SPECIAL REPORT ON DISEASES OF CATTLE TEXT

and head twisted over each other as above. The limbs may be twisted by an assistant when the head is manipulated by the operator, who drags on the rope turned halfway round the limbs and assists in the rotation with his other hand in the passages. _Head and fore feet presented--Back turned down toward the udder._--This position (Pl. XVI, fig. 6) is unnatural, and the parturition is difficult for two reasons: First, the natural curvature of the fetus is opposed to the natural curvature of the passages; and, second, the thickest part of the body of the calf (the upper) is engaged in the narrowest part of the passage of the pelvis (the lower). Yet unless the calf is especially large and the pelvis of the cow narrow, parturition may usually be accomplished in this way spontaneously or with very little assistance in the way of traction on the limbs. If this can not be accomplished, two courses are open: First, to rotate the calf as when the back is turned to one side; second, to push back the presenting fore limbs and head and search for and bring up the hind limbs, when the presentation will be a natural, posterior one. _Presentation of the hind feet with the back turned to one side or downward._--These are the exact counterparts of the two conditions last described, are beset with similar drawbacks, and are to be dealt with on the same general principles. (Pl. XVII, fig. 4.) With the back turned to one side the body should be rotated until the back turns toward the spine of the dam, and with the back turned down it must be extracted in that position (care being taken that the feet do not perforate the roof of the vagina) or it must be rotated on its own axis until the back turns upward, or the hind limbs must be pushed back and the fore limbs and head advanced, when the presentation will be a natural anterior one. _Impaction of twins in the passage._--It is very rare to have twins enter the passages together so as to become firmly impacted. As a rule, each of the twins has its own separate membranes, and as the water bags of one will naturally first enter and be the first to burst, so the calf which occupied those membranes will be the first to enter the passage and the other will be thereby excluded. When the membranes of both have burst without either calf having become engaged in the pelvis, it becomes possible for the fore legs of one and the hind legs of the other to enter at one time, and if the straining is very violent they may become firmly impacted. (Pl. XVIII, fig. 1.) The condition may be recognized by the fact that two of the presenting feet have their fronts turned forward, while the two others have their fronts turned backward. If the four feet belonged to one natural calf, they would all have the same direction. By means of this difference in direction we can easily select the two feet of one calf, place running nooses upon them just above the hoofs or fetlocks, and have an assistant drag upon the ropes while the feet of the other calf are pushed back. In selecting one of the twins to come first several considerations should have weight. The one that is most advanced in the passage is, of course, the first choice. Though the fore feet of one are presented, yet if the head is not in place the calf presenting by its hind feet is to be chosen as being less liable to obstruct. Again, if for either calf one limb only is presented and the other missing, the one presenting two feet should be selected to come first. As soon as one calf has been advanced so as to occupy the pelvis the other will be crowded back so that it will not seriously obstruct. _Fore limbs curved at the knee--Limbs sprawling outward._--In this case not only are the knees somewhat bent in a curve, but the calf has a position as if it rested on its breastbone, while the legs were drawn apart and directed to the right and left. The shoulder blades being drawn outward from the chest and the elbows turned out, the muscles extending from the trunk to the limb are unduly stretched and keep the knees bent and the feet directed outward so as to press on the sides of the passages. They become retarded in their progress as compared with the more rapidly advancing head, and may bruise or even lacerate the walls of the vagina. It would seem easy to rectify this by extending the legs, but the already tense and overstretched muscles operate against extension in the present position, and it is not easy to rotate the limbs so as to apply the shoulder flat against the side of the chest. Under these circumstances a repeller (Pl. XX, fig. 7) may be planted in the breast and the body of the calf pushed backward into the womb, when the limbs will extend easily under traction and the presentation becomes at once natural. _Fore limbs curved at knee--Flexor tendons shortening._--In this case the feet will press against the floor of the pelvis though the limb has no outward direction, and the shoulder meanwhile presses