230 Diseases of the Genital Organs 



disregarded, but there has been a very general disregard 

 for surgical invasion of the cervix in a manner equivalent 

 to laceration. There has come down to the present day a 

 legend of frequent stricture and induration of the cervix, 

 of a character to prevent parturition, which may be relieved 

 by a free and careless dilation of the canal by incision. Ow- 

 ing to a gross and common misconception with reference to 

 the non-dilation of the bovine cervix at the time of parturi- 

 tion, it is quite habitual to dilate a perfectly normal cervix 

 by cutting, when, as a matter of fact, the whole fault lies in 

 a paretic uterus. The cervix has no inherent power to di- 

 late, but is dilated passively by the contraction of the uter- 

 ine walls upon the fetus and its fluids. Adhesions, or in- 

 durated thickenings, in the cervix occur with such frequency 

 as to constitute a basis for the fiction of the frequency of 

 induration. Practitioners should be on the alert and re- 

 member the three salient facts — that the cervix of the cow 

 is physiologically very rigid, that its non-dilation at time of 

 parturition is almost always due to atony of the uterus from 

 intra-uterine infection, and that the part played by the cer- 

 vix is essentially passive. If this is fully understood, dila- 

 tion of the cervix by incision will not be rashly applied. 



In whatever manner the laceration or division of the cer- 

 vical wall occurs, the fissure heals neither perfectly nor 

 readily and the vaginal opening of the cervical canal gapes. 

 Naturally infection of the cervix follows and a pernicious 

 interference with fertility results. 



Lacerations of the cervix should be repaired as promptly 

 and accurately as possible. If recognized at first, they 

 should be carefully sutured with slow-dissolving catgut un- 

 der the best available asepsis. When a persistent fissure in- 

 terferes with fertility, the vaginal end of the cervix had best 

 be amputated as far forward as the fissure extends. The 

 technic of trachelectomy is described later under "Cervici- 

 tis". 



