468 FCETAL DYSTOKIA. 



the pelvic canal, at the same time as the anterior part of the body, the 

 position of the young creature being consequently more or less vertical 

 and the body bent at the loins. 



As in the preceding deviation, nothing is at first known of the existence 

 of the displacement. Parturition commences and appears to be going 

 on favorably ; the foetus, in the vertebro-sacral position, arrives at the 

 inlet, the head and fore-limbs in advance as in normal birth. Progres- 

 sive expulsion may continue until the head of the young animal is beyond 

 the inlet, and as far as, or even external to, the vulva — sometimes the 

 head, fore-limbs, neck, and half of the chest hanging outside the vagina. 

 But further progress is checked, and neither the most energetic straining 

 on the part of the animal, nor the most violent traction by those persons 

 who may be with it, can advance the foetus beyond this point. 



The obstetrist has great difficulty in ascertaining the cause of delay 

 in birth : the difficulty varying, and depending upon the volume of .the 



Fig. 130. 

 Deviation of the Hind-limbs in the Pelvis in the Anterior Presentation. 



foetus, and whether its body more or less completely fills the pelvic canal. 

 The hand can generally only be introduced after much trouble and tact 

 into the passage, and having got to a certain distance it encounters either 

 under the body or head (Fig. 131), to one side of the neck or head, or 

 even projecting upwards above the head (Fig. 130), first one, then a 

 second foot or limb, which are recognized by a careful examination to be 

 those of the hinder part of the body. Sometimes the feet and metatarsal 

 bones have alone entered the pelvis, the other parts of the limbs being 

 in the uterus (Fig, 131) ; in other cases the hocks may be in the inlet, or 

 even well through 'the passage — depending upon the size of the foetus 

 and the capacity of the maternal pelvis ; more rarely the stifles have 

 cleared the inlet, and the hind-feet are arrived at the vulva. The more 

 advanced the hind-limbs are, so the more is the body of the foetus bent 

 on itself, and the greater is its resemblance to a dog in a sitting posture. 

 It is needless to state that the foetus cannot be extracted in this malposi- 

 tion, no matter what amount of force may be exercised ; and that violent 

 measures are certain to lead to serious injury to the mother. The great- 

 est care is therefore necessary, in order to ascertain the exact state of 



