596 ACCIDENTS INCIDENTAL TO PARTURITION. 



appear to have obtained much favor ; while in France, though they have 

 often been resorted to, yet their use has been only limited, as their prac- 

 tical utility has been questioned by many excellent obstetrists. 



It has been pointed out that if they can be supported without incon- 

 venience by some phlegmatic unimpressionable animals, more frequently 

 they irritate the organs in the pelvis, cause straining and uneasiness, and 

 produce those relapses which their application was intended to prevent. 

 Therefore it is that, nowadays, they are not made available to any thing 

 like the extent of a few years ago. 



Saint-Cyr admits that if, in some exceptionable case, it is necessary to 

 employ a pessary, the/z^V bladder deserves the preference for the larger 

 animals. It is found nearly everywhere, requires no other preparation 

 than merely softening its texture by pouring some tepid water into it, 

 whilst its outer surface is well oiled. It is easily placed where desired, 

 even in the uterus ; its soft, flexible walls cannot bruise or excoriate ; 

 and, by inflation, it can be distended to the size necessary for each par- 

 ticular case. 



Sutures. — The suture is generally preferred to the pessary, as being 

 simpler, more easily applied, and having fewer inconveniences than the 

 latter. Being inserted outside the genital organs, they do not irritate 

 those which are most concerned in inversion, neither do they provoke ex- 

 pulsive efforts on the part of the animal. 



The sutures may be of hemp or silk, or metal ; and they may be 

 passed directly through the lips of the vulva, or include the skin towards 

 the point of the hip, on each side. The first may be named the labial 

 suture., the second the hip suture. 



The labial suture may be " interrupted," or " quilled," and is made ac- 

 cording to the principles of surgery. A saddler's large needle, or a sack- 

 ing-needle with a handle at one end and an eye near the point, is the 

 most useful. Through the eye is passed a piece of whipcord, two or 

 three strands of well-waxed thread, or a piece of cotton or silk tape, or 

 moderately thick carbolized catgut. The needle is passed through one 

 lip of the vulva — say the right — from the outside, and near the upper 

 commissure ; it is then passed through the left lip, from within to with- 

 out, towards the inferior commissure. 



The needle is then cut from the suture, sufficient of the latter being 

 left for both ends to tie in the middle of the vulva. A second suture is 

 then placed in the contrary direction — upper part of left to lower part of 

 right lip — so that the two sutures cross each other obliquely, in an X 

 fashion. The ends are now tied towards the centre of the vagina ; and, 

 if thought necessary, a third suture, directly transverse, may be placed 

 between these. 



It is more convenient than painless to pass the needle first through the 

 tissues, then the suture through the eye of the needle, withdrawing the 

 latter, which carries the suture with it. 



This labial ^\x\MX% is painful, as it is placed in textures already swollen 

 and sore, and it does not always retain a sufficiently solid hold to pre- 

 vent the uterus tearing it out when the straining is very severe and vio- 

 lent. The hip suture has therefore often been resorted to in these cases, 

 and with advantage. The needle — either the above, or a small seton 

 needle — is passed through a fold of skin lifted up at the point of the hip 

 or ischium, on a level with the upper commissure of the vulva, and carried 

 across to the other hip. The next suture is a trifle lower, and the others 



