Examination of Vulva and Vagina 87 



were so constricted by this cord-like structure that a small 

 hand could not be inserted. The difficulty was overcome by 

 severing the cord at one or two points. I encountered one 

 sterile Jersey heifer of breeding age, with so small a vulva 

 that I could not insert my hand at all and so small an anus 

 that I could not palpate her genitalia, per rectum, though the 

 heifer herself was not extremely small. Vulvo-vaginal stric- 

 tures occur from disease, rendering palpation of the anterior 

 end of the vagina impossible. These will be considered later. 



Albrechtsen makes extensive use of the vaginal speculum 

 in studying the vagina and cervix, but I have not found it of 

 great value. When one pair of the uterine forceps is at- 

 tached to the right and the other pair to the left lip of the 

 os uteri externum, traction exerted, and the forceps pressed 

 apart, the vulvar opening is widely dilated and in almost all 

 animals all parts of the vaginal mucosa and the vaginal por- 

 tion of the cervix are brought into view more clearly than 

 with the speculum. The visual examination of the vaginal 

 end of the cervix may be further facilitated in cases of need 

 by applying a third pair of forceps to the superior margin of 

 the cervical border. In a few instances of a very narrow 

 vulva or vagina, a speculum of sufficiently small size may 

 be of great aid. The best speculum in my experience for 

 this purpose is that of Bischoff's Vaginal Dilator, shown in 

 Fig. 38. 



In the manual examination of the vulva and vagina, the 

 examiner should take note of all abnormal contents and of 

 abnormalities of the vulvo-vaginal mucosae and of the peri- 

 vaginal tissues and organs. Physiologically, the vagina of 

 the cow at estrum and when nearing parturition contains 

 an abundance of clear, rather fluid, highly lubricant mucus. 

 The vagina of the non-pregnant cow in the interval between 

 estrual periods contains a small amount of lubricant mucus. 

 The vagina of the pregnant cow, except when nearing par- 

 turition, contains a highly adhesive mucus. These physio- 

 logic variations in quantity and quality of vaginal mucus 

 need to be learned by actual clinical observation before the 

 various pathologic contents may be readily recognized. 



