430 



FCETAL DYSTOKIA. 



beyond the inlet, and as far as, or even external to, the vulva — some- 

 times the head, fore-limbs, neck, and even half of the body hanging 

 outside the vagina. But further progress is checked, and neither the 

 most energetic straining on the part of the animal, nor the most violent 

 traction by those persons who may be with it, can advance the foetus 

 beyond this point. 



The obstetrist has great difficulty in ascertaining the cause of delay 

 in birth — the difficulty varying, and depending upon the volume of the 

 foetus, and whether its body more or less completely fills the pelvic 

 canal. The hand can generally only be introduced after much trouble 

 and tact into the passage, and having got to a certain distance it 

 encounters either under the body or head (Fig. 126), to one side of the 

 neck or head, or even projecting upwards above the head (Fig. 125), 

 first one, then a second foot or limb, which are recognised by a careful 

 examination to be those of the hinder part of the body. Sometimes the 

 feet and metatarsal bones have alone entered the pelvis, the other parts 



Fig. 125. 

 Deviation of the Hind-Limbs in the Pelvis in the Anterior Presentation. 



of the limbs being in the uterus (Fig. 126) ; in other cases the hocks 

 may be in the inlet, or even well through the passage — depending upon 

 the size of the foetus and the capacity of the maternal pelvis ; more 

 rarely the stifles have cleared the inlet, and the hind-feet are at the 

 vulva. The more advanced the hind-limbs are the more are they flexed, 

 and so the more is the body of the foetus bent on itself, until it is like a 

 dog in a sitting posture. It is needless to remark that unless the foetus 

 is exceptionally small in proportion to the pelvic capacity, it cannot be 

 extracted in this position, when the hind-limbs, and especially the 

 stifles and hocks, add so largely to the volume of the body ; traction 

 will probably kill the creature, and in all likelihood injure the mother. 

 Some cases are recorded in which delivery was effected, however, but 

 then circumstances were favourable, both as to time and the position 

 of the foetus. The greatest care is therefore necessary, in order to 

 ascertain the exact state of afl'airs ; indeed, in all cases of dystokia it 

 cannot be too often impressed on the mind of the young practitioner, 

 that a careful examination is absolutely essential before attempting 



