312 



MATERNAL DYSTOKIA. 



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 offer to version manoeuvres. 



" Nothing," says Mazure, 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 fail- 

 ing in other manoeuvres 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 distended, so com- 

 pletely filled the abdominal cavity that the hand could scarcely be intro- 

 duced 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 ka-dpa^Jlank or loins^ and rijjysiv^ to ait) — 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 ( Wochenschrift fiir Thierheil- 

 kunde, 1869). This veterinarian had three 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 suffi- 

 ciently often, and then sometimes in very unfavorable circumstances, 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 



* It is worthy of note that the idea of resorting to laparotomy occurred to an excellent veterinary practi- 

 tioner in Scotland, perhaps long before it did to Fause!, though for lack of opportunity it was not carried 

 into effect. Mr. Cartwright, of Whitchurch, writing, m 1850, "On Torsion of the IJterus in the Cow" 

 {Veterinarian, vol. xxiii., p. 248), and its treatment, and proposing to try rolling the animal, adds : " If I 

 did not succeed in this way, I should proceed according to a suggestion given me by Mr. John Steel, of 

 Biggar, Lanarkshire— viz., to make an incision between the ilium and the ribs on the right side, and try to 

 untwist it (the uterus). If I succeeded, I should sew up the wound and allow the labor to take its natural 

 course ; but if not, I am not aware that there is any other means but that of performing the Cjesarean 

 operation. Mr. Sfeel, althou2:h he has not yet had an opportunity of testing its practicability, deserves 

 the thanks of the profession for such a suggestion, and it is one which I think very likely to succeed. At 

 any rate, if it does not, we can but perform the Cjesarean operation." 



