Puerperal Diseases of the Uterus 547 



if not through the puerperal period. Even more commonly 

 there is present in the gravid uterus a slight endometritis 

 which does not reveal itself in the puerperal animal by abor- 

 tion, premature birth, or retained fetal membranes, but may 

 pass unobserved until several days have elapsed after par- 

 turition, when clinical evidence appears in the form of an 

 obvious and characteristic genital discharge. In many 

 other instances the exudate in the uterus is not visibly dis- 

 charged but eventually undergoes resorption unless recog- 

 nized and removed by surgical interference. The vast ma- 

 jority of cases of endometritis during the puerperal period 

 are unquestionably continuations of the endometritis of 

 pregnancy, but to these must be added some cases of the in- 

 vasion of the uterine cavity immediately after the termina- 

 tion of pregnancy. 



The clinical manifestations of endometritis consist chiefly 

 of the discharge from the vulva of varying amounts of a 

 scarlet-gray exudate, apparently scarlet blood intimately 

 mixed with dirty gray or grayish yellow masses of pus or 

 tissue debris, usually thick like a heavy gruel. It adheres 

 to the tail, exterior of the vulva and surrounding parts. In 

 its most typical form the exudate is not fetid, but has a 

 faintly sweetish odor. The appetite, temperature and lacta- 

 tion may be slightly or not at all disturbed. 



The discharge may be clinically evident during parturi- 

 tion as soon as the uterine seal gives way and the chorion is 

 forced against the uterine wall at the cervical end, which 

 presses out some of the endometritic exudate ahead of the 

 fetus itself. After the fetus and its membranes have been 

 expelled, the visible discharge of the exudate is largely de- 

 pendent upon the volume present and the degree of tone re- 

 tained by the uterus. Generally the discharge is not promi- 

 nent until two to five days after pregnancy has terminated. 

 It may be delayed even longer and, although the exudate 

 may be present in considerable quantity (one-quarter to 

 one-half pint) , no recognizable discharge may occur. 



Ideally, physiologic parturition is completed in the cow or 

 heifer in one and one-half to two hours, and no recognizable 

 uterine discharge follows. If examined cHnically, the 



