584 ACCIDENTS AFTER PARTURITION. 



— wholly or partially — they must be carefully removed without injuring 

 the cotyledons, enucleation being effected in the manner already 

 described. If properly performed, this removal should not cause any 

 haemorrhage ; and if any pulpy gangrenous cotyledons are found, it is 

 better to remove them at once with scissors than leave them to be 

 eliminated in the ordinary way ; though if they show any vitality at all 

 they need not be interfered with. Torn or gangrenous portions of 

 mucous membrane are also to be excised in the same manner. 



This done, the uterus should be cleansed from matters adhering to its 

 surface- — such as litter, mud, dirt, filth or blood; this may be effected 

 by means of a fine soft sponge or cloth, the fluid employed being either 

 cold or tepid water, milk and water, some astringent or soothing lotion, 

 if there is much tumefaction or irritation, or a stimulating fluid— as the 

 dilute tincture of opium — if the organ is much bruised and congested. 

 Some practitioners immerse the entire uterus in a bucket containing 

 either of these fluids ; and some particularly prefer cold water, allowing 

 the organ to remain in it for as long as five or ten minutes. By this 

 means it is freed from extraneous matters and cleansed ; while the con- 

 gestion is allayed and the mass considerably reduced in size.^ Meyer, 

 Pfirter, and others state that this immersion in cold water has an 

 astonishing effect, and greatly facilitates reposition. Schnee even recom- 

 mends the application of ice, which, he asserts, not only diminishes the 

 volume of the protruded organ, but allays its irritability and contractions. 

 When attempting to reduce the cornu or uterus, he holds a piece of ice 

 in the hand he applies to the part. 



If from long inversion and consequent congestion, infiltration or 

 inflammation, the volume of the uterus is so increased that it appears 

 impossible to return it, scarifications may be made on its surface ; these 

 often lead to a notable decrease in its size, and reduction may then be 

 effected. If it is determined to scarify the organ, the greatest circum- 

 spection should be observed in making the incisions ; they must be quite 

 superficial, and only a few at a time. Should the haemorrhage prove 

 excessive — which it sometimes does when the scarifications are deep 

 and numerous — then styptics must be applied. 



When the organ is so increased in size that it cannot be returned, it 

 is well to ascertain whether this is not due chiefly to the intestines 

 having entered the pelvic cavity and filled the space in the inverted 

 uterus. If this be the case, they must be removed from it before reduc- 

 tion is attempted. 



Coculet's- method of reducing the size of the congested uterus has 

 been successfully employed on many occasions. A dry and clean 

 piece of linen, about a yard in length, and twenty-eight to thirty 

 inches wide, is passed beneath the inverted uterus, and close up to the 

 vulva ; its lower border is then lifted over the organ, one of the ends 

 folded over it, and the other end over this, so as to envelop the entire 

 uterus — the four corners of the wrapper being uppermost. Tepid 

 water is now kept incessantly applied to this cloth, which is gradually 



^ A little care on the part of owners of animals would often prove of great advantage 

 in averting serious consequences in such an accident as inversion of the uterus, befoie 

 the arrival of the veterinary surgeon. This care should be mainly directed to keeping 

 the animal in a standing attitude, and preventing the uterus from being soiled, bruised 

 or torn, as well as swollen. The organ may readily and easily be preserved from injury 

 by receiving it on a sheet or large cloth, or. better still, a basket or tray, and keeping 

 it well raised until professional assistance arrives, 



2 Journal des Veterinaires du Midi, 1862. 



