Eju bryotomy . 645 



Technic. Some obstetrists advise the use of Persson's chain-saw, Fig. 103 

 or the chain sector of Masch. More recently there has come into high 

 repute, in some portions of continental Europe, the embryotom of Pfianz, 

 Fig. 99. These instruments are passed around the curved neck, and act 

 chiefly from the distal side of the member. 



The most effective instrument of the group is apparently the Pflanz 

 embryotom. However, any one of them will accomplish the purpose, once 

 they haV^e been passed around the neck, but this offers considerable difficulty. 

 The chain-saw and sector have the disadvantage, as compared with the 

 Pflanz embryotom, that the)' must be drawn backward and forward in 

 order to saw their way through the tissues, and constantly tend to wound 

 the soft parts of the genital canal by coming in contact with them. This may 

 be largely or wholly obviated by passing a sheath of leather or other 

 material over the chain, and working it through this. 



When the Pflanz embryotom has been applied to the part, danger of iujur\- 

 becomes virtually excluded, and the work of section is rapidly and easily 

 carried out. 



In the application of these instruments, some operators claim that there 

 is an advantage in first passing a cord around the neck, with the bent porte- 

 cord or the bent cord-sound. Once the cord has been passed around the 

 neck and is attached to the chain-saw or sector, the latter may be eisily 

 drawn into position. 



With the Pflanz instrument, a smooth chain is first used to pass around 

 the neck, which is free from any danger of inj ury to the soft parts of the 

 mother and is comparatively easy to handle. 



Other operators divide the neck by means of cutting instruments acting 

 upon the front or proximal side, and use for this purpose the finger-knife, 

 bistoury, or chisel, but with these instruments the process is a comparatively 

 tedious one, as it is difficult to cut through every portion of the tissues. 

 With the knife it is impracticable to sever the cervical column, since the 

 vertebrcC cannot be disarticulated, and it becomes necessary to use so iie 

 more powerful instrument for severing the bony column. This may best be 

 done with the chisel. 



Each plan has its advantages and disadvantages. The latter may be pre- 

 ferable or necessary where it is extremely difficult or even impossible to 

 apply the chain to the neck. 



In our personal experience we have not found it desirable to resort to the 

 amputation of the neck in cases of deviation of the head, but have constantly 

 preferred to amputate one anterior limb subcutaneousl}-, followed by 

 evisceration, which operations we shall describe below, after which the fetal 

 renmant may be extracted without difficult^', with the head turned back, 

 or the head may be readily brought into position ,as the operator may prefer. 



d. Subcutaneous Amputation of the Anterior Limbs. 



Amputation of the anterior limbs i.s very frequently called for 

 in obstetric practice, especially in the mare, chiefly in cases of 

 the ventral transverse presentation, with all four feet offering 



