Prolapse of the Vagina 453 



to remain in its normal situation. In order to maintain the organ 

 in position, we need overcome the straining, due to the pain, and 

 the infection. Before the prolapsed organ is replaced into its 

 position it must be cleansed thoroughly. After its reposition it 

 is to be straightened out in its normal situation ; the replacement 

 must be as complete and perfect as possible. After it has been 

 replaced, we should introduce into the cavit}' of the organ reme- 

 dies which will overcome the infection and ameliorate the pain. 



The reposition of the extruded organ is not always easy, be- 

 cause of the straining. First, the part should be bathed with a 

 tepid antiseptic solution, for which lysol is especially useful be- 

 cause of its unctuous character. Care is to be taken that the 

 antiseptic is not too irritant. The lysol solution should not ex- 

 ceed I %. It may even be omitted and tepid water alone used. 

 If the organ is very irritable and painful and its reposition causes 

 great resistance we may apply to it one of the local anaes- 

 thetics, such as cocaine, or eucaine in order to overcome the re- 

 .sistance in returning the organ and to diminish the straining after 

 it has been replaced. An addition of adrenalin to the anaes- 

 thetic solution blanches the mucosa and decreases the congestion. 

 The replacement of the organ in the cow should be brought 

 about by gentle and careful pressure with the palms of the hands, 

 until it has retreated within the vulva, when one hand should be 

 introduced and the walls of the organ straightened out in their 

 normal position. If for any reason the animal should be re- 

 cumbent, great difficulty may be found in replacing it. When- 

 ever possible, the animal should be caused to stand, preferably 

 with its hind feet upon higher ground than the fore-feet, so that 

 the anterior part of the body slopes downward and the abdominal 

 viscera drop forward away from the pelvis. 



The ewe, or other small patient, should be seized by the hind 

 legs and suspended with the head downward, when the diseased 

 organ will return to its position spontaneously or with very slight 

 pressure. After the organ has been replaced, the operation may 

 be completed by pouring into the vagina, through a funnel or 

 tube, a tepid antiseptic solution. This tends to smooth out all 

 irregularities and make the replacement complete. In the ewe 

 we have found that a i-iooo solution of corrosive sublimate is 

 not so highly irritant in the diseased vagina as it would be in 



