With a well-formed cow and calf and a natural presentation as above, calving is usually prompt and easy. Obstacles may, however, come from failure of the mouth of the womb to dilate; from twisting of the neck of the womb; from tumors in the v.a.g.i.n.a; from dropsy in the womb or abdomen; from overdistention of the r.e.c.t.u.m or bladder; from undue narrowing of the pa.s.sages; from excess of fat in the walls of the pelvis; from the disturbance of a nervous cow by noises; from stone or urine in the bladder; from wrong presentation of the calf, its back being turned downward or to one side in place of upward toward the spine of the dam; from the bending backward of one or more limbs or of the head into the body of the womb; from presentation of the back, shoulder, or croup, all four limbs being turned back; from presentation of all four feet at once; from obstruction caused by an extra head or extra limbs, or double body on the part of the offspring (Pl. XIX); from dropsy or other disease of the calf; from excessive or imperfect development of the calf; from the impaction of twins into the pa.s.sages at the same time; or at times it may be from the mere excessive volume of the fetus.
GENERAL MAXIMS FOR THE a.s.sISTANT CONCERNING DIFFICULT PARTURITION.
Do not interfere too soon. "Meddlesome midwifery is bad" with animals as with women. After labor pains set in, give a reasonable time for the water bags to protrude and burst spontaneously, and only interfere when delay suggests some mechanical obstruction. If there is no mechanical obstruction, let the calf be expelled slowly by the unaided efforts of the cow. Bruises and lacerations of the pa.s.sages and flooding from the uncontracted womb may come from the too speedy extraction of the calf. When a.s.sistance is necessary, the operator should dress in a thick flannel shirt from which the sleeves have been cut off clear to the shoulders. This avoids danger of exposure and yet leaves the whole arm free and untrammeled. Before inserting the hand it and the arm should be smeared with oil, lard, or vaseline, care being taken that the oil or lard is fresh, neither salted nor rancid, and that it has been purified by boiling or rendered antiseptic by the addition of a teaspoonful of carbolic acid to the pound. This is a valuable precaution against infecting the cow by introducing putrid ferments into the pa.s.sages and against poisoning of the arm by decomposing discharges in case the calving is unduly protracted.
When labor pains have lasted some time without any signs of the water bags, the dropping in at the sides of the rump, and the other preparations for calving being accomplished, the hand should be introduced to examine. When the water bags have burst and neither feet nor head appear for some time, examination should be made. When one fore foot only and the head appear, or both fore feet without the head, or the head without the fore feet, examine. If one hind foot appears without the other, make examination. The presenting limb or head should be secured by a rope with a running noose, so that it may not pa.s.s back into the womb and get lost during the subsequent manipulations, but may be retained in the v.a.g.i.n.a or brought up again easily. In searching for a missing member it is usually better to turn the head of the cow downhill, so that the gravitation of the fetus and abdominal organs forward into the belly of the cow may give more room in which to bring up the missing limb or head. If the cow is lying down, turn her on the side opposite to that on which the limb is missing, so that there may be more room for bringing the latter up. Even if a missing limb is reached, it is vain to attempt to bring it up during a labor pain. Wait until the pain has ceased and attempt to straighten out the limb before the next pain comes on. If the pains are violent and continuous, they may be checked by pinching the back or by putting a tight surcingle around the body in front of the udder. These failing, 1 ounce or 1-1/2 ounces of chloral hydrate in a quart of water may be given to check the pains. If the pa.s.sages have dried up or lost their natural, lubricating liquid, smear the interior of the pa.s.sages and womb and the surface of the calf, so far as it can be reached, with pure fresh lard; or pure sweet oil may be run into the womb through a rubber tube (fountain syringe). In dragging upon the fetus apply strong traction only while the mother is straining, and drag downward toward the hocks as well as backward. The natural curvature of both fetus and pa.s.sages is thus followed and the extraction rendered easier.
LABOR PAINS BEFORE RELAXATION OF THE Pa.s.sAGES.
Any of the various causes of abortion may bring on labor pains before the time. Straining comes on days or weeks before the time, and there is not the usual enlargement, swelling, and mucous discharge from the v.u.l.v.a. There is little or no falling in by the sides of the root of the tail; the abdomen has not dropped to the usual extent, and the udder is less developed and yields little or no milk. In spite of the pains no water bags appear, and the oiled hand cautiously introduced into the v.a.g.i.n.a finds the neck of the womb firmly closed, rigid, and undilatable. If it is known that the cow has not reached her proper time of calving, the examination through the v.a.g.i.n.a should be omitted and the animal should be placed in a dark, quiet place by herself, and be given 1 to 2 ounces laudanum. _Viburnum prunifolium_ (black haw), 1 ounce, may be added, if necessary, and repeated in three hours. The pains will usually subside.
In some instances the external parts are relaxed and duly prepared, but the neck of the womb remains rigidly closed. In such case the solid extract of belladonna should be smeared around the constricted opening and the animal left quiet until it relaxes.
DISEASED INDURATION OF THE MOUTH OF THE WOMB.
