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 TORSION OF THE UTERUS.

Although torsion of the uterus is a condition more particularly

pertaining to the domain of obstetrics, a few remarks on the subject
may not be altogether out of place at this point.
The accident is commonest in the cow, but it has also been
described in the mare, ewe, bitch and cat, and it probably occurs,
though less frequently, in the other domestic animals. In the cow it is
commonest during the last month of pregnancy.
Very little is known as to its cause, though the consensus of
opinion—if any consensus can be said to exist in face of the existing
divergent views—appears rather to indicate that it follows falls in
awkward positions, sudden efforts, severe prolonged exertion, or
tympanites.
In pregnant cows the uterus assumes the appearance of a
pendulous organ the body and horns of which constitute the bob of
the pendulum, whilst the ligaments represent the cords by which it is
suspended. The fixed points are formed by the insertions of the two
ligaments in the neighbourhood of the two external iliac angles.
The uterus, however, is also steadied in position by the vagina and
by the cellular tissue surrounding it; in fact, in non-pregnant animals
it can scarcely be regarded as pendulous, but rather as freely floating
and readily yielding to the movements of the surrounding organs.
As soon as the uterus is occupied by a fœtus, however, the
conditions become changed. In consequence of the increased weight
of its contents the uterus exerts a pull on the broad ligaments and
sinks lower in the abdominal cavity. The vagina and the surrounding
connective tissue are rendered tense to a degree depending on the
increasing weight of the calf. The uterus then more closely resembles
a pendulum, the bob being represented by the fœtus and its
envelopes. The suspensory apparatus can be divided into three parts,
viz., the two broad ligaments and the tissue connecting the uterus to
the vagina.
The pull on the vagina increases greatly as soon as the gravid
uterus is twisted either to the right or left, for, torsion being attended
with more or less extensive displacement towards the lower
abdominal wall, the tension on the vagina must become more
marked.
Considering now how the spiral folds and the constrictions which
are of such importance in diagnosis are formed, we find that both
structures, viz., the wall of the uterus and the ligaments, are
implicated, though to different degrees. Whilst the spiral folds are
more particularly formed by the wall of the uterus, the broad
ligaments are chiefly responsible for the constrictions, though to
some extent the spiral folds also contribute to their production. The
spiral folds of the body of the uterus are formed solely by twisting of
its own walls. This can easily be shown by taking any tubular organ
whose walls are not too rigid, and twisting it round its horizontal
axis.
The broad ligaments contribute less to the formation of the spiral
folds, though they play a more important part in producing
constrictions and thus in compressing the wall of the uterus.
The symptoms are ill-defined. Sometimes there is difficulty in
micturition, but as a rule little evidence exists of any abnormal
condition until the advent of labour pains. The first pains, which are
usually feeble and separated by rather long intervals, are succeeded
by colic. The succeeding efforts steadily become more violent and
frequent, but the “water-bag” fails to appear, and in a period varying
between twelve and forty-eight hours the pains subside. Rumination
is at first suspended, the pulse and respiration are accelerated, and
the surface temperature is irregular.
If treatment is not undertaken similar symptoms, but of
exaggerated intensity, may again appear in from one to six days.
Failing relief death always follows after a varying interval.
The diagnosis is not difficult, provided the maternal passages be
examined. On passing a carefully lubricated hand into the vagina the
operator discovers, at a varying distance from the os uteri, signs of
collapse and twisting of the canal. In cases of quarter twist it is often
possible, by rotating the hand so as to follow the spiral folding of the
vagina, to introduce the fingers as far as the os uteri; but in half or
complete rotation only one or two fingers can be passed so far, or it
may be altogether impossible to reach the os.
 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.

TUMOURS OF THE OVARY.

