338 BOVINE OBSTETRICS 



Course and Prognosis. — Most cases terminate fatally. The 

 swelling increases, and after a few da}-s death sets in, often 

 quite unexpectedly. 



Treatment in this disease is only slightly successful 

 when the condition is still in its initial stage. When the swel- 

 ling once extends over the sacrum and inner surface of the 

 thighs, treatment is of little use. 



Care should be taken that air is given a chance to enter 

 the tissues, as there is no greater enemy for the bacilli of 

 malignant cedema than air. For this purpose deep, long 

 incisions are made into the most prominent portion of the 

 swelling in the direction of the posterior border of the broad 

 pelvic ligament. 



Should the infiltration extend into the broad pelvic liga- 

 ment and a communication exist with the vagina, a drainage- 

 tube is introduced. The other side is treated in the same 

 manner. Here one must not be knife-shy, but each canal must 

 be searched for and split. The wounds are douched with a 2 

 to 3 per cent, carbolic acid solution. 



Internally camphor and oleum terebinthina are given. The 

 infection described as puerperal emphysematous anthrax has 

 nothing common, according to Carl's investigations, with 

 symptomatic anthrax, but is simply a septicemia puerperal is 

 of unknown genesis, in which the bacillus of malignant oedema 

 produces symptomatic anthrax-like phenomena. The cases of 

 puerperal phlegmon observed by me strongly resemble the 

 cases described in the literature as puerperal emphysematous 

 anthrax. Some of the cases terminated fatally in one to three 

 days, but on the whole the processes extended over more time. 

 That the swelling ever involved the whole body, I never 

 observed. 



2. Metritis Sej>/i<-'i. 



Definition. —Metritis septica is an inflammation of the 

 mucosa and submucosa of the uterus, due to infection, accom- 

 panied by serious disturbances of the whole organisms, depend- 

 ing on tin- presence of toxines in the circulatory system. 



