454 



FCETAL DYSTOKIA. 



fixed in the pelvis, that it was impossible to push the foetus into the 

 uterus. This was attempted, however, by squeezing the head closer to 

 the neck, the hand being passed alongside the cheek and the nose grad- 

 ually raised ; at the same moment the Mare strained doubly hard, and 

 gentle traction being applied, the foal was expelled with its head in this 

 position, but without injuring the perineum of the mother. The latter 

 soon recovered, but the foal, as is usual in such cases in the equine 

 species, was dead. 



In this degree of deviation, as well as in the others, great assistance 

 will be afforded by raising the hinder parts, of the mother to the extent 

 of one, two, or more feet. Lecoq, Rueif, and others have recommended 

 placing the animal on its back. It is perhaps better, however, to elevate 

 the hind-quarters, and to resort to retropulsion either by tne hand or the 

 crutch ; then after injecting warm water or oleaginous fluids, to either ex- 

 tend the head, or to attempt forced extraction. The blunt hooks fixed 

 firmly in the orbits of the foetus, will be found most useful in the latter 

 operation. 



When the upper part of the neck alone presents, reduction is still pos- 

 sible, provided no great delay has occurred, nor mismangement by un- 

 skilful people allowed. But when the " waters "have been long expelled, 

 the legs pulled at by amateurs, and the uterus closely applied to the body 

 of the foetus, the case is most difficult j as then manipulation and retro- 

 pulsion cannot effect much in many instances. 



The doubled neck is too voluminous to enter the pelvis, and the longer 

 the pains continue, so the farther is the head pushed forward from the in- 

 let, and therefore away from the reach of the obstetrist. 



The contractions of the closely applied uterus also render attempts at 

 delivery almost impossible, by their paralyzing the hand and arm. 



Large quantities of warm lubricating fluids must be injected, retropul- 

 sion attempted by one or two crutches applied to shoulders of the foetus 

 — not to the neck ; while the hand manipulates, aided, if need be, by the 

 finger-hook (Fig. 120). A blunt hook (Fig. 121) inserted on each side of 

 the lower jaw — when this can be reached, towards the root of the ear, or 

 into the orbits ; a cord round the neck — if it can be passed ; and other 

 devices may be tried. If they all fail, then the animal should be thrown 

 on its back ; indeed, the success which has attended this change of atti- 

 tude in so many recorded instances, would incline the obstetrist to adopt 

 it without much delay. Very often the altered position of the mother at 

 once disengages the head of the foetus from its deviation ; if this does not 

 happen, then the other means may be tried as in the standing position. 

 Pelvic version may be resorted to in some cases, the anterior presenta- 

 tion being converted into a posterior one. 



When reduction cannot be effected, and delivery of the entire foetus 

 cannot be accomplished, then the obstetrist has no other course left open 

 to him but the adoption of embryotomy. The head may be amputated 

 through the presenting part of the neck, or the fore-limbs removed sub- 

 cutaneously at the shoulders — the latter is to be preferred in the majori- 

 ty of cases, at least before incision of the neck is begun. This gives 

 more room for manipulating the body, and effecting extraction. 



In all these amputations and incisions, care must be observed in pre- 

 venting the maternal organs being injured either by instruments or ex- 

 posed bones ; and when traction on the limbs, or what remains of them, 

 is resorted to, it should be applied to both alike — not to one, as this 

 would be worse than useless. 



