Puerperal Diseases of the Uterus 551 



animal. In other cases endometritis passes quickly into 

 that type of disease I have designated as septic metritis, or 

 into pyometra. 



The prognosis is generally good. If timely attention is 

 given it can usually be promptly controlled and the fertility 

 of the patient retained. Sometimes the infection is of high 

 virulence, or, which amounts to the same thing, the patient 

 has such low resistance that, in spite of treatment, ruinous 

 or fatal septic metritis ensues. 



The handling of puerperal endometritis is to be based 

 upon the fact that it is ordinarily a disease persisting from 

 the pregnant state. Therefore, if it is to be prevented, the 

 uterus should be rendered as nearly aseptic as is practicable 

 prior to conception and all available precautions taken 

 against coital infection by the bull. When genital infec- 

 tions in a herd have become intense as a result of profes- 

 sional neglect, each female should be regarded as probably 

 infected and the presence of endometritis at the close of 

 pregnancy anticipated. In such instances I have advised 

 as a general procedure the introduction of iodoform with 

 boric acid, bismuth, thymol or other antiseptics into the 

 uterine cavity (or if the fetal membranes are retained, into 

 the chorionic cavity). A very satisfactory formula is one- 

 half ounce each of powdered iodoform and boric acid, with 

 five or six grains of powdered thymol enclosed in a gelatin 

 capsule and deposited deeply in the cavity of the gravid 

 horn. This should be done within two to five hours after 

 calving or aborting. This can be done safely by an intelli- 

 gent herdsman or caretaker, if he has first been carefully 

 instructed regarding the necessity for cleansing his hands 

 and shown how and where to deposit the capsule. The 

 operation must of course be carried out with the greatest 

 possible care in cleansing and disinfecting the hands, and 

 the cow's tail, buttocks, and vulva. The same result may 

 be accomplished, sometimes perhaps better and sometimes 

 not so well, by suspending the iodoform and boric acid in 

 white mineral or other bland oil and introducing the prepa- 

 ration deeply into the uterus by means of a hospital irriga- 

 tor with the bull-douching catheter attached. 



