482 USE OF THE FORCEPS. 



sufficient to admit of the transit of the trunk, is so contracted as 

 completely to arrest the head, that it might perhaps become useful to 

 separate the portion of the cliild that is without from that which 

 remains enclosed within the genital organs. 



But admitting that this necessity does exist in some cases, it still 

 must be very rare, since the delivery of the body does not absolutely 

 prevent the application of the forceps to the head; nevertheless, as 

 we unfortunately meet with a good many persons who undertake the 

 practice of midwifery without possessing the least knowledge of the 

 subject, it would be imprudent for the educated practitioner not to re- 

 flect upon what he would do if called to a woman whose foetus had 

 been thus detruncated, either voluntarily or involuntarily, by immode- 

 rate pulling or by means of an instrument. 



1084. In the first place, the head must be placed in a proper 

 situation, that is to say, its occipito-mental diameter must be adapted 

 to the axes of the pelvis, and the face turned backwards. 



When in the excavation, it is almost as easy to get hold of it as 

 if it were not separated from the body. At the superior strait, the 

 operation is often found to be one of the utmost difficulty, and appears 

 to be even impracticable, when the womb is scarcely contracted, 

 and the face and occiput are not yet engaged. When the head is 

 firmly fixed by the contraction of the uterus, or when it can be kept 

 still with the hand so as not to slip out of the grasp of the instru- 

 ment, we are to proceed just as if the body were still attached; only, 

 in order to make surer of its not turning so as to put the occipito- 

 frontal in place of the occipito-mental diameter during the process 

 of extraction, we should endeavor to steady it by applying a couple 

 of fingers of the hand that holds the root of the forceps near the 

 vulva, to the face or chin. 



§. YIH. Recapitulation, on the Employment 

 of the Forceps. 



In bringing this article to a close, 1 think it a duty to repeat the 

 following corollaries: 



1. The forceps ought never to be applied without an evident 

 necessity, because, although it might not be mischievous to the 

 child, the mother may receive the greatest injury from it. 



2. In the practice of good accoucheurs the forceps is scarcely 

 employed once in two hundred labors;* and as every thing tends to 



• Dr. Collins, page 10, tell us that during his mastership of the Dublin lying- 

 in Hospital, in 16,414 deliveries the forceps was used only 24 times, and the lever 

 three times, making 27 cases in all, or one case in 608 deliveries. It is to me 

 inconceivable, that, viewing the class of the population which resorts to that insti- 



