DYSIORIA DEPENDING ON THE ANTERIOR PRESENTATION 819

Donation Upward and

The deviation of the head more or less upward and back-
ward — the inferior borders of the lower jaw being vertical or
turned towards the maternal sacrum — is an extremely rare
condition, and is chiefly met with in the mare, in which it
has led to rupture of the uterus and rectum, and delivery by
the latter.

The cause Is probably the same as in other deviations of
the region.

On exploration, if the f tutus is in the dorso- sacral region,

FIG. 104.—ANTERIOR PRESENTATION, DORSO-SACEAL POSITION : DEVIATION
OF THE HEAD UFWAKDS AND BACKWARDS. (SAINT-CYK.)
the fore-limbs may be found more or less advanced in the
vagina, and beyond them, at the inlet, the hand meets the
sternum; while above it is the front part of the neck, with
the trachea leading upwards to the head, which may be bent
more or less back on the withers or loins, or inclined to one
side of the foetus, the lower jaw always facing the iumbo-
sacral region of the mother, or twisted slightly round.
Indications.—First retropulsion should be practised on the
sternum of the foetus, and this alone will often bring the head