96 BOYINE OBSTErEICS 



cloth in order to avoid injury to the parts. The pressure, 

 which must be gentle, even and continuous, must be exerted 

 with the whole hand. In this manner the vaginal walls can 

 usually be replaced. 



Following reposition, the hand is introduced into the 

 vagina ; wherever necessary, folds are smoothed and the 

 anterior position of the inferior wall is slowly and gently 

 replaced. An extensive inversion, especially when exposed to 

 the air for some time, cannot always be reduced in this manner. 

 Here another method is employed. The animal is prepared as 

 before, but the prolapsed portion should be bathed with a 2 

 per cent, alum solution for ten to fifteen minutes. Now a 

 bandage, 20 cm. wide and 1.5 m. long, moistened with the alum 

 solution, is slowly and tightly wound around the inverted 

 vagina. Reduction of the prolapsus is effected by pushing in 

 an upward and forward direction with both hands. 



Continuous straining makes reposition very difficult. 

 Internal medication is not required, as it may be limited by 

 simple means. Already elevation of the hindquarters dim- 

 inishes, straining; it is decreased still more by pinching the 

 back of the patient while reducing the parts. Walking the 

 animal slowly and reducing the prolapsus at the same time, if 

 possible, often gives good results. (Veiy bad cases can usually 

 be managed nicely after giving them chloral hydrate, 60 ; tinct. 

 opii., 30.- W.) 



In order to prevent excessive straining after reposition of 

 the prolapsus, gentle exercise is useful. 



It does not suffice to reduce the inversion ; its eventual 

 recurrence must also be prevented. 



A displacement of the vaginal walls only could be pre- 

 vented by introducing a pessary, by a rubber pouch or pig's 

 bladder distended with air and held in place by suturing the 

 lips of the vulva. Theoretically, this is very nice, but practice 

 teaches that the application of such means is useless, as the 

 patients strain violently after the introduction of the pessary, 

 this making the cure worse than the evil. Therefore, this 

 method is best left alone, and other means quite efficient in 