against the roof of the same passage. Unless the knees can be sufficiently straightened by force a knife must be used to cut across the cords behind the knee, when the limbs may be straightened sufficiently. _Fore limbs flexed at knee--Flexor tendons unshortened._--This is mostly seen in cases in which the body of the calf is in the proper position, its back being turned up toward the back of the dam, and in cows with a drooping abdomen. The feet have been supposed to catch beneath the brim of the pelvis, and being retarded while the head advances into the passages, they get bent at the knee and the nose and knees present. (Pl. XVI, fig. 2.) The calf, however, is not an inanimate body advanced by the mere contraction of the womb, but it moves its limbs freely under the stimulus of the unwonted compression, and in moving the feet as they are advanced they slip down over the pelvic brim and finding no other firm support they bend back until, under the impulsion, they can no longer straighten out again. The knees, therefore, advance with the neck and head, but the feet remain bent back. The result is that the upper part of the limb is also flexed, and the shoulder blade and arm bone with their masses of investing muscles are carried backward and applied on the side of the chest, greatly increasing the bulk of this already bulky part. As the elbow is carried back on the side of the chest, the forearm from elbow to knee further increases the superadded masses of the shoulder and renders it difficult or impossible to drag the mass through the passages. When the fore limbs are fully extended, on the contrary, the shoulder blade is extended forward on the smallest and narrowest part of the chest, the arm bone with its muscles is in great part applied against the side of the back part of the neck, and the forearm is continued forward by the side of the head so that the nose lies between the knees. In this natural presentation the presenting body of the calf forms a long wedge or cone, the increase of which is slow and gradual until it reaches the middle of the chest. The difficulty of extending the fore limbs will be in proportion to the advance of the head through the pelvic cavity. In the early stage all that is necessary may be to introduce the oiled hand, the left one for the right leg or the right one for the left, and passing the hand from the knee on to the foot to seize the foot in the palm, bend it forcibly on the fetlock, and lift it up over the brim of the pelvis, the knee being, of course, pressed upward against the spine. As soon as the foot has been raised above the brim of the pelvis (into the passage) the limb can be straightened out with the greatest ease. When, however, the shoulders are already engaging in the pelvis the feet can not thus be lifted up, and to gain room a repeller (Pl. XX, fig. 7) must be used to push back the body of the calf. This is an instrument with a long, straight stem, divided at the end into two short branches (2 to 3 inches long) united to the stem by hinges so that they can be brought into a line with the stem for introduction into the womb and then spread to be implanted in the breast. In the absence of a repeller a smooth, round, fork handle may be used, the prongs having been removed from the other end. A third device is to have an assistant strip his arm to the shoulder and, standing back to back with the operator, to introduce his right arm into the passages along with the operator's left (or vice versa) and push back the body of the calf while the operator seeks to bring up a limb. The repeller or staff having been planted safely in the breast of the calf, an assistant pushes upon it in a direction either forward or slightly upward, so as not only to follow the natural curve of the body and favor its turning in the line of that curve within the womb, but also to carry the shoulders upward toward the spine and obtain more room for bringing up the missing feet. It is good policy, first, to put a halter (Pl. XXI, figs. 4_a_ and 4_b_) on the head or a noose (Pl. XXI, fig. 3) on the lower jaw and a rope round each limb at the knee, so as to provide against the loss of any of these parts when the body is pushed back into the womb. This offers the further advantage that by dragging upon these ropes the body can be advanced in the passage until the foot is reached, when the rope must be slackened and the repeller used to get room for bringing up the foot. If the cow is lying, the operator should first secure the foot on the upper side and then, if necessary, turn the cow on its opposite side so as to bring up the other. In using the instruments some precautions are demanded. They must be invariably warmed before they are introduced, and they should be smeared with lard or oil to make them pass easily and without friction. The assistant who is pushing on the instrument must be warned to stop if at any time resistance gives way. This may mean the turning of the fetus, in which