470 FCETAL DYSTOKIA. 



the vagina. In this way the thigh is encircled by a loop, as in Fig. 143. 

 The other thigh may be secured in the same way by another cord, and 

 this part of the operation will perhaps be much facilitated by using the 

 long bent porte-cord (Fig. 171). 



Saint-Cyr states that one thigh corded may be sufficient ; but it is 

 undoubtedly better to cord both, if possible, as traction on the two 

 limbs keeps the body of the foetus in a straight direction. 



The ends of the cord being joined together outside, assistants, under 

 the direction of the operator, pull with the necessary amount of force ; 

 while the hand of the operator assists in the vagina, either in guiding 

 the foetus, seizing on and pulling at any part that may offer, or smooth- 

 ing down the folds of the mucous membrane in the canal which might 

 otherwise increase the obstacles. The foetus has been extracted alive 

 by this procedure. 



Saake's method^ is somewhat similar, except that there is only one 

 cord, and that encircles the body instead of the thigh. The cord has 

 a ring or noose at the end, and this or the other end is passed between 

 the thighs and brought out at the flank of one side ; then the other 

 end is also brought out in front of the other flank. Both ends are 

 carried to the top of the back, the plain end is passed through the 



Fig. 144. 

 Thigh and Croup Presentation : Body corded. 



ring (Fig. 144) and brought outside the vulva. The body of the foetus 

 is, it will be observed, enclosed in a loop, the upper part of which — 

 that over the loins — is carried back over the tail to the buttocks, so 

 that the cord now only encircles the flanks. The advantages of this 

 method over the other are chiefly its simplicity, only one cord being 

 required, and the better direction in which traction can be exercised. 



In three cases this method was successfully employed by Saake. 



Deneubourg makes use of the tail of the foetus for traction. 



There can be no doubt that the foetus may be removed in this mal- 

 position, with both the hind-limbs extended forward under the abdo- 

 men. Cartwright says : " I perfectly recollect, in one instance, delivering 

 a Cow of a very large Calf with both its hind-legs under its abdomen, 

 and I never saw a Cow after calving do better." In those instances 

 which are attended by success, it will generally be found, however, 

 either that the foetus is small or the pelvis large and well formed. 



Some practitioners resort to the sharp crotchets, fixing them in the 

 muscles of the croup, towards the hip-joint ; but unless the hook has 

 a bearing on the femur the hold is not very firm. In a case of this 

 kind, Drouard found that the skin and muscles yielded, the femur was 

 disarticulated, and the hind-limb itself entirely torn away from the 

 ^ Magazin von Gurlt und Hertwig, 1869. 



