THE CROTCHET. 533 



This point, which is single in some and in others double, may be 

 continuous with a straight or with a curved stem, or it may resem- 

 ble a hook of a chain, of greater or less length, like what is seen in 

 Scultetus's Armamentarium; the point, which in most of the speci- 

 mens is fixed, may however bend, and also open as in the instru- 

 ments of Aitken and Saxtorph. Forceps or pincers with sharp 

 crotchets have also been constructed; Mesnard, Levret, Smellie, Bau- 

 delocque, and many others have boasted of the value of the crotchet- 

 forceps, a model of which is to be seen in the Museum de la Faculte, 

 and which are nothing more than Smellie's small forceps without 

 fenestres in the blades, which are terminated by a triangular, sharp 

 and bent point. The forceps •\vith wolf-teeth of Avicenna, and the 

 dentated pincers of Rueff ought also to be classed among the sharp 

 crotchets. 



J 170. After the performance of craniotomy, if the powers of na- 

 ture are insufficient, Burns thinks that we ought to wait twenty-four 

 hours before we resort to the triple forceps of Levret, and more es- 

 pecially to the sharp crotchet; he founds this doctrine on the circum- 

 stance, that the foetus, passing rapidly into a state of putrefaction, 

 softens, and becomes much easier to extract the longer we wait, even 

 admitting that it shall not be spontaneously expelled. 



This practice, although recommended by Kelly, M'Kenzie, Den- 

 man, Osborn, Boer, Simson and Asdrubali, does not appear to me 

 to be one that ought to be followed; I agree with M. Duges that 

 it is useless to protract, in this way, the patient's anguish; and be- 

 sides, a labor that is already tedious cannot be with impunity pro- 

 tracted for twenty-four or forty-eight hours longer; and were there 

 no other reason than the necessity for renewing the preparations 

 for a forced delivery, which are always frightful, it ought to be re- 

 jected. 



1171. The sharp crotchet is to be applied to one of the most solid 

 parts of the cranium, for example, to the occiput or the mastoid pro- 

 cess, when the head comes foremost; upon the lower jaw, in the or- 

 bit, or upon the forehead, when it descends after the trunk; in short, 

 in such a way as to prevent, as far as possible, the occipito-mental 

 diameter from abandoning the line of the axes of the pelvis, and to 

 retain it in its natural state of flexion. It may also be applied inside 

 of the cranium, by fixing it on the petrous portion or the basilar 

 apophysis; but in that case it is of essential importance that it shall 

 not slip, that it shall not act upon one of the bones of the vault of 

 the cranium, for by pulling them downwards it might pass through 

 them and injure the organs of the woman. Like the perforator, the 

 sharp crotchet ought never to be plunged into the foetus without be- 



46* 



