f the fetus.
_Division across the middle of the body._--In cases of extra size,
monstrosity, or distortion of one end of the body it may be requisite to
cut the body in two and return the half from the passages into womb, even
after one-half has been born. The presenting members are dragged upon
forcibly by assistants to bring as much of the body as possible outside.
Then cut through the skin around the body at some distance from the vulva,
and with hand, knife, and spud detach it from the trunk as far back into
the passages as can be reached. Next cut across the body at the point
reached, beginning at the lower part (breast, belly) and proceeding up
toward the spine. This greatly favors the separation of the backbone when
reached, and further allows of its being extended so that it can be divided
higher up. When the backbone is reached, the knife is passed between the
two bones, the prominent ridges across their ends acting as guides, and by
dragging and twisting the one is easily detached from the other. With an
anterior presentation the separation should, if possible, be made behind
the last rib, while with a posterior presentation as many of the ribs
should be brought away as can be accomplished. Having removed one half of
the body, the remaining half is to be pushed back into the womb, the feet
sought and secured with nooses, and the second half removed in one piece if
possible; and if not, then after the removal of the extra limb or other
cause of obstruction.
_Removed of the contents of chest or abdomen._--If the body of the calf
sticks fast in the passages by reason of the mere dryness of its skin and
of the passages, the obstacle may be removed by injecting sweet oil past
the fetus into the womb through a rubber or other tube, and smearing the
passages freely with lard. When the obstruction depends on excess of size
of the chest or abdomen or thickening of the body from distorted spine,
much advantage may be derived from the removal of the contents of these
great cavities of the trunk. We have already seen how the haunches may be
narrowed by cutting the bones apart in the median line below and causing
their free edges to overlap each other. The abdomen can be cut open by the
embryotomy knife or the long embryotome in the median line, or at any
point, and the contents pulled out with the hand, the knife being used in
any case when especial resistance is encountered. If the abdomen is so
firmly impacted that it
|