Induration and Atresia of the Cervix Uteri 687 



Induration or atresia is to be differentiated from spasm of the 

 cervix, which is purely temporary in character and may yield 

 with comparative promptness to mechauicaldilation or somewhat 

 later to the natural dilating forces of the expulsive powers. In- 

 duration is also to be distinguished from malignant or other new 

 formations, such as carcinom, sarcom, actinomycosis or tuber- 

 culosis. These diseases usually reveal to the sense of touch a 

 diseased state of the tissues, with a tendency to bleed upon be- 

 ing handled. 



The prognosis of induration or atresia of the cervix uteri will 

 depend very largely upon its location and extent. When con- 

 fined to the vaginal portion of the cervix uteri, the prognosis is 

 distinctly favorable, because this portion admits of the freest 

 possible manipulation and operation without imperiling the in- 

 tegrity of the walls of the organ. When the induration is more 

 extensive, and involves the anterior portion of the cervix or its 

 entire length, the prognosis becomes more serious because any 

 extensive operation or accidental tear during the extraction of 

 the fetus may bring about a perforating wound communicating 

 with the peritoneal cavity, and lead to the death of the animal. 



Handling. Three courses of handling are open for consider- 

 ation ; manual or mechanical dilation, followed by forced extrac- 

 tion of the fetus ; dilation by incision or vaginal hysterotomy; 

 and gastro- hysterotomy or Caesarian section. 



Forced dilation of the cervical canal and extraction of the 

 fetus should be attempted only in those instances where the vet- 

 erinarian feels confident that it ma}- be accomplished without 

 serious mutilation of the cervix. If it appears that forcing the 

 fetus through the canal would probably cause extensive tears, 

 and perhaps penetrant wounds of the cervical walls, forced ex- 

 traction should be abandoned. The os uteri and cervical canal 

 are first to be gradually dilated with the hand or uterine dilator, 

 until the operator ma}' introduce his hand into the uterine cavity. 

 The fetus may be secured by the presenting extremities, each 

 carefully arranged in its proper position, and the cervical canal 

 thoroughly lubricated, after which traction may be applied slowly 

 and judiciously and the fetus forced away. The general direc- 

 tions for the application of traction have been given on page 586. 



Vaginal Hysterectomy. The dilation of the cervix by in- 

 cision, or vaginal hysterotomy, is usually to be preferred to forced 



