86 Diseases of the Genital Organs 



amined in order to arrive at a reliable diagnosis. The vulva 

 and vagina then need to be forcibly dilated. This is best 

 done with the hand. After lubricating with warm oil, fat, or 

 emulsion of elm bark, the fingers should be formed in a cone 

 and, under gradual and firm pressure, the vulva slowly di- 

 lated. In extreme cases the dilation may require an hour or 

 two, or may demand repeated efforts on successive days. 

 Any intelligent helper may, under proper instruction and 

 caution, undertake the work, but it must not be unduly 

 rushed. In some extreme cases I have inserted the uterine 

 forceps into the vagina without inserting my hand, directing 

 it on the median line, from side to side, inclined very slightly 



Fig. 38— Bischoff's Vaginal Dilator. 



downward, to the end of the vagina. Opening the forceps 

 moderately and pressing them forward against the cervical 

 end of the vagina, closing and locking them, and then apply- 

 ing gentle traction, I have occasionally been able to draw the 

 vaginal portion of the cervix back to the vulva, where it 

 could be palpated by inserting one or two fingers and even- 

 tually secured by guiding the second pair of forceps to the 

 part by palpation. With both forceps applied to the cervix, 

 the vagina may be visually inspected and the cervical canal 

 and uterine cavity examined instrumentally. 



In some heifers, the vulva is constricted by the presence 

 of a small band of connective tissue or aponeurosis, located 

 about one-half inch from the margin of the lips, just beneath 

 the vulvar mucosa. When vulvar dilation is attempted, the 

 veterinarian encounters this firm, small, cord-like structure, 

 which under the force employed cuts into his hand. I have 

 observed this in one family of Holstein heifers, the members 

 of which were unusually large and rugged, where the vulvae 



