476 FCETAL DYSTOKIA. 



this at the expense of much patience, fatigue, and skill. But in what 

 direction is version to be practised ? Eainard lays it down, as a rule, 

 that the extremities of the foetus which are nearest the pelvis are those 

 which should be brought into the inlet ; and that if both ends of the 

 foetus are at about an equal distance from it, the anterior should be 

 chosen, because it is the easiest for delivery. This rule, however, has 

 not been recognised by the majority of the best authorities. On the 

 contrary, experience and theory have demonstrated that in the majority 

 of cases pelvic version is the most advantageous ; inasmuch as, when 

 this has been effected, there are only the hind-limbs of the young 

 creature to deal with, whereas in anterior version there is the head in 

 addition to the fore-legs, and this may offer difficulties which have not 

 to be encountered in the posterior presentation — more especially if 

 there is anything abnormal in the condition of the head. Not unfre- 

 quently, and particularly when the foetus is yet alive and vigorous, a 

 kind of spontaneous change is effected in an unexpected direction ; for 

 it has been found that, in acting on the croup of the foetus, this has, 

 by energetic movements of its own, and coincident with sudden con- 

 tractions of the uterus, described nearly a half-circle ; so that instead 

 of the loins being under the hand, the withers and upper part of the 

 neck are encountered, and delivery can be readily accomplished. 



But this spontaneous mutation cannot take place if the foetus is- 

 torpid or dead, and then version becomes imperative. Before this is 

 attempted, the intrauterine injection of emollient fluids should be 

 practised ; this is most essential if the waters have escaped for some 

 time. Then retropulsion must be had recourse to. The foetus must not 

 be pushed directly forward into the uterus, but rather obliquely, and in 

 a direction the opposite to that of the part we wish to bring before the 

 inlet. The hand or repeller must be used for this purpose, and in 

 proportion to the difficulty of effecting it, so must the intra-uterine in- 

 jections be frequent. 



The retropulsion and injection, together with the uterine contractions, 

 have the effect, in many cases, of making the body of the foetus glide 

 around the inner surface of the uterus, until a convenient part presents. 

 Then the limbs and head — if they are required, or only the hind-limbs, 

 if it should be so decided — are brought into the genital canal by the 

 hand or by cords. If the occasion demands it, rotation may be resorted 

 to, in order to convert the vertebro-ilial position into the vertebro-sacral 

 or vertebro-pubic. Delivery is completed by moderate traction. 



The manipulations will, of course, vary with circumstances ; but it 

 will generally be found that, in all cases, raising the hind-quarters of the 

 mother will render them much easier of accomplishment. 



When these manoeuvres have failed, embryotomy must be practised. 

 The intestines and other organs can be extracted by an incision in the 

 flank ; the vertebrae may be divided at the presenting part, and the 

 entire body cut through at this division ; then each half can be extracted 

 in the best and easiest manner possible. 



The same indications are applicable to this kind of dystokia in the 

 Ewe and Goat ; though if version be impossible and embryotomy not 

 practicable, the Caesarian operation may be successful. In the Bitch 

 and Cat, when other measures fail, the latter operation may be attempted 

 with some prospect of a favourable result ; though version by means of 

 forceps or external abdominal manipulation is often effected. 



