580 Diseases of the Genital Organs 



curred I could not determine. Either the uterus ruptured 

 from the weight of the fluid, the os uteri internum acted as 

 a collapsing valve and imprisoned the fluid, or portions of 

 the membranes floated against the cervical opening and 

 blocked it. In one instance, where the fetal membranes, de- 

 tached from the uterus, were detained within the uterine 

 cavity and the cervix had contracted and would not admit 

 my hand, I introduced a small amount of physiologic salt 

 solution through a rubber catheter from a hospital irrigator 

 elevated fifteen or twenty inches. The cow began to make 

 expulsive efforts, the membranes blocked the cervical canal, 

 and disaster followed. 



Arbitrary rules for douching are accordingly unwise. It 

 is equally unsound in principle to condemn douching unre- 

 servedly. When the membranes are firmly retained and are 

 undergoing putrefactive decomposition, the cervical canal 

 is often very narrow and the debris is imprisoned. The ne- 

 crotic cotyledons and placental debris must be removed. If 

 one undertakes dilation of the cervical canal, the inflamed 

 cervix yields but little, the force required is great, and both 

 cervix and vagina are severely injured. The abrading and 

 stretching open important avenues for infection, the pain 

 causes straining and exhaustion, and the results are unsat- 

 isfactory. If the membranes are well broken up, I have had 

 excellent results in douching carefully with the large, single- 

 curved uterine catheter shown in Fig. 179a. In such cases 

 I use an irrigator elevated barely above the back of the cow 

 and watch carefully for blocking of the return flow. Should 

 this occur, the inflow is stopped and the catheter withdrawn. 

 It is commonly found that the catheter is blocked by large 

 pieces of membranes or by necrotic cotyledons. Pieces of 

 moderate size can be washed out with this instrument, but 

 it must be used cautiously. The uterus is frail and the cath- 

 eter is easily pushed through the walls. If the animal 

 strains and pressure upon the catheter is felt, it must be 

 permitted to move backward, or puncture is probable. The 

 horse stomach tube may be substituted, but it is not as 

 practical. The tube, especially the heavy type, is as danger- 



