488 OBSTETRICAL OPERATIONS. 



when the foetus is in a good position, to enable the obstetrist to attach 

 cords to the limbs or some part of the head or body. 



In the anterior presentation, for instance, the fore-limbs have often 

 to be pushed forward from the pelvic cavity, in order that the operator's 

 arm may find room to search for and seize the head ; or the latter has 

 to be pushed into the uterus to allow the limbs to be felt for; and 

 even in this presentation retropulsion of the hinder limbs may be 

 necessary. This procedure may also have to be adopted in the posterior 

 presentation when these limbs are flexed in the uterus, and the body 

 has to be pressed forward as far as possible, so that they may be 

 extended and brought into the pelvic inlet ; while it is also advantageous 

 in transverse presentations when version has to be attempted. 



This retropulsion is sometimes easy, at other times it is most difficult 

 and laborious, and in certain cases it may even be altogether im- 

 possible. 



The most favourable attitude for performing this operation, in the 

 larger animals at least, is undoubtedly the standing one ; but the body 

 of the animal should not be perfectly horizontal, for a great advantage 

 will be derived by raising the hind-quarters to a considerable degree, 

 as we thereby throw the uterus and its contents forward, and away 

 from the pelvic inlet. This elevation may be effected by straw or litter 

 placed under the animal's hind-feet. In order to obtain this inclina- 

 tion promptly, the Cow may be made to kneel, two assistants keeping 

 the fore-limbs flexed, while other two maintain the hind-quarters in an 

 upright position. 



When the animal is recumbent and cannot be induced to rise, there 

 is little, if anything, to be gained by raising and supporting it by means 

 of slings or other appliances ; as the pressure which these produce on 

 the abdomen opposes the manoeuvres we have mentioned. Not un- 

 frequently the sight of a strange dog, as has been mentioned, will cause 

 the animal to get up. 



When, however, the Mare or Cow is exhausted, and it would be 

 injudicious or impossible to make it stand, then manipulation must be 

 attempted in the recumbent posture. When this is decided upon, in 

 the great majority of cases it will be found that a considerable advan- 

 tage will be obtained by placing the animal on its back, propping it up 

 in this position with trusses of straw placed on each side, and raising 

 the croup by introducing another truss beneath the hind-quarters. 



With regard to the smaller animals, such as the Bitch, they can be 

 placed on their back on a table, and an assistant will raise the pelvis 

 as high as may be deemed necessary. Eetropulsion of the foetus may 

 be effected with the hand in the large animals, the operator supporting 

 himself firmly on his legs ; but the arm must be strong, and very often 

 it has to be engaged in the genital canal as high as the shoulder. It 

 may sometimes happen that both hands have to be employed as 

 repellers, and the body of the operator pushed forward by assistants. 



Seeing the difficulties attending this operation, and finding that the 

 hand and arm are not always sufficient, Continental veterinarians have 

 for a long time resorted to a "crutch" or " repeller " (French, 

 repoussoir ; German, Geburtskrilcke), in conjunction with the hand. 



This instrument is of iron, and is between two and three feet in 

 length; it has a handle at one end, and a concave transverse piece, 

 like the head of a crutch, at the other. This piece may be either solid 

 or jointed (Figs. 150, 151, 152, 153). Provided the latter is sufficiently 



