604 ACCIDENTS AFTER PARTURITION. 



extreme ; though in such a case it does not add to the symptomatology 

 or gravity of the accident. 



It may occur in other than pregnant or parturient animals, though 

 rarely ; the cases recorded of Mares had no assignable cause for the 

 accident, though those occurring in the Bitch were observed immedi- 

 ately after copulation, and ascribed to anatomical and physiological 

 peculiarities. It may also take place during pregnancy, particularly 

 towards its termination, when the gravid uterus pushes it outwards. 

 Most frequently, however, it is witnessed after parturition, particularly 

 when delivery has been difficult and protracted, owing to a disproportion 

 between the size of the foetus and the passage through which it passes, 

 and especially when force has been necessary to extract it, and the ex- 

 pulsive efforts have been severe. 



It often occurs when the " waters " have escaped for some time, and 

 the young creature, lodged in the genital canal, is extracted without 

 the precaution of lubrication. The progress of the foetus through the 

 di'y, tenacious passage causes the mucous membrane of the vagina to 

 gather in ridges and folds ; the connective tissue beneath is torn, and 

 this leads to inversion, which may occur immediately, along with the 

 exit of the foetus, oi when the animal afterwards strains — sometimes so 

 long as four, six, or eight days subsequent to parturition. 



Fatigue, such as that induced by travelling, or severe exertion imme- 

 diately or soon after calving, or keeping the animal in a stall the floor 

 of which slopes too much backwards, are also likely to produce, or at 

 least predispose to, the accident. It may also take place after abortion 

 and retention of the placenta. 



When inversion of the vagina occurs without that of the uterus, the 

 latter is propelled backwards by the contractions of the abdominal 

 muscles, pushing before it the walls of that canal until it has extruded 

 them beyond the vulva, and itself occupies the cavity of the pelvis. 

 During this extrusion, the connective tissue which attaches the vaginal 

 mucous membrane to the adjacent organs and the pelvis is more or less 

 lacerated ; and it is this laceration which constitutes the serious character 

 of the accident, and differentiates it from simple prolapse due to relaxa- 

 tion of the connective tissue, w^hich is of no great moment. The latter 

 condition is not very rare towards the end of pregnancy, and under cer- 

 tain circumstances may lead to complete inversion. Eainard mentions 

 having seen a Goat which had inversion of the vagina fifteen days 

 before parturition, and to such an extent that the mouth and nostrils 

 of the foetus protruded through the half-open os uteri, so that it could 

 breathe and lick the hand. 



This simple inversion of the vagina during pregnancy, however, dis- 

 appears spontaneously after parturition, as it is simply due to the 

 backward pressure of the gravid uterus ; but that occurring after birth 

 has no tendency to spontaneous reduction any more than complete 

 inversion of the uterus. Very exceptional cases have been reported, in 

 which the simple form was succeeded by the more serious one ; but 

 Saint-Cyr insists upon these being so rare that they only serve, when 

 compared with the latter, to prove the rule. 



x\s has been said, this serious inversion of the vagina occurs far more 

 frequently after abortion and parturition, though not so often as inver- 

 sion of the uterus. 



