SPECIAL REPORT ON DISEASES OF CATTLE
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416 XXXVIII. Tuberculosis of cow's udder 416 XXXIX. Actinomycosis
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ng, as well as in regurgitation for rumination or the chewing of the cud. The action of the first three stomachs is merely preparatory to digestion. Thus it would seem that as a resu
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of the surface, it is found to fluctuate or "give," then we may conclude that there is a collection of pus at that place. It is well not to open the abscess until the fluctuation is
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those who are competent. IMAGINARY DISEASES (HOLLOW HORN; LOSS OF CUD; WOLF IN THE TAIL). It would appear quite in place here, in connection with the diseases of the stomach and
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stic, are pain when getting up or lying down; grunting and pain upon sudden motion, especially downhill; coughing; pain on pressure over the second stomach, which lies immediately ab
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carefully laid open in the long direction, the adhesions of the protruding organs carefully separated from the umbilicus, and after the protruding parts have been returned into the
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horoughly chewed, and this constitutes what is known as "chewing the cud." From the second stomach the food passes into the third, and from the third into the fourth, or true, stomac
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Acetic acid is irritant to the gastrointestinal tract, and may cause sudden paralysis of the heart. _Treatment._--The action of the acid should be counteracted by the use of alkalie
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lysis and the animal dies in convulsions. LAUREL. The laurels, including the broad-leafed laurel, _Kalmia latifolia_, the narrow-leafed laurel, _Kalmia angustifolia_, the rhododen
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d is particularly noticeable while they are ruminating--"chewing the cud." It is not always associated with disease, but may be a symptom of some disease of the heart; in such cases
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s disinclined to move actively, the step is restricted and cautious, sudden motion causes grunting, the attitude is constrained, the feet are drawn somewhat together, the back is arc
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e of most of the diseases under consideration in this chapter. _Attitude and general condition._--The feeling of pain in animals suffering from serious affections of the organs of r
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the majority of cases it is attributable to some form of exposure, a sudden change from warm to cold surroundings, or exposure to cold storms. It may also result from inhaling irrita
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upplied by the cut nerve is paralyzed. The nervous system is often studied in two divisions--the cerebrospinal division and the sympathetic division. The cerebrospinal division con
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s, but there is paralysis in all parts posterior to the fracture, including the fore and hind legs. When the fracture is in the region of the loins the hind legs are paralyzed, but t
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nt passage of urine in driblets, its continuous escape in drops, the sudden arrest of the flow when in full stream, the rhythmic contraction of the muscles under the anus without any
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ed and inflamed kidneys it is present as a part of the inflammatory exudate. Apart from these, albumin in the urine represents in different cases a variety of diseased conditions of
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r, by the presentation of a female, the animal can be tempted to protrude the penis, so that it can be seized and extended, or when it can be manipulated forward out of the sheath, i
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cting stone, may slowly push it on into the bladder. Large doses of laudanum (2 ounces) or of solid extract of belladonna (2 drams) will not only soothe the pain but relax the spasm
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nclosing the tip of a conical mass of tissue from which the urine excludes. Fig. 2. Genital and urinary organs of the bull. (From Leisering, Mueller, and Ellenberger, Handbuch des V
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has a very small external opening, the mucous membrane of which is studded with sebaceous glands secreting a thick, unctuous matter of a strong, heavy odor. Behind this orifice is a
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ack toward the root of the tail. In the early stages of pregnancy the udder develops slowly, and toward its completion quite rapidly. For a long time there is merely a sense of great
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ult from poor or insufficient feed, from the excessive drain upon the udder while bearing the calf, from the use of feed deficient in certain essential elements, like the nitrogenous
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med condition of the membranes of the vagina results in a catarrhal exudate, and this discharge, which soils the external genitals and the tail, and the uneasiness and sometimes the
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was thoroughly closed in and the cow secluded from the constant stream of visitors and the incessant noise, when at once the pains became strong and effe
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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,
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for success, but if the calf is placed with its back down toward the udder, and if the head is bent down under the brim of the pelvis, the best position for the cow is on her back,
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ised a presentation with the back of the fetus turned down toward the udder, and the anterior extremities one with the back turned up toward the spine, the latter should be selected.
