DISEASES FOLLOWING PARTURITION.
By James Law, F. R. C. V. S.,
Formerly Professor of Veterinary Science, etc., in Cornell University.
FLOODING (BLEEDING FROM THE WOMB).
Though not so common in the cow as in the human female, flooding is sufficiently frequent to demand attention. It may depend on a too rapid calving and a consequent failure of the womb to contract when the calf has been removed. The pregnant womb is extraordinarily rich in blood vessels, especially in large and tortuous veins, which become compressed and almost obliterated under contraction, but remain overfilled and often bleed into the cavity of the womb should no contraction take place. Cox records cases in which the labor pains had detached and expelled the fetal membranes, while the calf, owing to large size or wrong presentation, was detained in the womb, and the continued dilatation of the womb in the absence of the fetal membranes led to a flow of blood which accumulated in clots around the calf. Other causes are laceration of the cotyledons of the womb, or from an antecedent inflammation of the placenta, and the unnatural adhesion of the membranes to the womb, which bleeds when the two are torn apart. Weakness of the womb from overdistention, as in dropsy, twins, etc., is not without its influence. Finally, eversion of the womb (casting the withers) is an occasional cause of flooding. The trouble is only too evident when the blood flows from the external passages in drops or in a fine stream. When it is retained in the cavity of the womb, however, it may remain unsuspected until it has rendered the animal almost bloodless. The symptoms in such case are paleness of the eyes, nose, mouth, and of the lips of the vulva, a weak, rapid pulse, violent and perhaps loud beating of the heart (palpitations), sunken, staring eyes, coldness of the skin, ears, horns, and limbs, perspiration, weakness in standing, staggering gait, and, finally, inability to rise, and death in convulsions. If these symptoms are seen, the oiled hand should be introduced into the womb, which will be found open and flaccid and containing large blood clots.
Treatment.—Treatment consists in the removal of the fetal membranes and blood clots from the womb (which will not contract while they are present), the dashing of cold water on the loins, right flank, and vulva, and if these measures fail, the injection of cold water into the womb through a rubber tube furnished with a funnel. In obstinate cases a good-sized sponge soaked in tincture of muriate of iron should be introduced into the womb and firmly squeezed, so as to bring the iron into contact with the bleeding surface. This is at once an astringent and a coagulant for the blood, besides stimulating the womb to contraction. In the absence of this agent astringents (solution of copperas, alum, tannic acid, or acetate of lead) may be thrown into the womb, and one-half-dram doses of acetate of lead may be given by the mouth, or 1 ounce powdered ergot of rye may be given in gruel. When nothing else is at hand, an injection of oil of turpentine will sometimes promptly check the bleeding.
EVERSION OF THE WOMB (CASTING THE WITHERS).
Like flooding, this is the result of failure of the womb to contract after calving. If that organ contracts naturally, the afterbirth is expelled, the internal cavity of the womb is nearly closed, and the mouth of the organ becomes so narrow that the hand can not be forced through, much less the whole mass of the matrix. When, however, it fails to contract, the closed end of one of the horns may fall into its open internal cavity, and under the compression of the adjacent intestines, and the straining and contraction of the abdominal walls, it is forced farther and farther, until the whole organ is turned outside in, slides back through the vagina, and hangs from the vulva. The womb can be instantly distinguished from the protruding vagina or bladder by the presence, over its whole surface, of 50 to 100 mushroomlike bodies (cotyledons), each 2 to 3 inches in diameter, and attached by a narrow neck. ([Pls. XXII], [XXIII].) When fully everted, it is further recognizable by a large, undivided body hanging from the vulva, and two horns or divisions which hang down toward the hocks. In the imperfect eversions the body of the womb may be present with two depressions leading into the two horns. In the cases of some standing the organ has become inflamed and gorged with blood until it is as large as a bushel basket, its surface has a dark-red, bloodlike hue, and tears and bleeds on the slightest touch. Still later lacerations, raw sores, and even gangrene are shown in the mass. At the moment of protrusion the general health is not altered, but soon the inflammation and fever with the violent and continued straining induce exhaustion, and the cow lies down, making no attempt to rise.
Treatment.—Treatment varies somewhat, according to the degree of the eversion. In partial eversion, with the womb protruding only slightly from the vulva and the cow standing, let an assistant pinch the back to prevent straining while the operator pushes his closed fist into the center of the mass and carries it back through the vagina, assisting in returning the surrounding parts by the other hand. In more complete eversion, but with the womb as yet of its natural bulk and consistency and the cow standing, straining being checked by pinching the back, a sheet is held by two men so as to sustain the everted womb and raise it to the level of the vulva. It is now sponged clean with cold water, the cold being useful in driving out the blood and reducing the bulk, and finally it may be sponged over with laudanum or with a weak solution of carbolic acid (1 dram to 1 quart water).