552 OBSTETRICAL OPERATIONS. 



Horsburgi recommends, if atresia is complete, to pass the finger or 

 a blunt instrument into the os, then introduce a stout, sharp-pointed, 

 curved bistoury about four inches long — dividing the stricture laterally 

 by two incisions — always drawing the bistoury towards the operator ; 

 after which he is to introduce both hands, with the palms towards each 

 other, and press them apart. " He will find the part immediately 

 dilate to the proper size, and labour may go on naturally ; or he may 

 then proceed to extract the Calf if labour has been protracted." 



The object in making the incisions only to a comparatively slight 

 depth, and not through the entire thickness of the os, is to prevent 

 extensive lacerations of the organ during the passage of the foetus. It 

 will generally be found that these partial incisions will, with a little 

 patience, admit the hand ; this being passed into the uterus, seizes the 

 presenting part of the young creature, places it in a favourable position 

 if necessary, and then begins to draw it gently into the os. 



Sometimes with primiparaB in good health and strong, delivery is 

 afterwards effected spontaneously, and this is the most favourable 

 result ; but in the majority of cases labour has been going on for a long 

 time — perhaps two days or more, the parent is exhausted, and the 

 uterine contractions are either suspended, or so feeble, as to preclude all 

 hope of their expelling the foetus. The head and fore-feet must then be 

 corded, and delivery accomphshed in the ordinary way. 



It is well to remember, however, that the traction resorted to must 

 be judiciously employed. It should be moderate, gradual, and sustained, 

 in order to allow the tissues of the cervix time to accommodate themselves 

 to the eccentric pressure imposed on them by the advancing foetus. To 

 act otherwise is to incur the grave risk of lacerating the uterus beyond the 

 possibility of repair, and is quite as reprehensible as making deep 

 incisions. 



"With regard to the consequences of vaginal hysterotomy, it must be 

 admitted that it is not without danger, and that death not infrequently 

 results. There are no reliable statistics to serve as a guide in estimating 

 the amount of success or non-success following its performance, as not 

 all— or perhaps not many — of the cases are published. Saint-Cyr has 

 collected forty cases — all published in France and Belgium since the 

 commencement of the century, and an analysis of these gives the follow- 

 ing results : 



Mother and progeny saved in 14 instances. 



Mother saved — fate of the progeny not mentioned — in 9 

 Mother alone saved in - - - - - - 5 



Progeny saved, mother died, in - - - - - 6 



Mother succumbed — fate of progeny not mentioned — in 5 

 Mother and progeny perished in . . . - 1 



So that of 40 Cows operated upon, 28 survived, and twelve — or 30 

 per cent. — succumbed ; while, with regard to the progeny, 14 Calves 

 were delivered alive and continued to live, and 6 were dead ; nothing is 

 said as to the other 14. 



In other words, of 80 lives more or less compromised, 18 at least — or 



22i per cent. — were not saved by the operation. But Saint-Cyr is 



inclined to think that if all the successful cases have been published, 



there is reason to believe that all the unsuccessful ones have not ; and 



^ Veterinarian, vol. xviii., p. 215. 



