784 Veterhiarv Obstetrics 



of the fetus, and in many cases can only touch the tibia or other 

 portion of the limb with very great difficulty. Sometimes na 

 part of the hind limb can be grasped or recognized until after re- 

 pulsion has taken place. 



1. The adjustment of the deviated limbs is first of all indi- 

 cated. The fetus should be repelled, as described on page 595, 

 after which the tibia or metatarsus, as may be available, should 

 be secured by means of cords, as described on page 579. By 

 continuing repulsion, the position is to be converted into a hock 

 presentation, after which the further handling of the case is iden- 

 tical with that position which has already been described. 



2. Forced extraction has been advised by some operators in 

 these cases. As to how successful they have been our veter- 

 inary literature is not very clear. They suggest a variety of ways 

 for bringing about forced extraction. Some recommend that a 

 cord with a running noose be passed around the loins of the fetus 

 and secured, or rather that the cord be passed around each of the 

 thighs and then passed through the noose at the top of the back, 

 so that the loins of the fetus are secured and the operator is 

 enabled to apply any degree of traction which may be desired. 



Others would apply traction by means of sharp hooks deeply 

 imbedded in the flanks, like the flank hooks of Harms. Yet other 

 obstetrists would incise the perineum of the fetus and, inserting 

 the hook through the fetal pelvis, engage it in the obturator 

 foramen or in front of the pelvis, and exert traction in this way. 



While forced extraction may be somewhat easier for the ob- 

 stetrist, we do not consider it warranted by modern surgical prin- 

 ciples. We have at no time found any need for applying forced 

 extraction. 



3. Embryotomy offers the most valuable method for over- 

 coming this form of dystokia, especially in the mare, in all those 

 cases where adjustment is impossible or difficult. Whenever the 

 fetus is comparatively large or is dry or emphysematous, or for 

 any other reason it is exceedingly difficult or impracticable to 

 bring about an adjustment of the position, embryotomy is highly 

 commended, and should be undertaken promptly, before the ope- 

 rator and patient have become exhausted in fruitless endeavors. 

 Various forms of embryotomy have been recommended b\' differ- 

 ent writers, but we greatly prefer the intra-fetal amputation of 

 the two posterior limbs, as described on page 653. Others prefer 



