PUERPERAL INFECTION 349 



Parametritis is often accompanied by considerable exuda- 

 tion into the muscularis and submucosa of the uterus. The 

 inflammation also attacks the serosa of the uterus (perimetritis), 

 so that even adhesions with the neighboring organs may take 

 place. 



The wall of the uterus thickens two to five times. Later 

 multiple abcesses of pea to walnut size or single large abcesses 

 form in the wall and possibly in the tissues of the pelvis. 



Symptoms. — In the first few days after parturition the 

 symptoms of an acute puerperal infection are manifested, 

 usually due to a retained afterbirth. At that time the diagno- 

 sis is septic metritis. A few days after the afterbirth has been 

 expelled or removed by hand, improvement apparently sets in. 

 The owner nevertheless observes that the cow is not well, 

 feeds poorly, ruminates slowly and that the lacteal secretion 

 is limited. On examination the following phenomena are 

 noticed : temperature 39 to 40 deg. C, pulse normal, respira- 

 tion slightly accelerated. Defalcation is normal or thinner 

 than usual. When such an animal is taken out of the stall, 

 dragging of the hind legs so that the toes trip is conspicuous. 

 Occasionally one hind leg is seen to knuckle over. Lameness 

 or pain about a joint is not seen in the beginning. The latter 

 are occasionally observed later in consequence of pysemic 

 metastasis. On exploration per vaginam the cervix is found 

 closed, or when the examination is conducted in the first week 

 after parturition, two fingers may be possibly passed. A few 

 rotatory movements of the hand suffice to enter the uterus. 

 The uterus is not contracted, its lumen is still quite large. As 

 a result of this the lochise have accumulated and a brown, 

 muco-purulent liquid is found in the uterus. Rectal examina- 

 tion also confirms the dilated state of the uterus. 



The course is that of a chronic disease, followed occasion- 

 ally by recovery, while at the same time chronic pyaemia is the 

 more common termination. 



Prognosis is unfavorable. 



Therapeutics. — When the cervix is still open, antiseptic 

 uterine irrigation must be made. To produce contraction of 



