Signs of Pregnancy 393 



two preceding classes of symptoms rather than upon direct in- 

 vestigation. Among these direct methods, that most early 

 available is the manipulation per rectum, which can be made to 

 succeed as early as a fetus has acquired sufficient size to be felt 

 floating within the uterus. In this case, upon examination per 

 rectum, the uterus is found markedly enlarged and softened and 

 more or less fluctuating or sugillating. Floating somewhere 

 within the liquid, usually lying at the bottom on account of its 

 high specific gravity, is the fetus, which is perfectly movable 

 and some of the parts of which may be recognized. 



The differentiation of pregnancy from various diseases of 

 the uterus or abdominal organs sometimes causes difficulty. 



The uterus itself is subject to a variety of diseases which cause 

 its enlargement and thereby simulate the pregnant condition. 

 In very rare cases there has been observed, especially in the 

 cow, a dropsical condition of the uterine walls, which causes the 

 organ to become enormously enlarged and leads sometimes to 

 the supposition that the animal is pregnant. In such cases, our 

 only positive means for differentiation is the determination of the 

 presence or absence of the fetus itself within the uterine cavity, 

 by one or several of the methods which we have already described. 

 Such a uterus will not respond to ballottement, there can be no 

 fetal heart-beat and no fetus can be touched by rectal explora- 

 tion. 



Extensive abscess of the uterus, or pyometra, might be mis- 

 taken for pregnancy. In the case of pyometra, there is usually 

 some abnormality of the cervix uteri and a more or less constant 

 discharge from the vulva, while the uterus itself is very flaccid 

 and the two horns are usually distended alike, no fetus being 

 recognizable in either. In abscess of the uterus, the organ is 

 large and more or less spherical and its walls are hard and tensely 

 stretched, while an examination through the vagina shows that 

 the OS uteri is obstructed or effaced. 



Uterine tumors may be mistaken for a fetus, but should be 

 distinguishable by the fact that they do not move in the uterus, 

 but only with the uterus or its walls ; that is, the tumor may be 

 pushed back and forth only to the same degree as the uterus it- 

 self moves with it, while the fetus may move freely within the 

 cavity of the organ, except in cases of mummification. 



