_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 v.u.l.v.a, 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 ma.s.s 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 v.a.g.i.n.a, and hangs from the v.u.l.v.a. The womb can be instantly distinguished from the protruding v.a.g.i.n.a 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. XII, XIII.) When fully everted, it is further recognizable by a large, undivided body hanging from the v.u.l.v.a, 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 ma.s.s. 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 v.u.l.v.a and the cow standing, let an a.s.sistant pinch the back to prevent straining while the operator pushes his closed fist into the center of the ma.s.s and carries it back through the v.a.g.i.n.a, a.s.sisting 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 v.u.l.v.a. 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).

The closed fist may now be planted in the rounded end of the largest horn and pushed on so as to turn it back within itself and carry it on through the v.a.g.i.n.a, the other hand being used meanwhile to a.s.sist in the inversion and in pushing the different ma.s.ses in succession within the lips of the v.u.l.v.a. In case of failure, resort should be had at once to a plan which I have successfully followed for many years. Take a long linen or cotton bandage, 5 or 6 inches wide, and wind it around the protruding womb as tightly as it can be drawn, beginning at the free end and gradually covering the entire ma.s.s up to the v.u.l.v.a. By this means the greater part of the blood will be forced out of the organ and its bulk greatly reduced, so that its reduction is much facilitated. An additional advantage is found in the protection given to the womb by its investing bandage while it is being pushed forward into the v.a.g.i.n.a and abdomen. In manipulating the exposed womb there is always danger of laceration, but when the organ is covered with a sheet it is next to impossible to tear it. The subsequent manipulation is as in the other case, by pushing the blind end forward within itself with the closed fist and carrying this on through the v.a.g.i.n.a into the abdomen with the constant a.s.sistance of the other hand. Often it will be found convenient to use the edge of the left hand to push the outer part of the protruding ma.s.s inside the lips of the v.u.l.v.a, while the right hand and arm are carrying the central portions forward through the v.a.g.i.n.a.

An intelligent a.s.sistant, pushing with the palms of both hands on the outer portion of the ma.s.s, will also afford material a.s.sistance. As the womb is turned within itself the wrapping bandage will gradually loosen, but once the great ma.s.s has entered the pa.s.sages it is easy to compel the rest to follow, and the compression by the bandage is no longer so important. When the womb is fully replaced the bandage is left in its interior in a series of loose folds, and can be easily withdrawn. It is well to move the hand from side to side to insure that the two horns of the womb are fully extended and on about the same level before withdrawing the arm and applying a truss.

When the womb has been long everted and is gorged with blood, inflamed, and friable there is often the additional disadvantage that the animal is unable or unwilling to rise. When lying down the straining can not be controlled so effectually, and, even in the absence of straining, the compression of the belly is so great as to prove a serious obstacle to reduction. The straining may be checked by 2 or 3 ounces of laudanum or 2 ounces of chloral hydrate, or by inhalation of chloroform to insensibility, and then by raising the hind parts on straw bundles the gravitation of the abdominal organs forward may be made to lessen the resistance. If not successful in this way, the cow may be further turned on her back, and if return is still impossible, the hind limbs may be tied together and drawn up to a beam overhead by the aid of a pulley. In this position, in place of the pressure backward of the bowels proving a hindrance, their gravitation forward proves a most material help to reduction. In seeking to return the womb the sponging with ice-cold water, raising on a sheet, and wrapping in a tight bandage should be resorted to. Another method which is especially commendable in these inflamed conditions of the womb is to bring a piece of linen sheet, 30 by 36 inches, under the womb, with its anterior border close up to the v.u.l.v.a, then turn the posterior border upward and forward over the organ, and cross the two ends over this and over each other above.

The ends of the sheet are steadily drawn, so as to tighten its hold on the womb, which is thus held on the level of the v.u.l.v.a or above, and cold water is constantly poured upon the ma.s.s. The reduction is further sought by compression of the ma.s.s with the palms applied outside the sheet. Fifteen or twenty minutes are usually sufficient to cause the return of the womb, provided straining is prevented by pinching the back, or otherwise.

In old and aggravated cases, with the womb torn, bruised, or even gangrenous, the only resort is to amputate the entire ma.s.s. This is done by tying a strong, waxed cord around the protruding ma.s.s close to the v.u.l.v.a, winding the cord around pieces of wood, so as to draw it as tightly as possible, cutting off the organ below this ligature, tying a thread on any artery that may still bleed, and returning the stump well into the v.a.g.i.n.a.

