FOOTNOTES:
[1] Encyklop. der Thierheilk., Vol. IV, p. 208.
DISEASES OF THE GENERATIVE ORGANS.
By James Law, F. R. C. V. S.,
Formerly Professor of Veterinary Science, etc., in Cornell University.
[Revised by Adolph Eichhorn, D. V. S.]
GENERAL DISCUSSION.
Diseases of the generative organs are practically confined to animals which are kept for reproduction and the dairy. The castration of the bull condemns these organs to inactivity and protects them from the many causes of injury attendant on the engorged blood vessels in the frequent periods of sexual excitement, on the exposure to mechanical violence, and on the exposure to infective inoculation. In three respects the castrated male is especially subject to disease: (1) To inflammation and tumefaction of the cut end of the cord that supported the testicle and of the loose connective tissue of the scrotum; (2) to inflammation of the sheath and penis from the accumulation of gravel in the former, from which the penis is not usually protruded in passing water; and (3) to bruising, abrasion, and inflammation of the sheath and penis during suspension in the stocks for the purpose of shoeing. Apart from these the ox is practically almost exempt from the inflammations and injuries of the genital organs. The same applies to the castrated heifer. Inflammation may occur in the broad ligament of the womb whence the ovary has been removed or infective inflammation in the abdominal cavity (peritonitis) in case the operation has been performed through the flank, as it usually is in the young heifer. Apart from these, the castrated heifer is practically immune from any trouble of the generative apparatus. Even the virgin heifer is little subject to such troubles, though she is not exempt from inflammations, and above all, from morbid growths in the ovaries which are well developed and functionally very active after the first year, or in precocious animals after the first few months of life. The breeding cow, on the other hand, is subjected to all the disturbances attendant on the gradual enlargement of the womb, the diversion of a large mass of blood to its walls, the constant drain of nutrient materials of all kinds for the nourishment of the fetus, the risks attendant and consequent on abortion and parturition, the dangers of infection from the bull, the risks of sympathetic disturbance in case of serious diseases of other organs, but preeminently of the urinary organs and the udder, and finally the sudden extreme derangements of the circulation and of the nervous functions which attend on the sudden revulsion of a great mass of blood from the walls of the contracting womb into the body at large immediately after calving.
In reviewing this class of diseases, therefore, we have to note, first, that they are almost exclusively restricted to breeding animals, and secondly that in keeping with the absolute difference of the organs in the male and female we find two essentially distinct lists of diseases affecting the two sexes.
EXCESS OF VENEREAL DESIRE (SATYRIASIS IN MALE, OR NYMPHOMANIA IN FEMALE).
This may occur in the male from too frequent sexual intercourse, or from injury and congestion of the base of the brain (vasodilator center in the medulla), or of the posterior end of the spinal cord, or it may be kept up by congestion or inflammation of the testicles or of the mucous membrane covering the penis. It may be manifested by a constant or frequent erection, by attempts at sexual connection, and sometimes by the discharge of semen without connection. In bad cases the feverishness and restlessness lead to loss of flesh, emaciation, and physical weakness.
It is, however, in the female especially that this morbid desire is most noticeable and injurious. It may be excited by the stimulating quality of the blood in cows fed to excess on highly nitrogenous feed, as the seeds of the bean, pea, vetch, and tare, and as wheat bran, middlings, cotton seed, gluten meal, etc., especially in the case of such as have no free exercise in the fields, and are subject to constant association with a vigorous young bull. A more frequent cause is the excitation or congestion of some part of the genital organs. Disease of the ovaries is preeminently the cause, and this may be by the formation of cysts (sacs containing liquid) or of solid tumors or degenerations, or, more commonly than all, the formation of tubercle. Indeed, in case of tuberculosis attacking the abdominal organs of cows, the ovaries or the serous membranes that support and cover them (the broad ligaments of the womb) are peculiarly subject to attack, and the animal has constant sexual excitement, incessantly riding or being ridden by other cattle, having no leisure to eat or chew the cud, but moving restlessly, wearing the flesh off its bones, and gradually wasting. In some localities these cows are known as "bullers," because they are nearly always disposed to take the bull, but they do not conceive, or, if they do, they are subject to early abortions. They are, therefore, useless alike for the dairy and for the feeder, unless the removal of the ovaries subdues the sexual excitement, when, in the absence of tuberculous disease elsewhere, they may be fattened for the butcher.
Among the other sources of irritation charged with causing nymphomania are tumors and cancers of the womb, rigid closure of the neck of the womb so that conception can not occur and the frequent services by the male which stimulate the unsatisfied appetite, inflammation, and a purulent discharge from the womb or vagina.
Treatment.—The treatment in each case will vary with the cause and is most satisfactory when that cause is a removable one. Overfeeding on richly nitrogenous feed can be stopped, exercise in the open field given, diseased ovaries may be removed (see "Castration," [p. 299]), catarrhs of the womb and passages overcome by antiseptic, astringent injections (see "Leucorrhea," [p. 224]), and tumors of the womb may often be detached and extracted, the mouth of that organ having been first dilated by sponge tents or otherwise. The rubber dilator (impregnator), sometimes helpful in the mare, is rarely available for the cow, owing to the different condition of the mouth of the womb.
DIMINUTION OR LOSS OF VENEREAL DESIRE (ANAPHRODISIA).
This occurs in either sex from low condition and ill health. Longstanding, chronic diseases of important internal organs, leading to emaciation and weakness, or a prolonged semistarvation in winter may be sufficient cause. It is, however, much more common as the result of degeneration or extensive and destructive disease of the secreting organs (testicles, ovaries) which elaborate the male and female sexual products, respectively. Such diseases are, therefore, a common cause of sterility in both sexes. The old bull, fat and lazy, becomes sluggish and unreliable in serving, and finally gets to be useless for breeding purposes. This is not attributable to his weight and clumsiness alone, but largely to the fatty degeneration of his testicles and their excretory ducts, which prevents the due formation and maturation of the semen. If he has been kept in extra high condition for exhibition in the show ring, this disqualification comes upon him sooner and becomes more irremediable.
Similarly the overfed, inactive cow, and above all the show cow, fails to come in heat at the usual times, shows little disposition to take the bull, and fails to conceive when served. Her trouble is the same in kind, namely, fatty degeneration of the ovaries and of their excretory ducts (Fallopian tubes), which prevents the formation or maturation of the ovum or, when it has formed, hinders its passage into the womb. Another common defect in such old, fat cows is a rigid closure of the mouth of the womb, which prevents conception, even if the ovum reaches the interior of that organ and even if the semen is discharged into the vagina.
Preventive—The true preventive of such conditions is to be found in a sound hygiene. The breeding animal should be of adult age, neither overfed nor underfed, but well fed and moderately exercised; in other words, the most vigorous health should be sought, not only that a strong race may be propagated, but that the whole herd, or nearly so, may breed with certainty. Fleming gives 79 per cent as the general average of cows that are found to breed in one year. Here more than a fifth of the progeny is sacrificed and a fifth of the product of the dairy. With careful management the proportion of breeders should approach 100 per cent. The various local and general obstacles to conception should be carefully investigated and removed. The vigorous health which comes from a sufficiently liberal diet and abundant exercise should be solicited, and the comparative bloodlessness and weakness which advance with undue fattening should be sedulously avoided. In bull or cow which is becoming unduly fat and showing indications of sexual indifference, the treatment must be active. Turning out on a short pasture where it must work hard for a living will often suffice. The bull which can not be turned out to pasture may sometimes be utilized in the yoke or tread power, or he may be kept a part of his time in a field or paddock chained by the ring in his nose to a strong wire extending from one side of the lot to the other and attached securely to two trees or posts. The wire should be higher than the back of the bull, which will move frequently from end to end. If he is indisposed to take sufficient exercise in this way he may be safely driven. An instance of the value of the exercise in these incipient cases of fatty degeneration is often quoted. The cow Dodona, condemned as barren at Earl Spencer's, was sold cheap to Jonas Webb, who had her driven by a road a distance of 120 miles to his farm at Wilbraham, soon after which she became pregnant. In advanced cases, however, in which the fatty degeneration is complete, recovery is impossible.
In case of rigid closure of the mouth of the womb the only resort is dilatation. This is far more difficult and uncertain in the cow than in the mare. The neck of the womb is longer, is often tortuous in its course, and its walls so approximated to each other and so rigid that it may be all but impossible to follow it, and there is always danger of perforating its walls and opening into the cavity of the abdomen, or, short of that, of causing inflammation and a new, rigid, fibrous formation which on healing leaves matters worse than before. The opening must be carefully made with the finger, and when that has entered the womb further dilatation may be effected by inserting a sponge tent or by careful stretching with a mechanical dilator. ([Pl. XX], fig. 6.)
STERILITY FROM OTHER CAUSES.
The questions as to whether a bull is a sure stock getter and whether a cow is a breeder are so important that it would be wrong to pass over other prominent causes of sterility. Breeding at too early an age is a common source of increasing weakness of constitution which has existed in certain breeds. Jerseys have especially been made the victims of this mistake, the object being to establish the highest milking powers in the smallest obtainable body which will demand the least material and outlay for its constant repair of waste. With success in this line there has been the counterbalancing disadvantage of impaired vigor, with too often lessened fertility as well as increased predisposition to disease. When the heifers of the race have for generation after generation been bred under a year old, the demand for the nourishment of the fetus is too great a drain on the immature animal, which accordingly remains small and stunted. As it fails to develop in size, so every organ fails to be nourished to perfection. Similarly with the immature bull put to too many cows; he fails to develop his full size, vigor, or stamina, and transfers his acquired weakness to his progeny. An increasing number of barren females and an increasing proclivity to abortions are the necessary results of both courses. When this early breeding has occurred accidentally it is well to dry up the dam just after calving, and to avoid having her served again until full grown.
Some highly fed and plethoric females seem to escape conception by the very intensity of the generative ardor. The frequent passage of urine, accompanied by contractions of the womb and vagina and a profuse secretion from their surfaces, leads to the expulsion of the semen after it has been lodged in the genital passages. This may be remedied somewhat by giving 1½ pounds of Epsom salt a day or two before she comes in heat, and subjecting her at the same time to a spare diet. Should the excessive ardor of the cow not be controllable in this way, she may be shut up for a day or two, until the heat is passing off, when under the lessened excitement the semen is more likely to be retained.
The various diseases of the ovaries, their tubes, the womb, the testicles and their excretory ducts, as referred to under "Excess of venereal desire," are causes of barrenness. In this connection it may be said that the discharges consequent on calving are fatal to the vitality of semen introduced before these have ceased to flow; hence service too soon after calving, or that of a cow which has had the womb or genital passages injured so as to keep up a mucopurulent flow until the animal comes in heat, is liable to fail of conception. Any such discharge should be first arrested by repeated injections as for leucorrhea, after which the male may be admitted.
Feeding on a very saccharine diet, which greatly favors the deposition of fat, seems to have an even more direct effect in preventing conception during such regimen. Among other causes of barrenness are all those that favor abortion, ergoted grasses, smutty wheat or corn, laxative or diuretic drinking water, and any improper or musty feed that causes indigestions, colics, and diseases of the urinary organs, notably gravel; also savin, rue, cantharides, and all other irritants of the bowels or kidneys.
Hermaphrodites are barren, of course, as their sexual organs are not distinctively either male or female. The heifer born as a twin with a bull is usually hermaphrodite and barren, but the animals of either sex in which development of the organs is arrested before they are fully matured remain as in the male or female prior to puberty, and are barren. Bulls with both testicles retained within the abdomen may go through the form of serving a cow, but the service is unfruitful; the spermatozoa are not fully elaborated. So I have examined a heifer with a properly formed but very small womb and an extremely narrow vagina and vulva, the walls of which were very muscular, that could never be made to conceive. A post-mortem examination would probably have disclosed an imperfectly formed ovary incapable of bringing ova to maturity.
A bull and cow that have been too closely inbred in the same line for generations may prove sexually incompatible and unable to generate together, though both are abundantly prolific when coupled with animals of other strains.
Finally, a bull may prove unable to get stock, not from any lack of sexual development, but from disease of other organs (back, loins, hind limbs), which renders him unable to mount with the energy requisite to the perfect service.
CONGESTION AND INFLAMMATION OF THE TESTICLES (ORCHITIS).
This visually results from blows or other direct injuries, but may be the result of excessive service or of the formation of some new growth (tumor) in the gland tissue. The bull moves stiffly, with straddling gait, and the right or left half of the scrotum in which the affected testicle lies is swollen, red, and tender, and the gland is drawn up within the sac and dropped again at frequent intervals. It may be treated by rest; by 1½ pounds Epsom salt given in 4 quarts of water; by a restricted diet of some succulent feed; by continued fomentations with warm water by means of sponges or rags sustained by a sling passed around the loins and back between the hind legs. The pain may be allayed by smearing with a solution of opium or of extract of belladonna. Should a soft point appear, indicating the formation of matter, it may be opened with a sharp lancet and the wound treated daily with a solution of a teaspoonful of carbolic acid in a half pint of water. Usually, however, when the inflammation has proceeded to this extent, the gland will be ruined for purposes of procreation and must be cut out. (See "Castration," [p. 299].)
INFLAMMATION OF THE SHEATH.
While this may occur in bulls from infection during copulation and from bruises, blows, and other mechanical injuries, the condition is more common in the ox in connection with the comparative inactivity of the parts. The sheath has a very small external opening, the mucous membrane of which is studded with sebaceous glands secreting a thick, unctuous matter of a strong, heavy odor. Behind this orifice is a distinct pouch, in which this unctuous matter is liable to accumulate when the penis is habitually drawn back. Moreover, the sheath has two muscles (protractors) which lengthen it, passing into it from the region of the navel, and two (retractors) that shorten it, passing into it from the lower surface of the pelvic bones above. ([Pl. IX], fig. 2.) The protractors keep the sheath stretched, so that it habitually covers the penis, while the retractors shorten it up in the act of service, so that the penis can project to its full extent. In stud bulls the frequent protrusion of the erect and enlarged penis and the retraction and dilation of the opening of the sheath serve to empty the pouch and prevent any accumulation of sebaceous matter or urine. In the ox, on the other hand, the undeveloped and inactive penis is usually drawn back so as to leave the anterior preputial pouch empty, so that the sebaceous matter has space to accumulate and is never expelled by the active retraction of the sheath and protrusion of the erect penis in service. Again, the ox rarely protrudes the tip of the penis in urination, the urine is discharged into the preputial pouch and lodges and decomposes there, so that there is a great liability to the precipitation of its earthy salts in the form of gravel. The decomposing ammoniacal urine, the gritty crystals precipitated from it, and the fetid, rancid, sebaceous matter set up inflammation in the delicate mucous membrane lining the passage. The membrane is thickened, reddened, rendered friable, and ultimately ulcerated, and the now narrowed sheath is blocked by the increasing mass of sebaceous and urinous material and the decomposing mucus and pus. The penis can no longer be protruded, the urine escapes in a small stream through the narrowing sheath, and finally the outlet is completely blocked and the urine distends the back part of the sheath. This will fluctuate on being handled, and soon the unhealthy inflammation extends on each side of it, causing a thick, doughy, tender swelling under the belly and between the thighs. The next step in the morbid course is overdistention of the bladder, with the occurrence of colicky pains, looking at the flanks, uneasy movements of the hind limbs, raising or twisting of the tail, pulsatory contractions of the urethra under the anus, and finally a false appearance of relief, which is caused by rupture of the bladder. Before rupture takes place the distended bladder may press on the rectum and obstruct the passage of the bowel dejections. Two mistakes are therefore probable—first, that the bowels alone are to be relieved, and, second, that the trouble is obstruction of the urethra by a stone. Hence the need of examining the sheath and pushing the finger into its opening to see that there is no obstruction there, in all cases of retention of urine, overdistended bladder, or blocked rectum in the ox. The disease may be acute or chronic—the first by reason of acute, adhesive inflammation blocking the outlet, the second by gradual thickening and ulceration of the sheath and blocking by the sebaceous and calculous accretion.
Treatment.—The treatment of this affection depends on the stage. If recent and without instant danger of rupture of the bladder, the narrow opening of the sheath should be freely cut open in the median line below, and the sac emptied out with a finger or spoon, after which it should be thoroughly washed with tepid water. To make the cleansing more thorough a catheter or a small, rubber tube may be inserted well back into the sheath, and water may be forced through it from a syringe or a funnel inserted into the other end of the tube and considerably elevated. A fountain syringe, which should be in every house, answers admirably. The sheath may be daily washed out with tepid water, with a suds made with Castile soap, or with a weak solution of sulphate of zinc (one-half dram to a quart of water). If these attentions are impossible, most cases, after cleansing, will do well if merely driven through clean water up to the belly once a day.
