EMBRYOTOMY. 548 



Decapitation is indicated when a double-headed monstrosity — 

 nionosomian or sysomian — is presented, and in certain irreducible mal- 

 positions of the head or limbs — especially in Heifers, wliun the head of 

 the Calf is in the genital canal, and can neither be advanced nor pushed 

 into the uterus. 



The operation is more or less ditVicult, according to the situation of 

 the head — if entirely in the uterus or fixed in the passage, or if it is at, 

 or can be brought near or beyond the vulva. In the latter case, it is easily 

 accomplished ; although, except in the case of double monstrosities, it 

 is rarely very useful, as when the head is in this situation it is not an 

 obstacle to birth, and its removal deprives the operator of a most 

 powerful means of exercising traction on the parts wliich are firmly 

 retained in the maternal organs. When wedged in the canal, however, 

 the head may prove a troublesome obstacle to the performance of those 

 mancDUvres necessary for the reduction of other parts ; as it may not 

 be possible either to advance or repel it, nor yet to pass the hand 

 between it and the pelvic walls to search for a deviated limb, for example, 

 or to bring that limb into a proper position. 



The passage must therefore be freed from the obstacle, and this can 

 be accomplished in various ways, the most common of which is as 

 follows : The fore-limbs, if present, are corded and pushed as far 

 towards the uterus as possible ; then the head is secured by cording 

 the lower jaw, a pointed hook fixed in each orbit, or a head-collar over 

 the head if it can be placed. Four or five assistants now pull at the 

 head by these appliances, so as to bring it as near the vulva as circum- 

 stances will permit ; while another assistant keeps the labia apart, in 

 order to expose as much of the head as he can, and prevent injury to 

 the organs of tlie parent. The operator, with a convenient knife (the 

 curved finger-scalpel is very useful), incises the skin around the neck — 

 first one side, then the other — close to the occiput, passes his fingers 

 between it and the muscles beneath, and pushes it well back on the 

 neck — the assistants pulling at the head at the same time, facilitate 

 this separation. A few cuts now divide the soft tissues down to the 

 vertebric, and nothing more remains to be done than to produce dis- 

 articulation by vigorous traction and a twisting movement of the 

 head at the same time ; the ligaments gradually yield and tear, the 

 head extends and at last comes away, and the body of the foetus 

 recedes more or less suddenly into the abdominal cavity. If the limbs 

 have been previously secured, they are brought into the passage by the 

 cords attached to them ; or if they are not so accessible, they must be 

 sought for in the way already indicated, and delivery completed ; care 

 being taken to cover the exposed bones of the neck by the surplus skin, 

 while the foetus is being brought through the passage. 



Another method is to make an incision tiirough the skin across the 

 forehead, in front of the ears, and to separate it by means of the fingers 

 or spatula, as far as the occipital articulation. The knife divides this 

 joint, as well as the soft tissues around it, and particularly the liga- 

 ments ; traction will bring away the head. The upper part of the neck 

 is covered by the loose skin — which may be fixed there by ligature — 

 and directed into the middle of the passage. Crotchets sliould now be 

 placed on the bodies of the vertebra?, or even on the ribs if they can be 

 reached ; as the limbs do not offer sufJicient resistance when they alone 

 are pulled at, neither do they bring the body fairly into the passage. 



