PROLAPSE OF THE UTERUS. 691 



and had good results. Violent pains and delirious attacks certainly 

 occurred, but only lasted one day. Goats and pigs have also been 

 saved by amputation. 



Not infrequently the uterus or vagina is ruptured, leading to 

 prolapse of the bowel, in which case the animals always die unless 

 assistance is promptly afforded, and often even when it has been 

 given. 



Treatment. The organ must first be protected from injury by 

 applying a clean cloth. Provided the prolapsed part has undergone 

 no great change, reposition should be attempted. The operation 

 is assisted by placing the animal with the fore-quarters lower than 

 the hind ; but if it cannot stand, it is placed on its back, with the 

 hind-limbs as high as possible. 



Anaesthesia greatly assists reposition. Bang recommends giving 

 the cow. subcutaneously 7 to 20 grains of morphine, and a dose of 

 6 to 10 drachms of chloral hydrate, by the mouth or in a clyster. 

 Failing this, 1 to 2 pints of brandy may be given. Morphine often 

 acts as an excitant ; chloral is preferable. To diminish the severe 

 straining, if the animal is standing, continuous powerful pressure 

 must be exercised over the loins. Where the prolapsed portion is 

 large the rectum and bladder should first be emptied. To provoke 

 micturition it is often sufficient in cows, &c, to lift the protruding 

 mass and pass a finger into the urethra ; should this fail the catheter 

 must be passed. 



After carefully cleansing the prolapsed part with 2 per cent, carbolic 

 or dilute iodine solution, and removing any traces of foetal membranes, 

 the operator must discover whether any deep injuries exist. It may 

 be necessary to insert sutures. The size of the prolapsed mass often 

 presents a serious obstacle to reduction. In such cases the late 

 Professor Robertson used to effect methodical compression by passing 

 a long, broad strip of linen around the uterus and causing assistants 

 to pull steadily on the ends. A broad strip of Mackintosh cloth 

 or a linen sheet may be used for the same purpose, the uterus being 

 placed in the middle of the sheet, which is held by the ends, and 

 twisted until compression of the womb takes place. If the 

 patient be tympanitic puncture of the rumen or csecum may be 

 necessary. 



The first portions to be replaced are those lying nearest to the 

 vulva, particularly the upper sections, the other prolapsed parts 

 being meanwhile supported ; an attempt is then made to thrust 

 these into the vagina, and with the fist applied at the point farthest 

 from the vulva to pass the entire mass as far forward as possible. 



