TURNING. 443 



both together, and should be obliged to bring them down one after 

 the other, we should at all events carefully try to bring down the pos- 

 terior limb first, even although it should be the most distant one from 

 the orifice. 



995. In the first case, to continue the operation, the hand has 

 only to slip along behind the thighs and legs, which it pushes before 

 it, extending them as they come down; in this way the feet can 

 neither escape nor deviate, and may be conducted without difficulty 

 to the superior strait. 



In the second case, more difficulty is generally met with; we are 

 sometimes obliged to act successively on the thigh and leg as if they 

 were levers of the first kind; while we are searching for one foot 

 the other escapes, and it is always a difficult matter to draw them 

 both down together, unless we have been so fortunate as to get hold 

 of the hams with the fingers and thumb at the commencement of the 

 search. 



In the third case, that is to say, when the limbs are far removed 

 from their natural attitude, and always when we are obliged to bring 

 them down one after the other, we act as we best can; only we 

 should, while pulling at the leg first got hold of, endeavor to make 

 it approach the opposite limb; by abducting it, which is naturally a 

 very limited motion, and which would expose the child to the risk 

 of luxations or fractures, we should also have the disadvantage of 

 fatiguing the uterus far more than by following an addnctive move- 

 ment for its free exercise, also, the last named movement requires 

 much less space than the other. 



996. However it may be, when one of the feet has reached the 

 vagina or the vulva, it should be secured by means of a fillet pre- 

 viously to going in search of the other; not with a view of hindering 

 it from mounting upwards again, as some of the ancient authors 

 imagined, but only that it may be found again, when wanted. This 

 precaution being taken, the left hand is again carried into the womb; 

 and that it may more readily reach the other foot, it should follow 

 along the inner and posterior surface of the one held in the fillet; 

 by conforming to this rule we necessarily meet with the crease of 

 the breech and sexual organs, the thigh we are in search of cannot 

 now be mistaken, and we thus avoid a good deal of tiresome feeling 

 after an object. It ought to be well understood that this foot is 

 to be brought down in adduction, by following the anterior surface 

 of the foetus, and the side of the other leg. 



After having succeeded, in any way, in extending the legs, and 

 bringing them down into the excavation, we place the index between 

 them above the inner ankles, while the thumb and the other fingers 



