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Ohe
STERILITY OF COWS

Its Causes and Treatment

BY
DR. J. ALBRECHTSEN

Veterinarian
Aakirkeby, Bornholm, Denmark

8B

English Translation by
DR. H. WEHRBEIN

Late Specialist for Infectious Abortion Investigations
U.S. Bureau of Animal Industry
Washington, D. C.

&

CHICAGO, U.S.A.

ALEXANDER EGER

PUBLISHER

1917

Lobos

No. 2225

COPYRIGHTED AT WASHINGTON, D. C.

ALEXANDER EGER
1917
“at va ~
ug so .

Pretace of the Author.

In Denmark, as elsewhere, losses caused by the sterility
of cows are the object of persistent complaints among stock-
raisers. In my country especially, where the raising of milk
cattle is one of the chief economical resources, this path-
ological condition is of prime importance.

Working as a practitioner with many cases of sterile
cows, I was successful in working out a technique, which
enables me to eliminate those losses to a considerable extent,
even to make them insignificant.

This treatise contains my experience in the treatment of
the sterility of cattle: it does not claim to be an exhaustive
scientific elaboration on the subject, but intends only to
incite others to further studies in this field, by making them
acquainted with my observations and successes.

I would be glad indeed if the publication of this small
volume should achieve this end.

Aakirkeby, Bornholm, Denmark.

J. ALBRECHTSEN, V. S.

Preface of the Translator.

The ravages of the infectious abortion disease in the
United States are well enough known to every man con-
nected with the agricultural industry. This English edition
of Albrechtsen’s little book on the sterility of cattle is being
undertaken in appreciation of the fact that the chief losses
from infectious abortion are losses through the resulting
sterility.

Albrechtsen, whose work has been widely recognized in
Europe, is able to demonstrate the curability of the general
sterility case; and, with the elimination of this phase of the
trouble, the damages done by infectious abortion would be
trifling compared with what they are now.

The translator believes, therefore, that he is rendering a
service to the practitioner as well as to the stockraiser; and
hopes that sterility cases will be approached with the same
basical knowledge and confidence as any other well treated
ailment.

He would especially like to point out the difference be-
tween Albrechtsen’s conception of the real cause of sterility
on the one hand, and the conception of Hess on the other.
Albrechtsen defends his point of view very well, and I have
little doubt that the experienced practitioner will find his
own observations bearing out the former.

Washington, D. C., July, 1917.

DR. H. WEHRBEIN.

uy ra HE intense interest of veterinarians and
ha farmers alike in the sterility question is the
bs best indication of its importance. As a
iWlhes ¢. matter of fact, numerous cases of sterility
a in a herd not only diminish the milk pro-

Wags) 7°
duction to a considerable extent, but render

the whole business a questionable one from the standpoint
of profit.

One has to take into consideration the increasing values
invested in milk cows to understand the strenuous interest
and effort with which the farmer tries to achieve a condition
of regular pregnancy among his milkcows, as the only means
to produce a large enough amount of milk, to make his in-
vestment profitable.

If cows do not become pregnant in due time, being per-
sistently sterile, or conceiving only after a lapse of time, the
milk production will be, sooner or later, lower than the
standard. Generally the milk revenue will be also less if
pregnant cows do not carry out their calves, that is, if they
abort.

Anamnestic complaints from the farmers about sterility
therefore have to be considered with the understanding that
there is:

1. Actual sterility, where reproduction is impossible.

2. Temporary sterility, where an irregular length of
time elapses between the periods of pregnancy.

3. Abortion in different stages of pregnancy.

9

10

Absolute sterility in cows is not so common as is generally
supposed, most likely not occurring more frequently than
among our other domestic animals.

Many animals which are being disposed of would cer-
tainly become pregnant if kept longer and treated properly.
As it is now, these cows are sold as soon as their daily
amount of milk has sunk to a certain minimum; if they are
very valuable breeding animals they are kept longer, and
then generally become pregnant again.

Temporary sterility is the form of sterility most fre-
quently met with here. Abortion ranks next, and in many
stables is the real cause of the irregularities.

The question arises of what is the significance of sterility
in its different forms, and to what extent are the persistent
complaints of the farmer justified.

I mentioned before that irregular periods of pregnancy
cause a decrease in the milk production, but many: other
causes are cooperative in causing the decrease. Comparisons
of different cases indicate that the loss can vary between
fifty to several hundred crowns per cow and per year, when
herds of equal size with an equal number of abnormal cows
are compared.

It is a fact that the loss in milk production is the larger
the more cases of abortion happen in the time of the year
when the best and most abundant food is to be had which
in Denmark is in the fall and winter. Furthermore a good
milk cow is more steady in her productiveness than a poor
one, who soon deteriorates after her last parturition.

There are reports from a few herds which are quite con-
clusive on this subject.

In the herdbook of Fuehnen and in the herdbooks of the
red Danish cattle are many notes which prove that the tem-
porary sterility of a cow is generally accompanied with a
decrease in the milk production. This decrease often
amounts to a half or more of the produce in normal years.

11

The following excerpt from the Fuehnen herdbook
illustrates the relations very well; the cows 1, 4, 5, 11, 12,
15, 35, and 45 gave 183, 139, 158, 184, 126, 115, 109 and 187
Ibs. of butter less in the year when they were sterile than in
the preceding normal year.

The higher milk production which generally sets in in
the year following the temporary sterility is not sufficient
to compensate the loss. For example the cow “Thyra” of
Bellinge gave in her sterile years only 144 lbs. of butter,
while giving in the two preceding years 320 and 370 Ibs.,
and in the two following normal years 442 and 409 Ibs.
Granted that this may be an extreme example, there are still
the many corroborating reports of the farmers, that they
are experiencing a loss of 2000 lbs. of butter or more, in the
yearly production due to temporary sterility. Of course
single or few cases are of no signifiance, especially not in the
big herds; but if many herds and many cows in each herd are
affected, it is a serious matter.

Another result of sterility is the difficulty of procuring
the necessary offspring; a selection of the best calves for
breeding purposes is then, of course, out of question, since
one has to breed every heifer calf. Therefore in herds with
a high breeding standard, sterile animals, even if only tempo-
rarily sterile, are a serious handicap.

The number of sterile animals in our country can be
rather accurately ascertained through the books of the
Breeders’ Societies. It is shown there that about 11% of
the registered cows have either aborted or been sterile during
the year. That number is nearly constant from year to year,
a good indication of its correctness.

Eleven per cent does not appear to be such a high per-
centage, but one has to bear in mind that many of the herds
included in the records were entirely free from either abor-

tion or sterility.

12

Table No. 1.
A 2 9.4 4 ae)
me ae Fos ° )
Pe 3 os 5B? 3 » °
eo BS 5 0f = o
a8 “f 998 : =
at a te »
ag m Fee e
° are i
af ig =e
98 a ge
Fuehnen and Langeland 1903-1904 |.23817 2601 10.9

i
oO by
D oO
wd
me
wW
fan)
No}

Fuehnen and Langeland 1904-1905. | 30680 1549 3512 11.7
Fuehnen and Langeland 1905-1906 | 33903 1934 1667 3601 10.6
Seeland 1904-1905 occ 24000 1508 1284 2792 11.2
Lalland Falster 1906 202. 13611 — — 1434 10.0

Of the 2390 herds or stables in Fuehnen and Langeland
1301 were entirely free from these two troubles in the year
1905-1906; so the 3601 animals which were either sterile or
had aborted belong to only 1089 farms or herds. There is
still another point to consider; the very big herds where the
state of affairs is much worse than in the medium sized or in
the small herds, are not included in these records.

I admit that the percentage does not appear to be very
bad, but if one actually works with these herds, and has a
chance to examine many of the animals for irregularities in
their sexual life, the proposition is a much more serious one.
I do not have in mind those herds where most of the cows
have aborted through infectious abortion, but I refer chiefly
to those characterized by many cases of temporary sterility.
It is nothing uncommon to find on may farms 20%, 30-50%,
even 100% of the cows to be temporarily sterile. In the big
herds, only exceptionally less than 10-20% are found.

Causes. Among laymen a number of reasons more or
less popular, are held responsible for sterility in general.

There is, for example, the opinion that our modern dairy-
cattle are overbred, and therefore less resistant towards cer-
tain noxious influences.

i

Very generally the bull was first held to be responsible
and only after changing him several times attention was paid
to the cows and an explanation sought there.

In the veterinary literature a number of probable causes
were discussed and as many treatments proposed. The most
complete work was done in Switzerland.

Zschokke (Zurich), who worked extensively on the ques-
tion, gives a number of reasons for the sterility of cattle.
He does not, however, specify the importance of the different
causes.

I think it advantageous to discuss Zschokke’s work in
detail as he not only had a large amount of clinical material
at his disposal, but also bases his conclusions on many
diligent histological examinations.

Zschokke claims that sterility is in general an ailment of
the cow, in a less degree of the bull. In the latter the follow-
ing conditions are observed: 1. Difficulties in executing the
mating act, due to obesity, pathological conditions of the
penis, the legs or the feet: 2. Disinclination to mate, on ac-
count of malnutrition, lack of exercise, exhaustion by too
frequent cohabitations and several other pathological condi-
tions; 3 Impossibility to mate on account of the painful con-
dition of the preputium or of the penis, paralysis of the penis,
fracture of the penis or a rupture in the cavernous parts of
it; 4. Complete impotence through pathological changes in
the sexual glands.

Sometimes no lesions can be found in the sexual glands,
even if a careful postmortem is made, which would explain
the permanent or periodic impotence; in such cases a les-
sened motility of the spermatozooa is supposed. This form
of impotence is specially often found in inbred animals and
there again most frequently in pigs. In the most cases of
complete impotence it is possible to demonstrate lesions in
the sexual glands; there are innate and acquired lesions, the
latter much more prevalent. The acquired lesions are of
either traumatic or infectious origin.

14

So far as the sterility of cows is concerned, Zschokke dis-
cusses numerous conditions which generally disturb the
regular estrum, or prevent pregnancy altogether.

The heat can be intermittent or entirely absent, it can
be too weak or too irregular, or else it can be persistent.

The irregular or totally absent estrum has either causes
of a more general nature, or is caused by lesions of the
ovaries. The missing heat period can be caused through
age. It is, however, known that a cow in England produced
her twentyfifth calf in her twentyninth year. Other causes
are the passing of the first few heatperiods, obesity and
phlegmatic temper. Several fat cows were examined but no
pathological changes of the ovaries could be found; however
a too narrow cervix and an abundant amount of mucous dis-
charge were noted. Zschokke concludes that in these cases
the heat had been very mild and had passed by without
being noticed. Asa last general cause he mentioned malnu-
trition, due to a quantitative or qualitative misproportion in
the feed.

As ailments of the ovaries he names: (a) Fibrous tumors
on the surface of the ovaries. He found such in 8% of 300
examined ovaries, and most frequently in older cows, (b)
Congenital deformities, where the ovaries are either entirely
lacking or not enough developed. This was quite frequent in
twins, where normal ovaries were found in only 70% of the
heifer calves, (c) Chronic oophoritis, generally caused by
tuberculosis, (d) Sklerosis of the ovaries, (e) different tu-
mors, and (f) corpus luteum persistens. The yellow bodies
do not atrophy if there is an abnormal content in the uterus.
This may be a dead fetus, a retained placenta or a patholo-
gical discharge of the uterus. Sometimes, however, the yel-
low bodies are found without a corresponding abnormality
in the uterus and then the feeding with malt, rye, corn or slop
from sugar beets may be responsible.

Very mild heat symptoms may be an individual charac-
teristic or may be caused by the feeding, by a continuous

15

confinement in the stable, or by a certain number of patho-
logical conditions.

The irregular and too frequent heat which is typical of
nymhomaniac cows has always an abnormality of the ovaries
as its cause. Zschokke never found any other lesion of the
genital apparatus causative for it. The postmortem findings
in nymphomania are cysts of the ovaries. They can origi-
nate in the follicles, in the yellow bodies and in hemorrhages.
The two latter forms, however, occur but seldom.

The first form can be solitary or multiple, generally is
solitary however. Other pathological conditions of the
ovaries are produced by edemas, atrophy and tuberculosis.
One hundred and ten cows which had nymphomania during
life showed the following postmortem lesions:

Large cysts in one or in both of the ovaries....74%
Multiple Cysts acsvacgaaateateweey ie cick eee we 8%
Central cysts with thick walls........ ..... .. 6%
SEED ECUIOSIS oo 4 oe rssh Mare le tices ola cde ea 2%

In the rest atrophy, yellow bodies or carcinoma were
found.

Is is very common that animals who have regular heat
periods and who are regularly mated remain sterile. The
following causes may be present: (1) Mechanical obstacles,
as unrest of the cows during the mating act, a too deep situa-
tion of the vagina, abnormalities of the vagina, which can be
too narrow or obstructed through tumors, scars, cysts or
mucous matter, pressing after the cohabitation, and similar
conditions. (2) A too early coitus in the heat period, when
the cervix is not yet open. (3) Occlusion of the cervix by
spasms or other pathological conditions. (4) A diseased
uterus, since a conception is impossible if its mucosa is in-
flammed and covered with discharge.

He mentiones briefly contagious abortion, which appar-
ently is not of much importance in Switzerland, finally he
names follicular and vesicular vaginitis.

16

It can readily be seen that sterility comprehends a
number of pathological conditions which can be of a more
localised or of a more general nature. Zschokke does not
emphasize what he thinks important and what of less sig-
nificance, paying, however, most attention to the ovaries.
Neither does he give any data on the treatment of his cases,
or rather on the results of his treatments. In Denmark, not
much in this line has been done, with the exception of the
study of contagious abortion. This disease has, however,
much significance for us, as it is very often the only cause of
the sexual disturbances. We all agree, of course, that the
greatest percentage of abortions in advanced pregnancy are
caused by the abortus bacillus of Bang and Stribolt.

Aside from contagious abortion we have treated only a
few of the conditions connected with sterility. They are
especially: the stenosis of the cervical canal, causing con-
tinuous nonconception, the cystous degeneration of the
ovaries in nymphomania, and finally the very frequent per-
sisting yellow bodies. In a few cases we have treated too the
follicular vaginitis. Most of the writers have restricted them-
selves to the study of these conditions.

K. Nielsen (Sorring) was the first to mention the cor-
pus luteum persistens as a significant condition in the ster-
ility of cows. He abandoned the old methods of cervix
dilatation and uterus irrigation and treated the ovaries by
pressing out the yellow bodies. He claimed this treatment
to be successful in most cases of sterility.

Martin Poulsen (Ringsted) accepted the method, and
states that pathological conditions of the ovaries are the
most common cause of sterility in cattle. He has an experi-
ence of years, and has made systematic examinations of
pregnant cows.

He pays much attention to the persistent corpus luteum
and claims that nearly all cases of sterility are caused by it.
It is as common in big herds as in small stables, and can be
found occassionally in 70% of a herd, this being the highest

17

percentage observed. It is closely connected with infectious
abortion, retentio secundinarum, metritis, but can be found
also without these foregoing complications. Through his
very numerous examinations of sterility cases in different
environments he comes to the conclusion that the corpus
luteum persistens is the most important and the most com-
mon cause of sterility in cows.

E. Hess gives a detailed report of his investigations in
this line. He too contends that the most frequent cause of
sterility in cattle are diseases of the ovaries. He pays more
attention however to the cystic degeneration of the ovaries
than to the yellow bodies. Apparently nymphomania is an
ailment of much importance in his part of the country, for
he gives all the symptoms, one of which is sterility, of course,
and advises as a therapeutic measure the rupture of the cysts
through the vagina. If heat is absent, he also finds quite
often cystic degeneration (in which case the cysts are, how-
ever, of a more flaccid constitution), and frequently the per-
sistent yellow body. It is remarkable that he treats pyo-
metra also with the removal of the yellow body; he claims
that this operation and the gentle massaging of the uterus
are much more efficient therapeutic measures than the irriga-
tion of the uterus.

W. L. Williams in his book: Veterinary Obstetrics, gives
much space to the discussion of sterility in domesticated
animals. He reconsiders the work of Hess, adds some of his
own observations, and gives with many references a very
complete review of the whole question.

We see that there is an inclination to connect sterility in
cows primarily with pathological conditions of the ovary.
Such a point of view can not be criticised if the consequent
methods of treatment give practical results. It is not so im-
portant here that there are ostensibly other causes which
may cause sterility, since we must strive to satisfy our cli-
ents with successful treatments, and not with the most
plausible explanations.

