552 GENITAL APPARATUS. 



slightly to curette the mucous membrane of the uterus and plug the 

 cavity with iodoform gauze. 



Where, however, the neck of the uterus is so far contracted as no 

 longer to admit a sound or canula for irrigation, the difficulties are very 

 great. Nothing effectual can be done until the neck of the uterus is 

 dilated, an exceedingly troublesome operation. 



In the forms termed " post-partum traumatic metritis " antiseptic 

 injections must not be made with any considerable pressure, because 

 of the danger of rupture ; plugging the cavity with antiseptic gauze is 

 preferable. 



CHRONIC METRITIS. 



Chronic metritis is often the termination of acute metritis, though in- 

 flammation of the uterine mucous membrane may assume the chronic 

 form from the first. All post-partum infections with pathogenic microbes 

 may give rise to chronic metritis, as may the various forms of cystitis, 

 vaginitis, rupture of the vulva, etc. Tuberculosis also leads to chronic 

 metritis, which is easily diagnosed by a simple bacteriogical examination 

 of the discharge. 



Symptoms. Chronic metritis is accompanied by bad general health 

 and persistent local disturbance. The animals show a permanent muco- 

 purulent discharge varying in amount, or simply an intermittent dis- 

 charge, which is then more abundant and only lasts some hours or 

 some days, but reappears after irregular intervals. On examination the 

 neck of the uterus is found to be half open, slightly hypertrophied, 

 sometimes sensitive, and covered with vegetations. 



Examination through the rectum may show the organ to be con- 

 siderably hypertrophied, sensitive, and comparatively immobile. Cases 

 are numerous, however, in which the examination reveals nothing 

 very striking. 



In other cases, vaginal examination by means of the speculum reveals 

 nothing, except that the neck of the uterus is completely closed, and yet 

 on rectal examination the uterus is found to be of large size, tense, uni- 

 formly fluctuating, and in exactly the position to be expected were the 

 animal pregnant. This clinical form was formerly termed '* hydro- 

 metritis," but it would be better named " pyo-metritis," inasmuch as it 

 depends on chronic metritis. The neck of the uterus remains con- 

 tracted, and the morbid products accumulate in the body and uterine 

 horns, which are gradually dilated. Then suddenly the uterus is 

 seized with reflex contractions overcoming the resistance of the neck 

 and expelling the contents in one jet. The discharge may continue 

 for some days, after which the neck again closes and the disease 

 enters on a new phase. 



Lesions. The lesions affect the mucous membrane, more particularly 