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w is to be sacrificed a blow on the head with an ax will produce quietude. Then the prompt cutting into the abdomen and womb and the extraction of the calf requires no skill. If, how
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of the lips of the vulva, a weak, rapid pulse, violent and perhaps loud beating of the heart (palpitations), sunken, staring eyes, coldness of the skin, ears, horns, and limbs, pers
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connections with the womb are severed and the remainder is expelled suddenly en masse. It is quite evident that neglected cases with putrid membranes are poor subjects for this meth
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examples of udder poisons are found in the first milk (colostrum), which is distinctly irritant and purgative, and in the to
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f the disease gangrene may ensue, a quarter or half or even the whole udder, losing its vitality, and sloughing off if the cow can bear up against the depressing influence. These gan
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anything which irritates them. The powerful sucking of the calf; the sudden chilling of the teat in winter after the calf has just let it go or after the completion of milking with a
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in as a swelling after the bowel has been returned; and when the protruding bowel has contracted permanent adhesion to the sac, it is impossible to return it fully without first seve
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reen all act in this way. The same may come from disease in the cow's udder, or any general disease of the cow with attendant fever, and in all such cases the tendency is to rapid ch
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D.] Some knowledge of the skeleton is advisable to facilitate the study of diseases of bones and the accidental injuries to which they are exposed. The skeleton of the adult ox is
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is one in which the bone is severed in two parts, transversely, longitudinally, or obliquely, without serious injury to the adjoining structures. COMPOUND FRACTURES.--Compound fract
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oken down and the bones are united (anchylosis). This process may include any or all of the three lower joints of the hock. The joint of motion which is situated on the lower end of
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t unknown. _Symptoms of articular rheumatism._--The symptoms appear suddenly and with varying degrees of severity. The animal presents a downcast appearance, with staring coat, horn
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far as possible to make the trachea tense and prominent; make a longitudinal incision about 2 to 2-1/2 inches long through the skin and deeper tissues and trachea at the most promine
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arly exercised or be allowed freedom so that it can exercise itself. Sudden changes of the temperature are dangerous. The animal should be fed moderately, but of a diet easily digest
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considerable rotary motion or twisting is possible. Their color is cloudy gray or grayish red, with white bands of connective tissue radiating from the center. Their consistence vari
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ts in the early and complete removal of the tumor, taking care to include a wide border of healthy tissue. This has been most successful in such superficial cancers as those of the e
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ns of the legs become irritated and chapped when cattle are fed in a muddy or wet yard in winter, or if they are compelled to wade through water in frosty weather. Another form of er
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the formation of circular patches on the skin, which soon becomes denuded of hair. The cuticular layer of the skin in slightly inflamed, and vesication with exudation occurs, follow
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sclerotic, or white of the eye, is bloodshot and the cornea may be cloudy. If the disease advances, keratitis results, with its train of unfavorable symptoms. _Treatment._--Careful
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a long time, but will eventually induce keratitis with inflammatory exudations. _Treatment._--The cornea may be punctured at its upper and outer margin, and the worm squeezed out wi
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hiefly responsible for the morbid changes. This definition might include diseases caused by certain animal parasites, such as trichinÊ, for example, which multiply in the digestive
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ected by means of chlorin gas liberated from the chlorid of lime by crude carbolic acid. This is accomplished by making a cone of 5 or 6 pounds of chlorid of lime, in the top of whic
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acute one, as is frequently seen in hot weather, the symptoms appear suddenly; the breathing becomes rapid and difficult, the animal grunts or moans with each expiration, the shoulde
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he same time similar changes may go on in the skin of the thighs, the udder, or the scrotum, or about the vagina, which lead to small sloughs. In severe cases, which are the most co
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loss in flesh and a lessening or cessation of the milk secretion. The udders often become inflamed and ruined by the formation of abscesses, and cows affected in this way are sometim
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that in the latter there is a rapid infection of the entire herd, including the adult cattle, as well as the infection of hogs and sheep. The characteristic lesion of foot-and-mouth
