MECHANICAL EXTRACTION OF THE FCETUS. 515 



one being kept in reserve until this has failed, or it may be used at first 

 when the young creature is dead. 



The. pa/atifte arch affords a very solid and useful point of attachment 

 for the crotchet, and many obstetrists have successfully utilized it in ex- 

 tracting the foetus ; some authorities — among them is Schaack — assert- 

 ing that hooking this part is easier, and the results more certain and 

 direct, than fixing the instrument in the orbit. The stalk of the crotchet 

 is somewhat long ; the hook end is passed sideways into the mouth of 

 the foetus, and over the tongue until it gets be3^ond the palate, when it 

 is turned point upwards, and seizes the base of the vomer. According 

 to Schaack and others, a very strong degree of traction can be made on 

 this part without inconvenience to the young creature. It appears to be 

 an excellent situation to plant the crotchet in the calf — particularly if it 

 is de^d, and it is desired to effect extraction as quickly as possible. It 

 may be also employed in the foal, the only risk being more or less dis- 

 union of the palate, which may render sucking difficult or imperfect for a 

 short time after birth. 



Of course, the head must be in a good position either in the inlet or 

 in the genital canal, before the crotchet can be placed behind the palate. 

 The traction must also be moderate and steady, and the usual precau- 

 tions observed. 



3. T/ie SpiJie. — When embryotomy is practised, or the foetus is dead, 

 the vertebrae, their transverse processes, or the ribs, afford excellent hold 

 for hooks, though care must be observed in placing them securely, and 

 guarding them when they are being pulled at. 



4. The Pelvis. — In posterior presentations, when cords cannot be em- 

 ployed to the hind limbs, the loins, or the croup, or when they have not 

 sufficient power, then crotchets must be resorted to \ and with this view 

 the foetal pelvis offers several very advantageous points. After removal 

 of one or both hind-limbs, the cotyloid cavities, by their depth and the hard- 

 ness of their walls, are admirably adapted for receiving the hooks and 

 withstanding energetic pulling. If both limbs are amputated from the 

 hip joints, then a hook may be placed in each cavity ; if ablation of only 

 one limb has been effected, then one hook will be most useful, 



The pubic arch and the oval foramina of the pelvis are likewise well 

 suited for crotchet traction in the posterior presentation, when the foetus 

 is dead. In some cases the sharp-pointed crotchet may be passed 

 directly through the rectum, and pushed forward so as to seize the ante- 

 rior border of the pubis, the margin of one of the oval foramina, the base of 

 the sacrum, or the shaft of the ilium ; care being taken that the point does 

 not pass through the skin. Or the crotchet may be passed from without 

 inwards — the safest method — after the pelvic bones have been denuded 

 as much as possible of their soft tissues. This is, perhaps, the most prac- 

 ticable method, if the hind-limbs have been already removed. But if they 

 have not, then Saint-Cyr recommends that all the soft tissues of the foetus 

 from the root of the tail to the ischial arch, should be largely incised, and 

 the hand passed through the incision into the pelvds, which is emptied of 

 its viscera. The crotchet is then pushed into it, and planted either on 

 the brim of the pubis, or in the oval foramen. 



It is always safer to pass the hook from without inwards, whenever this 

 is possible, as the point is then in the pelvic cavity of the foetus. 



Forceps. 



The introduction of forceps into human obstetricy marked a new era in 



