BLEEDING; TORSION; CASTRATION, PARTURITION; AND SOME DISEASES
CONNECTED WITH THE ORGANS OF GENERATION.
BLEEDING.
This operation is exceedingly useful in many accidents and diseases. It
is, in fact, as in the horse, the sheet-anchor of the practitioner in
the majority of cases of an inflammatory character. There is some
difference, however, in the instrument to be used. The lancet is the
preferable instrument in the performance of this operation. The fleam
should be banished from among the instruments of the veterinary surgeon.
A ligature being passed round the lower part of the neck, and the head
being held up a little on one side, the vein will protrude on either
side of the windpipe. It will usually be advisable to cut away a little
of the hair over the spot designed to be punctured. When a sufficient
quantity of blood is abstracted, it will generally be necessary, and
especially if the dog is large, to pass a pin through both edges of the
orifice, and secure it with a little tow.
When no lancet is at hand, the inside of the flap of the ear may be
punctured with a pen-knife, the course of a vein being selected for this
purpose. In somewhat desperate cases a small portion of the tail may be
amputated.
The 'superficial brachial vein', the 'cephalic' vein of the human
subject, and the 'plat' vein of the farrier, may be resorted to in all
lamenesses of the fore limb, and especially in all shoulder-wrenches,
strains of the loins, and of the thigh and the leg, and muscular and
ligamentous extensions of any part of the hind limbs; the 'vena saphena
major', and the 'anterior tibial' vein may be punctured in such cases.
The quantity of blood to be abstracted must be regulated according to
the size and strength of the dog and the degree of inflammation.
One or two ounces may be sufficient for a very small dog, and seven or
eight for a large one.
TORSION
To M. Amusat, of Paris, we are indebted for the introduction of the
artery-forceps for the arresting of hemorrhage. I shall do but justice
to him by describing his mode of proceeding. He seizes the divided
vessel with a pair of torsion-forceps in such a manner as to hold and
close the mouth of the vessel in its teeth. The slide of the forceps
then shuts its blade, and the artery is held fast. The artery is then
drawn from out of the tissues surrounding it, to the extent of a few
lines, and freed, with another forceps, from its cellular envelope, so
as to lay bare its external coat. The index and thumb of the left hand
are then applied above the forceps, in order to press back the blood in
the vessel. He then begins to twist the artery. One of the methods
consists in continuing the torsion until the part held in the forceps is
detached. When, however, the operator does not intend to produce that
effect, he ceases, after from four to six revolutions of the vessel on
its axis for the small arteries, and from eight to twelve for the large
ones. The hemorrhage instantly stops. The vessel which had been drawn
out is then replaced, as the surrounding parts give support to the knot
which has been formed at its extremities. The knot becomes further
concealed by the retraction of the artery, and this retraction will be
proportionate to the shortening which takes place by the effect of the
twisting, so that it will be scarcely visible on the surface of the
stump. It is of the utmost importance to seize the artery perfectly, and
to make the stated number of twists, as otherwise the security against
the danger of consecutive hemorrhage will not be perfect.
Mr. W. B. Costello, of London, was present when the operation was
performed at Paris. He brought back a full account of it as performed
there, and availed himself of an early opportunity of putting it to the
test before some of our metropolitan surgeons. A dog was placed on the
table, the forceps were applied, and the operation perfectly succeeded.
A few days afterwards a pointer bitch was brought to my infirmary, with
a large scirrhous tumour near the anterior teat on the left side. It had
been gradually increasing during the last five months. It was becoming
more irregular in its form, and on one of its tuberculous prominences
was a reddish spot, soft and somewhat tender, indicating that the
process of suppuration was about to commence.
I had often, or almost uniformly, experienced the power of iodine in
dispersing glandular enlargements in the neck of the dog, and also those
indurated tumours of various kinds which form about the joints of some
domesticated animals, particularly of cattle; but frequent
disappointment had convinced me that it was, if not inert, yet very
uncertain in its effect in causing absorption of tumours about the mammæ
of the bitch. Having also been taught that the ultimate success of the
excision of these enlargements depended on their removal before
suppuration had taken place, and the neighbouring parts had been
inoculated by the virus which so plentifully flowed from the ulcer, I
determined on an immediate operation; and, as the tumour was large, and
she was in high condition, I thought it a good case for 'the first trial
of torsion'. She was well physicked, and on the third day was produced
before my class and properly secured. I had not provided myself with the
'torsion forceps', but relied on the hold I should have on the vessel by
means of a pair of common artery forceps; and the effect of imperfect
instruments beautifully established the power of torsion in arresting
hemorrhage.
