550 Diseases of the Genital Organs 



I am not aware that this exudate has been subjected to 

 any material study. Hence its composition and the identity 

 of the bacteria present are unknown. Logically the bacteria 

 are chiefly those which existed in the utero-chorionic cavity 

 of the recently pregnant organ, to which organisms from 

 the exterior may have been added. So far as I have been 

 able to determine, the exudate consists primarily of blood 

 due to limited capillary hemorrhage from the placental 

 areas. This becomes mixed with small masses of pus and 

 necrotic particles of placental tissue. The blood is scarlet, 

 similar to that of the severe uterine hemorrhage described 

 in the preceding article. Perhaps there is a causal rela- 

 tionship between the two conditions. There is one marked 

 clinical difference. The gross hemorrhage produces a clot 

 which, so far as I have seen, tends to desiccate but not to 

 putrefy. The same tendency is present for a brief interval 

 in the scarlet-gray exudate of endometritis, but this is of 

 brief duration and, unless recovery promptly occurs, putre- 

 faction or suppuration finally takes place. Then follows 

 septic metritis, pyometra, or other phases of intra-uterine 

 infection. 



Endometritis is exceedingly common in most dairy and 

 beef herds. In dairy herds where genital infections are se- 

 vere, endometritis is sometimes essentially universal for 

 some months. If there are 25 per cent, of observed expul- 

 sion of fetal cadavers (abortion), careful clinical study will 

 reveal probably 80 to 90 per cent, of cases of endome- 

 tritis. Endometritis in the cow is so common that Fleming 

 and other obstetrists describe it as "normal" and designate 

 the exudate when discharged from the vulva as "lochia." 

 The course of puerperal endometritis is technically brief. 

 Numerous cases recover spontaneously and promptly and 

 retain their fertility. Perhaps more frequently the puer- 

 peral infection passes over into the post-puerperal era as a 

 mild, persistent endometritis with a pernicious tendency to 

 extend by continuity into the oviducts, causing the various 

 tubal infections, or into the cervix, inducing cervicitis, with 

 all that these mean for the future reproductive powers of the 



