TlLil'MATIC LKSIDXS nF TllK HKSITAL i >/;'.-. I \S, KTC. 617 



When the hnibs or other parts of the fcetus protrude through the 

 anus, it is nearly always advisable to amputate them, in order to move 

 the body more easily in the vaj^'ina, and with less risk of further injury to 

 the parent. Once in the {genital canal, then the firtus can be extracted 

 in the ordinary manner. Opiates should be largely administered. 



Ri TTfUK OK THE Pkkin.ki M. — Laceratiou of the vagina is not at all 

 infrequently complicated with more or less extensive rupture of the 

 perin;eum, and occasionally rupture of the vagina, rectum, and perineum 

 may be met with in the same animal. Sometimes it is only the /o/nc/«'/<e 

 and superior commissure of the vulva which are involved; in others the 

 entire extent of the perina^um is lacerated, and the lesion only ends at 

 the anal sphincter ; while in others, again, the sphincter and part of the 

 rectum are included. 



If, in malpositions of the ftetus, assistance is not timeously afforded — 

 particularly in the Mare — the young creature is pushed onwards by the 

 violent uterine contractions, and should it enter the rectum the anus is 

 dilated ; while, if the expulsive etTorts are continued, the sphincter and 

 all the tissues between it and the vulva are greatly stretched and 

 strained until they tear. Then the fcetus is finally expelled — sometimes 

 dead, at other tinies alive — and there remain immense lacerations which 

 convert the rectum and vagina into one vast opening, in which the 

 termination of the digestive and genito-urinary organs open in common. 



In rare cases the injury is not so extensive, owing to the anal sphincter 

 being sufficiently elastic to yield to the pressure without being much 

 torn, in this way exempting the periniEum ; so that there is only a wide 

 recto-vaginal fistula to deal with. 



These ruptures, occurring immediately after birth, appear two or 

 three times larger than they are some days afterwards, when the dis- 

 tended textures have contracted somewhat ; the borders of the lacera- 

 tion are sometimes even, in other cases uneven, ragged and shreddy. 



The consequences are variable, according to the extent of the injury. 

 Moderate laceration does not usually prove very prejudicial ; but if 

 severe, serious inflammation of the perina^um, extending sometimes to 

 neighbouring tissues and organs, sets in. If the tear involves the anus 

 and its sphincter, there will be involuntary escape of ficcal matters and 

 flatus ; and in the most formidable cases — those in which the vagina 

 and rectum form one wide gaping cavity — the mucous membrane is 

 irritated by the free admission of air and excreta, inflammation and 

 suppuration ensue, fistulas are formed, and the poor animal only too 

 often presents a painful and repulsive spectacle. 



In other instances, partial recovery takes place, and the animals do 

 not appear to be much affected or inconvenienced. They maintain good 

 health, rear their progeny, if born alive, and may even bring forth 

 young again, though the wound has not cicatrised. Indeed, in severe 

 cases, union of the edges of the wound is exceptional, and in the large 

 majority only the margin of the tear cicatrises, and a gaping, unsightly 

 cavity remains. 



The treatment will vary, according to circumstances. If there is 

 much hiemorrhage, styptics must be employed ; if the bleeding is slight, 

 cold may check it ; but if severe, iron perchloride must be used. 



The lacerated margins, if much torn, nmst be freed from shreds which 

 are likely to lose, or have already lost, their vitality. They must then 

 be brought together by sutures — either of metal, carbolised silk, or 



