On the history and use of the short straight midwifery forceps as a tractor, and of the long double curved forceps as a compressor and lever / by Thomas More Madden.

Date:
[1875?]
Catalogue details

Licence: Public Domain Mark

Credit: On the history and use of the short straight midwifery forceps as a tractor, and of the long double curved forceps as a compressor and lever / by Thomas More Madden. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    fingers of his right hand and the child’s head, until the fenestrum is well over the ear, and the lock rests against the perinmum. In like manner the sacral or lower blade is now to be introduced, the operator merely reversing the previous position of his hands. As soon as the locking is effected, which with this instrument is peculiarly easy, and requires no force, the operator introduces his right index finger into the ring already described, and very gently draws the head in the axis of the pelvis, at first downwards and backwards, and then downwards and forwards, until the vertex protrudes through the vulva, when the blades are unlocked and withdrawn, so as to avoid any possibility of lacerating the perincenm, and the child is helped out by manual pressure from the coccyx forwards over the perinaeum. The long double-curved forceps is to be used nearly in the same manner, except that, whenever practicable, it should be applied with the patient lying in the supine position, and drawn dowu to the end of the bed, with her legs flexed on the body, as though she were about to undergo lithotomy. As very few patients in this country will submit to be so placed, however, this instrument may be applied as the short forceps, bearing in mind that whatever situation the child’s head may be in, the position of the blades of the long forceps must correspond with that of the transverse diameter of the brim of the pelvis. Another point of difference is, that this being a compressing instrument, the handles must not be suddenly or forcibly closed. In the case of a normal foetal head at full term, they should remain a full inch apart. When further compression is absolutely necessary to accomplish delivery, this may be cautiously and gradually applied by the screw already described, turn by turn, until the blades are sufficiently approximated to allow of their being slowly drawn down through the pelvis. In this operation it must never be lost sight of that these blades include in their iron grasp the fragile head of a living child, to which any hidden, violent, or excessive compression would prove destructive, but which may, within certain limits, be safely assisted in that gradual moulding and elongation necessary to effect its passage through the pelvis.