286 MATERNAL DYSTOKIA. 



greatly in favor of delivering a living foetus ; with the Cow, as Saint-Cyr 

 has stated, a living and perfectly viable calf is almost certain to be 

 obtained, even a long time after labor is commenced and the " water- 

 bag" has ruptured. 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 membranes. 



The chances in favor of the mother are, of course, fewer than with the 

 foetus ; for under the most favorable conditions, after removal of the 

 progeny, there will still remain the great hernial sac, which it will be 

 most difficult to keep the intestines from occupying, and still more diffi- 

 cult to cure in a radical manner : judicious trussing and bandaging being 

 nearly all that can be done to palliate the effects of the accident. 



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 ex- 

 pense 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 abdom- 

 inal hernia of any description, notwithstanding the fact that this condition 

 may not militate against gestation and parturition in every case. 



With the smaller animals, and especially the Bitch, the Caesarean ope- 

 ration has usually to be resorted to for various reasons, the chief of 

 which are the small size of the creature, the difficulty in reaching the 

 foetus or foetuses and extracting them by the natural passages, 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. 



Every thing is therefore in favor of gastro-hysterotomy in the uterine 

 hernia of the pregnant Bitch ; but in order to ensure whatever success 

 may be possible, it must be performed early, and before serious injury 

 has been done by attempts at reduction or delivery in other ways. It has 

 been argued that it might be preferable to open the sac, divide the con- 

 striction which prevents reduction, and return the gravid uterus to the 

 abdomen, when delivery might be effected in a natural and spontaneous 

 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 expe- 

 rience gained in such cases, however, does not testify very markedly in 

 favor of this procedure, and the evidence is certainly in favor of the Cae- 

 sarean operation, and particularly when adhesions exist. 



The dangers to be apprehended from gastro-hysterotomy are inflamma- 

 tion 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 Caesarean operation in another place. 



