DISEASES OP THE GENERATIVE ORGANS. 223 



in subsequent traction on the body of the calf; (c) the dissection and 

 separation of the limb are far more safely accomplished under the pro- 

 tection of the enveloping skin than if the operator's hands and instru- 

 ments were in direct contact with the walls of the passages or womb; 

 (d) the dissection can be much more easily effected while the skin is 

 stretched by the left hand so as to form a comparatively firmer resist- 

 ant point for the knife than when it is attempted to cut the soft, yield- 

 ing, and elastic tissues which naturally offer little solid resistance, 

 but constantly recede before the cutting edge of the instrument The 

 pivM'i-vafion of the skin is, therefore, & cardinal principle in the ampu- 

 tation of all parts in winch it is at all feasible. 



The presenting foot is inclosed in a noose and drawn well out of the 

 pomgM. Then a circular incision through :':< skmfeBUfe ;ir;n:d 

 the limb just above the fetlock. From this the skin is slit up on the 

 inner side of the limb to the breast. Then the projecting part of the 

 limb is skinned up to the vulva, traction being made on the foot by an 

 -tant so as to expose as much as possible. The embryotomy knife 

 may now be taken (Plate xxi, Fig. 2), and a small hole having been cut 

 in the free end of the detached portion of skin, that is seized by the left 

 hand and extended while its firm connections with the deeper struc- 

 tures are cut through. The looser connections can be more quickly 

 torn through with the closed fist, or the tips of the four fingers held 

 firmly together in a line, or with the spud, of which there are several 

 kinds. Much of the upper "part of the limb can be skinned more 

 lily without the knife, but that must be resorted to to cut across 

 toiiirh bands whenever these interrupt the progress. The skinning 

 should bo carried upward on the outer side of the shoulder blade to 

 the spine, or nearly so. Then with the knife the muscles attaching the 

 elbow and shoulder to the breastbone are cut across, together with 

 those on the inner side of the shoulder joint, and in front and behind 

 it so far as these can be reached. Steady traction is now made upon 

 the foot, the remaining muscles attaching the shoulder blade to the 

 trunk are torn through with a crackling noise, and the whole limb, 

 including the shoulder blade and its investing muscles, comes away. 

 If the shoulder blade is left the bulk of the chest is not diminished, 

 and nothing has been gained. Before going farther it is well to see 

 whether the great additional space thus secured in the passages will 

 allow of the missing limb or head to be brought into position. If not, 

 the other presenting part limb or head, is to be amputated and 

 extracted. For the limb the procedure is a repetition of that just 

 described. 



AMITTATION OP TIIR IIKAI>. 



The head is first seized and drawn well forward, or even outside the 

 vulva, by a rope with a running noose placed around the lower jaw just 

 behind the incisor teeth, by a sharp hook inserted in the arch of the 



