DYSTOKIA FROM TRANSVERSE PRESENTATIONS. 



497 



is small and short-limbed, and the maternal pelvis roomy, this can be 

 done. But, as a rule, it is not advisable to attempt it, for the simple 

 reason that they become jammed either against the sacrum, ilium, or 

 pubis of the mother ; and if traction is then resorted to, rupture of the 

 uterus will be the result. But if this does not happen, the straining of 

 the mother only too frequently throws the returned limbs again into the 

 passage immediately. 



Therefore it is that Donnarieix, after much successful experience of the 

 plan, advises that the fore-limbs be corded, brought one after another as 

 far as possible into the passage by slow and gradual, yet firm pulling, and 

 disarticulated at the elbow-joint. 



Darreau, however, either from want of practice in this 

 method, or the difficulty in practising it, only succeeded in am- 

 putating the limbs after great trouble ; and even then the op- 

 eration was generally followed by serious, sometimes fatal, 

 accidents. He therefore adopted the following method, which 

 he declares has yielded excellent results. After cording the 

 hind-limbs, an olive-shaped repeller, armed with a noosed cord 

 (Fig. 144), is attached to each of the fore pasterns, the cord 

 passing through a ring in the handle. This cord is drawn 

 tightly around the pastern, and the free end fastened to the 

 handle of the instrument. By this means each repeller be- 

 comes a solid fixture to the fore-limbs, and it is confided to 

 an assistant. The operator then pushes back the fore-limbs 

 as far as possible, while each assistant seconds his efforts with 

 the repellers. When all has been conveniently adjusted, trac- 

 tion is made on the hind-limbs, the repellers still being em- 

 ployed to overcome the resistance of the foetus, and follow its 

 movements. 



These instruments, however, are not always, nor yet often, 

 at hand ; and there can be no doubt that retropulsion may be 

 employed by the hand, wdih care, and often successfully, es- 

 pecially with the calf, whose limbs are comparatively short. 



But cases may occur in which anterior versio7i may be pref- 

 erable, and particularly when the head and fore-limbs are 

 most engaged in the pelvic canal ; many instances are re- 

 corded in which it has been resorted to with perfect success. 



Then the hind-limbs must be pushed into the uterus, after 

 being corded ; and this retropulsion may be -greatly aided by 

 the cords previously fixed on them, as these can be run through 

 the porte-cords, which may then be employed as repellers, as 

 with Darreau's olive-shaped repeller. 



In some instances, retropulsion and version are impossible , 

 and should the foetus be dead, there ought to be no hesitation 

 in resorting to embryotomy. It will generally be found the 

 best plan to remove the fore-limbs subcutaneously, either at 

 the knee or elbow-joints — the lower part of the legs being re- 

 moved, the remaining portion can be more readily pushed 

 back into the uterus. 



I. Gierer [Oesterr. Vierteljahrschrift, 1867, p. 84) attended a Mare 

 which could not foal, and it was thought the fcetus was a monstrosity, 

 from all the feet being in the passage. Gierer found the animal lying on the left side, 

 the vulva greatly swollen, and the vaginal mucous membrane dark-colored. The feet of 



32 



Darreau's 



Ol.IVE-SHAPED 



Repeller. 



1 



