Position and Control of Patient 617 



absolutely refuses to try to stand. If slings are placed under her 

 and she is raised by means of pulleys, she still thwarts the ob- 

 stetrist's aim by lying limp in the apparatus and producing the 

 same or even worse conditions than though she were lying down. 



The most efficient method of getting an obstinate cow to stand 

 is by means of a well-trained dog. When such a dog is brought 

 into the stall and will take hold of the cow in a vigorous manner, 

 if she has enough strength to rise, she will get up very promptly, 

 and, as long as the dog will stand b3^ ready to interfere the mo- 

 ment she attempts to lie down, she will continue to stand as long 

 as she is able. It might not be an unwise plan for the veterinary 

 obstetrist, with much cattle obstetrics, to regard a well- trained 

 dog as a part of his obstetric equipment and have the animal ac- 

 company him in all cases of dystokia, read}' to render such a 

 service. 



Some animals suffering from dystokia are vicious, and the op- 

 erator must take precautions against injury from them. In 

 carnivora it is wise to muzzle the patient before attempting any 

 work which may induce any vicious resistance. In ruminants 

 there is almost no danger to the operator because of any vicious- 

 ness upon the part of the patient. Very rarely the cow may 

 kick, but this we have not observed. 



It is very rare that the mare offers any violent resistance to the 

 work of the operator. Some have suggested that in all, or in 

 most cases, an assistant should hold up the mare's forefoot, but 

 in an extensive experience among mares we have encountered 

 only one which required any definite restraint in so far as vicious- 

 ness was concerned. Almost always the mare stands quietly, or 

 at most merely steps from side to side, and does not offer to kick. 

 In the one exception in our experience we found it necessary to 

 cast the mare and tie all four feet, because she persistently and 

 viciously kicked and fought, and rendered our work both highly 

 dangerous and wholly inefficient until she was thoroughly secured. 

 The securing of the animal, by tying, compressed the abdomen 

 and greatly increased the difficulty of our operation. The diffi- 

 culty would have been largely obviated by general anaesthesia. 



Although the standing position is usually the most favorable 

 one for operating, it is not uniformly so, and in some instances 

 recumbency is preferable. 



Whether the recumbency is unavoidable or is brought about 



