This may result from compression by gravid womb, and is best corrected by a graduated allowance of boiled flaxseed.

PARALYSIS.

The pressure on the nerves of the pelvis is liable to cause paralysis of the hind limbs or of the nerve of sight. These are obstinate until after parturition, when they recover spontaneously, or under a course of nux vomica and (local) stimulating liniments.

PROLONGED RETENTION OF THE FETUS (FOAL).

Though far less frequently than in the case of the cow, parturition may not be completed at term, and the mare, to her serious and even fatal injury, may carry the foal in the womb for a number of months. Hamon records one case in which the mare died after carrying the fetus for 17 months, and Caillier a similar result after it had been carried 22 months. In these cases the fetus retained its natural form, but in one reported by Gohier the bones only were left in the womb amid a mass of apparently purulent matter.

Cause.—The cause may be any effective obstruction to the act of parturition, such as lack of contractile power in the womb, unduly strong (inflammatory) adhesions between the womb and the fetal membranes, wrong presentation of the fetus, contracted pelvis (from fracture or disease of the bones), or disease and induration of the neck of the womb.

The mere prolongation of gestation does not necessarily entail the death of the foal; hence the latter has been born alive at the four hundredth day. Even when the foal has perished putrefaction does not set in unless the membranes (water bags) have been ruptured and septic bacteria have been admitted to the interior of the womb. In the latter case a fetid decomposition advances rapidly, and the mare usually perishes from poisoning with the putrid matters absorbed.

At the natural period of parturition preparations are apparently made for that act. The vulva swells and discharges much mucus, the udder enlarges, the belly becomes more pendent, and the animal strains more or less. No progress is made, however; there is not even opening of the neck of the womb, and after a time the symptoms subside. The mare usually refuses the male, yet there are exceptions to this rule. If the neck of the womb has been opened and putrefying changes in its contents have set in, the mare loses appetite and condition, pines, discharges an offensive matter from the generative passages, and dies of inflammation of the womb and putrid infection. In other cases there is a slow wearing out of the strength, and she finally dies of exhaustion.

The treatment is such as will facilitate the expulsion of the fetus and its membranes and the subsequent washing out of the womb with disinfectants. So long as the mouth of the womb is closed time should be allowed for its natural dilatation, but if this does not come about after a day or two of straining, the opening may be smeared with extract of belladonna, and the oiled hand, with the fingers and thumb drawn into the form of a cone, may be inserted by slow oscillating movements into the interior of the womb. The water bags may now be ruptured, any malpresentation rectified (see "Difficult parturition"), and delivery effected. After removal of the membranes wash out the womb first with tepid water and then with a solution of 2 ounces of borax in half a gallon of water.

This injection may have to be repeated if a discharge sets in. The same course may be pursued even after prolonged retention. If the soft parts of the fetus have been absorbed and the bones only left, these must be carefully sought for and removed, and subsequent daily injections will be required for some time. In such cases, too, a course of iron tonics (sulphate of iron, 2 drams daily) will be highly beneficial in restoring health and vigor.

ABORTION.

Abortion is, strictly speaking, the expulsion of the impregnated ovum at any period from the date of impregnation until the foal can survive out of the womb. If the foal is advanced enough to live, it is premature parturition, and in the mare this may occur as early as the tenth month (three hundredth day).

The mare may abort by reason of almost any cause that very profoundly disturbs the system; hence, very violent inflammations of important internal organs (bowels, kidneys, bladder, lungs) may induce abortion. Profuse diarrhea, whether occurring from the reckless use of purgatives, the consumption of irritants in the feed, or a simple indigestion, is an effective cause. No less so is acute indigestion with evolution of gas in the intestines (bloating). The presence of stone in the kidneys, uterus, bladder, or urethra may induce so much sympathetic disorder in the womb as to induce abortion. In exceptional cases wherein mares come in heat during gestation, service by the stallion may cause abortion. Blows or pressure on the abdomen, rapid driving or riding of the pregnant mare, especially if she is soft and out of condition from idleness, the brutal use of the spur or whip, and the jolting and straining of travel by rail or boat are prolific causes. Bleeding the pregnant mare, a painful surgical operation, and the throwing and constraint resorted to for an operation are other causes. Traveling on heavy, muddy roads, slips and falls on ice, and jumping must be added. The stimulation of the abdominal organs by a full drink of iced water may precipitate a miscarriage, as may exposure to a cold rainstorm or a very cold night after a warm day. Irritant poisons that act on the urinary or generative organs, such as Spanish flies, rue, savin, tansy, cotton-root bark, ergot of rye or other grasses, the smut of maize and other grain, and various fungi in musty fodder are additional causes. Frosted or indigestible feed, and, above all, green succulent vegetables in a frozen state, have proved effective factors, and filthy, stagnant water is dangerous. Low condition in the dam and plethora have in opposite ways caused abortion, and hot, relaxing stables and lack of exercise strongly conduce to it. The exhaustion of the sire by too frequent service, entailing debility of the offspring and disease of the fetus or of its envelopes, must be recognized as a further cause.

