted with ten times its bulk of water, injected 
 into the te*t of the left anterior quarter. Next day this quarter had all the appearance 
 of being affected with parenchymatous inflammation. The other three quarters were 
 generally intact. The secretion from the diseased quarter was yellow, creamy, and pus- 
 like. It only contained pus-globules in great quantity, and these weie studded with 
 micrococci ; there were also some epithelial cells, milk globules and small masses of 
 coagulated casein. On February 28, the inflammation had extended to the left posterior 
 quarter. 
 
 In another experiment he injected some putrid flesh-fluid into the milk-duct of a teat. 
 Next day this quarter of the udder was affected with acute parenchymatous inflamma- 
 tion ; the milk was curdled, purulent, and contained large numbers of pu3 corpuscles and 
 micrococci. In a few days the adjoining quarter was likewise involved. 
 
 In the veterinary journal of the University of Pisa {Giornale di Anatomia, etc., degli 
 Anbnali, 1875), Professor Rivolta describes a form of mammitis prevailing among Sheep 
 in the neighbourhood of Pisa, towards the end of winter and commencement of spring, 
 and to which he has prefixed the designation of " septic." He gives it this designation 
 because, when it begins at a certain part of the mammary gland, there is noted a kind 
 of putrefaction of the juices of the skin, as well as of the gland itself ; and besides, in 
 the sero-sanguinolent fluid in the connective tissue of the gland are remarked a very 
 active element in the process of putrefaction, in the presence of micrococci and bacteria. 
 
 The disease appears to be perfectly distinct from the gangrenous mammitis, and the 
 gangrenous or anthracoid erysipelas, described by various writers. It is a local malady 
 which usually invades the gland, extending at a certain rate of progress, and most 
 frequently proving fatal. It ordinarily commences in the neighbourhood of, or in one of 
 the teats ; if the latter, it offers a circumscribed ojderaatous tumefaction, while the 
 surface of the skin thereon is intensely red. This red patch rapidly assumes a grey 
 colour, and finally becomes almost black. Sometimes blood escapes from the affected 
 teat. This oedematous swelling and discoloration gradually extend, and in a more or 
 less brief period of time have invaded one-third or one-half of the udder — not even sparing 
 the tissue of the gland. The whole of the affected part is then tumefied, doughy, some- 
 
.1/./.1/.W77.S' OR MASTITIS. 689 
 
 The structure of the teat and arran^'einent of the inilk- sinuses and 
 ducts in the Mare, Ruminants, and Swine, are, in the opinion of Franck, 
 favourable for the reception of infection ; and this accounts for the 
 readiness with which parenchymatous inflammation of the udder occurs 
 very early in foot-and-mouth disease, the virus of this specific malady 
 finding its way from the surface of the gland into the teat. The wider 
 prevalence of mammitis in close sultry weather during summer, than in 
 cold winter weather, may be accounted for by the readiness with which 
 organic matters putrefy. By the way of infection, those extensive out- 
 breaks of mammitis which occur among flocks of sheep may also 
 be explained. Those cases of the disease which follow abortion, or 
 accompany metritis or vaginitis, may also be attributed to auto-infection, 
 instead of metastasis; indeed, in Franck's view those maladies which 
 lead to the formation of putrid or septic matter — such as parturient 
 fever, omphalitis in the progeny, retention and putrefaction of the after- 
 birth, etc. — may all be productive of mammitis in this way. Disease of 
 the progeny may also give rise to it, the infection being conveyed to the 
 teat by the young in the act of sucking. The hands of milkers or others, 
 or soiled litter or gi'ound on which the animal lies, may also be the 
 means of conveying the infection. Franck believes that the column of 
 milk in the sinuses and ducts is first tainted, and that this is effected 
 through the milk at the end of the teat — a drop or two of which may 
 be suspended therefrom. A chemical change is thereby brought about 
 in the milk, and this altered secretion leads to the inflammation, wliich 
 is secondary. An alteration in the character of the milk is, it will be 
 remembered, one of the first symptoms — if not the first — of mammitis. 
 Consequently, "dry"' Cows, or those to which the infection cannot 
 obtain access, are not attacked by the malady ; and " dry " Cows 
 suffering from foot-and-mouth disease never have parenchymatous 
 mammitis. 
 
 In 1SS4, Nocard bad an opportunity of confirming Franck's views 
 while investigating an enzooty of mammitis that had prevailed among a 
 number of Cows for six years. In milk from the affected udders, he 
 constantlj' found a special micro-organism which could be readily culti- 
 vated in milk and other fluids ; when the twelfth culture of this germ 
 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 
 health. This injection had no effect on the Bitch. 
 
 what consistt^nt, slightly f)r not at bII sensitive, .ind dark or blftck in \\\\v. Tlie line oi 
 demarcation between the healthy and diseaoed portion in perfectly defined ; the former 
 being of a ro'v colotir, and normal in nizn and consistency. The diseased condition 
 spread.** l>eyond the tidder to beneath the alnlonien, and when an ulcer apfiears on the 
 ^land. di<chart;ini,' a f<itid sanguinolent fluid, the animal then becomes depressed and 
 le\eri^h, debility and emaciation set in, and the cr'ature succumbs to an attack rif 
 septika'mia. 
 
 The numerous necroscopical examinations made by Kivulta confinn, in his opinion, the 
 distinction he has establi."he<l lH;tween this special malady and erysipelatous mammitis. 
 With reijard to the causeo, the shepherds affirm that the malady attacks those sheep 
 which are kept for a long time "n a thick bed of litter ; others, again, .i.Hsert that it 
 appears when they .tre allowed to pasture in the oj>en air, and are not confined. The 
 same uncertainty prevail- with regard to its contagiousne«s. The shej>herds carefully 
 isolate the affecte<l animals : and it would seem that, by their doing so, the disease is 
 limited to those first attacked. 
 
 Rivelta is of opinion that this form of mammitis is produced and maintained by 
 special micrococci and bacteria, which penetrate by the teats, or at some part of the skin 
 covering the gland. 
 
 44 
 
690 PATHOLOGY OF PARTURITION. 
 
 Several Italian authorities, and among them Brusasco, Oreste, 
 Metaxa, and Provizano, have drawn attention to a peculiar 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 becomes 
 sour. The disease appears to be contagious, for it could be produced by 
 injecting the milk from affected Sheep into the teats of healthy Sheep 
 and Goats. All the animals so experimented upon became affected, 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 w^as 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 diffused abscesses. 
 
 Cojnjjlications. 
 
 With Euminants, 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 affected, but the patellar and tarsal aj^pear to be the most pre- 
 disposed. Septic infection and pyaemia are 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. 
 
 Prog7iosis. 
 
 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 mammas, it is then most serious, and rarely indeed can a 
 favourable result be prognosticated. When 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, mammitis is often a most serious disease, from 
 the fact that its existence is generally not perceived 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 
 mammae, is always to be apprehended w^hen the inflammation 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 slight 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 or three days alterations may be 
 produced in the secretory apparatus of the gland which medical skill 
 may be unable to amend. 
 
M.IMMITIS on MASTITIS 691 
 
 When the udder or quarter is simply engorged witli milk, nothing 
 more has to be done than to thoroughly remove this lluid. This, of 
 course, cannot be accomplished at once, and it may be necessary to 
 milk tlie animal several times 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 Huid 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 (Fig. 222) may be 
 employed, its retention being effected by a cord or tape passed through 
 the rings and tied over the animal's loins. In all cases in whicli hand- 
 milking causes pain, and is likely to increase the evil it is intended to 
 
 Fig. 221. 
 Tk.vt svphon. 
 
 avert, the teat-syphon should be resorted to.^ 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 
 laxative or purgative medicine. Application of vinegar to the gland has 
 been recommended ; painting it 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 
 
 mT MLLtKS »(' 
 
 Q 
 
 U 
 
 Fig. 22'-'. 
 
 RlX« TE.\T-SYrHON. 
 
 veins be gorged witli blood, nmch relief will be afforded by bleeding 
 from the corresponding mammary or " milk " vein, if a Cow. 
 
 The animal should not be exposed to cold or draughts, and it may be 
 advisable to cover the body with a large blanket. If fever is appre- 
 hended, enemas may be 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 may then be pushed d'own to the end of the 
 
 ' Franck very properly drew attention to the necesK-ity for thoroughly cleansing these 
 syphons in boilini,' water or carbolic »cid .solntion. The danger of conveying infection Ut 
 other quarters of the mammse, or to the udder of healthy animal.^, is obvious unless this 
 precaution is adopted. 
 
692 PATHOLOGY OF PARTURITION. 
 
 teat, and pressed through. A coagulum or concretion as large as a 
 nut has been extracted in this manner. When it is too voluminous, 
 however, it may be necessary to introduce a sound carefully into the 
 canal, in order to break it up ; 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. 
 
 Eetention 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 mamraitis is present, the 
 treatment must be energetic and adopted early, in order to prevent 
 those serious alterations in the 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 Bouley 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 withdi'awn each time. The 
 teat-syphon may 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 upon the condition of the animal 
 and the nature and degree of the disturbance, and must be, in principle, 
 that of all inflammation. The local treatment is a matter of much 
 importance, and here we find the most diverse recommendations. 
 
 Zundel, Baumeister and Euefi', 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, which is applied either over the whole 
 gland or the inflamed quarter or quartei's, 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 mammitis, 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 commencement of slight inflammation; 
 but when the inflammation has become fairly established, 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 they may be resorted 
 to with some advantage. 
 
 Emollient applications, and especially when warm, afford more 
 
MA MM IT IS on MASTITIS. 693 
 
 satisfactory results. In this direction warm fomentations and poultices 
 appear to be most grateful to the animal, and to dissipate the inllainma- 
 tion most readily. They must not be too hot, astlie skin of the udder 
 is so thin that it is easily injured by inordinate heat. Poultices of 
 linseed-meal, oatmeal, marsh-mallows, dough, etc., covered witli olive- 
 oil, laudanum, opium, or extract of belladonna, are especially to be 
 reeonunended, in preference to fomentations which retjuire much time; 
 and as they cannot be applied continually, the udder often sulVers 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 piline, 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. Williams recommends " spent" 
 hops, which are very light, contain much moisture, 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 applications 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- 
 ficial 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 eflica- 
 cious they umst 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 a})plied 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 inflannnation in that interval, the 
 swelling disappearing in one or two days. 
 
 Kychner 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 tiie mixture rub 
 it on the udder. Rychner is of opinion that the potash in the ashes 
 prevents 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 lias 
 obtained more success than any other, when applied before the 
 inflammation had attained its greatest intensity : 
 
 Potass 1 part. 
 
 Water - - - - - - - 2 parts. 
 
 Olive-oil -^ M 
 
 These are to be well mixed, and then four or five parts more water 
 are to be added. Often, after five or six hours, during which nothing 
 could be drawn from the teat except a small quantity of thin curdled 
 milk, there is obtained a whitish-yellow fluid, more like pus than milk, 
 which is a very favourable sign. 
 
 Ointments and embrocations of various kinds are also employed — as 
 those of belladonna, henbane, moi-phia, camphor, laurel, etc. In 
 
694 PATHOLOGY OF PARTURITION. 
 
 England, the extract of belladonna is much used as an application to the 
 inflamed 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 
 ointment 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 applications should not be employed, unless the disease 
 is in a chronic form, and then their effect must be noted. 
 
 When 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 
 liniments, 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 
 closing too early — which 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 fistula. In such circumstances, a counter-opening must be made ; 
 and if there is any necrotic tissue to be found, it should be removed. In 
 all operations on the mannnary glands, the 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 happens that, in opening them, one or 
 perhaps more of the milk-ducts are wounded, and then we may have 
 " lacteal fistuUe." From these the milk escapes, and this renders their 
 cicatrisation difficult and tedious, if the gland is active. The treatment 
 must chiefly consist in the application of caustics to the walls of the 
 fistulae, 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. 
 
 The 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 
 icorrhaemia or septiksemia. When 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 the strength of 
 the animal, accelerating the separation of the dead from the living 
 tissues, favouring the free escape of pus and putrid matters, so as to 
 hinder their absorption, making counter-openings, and applying anti- 
 
MAMMITIS on MASTITIS. 095 
 
 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 
 lingers, keeping clear as nmch 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 
 hanuorrhage occurs, the actual cautery or perchloridc 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 oil' a bad 
 odour, and is throwing out liealthy 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 
 h-on, 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 surrovyided 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 be 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 lime, 
 carbolic acid, and other antiseptics. At the same time, antiseptic 
 medicines, tonics, and stiumlants, should be administered internally. 
 It might be well wortli trying the injection of antiseptic agents — such 
 as carbolic acid, tincture of iodine, etc., into the gangrenous tissues, by 
 means of deep incisions and a Prava;^ 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 
 recommends the following ointment to be applied once a day, with smart 
 friction : 
 
 Soft soap \ lb. 
 
 Mercurial ointment - - - - 1 oz. 
 
 Camphor ointment - - - - 4 ,, 
 
 Extract of belladonna - - - 4 drams. 
 
 Or the following tincture : 
 
 Tincture of iodine - - - - G oz. 
 Tincture of opium - - - - ^ ,, 
 Soap liniment - - - - - 4 ,, 
 
 Frequent and gentle milking may also prove seniceable, as well as 
 dry friction. 
 
 As a preventive measure when infection is apprehended — as in reten- 
 tion of the placenta, metritis or vaginitis, etc. — it is advisable to inject 
 
696 PATHOLOGY OF PARTURITION. 
 
 a weak solution of carbolic acid (2| per cent.) or alum (2 per cent.), up 
 tlae teat by means of a glass syringe, always after milking ; the fluid 
 should be at a temperature of 95^ Fahr. Franck has proved the value 
 of this precaution, and also its utility as a remedial measure; indeed, 
 Armatage had previously recommended the injection of weak solutions 
 of 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 
 development of micrococci and bacteria in the milk, as well as prevented 
 curdling of that fluid in the ducts and sinuses. Solutions of alum — ten 
 per cent., 100 grammes injected daily — appeared to be also beneficial in 
 this direction. And Nocard successfully treated the chronic catarrhal 
 form of mammitis in which he found a special bacillus, by injecting up 
 the 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 eight 
 days, two or three repetitions being sufficient. The induration of the 
 gland gradually diminished, the milk resumed its ordinary characters, 
 and the bacillus 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 
 of carbolic acid, the aflected cow^s being the last to receive his attention. 
 Their milk was kept apart and given to pigs. 
 
 Armatage reconmiends that animals suffering from gangrene of the 
 mammee should be removed from those which are pregnant, " as great 
 excitement will be produced by the odour of decomposition,'' and abortion 
 is probable. 
 
 CHAPTEE X. 
 Agalactia. 
 
 " Agalactia," or absence of milk in the mammae, 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 secre- 
 tion may occur even when pregnancy has been normal and has reached 
 its full limit. 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 mammae ; atrophy of these glands ; ex- 
 haustion following disease ; severe labour ; insufficient 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 quantity is secreted ; but in the majority of 
 cases it is either not produced at all, or only in very small quantity. 
 This 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 be suckled. 
 
 The treatment of this condition frequently proves unsuccessful. It 
 must chiefly consist in giving good food, particularly of a leguminous 
 kind, with aniseed and fennel, fennel-seeds, water fennel, ilfe«7?i mutelli- 
 num, antimonials, and other agents which are likely to stimulate the 
 
IXJrniES TO THE Th'.lTS. G97 
 
 secretory function of the inanimoe. Great attention must be paid to 
 the digestive organs, and tlie teats should be frequently stripped and the 
 niamune rubbed, either dry or with some stimulating application. 
 
 Macorps' 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 bo 
 combated according to the indications. 
 
 CHAPTER XL 
 Injuries to the Teats. 
 
 FiSSUKES. 
 
 Thk chief injuries to the teats consist of wounds, in the form of fissures 
 or " cracks," 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 icorrhaimia or septicicmia ; 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 line — as in primi- 
 paru>. 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 subjacent 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 
 development 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 the saliva in the young creature also lead to irrita- 
 tion. Cows with voluminous udders and long teats are often the 
 subjects of this injury. 
 
 Si/niploms. 
 
 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 Jahi-etberichl, 1S60. 
 
698 PATHOLOGY OF PARTURITION. 
 
 and bleeding ; then they are extremely painful, and the animal refuses 
 to be suckled or milked, while attempts to handle the teat cause the 
 creature to offer 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 firm and blocks up the canal, 
 which may ultimately be completely obliterated, causing retention of 
 the milk, inflammation 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 primiparae, and especially the finer 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 affected 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. 
 
 Emollient 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 may 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 
 carbohsed glycerine (1 to 20), or, in very severe cases, a watery solution 
 of silicate of soda. Dry dressings — 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. 
 
 Obliteeation 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 aflbrded 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 
 
IXJCJilES TO THE TKATS. 699 
 
 higher, and the whole or a portion of the sinus be obliterated, then this 
 prominence will not be produced, and the obstacle will bo 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 primipane — 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 operatiou had to be performed at the next calving. 
 
 4^^ 
 
 B. 
 Fig. 223. 
 
 LCTHI's rERKOB.VTING SoCNn. 
 
 A. Il.alf the Natural Size. R. 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-peixha 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- 
 
700 PATHOLOGY OF PARTURITION. 
 
 syphon, or a piece of thick carbohsed catgut, introduced. Zundel 
 mentions that Liithi and Strebel have been very successful by this 
 method of operating. 
 
 In all cutting operations on the teat, every precaution must be adopted 
 for the prevention of mastitis ; and this must chiefly consist in follow- 
 ing out the antiseptic method of treatment of the incisions as closely as 
 possible. 
 
 Fistula of the Teat. • 
 
 We have seen several cases of fistula of the teat which proved very 
 troublesome to cure during the period of lactation. From injury or 
 disease, an opening is established between the milk sinus and the side 
 of the teat ; so that the milk, instead of passing through the canal in 
 the extremity, escapes in a jet at the side, and its flow is nearly con- 
 stant. This is a source of loss, and has often an unpleasant appearance. 
 If it is decided to cure the fistula during the lactation period, and the 
 opening is towards the middle of the teat, then the ring teat-syphon 
 must be kept in the sinus for some time, and the fistula treated accord- 
 ing to surgical principles. When the fistula is towards the extremity 
 of the teat, however, the case is more difficult, and the teat-syphon only 
 too often renders it worse. Then it is generally necessary to wait until 
 the Cow is " drj'," when, with a little attention, the fistula is readily 
 cured. 
 
AurHYXJA OF THE XEU'IlOJLX AMMAL. 701 
 
 BOOK VI. 
 
 DISEASES AND ABNORMALITIES OF THE YOUNG ANIMAL. 
 
 The diseases and abnormalities of the young animal, observed imme- 
 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 brief 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 described in the following order : — 
 (1) Asphi/xia, (2) Umbilical Hcemorrhage, (3) Persistence of the Urachus, 
 (4) Umbilical Hernia, (5) CEdema of the Umbilicus, (6) Inflammation of 
 the Umbilical Cord, (7) Arthritis, (8) Indigestion, (9) Gastro-intestinal 
 Catarrh, (10) Dysentery of Young Animals, (11) Betention of Meconium, 
 (12) Eclampsia of Young Animals, (13) Tetanus Agnorum, (14) Cyanosis, 
 (lo) Skin Dryness, (16) Iinperforatc Anus, (17) Imperforate Vulva and 
 Vagina, (18) Imperforate Prepuce, (19) Occlusion of the Eyelids, (20) Oc- 
 clusion of the Auditory Canal, (21) Tongue-tie, (22) Cleft Palate. 
 
 CHAPTEE L 
 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 
 of the new-born child — and brief mention was made of the measures 
 necessaiy for restoration. The immediate cause of this condition was 
 also referred to. It has been recognised that when animals ai-e sub- 
 mitted during pregnancy to insufficient food, to severe exertion, have 
 sutTered from chest disease, or from colic a short time before parturition, 
 or when labour has been difficult and protracted, the young creature at 
 birth is often so exhausted that it lies apparently dead — all the tissues 
 being pale and flaccid and the body low in temperature, while the 
 heart's beats and the respiratory movements are very feeble or quite 
 imperceptible. 
 
 There may also be syncope or asphyxia from pletliora or cyanosis; 
 asphyxia may likewise be due to interrupted circulation in the umbilical 
 cord, and intra-uterine respiration. 
 
 Apparent death, or suspended animation, must be treated in the 
 manner indicated at p. 265. The mouth and trachea should be 
 cleared of mucus and amniotic fluid, if any of the latter has passed 
 into the 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 thi-ough the nostril 
 into the trachea, and by means of a syringe to remove much of the fluid 
 therefrom. 
 
 Aspersion of the skin with cold water, or flicking it with a wet towel, 
 may also be useful in stimulating the respiratory nerve-centre, 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 
 
702 DISEASES AND ABNORMALITIES OF THE YOUNG ANIMAL. 
 
 of the skin may also be useful in this direction. Direct electric stimu- 
 tion of the phrenic nerve might be attempted. Artificial inflation of 
 the lungs should not be tried until the mouth and fauces have been 
 cleared of mucus; this may be effected by suction, which has a very 
 beneficial action otherwise. Indeed, some authorities prefer aspiration 
 to inspiration or blowing into the mouth ; and Albert^ has restored 41 
 out of 47 cases of apparently dead animals by aspiration or suction. 
 
 Transfusion of blood by the umbilical vein might prove useful ; between 
 one-half and a litre of blood should be sufficient 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 brandy 
 might also be poured into the nostril. 
 
 CHAPTER II. 
 Umbilical Haemorrhage. 
 
 HAEMORRHAGE from the 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 haemorrhage 
 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, during 
 difficult parturition, when violent traction tears it close to the abdominal 
 ring ; in very rare instances it may be due to a varicose condition of the 
 vessels. Zundel alludes to a predisposition to umbilical haemorrhage — 
 a kind of hemophilia. 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 haemorrhage may take place from the artery, as that 
 vessel is firmly attached to the umbilical ring ; with Euminants it takes 
 place from the vein, because of the existence of the ductus Arantii, and 
 the retraction of the artery within the abdomen. 
 
 Trcatvient. 
 
 When the bleeding is trifling and not likely to continue long, little, if 
 anything, requires to be done ; but when it is copious and continuous, 
 active and prompt treatment must be adopted. 
 
 If the cord is extremely short, astringents — as alum, tannic acid, etc. 
 — maybe 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 sufficiently long, it is better to apply a ligature ; 
 this will check the bleeding, and the cord will slough away in four or 
 five days. In applying the ligature, however, the operator must be 
 careful not to include a poi-tion of intestine within it; and when there is 
 much infiltration of the cord, as sometimes happens, the serum should 
 be got rid of, as much as possible, by squeezing with the fingers or 
 scarification, in 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 haemorrhage to cease. 
 
 The transfusion of blood may be urgently demanded in extreme cases. 
 1 Renke's Zeiischri/tfur Staatsarzneikitnde, vol. xxiii,, p. 279. 
 
PERSISTEXCE OF THE rUArlll'S. 703 
 
 CHAPTER III. 
 Persistence of the Urachus. 
 
 In studying the development of the foetus the urachus was described 
 (pp. S2, 94), and it was pointed out that it is a canal formed by the 
 middle portion of the allantois, which passed throu^'h the umbilical 
 rin^', and durinj^ foetal life communicated with the bladder, from which 
 it conveyed the urine into the allantoid sac. After birth this canal is 
 obliterated, its walls become a thin cord, and the bladder is retracted 
 within the pelvic cavity, the urine tlien passing through the urethra. 
 It not unfrequently happens, however, that, from accidental circum- 
 stances or some malformation, the canal of the urachus is only partially, 
 or not at all obliterated after birth ; consequently, the urine continues 
 to escape by drops or in a thin stream from the umbilicus or umbilical 
 cord. This condition is far more frequent in Solipeds than in Ruminants, 
 owing to the urachus — like the umbilical artery — being firmly attached 
 to the umbilical ring in the former, and therefore not at once withdrawn 
 into the abdomen, as in the latter, when the umbilical cord is divided 
 at birth. Therefore it is Ihat escape of urine from the navel is very 
 seldom noticed in the Calf; while in the Foal it is often witnessed, 
 particularly when the abdominal ring remains very open, or the cord is 
 excised close to the body. This condition has, however, been seen in 
 Calves. 
 
 It appears to be more frequent in male than female animals, and is 
 most serious in the former ; in the latter, the discharge of urine by this 
 abnormal channel often ceases spontaneously, only passing at first in 
 drops ; whereas, in the male it generally escapes in a stream, little or 
 no urine being discharged from the urethra. 
 
 Treatment. 
 
 In some cases scarcely any treatment is necessary, the escape of 
 urine ceasing in a few days after birth ; and when interference is 
 demanded, a cure can generally be effected in a short time if the urethra 
 is pervious. Benard' mentions an instance of this accident, in which 
 death occurred two days after applying a ligature to the urachus ; it 
 was then discovered that the urethra was imperforate, so that the urine 
 could not be expelled at all. It is therefore necessary, before adopting 
 remedial measures, to ascertain whether the urethra is patent. 
 
 When the urachus protrudes sutViciently from the umbilical ring, a 
 ligature may be fastened firmly around it. When it is close to the 
 abdominal ring, and consequently too short to be tied by the ordinary 
 ligature, it must be secured by a curved needle. The Foal is thrown on 
 its left side, and the operator, holding the needle armed with the thread 
 in his right hand, seizes the urachus — which is covered by the skin — 
 between the thumb and index-finger of the left hand, and pulls it out- 
 wards ; the needle is then passed through behind the canal, including 
 as little of the skin as possible, and the ends tied. If there is any doubt 
 as to the patency of the urethra, the ligature should only be partially 
 tightened until the nature of the obsti-uction is ascertained and removed. 
 When this is done, then the ligature may be firmly tied, when the urine 
 escapes freely by the natural channel. 
 
 ^ Secue'tl lie Midtcine Viterinairt, 1828. 
 
704 DISEASES AXD ABXOBMALITIES OF THE YOUXG ANIMAL. 
 
 In those cases in which the urachus cannot be secured by this proce- 
 dure, astringents or caustics — -such as the sulphate of copper — may be 
 successfully employed. Beneficial results have been obtained by the 
 application of a strong vesicant around the umbilical ring, the tumefac- 
 tion caused by it closing the opening. The actual cautery has also been 
 most successfully employed, particularly in a fine point. 
 
 CHAPTEE IV. 
 Umbilical Hernia. 
 
 ExoMPHALis, omphalocele, or umbilical or ncivel hernia, is not at all rare 
 in young animals, and is perhaps most frequently observed in Foals and 
 Puppies ; it does not appear to be so common in Calves, and in Pigs 
 and Lambs it is seldom seen. It would appear to be more prevalent in 
 some countries or regions than in others. Marlot states that in every 
 score of Foals or Mules bred in France, one is so affected. The hernia 
 or rupture may appear at birth or some time after, and may continue 
 during the life of the animal if no measures are adopted to cure it ; 
 it may be congenital or acquired. The congenital form is produced 
 during fa^tal life, when a portion of the digestive and biliary apparatus 
 is contained in the umbilical cord. The embryonic connective tissue, or 
 Whartonian gelatine, in which are imbedded the two umbilical arteries 
 and vein (two in the Calf and Pig), is very abundant at the elliptical 
 opening named the umbilical ring — through which also pass the urachus, 
 the omphaio-mesenteric vessels, and a portion of intestine. After birth 
 the umbilical cord shrivels, and the Whartonian gelatine becomes con- 
 densed and organised, forming a fibrous membrane that closes the 
 umbilical opening and, gradually contracting, brings the two edges 
 together ; these unite, and soon nothing is left to mark the situation of 
 the opening, except a short lozenge-shaped fibrous cicatrix. The intes- 
 tine had previously been withdrawn into the abdomen, the urachus 
 becomes contracted after birth into a thin ligament, while the blood- 
 vessels are obliterated. 
 
