INVERSION OF THE UTERUS. 605 



" I have been often called upon to remedy this kind of displacement, and 

 from what I have seen I am led to believe that the impossibility of reduc- 

 tion is not so much due to the difficulties in the cases themselves, as to 

 the hurtful manoeuvres which have been performed. Nevertheless, it 

 must be acknowledged that the development of the hernia and the rigid- 

 ity of the tissues are sometimes so great that it requires a certain amount 

 of confidence in one's self neither to be disconcerted nor afraid. - . To 

 be successful it is necessary to insist — to insist in spite of every thing — 

 on applying one's self to seize each alternative point of relaxation ; to 

 engage, bit by bit, the displaced organ in the vulva, in commencing with 

 that which is nearest this opening, then successively all the remainder." 



This advice is judicious and sound ; but, as we have said, in certain 

 cases the extruded organ is so injured, either by the unskilful attempts 

 of ignorant men to return it, or from other causes, that it would be cer- 

 tain death to the animal to replace it in the abdomen. We refer now to 

 extensive lacerations and bruises, or when the organ has become softened 

 and gangrenous. Lacerations and ruptures are always more serious, it 

 must be remembered, in the lower than the upper wall of the uterus. 



In other cases, when reduction has not been complete, and one horn 

 remains more or less invaginated, or the body of the d^'gan is not well 

 adjusted, inversion will again and again occur in spite of all attempts at 

 retention ; and this only too frequently leads to such grave injury, that 

 there is no hope of the organ regaining its normal condition, even should 

 reposition be at last successful. Indeed, its walls are so softened and 

 friable that they cannot withstand the least pressure, but tear whenever 

 an attempt is made to carry the uterus into the vulva. 



With certain animals, too— as Swine — reposition is extremely difficult, 

 particularly when one or both cornua are inverted ; as the smallness of 

 the organ, as well as of the pelvis, is a great obstacle to manipulation. 



In such exceptional circumstances complete extirpation of the uterus 

 (^Metrotomy) has been recommended and practised. 



It is now many years since the operation was introduced into veterinary 

 surgery, as Binz states that it was performed by Jenne, a German veter- 

 inarian in Forchheim, so long ago as 1802. 



Though the operation is apparently a most formidable and painful one, 

 and only to be ventured upon as a last resource, yet, on the whole, it is 

 tolerably successful. Of twenty-five cases collected by Saint-Cyr, no 

 fewer than nineteen recovered from the operation. Franck refers to 

 thirty cases, eighteen of which recovered, and four (two Cows and two 

 Goats) were killed, though not, it would appear, on account of the opera- 

 tion. Of these thirty cases only one was a Mare ; 17 were Cows ; 3 Goats ; 

 4 Sows ; I Ewe ; 2 Bitches ; and 2 Cats. He remarks that of the unfor- 

 tunate cases, there were probably some which died from other causes 

 than the amputation ; while some evidently perished from septic infec- 

 tion. We know that recoveries have taken place after the C^esarean sec- 

 tion and excision of the uterus in the same animal, at the same time. 



The operation might be more successful did it not happen that it is 

 late before it is resorted to, and very often the animal is already greatly 

 exhausted. 



It is curious to note that it has been recorded by several observers, that 

 some Cows which recovered have shown signs of oestrum — doubtless be- 

 cause the ovaries were left intact ; while other Cows have yielded milk 

 after the operation. Lecoq informed Saint-Cyr that he knew of a Cow 



