1000000031

T h, melh.J

o¡

u¡;nc Ih,

Sc':¡¡:'rJ,

bI~/l1

Ho.k,

and

CROT CHE T .

" TH E "

' the heaJ prefen", and fueh i. the clfe that

(he chdd

C?oll

n,úther be

ddivcrcd

turniofl. nor extrae–

ted

wil" lile

fo rcers, and

;¡l>fOlt.llCly

nccelEuy ro de–

Ever

lhe

wom~ n

f:l\'c hcr Jife, (]lis

op:ration

mull (hen

be pcrformed in the

following

mannér.

The oper:nor muH be provided with a p

:z.ir

curved

trolchcrs,

made acccrding

lhe

improveOlents

u?on

thofe

propb fed by M efnarel, togetber with a patr of feilfar. a–

bOUI

ni"c ¡nches IO:lg, wilh re(ls near

lhe

middle

of th'e

blade., aDd tbe bl"nt hook.

Oí Ihe

[V.man'l

Poj1ure ,

TH E

patien,' ought tO be h id on her back or fioe in ,he

fame pofition oiretled in-the ufe of the foreers ; the ope·

ratar ,mua be reated ,on a low chair, ano lhe in{lruments

concealcd and difpofed

[)~e

fame

manner, and for the

fame

rearO"

m~ntiODed

tr eating

of _the forceps. The

paru of the woman have already, in 311 likehhood, been

fuffi éicndy dilated by his endeavours to turo or dc:liver

"'·¡th toe forceps ; .or

no etrons of "'tllat kind have

been

ufcd,

b~c.ufe

by the touch he had' leuDed tha! no fueh

endeavours would fucceed, as in the.ctafe of a 'Iarge

hy–

_drocephalus, when lhe bone! of lhe eraniuen are often fe –

parated at a great di(bmce from eaeh other ; or uron per–

,ceiving that lhe pelvis was extremely narrow:

1(,

upon

,t-befe confide:rations, be hath m;¡de

tríals in whieh the

part!

were opened, iet him gradúalJy

dilate

the os eXler–

num al1d intcrnum, as forme'rly direéled.

The head is commonly kcpt down pretty firm , by ,he

llrong contraétion of the Ule{Us. round lhe ehild ;

bút

/hould i, yield to one fide, let it be kept fl eady by ,he

band of an aJ!iflant, prelling upon the belly of the woman;

let him introduce bis hand, and prefs two fingers againH

ooe ni' the fUlurés of lhe cranium; lhen . take

OUt

his

fcilf.rs

from the place iD whieh they were depofited, and

guiding them bj' the hand and tinger. till they reach the

hairy fcaJp, pUOl them gradually into it, un,ti! their pro –

gref. is llopped by the re/Is.

the head Oips afide ; in fuch a ",anne(, as tha, they

canDOt be pu/hed iDto the tkull 'at the future, ,hey will

make their way Ibrough the folid bones , if they are moved

id a remieireuJar

tu ro,

like thc motioa ofboring-, and lhis

'method conlinued till you find the point firmly 6xed ; (or,

.if this i. not obferved. the 'points Oide along ,he bone•.

The fciffars ought tObe fo fh arp at the poinu, as to

penetrate- lhe integuments and bones when punlcd Wilh a

.moderate force; bu[ not fo keen as to cut the opcrator's

fingers, or the vagina in inlroducing lhcm.

The fcilfars being thus foreed inlo lhe.brain, ;as far

,he rdl! at the 'middle o( the blade., let them

kep'

firm in thu fit uatioll; and 'the hand that \t'as in lhe va·

gina being ' wjthdrawn, lhe oper:aor mufi t:.tke hold of

tbe handles wilh cach hand, and puJllhem afuntJer, that

the bl.des may dilate .nd make a ' Iarge opening in the

O, ull; then they muft be Olllt, ,urned,

~nd

again pull,d

arunder, fo as to make the ¡nci(jon cruci:a l ; by which

m~"ns

lhe opeDing

wiJl

be cnJat'gcd, aDd (ufficient room

made (or the iotrooutlion' of Ihe

fin~rs :

let Ihem be

af·

VOL .

IlI. N°.