 It sometimes happens, however, that the process of cicatrisation is 
 either prevented, retarded, or interrupted ; consequently, the umbilical 
 ring continues more or less patent, and certain viscera either remain in 
 it, or are pushed into it by internal pressure, and lodged in the pouch 
 formed externally by the skin. In this congenital hernia, the vein or 
 veins and the arteries are separated by the misplaced viscera, the former 
 being usually in front, the latter behind. 
 
 The lesion may be observed at the moment the animal is born ; and 
 after the cord is ruptured it may happen that the abdomen remains open 
 and the viscera are exposed ; the creature then generally succumbs 
 quickly. 
 
 Acquired or accidental umbilical hernia usually appears soon after the 
 cord has withered, or within a few months after birth. 
 
 A true Sund false exomphalus have been described : the first being that 
 just mentioned, in which hernia takes place through the umbilical ring; 
 while the second is due to an accidental opening in the neighbour- 
 ing aponeurotic or muscular tunics of the abdomen, and is in reality 
 ventral hernia — occurring, as it generally does, after birth and in adult 
 animals. Various kinds of umbilical hernise have also been alluded to, 
 
UMBILICAL IIEJtXIA. 705 
 
 according as the viscus is intestine or onientuiu, or both ; thus we have 
 entcromphalus, mcscntcro- or cpiploviphalus, and entcro-cpiploniphalus. 
 The last is most frequently observed in Carnivorous animals. 
 
 Causes. 
 
 Wo have just alluded to the cause of congenital hernia. Acquired or 
 accidental hernia may be due to severe or sudden muscular exertion ; 
 as when the Foal or Calf runs or jumps very actively during its gambols, 
 or wiien pursued, or in falls. It is sometimes produced when the young 
 creature is separated from its parent, and being kept in an isolated 
 place, it rushes about and cries energetically. Umbilical hernia has 
 also been known to follow an attack of colic, and after constipation or 
 diarrhcca. 
 
 There appears to be generally present, in umbilical hernia, a certain 
 organic predisposition, due to the suppressed or imperfect organization 
 of the Whartonian gelatine ; and it has been remarked that common- 
 bred animals are more liable to it than those of the higher breeds. 
 Nevertheless, in all those in which it manifests itself— no matter what 
 the 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 unusually frequent, and particularly wlien much rain prevails, 
 as then the food of Herbivorous animals is more aqueous than at other 
 times. Low, wet, marshy pastures are also believed to predispose to 
 hernia ; as in them the tissues become soft and relaxed, and the 
 digestive organs inordinately bulky; Foals and Calves kept in these 
 situations have the belly voluminous, and the extrinsic pressure weakens 
 the abdominal walls. Bcnard, Hamon, Cruzel, Bouley, and others, 
 believe in heredity as a predisposing cause. Mares which were afTected 
 with umbilical hernia when young, have produced foals which presented 
 this lesion. 
 
 Patholoijical Anatomy. 
 
 The hernial pouch or sac is nearly always lined by peritoneum — the 
 peritoneal investment being produced at the same time as the hernia. 
 In some instances, however, the peritoneum gives way to the pressure 
 of the viscera, and then the walls of the sac are composed only of 
 connective tissue and skin. The latter is frequently so much stretched 
 that it becomes thinner, and in Puppies is generally quite transparent. 
 
 Marlot says that the sac is usually composed of five layers: I. The 
 parietal peritoneum ; 2, A very fine fibrous layer constituted by the 
 fascia transversalis ; 3. A kind of dartos formed by the tunica abdo- 
 minalis ; 4. The panniculus carnosus muscle ; 5. The skin — the whole 
 being connected by connective tissue. But this arrangement is far 
 from being constant. The opening of the iiernial sac corresponds to the 
 umbilical opening, which is elongated, and measures in the Foal from 
 \\ to 3.1 inches in length, its width being variable, but never exceeding 
 2'inche's. The viscera contamed in the sac are usually the small 
 intestine, omentum, free colon, and the point of the caecum. Lanclot, 
 Bonard, Delafond, Ilertwig, and others, have sometimes found tlic 
 urachus in the sac, as well as intestine ; but in congenital hernia the 
 \nachu3 can scarcely fail to be absent, and we may also have the 
 lunbilical veins. It rarely happens that there is any adhesion between 
 th« hernied organs and the sac containing them, inflammation being 
 
 45 
 
706 LISEASES AXD ABNORMALITIES OF THE YOUXG ANIMAL. 
 
 rare ; the sac seldom indeed contains any serum, and is therefore in 
 immediate contact with the misplaced viscera. When ascites is present, 
 however, serous fluid may then be present, and constitute the diseased 
 condition termed " hydro-enteromphalus." 
 
 Symptoms. 
 
 The symptoms of umbilical hernia are, as a rule, entirelj* local. 
 There is a round or pyriform tumour situated in the region of the 
 umbilicus or " navel," varying in size in different individuals and species 
 — from that of a pigeon's egg to a child's head, or even larger. The size 
 also varies in the same individual at different times, according as the 
 digestive organs are full or empty, the attitude standing or recumbent, 
 at rest or undergoing active exertion, or the duration of the hernia — 
 the older it is, the larger the tumour. It is usually soft, fluctuating, 
 easily depressed by the finger, and as readily resuming its ordinary size 
 and shape ; when recent, however, it is often tense and not depressible. 
 Sometimes it has a doughy feel and fluctuates much, and at other times 
 it is flaccid, according as the portion of intestine which it contains is 
 empty or filled with alimentary matters. It is nearly always indolent, 
 and in the large majority of cases can be reduced by throwing the 
 animal on its back, by manipulation externally, or by taxis internally. 
 The tumour soon returns, however, especially when the animal lies down 
 or moves about ; closing the nostrils or causing the animal to cough, 
 will also produce its immediate appearance. 
 
 "When the sac has been emptied by pressure or taxis, the opening in 
 the abdomen can then be perceived. As a general rule, the volume of 
 the tumour corresponds to the dimensions of this opening, which is 
 sometimes elliptical, at other times nearly or completely circular ; in 
 false or accidental hernia it is usually irregular in outline. The borders 
 of the opening feel tense and resisting. 
 
 On applying the open hand against the tumour, the vermicular move- 
 ment of the intestine can be ascertained ; careful taxis may lead to the 
 discovery of a loop of intestine in the sac ; while auscultation may 
 detect the rumbling of the displaced viscus. 
 
 When the tumour is not reducible, this is generally due to the presence 
 of an accumulation of fscal matters or other substances in the intestine. 
 Inflammation is rare, and is usually due to contusions or other external 
 influences. Strangulation of the intestine is likewise far from frequent. 
 
 Prognosis. 
 
 Umbilical hernia is not a serious condition in young animals, except 
 in rare cases. Sometimes spontaneous recovery takes place ; in the 
 great majority of instances a cure is easily effected ; and even when the 
 hernia persists there is but little danger, health and utility being seldom 
 interfered with. When the hernial sac is occupied by omentum only, 
 and the abdominal opening is small, there is much less danger than 
 when the intestine is involved, while spontaneous recovery is much 
 more probable. In adult animals umbilical hernia is often a serious 
 accident ; and its gravity generally depends on the volume of the tumour. 
 Complicated hernia is always dangerous. 
 
 Though not at all serious in itself when affecting young animals, yet 
 from their diminished value and the expense of treatment, umbilical 
 hernia may become a cause of much loss. 
 
VMlilUCAL IIKllXIA. yoy 
 
 prevalence in this country. ''°"'=""""- ^^^ ''"ow nothing as to its 
 
 Diagnosis. 
 
 cor;fi'':irt,:[.r^^.^irt'htTn"it"irhtf ;"i;; J 's V' ': "- 
 
 .t may he „,istai<eu for an abscess o° a ec^nt' t'^rnmi^ f. «den,atous, 
 lunWIical he?:^ a but also whether ?t iLf° t^""°'^ ""= '^"''''"'^ "' 
 
 Treatment. 
 
 We have stated that umbilical hernia in youn- anin.nl^ nffo. a- 
 
 Piiiifiiilii 
 
 for'2^Foara''d'?L'rai?l^irth:V°r' '' generally .-eco^nised that. 
 
 and stron,^er. am tss TkX to -ff- '^ ''^'^•°' ""' '' ^""'"^^ '' °^*^'' 
 The methods of treatment CO nnrirm/ )" ^^^^"f ^^^.^^y operations. 
 
 heJni^?ons^Ts';;L';7airo/l'''T^ '^"^^^^'^ ^^^ '^^ ^"^« °f ""^^ilical 
 body. b> t^rlid 'r^h ch the-i ' ^"-''r' '5"^'' P^"^«^ ^'•-""^i 'he 
 aga.^st\he umbihearopenin' a ild"" tended t""^ the tumour, and 
 from a^ain descendincr w In Vi ^ '^tended to prevent the viscera 
 
708 DISEASES AND 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. This 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 slipping 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, with 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. 
 
 rig. 224. 
 Armatage's Truss applied for Umbilical Hernia. 
 
 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. 
 
 Before the truss is applied, it is, of course, necessary to reduce the 
 hernia, and place the pad exactly over the umbilical opening. 
 
 Trusses are chiefly objectionable from the long time thej'^ must remain 
 on the animal, and the tightness with which they must be applied in 
 order to act beneficially. This inconveniences and often injures the 
 young creature, and not infrequently causes it to fret, impairs its 
 appetite, and induces loss of condition ; and though highly recom- 
 mended by Ma riot, Lafosse, Perosino, Schreger, Strauss, Ungefrohrn, 
 
I'MIULIVAL IllJllXI.t. 709 
 
 and many others, they are not always to be preferred to other methods 
 of treatment. 
 
 2. Topical Applications. — Topical applications have been for 
 centuries employed for the cure of hernia, Celsus having recommended 
 the use of sulphuric acid, which was resorted to at a later period by the 
 early hippiatrists ; and since 1833, when it was brought to notice by 
 Hertwig. it has been used in Germany, being applied to the tumour 
 every two or three days. The subcutaneous serous inliltration and the 
 plastic exudation in tbe hernial sac, drive the misplaced viscera into the 
 al>domen, and, in becoming absorbed afterwards, produce obliteration 
 of the cavity and its opening. Blisters act in the same way; and appli- 
 cations of alcohol, creosote water, and other agents, have been largely 
 resorted to. But Girax-d, D'Arboval, Benard, and Mignon have asserted 
 that these topical applications are very uncertain, and even dangerous, 
 as the irritation produced readily causes adhesion between the wall 
 of the sac and the organs it contained, and thus renders i^eduction im- 
 possible. 
 
 But in 1848, Dayot, and more recently other veterinarians, had drawn 
 attention to the value of nitric acid cauterisation in umbilical hernia. 
 The acid is applied to the skin covering the tumour until at first an 
 eschar is formed, and, finally, detachment of the cutaneous hernial sac 
 is achieved. In order to efl'ect this, the hair is removed from the skin, 
 and by means of a spun-glass brush or cotton- wool fi.xed on a glass rod, 
 nitric acid of commerce is applied around the base of the tumour at 
 first ; then over the other part it is used in sufticient quantity, and with 
 friction, so as to destroy the skin and ensure its speedy mortification and 
 sloughing. Experience has proved that the more profound the dis- 
 organisation the more certain is the beneficial action. According to 
 Lafosse, it requires from 24 to 32 grammes of acid for a hernial tumour 
 the size of a fist ; and the friction, which ought to be as equable as 
 possible over the whole surface, should be continued for three to five 
 minutes — supposing the animal to be quiet and the rubbing not inter- 
 rupted. A smaller quantity of acid and less friction may be employed 
 to herniie which are not so considerable in volume, and are covered by 
 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 reconmiends that the application 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 
 elapse in order to watch the result. If at the end of this time the skin 
 is not destroyed, the application may be repeated. 
 
 The nitric acid produces a yellow eschar, which, if not dry on the first 
 day, soon becomes soft, unctuous to the touch, and easily destroyed. 
 With the formation of this eschar there is much swelling, either imme- 
 diately on the application of the acid, or soon after; in some cases there 
 is but little if any swelling. The tumefaction is due to the action of the 
 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 being pushed into the abdomen and kept there as if by a 
 truss. The oedematous swelling established external to the tumour, is 
 oblong and depressed in the centre, in consequence of the diminished 
 elasticity of the central portion of the escharified skin ; in a few days it 
 is gradually absorbed and becomes more consistent, while the skin in 
 
710 DISEASES AXD ABNORMALITIES OE THE YOUNG AXIMAL. 
 
 the centre becomes dry and hard, like parchment. Instead of the 
 hernia, there is now only a newly-formed mass of fibrous tissue, which 
 is gradually lessened in volume, condensed, and partly absorbed, like 
 cicatricial tissue. At the same time the cauterised skin begins to be 
 thrown off at the margin, the process of separation extending to the 
 centre, where it takes a long time to be completed, because of the re- 
 mains of the umbilical cord. When completely detached, there is a 
 granulating healthy-looking wound left, which may have some fibrous 
 masses in its middle. This suppurates, dries, becomes covered with a 
 crust, and is gradually furnished with epithelium'. In retracting, the 
 wound contributes largely in closing the hernial opening, while the in- 
 durated skin which continues for some time to adhere to the abdominal 
 walls through the medium of the condensed connective tissue, contri- 
 butes its share. In about a month cicatrisation is finished ; the cicatrix 
 remains destitute of hair, and often of pigment. 
 
 According to the testimony of Zundel and others, this mode of treat- 
 ing an umbilical hernia is prompt and speedy. There is generally no 
 occasion to throw the animal down, and one assistant only is necessary ; 
 it is rarely followed by accidents. These do occur, however, and the 
 most serious and frequent is the escape of the intestines through the 
 eschar, about eight days after the nitric acid has been applied. This 
 unfortunate result has been attributed to excessive cauterisation when 
 the skin is thin and fine, though it may also occur from the animal 
 rubbing or tearing off the sloughing cuticle when the pain or itching are 
 troublesome. To obviate this accident, Eey, Lafosse, Legoff, and others 
 recommend the employment of a bandage, and quietude after the opera- 
 tion. Eeynal has observed peritonitis as a consequence of nitric acid 
 cauterisation, and Lafosse mentions a case of tetanus due to this treat- 
 ment. 
 
 When the cauterisation has not been sufficient, a relapse is likely to 
 occur ; Lafosse has observed one in twenty successful cases. This in- 
 sufficiency is generally noticed on the following day, in the absence or 
 trifling amount of swelling ; but the cauterisation must not be attempted 
 again in less than two or three weeks. 
 
 Hertwig, as has been mentioned, recommends sulphuric instead of 
 nitric acid, and applies it in lines, night and morning, for two days, by 
 means of a glass rod. CEdema soon sets in, and it may be increased by 
 rubbing the cauterised surface with oil of turpentine and oil (one to 
 two). The sulphuric acid, however, appears to be less prompt than the 
 nitric. Strong blistering ointment applied at intervals of three days ; 
 chromate of potass ointment (one to three) rubbed in once a day for 
 five minutes at a time, on two consecutive days ; solution of bichloride 
 of mercury, and other topical irritants, have all been more or less suc- 
 cessfully employed. Even the actual cautery, in lines and points, has 
 been resorted to ; but the beneficial effect to be derived from it is un- 
 certain, and at best it is very painful. 
 
 Boulej^^ draws attention to Luton's method of subcutaneous injections 
 for the cure of congenital hernia? in infants, and believes it will be found 
 more advantageous than any other treatment yet attempted for umbilical 
 hernia in animals. Luton's method consists in the subcutaneous injec- 
 tion of a few drops of common salt solution around the hernial tumour, 
 by means of the ordinary subcutaneous-injection syringe. ITnder the 
 irritating influence of this injection oedema sets in, and this mechanic- 
 ' Bizictil de Mtderine Veterinaire, 1877. 
 
r.Mim.li-.lL IIERXIA. 711 
 
 ally repels the contained viscus, the margins of the abdominal opening 
 come into apposition, and, with the connective tissue, are inflamed and 
 soon unite. 
 
 The needle of the syringe must not pass beyond the subcutaneous 
 connective tissue. 
 
 3. CoxsTuicTiON. — Constriction of the hernial sac has been largely 
 reported to for the cure of umbilical hernia, with the view of destroying 
 it by mortification, causing adhesion above the part where this has 
 taken place, and including secondary cicatrisation when the sac has 
 sloughed away. The constriction is produced by li(ialurc, cla)ns, and 
 .suture. To apply these, the animal must, in nearly all cases, be thrown; 
 but before this is attempted, the tumour should be well examined, in 
 order to ascertain if it is reducible, if there are adhesions, the extent of 
 the abdominal opening, and the limits within which the constricting 
 iipparatus should be applied. 
 
 The best position for reduction and constriction is the dorsal. The 
 animal, if a Foal, should be cast on a good bed of litter, and placed on 
 Its back. Very often the change of position reduces the hernia ; if not, 
 gentle manipulation and pressure will effect this, and then the empty 
 sac is pulled well away from the body, and the operation completed. 
 
 The oldest procedure is ligaturing the entire mass of the hernial sac 
 by a piece of cord tied firmly round it, close to the body. This produces 
 at first a merely mechanical occlusion, but subsequently this is physio- 
 logical — exudation and organisation of the plasma thrown out by the 
 iiiHammatory process set up, producing adhesion of the peritoneal 
 surfaces. A piece of whipcord answers very well for this ligature, but 
 it must be drawn very tight around the neck of the sac, in order to pro- 
 duce its immediate and consecutive effects. 
 
 To keep the ligature in place, some practitioners pass one or two 
 wooden pegs through the sac where it is encircled by the ligature; these 
 ])revent the twine being displaced by the swelling which quickly super- 
 venes. Sometimes a ring is employed, which is less in diameter than 
 the umbilical opening, and through which the hernial sac is passed 
 before the ligature is made. 
 
 Some authorities prefer a double ligature, made by passing a double 
 cord through the base of the sac by means of a sacking needle, and tying 
 each separately or entirely round the sac. Sometimes the ligatures are 
 multiple ; and Legoff has recommended the employment of several 
 ligatures passing through the sac from apex to base, each becoming 
 tighter as the abdomen is neared. 
 
 Ligatures are very simple and easily applied, but they have their 
 drawbacks, and these have led to their disuse. .\mong their dis- 
 advantages are uncertainty in their action — which is sometimes too 
 intense, at other times insufVicient ; the sac often sloughs off before 
 adhesion has taken place to such a degree as to sustain the weight of 
 the abdominal viscera ; and it has been pointed out that there is risk of 
 including or wounding the intestine. 
 
 Very favourable results obtained by the elastic ligature in castration 
 have been reported by Guerin ;* this ligature might prove effective in 
 umbilical hernia. 
 
 The procedure by clains is often resorted to, particularly when the 
 hernia is serious. The ordinary wooden clam (Fig. 225) may be employed, 
 ' Jiccucil de Ucdccine Vttirinaire, 1S77. 
 
712 DISEASES AND ABNORMALITIES OF THE YOUNG ANIMAL. 
 
 or one of iron, either hinged at one end or tightened by screws. To 
 render the coaptation of the two branches of the clam more perfect, and 
 to prevent the instrument shpping when tumefaction sets in, as well as 
 to produce more prompt inflammation, adhesion, and gangrene, various 
 contrivances are in use. Borhauer has used a clam, in the branches of 
 which are a number of holes placed opposite each other, through which 
 wooden or metal pins can be passed when the instrument is fixed on the 
 sac. Other practitioners employ a clam with toothed branches, the 
 teeth perforating the walls of the sac. Armatage. recommends an iron 
 
 rig. 225. 
 Umbilical Clam. 
 
 screw clam, one branch of which has a long deep groove, and into this 
 fits a narrow projecting ridge on the opposite branch (Fig. 226). To 
 apply the clam, he gives the following directions: "The animal is 
 secured and placed on its back. The skin over the rupture is drawn 
 together by the fingers in aflat fold, corresponding w'ith a central longi- 
 tudinal line through the abdomen {linea alba), and elevated from the 
 parts beneath, in order to cause the intestines or omentum to descend. 
 The clam is then put over the skin, as close to the abdomen as possible, 
 and the screws tightened. The pressure must not be too severe, or the 
 
 Fig. 226. 
 Armatagk'8 Iron Umbilical Clam. 
 
 parts will drop off too soon, and possibly the intestines may escape. 
 The operation, therefore, requires to be carefully w^atched." 
 
 Degive^ has improved upon this method, by introducing two strong 
 steel needles through the skin and margins of the umbilical opening — 
 guiding their points so as to prevent injury to the intestine, by a finger 
 passed through a small incision at the base of the tumour. Above these 
 needles, i.e., closer to the body, the clam is applied; this can be 
 tightened to the necessary degree by the screw at each end. In order 
 to prevent displacement of the clam when the needles are withdrawn, 
 some small steel pins are passed through the skin immediately beneath it. 
 ^ 7'Ae Ve.ierip.ary Journal, 1894, p. 156. 
 
(EDEMA OF THE r.]f/!fLTCrs. Tl-'i 
 
 Sutures are frequently employed, and there are various ways of using 
 them. One method is the " twisted " suture, which is applied as 
 follows : The hernial sac is included between two round })ieces of hard 
 wood or iron, which are drawn ti^'htly 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 first perforation, and the 
 two portions of suture firmly tied, so as to draw the skin together like 
 the mouth of a sac. Sutures are then passed through the sides of the 
 pedicle and tied, so as to include the whole of the skin in the multiple 
 loops. A cure by this procedure is usually effected in al)out fifteen days. 
 The 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 belly ; then the needle can be used without risk, as the lead — 
 which is secured in situ — forms a shield as well as a truss, and prevents 
 the descent of the intestine until adhesion has taken place. 
 
 When the hernia is irreducible or strangulation has taken place, then 
 it will be 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. 
 
 CHAPTER V. 
 (Edema of the Umbilicus. 
 
 TuMEF.vcTioN, or rather " u tlema " of the umbilical region, is not at all 
 uncommon. Often it is simply due to an effusion of serum in the 
 connective tissue of the umbilical cord, and sometimes to an infiltration 
 of blood in this pai-t and the surrounding connective tissue. 
 
 The accident is usually 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 inflammation of this 
 part, or the 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 DISEASES AXD ABNORMALITIES OF THE YOUXG AXIMAL. 
 
 defect in young Bulls, which it mechanically prevents from copulating. 
 When due to sclerosis of the connective tissue, it is usually persistent. 
 
 Treatment. 
 
 Cold applications and compresses have been recommended in the way 
 of treatment, as well as lotions of arnica, camphorated spirits of wine, 
 preparations of iodine, mercury, etc. These often fail, however, and it 
 is generally better to resort to scarifications or leeches at once, to be 
 succeeded by hot water fomentations. When the swelling is chronic 
 and due to a blood clot, which is sometimes the case, Baumeister 
 recommends enucleation. 
 
 CHAPTEE YI. 
 
 Inflammation of the Umbilical Cord. 
 
 Inflamjiatiox of the umbilicus, or omphalitis (the so-called " navcl-iU" 
 of shepherds), is a serious accident, and often terminates fatally. It 
 consists essentially in inflammation of the umbilical vein, which sooner 
 or later involves the adjoining tissues, and is often followed by suppura- 
 tion and pytemia, which causes the death of the young creature. It is 
 rare indeed that the inflammation remains of a simple kind throughout 
 its course. As a rule, it is not merely an omphalo-phlebitis, but involves 
 the abdominal portion of the umbilical vein. There is a thrombus, 
 which soon suppurates ; a fistula appears at the umbilicus, the umbilical 
 vein is inflamed as far as the liver, to which the thrombosis extends, 
 and the portal and hepatic veins may even be affected. As a conse- 
 quence, the most serious accidents may arise. Embolic infarction of 
 the lungs, liver, or other organs is likely to occur, with gangrene, septi- 
 caemia or pyaemia. 
 
 Symj^tojns. 
 
 The inflammation commences soon after birth. The remains of the 
 umbilical cord, in the normal condition, quickly dries up and withers, 
 as it were, within a few days after the creature is born. When inflamed, 
 however, the part appears to be moist, and projects from the abdomen 
 as an enlarged, compact, and hard mass, from the centre of which flows 
 a small quantity of thin, unhealthy, purulent-looking fluid that soils the 
 surrounding skin. The peculiar tap-like appearance of the umbilical 
 cord, its density and high temperature, with the discharge therefrom, 
 will lead the careful observer to recognise the existence of omphalitis. 
 
 A probe can be readily passed into the umbilical vein, which remains 
 patent to a considerable extent. The local symptoms are often over- 
 looked at the commencement, and the first general signs of omphalitis 
 observed are usually dulness, arched back, indifference to the teat and 
 to surrounding objects, persistent recumbency, fever, and hurried pant- 
 ing respiration when general infection takes place, and embolism of the 
 lungs is occurring. As the malady progresses, great prostration is 
 manifest ; there is swelling at the umbilicus, and intense pain on 
 manipulation of that region : the eyes are dull and injected, the mouth 
 very hot and dry ; the pulse is so small and quick as to be scarcely 
 perceptible ; the bowels may be constipated and the faeces scanty, or 
 obstinate diarrhoea may supervene ; the urine is greatly diminished in 
 quantity ; the mucous membranes frequently assume a yellowish tint ; 
 
IXh'LAMMATloX "F THK I M i:l IJf.l L rni;],. 715 
 
 soft, rtuctuatiii^' swellings, containing a yellow gelatinous iluid, often 
 appear on various parts of the body ; the creature refuses to suck ; 
 indications of colic or peritonitis are sometimes manifested, with enteror- 
 rhagia ; and in the majority of cases death rapidly ensues. 
 
 Not infrequently the phlebitis is most intense in the internal abdominal 
 portion of tlie vein, and the pus, instead of freely escaping from the ex- 
 ternal opening, accumulates in the canal to such a degree as to form a 
 large swelling at the umbilical ring, which might be mistaken at the first 
 glance for a hernia. When this swelling has been opened, about half a 
 [)int of pus escapes in some instances. 
 
 When a fatal termination does not quickly follow from septika'mia, or 
 from embolism of some important organs, through detached portions of 
 the thrombus being carried into them by the circulation, we may have 
 1 ironic morbid conditions of a pya^nic character set up, which are 
 iiaracterised by metastatic inflammation of the serous membranes in 
 various parts of the body, and particularly of the articulations. Indeed, 
 it is now recognised by the highest Continental veterinarians, that the 
 destructive arthritis or "joint disease" of Foals, Calves, and Lambs is 
 attributable to omphalo-phlebitis. Inflammation of the joints — especi- 
 ally of the hocks — has often been accidentally produced by tlie inllam- 
 mation excited through ligaturing the umbilical cord. 
 
 Metastasis to the iris, choroid coat of the eye, diarrhoea, tumefaction 
 of the lymphatic glands, abscesses in the muscles and other parts, 
 etc., have been observed as a result of inflammation of the umbilical 
 cord. 
 
 Pathological Anatoviy. 
 
 In animals which have died or been killed in consequence of this 
 disease, the walls of the umbilical vein throughout the course of the 
 vessel are much thickened, and tlie communication with tlie portal vein 
 entirely interrupted by a blood clot. The vessel is flUed by a yellow 
 pulpy mass, foul-smelling in some cases, odourless in others ; while its 
 intinia is detached, and forms part of the contents. In the abdominal 
 cavity we may And effusion, exudation, and adhesion of various viscera, 
 with peritoneal ha^norrhagic spots. The portal and other abdominal 
 veins often contain matter similar to that in the uml)ilical vein ; the 
 liver is enlarged, in some cases atrophied, clay-coloured, and almost 
 bloodless. The lymphatics of the liver and mesentery are usually 
 nodulated, swollen, and infiltrated. The lungs in many instances 
 exhibit intense httMnorrhagic infarction, lobular pneumonia and its con- 
 sequence, and particularly purulent broncho-pneumonia. In special 
 cases, to be alluded to hereafter, the joints are swollen and inflamed, 
 and their capsules contain pus. When the creature lives until it 
 becomes cachectic, fatty degeneration of tiie muscles, with ecchymoses 
 in various parts of the body, is nearly always noted. 
 
