Post- Puerperal Infections of the Uterus 809 



nic of cervical dilation may be varied according to condi- 

 tions. Frequently the operator may dilate the canal manu- 

 ally. First one finger is pushed through the canal, then a 

 second finger, and finally the entire hand. It is not usually 

 desirable to attempt the complete dilation at one operation, 

 but the effort should be renewed daily until success is at- 

 tained. If room permits, after the pus has been washed out 

 of the uterus, the closed end of a long cheesecloth bag may 

 be introduced into the uterus and the bag then filled by pack- 

 ing a continuous long strip of cheesecloth into it by means 

 of long dressing forceps, uterine dilators, or other instru- 

 ment. A rubber dilator patterned after those used in human 

 practice can be used in some instances. The veterinarian 

 needs to select his method according to circumstances, and 

 persist day after day until ample dilation has been attained. 

 I have set my mark at sufficient dilation to permit the pas- 

 sage of my hand. 



Once ample dilation has been accomplished, effort may be 

 centered upon disinfection of the suppurating cavity. The 

 disinfection should be largely mechanical, douching out the 

 pus with physiologic salt solution, boric acid or other very 

 mild disinfectants. The soft rubber horse catheter may be 

 used advantageously for douching and siphoning. After 

 cleansing the uterus as thoroughly as practicable by these 

 means, improvement may follow the introduction of iodo- 

 form or bismuth subnitrate, or both, in liquid paraffin. At 

 first the uterus should be handled daily because the force 

 used in dilating the cervix accelerates the infection and gen- 

 erally causes fetor or increases the fetor existing. Later, 

 as the uterus and cervix soften and approach their normal 

 size, consistency and function, the handling should be con- 

 tinuously toned down and finally discontinued, but the pa- 

 tient should still be examined from time to time for a few 

 weeks to make sure that no perilous trace of infection has 

 been left behind. 



d. Pyemic abscesses from metritis are rare in mares. I 

 have observed them occasionally in the pelvic tissues and, 

 in one instance following dystocia, in the sub-lumbar lymph 

 glands. There appears to be scant inclination to the pyemic 



