326 MATEEXAL DYSTOKIA. 



Prognosis. 



With the Cow, torsion of the uterus must be looked upon as a serious 

 accident ; for except in a few exceptional cases, when assistance is not 

 rendered the foetus and mother have always perished. Nevertheless, 

 notwithstanding its grave character, modern veterinary science does 

 not consider it beyond remedy ; and its records show that, by judicious 

 intervention, mother and offspring may often be saved. 



But in order to attain this happy result, a careful diagnosis must not 

 only be made, and the direction and extent (if possible) of the torsion 

 clearly ascertained, but the proper mode of restoring the uterus to its 

 normal position must also be observed and skilfully carried out. 



A cautious opinion must always be given, but its favourableness will 

 of course depend upon the brief duration of the parturient symptoms, 

 the degree of torsion, the condition of the animal, and whether it has 

 been subjected to unskilful manipulation before the veterinarian has 

 been called in. 



Pathological Anatomy. 



When the animal has been subjected to manipulatory manoeuvres to 

 effect delivery, or when it has been permitted to live many hours after 

 signs of parturition have appeared, the first important alteration noted 

 on opening the abdomen is that due to peritonitis. There is a quan- 

 tity of blood-tinted serum effused into the peritoneal sac, in which float 

 shreds of fibrin ; and the lining membrane is reddened, deeply injected 

 with blood in parts, and particularly those which have been in contact 

 with the uterus ; not uufrequently there is a fibrinous exudate on its 

 surface, and this may cause adhesion between it and different organs. 



On removing the intestines and the floor of the pelvis, the uterus and 

 vagina are exposed, and the torsion is visible. This appears as a large, 

 hard cord, composed apparently of a number of spiral strands of unequal 

 size, the closest twined of w^hich are in the middle of the strangulation ; 

 this cord — formed by the termination of the vagina and the cervix and 

 body of the uterus — opens out its strands as it recedes from the densely- 

 twined portion towards the fundus of the uterus on one side, and to the 

 vagina on the other (Fig. 93). 



The broad ligaments are sometimes compressed between the spiral 

 folds, which they concur to form, and with which they are so intimately 

 connected that very often they cannot be recognised until the uterus 

 has been untwisted. In other instances, they merely envelop the twist 

 in crossing it ; so that the extent of the torsion cannot be seen until 

 the ligaments are detached from the ilium on each side. 



Earely, as we have remarked, are these ligaments ruptured ; and 

 though some veterinary authorities have maintained that torsion is 

 impossible w^ithout one or both being torn, yet this lesion is seldom 

 witnessed. In the large majority of cases, they are tense and greatly 

 stretched, tightly compressing the cervix and rendering occlusion of the 

 OS all the more rigid ; but when the uterus is reinstated in its natural 

 relations, they are found to be intact. 



If the uterus be seized at its fundus and turned in a direction con- 

 trary to that of the torsion, the strands of tbe latter gradually open, 

 widen, and are effaced ; while the strangulation disappears, the cervix 

 comes into view, and the vagina assumes its normal length and w^idth, 

 as well as its almost cylindrical form. 



So that the hand introduced into the vagina, ^;cr vulvam, no longer 