 Caitses. 
 The causes of omphalitis are numerous. They may be enumerated 
 as follows : the admission of air or foreign matters to the interior of the 
 umbilical vessels; bruises or injury to the umbilicus, either during birth 
 or afterwards : irritation of this part either by the litter, manure, or 
 urine ; the habit which certain females have of licking the umbilicus of 
 their progeny, or of young ci-eatures to suck the remains of the umbilical 
 cord of each other ; rupture of the cord close to, or within the abdomen; 
 
716 DISEASES AXD ABKOBMALITIES OF THE YOUNG ANIMAL. 
 
 improper food given to the motlier ; 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 cicati'ix in new- 
 born children in maternity hospitals. Eueif 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, the 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 tlie 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. Alongside 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 lie 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 affected 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 present 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 within a few days of each other 
 and kept together, half the number have become affected with this 
 inflammation of the navel, and the remainder has escaped. 
 
 It must be remembered, too, that the discharge from one diseased 
 umbilicus may afford sufficient material 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 
 overcrowding in badly-ventilated dwellings — something analogous to 
 
IXFLAMMATloX OF TIIK UMBILICAL CORD. 717 
 
 the puerperal infection observed in certain maternity and other 
 hospitals. 
 
 A niali^'nant and a l)eni^'nant form of omphalitis have been described 
 by various autliorities ; but the distinction, 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 mali^Miant. It would 
 appear to be fully ascertained that septic infection gives rise to far more 
 serious and destructive intlammation than that due to entrance of the 
 air, or an aerial ferment, into the wound or open vessels of the cord. 
 
 As lias been remarked, this inflammation of the umbilical 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 tliere 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 ditl'erent species of animals, that putrid or septic diseases 
 are much more conunon 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. 
 
 Ulrich' reports that he saw an extensive outbreak of the disease in a 
 flock of Lambs, many of which died from abscess in the liver. Jle 
 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 bad something to do with the outbreak. 
 
 Treatment. 
 
 The prophi/laxis of omphalitis, or purulent phlebitis of the umbilical 
 cord, is very important, and nmst be based on knowledge of the etiology 
 I if 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 itifection. 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 be 
 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 Calf 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, salicylic 
 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. 
 ' Canstatt's Jahrcsberichf, 1860, p. 41. 
 
71S DISEASES AXD ABXOIUIALITIES OF THE YOUXG AXIMAL. 
 
 Franck states that a five per cent, solution of carbolic acid may be 
 passed in 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 inflammation is very intense, several authorities recommend 
 recourse to vesicating agents; others employ ammoniacal liniment, and 
 Eueff advocates tartarised antimony ointment. 
 
 When there is danger of general infection, or this has already 
 occurred, then the internal administration of antiseptic agents must be 
 resorted to. Franck recommends salicylate 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 alternately 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 post 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 
 abdomen in the second. The peripheral portion is 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 health V portion. General infection or pytemia rapidly follows 
 umbilical arteritis. 
 
 CHAPTEE VII. 
 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 " x\rthrite " or " Paralysie des 
 Jeunes Animaux," in Germany as the " Fohlenlahme," " Kalbliihme," 
 and " Liimmerliihme " ; and in this country — where it has evidently 
 been but little studied, it has been popularly known as " Joint III," and 
 technically as "Scrofulous Disease of the Joints," or "Specific" or 
 " Constitutional Synovitis." 
 
 The disease was first described, we believe, by Brugnone -^ then it 
 was noticed by Eoupp,- Lecoq in 1828, Strauss-' in 1831, Benard* in 
 
 1 Traltato clelJe Bazzf de' Cavalli. Turin, 1781. 
 - Recueil dt Mn/cci)!,; Vt'ttrinaire, 1S25. 
 ' Darr-fucht der Fohlen. Vienna. 1831. 
 ** Rtcue'd de Alidtrint Vtterinaire, 1832. 
 
AiriJUUI IS. 719 
 
 1S32, Triiger' in 1S30, Noll in 1S40, Darreau^ in 1842, Anacker' in 1848, 
 Roloff^ in ISGo, and Bollinger' in 1S73 and in 1875.'' In Jhiglaiid, 
 perliaps the most valuable description of the malady which has appeared 
 is by SValley." It has been more particularly described as it occurs in the 
 Equine race in Normandy, by Lecoq and Darreau, and in Poitou by 
 Terai ; in North (lermany by Thiger, Bollinger, Strauss, and Koloff. 
 In the Bovine species, it has been portrayed as it prevails in Bour- 
 honnais, by Bt'nard and Gay ; in Switzerland, by Anacker, and in 
 Bavaria by Bollinger. In the Ovine species, Hull describes it as existing 
 in Hungary, llaubner in Saxony, Kuers in Prussia, and Chambert and 
 Cauvert in the South of France. Walley alludes to its principal 
 features as it is witnessed in Lambs in England. 
 
 In some years it prevails very extensively, and appears to be almost 
 ■ nzotitic in some portions of the above-mentioned countries. 
 
 By some authorities it has been supposed to be a constitutional 
 disease, by others as scrofulous in its nature ; while others, again, 
 consider it as essentially pyiemic, and a sequel of purulent omphalo- 
 phlebitis. 
 
 Roloff is of opinion that the afifection is due to an alteration in the 
 blood — to a diminution in the amount of mineral salts in that Huid — a 
 veritable cachexia, in fact, allied to rachitism or osteomalacia. In this 
 view, the inflammation which attacks the joints and is symptomatic of 
 the disorder, should be attributed, primarily, to a cachectic or scrofulous 
 diathesis, and, secondarily, to the traction exercised by the ligaments, 
 connective tissue, and periosteum imperfectly attached to the soft and 
 unequally consistent bones, when the animal moves. 
 
 Walley defines it as an inflammatory affection of the synovial mem- 
 brane of the joints, of a specific character ; hence the terms " Specific 
 Synovitis" and " Specific Arthritis." 
 
 Causes. 
 
 If there is some diversity of opinion as to the etiology of this joint 
 disease of young animals, there is absolute unanimity as to its predis- 
 posing cause — the period of youth, as it only appears dui-ing lactation. 
 This fact disposes of its constitutional or hereditary nature, and has 
 inclined some veterinary pathologists to attribute its occurrence to an 
 alteration in the composition of the milk of the parent. 
 
 Darreau believed that the malady is more frequent among Foals 
 which do not receive the first milk, which contains colostrum ; but this 
 view is not borne out by other obsen-ers. RolofT witnessed its advent 
 in such a manner, that he thought it nmst be sometimes congenital. 
 Walley stated that the causes are entirely local, and can be traced to an 
 impure or antemic condition of the milk of the dam, as the result of 
 improper systems of management, or giving food deficient in the 
 necessary constituents of the blood. Hence, he asserted, it is seen 
 when Ewes have been fed on an abundance of turnips, without a sulfi- 
 cient allowance of hay or corn, particularly if the turnips are decaying, 
 or have been unduly forced with artificial manures. 
 
 ' Fiihlenkrankhfi'en. Berlin, 1839. 
 
 - Rentfil df Mnierine Velerinaire, 1842. 
 
 ' Kalhfrlahme. Zurich, 1848. 
 
 •• Fohlnihihm''. Berlin, lSt).'>. 
 
 '" Zur Kntt !>%■<.<< dtr Fohknlahmf, Virchow'a Archh; Band, 58, 1S"3. 
 
 " Dutlirli^ Zrit-^chrijt fur Thitrnudicin, 187.'». 
 
 "■ " Joint 111 in Lambs," Vtttrinary Journal, 1876, p. 406. 
 
720 DISEASES AND ABNOIUIALITIES OF THE YOUXG AXIMAL. 
 
 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 at the 
 teat, rather negatives the idea that exposure has anything to do with it. 
 It has likewise been noted that when Ewes are fed on decaying turnips 
 or mangold-wurtzel, the Lambs are frequently the subjects of effusions 
 of lymph between the muscles — the eifusion 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 Vv'hiie 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 pastures 
 (hence the more frequent localization 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 originated 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 foetus is being developed, and 
 when suckling, that the cause of the disorder must be especially sought 
 for. Careful analyses have shown that the ash of the herbage or hay 
 in the localities where the malady makes the largest number of victims, 
 does not contain more than six to eight per cent, of lime salts, while 
 that of good quality should have from eleven to thirteen per cent. 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 origin 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. 
 
 Bollinger, 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 anatomo- 
 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 enzooti- 
 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 
 
ARTHIUTIS. 721 
 
 per cent, of the cases) during the three weeks succeeding birth. Of tho 
 forty Foals above alluded to, twenty were ill within the lirst eight days, 
 ten in fifteen days, and the others in the fourth or sixth week. The 
 period of the malady was, of course, related to the foaling season — 
 April, May, and June. After an attentive study of the symptom and 
 making post /«o/-/t'»i examinations, Bollinger came to the conclusion that 
 there is a complete analogy between the arthritis of Foals — particularly 
 in the lesions observed — and the results noticed as a consequence of 
 omphalitis in infants. In his opinion, this joint disease, with its com- 
 plications, is due to metastatic pyasmia, which has its point of departure 
 in the purulent umphalo-phlebitis described in the preceding section of 
 this work. 
 
 In a more recent publication, Bollinger returns to this subject ; and 
 after alluding to his former opinion, founded on literary studies and 
 clinical observations, that the lameness or disease of the joints which 
 attacks Foals and Calves during the first weeks after birth, are due to 
 l)rimary alterations in the apparatus of the circulation, viz.— inflamma- 
 tion of the umbilicus and umbilical vessels, he gives further evidence in 
 support of this supposition. The autopsies of the Calves which form 
 tlie subject of his second communication, will be noticed hereafter; but it 
 may be mentioned that they afford indubitable evidence of the existence 
 of purulent omphalo-phlebitis and its consequences. As in Foals, so in 
 Calves, he traces the origin of joint disease to violent inflanmiation of 
 the umbilical veins. He notes that in Calves — which have a ductus 
 ccnosus Arantii and Foals have not — the direct opening of the vessels 
 into the posterior vena cava, as well as the general implication of the 
 latter, causes a proportionately larger number of cases in them than in 
 Foals. The influences at work in the production of omphalitis have 
 been enumerated ; but Bollinger lays great stress on the want of care, 
 which is, as a rule, bestowed on the umbilical cord in newly-born 
 animals, and compares this neglect with the scrupulous attention paid 
 to that of infants, which is severed and bandaged immediately after 
 birth ; while the former have to lie with an open wound in all kinds of 
 filth, and are thus readily exposed to inoculation witli poisonous or 
 injurious matters, which cannot be excluded even from stables built 
 specially for the purpose, and kept thoroughly clean. If the navel 
 wound of an infant were exposed to the filth which young Foals and 
 Calves have to lie in, it would be quite as liable to blood-poisoning as 
 animals, and to the consequent afifection of the joints. 
 
 Bollinger contests the influence of food in the production of the 
 disease, as strong, no less than weak, animals are attacked; it also 
 appears when every kind of diet is given to the parent. 
 
 He also denies that it is produced by chills, and attributes its advent 
 chiefly to pyajmic or septic infection. He compares the enzootic appear- 
 ances of joint lameness with the endemic outbreaks of pya}mia and 
 septicaemia (or puerperal fever), and points out that the only real 
 difference between man and beast lies in the simultaneous appearance 
 of puerperal fever epidemics with pyaemia in infants. One point is 
 certain, he adds, and that is that there is a physiological and anatomical 
 difTerence between woman and the domestic animals. The anatomical 
 structure of the placenta and its villi, and its relations with the placenta 
 inatcrna, are of such a nature in animals as to prevent (on the normal 
 detachment of the placenta) any rupture of bloodvessels, and conse- 
 -quent haemorrhage. In other words, if deUvery has been successfully 
 
 46 
 
722 DISEASES AND ABKOBMALITIES OF THE YOUNG ANIMAL. 
 
 accomplished, no injury in the shape of wounds or abrasions is inflicted 
 on the inner surface of the uterus ; and owing chiefly to this fact is the 
 inflammatory reaction and consecutive lochial fever reduced to a 
 minimum among animals, the introduction of poisonous matters (be 
 they vegetable organisms or other injurious substances) into the uterus 
 being rendered much more difficult ; while we frequently find instances 
 of the pyemic process, due to inflammation of the navel and its vessels, 
 among sucking animals, with the parent — except in the case of the Cow 
 — this process is rare. 
 
 SymiHoms. 
 
 The symptoms of this form of arthritis are variously enumerated. 
 The principal is extreme difficulty in moving, which is often noticed 
 without any other premonitory indication. The movements are pain- 
 fully and reluctantly performed, so that the young creature generally 
 persists in lying. Around the epiphyses of the bones, and consequently 
 near the articulations, there is swelling not only of the proper tissues of 
 the joints, but also of the surrounding connective tissue, with hot,, 
 cedematous, and very painful infiltration of the region. From the very 
 commencement the symptoms are most acute, and similar to those of 
 ordinary arthritis ; and they are rendered more marked by the least 
 movement, the lameness being then extremely great ; generally all the 
 joints are involved. The fever is extreme, the respiration hurried, and 
 the visible mucous membranes highly injected; sometimes, and especially 
 with Lambs, there are quasi tetanic spasmodic contractions. The 
 appetite is lost, but thirst is intense, and the suffering creature will 
 often be observed dragging itself along the ground to reach water or the 
 teat of its dam. Not unfrequently there is at the same time a debili- 
 tating diarrhoea or dysentery, and sometimes in Lambs a purulent nasal 
 discharge. 
 
 The progress of the disease is sometimes very rapid, death occurring 
 in twenty-four or forty-eight hours after the manifestation of the earliest 
 symptoms. This rapid course is, however, rare, and the animal may 
 live for twenty or thirty days, or even longer. Eecovery is also rare,, 
 and death is the usual termination ; it is quite exceptional that the 
 disease becomes chronic. The malady usually ends in suppuration, 
 which nearly always becomes general, numerous abscesses forming 
 around the joints, the capsules of which contain pus ; there are also- 
 purulent deposits in other regions of the body. Generally after the 
 fourth day, when the joints are greatly swollen, the hair falls off in 
 these parts, and a yellowish or citron-coloured fluid, then pus, begins- 
 to exude through the skin, which sloughs away ; the ligaments are also- 
 involved in this sloughing process, and at last the articulations are com- 
 pletely disorganised. In some cases the limb is only retained by 
 remains of tendons, the bones being exposed, the articular surfaces 
 destroyed, and the odour almost insupportable. The complications 
 may be pneumonia, pleurisy, pericarditis, and the usual indications of 
 pyaemia. 
 
 In Foals, Bollinger noted, as the chief symptoms, violent fever with 
 very hurried respiration ; the animals did not suck so much as usual, and 
 if lively and attentive at the commencement of the disease, they quickly 
 became extremely weak and torpid. They also became emaciated, and 
 the coat was harsh and lustreless ; often there was nasal catarrh and 
 discharge, tumefaction of the submaxillary lymphatic glands, sometimes- 
 
AirnmiTix. 723 
 
 capillary bronchitis, and generally diarrhcra. With the majority there 
 was tumefaction of certain joints, and particularly of the hocks. In 
 addition to the swelling', there were heat and pain, with ^a-eat lameness. 
 Not infrequently there were immense subcutaneous abscesses. Stupor 
 c\eutually set in, and the creatures looked as if half asleep; then coma 
 was soon manifested ; there was dysenteric diarrhcea, the dejections 
 being quite fluid, greyish-coloured, and extremely fcetid ; while the 
 visible nmcous membranes had often a yellowish tint, denoting the exist- 
 ence of icterus. 
 
 In Lambs the symptoms are similar to those just enumerated. 
 Walley described them as follows : — A general febrile condition of the 
 system, as shown by the injected state of the mucous membranes; 
 quick, irritable pulse, irregularity of the bowels, hurried respiration, and 
 refusal to suck. The animal persistently lies, and if made to move does 
 so unwillingly and very stiffly, with the back arched, and placing as 
 little weight as possible on the afifected limb or limbs, which are 
 usually flexed, even in recubation, to remove pressure— this persistent 
 flexion ultimately leading to contraction of the tendons and distorted 
 limbs. If the disease continues, the muscles waste, causing the affected 
 joint to appear larger than it really is. The characteristic swellings 
 usually appear in the hocks, knees, and stifles, though they are not by 
 any means confined to these particular joints. In character they are 
 round, have a doughy feel, are intensely painful to the touch, very hot, 
 immovable, and increase in size. Thus they are like, yet dissimilar to, 
 rheumatismal swellings — like them in being located in the joints, and 
 being hard, round, and tender ; unlike them in being stationary, and 
 attacking the internal structures of the joints — the primary lesions in 
 rheumatism being confined to the external ligamentous structures of 
 these organs, and when attacking the interior of the joints formative 
 processes are evidenced; while in "joint-ill" degenerative processes 
 predominate. As the disease progresses, and life is prolonged, the 
 animal becomes emaciated, diarrhoea sets in, the wool falls olT, and a 
 variety of changes are detected in the joints. Erysipelatous inflamma- 
 tion makes its appearance in various parts of the skin of the body, 
 especially at the external orifice of the urino-genital organs, at the 
 postero-inferior part of the abdomen, and round the navel, in the latter 
 position constituting " navel-ill." Local dropsies are frequent under 
 the jaw and other dependent positions — as the navel, which is said to 
 be pocked. If blood is abstracted during life, or collected after death, 
 and set at rest for a time, it deposits a peculiar dark-coloured, grumous 
 mass at the bottom of the vessel, composed, so far as can be seen by 
 the microscope, of altered blood-cells. This deposit lacks the firmness 
 of the other parts of the clot, and bears a close resemblance to half- 
 fermented damson pulp. Bacteria are developed in the blood shortly 
 after death, and long before any putrefactive odour can be detected. 
 Al-'irption of pus into the blood — py.rmia — is indicated by elevation of 
 tl.' temperature, foctor of the breath, diarrhoea, dark yellowish-red 
 colour of the mucous membrane, gnashing of the teeth, rigors, and hectic 
 fever — the latter being present also in ulceration of the joints. 
 
 In the latter, the swellings become softer and very irregular in outline, 
 from bulging of the more flaccid portions of the synovial membrane and 
 skin : and, from portions of the effused lymph becoming liquefied, 
 fluctuation is produced — other portions remaining solid. The fluctuating 
 swellings extend along the thecae or sheaths of the tendons — two joints 
 
724 DISEASES AND ABNORMALITIES OF THE YOUNG ANIMAL. 
 
 often becoming in this way connected with each other ; finally, the skin 
 over the most prominent portions of the joint becomes absorbed, 
 ulcerates, and if not divided by the lancet or by accidental violence, 
 bursts— allowing the escape of the contained fluids and semi-solid 
 matters, and being followed by sinuous ulcers, caries, or abscess proper, 
 of the joint. The sinuses may extend a considerable distance from the 
 joint, and discharge an ichorous unhealthy fluid, accompanied by fcetor 
 if bony or ligamentous structure is involved. In some cases the exuded 
 lymph simply becomes liquefied and absorbed, without any external 
 opening being formed; in others — i.e., when the lymph is plastic and 
 the constitution strong — it undergoes healthy organisation, and remains 
 as a part of the joint, producing, however, permanent thickening, dis- 
 tortion, and stif&iess. 
 
 Prognosis, 
 
 From what has been stated, it will be seen that the prognosis with 
 regard to this disease must always be unfavourable, especially when the 
 creature is very young. The mortality reaches as high as forty, fifty, 
 sixty, and even more per cent. Indeed, Darreau states that eighteen 
 out of every twenty Foals die ; and Lecoq says that the breeders in 
 Normandy have an axiom, " Poulain boiteux, poulain perdu." 
 
 Pathological Anatomy. 
 
 According to Eoloff, the predominant lesions are the characteristic 
 alterations of rachitism and periostitis. The cartilage uniting the 
 epiphyses to the shaft of the bones is soft from cellular proliferation, and 
 injected in places by hsemorrhagic spots ; the periosteum is also 
 thickened, injected, and here and there detached from the bones; while 
 towards the diarthrodial surfaces the bone tissue is greatly involved. 
 There are, in fact, all the lesions of arthritis, but they are of a much 
 more serious character than those observed in adult animals. The 
 synovial membrane is highly inflamed, and there is great infiltration of 
 the connective tissue around the joints. 
 
 Eeynal has found in the intra-articular cavities of the joints, deep- 
 yellow-coloured clots streaked with red, and elastic and firm, which are 
 nothing more than false membranes that have had time to form in the 
 short space of two to five days. 
 
 Walley remarked that, in Lambs, the 2wst mortem appearances are 
 general and local. The general, in the earlier stages, are effusion of 
 lymph between the intercostal muscles, beneath the pleura and into the 
 lungs, and in other organs ; with hyperemia or engorgement of the 
 small bloodvessels of the mucous membrane of the stomach (fourth 
 compartment) and intestines. 
 
 If the disease has existed for any length of time, erysipelatous exuda- 
 tions are found under and within the structure of the skin of dependent 
 parts, or effusion of serum (dropsy) into the connective tissue and the 
 various cavities of the body. The large bloodvessels — even those of the 
 brain — are filled with dark, grumous, damson-coloured blood ; the 
 structure of the brain is dark ; the liver is often enlarged, friable, and 
 full of minute abscesses, which give it a mottled appearance that is fre- 
 quently mistaken for tuberculosis ; all the organs and tissues are tinged 
 with the colouring matter of the bile ; the small vessels of the omentum 
 are charged with blood, and the mucous lining of the fourth division of 
 the stomach is congested and black wherever the milk has lain in con- 
 
AIlTHIiiris. 72r. 
 
 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 cheesy material — de- 
 generated lymph, or coagulum of blood. 
 
 The local ai)pearances — /.c, 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 iiaving 
 an intensely scarlet hue, which diminishes in a few days. Coagulablf 
 lymph becomes etVused into the cavities of the joints, forming perfect 
 casts of their interior, and tilling up the interspaces between the bones. 
 In time, the exuded lymph conunences 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, wiiich, 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 sufli- 
 ciently long, multiple pyicmic 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 
 liepatic abscesses. 
 
 From this description of the pathological anatomy of the malady, 
 there can scarcely be any doubt as to its pyirmic or septic origin, and 
 this is further demonstrated by the description of its morbid anatomy 
 by Bollinger.' 
 
 ' Jhnt-rhf Z'i/'rhrif'/jiir T/iif mifdirhi, IS?'-.— A nuile Calf Ix.rn at tlif Agricultural 
 School of Strickhof, near Zurich, showed H^inptoiiiH, soon aftrr l>irth, of inHainination of 
 the unihilicUM. As the joints began to swell, ancl there wa« nn hoj)e of saving the 
 animal from the efftcts of the drea^lful jnint disease — " gelenk.seuche "—it was destroyed 
 eight days afterwards. The body was dissected an hour after death, but the examination 
 w.-vs imperfectly made. The umbilical ring was discovereil to be still open ; it formed a cir- 
 cular aperture alxiut 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 thertfore the investigation cfjuld not be continued. Projecting about the 
 upper margin of lx)th hmgs were several cuneiform tumours of a dark-red colcvur, and of 
 a solid consistency. In the ]>ericardium was a quantity of pale serum, in which floated 
 loose stringy fibres. In the cavity of the heart were » few detached fibres and blood- 
 clots. Benrath the endix»rdium were various-sized patches of ecchymoses and bloo«l 
 extravasations. Nothing abnormal was observed in the liver and kidneys except 
 bloodlessness. 
 
 Another Calf was bom at the same establishment on Febrtiary Gth. Its birth had 
 been laborious, and thy umbilical cord was divirled in the ordinary natural manner. The 
 animal did not appear to k>e 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 app>eared on the inner aspect of the knee joints. Until this time the 
 creature had a gootl appetite, and h.ad taken a plentiful supply of milk regtilarly every 
 d.iy. On Febnian.- 27th, the appetite entirely failed, and on the 28th the Calf ^was 
 
726 DISEASES' AND ABNORMALITIES OF THE YOUNG ANIMAL. 
 
 The result of his autopsies, together with the symptoms observed 
 during life, led Bollinger to the conclusion that the development of the 
 pathological process is as follows : inflammation of the umbilical vessels, 
 notably the vein, with its decomposed and softened thrombus, which 
 passes into the vena portae, and forms the point of departure or source 
 of a metastatic pygemia, and from it embolism of the lungs is sometimes 
 directly originated ; or at other times, in consequence of alteration in 
 the blood, which is septic, and of the general character of the inflam- 
 
 killed, in order that the carcase might realise something. The most important organs 
 were sent to Bollinger, and their examination yielded the following results : There was 
 purulent emphalo-fhrombo-phlebitis, loith thrombosis of the portal vein ; fibro-purtdent 
 gonarthritis of the stifle joints and purident peri-arthritis ; ptirident tracheo-bronchitis, 
 embolic infarction of the lungs, commencing endocarditis of the mitred valves, and 
 generalised icterus. The parts surrounding the stifle joints were of a pale-yellow colour, 
 infiltrated with a sero-purulent fluid, and moderately thickened. In the cavity of the 
 joints there was a tolerable quantity of dark-tinted serum, and on the synovial membrane 
 more especially was a mass of yellowish-green and firm fibro-purulent matter, about two 
 centimetres thick, which projected into the synovial cavity. The cartilages of the joints 
 were covered with similar matter, and in some places they were quite rough. The entire 
 capsule of the joint was inflamed, softened, and purulent. The trachea and bronchial 
 tubes contained a quantity of muco-purulent fluid, which, in the latter, formed itself into 
 one mass. The mucous membrane was pale ; the almost bloodless lungs had ecchymosed 
 spots beneath the pleura, and in one place were two wedge-shaped masses the size of a 
 pea, which on being cut open were found to contain pus in the centre. The heart and 
 pericardium were normal, with the exception of the mitral valve, which was of a dark- 
 red colour, thickened, and exhibited hsemorrhagic infiltration in places ; by means of the 
 microscope, a notable cellular opening could be perceived in the connective tissue close 
 to the haemorrhage. The spleen was of normal size, but pale and bloodless ; the liver 
 was enlarged, full of blood, icteric in tint ; in parts were small, subperitoneal haemor- 
 rhagic deposits. The umbilical vein was distended throughout its entire length ; its 
 walls were considerably thickened, and the inner surface was of a dirty-grey colour, 
 rough, uneven, and studded with greyish -white puriform deposits. This alteration in 
 the umbilical vein extended as far as its junction with the posterior vena cava, which, 
 owing to the closure of the ductus venosus, is not in direct communication with the 
 umbilical vein. Where the latter enters the portal vein was a purulent cloaca, beyond 
 which was a large thrombotic puriform mass that obliterated the cavity of the latter 
 vessel as far as its bifurcation. As fatty degeneration of the heart was suspected from 
 its appearance, the tissue of that organ was examined microscopically, but it was found 
 to be normal. The voluntary muscles in the vicinity of the diseased joints, and which 
 appeared very pale to the naked eye, were only clouded with granular matter. The puri- 
 form contents of the umbilical vein consisted of fatty granular detritus, in which it was 
 difficult to detect pus corpuscles ; bacteria could not be found in any number. The liver 
 offered indications of a violent icterus, and exhibited all the alterations of acute paren- 
 chymatous hepatitis, with marked granular degeneration of the hepatic cells. 
 
 In the three autopsies of Foals made by Bollinger at Graditz (Virchow^s Archiv., 
 1873), he found double broncho-pneumonia of the anterior lobes of the lungs, pulmonary 
 abscesses, purulent arthritis, intra-muscular abscesses, caries of the bones, and fatty 
 degeneration of the muscles of animal life, particularly in the neighbourhood of the 
 affected joints ; as well as fatty degeneration of the heart tissue, liver, and kidneys. In 
 the intestinal canal were lesions of catarrhal enteritis, accompanied by hyperplasia of 
 the mesenteric glands. Neither in the animals when alive, nor at their autopsy, were 
 there any of the signs of rachitism mentioned by Koloff. The umbilical cord was unfor- 
 tunately not examined. 
 