We might repeat in regard to tumours of the ovary what has just

been said as regards those of the uterus, though the former are much
commoner than the latter.
Clinically, ovarian tumours may be grouped under two heads, solid
tumours and cystic tumours—the first represented by the fibromata,
fibro-sarcomata and epitheliomata, the second by uni- or multi-
locular cysts.
All these tumours are dangerous; they may develop rapidly, and
they rarely fail to produce disturbance, the animals presenting
various genital troubles, among which may be mentioned sterility
and nympho-mania.
 The cystic tumours, which develop at the expense of epithelial
invaginations of the peritoneal covering or at the expense of Pflüger’s
tubes, and not, as was formerly believed, by the morbid development
of the Graafian vesicles, constitute dangerous growths, true cysto-
epitheliomata or cystic epitheliomata, capable of producing fatal
complications (vascular disturbance, local or general peritonitis,
compression of the ureters, etc.).
The diagnosis must be arrived at by vaginal and rectal
examination. It is usually possible to distinguish the condition from
disease of the kidney, bladder, or pelvic lymphatic glands.
Treatment. The only possible treatment is removal of the
diseased ovary and of the ovarian tumour, but much depends on
circumstances. If a large tumour has formed extensive adhesions,
ablation may be impracticable or so dangerous that under the
circumstances in which veterinary practitioners are forced to operate
it cannot be undertaken. If, on the contrary, the ovarian growth is
free and pedunculated, even though of large size, extirpation is
possible.
The method is exactly similar to that of castration of the cow, and
follows the same rules, but the vaginal incision has to be much
longer, so as to allow the entire hand to be passed as far as the
tumour. The pedicle is divided by means of the écraseur, which
should be worked very slowly. In removing very large tumours,
however, it is possible to operate from the flank.

GENITAL MALFORMATIONS.

IMPERFORATE VAGINA.

Many forms of genital malformation occur, but only those which

produce sterility are pathologically important.
One alone causes very marked disturbance, viz., imperforate
vagina. This condition may be accidental or acquired, and may follow
either difficult parturition, with circular lesions of the vagina, or
burns or cauterisation of the vagina, followed by adhesion of its
walls.
 It is generally of congenital origin, and the obstruction as a rule is
in the region of the hymen, as a consequence of some anomaly in
development, and not of abnormal development of the hymen itself.
This imperforate condition of the vagina is not attended by grave
consequences during early life; but later, when the generative
functions become active, all the products of secretion of the uterine
and vaginal mucous membranes accumulate in the closed cavity,
giving rise first to muco-metritis, then to muco-kolpitis, similar in its
development to the hæmato-kolpitis of young girls. The uterus
gradually becomes distended with liquid, the neck is dilated, and a
portion of the vagina may attain enormous dimensions, so much so
as to suggest pregnancy.
Symptoms. The symptoms become appreciable only after a time
—about one year or fifteen months in heifers—and they seem to be
associated with the appearance of œstrum. The animals make
continued expulsive efforts, which when the genital canal is much
distended may become extremely violent. There is also dysuria as a
consequence of compression, together with uterine and vesical colic,
loss of appetite and wasting.
Diagnosis. The diagnosis requires care, and can only be arrived
at after examination of the vagina and examination per rectum. In
young females this examination is extremely difficult, because of the
narrowness of the genital tract and of the rectum. For vaginal
examination we prefer to use a small speculum, which exposes the
depths of the vagina or the transverse septum without necessitating
other manipulation. On rectal examination the uterus and vagina are
sometimes found to be enormously enlarged, and to contain a
quantity of fluid, but no fœtus.
Fig. 235.—Imperforate vagina: position and appearance of the genital organs. Cu
Distended uterine horns (muco-metritis); Va, dilated extremity of the vagina; Ve,
bladder, distended with urine, owing to compression of the urethra. The hymen
was situated about 1¼ to 1½ inches in front of the meatus urinarius.

Prognosis. The prognosis is grave. Unless treatment is

undertaken the animals die in consequence of exhaustion or
secondary peritonitis.
The treatment is simple, and consists in aseptic puncture of the
septum and evacuation of the contents. The operation is carried out
with a long, large-sized trocar, which is passed through the centre of
the most prominent portion of the transverse septum where it
projects towards the vulva. Five, ten, or fifteen quarts of mucous
fluid escape, and the constitutional disturbance disappears almost
instantly.
Antiseptic precautions are necessary in order to avoid the
development of secondary pyo-metritis. The artificial orifice can
afterwards be gradually dilated to allow free exit to the discharges,
but in practice, as the animals cannot be used for breeding purposes,
they are usually fattened for slaughter.
 NYMPHO-MANIA.

