586 Diseases of the Genital Organs 



without very marked uterine lesions. There is little or noth- 

 ing to be done for puerperal meningitis. It apparently sig- 

 nifies that a metastasis from the infected genital tract has 

 occurred and the matter has already largely passed beyond 

 control before clinical warning has been given. Chloral or 

 narcotics might be used to quiet the patient and an effort to 

 counteract the infection may be made with ounce doses of 

 formalin or with other agents which tend to act as systemic 

 disinfectants. 



There is little limit to the metastases which may occur 

 during the puerperium. Infections of the pregnant uterus 

 are so common, and the endometrium is so largely denuded 

 at parturition that the intra-uterine infections have an un- 

 usually favorable opportunity to reach the lymph or blood 

 stream and be borne to any organ or tissue in the body. The 

 infection may lodge in the liver, lungs, joints, or in any or- 

 gan or tissue, and there produce symptoms of disease wholly 

 unsuggestive of genital origin unless the observer is fully 

 cognizant of the possibilities and is on the alert. 



5. Post-Puerperal Infections of the Uterus 



After the puerperal period, which may be regarded ordi- 

 narily as comprising ten to fifteen days, there follows ideally 

 in cows an interval of sixty to ninety days before it is de- 

 sirable to breed them again. In approximately ninety per 

 cent, of cows, rebreeding is delayed beyond ninety days be- 

 cause of disease or for other reasons, and the period is yet 

 further prolonged in many cows by their failure to conceive 

 when bred. During this interval infinite changes in the in- 

 tra-uterine infections may occur. Historically most of the 

 uterine infections of the post-puerperal epoch are continua- 

 tions of infections which have persisted through pregnancy 

 and the puerperal period and have been modified in their in- 

 tensity and behaviour by the changes in environment. 

 Sometimes the infections of the puerperal period advance in 

 intensity in the post-puerperal era. In many instances there 

 is a strong reaction to the infection present and recovery, 

 entire or partial, often occurs. Thus many cows which had 



