MORBID ALTERATIONS IN THE GENITAL ORGANS. 



345 



then immediately came away, and the uterus became inverted. The placentulae were 

 removed and the organ was returned. 



The annnal continued to strain for about a week, and nineteen days after delivery a 

 fireat quantity of putrefying matter was removed from the inner surface of the uterus by 

 manual exploration ; in four days after this, the creature being in a helpless state, it was 

 killed. 



The uterus was found to be quite contracted, and contained about a pint of matter. 

 There was a distinct cicatrix, about four inches long, over a portion of the cervix and 

 vagina, where probably the laceration had occurred. " Taking the cervix uteri, uterus, 

 and vagina all together, there was little amiss with them, more than after an ordinary 

 case of parturition. The cervix uteri was a little rigid, but perhaps scarcely more than 

 usual," 



Mechanical dilatation of the os by means of the sponge tent has been 

 much, and most successfully, employed in human obstetrics for a long 

 time, and the method has recently been greatly simplified and perfected 

 by Sims and Joulin, Saint-Cyr thinks that it is perfectly applicable to 

 animals, and we are of the same opinion. The tent can perhaps be pur- 

 chased at any druggist's, but if not it is easily made, Joulin makes those 

 he uses \w the following manner : — From a somewhat fine and dry sponge 

 of inferior quality, he cuts two long conical pieces, one about three and 

 a quarter inches in length, about an inch wide at the base, and one-third 

 of an inch at the apex ; the other five or six inches in length, two and a 

 half inches at the base, and one-third of an inch at the apex. Of course 

 they would require to be larger for animals. 



These cones are then prepared for use by wrapping them closely round 

 in twine, the circles of which should be so near each other as not to leave 

 ridges on the sponge. By this pressure the tents become extremely com- 

 pact, and look like a thick bougie. 



When required for use, the twine is removed — this should not be done 

 until the tent has been prepared for at least two or three hours, when it 

 will have acquired sufficient rigidity. A piece of cord should be attached 

 to its base, so as to allow it to be withdrawn when inserted in the os ; 

 but before this insertion takes place, the apex must be covered with a 

 little lard, cerate, or extract of belladonna. The sponge is passed into 

 the OS as far as possible, either by the fingers or forceps, and until the 

 base of the tent is close to the margin of that opening. The narrow and 

 slightly flexible apex of the tent allows of its passage through the os into, 

 the uterine cavity ; but in order to be successful the operation must be 

 quickly performed. Otherwise, the sponge rapidly absorbs mucus and 

 loses Its rigidity. 



No plugging or other means are necessary to retain the tent, as the 

 portion which projects into the uterus quickly increases in size from the 

 absorption of moisture ; so that, after a few minutes, a certain amount of 

 force is necessary to withdraw it therefrom by means of the cord. 



The sponge-tent acts in several ways, and simultaneously: i. It 

 detaches the membranes, and this is often sufficient to induce labor; 2. 

 It acts as a foreign body in irritating the posterior segment of the uterus, 

 which reacts by contracting ; 3. It dilates the inner opening of the os \ 

 4. It also dilates the entire length of the os, by swelling through imbibi- 

 tion of the uterine mucus. 



To obviate the risk of softening before it is inserted into the os, Joulin 

 prepares the tent in the following manner. Instead of wrapping it round 

 with twine while it is in a dry state, he saturates the sponge in a solution 

 of gum Arabic, and then having rolled the twine round it, leaves it to 



