THE FORCEPS. 93 



Method of Application. — Having determined to apply the forceps, 

 the same general rules should be observed as in turning, viz. : eva- 

 cuate the bladder and rectum ; draw the patient to the edge, or side 

 of the bed, having previously protected it from injury, and place her 

 either on her back with the feet supported, or as the English prac- 

 titioners prefer, on her left side. The necessity and nature of the 

 operation should always be explained to the patient or her friends, 

 before proceeding to its performance. 



The instruments should always be warmed and well anointed be- 

 fore using them, and some mild unguent should also be applied to 

 the external organs, and the patient protected from exposure, by a 

 sheet or blanket thrown over her. The great importance of a precise 

 knowledge of the 2^ositio?i of the head should be impressed upon the 

 mind of the practitioner, before commencing this operation. 



Which blade must he introduced first ? — In this country and on 

 the continent, where the long curved forceps are used, very explicit 

 directions are laid down for the choice of the blade. In England, 

 where the short straight forceps are employed, it seems to be a mat- 

 ter of indifference which is applied first, the general directions being 

 to apply that blade first, the lock of which looks forwards. The fol- 

 lowing directions, therefore, apply to the use of the long curved 

 forceps. Let the student remember, in the first place, that the forceps 

 are to be applied perpendicularly to the transverse, parallel with the 

 occipito-mental diameter of the child's head. As a general rule, the 

 left hand, or male blade., should always be introduced ^rs^. 



Occipito-anterior position, where the vertex presents and rotation 

 has taken place. The left hand, or male blade, is to be taken in the 

 lef\ hand as a writing pen is held, two or three fingers of the right 

 hand are to be introduced between the left side of the vagina and 

 the child's head, so that their extremities may touch the os uteri ; the 

 handle of the instrument is first raised up high in front of the 

 woman's right groin, so as to bring the other extremity in the line 

 of the axis of the vulva, into which it is next gently and slowly in- 

 troduced in the interval between the pains ; in proportion as it enters, 

 the handle is by degrees brought from above downwards, and from 

 right to left, towards the median line. The point of the instrument 

 must be kept carefully in contact with the child's head, and no force 

 used in the introduction. It is thus moved onwards, making it follow 

 the left posterior inclined plane, gradually deprcssing the handle 

 until the instrument has been placed by the side of the child's head 

 in the direction of the occipito-mental diameter. The handle is then 

 to be given in charge of an assistant, and the right hand, ot female 

 blade, to be taken in the right hand in the same manner as before, 

 while the fingers of the left are to be introduced between the right 

 side of the vagina and the child's head. Upon these, as the guide, 

 the blade is to be introduced as before described, gradually depressing 



