DYSTOKIA BY DISPLACEMENT. 283 



or the margin of the hernial opening strangulating the foetus and 

 hindering its advance. These obstacles must be combated by appropri- 

 ate measures. 



In consequence of the foetus lying so far below the pubis, the hand 

 introduced through the os cannot feel it, even when the whole length of 

 the arm is inserted ; in which case, if the animalis standing, the abdomen 

 may be raised by means of a sheet or blanket, so as to bring the foetus 

 within reach. If the animal is recumbent and cannot rise, then it should 

 be placed on its back and secured in that position, the croup being 

 raised by bundles of straw. The tumor may then be examined by 

 external palpation, as well as by rectal and vaginal exploration, and the 

 position of the foetus determined. 



As a rule, the position is never completely normal. In the most favor- 

 able cases, the head is found to be directed backwards and near to the 

 pubis — sometimes partly in the pelvis, with the face upwards and slightly 

 forwards ; the fore feet being more or less doubled back against the body, 

 which lies deep in the tumor, the buttocks resting on the mammae of the 

 mother — the foetus being altogether in the recumbent female in the posi- 

 tion of a sitting dog. 



The state of the borders of the hernial orifice should be carefully 

 ascertained, and their rigidity and tension, together with the degree of 

 constriction they exercise on the body of the foetus, noted. This impor- 

 tant examination should be made before any traction is exercised on the 

 foetus ; for on the information gained by it will depend the choice of 

 means to effect delivery. 



With the Bitch uterine hernia is frequently most difficult to diagnose, 

 and errors are far from unfrequent : the most common mistake is fixing 

 on jthe tumor as a cancerous mass. But mammary tumors are very dif- 

 ferent to that of hernia ; they are generally nodulated, very hard, and the 

 skin is closely adherent to them ; whereas the uterine hernia has not the 

 fluctuation of a kyst or abscess, neither has it the resistance of a carci- 

 noma, fibroma, or adenoma, while the skin covering it is smooth, supple, 

 perfectly natural, without ulcerations, discolorations, and other signs 

 which mark the presence of mammary enlargements. The uterine 

 tumor can also be reduced by taxis or manipulation, while the fissure in 

 the abdominal wall can be felt. This, together with the fact that it is 

 only developed rapidly after impregnation, and without any local or gen- 

 eral inflammatory symptoms, or disturbance of the general health, should 

 settle the question. 



However, should any doubt yet remain, or if it is desired to ascertain 

 the exact state of affairs, a more careful examination will be necessary, 

 it being always born in remembrance that his hernia in the Bitch appears 

 in different regions. Vaginal exploration cannot be resorted to with this 

 animal because of the smallness of the pelvis — unless the Bitch is a large 

 one, and then the fingers are too short to explore to any depth. 



An external examination must, therefore, be relied upon, and this is 

 easier and more certain than with the larger creatures. By it the size of 

 the abdominal rent will be ascertained, and also whether the foetus can 

 be passed through it into the abdomen ; though this is rarely possible, 

 owing to the hernia occurring when the uterus was empty, and when it 

 could pass through an opening which will not be sufficient for a foetus 

 when fully developed. 



All manipulatory operations on the Bitch should be practised with as 