In case the disease has progressed to absolute obstruction, with the bladder ready to rupture any moment, no time must be lost in opening into the urethra with a sharp knife over the bony arch under the anus, where the pulsations are seen in urinating. This incision is best made in the median line from above downward, but in the absence of a skillful operator a transverse incision with a sharp knife over the bone in the median line until the urine flows with a gush is better than to let the patient die. Considerable blood will be lost and the wound will heal tardily, but the ox will be preserved. Then the slitting and cleansing of the sheath can be done at leisure, as described above. If the bladder is ruptured, the case is hopeless.
INFLAMMATION OF THE SHEATH AND PENIS FROM BRUISING.
This also is an affection of work oxen, caused by the pressure and friction of the sling when the animals are held in stocks for shoeing. This crushing of both sheath and penis for half an hour or more leads to the development, some hours later, of a hard, hot, and painful swelling, extending from the scrotum as far as the opening of the sheath. Fever sets in, with dry muzzle, red eyes, hard, full, rapid pulse, accelerated breathing, and elevated temperature. The ox stands obstinately with his hind legs drawn apart and urine falling drop by drop from the sheath. Appetite and rumination are suspended. In twenty-four hours there may be indications of advancing gangrene (mortification), the swelling becomes cold, soft, and doughy; it may even crack slightly from the presence of gas; a reddish brown, fetid liquid oozes from the swelling, especially around the edges, and if the animal survives it is only with a great loss of substance of the sheath and penis.
Prevention.—The prevention of such an injury is easy. It is only necessary to see that the slings do not press upon the posterior part of the abdomen. They must be kept in front of the sheath.
Treatment.—Treatment, to be effective, must be prompt and judicious. Put around the patient a strap with soft pads in contact with the affected parts, constantly soaked in cold water for at least 24 hours. A pound or two of Epsom salt in 4 quarts of hot water should also be given. The second day the parts may be washed with 1 quart of witch-hazel (extract), 2 drams sugar of lead, and 1 ounce laudanum, or the cold-water irrigations may be continued if the active inflammation persists. In case the swelling continues hard and resistant, it may be pricked at the most prominent points to the depth of one-third of an inch with a lancet first dipped in dilute carbolic acid, and the whole surface should be washed frequently with some antiseptic solution.
When softening occurs in the center of a hard mass and fluctuation can be felt between two fingers pressed on different parts of such softening, it should be freely opened to let out the putrid pus, and the cavity should be syringed often with antiseptic solution.
In bad cases extensive sloughs of dead skin, of the whole wall of the sheath, and even of the penis, may take place, which will require careful antiseptic treatment. The soaking of the urine into the inflamed and softened tissue and the setting up of putrefactive action not only endanger great destruction of the tissues from putrid inflammation, but even threaten life itself from a general blood poisoning (septicemia). Every case should have skillful treatment to meet its various phases, but in the severe ones this is most urgently demanded.
INFLAMMATION OF THE URETHRA.
Like other males, the bull sometimes suffers from inflammation of the canal which conveys the urine through the penis, and a whitish mucopurulent discharge forms in consequence. It may have originated in gravel, the excitement of too frequent service, infection from a cow with leucorrhea, or from extension of inflammation from the sheath. Besides the oozing of the whitish liquid from the end of the penis and sheath, there is tenderness and pain when handled, and while there is no actual arrest of the urine, its flow is subject to frequent voluntary checks, as the scalding liquid irritates the tender surface.
Treatment.—If recognized before the discharge sets in, a dose of 1½ pounds of Epsom salt and local, warm fomentations would be appropriate. After the onset of the whitish discharge a daily injection of a solution of 20 grains of permanganate of potassium in a pint of water into the penis will be beneficial.
WARTS AND PAPILLARY GROWTHS ON THE PENIS.
These are not frequent in bull or ox. They may interfere with the protrusion of the organ from its sheath or with service, and always give rise to a bad-smelling discharge.
Treatment.—They may be twisted off with a pair of small tweezers or cut off with a pair of scissors, and the seat burned with a pencil of lunar caustic. To get hold of the penis in the bull, bring him up to a cow. In the ox it will be necessary to push it out by manipulation through the sheath. In difficult cases the narrow opening of the sheath may be slit open.
WOUNDS OF THE PENIS.
The most common wounds are those sustained by blows of horns, sticks, etc. The blood vessels and sacs are ruptured to a greater or less extent and considerable swellings filled with coagulated blood and inflammatory products occur, leading to distortion of the organ, and it may be to the impossibility of protruding it.
Treatment.—A lotion of a dram of alum in a quart of water may be applied (injected into the sheath, if necessary), and a large sponge constantly irrigated by a stream of cold water may be kept applied by means of a surcingle to the outer side of the sheath. Incisions are rarely applicable to an organ of this kind, but in case of the existence of an extensive clot which is unlikely to be absorbed the lancet may be resorted to. If the injury leads to paralysis of the penis and hanging out of its sheath, it should be supported in a sling and astringents used freely until inflammation subsides. Then the restoration of power may be sought by a blister between the thighs, by the use of electricity, or by the careful use of nerve stimulants, such as strychnin, 1 grain twice daily.
ULCERS ON THE PENIS.
Sores on the penis of the bull may result from gravel or sebaceous masses in the sheath or from having served a cow having leucorrhea.
Treatment.—These may be treated by frequent injections into the sheath of a lotion made with 1 dram sugar of lead, 60 drops carbolic acid, and 1 quart water.
POLYPUS OF THE VAGINA OR UTERUS.
A polypus is a tumor growing from the mucous membrane, and often connected to it by a narrow neck. A definite cause can not always be assigned. If growing in the vagina, a polypus may project as a reddish, rounded tumor from the vulva, especially during the act of passing water. It can be distinguished from descent of the womb by the absence of the orifice of that cavity, which can be felt by the oiled hand beyond the tumor in the depth of the vagina. From a vaginal hernia caused by the protrusion of some abdominal organ enveloped by the relaxed wall of the vagina it may be distinguished by its persistence, its firm substance, and the impossibility of returning it into the abdomen by pressure. A hernia containing a portion of bowel gurgles when handled and can be completely effaced by pressure, the gut passing into the abdomen.
A polypus in the womb is less easily recognized. At the time of calving it may be felt through the open mouth of the womb and recognized by the educated touch (it must be carefully distinguished from the mushroom-formed cotyledons ([Pl. XIII], fig. 2), to which in ruminants the fetal membranes are attached). At other times, unless the womb is opened in the effort to expel it, the polypus can be detected only by examining the womb with the oiled hand introduced through the rectum.
Polypi may cause a mucopurulent discharge or they may only be suspected when they prove an obstacle to parturition. The best way to remove them is to put the chain of an écraseur around the neck, or pedicle, of the tumor and tear it through; or the narrow neck may be torn through by the emasculator, or in an emergency it may be twisted through by rotating the tumor on its axis. The removal of the tumor will allow calving to proceed; after this the sore may be treated by a daily injection of one-half dram sulphate of zinc, 1 dram carbolic acid, and 1 quart milk-warm water.
SIGNS OF PREGNANCY.
If a cow remains for three or four weeks after service without showing signs of heat (bulling), she is probably pregnant. There are very exceptional cases in which the well-fed cow will accept the bull weeks or months after actual conception, and others equally exceptional in which the well-thriven but unimpregnated female will refuse the male persistently, but these in no way invalidate the general rule.
The bull, no matter how vigorous or how ardent his sexual instinct, can not be made to pay any attention to a cow which is not in heat; hence indications of pregnancy can be had from both the male and female side. When she has conceived, the cow usually becomes more quiet and docile, and lays on flesh and fat more rapidly, especially during the first four months of gestation. The stimulus to digestion and nutrition created by the demands of the growing fetus, added to the quieter and more uneventful life, contributes to this result. Some feeders avail themselves of this disposition to prepare heifers and cows speedily for the butcher.
The enlargement of the abdomen, and its dropping so that it bulges below and to each side, while it falls in at the flank, between the outer angle of the hip bone and the last rib, are significant features which, though they may be caused by abdominal tumor or dropsy, are usually marks of pregnancy. From the same increasing weight of the abdomen the spine in the region of the loins sinks so that the bones of the croup seem to rise, especially back toward the root of the tail. In the early stages of pregnancy the udder develops slowly, and toward its completion quite rapidly. For a long time there is merely a sense of greater fullness when handled; the wrinkles in the skin become shallower and are effaced, and the teats are materially enlarged. Beginning a few weeks after conception, this tends to a steady development, though slight alternations in the sense of successive growth and shrinkage are not uncommon. In milking cows this does not hold, as the milk usually tends to a steady diminution and the udder shrinks slowly until near the completion of the period, when it undergoes its sudden, remarkable development, and yields at first a serous liquid and then the yellow colostrum, which coagulates when heated. As pregnancy advances the mucous membrane lining the vulva becomes swollen and of a darker, bluish-red hue; the mucous secretion also increases, becoming very abundant just before calving. When the feeding has not been altered or restricted, a steady diminution of the salts of lime excreted in the urine is an attendant on pregnancy, the lime being demanded for the growing body of the fetus.
After the fifth month the movements of the calf may often be observed in the right flank, nearly in front of the stifle, when the cow is drinking cold water. The sensation of cold on the side of the first stomach, which lies to the left and directly below the womb ([Pl. I]), stimulates the calf to active movements, which are detected on the sudden jerking outward of the abdominal wall as if from blows delivered from within. In a loose, pendent abdomen in the latter months of gestation the skin may often be seen pushed out at a sharp angle, irrespective of the period of drinking.
Another mode of examination through the flank is by touch. The palm of the hand is pressed strongly inward, about 8 inches in front of the stifle and a little below, several times in succession, and is then brought to rest with the pressure maintained. Presently there are felt distinct and characteristic movements of the fetus, which has been disturbed and roused to action. Another mode is to press the closed fist strongly inward in the same situation and hold it so, forming a deep indentation in the abdominal wall. Presently the knuckles are felt to be struck by a solid body, which is no other than the fetus that has been displaced to the left by the push of the hand, and now floats back in its liquid covering (amniotic fluid; see [Pl. XII]) downward and to the right.
Of all the modes of examination by touch, that done through the rectum gives the earliest satisfactory indications. The hand and arm, well oiled, are introduced, and the excrement having been removed if necessary, the palm of the hand is turned downward and the floor of the pelvis carefully examined. There will be felt in the median line the pear-shaped outline of the bladder, more or less full, rounded or tense, according to the quantity of urine it contains. Between this and the hand will be felt a soft, somewhat rounded tubular body, which divides in front into two smaller tubes or branches, extending to the right and left into the abdomen. This is the womb, which in its virgin, or unimpregnated, condition is of nearly uniform size from before backward, the main part or body being from 1½ to 2 inches across, and the two anterior branches or horns being individually little over an inch wide. Immediately after conception the body and one of the horns begin to enlarge, the vacant horn remaining disproportionately small, and the enlargement will be most marked at one point, where a solid, rounded mass indicates the presence of the growing embryo. In case of twins, both horns are enlarged. At a more advanced stage, when the embryo begins to assume the form of the future animal, the rounded form gives place to a more or less irregular nodular mass, while later still the head, limbs, and body of the fetus may be distinctly made out. The chief source of fallacy is found in the very pendent abdomen of certain cows, into which in advanced gestation the fetus has dropped so low that it can not be felt by the hand in the rectum. The absence of the distinct outline of the vacant womb, however, and the clear indications obtained on external examination through the right flank will serve to prevent any mistake. The fetus may still be felt through the rectum if the abdomen is raised by a sheet passed from side to side beneath it.
Still another sign is the beating of the fetal heart, which may be heard in the latter half of pregnancy when the ear is pressed on the flank in front of the right stifle or from that downward to the udder. The beats, which are best heard in the absence of rumbling, are about 120 a minute and easily distinguished from any bowel sounds by their perfect regularity.
DURATION OF PREGNANCY.
From extended statistics it is found that the average duration of pregnancy in the cow is 285 days. A calf born at the two hundred and fortieth day may live, and Dietrichs reported a case of a calf born on the three hundred and thirty-fifth day, and another was reported by the American Journal of Medical Science as having been born on the three hundred and thirty-sixth day. It is the general observation that in most cases of prolonged pregnancies the offspring are males. Lord Spencer found a preponderance of males between the two hundred and ninetieth and the three hundredth days, but strangely enough all born after the three hundredth day under his observation were females. It may be reasonably inferred that while the prevailing tendency is to carry the males overtime, yet that the smaller and comparatively much less developed female sometimes fails to stimulate the womb to contraction until very far beyond the regular date.
HYGIENE OF THE PREGNANT COW.
Among domestic animals considerations of hygiene must be made subservient to profit, and therefore the first consideration is not to obtain the most robust health, but such a measure of vigor and stamina as is compatible with the most profitable utilization of the animal. The breeding cow must carry a calf every year, and this notwithstanding that she is at the same time suckling another large, growing calf. The dairy cow must breed every year, and at the same time must furnish a generous flow of milk from nine to eleven months yearly. If her health is lowered thereby or her life shortened, the question of profit must still hold sway, and, when disqualified, she must yield her place to another. There are exceptions, of course, but this rule generally holds.
There are certain points, however, in which the interests of hygiene may be considered. The pregnant cow should have exercise, and as regards both exercise and feed, nothing is better than a run on a smooth pasture. She should be withheld from all violent excitement, hunting with dogs, riding or being ridden by cows in heat, driving in herd rapidly through narrow gateways, causing to jump ditches or fences, subjecting to blows with the horns of pugnacious cattle, driving on icy or otherwise slippery ground, carrying in railroad cars, kicking by vicious attendants, and fastening or throwing down for operations. The diet should be good, not of a kind to fatten, but with a generous quantity of nitrogenous constituents which will favor both the yield of milk and the nourishment of the fetus. Aliments like wheat bran, middlings, etc., which are rich in lime and phosphates, can be used to advantage, as there is a constant drain of earthy salts for the building of the body of the calf, and thereby the danger of undue concentration of the urine is lessened. Hard, innutritious, and indigestible aliments, musty grain or hay, partially ripened rye grass, millet, Hungarian grass, vetches, peas, or maize are objectionable, as they are liable to cause indigestion or even paralysis; and corn or hay affected by smut or ergot, or that has been spoiled by wet, overripened, and rendered fibrous and innutritious, is equally objectionable. In the main the feed should be laxative, as costiveness and straining are liable to cause abortion. Roots and green feed that have been frosted are objectionable, as being liable to cause indigestion, though in their fresh condition most wholesome and desirable. Ice-cold water should be avoided, as calculated to check the flow of milk, to derange digestion, and to cause abortion. A good temperature for the drink of the dairy cow is 55° F.
In the case of plethoric and heavy-milking cows of mature age and in the prime of life, the hitherto liberal diet must be changed at the last week for the scantiest possible fare, and the bowels must be kept open by laxatives, if need be, if the owner would avoid milk fever. Her stall should not incline downward from shoulder to croup, lest the pressure of the abdominal organs should produce protrusion or abortion. She should be kept aloof from all causes of acute diseases, and all existing diseases should be remedied speedily and with as little excitement of the abdominal organs as possible. Strong purgatives and diuretics are to be especially avoided, unless it is in the very last days of gestation in very plethoric cows.
PROTRUSION OF THE VAGINA (PROLAPSUS VAGINÆ).
During pregnancy this is common from chronic relaxation of the vaginal walls and from lying in stalls that are lower behind than in front. The protrusion is of a rounded form and smooth, and if it embraces both sides of the canal it is double, with a passage between. It may sometimes be remedied by raising the hind part of the stall higher than the front part. This failing, a truss may be applied as for eversion of the womb, and worn until the period of calving approaches. ([Pls. XXII], [XXIII].)
HERNIA (BREACH) OF THE UTERUS.
In advanced pregnancy this occurs usually from a gradual relaxation and distention of the lower wall of the abdomen in the region of the udder, so that the latter is displaced downward, and in the sac above and in front of it may be felt the form and movements of the fetus. In other cases the womb escapes through a great laceration of the abdominal muscles to one side of the udder, and the hernial mass extends down to one side of that organ. However unsightly, this often allows the animal to complete its pregnancy naturally, and a broad, supporting bandage placed around the abdomen is about all that can be recommended. After calving it is best to fatten the cow.
CRAMPS OF THE HIND LIMBS.
The compression of the nerves by the womb and fetus passing through the pelvis sometimes causes cramp and inability to move the limb, but it disappears under friction and motion and is never seen after calving.
DROPSY OF THE HIND LIMBS AND BETWEEN THE THIGHS.
In the latter months of pregnancy the hind legs may swell beneath the hocks, or a soft swelling which pits on pressure with the finger appears from the vulva down between the thighs to the udder and in front. It is mainly ascribable to the pressure of the enlarged womb on the blood vessels, is not dangerous, and disappears after calving.
DROPSY OF THE MEMBRANES OF THE FETUS (DROPSY OF THE WOMB).