 On another occasion, the same excellent veterinary pathologist examined the bodies of 
 two Foals — one three weeks, the other five weeks old, which had succumbed to this 
 malady. In these there was inflammation and thrombosis of the umbilical vessels, con- 
 tinuation of the thrombosis of the umbilical vein (in process of suppuration) into the 
 portal vein, which was also afifected with thrombosis, as well as its hepatic ramifications. 
 In one of these cases there was likewise thrombosis of the pulmonary artery, double 
 pleurisy with pericarditis, purulent arthritis affecting several joints, vast intra-muscular 
 or subcutaneous abscesses, and cutaneous erysipelas. In the other case there were pul- 
 monary abscesses, circumscribed pleurisj^ purulent irido-choroiditis, and, finally, in 
 addition to general anaemia there was great tumefaction of the bronchial and mesenteric 
 glands. 
 
ART II HIT IS. 727 
 
 Illations, there are metastatic intiaramations of the serous and synovial 
 membranes (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 series of clinical and anatomical alterations which 
 constitute the complicated arthritis of Foals. 
 
 More x-ecent investigators have detected special micrococci in the 
 fluids and tissues, to which the origin of the disease must be attributed. 
 The most important of these is the Streptococcus pj/oijenes, to which tlie 
 more ditTuse suppurations may be due ; and the Sta2)lii/lococcus pyogenes 
 <ilbus and Stitjilii/lococciis aureus, which probably produce the more 
 localised lesions due to inflammation. These find easy access to the 
 body through the umbilicus when circumstances are favourable. 
 
 Treatment. 
 
 Curative treatment of this form of joint disease being, under the most 
 favourable circumstances, veiy unsatisfactory unless it is adopted at the 
 very commencement, the greatest importance must be attached to 
 preventive measures, and especially if the malady is enzootic. On the 
 Continent, those veterinarians who adopt Eoloff'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 
 be well fed during pregnancy, and aliment rich in earthy salts is to be 
 ;^'iven. In addition, bone-dust is to be mixed with their prepared food, 
 or witli 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- 
 <lressings, the mineral elements abstracted by the growth of forage or 
 the herbage consumed by the 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 ditliculty in applying remedies to tliem, but also from 
 the very serious nature of the disease, and the 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 he treated as in omphalitis, a solution of 
 corrosive sublimate (1 to 1,00()) 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 ligatured. Hot 
 water fomentations ought to be applied 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, 
 
72S DISEASES AND ABNORMALITIES OF THE YOUNG ANIMAL. 
 
 the inflamed joints being enveloped afterwards in linen bandages. 
 Anodyne lotions and embrocations have also been recommended, in 
 order to allay the pain and irritative fever ; as well as the application 
 of tinctm'e of iodine before the suppuration period. "When suppuration 
 is established, the abscess should be opened at the proper time. 
 
 Tonics have been given with advantage, as well as cod-liver-oil» 
 castor-oil, and even ordinary oils and fats. These not only aid in the 
 assimilation of earthy salts and nitrogenous matters, but to some 
 extent act as a laxative — a service of some importance. Small doses 
 of sulphate of magnesia or soda, or even aloes, may also be given with 
 the last-named object, or to produce continuous purgation for some 
 time. 
 
 With regard to the ti-eatment of the disease in Lambs, Walley 
 advises that those affected be removed from the dam, and receive milk 
 from healthy animals. This milk may be mixed with beaten-up eggs, 
 and good nitrogenised gruels may also be allowed. " Place in dry, 
 warm houses, and give gentle aperients — as castor-oil — or better, a 
 small dose of mercury with chalk ; follow up by febrifuges and 
 diuretics, as nitrate of potash and camphor, with nitric ether, or car- 
 bonate of ammonia ; if much pain is evinced, give small doses of opiates 
 — Dover's powder being the best agent of this class ; or inject a small 
 quantity of the solution of morphia underneath the skin of the joints. 
 In the course of a few days, tonic treatment should be adopted, as the 
 administration of iron, alternated with iodide of potassium ; or mineral 
 acids with cinchona, or other vegetable tonics ; and allow a little wine, 
 good old ale, or porter." The same authority recommends, as local 
 treatment, the application of a strong blister — as the compound tincture 
 of iodine ointment — all round the joint, at the commencement of the 
 disease ; and when the subsequent inflammation has subsided, to keep 
 the joints at rest and in their proper position by the use of light splints 
 and bandages, leaving the joint exposed for further observation. As 
 soon as any tendency towards " pointing " in suppuration is perceived, 
 the joint is to be opened freely, the inflammatory products removed, 
 and the interior washed out with a solution of carbolic acid in glycerine 
 and warm water — one part of the first, two of the second, and forty or 
 fifty of the last. Afterwards, pads of soft lint or linen and tow, saturated 
 in carbolised oil (one to eight or ten) should be applied, leaving an 
 aperture inferiorly for the escape of discharge ; the dressings are to be 
 renewed every day. Mild caustics or astringent lotions are to be 
 applied if granulations project above the skin. If the ends of the bones 
 are carious, they must be scraped, and nitric or muriatic acid applied ; 
 should sinuses have formed, they must be obliterated by the use of 
 setons, or laying them open with the knife, and treating them after- 
 wards as ordinary wounds. " In treating the results of this disease, it 
 must be borne in mind that in young animals the reparative processes 
 go on very rapidly ; and that what appears to be a very formidable 
 wound, is soon converted into a comparatively simple one. Animals, 
 too, may, with a little trouble, be fattened and their flesh utilised ; few 
 can be preserved for breeding purposes."^ 
 
 As salicylic acid is unrivalled for its antipyretic properties, and par- 
 ticularly in inflammation of the fibro-serous membranes, its internal 
 administration should be tried in this arthritis of young animals. The 
 
 ^ The flesh of animals which have been suffering from this disease should be interdicted 
 as food, as it is positively dangerous to those who consume it. 
 
IXninKSTloX. 72» 
 
 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. 
 
 CHAPTER YIII. 
 Indigestion. 
 
 Indigestion sometimes attacks young animals soon after birth, and is 
 perhaps most frequently observed in Calves, seldoinor in Lambs ; in 
 Foals and the young of Carnivora it is rarely met with. 
 
 Causes. 
 
 The principal cause would appear to be too rich milk, or even milk diffi- 
 cult of digestion from its poorness, or fi-om 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 rise 
 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, or 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 are 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 brenth 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 ficces being yellow and fcetid— sets in, which is frequent — though 
 constipation is not rare ; and at this period symptoms of colic are often 
 noted, and the respiration is at times hurried. The diarrhcra 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, and 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 condition, 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 DISEASES AXD ABXORMALITIES OF THE YOUXG AXIMAL. 
 
 Under the most favourable circumstances it causes loss of condition, 
 and often retards growth. 
 
 Treatment. 
 
 Preventive treatment is to be based on the predisposing or exciting 
 •causes just enumerated. Over-repletion with milk should be guarded 
 against, and if the animal is being reared artificially, great care must 
 be paid to the diet. If at the teat, the food and water of the mother 
 should be attended to ; and if the milk is too rich, this may be remedied 
 by giving less stimulating food. With Mares which are worked during 
 the suckling period, the milk is often retained for a long time in the udder, 
 and becomes altered ; on returning to the Foal, this is ravenously hungry, 
 and over-gorges itself with the unhealthy fluid. The preventive measures 
 are obvious in such a case. 
 
 Indigestion may be due to an insufficiency of oily matters in the milk 
 ■of the mother ; here the diet of the latter must be altered. 
 
 The curative measures in mild cases are simple. Some French and 
 Italian veterinarians recommend the administration of barley-water or 
 very weak beef-tea, and if there is not speedy amendment they prescribe 
 a spoonful of rennet, which, they assert, readily effects a cure. 
 
 When the indigestion is due to acidity, alkaline agents — as carbonate 
 of potass or soda, lime-water, calcined magnesia, etc. — and afterwards 
 castor-oil — are generally effective. A mild purgative — such as castor- 
 oil, manna, cream of tartar, olive-oil, or a dose of glycerine in albumin- 
 ised water — is very useful, even when diarrhoea has set in. Manna has 
 proved an excellent remedy for Lambs, and even Calves. When con- 
 stipation is present, enemata of soap and water may prove serviceable. 
 Vegetable bitters — as tincture of gentian — and mild stimulants, are 
 often beneficial; much success has attended the administration of 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 diarrhoea 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 inefficacious in these cases, and puts them to be 
 suckled by Cows which have newly calved, dieting them carefully at the 
 same time. 
 
 CHAPTEE IX. 
 Gastro-intestinal Catarrh. 
 
 According to Friedberger and Frohner,^ by its etiology and course, as 
 well as in the treatment to be adopted, the gastro-intestinal catarrh of 
 young animals differs essentially from the same affection in adults. It 
 has been confounded with the dysentery of young animals, and in the 
 first edition of this work, this error was committed ; indeed, for more 
 than a century the two diseases have been, and are even now, described 
 as one. But a distinction must be made, and they are separately dealt 
 with here. 
 
 ^ Lehrhuch der Specidlen Pathologie unci Theraple der Hausthiere, vol. i., p. 199, 
 Stuttgart, 1887. 
 
GASTROIXrESTIXA L CA T. i lUill, 731 
 
 Sjimptoms. 
 
 The early symptoms vary somewhat, according to the exciting causes. 
 SoniL'times they are suddenly manifested, and at other times they are 
 so gradually developed that they do not attract attention for a day or 
 longer. With sucking animals the principal symptom, diarrhcea, is 
 usually preceded by slight anorexia, dulness, and weakness ; but with 
 animals which are 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)ance — the temperature of the body being irregularly 
 distributed, limbs cold and muHle dry, and much nervous depression — 
 sensory and motor. Diarrhoea soon sets in, the dejections quickly 
 becoming watery, and frequently energetically expelled ; they are not 
 long before they are fcetid 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, perinieum, and thighs, to be shed. 
 
 Usually there is tenesmus and signs of colic, 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 present, the gases accumulating in the 
 rumen and intestines of the Calf producing great distension — though 
 this may be present before, during, and after the diarrhoea stage, being 
 due to abnormal fermentation. 
 
 In some cases death occurs within a few days or as many weeks, and 
 is generally the result of exhaustion, amemia or hydrajmia; though 
 sometimes the 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 
 diarrhea. Constitutional diseases, antrmia, debility and disturbance in 
 the digestive apparatus or in nutrition, which are usually accomjianied 
 by alterations in the milk, have an unfavourable effect on young animals; 
 infectious maladies — sucli 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 fjuality 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 diarrhcea 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, ovcrgorging 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. W'ith 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 AXD ABNORMALITIES OF THE YOUXG AXIMAL. 
 
 injurious foreign 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. 
 
 Pathological Anatomy. 
 
 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. The mucous membrane of the stomach and intes- 
 tines presents variable appearances — redness, tumefaction, follicular 
 catarrh, 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 hydraemia are 
 present. 
 
 Prognosis. 
 
 The prognosis must always be carefully given, and will be based on 
 the cause or causes of the attack. It is generally unfavourable when the 
 diarrhoea and tympanitis have continued for a considerable time. 
 
 Treatment. 
 
 If possible the exciting cause 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, w^hich ought 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 Hnseed mucilage, raw eggs, 
 gelatine water, decoction 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 the diarrhoea 
 be due to worms, these will probably lead to their expulsion. 
 
 When the diarrhoea is very intense, opium and rhubarb have rendered 
 good service, as well as Dover's powder, tincture of opium, or, perhaps 
 better still, chlorodyne. 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. 1 Filliatre- has been particularly successful 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 
 
 1 Friedberger and Fruhner, o;?. cit., vol. ii., p. 389. 
 - Rfcueil de Midecine VeU'rivaire, 1886. 
 
nysExrj-JL'y of ynrxc ammals. 733 
 
 litre is given in enema every half-hour until the diarrhoea 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 be continued 
 for two days. 
 
 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 
 specific nature, its almost incuraVjle 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 " \Veisse Kuhr" of the Germans, and the " Diarrhee des Jeunes 
 Animaux " of the French), it is generally acknowledged that Calves are 
 far more fi-equently attacked than other animals ; though it is also an 
 extremely fatal disease among Foals. Brugnone^ 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 pyiRmic polyarthritis of young animals, it is one of the most 
 fatal disorders to which tliey are liable. According to Roll it is very 
 prevalent in some parts of Austria, and in one region alone, of 3,318 
 Calves, 1,196 were attacked, of which l,lo2 — 97 percent. — perished; 
 in 1884, in the same districts the mortality 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 \novQ often and severely visited than 
 elevated, dry situations. 
 
 Epizo()tic abortion and this disease have been noted to co-exist, and 
 it has been supposed there is some 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 tlie young creatures are atTected before they liavc sucked ; so 
 that the milk could not have had any influence in its production. 
 
 Symptoms. 
 
 The symptoms are described as somewhat 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 ftetid ; while the expired air and 
 cutaneous exhalations often have a foul odour. The eyes become sunk 
 
 ' La Moicalcia, Turin, 1S93. 
 
734 DISEASES AXD ABXOItMALITIES OF THE YOUNG ANIMAL. 
 
 in their orbits ; great debility sets in ; thirst is intense ; the abdomen is 
 retracted ; and in some cases a cutaneous eruption is observed, which 
 is generalised or is located in the parts around the anus. 
 
 More than a century ago, Brugnone described the symptoms in the 
 Foal as follows : The diaiTha3a commences two or three days after 
 birth ; a yellow, acrid, sometimes purulent-looking fluid is evacuated ; 
 the animal becomes rapidly emaciated, and is nearly always lying ; it 
 is weak and staggers about, sucks little or none at all, and at last falls 
 into a state of complete marasmus. During the first period, it is not 
 rare to observe a general ophthalmia occur : the humours of the eyes are 
 turbid and these organs are painful ; tears flow continually ; 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 has begun to 
 do so ; for Franck has known the diarrhoea to appear immediately 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 diarrhoea sets in. 
 When it no longer sucks, it becomes uneasy and bellows ; the faeces, 
 expelled violently, are at first very soft, then fluid and white (mucous 
 diarrhoea), or mixed with particles of casein (white dysentery), and very 
 often streaked with blood ; at a later period the evacuations are con- 
 tinuous and made involuntarily. Exhaustion is rapid and the creature 
 cannot rise ; convulsions occur frequently, similar to those witnessed in 
 infantile diarrhoea ; saliva or foam flows from the mouth ; the expired 
 air has a sour or foetid 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 without a struggle in from one to three days. Allusion has 
 been made to its fatality ; in Bovines from 50 to 100 per cent, die, and 
 in many outbreaks it kills all the Calves in an establishment ; if any 
 chance to survive an attack, they 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 106' 
 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 ; Nikolski^ gives its 
 appearance as 30 per cent, the first day, 40 per cent, the second day, 
 25 per cent, the third day, and only 5 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.- 
 
 1 Veterinary Archives of St. Petershirg, 188.5. 
 
 - With regard to the disease in Lambs, Benedikt{SachsenJahreKberichf, 1871, p. 140) 
 describes it under the head of " typhous diarrhoea in Sheep " {Typhose Bulir bei Scha/en). 
 He writes : " At the commencement of lambing-time, the Lambs are observed, soon after 
 birth, to be dull and dejected ; they do not care to suck ; there is great debility ; the 
 eye is dull and sunken ; there are involuntary evacuations of a fcBtid, brownish-yellow 
 colour, which are ejected some distance ; and in three or four hours death ensues. In all 
 the cases the Lambs appeared to be quite healthy when born ; but in two or three 
 hours afterwards they began to exhibit these symptoms, and during the fir.-t, seldom the 
 second, day they perished. On examination of the carcase, bright-rtd spots were observed 
 in the true stomach and intestines, which contained matter having an unpleasant odour. 
 The Ewes remained healthy." 
 
DYSKXTEIiV OF YOUXiJ AXIMALS. 73S 
 
 Pathological Anatomy. 
 
 There is nothing very characteristic in the alterations observed after 
 death. The intestinal mucous membrane is covered by amuco-purulent 
 exudate containing; numerous bacteria ; the epithelium is desquamated 
 in dilTerent parts, and the coriuin and Peyer's patches are tumehedand 
 softened ; while in acute cases the contents of the intestine are san- 
 guinolent. Ulceration is not present, probably owing to the very brief 
 duration of the malady. The mucous membrane of the true stomach 
 (fourth compartment) is congested on the summit of its folds, particularly 
 in the pyloric portion ; it is also ecchymosed and infiltrated, frequently 
 looking as if it had been sodden, while there are often traces of hicmor- 
 rhage ; this compartment generally contains clots of casein which have 
 an acid reaction. 
 
 General amemia of the body is most marked, and in some cases there 
 may be evidence of globular broncho-pneumonia, induced by fluids 
 obtaining access to the air passages.^ 
 
 ' Franck is, perhaps, the best authority on this malady, and his observations are of 
 great imiwrtance, not only from the care with which ho studied it, but also from the 
 scientiKc manner in which he investigated its pathological anatomy. He examined a 
 number of b*>dies of Calves which had recently died of the disease, and alwayd found the 
 same characteristic alterations, of which the following are given as typical : 
 
 A Bull-calf of the Algiiuer breed, which died on the third day after birth, the second 
 day of the disease. Weight 37 '4 kilogrammes. The remaining portion of the umbilical 
 cord is perfectly dry. The hind parts are somewhat soiled by fieces, the eyes are deep in 
 their sockets ; there is no meteorismus. Eight incisors are cut. There is a remarkable 
 and general bliKkllessness observed, and this is more particularly noted in the digestive 
 organs, which look very white. (This aniemia was present in all the castas to the highest 
 degree : so much so, indeed, that the tanner who bought the skins thought they were 
 from calves which had been slaughtered in the ordinary way, i.e., bled to death — " white 
 Veal.") The umbilical artery is, at the torn extremity, retracted, dark-red in colour, and 
 contracted towards the pelvic opening ; it is distended by a dark-red blood-clot, which 
 extends as fur as the aorta. The umbilical vein is not inflamed, b<it contains a (piantity 
 of dark, small blood-clots (these were not always present) ; it had been torn through 
 towards the outer half of the navel-ring, so that both divisions were visible. The 
 nrachus is ruptured at the inner portion of the umbilical opening. Around the latter are 
 a numV)er of generally small ecchymoses. The abdominal cavity is filled with a dark 
 fluid, which extends through the second and third compartments of the stomach, as far 
 as the fourth compartment. This fluid is also found in the mouth and pharynx, as well 
 as in the trachea ; though none is observed in the lungs. In the tnie stomach is dis- 
 ct)vered a greater ((uantity (about one and a half litre) of curdled milk, in which were 
 dirty-white tuaases of casc^in ; this fluid has an .icid reaction — m:ikiiig litmus paper 
 double-red : its normal condition. The mucous membrane of tlii^ jxirtion of the 
 stomach is o-dematous, of a dirty ytllowishred colour, with traces of pout mortem solu- 
 tion. In the third compartment are a number of isolated ecchymoses al>out the size of 
 a pin's head. The intestines are (|uite empty, and their lining membrane is covered by 
 a thin layer of purulent-looking matter, which has a feeble alkaline reaction. Peyer's 
 glands are slightly swollen, somewhat injected, but otherwise normal. The aecum is 
 remarkably void of solid or fluid contents, and is full of gits. The liver is very small, 
 pale, clay-c<iloured, and bloodless ; the little gall-bladder is completely empty ; the 
 spleen is normal. The lungs are speckled red ; at some jwints the patches are reddish- 
 brown ; the organs are permeable to air. The cavities in lx)th sides of the heart are full 
 of dark, coagtdated blood, and l>eneath the epicardiiim are a number of small ecchy- 
 moses. Otherwise the heart and its %-alves are very he;illhy. The dura mater of the 
 brain is strongly attached to the cranium. The minuses are dark coloured, and fidl of 
 coagulated bloo<l. The brain is remarkablj- aujemic ; its lateral ventricles are di»tended 
 by a clear serous fluid ; the rete mirabile at its baie, and the neighlxiuring membranes, 
 are also distended by coagulated blood. 
 
 Microscopic examination of the blood and the blood-clots in the heart, umbilical vein 
 and artery, proved that these were perfectly normal. The red and white corpuscles in 
 them were unaltered, and there were no special organisms ; the colour of the bl'Hxi was 
 not diminished. All those appearances which are particularly noted in putrid diseases — 
 as in puerperal fever, and particularly in septicaimia, were absent. The liver-cells were 
 
736 DISEASES AND ABNORMALITIES OF THE YOUNG ANIMAL. 
 
 Etiology. 
 
 From its mode of origin and extension, as well as its com'se, this 
 •disease is now generally recognised as due to micro-organisms, though 
 their exact characters are not yet accurately ascertained. The best 
 authorities class it with the miasmatico-contagious maladies, trans- 
 missible from a diseased to a healthy animal, the infecting agent being 
 most abundant in the excreta. Kotelmann^ asserts he was successful in 
 conveying the malady from the Calf to the Lamb ; though Gutmann- 
 did not succeed in producing it by making animals ingest diseased 
 excreta. Neither could Pranck produce the disease; for though he 
 administered in milk a quantity of the intestinal matter (which swarmed 
 with bacteria) to Sheep, Goats, and Eabbits, no positive result was 
 noted. This, however, can scarcely be deemed a satisfactory experi- 
 ment ; and it would be better to try the effects of the morbid products 
 on sucking calves or other creatures at the teat. 
 
 According to Roloif,^ it is due to a " stable miasma " ; while Obich,* 
 who was the first to differentiate it from gastro-intestinal catarrh, 
 
 certainly partly filled with fat granules, but there was otherwise no indication of fatty 
 degeneration. 
 
 A very special feature of the disease was always found in the microscopical examina- 
 tion of the contents of the true stomach and small intestine. In these were discovered 
 great quantities of epithelium, and crowds of minute organisms. This purulent-looking 
 matter appeared to be a kind of bacteria-pulp {Balcterien-hr-ei). Besides innumerable 
 micrococci, there were also immense numbers of vibratile staff-shaped bodies {achwingende 
 Stcibcken). In the present state of uncertainty of the question with regard to minute 
 vegetable organisms, Franck declines to give an opinion as to the species to which the 
 last-described bodies belong. 
 
 ^ Archiv. fur WissenschaftUche unci Praktische Thierhtilkunde, 1885, p. 298. 
 
 ^ Ellenberger's JahresbericJit for 1883, p. 93. 
 
 ^ Miitheiiungen aus der Thierdrztlicheii Praxis, 1875, p. 119. Eoloff says : "The 
 malady will suddenly appear in a cowshed, and vanish again after a time, without any 
 alteration having been made in the feeding or management of the Cow. I was consulted 
 in a case of this kind, where, in a large cowshed, during eight weeks every Calf pro- 
 duced therein had perished. The Calves were generally, about the second day after birth, 
 uneasy ; they bellowed, appeared to be suffering from abdominal pain, had no appetite, 
 rapidly lost conditicm, passed watery stools, and died within twenty-four hours. All 
 remedies tried — among them, large doses of opium — were useless. Some of the new- 
 born Calves were fed on skimmed milk, othera on boiled milk diluted with water, while 
 others received no milk at all, but were fed on oatmeal gruel with which preparations of 
 iron were mixed— but all to no purpose, as they died all the same. The feeding of the 
 Cows was in every way good, and had not varied from that of other times, when this 
 disease did not appear. Roloff therefore concluded that the mortality was due to a 
 miasma in the shed ; consequently all the Cows which had not yet calved were removed 
 to another dry and airy shed. In this they brought forth at various times, and the 
 Calves remained healthy." 
 
 In a second instance, the malady broke out suddenly in a cowshed at the commence- 
 ment of 1874. The Calves were apparently healthy when born, but in about two days 
 they became unwell and soon died in the usual way. As an experiment, some new-born 
 Calves were not allowed to get milk from their parent, but were fed on milk from Cows 
 in other sheds where the disease did not exist. On the second day, however, the Calves 
 sickened all the same, and succumbed. The feeding of the Cows was modified, but 
 without benefit. 
 
 In a third instance, Roloflf mentions that, for a long time, all the Calves in a large 
 cowshed had perished in a similar manner, and though many of them had not received 
 any of their mother's milk — some of them no food at all — yet it made no difference. 
 This instance was particularly conclusive that the milk of the parenb was certainly not 
 the cause of the disorder. The Cows near their time for calving were moved from this 
 shed into another some distance away, and the change was attended with the happiest 
 results. 
 
 * Wochenschri/t fur Thierheilhmde, 1865. 
 
l>ySEXTKi:V OF YOUXG AXIMALS. 737 
 
 thought the infecting agent must be volatile, and gives instances which 
 he believed proved it to bo so. 
 
 Franck admitted the possibility of intra-uterine infection through the 
 genital canal, and in this way he explained the appearance of the 
 tlisease in the young animal so soon after birth ; while Ellenberger and 
 Frohner' think it probable that this intra-uterine infection is realised 
 by tiie transmission of an infective catarrh of the vagina and uterus of 
 the parent to the digestive mucous membrane of the fcetus. In this 
 respect it is interesting to note, that wlien pregnant Cows are trans- 
 ferred from an infected to a healthy stable, and soon after calve there, 
 their progeny may still be attacked. But if the transfer has taken 
 place so long as six weeks or two months before parturition, then there 
 is indeed but little risk of the young creatures being seized with this 
 dysentery. 
 
 The malady is most intense during permanent stabling ; with the 
 advent of grazing, when the cattle are driven to pasture, it begins to 
 disappear, and is no more heard of until the pregnant Cows are again 
 ^tabled and commence to calve. Bad food, cold and wet, and other 
 similar influences, will not cause the disease, though they may more 
 or less predispose to it. 
 
 Diagnosis. 
 
 The diagnosis of the disease is established by the very rapidly fatal 
 diarrhaa prevailing in an enzootic manner, and at or soon after birth. 
 
 The only disorder it might be mistaken for is the gastro-intestinal 
 catarrh already described ; but, as will be seen, it is different to that 
 disease, which usually appears at a later period of life, and has a 
 milder course. 
 
 Prognosis. 
 
 The prognosis of this disease in generally unfavourable. Nearly all 
 the young animals seized with it perish ; and when a few recover, it is 
 either through energetic and appropriate treatment, from their being 
 attacked in a less severe manner, or from being endowed with greater 
 vital tenacity. And even those which recover are usually so reduced 
 in strength and condition, and convalescence is so protracted and 
 unsatisfactory, that there is little if any profit in rearing them. As a 
 rule, all those born about the same period succumb ; but after the 
 malady has prevailed for one or two years in a shed, it assumes a 
 milder form, and more recoveries are recorded. When the disease 
 appears in small cowsheds, where there are fewer calves and compara- 
 tively more space, it is much less to be dreaded. Sometimes it dis- 
 appears from a cowshed for some months. Old calves are not so 
 readily affected, and recover more readily. Weaned calves which are 
 fed on fodder, appear to enjoy immunity from attack. 
 
 Treatment. 
 
 As with every other animal malady, preventive treatment is the most 
 important with regard to this dysentery of young animals. Attention 
 to hygiene is very necessary at all times, and more so when the disease 
 has shown itself in a stable or shed. It is much the safer plan, how- 
 ever, to remove all pregnant animals from the dwelling in which it has 
 appeared, and the longer the inten'al which elapses between their 
 removal and the occurrence of parturition, so the more likeHhood there 
 > Op. cil., vol. ii., p. 391. 
 
 47 
 
738 DISEASES AND ABNORMALITIES OF THE YOUNG ANIMAL. 
 
 is of their progeny escaping. If moved in three to four, or four to six 
 weeks before parturition, their safety may be fairly assured. The stable 
 or shed in which the malady has occurred should be well disinfected, 
 and, if possible, left unoccupied during the grazing season. The floor 
 particularly demands attention, as it is not at all improbable that the 
 infection is retained there ; if possible, the floor should be renewed. 
 Strong carbolic acid, or chloride of lime wash, must be freely employed, 
 and especially where the excreta from the sick animals have fallen. 
 Thorough disinfection of the building with sulphurous acid or chlorine 
 gas is advisable. 
 
 With regard to curative measures, but little, unfortunately, can be 
 said. The history of the outbreak may suggest the nature of predisposing 
 causes, and furnish indications for their removal. 
 
