THE FEMALE GENERATIVE OEGANS. 471 



Treatment comprises restoration of the organ, its 

 retention, and the counteraction of the ill consequences 

 of the accident. Restoration may be effected either from 

 the neck or from the fundus, or by both these methods 

 combined. As a preliminary measure the surface of the 

 womb must be cleansed from all foreign bodies, especially 

 also from adhering portions of the foetal membranes. The 

 animal must be placed with the hind part of the body 

 raised and kept in that position, which is important not 

 only as a means of facilitating return of the part but 

 also of retention. The protruding organ must be sup- 

 ported by a towel held on each side during the process 

 of cleansing and return. In the latter effort the fist 

 must be closed and applied to the fundus of the organ 

 which must be pressed inwards at the intervals between 

 the throes and prevented from return during their efforts, 

 which must be prevented as much as possible by distrac- 

 tion of the patient's attention and pressure on the loins. 

 While the pressure is brought to bear on the fundus an 

 endeavour must be made to gradually return the neck, for 

 a combination of the two methods is decidedly the most 

 satisfactory. When the protruded uterus is very much 

 swollen, it may be reduced in size by cold-water applica- 

 tions and by pressure evenly applied from the fundus 

 towards the neck. This may be best accomplished by an 

 Esmarch's bandage, which also assists in the return of 

 the organ, but it may be effected by fixing a carbolised 

 cloth around the protruding organ and manipulating in a 

 manner which may be learned rather from observation 

 than description. The fist with the fundus must be 

 passed in so far as not to cause great increase in the 

 expulsive efforts, and must be kept in position for some 

 time. Of retentive means the most important are dis- 

 tension of the uterus with some bland mucilaginous fluid, 

 with an antispasmodic dissolved in it ; the use of a 

 special retentive appliance termed a pessary. These are of 

 various kinds, but the most readily available and simple 

 of all is an ordinary glass bottle. The concavity on the 

 floor of this fits well against the os uteri, and its neck 



