INVERSION OF THE UTERUS. 607 



opinion, the danger of haemorrhage when dealing with such a large and 

 vascular organ as the uterus is at parturition. Others, dreading the dan- 

 gers resulting from the retention of such an enormous mass suspended 

 behind the animal, counsel its immediate amputation. The incessant 

 traction it exercises on the vagina, the obnoxious odor it gives off, the 

 contact with the absorbing surface of the septic products resulting from 

 its mortification, expose the animal, they declare, to serious accidents, 

 which can only be averted by at once cutting away the uterus. 



We quite agree with these authorities, and with Saint-Cyr, that these 

 dangers are most serious ; and as the risk of hgemorrhage may be obvi- 

 ated by sufficiently constricting the base or pedicle of the mass, it is cei'- 

 tainly most advisable to amputate it at once, and at a short distance — 

 from an inch to three inches — behind the constriction. 



Trasbot (^Bulletin de la Soc. Centrak de Med. Vetermaire, 1870) brings 

 under notice the use of the ecraseiir in amputating the uterus. The case 

 to which he refers was not successful ; but it is probable that this result 

 was due to the imperfect or improper manner in which the instrument 

 was used. 



With the kraseur^ the tissues should be slowly and gently cut through. 

 The entire pedicle may be included, or the chain may be passed through 

 the middle of it by means of a needle, like the double ligature. 



The elastic ligature (Dittel's) has been suggested as worth a trial, and if 

 properly applied we think the result might be favorable. This consists in 

 applying a long piece of india-rubber tubing around the pedicle, and tying 

 it firmly there. The tissues are cut through by the continuous pressure, 

 which causes obliteration of the vessels and cessation of nutrition. 



It has also been suggested that Esmarch's method of amputation by 

 elastic compression of the part to be excised, might be most successfully 

 employed in ablation of the uterus in animals. Considering the volume 

 of the uterine tumor and its great vascularity, there must be an immense 

 advantage in sending back into the circulation of the animal the larger 

 part, or even the whole, of the blood contained in the organ, before sep- 

 arating this from the body, and in addition performing a bloodless opera- 

 tion. Coculet's method of reducing the volume of the inverted uterus by 

 compression has been already alluded to, and is the same in principle. 

 Esmarch's method essentially consists in winding around the part to be 

 amputated — commencing at the distal extremity — an elastic band, so as to 

 press the blood from this part into the body ; and above the band to tie 

 firmly a piece of india-rubber tubing, so as to prevent a reflux of blood 

 by the arteries. The elastic band is now removed and the part — pale and 

 bloodless — is excised. 



When the uterus has been cut away, the portion of vagina or cervix re- 

 maining should be returned as far as possible into the genital canal, and 

 if there is any haemorrhage, injections of cold water will probably check 

 it. Cicatrization generally occurs within fourteen days. If ablation of 

 the uterus is not effected immediately after constriction of the pedicle, 

 but is allowed to take place spontaneously, mortification and sloughing 

 are completed in from six to ten days. 



In some cases, the animal does not appear to be much disturbed after 

 the operation, in others it is very uneasy. Ledru describes an instance 

 {Rec. de Med. Vet'erinaire, 1866, p. 115) in which the Cow operated upon 

 was for an hour as if mad. It lay down, got up, rolled about, kicked and 

 stamped, and climbed into the manger. Its eyes appeared to be starting 



