DETRUNCATED HEAD IN PELVIS. 483 



show that the ergot will be advantageously substituted for it in a mul- 

 titude of cases, its employment will doubtless continue to be more 

 and more rare. Most of those who make a more frequent use of it 

 are not wrong merely because they perform an operation that is use- 

 less, but also, and especially, because they needlessly derange the 

 progress of a natural function; and because they voluntarily expose 

 themselves to the risk of complicating the sequel of delivery, even 

 admitting they are sure of not wounding any organ. 



3. The forceps cannot be beneficially applied, except to the head, 

 either when it descends foremost, or when it follows the trunk of the 

 body. 



4. It is much more to be relied on for the purpose of grasping, and 

 extracting the head, than for diminishing its size. 



5. It is not allowable to introduce it into the wonib until the orifice 

 is sufficiently dilated, and the head ceases to be movable and loose 

 above the superior strait. 



6. As far as possible, the blades of the forceps ought accurately to 

 embrace the two sides of the head in the direction of the occipito- 

 mental diameter; nevertheless, where some difficulty or doubt is ex- 

 perienced, it is more convenient and more prudent to pass them up 

 along the sides of the pelvis. 



7. Except in the right occipito-iliac position, if it ever does occur 

 and we should wish not to grasp the head by the occiput and fore- 

 head, the left branch must always be introduced first, because it is 

 the undermost. 



8. In whatever manner the branches are introduced, their concave 

 edges must be ultimately brought in front; but if the head had been 

 seized by the ends of its occipito-frontal diameter, and had not, while 

 descending, rotated between the clams of the instrument, it must be 

 abandoned at the inferior strait, to be taken hold of more advantage- 

 ously, should the forceps still continue to be necessary. 



9. The extraction should always be performed in the line of the 

 axes; always with gentleness, never precipitately, nor by jerks; the 

 tractions from handle to handle are of no use after the head occupies 

 the vulva, and if performed while it is at the superior strait, would 

 sometimes be dangerous. 



10. It is not only because it has become useless that the instru- 

 ment should be taken off" when the head, at the lower strait, is only 

 resisted by the soft parts, but also, and chiefly, in the view of avoid- 



tution, many more examples should not have occurred requiring the application of 

 the instrument. Perhaps, had the forceps been less timidly resorted to, the ratio 

 of cures or recoveries already so honorable to that house, would have been still 

 more creditable to it. — M. 



