544 



Diseases of the Genital Organs 



sels would prevent the escape of blood in the manner de- 

 scribed. The first clinical evidence of the hemorrhage is 

 the escape from the vulva of large volumes of an unusually 

 bright scarlet blood without history of traumatic injury. 

 The cow is generally uneasy (the cramps of severe hemor- 

 rhage?) and moves about restlessly, occasionally lying down 

 and getting up. The bright scarlet blood escaping from the 

 vulva stains the bedding, walls, and any object with which 

 the posterior parts of the cow may come in contact. De- 

 pending upon the degree of hemorrhage, there is weakness. 

 An examination of the uterus reveals a great hematoma fill- 

 ing the recently gravid horn. The clot is moderately firm. 

 The treatment should consist at first of efforts to control 

 the hemorrhage. With the very limited knowledge possessed, 

 I would counsel leaving the clot alone for a time and would 

 limit efforts at control to the hypodermic administration of 

 adrenalin chlorid in doses of one-fourth to one-half ounce 

 of the 1-1000 solution. It should be repeated at intervals 

 of one-half to one hour if the case demands. Efforts should 

 be made to keep the patient quiet. 



Once the hemorrhage has ceased, the removal of the clot 

 should be undertaken with the hope of obviating three possi- 

 ble dangers: (1) If the hematoma is removed too early, the 

 manipulation may revive the hemorrhage. (2) If permitted 

 to remain for several days, the cervix may contract, ren- 

 dering the removal of the clot very difficult. (3) If still 

 further neglected, the clot becomes desiccated, exceedingly 

 sticky, virtually insoluble, can not be suspended in water, 

 and can not readily, by any known method, be removed by 

 douching. The veterinarian need not hasten the removal 

 for fear of putrefaction of the clot because, so far as known, 

 it possesses properties which inhibit purulent destruction. 

 The closure of the cervical canal sufficiently to offer great 

 obstruction to the insertion of the hand will not, as a rule, 

 occur until two or three days have elapsed after the hemor- 

 rhage. The physiologic uterus closes of course at an earlier 

 date, but the uterus under consideration is paretic. Other- 

 wise the hemorrhage would not have occurred. The behav- 



