442 FCETAL DYBTOKIA. 



head of the foetus is propelled outwards, but as soon as this ceases it 

 recedes again, as if thrown back by a spring. 



With small-sized Cows, the hand introduced deeply into the uterus 

 may find the extremity of the fore-limb ; but in large Cows, and in the 

 Mare, particularly if the abdomen be pendulous, this is rarely, if ever, 

 the case ; indeed, sometimes the limbs can only be reached with the 

 greatest difficulty, though there is generally no trouble in introducing 

 the arm. When the limbs can be felt, they are usually found to be 

 in one of three positions : directed nearly vertically downwards, the 

 fore-arms resting against the brim of the pubis ; lying beneath the 

 abdomen (Fig. 131) ; or closely applied against the walls of the chest 

 and the flanks. In many of these cases, the head is also in a vicious 

 position. 



In the larger animals, when the two limbs are retained birth is 

 nearly always impossible ; it may certainly be sometimes effected by 

 violent means, but then these are the resort of brute force, and not of 

 humane and intelligent device, and nearly always entail the death of 

 the mother. With the smaller animals, when this complication is a 

 cause of dystokia, delivery can generally be effected by simple measures 

 and gentle force. 



Indications. — The indications are to reach the limb or limbs with 

 the hand — resorting to retropulsion if necessary, to gradually raise and 

 bring them forward, joint by joint, into the pelvis, and then to extract 

 the foetus by judicious traction. These indications are not attended 

 with difficulty in those cases in which the head is yet in the abdomen, 

 or only at the pelvic inlet, and are easier carried out in the Cow than 

 the Mare. The method of rectifying the direction of the limbs will be 

 referred to hereafter. 



It sometimes happens, especially with the Mare, and with Heifers 

 which have been rudely manipulated before the arrival of the veterinary 

 surgeon, that the foetus is so engaged in the genital canal that retropul- 

 sion is impossible. In such circumstances some authorities have re- 

 commended forced extraction, traction being exerted on the head of 

 the foetus either by assistants or mechanical means ; others have 

 advised decapitation — skinning the head and removing it at the first 

 or second cervical vertebra, taking care that the ends of the bones 

 are covered by the skin of the skull, to prevent laceration ; then 

 retropulsion is possible, the limbs can be extended, and extraction may 

 be effected. 



With regard to forced extraction, there can be no doubt that if both 

 fore-limbs are retained, the life of the foetus is endangered, and that of 

 the mother also ; though it may be successfully practised with the 

 Sheep, Goat, and other small animals. When only one limb is retained 

 in the Mare or Cow, forced extraction may, nevertheless, succeed ; and 

 Eueff, Harms, Darreau, and other practitioners, have proved that it is 

 possible, traction being employed on the head and normally-presented 

 leg. Amputation of the head will not always prove advantageous 

 in retropulsion ; indeed, it will often be found that it is a dis- 

 advantage. 



The most rational and hopeful operation is detaching the shoulder from 

 the trunk ; or the flexor brachialis muscle may be cut through by means 

 of the curved finger-knife (to be hereafter described) in its thickest part at 

 the shoulder-joint, or above the elbow-joint. Then extraction may be 