The symptoms vary mainly according as the abortion is early or late in pregnancy. In the first month or two of pregnancy the mare may miscarry without observable symptoms, and the fact appears only by her coming in heat. If more closely observed a small clot of blood may be found behind her, in which a careful search reveals the rudiments of the foal. If the occurrence is somewhat later in gestation, there will be some general disturbance, loss of appetite, neighing, and straining, and the small body of the fetus is expelled, enveloped in its membranes. Abortions during the later stages of pregnancy are attended with greater constitutional disturbance, and the process resembles normal parturition, with the aggravation that more effort and straining is requisite to force the fetus through the comparatively undilatable mouth of the womb. There is the swelling of the vulva, with mucus or even bloody discharge; the abdomen droops, the flanks fall in, the udder fills, the mare looks at her flanks, paws with the fore feet and kicks with the hind, switches the tail, moves around uneasily, lies down and rises, strains, and, as in natural foaling, expels first mucus and blood, then the waters, and finally the fetus. This may occupy an hour or two, or it may be prolonged for a day or more, the symptoms subsiding for a time, only to reappear with renewed energy. If there is malpresentation of the fetus it will hinder progress until rectified, as in difficult parturition. Abortion may also be followed by the same accidents, as flooding, retention of the placenta, and leucorrhea.

The most important object in an impending abortion is to recognize it at as early a stage as possible, so that it may, if possible, be cut short and prevented. Any general, indefinable illness in a pregnant mare should lead to a close examination of the vulva as regards swelling, vascularity of its mucous membrane, and profuse mucus secretion, and, above all, any streak or staining of blood; also the condition of the udder, if that is congested and swollen. Any such indication, with colicky pains, straining, however little, and active movement of the fetus or entire absence of movement, are suggestive symptoms and should be duly counteracted.

The changes in the vulva and udder, with a soiled and bloody condition of the tail, may suggest an abortion already accomplished, and the examination with the hand in the vagina may detect the mouth of the womb soft and dilatable and the interior of the organ slightly filled with a bloody liquid.

Treatment should be preventive if possible, and would embrace the avoidance of all causes mentioned, and particularly of such as may seem to be particularly operative in the particular case. If abortions have already occurred in a stud, the especial cause in the matter of feed, water, exposure to injuries, overwork, lack of exercise, etc., may often be identified and removed. A most important point is to avoid all causes of constipation, diarrhea, indigestion, bloating, violent purgatives, diuretics or other potent medicines, painful operations, and slippery roads, unless well frosted.

When abortion is imminent, the mare should be placed alone in a roomy, dark, quiet stall, and have the straining checked by some sedative. Laudanum is usually at hand and may be given in doses of 1 or 2 ounces, according to size, and repeated after two or three hours, and even daily if necessary. Chloroform or chloral hydrate, 3 drams, may be substituted if more convenient. These should be given in a pint or quart of water, to avoid burning the mouth and throat. Or Viburnum prunifolium (black haw), 1 ounce, may be given and repeated if necessary to prevent straining.

When all measures fail and miscarriage proceeds, all that can be done is to assist in the removal of the fetus and its membranes, as in ordinary parturition. As in the case of retention of the fetus, it may be necessary after delivery to employ antiseptic injections into the womb to counteract putrid fermentation. This, however, is less necessary in the mare than in the cow, in which the prevalent contagious abortion must be counteracted by the persistent local use of antiseptics. After abortion a careful hygiene is demanded, especially in the matter of pure air and easily digestible feed. The mare should not be served again for a month or longer, and in no case until after all discharge from the vulva has ceased.

INFECTIOUS ABORTION IN MARES.

This disease is discussed in the chapter on "Infectious Diseases."

PARTURITION.

SYMPTOMS OF PARTURITION.

As the period of parturition approaches, the swelling of the udder bespeaks the coming event, the engorgement in exceptional cases extending forward on the lower surface of the abdomen and even into the hind limbs. For about a week a serous fluid oozes from the teat and concretes as a yellow, waxlike mass around its orifice. About 24 hours before the birth this gives place to a whitish, milky liquid, which falls upon and mats the hairs on the inner sides of the legs. Another symptom is enlargement of the vulva, with redness of its lining membrane, and the escape of glairy mucus. The belly droops, the flanks fall in, and the loins may even become depressed. Finally the mare becomes uneasy, stops feeding, looks anxious, whisks her tail, and may lie down and rise again. In many mares this is not repeated, but they remain down; violent contractions of the abdominal muscles ensue; after two or three pains the water bags appear and burst, followed by the fore feet of the foal, with the nose between the knees, and by a few more throes the fetus is expelled. In other cases the act is accomplished standing. The whole act may not occupy more than 5 or 10 minutes. This, together with the disposition of the mare to avoid observation, renders the act one that is rarely seen by the attendants.

The navel string, which connects the foal to the membranes, is ruptured when the fetus falls to the ground, or when the mare rises, if she has been down, and the membranes are expelled a few minutes later.

NATURAL PRESENTATION.

When there is a single foal, the common and desirable presentation is with the fore feet first, the nose between the knees, and with the front of the hoofs and knees and the forehead directed upward toward the anus, tail, and croup. (Plate XII, fig. 1.) In this way the natural curvature of the body of the fetus corresponds to the curve of the womb and genital passages, and particularly of the bony pelvis, and the foal passes with much greater ease than if placed with its back downward toward the udder. When there is a twin birth the second foal usually comes with its hind feet first, and the backs of the legs, the points of the hocks, and the tail and croup are turned upward toward the anus and tail of the mare. (Plate XII, fig. 2.) In this way, even with a posterior presentation, the curvature of the body of the foal still corresponds to that of the passages, and its expulsion may be quite as easy as in anterior presentation. Any presentation aside from these two may be said to be abnormal and will be considered under "Difficult parturition."

