/M'J-JnSIOX OF TUB UTERUS. r.91 



form, or such other shape as may best accommodate its contact with 

 surrounding parts. 



The value of pessaries in inversion of the uterus in animals has 

 been a good deal discussed. We are not aware that they have been 

 much, if at all, employed in this country ; and in Germany they do not 

 appear to have obtained much favour ; while in France, though they 

 have often been resorted to, yet tlieir use has been only limited, as their 

 practical utility has been questioned by many excellent obstetrists. 



It has been pointed out that if they can be supported without incon- 

 venience by some phlegmatic unimpressionable animals, more frequently 

 they irritate the organs in the pelvis, cause straining and uneasiness, 

 and produce those relapses which their application was intended to 

 avert. Therefore it is that, nowadays, they are not made available to 

 anything like the extent they were a few years ago. 



Saint-Cyr admits that if, in some exceptional case, it is necessary to 

 employ a pessary, the Piifs bladder deserves the preference for the 

 larger animals. It is found nearly everywhere, requires no other pre- 

 paration than merely softening its texture by pouring some tepid water 

 into it, whilst its outer surface can be well oiled. It is easily placed 

 where desired, even in the uterus ; its soft, flexible walls cannot bruise 

 or excoriate ; and, by inflation, it can be distended to the size necessary 

 for each particular case. 



Sutures. — The suture is generally preferred to the pessary, as being 

 simpler, more easily applied, and having fewer inconveniences than 

 the latter. Being inserted outside the genital organs, they do not 

 irritate those which are most concerned in inversion, neither do they 

 provoke expulsive etTorts on the part of the animal. 



The sutures may be of hemp, silk, or metal ; and they may be passed 

 dii-ectly through the lips of the vulva, or include the skin towards the 

 point of the hip, on each side. The first may be named the labial 

 suture, the second, the Jiip suture. 



The labial suture may be " interrupted," or " quilled," and is made 

 according to the principles of surgery. A saddler's large needle, or a 

 sacking-needle with a handle at one end and an eye near the point, is 

 the most useful. Through the eye is passed a piece of whipcord, two 

 or three strands of woll-waxed thread, or a piece of cotton or silk tape, 

 or moderately thick carbolised catgut. The needle is passed through 

 one lip of the vulva— say the right — from the outside, and near tlic 

 up})er commissure ; it is then passed through the left lip, from within 

 to without, towards the inferior commissure. It is then cut from the 

 suture, sutVicient of the latter being left for both ends to tie in the 

 middle of the vulva. A second suture is placed in the contrary direction 

 — upper part of lt»ft to lower part of right lip- so that the two sutures 

 cross each other obliquely, in an X fashion. The ends are now tied 

 towards the centre of the vagina ; and, if thought necessarj', a third 

 suture, directly transverse, may be placed between these. 



It is more convenient and painless to pass the needle first through 

 the tissues, then the suture through the eye of the needle, withdrawing 

 the latter, which carries the suture with it. 



This labial suture is painful, as it is placed in textures already swollen 

 and sore, and it does not always retain a sufficiently solid hold to pre- 

 vent the uterus tearing it out when the straining is very severe and 

 violent. The hip suture has therefore often been resorted to in these 



