MORBID ALT Kll AT IONS IX THE GENERATIVE OROANH. 353 



pass for a certain distance between the membranes before entering the 

 cavity of the sac, in this way imitating the entrance of the ureters. The 

 operation was completely successful, as the bladder had been little more 

 than half emptied before the hernia was spontaneously reduced. 



Cartwright says, with regard to treatment of cystic inversion : "Pro- 

 vided we are called to the case at an early period, and before a thicken- 

 ing of the parietes of the bladder and sphincter has taken place, we 

 most probably will succeed. We should, with the left hand, press 

 gently upon the sides, and with the right hand the fundus of the 

 bladder, until we feel it gradually receding from us ; after which we 

 may carefully introduce a pessary or catheter, so as fairly to force it 

 mto its natural situation. If there should be violent straining at the 

 moment we are employing the staxis, we had better desist for a time 

 until we have abstracted four or live quarts of blood, or give a dose of 

 opium in solution, to allay any irritation or spasm. But if we cannot 

 succeed in this way, I think a far more preferable plan will be to get a 

 stick with a round blunt point that will pass through the sphincter, and 

 force it against the base of the protruded fundus. A very excellent 

 instrument would be a female catheter, such as is used for the Cow or 

 Mare, as it would have the necessary curve. In thus trying to re-invert 

 it, we may use considerable force without rupturing it ; though, of 

 course, we must be cautious in our pressure." 



Sometimes it is no sooner returned than it is again everted, and this 

 repeatedly. In such cases pencilling around the meatus with nitrate of 

 silver, dashing cold water on the vulva, and walking the animal quickly 

 about, have caused its retention. 



Should the distended cystocele be immediately in the track of the 

 foetus, and the expulsion of the latter urgent, if the bladder cannot be 

 returned before birth it must at least be emptied, to allow the young 

 creature to get through the vagina. As the latter passes over it, the 

 viscus should be protected from injury by the fingers. 



We will return to a consideration of this condition when treating of 

 the accidents occurring as a sequel of parturition. 



TUMOUKS IN THE VICINITY OF THE GENITAL ORGANS. 



Tumours in the bladder, when of large size — as polypi, steatomatous 

 growths, etc., as well as calcareous concretions, may hinder parturition, 

 or even render it impossible, j-^ven an excessively distended bladder 

 may ofifer an obstacle to the accomplishment of this act, either in 

 checking the advance of the foetus, or by sympathetically disturbing the 

 uterine contractions. 



The indications here are obvious. 



Tumours of various kinds may be developed in the connective tissue 

 of the pelvic organs, and especially between the vagina and rectum, and 

 more or less obstruct labour. Ovarian tumours may also prove trouble- 

 some, as may likewise multiple abscesses and cysts in the neighbour- 

 hood of the genital passages. In some cases these may be successfully 

 punctured ; in others extirpation may be possible ; while in others, 

 again, the obstetrist can only choose between embryotomy and the 

 Caesarian section. 



Distention of the rectum from an accumulation of faeces may prove a 

 cause of dystokia — particularly in the Mare ; but this should be easily 



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