360 MATERNAL DYSTOKIA. 



fair condition, and up to a recent date had been in apparent good health. At the usual 

 time of parturition, it exhibited a few symptoms of labor ; but they disappeared, though 

 only to manifest themselves in eight days — the evening previous to the arrival of the 

 pupils. For more than twenty-four hours the animal lay on its litter, straining so vio- 

 lently and continuously, that it was then nearly exhausted. There was anorexia, the 

 pulse was small without being quick ; and the mammae, which had previously been dis- 

 tended with milk, were empty and flaccid. 



Palpation in the right flank, as well as an examination /^r r^<r/z/w, led to the belief 

 that the foetus was dead. Vaginal exploration proved the cervix to be contracted, but 

 moderately tense ; the " water-bag " had not appeared. A stimulating draught was pre- 

 scribed, friction was applied to the skin, and the animal was walked about in order to 

 excite the uterine contractions, which were now weak. In about half an hour the con- 

 tractions were stronger, but birth did not progress. 



It was then decided to forcibly dilate the os uteri, and as this dilatation could not be 

 effected by the hand, the cervix was incised in a crucial manner by four cuts. The 

 animal appeared scarcely to feel the incisions. Then one of the pupils introduced his 

 hand to extract the fcetus, and in doing so ruptured the membranes, when a quantity of 

 foetid liquor amnii escaped. The foetus was placed in the dorso-lumbar position, and 

 every means of extraction employed, but without success. The Cow died. 



The autopsy showed that a portion of the placenta had become fibrous and resisting, 

 and adhering firmly to the uterus, near the cervix, had prevented the dilatation of the 

 OS and the passage of the shoulders of the foetus. 



Rainard remarks that in such a case, serious though it was, there might have been a 

 different termination had an experienced Veterinarian attended it ; as he would have 

 recognized the nature of the obstacle by passing his hand around the inner surface of 

 the uterus, and finding the indurated adhering placenta, he would have torn it away or 

 incised it, so that delivery would have been easy. 



2. Vincent, cited by the same authority {Op. cit., p. 463), was consulted by a col- 

 league in a similar case of difficult labor occurring in a Mare. The skin covering the 

 first and second phalanges of the right anterior limb had contracted a strong adhesion 

 with the uterine mucous membrane, not far from the os. The skin of the foetus was 

 also attached to the membranes, which themselves adhered to the internal surface of 

 the uterus. These adhesixjns offered a formidable obstacle to delivery, which could 

 only be accomplished after they had been fully recognized ; they were destroyed by the 

 fingers, without using a cutting instrument. 



3. " Nemo " ( Veterinary Journal, October, 1876) was sent for to attend a valuable 

 short-horn pedigree Cow, reported unable to calve. Labor had commenced more than 

 four hours previous to his arrival, and on examination it was found that the foetus was 

 dead, though the presentation was natural. After futile attempts at extraction, embry- 

 otomy was resorted to ; the fore extremities, head, and part of the neck being detached. 

 The traction hooks were then inserted into the integument, close to the spine, and as 

 far back as could be reached on both sides, so that evisceration could be accomplished. 

 Having obtained the assistance of three men to each hook-cord, an attempt was made 

 to extract the remainder of the foetus, but it could not be moved. Even lashing the 

 Cow by a rope round its horns to the stall-posts, and using a lever, failed to bring it 

 away. 



The case being deemed hopeless, the animal was killed and an autopsy made. All 

 the organs were healthy, except the uterus and vaginal canal. On opening the uterus, 

 surprise was excited in finding the placental membranes firmly attached to the foetus 

 from the shoulders to the sacrum, and "forming, in addition, a solid mass with the ute- 

 rine parietes, thereby suspending the calf." " So close and compact was the union, that 

 a sharp scalpel had to be employed to dis.sect them from each other ; thus proving that 

 no traction or other means could have severed them during the life of the Cow. My 

 only wonder was that we did not pull away the uterus from its attachments altogether, 

 in our efforts to extract the foetus before the animal was killed. The lining membrane 

 of the uterus exhibited depressions like sulci, denoting the former site of ulcers : there 

 was also considerable thickening of the floor of the vagina, evidently of some dura- 

 tion." 



It was elicited, on inquiry, that the Cow had been put to a Bull suffering from gon- 

 orrhoea, and about twelve or fourteen days afterwards a vaginal discharge was perceived, 

 which soon became purulent ; the Cow frequently micturated, and occasionally strained 

 and moaned previous to doing so. This condition continued for at least a month. 

 Hence " adhesion of the placental membranes to the embryo and uterus during gesta- 

 tion." 



Naylor ( Veterinarian, yo\. xxiii., p. 324), attending a Mare in parturition, found both 

 fore-feet of the foetus protruding, but no head ; the latter was discovered to be lying 

 back towards the side of the foal, though it was immovable. While attempts were 