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pressure. This tumefaction consists essentially of a cerogelatinous exudate into the subcutaneous and intermuscular tissues. Bloody extravasations may take place in subcutaneous tis
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68 cows, 69, or 41 per cent, being tuberculous, and 2 having diseased udders. The result of testing the Queen's herd at Windsor was that 36 out of 40, or 90 per cent, were found tub
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under the jaw, and along the neck. Of late tubercular disease of the udder in cows (Pl. XXXVIII) has received considerable attention from sanitarians, owing to the infection of the
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of the cases tested. The relatively few failures in diagnoses are included among two classes of cattle. The first class contains those that are tuberculous, but which do not react ei
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unanimity of opinion on the part of all who are best calculated to judge that such an injurious effect does not occur. Even those who have been most pronounced in the claim tha
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xperimented with such virus. It was the experiments and comparative studies of Theobald Smith, however, which attracted special attention to the difference in virulence shown by tube
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ppearance of reddened, inflamed areas, principally upon the teats and udder, and at times on the abdominal skin or the skin of the inner surface of the thighs. In a few cases the ski
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t occurring in bovine affections. It is therefore of interest to conclude this article with a brief discussion of the disease in man and its relation to actinomycosis in cattle. In
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called anthrax peracutus or apoplectiform, when the animal dies very suddenly as if from apoplexy. Such cases usually occur in the beginning of an outbreak. The animal, without havin
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es will hardly hold, as it is found in all kinds of soil, in all altitudes, at all seasons of the year, and under various climatic conditions. It occurs in this country from the Atla
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etimes the mouth is kept open, permitting the tumefied tongue to protrude. One or more of the above symptoms direct the attention to the mouth as the seat of disease; or, having noti
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a uniform brownish tint, dissociated by gas and with a blood-tinged exudate. This gangrenous tissue, when present before death, can be removed without pain to the animal. The intesti
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thropoda and to the genus _Margaropus_ (or _Boophilus_), which is included in the order Acarina. Its life history is quite simple and easily traced from one generation to another. It
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clear solution, except for dirt. If the liquid persistently remains muddy or milky, it may be because the operation has been conducted so fast that much water has been boiled out an
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ed territory has in every instance been found a certain method of excluding Texas fever. The regulations governing the movement of cattle from below the quarantine line are made year
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laundry soap 1 pound. Water 4 gallons. Crude petroleum 1 gallon. Powdered naphthalin 4 ounces. Cut the soap into thin shavings and disso
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equal parts; (2) kerosene, 1/2 pint, mixed with lard, 1 pound; (3) crude petroleum; (4) any of the dips recommended for use in dipping, and diluted in the same proportions as for di
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d scattered their droppings. The worms in the stomach produce a multitude of eggs (fig. 14_c_) of microscopic size, which pass out of the body in the feces. In warm weather these egg
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as they are rather common among sheep in the Northwest. As already alluded to, these worms are the intermediate stage of a tapeworm found in dogs, and their life history and the mean
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earance of vesicles containing serous fluid in the mouth and upon the udder, teats, heels, and coronary bands of the affected animals. Drooling is profuse, and there is a peculiar sm
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f premises, 363 inflammation of the udder, description, prevention, and treatment, 237 ma
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, causes, symptoms, and treatment, 103 contagious, of the udder, description, prevention, and treatment, 237 ea
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, causes and treatment, 322 Pseudoplasm. _See_ Tumors. Psoroptic mange, description and treatment, 513 _Pucinia a
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nic, causes and treatment, 25 Udder-- congestion, description and treatment, 233 contagious inflammation af
chances of bringing forward the nose. If, at first, or if now, the lower
jaw can be reached, a noose should be placed around it behind the incisor
teeth and traction made upon this, so that the head may continue to be
turned, forehead up, toward the spine and jaws down, thereby continuing to
undo the screwlike curve of the neck. If, on the contrary, the nose is
dragged upon by a cord passing over the upper border of the neck, the
screwlike twist is increased and the resistance of the bones and joints of
the neck prevents any straightening of the head. As soon as the lower jaw
has been seized by the hand or noose, a repeller (Pl. XX, fig. 7), planted
on the inside of the elbow or shoulder most distant from the head, should
be used to push back the body and turn it in the womb, so that the head may
be brought nearer to the outlet. In this way the head can usually be
brought into position and the further course of delivery will be natural.