Two elliptical incisions were made on the face of the tumour, and
prolonged anteriorly and posteriorly about an inch from it. The portion
of integument that could be spared was thus enclosed, while the opposed
edges of the wound could be neatly and effectually brought together
after the operation. The dissection of the integument from the remaining
part of the face of the tumour was somewhat slow and difficult, for it
was in a manner identified with the hardened mass beneath; but the
operation soon proceeded more quickly, and we very soon had the scirrhus
exposed, and adhering to the thorax by its base. About two ounces of
venous blood had now been lost.
I was convinced that I should find the principal artery, by which the
excrescence was fed, at its anterior extremity, and not far from the
spot where the suppuration seemed to be preparing: therefore, beginning
posteriorly, I very rapidly cut through the cellular texture, elevating
the tumour and turning it back, until I arrived at the inner and
anterior point, and there was the only source of supply; the artery was
plainly to be seen. In order to give the experiment a fair chance, I
would not enclose it in the forceps, but I cut through it. A jet of
blood spirted out. I then seized the vessel as quickly as I could, and
began to turn the forceps, but before I could effect more than a turn
and a half I lost my hold on the artery. I was vexed, and paused,
waiting for the renewed gush of blood that I might seize the vessel
again; but to my surprise not a drop more blood came from the arterial
trunk. That turn and a half, considerable pressure having been used, had
completely arrested the hemorrhage. I can safely say that not more than
four drachms of arterial blood were lost.
The wound was sponged clean: there remained only a very slight oozing
from two or three points; the flaps were brought together, secured by
the ordinary sutures, and the proper bandages applied. The weight of the
tumour was twenty-two ounces; there was no after-bleeding, no unpleasant
occurrences; but the wound, which had been nearly six inches in length,
was closed in little more than three weeks.
He will essentially promote the cause of science, and the cause of
humanity, who will avail himself of the opportunity which country
practice affords of putting the effect of torsion to the test: and few
things will be more gratifying than the consciousness of rescuing our
patients from the unnecessary infliction of torture.
In docking, it will be found perfectly practicable: our patients will
escape much torture, and tetanus will often be avoided. The principal
danger from castration has arisen from the severity with which the iron
has been employed. The colt, the sheep, and the dog will be fair
subjects for experiment. The cautery, as it regards the first, and the
brutal violence too frequently resorted to in operating upon the others,
have destroyed thousands of animals.
CASTRATION.
This operation is performed on a great portion of our domestic animals.
It renders them more docile, and gives them a disposition to fatten. It
is followed by fewest serious accidents when it is performed on young
animals. The autumn or spring should, if possible, be chosen for the
operation, for the temperature of the atmosphere is then generally
uniform and moderate. It should be previously ascertained that the
animal is in perfect health; and he should be prepared by a mash diet
and bleeding, if he is in a plethoric state, or possessed of
considerable determination. If it is a young animal that is to be
operated upon, an incision may be made into the scrotum, the testicle
may be protruded, and the cord cut without much precaution, for the
blood will soon be stayed; but for older animals it will be advisable to
use a ligature, applied moderately tightly round the spermatic cord a
little more than an inch beyond its insertion into the testicle; the
scalpel is then used, and a separation effected between the ligature and
the testis. The vas derens needs not to be included; a great deal of
pain will then be spared to the animal.
The ordinary consequences of castration are pain, inflammation,
engorgement, and suppuration. The pain and suppuration are inevitable,
but generally yield to emollient applications. The engorgement is often
considerable at first, but soon subsides, and the suppuration usually
abates in the course of a few days. It has been said that the castrated
dog is more attached and faithful to his master than he who has not been
deprived of his genital powers: this, however, is to be much doubted. He
has, generally speaking, lost a considerable portion of his courage, his
energy, and his strength. He is apt to become idle, and is disposed to
accumulate fat more rapidly. His power of scent is also very
considerably diminished and he is less qualified for the sports of the
field. Of this there can be no doubt. It has been said that he is more
submissive: I very much doubt the accuracy of that opinion. He may not
be so savage as in his perfect state; he may not be so eager in his
feeding; but there is not the devotion to his master, and the quickness
of comprehension which belongs to the perfect dog.
