Position of the Patient 619 



mal, the better for the operator. In order to prevent the patient 

 from sliding down the incline, ropes maj- be attached to the hind 

 feet, and held by assistants or attached to a post or beam. 



Even greater advantage may be afforded sometimes by placing 

 stout ropes upon the hind legs, carrying them over pulleys at- 

 tached to a beam above, and, turning the patient upon her back, 

 more or less completely suspend her with the head downwards. 

 This causes the fetus, along with the rumen and other viscera, 

 to drop forward by gravity, and affords room for version or other 

 manipulations. The position cannot be maintained for a very 

 long period. 



The question of the exact attitude of the patient during ob- 

 stetric operations is to be determined in each case by the charac- 

 ter of the obstacle to parturition. 



The expulsive efforts of the mother frequently constitute an 

 important impediment to obstetric operations, and sometimes 

 render an otherwise very trivial procedure exceedingly difficult, 

 or impos.sible. Sometimes the slight deviation of a forelimb 

 could be corrected in a few minutes if the patient would not 

 strain, but under constant and violent expulsive efforts it may 

 become a very laborious operation of long duration. So with 

 many other manipulations. It is consequently important that 

 we should understand and apply as fully as possible our means 

 for controlling the expulsive efforts of the mother. 



In many cases the expulsive efforts can be largely prevented by 

 attracting the animal's attention, either by frightening it some- 

 wjiat or by some physical punishment of a moderate character. 

 In the mare a twitch upon the nose will sometimes tend to inhibit 

 violent expulsive efforts. In other cases slight strokes upon the 

 nose and lips with a strap, stick or rope will so attract her at- 

 tention as to stop the straining. The owner may be able to 

 attract her attention by gently stroking her with the hand, by 

 moving the head up and down or otherwise keeping her atten- 

 tion somewhat attracted by caressing her. 



The mare may also be largely prevented from straining by pinch- 

 ing the back or loins with the fingers or by placing a stick of 

 wood, especially one with square corners, across the loins, 

 and having a man on either side press down upon the stick in a 



