474 use OF THE FORCEPS. 



berance, so that their extremities may touch the os uteri; the instru- 

 ment is then taken by the left hand, as a writing pen is held, and the 

 handle 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 or 

 inferior strait: as for the introduction of the hand, the interval be- 

 tween two pains must be chosen; it is introduced gently, without 

 force; in proportion as it enters, the handle is by degrees brought 

 from above downwards and from right to left, towards the median, 

 line; after this it is frequently necessary to place the thumb above 

 and to the right of the pivot, instead of leaving it beneath it; it 

 is thus moved onwards, making it follow the left posterior inclined 

 plane or front of the sacro-iliac symphysis, rather than the left side 

 of the pelvis properly so called, until its entablement shall have ar- 

 rived between the labia; after which the handle is brought near the 

 internal surface of the left thigh, depressing it more or less accord- 

 ing to the depth to which the blade has been carried. 



During this introduction the point of the clam, held very strictly 

 betwixt the head of the foetus and the parts of the woman, ought 

 never to deviate from the curve of the excavation. By deviating 

 from the axes of that cavity, it would be arrested by the vagina, 

 which it turns up in folds, or might lacerate; if inclined too much in 

 front or to the rear, it would involve the bladder or rectum in the 

 danger of being wounded. On the other haad, by turning too much 

 inwards, which almost always happens in using a forceps with a very 

 concave blade, it abuts against the child's head, and is soon stopped 

 by the folding up of the scalp; so that in any way it would be dan- 

 gerous to introduce it by force. 



Whenever, therefore, any resistance is experienced that does not 

 appear to be natural, instead of pushing it on with too much vio- 

 lence the instrument should be withdrawn a little ways so as to dis- 

 engage it, and afterwards slip it up in a more favorable direction. 



Where the head has passed through the os uteri, as long as the 

 forceps does not abandon the fingers that are in the vagina, one must 

 be very awkward to go amiss; but this is not the case where the head 

 is almost inaccessible, and where the circle of the orifice still enve- 

 lopes it in the shape of a crown fitting more or less tightly. The 

 greatest attention is necessary here: if the end of the clam deviates 

 from the cranium, it slides over the outer surface of the os uteri, and 

 gets into the cul de sac, or circular groove formed by the vagina, 

 where it is attached to the neck of the uterus. If the accoucheur 

 should not perceive this deviation, it is easy, without pointing them 

 out, to comprehend the havoc and danger that might ensue. How- 