PREMATURE LABOR PAINS.

These may be brought on by, any violent exertion, use under the saddle, or in heavy draft, or in rapid paces, or in travel by rail or sea, blows, kicks, crushing by other animals in a doorway or gate. Excessive action of purgative or diuretic agents, or of agents that irritate the bowels or kidneys, like arsenic, paris green, all caustic salts and acids, and acrid and narcotico-acrid vegetables, is equally injurious. Finally, the ingestion of agents that stimulate the action of the gravid womb (ergot of rye or of other grasses, smut, various fungi of fodders, rue, savin, cotton root, etc.) may bring on labor pains prematurely.

Besides the knowledge that parturition is not yet due, there will be less enlargement, redness, and swelling of the vulva, less mucous discharge, less filling of the udder, and fewer appearances of wax and probably none of milk from the ends of the teats. The oiled hand introduced into the vulva will not enter with the ease usual at full term, and the neck of the womb will be felt not only closed, but with its projecting papillæ, through which it is perforated, not yet flattened down and effaced, as at full term. The symptoms are, indeed, those of threatened abortion, but at such an advanced stage of gestation as is compatible with the survival of the offspring.

Treatment.—The treatment consists in the separation of the mare, in a quiet, dark, secluded place, from all other animals, and the free use of antispasmodics and anodynes. Opium in dram doses every two hours, or laudanum in ounce doses at similar intervals, will often suffice. When the more urgent symptoms have subsided these doses may be repeated thrice a day till all excitement passes off or until the passages have become relaxed and prepared for parturition. Viburnum prunifolium (black haw), in ounce doses, may be added if necessary. Should parturition become inevitable, it may be favored and any necessary assistance furnished.

DIFFICULT PARTURITION.

With natural presentation this is a rare occurrence. The great length of the fore limbs and face entail, in the anterior presentation, the formation of a long cone, which dilates and glides through the passages with comparative ease. Even with the hind feet first a similar conical form is presented, and the process is rendered easy and quick. Difficulty and danger arise mainly from the act being brought on prematurely before the passages are sufficiently dilated, from narrowing of the pelvic bones or other mechanical obstruction in the passages, from monstrous distortions or duplications in the fetus, or from the turning back of one of the members so that the elongated conical or wedge-shaped outline is done away with. Prompt as is the normal parturition in the mare, however, difficult and delayed parturitions are surrounded by special dangers and require unusual precautions and skill. From the proclivity of the mare to unhealthy inflammations of the peritoneum and other abdominal organs, penetrating wounds of the womb or vagina are liable to prove fatal. The contractions of the womb and abdominal walls are so powerful as to exhaust and benumb the arm of the assistant and to endanger penetrating wounds of the genital organs. By reason of the looser connection of the fetal membranes with the womb, as compared with those of ruminants, the violent throes early detach these membranes throughout their whole extent, and the foal, being thus separated from the mother and thrown on its own resources, dies at an early stage of any protracted parturition. The foal rarely survives four hours after the onset of parturient throes. From the great length of the limbs and neck of the foal it is extremely difficult to secure and bring up limb or head which has been turned back when it should have been presented. When assistance must be rendered, the operator should don a thick woolen undershirt with the sleeves cut out at the shoulders. This protects the body and leaves the whole arm free for manipulation. Before inserting the arm it should be smeared with lard. This protects the skin against septic infection and favors the introduction of the hand and arm. The hand should be inserted with the thumb and fingers drawn together like a cone. Whether standing or lying, the mare should be turned with head downhill and hind parts raised as much as possible. The contents of the abdomen gravitating forward leave much more room for manipulation. Whatever part of the foal is presented (head, foot) should be secured with a cord and running noose before it is pushed back to search for the other missing parts. Even if a missing part is reached, no attempt should be made to bring it up during a labor pain. Pinching the back will sometimes check the pains and allow the operator to secure and bring up the missing member. In intractable cases a large dose of chloral hydrate (1 ounce in a quart of water) or the inhalation of chloroform and air (equal proportions) to insensibility may secure a respite, during which the missing members may be replaced. If the waters have been discharged and the mucus dried up, the genital passages and body of the fetus should be lubricated with lard or oil before any attempt at extraction is made. When the missing member has been brought up into position and presentation has been rendered natural, traction on the fetus must be made only during a labor pain. If a mare is inclined to kick, it may be necessary to apply hobbles to protect the operator.

Difficult parturition from narrow pelvis.—A disproportion between the fetus got by a large stallion and the pelvis of a small dam is a serious obstacle to parturition, sometimes seen in the mare. This is not the rule, however, as the foal up to birth usually accommodates itself to the size of the dam, as illustrated in the successful crossing of Percheron stallions on mustang mares. If the disproportion is too great the only resort is embryotomy.

Fractured hip bones.—More commonly the obstruction comes from distortion and narrowing of the pelvis as the result of fractures. (Plate XIII, fig. 2.) Fractures at any point of the lateral wall or floor of the pelvis are repaired with the formation of an extensive bony deposit bulging into the passage of the pelvis. The displacement of the ends of the broken bone is another cause of constriction, and between the two conditions the passage of the fetus may be rendered impossible without embryotomy. Fracture of the sacrum (the continuation of the backbone forming the croup) leads to the depression of the posterior part of that bone in the roof of the pelvis and the narrowing of the passage from above downward by a bony ridge presenting its sharp edge forward.

