DYSTOKIA DUE To TIIK UKAD AXD FORE OK IIIXIJ LIMBS. 455 



Embryotomy is rarely necessary. 



In the smaller animals— at least in the Bitch — delivery has been 

 etlected without reduction of the deviation. 



SECTION III.— DYSTOKIA DUE TO THE HEAD AND FOIiE OlC HIND 



LIMBS. 



Saint-Cyr speaks of complicated cases of dystokia in the anterior pre- 

 sentation, due to the head and fore or hind limbs, which are sometimes 

 met with, and the principal of which are the following. 



Ilead retained, and xcith it One or Both of the Fore-Limbs. 



No matter what the abnormal direction and position of the head and 

 neck may be, the ditliculty may be complicated — and very frequently is 

 — by retention of one of the fore-limbs, which may be either Hexed at 

 the knee or detained in the abdominal cavity ; the detention of both 

 fore-limbs, though very rare, yet is not impossible. 



In such a case the deviated parts are successively rectified, usually 

 commencing with the limbs, as their presence in the genital canal does 

 not interfere with the manipulation of the head ; but it sometimes 

 happens that it is more advantageous to begin with the head — for 

 instance, when it is much forward in the uterus. But it is really of no 

 great moment which part is first dealt with, so long as the precaution is 

 taken first to cord those which are deviated. How they are to be 

 rectified will be explained presently — but it may be remarked that such 

 rectifications succeed most frequently in the Cow, from which the Calf 

 may be extracted alive ; but the fcctus of the Mare usually dies so soon 

 that there is no time for their adoption, so that — putting forced extrac- 

 tion aside as dangerous — version should be tried if circumstances will 

 admit, before resorting to embryotomy. 



Head or One of the Fore-Legs retained^ and One or Both of tJie 

 Hind-Legs in the Genital Canal. 



It may happen that one or more of the anterior parts of the body are 

 retained, and yet one or both of the hind-legs enter the genital canal, 

 this depending upon the manner in which the fcctus originally presented 

 itself — the presentation being generally sterno-abdominal, with either 

 hind or fore limbs, or both, in the inlet, and a change occurring in the 

 position subsequently. 



When a fore-limb is retained and a hind one is in the passage, the 

 former may be bent at the knee or be under the chest. If possible, it 

 should be straightened and brought into the passage, and the hind- 

 limb also pulled towards the head of the futus, the foot as high as the 

 ear, and traction made on the head and feet. If delivery cannot be 

 accomplished, then propulsion may be attempted, and, if successful, the 

 position rectified — though this attempt is likely to prove futile. Then 

 it will be necessary to remove one of the fore-limbs at the scapula, or 

 cut through the trunk of the fuitus. 



When the head is retained and one of the hind-legs has entered the 

 genital canal, in the dorso sacral position, an endeavour should be made 

 to push the hind-leg into the uterus, and even the head may be 

 pushed forward. But if for certain reasons this cannot be done, it may 

 be advisable to proceed to embryotomy — removing both fore-limbs 

 entirely, which will then admit of retropulsion of the trunk and adjust- 

 ment of the head and neck. 



