322 



3IATERNAL DYSTOKIA. 



In very exceptional instances, however, the torsion may have occurred 

 in front of the cervix — in the body of the uterus ; and then the cervix 

 may be easily reached, while the os may even be penetrated, without 

 discovering any indications of the accident. Such occurrences have 

 been recorded by Stockfleth, Ercolani, and Eueff ; and these excellent 

 authorities have also witnessed the torsion limited to the cornu contain- 

 ing the foetus. Here we have neither the constriction of the vagina, 

 nor the spiral involutions of its lining membrane, to guide us to a con- 

 clusion, and we must mainly rely on rectal exploration. 



Fortunately, such cases are all but unknown in practice, and prob- 

 ably in ninety-nine per cent, it will be found that the twisting has taken 

 place at the cervix, when we have the infallible distinctive sign — the 

 spiral rugae in the vagina. 



2. The Direction of the Torsion. — It has been demonstrated that the 

 uterus may revolve on itself in two different directions, and that in 



A B 



Fig. 88. 

 A, Cord twisted to the Right ; B, Cord twisted to the Left. 



order to make a complete revolution, its upper face may become right 

 lateral, then inferior, then left lateral, and again superior; or if it re- 

 volves in the opposite direction, it will become successively left lateral, 

 inferior, right lateral, and once more superior. 



We have casually indicated how the direction of the twist may be 

 discovered when it has not made a complete revolution. But the 

 manner of discovering to which side the gravid uterus has inclined, 

 has been one of the most debatable in the history of this accident, 

 and has occasioned much controversy and the most contradictory in- 

 terpretations ; up to the present time, in fact, the problem has not 

 met with a satisfactory solution. The confusion prevailing with re- 

 gard to what appears such a simple matter, is well exemplified in the 

 discussion which took place in 1860, at a meeting of the Central Veter- 

 inary Medical Society of Paris, at which the most opposite notions were 

 promulgated. And yet, next to assuring one's self that torsion does 

 exist, the ascertaining of the direction it follows is of supreme impor- 



