DYSrOKIA DEPENDING ON ANTERIOR PRESENTATION. 471 



the remains of the foetus can be removed. This part of the operation is 

 tlie most difficult and fatiguing for the obstetrist, as well as the most 

 dangerous for the mother, and requires both strength and dexterity to 

 push back the loins and pelvis of the foetus while advancing the hind- 

 limbs, thighs, and croup towards the outlet ; 5. Nothing now has to be 

 done but to exercise moderate traction, and terminate, in the lumbo- 

 pubic position of the posterior presentation, a birth commenced in the 

 vertebro-sacral position of the anterior presentation. 



Dietrich recommends eventeration of the fcetus, removal of one of the 

 huid limbs, and the adjustment of the hinder parts through the abdom- 

 inal opening ; if this cannot be effected, then these parts are to be drawn 

 into the vacant cavity of the abdomen. 



When only one hind leg is in the pelvis, retropulsion of the body may 

 be tried, the fore legs and head being corded, and the misplaced hind 

 limb finally extended backwards in the uterus. If this cannot be accom- 

 plished, the hind leg must be drawn forward and amputated at the hock 

 or beyond, and the thigh then carefully pushed towards the uterus. 



Removal of the abdominal viscera favors these manoeuvres. 



1. Cartwright describes the case of a Cow which showed signs of calving, and soon 

 after the fore feet appeared, and subsequently the head. A variety of assistance had 

 been called in previous to his arrival, but the calf could not be advanced farther than 

 the loins. He found the Cow in a very exhausted state, with one-half of the foetus 

 hangnig out. On examination it was discovered that the hind legs were in the pelvis ; 

 '* thus preventing us, with all the strength we could muster, drawing the foetus away ; 

 as the hind parts, together with the metatarsal and tibial bones, were doubled up, and 

 thus completely blocked tlie passage. Of course, in trying to pull it away in this posi- 

 tion, the femoral bones would be thrown up before the hind parts could pass." Cords were 

 attached to the hind legs, the thoracic and abdominal viscera removed, as well as the 

 protruding portion of the body, and the loins were then forced back, while assistants 

 pulled at the hind legs and extracted the remainder of the body without any further 

 dithculty. The Cow received stimulants, but died in a short time. The uterus was 

 found to be ruptured at the cervix. 



2. In the Edinburgh Veterinary Review, mention is made of a case in which only one 

 hind leg m the pelvis proved an insurmountable obstacle to birth. The abdominal or- 

 gans were removed, the leg in the pelvis drawn forward, and traction at the same time 

 exercised on the hind and fore limbs. The foetus was in this way removed. 



3. Gierer [Magazin von Giirlt unci Hertwig, 1865, p. 78) describes the case of a Mare, 

 which six men attempted to deliver by dragging at the foal. Gierer found the latter 

 hangmg dead from the vagina. Removing the viscera from the chest and abdomen, the 

 hind feet were reached through the cavity of the body ; the abdominal muscles and 

 skin were cut through, but the hind legs could only then be imperfectly pushed back- 

 wards. With the help of five men pulling, however, the foal was extracted. There 

 ensued much swelhng of the vulva, but the Mare eventually did well. 



4. Marty (Journal des Veterinaires du Midi, vol. xiv., p. 400) attended a case in which 

 the front part of the foal was born, but the hinder extremities were firmly retained, the 

 hind feet beneath the body. Dividing the trunk, cording the hind pasterns, and push- 

 ing the loins into the uterus while the cords were steadily pulled at, the Mare was de- 

 livered and did well some time afterwards. 



5 Walther (6'aV/^i-m Jahresbericht, 1861, p. 123) had a Cow in which all the feet of 

 the calf presented. The fore limbs were corded, the hind ones secured and drawn to- 

 wards the vulva. Suddenly the progress of the calf towards the outlet of the pelvis was 

 checked, and on examination it was discovered that one of the hind feet had passed be- 

 tween the fore ones. This state of affairs changed, however, and the foetus, in altering 

 its position slightly, had both hind feet jammed against the pelvis, and the body pro- 

 truded as far as the shoulder. Embryotomy was decided upon, and the viscera were 

 removed from the fcetus, as well as the front part of the body ; the hind feet were corded, 

 and traction soon removed them and the croup. 



6. In the Repertoriumfiir Thier.heilkuttde (1875, P- -57) '■'' ^" account of a Mare which 

 had been in labor for eighteen hours. The foetus was dead , both the fore feet were in 

 advance and visible, one hind foot was fixed against the side of the mother's pelvis, 

 while the other pressed against the inlet, the head being turned back to the left side. 



