314 MATERNAL DYSTOKIA, 



3. Vaginal Taxis. — All sanguinary and serious operations for the cure 

 of uterine torsion^like the two preceding — should be avoided, if possi- 

 ble, until the simpler means which modern veterinary science has indi- 

 cated are tried. We allude more particularly to version, which rarely 

 fails to bring the case to a satisfactory termination. That is, of course, 

 on the assumption that this is resorted to sufficiently early ; for it must 

 be remembered that nothing is gained by delay in this accident, and if 

 relief is to be afforded it must be rendered promptly, and as soon as the 

 existence of displacement is fairly established. When delay has been 

 allowed to take place, more or less serious consequences must ensue to 

 either the foetus or the maternal organs, or to both. 



In certain cases of very incomplete torsion — quarter rotation of the 

 uterus, for instance — and when there is sufficient space in the vagina for 

 the hand to pass through the obstacle and into the os or uterus, detorsion 

 has been accomplished by seizing the most suitable parts of the foetus 

 and exercising direct traction on it. Instances of success by adopting 

 this course have been furnished by Chambon, Cann, Gaven, Darreau, and 

 others. 



The mode of procedure may be as follows : — After ascertaining the 

 direction of the torsion, the arm is to be introduced into the uterus as 

 deeply as possible ; if the foetal membranes are yet intact, they must be 

 largely ruptured, and the most convenient parts of the foetus sought for. 

 In this respect it will be found that every part of the young animal does 

 not offer the same advantages to the operator, for reposition of the uterus. 

 The head is too large and does not afford sufficient hold for the hand ; 

 the pasterns and knees are too much removed from the body and too 

 round ; but the hocks and elbows are, of all parts perhaps, -those best 

 adapted for this kind of manipulation. If one of them can be reached, 

 it should be firmly grasped, and endeavors made by it to raise the body 

 of the foetus, at the same time giving it a turning movement contrary to 

 that which we would give the uterus in order to untwist it. 



Supposing, for example, that the torsion is to the right, and that the 

 foetus, offering an anterior presentation, is, from the fact of the quarter 

 revolution of the organ, in the right vertebro-ilial position ; then the object 

 must be to place it in the vertebrosacral position. 



To effect this, the right hand, in a state of supination (knuckles down- 

 wards, palm upwards), must be introduced be?ieath the foetus, and, if pos- 

 sible, the left fore limb seized by the elbow ; then the operator, turning 

 his arm round, raises the body of the creature, at the same time turning 

 so that the withers describe the arc of a circle from right to left — from 

 the right flank of the Cow towards the sacrum. 



Sometimes when the foetus is alive, at the moment this manoeuvre is 

 being executed it makes a movement which greatly assists the efforts of 

 the operator. 



If the dimensions of the vagina admit of it, the limbs of the foetus may 

 be drawn into the pelvis, and even as far as the vulva ; and while the 

 operator is acting as described on the upper part of one of the legs, an 

 assistant presses on the free portion, and by thus aiding in the version 

 considerably facilitates the task. 



By this procedure several ob^tetrists have been successful in re-adjust- 

 ing the uterus, through the medium of the foetus ; the adjustment being 

 ascertained by the disappearance of the spiral mucous folds from the 

 vagina and the patency of the canal. 



