DYSTOKIA DUE TO DISPLACEMENTS OF UTERUS. 



a. Hernia of the Uterus, or Hysterocele. In considering 

 the accidents and diseases of the pregnant female, we have already 

 had occasion to refer on page 436 to the rupture of the prepu- 

 bian tendon, and to other forms of uterine hernia by which the 

 gravid uterus may escape through an opening in the muscular 

 walls of the abdomen. In considering those accidents, we neces- 

 sarily dealt with their causes, prevention, and method of 

 handling. 



b. Deviation of the Uterus. Various writers describe a dis- 

 placement of the uterus obliquely downward, which they com- 

 pare with ante-version of the gravid uterus of woman. The ex- 

 act condition is not very clear. According to Fleming, when the 

 hand is introduced into the vagina it reaches an imperforate cul- 

 de-sac, which consists of the floor of the uterus pushed up against 

 the floor of the vagina, thus projecting into the pelvic cavity, 

 while the os uteri is situated high toward the sacrum and is not 

 much dilated. The fetus lies beneath the vaginal floor and cor- 

 responds somewhat in its position to what we describe on page 715 

 as bi-cornual or transverse development of the fetus. 



While considering the location and attitude of the fetus in preg- 

 nant animals, on page 379, we have recorded occasionally finding, 

 during the later stages of gestation, an extremity of the fetus, 

 usually the head and two anterior feet, projecting into the pelvis 

 or immediately against the pelvic inlet, either above the vagina 

 or alongside of it, but we did not consider that this was abnormal. 



Fleming, citing Garreau, relates one case in which, in this 

 deviation, the os uteri was closed and the cervix was thickened 

 and indurated. Later it became necessary to perform Caesarian 

 section, by which the life of the cow was saved. This seems 

 rather to have been induration of the cervix. 



In another case, described by Schaack, the fetus was in a 

 normal position and was extracted, but the cow died almost im- 

 mediately from an extensive rupture in the floor of the uterus, 

 which led to a fatal hemorrhage, in a similar way, apparently, to 

 what we record as a common consequence of forcible extraction 

 in cases of bi-cornual development of the fetus. 

 692 



