Maceration and Decomposition of the Fetus 463 



according to Hess, that tlie expulsion of the fetus might be 

 brought about by the artificial pressing out of this body, there- 

 by inducing uterine contraction, which may be further favored 

 by massage of the uterus per rectum. This failing, our only 

 recourse is the mechanical dilation of the cervical canal and the 

 extraction of the mummy. In the extraction of this unyielding 

 mummy, considerable difficulty may be encountered if it is of 

 very large size or when one or more of the limbs project in an 

 unfavorable direction. It may be necessary to perform em- 

 bryotomy. 



Maceration and Putrid Decomposition of the Fetus. 



When the fetus perishes in the uterus and the os uteri is per- 

 vious and permits the entrance of micro-organisms, the fetal body 

 quickly undergoes maceration or putrefaction. The exact type 

 of decomposition varies in different cases. In one, it may simply 

 amount to a softening and solution of the fetal body and mem- 

 branes, with some fetor. In other cases putrefaction takes on the 

 ordinary type, with a great fetor and the formation of large vol- 

 umes of gases. When the putrefaction is rapid, so that the uter- 

 ine walls can not readily and quickly expand to accommodate 

 the large volume of gases, rupture of the uterus may occur. If 

 the decomposition and formation of gases are not so rapid, the 

 walls of the uterus become inflamed and thickened and lose their 

 contractile power. There is an abundance of pus formed from 

 the mucous membrane. Sometimes the cavity of the uterus as- 

 sumes the type of an abscess which eventually opens upon the 

 exterior, either directly through the abdominal walls, or indi- 

 rectly through the os uteri, vagina, intestines, or rumen. When 

 the disease pursues such a course, the uterine walls become ad- 

 herent to that part through which the opening is to occur and 

 eventually the fetus, with other putrid contents of the uterus, is 

 expelled. Through the abscess opening there may enter into the 

 uterine cavity particles of food from the intestinal tract. When 

 the uterine abscess empties itself through the cervical canal into 

 the vagina, the os uteri becomes slightly dilated and portions of 

 the fetus may from time to time be expelled through this 

 opening. 



The symptoms of maceration or putrefaction of the fetus are 

 extremely varied. When portions of the fetus are expelled 



