Lateral Deviation of the Head 767 



either to the left or the right and then backwards, he may trace 

 the top of the neck, bearing the mane. At the lower margin of 

 the neck, the operator will usually be able to identify the trachea. 

 In one direction he can trace this to its point of disappearance 

 within the fetal chest between the two anterior limbs, and in the 

 other may follow it across the right or left anterior limb to later 

 turn backward toward the patient's head. 



In the upward and downward deviations of the head, the rela- 

 tions of the trachea and the superior border of the neck or mane 

 are wholly different, and serve to distinguish these displacements. 

 In the upward deviation of the head, the top of the neck or the 

 mane is out of reach, whereas the lower margin of the neck or 

 the trachea is quite fully exposed, and curves upward and then 

 backward above the withers and disappears. When the devia- 

 tion is downward, the trachea cannot be discovered, but the 

 superior portion of the neck or the mane disappears downward 

 between the two anterior limbs. 



The indications in lateral deviations of the head will vary 

 greatly according to species and individual cases. 



I. Mutation. In those cases where the deviation is recent, 

 where wry-neck is not present, where the fetus is not emphy- 

 sematous or there are uo other evidences of insurmountable 

 obstacles to the correction of the deviation, this is the conserva- 

 tive and proper course. The cow- or mare should be operated 

 upon in the standing position, with the hind parts elevated, or, if 

 recumbent, should be placed in lateral recumbency on the side 

 opposite to the fetal head, with her hind-quarters elevated. 



The operation consists, first, of repulsion, as described on page 

 595, which is to be applied to the chest of the fetus, directed 

 obliquely backward and away from the misdirected head. If 

 the head is deviated to the right side of the mother, the repulsion 

 should be obliquely toward her left side, so as to tend to release 

 the head and cause it to advance toward the pelvic inlet. 



After repulsion has been accomplished, the operator should 

 secure and extend the head of the fetus by those means most 

 available in the particular case, under the rules laid down on page 

 636. In many instances it is merely necessary to grasp some 

 portion of the head with the hand or fingers, and give it a sharp 

 pull, by which it is brought into its normal position. When the 

 nose is pointing backward, that is, toward the anterior part of 