From previous lacerations or other injuries the neck of the womb may have become the seat of fibrous hardening and constriction, so as to prevent its dilatation, when all other parts are fully prepared for calving. The enlarged, flabby v.u.l.v.a, the sinking at each side of the rump, the full udder, and drooping abdomen indicate the proper time for calving, but the labor pains effect no progress in the dilatation of the mouth of the womb, and the oiled hand introduced detects the rigid, hard, and, in some cases, nodular feeling of the margins of the closed orifice which no application of belladonna or other antispasmodic suffices to relax. Sponge tents may be inserted or the mechanical dilator (Pl. XX, fig. 6) may be used if there is opening enough to admit it, and if not, a narrow-bladed, probe-pointed knife (Pl. XXIV, fig. 2) may be pa.s.sed through the orifice and turned upward, downward, and to each side, cutting to a depth not exceeding a quarter of an inch in each case. This done, a finger may be inserted, then two, three, and four, and finally all four fingers and thumb brought together in the form of a cone and made to push in with rotary motion until the whole hand can be introduced. After this the labor pains will induce further dilation, and finally the presenting members of the calf will complete the process.
TWISTING OF THE NECK OF THE WOMB.
This is not very uncommon in the cow, the length of the body of the womb and the looseness of the broad ligaments that attach it to the walls of the pelvis favoring the twisting. It is as if one were to take a long sack rather loosely filled at the neck and turn over its closed end, so that its twisting should occur in the neck. The twist may be one-quarter round, so that the upper surface would come to look to one side, or it may be half round, so that what was the upper surface becomes the lower. The relation of the womb of the cow to the upper and right side of the paunch favors the twisting. The paunch occupies the whole left side of the abdomen and extends across its floor to the right side. Its upper surface thus forms an inclined plane, sloping from the left downward and to the right, and on this sloping surface lies the pregnant womb.
It is easy to see how, in the constant movements of the paunch upon its contents and the frequent changes of position of the growing fetus within the womb, to say nothing of the contractions of the adjacent bowels and the more or less active movements of the cow, the womb should roll downward to the right. Yet in many cases the twist is toward the left, showing that it is not the result of a simple rolling downward over the paunch, but rather of other disturbances. The condition may be suspected when labor pains have continued for some time without any sign of the water bags, and it is confirmed when the oiled hand, introduced through the v.a.g.i.n.a, finds the mouth of the womb soft and yielding, but furnished with internal folds running forward in a spiral manner. If the folds on the upper wall of the orifice run toward the right, the womb is twisted to the right; if, on the contrary, they turn toward the left, it indicates that the womb is turned over in that direction. The direction of the twist must be known before treatment can be undertaken. Then, if the twist is toward the right, the cow is laid upon her right side with her head downhill, the hand of the operator is introduced through the spirally constricted neck of the womb, and a limb or other portion of the body of the calf is seized and pressed firmly against the wall of the womb. Meanwhile two or three a.s.sistants roll the cow from her right side over on her back to her left side. The object is to hold the womb and calf still while the body of the cow rolls over. If successful, the twist is undone, its grasp on the wrist is slackened, and the water bags and calf press into the now open pa.s.sage. If the first attempt does not succeed, it is to be repeated until success has been attained. If the spiral folds on the upper wall of the opening turn toward the left, the cow is laid on her left side and rolled over on her back and on to the right side, the hand being, as before, within the womb and holding the fetus, so that all may not rotate with the cow. In introducing the hand it will usually be found needful to perforate the membranes, so that a limb of the calf may be seized direct and firmly held. Among my occasional causes of failure with these cases have been, first, the previous death and decomposition of the fetus, leading to such overdistention of the womb that it could not be made to rotate within the abdomen, and, second, the occurrence of inflammation and an exudate on the twisted neck of the womb, which hindered it from untwisting.
In obstinate cases, in which the hand can be made to pa.s.s through the neck of the womb easily, additional help may be had from the use of the instrument shown in Plate XX, figure 5. Two cords, with running nooses, are successively introduced and made fast on two limbs of the calf; the cords are then pa.s.sed through the two rings on the end of the instrument, which is pa.s.sed into the womb and the cords drawn tight and fixed round the handle. Then, using the handle as a lever, it is turned in the direction opposite to the twist. The hand should meanwhile be introduced into the womb and the snared limbs seized and pressed against its walls so as to secure the rotation of the uterus along with the body of the fetus. The relaxation of the constriction and the effacement of the spiral folds will show when success has been gained, and the different members at one end of the body should then be brought up so as to secure a natural presentation.
NARROW PELVIS FROM FRACTURE OR DISEASE.
In a small cow the pelvis may be too narrow to pa.s.s a calf sired by a bull of a large breed, but this is exceptional, as the fetus usually accommodates itself to the size of the dam and makes its extra growth after birth. When the pelvic bones have been fractured repair takes place with the formation of a large permanent callus, which, projecting internally, may be a serious obstacle to calving. Worse still, if the edge of the broken bone projects internally as a sharp spike or ridge, the v.a.g.i.n.al walls are cut upon it during the pa.s.sage of the calf, with serious or fatal result. In other cases, where the cow has suffered from fragility of bone (fragilitas ossium) the thickening of the bone causes narrowing of the long pa.s.sage of the pelvis and the crumbling fractures poorly repaired, with an excess of brittle new material, may form an insuperable obstacle to parturition. Cows affected in any of these ways should never again be bred, but if they do get pregnant and reach full time a careful examination will be necessary to determine whether natural parturition can take place or if the calf must be extracted in pieces. (See "Embryotomy," p. 202.)