The unimpregnated womb may be filled with a dropsical fluid, but the pregnant womb is more liable to become overdistended by an excess of fluid in the inner water bag in which the fetus floats. ([Pl. XII].) From an unhealthy state of this membrane or of blood of the fetus (water blood) this liquid may go on accumulating until the cow seems almost as broad as she is long. If the trouble has not originated in the ill health of the cow, the result is still to draw on her system, overtax her strength, and derange her digestion, so that the result may prove fatal to both mother and offspring. On the other hand, I have known extreme cases that came to the natural term without help and produced a living calf, after which the dam did well. The natural resort is to draw off a portion of the fluid through a hollow needle passed through the neck of the womb or through its tense wall adjacent. This may be repeated several times, as demanded, to relieve the cow from the injurious distention.
PARALYSIS OF THE HIND PARTS.
In ill-fed, weak, unthrifty cows palsy of the hind limbs and tail may appear in the last weeks of pregnancy. The anus and rectum may participate in the palsy so far as to prevent defecation, and the rectum is more or less completely impacted. Exposure to wet and cold are often accessory causes, though the low condition, general weakness, and the pressure on the nerves going to the hind limbs are not to be forgotten. Something may be done for these cases by a warm, dry bed, an abundant diet fed warm, frictions with straw wisps or with a liniment of equal parts of oil of turpentine and sweet oil on the loins, croup, and limbs, by the daily use of ginger and gentian, by the cautious administration of strychnia (1 grain twice daily), and by sending a current of electricity daily from the loins through the various groups of muscles in the hind limbs. The case becomes increasingly hopeful after calving, though some days may still elapse before the animal can support herself upon her limbs.
EXTRAUTERINE GESTATION (FETUS DEVELOPING OUTSIDE THE WOMB).
These curious cases are rare and are usually divided into three types: (1) That in which the fetus is formed in or on the ovary (ovarian gestation); (2) that in which it is lodged in the Fallopian tube, or canal between the ovary and womb (tubal gestation); and (3) that in which it is lodged in the abdominal cavity and attached to one or more of its contents from which it draws its nourishment (abdominal gestation). Undoubted cases of the first and last varieties are recorded as occurring in the cow. The explanation of such cases is to be found in the fact that the actively moving sperm cells (spermatozoa) thrown into the womb have made their way through the Fallopian tubes to the ovary. If they met and impregnated an ovum in the tube, and if the consequent growth of that ovum prevented its descent and caused its imprisonment within the tube, it developed there, getting attached to and drawing nourishment from the mucous walls. Such product has its development arrested by compression by the undilatable tube, or, bursting through the walls of the tube, it escapes into the abdomen and perishes. If, on the contrary, the spermatozoa only meet and impregnate the ovum on or in the ovary, the development may take place in the substance of the ovary, from which the fetus draws its nourishment, or the impregnated ovum, escaping between the ovary and the open end of the tube, falls into the abdominal cavity and becomes adherent to and draws nourishment from some of the abdominal organs (womb, bowel, liver, stomach, etc.).
Symptoms.—The symptoms are those of pregnancy, which may be suddenly complicated by inflammation (peritonitis), owing to rupture of the sac containing the fetus; or at full term signs of calving appear, but no progress is made; an examination with the oiled hand in the vagina or rectum finds the womb empty and its mouth closed. Further examination will disclose the fetal sac attached in some part of the abdominal cavity and containing the more or less perfectly developed body of a calf. In the most hopeful cases the fetus perishes at an early stage of gestation, becomes inclosed in a fibrous sac, and is slowly absorbed, its soft parts becoming liquefied and removed and the bones remaining encysted. In some cases the bones have finally sloughed into the rectum or through an artificial opening in the side of the belly.
Treatment.—Little can be done in such cases except to quiet pain and excitement by anodynes (opium, chloral, etc.) and leave the rest to nature. A fistula discharging bones may be dilated and the bones extracted, the sac being then washed out with a solution of 10 grains bichlorid of mercury in a quart of water. In certain cases with a live calf a skillful operator may be justified in cutting into the abdomen and extracting the calf with its membranes, using the lotion just named as an antiseptic.
PROLONGED RETENTION OF THE FETUS.
Even when the fetus has developed within the womb it may fail to be delivered at the proper time; labor pains have quickly subsided and the cow resumed her usual health. In such cases the calf dies, and its soft parts are gradually liquefied and absorbed, while its bones remain for years in the womb inclosed in the remains of the fetal membranes. These may be expelled at any time through the natural channels, or they may remain indefinitely in the womb, not interfering with the general health, but preventing conception.
If the true condition of things is recognized at the time of the subsidence of the labor pains, the mouth of the womb may be dilated by the fingers, by the insertion of sponge tents, or by a mechanical dilator ([Pl. XX], fig. 6), the fetal membranes may be ruptured and the calf extracted. After the removal of the calf and its membranes the danger of putrid poisoning may be obviated by injecting the antiseptic solution advised in the paragraph above.
ABORTION (SLINKING THE CALF).
Technically, abortion is the term used for the expulsion of the offspring before it can live out of the womb. Its expulsion before the normal time, but after it is capable of an independent existence, is premature parturition. In the cow this may be after seven and one-half months of pregnancy. Earl Spencer failed to raise any calf born before the two hundred and forty-second day. Dairymen use the term abortion for the expulsion of the product of conception at any time before the completion of the full period of a normal pregnancy, and in this sense it will be used in this article.
Abortion in cows is either contagious or noncontagious. It does not follow that the contagium is the sole cause in every case in which it is present. We know that the organized germs (microbes) of contagion vary much in potency at different times, and that the animal system also varies in susceptibility to their attack. The germ may therefore be present in a herd without any manifest injury, its disease-producing power having for the time abated considerably, or the whole herd being in a condition of comparative insusceptibility. At other times the same germ may have become so virulent that almost all pregnant cows succumb to its force, or the herd may have been subjected to other causes of abortion which, though of themselves powerless to actually cause abortion, may yet so predispose the animals that even the weaker germ will operate with destructive effect. In dealing with this disease, therefore, it is the part of wisdom not to rest satisfied with the discovery and removal of one specific cause, but rather to try to find every existent cause and to obtain a remedy by correcting all the harmful conditions.
NONCONTAGIOUS ABORTION.
As abortion most frequently occurs at those three-week intervals at which the cow would have been in heat if nonpregnant, we may assume a predisposition at such times owing to a periodicity in the nervous system and functions. Poor condition, weakness, and a too watery state of the blood is often a predisposing cause. This in its turn may result from poor or insufficient feed, from the excessive drain upon the udder while bearing the calf, from the use of feed deficient in certain essential elements, like the nitrogenous constituents or albuminoids, from chronic, wasting diseases, from roundworms or tapeworms in the bowels, from flat-worms (flukes, trematodes) in the liver, from worms in the lungs, from dark, damp, unhealthful buildings, etc. In some such cases the nourishment is so deficient that the fetus dies in the womb and is expelled in consequence. Excessive loss of blood, attended as it usually is with shock, becomes a direct cause of abortion.
Acute inflammations of important organs are notorious causes of abortion, and in most contagious fevers (lung plague, rinderpest, foot-and-mouth disease) it is a common result. Affections of the chest which prevent due aeration of the blood induce contractions of the womb, as shown experimentally by Brown-Sequard. Pregnant women suffocated in smoke aborted in many cases. (Retoul.)
Ergoted grasses have long been known as a cause of widespread abortion in cows. The ergot is familiar as the dark purple or black, hard, spurlike growths which protrude from the seeds of the grasses at the period of their ripening. ([Pl. V].) It is especially common, in damp localities and cloudy seasons on meadows shaded by trees and protected against the free sweep of the winds. The same is to a large extent true of smut; hence, wet years have been often remarkable for the great prevalence of abortions. Abortions have greatly increased in New Zealand among cows since the introduction of rye grass, which is specially subject to ergot. As abortion is more prevalent in old dairying districts, the ergot may not be the sole cause in this instance.
The riding of one another by cows is attended by such severe muscular exertion, jars, jolts, mental excitement, and gravitation of the womb and abdominal organs backward that it may easily cause abortion in a predisposed animal.
Keeping in stalls that slope too much behind (more than 2 inches) acts in the same way, the compression from lying and the gravitation backward proving more than a predisposed cow can safely bear.
Deep gutters behind the stalls, into which one or both hind limbs slip unexpectedly, strain the loins and jar the body and womb most injuriously. Slippery stalls in which the flooring boards are laid longitudinally in place of transversely, and on which there is no device to give a firm foothold, are almost equally dangerous. Driving on icy ground, or through a narrow doorway where the abdomen is liable to be jammed, are other common causes. Aborting cows often fail to expel the afterbirth, and if this remains hanging in a putrid condition it is most injurious to pregnant cows in the near vicinity. So with retained afterbirth in other cows after calving. That some cows kept in filthy stables or with slaughterhouses near by may become inured to the odors and escape the evil results is no disproof of the injurious effects so often seen in such cases.
The excitement, jarring, and jolting of a railroad journey often cause abortion, especially as the cow nears the period of calving, and the terror or injury of railway or other accidents proves incomparably worse.
All irritant poisons cause abortions by the disorder and inflammation of the digestive organs, and if such agents act also on the kidneys or womb, the effect is materially enhanced. Powerful purgatives or diuretics should never be administered to the pregnant cow.
Among other causes of abortion must be named the death or the various illnesses of the fetus, which are about as numerous as those of the adult; the slipping of a young fetus through a loop in the navel string so as to tie a knot which will tighten later and interrupt the flow of blood with fatal effect, and the twisting of the navel string by the turning of the fetus until little or no blood can flow through the contorted cord. There is in addition a series of diseases of the mucous membrane of the womb, and of the fetal membranes (inflammation, effusion of blood, detachment of the membranes from the womb, fatty or other degenerations, etc.), which interfere with the supply of blood to the fetus or change its quality so that death is the natural result, followed by abortion.
Treatment.—Although the first symptoms of abortion have appeared, it does not follow that it will go on to completion. So long as the fetus has not perished, if the waters have not been discharged, nor the water bags presented, attempts should be made to check its progress. Every appreciable and removable cause should be done away with, the cow should be placed in a quiet stall alone, and agents given to check the excitement of the labor pains. Laudanum in doses of 1 ounce for a small cow or 2 ounces for a large one should be promptly administered, and repeated in three or four hours should the labor pains recur. This may be kept up for days or even weeks if necessary, though that is rarely required, as the trouble either subsides or abortion occurs. If the laudanum seems to lack permanency of action, use bromid of potassium, or, better, extract of Viburnum prunifolium (black haw), 40 grains, at intervals of two or three hours until five or six doses have been given.
CONTAGIOUS ABORTION.
Contagious abortion (also known as epizootic abortion, enzootic abortion, and slinking of calves) is a disease affecting chiefly cattle and to a lesser degree other domestic animals, and characterized by an inflammatory condition of the female reproductive organs, which results in the expulsion of the immature young.
History.—This disease has been known in England and continental Europe for many years, and descriptions of it are mentioned in the writings of Mascal, Lafoose, Skellet, Lawrence, St. Cyr, Zündel, and Youatt. In the early part of the eighteenth century British veterinarians recognized its contagiousness, but it remained for Franck (1876), Lehnert (1878), and Bräuer (1880) to produce the disease in healthy, pregnant cows by the introduction of exudate and material from aborting animals. Nocard (1888) isolated from the exudate between the mucous membrane of the uterus and fetal membranes a micrococcus and a short bacillus which were found continually in contagious abortion, but he failed to reproduce the disease by inoculations of pure cultures of these organisms into healthy, pregnant animals. In 1897 Bang, assisted by Stribolt, published their findings regarding infectious abortion of cattle, in which they incriminated Bang's bacillus of abortion as the causative agent. With pure cultures of this bacillus they were able to produce the disease artificially and to recover the same organism from the experimental cases. Since that time many noted investigators, both in this country and in Europe, have confirmed these findings.
Cause.—The Bacterium abortus of Bang is now generally recognized as the causative agent of the disease of cattle. Formerly it was thought that abortion was due to injury, such as blows, horn thrusts, falls, etc., or the eating of spoiled feed and certain plants, and while this may be true in a limited number of cases, careful investigations have demonstrated these claims to be largely unfounded. It is now generally recognized that when abortion occurs in herds from time to time, it is safe to assume that the disorder is of an infectious nature and should be so treated.
Natural mode of infection.—This phase of the disease is of greatest importance for a clear understanding of the methods of prevention. Many investigators have demonstrated that the infection is transmitted through the digestive tract, through contaminated feed and water. The germs are taken up by the body from the intestines with the liquid nourishment, reach the blood, and are carried to the genital organs, where they find conditions best suited to their development. Some assert that calves are infected in this manner by suckling infected mothers, the germs being present in the milk, or the teats having been contaminated by coming in contact with infective discharges. It is claimed that infection contracted in this manner remains dormant in the body of the calf until pregnancy begins, and then the organism, finding conditions suitable for its development, produces the disease.
Abortion may occasionally be transmitted from cow to cow by direct contact. The discharges from diseased cows, swarming with the germs, soil the external genitals, tail, and hind quarters, and then a susceptible animal, by contact, gets the infective material upon the vulva, the infection traveling up the genital canal and directly infecting the uterus.
The belief long entertained that the female acquires the disease at the time of copulation as a result of transference of the infection from affected to healthy females on the genital organs of the bull has failed to receive the support of experimental evidence. The view that the disease is spread to any great degree in this way has been largely discredited. Cows of all ages are more or less susceptible, but young ones in first or second pregnancy most frequently abort. A second abortion is not unusual, and a third may occasionally occur, after which the cow usually becomes immune and thereafter carries her calf to maturity. Heifers from aborting mothers sometimes seem to be less susceptible than others.
Symptoms.—Contagious abortion is a very insidious disease, developing very slowly through several months of the gestation period, and resulting finally in the expulsion of the immature young, this act being simply an indication of the presence of the disease and not the disease itself. Because of this slow development and the fact that the health of the animal is not noticeably influenced, the presence of the disease may not be suspected until it has gained a firm foothold in the herd. The symptoms of approaching abortion are those preceding normal calving. In addition, there may be observed, a few days previous to abortion, a sticky, sometimes purulent, rusty, and odorless discharge. Abortion occurs most frequently from the third to the seventh month, according to the number of abortions, occurring early in first abortion, and later in each succeeding abortion until the calf is carried to full term and the mother has become immune. It happens frequently that calves are carried almost to full term, and are born alive, but are sickly, and soon die. Following abortion there is a dirty, yellowish-gray mucopurulent discharge which persists for two or more weeks. If abortion occurs early, the fetus is passed surrounded by its membranes, but if late in the period of pregnancy, the membranes are retained, decomposition sets in and blood poisoning, which may cause the death of the animal, or sterility may result.
Lesions.—The most characteristic change is found in the uterus where a dark-brown fluid, purulent or even gluey in consistency, and containing grayish-white flakes separates the material membranes from those of the fetus, preventing that intimate contact between the two which is so necessary for the interchange of fluids and gases by which the fetus is nourished and by which it obtains its oxygen. These being cut off, the fetus must of course die. The germs producing the disease are found in greatest numbers at this point. In addition there may be inflammatory changes, first in the walls of the uterus and then in the tissues of the fetus. These inflammatory changes seem most intense in the cotyledons and result in the destruction of the minute structure of those bodies, and they appear swollen, pale, and soft. The membrane of the uterus between the cotyledons also may show inflamed and necrotic patches.
Complications.—Serious results sometimes follow abortion, and this is particularly the case when there is retained afterbirth. The retained membranes decompose, the poisonous products of decomposition and the organisms of decomposition themselves are absorbed, blood poisoning results, and the animal dies. Sometimes, when the animal is able to resist the effects of this decomposition, the uterus becomes the seat of such severe changes that sterility results. The walls of that organ become thickened and hard, the lining membranes become eroded, and conception can not take place. At other times the ovaries, where the reproductive cells originate, become affected and lose their function. Abortion does not invariably follow infection, but the calf is carried to full term. In these cases, however, retained afterbirth is a common occurrence, even to the extent that frequent retention of afterbirth in a herd may be taken as an indication of the presence of the disease. Very often suppurative processes persist for a long time, preventing conception, or sterility may result without apparent cause. A sterile cow is valueless, of course, for any purpose except for beef. Such animals are a source of infection for the others and should not be allowed to remain in the herd.
Diagnosis.—The diagnosis of infectious abortion is made from the changes occurring in the fetal membranes and in the expelled fetus. This, however, is substantiated with certainty only by microscopic demonstration of the germ of abortion. The fact that repeated abortions are observed in a herd is also evidence of the presence of the disease. In consideration, however, of the fact that animals may be affected with the disease and disseminate the germs, even though they carry the fetus to full time, a diagnosis in such instances is only possible by laboratory methods. For this purpose the agglutination and also the complement-fixation tests are being used with splendid results, and by the aid of these biological tests it is possible to determine all infected animals in a herd. The tests are carried out with the serum from animals to be examined, only a teaspoonful of serum being necessary for the execution of both of these tests. It, however, has to be confined to laboratories which are properly equipped for such work.
Treatment and prevention.—It may be said in general that treatment is without avail and all efforts should be directed toward prevention. Various medicinal agents, such as carbolic acid administered subcutaneously and methylene blue fed in large quantities, have been recommended, but have failed to stand the tests of scientific investigation and practical use. Serums and vaccines have also been prepared and sold as cures and preventives, but the work is still considered in the experimental stage.
