558 



Diseases of the Genital Organs 



similar size. Abortion was no more common during the 

 outbreak than at other times. 



The prognosis of septic metritis should always be very 

 bad, first for the life of the patient, and second, if the pa- 

 tient survives, for her reproductive life. 



There is little to be done in the way of handling. If the 

 fetal membranes are retained and the veterinarian attempts 

 to remove them, his efforts apparently aggravate the dis- 

 ease; if he leaves the membranes alone, the patient dies. 

 It is impossible to disinfect the uterus; the infection has 

 permeated all the layers and involved all tissues. Besides, 

 the denuded uterine mucosa will not tolerate disinfectants 

 possessing any material efficiency. If uterine douching is 

 attempted, without skill and care, disaster follows. The 

 paretic organ will not empty itself. If the fetal membranes 

 are retained, they prevent siphoning of the uterine con- 

 tents by occluding the opening of the tube. If the fluids are 

 left, they injure the uterus by their weight and afford addi- 

 tional liquid in which bacteria may grow. If liquid is 



Fig. 179a — Large Single-Curved Uterine Catlieter. 

 inches, diameter ^ inch. 



Length 24 



forced into the uterus with a pump, the uterus often rup- 

 tures and the patient dies. The treatment must be con- 

 servative and mild. Retained fetal membranes may be re- 

 moved if they can be gently detached. The uterus may be 

 douched by means of a siphon, but not with a double tube. 

 The amount of fluid — preferably physiologic salt solution — 

 introduced at one time should be very small, not more than 

 a quart at first, and immediately siphoned out. If it can not 

 be siphoned out, no more should be added. The best appara- 

 tus for douching is the seven-foot pure gum catheter, de- 



