ABNORMALITIES IN THE PARTURIENT PASSAGES 179 



Unless proper aid is rendered the foetus soon succumbs. 

 It is often astonishing how long the calf lives in spite of the 

 disturbed placental circulation. When birth does not take 

 place, the calf usually becomes emphysematous, as the repeated 

 manipulations favor entrance of air. This is followed by a 

 septic metritis and peritonitis, ending fa,tally within a few 

 days. 



ABNORMALITIES IN THE VAGINA AND VULVA. 



In primiparsB, rigidity of the vaginal walls is often observed. 

 There are cases where it is difficult to pass the hand into the 

 vagina, while the cervix uteri maybe completely dilated. The 

 diagnosis is easily made. The head and fore legs are com- 

 pressed, the vaginal wall is tightly stretched. The greatest 

 obstacle is met with at the junction of vagina and vestibule. 

 This rigidity may depend on an insufficient infiltration of tlie 

 pelvic organs and is at times observed in the partus prsema- 

 turus. The treatment strives to expand the lumen of the vagina 

 and render easy the passage of the calf. At first mechanical 

 dilatation with the hand is attempted. The well oiled hand is 

 passed over the head of the calf and pressure exerted with the 

 dorsal portion of the hand. This requires a great deal of 

 patience, but is usually crowned with success on account of the 

 elasticity of the vaginal walls. By pulling gently and steadily 

 on the fixed head and fore legs dilatation may be effected, as 

 the advancing body acts like a wedge. 



If the vulva is too narrow aijd the muffle of the calf's head 

 visible between the labise, we try to pull the vulva back over 

 the head. For this purpose one hand on each side is placed 

 against the inner surface of the vulva and forward pressure ex- 

 erted while the calf is pulled in at the same time, thus pushing 

 the labiee over its head. Before beginning these manipulations, 

 thorough lubrication of the parturient passages is necessary ; 

 even then patience is required and traction must be moderate. 



Should dilatation of the vulva be unsuccessful in this way, 

 and positively no other obstacles be present, incision may be 

 made into the upper commissure. Thtee small incisions 



