THE OBSTETRICAL EORCEPS. 
Iii the fast growing and ambitious cities of the west it may 
often be noticed that more attention is given to laying out and 
grading new streets, than to keeping in good condition the old 
thoroughfares of daily business. In these last,masses of refuse 
will be seen to hide a dilapidated pavement, while far out on 
the city's verge the surveyor and the paver are busy. 
In our own art, if I mistake not, there is, in like manner, an 
eager pursuit of novelties, to the harmful neglect of principles 
and methods that are of daily application. I shall offer in this 
article some reasons for thinking that the rules and modes of 
using the obstetrical forceps have suffered this neglect, and I 
shall make some suggestions for their improvement. 
Notwithstanding the indisputable fact that only a few expe- 
rienced obstetricians acquire such dexterity and confidence in 
the use of the forceps as to resort to it freely, it may still be 
truly said that the whole armory of our art furnishes few instru- 
ments that are so useful in saving life and in lessening suffering. 
I think it furnishes none that are so capable of serving these 
ends. It fails of doing all it might do, because of the real or 
supposed difficulties and dangers that attend its use. Many 
an obstetrician, skilled and ready in every thing else, is afraid 
of the forceps. Distrusting his own dexterity and fearful of 
possible evils, he rarely or never resorts to this instrument. To 
the neophyte it is a terror. 
I think the consciousness of my young readers and the recol- 
lection of their elders will give consent when I say that no 
operation in instrumental therapeutics is more dreaded by the 
novice than the delivery of a parturient by the forceps. I, for 
one, shall never forget the anxiety, the agitation, the sinking of 
the heart, the fear of failure, and, worse still, of the exhibition 
of incompetency, that preceded, nor the blind groping with the 
blades and the vain attempt to remember and apply the precepts 
of the books that attended, my early trials with this instrument. 2 
Such repelling and unmanning terrors, and such fruitless 
efforts, be it observed, are doubly unfortunate, when, as in this 
operation, the crisis to be met is one that occurs to every prac- 
titioner, one that he must often meet alone, and one whose 
peculiar urgency is greatly augmented by the impatience, the 
anxiety and the expectation of friends, and by the suffering 
and often the danger of the patient herself. 
In my own case I cannot be wrong in attributing these early 
fears and perplexities to faulty instruction. My purpose in 
this article is to show that these terrors do not legitimately 
arise from the character of the operation itself, nor are these 
difficulties inherent in it; but that they result from the errone- 
ous way in which the subject is taught in books and in schools. 
I undertake to show that, in many of its most essential partic- 
ulars, that teaching is defective and erroneous in substance, and 
in manner unnecessarily complex and obscure. A total want 
of uniformity in the rules laid down by different authors adds 
to the perplexity of the pupil. 
In place of these obscure, complex, impracticable and dis- 
cordant instructions, I undertake to give a set of rules that shall 
be simple and intelligible, that shall be applicable to all cases, 
and that shall thus rob the operation of its terrors, and make its 
practice, for obstetricians of ordinary intelligence and dexterity, 
easy and certain 
The points that I propose to touch upon are: 
I. The danger that attends the use of the forceps. 
II. The exigencies that call for the forceps. 
III. The best kind of forceps. 
IV. The posit ion of the patient. 
V. The law of application. 
VI. The manner of introduction. 
VII. Locking 
VIII. Slipping. 
IX. Compression of the head. 
X. Management in extraction. 
On all of these points I shall venture to differ more or less 
widely from the received authorities, and I shall discuss only 
the particular matters in regard to which I thus differ from 
them. 
