PROLAPSE OF THE UTERUS. 693 



reduction very difficult some operators have had excellent results 

 from slinging. The hocks are fastened together and the hind-quarters 

 raised from the ground by means of a block and tackle until the 

 animal rests on the sternum. In this nearly vertical position the 

 prolapse is easily reduced, and the animal is cautiously lowered until 

 the hind-quarters rest on a bed of straw considerably higher than 

 the surrounding parts. This manipulation can be repeated if 

 necessary. 



When reposition is impossible, or the prolapsed organ is much 

 damaged or necrosed, amputation is the only resort. In cows it 

 is simple, and not particularly dangerous, but in no animal should 

 it be attempted until all other means have been tried or at least 

 considered. St. Cyr lost six animals of a total of twenty-five ; Franck 

 describes thirty cases of amputation, of which four (two cows and 

 two goats) had to be slaughtered. Lanzillotti-Buonsanti has collected 

 records of 140 cases. Of 86 cows, 77 recovered and 9 died ; of 8 

 mares, 6 recovered and 2 died ; of 27 cows, 22 recovered and 5 died ; 

 of 9 bitches, all recovered ; of 4 goats, all recovered ; of 3 sheep, 

 2 recovered and ] died ; of 3 cats, all recovered. Nevertheless, 

 these figures are not to be implicitly relied on. They truly represent 

 the records, but successes are more often recorded than are failures. 

 When the animal is not cast, precautions must be taken against its 

 lying down or kicking the operator. The surface is then cleansed, 

 and care taken to discover by palpation that no portion of bowel or 

 bladder is included in the inverted uterus. A strong tape or cord, 

 in the form of a surgical snare, is then passed round the neck of the 

 uterus, avoiding the urethra, and drawn very tight. In this case, 

 as in all where large masses of tissue have to be ligatured, it is 

 necessary to proceed slowly. The ends of the cord are tied to pieces 

 of stick to ensure a better purchase, and the ligature is drawn tight ; 

 the operator then waits a few seconds to allow the tissue fluids to 

 filter away, and again tightens the cord ; if the prolapsed uterus is 

 much swollen, the procedure requires repeating several times. The 

 elastic ligature has been recommended and successfully used on 

 sheep and swine by several operators. After applying the ligature, 

 the organ is cut away. 



In large animals, and where swelling is great, amputation by 

 multiple ligation has been recommended, or the mucous membrane 

 can be divided and the ligature applied to the muscular and serous 

 coats. These methods, however, have no particular advantage 

 over that above described. Bang also prefers the ligature ; the 

 portion thus tied off can at once be cut away, but should movement 



