nVSToKIA Dl'K TO THK UKAD. \\1 



and more under the neck until it gets beneath the chest, and even tlie 

 abdomen (Fig. 133), where it may deviate to one side. The fore-limbs 

 are, of course, in the genital canal. 



The accident is discovered by manual exploration ; the fore-limbs 

 being followed by the hand, the crest of the neck is found pressed 

 against the pubis, while the head can be traced by the ears and the 

 orbits, the face being towards the Uoor of the uterus ; or the hand may 

 discover the nose and mouth inclined upwards at one side of the chest, 

 behind the elbow. In this condition birth is impossible, as straining 

 and traction only make matters worse. 



Indications. — When the upper part of the neck alone presents, 

 reduction is still possible, provided no great delay has occurred, nor 

 mismanagement by unskilful people has been allowed. But when the 

 "waters" have been long expelled, the legs pulled at by amatem-s, 

 and the uterus closely applied to the body of the foetus, the case is 

 most ditticult ; as then manipulation and retropulsion cannot effect 

 much in many instances. 



The doubled neck is too voluminous to enter the pelvis, and the 

 longer the pains continue, so the farther is the head pushed forward 

 from the inlet, and therefore away from the reach of the obstetrist. 



The contractions of the closely applied uterus also render attempts 

 at delivery almost impossible, by their paralysing the hand and 

 arm. 



Large quantities of warm lubricating fluids must be injected, retro- 

 pulsion attempted by one or two crutches applied to the shoulders of 

 the fcetus — not to the neck ; while the hand manipulates, aided, if need 

 be, by the finger-hook. A blunt hook inserted on each side of the lower 

 jaw — when this can be reached, towards the root of the ear, or into the 

 orbits ; a cord round the neck — if it can be passed ; and other devices, 

 may be tried. If they all fail, then the animal should be thrown on its 

 back ; indeed, the success which has attended this change of attitude in 

 80 many recorded instances, should induce the obstetrist to adopt it 

 without much delay. Very often the altered position of the mother at 

 once disengages the head of the fcetus from its deviation ; if this does 

 not happen, then the other means may be tried as in the standing 

 position. Pelvic version may be resorted to in some cases, the anterior 

 presentation being converted into a posterior one. 



When reduction cannot be effected, and delivery of the entire foetus 

 cannot be accomplished, then the obstetrist has no other course left 

 open to him but the adoption of embryotomy. Indeed, it should be 

 resorted to early if the fcetus is dead, which is nearly always the case 

 in the Mare. The head maybe amputated through the presenting part 

 of the neck, or the fore-limbs removed subcutaneously at the shoulders 

 — the latter is to be preferred in the majority of cases, at least before 

 incision of the neck is begun. This gives more room for manipulating 

 the body and etlecting extraction. 



In many cases the removal of one fore-limb will permit delivery. 

 "Whether one or both be removed, it is generally necessary to pass a 

 cord round the bend in the neck and pull it so as to bring the head 

 nearer the inlet, where it may be possible to turn it into the genital 

 canal, or at least to amputate it more easily. 



