PROLAPSUS OF THE UTERUS 



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mucosa should be looked upon as gangrene. A uterus pro- 

 lapsed only a few hours is not yet gangrenous. At the same 

 time it is found where prolapsus follows embryotomy, where 

 the uterus was wounded, or where rough attempts at reposi- 

 tion of an abnormal presentation were made, in consequence 

 of which the auimal strains continually. At first an inver- 

 sion occurs, possibly wedged in the cervix or vagina ; finally 

 prolapsus takes places. It also happens that reposition of a 

 prolapse is followed on the next day by another one. In such 

 cases gangrene is sometimes seen. 



2. Uterine ivounds. Large wounds or those produced by 

 treads of a neighboring animal penetrating the three layers 

 indicate amputation. 



3. Impossibility of reposition. This indication. is rare. In 

 most cases — in fact, in all cases — reposition of the prolapsus is 

 possible. Amputation is only then indicated when all methods 

 have been employed in vain. As a rule the uterus is then 

 in a condition where its reposition would endanger the life 

 of the animal. Under such circumstances amputation is called 

 for. 



Prognosis. — When veterinary literature is consulted along 

 this line, we notice that most animals stand the operation well. 

 This deduction is not quite correct. The cow may stand 

 amputatio uteri when artfully performed very well, and may 

 suffer but little. But many cases are known where amputation 

 was soon followed by severe disturbances, and even death. 

 Some surgeons observed immediately after the operation great 

 restlessness or paralysis of the hind parts. This usually 

 lasted one half to one hour, eventually followed by improve- 

 ment. I have seen such a state of excitement terminate fatally 

 in one half hour. Prognosis therefore is doubtful. 



Modus operandi. — Before the operation is performed we 

 satisfy ourselves that the urinary bladder is empty and that no 

 intestines are lodged in the prolapsed uterus. When neces- 

 sary, the bladder is emptied, the intestines are put back into 

 the abdominal cavity by raising the uterus and elevating the 

 hind parts of the cow. On the whole, intestines are rarely pres- 



