In the Berliner Archiv for 1902 Lempen gave a summary of the extensive literature dealing with this disease and of the varying views held regarding its origin and treatment, particularly as to the direction in which the animal should be rolled in order to reduce the torsion.

In common with the majority of authors, Lempen rightly concluded that the rolling should be in the same direction as the torsion. He also proposed to describe the torsion as being to right or left, according to the direction of the spiral folds to be found on the upper wall of the dilated cervix uteri when the examiner stands behind the animal. This mode of describing the changes seems least likely to cause misunderstanding.

In describing the degree of torsion Haase takes as his index the upper wall of the uterus. Where this has moved through an angle of 90 degrees he speaks of quarter torsion; when through an angle of 180 degrees (in which case the upper wall will have become the lower) of half or semi-complete torsion; when through an angle of 270 degrees as three-quarter, and when through 360 degrees (the upper wall having then described an entire circle and returned to its former position) as complete torsion.

In forming a diagnosis, the extent to which the maternal passages seem fixed in position, the amount of resistance they offer to the hand, and the degree of tension in the spiral folds to some extent indicate how far torsion has proceeded. Where the spiral folds are very tense and the passages completely immovable, so that the operator cannot reach the fœtus, torsion is usually complete; in cases of less complete torsion (one-quarter to three-quarters) the cervix uteri is closed and displaced to a proportionate extent, and the resistance to the passage of the hand is in keeping.

The prognosis is very grave.

Treatment is difficult, and of the numerous methods suggested (laparotomy and direct abdominal taxis, vaginal hysterotomy followed by abdominal taxis, vaginal taxis, etc.) most have fallen into desuetude or are looked on as of so desperate a character as only to be justified in extreme cases. That which most merits attention and has been attended by most uniformly favourable results consists in the rotation of the animal’s whole body. The best results are said to be obtained by casting the animal, or causing it to lie down, on a sloping surface with the hind quarters higher than the fore and then to roll it down hill, in the same direction as the spiral twists discovered in the vagina. It is possible to follow the course of the manipulation by retaining the hand in the vagina, but failing this the vagina should be examined after each attempt. Even, though the first attempts fail hope should not be abandoned, for Haase has succeeded in effecting delivery after rolling the animal twenty times. The operation should be performed smartly and the animal’s body be rolled as a whole, the fore limbs turning along with the hind.

TUMOURS OF THE UTERUS.

The study of tumours of the uterus is still so incomplete that it would be impossible to give a precise description of them. This is to a great extent due to the fact that as treatment is difficult the animals are usually slaughtered as soon as an assured diagnosis can be given.

The general symptoms of tumours of the neck, body, or horns of the uterus resemble those of chronic metritis, viz., permanent or intermittent discharge from the vulva, wasting, expulsive efforts, dysuria and sterility. The position of the tumour, its form, point of insertion, size, consistency, mode of attachment, etc., can be detected by vaginal or rectal examination.

The diagnosis having been made, the only question is as to treatment. Should the tumour prove mobile, clearly delimited, and with a well-marked pedicle, it can be removed either by tearing away or by breaking into fragments, or again simply by dividing the pedicle and applying antiseptic pads to check bleeding. But if the tumour proves largely sessile and ill-defined and it extends into neighbouring tissues the animal should be slaughtered, as such patients can neither be fattened nor used for reproductive purposes.