Infections of the Gravid Uterus 467 



have not been studied in connection with it. The researches 

 of my colleagues, Carpenter and Hagan, have thus far indi- 

 cated that in the cases investigated by them the B. abortus 

 is not the dominant organism. 



The prognosis of cervical endometritis is unfavorable. 

 The fetus, which inevitably participates in the invasion, 

 may perish and be expelled, may be born highly infected, or 

 with large numbers of bacteria included within the meco- 

 nium and later break down with septicaemia, dysentery, 

 pneumonia, or pyaemia. In the cow the metritis inevitably 

 persists into the puerperal period or beyond, frequently 

 complicated with retained placenta. Cervical endometritis 

 is not amenable generally to handling during pregnancy. 

 When clearly recognized, in such cases as that illustrated in 

 Fig. 174, where abortion is clearly foretold, the emptying 

 of the diseased uterus should be the first aim. I have prac- 

 ticed, and recommend, douching the uterus with a weak 

 antiseptic solution, such as 0.5 per cent. Lugol's solution, 

 through the open cervical canal. This tends to detach the 

 fetal sac from the maternal placentules and to cause the 

 prompt expulsion of embryo and embryonic sac. Once the 

 uterus is empty, the diseased uterus may be handled and re- 

 stored to health. The prevention of the cervical endometri- 

 tis of pregnancy is fundamentally dependent upon the mat- 

 ing of two animals with clean sexual organs. 



D. Septic Metritis of Pregnancy with Uterine Gangrene 

 Septic metritis of the pregnant uterus with uterine gan- 

 grene is not rare. It bears a close relationship to the dif- 

 fuse endometritis of pregnancy and represents a more viru- 

 lent course of infection. As a rule, the existence of intra- 

 uterine infection passes unnoted clinically until suddenly the 

 disease breaks out in a storm and its presence becomes evi- 

 dent. Usually it appears at or near the close of the physio- 

 logic duration of pregnancy, showing itself in two types. 



Most commonly the animal unexpectedly becomes dull. 

 There may be some atonic expulsive efforts. Usually the 

 cervix relaxes and necrotic fetal membranes protrude from 



