492 FCETAL DYSTOKIA. 



presentation 7niist be converted into an anterior or posterior one, and this 

 'at tile expense of much patience, fatigue, and slcill. But in what direction 

 is version to be practised ? Rainard lays it down, as a rule, that the 

 extremities of the foetus which are nearest the pelvis are those which 

 should be brought into the inlet ; and that if both ends of the fcetus are 

 at about an equal distance from it, the anterior should be chosen, because 

 it is the easiest for delivery. This rule, however, has not been recognized 

 by the majority of the best authorities. On the contrary, experience, as 

 well as theory, has demonstrated that in the majority of cases pelvic 

 version is the most advantageous ; inasmuch as, when this has been 

 effected, there are only the hind-limbs of the young creature to deal with, 

 whereas in anterior version there is the head in addition to the fore-legs, 

 and this may offer difficulties which have not to be dreaded in the posterior 

 presentation — more especially if there is any thing abnormal in the condi- 

 tion of the head. Not unfrequently, and particularly when the foetus is 

 yet alive and vigorous, a kind of spontaneous evolution is effected in an 

 unexpected direction ; for it has been found that, in acting on the croup 

 of the foetus, this has, by energetic movements of its own, and coincident 

 with sudden contractions of the uterus, described nearly a half-circle ) so 

 that instead of the loins being under the hand, the withers and upper 

 part of the neck are encountered, and delivery is readily accomplished. 



Before version is attempted, the intra-uterine injection of emollient 

 fluids should be practised ; this is most essential if the waters have escaped 

 for some time. Then retropulsion must be had recourse to. The foetus 

 must not be pushed directly forward into the uterus, but rather obliquely, 

 and in a direction the opposite to that of the part we wish to bring before 

 the inlet. The hand or repeller must be used for this purpose, and as 

 version is difficult, so must the intra-uterine injections be frequent. 



The retropulsion and injection, together with the uterine contractions, 

 have the effect, in many cases, of making the body of the foetus glide 

 around the inner surface of the uterus, until a convenient part presents. 

 Then the limbs and head — if they are required, or only the hind-limbs, if 

 it should be so decided — are brought into the genital canal by the hand 

 or by cords. If the occasion demands it, rotation may be resorted to, in 

 order to convert the vertebro-ilial position into the vertebro-sacral or 

 vertebro-pubic. Delivery is completed by moderate traction. 



The manipulations will, of course, vary with circumstances ; but it will 

 generally be found that, in all cases, raising the hind-quarters of the 

 mother will render them much easier of accomplishment. 



When these manoeuvres have failed, embryotomy has been practised. 

 The intestines and other organs can be extracted by an incision in the 

 flank ; the vertebras may be divided at the presenting part, and the entire 

 body cut through at this division ; then each half can be extracted in the 

 'best and easiest manner possible. 



The following are a few illustrative cases of this presentation : 



I. Lecoq [Mem. de la Societe Veterinaire du Calvados, No. vi.), in 1824, was summoned 

 to assist a Mare in parturition. The " waters " had escaped three hours previously. 

 On the hand being introduced into the uterus, an undistinguishable mass was encoun- 

 tered. After a long exploration the withers and mane were distinguished, and it was 

 ascertained that the foetus was almost in a sitting attitude, the head and neck curved 

 upwards and forwards towards the sacro-lumbar region of the mother. A sharp hook 

 was fixed about an inch in depth in the middle portion of the neck, near its upper margin ; 

 the handle was given to an assistant, while Lecoq placed his hand, in supination, a little 

 higher than the withers. The foetus was carried towards the fundus of the uterus by 



