DISEASES OF THE GENERATIVE ORGANS. 193 
Plate XIII, fig. 3.) With an anterior presentation (fore feet and 
nose) this presents an insuperable obstacle to progress, as the dis- 
eased cranium is too large to enter the pelvis at the same time with 
the fore arms. With a posterior presentation (hind feet) all goes well 
until the body and shoulders have passed out, when progress is sud- 
denly arrested by the great bulk of the head. In the first case, the 
oiled hand introduced along the face detects the enormous size of 
the head, which may be diminished by puncturing it with a knife or 
trocar and cannula in the median line, evacuating the water and 
pressing in the thin, bony walls. With a posterior presentation, the 
same course must be followed; the hand passed along the neck will 
detect the cranial swelling, which may be punctured with a knife or. 
trocar. Oftentimes with an anterior presentation the great size 
of the head leads to its displacement backward, and thus the fore 
limbs alone engage in the passages. Here the first object is to seek 
and bring up the missing head, and then puncture it as above sug- 
gested. 
ASCITES, OR DROPSY OF THE ABDOMEN IN THE FOAL.—The accumula- 
tion of liquid in the abdominal cavity of the fetus is less frequent, 
but when present it may arrest parturition as completely as will 
hydrocephalus. With an anterior presentation the foal may pass as 
far as the shoulders, but behind this all efforts fail to effect a further 
advance. With a posterior presentation the hind legs as far as the 
thighs may be expelled, but at this point all progress ceases. In 
either case the oiled hand, passed inward by the side of the foal, 
will detect the enormous distension of the abdomen and its soft, fluc- 
tuating contents. The only course is to puncture the cavity and evac- 
uate the liquid. With the anterior presentation this may be done 
with a long trocar and cannula, introduced through the chest and 
diaphragm, or with a knife an incision may be made between the 
first two ribs and the lungs and heart cut or torn out, when the 
diaphragm will be felt projecting strongly forward, and may be 
easily punctured. Should there not be room to introduce the hand 
through the chest, the oiled hand may be passed along beneath the 
breast bone and the adbomen punctured. With a posterior presen- 
tation the adbomen must be punctured in the same way, the hand, 
armed with a knife protected in its palm, being passed along the side 
of the flank or between the hind limbs. It should be added that 
moderate dropsy of the abdomen is not incompatible with natural 
delivery, the liquid being at first crowded back into the portion of 
the belly still engaged in the womb, and passing slowly from that 
into the advanced portion as soon as that has cleared the narrow 
passage of the pelvis and passed out where it can expand. 
GENERAL DROPSY OF THE rEeTuUS.—In this case the tissues generally 
are distended with liquid, and-the skin is found at all points tense 
36444°—16——18 
