As we have passed the upper blade behind the right acetabulum or foramen
ovale, so now we must introduce the other in the opposite direction, viz.
before the left sacro-iliac synchondrosis: and, as the blades being
exactly opposite to each other is essential to the easy locking of the
instrument, it will be necessary to guide the course of the second blade,
not so much by the form of the pelvis, as by the direction of the first
blade. It must, therefore, pass up, so that when introduced to its full
extent, the inner surface of its handle shall correspond precisely to that
of the first blade. The easy or difficult locking of the blades is a proof
of their having been correctly or incorrectly introduced. If, therefore,
on bringing the locks together we find that they do not correspond, that
the inner surfaces of the handles are not parallel, but form an angle with
each other, we must endeavour to rectify this, by withdrawing, to a short
extent, that blade which deviates most from the proper direction, and pass
it up again more correctly. All attempts to twist the handles so as to
correspond with each other, are bad and cannot fail to put the patient to
much suffering.
When we are about to lock the blades, we cannot be too careful in
preventing the soft parts from being pinched between them, for it causes
most intolerable pain, and frequently makes the patient give such an
involuntary start, as to run the risk of altering the position of the
instrument.
The whole process of introducing and fixing the forceps should be
conducted in as gentle and gradual a manner as possible: no attempt should
be made to proceed with the operation during a pain; and in no case is
force either necessary or justifiable.
Public-domain text, read in full here on John Shaqi.
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