660 PATHOLOGY OF PARTURITION. 



Diagnosis. 



There should be no difficulty in diagnosing this condition from puer- 

 peral collapse, metritis, or other affection incidental to parturition. If 

 the paraplegia does not appear until a short time after that event, and 

 no accident has occurred to cause it, then it has been suggested that 

 myelitis has probably set in, and especially if the paralysis follows 

 mammitis ; in that case there is not only the loss of power, but also 

 diminished sensation in the hind-limbs. But if due to a sprain of the 

 back from slipping, then sensation is not impaired, and pain may be 

 indicated on pressure of the part injured. 



When due to fracture of the pelvis, crepitation may be heard on 

 movement, or an examination per rectum will detect the damage ; or if 

 there is dislocation of the hip-joints the accident will be manifest on 

 moving the limbs. Injury to the hind-limbs from fruitless attempts to 

 rise when recovering from puerperal collapse, can be detected on 

 examining them. When parturition has been very difficult, and great 

 force has been employed in removing the foetus, serious injury may 

 have been done to the organs in the pelvic cavity, and the lumbar nerves 

 themselves may be involved. Congestion of the spinal cord will produce 

 the same symptoms, but there are, in addition, fever, pain, and sometimes 

 convulsive movements of the limbs. 



Pathology. 



Little is known as to the nature of this affection. Harms and others 

 thought it was due to injury inflicted on the sacral and other nerves 

 during difficult parturition. The sciatic nerves are particularly liable 

 to injury. Post mortem examination, however, has only furnished nega- 

 tive evidence of this. Franck thinks that injury to the cervix uteri may 

 give rise to reflex paralysis ; this has been witnessed in a Bitch ; and 

 reflex paralysis of the legs has been seen in woman, and ascribed to 

 uterine injury or derangement — when this was remedied the paralysis 

 disappeared. It is not at all improbable that the same causes will pro- 

 duce the same effects in animals. 



In some cases the spinal cord has been found injured and its vessels 

 congested, with blood-clots in the spinal canal ; and in others the roots 

 of the abdominal nerves have been surrounded by serous efi'usion. 



It can easily be understood how paralysis is induced in parturient 

 apoplexy. Williams states that it is due to inflammation and red 

 softening of the spinal cord in the lumbar region. 



Prognosis. 



The prognosis must necessarily depend upon the diagnosis. The 

 paraplegia, real or simulated, is due to various causes, and therefore 

 the likelihood of recovery must be based upen the nature and degree of 

 the injury. 



If it is only simple congestion of the spinal cord, recovery may take 

 place in a few days ; but if decubitus persists after a week, there is 

 reason to apprehend haemorrhage as a complication of the congestion ; 

 though injury to the pelvic nerves will also cause the same symptoms 

 and prolonged inability to get up. These cases are generally hopeless, 

 as are the great majority of fractures. 



Whatever be the cause, if the animal can remain standing, when got 

 up, for ever so short a time, it will in all probability recover, though it 

 may be lame in one or both limbs for a considerable period. 



