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The discovery of M. Guénon, of Bordeaux, in France a man of remarkable practical sagacity, and a close observer of stock consisted in the connection between the milking qualities of the cow and certain external marks on the udder, and on the space above it, called the perineum, extending to the buttocks.

Intestinal fistulæ are sometimes met with in the abdominal wall after strangulated hernia, operations for appendicitis, tuberculous peritonitis, and other conditions. In the perineum, fistulæ frequently complicate stricture of the urethra. The treatment of these various forms of fistula will be described in the sections dealing with the regions in which they occur.

Cycling is beneficial for women who can ride without pain or discomfort, and, according to Watkins, it is even beneficial in many diseased and disordered pelvic conditions, but excessive cycling is evil in its results on women, more especially by inducing rigidity of the perineum to an extent which may even prevent childbirth and necessitate operation.

These marks, though often seen in many good cows, should be considered as certain only when the veins of the perineum form, under the skin, a kind of network, which, without being very apparent, may be felt by a pressure on them; when the milk-veins on the belly are well-developed, though less knotty and less prominent than in cows of the first class; in short, when the udder is well developed, and presents veins which are sufficiently numerous, though not very large.

Among those Asiatic races who extirpate the ovaries in young girls the skin remains white in the perineum, round the anus, and in the armpits. Even in mature women who undergo ovariotomy, as Kepler found, the pigmentation of the nipples and areola disappears, as well as of the perineum and anus, the skin taking on a remarkable whiteness.

It is also met with in the groin following on inflammation and suppuration of the inguinal glands, and cases are recorded in which the sloughing process has implicated the femoral vessels and led to secondary hæmorrhage. Cellulitis of the scalp, orbit, neck, pelvis, and perineum will be considered with the diseases of these regions.

On August 23d I removed the stone without difficulty by the lateral operation through the perineum. The lobe of the prostate was enlarged, which seemed to favor the extent of the incision beyond what would otherwise have been safe. The perineum was deep and the tuberosities of the ischii unnaturally approximated.

In the best cows these ovals exist with the lower mirrors very well developed, as represented in the cut just named. In short, it should be stated that, in order to determine the extent and significance of a mirror, it is necessary to consider the state of the perineum as to fat, and that of the fullness of the udder.

Payne's case was of a woman of thirty-five, well formed, who had been in labor thirty-six hours, when the physician examined and looked in vain for a vaginal opening; the finger, gliding along the perineum, came in contact with the distended anus, in which was recognized the head of the fetus.

But cows, whether having very well developed mirrors or not, may be reckoned as very good, and as giving as much milk as is to be expected from their size, food, and the hygienic circumstances in which they are kept, if they present the following characteristics: veins of the perineum large, as if swollen, and visible on the exterior as in cut A or which can easily be made to appear by pressing upon the base of the perineum; veins of the udder large and knotted; milk-veins large, often double, equal on both sides, and forming zig-zags, under the belly.