304 MATERXAL DYSTOKIA. 



gave birth to a dead Puppy, and on the foUowinsf day the dinsinished distention of the 

 abdomen enabled him to discover, beneath the skin, the presence of three fnetuses. On 

 inquiry, he ascertained that for some time the animal had been sufiFering from an 

 inguinal hernia on the left side, and this information led him to adopt active measures. 

 The skin was incised over the isolated hernial sac, as far as the inguinal c^nal ; then, 

 after largely opening the tumour, as well as the uterine cornu it cuntained, he was able 

 to remove the three dead foetuses and their membranes. The prolapsed uterine portion, 

 having been carefully cleansed, was closed by suture and returned to the abdominal 

 cavity, and a strong ligature placed round the sac. The inguinal canal had been widely 

 incised ; but notwithstanding this, the reduction of the uterus and its appendages offered 

 somo difficulties, in consequence of the great mass of fat in and upon the broad ligaments 

 surrounding them. Evei'ything appeared to be going on favourably until the ninth day, 

 when the animal suddenly succumbed. Death was attributed to purulent absorption, 

 produced through the agency of a small abscess on the broad ligament, which had been 

 abraded during the operation of reduction. There were no traces of metro-peritonitis, and 

 the wound in the uterus, as well as in that portion of the sac which had been ligatured, 

 was cicatrising most satisfactorily. According to Kopp, this was an instance of intra- and 

 extra-abdominal pi'egnancy at the same time ; and in proof of this, he pointed to the 

 narrowness of the inguinal canal, aiid the presence of the uterine hernia previous to 

 impregnation. 



Three of the foetuses were developed in the cornual hernia, and the fourth in the bod)' 

 of the uterus. 



Chanel reports that a Sow brought forth young after a portion of one 

 of the uterine cornua containing two foetuses, and which had been 

 hernied, was amputated. 



Notwithstanding these instances, however, the assistance of the 

 obstetrist is necessary to effect dehvery, for which a careful examina- 

 tion, as in diagnosis, will indicate the means. 



Previous to parturition the hernia should be supported, when pos- 

 sible, by a truss or retaining bandage, and care should be taken to 

 prevent over-exertion or straining. 



With the larger animals, delivery by the natural passage is, of course, 

 the chief object to be attained. In certain cases, the simplest measure, 

 and which is sometimes all that is necessary, is to elevate the hernia 

 by means of a sheet or blanket passed under it, and raised by an assis- 

 tant at each side of the animal. Manipulation ^^er vaginam may 

 supplement this support, and in the majority of such cases may even be 

 absolutely necessary to complete delivery. 



In other instances, however, the foetus cannot be removed from the 

 hernial sac without placing the female in a recumbent posture. Either 

 lateral or dorsal decubitus may be resorted to, according to circum- 

 stances, but the preference is usually given to the latter position ; 

 though when lateral decubitus is tried, the animal should be placed on 

 the side opposite to that in w^hich the hernia exists. 



In the dorsal position, the weight of the foetus and uterus is removed 

 from the floor of the abdomen ; consequently, the abdominal muscles 

 are relaxed, and the borders of the hernial opening are not so tense ; 

 while the uterus and its contents, by their own weight, have a tendency 

 to escape from the hernia and fall into the abdomen ; at the same time 

 the foetus is more accessible to the hand of the obstetrist. 



Should the os be contracted, it must be dilated by the hand; if the 

 membranes are intact, they are to be ruptured ; should the foetus make 

 an unfavourable presentation, which is not very frequent in these cases, 

 this can be rectified ; and if the creature is dead, which is nearly always 

 the case when assistance has not been rendered sufficiently early, and 

 the membranes are ruptured, it can be all the more easily removed. 



When the foetus presents anteriorly and the head can be seized, this 