 With regard to medical treatment of the affected animals, this should 
 commence with a slight laxative — such as castor-oil — to be followed by 
 doses of opium and calomel or Dover's powder, if deemed desirable ; 
 but there have been so many drugs recommended, that it is difficult to 
 say, without actual experience of their use, which should be adopted. 
 Hertwig had a recipe which he averred was almost a specific ; it is as 
 follows : 
 
 Pulv. rad. rhei - - - - 4-0 grammes. 
 ,, magnes. carb. - - - 1- ,, 
 
 ,, opii pulv. ... - 2- ,, 
 
 This is to be given to the Foal or Calf in 100 to 120 grammes of 
 camomile tea, or in fifty grammes of whisky — the dose to be repeated in 
 tvv'elve hours if necessary. 
 
 Salicylate of bismuth in two drachm doses for Foals and Calves, as 
 well as salicylate of iron, has been highly spoken of. 
 
 A mode of treatment said to be very effective in Italy, is the follow- 
 ing : Salol, 2 drachms ; oxide of bismuth, 4 drachms ; carbonate of 
 lime, 1 oz. Mix and divide into six equal parts or doses, the first two 
 doses to be administered at an interval of two hours, and the other 
 four every four hours. Each dose is to be given in a glass of camomile 
 infusion, to which add, if the animal is very ill, half a glass of good 
 wine. A cure is almost always obtained in two or three days, and 
 there is no necessity to prolong the treatment after this. The remedy 
 has failed only in those cases where it has been applied too late. The 
 antiseptic washing of the Cow's udder is also recommended, and the 
 disinfection of the stables. During the treatment the Calf should not 
 be forced to take milk, but left to do as it likes. 
 
 Tannic and salicylic acids, 2 drachms of each for a dose, given once 
 or twice a day in an infusion of camomile, to affected Calves, have also 
 been prescribed. Creolin in one gramme doses, dissolved in water, and 
 administered three times a day, has been favourably reported upon. 
 
 Zundel speaks of enemeta of starch or dextrine, or water slightly 
 carbolised ; and he particularly recommends those composed of a 
 dilute solution of permanganate of potass (1 or 2 to 100). Franck 
 suggests the employment of tepid enemas of the neutral salicylate 
 of soda (about ten grammes per diem), in doses of one or two 
 grammes. 
 
 If the animal can take food it should be given in small quantities, 
 and each meal of milk is to be diluted with about one-fourth of lime- 
 water, to prevent the formation of curd in the stomach. In more 
 
nKTEXTinX (>F .VEroxir.V. 739 
 
 seriouB cases, milk should be withheld, and instead of it may be sub- 
 stituted well-boiled ^Tuel made with wheaten Hour, Liebig's farinaceous 
 food, or even eggs and beef-tea may be administered. 
 
 The patient should be kept warm and comfortable; warm baths have 
 sometimes proved useful. 
 
 cn apti:k xi. 
 
 Retention of Meconium— Constipation. 
 
 The contents of the intestines — the meconium — are generally ex- 
 pelled immediately after birth, when the umbilical circulation is 
 tirst interrupted. When the meconium is retained much longer it 
 is abnormal ; and this perhaps occurs more frequently with the Foal 
 than other creatures. The prolonged retention of the meconium 
 gives rise to constipation, and this is often a serious condition. 
 The animals in which it occurs are generally weakly, and not well 
 developed. 
 
 Causes. 
 
 Constipation is usually observed in Foals which have been dropped 
 in February or March, and whose dams have been fed exclusively on 
 dry fodder during the winter. This result is still more likely to follow 
 if the dams have been worked until near foaling-time. Their milk is 
 then deficient in those purgative qualities which are so necessary for 
 the new born animal. It is the same with Cows which have been 
 stall-fed all the winter with dry food ; and the Calves are almost 
 certain to suffer from retention of the meconium if deprived of the first 
 milk, oven if the mothers have been properly fed. 
 
 Si/m2)toms. 
 
 One or two days after birth the Foal appears to be uneasy, refuses to 
 suck, has tenesmus, makes efforts to defecate, exhibits symptoms of 
 colic, rolls on the ground, and often looks towards the abdomen ; the 
 back is arched, micturition is suspended, pulse and respiration are 
 frequent, the eyes are injected, and there is grinding of the teeth. 
 Enteritis sets in, and death takes place in struggles and convulsions. 
 
 The symptoms are similar in the Calf : the abdomen is very much re- 
 tracted ; the respiration hurried ; the back is raised when the creature 
 is standing, though it generally persists in lying ; it moans continually; 
 refuses to suck ; and is very restless. 
 
 Treatvient. 
 
 The jyrcventivc treatment consists in attending to the feeding and 
 condition of the pregnant animal some time before parturition. The 
 young creature should be fed on the first milk its parent yields ; if this 
 cannot be given, then the animal should have a dose of castor-oil. 
 
 The curative treatment must be directed towards removing the 
 meconium from the intestines. This may be eCfected by giving a soap 
 or oil enema, or previously removing as much as is accessible to a well- 
 oiled finger. 
 
 That which is beyond reach of the finger, Franck recommends to be 
 brought away by means of a flexible, but not too weak, noose of wire. 
 The Cow should have an abundance of fluid to drink, and this may be 
 
740 DISEASES AND ABKOllMALITIES OF THE YOIWO AXIMAL. 
 
 rendered slightly laxative by the addition of cream of tartar or sulphate 
 of soda. 
 
 If the constipation persists, purgatives may be administered. These 
 may be castor-oil, manna, sulphate of soda, aloes, etc. If there is pain 
 from 10 to 20 drops of chlorodyne in water should be administered. 
 Frequent enemas will aid the action of the purgatives. 
 
 Sometimes constipation is due to giving too rich food, or, in artificial 
 rearing, to an excessive allowance of meal or flour. The treatment will 
 be the same. 
 
 CHAPTEE XII. 
 Eclampsia of Young Animals. 
 
 This nervous affection has been observed in the CaK, Pig, and Dog 
 within a variable period after birth, and presents somewhat the same 
 features as that disease (eclamjjsia infantum) in young children. 
 
 Si/mjjtoms. 
 
 In the Calf no premonitory symptoms have been observed, except 
 that perhaps when it goes to the teat it is not so hvely as usual, lags 
 behind the other Calves, and is rather unsteady on its limbs. Before 
 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 the mouth ; in a 
 few minutes the creature begins to bellow loudly and repeatedly, and to 
 perform strange antics — jumping forward as if thrown by a powerful 
 spring, and heedless of injury. The eye looks haggard and wild, the 
 respiration is hurried, and the heart beats tumultuously. When held, 
 it continues to struggle and bellow ; at last exhaustion ensues after an 
 hour or two, and if the Calf does not succumb it lies in a state of extreme 
 lassitude for a long time ; then 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 infrequently there is a renewal of the attacks 
 before that time elapses. 
 
 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, five 
 were affected — three males and two females ; the males perished at the 
 first seizure, but the females survived it, though one of them died from 
 a second attack three days subsequently, the other remaining well. 
 
 In the Pig the symptoms are similar. Before the seizure the creature 
 perhaps sucks less than usual ; it begins to cry and become restless — 
 running here and there and standing up against the side of its sty, 
 screaming loudly ; suddenly the screams cease, the animal falls down 
 in convulsions ; the respiration is noisy, the eyes pirouette in their 
 orbits, the masseter muscles have clonic spasms, the limbs are violently 
 agitated, and there is loss of sensation and consciousness. The attack 
 may continue for a variable period — from fifteen minutes to an hour or 
 more, and death may occur at the first, second, or third attack — it is. 
 usually the second. 
 
 In the Dog the symptoms differ very little from those just described. 
 
 ^ Revue Viterinaire, 1S79, p. 356. 
 
TKT.IM'S AnxonrM. — TETAXUS XEOXATOltUM. 1\\ 
 
 Treatment. 
 
 Little can be done for this disease in such young animals, beyond 
 giving antispasmodic remedies — such as chloral hydrate, bromide of 
 potassium, and the tincture of valerian in enema. Attention should 
 also be paid to the food of both mother and offspring, and if constipation 
 is present it may be combated by the means already mentioned. 
 
 CHAPTER XIII. 
 
 Tetanus Agnorum.— Tetanus Neonatorum. 
 
 Tetanus, or a form of that disease, is not infrequently witnessed in 
 Lambs, and sometimes it is so prevalent that it is regarded as en/.ocitic 
 or epizootic. It cannot be considered as in any way allied to tetany in 
 children. 
 
 It most frequently affects Lambs of the liner breeds, and usually 
 during the tirst two or three weeks after birth. 
 
 Symptovis. 
 
 The earliest symptoms are weakness, loss of vivacity, and diminished 
 appetite ; then the limbs become stiff" and the gait stilty, the back is 
 arched, and the neck and legs undergo convulsive contortions, so that 
 there is difficulty in rising or walking. Tlie cramps extend gradually 
 to other parts of the body, until at last tlie animal cannot move, and 
 to obtain food it has to be carried to the mother's teat, where it needs 
 to be supported. 
 
 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, tiie Lambs are predisposed to 
 the disease through improper feeding and management of the Ewes, 
 whose milk may be obnoxious from the food they receive. lOxposure 
 to extreme heat and cold, and particularly to cold winds, is supposed to 
 have much influence in the production of the malady. 
 
 Pathology. 
 
 Little appears to be known as to the pathology of the disease, but it 
 is evidently nervous — in its origin at least ; though no alteration lias as 
 yet been detected in the spinal cord to account for the tetanoid 
 symptoms. Only the characteristics of general antemia, with some- 
 times congestion of the true stomach and intestines, have been hitherto 
 noted. 
 
 Prognosis. 
 
 This is generally unfavourable, as a complete cure is very rare ; while 
 delicate 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 AXIJ ABXOIIMALITIES OF THE YOUXG AXIMAL. 
 
 Treatment. 
 
 Preventive treatment must be directed to keeping the Ewes in a 
 healthy condition by proper feeding, and sheltering them from the 
 •weather if this be severe at lambing time. The Lambs should also be 
 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 may be given in small and frequent doses, 
 alternated with sulphate of quinine. Friction may be applied to the 
 limbs, either without or with some stimulating liniment. 
 
 CHAPTEE XIV. 
 
 Cyanosis. 
 
 At page 105, in describing the foetal circulation and the modifications 
 which occur in it at birth, it was mentioned that the lungs then become 
 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 obliterated 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 becoming atrophied ; as does also the occlu- 
 sion of the foramen ovale, though the 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 
 affect the circulation ; for when the heart contracts, the auricles are 
 isolated by the narrowing of the orifice and the elevation of a valve. 
 
 Cases occur, nevertheless, in which, either from the persistence of 
 the foramen ovale, with perhaps defective auricular contraction, or an 
 abnormal disposition of the large bloodvessels at their origin, 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 mucous membranes, more or less debility and 
 difficulty in respiration, especially during exertion, coldness of the limbs 
 and surface of the body, and a great predisposition to haemorrhage. ^ 
 
 Cyanosis may occur in otherwise well-developed individuals, and be 
 due to a congenital adhesion between the lungs and pleura or pericar- 
 
 ' Vemant {Recueil de MM. Veterinaire, 1887, p. 592) was called to see a Calf which 
 had been born the previous evening, and with such ease that it was found behind the 
 Cow, no one being present at its birth. It was viable, in very good condition, fat, and 
 so well developed that it looked as if fifteen days old. But it could not stand, and lay 
 constantly in the sternal position, refusing to suck. The symptoms it presented were 
 markedly those of asphyxia ; the tongue was half-protruded from the mouth, the eyes 
 prominent, the respiration plaintive and hurried, and the flanks very agitated. 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 hour.s 
 after birth it died. The lungs were then found to be collapsed, and looked very con- 
 gested ; the anterior extremities of the lobules floated well in water, but the entire mass 
 was rather heavy. The foramen ovale was incompletely closed, so that the two auricles 
 could communicate with each other ; the opening was as large as a tive-franc piece, and 
 the auricular septum was extremely thin. 
 
SKIXJfKVXESS OF TIIK XKli'linllX AXIMAL. 7 I.} 
 
 dium ; it is also a symptom of asphyxia, and is sometimes witnessed 
 in colic in the Horse, complicated with meteorismus ; it likewise accom- 
 panies certain forms of poisonin>;. 
 
 When due to the tirst-nanied causes, this condition is manifested 
 during or immediately after hirth ; it is only in rare instances that it is 
 developed at a later period. It is needless to mention that such a 
 conformation is heyond remedy, though animals so affected will some- 
 times live for a long time ; Zundel has seen a horse seven years old 
 which was in this condition. 
 
 CHAPTEK XV. 
 Skin Dryness of the New-born Animal. 
 
 ObichI is, to my knowledge, the only writer who has alluded to this 
 peculiar condition of the Foal at birth. He says : " In the case of 
 some primiparous Mares, a fatal accident often happens to their 
 progeny. When parturition takes place without anyone being present, 
 the young creature, on being expelled from the mother, continues lying 
 away from her until its skin is dry. The consequence is that the Mare 
 does not care for it, does not lick or attend to it, and opposes all 
 attempts to compel her to suckle it. For some days constraint is 
 necessary, and nmch trouble and danger may be incurred before she is 
 accustomed to it. This may be averted if the new-born creature is 
 rubbed over with the * after - birth ' (placental membranes). The 
 instinct of the ^lare impels her then to lick and fondle her offspring, 
 and to take to it kindly and in a natural manner." 
 
 CH.\PTER XVI. 
 Imperforate Anus. 
 
 Impeufouate anus is not a very rare occurrence in new-born animals ; 
 it has been observed in Foals, Calves, Pigs, and Lambs. Tlie latter 
 appear to furnish the largest number of cases. This condition is, of 
 course, very serious unless surgical aid is quickly afforded, and even 
 then the young creatures are 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 (juickly causes death. 
 
 This occlusion or imperforation may exist in various degrees. There 
 may be merely a membrane covering and occluding the anal opening; 
 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 
 into the genito-urinary passages instead of at the anus. 
 
 SymiHoms. 
 
 W^hen no ficces can bo expelled, usually towards the second or third 
 day after birth, uneasiness and symptoms of acute colic are manifested; 
 the animal does not suck, the abdomen becomes distended, expulsive 
 ' WochtiuKhrift fur Thkrheilkunde, 1869, p. 105. 
 
742 DISEASES AXD ABXOIIMALITIES OF THE YOUXG AXIMAL. 
 
 Treatment. 
 
 Preventive treatment must be directed to keeping the Ewes in a 
 healthy condition by proper feeding, and sheltering them from the 
 weather if this be severe at lambing time. The Lambs should also be 
 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 may be given in small and frequent doses, 
 alternated with sulphate of quinine. Friction may be applied to the 
 limbs, either without or with some stimulating liniment. 
 
 CHAPTEE XIV. 
 
 Cyanosis. 
 
 At page 105, in describing the foetal circulation and the modifications 
 which occur in it at birth, it was mentioned that the lungs then become 
 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 flow of blood, and the ductus arteriosus 
 is obliterated 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 becoming atrophied ; as does also the occlu- 
 sion of the foramen ovale, though the 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 
 affect the circulation ; for when the heart contracts, the auricles are 
 isolated by the narrowing of the orifice and the elevation of a valve. 
 
 Cases occur, nevertheless, in which, either from the persistence of 
 the foramen ovale, with perhaps defective auricular contraction, or an 
 abnormal disposition of the large bloodvessels at their origin, 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 mucous membranes, more or less debility and 
 difficulty in respiration, especially during exertion, coldness of the limbs 
 and surface of the body, and a great predisposition to hemorrhage. ^ 
 
 Cyanosis may occur in otherwise well-developed individuals, and be 
 due to a congenital adhesion between the lungs and pleura or pericar- 
 
 ' Vemant {Recueil de MM. Veterinaire, 1887, p. 592) was called to see a Calf which 
 had been born the previous evening, and with such ease that it was found behind the 
 Cow, no one being present at its birth. It was viable, in very good condition, fat, and 
 so well developed that it looked as if fifteen days old. But it could not stand, and lay 
 constantly in the sternal position, refusing to suck. The symptoms it presented were 
 markedly those of asphj'xia ; the tongue was half-protruded from the mouth, the eyes 
 prominent, the respiration plaintive and hurried, and the flanks very agitated. 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 then f.iund to be collapsed, and looked very con- 
 gested ; the anterior extremities of the lobules floated well in water, but the entire mass 
 was rather heavy. The foramen ovale was incompletely closed, so that the two auricles 
 could communicate with each other ; the opening was as large as a five-franc piece, and 
 the auricular septum was extremely thin. 
 
SKIXI'JnWESS OF THE XKiriiDUX AXIMAL. 713 
 
 dium ; it is also a symptom of asphyxia, and is sometimes witnessed 
 in colic in the Horse, complicated with meteorismus ; it likewise accom- 
 panies certain forms of poisoninj^. 
 
 When due to the tirst-named causes, this condition is manifested 
 durinj^ or immediately after birth ; it is only in rare instances that it is 
 developed at a later period. It is needless to mention that such a 
 conformation is beyond remedy, though animals so atl'ected will some- 
 times live for a long time ; Zundel has seen a horse seven years old 
 which was in this condition. 
 
 CHAPTER XV. 
 Skin Dryness of the New-born Animal. 
 
 OniCH^ is, to my knowledge, the only writer who has alluded to this 
 peculiar condition of the Foal at birth. He says : " In the case of 
 some primipiirous Mares, a fatal accident often happens to their 
 progeny. When parturition takes place without anyone being present, 
 the young creature, on being expelled from the mother, continues lying 
 away from her until its skin is dry. The conse(]uence is that the Mare 
 does not care for it, does not lick or attend to it, and opposes all 
 attempts to compel her to suckle it. For some days constraint is 
 necessary, and much trouble and danger may be incurred before she is 
 accustomed to it. This may bo averted if the new-born creature is 
 rubbed over with the ' after - birth ' (placental membranes). The 
 instinct of the Mare impels her then to lick and fondle her offspring, 
 and to take to it kindlv and in a natural manner." 
 
 CH-\PTER XVI. 
 Imperforate Anus. 
 
 I>ri'F.KF0i{.\TE anus is not a very rare occurrence in newborn animals ; 
 it has been observed in Foals, Calves, Pigs, and Lambs. The latter 
 appear to furnish the largest number of cases. This condition is, of 
 course, very serious unless surgical aid is quickly afforded, and even 
 then the young creatures are 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 tliis <}uickly causes death. 
 
 This occlusion or imperforation may exist in various degrees. There 
 may be merely a membrane covering and occluding the anal opening; 
 the borders of the anus may be adlierent to a greater or less extent ; 
 the rectum may be more or less absent or incomplete ; or it may open 
 into the genito-urinary passages instead of at the anus. 
 
 Symptoms. 
 
 When no faices can be expelled, usually towards the second or third 
 day after birth, uneasiness and symptoms of acute colic are manifested; 
 the animal does not suck, the abdomen becomes distended, expulsive 
 ' WochtivKhriftfur Thierhtilkunde, 1869, p. 105. 
 
742 DISEASES AND ABNORMALITIES OF THE YOUNG ANIMAL. 
 
 Treatment. 
 
 Preventive treatment must be directed to keeping the Ewes in a 
 healthy condition by proper feeding, and sheltering them from the 
 weather if this be severe at lambing time. The Lambs should also be 
 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 may be given in small and frequent doses, 
 alternated with sulphate of quinine. Friction may be applied to the 
 limbs, either without or with some stimulating liniment. 
 
 CHAPTER XIV. 
 
 Cyanosis. 
 
 At page 105, in describing the foetal circulation and the modifications 
 which occur in it at birth, it was mentioned that the lungs then become 
 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 obliterated 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 becoming atrophied ; as does also the occlu- 
 sion of the foramen ovale, though the latter opening not infrequently 
 remains intact in young animals. Pvemarking upon the patency of the 
 foramen ovale, it was stated that, as a rule, this accident did not greatly 
 affect the circulation ; for when the heart contracts, the auricles are 
 isolated by the narrowing of the orifice and the elevation of a valve. 
 
 Cases occur, nevertheless, in which, either from the persistence of 
 the foramen ovale, with perhaps defective auricular contraction, or an 
 abnormal disposition of the large bloodvessels at their origin, 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 mucous membranes, more or less debility and 
 difficulty in respiration, especially during exertion, coldness of the limbs 
 and surface of the body, and a great predisposition to haemorrhage.^ 
 
 Cyanosis may occur in otherwise well-developed individuals, and be 
 due to a congenital adhesion between the lungs and pleura or pericar- 
 
 ' Vernant {Recueil de MM. Veterinaire, 1887, p. 592) was called to see a Calf which 
 had been born the previous evening, and with such ease that it was found behind the 
 Cow, no one being present at its birth. It was viable, in very good condition, fat, and 
 so well developed that it looked as if fifteen days old. But it could not stand, and lay 
 constantly in the sternal position, refusing to suck. The symptoms it presented were 
 markedly those of asphyxia ; the tongue was half-protruded from the mouth, the eyes 
 prominent, the respiration plaintive and hurried, and the flanks very agitated. 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 then found to be collapsed, and looked very con- 
 gested ; the anterior extremities of the lobules floated well in water, but the entire mass 
 was rather heavy. The foramen ovale was incompletely closed, so that the two auricles 
 could communicate with each other ; the opening was as large as a five-franc piece, and 
 the auricular septum was extremely thin. 
 
SKIXDJn'.VKSS OF TllK XKH' lioRX AXIMAL. 743 
 
 dium ; it is also a symptom of asphyxia, and is sometimes witnessed 
 in colic in the Horse, complicated with meteorismus ; it likewise accom- 
 panies certain forms of poisoninj:;. 
 
 Wlien due to the tirst-named causes, this condition is manifested 
 during or inunediately after birth ; it is only in rare instances that it is 
 developed ut a later period. It is needless to mention that such a 
 conformation is beyond remedy, though animals so atTected will some- 
 times live for a long time ; Zundel has seen a horse seven years old 
 which was in this condition. 
 
 CHAPTER XV. 
 Skin Dryness of the New-born Animal. 
 
 OiucH* is, to my knowledge, the only writer who has alluded to this 
 peculiar condition of the Foal at birth. He says : " In the case of 
 some primiparous Mares, a fatal accident often happens to their 
 progeny. When parturition takes place without anyone being present, 
 the young creature, on being expelled from the mother, continues lying 
 away from her until its skin is dry. The consequence is that the Mare 
 does not care for it, does not lick or attend to it, and opposes all 
 attempts to compel her to suckle it. For some days constraint is 
 necessary, and nmch trouble and danger may be incurred before she is 
 accustomed to it. This may be averted if the new-born creature is 
 rubbed over with the ' after - birth ' (placental membranes). The 
 instinct of the Mare impels her then to lick and fondle her offspring, 
 and to take to it kindly and in a natural manner." 
 
 CH.\PTER XVI. 
 Imperforate Anus. 
 
 iMrF.KFOH.VTE anus 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 largest number of cases. This condition is, of 
 course, very serious unless surgical aid is quickly alTordcd, and even 
 then the young creatures are 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 opening; 
 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 
 into the genito-urinary passages instead of at the anus. 
 
 Symptoms. 
 
 When no ftcces can be expelled, usually towards the second or third 
 day after birth, uneasiness and symptoms of acute colic are manifested; 
 the animal does not suck, the abdomen becomes distended, expulsive 
 ' Wocherv*clir\jl fur Thkrheilkunde, 1869, p. 105. 
 
744 DISEASES AND ABNORMALITIES OF THE YOUNG ANIMAL. 
 
 eiforts and pawing are observed, yet nothing is passed. The animal 
 shows 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 intestine opens into the vagina, and the faeces are 
 expelled by that canal. Eainard has witnessed this malformation in 
 several Fillies, and his attention was also drawn to four young Pigs — ■ 
 male and females — in which the anus was absent. They were the litter 
 of one Sow. It is therefore well to ascertain, in the case of female 
 animals destitute of an anus, whether the meconium or faeces 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 faeces. 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 
 injury. No sooner is this incision made than the meconium escapes ; 
 then the crucial division may be made with a pair of sharp scissors. 
 The 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 cicatrisation, a suppository 
 or tent may be introduced into the rectum, and withdrawn every now 
 and again in order to allow the fteces to be expelled — injections assist- 
 ing in 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 
 inflammation does not set in, recovery is certain. 
 
 When the prominence is not present, and yet there is complete occlu- 
 sion, with all the above-mentioned symptoms, the operation is more 
 difficult. The 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 
 is made through the skin only, in the middle line ; the subcutaneous 
 tissues are dissected away until the bulging of the 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 fine sutures, and attention is paid to the parts during 
 the healing process, in order to prevent the artificial anus becoming 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), then but little benefit 
 can be conferred. In a few instances nature has effected a partial 
 remedy, in establishing an artificial opening by ulceration through 
 organs and textures, and the faeces have escaped by the fistula. 
 Eainard mentions this natural colotomy as occurring in two young 
 
IMPERFORATE VULVA AXD VAUIXA, 745 
 
 Horses. An artificial opening may be made either in the perineal or 
 abdominal region ; but it is rare indeed that the animal is worth the 
 trouble and risk. 
 
 In those female animals in which the rectum communicates with the 
 vagina, Rainard makes the following remarks with regard to operation. 
 As the part of the vagina which has the opening into the rectum is 
 never very deep, a half S-curved sound is introduced by one of its ends 
 into the normal track, and pushed into the rectum until it reaches the 
 cul-de-sac in it. With a bistoury, an incision is made where the anus 
 should be ; the skin and subcutaneous connective tissue being divided, 
 the index finger is passed into the wound in search of the curved sound 
 in tlie rectum. When met with, an assistant takes the sound, while 
 the blade of the bistoury is made to glide over the nail of the index 
 finger, and the intestine opened by it. The same finger is pushed into 
 this new opening, and serves to guide the bistoury in dilating the inci- 
 sion as much as may be deemed necessary. After the skin and connec- 
 tive tissue are incised, a trocar of suliicient size may be employed to 
 puncture the intestine. 
 
 CHAPTER XVI r. 
 Imperforate Vulva and Vagina. 
 
 Imperforatiox, atresia, or occlusion of the Vulva is not infrequently 
 observed in new-born animals, they being often found after birth 
 without any apparent opening into this passage, the labia of which 
 are adherent. The adhesion may be general or partial. In the 
 former case the urine cannot escape ; or it may be expelled through the 
 urachus by the umbilical opening. W^hen the retention is complete, 
 the bladder soon becomes distended and ruptures, and death (juickly 
 ensues. 
 
 Complete occlusion is always a serious condition, as there is no 
 precise indication as to where the urethra opens, or even if it exists at 
 all ; so that it is scarcely possible to make an artificial opening for the 
 passage of the urine with perfect and permanent success. When the 
 labia are merely adherent, then there is no dilliculty, and not much 
 danger, in the case. The adhesion being destroyed and the labia freed, 
 the urine is no longer retained and the malformation is remedied. The 
 only precaution necessary is to prevent the labia again becoming united ; 
 this is easily effected by dressing the raw margins with oil or grease, 
 and, if need be, keeping them apart until healed. 
 
 When occlusion is only partial, the interference of the operator may 
 or may not be deemed necessary, according to circumstances ; but it 
 will be generally most judicious to enlarge the opening to its natural 
 dimensions before the animal becomes full-grown. 
 
 Imperforate Vagina is much less frequent than imperforate vulva. 
 Nevertheless, it is sometimes met with in new-born creatures. The 
 danger is the same as in the other malformation, as the external open- 
 ing of the urethra is situated below the pubic symphysis, immediately 
 anterior to the entrance to the vagina. Consequently, the urine may 
 be retained and the animal will soon perish from rupture of the bladder, 
 peritonitis, etc. 
 
 All that can be done in such a state of affairs, is to compensate for 
 the absence of the natural canal by making an artificial opening, and 
 
746 DISEASES AND ABNORMALITIES OF THE YOUNG ANIMAL. 
 
 to prevent it from closing by introducing a dilator, and keeping it there 
 (removing it, of com^se, from time to time) until there is no danger of 
 closure. 
 