In all cases in which there has been injury to the bones of the pelvis the obvious precaution is to withhold the mare from breeding and to use her for work only.

If a mare with a pelvis thus narrowed has got in foal inadvertently, abortion may be induced in the early months of gestation by slowly introducing the oiled finger through the neck of the womb and following this by the other fingers until the whole hand has been introduced. Then the water bags may be broken, and with the escape of the liquid the womb will contract on the solid fetus and labor pains will ensue. The fetus being small will pass easily.

Tumors in the vagina and pelvis.—Tumors of various kinds may form in the vagina or elsewhere within the pelvis, and when large enough will obstruct or prevent the passage of the fetus. Gray mares, which are so subject to black pigment tumors (melanosis) on the tail, anus, and vulva, are the most liable to suffer from this. Still more rarely the wall of the vagina becomes relaxed, and being pressed by a mass of intestines will protrude through the lips of the vulva as a hernial sac, containing a part of the bowels. If a tumor is small it may only retard and not absolutely prevent parturition. A hernial protrusion of the wall of the vagina may be pressed back and emptied, so that the body of the fetus engaging in the passage may find no further obstacle. When a tumor is too large to allow delivery the only resort is to remove it, but before proceeding it must be clearly made out that the obstruction is a mass of diseased tissue, and not a sac containing intestines. If the tumor hangs by a neck it can usually be most safely removed by the écraseur, the chain being passed around the pedicel and gradually tightened until that is torn through.

Hernia of the womb.—The rupture of the musculo-fibrous floor of the belly and the escape of the gravid womb into a sac formed by the peritoneum and skin hanging toward the ground is described by all veterinary obstetricians, yet it is very rarely seen in the mare. The form of the fetus can be felt through the walls of the sac, so that it is easy to recognize the condition. Its cause is usually external violence, though it may start from an umbilical hernia. When the period of parturition arrives, the first effort should be to return the fetus within the proper abdominal cavity, and this can sometimes be accomplished with the aid of a stout blanket gradually tightened around the belly. This failing, the mare may be placed on her side or back and gravitation brought to the aid of manipulation in effecting the return. Even after the hernia has been reduced the relaxed state of the womb and abdominal walls may serve to hinder parturition, in which case the oiled hand must be introduced through the vagina, the fetus brought into position, and traction coincident with the labor pains employed to produce delivery.

Twisting of the neck of the womb.—This condition is very uncommon in the mare, though occasionally seen in the cow, owing to the greater laxity of the broad ligaments of the womb in that animal. It consists in a revolution of the womb on its own axis, so that its right or left side will be turned upward (quarter revolution), or the lower surface may be turned upward and the upper surface downward (half revolution). The effect is to throw the narrow neck of the womb into a series of spiral folds, turning in the direction in which the womb has revolved, closing the neck and rendering distention and dilatation impossible.

The period and pains of parturition arrive, but in spite of continued efforts no progress is made, neither water bags nor liquids appearing. The oiled hand introduced into the closed neck of the womb will readily detect the spiral direction of the folds on its inner surface.

The method of relief which I have successfully adopted in the cow may be equally effective in the mare. The dam is placed (with her head uphill) on her right side if the upper folds of the spiral turn toward the right, and on her left side if they turn toward the left, and the oiled hand is introduced through the neck of the womb and a limb or other part of the body of the fetus is seized and pressed against the wall of the womb, while two or three assistants turn the animal over on her back toward the other side. The object is to keep the womb stationary while the animal is rolling. If success attends the effort, the constriction around the arm is suddenly relaxed, the spiral folds are effaced, and the water bags and fetus press forward into the passage. If the first attempt does not succeed, it may be repeated again and again until success crowns the effort. Among my occasional causes of failure have been the prior death and decomposition of the fetus, with the extrication of gas and overdistention of the womb, and the supervention of inflammation and inflammatory exudation around the neck of the womb, which hinders untwisting. The first of these conditions occurs early in the horse from the detachment of the fetal membranes from the wall of the womb; and as the mare is more subject to fatal peritonitis than the cow, it may be concluded that both these sources of failure are more probable in the former subject.

When the case is intractable, though the hand may be easily introduced, the instrument shown in Plate XIV, figure 7, may be used. Each hole at the small end of the instrument has passed through it a stout cord with a running noose, to be passed around two feet or other portion of the fetus which it may be possible to reach. The cords are then drawn tight and fixed around the handle of the instrument; then, by using the cross handle as a lever, the fetus and womb may be rotated in a direction opposite to that causing the obstruction. During this process the hand must be introduced to feel when the twist has been undone. This method may be supplemented, if necessary, by rolling the mare as described above.

Effusion of blood in the vaginal walls.—This is common as a result of difficult parturition, but it may occur from local injury before that act, and may seriously interfere with it. This condition is easily recognized by the soft, doughy swelling so characteristic of blood clots, and by the dark-red color of the mucous membrane. I have laid open such swellings with the knife as late as 10 days before parturition, evacuated the clots, and dressed the wound daily with an astringent lotion (sulphate of zinc 1 dram, carbolic acid 1 dram, water 1 quart). A similar resort might be had, if necessary, during parturition.

Calculus (stone) and tumor in the bladder.—The pressure upon the bladder containing a stone or a tumor may prove so painful that the mare will voluntarily suppress the labor pains. Examination of the bladder with the finger introduced through the urethra will detect the offending agent. A stone should be extracted with forceps. (See "Lithotomy.") The large papillary tumors which I have met with in the mare's bladder have been invariably delicate in texture and could be removed piecemeal by forceps. Fortunately, mares affected in this way rarely breed.

