420 FCETAL DYSTOKIA. 



In removing the body of the foetus by instalments, the limbs are 

 amputated one after the other, according to the rules to be prescribed 

 for this operation ; and it may be necessary to excise two, three, or 

 all of the legs, and even the head of the foetus, before delivery can be 

 completed. 



DoubijE and Tkiple Monstrosities. 



We have already alluded to monstrosities which have the head 

 double ; we now^ come to the consideration of those which have the body 

 more or less double, or even triple, and which have been designated by 

 G. Saint-Hilaire Eusomphalian, Monoinpkalian, and Monocejjhalian, 

 according to the degree of separation of the bodies, and whether two 

 are united to a single head — the double-headed creatures being desig- 

 nated Synceplialian. 



From an obstetrical point of view, there is little need to distinguish 

 between the Eusomphalian and Monomphalian monstrosities ; for, as 

 already explained, they consist of two distinct foetuses joined together 

 at some part of their body, the character distinguishing them being the 

 presence of a double or single umbilical cord (see Figs. 115, 117, 118, 

 119). 



The occurrence of such monstrosities is generally, though not 

 always, serious, so far as birth is concerned ; they are met with in all 

 the domesticated animals, but perhaps most frequently in the Bovine 

 and Ovine species. Several instances are mentioned in w^hich birth 

 has taken place wathout difficulty, and the young creatures have lived. 

 Holzner of Erding, quoted by Franck, states that a double Lamb, with 

 eight feet, double abdomen, and single breast, neck, and head, was born 

 without assistance. But in other cases, unless relief is afforded the 

 gravest results are certain to ensue. 



Saint-Cyr alludes to three instances in w^hich embryotomy had to be 

 practised, and in two of these the mother succumbed ; the third, how- 

 ever — a Mare — recovered. 



Diagnosis. 



The diagnosis of these monstrosities is often very difficult, as they 

 may be mistaken for ordinary twins. Franck has drawn attention 

 to the circumstance that there is very frequently a difference in the 

 presentation of the merely double-headed foetus and the double foetus, 

 particularly the double croup ; the first being mostly in the anterior 

 presentation, the latter in the posterior. 



In the case of the double fcetus, its presence may be suspected 

 when one cannot be moved without moving the other ; w^hen one is 

 brought into a good position with regard to passing through the pelvic 

 inlet, and it cannot be advanced beyond a certain point, though the 

 passage appears to be sufliciently wnde to permit easy delivery, because 

 the other lies across the inlet ; when the hand is passed between the 

 two foetuses and is stopped at the point where the skin is carried 

 between them at their junction ; and w^hen they are united by homolo- 

 gous parts, as already explained. With regard to the latter, we may 

 be positive. If, for instance, two foetuses lie together at the inlet in the 

 same presentation — anterior or posterior — there is nothing to be inferred 

 from this as to their being monstrosities or merely twins, as the pre- 

 sentation may be the same for these latter ; but if one is in the anterior 



