34 
EXTRUSION OF BLADDER IN A MARE. 
Having no assistance, and no means of casting her, which 
I considered indispensable, I returned home, a distance of 
nine miles, and consulted a medical friend (A. Oakes, Esq., 
M.R.C.S.), who took great interest in the case, offered many- 
valuable suggestions, and more than this, gave his personal 
assistance. We arrived about 7 p.m., and found the mare so 
weak that I thought it advisable, with assistance, to again try 
the reduction without casting, but she strained so violently 
that we quickly desisted. 
With great difficulty she was led, tottering as she went, to 
the straw yard, where we cast her. 
I then grasped the fundus and as much of the body of the 
bladder as I could, and persistently applied gentle pressure 
with three fingers upon the mouth of the urethra, when, to 
my great delight, whilst the mare made a slight struggle, I 
felt a good portion of my embarrassing handful recede ; now 
came another difficulty, that of pushing my hand forward, 
enveloped as it was by vesical folds, and subjected to the 
contractions of the urethra and the straining efforts of the 
mare; also the difficulty of withdrawing it, without the 
returned portions of the bladder, which lay just within the 
urethra following; when my friend, using my hand as a 
director, introduced his left hand, and pushed the whole of the 
viscus into its normal position, wondering where the whole 
of his arm had gone. 
I then injected the uterus, vagina, and bladder with di- 
luted carbolic acid (1 part to 60 of water made tepid) . The 
mare was then raised, and carefully helped into the box. 
I gave two ounces tincture of opium, with four ounces of 
whiskey, and ordered mash diet, warm clothing, &c. 
On the 28th I found her lying full length in the box, the 
tremors of the limbs continuing, slight perspiration, pulse 
80, and weak, respirations 40, and membranes healthy looldng; 
has eaten a little green food and hay. 
Repeat opium and whiskey, and inject bladder with decoc- 
tion of poppy heads and fresh barm. 
29th. — Patient looking much more composed and cheerful, 
body and extremities warm, tremors much abated, pulse has 
risen to 98, soft, and weak, respirations 32, appetite slightly 
improved, voids a pint of urine of good colour frequently in 
the day, without pain ; has passed a large quantity of dung, 
and is upon the whole decidedly better. 
To repeat treatment, with friction to extremities. 
30th. — Symptoms much the same as yesterday, pulse 80, 
and soft, appetite improved, tremors quite subsided, and 
moves with much more freedom. 