18

Now, we acknowledge that the treatment of the ovarial
conditions has been quite often a successful one in regard to
the sterility of the animals, but there is also a number of re-
ports where it was of very little or no use.

This is not to be wondered at; for just as the dilatation
of the cervix, is quite often a very successful operation,
without being a cure for all sterility cases, so the ovarial
treatment has had many successes; but there are also cases
with no improvement.

If one stops to consider the conditions which are pre-
valent, especially in the big stables, then one must come to
the conclusion that the ovary treatment is too one-sided to
be efficient. There are too many primary lesions to permit
the treatment of the secondary lesions to be sufficient.

It is further very unlikely that such a percentage of ani-
mals should suffer from ovarial diseases as Poulsen reports.
Neither women nor the domesticated animals are so afflicted
nor is the ovary considered there to be the chief source of
sterility troubles. Another fact to be considered is the fre-
quency of metritis in cows, undoubtedly a cause of sterility.
It is well known that cows which have suffered from septic
metritis, retentio secundinarum, torsio uteri etc., very often
become sterile. This is, of course, the result of a chronic
metritis. Cows which have a metritis from the cause men-
tioned, are apparently quite common; if one adds the cows
which have had infectious abortion, one will have a good
percentage of animals, whose sterile condition can be
explained quite easily. I have found that the permanent or
temporary sterility of cows which have aborted depends very
largely on the degree and the chronicity of the metritis
generally connected with the abortus. The metritis again is
much influenced by the retention or removal of the placenta,
and by the treatment of the cow. I never paid any attention
to the yellow body in cows which had aborted; I treated the
metritis at once and never had any trouble. This method I

19

find superior to the treatment of the secondary lesion, the
yellow body.

In old cases without a history of abnormal birth one
generally can find pronounced lesions on the cervix or in the
vagina, which easily explain the sterility, without the rather
forced supposition of an ovarial lesion.

I admit that often pathological conditions of the ovaries
are found in the rather rare cases where the cows have not
been under treatment and without estrum, or failed to con-
ceive for a long time. In these chronic cases yellow bodies
or cystic ovaries develop. If one treats big herds where all
the animals are under constant observation and regularly
examined, the ovarial lesions quite disappear, and the inflam-
matory processes of the uterus and the cervix prevail.

In a meeting of veterinarians, February 1906, I explained
why I paid more attention to the examination of the sexual
organs in sterile cows, and stated that lesions of the metra
are relatively frequent. In the following weeks of February
and March I found in 1000 cases 331 cows with a metritis.

Since then I have worked in the same line and improved
my technique. I am no longer satisfied with a rectal examina-
tion, but always draw the cervix into the vulva for an easier
inspection of its mucosa, and, eventually, of the uterus.

Between February 1906 and February 1908 I examined
together with my assistant Nissen Petersen four thousand
cases. Most of the animals belonged to regularly inspected
herds. Inthe vast majority of these cows I found a catarrhal
affection of the uterus, generally connected with an enlarge-
ment of this organ and a pathologic excretion. In nearly all
cases the cervix was affected, and in many cases preeminently
so. Only a few had a discharge from the vagina, and then,
as a rule, a pyometra was present. A few times the oviducts
and their ligaments were found to be affected; often the
vagina was the seat of various pathological processes. The
ovaries, aside from the presence of yellow bodies, and if af-
fected at all, showed most frequently cystous degeneration.

20

It is a matter of daily observation that metritis causes
sterility, and the authors who have treated the question
admit it, of course, as one of the causes; but they do not pay
as much attention to it as to the diseases of the ovaries, con-
sidering, as a matter of fact, only the very distinct cases with
much discharge and large accumulation of exudate, and
overlooking the more chronic and less impressive conditions.

Zschokke notes as obvious that a fecundation is impos-
sible if the uterus mucosa is infected and covered with pur-
ulent discharge; the estrum too is generally absent under a
catarrhal condition of the metra. It is possible that even
very slight and otherwise quite insignificant infections pro-
duce sterility by an acid or toxic exudate, which renders
the spermatozoa immobile. There is further the possibility
that sometimes the uterus mucosa is destroyed through a
protracted inflammatory process; it is known that cows
which have suffered for a long time from a metritis do not
conceive again even if they recover and have estrum periods
again.

Wapt has found that 40% of all cows with a cured metri-
tis remain sterile and Fiorentini made the diagnosis of ca-
tarrhal metritis seventeen times in fifty cases of sterility.
Zschokke several times found calcification of the cotyledones,
atrophy and sklerosis of the uterus mucosa, all of which is
generally the result of a chronic metritis. Martin Poulsen
states that diseases of the uterus are not infrequently the
cause of sterility, but he does not pay much attention to them
and thinks the secondary lesions of the ovaries to be the by
far most important cause.

K. Nielsen (Sorring) considers the granular venereal
disease as the predominant cause of sterility in cattle, and
employs a corresponding treatment.

The contentions of Poulsen and of Nielsen are based on
clinical observations and not on histological examinations, as
it is very difficult for the practitioner to work in that line.
It is also difficult for the practitioner to procure the material

Zi

for these investigations, and nearly all histological research
made on the genital organs of cows have had another object.
Tuff was the first to make histological sections on a big scale
to clear up the cause of sterility in cattle.

He examined the genital organs of ninety-seven sterile
cows and found sixty-four times pathological conditions in
the vagina, in the os uteri, in the uterus proper, in the
oviducts or in the ovaries. The uterus lesions were the most
frequent, being found in fifty-eight cases, mostly catarrhs,
and quite often of little intensity. In one case, tuberculosis
of the uterus was noted. In the vagina he found cysts of
the Gartner ducts, follicular vaginitis and scar formations.
Six times the oviducts were the seat of inflammatory pro-
cesses, four times in connection with a catarrhal metritis.
Yellow bodies were found in sixty-eight cases, thirty times
connected with cyst formation; in fourteen cases only cysts
were found.

The lesions of the uterus are of different nature, accord-
ing to their location and intensity if only the mucosa is af-
fected, the lesion is called an endometritis; if it is more pene-
trating, a metritis, and if involving the serosa, a peri- or para-
metritis.

The most frequent form to come up for treatment in
sterility cases, is the chronic endometritis and the pyometra.

Tuff found that an interstitial endometritis can exist with
or without defects of the uterine glands, which may be
present in smaller or larger numbers. If the first condition
is present, the uterus will be of normal size, the mucosa of
normal appearance or slightly injected, covered with much
mucous matter, the uterine glands normal, the connective
tissue increased, poor in cells and disposed in strong fibrous
strands, the walls of the blood vessels thickened.

Those lesions were found seventeen times. In the cases
of interstitial metritis where the number of the uterine
. glands are diminished, which were found twenty-four times,
the lesions are more distinct; the horns of the uterus are

,

22

assymetric, the mucosa very hyperemic and covered with an
abundant often bloody, exudate, which often also contains
pus flakes. The number of the uterine glands is decreased,
and they are found singly or in bundles, separated through
strong fibrous bands which transverse the mucosa in all di-
rections. The glands proper are dilated, corkscrew shaped
and have a ragged margin. The tissue between the glands
is infiltrated with roundcells, which very often are so dense
that they resemble an abcess. Endometritis without histo-
logical lesions was found nine times, in five cases of which
the uterus was enlarged, asymmetrical, its mucosa hyperemic
and containing much mucous matter and pus flakes. The
other four uteri were not asymmetrical, but contained exu-
date and were hyperemic. In purulent endometritis with
large accumulations of exudate, different changes in the
mucosa are found by Kitt. In recent cases the mucosa is
injected and infiltrated with roundcells, the surface epithe-
lium and the epithelium of the uterine glands is largely
necrotic. In other cases the mucosa shows a dirty grayish
discoloration from old hemorrhages and, together with the
whole uterus wall, becomes atrophic through the expansion
of the uterus. Sometimes the walls are not much thicker
than paper. In still other cases a thickening of the mucosa
is found, together with necrosis. These thickened walls are
of a grayish red or of a grayish white color. A few times
cysts in the walls of the uterus were observed.

The real chronic metritis does not seem to be very fre-
quent. Tuff found it only four times among his sixty-four
cases with lesions of the uterus, and Kitt says that a metri-
tis which becomes chronic generally becomes catarrhal.

In the four cases mentioned by Tuff the uterus was twice
considerably enlarged and filled with a yellow, thick pus. In
this pus streptococci were found in pure culture. In the two
other cases the uterus was thicker but not longer than nor-
mal; the uterine walls were thick and hard, forming a narrow
tube and containing a yellow pus. The mucosa was much

ZS

thickened, and its surface layers partly obliterated with bands
of connective tissue.

Tuff demonstrates with his histological sections that
diseases of the uterus are quite frequent, and that most of
these affections are catarrhs. Only three cases of cervical
trouble were found. These findings confirm the opinion ol
Kitt who says that the diphtheric, croupous, ulcerating,
hemorrhagical and phlegmonous metritis is generally of an
acute character, while the chronic cases are more catarrhal
or purulent. It is certain that many of these chronic cases
are slight inflammatory processes, which do not produce any
permanent change in the attacked mucosa. Many of them
show only hyperemia and swelling of the mucosa, and hyper-
secretion of sometimes quite normal exudate. Such condi-
tions are hard to recognize in a postmortem examination,
but are nevertheless capable of producing sterility if they are
prevalent in the time of the estrum.

If the veterinarian examines carefully the genital organs
of sterile cows per vaginam, per rectum and by drawing back
the cervix, he will in most of the cases find a pathologic con-
dition of the uterus.

Before entering in the description of these lesions I think
it opportune to give some diagnostic hints about the normal
and the diseased, the pregnant and the sterile uterus. In-
timate knowledge of these conditions is absolutely necessary,
as the treatment depends entirely on the ability to make the
proper diagnosis. It is specially important to differentiate
between an early stage of pregnancy and certain pathologic
conditions of the uterus.

The normal nonpregnant uterus is of different size,
according to the animals age; it is relatively longer and.
thinner in young animals than in old ones which have had
several calves, but much variation is found.

Zschokke states that the normal body of the uterus in a
nonpregnant stage is 2,5 cm. long and the horns up to 25
cm., with a thickeness of 34 cm. The cervix is on the average

24

6/8 cm. long, but can reach a length of 17 cm. The horns
are symmetrical and quite substantial, though soft and
fleshy, and smooth to the touch. The dimensions of the
normal uterus are rather variable, and it is impossible to
determine clinically the dividing line between the still normal
and the incipiently pathological uterus. The uterus with a
chronic metritis is as a rule symmetrical and a little enlarged,
its walls are thickened, and contract so that one can feel the
horns as hard thick cords, which never is the case in a preg-
nant uterus. During the estrum the uterus can be enlarged
in all its dimensions; the walls become hardened, and one can
feel contractions. This conditions can be easily recognized
through the other symptoms of the estrum and from the clear
mucous exudate present. It is, however, possible that cows
with even marked lesions of the uterus and with purulent
discharge show the regular heat symptoms; in such cases the
uterus is even more enlarged than outside of the estrum and
the discharge is even more abundant.

A pregnancy can be recognized from the size of the uterus,
the nature of its walls, its fluctuation and the appearance of
the cervix,

In the first five or six weeks, however, the diagnosis can
not be made absolutely; after that time it is quite possible.

In the first month of pregnancy the uterus does not
change enough to permit the condition to be recognized by
a rectal palpation. If normal conditions are found, however,
there is a more or less well founded probability of pregnancy.
The most valuable symptom at this time is the appearance
of the cervix; it speaks for pregnancy if it is tightly closed
and without any secretion; but if it is swollen, hyperemic,
covered with discharge and showing an irregular canal,
pregnancy can be in nearly all cases excluded.

In the second month the changes of pregnancy are so
pronounced that a diagnosis can be made on their strength.
The pregnant horn begins to be bigger than the other one in
the fifth or sixth week. The walls become soft and rather

25

thin and in one place fluctuation can be made out. In the
latter part of the second month these symptoms are so promi-
nent that the pregnancy can be rather safely recognized per
rectum, if a normal uterus is present; this is not always the
case, as there are many deviations, from the normal just at
this time.

There are also, of course, the fluctuations in the size of the
organ, so that two uteri in the same stage of pregnancy are
not always of the same size. As I mentioned before, an
asymmetrical uterus can be found also in cases of metritis;
neither is the thickness of the uterus walls a reliable sign, as
there may be pregnancy in a uterus with rather thick walls.
The best symptom is the fluctuation, which is, however,
sometimes difficult to feel before the eighth week, especially
when the horns are long, curved and thickwalled. It is
apparent that the fluctuation depends very much from the
size of the horn and from the thickness of its walls, and it is
therefore necessary to palpitate its whole length. If one is
unable to make sure, it is advisable to put a sharp hook in
the cervix and to draw it into the vulva. In this manner the
horn is fixed in its position, and with it the ovum; even a
very slight fluctuation can now be felt. With proper con-
sideration of all the circumstances, and specially noting the
appearance of the cervix, one can make the diagnosis of preg-
nancy as soon as one is able to find a distinct fluctuation.
Mistakes, however, may happen, and the fluctuation is then
not caused by pregnancy but by a pathological fluid. I found
once in a postmortem examination an asymmetrical horn
with fluctuation and a completely closed cervix, correspond-
ing entirely to a two month pregnancy, but containing only
a thin, clear exudate. Veterinarians who work in abattoirs
inform me that findings of that kind are not rare.

So the criterial symptom which differentiates the asym-
metrical pathological uterus from the pregnant uterus is the
muscular contractions which the latter never shows except
during an abortion. Aside from that, the appearance of the

26

cervix is of much importance. Sometimes a diseased uterus
with an open and inflamed cervix is found to be pregnant,
but then abortion is the sure outcome.

By a careful examination, and considering all irregulari-
ties which may complicate the second month of pregnancy.
one will be able to recognize a pregnant animal with sufficient
exactness. Broholm is justified in saying that it is easier to
make the diagnosis of pregnancy than to describe it; he was
the first to publish his technique. After examining more
than a thousand cows he states that, so far he knows, he
never mistook a three month pregnancy; according to him
it is also possible to make a reliable diagnosis in the 7th-8th
weeks of pregnancy. His chief symptom is the palpitating
of a fluctuating oblong body in the asymmetrical horn.

Martin Poulsen believes that it is possible to make a
diagnosis of pregnancy in the 4th-5th weeks, and a safe
diagnosis after the sixth week. He is also able to determine
the age of the pregnancy, viz. whether the fetus is six, eight,
ten or twelve weeks old. His indications also are the asym-
metry of the horns and the fluctuation of the larger horn.
He claims that in a pregnancy of six weeks the uterus is
situated entirely in the pelvis and can be wholly encompassed
with the hand. After eight weeks the uterus is said to
protrude slightly over the symphysis and can still be clasped
in the hand. It is quite incomprehensible to me that an
expert like Poulsen has been so deceived as to the situation
of the uterus, which depends so very much upon the varying
bulk of the abdominal organs. The non-pregnant uterus is
situated in the abdominal cavity proper, so that the cervix is
just above the symphysis, and the pregnant uterus cannot be
in the pelvis entirely if not forced in it by the intestines.

The discrimination between the pregnant and the patho-
logical uterus is no longer difficult after the middle of the
third month, as then the size and the fluctuation of the organ
are distinct characteristics. Besides, the cotyledons and the
fetus proper can be felt then.

av

There are, as a matter, of fact, only the purulent and the
mucouspurulent metritis which can be mistaken for preg-
nancy. Under these pathological conditions, however, the
uterus is generally thickwalled, and there is a discharge from
the vagina. Only once I had difficulty in making the proper
diagnosis in a pregnancy of three months. The uterus was
situated far from the abdominal cavity, so that it could not
be completely made out by the hand, the walls were thick-
ened, and there was a fluctuation in the apex of the right
horn; the cervix was swollen, injected, a little secernating,
and so wide open that I easily could go in with a large ca-
theter. In spite of intense treatment, as repeated douching,
the cow did not abort until twenty-eight days later.

A second time I misjudged a pregnancy of three ar
half months, and had the cow slaughtered. I had treate:
cow in January, April and June, first for a septic met
and later for an enlargement of the uterus. In July the .
came in heat, and in October I examined her again. I fot
the cervix unchanged, the uterus enlarged, but did not thi,
of pregnancy.

In the fifth month of pregnancy the uterus can be so
down in the abdominal cavity that it is impossible to rea
it with the hand. One feels only a more or less heavy cor
which goes from the cervix towards the adbominal cavity.

