DYSTOKIA DEPENDING ON POSTERIOR PRESENTATION. 487 



far distant from the os, as was demonstrated on opening the Cow. All the time the as- 

 sistant was striving to force the breech back, to obtain space to raise the leg, he was ac- 

 tually obstructing delivery by impacting the limb. Cording the hock, drawing it into 

 the vagina as far as possible, and amputating the leg at that or the hip joint, would have 

 been the proper procedure. 



2. The same practitioner {Veterinarian, vol. xv., p. 374) was sent for to see a Cow 

 which had been attempting to calve for a whole day. An examination proved it to be a 

 case of posterior presentation, with the hind legs down towards the udder. A cord was 

 tied round each hock, an assistant pulled gently at the left one, while Cartwright at- 

 tempted to reach the foot but could not. The Cow, which had been standing, now lay 

 down on the right side, and the hind-quarters were well raised by means of straw. An 

 assistant pushed back the croup of the calf, while the operator seized the foot ; but little 

 advantage could be gained. The Cow being a " roomy " one, the assistant was now di- 

 rected to firmly and steadily force the point of the hock forwards, while Cartwright 

 pulled at the foot ; in this way the latter was got up and brought straight into the pass- 

 age. This limb being raised, more room was allowed to manipulate and adjust the 

 other leg in the vagina. Both legs were now corded above the fetlock, the vagina was 

 lubricated with oil, and traction begun. The passage was, however, so narrow that the 

 calf could not be advanced ; " we then fastened a necking strap from the hames around 

 each leg just above the hock, by means of which it made more room to pull at and was 

 nearer the 'parts. By severe pulling we got the hind-parts through ; but when we arrived 

 at the chest the passage was tighter than ever, and we almost despaired of accomplish- 

 ing our object.'' A part of the cart-rope was finally tied round the body of the calf, by 

 which means two men pulled with great effect, and delivery was completed. The Cow re- 

 ceived gruel and brandy, and a truss was applied. Perfect recovery ensued. 



3. Naylor {Ibid., vol.'xxxiii., p. 323) examined a Mare in labor, and found the foal lying 

 on its back with its hocks at the os uteri. With difficulty one limb was got forward and 

 the other amputated at the hock-joint. A hook was placed within the pelvis of the foal, 

 and both hind-limbs having been secured, with much exertion rotation was effected, the 

 back of the young creature being upwards. Considerable force had to be employed in 

 extracting the foetus, during which the perinaeum gave way. Though the laceration was 

 sutured and the Mare placed under medical treatment, death occurred in two days. 



Dystokia from the Head and Fore-limbs in the Posterior Presen- 

 tation. 



• 



In posterior presentations, difficulties caused by the head or fore-limbs, 

 or perhaps both, have sometimes to be overcome by the obstetrist. 



With the fore-legs, the chief obstacle appears to be offered by the 

 elbows. If these limbs are in a state of abduction, and the elbows 

 widely separated from the body, these latter come in contact with the 

 brim of the maternal pelvis, and jam against it ; thus offering a formid- 

 able resistance to further progress. 



The head does not so readily constitute an obstacle to birth, though in 

 the posterior presentation, being the last portion of the foetus to enter 

 the passage, its widest part may become fixed either in the pelvic inlet, 

 or be retained by the' cervix uteri when this has happened to contract 

 •earlier than usual. This sometimes occurs with the calf and some of the 

 smaller animals, but more especially puppies. Indeed, it is not very 

 uncommon to witness Bitches with the hind part of the body of a puppy 

 hanging from the vulva, the head being firmly wedged in the passage. 



Indications. 



This resistance may be overcome in some instances, and especially if 

 the fcetus is dead, by considerable traction. In other cases, however, 

 and more frequently when the foetus is alive, this traction cannot be prac- 

 tised with impunity, so far as the fcetus, or even mother, is concerned. 

 Rotation of the foetus is then to be recommended ; and this is not diffi- 

 cult in carrying out, considering that a large portion of the body is al- 

 ready outside the vulva, and can be utilized in effecting the operation. 



