586 ACCIDENTS INCIDENTAL TO PARTURITION 



With uniparous animals, however, this cannot take place, it appears ; 

 as the uterus cannot become inverted without the fcetus being expelled. 

 Nevertheless, Aubry {Reaieil de Med. Veiermaire, 1859, p. 731) has pub- 

 lished a very curious observation, in which it is mentioned that a Cow, 

 affected with a prolapse of the vagina during pregnancy, had complete 

 inversion of the left cornu at the end of that period ; but the calf, which 

 was lodged in the right cornu, and which was alive and well developed, 

 was retained there for two entire days. It was then necessary to inter- 

 fere and effect delivery, which was followed by total inversion of the 

 organ. This incident, which appears to be unique, does not, however, 

 prevent us from accepting the rule as general, that inversion of the uterus 

 is absolutely incompatible with the prolongation of gestation. 



In order that this inversion can take place, it is essential that the os 

 uteri is more or less dilated ; consequently, the accident is only ob- 

 served in breeding animals, and either during or soon after parturition or 

 abortion. 



In order that it can occur, a certain degree of relaxation of the sub- 

 lumbar uterine ligaments must be present ; there must also be some 

 cause of irritation in operation after the expulsion of the fcetus, suffi- 

 cient to excite the contraction of the muscles of the uterus and lead 

 to inversion — though it is often difficult to ascertain what this ciuse 

 may be. 



In very many instances gestation has gone on to its full term, the an- 

 imal is strong and healthy, birth natural and easy, and there is nothing 

 to indicate the advent of such an accident — when, suddenly, after a few 

 expulsive efforts, the uterus is ejected in an inverted state. 



It has been attempted to explain the occurrence of the accident in 

 such cases, by alluding to the lymphatic temperament of the animals, 

 and their consequent laxity of tissue ; and it is often the case that Cows 

 which are " soft," and kept on food that is better suited for the produc- 

 tion of milk than flesh, are the most frequent subjects of inversion ; this 

 sometimes occurring after each birth, and though parturition was perfectly 

 normal. 



Inversion or retropulsion of the vagina during pregnancy, has also been 

 accused as the cause of inversion of the uterus ; and it may be so in 

 some instances, but it certainly is not s« in all. Indeed, excellent au- 

 thorities maintain that there is no proof that this accident is more fre- 

 quent in animals suffering from inversion of the vagina than those which 

 are not. And it must be remembered, as already stated, that the os 

 must be more or less dilated and dilatable for inversion of the uterus to 

 occur — a condition which does not always, nor yet frequently, co-exist 

 with vaginal inversion. The latter, indeed, is far from rare in non-preg- 

 nant animals, and in those which have never been pregnant ; and it is 

 not at all uncommon in those which are advanced in pregnancy, and yet 

 do not suffer afterwards from this uterine displacement. 



Difficult and laborious parturition, when much manipulation and ener- 

 getic traction on the foetus have been employed, has likewise been ac- 

 knowledged as a cause of uterine inversion ; and it is certain that the 

 efforts to remove a foetus which — whether from malposition, deviation of 

 parts, excess of volume, etc. — cannot be expelled in a natural manner, 

 are somewhat frequently followed by this accident. But on the other 

 hand, how often do we find that the most vigorous — even painful and 

 violent — traction, and long and complicated manoeuvres — are not sue- 



