Puerperal Diseases of the Uterus 553 



can not be too strongly insisted that the use of iodoform is 

 perfectly safe and that only its misuse makes trouble. 



In highly infected herds it is desirable that a skilled vet- 

 erinarian shall examine the genital organs of cows in which 

 pregnancy has recently terminated, where no external evi- 

 dence of important disease is manifest, in order to deter- 

 mine the presence or absence of endometritis or other hidden 

 disease important for the breeding life of the animal. This 

 examination may occur at any time from the fourth to the 

 fifteenth day post partum. 



When the simple type of endometritis here considered is 

 recognized by clinical manifestations or through a careful 

 examination of the uterus, including the douching of its 

 cavity in order to reveal the state of its interior, the uterus 

 should be washed clean with sterile 0.6 to 0.7 per cent, salt 

 solution, after which iodoform and bismuth suspended in 

 white mineral oil or liquid paraffin may be deposited in the 

 recently gravid horn, and the treatment repeated after one to 

 four or more days. Careful watch should be kept upon the 

 case in order to assure as far as possible prompt and com- 

 plete recovery with fertility fully maintained. Powerful 

 antiseptics are to be strictly barred from the genital tract 

 during the puerperal period, because the freshly denuded 

 endometrium and partially denuded vaginal mucosa will not 

 tolerate them. There is no potent disinfectant known which 

 can be freely and safely used in the puerperal uterus or va- 

 gina. Insoluble non-irritant drugs, such as iodoform and 

 bismuth, are well borne and such feeble antiseptics as boric 

 acid can be tolerated. Here and there some manufacturer of 

 antiseptics advertises a "non-irritant" drug of higher po- 

 tency than carbolic acid, but it is non-irritant only upon non- 

 irritable tissues and not, so far as known to me, upon the 

 puerperal uterus and vagina. Salt solution is safest. Da- 

 kin's solution or one of its reliable substitutes in sufficiently 

 high dilution may be used. No drug should be used which 

 causes pain or straining. Nothing so intensifies the infec- 

 tion present as the imprudent use of disinfectants. The con- 

 stant aim should be to wash out mechanically any deleteri- 



