590 ACCIDENTS INCIDENTAL TO PARTURITION. 



lently. Pinching the nose and loins will be found very effective in this 

 respect, and if a Cow, a dog may be introduced in front of it. Should 

 the animal be much exhausted or unsteady, two additional assistants may 

 be required to stand at each side. 



The uterus must be placed on a cloth or sheet in two or three folds 

 and well moistened, the ends being held by the two assistants at the 

 croup, so that the organ maybe lifted as high as the vulva. By doing so, 

 there is neither traction nor compression on the mass, and as the circula- 

 tion in it is thereby much facilitated, the tumefaction subsides to a cor- 

 responding degree. It also allows the operator more freedom, as he 

 could not sustain the weight of the prolapsed organ — sometimes as much 

 as ICO to 140 pounds — and at the same time attempt its reposition. 



Indeed, some practitioners recommend that the two corners of each end 

 of the cloth on which the uterus is placed, should be tied round the neck 

 of the assistants, so that their hands may also be free to aid the operator 

 in his manoeuvres : though this device must, one would imagine, have 

 more disadvantages then conveniences. 



When the animal strains very severely and almost continuously — as 

 sometimes happens during reposition — it is useful to constrain the chest 

 as much as possible by a girth, so as to prevent its expansion. It may 

 even be necessary to give a strong anodyne draught of chloral or opium. 



For effecting reposition, three methods are recommended, and these 

 we will now notice : merely observing that whichever may be adopted, the 

 operator always stands directly behind the animal, with the inverted organ 

 immediately before him. 



First Method. — If the inverted tumor formed by the uterus, external to 

 the vulva, is not very voluminous, and if by the application of cold water 

 to it — should it be tumefied — it is reduced in size, then reposition may 

 be effected by pressure on the fundus of the organ. This pressure is to 

 be made by the closed fist against the central part of the tumor ; and in 

 some instances, if it is well directed, and the inversion not serious, the 

 organ may be returned to the pelvic cavity by one push, while another 

 will carry it into the abdomen. 



Rainard and other practitioners approve of this method, and describe 

 it somewhat in detail. The operator is to seek for the largest cornu — 

 that which contained the foetus — seize it by the fundus, and reduce this 

 by pushing it inwards, as we would the finger of a glove which has been 

 turned outside in : continuing the reduction by successive portions until 

 the pedicle of the tumor is reached, when more serious resistance is 

 encountered from the os uteri. This being overcome, the body of the 

 uterus is next replaced, either by the fist pressing against ^the widest part, 

 or by using a pessary. The pressure is to be directed straight forward, 

 though the vulva and pelvic canal, upwards and inwards. 



Great care is necessary in exerting the pressure, which should not be 

 applied while the animal is straining. During expulsive efforts, the 

 operator must be content to wait, merely keeping the parts where he has 

 carried them, until the straining has ceased. The pressure must be 

 steady and well-directed, so as not to bruise or lacerate the uterus. 

 When a portion is got within the vulva, it is held there by one hand, 

 while the other manipulates the next part to be returned. Reduction 

 must be effected progressively, so that the organ may be completely 

 replaced ; if it is not, then reinversion is certain to occur. 



Some practitioners employ the pad or cup-shaped pessary, to aid them 



