PROLAPSE OF THE UTERUS. 
435 
more often recorded than are failures. When the animal is not cast, 
precautions must be taken against its lying down or kicking the 
operator. The surface is then cleansed, and care taken to discover by 
palpation that no portion of bowel or bladder is included in the inverted 
uterus. A strong tape or cord, in the form of a surgical snare, is then 
passed round the neck of the uterus, avoiding the urethra, and drawn 
very tight. In this case, as in all where large masses of tissue have to 
be ligatured, it is necessary to proceed slowly. The ends of the cord are 
tied to pieces of stick to ensure a better purchase, and the ligature is 
drawn tight; the operator then waits a few seconds to allow the tissue 
fluids to filter away, and again tightens the cord; if the prolapsed 
uterus is much swollen, the procedure requires repeating several times. 
The elastic ligature has been recommended and successfully used on 
sheep and swine by several operators. After applying the ligature, the 
organ is cut away. 
In large animals, and where swelling is great, amputation by multiple 
ligature is to be recommended, or the mucous membrane can he divided 
and the ligature applied to the muscular and serous coats. These methods, 
however, have no particular advantage over that above described. Bang 
also prefers the ligature ; the portion thus tied off can at once be 
cut away, but should movement of the ligature be feared, or further 
tightening become necessary, amputation may be postponed till next 
day. In such cases care must be taken that the weight of the uterus 
does not cause it to tear away, as such complications are often difficult 
to deal with. Hering recommends, where the animal is able to stand, 
to lay the prolapsed parts on its quarter. Without question, however, 
it is better to remove them at once, if for no other reason than the fact 
that this allows of reposition of the vagina. To remove inflammatory 
products, discharges from wounds and from the ligatured stump, the vagina 
must be repeatedly washed out during the following days. If swelling is 
severe, it may be necessary to pass the catheter. Should further prolapse 
of the vagina result from severe straining, either the truss, West’s clamps, 
or a few metallic stitches may be passed through the vulva. The opera¬ 
tion is not without danger ; loops of bowel may protrude, and cows often 
show great nervous excitement for some time. 
In bitches, the uterus has repeatedly been amputated with success. 
In them also the displacement of the pregnant uterus, in inguinal hernia, 
may render the operation necessary. Antisepsis must, as far as possible, 
be practised. 
In small animals, and especially in goats, prolapse of the uterus has 
been reduced by injecting water. The animal’s hind legs were held up, 
the smaller horn of the uterus reduced and filled with lukewarm water. 
The weight of the water carried back the horn or the uterus to its 
f f 2 
