472 USE OF THE FORCEPS. 



supposing we could ascertain it, it would not on that account be ne- 

 cessary to change the mode of application of the instrument, inas- 

 much as, in the diagonal positions, the mere power exerted in fixing 

 and uniting the blades brings the forehead in front of the sacrum or 

 behind the pubis; that completely transverse positions are exceed- 

 ingly rare, and would render the application of the forceps, too diffi- 

 cult, if the design of embracing the parietal protuberances were ob- 

 stinately persisted in; lastly, that by conforming to their doctrine the 

 operation is always extremely simple, and that the head almost al- 

 ways ends by placing itself, if it were not so already, in an antero- 

 posterior position; so that, after all, the same result is obtained, only, 

 by conforming to the principles generally adopted among us. 



1062. Without denying that there may be somewhat of truth in 

 this view of the subject, which, it seems to me, has not been suffi- 

 ciently attended to by the French, it may, nevertheless, be objected, 

 that as a general proposition, it will always be better to pass the 

 blades of the forceps immediately upon the temporo-parietal regions 

 of the head, than always to introduce them along the sides of the 

 pelvic cavity; that if it is rare to find the head situated directly across 

 the pelvis, it is at least common to find it turned towards one of the 

 acetabula, or sacro-iliac symphyses; that it is not only good, under 

 such circumstances, to have the forceps turned somewhat to the right 

 or left; but also, that it most commonly assumes that direction spon- 

 taneously; and, so to speak, in spite of the operator, provided the 

 head be pretty firmly fixed in the passage. Let us observe, further, 

 that by grasping the two ends of the occipito-frontal diameter, the 

 head is prevented from flexing; it is forced to descend transversely, 

 to present one of its longest diameters to the different passages, and 

 that if taken hold of in this situation, it cannot pass through the infe- 

 rior strait. 



1063. To conclude, inasmuch as the occipito-bregmatic and oc- 

 cipito-frontal diameters always turn more or less directly from front 

 to rear when they reach the excavation; as in cases where the head 

 has not yet cleared the superior strait, the occiput or forehead al- 

 most always looks towards one of the cotyloid cavities; as the clams 

 of the forceps, after their introduction, naturally incline towards 

 the sides of the head, or when it opposes but little resistance to the 

 force exerted upon it, cause it to turn on its vertical axis, it may 

 be said that the difference between our practice and that of the 

 Germans is greater in appearance than in reality, and that, in fact, 

 it does not appear that it can ever be indispensably 'hecessary to 

 place one of the branches of the instrument in front and the other 

 behind. 



