DISEASES OP THE GENERATIVE ORGANS. 201 



the dissection can be much more easily effected while the skin is 

 stretched by the left hand, so as to form a comparatively firmer re- 

 sistant point for the knife, than when it is attempted to cut the soft, 

 yielding, and elastic tissues which naturally offer little solid resist- 

 ance, but constantly recede before the cutting edge of the instrument. 

 The preservation of the skin is therefore a cardinal principle in the 

 amputation of all parts in which it is at all feasible. 



The presenting foot is inclosed in a noose and drawn well out of 

 the passages. Then a circular incision through the skin is made 

 around the limb just above the fetlock. From this the skin is slit 

 up on the inner side of the limb to the breast. Then the projecting 

 part of the limb is skinned up to the vulva, traction being made on 

 the foot by an assistant so as to expose as much as possible. The 

 embryotomy knife may now be taken (PI. XXI, fig. 2), and a small 

 hole having been cut in the free end of the detached portion of skin, 

 that is seized by the left hand and extended while its firm connec- 

 tions with the deeper structures are cut through. The looser con- 

 nections can be more quicldy torn through with the closed fist or 

 the tips of the four fingers held firmly together in a line or with the 

 spud, of which there are several kinds. Much of the upper part of 

 the limb can be skinned more speedily without the knife, but that 

 must be resorted to to cut across tough bands whenever these inter- 

 rupt the progress. The skinning should be carried upward on the 

 outer side of the shoulder blade to the spine or nearly so. Then with 

 the knife the muscles attaching the elbow and shoulder to the breast- 

 bone are cut across, together with those on the inner side of the shoul- 

 der joint and in front and behind it as far as these can be reached. 

 Steady traction is now made upon the foot, the remaining muscles 

 attaching the shoulder blade to the trunk are torn through with a 

 cracking noise, and the whole limb, including the shoulder blade and 

 its investing muscles, comes away. If the shoulder blade is left the 

 bulk of the chest is not diminished, and nothing has been gained. 

 Before going further it is well to see whether the great additional 

 space thus secured in the passages will allow of the missing limb or 

 head to be brought into position. If not, the other presenting part, 

 limb or head, is to be amputated and extracted. For the limb the 

 procedure is a repetition of that just described. 



Amputatwn of the head. — The head is first seized and drawn well 

 forward, or even outside the vulva, by a rope with a running noose 

 placed around the lower jaw just behind the incisor teeth, by a sharp 

 hook inserted in the arch of the lower jaw behind the union of its 

 two branches and back of the incisor teeth, or by hooks inserted in 

 the orbits, or, finally, in case the whole head protrudes, by a halter. 

 (PI. XXI, figs 4a and 4&.) 