Fecal impaction of the rectum.—In some animals, with more or less paralysis or weakness of the tail and rectum, the rectum may become so impacted with solid feces that the mare is unable to discharge them, and the accumulation both by reason of the mechanical obstruction and the pain caused by pressure upon it will impel the animal to cut short all labor pains. The rounded swelling surrounding the anus will at once suggest the condition, when the obstruction may be removed by the well-oiled or well-soaped hand.

Spasm of the neck of the womb.—This occurs in the mare of specially excitable temperament, or under particular causes of irritation, local or general. Labor pains, though continuing for some time, produce no dilatation of the neck of the womb, which will be found firmly closed so as to admit but one or two fingers; this, although the projection at the mouth of the womb may have been entirely effaced, so that a simple round opening is left, with rigid margins.

The simplest treatment consists in smearing this part with solid extract of belladonna, and after an interval inserting the hand with fingers and thumb drawn into the form of a cone, rupturing the membranes and bringing the fetus into position for extraction, as advised under "Prolonged retention of the fetus." Another mode is to insert through the neck of the womb an ovoid rubber bag, empty, and furnished with an elastic tube 12 feet long. Carry the free end of this tube upward to a height of 8, 10, or 12 feet, insert a filler into it, and proceed to distend the bag with tepid or warm water.

Fibrous bands constricting or crossing the neck of the womb.—These, occurring as the result of disease, have been several times observed in the mare. They may exist in the cavity of the abdomen and compress and obstruct the neck of the womb, or they may extend from side to side of the vagina across and just behind the neck of the womb. In the latter position they may be felt and quickly remedied by cutting them across. In the abdomen they can be reached only by incision, and two alternatives are presented: (1) To perform embryotomy and extract the fetus piecemeal, and (2) to make an incision into the abdomen and extract by the Cæsarean operation, or simply to cut the constricting band and attempt delivery by the usual channel.

Fibrous constriction of vagina or vulva.—This is probably always the result of direct mechanical injury and the formation of rigid cicatrices which fail to dilate with the remainder of the passages at the approach of parturition. The presentation of the fetus in the natural way and the occurrence of successive and active labor pains without any favorable result will direct attention to the rigid and unyielding cicatrices which may be incised at one, two, or more points to a depth of half an inch or more, after which the natural expulsive efforts will usually prove effective. The resulting wounds may be washed frequently with a solution of 1 part of carbolic acid to 50 parts of water, or of 1 part of mercuric chlorid to 1,000 parts of water.

Fetus adherent to the walls of the womb.—In inflammation of the mucous membrane lining the cavity of the womb and implicating the fetal membranes the resulting embryonic tissue sometimes establishes a medium of direct continuity between the womb and fetal membranes; the blood vessels of the one communicate freely with those of the other and the fibers of the one are prolonged into the other. This causes retention of the membranes after birth, and a special risk of bleeding from the womb, and of septic poisoning. In exceptional cases the adhesion is more extensive and binds a portion of the body of the foal firmly to the womb. In such cases it has repeatedly been found impossible to extract the foal until such adhesions were broken down. If they can be reached with the hand and recognized, they may be torn through with the fingers or with a blunt hook, after which delivery may be attempted with hope of success.

Excessive size of fetus.—It would seem that a small mare may usually be safely bred to a large stallion, yet this is not always the case; and when the small size is an individual rather than a racial characteristic or the result of being very young, the rule can not be expected to hold. There is always great danger in breeding the young, small, and undeveloped female, and the dwarfed representative of a larger breed, as the offspring tend to partake of the large race characteristics and to show them even prior to birth. When impregnation has occurred in the very young or in the dwarfed female there are two alternatives—to induce abortion or to wait until there are attempts at parturition and to extract by embryotomy if impracticable otherwise.

Constriction of a member by the navel string.—In man and animals alike the winding of the umbilical cord around a member of the fetus sometimes leads to the amputation of the latter. It is also known to get wound around the neck or a limb at birth, but in the mare this does not seriously impede parturition, as the loosely attached membranes are easily separated from the womb and no strangulation or retarding occurs. The foal may, however, die from the cessation of the placental circulation unless it is speedily delivered.

Water in the head (hydrocephalus) of the foal.—This consists in the excessive accumulation of liquid in the ventricles of the brain so that the cranial cavity is enlarged and constitutes a great, projecting, rounded mass occupying the space from the eyes upward. (See Plate XIII, fig. 3.) With an anterior presentation (fore feet and nose) this presents an insuperable obstacle to progress, as the diseased cranium is too large to enter the pelvis at the same time with the fore arms. With a posterior presentation (hind feet) all goes well until the body and shoulders have passed out, when progress is suddenly arrested by the great bulk of the head. In the first case, the oiled hand introduced along the face detects the enormous size of the head, which may be diminished by puncturing it with a knife or trocar and cannula in the median line, evacuating the water and pressing in the thin, bony walls. With a posterior presentation, the same course must be followed; the hand passed along the neck will detect the cranial swelling, which may be punctured with a knife or trocar. Oftentimes with an anterior presentation the great size of the head leads to its displacement backward, and thus the fore limbs alone engage in the passages. Here the first object is to seek and bring up the missing head, and then puncture it as above suggested.

