DISEASES OF THE CiENKRATIVE ORGANS. 193 



Plate XIIT, fig. J5.) AVith an anterior presentation (fore feet and 

 nose) this presents an insuperable dbstac-le t<» progress, as the dis- 

 eased cranium is too hirjje to enter the pelvis at the same time with 

 the fore arms. With a i)osterior presentation (liind feet) all goes well 

 until the body and shoulders have ])assed out, when progress is sud- 

 denly arrested by the great bulk of the head. In the first ease, the 

 oiled hand introduced along the face detects the enormous size of 

 the head, which may be diminished by puncturing it with a knife or 

 trocar and cannula in the median line, evacuating the water and 

 pressing in the thin, bony walls. With a i)osterior presentation, the 

 same course must be followed; the hand passed along the neck will 

 detect the cranial swelling, which may be punctured with a knife or 

 trocar. Oftentimes with an anterior presentation the great size 

 of the head leads to its disi>lacement backward, and thus the fore 

 limbs alone engage in the passages. Here the first object is to seek 

 and bring u}> the missing head, and tlien jiuncture it as above sug- 

 gested. 



AsciTKS, OR DitorsY OF THE AnooMEN IX THE FOAL. — The accumula- 

 tion of liquid in the abdominal cavity of the fetus is less frecjuent, 

 but when present it may arrest parturition as completely as will 

 hydrocephalus. With an anterior presentation the foal may pass as 

 far as the shoulders, but behind this all efforts fail to effect a further 

 advance. With a posterior presentation the hind legs as far as the 

 thighs may be expelled, but at this point all progress ceases. In 

 either case the oiled hand, passed inward by the side of the foal, 

 will detect the enormous distension of the abdomen and its soft, fluc- 

 tuating contents. The only course is to puncture the cavity and evac- 

 uate the liquid. With the anterior presentation this may be done 

 with a long trocar and cannula, introduced through the chest and 

 diaphragm, or with a knife an incision may be made between the 

 first two ribs and the lungs and heart cut or torn out, when the 

 diaphragm will be felt i)rojecting strongly forward, and may be 

 easily j)unctured. Shoukl there not i)e room to introduce the hand 

 through the chest, the oiled hand may be passed along beneath the 

 breast bone and the adbomen punctured. With a posterior presen- 

 tation the adbonien must be punctured in the same way, the hand. 

 armed witii a knife protected in its palm, being passed along tiie side 

 of the flank or In'tween the hind limbs. It should l»e added that 

 moderate dropsy of the abilomen is not incompatible with natural 

 delivery, the liijuid being at fii*st crowded back into the poition of 

 the belly still engaged in the womb, and passing slowly from that 

 into the advanced portion as soon as that has cleai('<l the narrow 

 passage of the pelvis and pas.sed out where it can exj^and. 



General nHorsv of the fkti s. — In this case the tissues generally 

 are distended with rujuid, and the skin is found at all points tense 

 36444°— 16 1^ 



