Occlusion of the Os Uteri 257 



When closure of the cervical canal has been definitely di- 

 agnosed, it becomes evident that the most direct and only 

 hopeful method of dealing with the consequent sterility is by 

 its artificial dilation. 



The manual dilation of the os uteri should be carried out under 

 the strictest aseptic precautions in order to avoid an inflammation 

 of the parts, which must be more or less injured during the pro- 

 cess. In the cow, the dilation must be very gradual and its 

 accomplishment requires much patience. As suggested above, 

 it is best, where we wish to use force in penetrating the cervical 

 canal, to first grasp the cervix uteri per rectum with one hand 

 and then carry out the dilating operation with the other hand in 

 the vagina. The operator should have the finger nails well 

 trimmed and perfectly smooth, the hands clean, disinfected and 

 well softened. The hand should be oiled or should be moistened 

 with some unctuous substance, like a solution of sodium bicarbon- 

 ate or a weak solution of salt at a temperature of about 100° F. 

 The index finger should be pushed gentl}' into the os with a 

 rotary motion and advanced until resistance disappears and the 

 finger tip enters the uterine cavity. After persisting in the effort 

 for a considerable period of time, until the finger becomes tired 

 and the animal considerably irritated, it maybe best to desist for 

 a while and renew the operation some hours later or upon the 

 following day. 



Zschokke condemns the use of wooden or metallic sounds in 

 bringing about this dilation because he considers them dangerous. 

 We hold, on the other hand, that they are quite as safe as the 

 finger, providing, always, that the precaution is taken to first 

 grasp and fix the cervix with one hand per rectum, in which 

 case the progress of the sound may be constantly determined and 

 the operator can know exactly if it is following the central line, 

 that is, the cervical canal, and may determine when it has reached 

 the uterine cavity. 



We even regard a metallic sound as distinctly safer, easier to 

 manipulate, and more effective than the finger, in dilating the 

 os or diagnosing its patency, because it can be much smaller and 

 more even than the finger. For the cow, this instrument should 

 be of well tempered, plated steel, fV to \ inch in diameter at the 

 point, 18 to 20 inches long and furnished with a handle con- 

 17 



