A textbook of obstetrics . backward, thus flex-ing the leg upon the thigh, occasionally makes it easier to grasp the foot. Another plan of manual extraction is to place the hand onthe infants back, so thatthe little and fore-fingershook over the crest of theilium, while the middle andthird fingers are extendedalong the spine. This isnot so good. For bothmanoeuvers the patientmust be anesthetized. Forceps.—If the breechis low in the pelvic canal,and it is impossible to passthe hand into the uterinecavity to seize a foot, itmay be most convenientto apply forceps over thetrochanters. By avoidingc
A textbook of obstetrics . backward, thus flex-ing the leg upon the thigh, occasionally makes it easier to grasp the foot. Another plan of manual extraction is to place the hand onthe infants back, so thatthe little and fore-fingershook over the crest of theilium, while the middle andthird fingers are extendedalong the spine. This isnot so good. For bothmanoeuvers the patientmust be anesthetized. Forceps.—If the breechis low in the pelvic canal,and it is impossible to passthe hand into the uterinecavity to seize a foot, itmay be most convenientto apply forceps over thetrochanters. By avoidingcompression of the han-dles, and simply makingtraction by hooking onesfingers over the shouldersof the instrument, thebreech may be extractedreadily, with no danger tothe child. Extraction by Fillet.—Each end of a strip ofbandage about two incheswide may be passed be-tween the thigh and theabdomen and brought down in front of the external genitalia. If drawn tightloop of the bandage is in contact with the childs sacrum. Fig- 545-—The handle of a long forceps useda? a blunt hook. theA very firm and convenient grip is thus taken upon the breech. Thefillet is very difficult to apply with the fingers. A fillet-carrier,shown in figure 544, makes the application much easier. Ananesthetic is required. This plan is excellent if the manual extrac-tion is impossible, or if it is considered inadvisable to use forceps. 74>s OBSTETRIC OPERATIONS. Blunt Hook.— This instrument is passed between the thighand the abdomen. It is an extremely dangerous instrument forthe infant. It is very likely, indeed, to fracture the thigh or to perforate the groin. Its use, therefore, is not recommended, and is never resorted to by the author unless the child is dead. THE ARTIFICIAL DILATATION OF THE CERVICAL CANAL. It is necessary to dilate the os artificially in eases of rigidity ofthe cervix, or when it is desired to hasten labor for any os may be dilated by Barnes bags, by graduated
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