Ascites, or dropsy of the abdomen in the foal.—The accumulation of liquid in the abdominal cavity of the fetus is less frequent, but when present it may arrest parturition as completely as will hydrocephalus. With an anterior presentation the foal may pass as far as the shoulders, but behind this all efforts fail to effect a further advance. With a posterior presentation the hind legs as far as the thighs may be expelled, but at this point all progress ceases. In either case the oiled hand, passed inward by the side of the foal, will detect the enormous distension of the abdomen and its soft, fluctuating contents. The only course is to puncture the cavity and evacuate the liquid. With the anterior presentation this may be done with a long trocar and cannula, introduced through the chest and diaphragm, or with a knife an incision may be made between the first two ribs and the lungs and heart cut or torn out, when the diaphragm will be felt projecting strongly forward, and may be easily punctured. Should there not be room to introduce the hand through the chest, the oiled hand may be passed along beneath the breast bone and the abdomen punctured. With a posterior presentation the abdomen must be punctured in the same way, the hand, armed with a knife protected in its palm, being passed along the side of the flank or between the hind limbs. It should be added that moderate dropsy of the abdomen is not incompatible with natural delivery, the liquid being at first crowded back into the portion of the belly still engaged in the womb, and passing slowly from that into the advanced portion as soon as that has cleared the narrow passage of the pelvis and passed out where it can expand.

General dropsy of the fetus.—In this case the tissues generally are distended with liquid, and the skin is found at all points tense and rounded, and pitting on pressure with the fingers. In some such cases delivery may be effected after the skin has been punctured at narrow intervals to allow the escape of the fluid and then liberally smeared with fresh lard. More commonly, however, it can not be reached at all points to be so punctured nor sufficiently reduced to be extracted whole, and resort must be had to embryotomy.

Emphysema, or swelling of the fetus with gas.—This has been described as occurring in a living fetus, but I have met with it only in the dead and decomposing foal after futile efforts had been made for several days to effect delivery. These cases are very difficult, as the foal is inflated to such extent that it is impossible to advance it into the passages, and the skin of the fetus and the walls of the womb and vagina have become so dry that it is impracticable to cause the one to glide on the other. The hair comes off any part that may be seized, and the case is rendered the more offensive and dangerous by the very fetid liquids and gases. The only resort is embryotomy, by which I have succeeded in saving a valuable mare that had carried a colt in this condition for four days.

Contractions of muscles.—The foal is not always developed symmetrically, but certain groups of muscles are liable to remain short, or to shorten because of persistent spasmodic contraction, so that even the bones become distorted and twisted. This is most common in the neck. The bones of this part and even of the face are drawn to one side and shortened, the head being held firmly to the flank and the jaws being twisted to the right or left. In other cases the flexor muscles of the fore limbs are contracted so that the latter are strongly bent at the knee. In neither of these cases can the distorted part be extended and straightened, so that body or limbs must necessarily present double, and natural delivery is rendered impossible. The bent neck may sometimes be straightened after the muscles have been cut on the side to which it is turned, and the bent limbs after the tendons on the back of the shank bone have been cut across. Failing to accomplish this, the next resort is embryotomy.

Inclosed ovum, or tumors of the fetus.—Tumors or diseased growths may form on any part of the foal, internal or external, and by their size impede or hinder parturition. In some cases what appears as a tumor is an imprisoned and undeveloped ovum which has grafted itself on the fetus. These are usually sacculated, and may contain skin, hair, muscle, bone, and other natural tissues. The only course to be pursued in such cases is to excise the tumor, or, if this is not feasible, to perform embryotomy.

Monstrosities.—Monstrosity in the foal is an occasional cause of difficult parturition, especially such monsters as show excessive development of some part of the body, a displacement or distortion of parts, or a redundancy of parts, as in double monsters. Monsters may be divided into—

(1) Monsters with absence of parts—absence of head, limb, or other organ.

(2) Monsters with some part abnormally small—dwarfed head, limb, trunk, etc.

(3) Monsters through unnatural division of parts—cleft head, trunk, limbs, etc.

(4) Monsters through absence of natural divisions—absence of mouth, nose, eyes, anus, confluent digits, etc.

(5) Monsters through fusion of parts—one central eye, one nasal opening, etc.

(6) Monsters through abnormal position or form of parts—curved spine, face, limb, etc.

(7) Monsters through excess of formation—enormous head, supernumerary digits, etc.

(8) Monsters through imperfect differentiation of sexual organs—hermaphrodites.

(9) Double monsters—double-headed, double-bodied, extra limbs, etc.

Causes.—The causes of monstrosities appear to be very varied. Some monstrosities, like extra digits, absence of horns or tail, etc., run in families and are produced almost as certainly as color or form. Others are associated with too close breeding, the powers of symmetrical development being interfered with, just as in other cases a sexual incompatibility is developed, near relatives failing to breed with each other. Mere arrest of development of a part may arise from accidental disease of the embryo; hence vital organs are left out, or portions of organs, like the dividing walls of the heart, are omitted. Sometimes an older fetus is inclosed in the body of another, each having started independently from a separate ovum, but the one having become embedded in the semifluid mass of the other and having developed there simultaneously with it, but not so largely nor perfectly. In many cases of redundance of parts the extra part or member has manifestly developed from the same ovum and nutrient center with the normal member to which it remains adherent, just as a new tail will grow out in a newt when the former has been cut off. In the early embryo, with its great powers of development, this factor can operate to far greater purpose than in the adult animal. Its influence is seen in the fact pointed out by St. Hilaire that such redundant parts are nearly always connected with the corresponding portions in the normal fetus. Thus superfluous legs or digits are attached to the normal ones, double heads or tails are connected to a common neck or rump, and double bodies are attached to each other by corresponding points, navel to navel, breast to breast, back to back. All this suggests the development of extra parts from the same primary layer of the impregnated and developing ovum. The effect of disturbing conditions in giving such wrong directions to the developmental forces is well shown in the experiments of St. Hilaire and Valentine in varnishing, shaking, and otherwise breaking up the natural connections in eggs, and thereby determining the formation of monstrosities at will. So, in the mammal, blows and other injuries that detach the fetal membranes from the walls of the womb or that modify their circulation by inducing inflammation are at times followed by the development of a monster. The excitement, mental and physical, attendant on fright occasionally acts in a similar way, acting probably through the same channels.

