464 FCETAL DYSTOKIA. 



trocar (for lack of a better instrument) was introduced between the ischio-rectal fascia 

 and the sacro-ischiatic ligament to form an opening, into which a probe-pointed bistoury 

 was inserted; with the other hand on the outside, the ligament was quite divided — 

 which was ascertained by feeling the point of the bistoury under the skin. Very little 

 haemorrhage supervened, and the calf was removed with but little difficulty from the 

 artificial opening thus made. A diffusible stimulant, followed by a laxative draught, 

 was all the after-treatment adopted. The small orifice " was cicatrized over on or 

 about the third day," and the Cow quickly recovered. 



This operation has not, so far as I am aware, been repeated. 



With the smaller animals — such as the Sheep and Goat — this deviation 

 must be remedied by forced extraction or the short blunt hook or finger- 

 hook, the fore-limbs of the fcetus being manipulated so as to push away 

 the unencumbered shoulder into the uterus, and bring forward that round 

 which the neck bends. The smallness of the genital passages in these 

 creatures is an obstacle to manipulation, but an intelligent boy with a 

 small hand may be of much service when acting under the direction of 

 the obstetrist. 



With the Bitch and Sow these deviations are extremely rare. When 

 they do occur it will be found that forceps will generally effect forced 

 extraction ; or a piece of strong catgut or brass or copper wire may be 

 passed round the bend of the neck. Traction on this will either remove the 

 fcetus, or by cutting through the neck permit it to be extracted by the 

 forceps hereafter to be described. Placing the Bitch in a warm bath for 

 a few minutes, and then laying it on the side opposite to that to which 

 the head of the puppy is inclined, will be found advantageous. 



Deviation Upward and Backward. 



The deviation of the head more or less upward and backward — the 

 inferior borders of the lower jaw being vertical or turned up. towards the 

 maternal sacrum — appears to be an extremely rare complication, and is 

 chiefly met with in the Mare, in which it has led to rupture of the uterus 

 and rectum, and delivery by the latter. 



The cause is probably the same as in the other deviations of this 

 region. 



On exploration, in the vertebro-sacral position, the fore-limbs maybe 

 found more or less advanced in the vagina, and beyond them, at the 

 inlet, the hand meets the chest with its sternum, and above" it the front 

 part of the neck with the trachea leading upwards to the head, which 

 may be flexed more or less back on the withers or loins (Fig. 128), or 

 inclined to one or other side of the foetus, the lower jaw always facing 

 the lumbo-sacral region of the mother, or twisted slightly round (Fig. 

 129). 



Indications. 



Retropulsion is the first indication, and this alone will often bring the 

 head into its normal position ; it should be practised on the sternum. 

 Should the head not drop down to the pelvic inlet, then, still continuing 

 the retropulsion, the hand may be introduced, the lower jaw seized i.nd 

 brought towards the os, by carrying it downwards and a little to one side 

 if necessary, by a slightly screwing motion. A cord on the lower jaw, 

 or around the head, may be useful if it can be applied. Rueff recom- 

 mends compression in the rectum, previously emptied, by the hand of an 



