2 1 4 DE CAPITA TION. 



ot the chisel firmly against the part with one hand in such 

 a manner as to effectively guard the instrument from slip- 

 ping aside and wounding the maternal organs, steady and 

 direct the handle with the other hand and have an assistant 

 drive the chisel by means of blows of proper vigor with the 

 mallet into the bones of the face and head. Do not drive 

 the chisel deeper than the length of the blade without stop- 

 ping and forcibly revolving it upon its long axis and break- 

 ing the foetal bones apart. The partially detached pieces of 

 bone may be torn away with the fingers or in case the skin 

 is quite adherent to them the bone may be held with the 

 fingers of one hand, the chisel introduced with the other 

 and using it as a spatula complete the separatioi;. Repeat 

 the use of the chisel as often as may be necessary in order 

 to bring about the required diminution of the head, care 

 being taken at all times not to wound the maternal parts 

 and to conserve as far as practicable the skin of the fetal 

 face and head in order that it may protect the maternal 

 parts from the jagged bones during the passage of the re- 

 mains of the head. The removal of the partially detached 

 pieces of bone may in many cases be greatly facilitated by 

 looping a cord over them and having an assistant apply 

 traction sufficient to pull them away, the operator guarding 

 the maternal organs by holding the piece of bone during its 

 detachment and extraction, in the palm of his hand. 



47. DECAPITATION. 



Objects. The facilitation of repulsion and correction of 

 the deviation of fetal parts. The operation is generally car- 

 ried out when the fetal head is far advanced in the pelvic 

 canal or has passed beyond the vulva. 



Technic. Attach a cord to the inferior maxilla or around 

 the neck of the fetus and have one or more assistants draw 

 the head out as far as possible. 



