DYSTOKIA DUE TO THE FORELIMHS. 433 



practising it, the following directions have been given, and their obser- 

 vance is important : 



1. Find the hind-limbs and secure them by cords around tlie pasterns ; 

 2. Cord the head and fore-limbs, and pull these out as far as possible 

 beyond the vulva ; 8. Remove the abdominal viscera, and divide the 

 spine as near the lumbar region as possible, taking the precaution to 

 leave a good piece of skin attached to the loins, so as to cover the 

 exposed bones and prevent the maternal organs being injured during 

 the subsequent steps in extraction ; 4. Obtain a solid bearing on the 

 divided spine, either with the hand or the repeller, and push steadily 

 and firmly against it so as to direct it into the uterus, when the cords 

 on the hind-pasterns being pulled by assistants, guided by the hand of 

 the operator, the remains of the fci'tus can be removed. This part of 

 the operation is the most difficult and fatiguing for the obstetrist, as 

 well as the most dangerous for the mother, and requires both strength 

 and dexterity to push back the loins and pelvis of the foetus while 

 advancing the hind-limbs, thighs, and croup towards the outlet ; 5. 

 Nothing now has to be done but to exercise moderate traction, and ter- 

 minate, in the lumbo-pubic position of the posterior presentation, a 

 birth commenced in the dorso-sacral position of the anterior presenta- 

 tion. 



Dietrich recommends eventeration of the fa-tus, removal of one of 

 the hind-limbs, and the adjustment of the hinder parts through the 

 abdominal opening ; if this cannot be effected, then these parts are to 

 be drawn into the vacant cavity of the abdomen. 



When only one hind-leg is in the pelvis, retropulsion of the body 

 may be tried, the fore-legs and head being corded, and the misplaced 

 hind-limb finally extended backwards in the uterus. If this cannot 

 be accomplished, the hind-leg must be drawn forward and amputated 

 at the hock or beyond, and the thigh then carefully pushed towards 

 the uterus. 



Removal of the abdominal viscera favours these manoeuvres. 



When this malpresentation occurs in the Sheep or Goat, embryotomy 

 will generally be necessary, as there is not suflicient room to attempt 

 delivery in any other way. 



B. AUNOHMAL AnTERIOH PRESENTATION. 



In dystokia accompanying the anterior presentation, the obstacle 

 may be due to the fore-limbs or head, or to both, as well as to 

 the hind-limbs ; and it may be met with in any position the foetus can 

 occupy in this presentation, though it is most frequent in the dorso- 

 sacral position, which we will commence with. 



SECTION I.— DYSTOKIA Dl'E TO THE FORE-LIMBS. 



In the anterior presentation, and what we have designated the 

 " normal position," the two fore-limbs of the foetus are extended in 

 front towards the pelvic inlet, the head being also extended and resting 

 either upon or between the legs, the distal extremities of which extend 

 beyond its nose — the whole forming a wedge-shaped mass. Con- 

 sequently, the fore-feet should be the first parts to pass through the 



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