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 perator, 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. 4a and 4b) 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.