A System of midwifery : including the diseases of pregnancy and the puerperal state . int to the conclusion that the application of the instru-ments in the manner generally recommended, instead of aiding, actuallyinterferes with the proper moulding of the head. If the pelvis is largeenough to allow the child to be born without injury, the application of XXIX.] USE OF THE FORCEPS. 489 the blade behind the pubis can only interfere with adaptation anddescent, while the presence of its fellow on the side of the cranium nextto the sacrum prevents the head from doubling the promontory, by mak-ing it
A System of midwifery : including the diseases of pregnancy and the puerperal state . int to the conclusion that the application of the instru-ments in the manner generally recommended, instead of aiding, actuallyinterferes with the proper moulding of the head. If the pelvis is largeenough to allow the child to be born without injury, the application of XXIX.] USE OF THE FORCEPS. 489 the blade behind the pubis can only interfere with adaptation anddescent, while the presence of its fellow on the side of the cranium nextto the sacrum prevents the head from doubling the promontory, by mak-ing it a centre of revolution, like that of the symphysis in the laterstages of labor. In place of the natural moulding, the head is violentlycompressed and dragged through the inlet without any regard to themeasures which nature herself adopts to remedy the results of theseerrors of conformation. Forceps are therefore to be applied in relationto the pelvis and not to its contents. They are to be used as tractors,not compressors. The instruments of Simpson, which are now begin- C D, curve of abnormal promontory ; B A, Caruss curve. Modified from BftrnM. ning to bo used in this country, have a space of three and one-quarterinches between the fenestme. Such an instrument is almost useless asa compressor, but as a tractor it is efficient and powerful. In speakingof this subject at the discussion at the Obstetrical Society of Philadel-phia, in lST^, Dr. W. F. Jenks called attention to the fact that thegreat advantage which results from the use of an instrument intendedonly to supplement a deficient vis a tergo^ is that the mechanism oflabor can, and does in most cases, when the contraction is not too great,proceed undisturbed, the head rotating anteriorly inside the blades. Inthese cases, where this rotation docs not take place, we only imitatenature, fur in cases of Contracted pelvis, when the maternal efforts are finally sufficient to effect delivery, we find that this rotati
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Keywords: ., bookcentury1800, bookdecade1870, booksubjectobstetrics, bookyear1
