592 ACCILEXTS AFTER PAETUBITIOX. 



cases, and with advantage. The needle — either the above or a small 

 seton needle — is passed through a fold of skin lifted up at the point of 

 the hip or ischium, on a level with the upper commissure of the vulva, 

 and carried across to the other hip. The next suture is a trifle lower, 

 and the others below this : there being, in all, about four to six sutures, 

 the ends of each being tied in the middle, or fastened to bits of round 

 wood at each side. In this way the vulva lies behind a number cf 

 strong cords — their strength and durability being in proportion to 

 the width of skin they are made to enclose. The sutures maybe drawn 

 more or less tightly, and they may either be transversely parallel or 

 cross each other obliquely. 



When the animal is not pregnant, the vulva is not nearly on a level 

 with the ischial tuberosities. After parturition, however, it is swollen 

 and prominent, and projects beyond these parts. It will therefore press 

 against the hip sutures, and may even become excoriated or cut by 

 them ; so that, to avoid injury and diffuse the pressure, it is well to 

 place a thick pledget of tow or other soft material on each side of the 

 vulva, on which the sutures may chiefly rest. 



Though good service has been obtained from these sutures in a 

 number of instances, yet many practitioners prefer the metallic suture. 

 This may be of lead, or iron wire softened. The needle is like that 

 used for the other sutures ; a pair of wire-pliers is necessary, and two 

 sizes of wire are recommended. The thickest size is cut into pieces of 

 a convenient length, and an eyelet turned at one end, w^hile the other 

 is made into a hook. The left lip of the vulva is seized by the left 

 hand, and the needle pushed through it from the outside, a little 

 obliquely upwards, so as to bring it out above the superior commissure ; 

 the wire is passed into the eye at the point, and the needle being 

 smartly withdrawn, the wire is pulled through. The needle is intro- 

 duced into the right lip in the same manner, but downwards, and the 

 wire pulled through it. The hooked end is now passed into the one 

 with the eyelet, drawn sufficiently through, cut off, and the end bent 

 also into an eyelet, the suture constituting an ellipse at this part, which 

 is opposite the vulvar opening. Beneath this suture one or two more 

 are placed, and all are joined together by the thinner wire, which, 

 doubled, is longer than the space occupied by the sutures ; each piece 

 is passed into each eyelet of the upper suture, and firmly crossed and 

 twisted as far as the two points of the suture ; the same is done with 

 the second and the third suture — the whole being joined into a solid 

 piece, which, according to report, does not interfere with the physiolo- 

 gical functions of the animal. 



The same objection applies to wire sutures through the vulva as to 

 vegetable sutures ; bub there can be no doubt that they are less painful 

 and more effective when passed through the skin at the point of the 

 hip. Two wires across are generally sufficient ; the ends are bent round 

 by pliers after they are inserted, and through these eyelets on each side 

 a vertical wire is passed (Fig. 213). This keeps the horizontal wires 

 together and in place. 



Metallic sutures in the form of pins, screwed at one end to fix into 

 plates after being passed through the labia of the vulva, and other con- 

 trivances of this description, have been described ; but in principle 

 they are all the same, and there is no manifest advantage in their 

 employment. 



In fact, it may be said of all the labial or other sutures, that they in 



