DYSTOKIA DEPENDING ON ANTERIOR PRESENTATION. 445 



ments : — i. The hand is passed alongside the neck of the foetus, the 

 fore-arm is seized in the middle, the radial border of the hand being 

 upwards, the cubital downwards ; then bending the hand, the knee of 

 the foetus is drawn towards the pelvis, while the elbow is pushed upwards 

 and backwards ; 2. The body of the foetus being thrust away from the 

 pelvis, the metacarpal bone is seized as the fore-arm was, and moving it 

 in the same manner, the knee is raised as high as, or higher than, the 

 point of the shoulder (Fig. \i2, a\.o b), and the foot to the level of the 

 maternal pubis ; 3. The foot is grasped in the hand, flexed strongly on 

 the fetlock and pastern, and drawn into the genital canal ; 4. The limb is 

 then extended towards the pelvic outlet, and if necessary a cord is placed^ 

 around the pastern, the other limb, if also flexed, being then sought for 

 and treated in a similar manner. 



Lecoq, according to Saint-Cyr, has described another method. This 

 consists in passing the arm alongside the head, and, putting the hand in 

 a state of supination, seizing the foot in such a way that the pastern faces 

 the palm and the fetlock the wrist. The operator then pushes the limb 

 away from him, at the same time flexing the fore-arm on the arm as much 

 as possible, until getting the pastern as high as the os, he straightens the 



Fig. 112. 

 Anterior Presentation: Extending the Fore-limb. 



leg and brings it towards the pelvic canal. Saint-Cyr has pointed out, 

 however, that this method of straightening the limb en ?nasse, and at once, 

 is only possible in quite exceptional cases, — when the foetus is quite 

 movable, and the extremity of the limb is sufficiently near the pelvis to 

 be easily accessible ; and he maintains that the method by progressive 

 extension just described, is that which should be generally adopted. 

 Lecoq's method might be possible with the Cow, but in the Mare it 

 would certainly be most difficult, if not impossible. 



This correction of knee-joint presentation is easy enough when the 

 foetus has not advanced far into the pelvis ; but when it is completely 

 engaged, then the operation is much more difficult. Retropulsion may 

 be necessary, and extension of the limbs is sometimes only possible when 

 the foetus is clear of the inlet. Thomas {jfournal de Med Veterinaire, 

 November, 1876), while pointing out that it is possible, and often easy, 

 to extend the limbs in the Cow's pelvis, and that the dimensions of the 

 head of the foetus allow sufficient space for these manoeuvres, insists 

 that the point of traction should be at the lower end of the radius, and 

 not the knee ; while Schaack's head-collar should be employed to extract 

 the head at the same time. The cord for the limbs should have a run- 

 ning noose. 



After labor has been in progress for some time, the " waters " have 

 long escaped, the head is gradually propelled towards the vulva, the nose 



1 