The monstrous forms liable to interfere with parturition are such as, from contracted or twisted limbs or spine, must be presented double; where supernumerary limbs, head, or body must approach the passages with the natural ones; where a head or other member has attained to an unnatural size; where the body of one fetus has become inclosed in or attached to another, etc.

Extraction is sometimes possible by straightening the members and obtaining such a presentation as will reduce the presenting mass to its smallest and most wedgelike dimensions. To effect this it may be needful to cut the flexor tendons of bent limbs or the muscles on the side of a twisted neck or body; one or more of the manipulations necessary to secure and bring up a missing member may be required. In most cases of monstrosity by excess, however, it is needful to remove the superfluous parts, in which case the general principles employed for embryotomy must be followed. The Cæsarean section, by which the fetus is extracted through an incision in the walls of the abdomen and womb, is inadmissible, as it practically entails the sacrifice of the mare, which should never be done for the sake of a monster. (See "Embryotomy," p. 202.)

Entrance of twins into the passage at once.—Twins are rare in the mare, and still more rare is the impaction of both at once into the pelvis. The condition would be easily recognized by the fact that two fore limbs and two hind would occupy the passage at once, the front of the hoofs of the fore feet being turned upward and those of the hind feet downward. If both belonged to one foal, they would be turned in the same direction. Once recognized, the condition is easily remedied by passing a rope with a running noose round each foot of the foal that is furthest advanced or that promises to be most easily extracted, and to push the members of the other fetus back into the depth of the womb. As soon as the one fetus is fully engaged into the passage it will hold its place and its delivery will proceed in the natural way.

ABNORMAL PRESENTATIONS.

(Pls. XV-XVIII.)

Abnormal presentations may be tabulated as follows:

Fore limbs incompletely extended.—In cases of this kind, not only are the back tendons behind the knee and shank bone unduly short, but the sinew extending from the front of the shoulder blade over the front of the elbow and down to the head of the shank bone is also shortened. The result is that the fore limb is bent at the knee and the elbow is also rigidly bent. The condition obstructs parturition by the feet becoming pressed against the floor of the pelvis or by the elbow pressing on its anterior brim. Relief is to be obtained by forcible extension. A rope with a running noose is passed around each fetlock and a repeller (see Plate XIV) planted in the breast is pressed in a direction upward and backward while active traction is made on the ropes. If the feet are not thereby raised from the floor of the pelvis the palm of the hand may be placed beneath them to protect the mucous membrane until they have advanced sufficiently to obviate this danger. In the absence of a repeller, a smooth rounded fork handle may be employed. If the shortening is too great to allow of the extension of the limbs in this way, the tense tendons may be cut across behind the shank bone and in front of the elbow, and the limb will be easily straightened out. This is most easily done with an embryotomy knife furnished with a ring for the middle finger, so that the blade may be protected in the palm of the hand. (See Plate XIII, fig. 4.)

Fore limb crossed over back of neck.—With the long fore limbs of the foal this readily occurs, and the resulting increase in thickness, both at the head and shoulder, offers a serious obstacle to progress. (See Plate XV, fig. 2.) The hand introduced into the passage detects the head and one fore foot, and farther back on the same side of the head the second foot, from which the limb may be traced obliquely across the back of the neck.

If parturition continues to make progress the displaced foot may bruise and lacerate the vagina. By seizing the limb above the fetlock it may be easily pushed over the head to the proper side, when parturition will proceed normally.

Fore limb bent at knee.—The nose and one fore foot present, and on examination the knee of the missing fore limb is found farther back. (Plate XV, fig. 1.) First place a noose each on the presenting pastern and lower jaw, and push back the body of the fetus with a repeller, while the operator seizing the shank of the bent limb extends it so as to press back the knee and bring forward the fetlock and foot. As progress is made little by little the hand is slid down from the region of the knee to the fetlock, and finally that is secured and brought up into the passage, when parturition will proceed without hindrance. If both fore limbs are bent back the head must be noosed and the limbs brought up as above, one after the other. It is usually best to employ the left hand for the right fore limb, and the right hand for the left fore limb.

Fore limb turned back from shoulders.—In this case, on exploration by the side of the head and presenting limb, the shoulder only can be reached at first. (Plate XV, fig 4.) By noosing the head and presenting fore limb, they may be drawn forward into the pelvis, and the oiled hand being carried along the shoulder in the direction of the missing limb is enabled to reach and seize the forearm just below the elbow. The body is now pushed back by the assistants pressing on the head and presenting limb or on a repeller planted in the breast until the knee can be brought up into the pelvis, after which the procedure is the same as described in the last paragraph.