Sometimes, however, the lower jaw can not be reached with the hand, and
then the orbit or, less desirably, the ear, may be availed of. The ear may
be pulled by the hand, and by the aid of the repeller on the other shoulder
the calf may be so turned that the lower jaw may be reached and availed of.
Better still, a clamp (Pl. XVIII, figs. 3 and 4) is firmly fixed on the ear
and pulled by a rope, while the repeller is used on the opposite shoulder,
and the hand of the operator pulls on the lower border of the neck and
lifts it toward the other side. To pull on the upper border of the neck is
to increase the spiral twist, while to raise the lower border is to undo
it. If the outer orbit can be reached, the fingers may be inserted into it
so as to employ traction, or a blunt finger hook (Pl. XXI, fig. 8) may be
used, or a hook with a rope attached, or, finally, a hook on the end of a
long staff. Then, with the assistance of the repeller, the body may be so
turned and the head advanced that the lower jaw may be reached and availed
of.
In case neither the ears nor the orbit can be reached, a cord should be
passed around the neck of the calf as near the head as possible, and
traction made upon that while the opposite shoulder is pushed toward the
opposite side by the repeller, assisted by the hand dragging on the lower
border of the neck. To aid the hand in passing a rope around the neck a
cord carrier (Pl. XXI, fig. 5) is in use. It fails, however, to help us in
the most difficult part of the operation--the passing of the cord down on
the deep or farthest side of the neck--and to remedy this I have devised a
cord carrier, furnished with a ring at the end, a joint 6 or 8 inches from
the end, and another ring on the handle, close to this joint. (Pl. XX, fig.
4.) A cord is passed through both rings and a knot tied on its end, just
back of the terminal ring. The instrument, straightened out, is inserted
until it reaches just beyond the upper border of the neck, when, by
dragging on the cord, the movable segment is bent down on the farther side
of the neck, and is pushed on until it can be felt at its lower border. The
hand now seizes the knotted end of the cord beneath the lower border of the
neck and pulls it through while the carrier is withdrawn, the cord sliding
through its rings. The cord, pushed up as near to the head as possible, is
furnished with a running noose by tying the knotted end round the other,
or, better, the two ends are twisted around each other so as to give a firm
hold on the neck without dangerously compressing the blood vessels. By
pushing on the opposite shoulder with the repeller, and, assisting with the
hand on shoulder, breastbone, or lower border of the neck, such a change of
position will be secured as will speedily bring the head within reach.
Afterwards proceed as described above.
These cases are always trying, but it is very rarely necessary to resort to
embryotomy. When absolutely required, first remove one fore limb, and then,
if still unsuccessful, the other, after which the head can easily be
secured. (See "Embryotomy," p. 202.)
_Head turned upward and backward._--In this case the face rests upon the
spine; the forefeet appear alone in the passage, but fail to advance, and
on examination the rounded, inferior border of the neck can be felt,
extending upward and backward beneath the spine of the dam, and if the calf
is not too large the hand may reach the lower jaw or even the muzzle. (Pl.
XVI, fig. 5.) A repeller is planted in the breast and the body of the calf
pushed backward and downward so as to make room and bring the head nearer
to the passage; or in some cases the body may be pushed back sufficiently
by the use of the fore limbs alone. Meanwhile the head is seized by the ear
or the eye socket, or, if it can be reached, by the lower jaw, and pulled
downward into position as space is obtained for it. If the hand alone is
insufficient, the blunt hooks may be inserted in the orbits or in the angle
of the mouth, or a noose may be placed on the lower paw, and by traction
the head will be easily advanced. In case of a large fetus, the head of
which is beyond reach, even when traction is made on the limbs, a rope may
be passed around the neck and pulled, while the breastbone is pressed
downward and backward by the repeller, and soon the change of position will
bring the orbit or lower jaw within reach. With the above-described
position the standing position is most favorable for success, but if the
calf is placed with its back down toward the udder, and if the head is bent
down under the brim of the pelvis, the best position for the cow is on her
back, with her head downhill.
