Embryotomy. 653 



obstetrists. and those who prefer to use the chain-saw, sector, 

 Pflanz instrument, or other foim of embryotom, would ampu- 

 tate with such an instrument. Any one of them is efficient, 

 providing always that the hock is easih^ reached and lies, or can 

 be placed, in such a position that the instrument can be applied. 

 It is possible also, though very difficult, to amputate the hock 

 with a scalpel. 



Instead of amputating the hock, in cases where it is offering 

 a serious obstacle to parturition, some operators sever the tendo- 

 Achilles, by which means they permit the metatarsus to fold 

 against the inferior surface of the tibia and the toe of the foot to 

 become somewhat extended, so that it will offer less obstruction. 



b. Intra-Pelvic Amputation of the Posterior Limbs in 

 the Breech Presentation. This operation is designed for the 

 overcoming of dystokia due to a posterior presentation with the 

 hind limbs completely retained in the uterus, the so-called breech 

 presentation, when the deviation cannot be readily corrected. 



Technic. Introduce one hand, armed with the embryotomy 

 knife, scalpel or chisel, through the maternal passages, until the 

 perineum of the fetus is reached, and make a free incision 

 through that part, including the anus in the male fetus and the 

 anus and vulva in the female, enlarging the incision sufficiently 

 to admit the operator's hand into the fetal pelvis. 



Locate the great sciatic ligament of the fetal pelvis and, in- 

 serting the knife into it just behind the shaft of the ilium, divide 

 the former backward to the perineum, thus enlarging the pelvic 

 cavity and giving ample operating room. If the pelvis of the 

 fetus is too small to admit the hand of the operator at all before 

 severing the sciatic ligament, this may be accomplished by cau- 

 tiously cutting from behind forward with Colin's scalpel or with 

 the chisel. 



When this has been severed and sufficient operating room, at- 

 tained, carry the chisel in the hand and place it against the shaft 

 of the ilium, as shown between I' and I', as nearly perpendicular 

 to the long axis of the iliac shaft as possible. Keeping the hand 

 in touch with the chisel blade, have an assistant drive it through 

 the bone until it and its periosteum are completely severed. 

 Forcibly rotate the chisel upon its long axis, in order to complete 

 the division of the bone and attached soft parts. Disengage the 

 chisel, and then place it against the symphysis pubis or 