Head bent down between fore limbs.—This may be so that the poll or nape of the neck, with the ears, can be felt far back between the fore limbs, or so that only the upper border of the neck can be reached, head and neck being bent back beneath the body. With the head only bent on the neck, noose the two presenting limbs, then introduce the hand between them until the nose can be seized in the palm of the hand. Next have the assistants push back the presenting limbs, while the nose is strongly lifted upward over the brim of the pelvis. This accomplished, it assumes the natural position and parturition is easy.

When both head and neck are bent downward it may be impossible to reach the nose. If, however, the labor has only commenced, the limbs may be drawn upon until the operator can reach the ear, by dragging on which the head may be so far advanced that the fingers may reach the orbit; traction upon this while the limbs are being pushed back may bring the head up so that it bends on the neck only, and the further procedure will be as described in the last paragraph.

If the labor has been long in progress and the fetus is jammed into the pelvis, the womb emptied of the waters, and firmly contracted on its solid contents, the case is incomparably more difficult. The mare may be chloroformed and turned on her back with hind parts elevated, and the womb may be injected with sweet oil. Then, if the ear can be reached, the correction of the malpresentation may be attempted as above described. Should this fail, one or more sharp hooks may be inserted in the neck as near the head as can be reached, and ropes attached to these may be dragged on, while the body of the foal is pushed back by the fore limbs or by a repeller. Such repulsion should be made in a direction obliquely upward toward the loins of the mother, so as to rotate the fetus in such a way as to bring the head up. As this is accomplished a hold should be secured nearer and nearer to the nose, with hand or hook, until the head can be straightened out on the neck.

All means failing; it becomes necessary to remove the fore limbs (embryotomy) so as to make more space for bringing up the head. If, even then, this can not be accomplished, it may be possible to push the body backward and upward with the repeller until the hind limbs are brought to the passage, when they may be noosed and delivery effected with the posterior presentation.

Head turned on shoulders.—In this case the fore feet present, and the oiled hand passed along the fore arms in search of the missing head finds the side of the neck turned to one side, the head being perhaps entirely out of reach. (Plate XVIII, fig. 1.) To bring the head forward it may be desirable to lay the mare on the side opposite to that to which the head is turned, and even to give chloroform or ether. Then the feet being noosed, the body of the fetus is pushed by the hand or repeller forward and to the side opposite to that occupied by the head until the head comes within reach, near the entrance of the pelvis. If such displacement of the fetus is difficult, it may be facilitated by a free use of oil or lard. When the nose can be seized it can be brought into the passage, as when the head is turned down. If it can not be reached, the orbit may be availed of to draw the head forward until the nose can be seized or the lower jaw noosed. In very difficult cases a rope may be passed around the neck by the hand or with the aid of a curved carrier (Plate XIV), and traction may be made upon this while the body is being rotated to the other side. In the same way in bad cases a hook may be fixed in the orbit or even between the bones of the lower jaw to assist in bringing the head up into position. Should all fail, the amputation of the fore limbs may be resorted to, as advised under the last heading.

Head turned upward on back.—This differs from the last malpresentation only in the direction of the head, which has to be sought above rather than at one side, and is to be secured and brought forward in a similar manner. (Plate XVIII, fig. 2.) If a rope can be passed around the neck it will prove most effectual, as it naturally slides nearer to the head as the neck is straightened and ends by bringing the head within easy reach.

Hind feet engaged in pelvis.—In this case fore limbs and head present naturally, but the hind limbs bent forward from the hip and the loins arched allow the hind feet also to enter the passages, and the further labor advances the more firmly does the body of the foal become wedged into the pelvis (Plate XVII, fig. 2.) The condition is to be recognized by introducing the oiled hand along the belly of the fetus, when the hind feet will be felt advancing. An attempt should at once be made to push them back, one after the other, over the brim of the pelvis. Failing in this, the mare may be turned on her back, head downhill, and the attempt renewed. If it is possible to introduce a straight rope carrier, a noose passed through this may be put on the fetlock and the repulsion thereby made more effective. In case of continued failure the anterior presenting part of the body may be skinned and cut off as far back toward the pelvis as possible (see "Embryotomy"); then nooses are placed on the hind fetlocks and traction is made upon these while the quarters are pushed back into the womb. Then the remaining portion is brought away by the posterior presentation.

Anterior presentation with back turned to one side.—The diameter of the axis of the foal, like that of the pelvic passages, is from above downward, and when the fetus enters the pelvis with this greatest diameter engaged transversely or in the narrow diameter of the pelvis, parturition is rendered difficult or impossible. In such a case the pasterns and head may be noosed, and the passages and engaged portion of the foal freely lubricated with lard, the limbs may be crossed over each other and the head, and a movement of rotation effected in the fetus until its face and back are turned up toward the croup of the mother; then parturition becomes natural.

Back of foal turned to floor of pelvis.—In a roomy mare this is not an insuperable obstacle to parturition, yet it may seriously impede it, by reason of the curvature of the body of the foal being opposite to that of the passages, and the head and withers being liable to arrest against the border of the pelvis. Lubrication of the passage with lard and traction of the limbs and head will usually suffice with or without the turning of the mare on her back.

In obstinate cases two other resorts are open: First, to turn the foal, pushing back the fore parts and bringing up the hind so as to make a posterior presentation, and, second, the amputation of the fore limbs, after which extraction will usually be easy.