OTHER CAUSES OF MATERNAL DYSTOKIA. 367 



1. In the Zeitschrift fiir Thierheilkunde imd Viehzticht (Band 7), there is the descrip- 

 tion of a case in which the wall of the vagina was some inches thick, and the diameter 

 of the canal only one and a half inch. This was the result of disease. 



2. Leconte (Mern. de la Societe de MJd. Veterinaire, vol. v., p. 185) has furnished us 

 with a very interesting case of this description. 



He attended a Mare in parturition, which had previously, and while at pasture, re- 

 ceived an injury from the horn of a Cow ; this injury was inflicted in the region of the 

 perinaeum, and the vulva had been torn as far the recto-vaginal septum. The cicatrices, 

 still visible, proved that the laceration had been very extensive, and the vulva was so 

 deformed and contracted that the hand could scarcely be passed into it. The vagina, 

 cervix uteri, etc., appeared to be all right. 



The Mare was making frequent parturient efforts ; the liquor amnii had escaped — it 

 was not known how long before ; and the foetus soon presented itself in a good position 

 at the vulvular orifice, the head resting on the two fore limbs. At this part, however, 

 the foetus met with serious resistance to its outward progress. Nature might have sur- 

 mounted this obstacle, perhaps, and birth might consequently have taken place without 

 assistance, but there must have occurred considerable lacerations. 



Leconte, therefore, preferred facilitating the exit of the young creature by operating 

 as in vaginal hysterotomy. He made two lateral incisions — one above the other — on 

 each side of the vulva, about an inch and a half apart, and about an inch in length ; these 

 incisions allowed sufficient space for birth to take place. Parturition was completed 

 without an accident, and the incisions, treated as simple wounds, cicatrized in a few 

 days. 



The treatment of stenosis of the vulva and vagina must be," of course, 

 surgical, and will vary according to the cause producing the constriction. 

 But it will chiefly consist in incisions carried to a depth and extent com- 

 mensurate with the exigences of each case, and modified according to the 

 anatomy of the part which forms the seat of stricture. It will be found 

 that lateral incisions are, when they can possibly be practised, preferable 

 to those made either superiorly or inferiorly, as they are less likely to be 

 followed by inconvenient alterations and unfavorable consequences ; 

 while, with regard to the vulva, the textures at the sides of that orifice 

 have more vitality, and therefore cicatrize more rapidly, than at the 

 superior commissure. 



