534 THE CROTCHET. 



ing guided, in some sort protected, or even covered by the accou- 

 clieur's finger; when fixed either on the interior or exterior of the 

 cranium, the stem must be supported by the thumb, while the fingers 

 remain firmly applied to the opposite side of the head, and the other 

 hand applied to the handle exerts the requisite extractive power. In 

 this way it cannot let go its hold without the accoucheur's perceiving 

 it at once; both the hands also act in concert, their efforts may be 

 exacdy combined, and the operation ceases to be dangerous. There 

 is no longer any danger of those dreadful slips, which chance alone 

 could prevent, when the operator is so rash as to pull, blindfold as it 

 were, with a single instrument. 



1172. When one of the bones breaks or gives way, the crotchet 

 must be again applied, upon a firmer part. Some advise that the 

 point should be directed in front toward the pubes. Others have 

 directed it to be applied behind, for the purpose of more easily 

 drawing the head down through the superior strait; but it is not 

 easy to lay down general rules on this subject; we must act in either 

 way, according to circumstances. Should the head rise up again, 

 strongly, whenever we cease to pull with the crotchet fixed at the 

 back part, it would be well to follow M. Duges's plan and fix a 

 second crotchet in front, while the head continues to be held down 

 with the first; this may be got higher up, or a third instrument may 

 be attached while the head is kept as low down as possible with the 

 others. 



To force the base of the cranium to clear the superior strait, we 

 sometimes meet with obstacles that are excessively difficult to over- 

 come. The bones of which it is composed do not bend like those 

 of the vault of the cranium, and the crotchet is quite as incapable 

 of lessening its size as the forceps; it is only by engaging it in an 

 oblique direction that we most generally succeed in extracting it in 

 cases where the antero-posterior diameter does not exceed two inches 

 or two inches and a quarter. 



Perhaps the terebellum of M. Duges might be beneficially em- 

 ployed in such cases as these: this is a sort of cooper's turrel, which 

 is capable of perforating the bones and cartilages, of breaking up 

 the base of the cranium so as to render it flexible, and of acting as 

 a substitute for most of the cephalatomes. 



1173. M. Baudelocque, Jun. has lately constructed a forceps, the 

 object of which is to overcome all these difficulties, and to render all 

 the perforators and most of the sharp crotchets superfluous. The 

 clams of this forceps are not fenestrated, and are but slightly 

 curved; so that by being closed they may pass through a strait that 

 does not exceed fifteen lines in its small diameter; through the 



