492 OBSTETRICAL OPERATIOXS. 



A longitudinal presentation is that in which spontaneous birth can 

 be alone effected ; transverse presentations render birth impossible, and 

 these, consequently, give rise to dystokia. Version is therefore in- 

 dicated in all transverse presentations, no matter what region of the 

 body may first offer at the pelvic inlet ; it may even be required in 

 certain forms of anterior or posterior presentation ; and in all cases it 

 is necessary to repel the presenting part, so as to bring one or other of 

 the ends of the oval mass formed by the body of the foetus to the pelvic 

 inlet. 



Hence we have two kinds of version : one which has for its object 

 the movement of the head of the foetus towards the pelvic inlet — 

 anterior or cephalic version ; and the other the posterior part of the 

 body to the same opening — posterior or pelvic version, corresponding to 

 the piodalic version in human obstetrics. Each of these versions has its 

 advantages and disadvantages, according to circumstances ; though the 

 majority of authorities prefer pelvic version, for the simple reason that 

 with this there are two mere appendages to care for — the hind-limbs, 

 to which it is comparatively easy to give a good direction ; while in 

 cephalic version there are not only the fore-limbs to attend to, but also 

 the head and neck, the unfavourable direction of which may give rise to 

 much trouble in delivery. 



Version can only be effected in the uterine cavity, and when the 

 uterus is entirely in the abdomen ; so if any portion of the foetus has 

 entered the inlet, retropulsion must be resorted to. Then the operation 

 can be commenced. It is divided into two principal movements : 

 Bepulsion and Evolution. 



In these manoeuvres, the veterinary obstetrist, as in so many other 

 instances, has not the advantages which the accoucheur of woman 

 possesses with regard to manipulation, and especially that which can 

 be practised outside the abdominal walls in conjunction with the 

 version movements in the uterus. 



Bepulsion.— The, hand — usually the right — being introduced into the 

 uterus, reaches the presenting part of the foetus, and by a succession of 

 forcible pushes, moves it away from the inlet— in fact propels it ; though 

 this retropulsion should not be made directly forward, but obliquely, 

 so as to press the region we desire to get rid of upward, downward, or 

 to either side, according to circumstances. In this way, the opposite 

 parts glide over the uterine walls — previously lubricated : they move 

 round towards the hand, and are more easily reached. 



Evolution. — When the parts which are sought for reach the hand, 

 they are firmly seized by the operator and drawn towards him. The 

 uterine contractions assist in this operation, the version movement is 

 continued, the foetus becomes lengthened, as it were, and unfolded, and 

 when its larger diameter is brought into the axis of the pelvis the 

 manoeuvre is completed. 



Version is not always successful when first attempted ; indeed, it has 

 often to be relinquished and again tried, until successful — notwithstand- 

 ing the fatigue and demands on patience these repeated efforts entail. 



Complete version is required in the transverse position of the foetus, 

 and is generally difficult ; it, and indeed all degrees of turning, and all 

 vicious positions of the foetus, demands that the first thing to be done 

 is to secure the most useful parts which present — as the limbs or head 

 — by cords or other appliances, so as to be able to find and utilise them 

 again if circumstances require that they should be used to assist in 



