404 Diseases of the Genital Organs 



held the opposite view but have failed to substantiate it 

 with extended clinical data. In my experience, less than 50 

 per cent, recover and many of these quite tardily. My cases 

 have been chiefly of long standing, which depresses the 

 prognosis. In numerous cases, especially when coming un- 

 der treatment very early, the animals respond immediately 

 and permanently. In other cases, if severe and neglected 

 for a year or more, recovery becomes a matter of great 

 doubt. I have found no criteria, except the duration of the 

 disease prior to handling, upon which to base the prognosis 

 in a given case. Some of my worst cases, like that portrayed 

 in Fig. 129, have recovered their fertility. Hess and others 

 have expressed the dictum that, when the cyst is too dense 

 for manual rupture and can be emptied only by instru- 

 mental puncture, the case is hopeless and the animal should 

 be slaughtered. This is not entirely correct, as I have had 

 several cases in very valuable cows which, like Fig. 129, 

 have recovered fertility after I had punctured the cysts once 

 or several times. If a cow is highly valuable and there is 

 present no recognizable lesion, aside from the cysts, which 

 constitutes an absolute bar to fertility, the case should not 

 be pronounced hopeless. 



The handling consists chiefly of the evacuation of the 

 cysts as rapidly as they form. Many of them can be rup- 

 tured safely and readily by digital compression per rectum. 

 The ovary should be manipulated carefully per rectum until 

 free from any chance covering or entanglement within the 

 mesosalpinx or mesometrium, so that the cyst comes into 

 immediate contact with the peritoneal wall of the rectum. 

 The cyst is then to be grasped between the thumb and two 

 or more fingers, and steady pressure exerted upon it with 

 the ball of the thumb. The thumb pressure should be con- 

 centrated upon the center of the cyst, and the hand should 

 encompass only as much of the cyst wall as essential to a 

 secure grasp. That is, the greater the area of the cyst free 

 from compression, and the more concentrated the compres- 

 sion upon a limited area, the more certainly the cyst may 

 be ruptured. I have found it advantageous sometimes to 



