274 BOVINE OBSTETRICS 



sent by which the parts can be fixed, as in subcutaneous re- 

 moval of the head. 



THE SUBCUTANEOUS REMOVAL OF THE HEAD. 



This difficult operation, which in most cases can be 

 avoided and which is performed outside the vulva whenever 

 possible, is performed as follows : 



The head is fixed with a small hook, inserted into a cut 

 on top of the nose. On both sides of the mouth along the ex- 

 ternal surface of the lower jaw the skin is incised and separ- 

 ated by the thumb and index finger. Now the spatula is intro- 

 duced and the skin separated as far as the temporo-maxillary 

 articulation over the masseter muscle. By gliding with the 

 spatula over the inferior border of the lower jaw toward its 

 internal face the tongue is freed. 



The hand, resting upon the skin, always follows the move- 

 ments of the spatula in order to prevent injury of the genitals 

 should it slip down. 



When the branches of the inferior maxilla have been 

 separated in this way, the skin still adhering to the chin is cut 

 with the bistoury. The probe-pointed sharp hook is placed 

 under the skin and pushed as high as possible behind the 

 posterior border of the lower jaw. After turning the instru- 

 ment its edge is applied against the joint, and by pulling slowly 

 the branch of the lower jaw is cut off close to the articula- 

 tion. The body of the lower jaw is also severed with the hook 

 or bistoury. 



Each branch of the jaw is now loose and may be taken 

 away with the forceps or loop placed around the jaw behind 

 the molars. The tongue still lies on the skin. 



The incision upon the nose is prolonged 5 to 6 cm. and 

 the skin separated with the finger and thumb as far as pos- 

 sible ; the small spatula is used as far as the eyes and curved 

 portion of the skull. Now the curved spatula is introduced to 

 separate the skin from the cranium and neck as well as behind 

 and to the sides of the ears. This is a difficult piece of work, 

 as here the skin is closely moulded to the parts. The spatula 