Retention of the returned womb is the next point, and is most easily accomplished by a rope truss. Take two ropes, each about 18 feet long and an inch in thickness. Double each rope at its middle, and lay the one above the other at the bend, so as to form an ovoid of about 8 inches in its long diameter. Twist each end of the one rope twice around the other, so that this ovoid will remain when they are drawn tight. (Pls. XXII and XXIII.) Tie a strap or rope around the back part of the neck and a surcingle around the body. Place the rope truss on the animal so that the ovoid ring will surround the v.u.l.v.a, the two ascending ropes on the right and left of the tail and the two descending ones down inside the thighs on the right and left of the udder. These descending ropes are carried forward on the sides of the body and tied to the surcingle and to the neck collar. The ascending ropes proceed forward on the middle of the back, twisting over each other, and are tied to the surcingle and collar. The upper and lower ropes are drawn so tightly that the rope ring is made to press firmly all around the v.u.l.v.a without risk of displacement. This should be worn for several days, until the womb shall have closed and all risk of further eversion is at an end. Variations of this device are found in the use of a narrow triangle of iron applied around the v.u.l.v.a and fixed by a similar arrangement of ropes, surcingle, and collar (Pl. XXIII, fig. 3), a common crupper similarly held around the v.u.l.v.a (Pl. XXII, fig. 1), st.i.tches through the v.u.l.v.a, and wire inserted through the skin on the two hips (Pl. XXIII, fig. 2), so that they will cross behind the v.u.l.v.a; also pessaries of various kinds should be inserted into the v.a.g.i.n.a. None of these devices, however, present any advantage over the simple and comparatively painless rope truss described above. Such additional precautions as keeping the cow in a stall higher behind than in front, and seeing that the diet is slightly laxative and nonstimulating may be named. If straining is persistent, ounce doses of laudanum may be used twice a day, and the same may be injected into the v.a.g.i.n.a.

If the womb has been cut off, injections of a solution of a teaspoonful of carbolic acid in a quart of water should be used daily, or more frequently, until the discharge ceases.

EVERSION OF THE BLADDER.

A genuine eversion of the bladder is almost unknown in the cow, owing to the extreme narrowness of its mouth. The protrusion of the bladder, however, through a laceration sustained in calving, in the floor of the v.a.g.i.n.a and its subsequent protrusion through the v.u.l.v.a, is sometimes met with. In this case the protruding bladder contains urine; this can never be the case in a real eversion, in which the inner surface of the bladder and the openings of the ureters are both exposed outside the v.u.l.v.a. The presence of a bag containing water, which is connected with the floor of the v.a.g.i.n.a, will serve to identify this condition. If the position of the bladder in the v.u.l.v.a renders it impracticable to pa.s.s a catheter to draw off the urine, pierce the organ with the nozzle of a hypodermic syringe, or even a very small trocar and cannula, and draw off the water, when it will be found an easy matter to return the bladder to its place. The rent in the v.a.g.i.n.a can be st.i.tched up, but as there would be risk in any subsequent calving it is best to prepare the cow for the butcher.

RUPTURE OF THE BLADDER.

This has been known to occur in protracted parturition when the fetus finally pa.s.sed while the bladder was full. The symptoms are those of complete suppression of urine and tenderness of the abdomen, with a steady acc.u.mulation of liquid, and fluctuation on handling its lower part. If the hand is introduced into the v.a.g.i.n.a it is felt to be hot and tender, and perhaps slightly swollen along its floor. As a final test, if the lower, fluctuating part of the abdomen is punctured with a hypodermic needle, a straw-colored liquid of a urinous odor flows out. The condition has been considered as past hope. The only chance for recovery would be in opening the abdomen, evacuating the liquid, and st.i.tching up the rent in the bladder, but at such a season, and with inflammation already started, there would be little to hope for.

RUPTURE OF THE WOMB.

When the womb has been rendered friable by disease rupture may occur in the course of the labor, but much more frequently it occurs from violence sustained in attempting a.s.sistance in difficult parturition. It is also liable to occur during eversion of the organ through efforts to replace it.

If it happens while the calf is still in the womb, it will usually bleed freely and continuously until the fetus has been extracted, so that the womb can contract on itself and expel its excess of blood. Another danger is that in case of a large rent the calf may escape into the cavity of the abdomen and parturition become impossible. Still another danger is that of the introduction of septic germs and the setting up of a fatal inflammation of the lining membrane of the belly (peritoneum). Still another is the escape of the small intestine through the rent and on through the v.a.g.i.n.a and v.u.l.v.a, so as to protrude externally and receive perhaps fatal injuries.

In case of rupture before calving, that act should be completed as rapidly and carefully as possible, the fetal membranes removed, and the contraction of the womb sought by dashing cold water on the loins, the right flank, or the v.u.l.v.a. If the calf has escaped into the abdomen and can not be brought through the natural channels, it may be permissible to fix the animal and extract it through the side, as in the Caesarian section. If the laceration has happened during eversion of the womb it is usually less redoubtable, because the womb contracts more readily under the stimulus of the cold air so recently applied. In case the abdomen has been laid open it is well to st.i.tch up the rent, but if not, it should be left to nature, and will often heal satisfactorily, the cow even breeding successfully in after years.

