558 GENITAL APPAKATUS. 



held regarding its origin and treatment, particularly as to the direction 

 in which the animal should be rolled in order to reduce the torsion. 



In common ^vith the majority of authors, Lempen rightly con- 

 cluded that the rolling should be in the same direction as the torsion. 

 He also proposed to describe the torsion as being to right or left, 

 according to the direction of the spiral folds to be found on the upper 

 wall of the dilated cervix uteri when the examiner stands behind the 

 animal. This mode of describing the changes seems least likely to 

 cause misunderstanding. 



In describing the degree of torsion Haase takes as his index the upper 

 wall of the uterus. ^Yhere this has moved through an angle of 90 degrees 

 he speaks of quarter torsion ; when through an angle of 180 degrees (in 

 which case the upper wall will have become the lower) of half or semi-com- 

 plete torsion ; when through an angle of 270 degrees as three-quarter, 

 and when through 360 degrees (the upper wall having then described 

 an entire circle and returned to its former position) as complete torsion. 



In forming a diagnosis, the extent to which the maternal passages 

 seem fixed in position, the amount of resistance they offer to the hand, 

 and the degree of tension in the spiral folds to some extent indicate 

 how far torsion has proceeded. Where the spiral folds are very tense 

 and the passages completely immovable, so that the operator cannot 

 reach the foetus, torsion is usually complete ; in cases of less complete 

 torsion (one-quarter to three-quarters) the cervix uteri is closed and 

 displaced to a proportionate extent, and the resistance to the passage 

 of the hand is in keeping. 



The prognosis is very grave. 



Treatment is difficult, and of the numerous methods suggested 

 (laparotomy and direct abdominal taxis, vaginal hysterotomy followed 

 by abdominal taxis, vaginal taxis, etc.) most have fallen into desue- 

 tude or are looked on as of so desperate a character as only to be 

 justified in extreme cases. That which most merits attention and 

 has been attended by most uniformly favourable results consists in 

 the rotation of the animal's whole body. The best results are said to 

 be obtained by casting the animal, or causing it to lie down, on a 

 sloping surface with the hind quarters higher than the fore and then 

 to roll it down hill, in the same direction as the spiral twists discovered 

 in the vagina. It is possible to follow the course of the manipulation 

 by retaining the hand in the vagina, but failing this the vagina should 

 be examined after each attempt. Even though the first attempts fail 

 hope should not be abandoned, for Haase has succeeded in effecting 

 delivery after rolling the animal tirciity times. The operation should 

 be performed smartly and the animal's body be rolled as a whole, 

 the fore limbs turning along with the hind. 