In neglected cases, with death and putrefaction of the fetus and dryness of
the passages, it may be necessary to extract in pieces. (See "Embryotomy,"
p. 202.)
_Outward direction of the stifles_--_Abduction of hind limbs._--As an
obstacle to parturition, this is rare in cows. It is most liable to take
place in cows with narrow hip bones, and when the service has been made by
a bull having great breadth across the quarter. The calf, taking after the
sire, presents an obstacle to calving in the breadth of its quarters, and
if at the same time the toes and stifles are turned excessively outward and
the hocks inward the combined breadth of the hip bones above and the
stifles below may be so great that the pelvis will not easily admit them.
After the forefeet, head, and shoulders have all passed out through the
vulva, further progress suddenly and unaccountably ceases, and some
dragging on the parts already delivered does not serve to bring away the
hind parts. The oiled hand introduced along the side of the calf will
discover the obstacle in the stifle joints turned directly outward and
projecting on each side beyond the bones which circumscribe laterally the
front entrance of the pelvis. The evident need is to turn the stifles
inward; this may be attempted by the hand introduced by the side of the
calf, which is meanwhile rotated gently on its own axis to favor the change
of position. To correct the deviation of the hind limb is, however, very
difficult, as the limbs themselves are out of reach and can not be used as
levers to assist. If nothing can be done by pushing the body of the calf
back and rotating it and by pressure by the hand in the passages, the only
resort appears to be to skin the calf from the shoulder back, cut it in two
as far back as can be reached, then push the buttocks well forward into the
womb, bring up the hind feet, and so deliver.
_Hind limbs excessively bent on the body and engaged in the pelvis._--In
this case the presentation is apparently a normal, anterior one; fore limbs
and head advanced naturally and the parturition proceeds until half the
chest has passed through the external passages, when suddenly progress
ceases and no force will effect farther advance. An examination with the
oiled hand detects the presence, in the passages, of the hind feet and
usually the hind legs up to above the hocks. (Pl. XVII, fig. 1.)
The indications for treatment are to return the hind limbs into the body of
the womb. If they have not advanced too far into the pelvis, this may be
done as follows: A rope with running noose is passed over each hind foot
and drawn tight around the lower part of the hock; the ropes are then
passed through the two rings in the small end of the rotating instrument
(Pl. XX, fig. 5) which is slid into the passages until it reaches the
hocks, when the ropes, drawn tight, are tied around the handle of the
instrument. Then in the intervals between the pains the hocks are pushed
forcibly back into the womb. If by this means flexion can be effected in
hocks and stifles, success will follow; the hind feet will pass into the
womb and clear of the brim of the pelvis and the body may now be advanced
without hindrance, the hind limbs falling into place when the hip joints
are extended. At the same time the pressure upon hind limbs must not be
relaxed until the buttocks are engaged in the pelvis, as otherwise the feet
may again get over the brim and arrest the progress of delivery.
When the hind limbs are already so jammed into the pelvis that it is
impossible to return them, the calf must be sacrificed to save the mother.
Cords with running nooses are first put on the two hind feet. The body must
be skinned from the shoulders back as far as can be reached, and is to be
then cut in two, if possible, back of the last rib. The remainder of the
trunk is now pushed back into the body of the womb and by traction upon the
cords the hind feet are brought up into the passages and the extraction
will be comparatively easy.
_Hind presentation with one or both legs bent at the hock._--After the
bursting of the water bags, though labor pains continue, no part of the
fetus appears at the vulva unless it be the end of the tail. On examination
the buttocks are felt wedged against the spine at the entrance of the
pelvis and beneath them the bent hock joints resting on the brim of the
pelvis below. (Pl. XVII, fig. 3.) The calf has been caught by the labor
pains while the limb was bent beneath it and has been jammed into or
against the rim of the pelvis, so that extension of the limb became
impossible. With the thigh bent on the flank, the leg on the thigh, and the
shank on the leg, and all at once wedged into the passage, delivery is
practically impossible.
