CLASSIFICATION OF ABNOKMAL PRESENTATIONS 241 



Should it be impossible to bring the head into the pelvic 

 canal with the hand, a loop is placed around the lower jaw and 

 traction practiced. At the same time the obstetrician repels 

 the calf by placing the hand against the sternum. With regard 

 to the fixing of the rope, attention should be paid that the hand 

 which cords the head stays on its side and does not glide across 

 the neck to the inferior maxilla. In the latter case the neck 

 would be twisted by pulling and reposition becomes impossible. 

 When the head rests against the right shoulder, the cow is 

 placed upon the right side, and upon the left side should the 

 head be turned against that side ; this renders reposition 

 easiest. 



When the calf is dead the head may be fixed by placing 

 the thumb and index finger into the orbital cavities, or a hook 

 may be used instead. It is advisable to use the hook only in 

 case of necessity. Only when reposition by hand fails, and 

 the eye, but not the mouth can be reached, is the application 

 of the hook indicated. 



In all cases where the foetal waters are completely dis- 

 charged and the uterus firmly contracted and the head cannot 

 be brought into the parturient passage, embryotomy is called 

 for. Both fore legs are removed subcutaneously ; this gives 

 ample room to draw the head into the pelvic canal and fix it. 



The head resting against the thorax. 



This abnormal presentation may follow the preceding one 

 when traction is exerted on the fore legs while the head is 

 turned against the shoulder (fig. 40). 



Diagnosis. — The internal examination, as in the preceding 

 portion, reveals the side of the neck in front of the pelvic in- 

 let, while the skin of the neck is more tense. The fore legs 

 are further advanced into the vagina. 



Treatment.— The method is the same as in the presentation 

 just discussed, but special attention must be paid that traction, 

 after cording the lower jaw, is practiced in the right direction, 

 to prevent twisting of the neck. On the whole, reposition is 

 here no more difficult than in the preceding position. 