The term “nympho-mania” is employed to describe a special

condition in female animals which is manifested by continual sexual
excitement. The animals are almost always sterile. The disease is
most frequent in cows.
Causation. This general condition may depend on one of many
causes, but is rarely due to a true neurosis, as was once believed.
Some morbid influence of genital origin is always responsible for the
appearance of the symptoms.
Nympho-mania, therefore, often co-exists with lesions of the
ovaries (simple ovaritis, cystic ovaritis, tumours of the ovary), with
lesions of the Fallopian tubes and of the uterus (salpingitis, chronic
metritis and tumours of the uterus), with chronic vaginitis and
lesions of the clitoris (hypertrophy and tumour formation), and even
with peri-vaginal or peri-uterine lesions (cysts or tumours).
In exceptional cases it may be found occurring as a simple nervous
disturbance without genital lesion, and it would then appear to be
due to some temporary genital affection having produced nervous
irritation.
In short, nympho-mania may be considered as almost invariably
the result of a genital lesion.
Symptoms. The symptoms are very clearly marked. They consist
in persistence of the sexual appetite, which is quite abnormal in
female domestic animals. The patients lose flesh, feed badly and
irregularly, annoy their fellows, cause accidents, and sometimes
become dangerous.
Diagnosis. The diagnosis of nympho-mania is so simple that the
condition is generally recognised by the owners or cow-herds. The
only difficult point lies in discovering the exact cause. Complete
examination of the genital organs per rectum and per vaginam is
absolutely necessary to settle this question.
Prognosis. From an economic standpoint the prognosis is
generally grave.
Treatment. The treatment varies considerably, according to the
nature of the lesion.
 In mild cases where nympho-mania is due to some lesion of the
clitoris (balanitis, hypertrophy, or tumour formation), the radical
treatment consists in clitoridectomy. The operation is comparatively
slight, the organ being removed with forceps and scissors, or with a
bistoury after the animal has been hobbled or placed in a trevis. The
hæmorrhage which follows removal of the clitoris is of little
importance, and after-treatment simply consists in keeping the parts
clean.
Animals so treated can sometimes be preserved for breeding.
When nympho-mania co-
exists with, and is a delayed
consequence of, either
chronic vaginitis or metritis
localised in the neck of the
uterus, or, again, chronic
metritis of the cavity of the
uterus, etc., the treatment
must be directed against
these diseases, and the
nervous condition may be
sufficiently modified to
render the animals useful for
breeding, or at least for
slaughter, while fattening is
easy.
Similarly, when the
nervous condition results
from a lesion of the ovary,
improvement will only follow
removal of the diseased part.
The operation is similar to Fig. 236.—Specimen of lesions found
that of castration of the in nympho-mania. V, Vagina laid
female. It presents, however, open; Cu, neck of the uterus; O, O,
certain added difficulties, in ovaries; Cd, right horn of the uterus;
consequence of the size of Cg, left horn of the uterus; K, K, K,
the organs and of the peri-uterine cysts.
abnormal adhesions which
often occur. Nevertheless, these difficulties are seldom
insurmountable.
In the case of peri-uterine disease operation is difficult, and it is
better to slaughter the animal.
Finally, as may occasionally happen, should there be no congenital
lesion capable of explaining the appearance of nympho-mania, the
disease may be regarded as a neurosis, and may then be treated by
such sedatives as the bromides of potassium, sodium and strontium,
in doses of 2 to 3 drachms per day, divided into two or three
portions. Bromide of camphor also gives excellent results by acting
simultaneously on the nervous system and calming excessive genital
irritation.
The above method of treatment is much preferable to performing
clitoridectomy, or ovariotomy as a kind of panacea, although certain
writers have suggested these operations without taking into account
the special local conditions.
 CHAPTER V.
DISEASES OF THE MAMMARY GLANDS.