The obvious remedy is to push the croup upward and forward and extend the
hind legs, and in the early stages this can usually be accomplished in the
cow. A repeller (Pl. XX, fig. 7) is planted across the thighs and pointed
upward toward the spine of the cow and pushed forcibly in this direction
during the intervals between labor pains. Meanwhile the oiled hand seizes
the shank just below the hock and uses it as a lever, pushing the body back
and drawing the foot forward, thus effectually seconding the action of the
repeller. Soon a distinct gain is manifest, and as soon as the foot can be
reached it is bent back strongly at the fetlock, held in the palm of the
hand, and pulled up, while the repeller, pressing on the buttocks, assists
to make room for it. In this way the foot may be brought safely and easily
over the brim of the pelvis without any risk of laceration of the womb of
the foot. After the foot has been lifted over the brim, the whole limb can
be promptly and easily extended. In cases presenting special difficulty in
raising the foot over the brim, help may be had by traction on a rope
passed around in front of the hock, and later still by a rope with a noose
fastened to the pastern. In the worst cases, with the buttocks and hocks
wedged deeply into the passages, it may prove difficult or impossible to
push the buttocks back into the abdomen, and in such case the extension of
the hind limb is practically impossible without mutilation. In some roomy
cows a calf may be dragged through the passages by ropes attached to the
bent hocks, but even when this is possible there is great risk of
laceration of the floor of the vagina by the feet. The next resort is to
cut the hamstring just above the point of the hock and the tendon on the
front of the limb (flexor metatarsi) just above the hock, and even the
sinews behind the shank bone just below the hock. This allows the stifle
and hock to move independently of each other, the one undergoing extension
without entailing the extension of the other; it also allows both joints to
flex completely, so that the impacted mass can pass through a narrower
channel. If now, by dragging on the hocks and operating with the repeller
on the buttocks, the latter can be tilted forward sufficiently to allow of
the extension of the stifle, the jam will be at once overcome, and the calf
may be extracted with the hock bent, but the stifle extended. If even this
can not be accomplished, it may now be possible to extract the whole mass
with both hocks and stifles fully bent. To attempt this, traction may be
made on the rope around the hocks and on a sharp hook (Pl. XX, fig. 2)
passed forward between the thighs and hooked on to the brim of the pelvis.
Everything else failing, the offending limb or limbs may be cut off at the
hip joint and extracted, after which extraction may proceed by dragging on
the remaining limb, or by hooks on the hip bones. Very little is to be
gained by cutting off the limb at the hock, and the stifle is less
accessible than the hip, and amputation of the stifle gives much poorer
results.
_Hind limbs bent forward from the hip_--_Breech presentation._--This is an
exaggeration of the condition last described, only the hocks and stifles
are fully extended and the whole limb carried forward beneath the belly.
(Pl. XVII, fig. 2.) The water bags appear and burst, but nothing presents
unless it may be the tail. Examination in this case detects the outline of
the buttocks, with the tail and anus at its upper part.
The remedy, as in the case last described, consists in pushing the buttock
upward and forward with a repeller, the cow being kept standing and headed
downhill until the thigh bone can be reached and used as a lever. Its upper
end is pushed forward and its lower end raised until, the joints becoming
fully flexed, the point of the hock can be raised above the brim of the
pelvis. If necessary a noose may be passed around the leg as far down
toward the hock as possible and pulled on forcibly, while the hand presses
forward strongly on the back of the leg above. When both hocks have been
lodged above the brim of the pelvis the further procedure is as described
under the last heading.
If, however, the case is advanced and the buttocks wedged firmly into the
passages, it may be impossible safely to push the fetus back into the womb,
and the calf must either be dragged through the passage as it is or the
limbs or the pelvis must be cut off. To extract successfully with a breech
presentation the cow must be large and roomy and the calf not too large.
