The head may also be displaced laterally, i.e. thrown back on to the right or left side of the neck or body. Here again the degree of displacement will vary in different cases. Sometimes the head is merely flexed on the neck, while in others the neck is bent backward and may carry the head as far as the flank (fig. 556). The long neck of the foal tends to render these presentations difficult and sometimes impossible to rectify. On the mode of procedure in these cases the late Dr. Fleming observes: "The principal aim is, of course, to get hold of the head, adjust it, bring it into a favourable position in the genital canal, and then terminate delivery. With regard to adjustment the better plan appears to be as follows: - Cord the presenting fore-feet, push the foetus into the uterus so as to clear it from the pelvic inlet, pushing either on the flexed neck or chest, and not directly backward, but rather obliquely to the side opposite that to which the head inclines, so as to bring this round to the inlet. If the fore-limbs are in the way of the operator they may also be pushed back into the uterus." The head should then be sought for and brought into position.
Fig. 556. - Legs and Breast presented.
Here the ears are the most accessible parts to which force may be applied; then, if necessary, blunt hooks may be inserted into the orbits, or into the angles of the mouth, and the head drawn forwards by means of cords, while the body is being pushed backwards with a crutch or repeller. When the head has been brought into line with the body, delivery is then effected in the usual way. Besides this faulty position the head may also be thrown upwards and backwards while the fore-limbs are presented in the passage. As we have already pointed out, these are always most difficult tasks, and require a large practical experience, skill, and judgment to ensure success. They are not such as to be undertaken by the amateur if professional assistance can be procured.