PROLAPSUS OF THE UTERUS 325 



danger exists that the ligature might slip off. When the liga- 

 ture is applied properly, the uterus is severed and the stump 

 replaced. 



The after-treatment consists in douching the vagina with 

 warm antiseptic solutions. The ligature drops off in fifteen 

 to twenty days. Should prolapsus of the stump appear, the 

 vulva is sutured when necessary. 



Veterinarian de Vries at Zaltbommel (Holland) reports 

 the following case. A cow which had calved normally retained 

 the after-birth. Seven days later the owner, ou entering the 

 stable in the morning, found the uterus prolapsed and the 

 decomposing secundines- adhering to it. The uterine mucosa 

 was dark red and on some places almost black. In con- 

 sequence of venous stasis, considerable infiltration of the sub- 

 mucosa and muscularis had taken place, thus rendering the 

 uterus enormously swollen. Eeposition of the voluminous 

 uterus was impossible, as there was danger of puncturing 

 it with the hand, its powers of resistance being so little. De 

 Vries therefore decided upon amputation. As a ligature a 

 rope of pencil size was used. It was placed in the shape of a 

 surgical loop around the folds of the cervix and tightened ; in 

 order to make it slip better the loop was dressed with soap. 

 The ends of the ligature were secured to two sticks, on 

 which two men pulled vigorously. To satisfy himself that no 

 intestines were included by the loop he incised the uterus and 

 introduced the hand. By holding the finger on the spot to be 

 constricted he appreciated the complete strangulation of the 

 parts. After tieing the loop the uterus was severed 5 cm. 

 posterior to it. The stump was placed into the pelvic cavity 

 and the animal walked about. The cow swayed to and fro, 

 rotating the tail furiously. These symptoms disappeared within 

 an hour, and the cow began to eat. Next day the temperature 

 was 38.5 deg. C, the lacteal secretion had diminished, but 

 increased on the following day. The vagina was syringed with 

 a 1 per cent, pyoctanin solution. For six weeks the animal 

 discharged a limited muco-purulent excretion. The animal 

 was kept as a milch cow for 1^ years and was then fattened. 



