Examination of the Patient 627 



are lying outside the fetal body, free in the uterine cavity, 

 while the skin of the posterior part of the body is turned inside 

 out and envelops the anterior portion as a bag, with the hair on 

 the inside and the head and all four feet presenting toward the 

 pelvis, without regard for any systematic arrangement, in a con- 

 fusing tangle. 



A more orderly deformity of the fetus, which we have seen in 

 the cow, is the campylorrhachis contortus, in which there is an 

 abrupt lateral curvature of the spine, without the body being 

 open. In this we find the fetal head, resting upon the two fore 

 limbs, presenting at the pelvic inlet, and with it the two 

 hind-feet with the soles of the feet turned upward; or in other 

 words, we find the anterior portion of the fetus in an apparently 

 normal anterior presentation, dorso-sacral position, with the head 

 and anterior feet presenting in the most favorable manner, and 

 also an apparently normal posterior presentation, dorso-sacral 

 position, with the hind feet f^Uy extended in the pelvis. Such 

 a presentation is exceedingly confusing because it constantly 

 suggests twins, though when attempts are made to repel one part 

 and advance the other it is found to be impossible. On the other 

 hand, when one part is repelled the other recedes, and when 

 one is advanced the other advances likewise. 



In some cases, where there are important teratologic condi- 

 tions, it is difficult to determine the part of the body with which 

 one is dealing. It is necessary to study carefully the anatomical 

 relations of each part. In hydrocephalus, with a large amount 

 of fluid in the greatly distended cranial cavity, the part some- 

 times reminds one very much of the fluctuating abdomen of the 

 fetus, and can be differentiated only by finding and recognizing 

 the ears, eyes, mouth, or some other definite part of the fetus. 



So with every other part, the veterinarian must continue his 

 search until he is able to fully recognize the anatomical charac- 

 ters with which te is dealing. It may be necessary, for this 

 purpose, to extend his search for a considerable distance in every 

 direction in order to make out fully and safely the character of 

 the position with which he has to deal. The special difficulties 

 of diagnosis in given cases will be more fully considered under 

 their various heads. 



The General Handling op Dystokia. 



A thorough examination, such as we have already outlined, 

 should result in a diagnosis of the presentation and position of 