OBSTRUCTION BY Ma.s.sES OF FAT.
This is not unknown in old cows of the beef breeds, the enormous ma.s.ses of fat upon and within the pelvis being a.s.sociated with weakness or fatty degeneration of the muscles. If the presentation is natural, little more is wanted than a judicious traction upon the fetus to compress and overcome the soft resisting ma.s.ses.
OBSTRUCTION BY A FULL BLADDER OR r.e.c.t.u.m OR BY STONE.
In all cases of delayed or tardy parturition the evacuation of r.e.c.t.u.m and bladder is important, and it is no less so in all difficult parturitions.
Stone in the bladder is fortunately rare in the cow, but when present it should be removed to obviate crushing and perhaps perforation of the organ during calving.
CALVING r.e.t.a.r.dED BY NERVOUSNESS.
In a public fair ground I have seen labor pains begin early in the day and keep up in a weak and insufficient manner for many hours, until the stall was thoroughly closed in and the cow secluded from the constant stream of visitors and the incessant noise, when at once the pains became strong and effective and the calf was soon born.
COAGULATED BLOOD UNDER THE v.a.g.i.n.aL WALLS.
This is common after calving, but sometimes occurs before, as the result of accidental injury. The ma.s.s may be recognized by its dark hue and the doughy sensation to the touch. It may be cut into and the ma.s.s 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 r.e.t.a.r.d 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 antic.i.p.ate 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 acc.u.mulation 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 pa.s.sages will feel the nose presenting between the fore limbs, and on pa.s.sing the hand back over the face the hard rounded ma.s.s 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 ma.s.s 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 pa.s.sed 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 pa.s.sed 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 pa.s.sage, 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 s.p.a.ce 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 pa.s.sed 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 pa.s.sages. With a posterior presentation the abdomen may be punctured more easily either in the flank or with a trocar and cannula through the a.n.u.s.
GENERAL DROPSY OF THE CALF.
This occurs from watery blood or disease of some internal organ, like the liver or kidney, and is recognized by the general puffed-up and rounded condition of the body, which pits everywhere on pressure but without crackling. If not too extreme a case, the calf may be extracted after it has been very generally punctured over the body, but usually the only resort is to extract it in pieces. (See "Embryotomy," p. 202.)
SWELLING OF THE CALF WITH GAS.
This is usually the result of the death and decomposition of the fetus when extraction has been delayed for a day or more after the escape of the waters. It is impossible to extract it whole, owing to its large size and the dry state of the skin of the calf, the membranes, and the wall of the womb. These dry surfaces stick with such tenacity that no attempt at traction leads to any advance of the calf out of the womb or into the pa.s.sages. When the fetus is advanced the adherent womb advances with it, and when the strain is relaxed both recede to where they were at first. The condition may be helped somewhat by the free injection of oil into the womb, but it remains impossible to extract the enormously bloated body, and the only resort is to cut it in pieces and extract it by degrees. (See "Embryotomy," p. 202.)
RIGID CONTRACTIONS OF MUSCLES.
In the development of the calf, as in after life, the muscles are subject to cramps, and in certain cases given groups of muscles remain unnaturally short, so that even the bones grow in a twisted and distorted way. In one case the head and neck are drawn round to one side and can not be straightened out, even the bones of the face and the nose being curved around to that side. In other cases the flexor muscles of the fore legs are so shortened that the knees are kept constantly bent and can not be extended by force. The bent neck may sometimes be sufficiently straightened for extraction by cutting across the muscles on the side to which it is turned, and the bent knees by cutting the cords on the back of the shank bones just below the knees. If this fails, there remains the resort of cutting off the distorted limbs or head. (See "Embryotomy," p. 202.)
TUMORS OF THE CALF (INCLOSED OVUM).
Tumors or new growths grow on the unborn calf as on the mature animal, and by increasing the diameter of the body render its progress through the pa.s.sage of the pelvis impossible. In my experience with large, fleshy tumors of the abdomen, I have cut open the chest, removed the lungs and heart, cut through the diaphragm with the knife, and removed the tumor piecemeal by alternate tearing and cutting until the volume of the body was sufficiently reduced to pa.s.s through. Where this failed it would remain to cut off the anterior part of the body, removing as much of the chest as possible, and cutting freely through the diaphragm; then, pushing back the remainder of the body, the hind limbs may be seized and brought into the pa.s.sages and the residue thus extracted. The tumor, unless very large, will get displaced backward so as not to prove an insuperable obstacle.
In many cases the apparent tumor is a blighted ovum which has failed to develop, but has grafted itself on its more fortunate twin and from it has drawn its nourishment. These are usually sacs containing hair, skin, muscle, bone, or other natural tissues, and only exceptionally do they show the distinct outline of the animal.