Inversion of the Uterus 843 



in efficiency, and the prolapsed organ may push it aside and 

 escape. According to our observations, trusses generally become 

 relaxed and loosened when the patient arches her back in order 

 to strain. •- Should we desire to prevent this relaxation, it is 

 advisable in our judgment to carry the two inferior cords upward 

 and forward over the flanks, and cross them over the loins of the 

 animal, from whence they are to be carried downward and 

 forward along the sides of the chest to pass between the fore-legs, 

 and attached in such a manner that, if the animal arches her 

 back in order to make an expulsive effort, the tension upon these 

 cords is increased rather than decreased. 



In any event, however, the most important point is to have the 

 truss very carefully adjusted, and then to watch it very closely. 

 The truss cannot prevent the inversion of the organ and its pass- 

 age into the vagina and vulva, but can only tend to prevent its 

 prolapse through the vulvar opening. This is equally true of 

 sutures. While this truss is recommended by one and , that 

 truss by another, the best one always is that one which is best 

 applied. The actual value of the truss is not so great as many 

 suppose, but after all it has an important influence from a senti- 

 mental standpoint, and has none or few of the objections which 

 can be raised against sutures and pessaries. Since the owner of 

 an animal which has suffered from prolapse of the uterus is con- 

 stantly afraid of its recurrence, it is good practice to apply the 

 truss in the majority of cases simply to allay his fears, if it 

 accomplishes nothing else. Should the truss become displaced 

 somewhat, and the prolapse recur, the owner still considers that 

 the veterinarian has at least attempted the retention of the 

 organ. 



We prefer to show the owner how to apply the truss, 

 should it become necessary, then have him watch the patient 

 and so care for her that the truss will not be needed. We 

 have in mind here the patient which is able to stand. If 

 the patient is recumbent, the case is graver, and retention appar- 

 atus usually imperative. She should be kept with her hind parts 

 elevated and abdominal pressure reduced to a minimum. 



The handling of prolapse of the uterus, after the organ has been 

 replaced and the precautions against a recurrence taken as sug- 

 gested, demands little except to care for the general well-being 

 of the animal. It is well to bear in mind that any increase of 



