IPounds and Injuries to the Genital Organs 813 



tention it is impracticable to separate the envelopes at once be- 

 cause of hemorrhage due to the uterine injuries. In the cow, 

 when the placenta is retained and involution of the uterus has 

 not yet occurred, and the layman or empiric attempts to de- 

 tach the membrane, profuse and fatal hemorrhage is liable to 

 result, which is greatly accentuated when the cotyledons are rudely 

 torn away from the uterus. 



In one instance observed by us, an empiric attempted to remove 

 the membranes from a cow immediately after calving, and, by 

 tearing them away, brought on a hemorrhage which proved fatal 

 to the patient in 4:he course of a few hours. When we were 

 called, the entire uterine cavity was filled with a great mass of 

 blood ; much blood had already escaped from the vulva ; the 

 cow was down, and unable to rise ; the mucous membranes were 

 blanched ; the animal was pulseless, and in a dying condition. 

 In the mare we have observed fatal hemorrhage as a result of 

 ruptures during difBcult labor. 



Hemorrhage from the uterus occurs also in cases of pro- 

 lapse or inversion, and usually of two types. There may be a 

 general capillary hemorrhage from the entire mucous surface, or 

 rather from the placental surfaces of the uterus, and there may 

 also occur hemorrhage from wounds of the uterine walls or 

 placentae involving large vessels. 



Symptoms. Generally there is an escape of blood from the 

 vulva. The blood may, however, be largely retained within the 

 uterus, and coagulate promptly. In case of rupture of the uterine 

 walls, and especially of the uterine floor, when involving large 

 vessels, a profuse and even fatal hemorrhage may occur into 

 the peritoneal cavity, without any appreciable amount of blood 

 escaping from the vulva. In these instances of intra-uterine 

 or intra-peritoneal hemorrhage, the symptoms, in general, are 

 those of internal hemorrhage, such as the blanching of the 

 mucous membranes, weakness of the animal, pain, anxiety and 

 sweating. Death frequently follows quickly. The diagnosis 

 must be made by these symptoms, in conjunction with a manual 

 exploration of the uterine cavity. 



The indications in uterine hemmorrhage will depend largely 

 upon the cause and origin. When due to extensive wounds of 

 the uterine walls, involving the large vessels, and the uterus is in 

 position, it is well-nigh beyond the obstetrist's control, though 



