OBSTETRICS 233 



every effort must be made to manipulate the fetus 

 into one or the other of these two positions. Great 

 patience and skillful manipulation with the finger 

 are required and must be persisted in until either 

 the desired result is attained or found to be impos- 

 sible, when a decision between embryotomy and 

 cesarean section must be made. 



3. Abnormal size. 



4. Hydrocephalus. — The abnormal size of the head 

 must be reduced by puncture and draining with a 

 trocar and cannula, followed by crushing with the 

 forceps, when delivery can usually be effected easily. 



5. Gaseous distension. — Gaseous distension of the 

 abdomen of the fetus should be reduced by puncture 

 with the trocar and cannula. 



6. Double engagement. — Two puppies presenting 

 at the same time is a common occurrence, and is 

 a source of great trouble to the practitioner, it being 

 difficult to diagnose and still harder to rectify. Hav- 

 ing recognized the condition by digital examination, 

 the head of one puppy must be grasped with the 

 forceps and traction exerted, the other puppy in the 

 meanwhile being pushed back as far as possible with 

 a repeller. 



Accidents Liable to Occur During Parturition 

 Exhaustion 



In difficult and prolonged deliveries one or more 

 of the puppies may die, or the bitch may gradually 

 sink from exhaustion. 



Lacerations of the Vagina 



This accident usually occurs either from the in- 

 cautious use of forceps or from the use of unsuit- 

 able forceps. The author has seen cases where com- 

 plete rupture of the vagina had occurred and pro- 

 lapse of the intestines taken place. These lacera- 



