PUERPERAL INFECTION 



337 



Thrombi are formed, offering a favorable medium for 

 pathogenic micro-organisms (streptococci, bacillus of malignant 

 oedema). The infectious material is often furnished by decom- 

 posing foetuses or foetal envelopes, but may also be introduced 

 from without by manure, earth, dirty hands, etc. 



Granulating wounds are often observed in the vagina and 

 on the labia}, while a decaying afterbirth is present at the same 

 time. The granulating surface forms a protecting cover against 

 many infectious substances. 



Symptoms. — The first three days following parturition 

 usually pass without any symptoms, so that everything seems 

 to take a natural course. On the 4th or 5th day swelling of the 

 vulva sets in, confining itself at first to the labise, on the follow- 

 ing day extends over the anus, laterally forward over the pos- 

 terior borders of the broad pelvic ligaments. The swelling 

 may even extend to the flat of the thigh. The skin of the 

 labise is glistening and tense, the mucous membrane yellowish 

 red. A thin, yellowish fluid flows out of the vulva, dripping 

 regularly from the lower commissure. The skin is tense as far 

 as it is swollen ; percussion gives a full sound. When the 

 hand is passed over the swollen surface, crepitation is similar 

 to symptomatic anthrax (black leg). The disease really resem- 

 bles symptomatic anthrax very much, but when the swollen 

 parts are incised subcutaneous and intermuscular accumulation 

 of fetid gases is observed. The animal walks stiffly, appetite 

 and rumination decrease. Defsecation and micturition are 

 mechanically suppressed on account of the oedema. The 

 urine is discharged in small quantities under violent straining. 

 The faeces accumulate in the rectum, to be discharged now and 

 then in the form of small, hard balls; occasionally it is of 

 thin consistency. The temperature is 39 to 40 deg. C, the 

 pulse at first normal, later accelerated. 



Vaginal examination, quite difficult on account of the 

 swelling, reveals necrosis of the mucous membrane of the 

 vagina here and there, so that the necrotic tissue adheres 

 to the hand and arm. The cervix uteri is usually partly 

 open. 



