162 



may Lave been entirely effaced, so that a simple round opening is left 

 with rigid margins. 



The simplest treatment consists in smearing this part with solid ex- 

 tract of belladonna, and after an interval inserting the hand with fin- 

 gers and thumb drawn into the form of a cone, rupturing the mem- 

 branes and bringing the fcetus into jiosition for extraction, as advised 

 under "Prolonged Eetention of the Foetus." Another mode is to in- 

 sert through the neck of the womb an ovoid caoutchouc bag, empty, 

 and furnished with an elastic tube 12 feet long. Carry the free end 

 end of this tube upward to a height of 8, 10, or 12 feet, insert a tiller 

 into it, and proceed to distend the bag with tepid or warm water. 



FIBROUS BANDS CONSTRICTING OR CROSSING THE NECK OF THE WOMB. 



These occurring as the result of disease have been several times ob- 

 served m the mare. They may exist in the cavity of the abdomen and 

 compress and obstruct the neck of the womb, or they may extend from 

 side to side of the vagina across and just behind the neck of the womb. 

 In the latter position they may be felt and quickly remedied by cut- 

 ting them across. In the abdomen they can only be reached by incis- 

 ion, and two alternatives are presented : (1) To perforna embryotomy 

 and extract the foetus piecemeal ; and (2) to make an incision into 

 the abdomen and extract by the CiBsarian operation, or simply to cut 

 the constricting band and attempt delivery by the usual channel. 



FIBROUS CONSTRICTION OF VAGINA OR VULVA. 



This is probably always the result of direct mechanical injury aud 

 the formation of rigid cicatrices which fail to dilate with the remainder 

 of the passages at the approach of parturition. The presentation of 

 the foetus in the natural way and the occurrence of successive and 

 active labor pains without any favorable result will direct attention 

 to the rigid and unyielding cicatrices which may be incised at one, 

 two, or more points to a depth of half an inch or more, after which the 

 natural expulsiv.e efforts will usually prove effective. The resulting 

 wounds may be washed frequently with a solution of one part of car- 

 bolic acid to 50 parts of water, or of 1 part of mercuric chloride to 

 to 500 iiarts water. 



FCETUS ADHERENT TO THE WALLS OF THE WOMB. 



In inflammation of the mucous membrane lining the cavity of the 

 womb and implicating the fcetal membranes, the resulting embryonic 

 tissue sometimes establishes a medium of direct continuity between 

 the womb and foetal membranes; the blood vessels of the one communi- 

 cate freely with those of the other and the fibers of the one are pro- 

 longed into the other. This causes retention of the membranes after 

 birth, and a special risk of bleeding from the womb, and of sep- 

 tic poisoning. In exceptional cases the adhesion is more extensive 



