Puncturing Cysts through the Vaginal Wall 211 



boring parts so that they cannot be pushed backwards per rectum, 

 as well as in cases of abscess of the ovary, it is good policy to 

 abandon manual handling and, instead, to castrate the animal by 

 intra-abdominal ligation. And, finally, in cases of encapsulated 

 ovaries which cannot be detached and which resist attempts to 

 rupture them in their sinuses, there only remains castration with 

 ligation of the ligamentary apparatus. 



3. Thk Puncture of the Cysts Through the 

 Superior Vaginal Wall. 



This operation is indicated in cases of very thick-walled pe- 

 ripheral or central cysts which cannot be ruptured per vaginam. 



It may be carried out with a very small concealed bistoury or 

 with equal facility by means of the 5.5 cm. long intestinal trocar 

 without canula such as we have used for some years and is made 

 by Hauptner in Berlin. The strictest possible antisepsis of the 

 external genitals, of the hand introduced into the vagina and 

 disinfection of the instruments, is essential. The operation is 

 simple and is not followed by important sequelae. The affected 

 ovary is grasped and fixed with the right hand per rectum while 

 the instrument, carried into the vagina with the left, is passed 

 through the superior vaginal wall into the cysts. 



The puncture of the cyst causes a disappearance of resistance 

 and by light pressure complete evacuation is readily induced. 

 The ovary then consists essentially of an empty capsule. If the 

 first effort is unsuccessful, draw the trocar back into the vagina 

 somewhat and insert it at a different point in the ovary. 



In this operation, owing to the fact that the ovary is fixed 

 by the hand in the rectum, it occasionally happens that the 

 intestinal wall is wounded, but this is of no consequence since 

 the muscles, being both circular and longitudinal, promptly 

 close the small wound and prevent any escape of contents. This 

 occurrence may be avoided in old cows with roomy vaginae by 

 grasping the ovary through the vaginal walls with the left hand 

 and holding it far backwards, and then passing the right hand, 

 armed with the instrument, alongside the left and making the 

 puncture with entire safety. 



When the ovary can be drawn far backwards we have been 

 enabled to make the puncture with the intestinal trocar by 