I. Dangerousness of the forceps. 
Is the delivery of a parturient woman by the forceps attended 
with any considerable degree of danger to her ? The general tone 3 
of our teachers and text books replies in the affirmative to this 
question. I shall never forget the earnestness with which that ex- 
cellent and conscientious instructor, the late Prof. C. JR,. Gilman, 
used to impress upon the minds of his pupils the terrible dangers 
that attend the use of all midwifery instruments. It was his 
custom, in closing his lecture, to fling them from him with a 
somewhat theatrical show of terror and aversion, and to warn 
us in the most impressive manner of the fearful responsibility 
that accompanies their use. An innocent pupil was almost led 
to think that, in certain bad cases of labor, it was pretty much 
an even thing between letting the woman die a natural death, 
and twisting her womb off with the forceps, or letting her bowels 
out with the perforator. 
On looking over authors I find that these terrors are by no 
means peculiar to Professor Gilman. Cazeaux warns us of 
" lesions of the cervix and perforations of the vagina." He 
says: "There can be no doubt that the use of the forceps 
increases the danger of delivery." Churchill speaks of "lacer- 
ation of the vaginal parietes, bruising the os-uteri," etc., etc. 
Blundell says: "In violent hands the long forceps is a tremen- 
dous instrument. Force kills the child, bruises the soft parts, 
occasions mortification, breaks open the neck of the bladder, 
crushes the nerves," etc., etc. So much is he afraid of wound- 
ing the soft parts, that he advises us always to count the pulse 
between the pains, to see whether we are killing our patient! 
It was reserved for Dr. G. S. Bedford to reach the acme of 
terrorism, and to stir the imagination of his hearers and his 
readers with the most fearful pictures of ruin wrought by the 
forceps. 
"The use of the forceps," he says, "is too often a scene of 
harrowing agony to the patient." He speaks of "fractured 
pelvic bones" and "disparted symphyses;" of "vesico-vaginal 
fistula," of "occlusion of the vaginal walls and the meatus 
urinarius," etc., etc., as common results after forceps delivery. 
He pretends to support these statements by cases; but the 
reader who carefully examines these cases will see that they 
really give his representations no countenance. In the case, for 
example, which he gives on page 570, the history that he nar- 
rates in no way warrants him in attributing the calamitous 
result to the use of the forceps. It was probably due to the 
length-three days - and the severity of the labor, and would in 
all likelihood have been different if the forceps had been used 
in time. It was probably "masterly inactivity," and not the 4 
forceps, that did the damage. I believe that similar criticism 
will apply to almost all of the cases that are given in books to 
illustrate the dangers of the forceps : the premises will not 
warrant the conclusion, and, indeed, the history is generally 
too imperfect to warrant any conclusion. To me, with some 
observation and experience of my own, these terrible represen- 
tations seem ridiculous and absurd. I affirm that the forceps 
is not in any material degree a dangerous instrument to the 
mother. In my own practice and observation I have but once 
seen death follow a delivery by the forceps. In that case the 
fatal flooding was clearly due to exhaustion and uterine atonicity 
from too long delay of delivery; the application of the forceps 
and the extraction of the child was quick, easy and painless. 
I have seen some discreditable fooling, and a little cruelty, with 
the forceps, but I have never seen a case in which there was 
reason to attribute any injury of the paturient to its employ- 
ment. When skilfully used it is not only harmless but pain- 
less. I never attend a patient whom I have delivered with this 
instrument without her asking for it again. The forceps is, 
indeed, a peculiarly innocent instrument. With its curved 
form and rounded edges it is almost incapable of mischief. It 
cannot cut, or puncture, or tear, or scrape. Neither can it 
bruise the soft parts, without the most stupid and reckless vio- 
lence. As for its being pushed through the vaginal or uterine 
walls, it would be difficult or impossible to do it intentionally. 
Injury to the bony parts of the pelvis is equally out of the 
question. 
The proportion of women that die after the use of the forceps 
is no evidence of its dangerousness; as well might we in the 
same way argue that bleeding, or opium, or any other treatment 
is dangerous in puerperal convulsions. Statistics are therefore 
of no value. It is obviously impossible to distinguish between 
the deaths that are caused by the forceps - if it is claimed that 
any one so caused - and those that result from the conditions 
that called for them, or from other causes. The forceps is seldom 
resorted to save in protracted and difficult cases, and in these 
a considerable mortality is to be expected from causes entirely 
independent of the instrument. 
