572 Diseases of the Genital Organs 



ard and there is much misinformation. One of the chief 

 elements of confusion is the belief of the breeder and dairy- 

 man that a skillful veterinarian can successfully remove a 

 retained afterbirth at will. Accordingly the owner calls the 

 veterinarian to "remove" irremovable fetal membranes. 

 The practitioner is not left free to exercise his judgment 

 and attempts the impossible. 



No chronological date can be fixed upon, at which it is pru- 

 dent to attempt the manual removal of the fetal membranes. 

 So many cows have been killed or ruined by attempts at the 

 removal of the membranes that it has become the fixed 

 policy of many practitioners to abstain from all attempts 

 at manual removal, and they have justified their methods 

 by results attained. I hold that, between the extremes of 

 non-removal and the arbitrary removal or attempts at re- 

 moval, there is a middle ground in thorough harmony with 

 the principles of surgery and fully justified by clinical ex- 

 perience. Once the fetal membranes become retained within 

 the uterus owing to the incarceration of the chorionic tufts 

 within the placental crypts, certain established disease pro- 

 cesses must continue in their course to their logical end. In 

 the types described above there is a course and termination 

 for each, and it is impracticable to modify materially or to 

 abbreviate that course in a favorable direction. As in other 

 infections, it is easy to affect its course unfavorably, leading 

 to disaster. There is always present within the uterus a de- 

 termined battle between the infection and the powers of 

 resistance in the uterus and the body as a whole. The in- 

 fection has a notable advantage in the presence of the ne- 

 crotic membranes, which afford an inexhaustible nutritive 

 supply for the bacteria, and the additional advantage of the 

 presence of the utero-chorionic cavity, with the necrotic 

 chorion forming one wall and the diseased uterus the other 

 wall, and the virulent infection lying between the two struc- 

 tures beyond surgical reach. The tendency is therefore for 

 each case of retained afterbirth belonging to the first and 

 most benign type, a group which fortunately contains most 

 cases, to become more intense and to move into one of the 



