INVERSION OF THE UTERUS. 609 



found that therein was also a knuckle of intestine as well as the bladder. I returned the 

 bladder and intestine into the cavity of the abdomen, and raised the hind jiarts of the 

 Bitch, so as to keep them there whilst the operation was performed. This was done in 

 the following manner : A needle armed with a strong ligature was passed through the 

 neck of the uterus, behind the meatus urinarius, including one-fourth of its substance, 

 which being tightly tied, the needle was again passed through another fourth and tied 

 in the same manner ; then again through another fourth in the same way, leaving one- 

 fourth up to this time fre^. The whole of the neck of the uterus was then included in 

 one strong ligature, which closed the aperture ittto the abdomen?'' The parts behind 

 the ligatures were then removed by the scalpel, and the remainder returned in the 

 vagina. The haemorrhage was very trifling ; the parts were sponged with cold water ; 

 a dose of opium was administered, and a good dry bed allowed. Next morning more 

 opium was given, and the animal partook freely of bread and milk. No untoward 

 symptoms intervened, and in about a fortnight the Bitch had quite recovered. This 

 case demonstrates the necessity for a careful examination of the tumor before excision 

 is ventured upon, as the inverted uterus contained both bladder and intestine, and if 

 these had been included death was certain in a brief period. 



8. Brown [Ibid., vol. xl., p. 845) partially amputated the uterus of a setter Bitch. The 

 organ had a tumor upon it, and a ligature was passed round it near this tumor^nd the 

 latter, with the distal portion of the uterus, cut away. There was considerable haemor- 

 rhage, and the uterus was returned with some dilificulty. The ligature came away on 

 the third day, and recovery was rapid. Before the operation the Bitch was in a very 

 sorry condition ; after recovery there was a wonderful improvement. The case was 

 complicated by a fracture of the ilium. 



9. Barnes [Ibid., vol. xliv., p. 656) amputated the uterus of a Ewe which had lambed, 

 and the inversion had occurred four hours before his arrival. The organ was so much 

 torn and swollen, that it was impossible to effect its return. A ligature was firmly tied 

 round the cervix, and the mass removed by a sharp bistoury, the arteries being ligatured 

 as a further precaution against haemorrhage ; the vulva was likewise sutured, to prevent 

 a protrusion of the remaining parts.. When the operation was finished the Ewe was in 

 a sinking condition; but stimulants were given, and, with attention, in a week it was 

 convalescent. 



10. Olver {Ibid., vol. xlv., p. 98) removed the uterus of a Bitch by a ligature placed 

 close to the vulva, and excising the body of the organ by the knife. There was little 

 bleeding, and the remaining portion of the organ was returned. A stimulant was given, 

 and good food, and recovery was rapid. 



If. Broad {Ibid., xlviii., p. 175) removed the inverted uterus of a Bitch by means of 

 clams and the hot iron. " Bitches appear to suffer very little from the operation. . . In • 

 all cases where it is possible to use the clams and hot iron I do so, as I find that liga- 

 tures cause the animals much suffering ; besides which, there is a greater danger of 

 blood-poisoning from absorption of the morbid products during the sloughing process." 

 In all cases of cauterizing it is better to use the iron at a black heat. 



12. Goffi (// Medico Veterittario, 1876) had to attend a Cow — primipara— for inversion 

 of the uterus. The organ had been greatly contused and lacerated through the attempts 

 of the owner and his friends to return it, and reposition was hopeless. After assuring 

 himself that the extruded sac did not contain any viscera, he tied a strong ligature 

 round it, near the vulva, then ampirtated it about two inches beyond the ligature. There 

 was a slight haemorrhage, and when this was subdued the remaining portion was put 

 back into the pelvis. Soon after, the Cow was very restless, and strained severely. It 

 was bled and sedatives were given. On the fourth day there was acute traumatic 

 fever, and inappetence ; small doses of carbolic acid were administered, and improve- 

 ment took place ; but on the eighth day superficial oedema manifested itself. This was 

 combated bv oil of turpentine itttus and extra. Gradually recovery took place, and 

 about the thirteenth day there was so little amiss that the Cow was turned out to 

 pasture. It never went off its milk, though the calf died on the fourth day. 



13. Lorretta {Ibid., 1876) returned the inverted uterus of a Cow, and every thing ap- 

 peared to be well until the fourth day, when the accident again occurred. During the 

 owner's journey to request the attendance of Lorretta, a large Saint Bernard dog in the 

 cow-shed devoured a large portion of the protruded uterus. On the arrival of the 

 owner and veterinary surgeon, the Cow was lying on the floor inundated with blood, 

 and apparently about to die. A knuckle of intestine protruded through a rent in the 

 uterus. Nothing could be done but to amputate the organ. This was ligatured close 

 to the vulva — after the intestine had been returned — by a well waxed and soaped cord, 

 which Avas passed round it several times, being tied each time. Then by means of a 

 convex bistoury, he cut through the mass about two inches below the ligature, applied 

 an astringent lotion to the ligatured end, and Replaced it in the pelvic cavity. From 



39 



