358 MATERNAL DYSTOKIA. 



made. Joulin makes those he uses in the following manner : — From a 

 somewhat fine and dry sponge of inferior quality, he cuts two long 

 conical pieces, one about three and a quarter mches in length, about an 

 inch wide at the base, and one-third of an inch at the apex ; the other five 

 or six inches in length, two and a half inches at the base, and one-third 

 of an inch at the apex. Of course they would require to be larger for 

 animals. 



These cones are then prepared for use by wrapping them closely 

 round in twine, the circles of which should be so near each other as not 

 to leave ridges on the sponge. By this pressure the tents become 

 extremely compact, and look like a thick bougie. 



When required for use, the twine is removed — this should not be 

 done until the tent has been prepared for at least two or three hours, 

 when it will have acquired sufficient rigidity. A piece of cord should 

 be attached to its base, so as to allow it to be w^ithdrawn when inserted 

 in the os ; but before this insertion takes place, the apex must be 

 covered with a little lard, cerate, or extract of belladonna. The sponge 

 is passed into the os as far as possible, either by the fingers or forceps, 

 and until the base of the tent is close to the margin of that opening. 

 The narrow and slightly flexible apex of the tent allows of its passage 

 through the os into the uterine cavity ; but in order to be successful the 

 operation must be quickly performed, otherwise the sponge rapidly 

 absorbs mucus and loses its rigidity. 



No plugging or other means are necessary to retain the tent, as the 

 portion which projects into the uterus quickly increases in size from the 

 absorption of moisture ; so that, after a few minutes, a certain amount 

 of force is necessary to withdraw it therefrom by means of the cord. 



The sponge-tent acts in several ways, and simultaneously : 1. It 

 detaches the membranes, and this is often sufficient to induce labour ; 

 2. It acts as a foreign body in irritating the posterior segment of the 

 uterus, which reacts by contracting ; 3. It dilates the inner opening of 

 the OS ; 4. It also dilates the entire length of the os, by swelling through 

 imbibition of the uterine mucus. 



To obviate the risk of softening before it is inserted into the os, Joulin 

 prepares the tent in the following manner. Instead of wrapping it 

 round with twine while it is in a dry state, he saturates the sponge in a 

 solution of gum arabic, and then having rolled the twine round it, 

 leaves it to dry for some days. After this treatment it preserves a cer- 

 tain degree of suppleness, but may remain for a minute or two in 

 contact with mucus before imbibing it. 



Barnes' procedure for the dilatation of the os uteri in woman, has 

 also proved of great service in human obstetrics ; but to our knowledge 

 it has only once been tried with animals, though there is no reason why 

 it should not be successfully employed, not only in producing abortion 

 in those cases to which we have pi'eviously alluded, but also in the 

 morbid condition now under consideration. 



This procedure consists in dilating the os by means of fiddle-shaped 

 india-rubber bags, which, for women, are of three different sizes ; but 

 the very largest of them would probably be required as the smallest size 

 that could advantageously be used for the Cow or Mare.^ 



The bag (Fig. 95), in an empty condition, is introduced into the os by 

 means of a whalebone sound or director, which fits into a small pocket 



^ These bags are made by Weiss and Son, surgical instniment makers. Strand, 

 London. When ordered, the animal for which they are to be used should be mentioned. 



