DISEASES OF THE GENERATIVE ORGANS. 175 



paunch occupies the whole left side of the abdomen and extends 

 across its floor to the right side. Its upper surface thus forms an 

 inclined plane, sloping from the left downward and to the right, and 

 on this sloping surface lies the pregnant womb. 



It is easy to see how, in the constant movements of the paunch 

 upon its contents and the frequent changes of position of the growing 

 fetus within the womb, to say nothing of the contractions of the adja- 

 cent bowels and the more or less active movements of the cow, the 

 womb should roll downward to the right. Yet in many cases the 

 twist is toward the left, showing that it is not the result of a simple 

 rolling downward over the paunch, but rather of other disturbances. 

 The condition may be suspected when labor pains have continued 

 for some time without any sign of the water bags, and it is con- 

 firmed when the oiled hand, introduced through the vagina, finds the 

 mouth of the womb soft and yielding, but furnished with internal 

 folds running forward in a spiral manner. If the folds on the upper 

 wall of the orifice run toward the right, the womb is twisted to the 

 right ; if, on the contrary, they turn toward the left, it indicates that 

 the womb is turned over in that direction. The direction of the twist 

 must be known before treatment can be undertaken. Then, if the 

 twist is toward the right, the cow is laid upon her right side with her 

 head downhill, the hand of the operator is introduced through the 

 spirally constricted neck of the womb, and a limb or other portion of 

 the body of the calf is seized and pressed firmly against the wall of 

 the womb. Meanwhile two or three assistants roll the cow from her 

 right side over on her back to her left side. The object is to hold the 

 womb and calf still while the body of the cow rolls over. If success- 

 ful, the twist is undone, its grasp on the wrist is slackened, and the 

 water bags and calf press into the now open passage. If the first 

 attempt does not succeed, it is to be repeated until success has been 

 attained. If the spiral folds on the upper wall of the opening turn 

 toward the left, the cow is laid on her left side and rolled over on 

 her back and on to the right side, the hand being, as before, within 

 the womb and holding the fetus, so that all may not rotate with the 

 cow. In introducing the hand it will usually be found needful to 

 perforate the membranes, so that a limb of the calf may be seized 

 direct and firmly held. Among my occasional causes of failure with 

 these cases have been, first, the previous death and decomposition 

 of the fetus, leading to such overdistention of the womb that it could 

 not be made to rotate within the abdomen, and, second, the occur- 

 rence of inflammation and an exudate on the twisted neck of the 

 womb, which hindered it from untwisting. 



In obstinate cases, in which the hand can be made to pass through 

 the neck of the womb easily, additional help may be had from the use 

 of the instrument shown in Plate XX, figure 5. Two cords, with run- 