Bacterial vaccines are at present extensively used in the control of this disease, and while numerous reports indicate beneficial results from their administration, in other instances total failures have been recorded. It appears that the experiments in this line have not progressed sufficiently to justify definite conclusions.
The spread of the disease can be controlled to a great degree by the practice of sanitary measures directed toward the disinfection of premises and the isolation of animals at time of calving and aborting. For methods of disinfection of premises see page 363.
Make frequent observations of the animals of affected herds for symptoms of aborting, such as swelling of vulva or udder enlargement, and upon the discovery of an animal showing these symptoms place her immediately in a stall which is somewhat remote from healthy stock as a means of confining the products of abortion as much as possible should the act occur. If an animal aborts unexpectedly she should be removed to separate quarters and given proper attention as promptly as possible. The fetus, afterbirth, provided it has been expelled, and all litter that has been contaminated with them and uterine discharges should be gathered up and destroyed either by burning or burying. Clean and thoroughly disinfect the floor, gutters, and manger in the vicinity of the aborting animal.
Daily irrigations of the uterus with nonirritating antiseptic solutions, such as 0.5 per cent solution of cresol or compound solution of cresol, at body temperature have a tendency to prevent the multiplication of microorganisms in the uterus and in this way promote recovery. Douching of the uterus should be continued until the discharge ceases. In addition, the external genitals, root of the tail, escutcheon, etc., should be sponged daily with the antiseptic solution.
Aim to place all pregnant animals in disinfected individual pens or stalls a few days before they are expected to calve, and confine them to these quarters for three or four weeks following the delivery of the calf, or as long thereafter as uterine discharges are observed. Avoid carrying infection from the maternity stalls to other portions of stable, on shoes or otherwise. This may be prevented to some degree by the use of disinfectant solutions on shoes after the stalls have been entered or by wearing rubbers while in the maternity stalls, removing them after the isolated animals have been attended to. The isolation of cows at time of calving and the aborting animal is based upon the knowledge that the fetus, afterbirth, and uterine discharges of an affected animal at these times very frequently contain myriads of the abortion bacteria, and that unless these substances are confined and promptly destroyed an abundant opportunity is provided for the contamination of the food substances of the healthy animals and their contraction of the disease.
Refrain from breeding fresh cows for a period of six weeks to two months following calving. The aborting animal should be isolated for a period of six weeks to two months and under no consideration be permitted to mingle with the rest of the herd as long as uterine discharges are observed.
Douching of the external genitals of the bull, a practice formerly regarded as highly important for preventing the spread of the disease, is now recognized as being of doubtful value. The bull is protected from abortion infection to a great degree by permitting him to serve only such animals as have calved or aborted from six weeks to two months previously. Investigational work has indicated that when the bull is affected with the disease the organs of his generative system commonly involved are not reached by the antiseptic solutions. A more rational method for the prevention of the spread of the disease by the bull consists in keeping him in an inclosure separate from the females and in having all services take place on neutral ground.
Great care should be used in purchasing cattle, and cows not known to be free from the disease should be kept in separate quarters until this point is determined.
GRANULAR VENEREAL DISEASE (INFECTIOUS GRANULAR VAGINITIS).
The affection to which the foregoing names have been given is a chronic, mild, and apparently contagious disease of cattle, characterized by an inflammatory condition of the mucous membrane of the vagina and the development of nodules upon its surface.
This disease is very widely spread, but from an economic point of view it does not appear to have great significance. Williams, who investigated it, asserts that it is difficult to find a single herd in this country which is free of this disease. He considers it of great importance, claiming that granular vaginitis has a vital relation to abortion. This view, however, is not substantiated by other investigators, it being now generally accepted that the disease is only rarely responsible for abortion, and further, that it exerts no apparent ill effects on the health of the animal and that it has no effect on the milk yield.
Symptoms.—Natural infection may take place either by direct contact of animals or at the time of service. Most of the cows in the affected herd contract the disease, but the bulls are rarely or very mildly affected. The inflamed condition of the membranes of the vagina results in a catarrhal exudate, and this discharge, which soils the external genitals and the tail, and the uneasiness and sometimes the straining of the animal, are the first and most prominent symptoms observed. Upon examination, small, hard, grayish nodules can be seen and felt upon the inflamed membranes. This acute stage may last for three or four weeks, then it gradually subsides and assumes the chronic form, only to flare up again as the animal comes in heat.
These nodules are sometimes found on the membranes of the uterus, and some investigators have argued from this fact that it was responsible for abortion and sterility. Others, however, deny this and point out that the bacillus of abortion can be demonstrated in nearly every case. The importance of the disease is therefore in dispute and the decision must be left to future investigation.
Treatment.—The exaggerated importance which has been attached to this disease resulted in the exploitation of the most varied kinds of remedies for its treatment. It is true that with a protracted and laborious treatment it is possible to effect cures in from one to three months, but with our present knowledge of this disorder it is advisable to limit the treatment to animals which show an acute inflammatory condition of the vagina and vulva with a discharge as a result of the granular affection. The treatment should be local and confined to the application of antiseptic washes in the form of irrigations. For this purpose a 0.5 per cent solution of the compound solution of cresol or of Lugol's solution has been found satisfactory.
PARTURITION (CALVING).
SYMPTOMS OF CALVING.
In the cow the premonitions of calving are the enlargement of the udder, which becomes firm and resistant to the touch, with more or less swelling in front, and yields a serous, milky fluid; the enlargement and swelling of the vulva, which discharges an abundant, stringy mucus; the drooping of the belly, and the falling in of the muscles at each side of the root of the tail, so as to leave deep hollows. When this last symptom is seen, calving may be counted on in 24 hours or in 2 or 3 days. When the act is imminent, the cow becomes uneasy, moves restlessly, leaves off eating, in the field leaves the herd, lies down and rises again as if in pain, shifts upon her hind feet, moves the tail, and may bellow or moan. When labor pains come on the back is arched, the croup drooped, the belly is drawn up, and straining is more or less violent and continuous. Meanwhile blood may have appeared on the vulva and tail, and soon the clear water bags protrude between the lips of the vulva. They increase rapidly, hanging down toward the hocks, and the fore or hind feet can be detected within them. With the rupture of the bags and escape of the waters the womb contracts on the solid, angular body of the fetus and is at once stimulated to more violent contractions, so that the work proceeds with redoubled energy to the complete expulsion. This is why it is wrong to rupture the water bags if the presentation is normal, as they furnish a soft, uniform pressure for the preliminary dilation of the mouth of the womb and passages, in anticipation of the severe strain put upon them as the solid body of the calf passes.
The cow often calves standing, in which case the navel string is broken as the calf falls to the ground. If, however, she is recumbent, this cord is torn through as she rises. The afterpains come on 3 or 4 hours later and expel the membranes, which should never be left longer than 24 hours.
NATURAL PRESENTATION.
When there is but one calf the natural presentation is that of the fore feet with the front of the hoofs and knees turned upward toward the tail of the dam and the nose lying between the knees. ([Pl. XV].) If there are twins the natural position of the second is that of the hind feet, the heels and hocks turned upward toward the cow's tail. ([Pl. XVIII], fig. 1.) In both of these natural positions the curvature of the body of the calf— the back arched upward—is the same with the curvature of the passages, which descend anteriorly into the womb, ascend over the brim of the pelvis, and descend again toward the external opening (vulva). Any presentation differing from the above is abnormal.
OBSTACLES TO PARTURITION.
With a well-formed cow and calf and a natural presentation as above, calving is usually prompt and easy. Obstacles may, however, come from failure of the mouth of the womb to dilate; from twisting of the neck of the womb; from tumors in the vagina; from dropsy in the womb or abdomen; from overdistention of the rectum or bladder; from undue narrowing of the passages; from excess of fat in the walls of the pelvis; from the disturbance of a nervous cow by noises; from stone or urine in the bladder; from wrong presentation of the calf, its back being turned downward or to one side in place of upward toward the spine of the dam; from the bending backward of one or more limbs or of the head into the body of the womb; from presentation of the back, shoulder, or croup, all four limbs being turned back; from presentation of all four feet at once; from obstruction caused by an extra head or extra limbs, or double body on the part of the offspring ([Pl. XIX]); from dropsy or other disease of the calf; from excessive or imperfect development of the calf; from the impaction of twins into the passages at the same time; or at times it may be from the mere excessive volume of the fetus.
GENERAL MAXIMS FOR THE ASSISTANT CONCERNING DIFFICULT PARTURITION.
Do not interfere too soon. "Meddlesome midwifery is bad" with animals as with women. After labor pains set in, give a reasonable time for the water bags to protrude and burst spontaneously, and only interfere when delay suggests some mechanical obstruction. If there is no mechanical obstruction, let the calf be expelled slowly by the unaided efforts of the cow. Bruises and lacerations of the passages and flooding from the uncontracted womb may come from the too speedy extraction of the calf. When assistance is necessary, the operator should dress in a thick flannel shirt from which the sleeves have been cut off clear to the shoulders. This avoids danger of exposure and yet leaves the whole arm free and untrammeled. Before inserting the hand it and the arm should be smeared with oil, lard, or vaseline, care being taken that the oil or lard is fresh, neither salted nor rancid, and that it has been purified by boiling or rendered antiseptic by the addition of a teaspoonful of carbolic acid to the pound. This is a valuable precaution against infecting the cow by introducing putrid ferments into the passages and against poisoning of the arm by decomposing discharges in case the calving is unduly protracted. When labor pains have lasted some time without any signs of the water bags, the dropping in at the sides of the rump, and the other preparations for calving being accomplished, the hand should be introduced to examine. When the water bags have burst and neither feet nor head appear for some time, examination should be made. When one fore foot only and the head appear, or both fore feet without the head, or the head without the fore feet, examine. If one hind foot appears without the other, make examination. The presenting limb or head should be secured by a rope with a running noose, so that it may not pass back into the womb and get lost during the subsequent manipulations, but may be retained in the vagina or brought up again easily. In searching for a missing member it is usually better to turn the head of the cow downhill, so that the gravitation of the fetus and abdominal organs forward into the belly of the cow may give more room in which to bring up the missing limb or head. If the cow is lying down, turn her on the side opposite to that on which the limb is missing, so that there may be more room for bringing the latter up. Even if a missing limb is reached, it is vain to attempt to bring it up during a labor pain. Wait until the pain has ceased and attempt to straighten out the limb before the next pain comes on. If the pains are violent and continuous, they may be checked by pinching the back or by putting a tight surcingle around the body in front of the udder. These failing, 1 ounce or 1½ ounces of chloral hydrate in a quart of water may be given to check the pains. If the passages have dried up or lost their natural, lubricating liquid, smear the interior of the passages and womb and the surface of the calf, so far as it can be reached, with pure fresh lard; or pure sweet oil may be run into the womb through a rubber tube (fountain syringe). In dragging upon the fetus apply strong traction only while the mother is straining, and drag downward toward the hocks as well as backward. The natural curvature of both fetus and passages is thus followed and the extraction rendered easier.
LABOR PAINS BEFORE RELAXATION OF THE PASSAGES.
Any of the various causes of abortion may bring on labor pains before the time. Straining comes on days or weeks before the time, and there is not the usual enlargement, swelling, and mucous discharge from the vulva. There is little or no falling in by the sides of the root of the tail; the abdomen has not dropped to the usual extent, and the udder is less developed and yields little or no milk. In spite of the pains no water bags appear, and the oiled hand cau tiously introduced into the vagina finds the neck of the womb firmly closed, rigid, and undilatable. If it is known that the cow has not reached her proper time of calving, the examination through the vagina should be omitted and the animal should be placed in a dark, quiet place by herself, and be given 1 to 2 ounces laudanum. Viburnum prunifolium (black haw), 1 ounce, may be added, if necessary, and repeated in three hours. The pains will usually subside.
In some instances the external parts are relaxed and duly prepared, but the neck of the womb remains rigidly closed. In such case the solid extract of belladonna should be smeared around the constricted opening and the animal left quiet until it relaxes.
DISEASED INDURATION OF THE MOUTH OF THE WOMB.
From previous lacerations or other injuries the neck of the womb may have become the seat of fibrous hardening and constriction, so as to prevent its dilatation, when all other parts are fully prepared for calving. The enlarged, flabby vulva, the sinking at each side of the rump, the full udder, and drooping abdomen indicate the proper time for calving, but the labor pains effect no progress in the dilatation of the mouth of the womb, and the oiled hand introduced detects the rigid, hard, and, in some cases, nodular feeling of the margins of the closed orifice which no application of belladonna or other antispasmodic suffices to relax. Sponge tents may be inserted or the mechanical dilator ([Pl. XX], fig. 6) may be used if there is opening enough to admit it, and if not, a narrow-bladed, probe-pointed knife ([Pl. XXIV], fig. 2) may be passed through the orifice and turned upward, downward, and to each side, cutting to a depth not exceeding a quarter of an inch in each case. This done, a finger may be inserted, then two, three, and four, and finally all four fingers and thumb brought together in the form of a cone and made to push in with rotary motion until the whole hand can be introduced. After this the labor pains will induce further dilation, and finally the presenting members of the calf will complete the process.
TWISTING OF THE NECK OF THE WOMB.
This is not very uncommon in the cow, the length of the body of the womb and the looseness of the broad ligaments that attach it to the walls of the pelvis favoring the twisting. It is as if one were to take a long sack rather loosely filled at the neck and turn over its closed end, so that its twisting should occur in the neck. The twist may be one-quarter round, so that the upper surface would come to look to one side, or it may be half round, so that what was the upper surface becomes the lower. The relation of the womb of the cow to the upper and right side of the paunch favors the twisting. The paunch occupies the whole left side of the abdomen and extends across its floor to the right side. Its upper surface thus forms an inclined plane, sloping from the left downward and to the right, and on this sloping surface lies the pregnant womb.
It is easy to see how, in the constant movements of the paunch upon its contents and the frequent changes of position of the growing fetus within the womb, to say nothing of the contractions of the adjacent bowels and the more or less active movements of the cow, the womb should roll downward to the right. Yet in many cases the twist is toward the left, showing that it is not the result of a simple rolling downward over the paunch, but rather of other disturbances. The condition may be suspected when labor pains have continued for some time without any sign of the water bags, and it is confirmed when the oiled hand, introduced through the vagina, finds the mouth of the womb soft and yielding, but furnished with internal folds running forward in a spiral manner. If the folds on the upper wall of the orifice run toward the right, the womb is twisted to the right; if, on the contrary, they turn toward the left, it indicates that the womb is turned over in that direction. The direction of the twist must be known before treatment can be undertaken. Then, if the twist is toward the right, the cow is laid upon her right side with her head downhill, the hand of the operator is introduced through the spirally constricted neck of the womb, and a limb or other portion of the body of the calf is seized and pressed firmly against the wall of the womb. Meanwhile two or three assistants roll the cow from her right side over on her back to her left side. The object is to hold the womb and calf still while the body of the cow rolls over. If successful, the twist is undone, its grasp on the wrist is slackened, and the water bags and calf press into the now open passage. If the first attempt does not succeed, it is to be repeated until success has been attained. If the spiral folds on the upper wall of the opening turn toward the left, the cow is laid on her left side and rolled over on her back and on to the right side, the hand being, as before, within the womb and holding the fetus, so that all may not rotate with the cow. In introducing the hand it will usually be found needful to perforate the membranes, so that a limb of the calf may be seized direct and firmly held. Among my occasional causes of failure with these cases have been, first, the previous death and decomposition of the fetus, leading to such overdistention of the womb that it could not be made to rotate within the abdomen, and, second, the occurrence of inflammation and an exudate on the twisted neck of the womb, which hindered it from untwisting.
In obstinate cases, in which the hand can be made to pass through the neck of the womb easily, additional help may be had from the use of the instrument shown in [Plate XX], figure 5. Two cords, with running nooses, are successively introduced and made fast on two limbs of the calf; the cords are then passed through the two rings on the end of the instrument, which is passed into the womb and the cords drawn tight and fixed round the handle. Then, using the handle as a lever, it is turned in the direction opposite to the twist. The hand should meanwhile be introduced into the womb and the snared limbs seized and pressed against its walls so as to secure the rotation of the uterus along with the body of the fetus. The relaxation of the constriction and the effacement of the spiral folds will show when success has been gained, and the different members at one end of the body should then be brought up so as to secure a natural presentation.
NARROW PELVIS FROM FRACTURE OR DISEASE.
In a small cow the pelvis may be too narrow to pass a calf sired by a bull of a large breed, but this is exceptional, as the fetus usually accommodates itself to the size of the dam and makes its extra growth after birth. When the pelvic bones have been fractured repair takes place with the formation of a large permanent callus, which, projecting internally, may be a serious obstacle to calving. Worse still, if the edge of the broken bone projects internally as a sharp spike or ridge, the vaginal walls are cut upon it during the passage of the calf, with serious or fatal result. In other cases, where the cow has suffered from fragility of bone (fragilitas ossium) the thickening of the bone causes narrowing of the long passage of the pelvis and the crumbling fractures poorly repaired, with an excess of brittle new material, may form an insuperable obstacle to parturition. Cows affected in any of these ways should never again be bred, but if they do get pregnant and reach full time a careful examination will be necessary to determine whether natural parturition can take place or if the calf must be extracted in pieces. (See "Embryotomy," p. 202.)
