diseases of the digestive organs.

DISEASES OF THE GENERATIVE ORGANS. 219strong traction can be made without interfering with the full flexlimbs on the body, and if the case is a suitable one, and the body of thefetus and the passages are both well lubricated with oil or lard, a successfulparturition may be accomplished. A less desirable method is tcput a rope round one thigh or a rope round each and drag upon these.but manifestly the strain is not so directly on the spine, and the limbsmay be somewhat hampered in flexion.This method being inapplicable, the next resort is to cut off one 01both hind limbs at the hip joint. Free incisions are made on the sideof the haunch so as to expose the hip joint, and the muscles are cut awayfrom the head of the thigh bonedoAvnto its narrow neck, around Avhiclia rope is passed and firmlyfixed with a running noose. The joint isnow cut into all around, and while traction is made on the cord theknife is inserted into the inner side of the joint and the round ligamentsevered. The cord may now be dragged upon forcibly, and the musclesand other parts cut through as they are drawn tense, until finallythewhole member has been extracted. Traction on the rope round theother thigh will now suffice to extract, in the majority of cases, but ifitshould fail the other limb may be cut off in the same manner, and theuhooks inserted in front of the brim of the pelvis or in the openings irthe bones of its floor (obturator foramina) Avill give sufficient purchasefor extraction. Another method is to insert a knife betAveen the boneof the rump (sacrum) and the hip bone and sever their connections:then cut through the joint (symphysis) between the two hip bones in themedian line of the floorof the pelvis, and then with a hook in the opening on the pelvic bones (obturator foramen) to drag upon the limb andcut 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 rupturthe Avater-bags no progress is made, and the hand introduced wil"recognize the back with its row of spinous processes and the springingribs at each siele pressed against the entrance to the pelvis. (Plate xvnFig. 6.) The presence or absence of the ribs will show whether it hthe region of the chest or the loins. By feeling along the line of spinesuntil the ribs are met with Ave shall learn that the head lies in thaidirection. If, on the contrary, Ave follow the ribs until they disappearand a blank space is succeeded by hip bones, it shows that we arcapproaching the tail. The head may be turned upAvard, downwardto the right side or to the left.The object must be to turn the fetus so that one extremity or tinother can enter the passage, and the choice of Avhich end to bring forward will depend on various consielerations. If one end is much nearethe outlet than the other, that would naturally be selecteel for extraction, but if both ends are equidistant the choice would fall on the hincend, as having only the two limbs to deal with, without any risk o