Pregnancies in the left horn, torsio uteri in an early stage,
death or mummification of the fetus are rare and easily
recognized.

It is always important to make the diagnosis: pregnant
or not pregnant, and in the latter case, to determine what is
the pathological condition. The exact time of pregnancy is
of far less importance in the daily routine. Besides, the
time of the last estrum is a good enough indication for that.

Poulsen, however, pays much attention to this point, and
gives a lot of indications for the exact determination of the
time the pregnancy has progressed to. He gives data for
8-10, 10-12, 14-16, 18-20 weeks, and then month by month.

28

His indications are the length of the uterus, its width ex-
pressed in centimeters, and its contents approximately ex-
pressed in liters and in grams. The measurements are taken
according to the length of the arm and the width of the hand.

When one considers that the uterus of a three months old
pregnancy in one cow may be larger than the uterus of a
three and a half months old pregnancy in another cow, that
the intestines exercise a strong influence over the situation
and the shape of the pregnant uterus, that the time of con-
ception may differ even if the mating has taken place at the
same time, and that the duration of pregnancy may be
Setween 210 and 321 days, then it becomes evident that exact

“culations of the age of pregnancy are rather vain. It is

yossible, anyhow, to pay so much attention to the dimen-

of the genital organs, if one has to examine about 50
.in one hour.

.t is generally possible to find pathologic conditions in
vs which are sterile or have irregular estrum periods. The
sions may be present in different locations, as in the uterus,
he cervix, in the os uteri, in the vagina, in the ovaries, in

oviducts or in the surrounding tissues.

Examining per rectum one will often find the uterus
enlarged to a variable extent, its walls more or less thickened
or edematous, and containing a thick exsudate. In the quite
frequent cases of accumulations of pus in the uterus, this
organ is as a rule very much enlarged and protruding into
the abdominal cavity, its walls are thickened sometimes, how-
ever, thinned, and one can easily feel fluctuation. Gererally
discharge from the vagina is present.

In the majority of cases one will not find contents in the
uterus, but only an enlargement of the organ and thickened
walls. The horns of the uterus are generally asymmetrical
and rather long; they protrude into the abdominal cavity and
are felt as uneven, knotty cords; they can also be short, and
then more thick. Under the palpitation they contract, which
is specially noticeable in the diseased horn.

29

Per rectum the abnormalities of the ovaries and of the
oviducts can be made out, also tumors, adhesions, etc.

Examining the vagina, and pulling the cervix into the
vagina with a sharp hook or with a big forceps, one generally
will find that the cervix is the seat of considerable affections.
It is more or less swollen, injected and, as a rule, secernating.

The normal cervix is a cone of 2-3 cm. length which pro-
trudes into the oral part of the vagina, On its apex is the
os uteri which is surrounded by even folds of the pink
mucosa. (Fig. 1.) Under normal conditions the cervix is
dry without any considerable secretion and the os uteri is

Fig. 1—Normal Cervix and Orificium Extern.

tightly closed. During estrum a hyperemy is present, and
the mucosa is moderately, but distinctly, injected; the os
uteri and the cervical canal is then so far open that a finger
or a large catheter can easily penetrate; an abundant, thin,
glassy and mucous exsudate is discharged.

The cervical canal is 6-17 cm. long and has a mucosa
without glands. Zschokke says is has a stratified squamous
epithelium, Martin, that is has a simple columnar epithelium,
sometimes with ciliar cells. The mucosa has vertical folds
which form in three places heavy rings, partly through an
enlargment of the folds, and partly through a thickening of

30

the surrounding muscular layers. These rings are situated
on the os uteri externum and internum and approximately
in the middle between the two. The longitudinal folds become
heavier near the os uteri externum and form a rosette of
2-3 cm. in the vagina. On account of these folds the cervical
canal can open up considerably during the heat period; it
can be passed then in a straight line. Under normal condi-
tions the canal is closed tightly.

The changes of the cervix consist of a more or less promi-
nent swelling of the portio vaginalis and of the mucosa in-
side the cervical canal. Through these pathological condi-
tions the whole cervix, and, with it the canal, change in
regard to position. The direction of the canal deviates from
the normal, as does the condition of the os uteri externum
and internum. Sometimes these changes involve the mus-
cular layers also; then the cervix appears to be longer and
much thicker, hard and rigid to the touch.

The portio vaginalis can be swollen to a more or less
great extent, sometimes attaining a size equal to two fists
and more. Very frequently the portio is irregular, according
to the seat of the swelling on one side or the other. The
surface can be ragged or labiated, according to whether the
diametrical folds are swollen in different degress or only
partly. There is then present a number of little ridges vary-
ing in thickness and arranged radially. Sometimes the folds
are of a rather even size and pass smoothly over in the
mucosa of the cervical canal, but in other cases they are
quite uneven, and form the most irregular ragged swellings.
I mention the following examples:

Cow from Bonderup (Fig. 2), had a calf in the fall 1906.
In April 1907 the uterus was enlarged, the portio vaginalis
swollen and labiated. The folds of the portio were as thick
as a finger, very close together, and covered with a dirty,
viscous, and greasy exsudate. The cervical canal was open,
its mucosa swollen and injected; there was an abundant
muco-purulent discharge coming out of it.

31

Cow No. 126 of Tranekjar Slotsladegaard demonstrated
the same conditions in a more distinct way. She had a calf
on December 19, 1906 and was in heat on April 5 and 29,
1907. On April 16 the uterus was enlarged, the orificium
very much swollen, injected and ragged. There was a
profuse discharge. Treatment with alcohol and iodine.
On June 17 the uterus was again normal, the orificium of
normal pink color, but swollen, labiated and open. There
was still a discharge.

Fig. 2—Cow from Bonderup.

In some cases the folds of the cervix are quite thin and
flat, with spaces in between, which are often filled with a
greasy and mucous secretion. Sometimes these folds are
transversely interrupted, and then the surface of the cervix
looks as if covered with many little cones of different size.
In still other cases the folds of the mucosa, which are gen-
erally arranged radially, are not very distinct and form a little
ring in the middle of which the edematous and often en-
ormously swollen mucosa of the canal proper is seen.

32

Cow No. 86 of Marienborg had a normal parturition on
November 6, 1906. On May 6, 1907 the uterus is very much
enlarged and contains several liters of a purulent excretion,
which is removed. On July 8 the uterus is a little larger than
normal, has thick and hard walls and contains a small amount
of secretion. The os uteri externum is much larger than
usual, open, injected and secernating. The mucosa of the
canal is so swollen that it forms a cone which again is sur-
rounded by the folds of the cervix mucosa. The latter in

Fig. 3-Cow from Marienborg.

this case is not very much increased in size, and its folds pass
smoothly into the mucosa of the vagina. (Fig. 3.)

Cow No. 32 of Wilhelmsborg demonstrates the same con-
ditions very well. She had a calf in the spring 1907 and pretty
soon after was regarded as nymphomaniac. On July 2 the
uterus was a little enlarged, the portio vaginalis very much
swollen and the cervical canal wide open. Its mucosa formed
a cone in the opening of the orificium and was surrounded
with the radial folds of the cervix. There were cysts in the
ovaries. (Fig. 4.)

33

In other cases the folds of the cervix are scarcely in-
creased in size and of nearly normal color, but the mucosa
of the canal forms a large swelling of a dark red color and
covers the os uteri externum completely.

Cow No. 21 of Bygaden had a calf in the winter of 1905-
1906; before the first examination on July 12, 1907 she had
been a nymphomaniac for over a year; the vulva was swol-
len, the uterus nearly normal, the orificium increased in size,
and its folds hyperemic, partly injected and covered with

Fig. 4~Cow from Wilhelmsborg.

mucous matter. The mucosa of the cervical canal was swol-
len, and protruded in the form of a dark red, egg-sized tumor.
There were cysts in both ovaries.

The cow from Almindingen (Fig. 5) had a calf on
Christmas 1906, followed by a septic metritis, necrosis of the
cotyledons and a pyometra; the contents of the uterus were
twice removed and the discharge ceased; she was twice in
heat the following spring. On July 29, 1907 the uterus is
normal, the os uteri externum swollen and secernating, the

34

radial folds of the cervix are also swollen, but of normal
color; in the midst of these folds the mucosa of the canal is
seen as a dark red, egg-sized tumor. So far as one could see
the mucosa of the canal was of this color and swollen.

I have met with this condition quite often; the cases are,
however, not so pronounced as they are seen in the illustra-
tions. The portio vaginalis is generally of normal color, but
in the middle of it is to be seen the swollen mucosa of the
canal, which contrasts by its dark red color from the pink

Fig. 5—Cow from Almindingen.

color of the vaginal mucosa. The tumor of the mucosa
generally obstructs the lumen of the cervical canal.

In other cases the radial folds of the cervix are ob-
literated, and the portio vaginalis consists of an irregular
mass of tissue with a secernating and injected surface which
bleeds on the slightest provocation.

Fig. 7 is a case of this kind. The cow had delivered a
calf of January 25, 1907, and was in heat on March 9 and on
April 5. On April 16 the uterus was normal, the orificium
increased in size, hyperemic and secernating. The radial

35

folds were indistinct, their surface like granulations, easily
bleeding. There was an abundant discharge. After treat-
ment with iodine the cow was in heat on June 9.. On August
17, the uterus was normal, the vaginal portio nearly normal
of color, but still swollen and open. There was still dis-
charge, and there were cysts in the ovaries. (Fig. 6.)

Fig. 6.

On the whole, the changes of the portio vaginalis are
very varying. One needs only to compare the following
illustrations with the appearance of a normal cervix to
realize this.

Fig. 7 is taken from a nymphomaniac which had delivered
a calf in spring and had shown nymphomaniac symptoms
since May. The picture was taken in August. The orificium
was then much swollen, labiated and secernating. Despite of
careful treatment the cow could not be cured.

36

Cow. No. 56 (see Fig. 8—Cow from Myregaard), had
calved on October 24, 1906, and was a nymphomaniac dur-
ing the winter. She quieted down during the summer after
two treatments, but still had sunken pelvic ligaments and an
edematous vulva. In September 1907 the orificium was very
much enlarged and secernating.

Other abnormalities of the portio vaginalis are frequently
met with, for example rents, which are generally located on
the sides of the canal.

Fig. 7.

At the parturition the cervix quite often is ruptured, but
generally the lesions heal completely; sometimes, however,
infection results, and the wounds do not close. The cervical
canal remains inflamed and a fissure of variable extent
persists,

This is nicely demonstrated in the cow from Wallens-
gaard. (Fig. 9.) The cow calved in May 1906, and was
regularly in heat since then. On February 15, 1907 the
uterus was a little enlarged, and its walls were thick and
hard; the orificium was swollen and hyperemic, the os exter-
num wide open ,and its walls ragged and red. On the right

ae

side was a rent with smooth walls, which was 3% inches long
and reached to within about one inch of the os uteri in-
ternum. The cervical canal was wide open, and only a little
narrower on its inner end. There was an abundant purulent
discharge, and the uterine wall was involved. During the
summer of 1907 cystic degeneration of the ovaries set in, and
the cow did not become pregnant.

Fig. 8—Cow from Myregaard.

Sometimes bands of connective tissue are met with; they
may cover the entire portio, and grow from the sides. Their
size varies; the smaller ones, from the size of a leadpencil to
the size of a finger, most likely do not interfere with fecunda-
tion nor with delivery.

Fig. 10 shows a remarkable abnormality of that kind.
The cow had a calf in the winter and was examined in May
of the following year. She had cystic degeneration of the

38

ovaries, and pronounced symptoms of nymphomania. A
bridge of connective tissue passed from the fundus of the
portio over the orificium and then joined the vaginal mucosa.
It was 5 cm. wide and 2cm. thick, and passed in a vertical
direction over the os externum. On both sides there were
little openings through which the orificium could be reached.
in Figs. 10 and 11, the band can be seen; in Fig. 12 it is cut.

Fig. 9—Cow from Wallensgaard.

I cannot say whether this abnormality is inherited or
acquired. I have never found it in heifers, however. Even
if such an obstacle is not able to prevent the delivery, it cer-
tainly leaves not much chance for the fertilization, as the two
little openings on the sides are by no means equal to the
normal orificium.

I saw a similar case in a cow with nymphomania in Mari-
enburg. The cow had calved for the sixth time two years

39

ago and had not become pregnant again. A band over the
orificium prevented the fecundation completely. The portio
was very much enlarged, and the openings on each side of
the band were so small that I could not put in my finger on
either side without tearing or dilating the opening. The
band was 1¥% inches thick.

As I mentioned before, the cervical canal can vary in
regard to its direction, its width and the quality of the

Fig. 10—Cow from Bonderup.
Note the sinewy band covering the orifice.

mucosa. The width of the os uteri externum and internum
also differs very much. On account of the frequent swel-
lings of the mucosa the orificium can change its location in
every direction and can be of varying size. Sometimes it is
hidden through the swollen mucosa or through one of the
above mentioned bands of connective tissue; it can have the
shape of a round and wide hole or of a mere slit.

In sterile cows the cervical canal is generally so wide that

40

one can introduce the large catheter of Bozemann with ease.
There is nearly always a discharge which, according to the
case, is prevailingly mucous or purulent and often mixed
with flakes or little clumps. In many cases the discharge is
restricted to the cervical canal, which is specially the case
in cows with nymphomania, so that the canal and the ori-
ficium are covered with a whitish viscous and greasy secre-

Fig. 11—Cow from Bondcrup.

The sinewy band is stretched with the finger.

tion. The whole canal can be filled with a thick and very
tough discharge which protrudes from the orificium like a
prop; in one case I found the whole uterus filled with it.

If the secretion is chiefly mucous it is formed in the cer-
vix; the more purulent secretion, which also contains pus-
flakes, is a product of the uterus.

The inflamed mucosa bleeds very easily.

In the cervical canal sometimes cysts are found which
obstruct the lumen.

41

In the vagina cysts, tumors, wounds, adhesions and
strictures may be present, which, however, very seldom are
the cause of sterility.

The majority of endometritis and metritis cases in chroni-
cally sterile cows are caused by:

(1) Acute, more or less septic metritis which becomes
chronic;

Fig. 12—Cow from Bonderup.

The sinewy band is cut through.

(2) Benign and at once chronic and subdued processes
with no or only little discharge;

(3) Infection through the copulation, which, however, is
very rare.

The history of many cases, and a large number of exami-
nations on cows, made one month after the last parturition,
have convinced me that nearly all cases of endometritis are
caused by an infection during the last delivery. These in-
fections are the reason for inflammatory processes of differ-

42

ent degree and nature, depending on the condition of the
organs through wounds and lesions, and on the quantity and
the virulence of the introduced infections material.

These assumptions agree with the observations of Kitt
who says: that abnormalities of this kind are seldom found
in animals which never have been pregnant; they are mostly
derived from an abnormal delivery, with its apparent chance
for infections of different kinds. Diseases of the genital
organs connected with exsudation can nearly always be
traced to an infection. Even the more chronic lesions, where
only a benign and mucous or muco-purulent exsudation
exists, are apparently caused by different micro-organisms.
That the more septic forms of metritis are produced by very
virulent bacteria is generally admitted.

The etiology of the acute and septic metritis which is
marked by a thin, discolored, and evil smelling secretion,
and its influence on the general conditions and wellbeing of
the animal, is well known. Dystocia, torsio uteri, death or
decomposition of the fetus are generally the causes. We
know how common such cases are, and are not surprised if
the patients show afterwards irregularities in their sexual
life.

The causes of endometritis mentioned are, however, all
together not so important as the retentio secundinarum,
which is so very frequent as to deserve the most careful
consideration.

In this connection, again, we wish to call attention to
infectious abortion, which is so often attended by a subse-
quent sterility. This, however, depends very much upon
how well the animal gets over the usual metritis, and this,
again, depends on whether the secundinae are retained or
not. Aborting cows generally retain their placenta.

The retentio secundinarum is also quite common in cows
which have delivered normally, and is thus a serious annoy-
ance. Farmers are as a rule well aware of the importance
of this and always ask what is to be done if a cow does not

43

clean herself. Twenty-five per cent of all the cows which I
had under treatment from May 1, 1906 up to May 1, 1907,
suffered from a retained placenta, and not half of these cows
had aborted. Eleven per cent were cases of dystocia, torsio
uteri and septic metritis. If I add the 26% of sterile cows,
which nearly all had metritis, then I had 63% of all the cows
treated which suffered from metritis.

