DECAPITATION 177 



that part of the head of the fetus where it is desired to begin 

 the operation ; generally on the median line of the nose 

 with the blade of the chisel standing parallel to the septum 

 nasi of the fetus. Holding the blade of the chisel firmly 

 against the part with one hand in such a manner as to 

 effectively guard the instrument from slipping 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 stopping and forcibly 

 revolving it upon its long axis and breaking the fetal 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, 

 the separation completed. The removal of the partially 

 detached pieces of bone may in many cases be greatly facili- 

 tated 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. 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 jagged bones during the passage of the 

 remains of the head. 



52. DECAPITATION 



Objects. The facilitation of repulsion and correction of 

 the deviation of fetal parts. The operation is generally 

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

 canal or has passed beyond the vulva. 



