578 ACCIDENTS INCIDENTAL TO PARTURITION 



commenced immediately after the separation of tlie placenta. I have 

 seen these cases only in cattle." 



In certain instances, there can be no doubt that, as in woman, insuffi- 

 cient contraction of the uterus is a cause of post partum haemorrhage ; 

 and, according to Schroeder, this atony of the organ is especially observed 

 after a rapid emptying of its cavity, whether artificially or naturally pro- 

 duced, also after a previous and very considerable distention. It there- 

 fore occurs after very rapid deliveries, too early turning, and extraction, 

 in hydramnios, and twins. The haemorrhage is sometimes also due to 

 general debility, and too feeble development of the uterine muscles 

 (either congenital or depending upon previous very difficult labors). 

 Partial adhesions of the placenta to the uterine wall, which, however, 

 are rarely caused by real connective-tissue bands, may also give rise to 

 profuse haemorrhage ; because the separated places in the vicinity of the 

 adhesions can only imperfectly contract. 



Symptoms. 



The symptoms of post partum haemorrhage are not well marked, unless 

 die bleeding is visible, though they are those of profuse haemorrhage in 

 general. There is the quick, weak, running down pulse, which, becomes 

 imperceptible as death approaches, and the throbbing, irregular contrac- 

 tions of the heart ; the decoloration of the mucous membranes, rapidly 

 increasing prostration of the animal, with the unsteady staggering gait 

 on movement, and the difficulty of maintaining the standing position to- 

 wards the end ; the haggardy^^/Vj-/ with chilliness of the surface, cold, 

 clammy perspiration breaking out over the body ; and, finally, the re- 

 cumbent position, convulsions and death. 



Sometimes there are indications of abdominal pain — indicated by paw- 

 ing and looking anxiously at the flanks ; but these indications are only 

 likely to be present when the haemorrhage is due to traumatic influences. 

 When the haemorrhage /<?r 27///z'rt;/« is discernible, then, of course, there 

 can be no difficulty in diagnosing the accident ; but when it is entirely 

 internal, the manifestation of the symptoms above indicated should give 

 rise at once to a suspicion of the state of affairs, and lead to a manual 

 exploration of the uterus. 



Treatment. 



The essential indication in the treatment, is to suppress the haemor- 

 rhage as speedily as, possible ; the next, to sustain the vital powers of the 

 animal. 



If the foetal membranes have not been expelled, they must be removed 

 without delay — yet as gently as may be \ as, until this removal is effected, 

 the uterus will perhaps not contract. The contraction of the organ is 

 very important, and when the membranes are present, it often happens 

 that the manipulation required to remove them, brings about this result. 

 If the membranes are not present, then the hand and arm must be pushed 

 into the uterus, and gently mov^ed about, in order to excite contraction, 

 if the organ is flaccid and uncontracted. 



At the same time, the interior of the organ should be freed from the 

 blood and clots it may contain ; cold water douches ought to be applied 

 to the loins and vulva, as well as injections of the same. If deemed neces- 

 sary, a towel, or sheet, steeped in cold water, or a large sponge impreg- 



