Uterine Abscess 897 



temporary atresia of the os or the cervical canal, and the 

 final discharge of the accumulated fluid may be the result of a 

 breaking down of the adhesions in the canal, in a way which 

 might be compared to the rupture of an abscess. In some cases, 

 however, the atresia or closure of the os is more persistent, and 

 brings about a state which cannot be better designated than as 

 abscess. 



The causes of abscess of the uterus are similar to those of 

 chronic metritis, and are very largely referable to infection fol- 

 lowing manipulations during dystokia or to retention of the fetal 

 membranes. 



The symptoms of uterine abscess differ from those which are 

 typical of chronic metritis. The disease is observed chiefly in the 

 mare. The principal symptoms observed are those of general 

 debility accompanied by some emaciation and general appear- 

 ances of ill-health, with evidences of abdominal pain, which may 

 be described as colic. Later, expulsive efforts appear. The 

 uterine walls serve as abscess walls, and the tension within the 

 cavity constantly increases, until finally the walls rupture in the 

 direction of least resistance, and the contents escape. So far as 

 we have observed, the abscess ruptures into the vagina, appar- 

 ently through the occluded os uteri. 



Under these conditions a manual exploration per rectum re- 

 veals an enormously enlarged uterus, very tense and fluctuating. 

 The uterus may contain as much as 4 or 5 gallons of pus. The 

 organ loses its usual form, and becomes more or less spherical. 



Manual exploration per vaginam reveals a normal vulva and 

 vagina ; but the os uteri is absent, and that portion of the uterus 

 which normally projects into the cavity of the vagina has be- 

 come wholly effaced. The anterior wall of the vagina appears as 

 a tense partition, without any opening toward the uterus. 

 Through this wall the distended organ may be readily felt, or 

 rather we might say that the anterior vaginal wall, with which 

 the hand comes in immediate contact, constitutes the posterior 

 wall of the abscess cavity. 



In one mare we had considerable difficulty in overcoming dys- 

 tokia. After the fetus was removed by means of embryotomy, 

 the mare did not recover with that promptness and completeness 

 which should be expected, and finally began to decline. Later 

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