Forward Extension of Posterior Litnbs 777 



The prognosis is extremely unfavorable. Next to bi-cornual 

 pregnancy, this is one of the most dangerous positions of the 

 fetus encountered in the mare. The fetus is doubled up in 

 such a manner as to cause very severe pain and violent straining, 

 constantly threatening serious or fatal injury to the mother. 

 The position offers unusual opportunity for damage by empirics, 

 and invites violent traction by laymen without knowledge of the 

 serious results which are almost sure to follow. When the two 

 posterior feet are lodged against the brim of the pubis, the danger 

 is perhaps greater than when the hind feet are well advanced in 

 the pelvis, because the expuLsive efforts of the mare, or traction 

 applied by attendants, tend to force the two po.sterior feet through 

 the floor of the uterus. It is also a position in which the laj-man 

 and empiric may undertake embryotomy, and in one case at- 

 tended by us they had performed detruncation through the 

 dorsal region, but had failed to protect the genital organs from 

 the sharp bones which thej^ had left. As a consequence, the 

 vagina was very badly lacerated and a chronic vagino-cystitis 

 followed, from which the mare never recovered, although she 

 survived. 



The method of handling varies greatly in the hands of different 

 obstetrists. 



I. Mutation. Some advise the adjustment of the misplaced 

 members, but we find no data to show in what proportion of cases 

 such a plan may succeed. The directions given are to repel the 

 two hind feet as far as possible into the uterine cavity and abdo- 

 men, and then by traction to bring the fetus away. It must be 

 evident that it is only in very favorable cases that such an oper- 

 ation can succeed in the mare. With the anterior portion of the 

 fetus and its body impacted firmly in the pelvic canal, the oper- 

 ator cannot reach very far into the abdominal cavit)^ and cannot 

 expect to repel the two posterior feet to any very great degree. 



The character of the position generally excludes all possibility 

 of repelling the head and body of the fetus, and if the hind limbs 

 are very far advanced in the pelvic canal it would seem impossi- 

 ble to effectively repel them. Even when repulsion has suc- 

 ceeded to a degree, it is impossible for the operator to know if 

 the two hind feet rest in a safe position where they may turn 

 backward as the fetus nioves forward, or not. It seems to us, 

 from our clinical observation, that there would be constant danffer 



