MECHANICAL EXTRACTION OF THE FOETUS. 



5" 



Gunther's long porte-cord (Fig. 149) can be most effectively used as a 

 blunt crotchet at the same time as a carrier of the cord, A German long 

 blunt crotchet has a concealed sharp blade in the concavity of the curve ; 

 by means of a spring in the handle, this blade can be projected, and the 

 instrument wiil then do good work in embryotomy. 



With the sharp crotchet, the curve should certainly not be very wide ; 

 the smaller it is, the more readily it can be passed into the genital pas- 

 sage, and the less chance of injurv is there to the mother or operator ; it 

 should not be greater than the hand can cover. At the same time, if the 

 curve is too small, the crotchet does not obtain sufficient hold of the foe- 

 tus, is readily torn out, and for this reason may be most dangerous. The 

 point should be so bent as to penetrate readily into the part in which it 

 is determined to fix it, and the angle of the curvature should be such that 

 the more the crotchet is pulled at, the deeper and more firmly the point 

 will enter. 



Fig. 160. Fig. 161. 



Short Sharp Crotchet, Short Sharp Crotchet, 



WITH Broad or Flanged Point. with Round Point. 



So it is that the point should not be turned round in a semicircular 

 manner, but rather at an acute angle, as in Figs. 164, 165. 



There is rather a diversity of opinion with regard to the preference to 

 be accorded to the crotchets ; some practitioners preferring the short 

 ones, as they can be readily carried into the uterus guarded by the hand 

 and moved about there, so as to be implanted in the most convenient 

 part of the foetus ; while the cords attached to them allow traction to be 

 made in the most favorable direction. Other obstetrists prefer the long 

 rigid crotchet, which they affirm is more easily placed — one hand guiding 

 the point though the passage, the other hand acting on the handle. 



These preferences depend very much upon whether the operator is 

 more practised in the use of one or other of the crotchets, and also, doubt- 

 less, upon circumstances peculiar to each case requiring the employment 

 of such instruments. Both long and short crotchets are most useful, and 

 the obstetrist should have several of each, and of various forms and dimen- 

 sions, so as to be able to select that which is best adapted to meet the 

 requirements of particular cases. 



It must be observed also, that many practitioners are not in favor of 

 crotchets, and decry their use. But we are of opinion that there is some- 

 thing unreasonable in this, and the experience of almost every day goes 

 to prove that these instruments afford a simple and ready means of get- 

 ting hold of the foetus in regions of its body which the hand cannot pos- 

 sibly reach, or if it could, where it could do very little service either from 

 the shape of the part, its slipperiness, or from the paralyzing effect of the 

 uterine contractions on the hand and arm of the operator. They can 

 also be profitably employed in cases in which cords and halters are use- 

 less ; for not only will they serve in allowing traction to be made on parts 

 which actually present at the inlet, but they can also be utilized in effect 



