Retained Placenta in the Cozv 805 



firmly attached to it, but sloughed away from the uterine walls. 

 The removal of the cotyledons and chorion, with irrigation of the 

 uterus, was followed by uneventful recovery, without destroying 

 the fertility' of the cow. 



Because of these experiences with necrosis of the cotyledons, 

 we hold in all those cases where the uterine walls are compara- 

 tively sound and the cotyledons have undergone necrosis, that 

 the veterinarian is not only warranted in removing them, but 

 that their removal is clearly indicated as the proper surgical 

 procedure. 



Such removal of the cotyledons in the cow is somewhat anal- 

 ogous to the curetting of the placenta in woman. It produces, 

 in proper cases, the same results. It removes the decaying frag- 

 ments of the fetal membranes and the irrecoverably diseased 

 maternal placenta. 



While the decomposing chorionic tufts are incarcerated within 

 the crypts of the cotyledons, and the cotyledons are yet alive but 

 diseased, the diseased surface, from which bacterial poisons may 

 be absorbed, is the superficial area of the mucosa of all the pla- 

 cental crypts. When the cotyledon has been removed, the re- 

 ceptive surface is reduced to the area of the cross section of the 

 cotyledonal stalk — probably less than 1 000th part of the area of 

 the placental epithelium. 



The collateral handling will vary greatly, according to cir- 

 cumstances. If the patient is not seriously depressed, if she is not 

 straining abnormally, if her temperature and appetite are good, 

 there is no call for general medication. When there are evi- 

 dences of serious constitutional disturbances, such as fever and 

 weakness, the patient should be supported and strengthened by 

 easily-digested, nutritive foods, if she will take them, to which 

 may be added stimulants and tonics. Alcohol is especially use- 

 ful, and may be given in large and frequent doses. When symp- 

 toms of septicaemia appear, it has been our practice to administer 

 large doses of quinine, and in our experience the results have 

 been good. 



Some have practiced and advised the administration of 

 ecbolics such as ergot, savin and rue, but this is opposed by many 

 and the clinical evidence of the value of this group of drugs is 

 not clear. 



