will turn in the same manner as in a natural labor. Therefore the 
instrament must also change its position according to the de cent, 
and the handles be gradually turned from the front bone and 5 red 
bone, where they .were first applied, to the sides of the pelvis; the. 
handles will also.be raised, as the child advances towards the front 
bone. ae 
_ The first action with the forceps must be to bring the handles, 
firmly grasped in one or both hands, slowly towards the pubes, till 
they come to a full-rest. After waiting till the pains return, or an 
imaginary interval if there should be a total want of pain, the han- 
dles are to be carried back again to the perineum, or fork, in the 
same cautious manner, using at the same time a certain degree of 
extracting force. The subsequent actions must be from handle to_ 
handle, or occasionally by simple attraction ; but that-action of the 
blade which was towards the pubes must be stronger and more ex- 
tensive throughout the operation, than the action of the other blade, 
which has no fulcrum to support it. 
By the repetition of these actions, always directed according to 
the position of the handles, withtheir force increased, diminished, or 
continued, according to the exigence of the case, we shall in a short 
time perceive the head of the child descending: when this is the 
case, the force of the action with the forceps must. be abated, and as 
that advances, the direction of the handles must change.Py- degrees, 
more and more to each side, and towards the pubes. e lower the 
head of the child descends, the more gently we must proceed, in 
order to prevent any injury or laceration of the fork, or external 
parts, which must be supported.as in natural labors. eee 
_ dn some cases, the mere excitement occasioned by the application 
of the forceps, or the very expectation of their being applied, will 
bring on a yeturn or an increase of the pains sufficient to expel the 
child without their assistance. In other-cases we are obliged to 
exert considerable force, and to continue it fur a long time ; so that 
one operation may be safely and easily. finished in twenty minutes, 
or even a less time, and another may require more than an hour for 
its completion, and the repeated. exertion of very considerable force, 
In some cases it happens also, that. the obstacles to the delivery 
exist at one particular part of the pelvis, and when_that issurmount- ~~ 
ed; the remainder of the operation will be easy ; but in other cases 
there is some difliculty through the whole course of the pelvis. 
Before the exertion of much force, we are always to be convinced +» 
that a moderate degree of force is not equal to our purpose. In every 
case 1n which the forceps have heen applied, they are not to be 
moved boiore the head is extracted, even though we might have little - 
or no occasion for them ; but when the head of the child is born, 
they are to be removed, and the remaining Circumstances managed- 
as if the labor had been natural. 
Note.—It would be very desirable that every student should haye — 
an opportunity of seeing the operation with the forceps performed — 
before he goes into practice; but that is not always possible. 
en properly instructed in the principles of the 
— 
and use @ e forceps, reflects seriously before he de 
sie: Bo iyi 
