258 Veierhiary Obstetrics 



venient for inanipulatiou. Some writers advise a curved point, 

 but the canal it is to penetrate is direct and the instrument 

 should be straight. 



An interesting question in the dilation of the cervical canal is 

 that in relation to the use of local anaesthetics, such as cocaine, 

 stovaine and others. We find no records of the use of these 

 drugs for this purpose. It would seem to us, however, that two 

 very marked advantages might result. First, the use of these 

 substances might diminish the resistance and straining, by 

 obviating the pain incident to the process, and thus do away 

 with one of the chief hindrances in the operation. In the second 

 place, we have found that stovaine, especially, paralyzes motor 

 nerves and it would appear to us that, if injected into the walls 

 of the cervix, it might inhibit the muscular power and render 

 the dilation of the canal easy, if not in itself accomplishing the 

 desired end. 



The smearing of the cervix of the uterus with belladonna and 

 other similar substances, with a view to relaxing the parts, has 

 not been followed by success, according to our observations. 



Having already indicated our skepticism concerning the .scien- 

 tific basis for attributing a large percentage of instances of 

 sterility to occlusion of the os uteri, it is essential to discuss 

 freely the prognosis of dilation in the presence of this alleged 

 cause. Numerous contributions appear here and there, in which 

 excellent results are recorded from "opening" the uterus and 

 it is a common practice among stallion grooms to ' * open ' ' the os 

 in mares which fail to conceive at the first or second service. It 

 becomes an exceedingly difficult and delicate task to differentiate 

 between fact and fancy, between science and mysticism. 



Except we have first learned positively that a barrier to 

 fecundation, not spontaneously removable, exists, we are not 

 prepared to say that a given coition will or will not prove suc- 

 cessful becau.se preceding copulations, be they one or many and 

 distributed over months or years, have failed. Without " open- 

 ing", without mystical concoctions, without interference of any 

 kind, we have observed the sudden and unexpected appearance 

 of fertility after barrenness, in mares, from maturity up to the 

 age of 10 or 12 years or more. In such cases, the reasons for 

 the final conception and prior sterility remained equally impene- 

 trable enigmas. 



