290 THE DOG IN DISEASE. 



However, if a bitch has long been straining and to no pur- 

 pose, the puppy being down within reach and pressing on 

 the perineum, a little timely assistance during the pains 

 only will facilitate progress. The hand alone should be 

 employed in such cases. It may be that the puppy is pre- 

 senting high in the vagina or in the uterus, and the natural 

 efforts of the bitch do not suffice to move it. In that case 

 the belly may be pressed upon during the pains and some 

 part of the whelp brought within reach of the finger. 



If a puppy is ascertained to be dead, from its being 

 cold, etc., the sooner it can be removed the better. 



The use of instruments is an important question. 

 Considering the smallness of the passages in all but the 

 largest specimens, the thinness of the vaginal and uterine 

 walls, the readiness with which they are torn, bruised, or 

 at least abraded, and the great danger of serious and in- 

 fective inflammations, the subject becomes of grave im- 

 port. 



Except for the largest bitches, forceps, however small 

 and well made, must be used with the greatest care, if at all. 



"We should be inclined to restrict instrumental interfer- 

 ence to the worst cases only, with a view of saving the life 

 of the bitch chiefly, and to such simple appliances as a very 

 blunt hook or crotchet and a sort of snare, such as is used 

 to remove polypi, etc., or some simple device extem- 

 porized for the occasion. All traction, whether with the 

 hand or aided by instruments, should be steady, and only 

 during the pains, unless these have quite ceased. 



When there is a dead puppy in utero, and it seems to 

 be hopeless to expect that the uterine contractions will ex- 

 pel it unaided, when the bitch shows signs of exhaustion 



