DYSTOKIA FROM MULTIPARITY. 



431 



ward, with the right hand, the foetus which presented the four limbs, while traction was 

 exercised on the other. 



This, however, was unavailing, for when the front part of the first foetus was pushed 

 the hind quarters presented, and vice versd ; so Canu was obliged to introduce both 

 hands into the vagina. The arms being sustained by an assistant, the anterior limbs 

 were seized by one hand, the posterior in the other, and then he pushed with all his 

 strength ; while two assistants, pulling at the moment when the Cow made a great 

 effort, advanced the first foetus, the chest of which caused Canu to withdraw his arms, 

 when the entire foetus soon came away. With regard to the second foetus, two cords 

 were fixed on the posterior limbs ; the tail was well placed, and the fore-arms being 

 grasped above the knees, they were pushed into the uterus. The assistants then pulled, 

 the croup passed into the genital passage, and birth was promptly terminated. 



6. Liautard {Joicrnal de Med. Veterinaire de Lyon, 1846, p. 575) states that a Mare 

 belonging to the Military Train had been accidentally impregnated by an Arab horse 

 while in bivouac. Experiencing difficulty in foaling, he was called upon to attend upon 

 this Mare. On his arrival, he found it to be in an anxious state, looking alternately to 

 the right and left side, and attempting to get rid, by rubbing, of a foetus half extruded 

 from the vulva, but whose posterior extremities evidently prevented further progress ; 

 the poor animal endeavored to seize the foal by its teeth, strained in an irregular man- 

 ner, and was much agitated ; then it gathered itself on its hind quarters, lay down on 

 the litter with a plaintive moan, sprang up again immediately, neighed, and impatiently 

 kicked the ground. 



The foetus was in a good position ; its envelopes were ruptured and the " waters " 

 had escaped ; the fore limbs rested on the Mare's thighs, while the head, hanging be- 

 tween them, showed some contusions ; the foal still lived. 



Two men placed at the head of the Mare grasped her securely, and a third held up a 

 fore foot ; while an intelligent assistant, standing beside Liautard, seconded his efforts. 

 The energetic straining of the Mare effectually prevented any retrograde movement of 

 the foal, which was otherwise too far expelled to be pushed forward. After a number 

 of fruitless efforts, the open hand, introduced on the left side of the foal, finally reached 

 the OS uteri, when it was found that the creature was not malformed, and the hind limbs 

 had a good direction , there was nothing anomalous in the cervix; but a hard movable 

 body, which the hand could scarcely disturb, because of the difiiculty of introducing it 

 farther, was engaged in the inlet, into which it entered more deeply as soon as the pres- 

 sure was removed. From an attentive examination, Liautard acquired the conviction 

 that this body was a second foetus, which must be moved out of the way if the Mare was 

 to be relieved from the painful state it was in, and delivery effected. With this view, it 

 was pushed into the uterus as far as possible, the arm was quickly drawn from the va- 

 gina, and the assistant at that instant pulling the partially extruded foal promptly and 

 energetically, while the Mare made a strong expulsive effort, the half-born creature was 

 extracted. 



Soon after, another foetus — dead, and in its envelopes — was ejected almost without 

 an effort. This one appeared to have died about the fifth month of gestation, and its 

 small size explained how it could _ partially enter the pelvis, even though the passage 

 was already occupied by the first. ' With regard to the latter, it died fourteen days after 

 birth, from the effects of an inguinal hernia produced during parturition — doubtless by 

 the compression the abdominal region experienced while passing through the narrowed 

 genital canal. 



7. Van Hertsen {Annales de Med. Veterinaire de Brzixelles, 1864, p. 281) communi- 

 cates the case of a fine Dutch Cow, for the fourth time pregnant, and in labor for an 

 hour. The two front limbs and the head of a calf appeared at the vulva, and notwith- 

 standing the energetic pulling of six men, by means of cords tied to the limbs and the 

 lower jaw, it was impossible to extract it. Introducing his oiled hand into the vagina. 

 Van Hertsen discovered that the head and two limbs of the foetus apparent at the vulva 

 were so tightly fixed in that canal that he could not turn them ; indeed, he could scarcely 

 pass two fingers as far as the middle of the passage. It therefore became necessary to 

 push the calf into the uterus, in order to discover the obstacle to birth ; but it was im- 

 possible to do so — // was like pushing against a wall. To make further traction on the 

 head and limbs appeared to be useless ; these appeared to belong to a calf of ordinary 

 size, and the obstacle to its expulsion must depend on some other cause. Embryotomy 

 appeared to be indispensable, and was at once resorted to. The lower jaw, already dis- 

 articulated, was removed ; then, though with much difficulty, the head was excised ; but 

 the limbs were not cut off, as it was thought they might prove useful to attach cords to 

 afterwards. It was again attempted to push the body into the uterus ; the Cow was 

 lying, and Van Hertsen, lying down also behind it, and placing his feet against a barrel, 

 seized with his right hand the first cervical vertebrae of the foetus, and in the left hand 



