1000000031

io lhal

~afo,

lhe child caooot be faved eilher by lurniog

and briogiog it b.y lhe feet, or delivered by the applica.

tiod'of

filie<

or forcep.; but the oper'lor muCl un.void.

ably

uC.

lhe difagree.ble ,,!ethod

extr. éling \Vid,' the

crolehet. N evenhet. fs, io .• 1I lheCe cafes, the forcep.

ought firCl to be tried; aod C" metimes they'will fucceed

b. yood expeélatioo, provided the binh is "larded by the

\Ve.knefs of lhe womao, and the Ceeond, lhird, fourth,

or fi Clh obClruaioos : but they caonot' be depended upon

even when th!'.enex preCeots, \Vith the forehe.d lO the

lide or back part of the pelvis, aod (lhough lhe wom'n has

h.d Clrong p.ios for olany &oun after the

membr.ne,

are

broke) the head is not forced. dowo into ,he pelvi., or

leaCl, but an iocoofiderable pan of it, reCembling lhe

Cm.1I end 9f . ·Cug" .lo.f. For, from lheCe eii-cumClan·

ces, you may conelude, th., the largeCl pan of 'i, i. Clill

above the: brim, and that eitber tbe hcad is too

h,rze,

the pelvis

tOO

narrow: . E\'cn in the{e cares, indeed, the

JaCl fillet Or • long pair of forcep. m. y take C"eh firm

hold, th.t, Wilh gr<at force .nd lhe Clrong purehafe, the

head will he deU.ered : but Cueh violenee is commooly

fatal to the

worn.ao

, by

caufio~

Cuch ao inOamma,ion, Bnd

perhaps lacer"ioo of the part., as is attended Wilh morti·

/icatioo.

Wheo lhe head i. hig\¡, the forcep' may be locked io

lhe middle of the pelvis; bu, in lh.t

c.fe

, gre.t care mun

be taken in feeliog with the fingers all round, ,h" no pan

of the vagina be inelud. d in ,he locking. Somelime"

",hen the head reCl" or is preffed 100 much on the fore·

pan or Cide of ,he

p~lvi"

eilher at the brim or lower

down, by introducing one blade, it may b. moved farther

down, provided lhe labour. pain, are Cl,oog, and the

per' lion afliCled by ,be fi ngers of lhe other hood applied

'o the oppofi,e fide of the head; but if the fingers cannot

r~"c\¡

high enough, the beCl me,hod i, 'o turo or move

,he blade ,oward, ,he ea(of ,he chíld, aod introduce ,he

"tber along the oppofite fideo

General ,ul" f or uJing ¡he

FORen • .

farther .the head is advanced in ,he pelvi., theea·

lier it i. delivered with the forceps ; becaufe theo, if in

,he 6th or 7th cafe, il i, chaoged from a rouod tO an ob·

loog figure, by beiog foreed

along.by

,he !abour·pains :

00 the contrary, when the head remaios high up, re(ling

upoo ,he brim of the pelvis, the forcep. are ufed Wilh

gre.ter difficulty and uoeertainty.

Tbe os exteroum muCl be gr. dually opcned by iotro·

ducing the

fingen

cae after another, in form of a conc,

.fter (hey have becn 'lubricatcd with pomatum,

mOl'ing

ano

turoing

them iD

femicircul ar

mOlían, as

thty

are

pufhed up.

the head i, fo low down lh.. , he hano

cannot be introduced high up in this

,form,

)et lhe parts

be dilated by the fingers turoed in. !he ¡lircélion of the

coeeyx, ,he back of the haod beiog upwords, nex' lOlhe

child'. head : the

exter~al

p. rts being Cuflicieotly open·

ed to admit al1 the fin gen , fet the back of the lund be

turned to the pcrinzum. while

lhe,

fingers

.m-i

Ihumb

being fl m eoed, will Oide along betwixt lhe h" d . nJ

the os Cacrum ,

,he right haod be ubl, l. , i, ue ' urn·

.d. liule 'o the lef, fide of lhe pelvis.

