Prolapse of the Vagina 449 



Exploration per vaginam reveals no data of value except the 

 cervix be dilated so that the hand may be passed into the uterus, 

 when the absence of the fetus in the uterine cavity becomes evi- 

 dent. The membranes have more or less completely escaped and 

 the rent in the uterus is easily recognizable. 



If the cervix is closed, the hand introduced into the rectum 

 may yield all needed data for a positive diagnosis. The uterine 

 body, somewhat retracted and without fetal contents, is recog- 

 nizable. Outside the uterus, lying more or less free in the peri- 

 toneal cavity, the fetus may be detected. 



The treatment of rupture of the gravid uterus in domestic 

 animals has not yet been made practical. In most cases of the 

 character here described, the patient dies without a positive diag- 

 nosis having been reached, and the actual nature of the accident 

 is only revealed post mortem. 



If recognized during the life of the patient there is scant basis 

 for hope of overcoming it by surgical means. Caesarian section 

 is indicated, if thereby there is a hope that the fetus and its 

 membranes may be removed, the hemorrhage from the ruptured 

 uterine walls controlled and the life of the mother saved. (The 

 operation of laparotomy is described later when dealing with ob- 

 stetric operations. ) In such cases, the operation should include 

 the removal of the fetus and its membranes, and the closing of 

 the uterine walls, with the consequent arrest of hemorrhage. 



Ante-partum Prolapse of the Vagina. 



Prolapse of the Vaginal Portion of the Uterus. 



Prolapse, or aversion, of the vagina is observed in the preg- 

 nant cow and ewe and more rarely in other domestic animals. 

 Fleming attributes the occurrence of this prolapse during preg- 

 nancy to a relaxation of the genital organs, and claims that it 

 occurs mostly in those animals of a lymphatic temperament 

 which are good milkers, have wide pelves and are fed abundant- 

 ly upon bulky food. He also believes that cows which are kept 

 on sloping floors are liable to this disease and that injuries of 

 various kinds may cause it. He claims that it occurs chiefly in 

 adult animals which have previously given birth to young. We 

 have observed it also in primiparse. The disease usually appears 

 29 



