DISPLACEMENT OF THE PREGNANT UTERUS 149 



possible that the fold, being as thick again as the uterine wall, 

 may become fastened at the pubis during rapid and strong 

 extraction, producing rupture. 



The presence of such an inflexion during extraction, pre- 

 disposes to rupture of the uterus. 



Treatment consists in elevating the posterior extremities. 

 If possible, the cow should be moved about, as exercise usually 

 removes the inflexion. 



Schaack advises to put the cow on her back. Rainard 

 suggests to raise the abdomen of the cow with a sheet immedi- 

 ately in front of the pubis. 



In some cases where the uterus contracts, clasping the calf, 

 inflexion cannot be corrected by placing the cow on her back 

 and elevating the hind legs. Under such circumstances large 

 quantities of warm water are to be introduced into the uterus, 

 followed by the above mentioned manipulations. 



Veterinarian Reimers (at Ruinerwold, in Holland) has 

 treated, as he told me, twenty cases of inflexion. It is his 

 opinion that it can only take place after evacuation of the foetal 

 water and cessation of labor pains. On exploration, he could 

 only reach the calf when introducing the arm as far as the 

 shoulder. An inflexion was found in front and below the pubis, 

 and behind it the calf. His treatment consists in elevating 

 the cow behind and raising her belly with a covered board at 

 the same time. Extraction, as a rule, is easy. 



(b) torsio uteri. 



By torsio uteri is understood a rotation of the uterus 

 around its long axis, either to the right or to the left. On 

 account of this displacement of the pregnant uterus, expulsion 

 of the foetus is impossible, and as a result of circulatory dis- 

 turbances both foetus and mother may die. 



History. — Most writers, among others Rainard, Saint Cyr, 

 Harms, state that Boutrolle was the first to mention this devia- 

 tion in 1766 ; while not describing it under that name in his 

 "Parfait Bouvier," there can be no doubt that he dealt with a 

 torsio uteri. In the works on obstetrics edited after that time,, 