The removal of the ovaries, or spaying of the female, used to be often
practised, and packs of spayed bitches were, and still are, occasionally
kept. In performing this operation, an opening is made into the flank on
one side, and the finger introduced--one of the ovaries is laid hold of
and drawn a little out of the belly; a ligature is then applied round
it, just above the bifurcation of the womb, and it is cut through, the
end of the ligature being left hanging out of the wound. The other ovary
is then felt for and drawn out, and excised and secured by a ligature.
The wound is then sewed up, and a bandage is placed over the incision.
Some farriers do not apply any ligature, but simply sew up the wound,
and in the majority of cases the edges adhere, and no harm comes of the
operation, except that the general character of the animal is
essentially changed. She accumulates a vast quantity of fat, becomes
listless and idle, and is almost invariably short-lived.
The female dog, therefore, should always be allowed to breed. Breeding
is a necessary process; and the female prevented from it is sure to be
affected with disease sooner or later; enormous collections and
indurations will form, that will inevitably terminate in scirrhus or
ulceration.
A troublesome process often occurs when the female is not permitted to
have young ones; namely, the accumulation of milk in the teats,
especially if at any previous time, however distant, she may have had
puppies once. The foundation is laid for many unpleasant and
unmanageable complaints. If she is suffered to bring up one litter after
another, she will have better health than those that are debarred from
intercourse with the male.
The temporary union which takes placed between the male and female at
the period at which they are brought together is a very singular one.
The corpora cavernosa of the male and the clitoris of the female being
suddenly distended with blood, it is impossible to withdraw either of
them until the turgescence of the parts has entirely ceased.
PARTURITION
The pupping usually takes place from the sixty-second to the
sixty-fourth day; and the process having commenced, from a quarter to
three quarters of an hour generally takes place between the production
of each puppy.
Great numbers of bitches are lost every year in the act of parturition:
there seems to be a propensity in the females to associate with dogs
larger than themselves, and they pay for it with their lives. The most
neglected circumstance during the period of pregnancy is the little
exercise which the mother is permitted to take, while, in point of fact,
nothing tends more to safe and easy parturition than her being permitted
or compelled to take a fair quantity of exercise.
When the time of parturition has arrived, and there is evident
difficulty in producing the foetus, recourse should be had to the ergot
of rye, which should be given every hour or half hour, according to
circumstances. If after a certain time some, although little, progress
has been made, the ergot must be continued in smaller doses, or perhaps
suspended for a while; but, if all progress is evidently suspended,
recourse must be had to the hook or the forceps. By gentle but continued
manipulation much may be done, especially when the muzzle of the puppy
can be brought into the passage. As little force as possible must be
used, and especially the foetus little broken. Many a valuable animal is
destroyed by the undue application of force.
If the animal seems to be losing strength, a small quantity of laudanum
and ether may be administered.
"The patience of bitches in labour is extreme," says Mr. Blaine; "and
their distress, if not removed, is most striking and affecting. Their
look is at such time particularly expressive and apparently
imploring."
When the pupping is protracted, and the young ones are evidently dead,
the mother may be saved, if none of the puppies have been broken. In
process of time the different puppies may, one after another, be
extracted; but when violence has been used at the commencement, or
almost at any part of the process, death will assuredly follow.
'June' 15, 1832.--A spaniel bitch was brought to my infirmary to-day,
who has been in great and constant pain since yesterday, making repeated
but fruitless efforts to expel her puppies. She is in a very plethoric
habit of body; her bowels are much confined, and she exhibits some
general symptoms of febrile derangement, arising, doubtless, from her
protracted labour. This is her first litter. Upon examination, no young
could be distinctly felt.
Place her in a warm bath, and give her a dose of castor oil, morning and
evening.
'June' 16.--The bitch appears in the same state as yesterday, except
that the medicine has operated freely upon the bowels, and the febrile
symptoms have somewhat decreased. Her strainings are as frequent and
distressing as ever. Take two scruples of the ergot of rye, and divide
into six doses, of which let one be given every half hour.
