Torsion of the Uterus 709 



and she is allowed to stand. If the operation has been successful, 

 the spiral folds of the vagina have disappeared, the hand can be 

 advanced without difficulty to the os uteri, and, if the cervical 

 canal is dilated, the hand may be passed on into the uterine 

 cavity and the fetus grasped. 



It is highly important, in this operation, that the veterinarian 

 should constantly keep, or frequently insert his hand into the 

 vagina in order to determine the progress which is being made. 

 Sometimes the operator becomes confused in reference to the di- 

 rection of the twist, and consequently in reference to the direc- 

 tion in which the animal should be rolled. If his hand is intro- 

 duced into the birth canal and the rolling process is begun in the 

 wrong direction, he at once recognizes the fact by the increased 

 pressure upon his hand as the twist becomes aggravated. If the 

 turning is in the right direction, and the torsion is reducible, the 

 vagina becomes more open and commodious, and the hand can 

 be advanced further into it. 



In some instances the torsion is not promptly reduced, al- 

 though it may eventually be accomplished by perseverance, so 

 that, if turning the animal once does not completely accomplish 

 the object, we should not despair, but should resort to several 

 turns and watch closely the result. 



4. When the rolling process, or the partial rolling with external 

 manipulation, fails to bring about a reduction of the torsion, it 

 has been recommended to perform laparotomy, reach into the 

 abdominal cavity with the hand, grasp the gravid uterus, and 

 reduce the torsion by acting directly upon the organ. In the 

 cow it would be preferable to operate upon the standing animal, 

 making the incision somewhat high in the right flank. If the 

 torsion is to the right, the operator reaches down between the 

 right abdominal wall and the gravid uterus ; inserting the hand 

 as far as possible alongside and beneath the organ, lifts up- 

 ward ; and, drawing somewhat to the right, attempts to cause it 

 to revolve to the left. If the twist is to the left, the operator 

 passes his hand over the top of the organ to the left side, and 

 downward as far as possible, and, grasping some projecting por- 

 tion, draws the organ upward and to the right. How often this 

 process succeeds, where rolling or external palpation fails, we 

 are unable to determine. Probably not often. The gravid 



