306 MATERNAL DYSTOKIA. 



being nearly all that can be done to palliate the effects of the acci- 

 dent. 



All these considerations should, of course, be duly estimated by the 

 veterinary surgeon in undertaking the treatment of such a case ; and 

 it is scarcely necessary to say that, with the Cow more especially, the 

 butcher will frequently have to be called in when the question of risk 

 and expense has been fairly discussed. 



It need hardly be pointed out that it is generally very injudicious to 

 attempt to breed from an animal affected with hysterocele, or an abdo- 

 minal hernia of any description, notwithstanding the fact that this con- 

 dition may not militate against gestation and parturition in every case. 



With the smaller animals, and especially the Bitch, the Caesarian 

 operation has usually to be resorted to for various reasons, if birth 

 cannot take place ; the chief of these are the small size of the creature, 

 the difficulty in reaching the foetus or foetuses and extracting them by 

 the natural passage, as well as the irreducible nature of the hernia, 

 which is often extremely constricted at the neck, and attempts at 

 reduction are often followed by death. Besides, the Bitch withstands 

 very serious operations in the abdominal region better almost than any 

 other animal, the entire uterus having been frequently removed by 

 abdominal section without a fatal termination. In this animal the 

 operation is also very simple, and demands only ordinary care and 

 manipulative skill. 



Everything is, therefore, in favour of gastro-hysterotomy in uterine 

 liernia of the pregnant Bitch ; but in order to ensure whatever success 

 may be possible, it must be performed early, and before serious injury 

 has been done by attempts at reduction or delivery in other ways. It 

 has been argued that it might be preferable to open the sac, divide the 

 constriction w^hich prevents reduction, and return the gravid uterus to 

 the abdomen, when delivery might be effected in a natural and spon- 

 taneous manner. And it has been shown that this mode of operating 

 is rational and possible, and may be followed by success should there 

 be no adhesions between the misplaced uterine cornu and the hernial 

 pouch. The experience gained in such cases, however, does not testify 

 very markedly in favour of this procedure, and the evidence is certainly in 

 favour of the Ceesarian operation, and particularly when adhesions exist. 



The dangers to be apprehended from gastro-hysterotomy are inflam- 

 mation and strangulation of the imprisoned cornu and of the uterus, 

 which at this time is so vascular, impressionable, and particularly 

 susceptible to the influence of the air on its internal surface. To avert 

 these dangers, it has been proposed to remove the uterine horn 

 altogether ; and we are certainly of opinion that, in certain cases, the 

 proposal is worthy of a trial. 



We will describe the Ceesarian operation in another place. 



Deviation of the Utekus. 



By the term deviation, when applied to the uterus, is meant a change 

 in the direction of the organ, by which the cervix and os no longer 

 correspond to the axis of the vagina. This change of direction in the 

 vaginal opening of the uterus may be productive of more or less 

 difficulty in parturition. 



Changes in the position of the uterus are somewhat common in 

 woman, whose vertical uterus may easily deviate in any direction, 

 producing those flexions and versions which not infrequently ofler 



