OBSTETRICS 267 



fomentation. Tears and severe bruises must have veterinary 

 service. This calls for immediate operation by a veterinarian, 

 and the injury is much more dangerous for the mare than for 

 the cow. 



Retention of the placenta (afterbirth). — This trouble is most 

 common in cows, but is less serious for cows than for mares. It 

 is caused by unusual adhesions between the placenta and the 

 womb, imprisonment of the placental tufts in the corresponding 

 cavities of maternal cotyledons and by a mild inflammation due 

 to infection, often from infectious abortion. 



There is normally a short period of exhaustion following 

 delivery. After this period the uterus should recover its nor- 

 mal tone and expel the afterbirth and accompanying fluids. 

 Note the order of development: infection, inflammation with 

 accompanying swelling, and then adhesion. 



Treatment. — For the mare the placenta should usually be re- 

 moved within twelve hours if it fails to come away naturally. 



If the cow's afterbirth can be removed easily and without 

 hemorrhage, then the sooner it is removed the better. 



Everything in this work must be done carefully and with a 

 view to cleanliness. First, irrigate the vagina with an antisep- 

 tic, e.g. one half per cent Lugol's iodin, and disinfect the sur- 

 rounding external parts. 



As nearly as possible the entire placenta should be removed 

 by introducing an oiled hand into the uterus, gently separating 

 the placenta from its uterine adhesions, and pulling with the 

 other hand outside. 



If a cow's afterbirth does not come away easily and com- 

 pletely and there be no urgent reason for removal, then treat- 

 ment should be directed against extension of infection. 



A good authority recommends iodoform and boracie acid, 

 equal parts, and suggests that this may be put in a capsule and 

 the capsule either left to dissolve in the uterus or opened and 

 the powder scattered in the uterus by hand. The purpose of 

 this treatment is, of course, to check the development of infec- 

 tive organisms. 



The patient should be examined from time to time, and it 

 will usually be found after awhile that the afterbirth has been 

 released and will come away easily. In some cases of retained 

 afterbirth there develops a rapid necrosis (death) of the ma- 

 ternal cotyledons, in which case the cotyledons themselves may 