The first step in this case is to separate the pelvic bones on the two
sides by cutting from before backward, exactly in the median line below and
where the thighs come together above. This may be done with a strong
embryotomy knife, but is most easily accomplished with the long embryotome
(Pl. XX, fig. 3). The form which I have designed (Pl. XX, fig. 1), with a
short cutting branch jointed to the main stem, is to be preferred, as the
short cutting piece may be folded on the main stem so that its cutting edge
will be covered, and it can be introduced and extracted without danger.
This is pushed forward beneath the calf's belly, and the cutting arm
opened, inserted in front of the brim of the pelvis and pulled forcibly
back through the whole length of the pelvic bones. The divided edges are
now made to overlap each other and the breadth of the haunch is materially
reduced. One end of the cord may then be passed forward by means of a cord
carrier (Pl. XXI, fig. 5) on the inner side of one thigh until it can be
seized at the stifle by the hand passed forward on the outer side of that
thigh. This end is now pulled back through the vagina, the other end passed
through the cord carrier and passed forward on the inner side of the other
thigh until it can be seized at the stifle by the hand passed forward
outside that thigh. This end is drawn back through the vagina like the
first, and is tied around the other so as to form a running noose. The rope
is now drawn through the ring until it forms a tight loop, encircling the
belly just in front of the hind limbs. On this strong traction can be made
without interfering with the full flexion of the limbs on the body, and if
the case is a suitable one, and the body of the fetus and the passages are
both well lubricated with oil or lard, a successful parturition may be
accomplished. A less desirable method is to put a rope around one thigh or
a rope around each and drag upon these, but manifestly the strain is not so
directly on the spine, and the limbs may be somewhat hampered in flexion.
This method being inapplicable, the next resort is to cut off one or both
hind limbs at the hip joint. Free incisions are made on the side of the
haunch so as to expose the hip joint, and the muscles are cut away from the
head of the thigh bone down to its narrow neck, around which a rope is
passed and firmly fixed with a running noose. The joint is now cut into all
around, and while traction is made on the cord the knife is inserted into
the inner side of the joint and the round ligament severed. The cord may
now be dragged upon forcibly, and the muscles and other parts cut through
as they are drawn tense, until finally the whole member has been extracted.
Traction on the rope round the other thigh will now suffice to extract, in
most cases, but if it should fail the other limb may be cut off in the same
manner, and then hooks inserted in front of the brim of the pelvis or in
the openings in the bones of its floor (obturator foramina) will give
sufficient purchase for extraction. Another method is to insert a knife
between the bone of the rump (sacrum) and the hip bone and sever their
connections; then cut through the joint (symphysis) between the two hip
bones in the median line of the floor of the pelvis, and then with a hook
in the opening on the pelvic bones (obturator foramen) drag upon the limb
and cut the tense soft parts until the limb is freed and extracted.
_Presentation of the back._--In this presentation straining may be active,
but after the rupture of the water bags no progress is made, and the hand
introduced will recognize the back with its row of spinous processes and
the springing ribs at each side pressed against the entrance to the pelvis.
(Pl. XVII, fig. 6.) The presence or absence of the ribs will show whether
it is the region of the chest or the loins. By feeling along the line of
spines until the ribs are met with we shall learn that the head lies in
that direction. If, on the contrary, we follow the ribs until they
disappear, and a blank space is succeeded by hip bones, it shows that we
are approaching the tail. The head may be turned upward, downward, to the
right side, or to the left.
The object must be to turn the fetus so that one extremity or the other can
enter the passage, and the choice of which end to bring forward will depend
on various considerations. If one end is much nearer the outlet than the
other, that would naturally be selected for extraction, but if they are
equidistant the choice would fall on the hind end, as having only the two
limbs to deal with without any risk of complication from the head. When the
head is turned upward and forward it will usually be preferable to bring up
the hind limb, as, owing to the drooping of the womb into the abdomen,
rotation of the fetus will usually be easier in that direction, and if
successful the resulting position will be a natural posterior presentation,
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