Post- Puerperal Infections of the Uterus 807 



ating abscess, the posterior wall of which occupies most of, 

 or the entire lumen of the pelvic cavity. Careful search 

 usually reveals traces of the os uteri externum, the lips of 

 which form a ring about the occluded mouth. The cervical 

 canal is nowhere to be found. Rectal exploration reveals 

 the presence of a great, tense abscess, continuous with the 

 anterior end of the vagina. 



The prognosis is good for the life of the mare, but essen- 

 tially hopeless for her fertility. The treatment consists of a 

 free opening of the abscess with disinfection of its cavity. 

 Careful palpation by both vagina and rectum should be made 

 and the position of the os uteri externum located approxi- 

 mately. In case of doubt a small trocar may be used to ex- 

 plore and the abscess cavity adequately located. The trocar 

 puncture may then be dilated by incising, and later the en- 

 largement may be continued by forcing the hand through 

 the wound into the abscess cavity. It should then be handled 

 like any abscess cavity, except that it is to be remembered 

 that antiseptics in escaping must flow over the vaginal walls 

 and, if too irritant, may cause serious harm. The opening 

 must be kept amply dilated until suppuration has ceased. 

 As a rule the uterine cavity will probably become obliter- 

 ated. 



c. Pyometra. The short, broad and readily dilatable cer- 

 vix of the mare renders her less subject than the cow to pyo- 

 metra. So far as I have observed, pyometra may well be 

 considered as a secondary lesion to cervicitis. The cervix 

 becomes inflamed and greatly indurated, incarcerating in- 

 fection within the uterine cavity. The uterine walls parti- 

 cipate importantly in the process, and ultimately become 

 quite paretic, and the indurated cervix, encroaching upon 

 the canal, so narrows it that the pus contents of the uterus 

 are not actively expelled. The principles involved are illus- 

 trated in Fig. 231. 



The symptoms are chiefly an intermittent, sometimes a 

 constant, vulvar discharge. Uusually the discharge is fetid 

 and consists of rather thick, dirty, yellowish pus. In one of 

 my cases the pus was black and looked like finely pulped 



