INVERSION OF THE VAGINA. 613 



canal. In the Bitch, inversion of the vagina has been sometimes mis- 

 taken for a condylomatous tumor ; and cases are recorded in which 

 tumors of this kind, protruding beyond the vulva, through insufficient 

 examination have been mistaken for inversion. Inversion of the bladder 

 has also b6en confounded with that of the vagina. The pyriform kysts 

 which sometimes form in that canal, and contain a citron-colored fluid, 

 have likewise been sometimes confounded with inversion of the vagina. 



To avoid errors which might have a serious tendency, a careful examina- 

 tion must be made, and nothing should be attempted in the way of opera- 

 tion until the state of affairs is exactly determined. 



Prognosis. 



Inversion of the vagina is not nearly so serious an accident as inver- 

 sion of the uterus ; and Cows, Mares, and Bitches may often suffer from 

 this condition for months without showing much apparent inconvenience. 

 This is the kind of inversion that is liable to recur ; reposition may be 

 readily effected, but no sooner is it accomplished than inversion again 

 takes place through the animal straining. 



In other instances, however, the accident is much more serious. The 

 mucous membrane of the vagina, exposed to contact with the urine, faeces, 

 and litter, in addition to friction from the tail and other objects, as well 

 as the attacks of flies, etc., becomes irritated, excoriated, abraded, and 

 indurated, while it is greatly thickened from exudation ; a more or less 

 foetid muco-purulent secretion covers its surface ; cicatrization of the torn 

 sub-mucous connective tissue ensues ; new adhesions are formed which 

 fix the part in its abnormal situation, and offer what is sometimes an 

 insurmountable obstacle, if not to reduction, at least to retention, after 

 that has been effected. If assistance is not afforded, the animal gradually 

 loses condition and becomes emaciated ; hectic fever sets in, and it falls 

 into a state of marasmus. At other times the extruded part becomes 

 acutely inflamed, intense fever supervenes, and the creature succumbs to 

 the effects of vaginitis — either simple or complicated with metritis— "-and 

 almost as rapidly as from inversion of the uterus. 



Treat77ie?it. 



The more speedily treatment is resorted to after inversion has occurred, 

 the more easily is reduction effected and likely to prove permanent, while 

 the risks from injury are greatly diminished. 



The treatment is somewhat similar to that recommended for inversion 

 of the uterus, the preli^ninary steps being the same in both accidents, and 

 reduction accomplished according to the same rules. The part of the 

 vaginal membrane nearest the vulva is to be carefully and gradually 

 returned should the tumor be large ; if comparatively small, then it may 

 be reduced en masse, by applying the closed fist to the centre of the most 

 dependent part, and pushing it into the canal. When reduction has been 

 effected, it is particularly necessary to observe that every part has assumed 

 its normal shape and position ; as it often happens that the mucous 

 membrane, particularly towards the bottom of the canal, forms a thick 

 fold, which must be effaced if it is desired to obviate renewed straining 

 and a recurrence of the inversion. All the folds and inequalities from 

 one end of the canal to the other, as far as the cervix, should be smoothed 

 carefully down by the hand or a soft damp cloth. If, after reduction, the 



