228 ]''eteri7iary Obstetrics 



recur and that, if it is removed, the estriim promptly reappears, 

 has long been known. Upon this point our statistics teach some 

 important lessons. In addition to the persistent absence of the 

 symptoms of estrum, such animals show the normal tension of the 

 sacro-sciatic ligaments as well as a normal uterus and vagina. 



There is regularly found, in those cases which have not yet 

 been handled, in one ovary a yellow body varying in size from a 

 pea to a hazelnut or small hickorynut, sometimes inconspicuous, 

 sometimes prominent and firm, often easily detached and many 

 times removable only with difficulty or even not at all, especially 

 when completely encapsulated in connective tissue. In rare 

 cases, in addition to the foregoing, there may exist in the same 

 gland a cyst the size of a hazelnut to a hickorynut ; conse- 

 quently the ovary is enlarged, smooth and fluctuating on one 

 end, while at the other it appears lumpy. 



It is to be observed in the dislodgement of the persistent 

 yellow bodies per rectum or per vaginam that, when these co- 

 exist in both ovaries, the elimination of the larger corpora lutea 

 as a rule suffices, and, when both a corpus luteum and a cyst exist 

 in one and the same ovary, the cyst should first be ruptured if 

 possible and then the yellow body pressed out. In this con- 

 nection, we have noted at times that, after rupturing the cyst, 

 the yellow body, which could be clearly recognized but could 

 not be dislodged, soon became absorbed and, after a time, estrum 

 spontaneously recurred ; on the other hand we have also seen 

 under like conditions, after an operative elimination of the cyst 

 and with the presence in the same ovary of a persistent yellow body 

 which failed to be absorbed, that the cyst only very rarely re- 

 turned. If the yellow body is small and not detachable, there is 

 yet hope for bringing about estrum through invigorating the ova- 

 rian circulation and causing the resorbtion of the corpus luteum 

 by the application of vigorous massage to the affected gland. 

 After squeezing out the corpus luteum, it should never be neg- 

 lected to apply after-compression to the ovary for 10-20 minutes. 

 If possible, the tip of a finger, either />^r rectum or per vaginam, 

 should be pressed into the cavity from which the corpus luteum 

 has been removed. In the walls of either the rectum or vagina 

 the pulsation of an artery is occasionally to be felt, which is 

 not to be confounded with the ovarian artery. 



