444 



FCETAL DYSTOKIA. 



Therefore it is that, in the larger domesticated animals, such a devia- 

 tion of the limbs is always a serious cause of dystokia — not so much, as 

 Saint-Cyr justly observes, from the increased volume that the doubled- 

 up limbs gives to the neck, as because the arms, incompletely extended 

 on the shoulders, retain the latter against the thorax, and prevent their 

 being lodged in the depression at the base of the neck— thus augmenting 

 the vertical and transverse diameter of the chest, while, at the same 

 time, the projecting elbows press against the border of the pelvis. 



Indications. 



. The indications are in this case also obvious : To find the retained 

 limbs, extend the fore-arm of each on the arm, and to straighten the legs 

 in the pelvic cavity, as they are in normal parturition. 



Anterior Presentation : Fore-Limbs Bent at the Knees. 



These indications are not so difficult to carry out when the obstetrist 

 is called in sufficiently early, and the head has made but little advance 

 into the pelvis. 



We will suppose both fore legs partially retained in the abdomen, and 

 flexed at the knees. The exploration which has led to this discovery has 

 perhaps also indicated that one limb is not so much flexed as, or is more 

 accessible than, the other. If this is the left limb, then the left hand and 

 arm must be employed ; if it is the right leg, then the right hand and arm 

 will be most convenient ; but if both limbs are alike implicated and acces- 

 sible, then it is immaterial which is first manipulated, so long as the cor- 

 responding hand and arm are employed. The same directions are 

 applicable to both, keeping in mind that the right and left hands are 

 opposite. The object is to adjust the direction of the fore-limbs, so that 

 delivery can be accomplished. This adjustment is effected in four move- 



