48o FCETAL DYSTOKIA. 



being the ray ; so that the foot, which is at first directed forward, may 

 be brought directly back towards the vuh'a of the mother. The Hmb 

 which is most convenient is first extended. Some obstetrists begin bv 

 seizing the hock, the fingers in front and below the joint, the palm and 

 thumb on the calcis and shank ; the lower part of the limb is then drawn 

 backwards, while the thigh i% pushed forward, and by a turn of the wrist 

 the leg is carried through the inlet and straightened. The same pro- 

 cedure is carried out with the other. 



Other practitioners endeavor to flex \h.^ limb as completely as possible, 

 commencing with the tibia and lifting it well up against the femur, then 

 the hock is bent ; the limb is now seized at the lower end of the cannon- 

 bone, or even at the fetlock, and is then lifted into the vagina. Schaack's 

 method does not differ much from this. He flexes the leg on the thigh 

 as much as possible, raising the point of the hock as near the buttock as 

 he can ; this elevates the foot and brings it nearer. As the labor-pains 

 usually push the foetus too near the pubis, it must be thrust forward again 

 by acting more particularly on the point of the hock, using it as a kind of 

 propeller. When sufficient space has been gained, the hand descends 

 along the cannon bone and grasps the front of the foot — the thumb and 

 index-finger meeting round the coronet, so that the toe is in the palm of 

 the hand j in this way the pastern and fetlock are forcibly flexed, when, 

 by a vigorous effort — seconded, if need be, by the cord placed round it — 

 the foot is raised above the pelvic brim, brought into the vagina, and the 

 leg extended — an easy operation, generally. With the foal, however, it 

 sometimes happens that, owing to the length of the limbs, the calcis 

 presses against the sacrum of the mother while the foot jams on the 

 pubis. In such cases the pastern-cord is most useful, as the operator 

 may allow the foot to pass from his hand, and press the point of the hock 

 towards the uterus, while an assistant pulls at the cord with such an 

 amount of force, and at such times, as the obstetrist may order. The 

 other limb is to be brought back in the same way. 



Cartwright mentions that, in those cases in which the limb cannot be 

 sufficiently extended backwards, the hock should be drawn as far as pos- 

 sible into the passage, and the tendon of the flexor metatarsi divided 

 above its point of bifurcation, in front and at the upper part of the joint ; 

 this allows greater mobility. If the foetus is dead, of course there can be 

 no objection to this section ; if alive, it will require consideration. 



This is the method to be recommended in every case ; and it will very 

 often be attended with success, even in the Mare, when the foetus is not 

 too firmly fixed in the pelvis, and can be pushed into the uterus. But it 

 frequently happens that retropulsion is not possible, the hind-feet cannot 

 be reached, and delivery cannot be accomplished in the way indicated. 

 We must then adopt other methods applicable to the Mare and Cow. 



With the Mare, when the foetus is wedged in the pelvis, so that it can- 

 not be moved forward, it may be presumed that it no longer lives, or that 

 it will perish before delivery is completed. There can be no objection, 

 then, in resorting to embryotomy, so as to relieve the Mare as quickly as 

 possible. 



The hind-limbs of the foetus may be amputated either at the stifle or 

 the hock — some authorities recommend the former, others the latter ; while 

 others, again, advise excision at the coxo-femoral articulations. Extraction 

 of the foetus has been effected after amputation in the three regions, but 