OBSTRUCTION BY MASSES OF FAT.
This is not unknown in old cows of the beef breeds, the enormous masses of fat upon and within the pelvis being associated with weakness or fatty degeneration of the muscles. If the presentation is natural, little more is wanted than a judicious traction upon the fetus to compress and overcome the soft resisting masses.
OBSTRUCTION BY A FULL BLADDER OR RECTUM OR BY STONE.
In all cases of delayed or tardy parturition the evacuation of rectum and bladder is important, and it is no less so in all difficult parturitions. Stone in the bladder is fortunately rare in the cow, but when present it should be removed to obviate crushing and perhaps perforation of the organ during calving.
CALVING RETARDED BY NERVOUSNESS.
In a public fair ground I have seen labor pains begin early in the day and keep up in a weak and insufficient manner for many hours, until the stall was thoroughly closed in and the cow secluded from the constant stream of visitors and the incessant noise, when at once the pains became strong and effective and the calf was soon born.
COAGULATED BLOOD UNDER THE VAGINAL WALLS.
This is common after calving, but sometimes occurs before, as the result of accidental injury. The mass may be recognized by its dark hue and the doughy sensation to the touch. It may be cut into and the mass turned out with the fingers, after which it should be washed frequently with an antiseptic lotion (carbolic acid 1 dram in 1 quart of water).
CONSTRICTION OF A MEMBER BY THE NAVEL STRING.
In early fetal life the winding of the navel string around a limb may cause the latter to be slowly cut off by absorption under the constricting cord. So at calving the cord wound round a presenting member may retard progress somewhat, and though the calf may still be born tardily by the unaided efforts of the mother, it is liable to come still-born, because the circulation in the cord is interrupted by compression before the offspring can reach the open air and commence to breathe. If, therefore, it is possible to anticipate and prevent this displacement and compression of the navel string it should be done, but if this is no longer possible, then the extraction of the calf should be effected as rapidly as possible, and if breathing is not at once attempted it should be started by artificial means.
WATER IN THE HEAD OF THE CALF (HYDROCEPHALUS).
This is an enormous distention of the cavity holding the brain, by reason of the accumulation of liquid in the internal cavities (ventricles) of the brain substance. The head back of the eyes rises into a great rounded ball ([Pl. XIX], figs. 4 and 5), which proves an insuperable obstacle to parturition. The fore feet and nose being the parts presented, no progress can be made, and even if the feet are pulled upon the nose can not by any means be made to appear. The oiled hand introduced into the passages will feel the nose presenting between the fore limbs, and on passing the hand back over the face the hard rounded mass of the cranium is met with. A sharp-pointed knife or a cannula and trocar should be introduced in the palm of the hand and pushed into the center of the rounded mass so as to evacuate the water. The hand is now used to press together the hitherto distended but thin and fragile walls, and the calf may be delivered in the natural way. If the enlarged head is turned backward it must still be reached and punctured, after which it must be brought up into position and the calf delivered.
If the hind feet present first, all may go well until the body and shoulders have passed out, when further progress is suddenly arrested by the great bulk of the head. If possible, the hand, armed with a knife or trocar, must be passed along the side of the shoulder or neck so as to reach and puncture the distended head. Failing in this, the body may be skinned up from the belly and cut in two at the shoulder or neck, after which the head can easily be reached and punctured. If in such case the fore limbs have been left in the womb, they may now be brought up into the passage, and when dragged upon the collapsed head will follow.
If the distention is not sufficient to have rendered the bony walls of the cranium thin and fragile, so that they can be compressed with the hand after puncture, a special method may be necessary. A long incision should be made from behind forward in the median line of the cranium with an embryotomy knife ([Pl. XXI], fig. 1) or with a long embryotome ([Pl. XX], fig. 3). By this means the bones on the one side are completely separated from those on the other and may be made to overlap and perhaps to flatten down. If this fails they may be cut from the head all around the base of the rounded cranial swelling by means of a guarded chisel ([Pl. XX], fig. 8) and mallet, after which there will be no difficulty in causing them to collapse.
DROPSY OF THE ABDOMEN OF THE CALF (ASCITES).
This is less frequent than hydrocephalus, but no less difficult to deal with. With an anterior presentation the fore limbs and head may come away easily enough, but no effort will advance the calf beyond the shoulders. The first thought should be dropsy of the belly, and the oiled hand introduced by the side of the chest will detect the soft and fluctuating yet tense sac of the abdomen. If there is space to allow of the introduction of an embryotomy knife, the abdomen may be freely cut with this, when the fluid will escape into the womb and parturition may proceed naturally. If this can not be effected, a long trocar and cannula may be passed between the first two ribs and straight on beneath the spine until it punctures the abdomen. ([Pl. XVIII], fig. 2.) Then the trocar is to be withdrawn and the liquid will flow through the cannula and will be hastened by traction on the fore limbs. In the absence of the trocar and cannula, two or three of the first ribs may be cut from the breastbone, so that the hand may be introduced through the chest to puncture the diaphragm with an embryotomy knife and allow an escape of the water. In some slighter cases a tardy delivery may take place without puncture, the liquid bulging forward into the chest as the abdomen is compressed in the pelvic passages. With a posterior presentation the abdomen may be punctured more easily either in the flank or with a trocar and cannula through the anus.
GENERAL DROPSY OF THE CALF.
This occurs from watery blood or disease of some internal organ, like the liver or kidney, and is recognized by the general puffed-up and rounded condition of the body, which pits everywhere on pressure but without crackling. If not too extreme a case, the calf may be extracted after it has been very generally punctured over the body, but usually the only resort is to extract it in pieces. (See "Embryotomy," [p. 202].)
SWELLING OF THE CALF WITH GAS.
This is usually the result of the death and decomposition of the fetus when extraction has been delayed for a day or more after the escape of the waters. It is impossible to extract it whole, owing to its large size and the dry state of the skin of the calf, the membranes, and the wall of the womb. These dry surfaces stick with such tenacity that no attempt at traction leads to any advance of the calf out of the womb or into the passages. When the fetus is advanced the adherent womb advances with it, and when the strain is relaxed both recede to where they were at first. The condition may be helped somewhat by the free injection of oil into the womb, but it remains impossible to extract the enormously bloated body, and the only resort is to cut it in pieces and extract it by degrees. (See "Embryotomy," [p. 202].)
RIGID CONTRACTIONS OF MUSCLES.
In the development of the calf, as in after life, the muscles are subject to cramps, and in certain cases given groups of muscles remain unnaturally short, so that even the bones grow in a twisted and distorted way. In one case the head and neck are drawn round to one side and can not be straightened out, even the bones of the face and the nose being curved around to that side. In other cases the flexor muscles of the fore legs are so shortened that the knees are kept constantly bent and can not be extended by force. The bent neck may sometimes be sufficiently straightened for extraction by cutting across the muscles on the side to which it is turned, and the bent knees by cutting the cords on the back of the shank bones just below the knees. If this fails, there remains the resort of cutting off the distorted limbs or head. (See "Embryotomy," [p. 202].)
TUMORS OF THE CALF (INCLOSED OVUM).
Tumors or new growths grow on the unborn calf as on the mature animal, and by increasing the diameter of the body render its progress through the passage of the pelvis impossible. In my experience with large, fleshy tumors of the abdomen, I have cut open the chest, removed the lungs and heart, cut through the diaphragm with the knife, and removed the tumor piecemeal by alternate tearing and cutting until the volume of the body was sufficiently reduced to pass through. Where this failed it would remain to cut off the anterior part of the body, removing as much of the chest as possible, and cutting freely through the diaphragm; then, pushing back the remainder of the body, the hind limbs may be seized and brought into the passages and the residue thus extracted. The tumor, unless very large, will get displaced backward so as not to prove an insuperable obstacle.
In many cases the apparent tumor is a blighted ovum which has failed to develop, but has grafted itself on its more fortunate twin and from it has drawn its nourishment. These are usually sacs containing hair, skin, muscle, bone, or other natural tissues, and only exceptionally do they show the distinct outline of the animal.
MONSTROSITY IN THE CALF.
As a monstrous development in the calf may hinder calving, it is well to consider shortly the different directions in which these deviations from the natural form appear. Their origin and significance will be rendered clearer if we divide them according to the fault of development in individual cases. Monsters are such—
(1) From absence of parts—absence of head, limb, or other organ—arrested development.
(2) From some organ being unnaturally small, as a dwarfed head, limb, trunk, etc.—arrested development.
(3) From unnatural division of parts—cleft lips, palate, head, trunk, limbs, etc.—abnormal growth.
(4) From the absence of natural divisions—absence of mouth, nose, eye, anus; the cloven foot of ox or pig becomes solid, like that of the horse, etc.—confluence of parts which are rightfully separate.
(5) From the fusion of parts—both eyes replaced by central one, both nostrils merged into one central opening, etc.—confluence of parts.
(6) From unnatural position or form of parts—curved nose, neck, back, limbs, etc.—lack of balance in the growth of muscles during development.
(7) From excessive growth of one or more organs—enormous size of head, double penis, superfluous digits, etc.—redundancy of growth at given points.
(8) From imperfect differentiation of the sexual organs—hermaphrodites (organs intermediate between male and female), male organs with certain feminine characters, female organs with certain well-marked male characters.
(9) From the doubling of parts or of the entire body—double monsters, doubled heads, doubled bodies, extra limbs, etc.—redundant development. ([Pl. XIX], figs. 1, 2, 3.)
Causes.—The causes of monstrosities are varied. Some, like extra digits, lack of horns, etc., run in families, which produce them with absolute certainty when bred in the direct line, although they were originally acquired peculiarities which have merely been fixed by long habit in successive generations. The earliest horse had five toes, and even the most recent fossil horse had three toes, of which the two lateral ones are still represented in the modern animal by the two splint bones. Yet if our horse develops an extra toe it is pronounced a monstrosity. A more genuine monstrosity is the solid-hoofed pig, in which two toes have been merged into one. Another of the same kind is the solid shank bone of the ox, which consists of two bones united into one, but which are still found apart in the early fetus. Though originally acquired peculiarities, they now breed as invariably as color or form.
Other monstrosities seem to have begun in too close breeding, by which the powers of symmetrical development are impaired, just as the procreative power weakens under continuous breeding from the closest blood relations. A monstrosity consisting in the absence of an organ often depends on a simple lack of development, the result of disease or injury, as a young bone is permanently shortened by being broken across the soft part between the shaft and the end, the only part where increase in length can take place. As the result of the injury the soft, growing layer becomes prematurely hard and all increase in length at that end of the bone ceases. This will account for some cases of absence of eye, limb, or other organ.
Sometimes a monstrosity is owing to the inclosure of one ovum in another while the latter is still but a soft mass of cells and can easily close around the first. Here each ovum has an independent life; they develop simultaneously, only the outer one having direct connection with the womb and being furnished with abundant nourishment advances most rapidly and perfectly, while the inclosed and starved ovum is dwarfed and imperfect often to the last degree.
In many cases of excess of parts the extra part or member is manifestly derived from the same ovum, and even the same part of the ovum, being merely the effect of a redundancy and vagary of growth. Such cases include most instances of extra digits or other organs, and even of double monsters, as manifested by the fact that such extra organs grow from the normal identical organs. Hence the extra digit is attached to the normal digit, the extra head to the one neck, the extra tail to the croup, extra teeth to the existing teeth, and even two similarly formed bodies are attached by some point common to both, as the navels, breastbones, backs, etc. ([Pl. XIX], figs. 1, 2, 3.) This shows that both have been derived from the same primitive layer of the embryo, which possessed the plastic power of building up a given structure or set of organs. An inclosed ovum, on the other hand, has no such identity or similarity of structure to the part with which it is connected, showing an evident primary independence of both life and the power of building tissues and organs. The power of determining extra growth along a given natural line is very highly developed in the early embryo and is equally manifest in the mature examples of some of the lower forms of animal life. Thus a newt will grow a new tail when that member has been cut off, and a starfish will develop as many new starfishes as the pieces made by cutting up the original one. This power of growth in the embryo and in the lower form of animals is comparable to the branching out again of a tree at the places from which branches have been lopped. The presence of this vegetablelike power of growth in the embryo accounts for most double monsters.
The influence of disease in modifying growth in the early embryo, increasing, decreasing, distorting, etc., is well illustrated in the experiments of St. Hilaire and Valentine in varnishing, shaking, or otherwise disturbing the connections of eggs and thereby producing monstrosities. One can easily understand how inflammations and other causes of disturbed circulation in the womb, fetal membranes, or fetus would cause similar distortions and variations in the growing fetus. It is doubtless largely in the same way that certain mental disturbances of a very susceptible dam affect the appearance of the progeny. The monstrosities which seriously interfere with calving are mainly such as consist in extra members or head, which can not be admitted into the passages at the same time, where some organ of the body has attained extra size, where a blighted ovum has been inclosed in the body of a more perfect one, or where the body or limbs are so contracted or twisted that the calf must enter the passages doubled up.
Treatment.—Extraction is sometimes possible by straightening the distorted members by the force of traction; in other cases the muscles or tendons must be cut across on the side to which the body or limbs are bent to allow of such straightening. Thus, the muscles on the concave side of a wry neck or the cords behind the shank bones of a contracted limb may be cut to allow of these parts being brought into the passages, and there will still be wanting the methods demanded for bringing up missing limbs or head, for which see paragraphs below. In most cases of monstrosity by excess of overgrowth it becomes necessary to cut off the supernumerary or overdeveloped parts, and the same general principles must be followed as laid down in "Embryotomy" (p. 202).
WRONG PRESENTATIONS OF THE CALF.
The following is a list of abnormal presentations of the calf:
Simultaneous presentation of twins.
A | | Limbs curved at the knee. Flexor tendons shortened.
n | | Limb crossed over the back of the neck.
t | Fore Limbs | Limb bent back at the knee.
e | | Limb bent back from the shoulder.
r |
i | | Head bent downward on the neck.
o P | | Head and neck turned downward beneath the breast.
r r | Head | Head turned to one side upon the side of the neck.
e | | Head and neck turned back on the side of the chest and abdomen.
s | | Head turned upward and backward on the back.
e |
n | | Hind limbs rotated outward. Toes and stifles turned outward.
t | Hind Limbs |
a | | Hind limbs bent forward, their feet resting in the pelvis.
t |
i |
o | Transverse | Back of the calf turned to the right or left side.
n |
s | Inverted | Back of the calf turned to the floor of the pelvis and udder.
P P |
o r | | Hind limb bent on itself at the hock. Hock and buttocks present.
s e | Hind Limbs |
t s | | Hind limb bent at the hips. Buttocks present.
e e |
r n |
i t | Transverse | Back of calf turned to the right or left side.
o a |
r t |
i | Inverted | Back of calf turned to the floor of the pelvis and udder.
o |
n |
T | |Head up toward the spine, croup toward udder.
r | | Position of calf vertical |
u P | Back and |Head down toward udder, croup toward spine.
n r | loins
k e | presented. |Head toward the right side, croup toward the left.
s | | Position of calf transverse |
e | |Head toward the left side, croup toward the right.
n |
t |
a |
t | Breast and |Head toward right side, croup toward left.
i | abdomen | Position of calf transverse |
o | presented. |Head toward left side, croup toward right.
n |
s |
These include all general presentations, yet other subsidiary ones will at once occur to the attentive reader. Thus, in each anterior or posterior presentation, with the back of the calf turned downward or to one side, the case may be complicated by the bending back of one or more members as a whole or at the joint just above the shank bones (knee or hock). So also in such anterior presentation the head may be turned back.
Head and fore feet presented—Back turned to one side.—The calf has a greater diameter from above down (spine to breastbone) than it has from side to side, and the same is true of the passage of the pelvis of the cow, which measures, on an average, 8-7/10 inches from above downward and 7-9/10 inches from side to side. Hence the calf passes most easily with its back upward, and when turned with its back to one side calving is always tardy and may be difficult or impossible. The obvious remedy is to rotate the calf on its own axis until its spine turns toward the spine of the cow. The operation is not difficult if the body of the calf is not yet fixed in the passages. The presenting feet are twisted over each other in the direction desired, and this is continued until the head and spine have assumed their proper place. If the body is firmly engaged in the passages the skin of the whole engaged portion should be freely lubricated with lard, and the limbs and head twisted over each other as above. The limbs may be twisted by an assistant when the head is manipulated by the operator, who drags on the rope turned halfway round the limbs and assists in the rotation with his other hand in the passages.