In about ten minutes after the exhibition of the last dose of this
medicine, she brought forth, with great difficulty, one dead puppy, upon
taking which away from her, she became so uneasy that I was induced to
return it to her. In about a quarter of an hour after this I paid her
another visit: the puppy could not now be found; but a suspicious
appearance in the mother's eye betrayed at once that she had devoured
it. I immediately administered an emetic; and in a very short time the
whole foetus was returned in five distinct parts, viz., the four
quarters and the head. After this, the bitch began to amend very fast;
she produced no other puppy; and as her supply of milk was small, she
was soon convalescent.
Twelve months afterwards she was again taken in labour, about eleven
o'clock in the morning, and after very great difficulty, one puppy was
produced. After this the bitch appeared in great pain, but did not
succeed in expelling another foetus, in consequence of which I was sent
for about three o'clock, P.M. I found her very uneasy breathing
laboriously; the mouth hot, and the bowels costive; but I could not
discover any trace of another foetus. She was put into a warm bath, and
a dose of opening medicine was administered.
About five o'clock she got rid of one dead and two living puppies.
'2d'. She is still very ill; she evinces great pain when pressed upon
the abdomen; and it is manifest that she has another foetus within her.
I ordered a dose of the ergot, and in about twenty minutes a large puppy
was produced, nearly dying. She survived with due care.
I cannot refrain from inserting the following case at considerable
length.
'Sept.' 4, 1820.--A very diminutive terrier, weighing not 5 lbs. was
sent to my hospital in order to lie in. She was already restless and
panting. About eight o'clock at night the labour pains commenced; but
until eleven scarcely any progress was made. The 'os uteri' would not
admit my finger, although I frequently attempted it.
At half-past eleven, the membranes began to protrude; at one the head
had descended into the pelvis and the puppy was dead. In a previous
labour she had been unable to produce her young, although the ergot of
rye had been freely used. I was obliged to use considerable force, and
she fought terribly with me throughout the whole process. At half-past
one, and after applying considerable force, I brought away a large
foetus, compared with her own size. On passing my finger as high as
possible, I felt another foetus living, but the night passed and the
whole of the following day, and she ate and drank, and did not appear to
be much injured.
Several times in the day I gave her some strong soup and the ergot. Some
slight pains now returned, and by pressing on the belly the nose of the
foetus was brought to the superior edge of the pelvis. The pains again
ceased, the pudenda began to swell from frequent examination, the bitch
began to stagger, and made frequent attempts to void her urine, with
extreme difficulty in accomplishing it. I now resorted to the crotchet;
and after many unsuccessful attempts, in which the superior part of the
vagina must have been considerably bruised, I fixed it sufficiently
firmly to draw the head into the cavity of the pelvis. Here for a while
the shoulder resisted every attempt which I could make without the
danger of detruncating the foetus. At length by working at the side of
the head until my nails were soft and my fingers sore, I extracted one
fore leg. The other was soon brought down; another large puppy was
produced, but destroyed by the means necessary for its production. This
was the fruit of two hours' hard work.
She was completely exhausted, and scarcely able to stand. When placed on
the ground she staggered and fell at almost every step. Her efforts to
void her urine were frequent and ineffectual.
At four o'clock I again examined her; the external pudenda were sore and
swelled, and beginning to assume a black hue. It was with considerable
difficulty that I could introduce my finger. A third foetus irregularly
presented was detected. I could just feel one of the hind legs. No time
was to be lost. I introduced a small pair of forceps by the side of my
finger, and succeeded in laying hold of the leg without much difficulty,
and, with two or three weak efforts from the mother,--I could scarcely
call them pains,--I brought the leg down until it was in the cavity of
the pelvis. I solicited it forward with my finger, and, by forcibly
pressing back the 'labia pudendi', I could just grasp it with the finger
and thumb of the right hand. Holding it there, I introduced the finger
of the right hand, and continued to get down the other leg, and then
found little difficulty until the head was brought to the superior edge
of the pelvis. After a long interval, and with considerable force, this
was brought into the pelvis, and another puppy extracted. This fully
occupied two hours.
