560 OBSTETRIC OPERATIONS. 



in the skin. An intelligent assistant should be at hand to prevent the 

 escape of the intestines through this large aperture. 



The arm of the operator is now pushed into the abdominal cavity in 

 search of the uterus, which, when found, is brought opposite the incision, 

 should it not be there at first. Two assistants compress the sides of the 

 wound, so as to maintain them closely against the uterus ; this the 

 operator cuts through slowly, layer after layer, using all diligence so as 

 to escape wounding the fcetal membranes. 



Two fingers are insinuated between the walls of the organ and these 

 membranes, and the bistoury is again employed to dilate the opening, as 

 in the peritoneal incision, so as to give it nearly the same direction and 

 extent of that in the abdominal wall. Should the membranes be still 

 intact, they are to be torn, and the " waters " allowed to flow — but only ^7//- 

 j"/V/(?the abdomen, if possible. The operator now, plunging his arm at once 

 into the cavity of the uterus, seizes the first parts of the foetus that come 

 to hand — fore-legs, head, or hind quarters, if possible — and removes it 

 quickly ; the umjjilical cord is torn or tied, and the young creature given 

 to those who will dry and rub it, wrap it in a warm blanket, and otherwise 

 attend to it. 



The obstetrist immediately, if the parent is to be preserved, removes 

 the fcetal membranes — an easy task comparatively in the Mare, much 

 more tedious and difficult in the Cow, as all the adhering cotyledons 

 must be separated one by one. Then, by means of a sponge, all the 

 fluid remaining in the organ is to be cleared out, as well as any that may 

 have escaped into the abdomen. It might be well to damp the interior 

 of the uterus with a very weak solution of carbolic acid. . This accom- 

 plished, the great wound is to be closed. 



Nothing is done to the uterus, as a rule ; the organ soon diminishes 

 very considerably in volume, and it would appear that the wound in it is 

 not long in cicatrizing. The borders of the wound in the abdomen, how- 

 ever, must be speedily and solidly united. The best means of union is 

 undoubtedly the quilled suture, which is to be applied according to the 

 ordinary rules of surgery ; care must be taken to make the sutures enter 

 at a good distance from the border of the wound, and to include the 

 muscles as well as the skin. If the cord fixing the outstretched hind 

 limb is slackened a little, it will facilitate closing the wound. A small 

 corner should be left open at the lower end of the wound, to allow the 

 products of inflammation and suppuration to escape. External to the 

 wound, either a layer of fine tow or lint, slightly carbolized, or oakum, 

 may be placed. Over this, long narrow strips of canvas covered with 

 melted glue may be fixed, to support the sutures and retain the dressing ; 

 then on these another thin layer of carbolized tow or oakum, and lastly, 

 the wide body-bandage around the abdomen and loins of the creature. 

 Though it is somewhat difficult to apply, yet it is essential that this 

 bandage or compress be put on before the animal is allowed to rise. 

 Afterwards, the bandage may be adjusted and tightened if necessary. 



When the incision is made at the lima alba the procedure is somewhat 

 similar ; but, as we do not recommend it for the reasons above stated, we 

 need not allude to it further. 



The after-treatment of the wound is that followed for all such serious 

 traumatisms. Cold water, or ice, or very dilute carbolic acid, may be 

 applied to the wound, if necessary ; but very often this requires only 

 ordinary surgical management. The patient must not be allowed to lie down 

 until the wound is united. 



