268 Diseases of the Genital Organs 



remainder of the operation is identical with what we have 

 described under 1. Under anaesthesia the vagina is flaccid 

 and cannot be made to "balloon" but may be distended with 

 sterile soda or salt solution. 



Dangers. Wounding of the rectum is scarcely possible un- 

 der the first method, if it has been emptied as advised above, 

 if care is taken not to attempt the incision until the vagina 

 is well "ballooned," and the stab wound is made directly 

 forward. If made upward when the organ is so tensed, the 

 accident is highly probable, and with the undilated vagina, 

 where it is necessary to cut upward, the danger is ever 

 present. In order to avoid this danger, when operating by 

 the lirst method, the operator should await the complete 

 "ballooning" and then make his incision as directed. In the 

 second method, the accident is to be prevented by being care- 

 ful to push the vagina down away from the rectum and hold 

 it away while the incision is being made. If the wound in 

 the rectum passes through the pelvic connective tissue be- 

 hind the peritoneum, it is of little consequence, but the oper- 

 ation should be abandoned ; if the bowel is opened into the 

 peritoneal cavity, the accident is generally, though not al- 

 ways fatal. The vaginal incision may be enlarged and the 

 wounded portion of the rectum drawn out through the vulva. 

 The wound may then be closed by sutures. 



Wounding of the iliac arteries, which generally produces 

 prompt death from hemorrhage, results from the incision 

 being made upward instead of forward when the vagina is 

 "ballooned" or from a failure to hold the roof of the vagina 

 down and away from the part while making the incision in 

 the flaccid organ, as is the case with the recumbent animal 

 under anaesthesia. It is most likely to occur with timid 

 operators who become nervous, especially when the vagina 

 does not "balloon" promptly or the mare is not well se- 

 cured. The accident is wholly unnecessary if the operator 

 will await the "ballooning" in the first operation, while by 

 the second method it is prevented by proper care in holding 

 the vagina downward and forward during the incision. 

 When it has occurred, it is generally beyond remedy, though 