The methodical examination of especially the big herds
reveals the frequency and the importance of the more or less
septic metritis. There are also sometimes diseases of the
uterus after a normal delivery, and without a retentio secun-
dinarum. These cases are as a rule not serious, and cause
no disturbance in the general state of health; most of these
cases, however, evade notice, since there is no abnormal dis-
charge, and since what there is, ceases very soon after the
parturition. There can be nevertheless an inflammation with
enlargement of the uterus and with accumulation of exsudate.
Ailments of this kind are later recognized by the abnormal
estrum and the failure of conception. The exact diagnosis,
of course, is made by an examination per rectum and per
vaginam one month after the delivery.

After a normal parturition the involution of the uterus is
finished in three or four weeks, so that the first estrum can
appear after that time. Very often, however, the heat comes
later, which is caused by the incomplete involution of the
uterus. This fact I found out through many examinations
on representative animals.

During the last year I systematically examined many
cows per rectum and per vaginam in the time after the nor-
mal parturition, to ascertain the course of the normal involu-
tion and to make an early diagnosis of an eventual metritis.
T found that there are many decisive differences. The
shortest time in which a uterus became involved again
was 12 days (one case) and only in few animals was the
uterus normal again after 14-18 days. In the most cases it

44

took three, four and even five weeks, which still can not be
called pathological.

I made the further observation that cows may have a
benign metritis without having any discharge or without
being disturbed in their general condition. In these cows
the uterus is often more or less enlarged even to the extent
that it cannot be encompassed with the hand; there is also
quite often an excretion in the uterus. Generally these ail-
ments are benign; they are caused by an infection which’
prevents the involution of the uterus.

If the apparent metritis cases are added to the less
obvious ones which can be made out only by an elaborate
examination, the total number very nearly equals the number
of sterile cows.

It is, therefore, apparent that the majority of sterility
cases are caused by inflammatory processes of the uterus,
which themselves are caused by infection.

The fact that so often many or even all animals of a
herd are diseased, and that the symptoms are so very differ-
ent in different herds or individuals, can only be explained
by the fact that the infections are of a different nature hence
of a different virulence. This also explains the continuity
of sterility complaints in certain herds.

It is a well known fact that puerperal infection is endemic
in many stables, and also that these infections may vary with
the locality. This is, for example, demonstrated by the
difference in time in which the secundinae may become de-
composed. In contagious abortion, where the placenta is
the seat of inflammatory and exsudative processes, the
secundinae decompose more quickly than in normal cows.
Even in the latter the conditions may vary very much, so
that in one case the placenta is found to be decomposed after
a few hours and in others even after days to be very little
changed. The only explanation for this is the difference in
the distribution and in the virulence of the infectious mater-
ial. In some stables it is impossible, to prevent malignant

45

metritis even with the utmost care, if one is forced to oper-
ate, be it on account of a dystocia, or removal of the
secundinae.

While therefore there is a big difference between the indi-
vidual herds in regard to the number of animals affected and
in the virulence of the infection; there is a certain conformity
between the number of acute and septic metritis cases and the
number of sterile animalsinaherd. In other words, in stables
where many cows with purulent or septic discharge from
the genital organs are found, there are also many animals
which have difficulty with conception.

Here are a few illustrations: On the ‘“Tranekjaer’”
farms, where the conditions of hygiene, feed and care were
uniform and beyond criticism, there were big differences in
the number of cases, and in the course of the chronic as well
as of the acute metrites. On all three farms the stables
were new, with beton floors, splendid light and ventilation,
peat being used asa litter. The cows were carefully groomed
and during the summer went out on the pasture every day
from 8 a. m. until 2 p. m. To be brief, the general condi-
tions were splendid. As I began the treatment in May, I
found in Paeregaard a smaller number of pregnant cows
than in Slotsladegaard and in Groenslettegaard, but a bigger
number of purulent and chronic metritis and endometritis
cases. Of the 170 cows in Paeregaard I treated 122 during
the year, and only 59 became pregnant without treatment.
Ninety cows had inflammatory processes in the uterus or in
the cervix, and eleven animals which were treated proved
to be normal; in seventy the changes were so extensive that
they could be recognized by the rectal examination; thir-
teen cows had aborted, and a number had retained the
placenta. On the first visit especially, many cases of septic
or purulent metritis were found, some of which were invet-
erate and resisted all attempts at treatment, but the cases
of metritis which came up during the following year were
also much more malignant than at the other two farms. The

46

most frequent uterus diseases, were a mucous catarrhal
metritis with the orificium open, injected and more or less
swollen. These cases were very difficult to cure. In Lade-
gaard the conditions were very much more favorable. One
hundred and thirteen out of 197 cows became pregnant with-
out treatment. Of the 66 treated cows 64 had inflammations
of the uterus or of the cervix, in 44 the uterus being en-
larged; two of them were normal, and nine had aborted.
The majority of these animals suffered from a chronic and
catarrhal metritis, but all these affections were much more
benign than in Paeregaard.

In the third herd, at Groensletegaard, I treated 41 cows
out of 112; 25 of them also had aborted. Of these 41 cows
37 had inflammations of the uterus or of the cervix, most of
them with an abundant purulent discharge which, however,
quickly disappeared after treatment. Only two cows which
had been sterile for a long time did not become pregnant
again,

In the beginning of the second year the metritis cases in
Paeregaard were again more numerous and more difficult
to treat than at the two other places. Accordingly the
number of pregnant cows was smaller.

Similar conditions existed on the two farms Brahesborg
and Wilhelmsborg which are close together and belong to
one master. In Brahesborg nearly all the cows became
pregnant every year, but in Wilhelmsborg considerable
irregularities had existed for the last ten years. In spite of
a yearly addition of about 40 heifers the number of the cows
had gone back from 130 to 100. The conditions were similar
to those in Paeregaard. Many of the animals were affected
with a catarrhal and others with a septic purulent metritis;
these ailments were, however, of a:tather benign character
and yielded to the treatment quickly. The percentage of
the cows which conceived became 76%, which is quite satis-
factory.

On another estate, Anhof, the conditions were similar to

47

those in Wilhelmsborg. The stables, however, were not so
well built, and the floor was contaminated from several cases
of infectious abortion. Malignant metritis cases after parturi-
tion were frequent, especially after retentio secundinarum,
the operative removal of which would cause death. Steril-
ity of course, was frequent through a number of years. The
septic as well as the more chronic catarrhal metritis cases
were cured in a remarkably short time, especially after the
treatment of the retained placenta was changed. The per-
centage of pregnant animals became satisfactory, and it was
evident that this fact was in correspondence with the elimin-
ation of the septic and purulent metritis.

On most of the other big estates irregularities of concep-
tion were more or less variable, but always too considerable.
On the small farms these troubles very rarely continue
through several years, yielding to the treatment and very
often disappearing completely.

Interesting examples are the stables in Lille Myregaard
and in Gadegaard Nylars. At the first place the trouble be-
gan in 1905 without any apparent cause, and spread over the
whole herd. Twenty-one cows out of thirty were
treated; eighteen had inflammatory processes in the uterus
and in the cervix, three were apparently normal and nine
had cysts in the ovaries. Starting in the fall of 1905 the
yellow bodies in each individual case were pressed out, with
very little success, as only three cows became pregnant.
The rest had to be treated with irrigations before conception
could take place. Of the twenty-one cows sixteen then
became pregnant, and since then the conditions are nearly
normal, with only sporadic cases of sterility.

In Gadegaard Hylars the trouble began in the beginning
of the year 1906; all the cows which had calved and had
been in heat again before Christmas 1905, became pregnant
without any difficulty, but all the cows which calved after
Christmas had to be treated several times with great care
before they conceived, again. The whole herd had to be

48

treated after a while on account of a very persistent, puru-
lent and catarrhal endometritis which in every case started
with a puerperal infection. Four of the cows had degenera-
tion of the ovaries and distinct symptoms of nymphomania.
Twelve out of the seventeen cows became pregnant again.

There was no good explanation for these uterus infec-
tion in the last case; therefore one is inclined to consider the
possibility of an infection through the bull, especially as the
first two cows which did not conceive again were bred to
the bull of the local breeding society. However, in the stable
where this bull was kept, no cases of sterility or metritis
happened, nor among the other cows of other stables where
this bull was used, at least not to any extent.

There is no doubt that an infection can be carried by the
cohabitation, as the many cases of infectious abortion or
granular vaginitis in cows, and the inflammations of the pre-
putium and of the penis in the bull clearly indicate.

The question is: Should there be any importance attached
to this method of infection, and in what relation does it stand
to the sterility of cows? Is it possible to explain the major-
ity of such ailments, as Nielsen (Sorring) does, on the
ground of a follicular vaginitis or metritis, which is admit-
tedly carried through the bull?

On the basis of my rather extensive observation I must
answer in the negative, since in our part of the country the
infection through the bull is absolutely insignificant. I do
not. consider here the infection with contagious abortion,
which, of course, is a separate question.

Considering the conditions as I found them in the many
herds where I attended regularly to the treatment, and
where I examined nearly all the cows one month after par-
turition, I must say that a considerable part of the uterine
diseases was present before the cows were bred to the bull
again. Furthermore it can be shown that the majority of
the treated animals did not show any heat symptoms, or
were not bred at all, so that in these cases an infection from

49

the bull is out of the question. If I include the animals which
suffered from a metritis subsequent upon parturition, we
have the following list:

Number of herds ................... 24
Treated animals ................... 777
Without estrum ................... 328
Festi cob gate a5. Snare ee useain te atts 313
Metritis after delivery .. ......... 130

It can be seen that more than the half of the animals
were not bred to the bull at all, as they did not show any
heat symptoms, and adding these to the 130 which had an
acute metritis, we have 458 or 59%, the sterility of which
can not be referred to the bull. Three hundred and fifteen
cows had been bred to the bull once or several times before
they were treated, but the existing lesions in the cervical
canal and on the orificium could not be explained through
an infection at the cohabitation. The only explanation is
the infection during the delivery or shortly after.

A small number of the cows which had only an endo-
metritis, but no lesions on the cervix, could have been in-
fected from the bull; but this number is so small, that it is in
no relation to the frequency of the infections supposedly
caused by the bull. I have therefore little doubt that the
few cases where the transmission of an infection through
the bull was evident have been exaggerated far beyond their
importance.

Kruse (Silkeborg) reports a case like that, where a bull
had infected 70 cows, only a few of which became pregnant.
Another case is mentioned by P. Jensen (Kvarndrup). I
must, however, object to the statements of Kruse, and, later,
of Nielsen (Sorring), who, on the basis of a few cases like
these, claim that the majority of all sterility complaints are
the result of follicular vaginitis and metritis derived from
an infected bull.

50

The presence of the follicular vaginitis in herds where
an infection through the bull has been observed is not enough
evidence to permit one to regard this catarrhal affection as
the cause of the sterility. Follicular vaginitis is only cap-
able of producing sterility when the infection extends itself
to the metra; but a metritis can have many other causes;
besides, the granular vaginitis is found very frequently with-
out the animals suffering at all from sterility.

The argument has been brought forward that the viru-
lence of the infectious material or the immunity of the ani-
mal may vary, and that accordingly the disease may prove
to be very harmful in one case and comparatively innocent
in the other. It can, however, be distinctly shown that
infectious vaginitis and_ sterility in individual herds
are in no relation; in other words, the infectious vaginitis
is an extremely innocent infection, which very rarely causes
any trouble at all. If one examines the propagation of
infectious vaginitis in a herd where sterility is also com-
mon, one will generally find that all individuals—cows, heif-
ers and calves—are infected, but that only the cows have
trouble with conception, the heifers becoming pregnant very
promptly. This demonstrates the fact that the sterility is
connected with a previous parturition.

If a large number of heifers does not become pregnant
then the bull was inferior, or one failed to note exactly the
estrum periods in the animals.

In the breeding herd of Traneka there was no difficulty in
getting the heifers pregnant, despite an extensive dissemina-
tion of the infectious vaginitis; many cows however remained
sterile. Out of forty-nine heifers in Bjerrebygaard forty-
eight became pregnant, and nearly all were suffering from
infectious vaginitis. Similar conditions are found frequently.
In Skovsbo for example 98 heifers out of 99 conceived, in
spite of the infectious vaginitis, but in the same herd I
treated 36 out of 70 cows on account of sterility, in one
year.

51

It surely must be admitted that the follicular vaginitis
ought to produce as much sterility in heifers as it is sup-
posed to do in cows. Nielsen (Sorring) describes the lesions
of the granular disease as they are seen in the vagina of the
cow and on the preputium and penis of the bull; he consid-
ers them as the most important causes of sterility. This, as
I mentioned before is not justifiable, since lesions so severe
as he describes are quite rare, and because the so infected
cows conceive quite often from the infecting coitus or very
soon after.

In the last 14 years I examined 30 to 40 bulls from two
to four times yearly, and I found only two cases of inflam-
mation of the preputium which forced the animals to a tem-
porary inactivity. One of these cases which happened in
February, 1907 was very interesting. The animal was two
years old, and a quite satisfactory breeding animal. The
owner had douched his preputium and his penis after the
bull had covered a cow with infectious abortion; the tube,
however, had been used on the same day on a cow with a
purulent metritis. The bull became infected, his preputium
showed inflammation and a slight discharge. In that stage
he infected six cows, which all contracted a vaginitis of dif-
ferent intensity. Two cows of his own stable had swelling of
the vulva, a membrane of the vaginal mucosa and an abund-
ant purulent discharge; a third cow acquired a distinct fol-
licular vaginitis. Three cows in two other stables became
affected with vaginal inflammations, two of them having
croupous membranes. A seventh cow became infected
through her neighbor. None of the cows however con-
tracted a metritis, and all of them recovered inside of 14
days, becoming pregnant afterwards.

During my work as practitioner I have not seen any
other cases of transmission through the bull in 21 years, nor
do I have reports of this kind from the breeding societies,
infectious abortion of course, excepted, which is often
reported as being transmitted through the bull.

Be

I practiced not only in Bornholm, but also in Fuhnen,
Langeland, Falster, Méen, Seeland and in Schonen. No-
where did I see a transmission of that kind, finding, however,
quite often a preputial catarrh in the bull. Many of my
colleagues had the same experience, but Martin Poulsen does
not mention that method of transmission at all.

It has been mentioned quite frequently that it is not
difficult to get cows with a follicular vaginitis pregnant; the
two important factors are really the metritis of the cow and
the quality of the bull.

The acute form of the granular disease is not at all com-
mon in our part of the country, and, if present, does not
always cause sterility. So there is hardly any probability
that the chronic and mild form should be the persistent
cause in so many sterility cases.

How then is chronic endometritis the cause of sterility?

Admitting that in the majority of sterile cows a metritis
is present, and that pregnancy becomes possible if the metri-
tis is eliminated, there are still a number of conditions to be
considered.

As I mentioned before, the endometritis may take a dif-
ferent course in different animals; it may be located in the
uterus proper or in the cervix; the amount of secretion may
differ; there may be complications in the form of a real
metritis or perimetritis, and, finally, the ovaries may be
involved to a certain extent.

It is therefore necessary to find in all cases the real cause
of sterility and to then apply the proper treatment.

In most cases the sterility is caused by one or several of
the following conditions:

1. Stenosis of the cervix, of the uterus horns or of the
oviducts. They are caused by lesions of the portio vagin-
alis, of the cervical canal, or of the two orificia, by swelling
of the mucosa in any part of the uterus, connected with an
increased and pathological secretion.

aS

2. Changes of the mucosa which prevent the implanta-
tion of the ovum, or cause an early abortion.

3. Lesions of the ovaries, which are generally second-
ary, or rather, reflexive processes, and which prevent the
normal ovulation, as cystic degeneration and corpus luteum
persistens.

So far as the stenosis is concerned there cannot be any
doubt that it can be the cause of sterility. If one considers
the anatomy of the bovine genital apparatus, the narrow
and indirect cervical canal, the long and curved uterus horns,
whose lumen is so very small, specially in the apices, one
must admit that even a little change can obstruct the pas-
sage of the spermatozoa. In addition to that the mating act
in cattle is a very short and quick one, the quantity of dis-
charged semen is comparatively small, and has to be depos-
ited on a definite place.

It is generally admitted that the sperma ought to be
deposited in the cervical canal; an ejaculation into the
uterus proper is uncertain and hardly necessary. Zschokke
states that the immission of the penis into the uterus is
unnecessary and unlikely; it is however necessary that the
sperma be deposited in the os uteri externum, as conceptions
are prevented if the penis is not introduced far enough.

