460 
RUPTURE OF THE PERINiEUM IN PARTURITION. 
the teat sacking, and the mother quite easy, only occasionally 
switching the tail and showing other slight signs of after-pains.. 
From the perinseum and vulva a small quantity of bloody fluid 
was discharged, with an occasional escape of afflatus. On inquiry, 
I learned from the attendant, who had assisted in many cases of 
parturition, that the foal made not only an anterior presentation, 
but was also in the vertebro-sacral position without any cause for 
dystocia. The feet had presented through the vulva, but the head 
had remained in the vaginal canal, where an examination revealed 
the nose caught in the mucous membrane just within the supeiioi 
commissure. Before the attendant had time to push the foetus 
forward and release the nose, the mare made a powerful effort at 
expulsion, which sent the head through the vaginal walls, and a 
moment after it presented from the anus, having also ruptured 
the coats of the rectum. 
A careful examination of the uterus was made and the foetal 
membranes removed, after which attention was given the wound. 
The laceration in the rectum extended forward on the median 
line, a distance of about five inches, the borders of the wound be¬ 
ing quite regular in outline. An attempt was made to close the 
wound in the intestine, with the glover’s suture, but it was not en¬ 
tirely successful, for on nearing the sphincter am it was found 
impossible to use the needles, owing to the contraction of the tis¬ 
sues. The suture was made fast, the parts dressed with carbolic 
acid and glycerine, and two sutures introduced into the perime- 
um. She was placed upon a few ten-drop doses of aconite for a 
day or two, ordered to receive enemas three times a day, and lax¬ 
ative, easily digested food, with occasional antiseptic injections 
into the vagina. The wound in the perinseum soon healed, but 
the torn rectum suppurated some near the anus, and during the 
few weeks she was under my observations, a fistula continued to 
exist, between the rectum and vagina, through which partly fluid 
fseces would sometimes pass, to be voided from the vulva; this 
presence of fecal matter in the vagina served to maintain a little 
catarrh of the mucous membrane, accompanied by frequent strain¬ 
ing and attempts at micturition. Otherwise, the mare soon re¬ 
trained her usual health, and, after a short period, resumed her 
