IM'EJiSIOX OF THE CTEIU'S. 587 



In ortler to accomplish this, the assistants on each side of the croup 

 raise the uterus in the manner ah-eady described, so as to bring it near 

 the vulva, and opposite the axis of the pelvis. Then the operator gently 

 presses with open hands at each side on the parts close to the vulvar 

 opening, in order to force them gradually into it. By acting in this way 

 with care and patience, and preventing, as well as he can, the expulsion 

 of those portions he has already reduced, the tumour by degrees becomes 

 diminished, and may even be entirely returned. But it is not necessai-y 

 to continue the method after two-thirds or three-fourths of the total 

 mass has been carried into the pelvic cavity ; for it is then more ex- 

 peditious, and quite as safe, to apply the closed fist to the extremity of 

 the tumour, and push it directly into the vagina and abdomen. In 

 some instances it will be found that, towards the termination of reduc- 

 tion, the organ itself returns to its normal position, and often quite 

 suddenly, as if it had been thrown forward ))y a spring. 



Sometimes a combination of the first and second methods is most 

 useful — an assistant pressing on the extremity of the tumour, while the 

 operator manipulates near the vulva. 



When the uterus has been returned to the abdominal cavity, the 

 operator has then to ascertain if it is properly disposed. It sometimes 

 happens that the extremity of one or other of the cornua remains 

 invaginated in itself to a certain extent, and thus renders reduction 

 incomplete ; this will undoubtedly induce renewed straining, and in 

 all probability bring about re-inversion. It is, therefore, essential 

 that the hand of the operator should carefully examine every part of 

 the interior of the uterus and the genital canal, and particularly around 

 the cervix. 



This is more especially necessary when, after reposition has been 

 efifected, straining continues — a sure indication that the parts are not 

 in their normal position. The hand must be again introduced, and if 

 any abnormal folds of the mucous membrane — any commencing invag- 

 ination — is encountered, they must be gently smoothed down or adjusted 

 — not forgetting, should the cornua be involved, the very dissimilar dis- 

 position of these in the Mare and Cow. 



When reposition has been finally accomplished, the straining ceases, 

 and the animal soon appears to be quite easy : that is, if reduction is 

 made early — on the same day, for instance — and provided there is no 

 injury to the organ. It is generally advisable to keep the hand in the 

 uterus for a short time until the latter begins to contract freely ; if this 

 is not done, the flaccid organ may again become inverted. 



With the smaller animals, reposition is rendered diflicult because of 

 the pelvis not admitting the hand ; and with some of them, and par- 

 ticularly the Sow, reduction of the prolapsed cornu or cornua is often a 

 serious matter. The cornua must bo reduced in the manner already 

 indicated, the finger, or even a tallow candle, being employed to adjust 

 them, then the body of the organ should follow ; a small pessary witli 

 a handle, or retroverter, may be used to complete the operation. Frick,* 

 a Swiss veterinarian, has adopted a plan which has succeeded in his 

 hands, and also with other obstetrists who have tried it. The inverted 

 organ being reduced, the animal is raised by the hind-limbs, and a 

 quantity of mucilaginous fluid is injected into the vagina and uterus, 

 until they are tilled. This fluid acts in a mechanical manner, forcing 

 the uterus to distend and assume its ordinary form. It has been 

 ' Schicfizer Archii:, vol. xii., p. '249. 



