Treatment.—Treatment varies according to the conditions. When the cow is in low condition, or when retention is connected with drinking iced water or eating frozen feed, hot drinks and hot mashes of wheat bran or other aliment may be sufficient. If along with the above conditions, the bowels are somewhat confined, an ounce of ground ginger, or half an ounce of black pepper, given with a quart of sweet oil, or 1½ pounds of Glauber's salt in at least 4 quarts of warm water, will often prove effectual. A bottle or two of flaxseed tea, made by prolonged boiling, should also be given at frequent intervals. Other stimulants, like rue, savin, laurel, and carminatives like anise, cumin, and coriander, are preferred by some, but with very questionable reason, the more so that the first three are not without danger. Ergot of rye, 1 ounce, or its extract, 1 dram, may be resorted to to induce contraction of the womb. The mechanical extraction of the membranes is, however, often called for; of this there are several methods. The simplest is to hang a weight of 1 or 2 pounds to the hanging portion, and allow this, by its constant dragging and by its jerking effect when the cow moves, to pull the membranes from their attachments and to stimulate the womb to expulsive contractions. It frequently happens that the afterbirth is only loosely adherent to the womb and its removal is effected if but a slight amount of traction on it is exerted. This can be determined by seizing the dependent part of the afterbirth between two sticks and rolling it up on them until they lie against the vulva; then, by careful traction, accompanied with slight jerking movements from side to side, the womb is stimulated to expulsive contractions and the afterbirth is wound up more and more on the sticks until finally its last connections with the womb are severed and the remainder is expelled suddenly en masse. It is quite evident that neglected cases with putrid membranes are poor subjects for this method, as the afterbirth is liable to tear across, leaving a mass in the womb. During the progress of the work any indication of tearing is the signal to stop and proceed with greater caution or altogether abandon the attempt in this way.
The following method (that with the skilled hand) is the most promptly and certainly successful. For this the operator had better dress as for a parturition case. Again, the operation should be undertaken within twenty-four hours after calving, since later the mouth of the womb may be so closed that it becomes difficult to introduce the hand. The operator should smear his arms with carbolized lard or vaseline to protect them against infection, and particularly in delayed cases with putrid membranes. An assistant holds the tail to one side, the operator seizes the hanging afterbirth with the left hand, while he introduces the other along the right side of the vagina and womb, letting the membranes slide through his palm until he reaches the first cotyledon to which they remain adherent. In case no such connection is within reach, with the left hand gentle traction is made on the membranes until the deeper parts of the womb are brought within reach and the attachments to the cotyledons can be reached. Then the soft projection of the membrane, which is attached to the firm fungus-shaped cotyledon on the inner surface of the womb, is seized by the little finger, and the other fingers and thumb are closed on it so as to tear it out from its connections. To explain this, it is necessary only to say that the projection from the membrane is covered by soft, conical processes, which are received into cavities of a corresponding size on the summit of the firm, mushroom-shaped cotyledon growing from the inner surface of the womb. To draw upon the former, therefore, is to extract its soft, villous processes from within the follicles or cavities of the other. [Pl. XIII], fig. 2.) If at times it is difficult to start this extraction it may be necessary to get the finger nail inserted between the two, and once started the finger may be pushed on, lifting all the villi, in turn, out of their cavities. This process of separating the cotyledons must be carefully conducted, one after another, until the last has been detached and the afterbirth comes freely out of the passages. I have never found any evil result from the removal of the whole mass at one operation, but Shaack mentions the eversion of the womb as the possible result of the necessary traction, and in cases in which those in the most distant part of the horn of the womb can not be easily reached, he advises to attach a cord to the membranes inside the vulva, letting it hang out behind, and to cut off the membranes below the cord. Then, after two or three days' delay, he extracts the remainder, now softened and easily detached. If carefully conducted, so as not to tear the cotyledons of the womb, the operation is eminently successful; the cow suffers little, and the straining roused by the manipulations soon subsides. Keeping in a quiet, dark place, or driving a short distance at a walking pace, will serve to quiet these. When the membranes have been withdrawn, the hand, half closed, may be used to draw out of the womb the offensive liquid that has collected. If the case is a neglected one, and the discharge is very offensive, the womb must be injected as for leucorrhea.
INFLAMMATION OF THE VAGINA (VAGINITIS).
This may occur independently of inflammation of the womb, and usually as the result of bruises, lacerations, or other injuries sustained during calving. It will be shown by swelling of the lips of the vulva, which, together with their lining membrane, become of a dark-red or leaden hue, and the mucous discharge increases and becomes whitish or purulent, and it may be fetid. Slight cases recover spontaneously, or under warm fomentations or mild astringent injections (a teaspoonful of carbolic acid in a quart of water), but severe cases may go on to the formation of large sores (ulcers), or considerable portions of the mucous membrane may die and slough off. Baumeister records two cases of diphtheritic vaginitis, the second case in a cow four weeks calved, contracted from the first in a newly calved cow. Both proved fatal, with formation of false membranes as far as the interior of the womb. In all severe cases the antiseptic injections must be applied most assiduously. The carbolic acid may be increased to one-half ounce to a quart, or chlorin water, or peroxid of hydrogen solution may be injected at least three times a day. Hyposulphite of soda, 1 ounce to a quart of water, is an excellent application, and the same amount may be given by the mouth.
LEUCORRHEA (MUCOPURULENT DISCHARGE FROM THE PASSAGES).
This is from a continued or chronic inflammation of the womb, or the vagina, or both. It usually results from injuries sustained in calving or from irritation by putrid matters in connection with retained afterbirth, or from the use of some object in the vagina (pessary) to prevent eversion of the womb. Exposure to cold or other cause of disturbance of the health may affect an organ so susceptible as this at the time of parturition so as to cause inflammation.
Symptoms.—The main symptom is the glairy, white discharge flowing constantly or intermittently (when the cow lies down), soiling the tail and matting its hairs and those of the vulva. When the lips of the vulva are drawn apart the mucous membrane is seen to be red, with minute elevations, or pale and smooth. The health may not suffer at first, but if the discharge continues and is putrid the health fails, the milk shrinks, and flesh is lost. If the womb is involved the hand introduced into the vagina may detect the mouth of the womb slightly open and the liquid collected within its cavity. Examination with the oiled hand in the rectum may detect the outline of the womb beneath, somewhat enlarged, and fluctuating under the touch from contained fluid. In some cases heat is more frequent or intense than natural, but the animal rarely conceives when served, and, if she does, is liable to abort.
Treatment.—Treatment with the injections advised for vaginitis is successful in mild or recent cases. In obstinate ones stronger solutions may be used after the womb has been washed out by a stream of tepid water until it comes clear. A rubber tube is inserted into the womb, a funnel placed in its raised end, and the water, and afterwards the solution, poured slowly through it. If the neck of the womb is so close that the liquid can not escape, a second tube may be inserted to drain it off. As injections may be used chlorid of zinc, one-half dram to the quart of water, or sulphate of iron, 1 dram to the quart. Three drams of sulphate of iron and one-half ounce ground ginger may also be given in the feed daily.