Rupture of the floor of the v.a.g.i.n.a has been already referred to as allowing the protrusion of the bladder. Laceration of the roof of this pa.s.sage is also met with as the result of deviations of the hind limbs and feet upward when the calf lies on its back. In some such cases the opening pa.s.ses clear into the r.e.c.t.u.m, or the foot may even pa.s.s out through the a.n.u.s, so that that opening and the v.u.l.v.a are laid open into one.

Simple, superficial lacerations of the v.a.g.i.n.al walls are not usually serious, and heal readily unless septic inflammation sets in, in which case the cow is liable to perish. They may be treated with soothing and antiseptic injections, such as carbolic acid, 1 dram; water, 1 quart.

The more serious injuries depend on the complications. Rupture of the anterior part of the ca.n.a.l, close to the mouth of the womb, may lead to the introduction of infecting germs into the cavity of the abdomen, or protrusion of the bowel through the rent and externally, either of which may prove fatal. If both these conditions are escaped the wound may heal spontaneously. Rupture into the bladder may lead to nothing worse than a constant dribbling of the urine from the v.u.l.v.a. The cow should be fattened if she survives. Rupture into the r.e.c.t.u.m will entail a constant escape of feces through the v.u.l.v.a, and, of course, the same condition exists when the a.n.u.s as well has been torn open. I have successfully sewed up an opening of this kind in the mare, but in the case of the cow it is probably better to prepare her for the butcher.

CLOTS OF BLOOD IN THE WALLS OF THE v.a.g.i.n.a.

During calving the v.a.g.i.n.a may be bruised so as to cause escape of blood beneath the mucous membrane and its coagulation into large bulging clots.

The v.u.l.v.a may appear swollen, and on separating its lips the mucous membrane of the v.a.g.i.n.a is seen to be raised into irregular rounded swellings of a dark-blue or black color, and which pit on pressure of the finger. If the acc.u.mulation of blood is not extensive it may be reabsorbed, but if abundant it may lead to irritation and dangerous inflammation, and should be incised with a lancet and the clots cleared out. The wounds may then be sponged twice a day with a lotion made with 1 dram sulphate of zinc, 1 dram carbolic acid, and 1 quart water.

RETAINED AFTERBIRTH.

The cow, of all our domestic animals, is especially subject to this accident. This may be partly accounted for by the firm connections established through the fifty to one hundred cotyledons (Pl. XIII, fig. 2) in which the fetal membranes dovetail with the follicles of the womb. It is also most liable to occur after abortion, in which preparation has not been made by fatty degeneration for the severance of these close connections. In the occurrence of inflammation, causing the formation of new tissue between the membranes and the womb, we find the occasion of unnaturally firm adhesions which prevent the spontaneous detachment of the membranes. Again, in low conditions of health and an imperfect power of contraction we find a potent cause of retention, the general debility showing particularly in the indisposition of the womb to contract, after calving, with sufficient energy to expel the afterbirth. Hence we find the condition common with insufficient or innutritious feed, and in years or localities in which the fodder has suffered from weather. Ergoted, s.m.u.tty, or musty fodder (Pl. V), by causing abortion, is a frequent cause of retention. Old cows are more subject than young ones, probably because of diminishing vigor. A temporary retention is sometimes owing to a too rapid closure of the neck of the womb after calving, causing strangulation and imprisonment of the membranes.

Conditions favoring this are the drinking of cold (iced) water, the eating of cold feed (frosted roots), and (through sympathy between udder and womb) a too prompt sucking by the calf or milking by the attendant.

_Symptoms._--The symptoms of retention of the afterbirth are usually only too evident, as the membranes hang from the v.u.l.v.a and rot away gradually, causing the most offensive odor throughout the building. When retained within the womb by closure of its mouth and similarly in cases in which the protruded part has rotted off, the decomposition continues and the fetid products escaping by the v.u.l.v.a appear in offensively smelling pools on the floor and mat together the hairs near the root of the tail. The septic materials retained in the womb cause inflammation of its lining membrane, and this, together with the absorption into the blood of the products of putrefaction, leads to ill health, emaciation, and drying up of the milk.

_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 1-1/2 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, c.u.min, 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 v.u.l.v.a; 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 ma.s.se.

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 ma.s.s 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 a.s.sistant 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 v.a.g.i.n.a 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 pa.s.sages. I have never found any evil result from the removal of the whole ma.s.s 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 v.u.l.v.a, 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 v.a.g.i.n.a (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 v.u.l.v.a, 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 a.s.siduously. 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 Pa.s.sAGES).