Head and fore feet presented—Back turned down toward the udder.—This position ([Pl. XVI], fig. 6) is unnatural, and the parturition is difficult for two reasons: First, the natural curvature of the fetus is opposed to the natural curvature of the passages; and, second, the thickest part of the body of the calf (the upper) is engaged in the narrowest part of the passage of the pelvis (the lower). Yet unless the calf is especially large and the pelvis of the cow narrow, parturition may usually be accomplished in this way spontaneously or with very little assistance in the way of traction on the limbs. If this can not be accomplished, two courses are open: First, to rotate the calf as when the back is turned to one side; second, to push back the presenting fore limbs and head and search for and bring up the hind limbs, when the presentation will be a natural, posterior one.
Presentation of the hind feet with the back turned to one side or downward.—These are the exact counterparts of the two conditions last described, are beset with similar drawbacks, and are to be dealt with on the same general principles. ([Pl. XVII], fig. 4.) With the back turned to one side the body should be rotated until the back turns toward the spine of the dam, and with the back turned down it must be extracted in that position (care being taken that the feet do not perforate the roof of the vagina) or it must be rotated on its own axis until the back turns upward, or the hind limbs must be pushed back and the fore limbs and head advanced, when the presentation will be a natural anterior one.
Impaction of twins in the passage.—It is very rare to have twins enter the passages together so as to become firmly impacted. As a rule, each of the twins has its own separate membranes, and as the water bags of one will naturally first enter and be the first to burst, so the calf which occupied those membranes will be the first to enter the passage and the other will be thereby excluded. When the membranes of both have burst without either calf having become engaged in the pelvis, it becomes possible for the fore legs of one and the hind legs of the other to enter at one time, and if the straining is very violent they may become firmly impacted. ([Pl. XVIII], fig. 1.) The condition may be recognized by the fact that two of the presenting feet have their fronts turned forward, while the two others have their fronts turned backward. If the four feet belonged to one natural calf, they would all have the same direction. By means of this difference in direction we can easily select the two feet of one calf, place running nooses upon them just above the hoofs or fetlocks, and have an assistant drag upon the ropes while the feet of the other calf are pushed back. In selecting one of the twins to come first several considerations should have weight. The one that is most advanced in the passage is, of course, the first choice. Though the fore feet of one are presented, yet if the head is not in place the calf presenting by its hind feet is to be chosen as being less liable to obstruct. Again, if for either calf one limb only is presented and the other missing, the one presenting two feet should be selected to come first. As soon as one calf has been advanced so as to occupy the pelvis the other will be crowded back so that it will not seriously obstruct.
Fore limbs curved at the knee—Limbs sprawling outward.—In this case not only are the knees somewhat bent in a curve, but the calf has a position as if it rested on its breastbone, while the legs were drawn apart and directed to the right and left. The shoulder blades being drawn outward from the chest and the elbows turned out, the muscles extending from the trunk to the limb are unduly stretched and keep the knees bent and the feet directed outward so as to press on the sides of the passages. They become retarded in their progress as compared with the more rapidly advancing head, and may bruise or even lacerate the walls of the vagina. It would seem easy to rectify this by extending the legs, but the already tense and overstretched muscles operate against extension in the present position, and it is not easy to rotate the limbs so as to apply the shoulder flat against the side of the chest. Under these circumstances a repeller ([Pl. XX], fig. 7) may be planted in the breast and the body of the calf pushed backward into the womb, when the limbs will extend easily under traction and the presentation becomes at once natural.
Fore limbs curved at knee—Flexor tendons shortening.—In this case the feet will press against the floor of the pelvis though the limb has no outward direction, and the shoulder meanwhile presses against the roof of the same passage. Unless the knees can be sufficiently straightened by force a knife must be used to cut across the cords behind the knee, when the limbs may be straightened sufficiently.
Fore limbs flexed at knee—Flexor tendons unshortened.—This is mostly seen in cases in which the body of the calf is in the proper position, its back being turned up toward the back of the dam, and in cows with a drooping abdomen. The feet have been supposed to catch beneath the brim of the pelvis, and being retarded while the head advances into the passages, they get bent at the knee and the nose and knees present. ([Pl. XVI], fig. 2.) The calf, however, is not an inanimate body advanced by the mere contraction of the womb, but it moves its limbs freely under the stimulus of the unwonted compression, and in moving the feet as they are advanced they slip down over the pelvic brim and finding no other firm support they bend back until, under the impulsion, they can no longer straighten out again. The knees, therefore, advance with the neck and head, but the feet remain bent back. The result is that the upper part of the limb is also flexed, and the shoulder blade and arm bone with their masses of investing muscles are carried backward and applied on the side of the chest, greatly increasing the bulk of this already bulky part. As the elbow is carried back on the side of the chest, the forearm from elbow to knee further increases the superadded masses of the shoulder and renders it difficult or impossible to drag the mass through the passages. When the fore limbs are fully extended, on the contrary, the shoulder blade is extended forward on the smallest and narrowest part of the chest, the arm bone with its muscles is in great part applied against the side of the back part of the neck, and the forearm is continued forward by the side of the head so that the nose lies between the knees. In this natural presentation the presenting body of the calf forms a long wedge or cone, the increase of which is slow and gradual until it reaches the middle of the chest.
The difficulty of extending the fore limbs will be in proportion to the advance of the head through the pelvic cavity. In the early stage all that is necessary may be to introduce the oiled hand, the left one for the right leg or the right one for the left, and passing the hand from the knee on to the foot to seize the foot in the palm, bend it forcibly on the fetlock, and lift it up over the brim of the pelvis, the knee being, of course, pressed upward against the spine. As soon as the foot has been raised above the brim of the pelvis (into the passage) the limb can be straightened out with the greatest ease.
When, however, the shoulders are already engaging in the pelvis the feet can not thus be lifted up, and to gain room a repeller ([Pl. XX], fig. 7) must be used to push back the body of the calf. This is an instrument with a long, straight stem, divided at the end into two short branches (2 to 3 inches long) united to the stem by hinges so that they can be brought into a line with the stem for introduction into the womb and then spread to be implanted in the breast. In the absence of a repeller a smooth, round, fork handle may be used, the prongs having been removed from the other end. A third device is to have an assistant strip his arm to the shoulder and, standing back to back with the perator, to introduce his right arm into the passages along with the operator's left (or vice versa) and push back the body of the calf while the operator seeks to bring up a limb. The repeller or staff having been planted safely in the breast of the calf, an assistant pushes upon it in a direction either forward or slightly upward, so as not only to follow the natural curve of the body and favor its turning in the line of that curve within the womb, but also to carry the shoulders upward toward the spine and obtain more room for bringing up the missing feet. It is good policy, first, to put a halter ([Pl. XXI], figs. 4a and 4b) on the head or a noose ([Pl. XXI], fig. 3) on the lower jaw and a rope round each limb at the knee, so as to provide against the loss of any of these parts when the body is pushed back into the womb. This offers the further advantage that by dragging upon these ropes the body can be advanced in the passage until the foot is reached, when the rope must be slackened and the repeller used to get room for bringing up the foot. If the cow is lying, the operator should first secure the foot on the upper side and then, if necessary, turn the cow on its opposite side so as to bring up the other.
In using the instruments some precautions are demanded. They must be invariably warmed before they are introduced, and they should be smeared with lard or oil to make them pass easily and without friction. The assistant who is pushing on the instrument must be warned to stop if at any time resistance gives way. This may mean the turning of the fetus, in which case the object of repulsion has been accomplished, but much more probably it implies the displacement of the instrument from the body of the fetus, and unguarded pressure may drive it through the walls of the womb.
When the calf enters the passage with its back turned down toward the belly and udder, the bending back of the fore limbs is rare, probably because the feet can find a straighter and more nearly uniform surface of resistance in the upper wall of the womb and the backbone, and do not slide over a crest into an open cavity, as they do over the brim of the pelvis. The weight of the calf, too, gravitating downward, leaves more room for the straightening of the bent limbs, so that the desired relief is much more easily secured. The manipulation is the same in principle, only one must add the precaution of a steady traction on the feet in extraction, lest, owing to the adverse curvature of the fetus, the hoofs are suddenly forced through the roof of the vagina, and, perhaps, the rectum as well, during a specially powerful labor pain.
When the back of the calf is turned to the right side or the left the main difference is that in addition to straightening the limbs the fetus must be rotated to turn its back upward before extraction is attempted. In this case, too, it may be difficult to bring up and straighten the lower of the two limbs until the body has been rotated into its proper position. Cord the upper straightened limb and head, then rotate the body and search for the second missing limb.
Fore limbs bent back from the shoulders.—This is an exaggeration of the condition just named, and is much more difficult to remedy, owing to the distance and inaccessibility of the missing limb. It usually happens with the proper position of the body, the back of the calf being turned toward the back of the mother. The head presents in the passage and may even protrude from the vulva during an active labor pain, but it starts back like a spring when the straining ceases. Examination with the oiled hands in the intervals between the pains fails to detect the missing limbs. ([Pl. XVI], fig. 1.) If, however, the hand can be introduced during a pain it may be possible to reach the elbow or upper part of the forearm. In the absence of a pain a halter or noose on the head may be used to advance the whole body until the forearm can be seized just below the elbow. This being firmly held and the head or body pushed back into the womb, room may be obtained for bringing up the knee. The forearm is used as a lever, its upper part being strongly forced back while its lower part is pressed forward. If a pain supervenes the hold must be retained, and whatever gain has been made must be held if possible. Then during the next pain, by pushing back the body and continuing to operate the forearm as a lever, a still further advance may be made. As the knee is brought up in this way, the hand is slid down from the elbow toward the knee, which is finally brought up over the brim of the pelvis and into the passage. It is now corded at the knee, and the subsequent procedure is as described in the last article. In a large, roomy cow with a small calf the latter may pass with one or both forelegs bent back, but this is a very exceptional case, and, as early assistance is the most successful, there should never be delay in hope of such a result.
One fore limb crossed over the back of the neck.—This is a rare obstacle to calving, but one that not altogether unknown. The hand introduced into the passage feels the head and one forefoot, and farther back on the same side of the other foot, from which the womb can be traced obliquely across the back of the neck. ([Pl. XVI], fig. 3.) This foot, projecting transversely, is liable to bruise or tear the vagina. If still deeply engaged in the vagina, it may be seized and pushed across to the opposite side of the neck, when the presentation will be natural.
Head bent down beneath the neck.—In this case, with drooping belly and womb allowing the brim of the pelvis to form a ridge, the advancing calf, having unduly depressed its nose, strikes it on the brim of the pelvis, and the neck advancing, the head is bent back and the poll and ears either enter the pelvis or strike against its brim. The two forefeet present, but they make no progress, and the oiled hand introduced can detect no head until the poll is felt at the entrance of the pelvis, between the forearms. The two forefeet must be fixed with running nooses and dragged on moderately while the oiled hand seeks to bring up the head. The hand is slid down over the forehead and brim of the pelvis until the nose is reached, when it is passed into the mouth, the muzzle resting in the palm of the hand. The legs are now pushed upon, and in the space thus gained the muzzle is drawn up so as to enter it into the pelvis. In doing this the operator must carefully see that the mouth does not drop open so that the sharp, front teeth cut through the floor of the womb. Should this danger threaten, the hand should be made to cover the lower jaw as well. The lessened security of the hold is more than compensated by the safety of the procedure. With the nose in the pelvis, it has only to be drawn forward and the parturition is natural.
Head bent down beneath the breast.—This is an exaggerated condition of that last named. The head, arrested by the brim of the pelvis and already bent back on the neck, is pressed farther with each successive throe until it has passed between the forelegs and lodges beneath the breast bone. ([Pl. XVI], fig. 4.) On examination, the narrow upper border of the neck is felt between the forearms, but as a rule the head is out of reach below. Keeping the hand on the neck and dragging on the feet by the aid of ropes, the hand may come to touch and seize the ear, or, still better, one or two fingers may be inserted into the orbit of the eye.
Then in pushing back upon the limbs, with or without the aid of a repeller applied against the shoulder, space may be obtained to draw the head into a vertical position, and even to slip the hand down so as to seize the nose. Should it prove impossible to draw the head up with the unassisted fingers, a blunt hook ([Pl. XXI], fig. 6) may be inserted into the orbit, on which an assistant may drag while another pushes upon the limbs or repeller. Meanwhile the operator may secure an opportunity of reaching and seizing the nose or of passing a blunt hook into the angle of the mouth. Success will be better assured if two hooks ([Pl. XXI], fig. 7) are inserted in the two orbits, so as to draw up the head more evenly. In other cases a noose may be placed on the upper jaw, or even around both jaws, and traction made upon this and on the hooks in the orbits while the legs are pushed back, and while the operator pushes back on the poll or forehead. In still more difficult cases, in which even the orbits can not be reached, a sharp hook on the end of a straight iron rod ([Pl. XX], fig. 2) may be inserted over the lower jaw as far forward as it can be reached, and by dragging upon this while the body is pushed back the head will be brought up sufficiently to allow the operator to reach the orbit or nose. If even the jaw can not be reached, the hook may be inserted in the neck as near to the head as possible and traction employed so as to bring the head within reach.
In all such cases the cow's head should be turned downhill, and in case of special difficulty she should be turned on her back and held there until the head is secured. In old-standing cases, with the womb closely clasping the body of the calf, relaxation may be sought by the use of chloroform or a full dose of chloral hydrate—2 ounces; the free injection of warm water into the womb will also be useful.
Head turned back on the shoulder.—With a natural, anterior presentation this may happen because of the imperfect dilation of the mouth of the womb. Under the throes of the mother the forefeet pass through the narrow opening into the vagina, while the nose, striking against it and unable to enter, is pressed backward into the womb and turns aside on the right or left shoulder. The broad muzzle of the calf forms an especial obstacle to entrance and favors this deviation of the head. The worst form of this deviation is the old-standing one with shortening of the muscles of the neck on that side, and oftentimes distortion of the face and neck bones, as noticed under "Monstrosities" ([p. 182]).
When the head is bent on the shoulder the feet appear in the natural way, but no progress is made, and examination reveals the absence of the nose from between the knees, and farther back, from above and between the elbows, a smooth rounded mass is felt extending to the right or left, which further examination will identify with the neck. Following the upper border of this the hand reaches the crown of the head with the ears, and still further the eyes, or even, in a small calf, the nose.
As the bulky head of the calf can not be extracted along with the shoulders, it becomes necessary to push the body of the fetus back and straighten out the head and neck. The cow should be laid with her head downhill and with that side up toward which the head is turned. If the throes are very violent, or the womb strongly contracted on the calf, it may be best to seek relaxation by giving chloroform, or 2 ounces of laudanum, or 2 ounces of chloral hydrate. If the calf or the passages are dry, sweet oil may be injected, or the whole may be liberally smeared with fresh lard. In the absence of these, warm water rendered slightly slippery by Castile soap may be injected into the womb in quantity. Ropes with running nooses are placed on the presenting feet and the oiled hand introduced to find the head. If, now, the fingers can be passed inside the lower jawbone, and drag the head upward and toward the passage, it unwinds the spiral turn given to the neck in bending back, and greatly improves the chances of bringing forward the nose. If, at first, or if now, the lower jaw can be reached, a noose should be placed around it behind the incisor teeth and traction made upon this, so that the head may continue to be turned, forehead up, toward the spine and jaws down, thereby continuing to undo the screwlike curve of the neck. If, on the contrary, the nose is dragged upon by a cord passing over the upper border of the neck, the screwlike twist is increased and the resistance of the bones and joints of the neck prevents any straightening of the head. As soon as the lower jaw has been seized by the hand or noose, a repeller ([Pl. XX], fig. 7), planted on the inside of the elbow or shoulder most distant from the head, should be used to push back the body and turn it in the womb, so that the head may be brought nearer to the outlet. In this way the head can usually be brought into position and the further course of delivery will be natural.
Sometimes, however, the lower jaw can not be reached with the hand, and then the orbit or, less desirably, the ear, may be availed of. The ear may be pulled by the hand, and by the aid of the repeller on the other shoulder the calf may be so turned that the lower jaw may be reached and availed of. Better still, a clamp ([Pl. XVIII], figs. 3 and 4) is firmly fixed on the ear and pulled by a rope, while the repeller is used on the opposite shoulder, and the hand of the operator pulls on the lower border of the neck and lifts it toward the other side. To pull on the upper border of the neck is to increase the spiral twist, while to raise the lower border is to undo it. If the outer orbit can be reached, the fingers may be inserted into it so as to employ traction, or a blunt finger hook ([Pl. XXI], fig. 8) may be used, or a hook with a rope attached, or, finally, a hook on the end of a long staff. Then, with the assistance of the repeller, the body may be so turned and the head advanced that the lower jaw may be reached and availed of.
