Selected writings of A. Jackson Howe.
This is a kindly word to the physician, who would exaggerate the trite old saying, "Meddlesome midwifery is bad," and then let the woman in parturient throes suffer excruciatingly when careful operative manipulations could quickly give relief. We frequently hear physicians say, "I never use forceps!" When we hear this we make a mental reservation that such a man will never attend a woman for us if we can legitimately prevent it. Forceps are a blessing. The long Hodge has saved countless lives, and the short forceps has made blessed many an accouchement that might have been endured only in torture. Badly and unskillfully used, or by one who is drunk, of course forceps are dangerous; but rightly employed by one who knows his anatomy and obstetrics—forceps both long and short—should be classed among the benefactions to the suffering parturient.—Ed. Gleaner.
SHORT OBSTETRIC FORCEPS.—Although a stanch advocate of the long and strong forceps of Hodge, I occasionally encounter a case of delivery in which a pair of short and light forceps is desirable. I refer to a primipara in prolonged and exhaustive labor, where the head of the child, during a uterine throe, is forced to the vulvar aperture, yet recedes an inch or more as soon as the energy subsides. The accoucheur tries, by applying pressure with his finger against the side of the foetal head, to prevent recession, but his efforts seldom succeed. The parturient woman becomes tired and discouraged, and the throes of the womb less energetic, so that failure is possible, if not probable. The child's head is almost within the grasp of the hand or fingers when a pain is on, but by receding gets quite out of reach. As time passes patience and energy are wasted, and dangers increase. If the worried woman be given cups of tea and encouraged she may weather the storm, and think the medical attendant has exhibited great skill; but what are the facts in the case? The obstetrician has done little or nothing, and the poor sufferer has done all. She triumphed because she possessed an enduring physique; the doctor is thanked because no one present is competent to criticise. Instead of wasting time and strength in stupidly waiting the obstetrician should be prepared to deliver the woman with forceps as soon as her energies begin to nag, and progress of the labor has virtually ceased. He should have at command a pair of light, short forceps and be prompt to use them. He can deliver the patient in five minutes and guard the perineum against rupture. He does all in a skillful and timely manner, and deserves praise and pay whether he gets either or not. He could have delivered the parturient woman with the heavy forceps of Hodge, but the implements are awkward and clumsy for a gentle piece of work. It is using a claw hammer to draw a carpet tack. An instinctive admiration for "the eternal fitness of things" will move the obstetrician to keep in store a light and short pair of delivery forceps.—HOWE, Eclectic Medical Journal, 1886.
The Biographies of King, Howe, and Scudder, 1912, was written by Harvey Wickes Felter, M. D.