348 MA TERNAL D YSTOKIA . 



2. By this means all preparatory treatment is needless. 



3. This procedure is easily employed, and not at all disagreeable to 

 the woman, as the injection of warm water does not produce any discom- 

 fort. 



4. It does not require much time. 



5. Its action can be graduated at the will of the obstetrist, who may, 

 according to requirements, increase or diminish the duration of the douche 

 and the temperature of the water, as well as vary the parts of the cervix 

 on which he directs it. 



6. Finally, it can never occasion lesions of the genital organs, nor yet 

 injure the foetal membranes or the fcEtus. 



We deem this uterine douche well worthy of notice, and though there 

 are only, so far as we can ascertain, three cases on record in which it has 

 been tried with animals, yet as these were most successfully treated by it, 

 it may be assumed that it will be found a most valuable means of not only 

 dilating the os uteri, but also of controlling the action or relieving certain 

 morbid conditions of the uterus itself. 



Quivogne communicates to Saint-Cyr {Traite de Obstetrique Veter- 

 itiaire, p. 373) the following three instances of the successful application 

 of the douche. 



1. In 1859, a Cow, aged five years, and seven months pregnant, was purchased, and 

 two days afterwards it jumped over the fence of the meadow in which it had been placed. 

 In a few hours it began to exhibit symptoms of colic. A vaginal examination was made, 

 and it was discovered that there was complete occlusion of the os, so that the extremity 

 of the little finger could not be introduced. Quivogne deemed it the best course to 

 wait before interfering. 



Some hours having elapsed, however, labor pains became frequent and energetic ; 

 though the cervix was in the same state as before. Still later, towards the evening, the 

 condition of the animal was more aggravated, and penetration of the os was altogether 

 impossible. All the measures that might be adopted in such a case were passed in re- 

 view, but none of them could be decided upon. Here was a cervix anatomically healthy ; 

 to resort to incision appeared to be imprudent, and too dangerous an operation. Irriga- 

 tions with tepid water were then thought of, and it was resolved to try them. 



In order to apply them, Quivogne had recourse to a small garden syringe, to which 

 was already attached an india-rubber tube. The irrigations were commenced and con- 

 tinued until the morning, at first under the direction of Quivogne, then by the people be- 

 longing to the house. The next morning at six o'clock the patient was lying quietly and 

 was being douched without the slightest manifestation of displeasure. Then an explo- 

 ration was made, and it was found that the os had sensibly dilated, as the whole of the 

 fingers of the hand, gathered together in a cone-like manner, could be inserted, and by 

 a slight pressure the whole hand was passed through. The douches were resumed, 

 but only for a short time, as the " water-bag " was not long in appearing, and very soon 

 after delivery was effected. 



2. In i860, the same veterinarian was called ^pon during the night to attend upon a 

 Goat, which was showing symptoms of abortion. Vaginal exploration, although difficult, 

 on account of the smallness of the pelvis, nevertheless satisfied him that this was another 

 case of rigidity of the cervix. He at once decided to have recourse to the uterine 

 douches. For lack of better apparatus, he was compelled to use a horse syringe, with 

 which he directed, as well as he could, frequent jets of tepid water on the cervix. Here 

 again, notwithstanding the imperfect apparatus employed, the result was favorable ; as 

 delivery was effected without any trouble at one o'clock next morning. 



3. In the same year, Quivogne was again requested to see a Goat which was about to 

 abort. The obstacle to the passage of the foetus was, in this case also, the rigidity of the 

 cervix and occlusion of the os uteri. Having already succeeded twice with the douche, 

 he was determined to give it another trial, though in a modified form. He placed a 

 washing-tub on a table, into the plug-hole of which he fitted a sufficiently-long india-rub- 

 ber tube ; having filled this vessel with tepid water, he immediately commenced the 

 vaginal douches, and these were productive of complete success in five hours. 



Rougher treatment for the dilatation of the cervix than that which has 



