510 



OBSTETRICAL OPERATIONS. 



sufficiently long to pass them to the region where they might be most 

 effectively fixed ; while the energetic uterine contractions paralyse the 

 hand of the operator, and often prevent it manipulating accessible j)arts 

 which it is desirable to secure by these means. In such circumstances 

 the porte-cord, or pass-cord — which has been sometimes referred to — 

 is of great service. The instrument is of two shapes, straight and 

 curved. 



The straight porte-cord is usually a rod of |- inch iron, furnished with 

 a wooden handle at one end, and an eyelet or double open- 

 ing at the other to receive the cord (Figs. 169, 170). 



The curved porte-cord has the end through which the 

 cord passes more or less bent, and in certain cases it is 

 more useful than the straight one, from which it only 

 differs in having this curvature (Figs. 171, 172). 



Different forms of these instruments have been described, 

 but in principle they are all really the same. 



The straight one can be used to pass the traction cord 

 around the limbs, or the neck of the lower jaw, and may 

 act with the cord in pulling these towards the vulva ; or, 

 if properly constructed, it may also be most serviceable as 

 a repeller in pushing them forward into the uterus. A very 

 good and simple pass-cord of this kind is that introduced 

 by Darreau (Fig. 173), which can be employed as a re- 

 tractor and repeller. Two of these may be used at the 

 same time, on two limbs. For instance, in the sterno- 

 abdominal presentation, when posterior version is decided 

 on, the hind-limbs are corded in the usual way ; then this 

 repeller, armed with a noosed cord of sufficient length, is 

 introduced, the noose passed on to the pastern or knee of 

 one fore-limb, and the cord drawn tight and fastened 

 around the handle. Another pass-cord is attached in the 

 same manner to the other fore-limb, so that each instru- 

 ment becomes a solid fixture to the leg, and is confided to 

 an assistant. The operator then pushes back the fore- 

 limbs as far as possible by hand, while each assistant 

 seconds his efforts with the repellers. When all has been 

 conveniently adjusted, ti-action is made on the hind-limbs, 

 the repellers being still employed to overcome the resistance 

 of the foetus and follow its movements. 



The curved pass-cord has its uses in certain cases when 

 the straight one cannot be serviceable — as in passing a cord 

 round the head or bent neck, thigh, or loins ; there are 

 also several patterns of this instrument, but if the straight 

 one is made of iron, it may be bent sufficiently to answer 

 the purpose in the case of flexed limbs or bent neck. An 

 ordinary walking-stick with a crook handle may, on an 

 emergency, be made to serve this purpose by making one 

 or two holes in the handle for the reception of the cord. Or when this 

 cannot be procured, an excellent substitute will be found in a piece of 

 iron or lead attached to the end of the traction cord, the weight of 

 which greatly facilitates the passage of the cord around the straight 

 or bent neck, hocks, or knees. 



Tyvaert^ has for a long time made profitable use of a simple porta- 

 ^ Annaks de Medicine Veterinaire, 1876, p. 320. 



Fig. 173. 



Dareead's 

 Repeller. 



