340 



MATERNAL DYSTOKIA. 



times within two hours, and there was little difficulty in doing so ; probal^ly owing to 

 unusual width of the urethra. 



Littler ( Veterinaria7t, vol. xxxvi., p. 273) was sent for to see a Mare which was^ unable 

 to foal. He found the animal being led about in a straw yard, in order to avert or miti- 

 gate the violent throes of parturition which had been present for two and a half hours. 

 Protruding from between the labia of the vulva, during each throe, were the Mare's 

 urinary bladder and three foetal feet. The bladder was completely inverted, and '* from 

 its elastic or yielding nature apparently contained gas on its peritoneal surface, distend- 

 mg it to the size of an inflated Sheep's bladder." It was not observed to have been in- 

 jured either by exposure to the air, or by the repeated and forcible compression to which 

 it had been subjected by the foetal extremities during the parturient paroxysms. Its 

 mucous membrane was not in the least discolored, being clean and shining, and without 

 the slightest trace of congestion. The foetus was lying on its left side, the head and 

 neck thrown back and extending along the floor of the uterus, from the right to the left 

 flank of the Mare. The fore-feet were beyond the vulva, and the right or upper hind- 

 foot was in the vagina. Reposition of the displaced bladder was the first thing attempted, 

 and this was readily effected by equable pressure being exerted by the hand on the 

 surface of the viscus, " when the elastic matter was speedily expelled, and the collapsed 

 body easily passed through its widely dilated neck, which was relaxed to such a degree 

 as to admit of the free introduction of the three middle fingers." 



Though so easily returned, however, it was as readily inverted again, every expulsive 

 effort bringing it into the vagina; and the frequent attempts made to prevent its pro- 

 trusion, by the operator placing his arm firmly on its cervix, while his hand was engaged 

 in rectifying the position of the foetus, were perfectly ineffectual, and even the applica- 

 tion of the hand of a strong assistant over the meatus was equally unavailing. Delivery 

 of the foetus, which was dead, had therefore to be effected over the cystic hernia ; this 

 was accomplished without any visible laceration of the bladder by the violence to which 

 it had been subjected ; its mucous membrane, however, was thickened and congested 

 throughout its whole extent, and the effusion of blood on its abraded surface gave it the 

 appearance of a " spherical mass of coagulated arterial blood." 



After being washed, it was readily placed in its natural situation by gentle pressure, 

 when its cavity was explored to " correct local deviation." No subsequent displace- 

 ment occurred. The operation occupied thirty-five" minutes. Suitable treatment was 

 adopted — chiefly the administration of opiates, clothing the body and limbs, with 

 mashes and infusion of linseed as diet ; thick dark bloody urine was passed for some 

 days ; there was also much difficulty in moving the limbs. In six days recovery was 

 complete. 



fi This was one of three cases of inversion of the bladder during parturition, which this 

 veterinary surgeon had met with in his practice. 



TUMORS IN THE VICINITY OF THE GENITAL ORGANS. 



Tumors in the bladder, when of large size — as polypi, steatomous 

 growths, etc., as well as calcareous concretions, may hinder parturition, 

 or even render it impossible. Even an excessively distended bladder 

 may offer an obstacle to the accomplishment of this act, either in check- 

 ing the advance of the foetus, or by sympathetically disturbing the uterine 

 contractions. 



The indications here are obvious. 



Tumors of various kinds may be developed in the connective tissue 

 of the pelvic organs, and especially between the vagina and rectum, and 

 more or less obstruct labor. Ovarian tumors may "also prove trouble- 

 some, as may likewise multiple abscesses and kysts in the neighborhood 

 of the genital passages. In some cases these may be successfully punc- 

 tured ; in others extirpation may be possible ; while in others, again, the 

 obstetrist can only choose between embryotomy and the Caesarean sec- 

 tion. 



Distention of the rectum from an accumulation of faeces may prove a 

 cause of dystokia — particularly in the Mare ; but this should be easily 

 discovered, and readily removed. Tumors in the immediate vicinity of 

 the anus are rarely a cause of difficult parturition. 



We have already alluded to melanotic tumors. 