This is from a continued or chronic inflammation of the womb, or the v.a.g.i.n.a, 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 v.a.g.i.n.a (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 v.u.l.v.a. When the lips of the v.u.l.v.a 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 v.a.g.i.n.a may detect the mouth of the womb slightly open and the liquid collected within its cavity. Examination with the oiled hand in the r.e.c.t.u.m 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.

INFLAMMATION OF THE WOMB (METRITIS, INFLAMMATION OF WOMB AND ABDOMEN, OR METROPERITONITIS).

Inflammation of the womb may be slight or violent, simple or a.s.sociated with putrefaction of its liquid contents and general poisoning, or it may extend so that the inflammation affects the lining membrane of the whole abdominal cavity. In the last two cases the malady is a very grave one.

_Causes._--The causes are largely the same as those causing inflammation of the v.a.g.i.n.a. Greater importance must, however, be attached to exposure to cold and wet and to septic infection.

_Symptoms._--The symptoms appear two or three days after calving, when the cow may be seen to shiver, or the hair stands erect, especially along the spine, and the horns, ears, and limbs are cold. The temperature in the r.e.c.t.u.m is elevated by one or two degrees, the pulse is small, hard, and rapid (70 to 100), appet.i.te is lost, rumination ceases, and the milk shrinks in quant.i.ty or is entirely arrested, and the breathing is hurried.

The hind limbs may shift uneasily, the tail be twisted, the head and eyes turn to the right flank, and the teeth are ground. With the flush of heat to the horns and other extremities, there is redness of the eyes, nose, and mouth, and usually a dark redness about the v.u.l.v.a. Pressure on the right flank gives manifest pain, causing moaning or grunting, and the hind limbs are moved stiffly, extremely so if the general lining of the abdomen is involved. In severe cases the cow lies down and can not be made to rise.

There is usually marked thirst, the bowels are costive, and dung is pa.s.sed with pain and effort. The hand inserted into the v.a.g.i.n.a perceives the increased heat, and when the neck of the womb is touched the cow winces.

Examination through the r.e.c.t.u.m detects enlargement and tenderness of the womb. The discharge from the v.u.l.v.a is at first watery, but becomes thick, yellow, and finally red or brown, with a heavy or fetid odor. Some cases recover speedily and may be almost well in two days; a large proportion perish within two days of the attack, and some merge into the chronic form, terminating in leucorrhea. In the worst cases there is local septic infection and ulceration, or even gangrene of the parts, or there is general septicemia, or the inflammation involving the veins of the womb causes coagulation of the blood contained in them, and the washing out of the clots to the right heart and lung leads to the blocking of the vessels in the latter and complicating pneumonia. Inflammation of the womb and pa.s.sages after calving are always liable to these complications, and consequently to a fatal issue. Franck records three instances of rapidly fatal metritis in cows, all of which had been poisoned from an adjacent cow with retained and putrid afterbirth. Others have had similar cases.

_Treatment._--Treatment in the slight cases of simple inflammation does not differ much from that adopted for vaginitis, only care must be taken that the astringent and antiseptic injections are made to penetrate into the womb. After having washed out the womb a solution of chlorid of lime or permanganate of pota.s.sium (one-half ounce to 1 quart of water), with an ounce each of glycerin and laudanum to render it more soothing, will often answer every purpose. It is usually desirable to open the bowels with 1-1/2 pounds of Glauber's salt and 1 ounce of ginger in 4 quarts of warm water, and to apply fomentation of warm water or even mustard poultices or turpentine to the right flank.

In the violent attacks with high temperature and much prostration, besides the salts agents must be given to lower the temperature and counteract septic poisoning. Salicylate of soda one-half ounce, or quinia 2 drams every four hours will help in both ways, or ounce doses of hyposulphite of soda or dram doses of carbolic acid may be given as often until six doses have been taken. Tincture of aconite has often been used in 20-drop doses every six hours. If the temperature rises to 106 or 107 F., it must be met by the direct application of cold or iced water to the surface. The animal may be covered with wet sheets and cold water poured on them frequently until the temperature in the r.e.c.t.u.m is lowered to 102 F. In summer the cow may be allowed to dry spontaneously, while in winter it should be rubbed dry and blanketed. Even in the absence of high temperature much good may be obtained from the soothing influence of a wet sheet covering the loins and flanks and well covered at all points by a dry one.

This may be followed next day by a free application of mustard and oil of turpentine. When the animal shows extreme prostration, carbonate of ammonia (1 ounce) may be given to tide over the danger, but such cases usually perish.

In this disease, even more than in difficult and protracted parturition or retained placenta, the attendants must carefully guard against the infection of their hands and arms from the diseased parts. The hand and arm before entering the pa.s.sages should always be well smeared with lard impregnated with carbolic acid.

MILK FEVER (PARTURITION FEVER, PARTURIENT APOPLEXY, OR PARTURIENT COLLAPSE).