78.

terwa rds c1ored , aad introduced eveo bc}'ond

'th~

rens:

when \hey mufl

ag.in

. be opened,

~no

turned h, lf roun:i

from (jde

fidc, 'uotil the Clru:ture or lhe braio is (o ef,

feétually denroycd. that it can be ev?cu:ltert with

C' ..

f!'.

This operatíon being pcrforrJlcd. Jet the fcilTHs be fl,u t

and wi lhdrawn

bUl, if this ¡nnrument will not afifwt- r

lhe. lan purpofe, lhe nu(i nefs may be done by inl rociucing

the CiOIChet within the

openin~

of the 0,,,11. The brain

being lhus dtnroyen, and the inllrumcnl withdrawn,

J¿t

him introduce his right hand lnto lhe vagina, and lv.'O

fingers ¡nlO lhe opeoiog which hath be(:a made, tllat if

any (harp fpli otcrs of lhe bones rC:11ain, they may

brokeo off and "ken out; lefl they O\ould injure the

woman's vagina, or the operator's own fin gers,

the cafe be an hyd roeephalus, let hi", fix his finge ra

on the infide and his lhumb on lhe out(ide of the opening.

and endeavour to pull along the Owll in lime of a p;,,¡jn ;

but. if labour is

we~k,

he muH delire [he \\loman ro

:l.ffil~

his endeavours by fo rcing clown; and tb us the chi ld is

frequently dcli"er!d ;

bec~ure,

the water ueing

e\'acua~

ted, the head collapfe. of cou rfe.

Hut ...-hen tbe pelvis is narrow, the head rcquires

mu~h

greater force tObe brought "long ; unJefs lhe labour-pains

are firong

enoug~

pre:fs

dowo an5i diminifh

it,

by '

fqu eezing out tbe cercbrum : in this

c~re.

let the

op~ra·

tor wirhdraw his fingers from the opening, 'and, fiidin'g

theOl along the head, pars lhe os Ulerí; IheD, .witb hi3

le(t hand, taking one o( Ihe crotehets froOl the place of

in concealmcnt. introduce

along his righl hand, with

lhe poinl tow2rds the child's heau, and fix it aboye the

chin in the mouth , baek par! of lhe'neck. or abovc lh<!

ears, or

any pl áee where it will ,take firm hold: h1-

ving

fi~ed

the inflrument, Jet him withdraw his right

hand, and wilh it take hold on the end or handle of the

crotehet; then introduce his lefe to {eize lhe ooncs at the

opeoiñg of Ihe Ikull (as aboye diretled ) thal the hcad may

be kepl n.ady,

~nd

pul! .Iong with both hands.

,he head is nill delaincd by the uneommon narrow–

nefs of the

p~eJ vjs,

let him introduce: his Jcft hand along

the oppoGte fide, iD order to guide the olher erotchet

" hieh beil1g . Ifo . pplie'd aDd loeked or joined with its fel·

low, in the manner o( the fortep•• he mufl pull with fuf·

fiCie'nt force, moving from Gde to fide, and as il advances,

turn the rore hetld ioto the hollow of the facrum, and ex ·

traét as Wilh the fo rceps, humouring lhe Chape of the

head and pelvis du ring the operation, which ough t

performed llow)y, with greilt judgnlcnt and caution ; am.l

from hence

appears ab(olutely neceITary

kno\V hOlV

the head pre(enls, in orde r

jtln;:: how [he crotche't

mun be fi xerl, aod the head brought .Iong tO tbe beH ad–

vantage.

Ir,

when the head is delivered in lhis manner, the bo–

dy cannot be extraélecl , on llccount of

l iS

being muéh

f",<lIed, ora monfl rous fize " or

("'h~h

is moH eomtnon–

Iy th e cafe) the n.rrownefs

the pelvis; I"t him de,f. '!

(rom pulling: lefl the head OlOulrl be fep.rated frolll tho

boay. and introducing One hand fo as

reach with his

tingers tO the /houlder-bl.dcs or

brc.fl

, coooutl . Iong it

aone

of the erolchets, Wi lh lhe point tow.:ucls

thc ,fU!: lI~.

2nd fi x

with a Ij lm appl ic:¡tio'n; then WilhdrJ\\'if'lg his

hand , employ it in

pulltn~

the crolchet, "hile the olha

3 III