INVERSION OF THE VAGINA DURING PREGNANCY 93 



the intestines widens this originally small excavation. As a 

 consequence, the superior and lateral walls of the vagina are 

 forced downward and backward, thus lessening the lumen of 

 the vagina. The continuous pressure displaces the vaginal 

 walls more and more, until it reaches the vulva or extends 

 beyond it. When limited inversion confines itself to the upper 

 wall, when more extensive to the upper and lateral walls, and 

 when complete, it also includes the floor of the vagina lying in 

 front of the meatus urinarius, the vaginal portion of the uterus 

 then becoming visible between the labise. 



Symptoms. — Prolapsus vaginae is mostly seen in cows 

 which have already calved several times ; it is frequently seen 

 in old cows, but also cows which only calved once may show an 

 inverted vagina toward the end of the second pregnancy. It 

 is occasionally noticed in heifers, where a previous dystokia 

 led to considerable destruction of the vagina and its sur- 

 roundings. 



The owner usually notices this affection when the inversion 

 is already quite considerable. More limited degrees, where 

 the superior wall is pushed backward and into the lumen of 

 the vagina, and which is not visible from without, escape his 

 observation. As the prolapsus progresses, the inverted parts 

 appear as a rose-colored tumor, separating the labise and only 

 noticeable when the animal is in the recumbent position. 



When the cow rises, the tumor mostly disappears, as the 

 abdominal pressure ceases and the upper, respectively, lateral, 

 walls of the vagina return to their original position. 



In cases of complete inversion and where the cow lies 

 very low behind, the prolapsus vagina extends beyond the 

 vulva. The tumor, which is now visible outside the vagina, is 

 as large as the head of a child or man ; its surface is formed 

 by the mucosa of the vagina. A prolapsus of head size may 

 disappear when the cow gets up, but appears as soon as she 

 lies down. A large prolapsus, and especially when the inverted 

 portion is exposed some time to the air, and the mucosa 

 inflamed, spontaneous reposition does not take place when the 

 the cow rises. 



