Examination of the Patient 623 



is desirable to spread a clean sheet or cloth, which has been 

 dipped in a disinfecting solution, immediately behind the animal 

 in a way to cover over any bedding or litter and prevent it from 

 being dragged into the genital tract of the mother upon the hands 

 or arms of the operator. 



After the removal of the fetus, in all cases of dystokia, it is 

 important at once to follow with the removal of the membranes, 

 if practical, after which the uterus should again be disinfected 

 thoroughly with a large volume of antiseptic solution, providing 

 always that we can be sure that the integrity of the uterine walls 

 has been preserved and that there are no penetrating wounds 

 into the peritoneal cavity. In the latter case we should simply 

 attempt to remove mechanically all the infectious material, so far 

 as is in our power, and be very careful to not inject fluids into the 

 uterus which will find their way into the peritoneal cavity and 

 probably at once cause the collapse and death of the patient. 

 If it has been clearly determined that the uterus is wholly intact, 

 the injection of large volumes of warm disinfectants into ics cav- 

 ity produces three important results : disinfects the cavity and 

 decreases the danger to the patient later, from infection and its 

 consequences ; serves an important purpose by straightening out 

 the walls of the uterus and tending to correct any displacements 

 of the organ — if one of the horns is somewhat displaced or has 

 begun to evaginate or evert, it tends to restore it to its proper 

 position ; the presence of the warm solution in the uterus, in suf- 

 ficient volume to cause distension, stimulates a quite vigorous 

 contraction of the organ — involution — which tends strongly to 

 eliminate the uterine cavity and prevent prolapse of the uterus or 

 vagina. 



The Examination op the Patient. 



Before proceeding with any operations in cases of dj'stokia, it 

 is essential that the practitioner should make a careful examina- 

 tion of his patient. First he should determine as well as practi- 

 cable her condition, whether she is strong and vigorous or weak 

 and debilitated, or he should determine if there is anything in 

 her general condition which would suggest some serious or fatal 

 lesion, such as internal hemorrhage from a uterine rupture. 

 This knowledge can be gained partly by the general appear- 

 ance of the patient and partly by examination of the pulse and 

 visible mucous membranes. 



