82 2 Veterinary Obstetrics 



the protrusion of the intestine. In uterine or vaginal rupture in 

 difficult parturition, where the intra-abdominal pressure is enor- 

 mously increased by the straining, a portion of the intestine fre- 

 quently passes into the uterus or vagina, and iinally beyond the 

 vulva. 



We have already noted that in some cases a rupture of the 

 uterus is caused by the meddling of empirics, by whom some 

 rude instrument is used, and that through this rupture the in- 

 testines protrude, if the fetus is prevented from escaping. In 

 one instance which we observed, an effort had been made to 

 catch some portion of the fetus by means of a hooked stick, 

 and in so doing a large rent had been caused in the wall of the 

 vagina. The fetus was retained within the uterine cavity 

 because of bad position. The expulsive efforts of the mare forced 

 the floating colon through the rent in the vagina, so that upon 

 my arrival the intestine had protruded beyond the vulva so far 

 that it dragged upon the ground. 



The indications usually are to at once destro}' the patient, 

 since the prognosis must necessarily be extremely bad. The 

 protrusion generally occurs before the expulsion of the fetus, and 

 it then becomes almost impossible to extract the fetus without 

 incidental injury to the intestine and infection of the peritoneal 

 cavity. If it be possible to return the intestines with hope of 

 saving the life of the patient, this should be done, and measures 

 taken to keep the intestines out of the way until the fetus has 

 passed beyond the point of injury. After the fetus has been re- 

 moved, it may in some cases be possible to suture the wound in 

 the uterus or vagina in order to guard against further prolapse 

 and decrease the danger of infection. 



9. ProIvApse op The Bi,adder through a Rupture 

 IN THE Floor op the Vagina. 



When the floor of the vagina becomes ruptured during partu- 

 rition, there is a somewhat remote pos.sibility that the urinary 

 bladder may be forced out through this rupture and extend into 

 the vagina or vulva. Necessarily such a prolapse involves the 

 bending of the organ upon itself to an extent which tends 

 to cause an obstruction to the passage of urine through the ure- 

 thra, and thereby favors an accumulation of urine in the bladder. 

 The accident is an exceedingly rare one, and has occurred only 

 with sufficient frequency to establish the possibility. 