The changes one finds so often in the cervix of sterile
cows are capable of preventing the passage of the sperma-
tozoa entirely or of making it at least very difficult.

During the normal estrum the cervical canal is open, the
os uteri externum forms a round, wide and funnel shaped
opening which leads into the entirely passable cervical canal;
the latter is now so straight that it may be passed by the
largest catheter without difficulty. The canal is filled with
a thin, clear and alkaline mucous matter which pours into
the vagina.

It can be easily understood that the above mentioned
lesions of the cervix may prohibit conception. The swol-
len, irregular and ragged portio vaginalis often has the ori-

54

ficium on the side, which may in addition be very narrow or
even entirely covered with folds of the mucosa.

Still more difficulties for conception may be present in
the cervical canal, which may be impassable on account of
being bent, narrow, or obstructed with folds of the mucosa.
Quite frequently also a viscous and greasy secretion blocks
the canal, and is then the cause of sterility.

Even apparently insignificant changes of the portio or
of the canal, which hardly obstruct during normal conditions,
may produce stenosis in the hyperemia of the estrum. I
found that often through the examination of bulling cows.

The same observation applies to the uterus proper, where
the injected mucosa becomes still more hyperemic with the
hyperemia of the estrum, and is then capable of obstructing
the passage of the spermatozoa. This is especially evident
on the os uteri externum, where sometimes a part of the
swollen mucosa covers the orificium entirely. (See Fig. 13.)

The cow of this illustration had calved in May, 1907, and
has had an estrum three times after that. The orificium was
swollen, injected and secernating; there were large folds of
the mucosa round the orificium, which covered the entrance
into the canal entirely.

Sometimes the mucosa of the canal protrudes from the
orifcium also during the heat-free time and can be easily
recognized by its dark red color; during the estrum this
mucosa increases still more in size and obstructs the canal
completely. Similar conditions may exist in the whole
length of the canal, but are especially frequent in the middle
and near the os uteri internum.

It is therefore necessary to extend the observation to the
direction of the cervical canal, to its width, to the color of
the portio and to the state of the mucosa; it is not sufficient
to be able to introduce a catheter into the uterus, when the
animal is not in heat.

The best procedure is to examine the animal during the
estrum, so as to be able actually to see the stenosis.

a0

We have often therefore an indication for the dilatation
of the cervix; the old reason for this operation, however,
viz., a growing together of the mucosa, is an extremely rare
one in cows which have had a calf. Stenosis of course can
be caused by other conditions than by the growing together
of the mucosa.

The dilatation of the cervix has been frequently a satis-
factory measure. Esbensen (Sollestedt) told me that he had

Fig. 13.

very good successes with this operation on one estate; but
in many other cases the treatment was without result, most
likely due to the circumstance that there were complications,
or that the operation was not complete.

It is also very possible that hyperemia of the uterus-horns
obstructs the passage of the spermatozoa. Its mucosa
may be covered with mucous matter and arranged in folds.
The lumen of the horns, specially in the apex, is so very
small that even a slight swelling of the mucosa can close the
opening.

An early abortion is nothing uncommon in cows, and it

56

may be that the cows which have an estrum every now and
then, have aborted in the meanwhile. Such an abortion
can be easily overlooked. A farmer reported once to me
that he saw a heifer abort a two months old fetus. The ani-
mal pressed only a little, and she did not seem to be in the
least disturbed, as it kept on feeding. One may imagine how
easily such an act may escape observation in a dark and dirty
stable. Sometimes the ovum is not expelled at once, but
after a while, in the form of a decomposed and greasy mass.
While irrigating a cow which came regularly in heat, I once
found a fetus, and several times I have found in similar cases
parts of tissue which apparently originated from a fetus.

The cause of these premature abortus cases is the patho-
logical condition of the uterus mucosa. The ovum can not
attain the necessary nourishment and is incapable of initi-
ating those changes which cause a more intimate con-
nection between the fetal and maternal placenta during the
second month. During the first month the ovum is loose
in the uterus horn and is nourished by diffusion from the
uterine milk.

Frank states that an incomplete production of this uter-
ine milk on account of pathologic conditions in the uterus
may be the cause of an early abortion, and so the cause of
sterility.

As I mentioned before, the mucosa which is covered with
a purulent secretion is not capable of forming a close con-
nection with the fetus in the second month; if the uterine
epithelium and the uterine glands are atrophic, then it is clear
that a nourishment of the ovum is out of the question, and
the sterility is then complete.

Early abortion on account of a chronic endometritis is of
common occurrence in women.

The Cystic Degeneration of the Ovaries.

In the above I have called degeneration a secondary
lesion, which is produced and sustained by the pathological

57

condition of the uterus. The reason for my contention is
the fact that one always finds a primary metritis together
with cystic degeneration of the ovaries, and that the treat-
men of the metritis does away with the cystic degeneration.

Ovarial cysts, originating in the follicles, are of very com-
mon occurrence. Of 863 cows which I treated in the years
1905-1906, I found cysts of the ovaries in 127, or in about
14%. In 1906-1907, I found 63 in 400 cows, or 15%. Only
on a very few farms with small herds did I find no cases of
this kind; in other herds the number of cows with cystic
degeneration of the ovaries varied between 20-40%, and in
still others a trifling percentage was found.

As a rule one finds, connected with the cystic degenera-
tion, an endometritis, which may be easily recognized
by a rectal or vaginal examination. The symptoms of
endometritis are: Asymmetrical uterus horns, an open cervi-
cal canal, and especially a swollen and secernating portio
vaginalis, which produces a thick, viscous and muco-ptrulent
secretion.

Of 181 cows with cysts, 25 of which had symptoms of
nymphomania, more than half had a metritis; 179 had an,
open cervical canal, the mucosa of which was swollen and
hyperemic; they also had a swollen, injected, deformed, and
secernating orificium.

It is possible that these symptoms are not so evident in
post mortem examinations, since Zschokke found lesions of
the ovaries only in cows with nymphomania; it may be,
however, that he only examined old cases, where the uterine
lesions were completely or nearly healed.

Hess generally found metritis in cows with a cystic
degeneration of the ovaries; he concludes that the cysts are
the primary lesions, and that the uterine disease is accidental,
or caused by the defect of the ovaries. Yet he states later
that there is a certain relationship between the degeneration
of the ovaries and the abnormal dilatation of the cervical
canal. He generally found in cases of nymphomania the ori-

58

ficium open so wide that a lead pencil or even one or two
fingers could be introduced; there was also a pathological
excretion of varying intensity. Furthermore he found in the
majority of cases an enlarged uterus, which was generally
asymmetrical; the uterus can be of the thickness of an arm
and twice or thrice longer than normal. Postmorten exam-
inations of Guillebeau found in four cases out of eight the
cystic degeneration, complicated with lesions of the uterus,
the cervix and the vagina.

Tuff examined the genital organs of 14 cows and found.
inflammatory processes of the uterus and of the oviducts,
together with a cystic degeneration of the ovaries.

Even if it is admitted that the cystic degeneration is
rarely found without lesions of the uterus or of the cervix,
it is still doubtful what kind of a connection, if any, they have.
Can one lesion be the cause of the other, and which is the
primary lesion, or is it accidental that they are together met
with so often?

Hess contends that the cystic degeneration of the ovaries
causes the endometiitis, which again is the cause of the ster-
ility.

This opinion can be proved to be wrong; it is not diffi-
cult to find out that the metritis is primary and the degen-
eration of the ovaries is secondary; furthermore, the cure
of the metritis means also the cure of the cystic degenera-
tion,

In my numerous systematic examinations of cows, one
month after they had calved, I never found a cystic degener-
ation of the ovaries without a considerable enlargement of
the uterus, whose contents quite often were several liters of
a purulent, bloody or viscous fluid.

On the estate Damsbo I found out of 28 cows which had
recently aborted, 8 with cysts of the ovaries, all these cows
having also a more or less purulent metritis. In the 181
cases of cystic degeneration mentioned above, 12 of the ani-

59

mals had aborted, one had a pyometra, and of the fifteen,
which had acquired the cysts in four to twelve months after
the parturition, the majority had been sick with a septic
metritis shortly after the delivery.

That these metritis cases were caused by an infection in
connection with the parturition I take for granted. But also
many cases where later inflammatory processes on the cer-
vix and on the orificium were found, can only be explained
by an infection during or shortly after the parturition.

The cysts are very rarely formed shortly after the calv-
ing; it generally takes two to three weeks, about to the
time of the first estrum. In the very numerous cases where
I examined cows for a metritis in connection with the
calving I never found cysts in the ovaries. As I said before,
they are formed, if early, two to three weeks after the deliv-
ery, but can also be formed very much later. According to
Hess it is not very uncommon to find cysts in the ovaries
of heifers or even of young calves.

It is easy to prove that the cystic degenerations are not
only secondary lesions, but also that they are caused by
the primary metritis.

A timely and proper treatment of the metritis puts an
end to the cystic degeneration of the ovaries, so that cows
with nymphomania are nearly never seen again in herds
where the treatment mentioned is carried out. Even old
cases are cured with the successful treatment of the chronic
metritis.

Therefore, I think it probable that the different lesions
and affections of the uterus are capable of producing,
directly or indirectly, a cystic degeneration of the ovaries.
One theory is that the inflammatory processes of the metra
encroach through the oviducts upon the ovaries; in post-
mortem examinations, however, an oophoritis is seldom
found to be connected with the usual cystic degeneration of
the ovaries. The only explanation then is a reflex action,

60

which agrees with the observation that the causal lesion very
often is an inflammation of the cervix.

In human medicine we have similar conditions. Inflam-
matory processes in the uterus are supposed to produce a
cystic degeneration of the ovaries, which again disappears
when the causal lesion is cured.

We have no intimate knowledge of the process of cyst
formation; we only know that generally, solitary and follicu-
lar cysts produce the symptoms of nymphomania; there are
different opinions about the real causes and the formation
of ovarial cysts.

Zschokke contends that the lack of a yellow body causes
the cyst to form, as otherwise the ripe follicle would rupture.
Therefore if an unknown cause prevents the formation of
the yellow body, the impetus for the rupture of the follicle is
wanting and it grows larger and larger, finally forming the
typical ovarial cyst.

Hess tries to explain the cyst formation by the anatomy
of the follicle walls, without considering the yellow body at
all. He explains that in such a fragile tissue as the Graaf fol-
licle a minute disturbance or an insignificant pathological
condition is enough to interrupt the alimentary processes, If,
therefore, the contents of the follicle die, the tunica interna
will not be able to fill the cavity with connective tissue, as
is done in the atresia folliculi, The fluid of the follicle is
then augmented through transudation, and a cyst with
anemic walls, containing a fluid poor of cells, is formed.

Hess is of the opinion that cystic degeneration of the
ovaries is especially frequent in very good milk cows of from
five to eight years of age; but it is just as often met with in
very young cows or even heifers. In very high bred animals,
which are kept all the time in the stable, and which are fed
with concentrated feed, the ailment is more common than in
cattle which go on the pasture. Hess thinks the granular
disease to be an important etiological factor, as he observed

61

more cases of cystic degeneration after an infection with this
disease.

Zschokke and Hess consider heredity also to be one of
the major causes.

Metritis, however, is a simple and satisfactory explana-
tion of all the cases of cystic degeneration, which sometimes
appear to be so erratic. It explains the single and the
accumulated cases, the cases in slovenly and in well kept
herds, the cases in the stable and in the pasture. It also
explains why the disease has a predilection for some loca-
tions, and why it is sometimes so unresponsive to treatment.
What other explanation is there for the fact that this ail-
ment per se so innocent, inclines so often to relapses, if there
is not another cause, of a much more obstinate persistence
and duration?

The successful treatment of metritis indicates also the
importance the latter has as a cause of cystic degeneration.
In the years 1905-1906 I treated 127 cows with nympho-
mania; 67 of them (which equals 56%) became pregnant
again; of the rest more than half became quiet, and only
a few animals had to be eliminated on account of their con-
dition. Among these animals there were, however, a num-
ber of old cases which gave so little milk that the treat-
ment did not pay. In the years 1906-1907, the second
year of the treatment, the number of diseased animals was
in the decrease. Of 700 cows which were then examined
I found 61 with cysts, of which 46, or 75%, became preg-
nant; the rest was cured with only a few exceptions.

The following tabulation gives a good idea of the suc-
cess of the treatment; all these herds were under continu-
ous observation.

62

z ee

eee 23
a0 +o

no @

Name of Estate _ 2.

9, 2S

a

Ss 2

i :

Damsbo 123 —
MPS DEIN: Cel eeveste es Marta, ore La et $ 189 —_
Wilhelmsborg o2...eeeececccccececeeeceseeseeeeseeseeateneceseoce 106 —
Dalum Landbrugsskole 20.0... 35 _—
Anhof 100 2
Frérup Praestegaard ... : 30 —
Falkensteen wes 130 1°
Holgershaab 70 1
SISO VIS DO ei tise oss esate dN Lorca erase eee eas 70 1
Skrébelevgaard ae 70 —_—
Hansen, Torpe ses 40 —_—
Larsen, Torpe 15 —_
Paeregaard, Tranekaer 170 1
Ladegaard, Tranekaer oo....cecceccceccccceseseeeeeeeees 169 1
Gronslettegaard, Tranekaer 2.0...2.02c0ceccceeeeesen 112 —
Marienborg 252 1
Barebroéndstrup 30 _—
Malléns@aand: 0c cues eety niece nates 45 —
Pigaard 7 28 —
Savskaeregaard ghd ci nents : 25 —
Langemyregaard . 32 —
Skovgaard 25 =
St. Hallegaard 45 2
1911 10

Only ten out of about 2000 animals could not be cured.
In the years 1907-1908 the number was nine out of 3100
cows. As cured cases I understand only such as showed no
symptoms for such a long time that a relapse could be pro-
duced. The number of cows with an incurable nymphomania
is therefore so small as to be negligible.

The majority of these cows came under treatment very

early, in most cases before the symptoms of nymphomania
were developed; the presence of cysts was always recognized

63

through an examination per rectum; and the initial symp-
toms, as the sinking of the pelvic ligaments, and edematous
swelling of the vulva, were seldom lacking.

The results might doubtfully be claimed for the treat-
ment, as the early rupture of the cysts may prove, under
certain conditions, to be a better treatment than the treat-
ment of the metritis in a late stage.

This consideration induced me to segregate all the ani-
mals, which had the typical symptoms of nymphomania
with the intention of finding out if the treatment of the
metritis alone could influence the nymphomania.

In the year 1906 I treated thus 107 cows with nympho-
mania; some of them were fresh cases, but others were quite
old, a few even of a year’s duration. These cows were ob-
served for a long time, so that an eventual relapse would
have been noted. Pregnancy was in all cases determined
by rectal examination.

Of these 107 cows 92, or 86%, were completely cured;
two animals were castrated, eleven became partly quiet, and
two could not be reported. Of 92 animals 72 became preg-
nant.

The success of the uterus treatment in nymphomania is
therefore evident. In the majority of the cases the symp-
toms disappeared very quickly, and in the others the relapses
were only mild; in only a few cases could the animals not be
kept on the pasture.

In more than half of the animals the treatment had to be
repeated however;

36 cases were once
32 cases were twice
19 cases were three times
7 cases were four times
5 cases were five times
and 8 cases were still oftener treated.

I must say, however, that many of these animals were
not so thoroughly treated as my present theory demands.

64

If I compare these results with those I used to get from
rupturing the cysts, the difference is very striking. Since
Hegelund advised the rupturing of the cysts I have used
this treatment quite often. I will give the experience of two
years. In the year 1904 I treated thus 30 cows, 22 of which
had to be castrated; in 1905 I treated 57 and in 37 had so
little success that they had to be castrated also. That is, of
course, a very poor result.

My present treatment of cystic degeneration of the
ovaries consists of rupturing the cysts, douching the uterus
and treating especially the cervix.

I always rupture the cysts through the rectum, and never
have been unsuccessful with that method.

