546 
W. H. RIDGE. 
make our efforts fruitless, then perform embryotomy—rather 
than resort to undue violence at traction. I would say a few 
words in regard to the double volsella forceps; the trouble 
with those is the difficulty in opening them while in the 
uterus, and we should have a pair that could be separated, 
having a male and female blade. These would be very use¬ 
ful when the head and neck are turned back out of reach, we 
could then pass one blade under, the other blade over the 
neck, when we could in many cases draw the head in a 
position so that we could reach it by hand. These means of 
force should be studied closely, as a few pounds of traction 
at this time would rectify a malposition that all the traction 
on the legs we might choose to employ would be fruitless. 
There is one force, a retrograde force, that we should study 1 
closely. I think the value of it is not known sufficiently, at 
least is not employed as much as it should be, that is the force 
of the repeller. Every practitioner should have one; the 
one I employ is three feet long, divided into three parts, hav¬ 
ing a handle on one end, and a cross-piece like a crutch (with 
a spear in the centre about one fourth of an inch long) on the 
other; this spear is to keep the repeller from slipping when 
pressed against the foetus. The wound this spear makes is so 
trivial that I have never had any trouble from it. Of all the 
instruments I use, there is none so valuable in a dystocia as a 
repeller. 
Three-fourths of our cases of dystocia are produced by 
some malposition of the foetus and the easiest way to rectify 
this position is by pushing the foetus into the abdominal cav¬ 
ity, so as to have room to turn or change it. If we repel by 
our hand, as soon as we take the pressure off the contraction 
of the uterus sends the foetus back into the pelvis again, and 
ofttimes the pressure is so great that you are unable to change 
the position. Now is the time, after fruitless endeavors, you 
resort to extreme traction, when by the use of the repeller 
you could have an assistant pushing on it holding the foetus 
back when you have room to change the position as desired. 
I have frequently had two men pushing on the repeller 
while rectifying the position of the legs, with no accident. 