case the object of repulsion has been accomplished, but much more probably it implies the displacement of the instrument from the body of the fetus, and unguarded pressure may drive it through the walls of the womb. When the calf enters the passage with its back turned down toward the belly and udder, the bending back of the fore limbs is rare, probably because the feet can find a straighter and more nearly uniform surface of resistance in the upper wall of the womb and the backbone, and do not slide over a crest into an open cavity, as they do over the brim of the pelvis. The weight of the calf, too, gravitating downward, leaves more room for the straightening of the bent limbs, so that the desired relief is much more easily secured. The manipulation is the same in principle, only one must add the precaution of a steady traction on the feet in extraction, lest, owing to the adverse curvature of the fetus, the hoofs are suddenly forced through the roof of the vagina, and, perhaps, the rectum as well, during a specially powerful labor pain. When the back of the calf is turned to the right side or the left the main difference is that in addition to straightening the limbs the fetus must be rotated to turn its back upward before extraction is attempted. In this case, too, it may be difficult to bring up and straighten the lower of the two limbs until the body has been rotated into its proper position. Cord the upper straightened limb and head, then rotate the body and search for the second missing limb. _Fore limbs bent back from the shoulders._--This is an exaggeration of the condition just named, and is much more difficult to remedy, owing to the distance and inaccessibility of the missing limb. It usually happens with the proper position of the body, the back of the calf being turned toward the back of the mother. The head presents in the passage and may even protrude from the vulva during an active labor pain, but it starts back like a spring when the straining ceases. Examination with the oiled hands in the intervals between the pains fails to detect the missing limbs. (Pl. XVI, fig. 1.) If, however, the hand can be introduced during a pain it may be possible to reach the elbow or upper part of the forearm. In the absence of a pain a halter or noose on the head may be used to advance the whole body until the forearm can be seized just below the elbow. This being firmly held and the head or body pushed back into the womb, room may be obtained for bringing up the knee. The forearm is used as a lever, its upper part being strongly forced back while its lower part is pressed forward. If a pain supervenes the hold must be retained, and whatever gain has been made must be held if possible. Then during the next pain, by pushing back the body and continuing to operate the forearm as a lever, a still further advance may be made. As the knee is brought up in this way, the hand is slid down from the elbow toward the knee, which is finally brought up over the brim of the pelvis and into the passage. It is now corded at the knee, and the subsequent procedure is as described in the last article. In a large, roomy cow with a small calf the latter may pass with one or both forelegs bent back, but this is a very exceptional case, and, as early assistance is the most successful, there should never be delay in hope of such a result. _One fore limb crossed over the back of the neck._--This is a rare obstacle to calving, but one that not altogether unknown. The hand introduced into the passage feels the head and one forefoot, and farther back on the same side of the other foot, from which the womb can be traced obliquely across the back of the neck. (Pl. XVI, fig. 3.) This foot, projecting transversely, is liable to bruise or tear the vagina. If still deeply engaged in the vagina, it may be seized and pushed across to the opposite side of the neck, when the presentation will be natural. _Head bent down beneath the neck._--In this case, with drooping belly and womb allowing the brim of the pelvis to form a ridge, the advancing calf, having unduly depressed its nose, strikes it on the brim of the pelvis, and the neck advancing, the head is bent back and the poll and ears either enter the pelvis or strike against its brim. The two forefeet present, but they make no progress, and the oiled hand introduced can detect no head until the poll is felt at the entrance of the pelvis, between the forearms. The two forefeet must be fixed with running nooses and dragged on moderately while the oiled hand seeks to bring up the head. The hand is slid down over the forehead and brim of the pelvis until the nose is reached, when it is passed into the mouth, the muzzle resting in the palm of the hand. The legs are now pushed upon, and in the space thus gained the muzzle is drawn up so as to enter it into the pelvis. In doing this the operator must carefully see that the mouth does not drop open so that the sharp, front teeth cut through the floor