In case neither the ears nor the orbit can be reached, a cord should be passed around the neck of the calf as near the head as possible, and traction made upon that while the opposite shoulder is pushed toward the opposite side by the repeller, assisted by the hand dragging on the lower border of the neck. To aid the hand in passing a rope around the neck a cord carrier ([Pl. XXI], fig. 5) is in use. It fails, however, to help us in the most difficult part of the operation—the passing of the cord down on the deep or farthest side of the neck—and to remedy this I have devised a cord carrier, furnished with a ring at the end, a joint 6 or 8 inches from the end, and another ring on the handle, close to this joint. ([Pl. XX], fig. 4.) A cord is passed through both rings and a knot tied on its end, just back of the terminal ring. The instrument, straightened out, is inserted until it reaches just beyond the upper border of the neck, when, by dragging on the cord, the movable segment is bent down on the farther side of the neck, and is pushed on until it can be felt at its lower border. The hand now seizes the knotted end of the cord beneath the lower border of the neck and pulls it through while the carrier is withdrawn, the cord sliding through its rings. The cord, pushed up as near to the head as possible, is furnished with a running noose by tying the knotted end round the other, or, better, the two ends are twisted around each other so as to give a firm hold on the neck without dangerously compressing the blood vessels. By pushing on the opposite shoulder with the repeller, and, assisting with the hand on shoulder, breastbone, or lower border of the neck, such a change of position will be secured as will speedily bring the head within reach. Afterwards proceed as described above.
These cases are always trying, but it is very rarely necessary to resort to embryotomy. When absolutely required, first remove one fore limb, and then, if still unsuccessful, the other, after which the head can easily be secured. (See "Embryotomy," [p. 202].)
Head turned upward and backward.—In this case the face rests upon the spine; the forefeet appear alone in the passage, but fail to advance, and on examination the rounded, inferior border of the neck can be felt, extending upward and backward beneath the spine of the dam, and if the calf is not too large the hand may reach the lower jaw or even the muzzle. ([Pl. XVI], fig. 5.) A repeller is planted in the breast and the body of the calf pushed backward and downward so as to make room and bring the head nearer to the passage; or in some cases the body may be pushed back sufficiently by the use of the fore limbs alone. Meanwhile the head is seized by the ear or the eye socket, or, if it can be reached, by the lower jaw, and pulled downward into position as space is obtained for it. If the hand alone is insufficient, the blunt hooks may be inserted in the orbits or in the angle of the mouth, or a noose may be placed on the lower paw, and by traction the head will be easily advanced. In case of a large fetus, the head of which is beyond reach, even when traction is made on the limbs, a rope may be passed around the neck and pulled, while the breastbone is pressed downward and backward by the repeller, and soon the change of position will bring the orbit or lower jaw within reach. With the above-described position the standing position is most favorable for success, but if the calf is placed with its back down toward the udder, and if the head is bent down under the brim of the pelvis, the best position for the cow is on her back, with her head downhill.
In neglected cases, with death and putrefaction of the fetus and dryness of the passages, it may be necessary to extract in pieces. (See "Embryotomy," p. 202.)
Outward direction of the stifles—Abduction of hind limbs.—As an obstacle to parturition, this is rare in cows. It is most liable to take place in cows with narrow hip bones, and when the service has been made by a bull having great breadth across the quarter. The calf, taking after the sire, presents an obstacle to calving in the breadth of its quarters, and if at the same time the toes and stifles are turned excessively outward and the hocks inward the combined breadth of the hip bones above and the stifles below may be so great that the pelvis will not easily admit them. After the forefeet, head, and shoulders have all passed out through the vulva, further progress suddenly and unaccountably ceases, and some dragging on the parts already delivered does not serve to bring away the hind parts. The oiled hand introduced along the side of the calf will discover the obstacle in the stifle joints turned directly outward and projecting on each side beyond the bones which circumscribe laterally the front entrance of the pelvis. The evident need is to turn the stifles inward; this may be attempted by the hand introduced by the side of the calf, which is meanwhile rotated gently on its own axis to favor the change of position. To correct the deviation of the hind limb is, however, very difficult, as the limbs themselves are out of reach and can not be used as levers to assist. If nothing can be done by pushing the body of the calf back and rotating it and by pressure by the hand in the passages, the only resort appears to be to skin the calf from the shoulder back, cut it in two as far back as can be reached, then push the buttocks well forward into the womb, bring up the hind feet, and so deliver.
Hind limbs excessively bent on the body and engaged in the pelvis.—In this case the presentation is apparently a normal, anterior one; fore limbs and head advanced naturally and the parturition proceeds until half the chest has passed through the external passages, when suddenly progress ceases and no force will effect farther advance. An examination with the oiled hand detects the presence, in the passages, of the hind feet and usually the hind legs up to above the hocks. ([Pl. XVII], fig. 1.)
The indications for treatment are to return the hind limbs into the body of the womb. If they have not advanced too far into the pelvis, this may be done as follows: A rope with running noose is passed over each hind foot and drawn tight around the lower part of the hock; the ropes are then passed through the two rings in the small end of the rotating instrument ([Pl. XX], fig. 5) which is slid into the passages until it reaches the hocks, when the ropes, drawn tight, are tied around the handle of the instrument. Then in the intervals between the pains the hocks are pushed forcibly back into the womb. If by this means flexion can be effected in hocks and stifles, success will follow; the hind feet will pass into the womb and clear of the brim of the pelvis and the body may now be advanced without hindrance, the hind limbs falling into place when the hip joints are extended. At the same time the pressure upon hind limbs must not be relaxed until the buttocks are engaged in the pelvis, as otherwise the feet may again get over the brim and arrest the progress of delivery.
When the hind limbs are already so jammed into the pelvis that it is impossible to return them, the calf must be sacrificed to save the mother. Cords with running nooses are first put on the two hind feet. The body must be skinned from the shoulders back as far as can be reached, and is to be then cut in two, if possible, back of the last rib. The remainder of the trunk is now pushed back into the body of the womb and by traction upon the cords the hind feet are brought up into the passages and the extraction will be comparatively easy.
Hind presentation with one or both legs bent at the hock.—After the bursting of the water bags, though labor pains continue, no part of the fetus appears at the vulva unless it be the end of the tail. On examination the buttocks are felt wedged against the spine at the entrance of the pelvis and beneath them the bent hock joints resting on the brim of the pelvis below. ([Pl. XVII], fig. 3.) The calf has been caught by the labor pains while the limb was bent beneath it and has been jammed into or against the rim of the pelvis, so that extension of the limb became impossible. With the thigh bent on the flank, the leg on the thigh, and the shank on the leg, and all at once wedged into the passage, delivery is practically impossible.
The obvious remedy is to push the croup upward and forward and extend the hind legs, and in the early stages this can usually be accomplished in the cow. A repeller ([Pl. XX], fig. 7) is planted across the thighs and pointed upward toward the spine of the cow and pushed forcibly in this direction during the intervals between labor pains. Meanwhile the oiled hand seizes the shank just below the hock and uses it as a lever, pushing the body back and drawing the foot forward, thus effectually seconding the action of the repeller. Soon a distinct gain is manifest, and as soon as the foot can be reached it is bent back strongly at the fetlock, held in the palm of the hand, and pulled up, while the repeller, pressing on the buttocks, assists to make room for it. In this way the foot may be brought safely and easily over the brim of the pelvis without any risk of laceration of the womb of the foot. After the foot has been lifted over the brim, the whole limb can be promptly and easily extended. In cases presenting special difficulty in raising the foot over the brim, help may be had by traction on a rope passed around in front of the hock, and later still by a rope with a noose fastened to the pastern. In the worst cases, with the buttocks and hocks wedged deeply into the passages, it may prove difficult or impossible to push the buttocks back into the abdomen, and in such case the extension of the hind limb is practically impossible without mutilation. In some roomy cows a calf may be dragged through the passages by ropes attached to the bent hocks, but even when this is possible there is great risk of laceration of the floor of the vagina by the feet. The next resort is to cut the hamstring just above the point of the hock and the tendon on the front of the limb (flexor metatarsi) just above the hock, and even the sinews behind the shank bone just below the hock. This allows the stifle and hock to move independently of each other, the one undergoing extension without entailing the extension of the other; it also allows both joints to flex completely, so that the impacted mass can pass through a narrower channel. If now, by dragging on the hocks and operating with the repeller on the buttocks, the latter can be tilted forward sufficiently to allow of the extension of the stifle, the jam will be at once overcome, and the calf may be extracted with the hock bent, but the stifle extended. If even this can not be accomplished, it may now be possible to extract the whole mass with both hocks and stifles fully bent. To attempt this, traction may be made on the rope around the hocks and on a sharp hook ([Pl. XX], fig. 2) passed forward between the thighs and hooked on to the brim of the pelvis. Everything else failing, the offending limb or limbs may be cut off at the hip joint and extracted, after which extraction may proceed by dragging on the remaining limb, or by hooks on the hip bones. Very little is to be gained by cutting off the limb at the hock, and the stifle is less accessible than the hip, and amputation of the stifle gives much poorer results.
Hind limbs bent forward from the hip—Breech presentation.—This is an exaggeration of the condition last described, only the hocks and stifles are fully extended and the whole limb carried forward beneath the belly. ([Pl. XVII], fig. 2.) The water bags appear and burst, but nothing presents unless it may be the tail. Examination in this case detects the outline of the buttocks, with the tail and anus at its upper part.
The remedy, as in the case last described, consists in pushing the buttock upward and forward with a repeller, the cow being kept standing and headed downhill until the thigh bone can be reached and used as a lever. Its upper end is pushed forward and its lower end raised until, the joints becoming fully flexed, the point of the hock can be raised above the brim of the pelvis. If necessary a noose may be passed around the leg as far down toward the hock as possible and pulled on forcibly, while the hand presses forward strongly on the back of the leg above. When both hocks have been lodged above the brim of the pelvis the further procedure is as described under the last heading.
If, however, the case is advanced and the buttocks wedged firmly into the passages, it may be impossible safely to push the fetus back into the womb, and the calf must either be dragged through the passage as it is or the limbs or the pelvis must be cut off. To extract successfully with a breech presentation the cow must be large and roomy and the calf not too large. The first step in this case is to separate the pelvic bones on the two sides by cutting from before backward, exactly in the median line below and where the thighs come together above. This may be done with a strong embryotomy knife, but is most easily accomplished with the long embryotome ([Pl. XX], fig. 3). The form which I have designed ([Pl. XX], fig. 1), with a short cutting branch jointed to the main stem, is to be preferred, as the short cutting piece may be folded on the main stem so that its cutting edge will be covered, and it can be introduced and extracted without danger. This is pushed forward beneath the calf's belly, and the cutting arm opened, inserted in front of the brim of the pelvis and pulled forcibly back through the whole length of the pelvic bones. The divided edges are now made to overlap each other and the breadth of the haunch is materially reduced. One end of the cord may then be passed forward by means of a cord carrier ([Pl. XXI], fig. 5) on the inner side of one thigh until it can be seized at the stifle by the hand passed forward on the outer side of that thigh. This end is now pulled back through the vagina, the other end passed through the cord carrier and passed forward on the inner side of the other thigh until it can be seized at the stifle by the hand passed forward outside that thigh. This end is drawn back through the vagina like the first, and is tied around the other so as to form a running noose. The rope is now drawn through the ring until it forms a tight loop, encircling the belly just in front of the hind limbs. On this strong traction can be made without interfering with the full flexion of the limbs on the body, and if the case is a suitable one, and the body of the fetus and the passages are both well lubricated with oil or lard, a successful parturition may be accomplished. A less desirable method is to put a rope around one thigh or a rope around each and drag upon these, but manifestly the strain is not so directly on the spine, and the limbs may be somewhat hampered in flexion.
This method being inapplicable, the next resort is to cut off one or both hind limbs at the hip joint. Free incisions are made on the side of the haunch so as to expose the hip joint, and the muscles are cut away from the head of the thigh bone down to its narrow neck, around which a rope is passed and firmly fixed with a running noose. The joint is now cut into all around, and while traction is made on the cord the knife is inserted into the inner side of the joint and the round ligament severed. The cord may now be dragged upon forcibly, and the muscles and other parts cut through as they are drawn tense, until finally the whole member has been extracted. Traction on the rope round the other thigh will now suffice to extract, in most cases, but if it should fail the other limb may be cut off in the same manner, and then hooks inserted in front of the brim of the pelvis or in the openings in the bones of its floor (obturator foramina) will give sufficient purchase for extraction. Another method is to insert a knife between the bone of the rump (sacrum) and the hip bone and sever their connections; then cut through the joint (symphysis) between the two hip bones in the median line of the floor of the pelvis, and then with a hook in the opening on the pelvic bones (obturator foramen) drag upon the limb and cut the tense soft parts until the limb is freed and extracted.
Presentation of the back.—In this presentation straining may be active, but after the rupture of the water bags no progress is made, and the hand introduced will recognize the back with its row of spinous processes and the springing ribs at each side pressed against the entrance to the pelvis. ([Pl. XVII], fig. 6.) The presence or absence of the ribs will show whether it is the region of the chest or the loins. By feeling along the line of spines until the ribs are met with we shall learn that the head lies in that direction. If, on the contrary, we follow the ribs until they disappear, and a blank space is succeeded by hip bones, it shows that we are approaching the tail. The head may be turned upward, downward, to the right side, or to the left.
The object must be to turn the fetus so that one extremity or the other can enter the passage, and the choice of which end to bring forward will depend on various considerations. If one end is much nearer the outlet than the other, that would naturally be selected for extraction, but if they are equidistant the choice would fall on the hind end, as having only the two limbs to deal with without any risk of complication from the head. When the head is turned upward and forward it will usually be preferable to bring up the hind limb, as, owing to the drooping of the womb into the abdomen, rotation of the fetus will usually be easier in that direction, and if successful the resulting position will be a natural posterior presentation, with the back of the calf turned toward the rump of the cow. Similarly with the croup turned upward and forward, that should be pushed on forward, and if the forefeet and head can be secured it will be a natural anterior presentation, with the back of the calf turned upward toward the rump of the cow.
The womb should be injected with warm water or oil, and the turning of the calf will demand the combined action of the repeller and the hand, but in all such cases the operator has an advantage that the body of the fetus is wholly within the body of the womb, and therefore movable with comparative ease. No part is wedged into the pelvic passages as a complication. The general principles are the same as in faulty presentation fore and hind, and no time should be lost in making the manipulations necessary to bring the feet into the pelvis, lest they get inbent or otherwise displaced and add unnecessary complications.
With a transverse direction of the calf, the head being turned to one side, the pressure must be directed laterally, so that the body will glide around on one side of the womb, and the extremities when reached must be promptly seized and brought into the passages. Sometimes a fortunate struggle of a live fetus will greatly aid in rectifying the position.
Breast and abdomen presented.—All four feet in the passages.—In this form the calf lies across the womb with its roached back turned forward and its belly toward the pelvis. All four feet may be extended and engaged in the passages, or one or more may be bent on themselves so as to lie in front of the pelvis. The head, too, may usually be felt on the right side or the left, and if detected it serves to identify the exact position of the fetus. The position may further be decided upon by examination of the feet and limbs. With the limbs extended the front of the hoofs and the convex aspect of the bent pasterns and fetlocks will look toward that flank in which lie the head and shoulders. On examination still higher the smooth, even outline of the knee and its bend, looking toward the hind parts, characterize the fore limb, while the sharp prominence of the point of the hock and the bend on the opposite side of the joint, looking toward the head, indicate the hind limb. ([Pl. XVII], fig. 5.)
The remedy of this condition is to be sought in repelling into the womb those limbs that are least eligible for extraction, and bringing into the passages the most eligible extremities. The most eligible will usually be those which project farthest into the passages, indicating the nearer proximity of that end of the calf. An exception may, however, be made in favor of that extremity which will give the most natural presentation. Thus if, owing to obliquity in the position of the fetus, the hind extremities promised a presentation with the back of the fetus turned down toward the udder, and the anterior extremities one with the back turned up toward the spine, the latter should be selected. Again, if the choice for the two extremities is evenly balanced, the hind may be chosen as offering less risk of complication, there being no head to get displaced.
The first step in the treatment is to place a running noose on each of the four feet, marking those of the fore limbs to distinguish them from those of the hind ones. In case it is proposed to bring the anterior extremities into the passage, a noose should also be placed on the lower jaw. Then run the ropes attached to the two feet that are to be pushed back through the ring of a cord carrier ([Pl. XXI], fig. 5), passing the rings down to the feet, and by the aid of the carrier push them well back into the womb and hold them there. Meanwhile drag upon the ropes attached to the two other feet so as to bring them into the passage (or, in case of the anterior extremity, on the two foot ropes and the head one). The other feet must be pushed back into the womb until the body of the calf is fully engaged in the passages. After this they can no longer find an entrance, but must follow as the body escapes.
NEGLECTED AND AGGRAVATED CASES.
