PAETIAL EMBEYOTOMT 275 



sometimes must be twisted right and left to accomplish its 

 purpose. 



Now the ears and the skin around the eyes still remain. 

 The former are cut off by passing the sharp hook underneath 

 the skin and inserting it back of the concha; (care must be 

 taken that the skin has been well separated previouslj'). 



After separating the skin between the eyes and ears with 

 the curved spatula, the sharp hook is placed underneath the 

 skin behind the eyelids, cutting them slowly. Finally the 

 union of the buccinator with the alveolar border and lip is 

 cut with the bistoury. The head is now only connceted with 

 the trunk by the occipitoatloid articulation ; otherwise it lies 

 loosely in the skin. Exarticulation of the head is performed 

 with the vertebral knife. It is carried with the hand along the 

 hard palate closely behind the styloid processes, the cutting 

 edge is placed laterally over the joint, the fingers pushing the 

 knife downward. While twisting the handle with the right 

 hand and pushing against the knife with the left one, the joint 

 is entered. The knife now turns and severs the parts. 



Finally the ligamentum nuchse and cervical muscles are cut 

 with a bistoury, when the head can be extracted by means of a 

 hook. 



The flaps of the skin are kept apart by two assistants by 

 means of two ropes, one on each side, which have been run 

 through the openings for the eyes. When necessary, the 

 obstetrician may now remove the neck subcutaneously. 



THE SUBCUTANEOUS REMOVAL OF ONE HIND LEG IN THE 

 PELVIC CANAL. 



When both hind legs lie in the parturient passage, but 

 total extraction impossible, one hind leg is to be removed. It 

 is not necessary to repel the other hind leg, as mostly ample 

 room is present for the operation. 



Modus operandi.— The hind leg to be removed is extracted 

 as far as possible until the fetlock appears in front of the vulva. 

 An assistant fixes it with a loop in the same way as it was 

 done in the fore leg. The skin is incised on either side of the 