The treatment of the uterus has to be very painstaking.
Even if it is enlarged only to an inconsiderable extent I apply
a massage over its entire length and make an irrigation with
alcohol. If there are no pus-flakes or other pathological
secretions present I fill the uterus with solution of Lugol
(Iodine 1, 0, Potassium Iod. 0, 3, Aqu. 97.0) ; in the contrary
case I use a solution which contains the same chemicals in a
concentration of 1:3:17. I inject it with a small rubber
catheter which I introduce with a mandrin, and which is not
dangerous, even if pushed to the apices of the uterus horns.
One also can use a small syringe. The treatment of the cer-
vix is the most important, however, as it is there that the
most prominent lesions are found. The inflamed and secer-
nating mucosa has to be cleaned with alcohol, and the entire
cervical canal has to be wiped with a cotton plug soaked in
Tincture of Iodine or in Lugol Solution.

I used to treat the vaginal portio, which is also generally
affected in cows with nymphomania, exactly as I treat the
cervical canal; but I found that I had better success if I cut
away all the pathological tissue which had formed round the
orificium. The recovery takes much less time, and is surer.
The operation is not painful, and the bleeding even in ex-
tensive operations is insignificant. I have used quite a num-

65

ber of other chemicals, as alumen, argentum nitricum, cre-
olin, lysol, lysoform, acid, pyrolign and glycerine, but the
iodine treatment gave the best result.

The success of the treatment depends to a large extent
upon the age of the affection. Very often the treatment has
to be repeated at frequent intervals.

The Persistent Yellow Bodies.

Much attention has been paid in this country to the cor-
pus luteum persistens as the cause of sterility in cows; espe-
cially in of late years the pressing out of the yellow bodies
has been used very frequently in the treatment of sterility.
It was supposed that this operation would not only excite
ovulation, but would cure also the different affections of the
metra. The treatment has even been used by farmers, in
the hope of having in it a simple cure of these troubles.

It is, however, no longer doubtful that those expectations
were exaggerated; disappointments were frequent, as was
inevitable when people thought to find in this operation the
universal cure of all genital troubles in cows.

So far, it is not known how the yellow bodies are formed,
whether from the tunica interna or from the membrana
granulosa; nor is their physiological function clear. Among
practitioners there is no knowledge about the significance
the yellow bodies may have in regard to sterility.

One needs only to compare the opinions of Nielsen and
Poulsen. Nielsen contends that the loosening of the yellow
body has the same effect as the complete pressing out, while
Poulsen states that the pressing out has to be quite com-
plete. It can be demonstrated, however, that neither the
loosening nor the pressing out are necessary operations to
produce a speedy appearance of the heat; a simple massage
of the uterus or a warm infusion in the vagina produces the
same result.

Moreover, it is more reliable and safer to treat the affec-
tions of the uterus than to try to produce an estrum by
pressing out the yellow bodies.

66

A comparison of results makes this statement very con-
vincing. In 143 cows, which were treated in 1905-1906 with
uterine douches, there were 139, or 96%, which showed heat
symptoms after the treatment. In 99 cases they appeared
inside of a month, in 35 inside of two months and in 4 in-
side of three months, which was, on an average, inside of 20
days after the treatment. Among the cases where the treat-
ment was unsuccessful was one old case, one cow with
nymphomania, and one with tuberculosis. 122 cows became
pregnant, 99 of which conceived after the first cohabitation.

I think it is quite evident that a metritis is more efficient-
ly influenced through a direct treatment than through the
pressing out of yellow bodies; specially in a pyometra I
consider the treatment of the ovaries as quite illusive. This
is still more the (illusive) case when a stenosis of the
cervical canal is present. I have therefore given up pressing
out the yellow bodies, and employ this treatment only in ex-
ceptional cases, for example, in cows with a very small vulva.

The Treatment of Sterility.

I first try to eliminate all the animals which may be preg-
nant by a careful examination per rectum; on the others I
employ the treatment according to the diagnostic examina-
tion per vaginam and sometimes also per rectum.

The treatment is different when a recent metritis, with a
more or less putrid discharge, or a chronic endometritic, or a
pyometra is present.

Since the endometritis as well as the pyometra is caused
by an infection during delivery, it is important to pay more
attention to diseases of the uterus shortly after the parturi-
tion.

The aim is

1. To prevent an infection of the uterus,
2. If an infection is present, to bring the metritis
which follows to a quick termination.

In regard to the first point, I think it important to note
the most frequent cause of a malignant infection. This is the

67

retentio secundinarum; operations during birth are of only
small importance.

The question is now, how to treat cows which retain their
placenta?

There are considerable differences of opinion on this
question; some advise leaving the secundinae undisturbed,
but the majority try to remove them. Others prescribe
medicaments, but nearly all order irrigations with indis-
criminately strong creolin—or lysol solutions.

If the removal of the placenta is done with all care, and
with proper consideration for all circumstances, it is with-
out doubt the best treatment.

It should be done within the first twenty-four hours after
calving, at a time when the uterus is not yet contracted
and the secundinae are still quite fresh. The wide open
uterus permits an easy operation, and the danger of infec-
tion is then as small as possible. It is absolutely impractica-
ble to wait for a few days; if the secundinae do not go out
in the first seven or eight hours, they only very rarely will
without operation, and it is therefore senseless to wait. The
operation has to be performed with the utmost care and
cleanliness.

The placenta should be removed entirely, but it does not
matter very much if little remnants of it are left in the apices
of the horns. If one is not able to remove the bulk of the
secundinae, viz., if the connection between them and the
uterus is too strong, or if the animal presses too much, one
should desist from the operation. The new treatment with
an injection of a normal salt solution into the vessels of the
placenta seems to offer a splendid solution of many diff-
culties.

After the removal of the placenta I usually do not make
an infusion, since the value of such a procedure at that time
is doubtful. If a malignant infection has taken place before or
during the operation, its development can not be prevented.
The straining of the cow, furthermore, is harmful, and so is

68

any quantity of the infused solution which may be retained
in the uterus. As a matter of fact it is nearly impossible to
remove all the fluid from the horns, where it then prevents
the contraction of the uterus, and facilitates an infection.

If the secundinae are decomposed I do not advise a pre-
mature attempt at removal, but think it better to wait until
it is possible to pull out the placenta in its entirety and with-
out violence; a careful irrigation should follow.

If an infection has taken place and a metritis is found,
then it is important to bring this metritis as quickly as possi-
ble to a conclusion. The contents of the uterus have to be
removed, and the organ carefully cleaned through disinfect-
ing irrigations. Till now this has been a difficult task; the
contraction of the cervical canal and the restlessness of the
animals have made the introduction of the catheter, which
was, moreover, inefficiently constructed, very difficult. The
whole technique has been very unsatisfactory. One has
generally been satisfied to infuse a solution of carbolic acid,
lysol or creolin, and has not taken care really to clean out
the uterus. This mistake can not be remedied by the use
of strong disinfecting solutions. On the contrary, the in-
fused fluid can be harmful by increasing the resistance which
the uterus has to overcome in its involution.

The important measure, therefore, is to remove all the
contents of the uterus, so as to make its contraction easy.

The following technique is an efficient and an easy one:

Fig. 14--Sharp hook.

A sharp hook (Fig. 14) is inserted into the cervical canal
and the cervix drawn into the vulva; a speculum (Fig. 15) is
then put into place. With two or only one big forceps (Fig.
16) the cervix is then securely held, so that a catheter easily
can be introduced into the uterus. The cows feel pain only

69

when the arm is introduced in the vagina, but do not mind
the subsequent operations.

I use for infusions and for the removal of the uterus con-
tents a thickwalled rubber catheter (Fig. 17), which is closed
at the end but has two openings on the side. Such a catheter
is easily introduced and does not clog up; another advantage

Fig. 15—Speculum.

of it is that it does not become closed by sharp turns or by
the pressure of the cervical canal. If the canal is so narrow
that I can not introduce this catheter, then I try to dilate it
by the use of a bigger one. If even that is of no use, I em-
ploy a metal tube as a mandrin. (Fig. 18.) After I have in-
troduced the catheter with the help of this instrument I draw
it so far back that its end is on the os uteri internum. The
rubber catheter is then in the uterus proper and the metal
tube keeps open the cervical canal. The contents of the
uterus can be then easily removed after they are diluted
with water. To remove the contents completely it is neces-
sary to massage the uterus from the rectum. It is quite
possible to clean the uterus by repeated infusions. If tissue
remnants or necrotic cotyledons are found which cannot pass
the catheter, one must try to press them through the cervix,
possibly after a dilatation of the latter with the knife.

For the irrigations I employ first pure luke-warm water
or weak solutions of lysol (14—1/10%), and afterwards a
solution of iodine and potassium iodide in the relation of
1:3:97 or 1:3:200, which, however, has to be removed again.

70

In the treatment of the chronic endometritis one has to
pay chief attention to the size of the uterus, to the thick-
ness of its walls and to the nature of the secretion; it is also
important to note whether the mucosa of the uterus is
affected, or whether the lesions are chiefly in the cervix. An
affection of the uterine mucosa without lesions of the cervix
is rarely found; the contrary however is quite frequent, spe-
cially in old cases.

The treatment consists of:

1. Drawing back the cervix,

2. Introducing the catheter,

3. Removing the discharge and

4. Infusing the disinfecting and astringent solution.

If the portio vaginalis and the cervix are much affected,
they are treated specially.

Fig. 17—Rubber catheters.

re

Fig. 18—Mandrin.

I always use a hook to draw forth the cervix, since it is
easier to insert than the forceps which I use afterwards to
hold the cervix in its new position.

My metal catheters (Fig. 19) are of two sizes; besides
them I use several rubber catheters of varying size. One

71

has to introduce the metal catheters with a boring motion,
but has to bear in mind that the body of the uterus is only
2-5 cm long. It is therefore easy to perforate the uterus
wall if the necessary care is not employed. If it is difficult
or impossible to penetrate the os uteri internum, it has to be
enlarged with a forceps (Fig. 20) or with the knife.

Fig. 19—Metal cathether.

yy aa-=
O

Fig.20—Forceps for the dilatation of cervex.

It is impossible to penetrate further with the metal
catheter than into the body of the uterus, and one can there-
fore remove only the discharge which is present there; no
doubt one can fill the horns of the uterus with the solution,
but it is impossible to get it completely out again with
massaging. I use therefore the rubber catheters which I
introduce with a mandrin; after the mandrin is removed one
is able to push the rubber catheters without danger of per-
foration inte the uterus horns. It is possible then not only
to remove all secretion present, but also to infuse concen-
trated solutions without bringing them into contact with the
vaginal mucosa.

I have used solutions of sodium carbonate, sodium chlor-
id, creolin, lysol, lysoform, alum, argentum nitricum and of
iodine. I had the best results with a diluted alcohol in-
fusion, which dissolves very well the viscous and greasy
secretion, followed with another infusion of Lugol solution,
1:3:17 or 1:3:97. In most of the cases the weaker solution
is sufficient, but in old and obstinate cases I always use the
stronger one, which I inject with a rubber catheter and a
glass syringe.

72

As a rule the cervix has to be specially treated. If the
cervical canal is narrow and crooked and its mucosa injected,
secernating and covered with a mucous, greasy excretion,
then all these parts have to be cleaned with diluted alcohol
and cotton, and afterwards painted with astringent solutions.
For a while I used ac. pyrolignos. crud., but gave it up on
account of its persistent odour; I am using now tinct. of
iodine (1:10) or Lugol solution (1:3:17).

If the lesions are very prominent and the portio vaginalis
is very much swollen and deformed, as is quite often the case
in cows with nymphomania, then the treatment must be re-
peated several times before satisfactory results are attained.
I prefer therefore in these cases to remove the pathological
parts of the mucosa with the knife or the scissors. The
operation is not very painful, and the hemorrhages are al-
ways insignificant; since the tissue is, however, rather tough,
it is necessary to have sharp and strong instruments. If
there are considerable lesions of the cervix I have daily in-
fusions made with a solution of sodium carbonate.

The pyometra is treated, just like the acute septic metri-
tis, by cleaning the uterus and subsequent disinfection. As
a rule a mandrin has to be used to introduce the catheter, as
the cervix is generally swollen and the cervical canal is very
narrow and crooked. The contents of the uterus have to be
removed by massage from the rectum; there are often con-
cretions. The discharge may be thick, and has then to be
diluted, or it may be purulent, fetid or odourless. It may
amount up to 12 liters. After the removal of the secretion
the uterus collapses and can be encompassed by the hand.
The walls are nearly always very thin, and the introduction
of even a soft catheter has to be done with the utmost care
so as not to perforate the walls. In some cases the uterus
does not collapse; the walls are then thick and contract into
folds. If the horns of such an uterus are massaged one feels
that an inside membrane becomes detached; in the ends of
the horns generally necrotic tissue is found.

73

It is advisable to begin the treatment of sterility as soon
as possible after the last parturition, as it is then less diffi-
cult to effect a cure. In old cases careful and often repeat-
ed treatment is necessary to limit the secretion and to make
the uterus normal again. The eventual pregnancy depends
on the condition of the cervical canal, whether it be passable
or not, and of the uterus mucosa, whether it be capable of
complying with the needs of the ovum. The majority of
old metritis cases is incurable, or if not the treatment would
demand so much time and labor that only very expensive
animals would be worth it.

.Fig, 21—Sterilizer.

The treatment of the uterus demands the most painstak-
ing cleanliness, as there is always a danger of infection. The
surgeon has to have clean hands and instruments; especially
the latter may transmit the infectious material. They have
therefore to be sterilized after each single case, which may
be easily done in sterilizer I am using (See Fig. 21).

It is remarkable how little the animals are disturbed by
the treatment and how negligible the eventual complications
are, provided that a careful technique is employed. The in-
sertion of the instruments in the cervix does not produce any
pain, nor is there a disagreeable reaction to the strain of the
ligaments when the cervix is drawn into the vagina. The

74

most painful operation is the introduction of the hand into
the vagina and the insertion of the speculum, especially if
the vagina is very narrow, as in heifers. The mucosa of the
vagina is very sensitive to strong disinfecting solutions, and
special care has to be taken not to let any of these solutions
come into contact with the urethral mucosa; this would pro-
duce much pain and restlessness. In cases with chronic in-
flammations the mucosa of the cervix and of the vagina do
not seem to be so very sensitive; the most irritating solu-
tion seems to be the creolin, while the Lugol solution irri-
tates the least.

The only dangerous complication is the perforation of
the uterus wall. If the contents of the uterus are putrid, a
dangerous and possible lethal peritonitis may be the result.
This happened twice to me; in the first case I perforated
with my largest metal-catheter in a rather recent metritis.
The cow contracted a peritonitis, but recovered after a long
time. The second cow had aborted, and the uterus walls
were very thin; I perforated with a rubber catheter and had
the animal killed, as it developed a peritonitis. Beside
these cases I had no other accident in the treatment of more
than 4,000 animals. With good technique and the proper
catheters, such as I use now, a perforation is nearly out of
the question.

In cases of catarrhal metritis a perforation with a sterile
catheter is of no significance.

I have made the important observation that one can
sometimes irrigate a pregnant uterus without disturbing the
pregnancy. In a number of cases the animals had been in
heat such a short time ago that it was not possible to make
the diagnosis of pregnancy; the uterus was enlarged, the
walls thickened and the cervical canal open and secernating.
JT made infusions, and found later that the animals were
pregnant, without having been covered since the treatment.
In the first cases I was dubious about the reliability of the
records, but later became convinced and now I have on rec-

75

ord about one hundred cases of this kind, among them
pregnancies up to three and a half months. A very remark-
able case I had in Skrébelevgaard, where I made a rectal ex-
amination in a cow and found a pregnancy of three and a
half months. However, I was informed that the cow had
not been bred, and then corrected my diagnosis, supposing
the presence of a pyometra. The cervix was open, and I in-
fused a Lugol solution of 1:3:97 strength. The cow,
however, was pregnant, yet did not react with an abortion.

The Results of the Treatment.

Several facts are to be considered in estimating the re-
sults of the treatment as they depend: 1, on the care and
efficiency, with which the breeding of the herd in question is
done, 2, on the percentage and character of the prevailing
irregularities and 3, on the technique and frequency of the
treatment. ;

As to the first point, it is of course necessary that the
animals be bred at the right time and to a good bull. Both
points are very often neglected; the estrum symptoms of the
cows are not sufficiently noted and are often passed by, or
the mating act is not satisfactory on account of a mediocre
or abused bull. The estrum symptoms in some cows may be
so slight or of such short duration that even a good-observer
may overlook them. In nearly all the large herds I find
cases of this kind, and there the care is generally better than
on the smaller estates. It is, therefore, advisable to make
regularly rectal examinations at least on the large estates, so
as to control efficiently the breeding of the animals.

