File:The principles and practice of obstetrics (1864) (14782783852).jpg

Identifier: 67240830R.nlm.nih.gov
Title: The principles and practice of obstetrics
Year: 1864 (1860s)
Authors: Hodge, Hugh L. (Hugh Lenox), 1796-1873
Subjects: Obstetrics Obstetric Surgical Procedures Pregnancy
Publisher: Philadelphia : Blanchard and Lea
Contributing Library: U.S. National Library of Medicine
Digitizing Sponsor: Open Knowledge Commons, U.S. National Library of Medicine

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proper: for, as already observed, theliability to injury of the perineum is not enhanced bythe presence of the blades; their removal also deprivesthe practitioner of power to render any further assist-ance, and may sometimes even necessitate a re-applica-tion ; and, moreover, this removal, under the circum-stances of a rigid perineum, is not a safe operation forthe tissues of the child, for it should be rememberedthat under the degree of pressure, to which the head isnecessarily subjected by the forceps, the skin of thescalp and face of the child project into the fenestrae,almost like a button. Hence, even if great care beemployed and a slight rotatory motion be given, theremust be danger of inflicting injury on these tissueswhile removing the blade. The best rule, therefore,is, that when the forceps are applied, to allow it toremain until the head be fairly delivered, when itsremoval, of course, is easily effected. If the head be in the cavity of the pelvis, (Hate Plate XX. Fig. 105
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Forceps oblique T Sinclairs lith Phi* FORCEPS AT THE SUPERIOR STRAIT. oo XVII., Fig. 98,) and the occiput opposed to the leftanterior inclined plane, and the forceps be properly-applied, so that the handles are oblique toward the leftthigh, the same general rules for the use of thisinstrument are applicable. A slight compression,therefore, is to be made, and traction effort shouldbe directed downward, and somewhat to the left in thedirection of the handles, while the leverage of the for-ceps should be exercised by directing the handlesobliquely from the left thigh of the mother toward theright groin ; that is, from one handle toward the other,taking care that the extent of the motion be even morelimited than when at the inferior strait. As the headdescends, the practitioner should bear in mind the neces-sity of rotation; at the same time he should not forceit, by twisting the forceps, as recommended by Vel-peau, Chailly, Oazeaux, and most of the French authori-ties, also by Ramsbotham

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