488 THE LEVER. 



Should the vertex be turned backwards instead of towards the 

 front of the pelvis, the lever ought to be applied to the temporo- 

 parietal region, in the direction of the occipito-bregmatic diameter, 

 and the see-saw should be performed in such a way that the occiput 

 which ought here to support the principal effort, may escape first, in 

 front of the perineum, and be strongly raised towards the centre of 

 the vulva; this position is less favorable than the other, without 

 doubt, but still, it is not very difficult. 



1094. I know that what the lever effects under these circum- 

 stances could be equally well done by the forceps, and perhaps with 

 more certainty; and indeed, it is not my design to substitute the 

 former of these instruments for the latter; I have merely wished to 

 show, that among us, the mechanism of the lever has been generally 

 misunderstood; that its employment, without being indispensable, 

 is perhaps not to be despised; and that its application is too simple, 

 too harmless, as compared with that of the forceps, for it not to 

 be had recourse to where the head presents at the perineal strait, and 

 appears to be arrested only by want of action of the woman's organs; 

 I will even add that its introduction will often be attended with the 

 great advantage of exciting the uterine contractions, as well as those 

 of the abdominal muscles, and thereby of accelerating, at least in- 

 directly, the termination of the labor, without exposing either the 

 woman or her child to any danger; I am happy, moreover, in find- 

 ing myself supported in almost the whole of this doctrine by M. 

 Desormeaux. 



ARTICLE IV. 



Of the Fillet. 



lt)95. The noose consists of cloth, thread or silk, wool, leather, 

 or cotton, sometimes strengthened by the addition of bulrushes, 

 whalebone, brass-wire, or plates of iron or steel, variously inter- 

 laced and worked, and which was formerly applied to different parts 

 of the foetus, so as to effect its extraction. The employment of 

 these means is of a very ancient date, and doubtless extends back as 

 far as the age of Hippocrates. Previously to the discovery of the 

 forceps and lever, the noose and fillet were the only instruments 

 made use of for the extraction of the child, where there was some 

 hope of preserving its life. Avicenna recommends that they should 

 be applied to the trunk; but it was particularly with a view of fixing 



