Examination of the Cervical Cana I 107 



tains a sufficient lumen so that a moderately large uterine 

 catheter may be passed through it without difficulty or dan- 

 ger. This having been attained, catheterization may be un- 

 dertaken. The catheter used should always be of as large 

 caliber as the cervical canal will readily and safely admit, 

 because the greater the caliber of the catheter, the more effi- 

 cient the douching of the uterus. If the operator has care- 

 fully observed the windings of the cervical canal while using 

 the dilator, he will better understand the direction which 

 the catheter must take. The catheter selected as of proper 

 dimensions should be introduced into the cervical canal very 

 gently and advanced with great care. Force is at all times 

 to be avoided. If the catheter will not pass without force, 

 it should be laid aside and the dilators again used and this 

 plan repeated until the dilation suffices. 



The uterine catheter, like the dilator, should not be 

 pressed deeply into the uterus but merely far enough that 

 the fenestrum of the instrument is free in the cavity of the 

 uterus so that douching will be practicable. At the moment 

 of entering the uterus, the concave side of the catheter 

 should be directed ventralward and so maintained through- 

 out douching. Occasionally blood escapes through the cathe- 

 ter, indicating mechanical injury to the uterine mucosa, and 

 this should cause the operator to beware of impending 

 trouble. Once I misjudged the length of the cervical canal, 

 pushed the uterine catheter too far, and caused an extensive 

 antero-posterior laceration in the uterine mucosa along the 

 dorsal surface with copious hemorrhage. I had been careful 

 and could not identify the character of the injury and it was 

 only later when she was slaughtered as a tuberculin reactor, 

 that the cicatrix in the organ revealed the character of the 

 lesion. In this instance the blood did not escape through the 

 catheter but was forced out after the withdrawal of the in- 

 strument. The cow suffered greatly, kicked at her belly, lay 

 down and rose frequently, trembled, sweat, and breathed 

 rapidly. The hemorrhage was not of sufficient volume to 

 cause the symptoms directly from the loss of blood nor could 

 the lesion in itself cause so much pain. Apparently the dis- 

 tress was due to uterine colic, that is, the small, empty 



