MUllBIl) ALTKllATinXS IX THE CEXERATIVE OUHAXS. 319 



the elongation of their pedicle, extend beyond the os into the va^'ina, 

 and even in some instances pass through the latter and the vulva, and 

 remain suspended between the thighs. A case of this kind has been 

 observed by Granaveri and studied by Ercolani.^ 



As we have observed, tlie presence of fibroids has a variable influence 

 on the process of parturition, according to their situation. Of course, 

 the larger, and particularly the submucous interstitial fibroids, only 

 very exceptionally allow successful fecundation to take ])lace ; though 

 in some instances, when this occurs, absorption follows. During labour 

 they may predispose to ruptui-e of the uterus, from the alteration they 

 have produced in the texture of the organ. 



Submucous or subperitoneal fibroids, when situated towards the 

 fundus of the uterus, or when only of a moderate size, very frequently 

 offer no particular obstacle to birth, and interfere but little with labour. 

 It is only when they are very large, and situated towards the cervix or 

 vaginal canal, that they may become a serious impediment to delivery. 

 Those with short pedicles, and which are designated " polypi," may be 

 rejected backwards before the advancing foetus, and be mistaken for 

 ^ome part of the latter by the unobservant obstetrist. 



Sometimes the tumours soften towards the termination of gesta- 

 tion, so that during parturition they may be sufficiently compressed 

 iud flattened for the fcetus to pass over them. If they have an 

 I longated pedicle attached to some part which is easily displaced, they 

 may be pushed beyond the vulva by the foetus, or the pedicle may be 

 ruptured by the latter, and the parturient passage thus left un- 

 obstructed. 



The recognition of these tumours is not very diflicult when they are 

 within reach of the hand. To prevent their being mistaken, during 

 manual exploration, for some part of an ordinary or deformed fcetus, 

 their nature and mode of attachment must be attended to. With this 

 object, the hand should be carefully passed between them and the 

 uterus and vagina in every direction, so as to find their pedicle, and 

 thus be assured that they do not belong to a fa^tus. 



With regard to the treatment, we must refer to the general indica- 

 tions already given. We may only add that when the tumours are not 

 very large, it is better not to interfere until Nature has done what it can 

 in overcoming the obstacle; for in these instances, as in so many others, 

 it sometimes effects surprising results. If they are pediculated and can 

 be reached, they may be incised, ligatured, or removed by the ocraseur ; 

 should the base not be attainable, or very extensive, they may be 

 partially extirpated. 



If, after parturition, there appears anything like serious hemorrhage 

 due to this extirpation, this may be suppressed by plugging with lint or 

 line tow, which may be steeped in perchloride of iron. 



THROMBI OR H^MATOMATA. 



Thrombus or ha-matoma of the vagina or \ailva, usually appears most 

 frequently after delivery. Pfirter, however, has recorded the case of a 

 Mare in which a large blood tumour, or hoematoma, was caused by the 

 rupture of bloodvessels and the escape of blood into the connective 

 tissue around the vagina. It formed a great swelling on the sides of the 



* OrtMc and Falconio. Studii suUe Xeoplasie a Massa distinta degli Animali Domestici, 

 p. 58. 