In laying down the foregoing rules for giving assistance in critical cases of calving it is not intimated that all cases and stages can be successfully dealt with. Too often assistance is not sought for many hours or even days after labor pains, and the escape of the waters intimate the danger of delay. Not seldom the long delay has been filled up with unintelligent and injurious attempts at rendering assistance, violent pulling when resistance is insurmountable without change of position, injuries to the vagina and womb by ill-considered but too forcibly executed attempts to change the position, the repeated and long-continued contact with rough hands and rougher ropes and hooks, the gashes with knives and lacerations with instruments in ignorant hands, the infecting material introduced on filthy hands and instruments, and the septic inflammations started in the now dry and tender passages and womb. Not infrequently the death, putrefaction, and bloating of the calf in the womb render the case extremely unpromising and make it impossible to apply successfully many of the measures above recommended. The labor pains of the cow may have practically ceased from exhaustion; the passages of the vagina may be so dry, tender, friable, red, and swollen that it requires considerable effort even to pass the oiled hand through them, and the extraction of the calf or any portion of it through such a channel seems a hopeless task; the womb may be equally dry, inflamed and swollen, so that its lining membrane or even its entire thickness is easily torn; the fetal membranes have lost their natural, unctuous and slippery character, and cling firmly to the dry walls of the womb, to the dry skin of the calf, or to the hands of the operator; the dead and putrefying calf may be so bloated with gases that the womb has been overdistended by its presence, and the two adhere so closely that the motion of the one on the other is practically impossible. In other cases reckless attempts to cut the calf in pieces have left raw surfaces with projecting bones which dangerously scratch and tear the womb and passages.
In many cases the extreme resort must be had of cutting the fetus to pieces (embryotomy), or the still more redoubtable one of Cæsarean section (extraction through the flank).
DISSECTION OF THE UNBORN CALF (EMBRYOTOMY).
In some cases the dissection of the calf is the only feasible means of delivering it through the natural passages; and while it is especially applicable to the dead calf, it is also on occasion called for in the case of the living. As a rule, the living calf should be preserved, if possible, but if this threatens to entail the death of the cow it is only in the case of offspring of rare value that its preservation is to be preferred. To those acquainted with the toil, fatigue, and discomfort of embryotomy, no discussion is necessary so long as there is a prospect of success from the simple and generally easier method of rectifying the faulty position of the calf. When the correction of the position is manifestly impossible, however, when distortions and monstrosities of the fetus successfully obstruct delivery, when the pelvic passages are seriously contracted by fractures and bony growths, when the passages are virtually almost closed by swelling, or when the calf is dead and excessively swollen, no other resort may be available. In many cases of distortion and displacement the dismemberment of the entire calf is unnecessary, the removal of the offending member being all that is required. It will be convenient, therefore, to describe the various suboperations one by one and in the order in which they are usually demanded.
Amputation of the fore limb.—In cutting off a fore limb it is the one presenting that should be selected, since it is much more easily operated on, and its complete removal from the side of the chest affords so much more space for manipulation that it often makes it easy to bring the other missing limb or the head into position. The first consideration is to skin the limb from the fetlock up and leave the skin attached to the body. The reasons for this are: (a) That the skin is the most resistant structure of the limb, and when it has been removed the entire limb can be easily detached; (b) the tough skin left from the amputated limb may be used as a cord in subsequent traction on the body of the calf; (c) the dissection and separation of the limb are far more safely accomplished under the protection of the enveloping skin than if the operator's hands and instruments were in direct contact with the walls of the passages or womb; (d) the dissection can be much more easily effected while the skin is stretched by the left hand, so as to form a comparatively firmer resistant point for the knife, than when it is attempted to cut the soft, yielding, and elastic tissues which naturally offer little solid resistance, but constantly recede before the cutting edge of the instrument. The preservation of the skin is therefore a cardinal principle in the amputation of all parts in which it is at all feasible.
The presenting foot is inclosed in a noose and drawn well out of the passages. Then a circular incision through the skin is made around the limb just above the fetlock. From this the skin is slit up on the inner side of the limb to the breast. Then the projecting part of the limb is skinned up to the vulva, traction being made on the foot by an assistant so as to expose as much as possible. The embryotomy knife may now be taken ([Pl. XXI], fig. 2), and a small hole having been cut in the free end of the detached portion of skin, that is seized by the left hand and extended while its firm connections with the deeper structures are cut through. The looser connections can be more quickly torn through with the closed fist or the tips of the four fingers held firmly together in a line or with the spud, of which there are several kinds. Much of the upper part of the limb can be skinned more speedily without the knife, but that must be resorted to to cut across tough bands whenever these interrupt the progress. The skinning should be carried upward on the outer side of the shoulder blade to the spine or nearly so. Then with the knife the muscles attaching the elbow and shoulder to the breastbone are cut across, together with those on the inner side of the shoulder joint and in front and behind it as far as these can be reached. Steady traction is now made upon the foot, the remaining muscles attaching the shoulder blade to the trunk are torn through with a cracking noise, and the whole limb, including the shoulder blade and its investing muscles, comes away. If the shoulder blade is left the bulk of the chest is not diminished, and nothing has been gained. Before going further it is well to see whether the great additional space thus secured in the passages will allow of the missing limb or head to be brought into position. If not, the other presenting part, limb or head, is to be amputated and extracted. For the limb the procedure is a repetition of that just described.
Amputation of the head.—The head is first seized and drawn well forward, or even outside the vulva, by a rope with a running noose placed around the lower jaw just behind the incisor teeth, by a sharp hook inserted in the arch of the lower jaw behind the union of its two branches and back of the incisor teeth, or by hooks inserted in the orbits, or, finally, in case the whole head protrudes, by a halter. ([Pl. XXI], figs 4a and 4b.) In case the whole head protrudes, a circular incision through the skin is made just back of the ear, and the cut edge being held firmly by the left hand, the neck is skinned as far as it can be reached. Then the great ligamentous cord above the spine is cut across at the farthest available point, together with the muscles above and below the spine. Strong traction on the head will then detach it at this point and bring it away, but should there still be too much resistance the knife is inserted between the bodies of two vertebræ just behind one of the prominent points felt in the median line below, and their connecting fibrous cartilage is cut through, after which comparatively moderate pulling will bring it away. The detached neck and body at once slip back into the womb, and if the fore limbs are now brought up and pulled they are advanced so far upon the chest that the transverse diameter of that is greatly diminished and delivery correspondingly facilitated.
If the head is still inclosed in the vagina two methods are available: (1) The removal of the lower jaw and subsequent separation of the head from the neck; (2) the skinning of the whole head and its separation from the neck.
To remove the lower jaw the skin is dissected away from it until the throat is reached. Then the muscles of the cheeks and side of the jaw (masseters) are cut through and those connecting the jaw with the neck. When traction is made on the rope around the lower jaw it will usually come away with little trouble. Should it resist, its posterior extremity on each side (behind the grinding teeth) may be cut through with bone forceps or with a guarded bone chisel. ([Pl. XX], fig. 8.) After the removal of the lower jaw the way will be open to separate the head from the neck, the knife being used to cut into the first or second joint from below, or the bone forceps or chisel being employed to cut through the bones of the neck. Then traction is made on the head by means of hooks in the orbits, and the hand, armed with an embryotomy knife, is introduced to cut through the tense resisting ligament, and muscles above the bones. The skin and the strong ligamentous cord attached to the poll are the essential things to cut, as the muscles can easily be torn across. Unless there are great difficulties in the way it is well to skin the head from the eyes back, and on reaching the poll to cut through the ligament and then bring the head away by pulling.
If it is decided to remove the entire head at once, it may be skinned from the front of the eyes back to behind the lower jaw below and the poll above, then cut through the muscles and ligaments around the first joint and pull the head away, assisting, if need be, in the separation of the head by using the knife on the ligament of the joint.
If the calf is a double-headed monster, the skinning of the head must be carried backward until the point has been reached where both heads branch from the single neck, and the separation must be made at that point. The muscles and ligaments are first to be cut through; and if the part can not then be detached by pulling, the bodies of the vertebræ may be separated by passing the knife through the joint. The second head may now be secured by a noose around the lower jaw or hooks in the orbits and brought up into place, the body being pushed back toward the other side by a repeller, so as to make room.
It should be added that, except in the case of a double-headed monster, or in case of the head protruding or nearly so, and one or both fore limbs presenting, it is rarely desirable to undertake amputation of the head. The space desirable in the passages can usually be obtained by the much simpler and easier procedure of removing one or both fore limbs.
Amputation of the hind limbs.—This is sometimes demanded on the one extended limb when the other can not be brought up and delivery can not be effected; also in case of monsters having extra hind limbs; when the calf is dead, putrid, and bloated with gas; and in some cases of breech presentation, as described under that head.
When the limb is extended the guiding principles are as in the case of the fore limbs. The skin is cut through circularly above the fetlock and slit up to beneath the pelvic bones on the inner side of the thigh. It is then dissected from the other parts as high as it has been slit on the inner side and to above the prominence (trochanter major) on the upper end of the thigh bone on the outer side of the joint. In this procedure the hands and spud can do much, but owing to the firmer connections the knife will be more frequently required than in the case of the fore limb. The muscles are now cut through all around the hip joint, and strong traction is made by two or three men on the limb. If there is still too much resistance, a knife is inserted into the joint on the inner side and its round ligament cut through, after which extraction will be comparatively easy. This accomplished, it will often be possible to extract the fetus with the other leg turned forward into the womb. If the calf is bloated with gas, it may be necessary to remove the other leg in the same way, and even to cut open the chest and abdomen and remove their contents before extraction can be effected. In the case of extra limbs it may be possible to bring them up into the passages after the presenting hind limbs have been removed. If this is not practicable, they may be detached by cutting them through at the hip joint, as described under "Breech presentation," page 197.
Another method of removing the hind limb is, after having skinned it over the quarter, to cut through the pelvic bones from before backward, in the median line below, by knife, saw, or long embryotome ([Pl. XX], fig. 1), and then disjoint the bones of the spine (sacrum) and the hip bone (ilium) on that side with embryotome, knife, or saw, and then drag away the entire limb, along with all the hip bones on that side. This has the advantage of securing more room and thereby facilitating subsequent operations. Both limbs may be removed in this way, but on the removal of the second the operator is without any solid point to drag upon in bringing away the remainder of the fetus.
Division across the middle of the body.—In cases of extra size, monstrosity, or distortion of one end of the body it may be requisite to cut the body in two and return the half from the passages into womb, even after one-half has been born. The presenting members are dragged upon forcibly by assistants to bring as much of the body as possible outside. Then cut through the skin around the body at some distance from the vulva, and with hand, knife, and spud detach it from the trunk as far back into the passages as can be reached. Next cut across the body at the point reached, beginning at the lower part (breast, belly) and proceeding up toward the spine. This greatly favors the separation of the backbone when reached, and further allows of its being extended so that it can be divided higher up. When the backbone is reached, the knife is passed between the two bones, the prominent ridges across their ends acting as guides, and by dragging and twisting the one is easily detached from the other. With an anterior presentation the separation should, if possible, be made behind the last rib, while with a posterior presentation as many of the ribs should be brought away as can be accomplished. Having removed one half of the body, the remaining half is to be pushed back into the womb, the feet sought and secured with nooses, and the second half removed in one piece if possible; and if not, then after the removal of the extra limb or other cause of obstruction.
Removal of the contents of chest or abdomen.—If the body of the calf sticks fast in the passages by reason of the mere dryness of its skin and of the passages, the obstacle may be removed by injecting sweet oil past the fetus into the womb through a rubber or other tube, and smearing the passages freely with lard. When the obstruction depends on excess of size of the chest or abdomen or thickening of the body from distorted spine, much advantage may be derived from the removal of the contents of these great cavities of the trunk. We have already seen how the haunches may be narrowed by cutting the bones apart in the median line below and causing their free edges to overlap each other. The abdomen can be cut open by the embryotomy knife or the long embryotome in the median line, or at any point, and the contents pulled out with the hand, the knife being used in any case when especial resistance is encountered. If the abdomen is so firmly impacted that it can not be dealt within this way, one hind limb and the hip bone on the same side may be removed as described under "Amputation of the hind limbs," page 205. This will allow the introduction of the hand into the abdomen from behind, so as to pull out the contents. By introducing an embryotomy knife in the palm of the hand and cutting through the muscle of the diaphragm the interior of the chest can be reached in the same way and the heart and lungs removed.
When, in dealing with an anterior presentation, it becomes necessary to remove the contents of the chest, the usual course is to cut through the connections of the ribs with the breastbone (the costal cartilages) close to the breastbone on each side, and from the abdomen forward to the neck. Then cut through the muscles connecting the front of the breastbone with the neck and its hinder end with the belly, and pull out the entire breastbone. Having torn out the heart and lungs with the hand, make the rib cartilages on the one side overlap those on the other, so as to lessen the thickness of the chest, and proceed to extract the body. If it seems needful to empty the abdomen as well, it is easy to reach it by cutting through the diaphragm, which separates it from the chest.
Delivery through the flank (Cæsarean section, or laparotomy).—This is sometimes demanded, when the distortion and narrowing of the hip bones are such as to forbid the passage of the calf, or when inflammation has practically closed the natural passages and the progeny is more valuable and worthy of being saved than the dam; also in cases in which the cow has been fatally injured, or is ill beyond possibility of recovery and yet carries a living calf. It is too often a last resort after long and fruitless efforts to deliver by the natural channels, and in such cases the saving of the calf is all that can be expected, the exhausted cow, already the subject of active inflammation and too often also of putrid poisoning, is virtually beyond hope. The hope of saving the dam is greatest if she is in good health and not fatigued, in cases, for example, in which the operation is resorted to on account of broken hip bones or abnormally narrow passages.
The stock owner will not attempt such a serious operation as this. Yet, if the mother has just died or is to be immediately sacrificed, no one should hesitate to resort to it in order to save the calf. If alive, it is important to have the cow perfectly still. Her left fore leg being bent at the knee by one person, another may seize the left horn and nose and turn the head to the right until the nose rests on the spine just above the shoulder. The cow will sink down gently on her left side without shock or struggle. One may now hold the head firmly to the ground, while a second, carrying the end of the tail from behind forward on the inside of the right thigh, pulls upon it so as to keep the right hind limb well raised from the ground. If time presses she may be operated on in this position, or if the cow is to be sacrificed a blow on the head with an ax will produce quietude. Then the prompt cutting into the abdomen and womb and the extraction of the calf requires no skill. If, however, the cow is to be preserved, her two forefeet and the lower hind one should be safely fastened together and the upper hind one drawn back. Two ounces chloral hydrate, given by injection, should induce sleep in 20 minutes, and the operation may proceed. In case the cow is to be preserved, wash the right flank and apply a solution of 4 grains of corrosive sublimate in a pint of water.
Then, with an ordinary scalpel or knife, dipped in the above-mentioned solution, make an incision from 2 inches below and in front of the outer angle of the hip bone in a direction downward and slightly forward to a distance of 12 inches. Cut through the muscles, and more carefully through the transparent lining membrane of the abdomen (peritoneum), letting the point of the knife lie in the groove between the first two fingers of the left hand as they are slid down inside the membrane and with their back to the intestines. An assistant, whose hands, like those of the operator, have been dipped in the sublimate solution, may press his hands on the wound behind the knife to prevent the protrusion of the intestines. The operator now feels for and brings up to the wound the gravid womb, allowing it to bulge well through the abdominal wound, so as to keep back the bowels and prevent any escape of water into the abdomen. This is seconded by two assistants, who press the lips of the wound against the womb. Then an incision 12 inches long is made into the womb at its most prominent point, deep enough to penetrate its walls, but not so as to cut into the water bags. In cutting, carefully avoid the cotyledons, which may be felt as hard masses inside. By pressure the water bags may be made to bulge out as in natural parturition, and this projecting portion may be torn or cut so as to let the liquid flow down outside of the belly. The operator now plunges his hand into the womb, seizes the fore or hind limbs, and quickly extracts the calf and gives it to an attendant to convey to a safe place. The womb may be drawn out, but not until all the liquid has flowed out, and the fetal membranes must be separated from the natural cotyledons, one by one, and the membranes removed. The womb is now emptied with a sponge, which has been boiled or squeezed out of a sublimate solution, and if any liquid has fallen into the abdomen it may be removed in the same way. A few stitches are now placed in the wound in the womb, using carbolized catgut. They need not be very close together, as the wound will diminish greatly when the womb contracts. Should the womb not contract at once it may have applied against it a sponge squeezed out of a cold sublimate solution, or it may be drawn out of the abdominal wound and exposed to the cold air until it contracts. Its contraction is necessary to prevent bleeding from its enormous network of veins. When contracted, the womb is returned into the abdomen and the abdominal wound sewed up. One set of stitches, to be placed at intervals of 2 inches, is passed through the entire thickness of skin and muscles and tied around two quills or little rollers resting on the skin. ([Pl. XXVII], fig. 7.) These should be of silver, and may be cut at one end and pulled out after the wound has healed. The superficial stitches are put in every half inch and passed through the skin only. They, too, may be of silver, or pins may be inserted through the lips and a fine cord twisted round their ends like a figure 8. ([Pl. XXVII], fig. 9.) The points of the pins may be snipped off with pliers. The edges may be still further held together by the application of Venice turpentine, melted so as to become firmly adherent, and covered with a layer of sterilized cotton wool. Then the whole should be supported by a bandage fixed around the loins and abdomen.