~ccaufe

lh. broad

ligameDl and membrane ,bat Gil up the Cr.Lee

UCl'VCW

lhe

[aeru

aod ifchia, will yield and al10w mOre Toom for

,he fiogen tO advaoce; for lhe fame reaCon, wbeo the

lef, hand i. introduced,

muCl be turoed a Iinle lo the

right fideo Haviog gained your poio,

far, cootinue tO

pufh up, uo,il your fingers paCs' ,he os internum; at Ihe

fame time, with the palm of your hand, raife or [coop

up .the head ; by which mran" you

will

be more a' lé–

berty

reaeb higher, dilate the inlernal part., aod diC.

tioguifh the fi,ua,ion and

fiz~

of the heod" together with

,be dimenfioo. of lhe pelvis : from which i,.e(ligatioo,

you will be able to judge, wh'ether the ehild ought to be

,uroed and brought by ,he feet, or delivered with the

forcep'; or, if the labour.pains are nroog, aod ,he head

preCeots , olerably fair, without being jammed in the pelo

vis, Y9u will reCol.e to wait fome time, io hope of feeipg

the child delivered by the labour. pains, Ofpecial/y whell

the Woman i. io 00 immediate danger, and the chief ob·

naele is the rigidity of the pam.

The pofilion of the head is diClinguifhed by feeliD!: for

one of the ears, the fore or Cmoo,h part of whieh is to–

ward. the faee of the child; if it caonot be afeertaioed by

thi. mark, the haod and fingen mun be pufued farther

up, to feel fo. ,he face or back par' of the neck; but, ir

tbe head canoot be traced, the obCer..tion muCl be ,akell

from the foo,anelle, or lhat part of ,he cranium where

,he lambdoidal croffe. the end of ,he fagittal [uture•.

Wheo the ears of the child are ,owards tbe fides of the

pelvis, or diagooal,

th~

forehead beiog dther lO the f.·

crum or pubés, •,he patient m'uCl lie

her back, with

her breeeh o li,tle

o.er

the bed.

ooe ear is to ,he

(a–

crum, .nd the other to the pybes, fue muCl be laid on

one fide, wi,h her breech over the bed, ·a. before, her

knees beíog pulled up 'o ber bel1y, and a pillow placed

betweeD them; except wheo lhe upper part of the facruru

je.. too much forward ; in whieh cafe, fue muCl lie up.

on her baek,

above dcCcribcd.

The ulade. of ,he foreeps oughl allllays, if poflible, 'o

be iotrodueed along the ears; by whieh means, ,hey ap·

proach

ne~ rer

to.eaeh ol her, gain a firmer bold, aDd hu"

the head leC. than in any other direélioo : frequently, in–

deed, nOt the lean m..k of

lh~ir

application i. 'o b. pero

c<ived; whereas, if the blades are opplied aloog ,he

forehead a"tI oecipu" they are at a gre..er diflanee from

t ach

othcr,

require more room, frcquently at theirpoints

pref, in the boneo of ,he Ikull, and endaoger a laceratio

in the os exteroum of lhe womaD.

See Plate

CXIl.

fig. 2.

The woman bein:: laid in

right pofition for ,he

IP'

plicalion of the Corccps. the bhdes ought tO be privatelr

cooveyed

b..

wceo ,he feather·bed , nd the eloath., at

fmall dill.oee from one or.other, or 00 e"eh fide of the

patient : that tBis

convey~ncc

may be the

mOf e

eafily cf·

f,éled, ,he I: g' of lhe inflrument ought tO be kept iD ,he

operator's fide·poek. t'. T hus provided, ' ",hec

fin

down

ddivtr,

let

him fpread

the

Ihec[ (hat hangs o\'er

the bcd, upcn his J:tp. and unde r

chal

cover,

u ke

o'ut

aod e/:CpoCe the 'blotlcs on caeh fid e of lhe patient ;

whilh m<"ans, he

witl

orten be able to

deliver

with the

f~;ceps,

without their bcing peraived

lhe

woman

her–

Celf, .or any olhe. of the .flifl.nts. Some people pin a

Oleet to eaeh fllOuiJ er,

and

lhrolV the other end over lhe

bcd,