590 Diseases of the Genital Organs 



emanates from the cervix — not from the uterus. Shortly 

 after ovulation, if conception does not occur, hemorrhage 

 ensues from the cotyledons (menstruation) which in pass- 

 ing out becomes incorporated vdth the mucus of the cervix. 

 The gradually increasing estrual engorgement requires two 

 to four days for its maximum development and a similar 

 period for its decline, so that of the twenty-one days usually 

 constituting the estrual cycle, the uterus is engorged in vary- 

 ing degrees approximately one-third of the time, and dur- 

 ing no two days is the engorgement the same. So it is with 

 infection. Bacteria may be present — commonly are present 

 — in considerable numbers without causing recognizable dis- 

 ease. The infection rarely remains static, but either ad- 

 vances to cause disease or is almost or wholly overpowered 

 by the uterus. After a heifer has failed to conceive, until 

 three years old or less, her uterus slowly loses its tone, en- 

 larges and becomes flabby. The same rule applies to the post- 

 puerperal uterus. ■ If the cow fails to conceive with reason- 

 able promptness, the organ loses its tone (if it had recov- 

 ered its tone during the puerperal era) , enlarges, becomes 

 flaccid, and drops far forward in the abdomen. Endome- 

 tritis becomes recognizable by the atony and the enlarge- 

 ment. By catheterization there is shown to be present in the 

 uterus muco-pus or, in the milder forms, mucus. The endo- 

 metritis may be due to infection extending from the cervix, 

 possibly originally coming from the bull through coitus, or, 

 as most frequently occurs, persisting in the uterus from the 

 puerperal period. The chief cause may reside outside the 

 uterus. Thus in nymphomania, while the disease is pri- 

 marily ovarian, due to a peculiar type of cystic degenera- 

 tion, endometritis is a constant result of the ovarian dis- 

 ease. Clearly the metritis needs to be referred flnally to the 

 presence of bacteria in the uterus, but the ovarian disease 

 so disturbs the genital system as a whole that existing in- 

 fections which would otherwise be held under control gain 

 in virulence and cause harm. 



The clinical evidence of endometritis is the recognizable 

 enlargement of the uterus. Palpated per rectum, the uter- 