The second point is of more importance still; it concerns
all the animals of a herd, while the overlooking of the estrum
is more or less exceptional, the circumstances that breeding
results are some times better in small stables than on large
estates, is often explained by the better attention which is
paid there to the mating act. In the large herds the breed-
ing makes much work, and is very often ordered to be done
in the leisure time of the attendants, much to their displeas-

76

ure. It can, therefore, be easily understood that an insufficient
mating act may be passed for a normal one under the cir-
cumstances. Very often the bulls are exhausted; and not
infrequently the bull which is the easiest to handle is used
over and over again, even if the others are quite fresh. The
most frequent difficulty in this regard is that the bull is in-
capable or unwilling to breed with the necessary energy.
The reason may be: too bulky abdominal organs, too long
hoofs, pains in the tendons or in the joints, or, especially, in-
flammatory processes of the preputium. The latter are often
overlooked on account of their chronic character; they may
be without significance and not deteriorate the qualities of
the bull, but very often they hinder the animal from perfect-
ing the mating act with the energy necessary for a fecunda-
tion. Sometimes these bulls infect the cows, and one is able
then to notice a few days after the breeding an injection of
the vaginal mucosa, and exudation. This infection is often
considered the cause of the sterility, which is usually present,
but the real cause is the deposition of the sperma in the
vagina, where it perishes.

These facts I have found out only of late years; I
had observed that in some herds which were under quite
similar ‘conditions of housing and care and where the per-
centage of metritis infection was rather even too, there
nevertheless was often an unexplainable difference in the
percentage of pregnant cows. For instance, in Paere-
gaard, an estate I mentioned before, the metritis cases
were more numerous and more malignant than in
Ladegaard, during the first year of treatment as well
as in the beginning of the second year, nevertheless 65% of
the animals compared with 72% in Ladegaard became preg-
nant. In the second year, however, the percentage of Paere-
gaard decreased in an inexplicable way, as the metritis cases
were now no worse than in the other two herds which be-
longed to the estate. The cause could be only the bulls;
there were three bulls used for the healthy cows, and one

77

which was bred only to the animals which had infectious
abortion. The lists indicated that the bull “Odin” had cov-
ered 72 cows, 25 of which became pregnant; in the case of
the bull “Bjarke” it was 37 out of 76, and in “Loke” 11 of
24. An examination of the genital organs offered the neces-
sary explanations of these poor results. Odin had a hard
tumor of an apparently tuberculous nature in the upper part
of his right testicle; the other three were affected with an in-
flammation of the preputium, which did not prevent the mat-
ing act but caused its being insufficiently executed. One
of the bulls infected the cows, but only in a hardly noticeable
degree, and was later cured; the affection of the other bulls
resisted treatment.

The preputial catarrh is per se of no influence in regard
to the fecundation, if only the act is perfected with the neces-
sary energy. In July 1906 all the bulls of the estate Falken-
steen became suddenly very slow in covering the cows, but
nevertheless did it satisfactorily. In November of the same
year I began the examination and treatment of the cows
there and found quite a number of fresh metritis cases.
During the fall and the winter the bulls became still more
slow and in February they refused entirely to cover the
cows; on all of them a preputial catarrh was found. The
animals were treated and the mating was discontinued for
one month. After the lapse of this time the bulls were
cured and the slowness in the mating act had disappeared;
there is, therefore, no doubt that the preputial catarrh was
the real cause of the trouble. The percentage of pregnancy
was, in spite of the conditions of the bulls, a quite favorable
one, namely 87%. Another example of the importance
which is to be attached to the condition of the bull, I found ina
herd of 12 cows, three of which had aborted. The affection
of all the cows was ofa slight nature and all showed symptoms
of heat 14 days after parturition. The three cows which had
aborted were covered by a strong and healthy bull, while the
others were bred to an overworked animal of a breeding

78

society. The first three cows all became pregnant after the
one cohabitation, but only one of the others did. None of the
animals showed any lesions after two careful examinations.

I saw also many other cases where the bulls did not breed
well, and it is necessary to keep this possibility in mind, in
passing a judgment on a treatment of sterility.

Sometimes in a herd of heifers only a few are pregnant;
then there is most certainly something wrong with the bull.
If the bull is together with the cows in a pasture, then the
breeding can not be observed and controlled; it may happen
that a number of cows come in heat at the same time and the
bull can then not be expected to cover them all well. Even
a young bull may early become a poor breeding animal.

The success of the treatment depends, of course, chiefly
on whether benign or more or less severe cases are the
subjects.

In the result of the treatment the date of commencement
of the pregnancy after the treatment, must also be considered
and not only that the animal becomes pregnant at all.

In the following tabulations only such herds are included
that were under observation and treatment for a considerable
time, and of which I have all the important observations and
the breeding lists, and in which I had the chance to make
the final diagnosis of pregnancy. Single animals and herds
where I undertook the treatment only casually, are not in-

cluded.

With the exception of the first eight herds, I have not
used the pressing out of the yellow bodies, to any extent.

The number of cows under observation was 3,527, 1,513 of
which were treated once or more often on account of
metritis, or of irregularities of the estrum. All the animals
came under treatment in an early stage.

Of these cows 1,176, or 78%, became pregnant again.

The value of the pregnancy, however, as I have already
stated, depends very much upon the length of time which
has elapsed before the fecundation. Therefore, in 1,004

79

cases, I give the exact time in which the fecundation took
place. I could not include all the animals, since I did not
always have complete lists, and as a part of the cows became
pregnant after I finished this report.
Out of 1,004 cows the following numbers became preg-
nant in the following time:
510 within 6 weeks.

187 within 2 months.
135 within 3 months.
64 within 4 months.
48 within 5 months.

39 within 6 months.
21 within more than 6 months.

The number of animals which became pregnant inside of
the first three months is therefore 832, or 83%. It is likely,
therefore, that if the animals come under treatment soon
after the last parturition, in 83% of them sterility can be
prevented. The normal term between two deliveries is 15
months; if, therefore, the cow calves later, a temporary ster-
ility is present. To prevent this condition the cows have
to come under treatment early.

In the last two columns of the tabulation the animals are
given which carried over into the next year, and those which
were discarded as hopeless. The first number 154 or 10%,
the latter 180 or 12%. Of the animals which were carried
over not all are sterile ones, as some came under treatment
shortly before the end of the year. Among the discarded
ones all animals are included which were treated, even if
found to be incurable after a short trial; not included, how-
ever, are the animals which were eliminated in the
first examination. Among the latter are all the animals
which had been sterile so long that a treatment would have
been unreasonable. In every herd many of such cows are
found at the beginning of the treatment.

In the now following tabulations is recorded the treat-
ment of the animals which had aborted is recorded.

80

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82

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84

Zz > 4 ica] ‘d ie) >
fo) o 4 () lay » o
os 8 8 = R = :
re = ao 5 Z a §
Estate 2 Es a. 3 = : B Remarks
5 . . . 7 .
Gronslette-] 18 8/,, 05 5/, 06 47, 06 yes 1/,,07
gaard. 3110/05 5/06 5/ ,,, 06 yes 7/,,07
32 /,, 06 5/, 06 5/,, 06 yes /,,07
36 2/06 5/. 06 6/,, 06 yes J oq 07
40 -7/,, 06 11/, 06 11/06 yes Lg OF:
43 9/, 06 ae er 06 AME eae 21 OF yes U/,, 07 Pp '
45 8/,,06 11/,06,3/,,07 1/,,,2/,,4/,,07 yes 12/,,07 ¢ al
49 4/).06 8/31/06 8/,,,1/,06 yes 6/07 Tul
51 8/06 1/,06, 1/,, 07 3/,,,9/,07 yes 7
54 8/,, 06 11/, 06,1/,, 07 ah 07 yes 1/,,07
92 7/5506. 17,,,2/,,.07 8/4, 3/50, 4/,,07 yes 1/,, 08
P /.,1/, 06 ad
56 4/,,, 06 1.) a}? 7 7 times yes
om 16
57 /,, 06 Tae LOT no estrum Sold
58 8/06 11/, 06, 1/,, 07 Bf os thie hg OF VES
61 */,06 31/,06,2/,.07 2/,3/"" 5/.07 yes 1/,, 08
63 °/,,06 11/,06,1/,,07 32/,2/,,,2/,,07 yes 12/, 07
72 ee 06 bag 07 2h as Shans ae 07 yes
74 10/,, 06 1/,, 07 2/,,3/,07 yes Dead
78 1/07 3/07 6/,)5/,07 yes 1/,,07
90 12/,,06 Ty O07 ay 2/8) 07 Yes
91 19/06 = 3/06 2/° 06 yes. %/,, 07
93 12/, 06 /,,,07 8/07 yes 10/07
94 12/06 1/07 5 times
96 1/07 1/4. 07 8/14,°/4,07 yes 1/07
98 1/07 -1/,,, ®/,, 07 4 times no
99 1/07 1/07 4 times no
Lade- ;
/,07 4/07 8/15 8/ oy O7 yes
caecaaad ane ae a, 4/06, Trap Mog 7 Yes
265 1,07 6/07 Wf OF yes
3164/07 8/07 7,07 ‘yes
Damsbo 8 4,05 12/505 1/, 06 yes 1°/, 06
Hoved- 10 8/05 12/505 1/06 yes 10/06
gaard. Ty 20/505 122/,05 1/, 06 yes 10/06
13.; Hey 5105 12/05 2/,, 06 yes 8/,, 08
13 8/,,06 10/, 12/, 06 2/07 yes
32 10/505 8/05 1/06 yes. 10/,, 06
63 7/05 12/05 1/, 06 yes 10/, 06

85

4 > a sa a) a) >
9° ea 3 & a 2 a
2 3 S 2 e = F
Estate 9 a. Be = 3 a a Remarks
= :
82 Uh 05 22/05 1/,, 06 yes 10/,, 06
109 8/,.05 37,05 1/, 06 yes 11/,, 06
131 21/,,05 */,, 06 4/,, 06 yes 1/,,07
163, 22/,,05 2/,, 06 4/, , 06 yes /,, 07
4 8/06 327,06 12/,,06,1/,,07 yes 1/,, 08
7 8/,,06 12/506 Bf sh a Sg OF yes 29/07 Sold.
24 9/, 06 12/06 2/1, 07 yes
29 10/,,06 many times 6/,,07 yes
149 11/,,06 12/, 06, 1/,, 07 yes
98 11/,,06 12/, 06,1/4,,°/5, 07 #/,,07 no
70 11/,,06 19/06, 1/,, 07 2/307 yes 1/,,07
44 12/,, 06 4 times no no
36 19/, 06 3 times 5 times yes 3/,, 08
Tybrind.
50. 22/505 2/. 06 47, °/,, 06 yes 7/, 07
83 8/,05 11/,,05,?/,06 1°/,,05,1/,,,3/,, 06 yes 12/ |, 06
88 = 7/,,,05 11/05 oa yes 1°/,, 06
138 11/,, 05 2/,, 06 4/, 06 yes 1°/,,07
165 22/05 2/,, 06 4/7, 06 yes 1V/,,07
214 -6/,, 06 3 times 3 times no
17z 97,05 11/,,05 12/,,05 yes 10/06
1549/05 11/,,, 06 12/, many times yes 9/,, 07
36 5/, 06 8/405 6/, 06 yes
16 9/,06 1°/, 06, 1#/, 06 10/.06,1/,4,1/3, 07 yes
31 °/,, 06 22/06 1/392 "/9,07 yes 1/, 08
46 10/06 10/06 u/, 06 yes 7/,,07
60 11/,, 06 1/07 « 3/07 yes 12/07
63 ?/,, 07 4/07 yes
66 8/06 1°/, 06, 5/,, 07 8/,, 07 no
78 ~=12/, 06 7/,,07 no no
141 11/_, 06 12/06 2/07 yes 12/07
210 4/,,06 7,5, 444407 yes 12/07
151 8/,, 06 10/_ 06 10/06 yes 1°/,,07
184 9/106 1°/,, 12/, 06 2/07 ~—syes. 12/07
183 11/, , 06 1/,, 07 4/°_ 07 yes ?/,, 08
Vilhelms- Se PO a en 8/4, 8/4306 yes °/,,07
borg. 10 1/,,, 06 Bf 4/006 5/,,°/,,06 yes
20 -1/,, 06 8/.,, 4749 06 8/, 06 yes

86

Z > ae ies} 5°] ie) a
= ce A pe a ian eq
2 ma = g Z a + Remarks
Estate a es as : 5 : A
85 1/,, 06 8/,, 7/,, 06 87 09°/45°/ 9957/ 406 yes
96 to OD 3/, 06 8/,, 06 yes
107 7/,, 06 Bfoq bag OO ee 06 yes Necrosis
148 42/,,05 3/,, 4/45, 1/, 06 no no ot
149 2,06 =—*/,, 7/06 yes vagina.
22 yes
Rissinge. 3 8/05 4 times Tf, 06 no
f 40f 05 12/. 05 1/,, 06 yes
224 6/05 12/,,2/,, 06 /,,06 yes */,,06
248 10f,, 05 2/,,, 06 4/06 yes
Dalum. 26 ah 06 5/ 06 yes 8/07 10223 1b.
2 e 06 BY ee 07 8) de 07 yes milk.
19 5/06 1/,,07 yes 403 Ib. but-
ter.
Anhoff, 9423 Ib.
6 7,08 4/,.6/,06 5/,4,9/,,7/,,06 yes 4/,, 07 ee
8 12/05 2/,, 06 4/06 yes 4/,,07 sau
9 8/,,05 7/55, 4/45, 9/, 06 7/,, 06 yes 4/,,07 fer,
12 9/05 #/,, 06 5/517 8/,06 yes 4/07
28 10/5,05 2/,5, 4/55, 9/, 06 8/., 9/06 yes 8/,07
82 4/05 2/55, fon, 81, 06 4/55, °/og06 yes 4/,07
38 2/,,06 —4/,, 6/,, 06 5/,,,°/,,06 yes 4/07
29 10/05 12/505, 2/,, 06 ?/,,,3/,,06 yes 1/,.07
17 12/,05 2/,, 06 4/,, 06 yes Sold.
22 2/,,05 2/,,060. £1. G. : yes Sold.
D. 8/ 06 127, 05,27. 06 4f5, 914,06 yes 3/,,.C/
56 1407 Th OF U5 yes
76 706 8/,, 1/4, 07 6 times yes
Bare
a ee
strup. 4 13 19
Falken: 26 12/,, 06 3 times 1 time no Pyome-
steer, 23 Aug. 05 u/,, 06 12/06 yes Oct. 07° tritis.
58 12/06 1/,,07 275 Ot OF yes
74 44/06 1/,, 07 4/07 yes
77 -1/,, 06 1/07 4/,,07 yes

87

a : oF fs
2 3 = ¢ G 3 g
Estate a & a. 8 B a cy ‘Reinails
z ; . f :
88 1/,, 07 174,07 2f ag OT ge OF yes
89 1/07 1/,, 07 8/4. 81,307. Yes
90 2/,, 07 3/07 8/4, aay 24 0% 0
Skovgaard) 1 4/,,06 8/,,8/,,14/,, 06 12/06 yes 9/07
2 12/06 2/07 3/,, 07 yes 12/, 07
7 14/,,07 igh OF Shige #/ gs Vg; Peg OF YES 5/, 08 “
12 2/06 8/06 177. 8/,,, 8/4407 yes 2/4, 07
12 Wg OE 5/07 Sa, ely OF = yes. BA 08
15 8/06 = 1/,, 06 27,06 = yes. 1°/, 07
19 3/,, 06 6/06 7,06 yes 4/, 07
21 3/,, 06 6/06 10/_, 06 yes 7/,,07
22 1/06 ~~ */,, 06 2/06 yes. 12/,, 06
23 4/06 6/, 06 6/, 06 yes 3/,, 07
24 3/, 06 4 times 9G. 6/07 yes 3/, 08
18 4/,, 06 8/06 6/,5,7/,06 yes 10/ 06
18 77/, 06 Sold.
14 5/,,06 not treated 7/06 yes Nov. 06
Lange- 54. 2/,, 07 once 4/oay°/1307 yes */,08
myre- 48 oe 07 ae o. fl. G. 5 times yes 8/08
gaard. 4 1/06 1/07 Sold in
16 af 02" Bhi Aer. 07 3 times no April
20 2/,,07 several times several times Pyome-
39 July06 many times many times tritis.
22 3/,,06 not known 9/,, 07 no Cyst.
33° 4f OF Alig, hgh 07 no
37 2/5207 Bhi 87, 8/,, 07 a ee 8/,, 08
41 12/,,06 4/07 4/07 yes 1/,, 08
43 2/,,07 4/07 7/, 07 yes 47, 08
44. Nov. 06 2/07 2/,,07 yes 11/,,07
46 11/,,06 1/,,,/,, 7/5 07 3/,, 07 yes 12/,,07
53 2/,,07 not treated 11/407
Raaby- 2 HE 06 97,475, 5/,,8/,,,07 yes 1/, 08
gaard. 4 1/,.07 2/07 4/07 yes 1/08
5 aH 06 te 07 2 as Ale Pa 07 yes Aa 08 Sold.
6 10/, 07 10/07 Pyome-
7 8/07 1/07 tritis.

