TORSION OF THE CTEKCS. 3M 



2. Vaginal Hystekotomy. — Vieillard, so long ago as 1823, removed 

 the fu'tus from a twisted uterus by means of vaginal section. In INOO 

 Ercolani proposed riKjiiuil lii/sterotomif, the opening being made through 

 the upper wall of the vagina, for the reposition of the twisted uterus. 

 The operation is of the same kind, and is conducted in a similar manner, 

 as that for the castration of Cows, introduced by Charlier ; except that, 

 instead of the ovaries being seized, the uterus is grasped through tlie 

 wound, and attempts iiuide to untwist it. Huetf speaks in favour of the 

 proceeding ; but we cannot find that it has ever been carried into 

 practice, and serious doubts may be entertained as to the likelihood of 

 its being successful, owing to the weight and size of the gravid uterus, 

 and only one hand being employed to turn the displaced mass, unless 

 the torsion be very trifling ; in which case a simpler operation might 



'succeed. 



If attempted, not much risk nu\y be apprehended from incising the 

 vagina, as it has generally been found to be attended with little danger, 

 and cicatrisation soon takes place. 



3. Vaginal Taxis. — All sanguinary and serious operations for the cure 

 of uterine torsion — like the two preceding — should be avoided, if 

 possible, until the simpler means which modern veterinary science has 

 indicated are tried. We allude more particularly to version, which 

 rarely fails to ])ring the case to a satisfactory termination. That is, of 

 course, on the assumption that this is resorted to sufliciently early ; for 

 it must be i-emembered tliat nothing is gained by delay in this accident, 

 and if relief is to be afforded it must be rendered promptly, and as soon 

 as the existence of displacement is fairly established. When delay has 

 been allowed to take place, more or less serious consequences must 

 ensue to either the fcetus or the maternal organs, or to both. 



In certain cases of very incomplete torsion — quarter rotation of the 

 uterus, for instance — and when there is sufficient space in the vagina 

 for the hand to pass through the obstacle and into the os or uterus, 

 detorsion has been accomplished by seizing the most suitable parts of 

 the fcetus and exercising direct traction on it. Instances of success by 

 adopting this course have been furnished by Chambon, Cann, Gaven, 

 Darreau, and others. 



The mode of procedure maybe as follows: — After ascertaining the 

 direction of the torsion, the arm is to be introduced into tlie uterus as 

 deeply as possible ; if the fastal membranes are yet intact, they must be 

 largely ruptured, and the most convenient parts of the fcjctus sought for. 

 In this respect it will be found that every part of the young animal does 

 not offer the same advantages to the operator, for reposition of the 

 uterus. The head is too large, and does not afford sufficient hold for 

 the hand ; the pasterns and knees are too much removed from the 

 body and too round ; but the hocks and elbows are, of all parts perhaps, 

 those best adapted for this kind of manipulation. If one of them can 

 be reached, it should be firmly grasped, and endeavours made by it to 

 raise the body of the fa?tus, at tlie same time giving it a turning move- 

 ment contraiy to that which would be given to the uterus in order to 

 untwist it. 



Supposing, for example, that the torsion is to the right, and that the 

 fcetus, offering an interior presentation, is, from the fact of the quarter 

 revolution of the organ, in the right dorso-ilial position ; then the object 

 must be to place it in the dorso-sacral position. 



