Observations on the Caesarean section and on other obstetric operations : with an appendix of cases.

  • Radford, Thomas, 1793-1881.
Date:
1865
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the Caesarean section and on other obstetric operations : with an appendix of cases. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    the forceps ought not to be used before the os uteri is fully dilated, or until the woman has been in labour a certain number of hours, or until the ear of the child can be felt, are highly dangerous. They are delusive, and would, if acted upon, altogether prevent the use of the long forceps. If these alleged conditions are required to exist to guide the prac- titioner when he ought to have recourse to this instrument, these rules are tantamount to a complete interdiction of its use. In fact, they are too absurd, unfounded, and dangerous, as indications of the propriety of even using the short forceps. To wait for the dilatation of the os uteri after the rupture of the membranes is a great mistake; for, in the great majority of cases which require aid by the long forceps, this organic change cannot take place. The obstacle being at the brim of the pelvis, the head of the infant cannot be pressed down upon it; so that, before this change happens, irretrievable mischief may be inflicted by the con- tinued pressure which the pelvic tissues must, under such circum- stances, endure. Therefore, as soon as the time has arrived for dehvery, we must not hesitate to apply the long forceps, provided the OS uteri is so far dilated, and further dilatable, to enable the practitioner safely to introduce the blades. If the instrument is in the hands of a discreet and judicious obste- trician, no mischief need be dreaded ; for the blades of a well-made instrument will rest as safely within the uterus as the hand of the practitioner. Time ought never to be considered an element of calculation, especially during the second stage of labour, for the use of instru- ments, except in creating an anxiety to be on the watch, and to take timely stejDS to deliver the patient. An early use of the long forceps, when the necessity of the case is established, will prevent those serious constitutional and local mis- chiefs (already mentioned) which are produced by the long continued pressure of the head of the infant upon the pelvic organs and tissues. Tliose who are opposed to the use of instruments, and advocate time and patience, attribute to their application those structural and organic lesions which are really the effects of delay. It has been already stated, that the head of the infant can only safely bear a certain amount of compression by the forceps; but it must also be understood, that the infant is frequently destroyed by injury inflicted upon the head during protracted labour. Procras-