The bitch now appeared almost lifeless. As she was unable to stand, and
seemed unconscious of every thing around her, I concluded that she was
lost: I gave her one or two drops of warm brandy and water, covered her
up closely, and put her to bed.
To my surprise, on the following morning, she was curled round in her
basket; she licked my hands, and ate a bit of bread and butter; but when
put on her legs staggered and fell. The pudendum was dreadfully swollen,
and literally black. In the afternoon she again took a little food: she
came voluntarily from her basket, wagged her tail when spoken to, and on
the following day she was taken in her basket a journey of 70 miles, and
afterwards did well; no one could be more rejoiced than was her master,
who was present at, and superintended the greater part of the
proceedings.
'The beneficial effect of Ergot of Rye in difficult Parturition'.--The
following case is from the pen of Professor Dick:
On the 10th instant, a pointer bitch produced two puppies; and it was
thought by the person having her in charge that she had no more. She was
put into a comfortable box, and with a little care was expected to do
well. On the next morning, however, she was sick and breathed heavily,
and continued rather uneasy all the day.
On the forenoon of the following day I was requested to see her. I found
her with her nose dry, breath hot, respiration frequent, mouth hot and
parched, coat staring, back roached, pulse 120, and a black fetid
discharge from the vagina. Pressure on the abdomen gave pain. A pup
could be obscurely felt; the secretion of milk was suppressed, and the
skin had lost its natural elasticity.
Tepid water with a little soap dissolved in it was immediately injected
into the uterus, which in a considerable degree excited its action; and
this injection was repeated two or three times with the same effect.
After waiting for half an hour, the foetus was not discharged nor
brought forward; therefore a scruple of the ergot of rye was then made
into an infusion with two ounces of water, and one-third of it given as
a dose; in half an hour, another one-third of it; the injections of warm
water and soap being also continued. Soon after the second dose of the
infusion, a dead puppy was expelled; the bitch rapidly recovered, and,
with the exception of deficiency of milk, is now quite well.
This case would seem to prove the great power of the ergot of rye over
the uterus; but, until more experiments are made, it is necessary to be
cautious in ascribing powers to medicines which have not been much tried
in our practice. It is not improbable that the warm water and soap might
have roused the uterus into action without the aid of the ergot; and it
is therefore necessary that those who repeat this experiment should try
the effects of the medicine unaided by the auxiliary.
The Professor adds, that the great power which this drug is said to have
on the human being, and the apparent effect in the case just given,
suggest the propriety of instituting a further trial of it, and of our
extending our observations to cattle, amongst which difficult cases of
calving so frequently occur.
Mr. Simpson thus concludes some remarks on ergot in difficult
parturition. This medicine possesses a very great power over the uterus,
rousing its dormant or debilitated contractility, and stimulating it to
an extra performance of this necessary function after its natural energy
has been in some measure destroyed by forcible but useless action. The
direct utility of the ergot was manifested in cases where the uterus
appeared quite exhausted by its repeated efforts; and certainly it is
but fair to ascribe the decidedly augmented power of the organ to the
stimulus of the ergot, for no other means were resorted to in order to
procure the desired effect. Its action, too, is prompt. Within ten
minutes of the administration of a second or third dose, when nature has
been nearly exhausted, the parturition has been safely effected.
'Puerperal Fits'.
Nature, proportions the power and resources of the mother to the wants
of her offspring. In her wild undomesticated state she is able to suckle
her progeny to the full time; but, in the artificial state in which we
have placed her, we shorten the interval between each period of
parturition, we increase the number of her young ones at each birth, we
diminish her natural powers of affording them nutriment, and we give her
a degree of irritability which renders her whole system liable to be
excited and deranged by causes that would otherwise be harmless:
therefore it happens that, when the petted bitch is permitted to suckle
the whole of her litter, her supply of nutriment soon becomes exhausted,
and the continued drain upon her produces a great degree of
irritability. She gets rapidly thin; she staggers, is half unconscious,
neglects her puppies, and suddenly falls into a fit of a very peculiar
character. It begins with, and is sometimes confined to, the respiratory
apparatus: she lies on her side and pants violently, and the sound of
her laboured breathing may be heard at the distance of twenty yards.
