94 OBSTETRICS. 



the handle till it comes in contact with and crosses the blade first 

 introduced ; the two are then to be locked, and the adjustment is 

 completed. Care should be taken that nothing be entangled in the 

 lock of the forceps, by carrying the finger round it. 



Should the handles of the forceps, when applied, come close to- 

 gether, probably the bulk of the head is not included between them, 

 and therefore, when we acted with them, they would slip. 



If the handles, when locked, are at a great distance from each 

 other, they are not accurately applied, and will probably slip. 

 Allowance should be made, however, in these estimates, for the 

 different dimensions of the heads of children. When the instru- 

 ments are thus adjusted, a slight compression, and traction should be 

 made in order to be sure the soft parts of the mother are not in- 

 cluded in the grasp, (which is known by her complaints,) and also 

 to bring the instrument to its proper adjustment on the child's head. 



As soon as a pain comes on begin the extraction by slowly moving 

 the forceps from handle to handle, thus causing them to act as double 

 levers, exerting at the same time sufficient extractive force to prevent 

 the opposite blade from slipping deeper into the organs, while the 

 handles are moved to the right, or to the left. 



Great care should be taken to support the perineum as the vertex 

 emerges, and at the same time to carry the handles of the forceps 

 upwards, towards the abdomcQ of the mother, causing the head to 

 execute the same movements, as though it were expelled by the na- 

 tural pains. 



The woman should be allowed intervals of rest between the ex- 

 tractive efforts, precisely as in a natural labour, unless there be some 

 pressing exigency for her rapid delivery; at the same time the hold 

 upon the forceps should be relaxed, so as to remove the pressure 

 from the head. 



When the head is born, the forceps should be removed, and the 

 labour completed by the natural powers of the woman. 



In the operation just described, that is, after rotation has taken 

 place, when the forceps are adjusted, the lock looks upwards, and the 

 concavity of the new curve is directed towards the symphysis pubis, 

 while the convexity coincides with the hollow of the sacrum. In 

 every application of this instrument, the general rule is that the con- 

 cave edges should look towards the pubes, and the convex towards 

 the hollow of the sacrum. 



In the first 'position^ before the rotation has taken place^ the same 

 general rules are to be observed in the introduction. When the 

 blades are locked they are inclined towards the left thigh, and the 

 lock looks upwards and to the left. The same rule of traction is to 

 be observed as before ; the rotation will take place as the head ad- 

 vances. 



In the second position the adjustment is not so easy, because aftet 



