606 ACCIDENTS AFTER PARTURITIOX. 



this condition for months without showing much apparent inconvenience. 

 This is the kind of inversion that is liable to recur ; reposition may be 

 readily effected, but no sooner is it accomplished than inversion again 

 takes place through the animal straining. 



In other instances, however, the accident is much more serious. The 

 mucous membrane of the vagina, exposed to contact with the urine, 

 fffices, and litter, in addition to friction from the tail and other objects, 

 as well as the attacks of flies, etc., becomes irritated, excoriated, abraded, 

 and indurated, while it is greatly thickened from exudation ; a more or 

 less foetid muco-purulent secretion covers its surface ; cicatrisation of 

 the torn submucous connective tissue ensues ; new adhesions are 

 formed which fix the part in its abnormal situation, and offer what is 

 sometimes an insurmountable obstacle, if not to reduction, at least to 

 retention, after that has been effected. If assistance is not afforded, the 

 animal gradually loses condition and becomes emaciated ; hectic fever 

 sets in, and it falls into a state of marasmus. At other times the 

 extruded part becomes acutely inflamed, intense fever supervenes, and 

 the creature succumbs to the effects of vaginitis — either simple or com- 

 plicated with metritis — and almost as rapidly as from inversion of the 

 uterus. 



Treatment. 



The more speedily treatment is resorted to after inversion has 

 occurred, the more easily is reduction effected and likely to prove per- 

 manent, while the risks from injury are greatly diminished. 



The treatment is somewhat similar to that recommended for inversion of 

 the uterus, the preliminary steps being the same in both accidents, and 

 reduction is accomplished according to the same rules. The part of the 

 vaginal membrane nearest the vulva is to be carefully and gradually 

 returned, should the tumour be large ; if comparatively small, then it 

 may be reduced en masse, by applying the closed fist to the centre of the 

 most dependent part, and pushing it into the canal. When reduction 

 has been effected, it is particularly necessary to observe that every part 

 has assumed its normal shape and position ; as it often happens that 

 the mucous membrane, particularly towards the bottom of the canal, 

 forms a thick fold, which must be effaced if it is desired to obviate 

 renewed straining and a recurrence of the inversion. All the folds and 

 inequalities from one end of the canal to the other, as far as the cervix, 

 should be smoothed carefully down by the hand or a soft damp cloth. 

 If, after reduction, the straining continues, it may be inferred that the 

 mucous membrane is irritated by the existence of wrinkles or folds on 

 its surface. The hand must then be introduced again into the vagina, 

 and the ridges effaced either by passing the hand over them, so as to 

 carry the membrane onwards, or by gentle pressure entirely obliterating 

 them. 



If the membrane is irritated and inflamed, astringents — such as 

 acetate of lead — and anodynes — such as opium — may be applied to it ; 

 and as a matter of precaution, a truss maybe used for a few hours. 



When the foetal membranes are still in the uterus, some obstetrists 

 recommend that they should be removed before reduction of the inver- 

 sion is attempted ; but others are of opinion that reduction should be 

 accomplished first, and removal of the membranes afterwards, unless 

 the latter are so lightly attached that they can be pulled away without 

 introducing the hand into the uterus. In any case the membranes 