 When the obliteration is only partial, the case is not so serious ; and, 
 provided the urine escapes at all freely, surgical interference may not 
 be necessary — at least until breeding-time arrives. 
 
 CHAPTER XVIII. 
 Imperforate Prepuce. 
 
 Imperforate prepuce of new-born creatures is evidently a very unusual 
 occurrence, as it is scarcely mentioned in veterinary literature. Brug- 
 none notices it as occurring in Foals, and he recommends that an 
 artificial opening be made in the prepuce where the natural aperture 
 should be ; the lips of the wound are to be kept apart by any suitable 
 contrivance, which may be secured in situ by attaching tapes to it, and 
 passing these round the body, securing them over the loins. When this 
 artificial opening is not made, the same grave results follow as in com- 
 plete occlusion of the vulva. 
 
 This operation is successful only when the urethral canal is patent 
 throughout its length ; when it is occluded also, the operation will no 
 longer be attended with benefit, and the operator must then endeavour 
 to discover where the obstruction is, and either overcome it, or make an 
 opening somewhere for the escape of the urine. 
 
 In some instances, when the orifice of the urethra is occluded, the 
 urine escapes by a congenital opening in some part of the canal. When 
 this opening exists at its upper surface, the defect receives the name of 
 episjxidias, and when at its lower kypospaclias. Such a malformation 
 has been seen in the Dog, Lamb, and Goat ; it is not of much import- 
 ance, so far as the flow of urine is concerned. If the opening is near 
 the end of the urethra, the urine runs into the prepuce, and passes 
 thence ; but if it is more behind, between the scrotum and ischium, it 
 then flows over the skin, abrades it, and dust and dirt accumulate; 
 this, together with the repulsive odour of the decomposed urine, renders 
 the case very unpleasant to the eye and nose. 
 
 Treatment is only too often unsuccessful, and it is always troublesome. 
 It is least so when the opening is near the termination of the urethra, 
 as then the defect is more accessible and easier remedied. 
 
 CHAPTER XIX. 
 Occlusion of the Eyelids. 
 
 Occlusion of the eyelids has been witnessed in Foals, Calves, and 
 other young animals. Of course we do not allude to the natural occlu- 
 sion of the eyehds of Puppies, Kittens, and young Rabbits, which pre- 
 vents their seeing for some days after birth. 
 
 This accidental occlusion of the eyelids presents itself in two forms. 
 In one, the margins of the upper and lower eyelids are only adherent ; 
 and in the other the eyelids are, in addition, adherent to the eye itself 
 throughout then- entire surface. 
 
OCCLUSIOX OF THE AUDITORY CANAL. 747 
 
 The first variety is alone curable, and in order to disunite the eyelids, 
 the operator, after producing local insensibility by the application of 
 cocaine, proceeds as follows : Securing the head of tlie creature in the 
 hands of an assistant, the upper eyelid is elevated by another assistant 
 by means of a pair of forceps. The operator himself seizes the lower 
 lid by the same means, and pulls it as far as possible from the eyeball 
 beneath ; then taking a pointed bistoury or sharp scissors in his right 
 hand, a small puncture or notch is made between the margins of the 
 lids, in such a manner as to injure neither, if possible, and much less 
 to wound the eye. A grooved director is passed into the puncture in 
 the direction of one of the canthi of the eye, the bistoury is run along 
 it and separates the two lids ; the director is then turned towards the 
 other canthus, and the same procedure is followed. If the scissors are 
 used the director is not necessary. All that is required after the opera- 
 tion, is to apply a little lard to the borders of the lids, should there be 
 any tendency to re-adhesion. 
 
 CHAPTER XX. 
 Occlusion of the Auditory Canal. 
 
 Occlusion of the auditory canal is much less rare than that of the 
 eyelids, and when it exists deafness is the consequence, as well as 
 dumbness. It is the latter condition which most frequently attracts 
 attention, and leads to the discovery that the real and serious defect is 
 deafness. Then a small prominent tumour is detected in the place of 
 the ear, or where the external auditory canal should be. Tliis tumour 
 is rather soft, and can be readily seized by forceps, when it may bo 
 punctured with a bistoury or a lancet and a crucial incision 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, 
 ;i quantity of grey cerumen is found obstructing the canal ; this can be 
 extruded by pressure, injections of tepid water, or a small scoop. To 
 iiinder the closure of the canal, a little morsel of lint or tine tow is placed 
 in the ear, and retained there by a bandage round the head. Witli the 
 1 )og, which is most frequently affected in this way, the bandage requires 
 to be more carefully f»xed than with otiier animals, as it uses its paws 
 iuid does not rest until the covering is removed. 
 
 If both ears are affected, one only should be operated upon at a 
 time ; and, as a inilo, it is better to wait until the slight inflammation 
 which follows tlie operation subsides, before the other ear undergoes 
 the same treatment. 
 
 So far as hearing is concerned, the result is often negative ; indeed, 
 Rainard confesses that, of the large number of Dogs he operated upon, 
 not one recovered its hearing. 
 
 CHAPTER XXI. 
 Tongue-tie. 
 
 Anothkk congenital defect of young animals is what is called " tongue- 
 tie "' ; it is most frequently obsen-ed in Calves,' and is similar to the 
 
 ' T}-vaert (Animle'* d>' ^f'll. Vtlt'rinaire, June, 1877) obB€r%ed this condition on six 
 occasions in calves. 
 
748 DISEASES AND ABNORMALITIES OF THE YOUNG ANIMAL. 
 
 condition in children which goes by the same name — being characterized 
 by the friBnum hnguas being too narrow from above to below, and too 
 much 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 the fluid as far as the eyes. The teat is seized 
 with difficulty, and the tongue is so limited in its movements that it 
 cannot be 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 
 frtenum to such an extent that the organ may recover its liberty of 
 movement. Immediately 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 without 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. 
 
ADJ)]:X])L'M. 
 
 Infectious Abortion. 
 
 So much attention has been recently duected to this important subject, 
 because of its increasing prevalence and the heavy losses it occasions 
 among breeding stock, that it has been considered necessary to add some 
 information which has come to hand since the sheets (pp. -!lG-22()) 
 dealing with it were printed oil". 
 
 There can be no doubt that in those instances in which abortions 
 occur on an extensive scale, so as to assume an enzootic or epizootic 
 character, and to continue in certain localities or establishments for 
 years, infection is the chief, if not the only cause ; the agencies usually 
 supposed to operate in their productions merely acting as predisposants, 
 Ijy weakening the constitution. 
 
 In addition to the authorities mentioned as having proved the 
 
 xistence of an infecting agent in the genital discharges, Lehnert' must 
 he alluded to as having induced abortion in Cows at the end of twelve 
 ;ind twenty days, by introducing into the vagina of pregnant Cows 
 mucus from that of animals which had aborted accidentally; while 
 Trinchera- has produced a vaginal catarrh and abortion in from nine to 
 thirteen days, by inoculating the purulent vaginal discharge from a Cow 
 just aborted, and the matter obtained by scraping the surface of the 
 chorion e.xpelled by another which had likewise met with the same 
 accident. 
 
 It is now recognised by the most competent veterinary authorities 
 that the disease — for so it must be considered — is eminently infectious 
 or contagious, and that it may be transmitted either directly, or through 
 the intervention of certain media — as infected urine, fteces, or litter, 
 tiy attendants on the animals which luive aborted, by the veterinary 
 
 hstetrist who has recently removed the placental membranes from an 
 i!iimal that has aborted, or even by the male animal in the act of 
 ' 'pulation. Whether the infecting agent produces its elTect if it obtains 
 
 Imission through the respiratory, digestive, or circulatory organs is 
 
 >t yet ascertained ; but there is every probability that it finds access to 
 i'AO interior of the uterus through the vagina and cervix, as in parturient 
 fever, and developing in the fcetal envelopes, produces alterations there 
 sufticient to kill the fcetus without affecting to any considerable extent 
 the health of the female. This occurs after each conception ; so that 
 repeated abortions eventually lead to sterility by causing the uterine 
 mucus to become acid — a change which is fatal to the spermatozoa. 
 
 Galtier ■ is of opinion that though the disease chiefly affects the Bovine 
 species, yet it is transmissible to other domestic species, and offers 
 
 ' Sdch-^fti Jahrcibrricht, 1878. 
 
 ' La Clinica Vtlerinaria, 1888. 
 
 ' Journal de Midtciiu ViUrinairt de Lyoni, 1890. 
 
750 ADDENDUM. 
 
 some characters common to the pneumo-enteritis of the Pig (Swine 
 plague) and Sheep (the pneurao-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 be 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 with a 1 per cent, solution of creolin, or i 
 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 organs being cleansed and disinfected before 
 and after service. 
 
 It is most important that 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 be 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. 
 
 1 Deutsche Ztitschr'ift fur Thiermelichie und V ergleichende Pathologie, xxi.. 1895. 
 
I .\ D i: X . 
 
 A. 
 
 Abdominal evisctration, 550 
 AWnminal fcitation, 175 
 Abdominal muscles, rupture of, 621 
 Abdominal taxis, 329 
 Abnormal anterior presentation, 433 
 
 posterior presentations, 460 
 
 iiuantity of placental fluid, 3S1 
 
 retention of the fu-tus, 108 
 Abnonnalities uf the youn^ animal, 701 
 Abortion, 204 
 
 artificial, 294, 561 
 
 enzootic, 216, 749 
 
 epizo<>tic, 216, 749 
 
 infectious, 216, 749 
 
 sjjoradic, 205 
 Accessory cotyledons, 87 
 Accidents after parturition, 564 
 
 of pregnancy, 191 
 After-pains, 268 
 At,'alactia, 696 
 Aid after labour, 263 
 
 during labour, 256 
 \l;c visj>ertilionis, 39 
 \n)uniinuria during pregnancy, 190 
 Alimentary canal of ftetus, 108 
 
 appendages of, 109 
 V.lantoic li<|uid, S3 
 !:intois, SI 
 
 ditfercncen in other animals, 84 
 Amaurosis during pregnancy, 190 
 Amnion, 79 
 
 differences in other animals, 81 
 Amniotic acid, 80 
 Amputation of the limb<i, 544 
 
 of the fore limVm, 545 
 
 of the hind limbs. 547 
 
 of the uterus. 600 
 Anasarca of folus. 387 
 Anatomy, obstetrical, 1 
 Anidian monsters. 178 
 Anomalies in pregnancy, 169 
 
 in the f<ital membranes, 380 
 
 in the placenta, 367 
 
 in the umbilical conl, 373 
 Ante-partum paresis, 187 
 
 prolapsus of vagina, 191 
 rtipture of the utenis, 194 
 Anus, imperforate, 743 
 Apoplexy, parturient, 636 
 
 Appendatjes of the firtus, 75 
 Arbor vitie uteriiia, 10 
 Area pri'ligera, 71 
 
 vasculosum, 71 
 Arthritis, 718 
 
 Articulations of the j)elvis, 8 
 Artificial abortion, 294, 561 
 
 passage for the fietus, 297 
 
 premature birth, 561 
 Ascites in fcrtus, 387 
 Ascitic hydronietra, 181 
 Asphyxia of the new-born animal, 701 
 Atresia of anus, 743 
 
 of OS uteri, 365 
 
 of vulva, 745 
 Attention to the mother during and after 
 parturition, 256 
 
 to the offspring, 265 
 Auscultation of the uterus, 146 
 Axis of the pelvis, 26 
 
 B. 
 Ballottemknt, 146 
 Bandages or tnisses, 594. 707 
 Bladder, inversion of, 608 
 
 rupture of, 620 
 Blastoderm, 70 
 Bones of the pelvis, 2 
 Broad ligaments of titerus, 39 
 Bulb of the ovary, 51 
 
 C.V-SAKiAN section, 340, 554 
 Calving fever. 636 
 Canal of cervix uteri, 40 
 Cancerous tumours, 347 
 Capacity of j)elvis, 21 
 Causes of parturition, 228 
 Cavity of {H-lvis, 12 
 Cephaloilial {K>siti<jns, 473, 478 
 
 •sacral jxjsition, 477, 481 
 Cephalotomy, 540 
 
 Cerebral ojngestion during pregnane)*, 189 
 Cervix uteri, 39. 44 
 
 canal of. 40 
 
 digital irritation of, 295 
 
 induratiim of, 361 
 
 rigidity of, 354 
 
 8pa.->ni of, 354 
 
 structure of, 41, 44 
 
752 
 
 INDEX. 
 
 Changes in the ovum, 68 
 Cliorda dorsalis, 71, 96 
 Chorial cotyledons, 90 
 Chorion, 75 
 
 differences in other animals, 77 
 
 frondosum, 85 
 
 schirrous, 367 
 Cleft palate, 748 
 Clitoris, 29 
 Coccyx, 6 
 Colic, 184 
 
 Collapse, puerperal, 636 
 Colostrum, 271 
 
 Comparison between manual and mechani- 
 cal force, 531 
 Complete deformity of the pelvis, 290 
 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 fffitus, 392 
 Cords and bands, 499 
 Cornua of uterus, 39 
 Corpus luteum, 53 
 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 fcetus, 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 fcetus, 96 
 
 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 fcetus at birth, 126 
 Diminution in the size of the foetus, 296 
 Diseases incidental to pregnancy, 181, 182 
 of the fiL'tus, 381 
 of the young animal, 701 
 Disproportion in size between male and 
 
 female, 375 
 Distorted monstrosities, 416 
 Division of the body of the foetus, 548 
 Dorso-pubic position, 427 
 Dorso-supra-cotyloidean position, 428 
 Double monstrosities, 398 
 Ductus arteriosus, 107 
 
 venosus of Aranzi, 94, 95, 106 
 Duration of pregnancy, 148 
 Dysenteria neonatorum, 733 
 Dysentery of young animals, 733 
 Dystokia, foetal, 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 fcetus, 424 
 morbid alterations in the gene)'a- 
 
 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, 661 
 
 during pregnancy, 189 
 
 in young animals, 740 
 Ectopia cordis, 403 
 Embryo, development of, 71 
 Embryotomy, 532 
 
 instruments, 534 
 
 preliminary arrangements for, 540 
 Emphysema of fostus, 391 
 Employment of force in dystokia, 523 
 Endo-metritis, 625 
 
 septica, 629 
 Enlargement of the genital canal, 29G 
 Enzootic abortion, 216 
 Epilepsia uterina, 668 
 Epispadias, 746 
 Epizootic abortion, 216 
 Establishing an artificial passage for the 
 
 foetus, 297 
 Eutokia, definition of, 1 
 Evisceration, 549 
 
 abdominal, 550 
 
 thoracic, 550 
 Evolution in dystokia, 492 
 Excess in growth of hair of fcetus, 379 
 
 in volume of the foetus, 374 
 
TXPEX. 
 
 763 
 
 Exomphalus, 704 
 Exostoses on pelvis, liOl 
 Expelling powti-s in pjirturition, 228 
 Kxpulsion of the f.itns, 234 
 
 of the fu'tal membranes, 238 
 Extension anil Ht-xion in delivery, 403 
 External gtnerative organs, 27 
 
 surface of pelvis, 12 
 Extraction of fn-tus, forcible, 295 
 Kxtra-uterine pregnancy, 173 
 
 V. 
 Fallopian lubes, 47 
 
 differences in, 48 
 Fecundation, 64 
 Female generative organs, 27 
 Fibroid tumours, 348 
 Fimbriit' of Fallopian tube, 47 
 Fi>isures in the teat*. 697 
 Fistula of the teat, 700 
 recto- vaginal, 616 
 vesico vaginal, 618 
 Foetal cotyledons, 86, 90 
 dystokia, 372 
 envelopes, 7'> 
 
 puncture of. 29.'» 
 retention i>f, .'164 
 membranes, anomalies in, 380 
 disease in, 3^0 
 FiEtus, abnormal retention of appendages 
 of. 7:. 
 artificial pas<>age for, 297 
 death of, 259, 394 
 development of, 96 
 diminution in size of, 296 
 diseases of, 381 
 forcible extraction of, 295 
 mechanical means for extraction of, 
 
 498 
 periods ■ f development of, 11. '> 
 physiological phenomena in, 11'^ 
 positions (jf, 242 
 presentations of, 241 
 weight and dimensions of, 12'> 
 Force, comparison between manual and 
 mechanical, 531 
 employment of in dystokia, 523 
 means for developing, 528 
 Forceps, 517 
 
 Forcible extraction of ff^tus, 295 
 Fractures of pelvis, 291 
 Free-martins, 161 
 Fre<|uency of monstrosities, 415 
 Functional mixlifications after parturition, 
 
 268 
 Functions of placenta, 93 
 Funic souffle, 147 
 Funis, 23 
 
 G. 
 Gal.\CTophorou.h sinusta, 33 
 
 obliteration of, 698 
 Gastro-hysterotomy, 310, 554 
 Gastro- intestinal catarrh in young animals, 
 
 730 
 Gelatine of \\'harton, 93 
 Gemelliparous pregnancy, 153 
 
 General care of offspring, 266 
 
 (Jeiicral considerations regarding dystokia. 
 
 279 
 (Jeneral mutatioi.s of the fa-tus, 493 
 Generation, 57 
 (tenerative organs, 27 
 
 external, 27 
 
 female, 27 
 
 internal, 36 
 Gern inal venicle, 50 
 Germinative area, 71 
 Gestation or pregnancy, 127 
 
 nnomalies in, 169 
 
 duratiin of, 148 
 
 gemelliparous, 153 
 
 influence of, 181 
 
 multiparous, 1 53 
 
 p:ithology of, 169 
 
 signs of, 13S 
 (ilanduliE utriculares, 41 
 GlanduliB vaginie, 31 
 Ciraafian vesicles, 49 
 
 maturation of, 63 
 Gubernaculnin testis, 112 
 
 H. 
 
 H.KMATOMATA, 349 
 
 Hiemorrhage, post partum, 571 
 
 umbilical, 702 
 
 uterine, 611 
 
 vaginal, (il5 
 Halter, head-cord, or head collar, 501 
 Heart, riipture of, 021 
 Hernia c f the bladder into the vagina, 351 
 
 of the intestines, 611, 615 
 
 of the uterus, 193, 297 
 
 umbilical, 704 
 Hipponianes, 83 
 Hock presentation, 162 
 Hooks, 511 
 
 Horizontal diameter of pi'his, 26 
 Hydatid cysts, ISO 
 Hydi amnios, 185 
 Hvdrocephalus, 381 
 Hydrometra, 180 
 Hydrops amnii, 185 
 Hydrops uteri, ISO 
 Hjdrothorax in futus, 387 
 Hygiene of pre^'nant animals, 166 
 Hymen, 30, 369 
 
 (>erttistent, 369 
 HyjxjHpadia^, 745 
 HysU^ria, 189 
 Hysterocele, 193, 297 
 Hysterotomy, vaginal, 331 
 
 I. 
 Ilh M. 3 
 Imperforate anus, 743 
 
 prepuce, 746 
 
 vagina, 715 
 
 vulva, 745 
 Indigestion in y-'Ung animals, 729 
 Induration of the cervix uteri, 361 
 Infectious abortion, 216, 749 
 Inflammation of the n amniie, 676 
 
 of the umbilical cord, 714 
 
 48 
 
"54 
 
 INDEX. 
 
 Influence of food on the foetus, 376 
 Influence of pregnancy on ordinary diseases, 
 
 181 
 Injuries to the teats, 697 
 Inlet of pelvis, 14 
 Internal organs of generation, 36 
 Internal surface of pelvi's, 13 
 Interstitial foitation, 175 
 Intestines, development of, 108 
 
 hernia of, 611, 615 
 
 rupture of, 620 
 Inversion of the bladder, 608 
 
 of the uterus, 576 
 
 of the vagina, 603 
 Ischio-pubic symphysis, 9 
 Ischium, 4 
 
 L. 
 
 Labour pains, 229 
 
 protracted, 258 
 
 tumultuous, 257 
 Laceration of the uterus, 609 
 
 of the vagina, 613 
 Lactation, 271 
 Lamina dorsalis, 71 
 Laminitis, parturient, 071 
 Laws of teratology, 411 
 Leucorrhoja, 624 
 Ligamentum ovarii, 49 
 Lipomatous tumours, 348 
 Liquor amnii, 80 
 Lithopnedian fcetus, 201 
 Localised placenta, 93 
 Lochia, 269 
 Locked fojtu.-es, 424 
 Lordosis, 291 
 
 M. 
 Mamm.e of Mare, 32 
 
 congestion of, 674 
 
 differences in other animals, 34 
 
 inflammation of, 676 
 Mammitis, 190, 673, 676 
 
 atrophy succeeding, 681 
 
 catarrhal, 677 
 
 during pregnancy, 190 
 
 induration succeeding, 681 
 
 infectious, 678, 688 
 
 parenchymatous, 678 
 
 phlegmonous, 679 
 Mania pnerperalis, (568 
 Manual and mechanical force considered, 
 
 531 
 Mastitis, 673, 676 
 Maternal cotyledons. 86 
 Maternal dystokia, 289 
 Maturation of Graafian vesicles, 63 
 Means for developing necessary force, 528 
 Mechanical means for the extraction of the 
 
 foetus, 498 
 Mechanism of parturition, 239, 250 
 Meconium, retention of, 739 
 Menstrual discharge, 60 
 Menstruation, 59 
 Metritis, 625 
 
 phlegmonosa, 629 
 Metro-peritonitis, 625, 629 
 Metrorrhagia, 197 
 
 Metrotomy, 600 
 
 Micrococcus septicus puerperalis, 633 
 Milk, 272 
 
 Milk-fever, 270, -636 
 
 Modifications in the uterus during preg- 
 nancy, 128 
 Moles, 178 
 Monstrosities, 394 
 
 classification of, 395 
 distorted, 416 
 double, 398, 420 
 double-headed, 417 
 frequency of, 415 
 origin of, 411 
 simple, 396 
 treble, 398 
 
 Acephalian monstrosities, 396, 405 
 
 Acephalus, 396 
 
 Amorphus, 396 
 
 Androgynus, 398 
 
 Anencephalian monstrosities, 405 
 
 Anidian or zoomylian monstrosities, 406 
 
 Aschistodactylus, 397 
 
 Atretocephalus, 397 
 
 Atretocormus, 397 
 
 Autositic, 401 
 
 Camylorrhacchis, 398 
 
 Camylorrhinus, 397 
 
 Celosomian monstrosities, 402, 418 
 
 Cephalotridymus, 398 
 
 Cormotridymus, 398 
 
 Cryptodidymus, 400 
 
 Cyclocephalian monstrosities, 405 
 
 Cyclopean monstrosities, 416 
 
 Cyclops or monophthalmus, 397 
 
 Dicephalus, 399 
 
 Dicranus, 399 
 
 Diphallus, 398 
 
 Diprospus, 399 
 
 Dipygus, 399 
 
 Ectromelian, 402 
 
 Emprosthomelophorus, 400 
 
 Epigastrodidymus, 400 
 
 Eusomphalian monstrosities, 407 
 
 Exencephalian monstrosities, 404 
 
 Gastrodidymus, 400 
 
 (4astro-thoracodidymus, 400 
 
 Hemiterics, 401 
 
 Hermaphrodites, 398 
 
 Heteralian, 409 
 
 Heterocephalus, 399 
 
 Heterodidymus, 399 
 
 Heterotaxies, 401 
 
 Heterotypian, 409 
 
 Ischiodidymus, 400 
 
 Megalocephalus, 398 
 
 Megalomelus, 395 
 
 Melotridymus, 398 
 
 Monocephalian monstrosities, 400 
 
 Monocranus, 399 
 
 ]\Ionomphalian monstrosities, 407 
 
 Monophthalmus, 397 
 
 Monosomian monstrosities, 409 
 
 Nanocephalus, 396 
 
 Nanocormus, 396 
 
 Nanomelus, 396 
 
 NanosomuB, 396 
 
/\/>KX. 
 
 756 
 
 M. instil >sities, Octopus, 400 
 
 ( )mi>halochroiuxlidy inu8, 400 
 
 Oiiiphalositic, 401 
 
 ( )pi8thoiuelophorus, 400 
 
 Para-sitic, 401 
 
 Perocephalus, ;{!'<! 
 
 Peroconnus, 3!'t! 
 
 Peronu'lus, 39ii 
 
 Perosouiiis, 3!*t> 
 
 Pleurt)inelophonis, 400 
 
 Polygnathian, 40'.' 
 
 Polynielian, 410 
 
 I'seudencephaliaii inonstrohity, 401, 110 
 
 Pseudo-lierinaphrodilus, 398 
 
 Pynadidyiims, 400 
 
 Schelddidyimis, 400 
 
 Schistepigastrii-o-sternalis, 403 
 
 Schist'Kephaliaii monstrosities, 40ti 
 
 Schistocephaliis, 3!'? 
 
 Schistocormus, 3'.»7, 402 
 
 SchistociTiuus tissisternalis, 403 
 
 Schistocorums reHexus, 403 
 
 SchistoniLlus, 397 
 
 Schistosoiuus, 397 
 
 Schistosomas contortus, 403 
 
 Si.iiiatotridynnua, 3'.'9 
 
 Symt-lian monstrosities, 402 
 
 SyncLphalian monstrosities, 4o7 
 
 Sysomian monstrosities, 409 
 
 Tutrachinis, 400 
 
 Tetrascuhis, 400 
 
 Thoracodidymus, 400 
 
 Trij,'eminal monstrosities, 398 
 Morbid adhesion between f<t-tu8 and uteni!', 
 
 ■itiS 
 Morsus dialx)li, 47 
 
 Mother and progeny, supplementary obser- 
 vations on, :>ti2 
 Mutations of the f(i>tu8, general, 493 
 
 jiartial, 493 
 Multiparity, dystokiu fri>m, 421 
 MultijKinjus pregnancy, 153 
 diagnosis of, 163 
 positions of fa-tuses in, lo4 
 Multiple placenta, 93 
 Muscles of vulva, 29 
 Myomatxis tumours, 348 
 
 N. 
 Navki. .sTiu\<;, 93 
 
 Necessary aid in normal |)arturition, '2l>'i 
 Normal anterior presentation, 427 
 
 jHisterior pre-it-ntation, 4'>7 
 Normal i>arturition, 227 
 Nymphomania, 63 
 
 O. 
 Oblitek.\tion of the golactophoruus sinus, 
 698 
 of the OS uteri, 36r> 
 Obstacles independent of preaentations and 
 
 positions, 372 
 Obstetrical anatomy, 1 
 o{>erations in. 483 
 physiology of, ."«.'. 
 Occlusion of the au<Htory canal, 717 
 of the eyelids, 746 
 of the uterus, 369 
 
 Occlusion of the vagina, 613 
 «Kdema during j)regnancy, 1S4 
 
 of the umbilicus, 713 
 (Kdeniatous hydrometra, 181 
 < Kstruni, [19 
 Offspring, attention to, 265 
 
 general care of, 266 
 Ouij>halocele, 704 
 Omphalomesenteric vessels, 91 
 Organic modifications after parturition, 
 
 275 
 Origin of monstrosities, 411 
 Os innominatum, 2 
 Osteomalacia, 183 
 Os tincie, 40 
 Ostium abdominalis, 17 
 
 uterinum, 47 
 Os uteri, 40 
 
 obliteration of, 365 
 Outlet of pelvis, lH 
 Ova of Naboth, 41 
 Ovarian fa'tation, 174 
 Ovaries, 48 
 
 development of, 51 
 
 differences in, 51 
 Oviducts, 47 
 Ovula Nabothi, 41 
 OvuTn, changes in, 68 
 
 P. 
 
