DISEASES OF THE FCETUS. 389 



order to allow the hand to explore the interior of the foetus. If the ob- 

 stacle is due to ascites, the convex condition of the diaphragm, and the 

 fluctuation of the fluid on the abdominal side of it, will be remarked. 



When the dystokia is owing to anasarca^ this will be distinguished by 

 the general roundness of the surface of the body, owing to the subcuta- 

 neous fluid, which effaces all the prominences, and to the oedematous 

 sensation communicated to the fingers by pressure. 



Indicatmis . 



When the condition of the foetus is once ascertained, the principal 

 indication, if delivery by traction cannot be effected, is to diminish its 

 volume, by producing the evacuation of the fluid which distends it, as 

 promptly and effectually as possible. 



In ascites, puncture of the abdomen through the parietes of that cavity, 

 if they can be reached, or puncturing the diaphragm through the chest, if 

 they cannot, must be practised. In the first, a bistoury or any kind of 

 convenient knife, or a trocar, will suffice j in the second, a long trocar or 

 long-bladed knife, wrapped round with tow to near the point, will answer 

 the same purpose ; or if the hand can be introduced into the thorax, the 

 fingers alone will rupture the diaphragm. As the fluid escapes, the 

 abdomen collapses, and delivery is then easy. 



When anasarca is present, the fluid must be got rid of by deep incisions 

 through the skin wherever the hand can reach. The mechanical extrac- 

 tion of the foetus should then be easy. In a case reported by Anacker, 

 however {Thierarzt, 1868, p. 85), the foetus was so large that it had to be 

 removed by gastro-hysterotomy. 



1. In 181 5, Rouchon communicated the following case to Rainard {Op.cit., p. 484). 

 He was called to see a Cow, ten years old, and which had always until then been in 

 good health, and had calved four times : but the belly had never been so large as during 

 the pregnancy with the calf which it was then attempting to get rid of. It was ex- 

 tremely feeble, and before anything could be done towards assisting it, a stimulant had 

 to be administered. No portion of the foetus was visible, but on Rouchon introducing his 

 hand into the uterus, he found the fore limbs and the head ; the creature was in the dorso- 

 lumbar position, and on the fingers being passed into the mouth, it was discovered that 

 it was dead. The limbs and jaw were corded, and on traction being patiently but forci- 

 bly exercised, the head and fore limbs were extracted, though it was impossible to 

 remove more than these. With very great difficulty the hand was again passed into the 

 genital passages, and it was found that the abdomen and scrotum of the foetus were of 

 an enormous volume. The abdomen was punctured with a bistoury, and Rouchon 

 estimated that from seven to eight litres of a yellow, oily-looking fluid escaped there- 

 from. The extraction of the calf was immediately effected, and soon after the Cow 

 expelled nearly three-fourths of a bucketful of the same kind of liquid. 



2. Courjon, according to the same authority, saw a Cow, three years old, the foetus of 

 which, in the same position, had the head and fore limbs protruded ; in the attempts to 

 extract this foetus, its abdominal parietes were ruptured, when it was calculated that 

 twenty litres of fluid escaped. Soon after, this veterinarian had to puncture the abdo- 

 men of another calf foetus with a bistoury, then to enlarge the incision with the fingers 

 and hand, in order to permit the escape of the fluid therein, which was supposed to 

 amount to twenty-five litres. The foetus had also anasarca of the hind limbs. 



Schvvarz, according to Franck, describes the case of a calf affected with hydrops 

 universalis, which an empiric had been trying for twelve hours to extract, and the four 

 feet of which had been drawn into the vagina. Schwarz incised the kystoid swelling 

 about the neck, after which the calf could be removed. 



3. Voigtlander (Sachs. Jahresbericht, 1861, p. 67) also mentions a similar case, in which 

 the fore limbs had to be extracted, and the chest and abdomen opened, before birth 

 could be effected. The Cow was saved. 



4. Miiller {Oesterr. Vierteljahresschrift, 1868, p. 36) likewise describes a dropsical calf. 