Sometimes spasms steal over her limbs; at other times the diaphragm and
respiratory muscles alone are convulsed. In a few hours she is certainly
lost; or, if there are moments of remission, they are speedily succeeded
by increased heavings.
The practitioner unaccustomed to this fearful state of excitation, and
forgetful or unaware of its cause, proceeds to bleed her, and he seals
her fate. Although one system is thus convulsively labouring, it is
because others are suddenly and perfectly exhausted; and by abstraction
of the vital current he reduces this last hold of life to the helpless
condition of the rest. There is not a more common or fatal error than
this.
The veterinary practitioner is unable to apply the tepid bath to his
larger patients, in order to quiet the erythism of certain parts of the
system, and produce an equable diffusion of nervous influence and
action; and he often forgets it when he has it in his power to save the
smaller ones. Let the bitch in a fit be put into a bath, temperature 96°
Fahrenheit, and covered with the water, her head excepted. It will he
surprising to see how soon the simple application of this equable
temperament will quiet down the erythism of the excited system. In ten
minutes, or a quarter of an hour, she may be taken out of the bath
evidently relieved, and then, a hasty and not very accurate drying
having taken place, she is wrapped in a blanket and placed in some warm
situation, a good dose of physic having been previously administered.
She soon breaks out in a profuse perspiration. Everything becomes
gradually quiet, and she falls into a deep and long sleep, and at length
awakes somewhat weak, but to a certain degree restored.
If, then, all her puppies except one or two are taken from her, and her
food is, for a day or two, somewhat restricted, and after that given
again of its usual quantity and kind, she will live and do well; but a
bleeding at the time of her fit, or suffering all her puppies to return
to her, will inevitably destroy her.
A bitch that was often brought to my house was suckling a litter of
puppies. She was foolishly taken up and thrown into the Serpentine in
the month of April. The suppression of milk was immediate and complete.
There was also a determination to the head, and attacks resembling
epilepsy. The puppies that were suffered to remain with the mother, were
very soon as epileptic as she was, and were destroyed. A seton was
inserted on each side of her neck. Ipecacuanha was administered; and
that having sufficiently worked, a small quantity of diluted sulphuric
acid was given. A fortnight afterwards she was perfectly well.
'Inversion of the Uterus in a Bull Bitch after Pupping. Extirpation
and Cure.'
By M. Cross, M. V., Milan.--In July, 1829, I was desired to attend a
small bull bitch six years old, and who had had puppies four times. The
uterus was completely inverted, and rested all its weight on the vaginal
orifice of the urethra, preventing the discharge of the urine, and thus
being the cause of great pain when the animal endeavoured to void it, or
the faecal matter. The uterus was become of almost a black colour,
swelled, softened, and exhaling an insupportable odour. Judging from
this that the preservation of the uterus was impossible, and reckoning
much on the good constitution of the patient, I warned the proprietor of
the danger of its reduction, even supposing that it was practicable, and
proposed to him the complete extirpation of the uterus as the only means
that remained of saving the bitch.
Armed with his consent, I passed a ligature round the neck of the
uterus, at the bottom of the vagina, and drew it as tight as I possibly
could. On the following day I again tightened the ligature, in order to
complete the mortification of the part, and the separation of the womb.
On the third day I extirpated the womb entirely, close to the haunch.
There was very slight loss of blood, but there ran from the walls of the
vagina a small quantity of ichorous fluid, with a strong fetid smell.
The operation was scarcely completed ere she voided a considerable
quantity of urine, and then searched about for something to eat and to
drink.
The portion of the uterus that was removed weighed fourteen ounces. The
mucous membrane by which it was lined was in a highly disorganized
state. From time to time injections of a slight infusion of aromatic
plants were introduced into the vagina, and the animal was nourished
with liquid food of easy digestion.
The first day passed without the animal being in the slightest degree
affected; but, on the following day, in despite of all our care, an
ichorous fluid was discharged, which the dog would lick notwithstanding
all our efforts to prevent it. The general health of the animal did not
seem to be in the slightest degree affected.
On the fourth day after the operation, the cords that had served as a
ligature fell off, and all suppuration from the part gradually ceased.
'October 20th'.--Three months have passed since the operation, and she
is perfectly well.
* * * * *