of the womb. Should this danger threaten, the hand should be made to cover the lower jaw as well. The lessened security of the hold is more than compensated by the safety of the procedure. With the nose in the pelvis, it has only to be drawn forward and the parturition is natural. _Head bent down beneath the breast._--This is an exaggerated condition of that last named. The head, arrested by the brim of the pelvis and already bent back on the neck, is pressed farther with each successive throe until it has passed between the forelegs and lodges beneath the breast bone. (Pl. XVI, fig. 4.) On examination, the narrow upper border of the neck is felt between the forearms, but as a rule the head is out of reach below. Keeping the hand on the neck and dragging on the feet by the aid of ropes, the hand may come to touch and seize the ear, or, still better, one or two fingers may be inserted into the orbit of the eye. Then in pushing back upon the limbs, with or without the aid of a repeller applied against the shoulder, space may be obtained to draw the head into a vertical position, and even to slip the hand down so as to seize the nose. Should it prove impossible to draw the head up with the unassisted fingers, a blunt hook (Pl. XXI, fig. 6) may be inserted into the orbit, on which an assistant may drag while another pushes upon the limbs or repeller. Meanwhile the operator may secure an opportunity of reaching and seizing the nose or of passing a blunt hook into the angle of the mouth. Success will be better assured if two hooks (Pl. XXI, fig. 7) are inserted in the two orbits, so as to draw up the head more evenly. In other cases a noose may be placed on the upper jaw, or even around both jaws, and traction made upon this and on the hooks in the orbits while the legs are pushed back, and while the operator pushes back on the poll or forehead. In still more difficult cases, in which even the orbits can not be reached, a sharp hook on the end of a straight iron rod (Pl. XX, fig. 2) may be inserted over the lower jaw as far forward as it can be reached, and by dragging upon this while the body is pushed back the head will be brought up sufficiently to allow the operator to reach the orbit or nose. If even the jaw can not be reached, the hook may be inserted in the neck as near to the head as possible and traction employed so as to bring the head within reach. In all such cases the cow's head should be turned downhill, and in case of special difficulty she should be turned on her back and held there until the head is secured. In old-standing cases, with the womb closely clasping the body of the calf, relaxation may be sought by the use of chloroform or a full dose of chloral hydrate--2 ounces; the free injection of warm water into the womb will also be useful. _Head turned back on the shoulder._--With a natural, anterior presentation this may happen because of the imperfect dilation of the mouth of the womb. Under the throes of the mother the forefeet pass through the narrow opening into the vagina, while the nose, striking against it and unable to enter, is pressed backward into the womb and turns aside on the right or left shoulder. The broad muzzle of the calf forms an especial obstacle to entrance and favors this deviation of the head. The worst form of this deviation is the old-standing one with shortening of the muscles of the neck on that side, and oftentimes distortion of the face and neck bones, as noticed under "Monstrosities" (p. 182). When the head is bent on the shoulder the feet appear in the natural way, but no progress is made, and examination reveals the absence of the nose from between the knees, and farther back, from above and between the elbows, a smooth rounded mass is felt extending to the right or left, which further examination will identify with the neck. Following the upper border of this the hand reaches the crown of the head with the ears, and still further the eyes, or even, in a small calf, the nose. As the bulky head of the calf can not be extracted along with the shoulders, it becomes necessary to push the body of the fetus back and straighten out the head and neck. The cow should be laid with her head downhill and with that side up toward which the head is turned. If the throes are very violent, or the womb strongly contracted on the calf, it may be best to seek relaxation by giving chloroform, or 2 ounces of laudanum, or 2 ounces of chloral hydrate. If the calf or the passages are dry, sweet oil may be injected, or the whole may be liberally smeared with fresh lard. In the absence of these, warm water rendered slightly slippery by Castile soap may be injected into the womb in quantity. Ropes with running nooses are placed on the presenting feet and the oiled hand introduced to find the head. If, now, the fingers can be passed inside the lower jawbone, and drag the head upward and toward the passage, it unwinds the spiral turn given to the neck in bending back, and greatly improves the