474 Diseases of the Genital Organs 



one-half ounce each of iodoform and bismuth subnitrate. 

 This serves to soften and to disinfect any debris left in the 

 uterine cavity, and finally to cause its expulsion. 



The prognosis is uncertain. I have been unable to follow 

 my cases properly and have not known accurately the re- 

 sults. They should largely recover their breeding power. 



(c) Incarcerating placentitis of pregnancy constitutes 

 the essential basis of retained fetal membranes during the 

 puerperal period. It is unrecognizable during pregnancy 

 and is first revealed when parturition or abortion has oc- 

 curred. Its intensity and degree of development during 

 pregnancy largely determines the intensity and duration of 

 the retention of the fetal membranes after calving or abort- 

 ing. Like cervical endometritis, it regularly has its incep- 

 tion at the cervical end of the uterus and radiates toward 

 the ovarian extremity. In abortion occurring the first few 

 months of pregnancy the course of the placentitis and the 

 detachment of the membranes are completed early and the 

 embryo is expelled surrounded by its membranes. Exten- 

 sive placentitis (cotyledonitis) during pregnancy is incom- 

 patible with birth, because the disease causes fetal death. 

 The tendency, therefore, is for the duration of the placen- 

 titis of pregnancy and that of the puerperal period to be in- 

 verted — the longer the placentitis has existed during preg- 

 nancy, the shorter its course after calving or aborting. This 

 rule is greatly disturbed, however, by the termination of 

 pregnancy. The birth or abortion, by causing extreme dila- 

 tion of the cervical canal, vagina, and vulva, opens the way 

 for fresh infection from without, and causes vital changes 

 in the supply of oxygen to the uterine cavity, with modifica- 

 tions of bacterial activity. The contusions and abrasions 

 incident to the expulsion of the fetus increase the opportu- 

 nity for bacterial multiplication. 



(d) Necrosis of the cotyledons at the cervical end of the 

 uterus occurs but rarely during pregnancy, and then only 

 to a limited extent, without seriously imperilling the life of 

 the fetus. In the non-gravid horn, however, all the cotyle- 

 dons may become necrotic, as shown in Colored Plate III, 



