MECHAXICAL EXTRACTIOX OF THE FCETUS. f.Ol 



a f:cntle pull of the cord, which can then be tightened and given to an 

 assistant. 



The other method, which is Schaak's, and by some obstetrists con- 

 sidered preferable to that just described, consists in placing the middle 

 of the noose on the dorsal aspect of the ends of the two middle fingers, 

 the finger on each side holding it against these, while the thumb keeps 

 it in the palm of the hand (Fig. 161). The left hand maintains the 

 cord sufficiently tense to assist in keeping the noose on the hand ; and 

 if the part of the cord which runs through the loop is placed towards 

 the thumb, the latter can readily increase the size of the noose. The 

 hand is passed into the vagina sideways, the little finger downwards, 

 and when the foot is reached, the thumb and index-finger are placed 

 within the noose, which they enlarge in separating from each other, 

 while the remaining fingers, flexing on the hand, are passed around the 

 foot, and cause the noose to glide over the hoof on to the pastern. The 

 fingers now press on the loop, while the other hand, drawing at the 

 cord outside the vulva, tightens the noose around the limb. 



When the limb is flexed and cannot be extended, as at the knee or 

 hock, the looped cord may be employed ; though a long cord, doubled, 

 will be found to answer very well. This is passed round the flexure, 

 the doubled end pulled to the vulva, and the other end passed through 

 the loop ; this done, the loop may be tightened, passed up to the 

 elbow or stifle, or down to the pastern. 



The lower jaw is "corded" in a similar manner; the mouth of the 

 foetus being opened, the noose is passed around the neck of the jaw, 

 and the knot or loop placed beneath the chin. 



In embr^'otomy cords render good service, as they can be attached 

 to any part within reach ; after decapitation of the fd'tus, for instance, 

 a cord passed through a thick fold of the skin on the upper part of the 

 neck affords an excellent means of traction. 



When long cords are used, and energetic traction is likely to be em- 

 ployed, it will be found convenient to have knots at intervals, to pre- 

 vent the hands of the assistants slipping. 



Jlaltcr, Head-Cord, or Ilcad-Collar. 



In addition to the limbs and other parts, we have stated that the 

 traction-cord can often be advantageously applied to the lower jaw. 

 Indeed, in the anterior presentation, even when the fore-limbs are 

 " corded " and the head is in a favourable position, it will generally be 

 found very useful to apply traction to the head in addition, as not in- 

 frequently pulling at the fore-limbs alone only fixes them more firmly 

 in the passage. 



We have also mentioned that the interdental space, or " neck " of the 

 lower jaw, is the most convenient for the attachment of the cord ; but 

 nevertheless it will be found in practice that this does not afiford nearly 

 so firm a hold as the limbs, and that if the noose does not slip off the 

 jaw, which is often the case, should the traction be at all energetic the 

 bones will probably be smashed, the foetus, if alive, irreparably damaged, 

 and an important accessory means to extraction lost ; besides, traction 

 on this part throws the head too much upwards. Should the head be 

 turned back towards the side, cording the neck does not reduce the 

 deviation, but only allows it to be brought in a doubled condition into 

 the genital canal. 



It is, therefore, most important that means be at hand to secure the 



