ACUTE METRITIS. 551 



on wounds by embryotomy hooks, crutches, cords, etc., etc. There is 

 no reason for maintaining this distinction, because the essential condi- 

 tion for the development of metritis is the infection of the injuries. 

 Acute metritis follows non-delivery, incomplete delivery, or acci- 

 dental infection. 



Symptoms. The external signs are very few, and must be carefully 

 studied, in order that wrong conclusons may be avoided. 



Certain of these external signs suggest general disturbance such as 

 one finds in all acute visceral inflammations, viz., loss of appetite, pro- 

 gressive wasting, irregular slight fever, diminution or cessation of the 

 secretion of milk, dulness, etc. 



The others are purely local. The discharge from the vagina is 

 mucoid, muco-puralent, sanguinolent or fretid, according to circum- 

 stances. It is small in quantity, and occurs only when the animal 

 lies down or makes expulsive efforts. Examination with the specu- 

 lum reveals the existence of slight secondary vaginitis and more 

 intense inflammation of the neck of the uterus, which remains half 

 open. Rectal examination shows that the uterus is abnormally large 

 and more difficult than usual to displace. If acute metritis has 

 existed for some weeks, the uterus is painful to the touch, and some- 

 times fixed in position in consequence of the development of para- 

 metritis and of slight pelvi-peritonitis, the occurrence of which is 

 always indicated by temporary tympanites. 



Cases of acute metritis may recover spontaneously, l)ut they rarely do 

 so. The condition usually tends to become chronic or to be complicated 

 with peri-uterine diseases which may prove fatal. 



Diagnosis. The diagnosis can be established without difficulty by 

 rectal examination and direct examination with a speculum. 



Prognosis. The prognosis is grave, because the patients are tem- 

 porarily or permanently incapable of becoming pregnant, and because 

 acute metritis may be complicated with pelvi-peritonitis, phlebitis of 

 the intra-jDelvic veins, etc. 



Treatment. The uterus, and particularly the uterine mucous mem- 

 brane, l)eing affected, all our efforts should be concentrated on that organ. 

 A careful study of the lesions shows that the glandular follicles are 

 infected, and with them the entire thickness of the mucous membrane. 

 The object to be attained, therefore, is the perfect disinfection of this 

 tissue. The parts should repeatedly be washed out with warm water at 

 blood-heat, followed by antiseptic injections containing 4 drachms of 

 chloral per pint ; a 1 in 2,000 iodine solution or 20 per cent, to 25 per 

 cent, hydroxyl solution, etc. Despite such injections, the inflamma- 

 tion disappears slowly and with difficulty, and when the neck is suffi- 

 ciently open it might perhaps be possible, as in human medicine, 