In animals used for the purpose of providing milk, viz., cows,

goats, and milch ewes, diseases of the mammary glands are of daily
occurrence, but are rare in those in which the mammary function is
limited to the nourishment of the young, such as the mare, female
ass, sow, etc.
In order clearly to understand the development of these diseases,
it is necessary to bear in mind the anatomical construction of the
organs, for which purpose we may take as a type the mammary gland
of the cow, which is the most complicated.
The udder of the cow is of hemispherical shape. It is situated in the
inguinal region, and is composed of two parts, the right and left,
which are absolutely independent and can easily be isolated from
each other along the median plane throughout their extent. The mass
of parenchyma is enveloped in a fibrous envelope, which is covered
with a very loose layer of subcutaneous connective tissue. Each half
is subdivided into two quarters, an anterior and a posterior quarter.
Each quarter again represents a distinct gland, although anatomical
separation between the anterior and the corresponding posterior
quarter would be almost impossible, the separating fibro-connective
partition being common to both glands.
In very good milkers it sometimes happens that two small
supplementary glands may be found behind the posterior quarters,
bringing up the total number to six.
Parenchyma.—Each of these glands is provided with a teat
containing a large sinus. Anatomically the mamma consists of
glandular tissue arranged like a bunch of grapes, in which the active
tissues of the acini deliver their secretion into little excretory canals,
which unite, forming a large collecting plexus. The collecting canals,
or galactophorous canals, open into the galactophorous sinus, which
occupies the entire depth of the teat and communicates with the
exterior by a small pore provided with a sphincter. The interacinous
connective tissue of the udder and the subcutaneous tissue of the
teat, which envelops the galactophorous sinus, is extremely rich in
elastic fibres, enabling the organ to undergo great changes in volume
without injury.
Vessels.—The mammæ are supplied by two great arteries, the
mammary arteries, which are given off from the prepubic arteries,
pass into the inguinal canal, and penetrate the gland by its upper,
deep face. Each principal lateral artery divides into two trunks, one
for the anterior, the other for the posterior quarter.

Fig. 237.—Schema showing the structure and organisation of the

udder. Antero-posterior section showing the arrangement of the
anterior and posterior quarters and the teats, skin, transverse
partition, etc. GRM, Retro-mammary lymph gland; Lp. lymphatics of
the posterior quarter; La, lymphatics of the anterior quarter; LE,
efferent lymphatics; AM, mammary artery; VM, mammary vein;
VMa, anterior mammary vein (subcutaneous abdominal vein); C,
transverse intermammary septum.

The veins which collect the blood from the mammæ form two
systems, the first accompanying the mammary arteries, the second,
more superficial, giving rise to the anterior subabdominal mammary
veins. The arterio-venous plexus of the udder, which represents the
vascular pedicle of the organ, penetrates the gland, near a line
dividing the posterior and middle thirds of the upper surface, an inch
or so in front of the mammary lymphatic gland.
Lymphatics.—On either side of the middle line lies an extremely
rich lymphatic plexus, the origin of which is to be found near the
ends of the teats and in the peri-acinous spaces.
The superficial collecting vessels are dispersed under the skin,
perforate the fibrous sheath towards the base of the teat, and
anastomose with one another on the surface of the gland, the
anastomosis being most intimate between those of the same quarter,
finally emptying separately by two large trunks into the retro-
mammary lymphatic gland of the same side.
The vessels of the anterior quarter enter the lymphatic gland at its
most anterior point; those of the posterior quarter join it a little
below.
The retro-mammary lymphatic glands are two in number, and are
situated very high and towards the back, above the posterior quarters
and close to the perineum, outside the fibrous envelope of the gland.
They are sheltered in a recess excavated within the depths of the
gland itself. The main collecting lymphatics from the anterior and
posterior quarters enter it separately.
The lateral efferent vessels are divided into two groups, one of
which ascends vertically in the perineal region, towards the
lymphatic glands round the anus; the other passes through the
inguinal canal towards the sublumbar region, together with the
blood-vessels.
The mammary nerves are two in number. The anterior has a
downward course outside the fibrous envelope and supplies the teat;
the posterior nerve is similarly distributed. In other domestic female
animals which have only two mammæ the general arrangement is
precisely the same.

