434 



FCETAL DYSTOKIA. 



in the recumbent posture. When this is decided upon, in the great ma- 

 jority of cases it will be found that a considerable advantage will be ob- 

 tained by placing the animal on its back, propping it up in this ]Dosition 

 with trusses of straw placed on each side, and raising the croup by intro- 

 ducing another truss beneath the hind quarters. 



. With regard to the smaller animals, such as the Bitch, they can be 

 placed on their back on a table, and an assistant may raise the pelvis as 

 high as may be deemed necessary. Retropulsion of the foetus may be 

 effected with the hand in the large animals, the operator supporting him- 

 self firmly on his legs ; the arm must be strong, and very often it has to be 

 engaged in the genital canal as high as the shoulder. It may sometimes 

 happen that both hands have to be employed as repellers, and the body 

 of the operator pushed forward by assistants. 



Seeing the difficulties attending this operation, and finding that the 

 hand and arm are not always sufficient, Continental veterinarians have 

 for a long time resorted to a "crutch" or "repeller" (French, /c*<?/r??/j-- 

 soir , German, Geburtskriicke) in conjunction with the hand. 



This instrument is of iron, and is between two and three feet in 

 length ; it has a handle at one end, and a concave transverse piece, like 

 the head of a crutch, at the other. This piece may be either solid or 

 jointed (Figs. io6, 107, 108, 109). Provided the latter is sufficiently 

 strong at the joints, it possesses advantages over the solid instrument : 

 the principal of which is its easier introduction into the vagina and uterus. 

 The crutch end being carefully carried by one hand through the genital 

 canal, towards the foetus, is applied to the most convenient part of the 

 latter ; while the handle is seized in the other hand, and the propulsion 

 may then be effected either by this hand, the breast of the operator, or 

 by an assistant. 



Many authorities speak very highly of this instrument, from the fact 

 that it permits the displacement of the foetus much further forward than 

 the hand alone can effect, and thus allows a wider space between the 

 pelvic inlet and the body of the young creature ; consequently, adjust- 

 ment of the latter can be more easily and promptly accomplished. 



An assistant can maintain the body of the foetus some distance from 

 the pelvis by this instrument, while the hand of the operator is making 

 the necessary rectifications ; the latter is therefore much relieved, and to 

 some extent he is also exempted from the difficulty and fatigue caused by 

 the uterine contractions. 



The ordinary repeller has some disadvantages, the greatest of which, 

 perhaps, is its being inapplicable to certain regions of the foetus which 

 may chance to be in an oblique line to its direction — such as the head, 

 limbs, etc. To remedy this defect, I have added a short, pointed spike, 

 which can be screwed into the middle of the crutch, opposite the handle, 

 when necessary (Fig. 106); and this effectually prevents its slipping; 

 the part in contact with the foetus, when provided with this tooth or 

 spike, resembles a trident. While the instrument is being employed — 

 all propulsion should only be made during the intervals between the 

 pains — one hand of the operator should guide and maintain it against the 

 foetus, to prevent injury to the maternal organs. 



Some authorities, however, object to the employment of the repeller — 

 or rather assert that they have never required its services. Brunet and 

 Schaack observe that when their own strength is not sufficient, they are 

 aided by an assistant. Brunet has the hand and arm of the latter acting 



