MORBID ALTERATIONS IN THE GENITAL ORGANS. 



349 



been described, is sometimes resorted to, either through impatience, 

 ignorance, or in cases which demand prompt action ; as the other measures 

 require a certain amount of time, from the slowness of their operation — 

 though perhaps this is rather an advantage than otherwise. 



Forcible dilatation of the os uteri has been practised in human obstetrics, 

 and special instruments have been devised with this object. Such dila- 

 tors have been constructed by Osiander, Busch, Mende, and Krause, but 

 they have not been much used, as milder measures are far more prefer- 

 able. The same remark is applicable to veterinary obstetrics, in which 

 there is only too often a tendency to imagine that because the patient is 

 an animal, so all the more force and brusqueness should be resorted to. 



Forcible dilatation of the cervix, which is not to be recommended, except 

 perhaps in very exceptional instances, has its advocates, and two cases re- 

 ported by Oschner, a Swiss veterinary surgeon, prove that it may be suc- 

 cessful, notwithstanding its disadvantages. In these cases, every other 

 known means had failed ; so Oschner procured a pair of large fire tongs 

 used by blacksmiths, and wrapping their jaws round with tow which was 

 smeared with grease, he introduced them, closed, through the os j then 

 an assistant gradually opened the shanks or handles of the tongs, and so 

 produced the desired widening of the passage. The inflammation set up 

 by this manoeuvre was dissipated by the employment of soothing reme- 

 dies, after fifteen days' treatment. 



It is obvious that such a mode of dilatation should not be practised, 

 unless there is something most unusual in the case ; as it is a most pain- 

 ful operation, and likely to produce -contusions and lacerations of the 

 cervix, which may require much tijne and attention to repair. 



Incision of the cervix {vaginal hysterotomy) is another operation which 

 can scarcely ever be required for rigidity or spasm of this part, and ought 

 to be reserved for more serious conditions. At any rate, it should not 

 be practised until the other measures we have enumerated have been 

 fairly tried, as it is an operation not without risk of ill consequences. 



In some cases, in which the spasmodic action of the uterus is irregular, 

 and leads to occlusion of the os, it might be advisable to resort to anaes- 

 thesia, produced by the inhalation of ether or chloroform. Of course 

 the anaesthesia should not be pushed to complete insensibilit}^, but be 

 limited to semi-consciousness or " obstretrical anesthesia." This is 

 more particularly to be recommended for the smaller animals. 



In the majority of cases, when the rigidity has been dispelled, or the 

 spasm relaxed, birth will take place without further assistance being 

 required ; though it may be well that the obstetrist assure himself that 

 the foetus is in a favorable position for delivery. If there appears to be 

 atony of the uterus, or the mother is exhausted, or if the foetus is dead or 

 in a faulty position, then it will be necessary to afford aid in parturition 

 by adjustment and traction. 



In very many instances, it must be remembered, that this rigid condi- 

 tion of the cervix is due to malpresentation or malposition of the foetus in 

 the uterus ; and even when the os has been sufficiently relaxed, the young 

 creature cannot pass through until it has been properly placed, and not 

 unfrequently aided through the genital canal. 



3. Induration of the Cervix Uteri. 



Induration of the cervix is the term applied to this part when its tex- 

 ture is altered in any way — whether the alteration may be fibrous, sar- 



