494 LOCKED-HEAD. 



cessful only because they were employed in cases very different from 

 those which are understood to be locked-head at the present day. 

 Roonhuysen's instrument is manifestly incapable of compelling the 

 head to descend, where there is a disproportion between it and the 

 straits; it might, at the most, serve to dislodge it and give it a more 

 favorable position, and in that case it would not be absolutely locked. 



1105. It is otherwise with the forceps, which admits of the ef- 

 forts of the accoucheur to be conjoined with those of the womb and 

 abdominal muscles. However, as the clams can be applied only 

 upon the sides of the pelvis, some practitioners have objected that 

 by compressing the head in a line from right to left, this instrument 

 might augment the pressure already experienced from front to rear, 

 instead of diminishing it; that it is better calculated to give rise to 

 locked-head than to relieve it; and consequently, more dangerous 

 than useful; but these fears, inspired by a theoretical view of the sub- 

 ject, must yield to facts; besides, it is not correct to say that the 

 diameters of the head gain by compression in one way what they 

 lose in another; I repeat that I am certain the forceps succeeds in ex- 

 tracting the locked-head far more by compelling it to traverse a circle, 

 which acts upon it like a ring, than by reducing it by means of a di- 

 rect pressure. 



Should it not succeed, and the child were ascertained to be dead, 

 recourse should be had to cephalotomy, and then to the crotchet; but 

 if the foetus were still living, the operation of symphyseotomy would 

 be indicated, and ought to be preferred to the cesarian operation, 

 which, in such a case, can never be necessary. 



ARTICLE VI. 



Of the measures rendered necessary hy narrowness of the 



Pelvis. 



"When the pelvis is so deformed as to render delivery impossible, 

 even with the assistance of the means I have now passed in review, 

 there remain only three kinds of resources for the delivery of the 

 woman: 1. To act upon the foetus so as to lessen its size; 2. To in- 

 crease the size of the pelvis; 3. To extract the child by an artificial 

 passage. As these three modes of delivery are excessively dan- 

 gerous, whether to the mother or her offspring, it is necessary, pre- 

 viously to putting them in practice, to determine in what cases they 

 are really indispensable. 



