PARTURIENT APOPLEXY— PUERPERAL COLLAPSE. 655 



of Williams } " If the Cow is already down when lirst seen by the 

 practitioner, his first care must be to see that she is made to lie as near 

 the natural position — on the sternum — as possible ; and this he will do 

 by liaving her packed up at the side by bundles of straw, or, what is 

 better, sacks tilled with straw, tirmly wedged under the quarter and 

 shoulder, the head at the same time being properly propped by the 

 same means, and care being taken at all times that the Cow is prevented 

 from injuring her head by striking it against hard bodies." It may be 

 added that some practitioners are particularly careful to have the head 

 well raised above the other parts of the body, especially when the 

 animal is comatose ; and this is sometimes effected by means of a halter 

 on the head, or a rope round tlie base of the horns, the other end being 

 passed over a beam in the stable. This elevation of the head prevents 

 increased congestion of the brain, and facilitates the return of blood 

 from that organ. 



It is often beneficial to alter the position at intervals — every two or 

 three hours ; and Williams recommends that the mammary gland be 

 also "stripped (emptied) and hand-rubbed." 



The abstraction of blood has found much favour with many authorities. 

 Williams says : " In the earlier stages, whether the animal is standing 

 or lying prostrate and in a state of coma, if the pulse be not excessively 

 weak and the heart's action almost fluttering, recourse must be had to 

 venesection. Slow and deep breathing, with a tendency to stertor, add 

 greatly to the necessity for immediate bleeding. The beneficial action 

 of the withdrawal of blood is shown by the pulse becoming fuller, 

 stronger, and better in tone. The opening into the jugular is to be a 

 large one, in order that the blood may How freely to relieve the conges- 

 tion — to check, if possible, a further extravasation of blood or effusion 

 of serum, and to divert its active flow into the head; but it must not be 

 carried out so as to debilitate the heart's action. When the pulse 

 becomes fuller and stronger, the bleeding is to be stopped ; from three 

 to five quarts will generally be sufficient." 



Theoretically, venesection is to be commended. If the theory be 

 accepted that the condition is due tohypera^mia — audit has been shown 

 that this opinion has a better foundation tlian any other, then a sudden 

 depletion of the vascular system, by which the pressure is diminished, 

 must stop the attack. It is known from experience, says Schroeder, 

 that after venesection the quantity of the blood soon becomes the same, 

 through the serum taken from all the tissues, whilst the quality is 

 gi-eatly deteriorated by the abstraction of blood. A short time after 

 venesection, we shall expect to find the former blood-pressure in the 

 arterial system, but the blood far more watery than jireviously. From 

 this theoretical consideration, it follows that abstraction of blood must 

 be attended by an immediately favourable result, and under certain cir- 

 cumstances the whole disease may surely be cut short by it. But if all 

 other conditions remain the same, the blood-pressure will, after some 

 time, again reach its previous height ; the quality of the blood has, in 

 the meantime, been greatly deteriorated, and consequently the danger 

 of the disease will be increased. 



Williams adds: " The bleeding is for the purpose of removing pressure 



from the brain, and although the pulse may indicate stimulants rather 



than depletion, it will be found that as the blood flows the tone of the 



pulse will improve ; for the weakness of the pulsation, the want of 



* Principles and Practice of Veterinary Medicine, p. 418. 



