484 FCETAL DYSTOKIA. 



This manipulation is rendered more difficult than in hock presentation, 

 from the fact that the hocks in this are deeper in the uterus, and jam against 

 the brim of the pelvis, where they cannot be freed by the hand. The 

 difficulty is surmounted by passing a blunt hook round them, or a cord as 

 in Fig. 135, the two ends of this outside the vulva being twisted and 

 drawn upwards and outwards by an assistant ; while the operator, push- 

 ing at the croup, throws the body of the foetus forward, and thus allows 

 the point of the calcis to rise above the pelvic brim, when the leg can 

 be extended backward as in hock presentation. 



This method, however, does not succeed in every case ; and when the 

 croup is firmly wedged in the pelvic canal and the thighs have cleared the 

 inlet, it is only too often impossible to effect retropulsion. Consequently, 

 there are but two courses open : extraction 06 the foetus in this abnormal 

 position, or removing it by embryotomy. 



Fi 

 Thigh and Croup Ppesent .t:on: Thigh Corded. 



Forced extraction of the foetus, without adjustment, is a very serious, 

 because a very violent, measure, and is frequently fatal to the mother, as 

 well as to the offspring. It should, therefore, not be lightly adopted, and 

 every other measure of a milder kind should be tried if it has any prob- 

 able chance of success. Throwing the mother on the back or side may 

 effect a change for the better in the position of the foetus ; or if standing 

 or lying, then raising the hind-quarters as high as may be without injury 

 should be tried. 



These failing, then Lecoq's method may be resorted to. This consists 

 in passing the hand, furnished with a cord, between the wall of the pelvis 

 and the body of foetus as far as the thigh of the latter ; the cord is then 

 pushed beneath the thigh as far as possible and left there, while the hand 

 is passed above — between the leg and body, so as to bring the end of 

 line up around the stifle and back through the vagina. In this way the 

 thigh is encircled by a loop, as in Fig. 137. The other thigh maybe 

 secured in the same way by another cord, and this part of the operation 

 will perhaps be much faciliated by using the long bent porte-cord (Fig, 

 148). 



Saint-Cyr states that one thigh corded may be sufficient ; but it is un- 

 doubtedly better to cord both, if possible, as traction on the two limbs 

 keeps the body of the foetus in a straight direction. 



