This is common after calving, but sometimes occurs before, as the result of accidental injury. The mass may be recognized by its dark hue and the doughy sensation to the touch. It may be cut into and the mass turned out with the fingers, after which it should be washed frequently with an antiseptic lotion (carbolic acid 1 dram in 1 quart of water).
CONSTRICTION OF A MEMBER BY THE NAVEL STRING.
In early fetal life the winding of the navel string around a limb may cause the latter to be slowly cut off by absorption under the constricting cord. So at calving the cord wound round a presenting member may retard progress somewhat, and though the calf may still be born tardily by the unaided efforts of the mother, it is liable to come still-born, because the circulation in the cord is interrupted by compression before the offspring can reach the open air and commence to breathe. If, therefore, it is possible to anticipate and prevent this displacement and compression of the navel string it should be done, but if this is no longer possible, then the extraction of the calf should be effected as rapidly as possible, and if breathing is not at once attempted it should be started by artificial means.
WATER IN THE HEAD OF THE CALF (HYDROCEPHALUS).
This is an enormous distention of the cavity holding the brain, by reason of the accumulation of liquid in the internal cavities (ventricles) of the brain substance. The head back of the eyes rises into a great rounded ball ([Pl. XIX], figs. 4 and 5), which proves an insuperable obstacle to parturition. The fore feet and nose being the parts presented, no progress can be made, and even if the feet are pulled upon the nose can not by any means be made to appear. The oiled hand introduced into the passages will feel the nose presenting between the fore limbs, and on passing the hand back over the face the hard rounded mass of the cranium is met with. A sharp-pointed knife or a cannula and trocar should be introduced in the palm of the hand and pushed into the center of the rounded mass so as to evacuate the water. The hand is now used to press together the hitherto distended but thin and fragile walls, and the calf may be delivered in the natural way. If the enlarged head is turned backward it must still be reached and punctured, after which it must be brought up into position and the calf delivered.
If the hind feet present first, all may go well until the body and shoulders have passed out, when further progress is suddenly arrested by the great bulk of the head. If possible, the hand, armed with a knife or trocar, must be passed along the side of the shoulder or neck so as to reach and puncture the distended head. Failing in this, the body may be skinned up from the belly and cut in two at the shoulder or neck, after which the head can easily be reached and punctured. If in such case the fore limbs have been left in the womb, they may now be brought up into the passage, and when dragged upon the collapsed head will follow.
If the distention is not sufficient to have rendered the bony walls of the cranium thin and fragile, so that they can be compressed with the hand after puncture, a special method may be necessary. A long incision should be made from behind forward in the median line of the cranium with an embryotomy knife ([Pl. XXI], fig. 1) or with a long embryotome ([Pl. XX], fig. 3). By this means the bones on the one side are completely separated from those on the other and may be made to overlap and perhaps to flatten down. If this fails they may be cut from the head all around the base of the rounded cranial swelling by means of a guarded chisel ([Pl. XX], fig. 8) and mallet, after which there will be no difficulty in causing them to collapse.
DROPSY OF THE ABDOMEN OF THE CALF (ASCITES).
This is less frequent than hydrocephalus, but no less difficult to deal with. With an anterior presentation the fore limbs and head may come away easily enough, but no effort will advance the calf beyond the shoulders. The first thought should be dropsy of the belly, and the oiled hand introduced by the side of the chest will detect the soft and fluctuating yet tense sac of the abdomen. If there is space to allow of the introduction of an embryotomy knife, the abdomen may be freely cut with this, when the fluid will escape into the womb and parturition may proceed naturally. If this can not be effected, a long trocar and cannula may be passed between the first two ribs and straight on beneath the spine until it punctures the abdomen. ([Pl. XVIII], fig. 2.) Then the trocar is to be withdrawn and the liquid will flow through the cannula and will be hastened by traction on the fore limbs. In the absence of the trocar and cannula, two or three of the first ribs may be cut from the breastbone, so that the hand may be introduced through the chest to puncture the diaphragm with an embryotomy knife and allow an escape of the water. In some slighter cases a tardy delivery may take place without puncture, the liquid bulging forward into the chest as the abdomen is compressed in the pelvic passages. With a posterior presentation the abdomen may be punctured more easily either in the flank or with a trocar and cannula through the anus.