THE LEVER. 4^5 



maintained that it is only useful in correcting the positions of the 

 head, in compelling the reverted occiput to replace itself at the centre 

 of the pelvis. 



1087. However this may be, instead of a bar of steel about ten 

 inches long by an inch and a half in breadth, curved at each end like 

 a spatula, enveloped in adhesive plaster, according to De Bruyn, or 

 chamoy leather, as Boom says; instead of a simple spatula or kind 

 of flat spoon, the handle of which was terminated by a broad ring, 

 which constituted the lever of Titsing, the modern lever, such as it 

 appeared when modified by Pean and Baudelocque, is nothing more 

 than one of the branches of Smellie's forceps, very much elongated, 

 without its notch, and very little curved. This stock, the blade of 

 Avhich is very widely fenestrated, and the root supported by an ebony 

 handle, has also been itself modified in a great variety of ways by 

 the moderns, either in regard to its length, or the degree and shape 

 of its curve, or because some have added a joint in the stock, so as to 

 bend and make it more portable. 



SECTION 2. 



Use of the Lever. 



1088. Subsequently to the idea originated by the axiom of Roon- 

 huysen, and which has particularly been adopted among us, it was 

 generally agreed that the lever is not destined to supply the place 

 of the forceps, that at most it can but serve to restore the flexion- 

 movement of the head, by hooking down the occiput; thenceforth its 

 employment necessarily became much restricted, for under those cir- 

 cumstances the fingers almost always suffice, and if, after all, any in- 

 strument were necessary, one of the branches of the forceps would 

 answer as good a purpose as the lever itself. 



But this is not the view the English accoucheurs take of the 

 subject, nor that taken by its inventors, nor indeed is it a correct 

 one. 



1089. The lever is an instrument that is applicable to two diffe- 

 rent objects: on the one hand, it may be employed for the purpose 

 of restoring or reducing the head to its natural position; and on the 

 other, it is possible to make use of it, as we do of the forceps, to 

 extract the head when it has descended into the excavation. In 

 the former case, the fingers, or one branch of the forceps, might, 

 strictly speaking, in most circumstances, be substituted for it: but, in 

 the latter, I am convinced that it is susceptible of advantageously 

 taking place of the forceps, and that pretty frequently. In the first 



4JJ* 