PHYSIOLOGICAL ANOMALIES.
 Imperforate condition of the Teat.—It sometimes happens
that although the udder is otherwise well formed, the teats, or more
frequently a single teat, proves to be imperforate. Between the
galactophorous sinus and the exterior, opposite the sphincter, a little
membrane may be found which closes the teat and entirely prevents
the contents of the udder from escaping. Its existence is only
discovered when the animal first calves and lactation commences.
Not a drop of milk can be withdrawn, although the udder is swollen.
Local examination readily reveals the defect.
Treatment is very simple and effective, the membrane being
perforated with the end of a milk catheter.
Contraction of the Sphincter (Atresia of the Extremity of the
Teat).—Under other circumstances the teat may present a distinct
perforation, and yet milking may be impossible, or at all events may
be extremely difficult. This is sometimes due to contraction of the
sphincter, or possibly to atresia of the orifice.
The diagnosis of this condition is easy, but the outlook is not
promising.
Treatment is rather difficult. Some operators recommend
dividing the terminal sphincter with a small, specially formed
bistouri caché, provided with two cutting points. The operation has
very satisfactory immediate results, but after the little wounds so
produced have healed, cicatricial contraction takes place around the
orifice.
Forcible dilatation is far preferable. It is carried out in the same
way as in human medicine, where the sphincter ani or the orifice of
the uterus has to be dilated. No superficial lesion and no incision is
produced; the result is therefore more permanent (see “Operative
Technique”).

WOUNDS OR TRAUMATIC LESIONS.

CHAPS AND CRACKS.

These injuries consist in little transverse or oblique wounds of the

teat.
 Causation. In free milkers the udder appears completely relaxed
after milking. In the intervals between the different milkings,
however, the quarters become swollen, and are sometimes so
distended as to overcome the resistance of the sphincter at the base
of the teat. The teats are then greatly elongated, and, despite the
richness of the tissues in elastic fibres, this distension leads to little
superficial epidermic fissures.
These small lesions are unimportant, but if they become infected
by contact with the litter they granulate and suppurate, so that grave
complications may eventually follow.
The wounds caused by the calves’ teeth when sucking, or simply by
the rough way in which the little animal seizes the teat, may produce
similar accidents.
Symptoms. The teat shows one or more little transverse fissures,
a few millimètres to a centimètre or more in length. The base of the
fissure appears of a reddish or brownish-red colour, and has
thickened, indurated, painful, discharging or suppurating margins.
Local sensitiveness may be either slight or very pronounced. In the
latter case, the patients resist being milked, and even refuse to let the
calf suck.
Diagnosis. The diagnosis is extremely simple.
In a general sense the prognosis is favourable, but nevertheless
the local infection may extend and become generalised, thus giving
rise to interstitial mammitis, sometimes of a very grave character. On
the other hand, the sensitiveness may of itself render milking
difficult or impossible, and thus cause serious distension of the gland
with milk.
Treatment. As both sucking and milking aggravate the lesions,
they should be prevented by the insertion of a milk catheter.
The surface of the udder and the wounds should be cleansed with
an antiseptic solution and be dressed with a 20 per cent.
camphorated vaseline or with carbolic or iodoform ointment, to
favour healing. If the cracks produce excessive sensitiveness a small
quantity of orthoform may be added to the camphor ointment.
Before the milk catheter is inserted, the teat should be very carefully
cleansed with boiled water and the catheter sterilised by boiling.
Neglect of these precautions may result in infection of the
galactophorous sinus and mammitis.

MILK FISTULÆ.

Causation. Any accidental injury to the udder which establishes

connection between the galactophorous canals or the galactophorous
sinus and the exterior may give rise to milk fistulæ, if the injury
occur during lactation.
Apart from lactation these wounds may be grave, though if
carefully treated they heal without complication. During lactation, on
the contrary, the milk escapes permanently from the injured spot,
cicatrisation cannot occur, and a fistula forms.

Fig. 238.—Milk fistulæ. 1, Deep suture—schema showing the course

of the suture; FL, base of the fistula; S, suture; 2, superficial
interrupted suture.

