Amputation of the Uterus 845 



this is especially true in the smallerdomesticanimals with very 

 long uterine horns. 



2. In some cases of prolapse of the uterus, when the organ has 

 remained extruded for a considerable period of time and has be- 

 come more or less necrotic and seriously infected, its return into 

 its usual position is followed by serious and even fatal conse- 

 quences to the patient. If the uterus has been prolapsed for a 

 few hours only, it is not gangrenous as a rule, because the ever- 

 sion of the organ does not wholly cut off the circulation in it, but 

 only interferes somewhat by doubling the vessels in their course, 

 so that the blood supply may be maintained for a long time, and 

 in some cases almost indefinitely. As soon as the organ hangs 

 down from the vulva in a complete state of prolapse,, the inter- 

 ruption to the circulation is important, since in addition to the 

 doubling of the vessels there-is also the impediment of gravity, 

 which causes the organ to become greatly engorged with blood 

 and interferes, in an important manner with its circulation. If 

 the organ has been seriously injured by rough handling during 

 dystokia, has been prolapsed for a number of hours and has been 

 bruised or crushed against the floor or wall, or has for a long time 

 been greatly soiled, by highly infectious manure, gangrene is 

 frequently inevitable. It is inadvisable to returo.such a uterus 

 into position. The condition may cause a recurrence of the pro- 

 lapse, in spite of any precautions to the contrary; or, if the organ 

 is retained in its position, it may undergo gangrene, and cause 

 the death of the animal. 



3. Wounds of the uterus of large extent usually call for ampu- 

 tation, especially when complicated with extensive infection of the 

 peritoneal surface. When only a small wound, or even 

 a large one which is moderately clean, occurs, amputation is 

 not necessary. It is by no means essential that the entire uterus 

 should be amputated because a small portion or even half of it has 

 been more or less damaged. It is presumably just as safe to am- 

 putate ^ or >^ as to amputate all of the organ, and it may at 

 times be of fundamental importance that we should save a portion 

 of it, if by so doing we may retain the power, of breeding. Con- 

 sequently, when a wound is present and we can close it accurately 

 by means of sutures, we have performed- an operation which is 

 quite as safe as the ablation of the organ. The principal ob- 

 jection to this is the fact that some infection will probably 