 Pai.atk, cleft, 748 
 Palnia plicata, 40 
 Papillomatous tumours, 348 
 Paralysis, post |)artum, 659 
 Parametritis, 629 
 i'araplegia of pregnancy, 187 
 
 jxjst partum, 659 
 Partial niuUitious of the fotus, 493 
 Parts into which crotchets may be ini- 
 
 l)lant»d, 515 
 Parturient apoi>lexy, 636 
 
 collaji^e, 636 
 
 eclampsia, 661 
 
 fever, 625, 6*29 
 
 laminitis, 670 
 I'arturition, 227 
 
 accidents after, 56 t 
 
 causes of, 22"^ 
 
 exi>elling j)<)wers in, 228 
 
 mechanism of, 239 
 
 necessary aid in, 255 
 
 normal, physiology of, 2*27 
 
 pathology of, ti22 
 
 sM'queljB of, 268 
 
 signs and course of, 232 
 Partus pnecipitatus, 257 
 Pa-HS- or portecords, 50'.t 
 Pathological congestion of the maium«, 
 
 674 
 Pathology of parturition, 622 
 T'athology of pregnancy, 169^ 
 Pavilion of Fallopian tube, 47 
 Pelvic cavity, 12 
 
 openings in, 1 4, 16 
 
 tumours in, 293 
 Pelvic cellulitis, 615 
 
 symphysis, relaxation of, 619 
 
756 
 
 JKDEX. 
 
 •Pelvimetry, ii'l 
 Pelvis, 1 
 
 •"Pelvis, articulations of, 3 
 axis of, 26 
 bones of, 2 
 capacity of, 2o 
 cavity of, 12 
 
 complete deformity of, 290 
 diameters of, 22, 26 
 differences in, 6, 17 
 
 according to sex, IP 
 exostoses on, 291 
 external surface of, 12 
 fractures of, 291 
 internal surface of, 13 
 openings in, 14 
 Perintfium, 31 
 
 rupture of, 617 
 Periods of development, 115 
 Persistent hymen, 369 
 
 urachus, 704 
 Peritonitis, 611, 615 
 
 Physiological phenomena in the fuetu.s, 11!: 
 a^^sorption, 120 
 circulation, 122 
 nervous functions!, 119 
 nutrition, 121 
 secretion, 124 
 Physiology of parturition, 227 
 Pica, 183 
 Placenta, 85 
 
 anomalies in, 367 
 differences in, 86 
 diffused, 92 
 fluid of, 80 
 functions of, 85, 93 
 multiple, 81 
 polycotyledonary, 86 
 prtevia, 87, 380 
 tufted, 86 
 zonular, 92 
 Placentee, 86 
 Placental fluid, SO 
 
 abnormal quantity of, 3S1 
 Placentulffi, 78, 86 
 
 accessory, 86 
 Pluriparous gestation, 153 
 Polysarcia of foetus, 391 
 Porte-cords, 509 
 Positions of the fretus, 242 
 in multiple, 137, 164 
 at parturition, 242 
 in pregnancy, 164 
 in the uterus, 137 
 Post partum hiemorrhage, 574 
 paralysis, 659 
 paraplegia, 659 
 Pregnancy, 127 
 
 accidents of, 191 
 anomalies in, 169 
 course of, 176 
 diagnosis of, 177 
 diseases incidi-ntal to, 181, \t'l 
 duration of, 148 
 in bitch, 153 
 in cat, 153 
 in cow, 151 
 
 Pregnancy, duration in goat, 152 
 in mare, 149 
 in pig, 153 
 in sheep', 153 
 extra-uterine, 173 
 gemelliparous, 153 
 multiparous, 153 
 prolonsied, 375 
 pseudo, 178 
 signs of, 138 
 
 of material, 149 
 of rational, 138 
 of sensible, 143 
 s2)urious, 178 
 symptoms of, 176 
 terminations of, 176 
 treatment of. 177 
 uniparous, 153 
 Pregnant animals, diseases of, 181, 182 
 
 hygiene of, 166 
 Preliminary precautions and operations, 484 
 Prepuce, imperforate, 746 
 Presentations of the fa'tus, 239, 241 
 Prolapsus of the bladder, 608 
 vagina, ante partum, 603 
 vesicae, 608 
 Protracted labour, 258 
 Pseudo-pregnancy, 178 
 Puberty, 57 
 Pubis, 4 
 
 Puerperal collapse, 600, 636 
 Puncture of the cranium, 541 
 of the fajtal envelopes, 295 
 
 C^UADRIGEMKLLAR pregnancy, 156 
 Quintuple pregnancy, 157 
 
 R. 
 
 Rectal exploration, 145 
 Recto-vaginal fistula, 616 
 Rectification of presentations and posi- 
 tions, 487 
 Red colostrum. 190 
 Reduced number of fa'tuses, 375 
 Relaxation of the pelvic symph3-sis, 619 
 Reproduction, 55 
 Repulsion, 492 
 Retention, abnormal, of the foetus, 198 
 
 of the fretal envelopes, 564 
 
 of the meconium, 739 
 Retropulsion, 487 
 Rickets, 183 
 
 Rigidity of the cervix uteri, 354 
 Rotation, 491 
 Rupture of abdominal muscles, 621 
 
 of bladder, 620 
 
 of diaphragm, 620 
 
 of heart, 621 
 
 of intestines, 620 
 
 of perinfeum, 617 
 
 of sacro-sciatic liiiament, 621 
 
 of uterus, ante partum, 194 
 post partum, 609 
 
 of vagina, 613 
 
 of water-bag, 234 
 Rutting, 59 
 
L\J>KX. 
 
 S. 
 S.vcKO rocTYfiKAL articulations, l» 
 SacTo- iliac iirticiilatioiis, l> 
 Sacruhimbar artifulatii>ii, 8 
 Sacro-sciatic liganunt, 11 
 
 rupture of, G'2\ 
 Sacnuu, '' 
 
 SarCDiiiatous tumours, ^47 
 ScliiiTous chorion, -W 
 St.-(|M«.'lii' of I arturition, 26S 
 Soruus cNst-", •• !!• 
 S'-xual maturity, ;>7 
 Signs of j>r«-^'narcy, 138 
 matirial, 1 !'.• 
 rational, l^JSj 
 sensible', 143 
 
 Simi)lu monstrosities, 39G 
 
 Sini;k' placenta, '.'•] 
 
 Sinus lactei, •"!:} 
 
 Skin dryness of the newl>orn animal, ~i''> 
 
 Spasm of the cervix uteri, 351 
 
 Si>ora<lic abortion, 20."i 
 
 Spurious prej;nancy, 178 
 
 Sterility, t).'- 
 
 Stricture of uterus, 369 
 
 Succus intestinalis, 81 
 
 Superfotiition, 160 
 
 Suspensory ligaments of uterus, 3'.* 
 
 Sutures, ;')91 
 
 Symphysis, pelvic, relaxation of, 61li 
 
 Symphysiotomy, r)61 
 
 Symphysis, ischio pubic, 4 
 
 Taxis, abdominal, 32'.» 
 
 vairinal, 331 
 Teats, structure of, 33 
 fisrtures in, 607 
 tistulif in, 700 
 injuries to, 607 
 T.at syphon, 601 
 Tiratol'-gy. laws of, 411 
 Testes muliibre-*, 10 
 Tetanus a&,,'noriun, 711 
 Tetanus neonatorum, 711 
 Thigh and croup presentation, 167 
 Thoracic evisceration, ^>^>0 
 Thrombi or hiematomata, 349 
 Thrombus of the vagina, 610 
 
 of the vulva. 619 
 Tokology, definition of, 1 
 Tongue-tie, 747 
 Torsion of the uterus, 309 
 in the i-ow, 312 
 in the mare, 340 
 in other animalu, 313 
 Traction, degree of, .'>2I 
 
 direction of, .''24 
 Traumatic le.«iona of genital and neigli 
 
 bouring organs, 600 
 Treble monstri>sitie8, 398 
 Trusses, .'.94, 707 
 Tubal fn>Utinn, 174 
 Tubuli liictiferi, 33 
 Tumours in fo-tus, 394 
 in j)elvic cavity, 203 
 in vicinity of genital organs, 353 
 
 Timiuurs, cancerous, 347 
 
 condvlomatous, 348 
 
 fibroid, 348 
 
 lipomatous, 348 
 
 myomatous. 348 
 
 papillomatous, 34S 
 
 sarcDUiatous, 317 
 
 utero vaginal, 31 I 
 Tumidtuous labour, '^'il 
 Turning, 401 
 
 r. 
 
 I'MitiLK Ai. cord, O:! 
 anomalies in, 373 
 ditferences in, 04 
 dimensions of, 01 
 hiemorrhasrt" from, 702 
 hernia of, 7S4 
 inHamniation of, 71 1 
 obstacle to birth, ^'73 
 vein, 94 
 vesicle, 84 
 
 ditferences in, 8."i 
 Umbilicus, udema of, 713 
 Urachus. 83, 94 
 
 persistence of, 703 
 Uterine arteries, 41 
 cvsta, 180 
 dilator, S.'iO 
 inertia, ill 
 milk. 91 
 Uterovaginal tumours, 344 
 Uterus, 39 
 
 amputation of, 600 
 
 deviations in, 306 
 
 diflerences in. 42 
 
 direction of, 134 
 
 form of, 39, 132 
 
 hernia of, 103 
 
 influence of on other organs, 135 
 
 inversion of, 576 
 
 laceration of, 600 
 
 modificationa in, during pregnancy, 
 
 12.-i 
 occlusion of, 360 
 position of f<etus in, 137 
 re<luction of, 585 
 reposition of, 385 
 retention of, 588 
 rupture of, 600 
 
 of ante juiitum, 613 
 of, during birth, 610 
 sensibility of. 131 
 situation of, 30, 131 
 structure of, 39, 128 
 t«)r8ion of, 309, 340, 343 
 volume of, 128 
 Utricular glan<ls, 41 
 
 V. 
 Vagina, 36 
 
 atresia of, 370 
 
 complications in rupture of, 616 
 
 differences in, 3*^ 
 
 imperforate. 74.'' 
 
 inversion of, 603 
 
 laceration of, 613 
 
 occlusion of, 618 
 
758 
 
 Vagina, rupture of, 613 
 
 thrombus of, 619 
 ^'aginal bulb, 28 
 
 constriction, 370 
 cystocele, 351 
 exploration, 146 
 fcEtation, 175 
 hysterotomy, 551 
 irrigations, 295 
 taxis, 331 
 Vaginitis, 622 
 Valvula vaginfe, 369 
 Venereal cestrum, 59 
 Ventral f(ttation, 175 
 Version, 491 
 
 Vertical diameter of pelvis 
 Vesicle, umbilical, S4 
 
 INDEX. 
 
 l-l, 26 
 
 Vesico-vaginal fistulis, 61 S 
 Vesicula alba, 84 
 Vomiting during pregnancy, 184 
 Vulva, 27 
 
 atresia of, 370 
 
 differences in, 30 
 
 imperforate, 745 
 
 thrombus of, 619 
 Vulvar atresia, 370 
 
 W. 
 
 Water-bag, rupture of, 234 
 Weight of foetus at birth, 125 
 Wharton's gelatine, 93 
 Wharton ian jelly, 93 
 
 Z. 
 
 Zonular placenta, 93 
 
 THE END. 
 
 Baillierc, Tindall <0 Coj:, 20 and 21, Kintj IFUliam Street, Strand. 
 
WILLIAM R. JENKINS' 
 
 Veterinary Books 
 
 1901 
 
 (•) Single asterisk designates New Books. 
 (•*) Double asterisk desiynates Recent Publieatians. 
 
 ANDEItSOy. "Vice in the Hors«" and other papers 
 on Horses and Riding. I{y E. L. Anderson. Demy, 
 8vo, cloth 2 00 
 
 — " How to Ulde and School a Horse." With a System 
 of Horse Gymnastics. By Edward L. Anderson. 
 Cr. 8vo 1 00 
 
 ARM STEAD. *' The Arli>tit Anatomy of the Horso." 
 
 A brief description of the various Aiiatoiulcai Struc- 
 tures which may be distin^julsiiud during Life thmuyli 
 the Skin. By Hugh W. Armstead, M.D., F.Ii.C.S. 
 Willi illustrations from drawings by thi- author. 
 Cloth oblong, 1'2} X 10 3 75 
 
 BACH. "How to JudfTC a Horse," A concise treatise 
 as to It.s Qualities and Soundness; Including Bits and 
 Bitting, Saddles and Saddling, SUiblo Drainage, Driv- 
 ing One Horse, a Pair, Four-ln-hand, or Tandem, etc. 
 By Captain F. W. Bach. 12mo, cloth, fully Illustrated, 
 $1 00 ; paper 50 
 
Veterinary Catalogue of William R. Jenkins 
 
 {*)BANHAM. "Anatomical and Physiological Model of 
 the Horse." Half life size. Composed of super- 
 posed plates, colored to nature, showing internal 
 organs, muscles, skeleton, etc., mounted on strong 
 boards, with explanatory text. By George A. 
 Banham, F.R.C.V.S. Size of Model 38x41 in... 10 00 
 
 — •' Tables of Veterinary Posology and Therapeutics," with 
 weights, measures, etc. By George A. Banham, 
 F.R.C.V.S. 12mo, cloth 100 
 
 BAUCIIEIl. "Method of Horsemanship." Including 
 the Breaking and Training of Horses 1 00 
 
 {*)BELL. "The Veterinarian's Call Book (Perpetual)." 
 
 By Roscoe R. Bell, D.V.S., editor of the American 
 Veterinary Review. Revised for 1901, 
 
 A visiting list, that can be commenced at any time 
 and used until full, containing much useful informa- 
 tion for the student and the busy practitioner. 
 Among contents are items concerning : Veterinary 
 Drugs; Poisons; Solubility of Drugs; Composition of 
 Milk, Bile, Blood, Gastric Juice, Urine, Saliva; Respi- 
 ration; Dentition; Temperature, etc., etc. Bound in 
 flexible leather, with flap and pocket 1 25 
 
 {*')BRADLEY. "Outlines of Veterinary Anatomy." 
 
 By O. Charnock Bradley, Member of the Royal Col- 
 lege of Veterinary Surgeons ; Professor of Anatoniy 
 in the New Veterinary College, Edinburgh. 
 
 The author presents the most important facts of 
 veterinary anatomy in as condensed a form as possible, 
 consistent with lucidity. 12mo. 
 
 Complete in three parts. 
 
 Part I. : The Limbs (cloth) 1 25 
 
 Pakt II. : The Trunk (paper) 1 25 
 
 Paet III. : The Head and Neclc (paper) 1 25 
 
 The Set complete 3 50 
 
B51-S53 Sixth Avenue {cor. iSth St.), New York. 
 
 CADIOr. "Roarinc: In Horses." Its TatholoKy and 
 TroatnitMit. Tliis work n'presonts the latest develop- 
 ment in opprativ»5 methods for the alleviation 
 of roaring. Each stop is most clearly dvflned by 
 oxceileul full-pnge illujrlrnlions. By 1*. .1. Cudiot, 
 Profes^jor at the Veterinary School, Alforl. Trans. 
 Tho8. J. Watt Dollar, M.R.C.V.S.. etc. Cloth 75 
 
 — " Exorcises in Equine Surprerj." By P. J. Cadiot. 
 Translated by Prof. A. W. Bitting, M.D.,V.S. ; edited 
 by Prof. A. Llautard, M.D.V.S. 8vo, cloth, illue- 
 trateU 2 50 
 
 (•)—'* A Treatise on Yoterlnany Thernpeutics of tlic Domestic 
 Animals." By P.J. Cadiot and J. Alvary. Translated 
 by Prof. A. Liauturd, M,D.,V.S. 2 Parts ready. 
 
 Part I, Vol. I, 8vo, 93 pages, 45 illustrations 1 00 
 
 Part II, Vol., I, 8vo, % pages .1 CO 
 
 (Part III, in Prcjxiratiun) . 
 
 OCHAPMAS. "Manual of the Pathological Treatment 
 of Lameness in the Horse," trentfd .solely by 
 mechiiidcal means. By (loorge T. Clmpman. 8vo, 
 cloth, 124 pages 2 00 
 
 CIIAUVEA(\ "The romparatlve Anatomy of the 
 Doniestlrated Animals." By .\. Chauveau. Now 
 edition, translated, oidarged and entirely revised by 
 George Fleming, F.R.C.V.S. 8vo. cloth with 586 
 Illustrations G 25 
 
 CLARKE. "(hart of the Feet and Teeth of Fossil 
 Horses." By W. II. Clarke 2.3 
 
Veterinary Catalogue of Williavi R. Jenkins 
 
 CLEMENT. ''Veterinary Post Mortem Examina- 
 tions." By A. W. Clement, V.S. Records of 
 autopsies, to be of any value, should accurately 
 represent the appearances of the tissues and organs 
 so that a diagnosis might bo made by the reader were 
 not the examiners' conclusions stated. To make the 
 pathological conditions clear to the reader, some 
 definite system of dissection is necessary. The 
 absence in the English language, of any guide in 
 making autopsies upon the lower animals. Induced 
 Dr. Clement to write this book, trusting that it 
 would prove of practical value to the profession. 
 12mo, cloth, illustrated , 75 
 
 CLEAVELAND. "Pronouncing Medical Lexicon." 
 
 Pocket edition. Cloth 75 
 
 COURTENAY, '« Manual of Veterinary Medicine and 
 Surgery." By Edward Courtenay, V. S. Crown, 8vo, 
 cloth 2 75 
 
 COX. " Horses : In Accident and Disease." The 
 
 sketches introduced embrace various attitudes which 
 have been observed, such as in choking; the disorders 
 and accidents occurring to the stomach and intestines ; 
 affection of the brain ; and some special forms of lame- 
 ness, etc. By J. Eoalfe Cox, F.R.C.V.S, 8vo, cloth, 
 fully Illustrated 1 &0 
 
 CURTIS. "Horses, Cattle, Sheep and Swine." The 
 
 origin, history, Improvement, description, characteris- 
 tics, merits, objections, etc. By Geo. W. Curtis, 
 M.S. A. Superbly illustrated. Cloth, $2 00; half 
 sheep, $2.75 ; half morocco 3 50 
 
851-853 Sixth Ai^nne (cor. 48/)i St.), New York. 
 
 C')l)ALIiyMl'LE. "Vetcriimry Obstetrics." A compen- 
 dium for the use of advanced sludonts and Practi- 
 tioners. By W. II. Dairyniple, M. li. C. V. S., 
 principal of tiie Department of Veterinary Science in 
 the Louisiana State University and A. & M. College; 
 Veterinarian to the Louisiana State Bureau of 
 Agriculture, and Agricultural Experiment Stations; 
 Member of the United Suites Veterinary Medical 
 As-soelations, etc. 8vo, cloth, illus 2 50 
 
 Jt.lLZIEL, " The Fox Terrier." Illustrated. (Monographs 
 on British Dogs) . By Hugh Dalzlel 1 00 
 
 — " The St. llernanl." Illustrated 1 00 
 
 — "Tlie IMseases of Dog's." Their Pathology, Diagnosis 
 
 an<l Treatment, with a dictionary of Canine Materia 
 Medlca. By Hugh Dalzlel. 12rao, cloth 80 
 
 — " Diseases of Horses." 12rao, cloth 100 
 
 — '• Ilrealiint; and Training; DoffS." Being concise 
 
 directions for the proper education of dogs, both 
 for the field and for companions. Second edi- 
 tion, rovisoil and enlarged. Part I, by Pathllmler: 
 Part II. by Hugh Dalzlel. 12mo, cloth, illus ..,.2 60 
 
 — "The Collie." Its History, Points, and Breeding. By 
 
 Hii;,'h Dalzlel. Illustrated, 8vo, cloth 1 00 
 
 — "The Greyhound. ■ 8vo, cloth, Illus 100 
 
 DANA. "Tables in Comparalive Pliyiiolopj." By Prof. 
 C. L. Dana, M.D 25 
 
 DANCE. "Veterinary Tablet." Fohled In cloth case. 
 The tablet of A. A. Dance i« a synopsis of thediseasee 
 of horses, cattle and dogs, with the causes, symptoms 
 and CUP'S 75 
 
 DAY. "The llace-horse in Training." By Wm. Day, 
 8vo 3 60 
 
Veterinary Catalogue of William li. Jenkins 
 
 {*)DE BR UIN. " BoYiue Obstetrics." By M. G. De Bruin, 
 Instructor of Obstetrics at the Stale Veterinary 
 School in Utrecht. Translated by W. E. A. Wyman, 
 Professor of Veterinary Science at Clemson A. & M. 
 College, and Veterinarian to the South Carolina 
 Experiment Station. 
 8vo, cloth, 382 pages, 77 illustrations 5 00 
 
 Synopsis of the Essential Features of Work. 
 
 1. Authorized translation. 
 
 2. The only obstetrical work which is up to date, 
 
 3. Written by Europe's leading authority on the 
 
 subject. 
 
 4. Written by a man who has practiced the art a 
 
 lifetime. 
 
 5. Written by a man who, on account of his eminence 
 
 as bovine practitioner and teacher of obstetrics, 
 was selected by Prof. Dr. Frohner and Prof. Dr. 
 Bayer (Berlin and Vienna), to discuss bovine 
 obstetrics, both practically and scientifically. 
 
 6. The only work containing a thorough differential 
 
 diagnosis of ante and post partum diseases. 
 
 7. The only work doing justice to modern obstetrical 
 
 surgery and therapeutics. 
 
 8. Written by a man whose practical suggestions 
 
 revolutionized the teaching of veterinary obste- 
 trics even in the great schools of Europe. 
 
 9. The only work dealing fully with the now no 
 
 longer obscure contagious and infectious dis- 
 eases of calves. 
 
 10. Ab3olutely original and no compilation. 
 
 11. The only work dealing fully with the difficult 
 
 problem of teaching obstetrics in the colleges. 
 
 12. The only work where the practical part is not 
 
 overshadowed by theory. 
 See also " Wyman," 
 
851 -S^S Sixth Avenue {eor. iSth St.), New Yurk. 
 
 ODOLLAR. "A Siirgriciil 0|M'iallnir Tabic for the 
 Horse." By Jno. A. W. Dollar, M.K.C.V.S '.»0 
 
 I*)— "Clinical Veterinary Medicine and Siirjferj." By John 
 A. W. Dollar, M.K.C.V.S 5 25 
 
 . . . Thi.s Work. containinK as it doo.s the ripe exper- 
 ience of tlie author, who may be confiidered one of the 
 foremost surgeons nnd cliiiieians of tlio ihiy. contains a 
 vast amount of exact sciontidc information of the utmost 
 value to tlie busy workaday practitioner, while for the 
 .student of either human or compa'ative medicine, no 
 l»«»tter bouk could lie placed in thoir hands, that will give 
 them a cloar insight into the many iiitricato problems 
 Willi which they are daily confronted. . . .—AmeririDi 
 I'fleriuaiu [{frietr. Now York, August, l'.»oi. 
 
 [*)— "A Hand-book of Horsc-Sliocing'," with introductory 
 i'hapters on the anatomy and phy.siology of the 
 horse's foot. By Jno. A. W. Dollar. M.R.C.V.S., 
 translator and editor of Mulltn's " Veterinary Sur- 
 gery," "An Atlas of Veterinary Surgical Opt'rations," 
 etc. ; with the collaboration of Albert Whoalley, 
 F.R.C.V.S. 8vo, cloth, 433 pp., 4l6 illustrations . .4.75 
 
 DUy. " Veterinary Medicines." By Flnlay Dun, V.S. Now 
 revised and enlargi-d English edition. 8vo, cloth. 3 75 
 
 liWYEIi. *• Seats and Saddles." Bits and Bitting, 
 Draught and Ilaniess and the Pn'venlion and Cure of 
 lifstlvone-ss In Horsi's. By Francis Dwyer. Illus- 
 trated. 1 vol., 12(uo, cloth, gilt 1 50 
 
 FLEHIXO. " Veterinary Obstetrics." Including the 
 Accidents and Disfimes Incident I,) Pr«»gnanoy, Parturi- 
 tion, and the early Age In Doiiiostkalod Animals. 
 By Geo. Fleming. F.R.C.V.S. With 212 illustrations. 
 New edition rrvutcd, 2 JO Illustrations, 758 poget. .-6 25 
 773 pages, 8vo, cloth (old edition) 3 50 
 
VeterinaTry Catalogue of William It, Jenkins 
 
 FLEMING. "Operative Veterinary Surgery." Part I, by 
 Dr. Geo. Fleming, M.R.C.V.S. This valuable work, 
 the most practical treatise yet issued on the 
 subject in the English language, is devoted to the 
 common operations of Veterinary Surgery ; and the 
 concise descriptions and directions of the text are illus- 
 trated with numerous wood engravings. 8vo,cloth.2 75 
 Second volume in preparation. 
 
 — "Tuberculosis." From a Sanitary and Pathological Point 
 
 of View. By Geo. Fleming, F.R.C.V.S .....25 
 
 — " Tlie Contag^ious Diseases of Animals." Their influence on 
 
 the wealth and health of nations. 12mo, paper 25 
 
 — " Human and Animal Variolae." A Study in Comparative 
 
 Pathology. Paper 25 
 
 — "Animal Plagues." Their History, Nature, and 
 
 Prevention. By George Fleming, F. R. C. V. S., etc. 
 First Series. 8vo, cloth, $6.00; Second Series. 
 8vo, cloth 3 00 
 
 — " Roaring in Horses." By Dr. George Fleming, 
 
 F.R.C.V.S. A treatise on this peculiar disorder 
 of the Horse, indicating its method of treatment 
 and curability. Svo, cloth, with col. plates 1 50 
 
 FLEMING-NEUMANN. "Parasites and Parasitic 
 Diseases of the Domesticated Animals." A work 
 which the students of human or veterinary medi- 
 cine, the sanitarian, agriculturist or breeder or rearer 
 of animals, may refer for full information regarding 
 the external and internal Parasites — vegetable and 
 animal — which attack various species of Domestic 
 Animals. A Treatise by L. G. Neumann, Professor 
 at the National Veterinary School of Toulouse. 
 Translated and edited by George Fleming, C. B., L.L. 
 D., F.R.C.V.S. 873 pages, 365 illustrations, cloth.? 50 
 
861-853 Sixth Avenue {cor. iSth St.), New Vork. 
 
 GRESSWELL. "ITie Diseases and Disordtrs of tlie 
 Ox." By George Grosswell, B.A. With Notes by 
 James B. Gresawell. Crown, 8vo, cloth, lllus 3 60 
 
 — " Diseases and Disorders of the Horse." By Albert, James 
 
 B. ami George Gresswell. Crown, 8vo, illus, cloth. 1 76 
 
 — " Veterinary riiarniaeolo^y and Tlierapeutics." By 
 
 James B. Gresawell, F.R.C.V.S. 16rao, cloth . . .1 60 
 
 — " The Bovine Presorlber." For the use of Veterina- 
 
 rians and Veterinary Students. By James B. and 
 Albert Gresswell.M. B.C. V.S Cloth 75 
 
 — "The Equine Hospital Preseriber." For the use of Veter- 
 
 inary Practitioners and Students. By Drs. James 
 B. and Albert Gresswell, M.R.C.V.S. Cloth 76 
 
 — "Veterinary Pliarninoopa'ia, Materia Medioa and 
 
 Therapeuties" By George and Cliaries Gresswell, 
 wltli descriptions and physiological actions of medi- 
 cines. By Albert Gresswell. Crown, 8vo, cloth. .2 75 
 
 — Manual of "The Theory and Praetlee of Equine Modieine." 
 
