600 ACCIDENTS AFTER PARTURITION. 



in the limbs, without swelling of the joints, but with marked knuckling 

 over of the hind-pasterns. It disappeared spontaneously as the patients 

 recovered from the other effects of the inversion. 



Abiputation of the Uterus — Meteotomy. — Though it should be 

 recognised as a rule that, provided there is no serious complication 

 and the obstetrist is called in good time, with patience and skill 

 reposition of the inverted uterus is possible, yet cases will occur in 

 which the operator is baffled in his attempts at reduction, or when, at 

 the first glance or after an examination, he has to recognise this as 

 impossible or useless. " Since I have been in practice," says Schaack, 

 " I have been often called upon to remedy this kind of displacement, 

 and from what I have seen I am led to believe that the impossibility 

 of reduction is not so much due to the difficulties in the cases them- 

 selves, as to the hurtful manoeuvres which have been performed. 

 Nevertheless, it must be acknowledged that the development of the 

 hernia and the rigidity of the tissues are sometimes so great that it 

 requires a certain amount of confidence in one's self not to be dis- 

 concerted nor afraid. ... To be successful it is necessary to insist — 

 to insist in spite of everything — on applying one's self to seize each 

 alternative point of relaxation ; to engage, bit by bit, the displaced organ 

 in the vulva, in commencing with that which is nearest this opening, 

 then successively all the remainder." 



This advice is judicious and sound ; but, as has been said, in certain 

 cases the extruded organ is so injured, either by the unskilful attempts 

 of ignorant men to return it, or from other causes, that it would be 

 certain death to the animal to replace it in the abdomen. We refer 

 now to extensive lacerations and bruises, or when the organ has 

 become softened and gangrenous ; and lacerations and ruptures are 

 always more serious, it must be remembered, in the lower than the 

 upper wall of the uterus. 



In other cases, when reduction has not been complete, and one horn 

 remains more or less invaginated, or the body of the organ is not well 

 adjusted, inversion will again and again occur in spite of all attempts 

 at retention ; and this only too frequently leads to such grave injury 

 that there is no hope of the organ regaining its normal condition, even 

 should reposition be at last successful. Indeed, its walls are so 

 softened and friable that they cannot withstand the least pressure, 

 but tear whenever an attempt is made to carry the uterus into the 

 vulva. 



With certain animals, too ■ — as Swine — reposition is extremely 

 difficult, particularly when one or both cornua are inverted ; as the 

 smallness of the organ, as well as the narrowness of the pelvis, is a 

 great obstacle to manipulation. 



In such exceptional circumstances complete extirpation of the uterus 

 {Metrotomji) has been recommended and practised. 



It is now many years since the operation was introduced into 

 veterinary surgery, as Binz states that it was performed by Jenne, a 

 German veterinarian in Forchheim, in 1802. 



Though the operation is apparently a most formidable and painful 

 one, and only to be ventured upon as a last resource, yet, on the whole, 

 it is tolerably successful. Of thirty cases collected by Saint-Cyr, no 

 fewer than twenty-three recovered from the operation. Franck refers 

 to thirty cases, eighteen of which recovered, and four (two Cows and 

 two Goats) were killed, though not, it would appear, on account of 



