Application of Traction 589 



to bear upon one small area of the genital passages of the mother, 

 the question of the amount of admissible traction changes greatly. 

 For example, if a fetus is presenting with its head deviated to 

 the side, one man by drawing upon it may cause far more injury 

 than five men might do if the fetus were presenting normally. 



Different practitioners, working under varying conditions, have 

 obtained apparently contradictory results in reference to the 

 amount of traction which it is desirable to employ. Some claim 

 that only moderate traction should be employed, and define their 

 term "moderate " as the force of from 2 to 4 men pulling simul- 

 taneously, Others have unhesitatingly employed the combined 

 strength of from 6 to 10 men and have claimed that their success 

 has fully warranted the amount of force employed. Personally 

 we have, when hard pressed, applied a force which would equal 

 that of 6 to 10 ordinary men, in those cases in the cow and mare 

 where the fetus lay in a wholly natural position, and when the 

 force of the traction fell alike over the entire birth canal. 

 Usually, when it reaches the point where so great force has be- 

 come necessary, we have not used this number of men, but have 

 substituted some mechanical appliance for their power, such as 

 the lever or pulley. 



Donnareix claims that three assistants are usually sufficient 

 for handling dystokia in the cow. Of these, he places one at the 

 head, another at the tail and a third to aid the operator. In 

 contrast with this he finds 10 men necessary for the mare and 

 distributes them somewhat similarly, except that an extra man 

 is needed to confine the limbs of the animal, while 5 or 6 are 

 needed to pull at the fetus. While the amount of assistance 

 required in a given case constantly varies in either the mare or 

 the cow, we have never found the great number either neccessary 

 or desirable, and have always considered that we could better 

 manage from 3 to 5 men than a larger number and that we could 

 always develop mechanical force of sufficient degree to get the 

 power desired. 



When traction is applied to a fetus which is not in a proper 

 position and in which the fetal pressure is not alike upon the en- 

 tire area of the maternal passages, great and even fatal injuries 

 to the mother are constantly threatened. If a limb is retained 

 or misdirected it is liable at any time to be forced through the 

 uterine wall into the peritoneal cavity and produce a rupture. 