 By James B. Gresswell, F.R.C.V.S., and Albert 
 Gresswell, M.R.C.V.S., second edition, enlarged, 
 8vo, cloth 2 75 
 
 GOTTIIEIL. "A Manual of (icneral lli.stolo^'y," 
 By Wm. 8. Gottheil, M D., Professor of Pathdogy in 
 the American VoU'dnary College, New York ; etc., etc. 
 Histology Is the basis of the phyhlcian's art, as 
 Anatomy is the foundation of the surgeon's science. 
 Only by knowing the processes of life can wo imder- 
 stand the changes of disease and theactlon of remedies; 
 as the architect must know his building materials, so 
 must the prai'litloner of medicine know the Intimate 
 structure of the body. To present this knowledge In 
 an acoessll)lo and .'-linplt> form has bet'U the author's 
 tAsk. 8to., cloth, 148 pag>>8, fully Illustrated. . . 1 00 
 
ib P^eterinary Catalogue of Williavi R. Jenkins 
 
 HASSLOCH. " A Coinpend of Veterinary Materia Medica 
 
 and Tlierapeiitics." By Dr. A. C. Hassloch, V.S., 
 Lecturer on Materia Medica and Therapeutics, and 
 Professor of Veterinary Dentistrj' at the New York 
 College of Veterinary Surgeons and School of Compa" 
 rative Medicine, N, Y, 12mo, cloth, 225 pages . .1 50 
 
 HEATLEY. " The Stock Owner's Guide." A handy Medi- 
 cal Treatise for every man who owns an ox or cow. 
 By George S. Heatley, M.K.C.V. 12mo, cloth.. .1 25 
 
 — "The Horse Owner's Safeguard." A handy Medical 
 
 Guide for every Horse Owner. 12mo, cloth 1 BO 
 
 — "Practical Veterinary Remedies." 12mo, cloth. . 1 00 
 
 HILL. "Tlie Management and Diseases of the Dog." 
 
 Containing full instructions for Breeding, Rearing and 
 Kenneling Dogs. Their Different Diseases. How to 
 detect and how to cure them. Their Medicines, and 
 the doses in which they can be safely administered. 
 By J. Woodroffe Hill, F.R.C.V.S. 12mo, cloth, extra 
 fully illustrated 2 00 
 
 (*)- "Tlie Diseases of the Cat." By J. Woodroffe Hill, F.R. 
 C. V.S. 12mo, cloth, illustrated 1 25 
 
 Written from the experience of many years' prac- 
 tice and close pathological research into the maladies 
 to which our domesticated feline friends are liable — a 
 subject which it must be admitted has not found not 
 prominence in veterinary literature to which it is 
 undoubtedly entitled. 
 
 HINEBAUCH. "Veterinary Dental Surgery." For the 
 
 use of Students, Practitioners and Stockmen. 
 
 12mo, cloth, illustrated 2 00 
 
 Sheep 2 75 
 
861-863 Sixth Ai'enne {cor. i8th St.), New York. 11 
 
 IIOARE. "A Maniuil of Veloriiiury Tliorapoiitics niid 
 
 riiurmacoloir.v" By E. Wallis Hour.-. F.K.('.V>. 
 I'imo, cloth, 5C0 pages 2 Tf) 
 
 "Dosorvos Ji cood place in tlio lihrarios of all voforina- 
 rlans. • • • Cannot help but be of the Krcatest assist- 
 ance to the young veterinarian and the every day busy 
 practitioner."— ^menVan Veterinary lievietc. 
 
 OnOJtDA y. " Canine and Folino Surgery." By Fmlei ick 
 T. G. Hobilay, F.H.C.V.S., rrof.'ssor In Ciiurge of the 
 Free Out-Patlents' Clinlquo at the Royal Veterituiry 
 College, London. The work contains 7('> illustrations 
 in the text. Demy 8vo, 152 pp., full-bound cloth ,2 00 
 
 \")Hl'yTI\G. The Art of Horse-slioelnpr. A manual 
 for Farriers. By William Hunting, F.U.C.V.S., edi- 
 tor of the Veterinary Record, ox-prtssidtMitof the Uoyal 
 College of Veterinary Surgeons. Mvo, cloth, with 
 nearly M) Illustrations 1 00 
 
 ( %/f;A'K lys. '' .Model of tlie llorNC." 10 00 
 
 ^See Banhara). 
 
 ( ')KOIiKRT. "Practical Toxicolopy for riiysioians and 
 Stndent.««." l'>y Professor I>r. Kudoijili Kobert, 
 Medical Director of Dr. Brehmer's S.inilariuni for 
 Pulmonary Di.seaac8 at Goerbersdorf in Silesia (l'ru.'>- 
 sla), hito Director of the Pharmacological Institute, 
 Dorpat, Kussia. Translated anil edited by L. H. 
 Frledburg, Ph.D. Authorized Edition. 8vo, cloth.2 50 
 
 KOCH. ".Ftlolosry of Tuberculosis." By Dr. R. Koch. 
 
 Translated by T. Sauf. bvo, cloth 1 00 
 
12 Veterinai'y Catalogue of William R. Jenkins 
 
 KEATING. "A New Unabridged Pronouncing Diction- 
 ary of Medicine." By John M. Keating, M.D.,LL.D., 
 Henry Hamilton and others. A voluminous and 
 exhausiive hand-book of Medical and scientific 
 terminology with Phonetic Pronunciation, Accentu- 
 ation, Etymology, etc. With an appendix containing 
 important tables of Bacilli, Microcci Leucomaines, 
 Ptomaines ; Drugs and Materials used in Antiseptic 
 Surgery ; Poisons and their antidotes ; Weights and 
 Measures ; Themometer Scales ; New OflBcinal and 
 UnofBcinal Drugs, etc., etc. 8vo, 818 pages 5 00 
 
 LAMBERT. "The (ierm Theory of Disease." 
 
 Bearing upon the health and welfare of man and the 
 domesticated animals. By James Lambert, F.R.C.V.S. 
 8vo. paper 25 
 
 LAW. "Farmers' Veterinary Adviser." A Guide to the 
 Prevention and Treatment of Disease in Domestic 
 Animals. By Prof. James Law. lUus., 8vo, cloth. 8 00 
 
 {'■)LEGGE. "Cattle Tuherciilosis." A Practical Guide 
 to the Farmer, Butcher and Meat Inspector. By T.M. 
 Legge, M.A., M.D., D.P.H., Secretary of the Eoyal 
 Commission on Tuberculosis, 1896-98; author of 
 " Public Health In European Capitals," and " Harold 
 Sessions, F.R.C.V.S." Cloth 1 00 
 
 LI A UTxiRD, " Mnnnal of Operative Veterinary Surgery " 
 By A. Liautard, M. D., V.M., Principal and Professor 
 of Anatomy, Surgery, Sanitary Medicine and Juris- 
 prudence in the American Veterinary College; 
 Chevalier du Merite Agricole de France, Honorary 
 Fellow of the Royal College of Veterinary Surgeons 
 (London), etc., etc. 8vo, cloth, 786 pages and nearly 
 600 illustrations 6 00 
 
«51-Sr)3 Si.rth Ar-enne {cor. AHth St.), AVtr York. 18 
 
 LIAUTAIil). "Median Nt'iirotoinj in the Troatmont of 
 Chronic Tendinitis and rcriostosis of flio Fetlock." 
 
 By C. I'ellorin, lato KopoUtor of Clinii- iiii<l Surgriy to 
 the Alfort Volorinary School. Translated with addi- 
 tional facts relating to it, by Prof. A. Liauturd, M.D., 
 V.M. 
 
 IIavin{? rendered good results when performed by 
 himself, the author l)elievos the operation, which 
 consists in dividing the cubito-plantar nerve and in 
 excising a portion of the peripherical end, the means 
 of improving the conditions, and consequently the 
 values of many apparently doomed animals. Agricul- 
 ture in particular will bo benefited. 
 
 The work is divided into two parts. Tlic first covers 
 the study of Median Neurotomy itself; the second, 
 the exact relations of the facts as observed by the 
 author. 8 vo. , boards 1 00 
 
 — "Animal Castration." A concise and practical Treatise 
 
 on the Castration of the Domestic Animals. The 
 onlj- work on the subject in the English language. 
 Illustrated with forty-four cuts. 12mo, cloth .\. 2 00 
 
 — **Vade Mocum of Equine Anatomy." By A. Liautard, 
 
 M.D.V.S. Dean of the American Veterinary College, 
 12tuo. cloth. Nf'W edition, with illustrations . . .2 00 
 
 — "Translation ofZnndel on the Horse's Foot," Clotli..2 00 
 
 — " lIoiT to Tell the Ape of the Domestic Animal." By 
 
 Dr. A. Liautanl, M.D., V.S. Profusely illustrated, 
 12mo, cloth 50 
 
 — **0n the Lameness of Horses." By A. Llautar.l, 
 
 M.l).,V.S 2 50 
 
 See also ^^CadioVs Surgery." 
 
 (•) -" A Treatise on Veterinary Tliorapentirs of the Domestic 
 Animals." (SeeCadlot.) 
 
14 Veterinary Catalogue of William R. Jenkins 
 
 LONG. "Book of the Pig." Its selection, Breeding, 
 Feeding and Management. 8vo, cloth 4 26 
 
 {**)LOWE. *' Breeding Racehorses by the Figure 
 System." Compiled by the late C. Bruce Lowe. 
 Edited by William Allison, •' The Special Commis- 
 sioner," London Sportsman, Hon. Secretary Sporting 
 League, and Manager of the International Horse 
 Agenc}' and Exchange. With numerous fine illustra- 
 tions of celebrated horses. Quarto, cloth 7 50 
 
 L UDL O W. " Science in the Stable "; or How a Horse can 
 
 be Kept in Perfect Health and be Used Without 
 Slioes, in Harness or under the Saddle. With the 
 Reason Why. Second American Edition. Enlarged 
 and Exemplified. By Jacob R. Ludlow, M.D. Late 
 Staff Surgeon, U. S. Army. Paper, 166 pages 50 
 
 LUPTON. "Horses: Sound and Unsound," with 
 Law relating to Sales and Warranty. By J. Irvine 
 Lupton, F.R.C.V.S. 8vo, cloth, illustrated 1 25 
 
 — *' The Horse." As he Was, as he Is, and as he Ought to Be. 
 By J. I. Lupton, F.R.C.V.S. Illus., Crown, 8vo. .1 40 
 
 MAGNEB. " Facts for Horse Owners." By D. Magner. 
 Upwards of 1,000 pages, illustrated with 900 engrav- 
 ings. 8vo, leather binding . . 7 50 
 
 MAYHEW. "The lUustrated Horse Doctor." An 
 
 accurate and detailed account of the Various Diseases 
 to which the Equine Race is subject ; together with the 
 latest mode of Treatment, and all the Requisite Pre- 
 scriptions written in plain English. By E. Edward 
 Maynew, M.R.C.V.S. Illustrated. Entirely new 
 edition, Svo, cloth 2 75 
 
851-853 Sixth Avenue {cor. iSth St.), Ncic Vork. 15 
 
 McIiJilDi:. ''Anatomical OiitUucs of the Horse." 
 
 I'imo, ololli. litMlueixi to 1 5U 
 
 McCOMBIE. "Cattle and Cattle Breeders." Cloth 1 00 
 
 W FA DYE AX. "Anatomy of the Horse." A Dis- 
 section Guide. J?y J. M. M'Fadyyan, M.lt.C.V.S. 
 
 8vo, clotii 5 50 
 
 Tiiis book is intended for Veterinary studonts, and 
 offers to tliem in its 48 full-page colored plates numer- 
 ous other engravings and excellent text, tiio most 
 valuable and practical aid in the study of Veterinary 
 Anatomy, eupecially in the dissecting room. 
 
 — ** Comparafiro Anatomy of the Domesticated Animals." 
 
 liy J. M'Fadyean. Profusely illustrated, and to be 
 issued in two ()arLs. 
 
 Part I— Osteology, ready. Paper, 2.50; cloth 2.75 
 
 (Part II In preparation.) 
 
 MILLS. "Ho^T to Keep a Dog in the City." By 
 
 We.sley Mills, M.U , V.S. It tells how to choose, 
 manage, iiou.se, feed, educate the pup, iiow to lieep Idm 
 clean and teach him cleanliness. Paper 25 
 
 MOSSELMAS-LIEXAUX. '' Veterinary .Miorobio- 
 logy." Hy Professors Mosselnian and I,i«iiaux, 
 Nat. Vt!t»>rinary College, Cureghem, Belgium. Trans- 
 lated and p<lite<l by R. It. Dinwiddle, Professor of 
 Veterinary Soionce, College of Agriculture, Arkansas 
 SUte Univerelty. 12rao, cloth, 342 pages 2 00 
 
 MORETOS. " On Horso.l)reaking." 12mo, cl 60 
 
16 Veterinary Catalogue of William R. Jenkins 
 
 MOLLER, "Operative Veterinary Surgery." By Trofes- 
 sor Dr. H, MoUer, Berlin. Translated and edited 
 from the 2nd edition, enlarged and improved, by 
 John A. W. Dollar, M.K.C.S. 
 
 Prof. Moller's work presents the most recent and 
 complete exposition of the Principles and Practice of 
 Veterinary Surgery, and is the standard text-book on the 
 subject throughout Germany. 
 
 Many subjects ignored in previous treatises on 
 Veterinary Surgery here receive full consideration, 
 while the better known are presented under new and 
 suggestive aspects. 
 
 As Prof. Moller's work represents not only his 
 own opinions and practice, but those of the best 
 ^ Veterinary Surgeons of various countries, the trans- 
 lation cannot fail to be of signal service to American 
 and British Veterinarians and to Students of Veter- 
 inary and Comparative Surgery. 
 1 vol., 8vo. 722 pages, 142 illustrations 5 25 
 
 NOCAHD. " Tlie Animal Tuberculoses, and their Relation 
 to Human Tuberculosis." By Ed. Nocard, Prof, of the 
 Alfort Veterinary College. Translated by H. Scurfield, 
 M.D. Ed., Ph. Camb. ]2mo, cloth, 143 pages. . . .1 00 
 Perhaps the chief interest to doctors of human 
 medicine in Professor Nocard's book lies in the 
 demonstration of the small part played by heredity, 
 and the great part played by contagion in the propa- 
 gation of bovine tuberculosis. It seems not unreason- 
 able to suppose that the same is the case for human 
 tuberculosis, and that, if the children of tuberculosis 
 parents were protected from infection by cohabitation 
 or ingestion, the importance of heredity as a cauge of 
 the disease, or even of the predisposition to it, would 
 dwindle away into insignificance. 
 
 PEGLEM, "TUe Book of tUe Goat," 12mo, cloth 1 75 
 
m\-85'3 SLvth Avemte (cor. i8thSt.), AVir York. 
 
 VKLI.EItiy. "Median Nciiiotoiiiy in llic Trcutmcnt 
 <»r('hr»iiii' rciiiliiiiti^ und I'criostosi^ ofllic Fctititl*." 
 
 By C. rolltMlii, lalo rcpotitor of Clinic and Surgery to 
 tlio Alfort Vetoriniiry School. Translutcil, wiLli Addi- 
 tional Facts Ilelutint: to It, l>y Prof. A. Liautard, M.D., 
 
 V.ll. 8vo, boards, ilhistnilt'd 1 CO 
 
 See also " Liuufanl." 
 
 rETERS. ' A Tiil):niiIoiis Htrd-Te^t wilh Tuber- 
 ciilin." By Austin IVtcrs, M. 11. C. V. S., Ciiief 
 Inspi'ctor of Cattlo for tlie New York Stato Board of 
 Health during the winter of 1892-93. Pamphlet 25 
 
 i')ri'EirrEIt - U ILLIAMS. " a Comx' of Siirjrinil 
 Operations for Voterlnarj StiHlenls and rracli- 
 tloMors.*' By \V. I'feilTer, Assistant in the Surgical 
 Clinii- of the Veterinary High School in Berlin, and 
 W. L. Williams, V.S., Professor of Surgery in the 
 New York State Veterinary College, Cornell Univer- 
 sity, Ithaca, N. Y. 
 With 12 illustrations, 12nio, cloth 1 2.") 
 
 A concise description of the more common major 
 surgical operations, designed as a laltoratory guide in 
 surgical exercises for veterlnarj* students and as a 
 ready reference for practitioners In surgical opera- 
 tions. Based upon a translation of Dr. PfeifTor's 
 •• Operatlons-Cursus," embodying the expi-rience of 
 Dr. Pf-ilffer and Prof. Dr. Frohner in the Berlin 
 Veterinary School. Wltli numerous annotations there 
 have been addc^l many of the nt'\v.>r, largely distinc- 
 tively American, operations. 
 
 REYyOTjD. "Breeding and .Management of Draught 
 Horses," «vo, cloth 1 iO 
 
18 Veterinary Catalogue of Williavi R. Jenkins 
 
 ROBERGE. " The Foot of the Horse," or Lameness 
 and all Diseases of the Feet traced to an Unbalanced 
 Foot Bone, prevented or cured by balancing the foot. 
 By David Roberge. 8vo, cloth 5 00 
 
 {**)SEWELi1j. " The Examination of Horses as to Sound- 
 ness and Selection as to Purchase." By Edward 
 Sewell, M.E.C.V.S.L. 8vo, paper 1 £0 
 
 — It Is a great advantage to the business man to 
 know something of the elements of law, and nobody 
 ought either to buy or own a horse who does not know 
 something about the animal. That something this book 
 
 gives, and gives in a thoroughly excellent way 
 
 Our Animal Friends, November, 1898. 
 
 SMITH. " A Manual of Veterinary Physiology." By 
 
 Veterinary Captain F. Smith, M.R.C.V.S. Author of 
 "A Manual of Veterinary Hygiene." 
 
 Throughout this manual the object has been to con- 
 dense the information as much as possible. The 
 broad facts of the sciences are stated so as to render 
 them of use to the student and practitioner. In this 
 second edition — rewritten — the whole of the Nervous 
 System has been revised, a new chapter dealing with 
 the Development of the Ovum has been added together 
 with many additional facts and illustrations. About 
 one hundred additional pages are given. Second 
 edition, revised and enlarged, with additional illus- 
 trations 3 75 
 
 — '^Manual of Veterinary Hygiene." 2nd edition, revised. 
 Crown, 8vo, cloth 3 25 
 
 {") STRANGE WAT. "Veterinary Anatomy." Edited by 
 I. Vaughan, F.L.S., MK.C.V.S. New edition revised, 
 with several hundred illustrations. Svo. cloth. . . .5 00 
 
851-833 Sixth Arcnue wor. 48//i St.), Neil' York. 19 
 
 (*')SrsSl)OIlI\ "Laryfe Coloivd >Viill Diagrams." By 
 
 I'lof. Siissdorf, M.D. (of G«")ltiiiKi'n). Text traiislatod 
 by Prof. W. Owon Williams, of tho Now Veterinary 
 C«)lleg«, Edinburgh. Size, 44 inches by 30 inelies. 
 
 1.— llorsj'. 4.— Ox. 
 
 2.— Maro. 5.— Boar and .S(»>v. 
 
 ;J.-C'»n. G.— Dog anil IJiUh. 
 
 Showing the position of the visceni in the large 
 cavities of tho body. 
 
 Price, unmounte<l I 75 each 
 
 " mounted on linen, with roller 3 50 •♦ 
 
 DFAN MATEIi, " .V Text HcM.k of Vetoriiiarv {)y\\- 
 Ihalmoloiry." By Georgf G. Van Mater, M.D., 
 I).\ .S., l'rof»^9sor of Ophthalmology in tho American 
 Vrteriiuiry College; Oculist and Auristto St. Martha's 
 Sanitarium and Dispensary; Consulling Eye and Ear 
 Sur;;eoti to the Twenty-si.xth Ward Dispensary; Eye 
 and Ear Surgeon, Brooklyn Eastern District Dispen- 
 sary, etc. Illustrated by one chromo lilbogruph plate 
 and seventy-one engravings, 
 bvo cloth 3 00 
 
 yETKIUSAUl in AG RAMS in Tabular Form. 
 Size, 2HJ in. x 22 inches. Piico per set of live. . . 4 75 
 
 No. 1. "The Kxtcrnnl Form and Eleniontarj Ana- 
 tomj of the Horse-' Eight colored illustraiions — 
 I. External regions; 2. Skidelon ; 3. Muscles (Superior 
 1-ayer); I Muscles (Deep Layer); 5. Resplratojy Ap- 
 panilus; ('•. Digestive Apparatus; 7. Circulatory Ap- 
 panitus ; 8. Nerve Apparatus ; with letter-press descrip- 
 tion 1 26 
 
20 Veterinary Catalogue of William R. Jenkins 
 
 VE TEBINA RY DIA GRAMS. —Continued . 
 
 No. 2. "The Ag^e of Domestic Animals." Fortj-two 
 figures illustrating the structure of the teeth, indicat- 
 ing the Age of the Horse, Ox, Sheep, and Dog, with 
 full description 75 
 
 No. 3. "The Unsoundness and Defects of the Horse." 
 
 Fifty figures illustrating— 1. The Defects of Confor- 
 mation ; 2. Defects of Position ; 3. Infirmities or Signs 
 of Disease ; 4. Unsoundnesses ; 5. Defects of the Foot ; 
 with full description 75 
 
 No. 4. "The Shoeing of the Horse, Mule and Ox," 
 
 Fifty figures descriptive of the Anatomy and Physio- 
 logy of the Foot and of Horse-shoeing 75 
 
 No. 5. "The Elementary Anatomy, Points, and But- 
 cher's Joints of the Ox." Ten colored illustrations 
 — 1. Skeleton; 2. Nervous Sj'stem : 3. Digestive 
 Sj-stem (Eight Side) ; 4. Respiratory Sj'stem ; 5. Points 
 of a Fat Ox ; 6. Muscular System ; 7. Vascular System ; 
 8. Digestive System (Left Side) ; 9. Butcher's Sections 
 of a Calf ; 10. Butcher's Sections of an Ox ; with full 
 description 1 25 
 
 WAliLEY. "Four Bovine Scourges." (Pleuro-Pneumonla, 
 Foot and Mouth Disease, Cattle Plague and 
 Tubercle.) With an Appendix on the Inspection 
 of Live Animals and Meat. 
 Illustrated, 4to, cloth 6 40 
 
851-853 Sixth Avenue (cor. ISth St.), New York 21 
 
 IVALLEr. "X Pratlical Guide to Meat Inspect ion." By 
 
 Tlioiuiia Wiilhy, M.K.C.V.S., foniH-rly piimipid of 
 the EiUiibur};h lloy.il (Dick) Voleriiiary College; Pro- 
 fessor of Veterinary Medicine and Surgery, etc. Third 
 Edition, thorouglily revised, with forty-five colored 
 Illustrations, 12mo, cloth 3 00 
 
 (llh edition in preparation.) 
 
 An experience of over 30 years in liis profession 
 and a long ofTlcial connection (sonio sixteen years) 
 with Edinburgli Abattoirs have enabled the autiior to 
 gatlier a large store of information on the subject, 
 which he has embodied in his book. Dr. Walley'.'^ opi- 
 nions are regarded as the highest authority on Meat 
 Inspection. 
 
 ff'ILLTAMS. " Principles and Practice of Veterinary 
 Medicine. " Now author's edition, entirely revised 
 and illustrated witli numerous plain and colored 
 plates. By W. Williams, M.R.C.V.S. 
 Svc, eloth 6 00 
 
 — '•Principles and Practice of Veterinary Surgery." New 
 author's e«litlon, entirely revised and Illustrated 
 witli numerous plain and colored plates. Hy \V. 
 Williams, M.ll.C.V.8. 
 8vo, cloth C 00 
 
 C)friLLIAMS . PFKIFFEn. "A Course of Snruical 
 Oprrations fur Veterinary Students nnd Pradi- 
 tioners." Wy W. I'f.-ilTer .'md W. L. Wiili:iiiis. V.S. 
 With 42 illustrallons. 12mo, eloth 1 V!5 
 
 See n/xo ^'Pfriff'tr-WillinwH." 
 
22 Veterinary Catalogue of William R. Jenkins 
 
 THE MOST COMPLETE, PROGRESSIVE AND 
 SCIENTIFIC BOOK ON THE SUBJECT IN 
 THE ENGLISH LANGUAGE 
 
 (*) WINSL O fV, "Veterinary Materia Medica and Tlierapeu- 
 tics." By Kenelm Winslow, B.A.S., M.D.V., M.D., 
 (Harv.); Assistant Professor of Therapeutics in tiie 
 Veterinary Scliool of Harvard University ; Fellow of 
 tiie Massachusetts Medical Society ; Surgeon to the 
 Newton Hospital, etc. 
 
 8vo, cloth, 750 pages 6 00 
 
 Youi' letter received and I am pleased to know that we 
 are to have an American Materia Medica.— J. H. Wattles, 
 Sr., M.D., D.V.S., The Western Veterinary College, Kansas 
 City, Mo. March 19th, mn. 
 
 . . . Am delighted with it. It is remarkably correct, 
 complete and up to date and is bound to supersede an>' 
 other work on the same subject heretofore before the pro- 
 fession. 
 
 No practitioner's library is complete without it and it 
 will be indispensable for students, as it does away with the 
 necessity of their having a number of collateral books tm the 
 subject. 
 
 It will be adopted as the text l)ook in the Chicago Veter- 
 inary College. — Dr. E. L. Quitman, Chicago Veterinary 
 College. June 35th, liWl. 
 
 . . . The book is of admirable merit and full of valuable 
 information from beginning to end, very explicit, rich and 
 interesting, and should be in the hands of every student as 
 well as practitioner of the art of Veterinary Medicine.— 
 Tlmrxton Miller, M.D., Professor of Materia Medica, Thera- 
 peutics and Chemistry, San Francisco Veterinary College. 
 July Sth, liWl. 
 
 . . . I have found the book very satisfactory as a 
 reference book to be used in connection witli lectures. . . 
 —Dr. ^y. A. Lnnthicve. College of Pliarmacy, Ohio State 
 University. August r.th, litUl. 
 
851-853 Sixlh Avnme (ror iHth St.), Xtw York 23 
 
 (*•) irr.)/.l .V. "TIic Clinical IMasrnosis oT liiiinono.ss 
 ill Iho Ilorso." ly W. E. A. Wyman, V S , Prof, of 
 Veterinary l?cionco, Clomson A. & M ColU'tiO, and 
 Veterinariiui to the South Carolina Experiment Sta- 
 tion. 8vo, cloth, iliudtruted 2 50 
 
 (•) — "Iloviiic OI)>lc(rics." By M. G. Do IJniln, Inslructor 
 of Obstetrics at the State Veterinary School in 
 I'lreciit. Translated by W. E. A. Wyniiin, ^I.D.V.. 
 V.S., Professor of Veterinary Science, Clemsoii 
 A. it M. College, and Veterinarian to the South 
 Carolina Experiment Station. 
 
 8vo, cloth, 382 pages, 77 illustrations 5 dO 
 
 See aho " De Bruin." 
 
 ZUNDEL. "The Horse's Foot and Its IMscasos." By 
 
 A. Ziintlel, Principal Veterinarian of Alsac«* Lorraine. 
 Translale<l by Dr. A. Liautard, V.S. 12mo, cloth 
 Illustrated 2 UO 
 
 ZUILL. •Typliiiiil Fever; »r Contaprious Influenza 
 in the Horse." By Prof. W. L. Zuiii, M.D.,D.V.S. 
 Pamphlet 26 
 
 Our lUmhs are for sale hjf all hooUsellvrs, 
 or trill hr srnt prrimid for tin- ftyirrsi lirrr t/iiotttl. 
 
 VVILUAH R. JENKINS, 
 
 851 and 853 Sixth Avenue, 
 NEW YORK. 
 
THIS BOOK IS DUE ON THE LAST DATE 
 STAMPED BELOW 
 
 AN INITIAL PINE OF 25 CENTS 
 
 WILL BE ASSESSED FOR FAILURE TO RETURN 
 THIS BOOK ON THE DATE DUE. THE PENALTY 
 WILL INCREASE TO 50 CENTS ON THE FOURTH 
 DAY AND TO $1.00 ON THE SEVENTH DAY 
 OVERDUE. 
 
 BIOLOGY 
 
 LIBRARY 
 
 OCT 1'^ 1934 
 
 
 DEC 6 193B 
 
 1 
 
 Nfiv 1 ^ t94& 
 
 
 flUV 1 & lu-nj 
 
 \ 
 
 iVjAY 1 ^ 1956 
 
 
 MAY 3 1 t956 
 
 
 
 
 
 \ 
 
 0c25'59F? 
 
 
 OCT 6 l^t' 
 
 \ 
 
 OCT ^-W^' 
 
 
 
 
 3 195.1 
 
 
 
 
 
 
 
 
 
 .' 
 
 
 1 
 
 ^..,«,:.««^. 
 
 LD 21-5m-7,'33 
 
'^^'•9(;