Symptoms. The principal symptom is the permanent discharge

of milk. The fistula may be large or small, according to
circumstances. In rare instances it is situated on the udder itself, but
it is commonest on the teat. Milk may escape in mere drops or, on
the other hand, in considerable quantities.
Diagnosis. The diagnosis presents no difficulty.
Prognosis. The prognosis is grave so far as the loss of milk is
concerned, although the lesion has no effect on the general health. It
is particularly serious, however, because it may cause the interior to
become infected, and an acute parenchymatous mammitis may thus
be set up. It must also be borne in mind that old fistulæ are much
more difficult to obliterate than recent ones.
Treatment is much more troublesome than might at first be
thought, the great obstacle to repair being the continual secretion
and discharge of milk.
At first, attempts should be made to re-establish and render
permanent the natural method of discharge. This can be effected by
inserting an aseptic milk catheter and fixing it in position with a little
pitch bandage.
The course of the fistula is then cleansed, curetted, and rendered
aseptic in some way, as for example by washing with boiled salt
solution and dilute hydroxyl.
As there is little hope of obliterating the fistula by merely suturing
the skin, its course should first be closed by passing one or two deep
sutures without touching the external orifice and without passing
over it (Fig. 238). The discharge of fluid being then entirely stopped,
the external portion of the fistula is thoroughly cleansed, powdered
with iodoform, and finally closed with external, closely-applied
sutures. These sutures are protected with a little cotton wool or
collodion dressing, and healing then almost invariably occurs.
The animal should be given a very clean bed, and closely watched
to prevent it tearing out the milk catheter. On the fourth or fifth day
the catheter is removed, and is afterwards only used at intervals.
As all the sutures can be of aseptic catgut or silk, there is no
necessity to trouble about their removal. The dressing can be left
until it falls away of itself.

INFLAMMATORY DISEASES.
 CONGESTION OF THE UDDER.

Congestion—i.e., distension of the vascular plexus as a

consequence of momentary stasis, vaso-motor disturbance, or
paralysis of the little vessels in the udder—can only be regarded as
pathological in cases when it precedes mammitis or when it results
from prolonged neglect to milk the animal, external irritation, etc. It
was studied long ago by H. d’Arboval, Gellé, Delafond, Trasbot,
Lucet, etc.
It also occurs, but in a form which might almost be termed
physiological, after the first parturition in the large milch breeds,
where the rush of blood which precedes secretion is very great.
Symptoms. The udder is swollen, tense, doughy, shining, and
œdematous, not very painful on pressure, but sufficiently so to
interfere with movement. The general condition is little altered, but
the temperature of the udder is abnormally high.
Manipulation reveals the existence of more or less œdema, the
parts preserving the imprint of the finger. Sometimes this œdema
extends along the abdominal wall in front of the udder. The milk may
be grumous or even sanguinolent. The congestive state continues for
some days, eight to ten at the most, and may gradually disappear by
resolution. Not infrequently it terminates in acute mammitis after
forty-eight hours.
Lesions. In simple mammary congestion the lesions are confined
to excessive dilatation of the peri-acinous capillary vessels, and
extravasation into the connective tissue. On section the tissue has a
dark-red appearance.
Diagnosis. The diagnosis is simple.
Prognosis. The prognosis is less alarming than might at first
sight be supposed.
The treatment consists simply in hygienic precautions, frequent
milking, emollient, sedative applications to the udder, and frequent
washing. As far as possible the use of milk catheters should be
avoided.
Boric vaseline and belladonna ointment may be recommended. In
very serious cases blood can be withdrawn from the jugular. This is
better than bleeding from the mammary vein, which always entails
the risk of thrombus formation.

MAMMITIS.

Under the heading “mammitis” are included different forms of

inflammation of the mammary tissue, whether such inflammation
attack the parenchyma of the gland or the interstitial tissue.
Generally the whole gland is invaded at the end of a few days,
whatever the point of origin, and the inflammation is therefore of a
mixed character.
Mammitis has been recognised from very early times. In his
researches on “contagious mammitis” Nocard in 1884 showed that
infection was the principal factor in its evolution.
Numerous classifications, based on the causes or on the
pathological anatomy of the condition, have been suggested; but
most appear too rigid, and therefore, without discussing them, we
confine ourselves to giving the following résumé:—