Puerperal Diseases of the Uterus 539 



A. Uterine Hemorrhage. Uterine Hematoma. 



Hemorrhage into the uterus of the cow during the puer- 

 perium is of two distinct classes. An insignificant hemor- 

 rhage regularly follows the prompt dehiscence of the fetal 

 membranes. Lacerations, especially of the cotyledons, fre- 

 quently cause slight hemorrhage. Hemorrhage is also 

 caused by imprudent attempts at removing retained fetal 

 membranes. These forms are to be handled according to 

 the general rules of surgery. 



Clinically the most interesting and most important type of 

 uterine hemorrhage is that which is apparently one of the 

 results of intra-uterine infection. The hemorrhage appears 

 without warning soon after, but not immediately following 

 parturition. I have observed it at two to four days post 

 partum. My cases have occurred in cows in intensely in- 

 fected herds. As I recall, each patient had given birth to a 

 calf, but the parturition was tardy, testifying to the pres- 

 ence of a uterine paresis due to a metritis of pregnancy. 

 The fetal membranes were not long retained and the pa- 

 tients were apparently going along favorably, when sud- 

 denly without warning a very profuse uterine hemorrhage 

 began. One of my cases had been left at night in a box 

 stall, apparently well. When the caretaker arrived in the 

 morning, the cow was weak from loss of blood and her stall 

 looked like shambles. Bright scarlet blood was spattered 

 over the walls and bedding, and blood was still trickling 

 from her vulva. A few hours later I found upon examina- 

 tion, as nearly as I could estimate, a blood clot in the uterus 

 equal to two or three gallons. The blood was coagulated, 

 odorless, and bright scarlet in color. Fearing recurrence, 

 I proceeded to remove with great care a portion of the clot 

 each day, until in three days I had completely evacuated the 

 uterus. It maintained throughout its bright scarlet color. 

 It underwent no visible decomposition and acquired no spe- 

 cific odor. The cow recovered and was fertile. In a second 

 case a colleague removed the blood from the uterine cavity, 

 first controlling the hemorrhage by the use of adrenalin 

 chloride hypodermically. 