88

‘Estate

a SMO) jo “ON
" payoqy

“payor,

“uni sy
‘*yueusoig

“ paarey
“ payoqy

Remarks

Varme-
lands-
gaard.

St. Myre-
gaard.

4/ 59 29/yq 07

2 6
eer ee 07

7/07
February
not treated
3 times
3 times
1 time
2 times
1 time

several times

December
December
December

°/,, 08

4/08

4/, 08
4/,,°/,, 08

not treated

Hf Lg, Wa, 81, OF VES

“a/. 07,3/,08 yes
#/,,°/,07 yes

Ron 07 yes

Blan Cac (ag! Yes
3/08 yes
2/4507 yes

a 07 yes
ae 07 yes

4 times yes

814 8A 207 yes

7/4407 yes

March yes

6 times no

3 times yes

February 07 yes

8/07 yes

4/,_ 08 yes

several times no

1/08 yes

several times yes

10/07 yes

5/, 08 yes

2/08 yes

5/,, 08 yes

2/,, 8/,,, °/,, 08 yes

fay, 08 yes

5/08 yes

Sere ce ay ass Abs yes
7/, 08

30

2 pet 28
| 55 8/5 08 yes
no
6/7, °/5,08 yes

Heifer.

Metritis.

Cysts in

the ovaries.

Heifer.

Sold.

89

sg 2 a 5 8 &
e 2 u 2 is F 5
Estate O a. a. 5 S = a Remarks
4 : * -
67 -1/,, 08 4/,, 8/,.08 pp aay Fa Maa yes
68 /,,08 4/,,°/,.08 "SP 08) yes
69 3/08 6/,. 08 8/4, thax 08 yes
70 9/08 += 4/,,6/,,08 + -4/,,, 8/,,, 7/,, 08 yes
71 8/,, 08 feo oe OS ef 8/08 yes
72 / 4 08 4/08 475, °/¢ 08 yes 7/,,08 | Estrum 8/,
73 3/,.08 4/08 5/08 no Pregnant
74 3/,, 08 oY. 08 5/6, 50 / og 08 yes Incurable.
Eskilds- | 3 °/, 08
gaard 13 10/ 07 en 08 AF 08 yes
6 9/07 J 9407 yes 3/,.08
17 10/,,07 12/07 | 59 08 yes Cysts.
21 8/07 12/07 4/08 yes
22 12/,, 07 12/07 /4_08 yes
23. 5/07 8/,, 07 9/07, syes_—7/,, 08
31 1907 8/04 9/07 yes /,, 08 :
34.4, 07. ~=—s not treated Killed.
36 = 1907 several times 8 times no
37 10/07 12/07, 2/4, 08 Vig, 4/o,08 yes
50) 497. OF 12/07 12/'.07,1/,08 yes
57 1/,, 08 2/,,08 3/,, 08 yes
32 «8/, 08 no estrum
Vente- 2 (8h 2072 10/507 Pyome,
godtgd By SA OF 10/07 12/,,07,1/,,08 yes tritis.
4 1/07 8/07 1/,08 yes
12. 7/,,07 8/,, °/,, 08 3/, 08 yes
15° 305202 March 07 4/,,, 7/, 08 yes 4/,.08
16 9/,,, 07 10/07 3/, , 08 yes
18 8/,. 07 10/07 1/,, 08 yes
20 /,, 07 2/, 08 Jay ?/4,98 yes
23 7/07 Bf. Hi OF n/,,07 yes
26 8/,, 07 BY 107 OF IY, 7/4, 08 yes
27 12/,, 06 March 07 6/,, 07 yes 3/,, 08
Ur son es Bah Oe
34. 4/, 07 2/,,5/, 08 4/,, 08 yes
8 10/07 10/2/08 2S gr 4,98 = yes

90

I have made the tabulations so explicit that each animal
can be followed up; the reason is that I believe the treat-
ment of aborting cows to be especially important, and often
very much neglected. It is well known that infectious abor-
tion plays an important role in the sterility question; at least
it takes a long time to get cows pregnant which have
aborted, and sometimes it is extremely difficult, so that the
revenue from these animals is considerably diminished. If
these animals abort a second time there is no profit at all. I
have therefore attended to all the abortion cases which hap-
pened in the herds I had under treatment. At first I met
frequently with septic metritis following an abortion, in
which the secundinae had not been removed and the uterus
had not been disinfected. Now on all the estates referred to
here the necessary measures were undertaken after each
abortion,

The tabulations indicate that it is not very difficult to get
the cows which have aborted pregnant again, as 179 out of
213, or 85%, conceived. They prove further that the time of
conception is not considerably retarted, even if many ani-
mals had to be bred several times on account of lesions on
the cervix’and on the orificium. Only 11 cows aborted a
second time, while 93 carried out their calves. When the
records were made a number had not yet finished their preg-
nancy, but on the basis of earlier experiences I do not ex-
pect many of them to abort.

On the large estates, with the exception of the herd in
Gronslettegaard, a relatively small number of animals has
aborted. It was to be expected that in the larger herds the
spread of the infection was not so quick as in the smaller
ones, and accordingly the losses smaller.

These results are a sufficient proof that infectious abor-
tions do not need to be accompanied by considerable losses
and that we have a means in the proper treatment of pre-
venting most of them. If all the cows which have aborted
come at once under the treatment indicated the metritis

91

either does not develop or is of short duration. In this case
also the milk production, especially when the cows do not
abort before the 5th or 6th month, is satisfactory, and the
conception takes place very soon. The reason for a de-
creased milk output is more the usual metritis than the abor-
tion, and the same is true of the temporary sterility. In
consequence of the possibility of treating and curing the
metritis after abortion, it would be inadvisable to postpone
the breeding of such cows for 4-6 months. This period is no
guarantee against the infection of the bull, and causes con-
siderable losses in the milk production.

The following examples are pertinent:

1. Inthe herd of Mr. J., Skovgaard, 13 out of 24 animals,
aborted during December 1905 and the year 1906; most of
them from January to May 1906. One of them retained the
placenta, and one was sold for a defect of the udder; the
others all became pregnant. Three aborted for a second
time, two of which conceived again.

2. Of the 34 cows in the herd of Mr. K., Langemyre-
gaard, 14 aborted between November 1906 and December
1907, most of them, however, in the winter 1907. All of
the cows retained the secundinae; eight became pregnant
again and one aborted for a second time; four had been sold,
two shortly after the calving; one had an incurable metritis
and cysts of the ovaries; and one was carried over under
treatment.

3. In the herd of Mr. J., Raaby, 16 cows aborted out of
24 between August 1906 and November 1907, 12 of them
between November 1906 and April 1907. Most of them
retained the placenta, which was removed in only a few;
all of the animals came under treatment only a considerable
time after the calving. 14 cows became pregnant again, and
one aborted for a second time. Ten gave birth to a normal
calf in the next year.

4. Between December 16, 1906 and April 23, 1907, Mr.
B., Vaermelandsgaard, had 15 out of 23 cows abort. Twelve

92

of them did not retain the placenta. One cow was elimi-
nated without treatment, and twelve became pregnant, six
of which had a normal estrum. One animal aborted for a
second time.

5. In the herd of Mr. D., St. Myregaard, 17 cows out of
30 aborted between July 1907 and May 1908, 14 became
pregnant again, two of which aborted for a second time.
Three animals were discarded, one during the treatment.

6. In the year 1907 14 cows out of 34 on the estate
Eskildsgaard aborted. Ten became pregnant again, none
of which aborted for a second time. Four cows were dis-
carded, three of them without treatment.

7. During the year 1907, 13 cows out of 35 aborted in
the herd of Mr. O. T., Ventegodgaard. Twelve conceived
again; one was affected with a pyometra.

The following tabulation indicates clearly that the milk-
production need not suffer in the year of the abortions;
whether or not it is deficient in the following year depends
on the time which was needed to cure the prevailing metritis
cases. The milk-production, in other words, depends on
whether the aborting animals conceive again in due time and
carry out in the second year.

Quantity of Milk
1904 1905 1906 1907 fan
Estate from 1./1, from 1./1, from1./1. from 1./1. until
until until until until 9/1. =

12.731, 12./31, 12./31, 12./31, 8th Month

Skovpaatd, wcisesees 4m 129 000 112000 128000* 126000 80 000
20 Cows 22Cows 23 Cows 20 Cows

Langemyregaard........ 169000 180000 211000 160000 130000
32 Cows 35 Cows 38Cows 34Cows 34 Cows

Jensen, Raaby tis dese ales goeek 133 000 130 000 88 000
24Cows 24Cows 24 Cows

Varmelandsgaard....... 151000 158000 109000
23 Cows 23 Cows 23 Cows

On three of the four estates the milk quantity was nor-
mal in the year of the abortion as well as in the following
*) The numbers of the abortion years are in heavy print.

93

year; this was not the case, however, in Langemyregaard.
The explanation is that there the cows had aborted in an
early state of pregnancy—before the fifth month—, and that
many others had not conceived in proper time in spite of
previous normal birth. In the time between December 1,
1907 and September 1, 1908 only three abortions were re-
ported on the four estates; they were all in older cows, while
generally abortions take place in young cows or heifers.

In conclusion I would like to say that we are able to com-
bat the damage from infectious abortion to a considerable
extent; even if we cannot prevent the spread of the infec-
tion and the abortions, we can bring the consequent lesions,
such as metritis, and sterility, to a speedy conclusion. Thus
we prevent a decrease in the milk-production, and, in most
c2ses, a second abortion.

94

PROF. W. L. WILLIAMS’

New York State Veterinary College, Cornell University,
Ithaca, N. Y., Modification of Albrechtsen’s Uterine
Catheters, Return Flow, and Knowles
Uterine Forceps for Sterility in the Cow.

Fig. 22. Knowles’ Special Uterine Forceps made in two lengths. Short
Forceps, 15 inches long. Long Forceps, 20 inches long.

Instructions for using these instruments:

1. The 20-inch long uterine forceps are inserted into
the vagina and guided by the hand to the external os uteri.
The forceps are then opened and the one jaw is inserted as
deeply as practicable into the os uteri; the other passes out-
side the lip of the os uteri. The forceps are then closed,
grasping the lip of the vaginal portion of the uterus. Trac-
tion is exerted upon the forceps and the cervical portion of
the uterus drawn back toward or into the vulva.

Albrechtsen’s Uterine Catheters made in two styles and four sizes.

Fig. 24. Albrechtsen’s Single Curve Catheter.

95

2. The shorter pair of forceps is now applied in a simi-

lar manner to the opposite lip of the external os uteri. Trac-
tion is applied to both pairs of forceps, the one being pressed
to the right and the other to the left, so that the os uteri is
exposed to view.

Extra small double curve taper point, size 14 inches long
and 3/16 inch diameter at point. Small double curve, size
14 inches long, 5/16 inch diameter. Medium double curve,
size 14+ inches long, 7/16 inch diameter. Large double
curve, size 24 inches long, 34 inch diameter. Extra long,
single curve taper point, 22 inches long, %4 inch diameter at
point.

3. The Albrechtsen uterine catheter of proper size is
now introduced carefully through the cervical canal. No
force is used. The catheter is revolved upon its long axis,
is pressed towards the left or right, and upwards or down-
wards, or may be partially withdrawn and then pushed for-
ward at a different angle, until the tortuous canal is finally
found and followed into the uterine cavity. If this is not
readily accomplished, introduce the Palmer’s Uterine dila-
tors carefully and trace the cervical canal. Open the dila-
tors and thus dilate the canal somewhat, and press aside the
transverse mucous folds. Repeat the application of the
dilator until the uterine catheter can be safely and easily
passed. The uterus is next douched by means of an ordinary
fountain syringe, with a two per cent Lugol’s solution, or
other disinfectant, according to the desire of the operator.
In cows which are sterile and where the uterus is slightly
enlarged from chronic endometritis, the douching should
occur one or two hours before breeding and all the solution
forced out by rectal pressure. In other cases, where there
is pus in the uterus, the douching may be repeated fre-

quently.

96

Fig. 25. Palmer’s Uterine Dilator (Modified.)

4. The large Albrechtsen uterine catheter is of special
value in pyometra, following retained afterbirth. As a gen-
eral rule it may be used without the application of forceps.
In the use of these instruments as the uterine walls are fre-
quently paralyzed, care is to be taken regarding the amount
of force used. In many cases it is necessary for the operator
to insert one hand into the rectum, and by pressing upon
the uterus force the fluid out through the catheter. In all
cases the fluid introduced through the catheter should be
pressed out by rectal massage, unless it escapes freely of
itself.

Fig. 26. Bozeman’s Uterine Dressing Forceps.

5. The extra long uterine catheter is useful in evacuat-
ing pus from the uterus when the cervix is contracted.
The inner tube may be detached and withdrawn, permitting
the pus to flow out through the large outer tube.

a

Fig. 27. Williams’ Guarded Knife.

The Williams guarded knife is used to puncture those
cysts of the ovaries which are too thick-walled to be

oF

ruptured by compression. In performing this operation, the
operator first grasps the ovary per rectum and draws it back
over the roof of the vagina. The other hand then grasps
the ovary, through the wall of the vagina and holds it
securely. The bistoury is then carefully introduced guarded
along the arm and hand, until the ovary is reached at the
desired point, when the guard is removed and the blade of
the instrument inserted.

LITERATURE.

E. Zschokke: Die Unfruchtbarkeit des Rindes, ihre Ursache und Bekampfung.
Ziirich 1900.

K. Nielsen: Maanedsskrift for Dyrleger. Vol. 19 and 20.
E. Hess: Die Sterilitat des Rindes. Bern 1907.

Tuff: Maanedsskrift for Dyrleger. Vol. 18.

Franks Geburtshilfe fiir Tierarzte, edited by Albrecht.
Th. Kitt: Lehrbuch der Fiathologischen Anatomie,
Broholm: Maanedsskrift for Dyrleger. Vol, 7.

W, L. Williams: Veterinary Obstetrics.

TI Oe oo De

wo

Contents

Preface of the Author.
Preface of the Translator.

The Different Kinds of Sterility ........ 9
Economical Effects of Sterility 10
The Frequency of Sterility 11-12
Causes of Sterility According to Different Authors... 13-16
Diagnosis and Differential Diagnosis of Pregnancy in its Different
Stages 23-27
Special lesions of
hie: Genvasd 224 eet eee ee lo a ees 30-39
The Vagina, csc: iid 34-35-36
The Uterus w+ ---40-41-43
Endometritis and Metritis 41-61
Infectious Abortion a 42
The Special Causes of Sterility 44-52-53
FA) ASC TSS 1S aa Gt cen re ee atl RO 52-53
b) Liesions “of thie: Mucosat scscecc.eceecenn eis es Avacdteeauereceueee 53-54
¢) Diseases: of the: “Ovaries: .ssccscccscuscesesslsseucrsseersaissctbecctrececetestees 53
1, Cystic Degeneration of the Ovaries..............ecscssceceeeeeeeees 56
2. Corpus Lutem Persistens. (The Persistent Yellow
Bodies)
Nymphomania
The Treatment of Sterility ..
General
Treatment of the Retentio Secundinarum 202.
i “ Metritis

“ce “

Chronic Endometritis

“ Pyometra

General Rules of the Treatment —.0.00

Eventual Complications -00....000.020000.-.

Results of the Treatment

Tabulation of the Results on Cows Treated
a) For Sterility F
b) For Infectious Abortion 0002.

Bata Remakes. awh soteenln tt Caden tC A nad SEh oe i ea

Prof. W. L. Wiiliams’ Modification of Albrechtsen’s Uterine
Catheters, Return Flow and Knowles’ Uterine Dressing
Forceps ps 94-97

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