92 Diseases of the Genital Organs 



far enough back to permit of visual examination or of de- 

 sired manipulations. 



When the operator inserts his hand into the rectum, the 

 logical starting point for the palpation is the cervix. With 

 the forceps applied to the vaginal end, the operator may 

 recognize the structure by following the instrument to its 

 point of attachment. When the forceps have not been ap- 

 plied, as in heifers, the cervix must be sought and recognized 

 by its location, size, consistence, and attachments. Without 

 traction with the forceps, the vaginal end of the cervix lies 

 eight to twelve or more inches anterior to the vulva. In the 

 non-pregnant heifer, it ordinarily lies not more than eight 

 inches from the vulva; in old, pregnant cows, it may be 

 dragged far forward out of the pelvic, into the abdominal, 

 cavity. Similar displacement may exist in pyometra, hydro- 

 metra, large ovarian and uterine tumors, and other patho- 

 logic conditions. Not infrequently, portions of the small in- 

 testines are pushed back in the recto-vaginal pouch, and 

 must be dislodged forward before the cervix, uterus, or 

 ovaries may be palpated. Ordinarily it is a very easy task 

 to dislodge these by applying very slight intermittent pres- 

 sure downward and forward. 



When the urinary bladder is empty, the cervix may lie 

 upon the empty viscus, but it is generally slightly deviated to 

 the right and rests upon the pelvic floor. When the urinary 

 bladder is distended, the cervix (and uterus) is almost al- 

 ways deflected to the right and lies in the furrow between 

 the distended viscus on its left, and the right pelvic wall. 

 Rarely the cervix and uterus lie upon the distended urinary 

 bladder or, yet more rarely, may be displaced to the left. 

 Sometimes the greatly distended urinary bladder, containing 

 four or more quarts of urine, almost fills the pelvis, the cer- 

 vix and uterus fall far down between the bladder and pelvis, 

 and the bladder rolls or extends over to the right, virtually 

 covering the cervix and uterus. The distended bladder then 

 needs to be pushed to the left in order to palpate the cervix 

 and uterus. Rarely I find it desirable, before satisfactory 

 palpation may be made, to catheterize the bladder and evacu- 



