126 
REP0RT8 OF OASES. 
breakfast only to learn that the accident had happened the third 
time. 
Having a mule in the barn to operate on that morning, and 
considerable other work to do, it was impossible for me to see the 
case before middle of afternoon, wheu I found patient recumbent 
and suffering terrible pain ; evidently could not last long unless 
relief was SQon afforded; administered opiates. Examination 
showed the tumor much enlarged and lacerated, leather colored, 
and pressing heavily on the urethra, bladder filled to its utmost 
capacity. By holding up the tumor 1 was enabled to empty the 
bladder, this gave relief; did not attempt to return the vagina in 
its lacerated and swollen condition. Resolved to amputate at 
once, etherized the patient, ligatured the entire inverted mass 
close to the vulva, made it as tight as two strong men could draw 
it, and proceeded to cut, tying the blood-vessels as I came to 
them ; just as I finished cutting the patient rallied, struggled and 
strained violently, the main ligature came off, and with it inverted 
uterus containing foetus. This 1 returned to its place, was not 
exposed a second, and injected cold water with astringent. 
Hemorrhage soon ceased. Patient got up without assistance, 
drank a little water, and picked some hay ; gave an opiate dose 
and some laxative medicine. Left some stimulating medicine to 
be given during the night, with directions to give some feed if 
patient would eat, if not to give some gruel, and take the best 
care possible. 
Saw patient at 10 a.m. Monday. Rain had set in the night be- 
before; she had become damp, and having had no clothing had 
chilled ; had had no medicine or anything since I left the evening- 
before. Gave stimulating medicine, could not procure any cloth¬ 
ing, and only a little corn meal for gruel. This patient seemed 
to relish, but under the circumstances* I gave up hope ; it was too 
far away for me to give the case the attention it needed, and it 
may be that all the care and attention that could have been given 
under more favorable circumstances would not have saved life. 
Ho not want to throw any discredit on Mr. G., who is a 
banker here, and plenty of business to attend to, and, I presume, 
would supply all wants at the ranch if the same were made 