I will not deny that, if the operator, following the instructions 
of the books, endeavors, obstinately and uncompromisingly, to 
introduce the long, double-curved forceps into the upper part 
of the pelvis, with its pelvic curve twisted from accordance with 
the anatomy of the passage thereto, he may injuriously bruise 5 
the maternal parts ; nor will I deny that a similar or even greater 
evil may result if he imitate Dr. Elliott (viz., his Obstetrical Clin- 
ique, passim), and wantonly and absurdly use such force as to 
"break" or "bend" a blade, "endanger the integrity of his 
instrument," "lay out his whole strength with braced feet," 
etc., etc. What I do claim is that, if he use ordinary anatomical 
knowledge, mechanical skill and common sense, the obstetri- 
cian cannot harm his patient with the forceps, and therefore the 
conscientious practitioner need never fear to try them. I think 
it would be difficult to find a single case in the books that, prop- 
erly interpreted, even tends to prove the contrary. I have not 
found one. I am substantially supported in my opinion of the 
innocence of the forceps by Professor Simpson, as the reader 
will see by reference to his obstetrical works. 
I shall not claim that this instrument is ordinarily as harmless 
to the child as it is to the mother. The features of the infant 
are in practice often temporarily, and sometimes permanently, 
disfigured by it, while the bones, and even the viscera of the 
head have been sometimes fatally crushed. Dr. Elliott, in his 
"Obstetrical Cases," furnishes several instances of this. I do, 
however, claim, that these injuries are entirely unnecessary, 
and proceed solely from want of skill in the operator. It is only 
when the grasp that the forceps gives is used for the purpose of 
compression, or to avoid slipping, that the instrument, when 
properly applied, can do any damage to the child's head. I 
expect hereafter to show that compression is never necessary or 
useful, and that, when properly applied, the forceps cannot slip. 
The fear that seems to possess many obstetrical authors of 
punching off the ears, or peeling the cranium of its scalp in 
passing the blades, is entirely absurd. Such an accident is 
substantially impossible. The beginner really need not have 
the bother of taking care of the child's ears added to his other 
troubles. 
II. What are the exigencies that call for the forceps ? 
This question in my opinion admits of a simple and compre- 
hensive answer. The occasion, the justification and the obli- 
gation, of using this instrument are co-extensive and identical. 
Whenever, in a head presentation, with probable room for the 
head to traverse the pelvis, and with the os fully dilated or 
partly dilated and easily dilatable, the longer continuance of 
unaided labor involves danger either to the mother or to the 
child, or even a long duration of suffering to the mother, the 6 
forceps should be used. I go further ; I hold that the forceps is 
justifiable sometimes in order to cut short the unnecessary 
protraction of those anxieties of the patient and her friends, 
that attend uncompleted labor, and even to save the time of the 
practitioner himself. I am well aware that in this opinion 
I widely depart from the maxim that authority sustains. 
Churchill, though reckoned an advocate and defender of the 
forceps, lays down the rule, in italics, for emphasis, that "they 
are to be applied in no case, till we are perfectly satisfied that 
the obstacle cannot be overcome by the natural powers with 
safety to the mother and the child." It is such a rule as this, 
causing perilous delay, that makes this instrument, in crude 
statistical tables, seem the means of death. I repudiate this 
rule. It is a rule that may fitly be followed by those who 
believe the operation to be difficult or dangerous, but it is not 
one for me, who think I find it as easy as the passing of a 
catheter, and as innocent as giving an enema. 
As it is not my purpose to write a systematic treatise on the 
forceps, but only to touch upon those matters where I think the 
existing practice is erroneous, I shall not enumerate and dis- 
cuss in detail the many items that are comprehended in the 
rule that I have laid down, but shall content myself with some 
observations on certain supposed limitations of it that are to be 
found in the text books. Those limitations that hang on the 
supposed dangerousness of the operation I have already suffi- 
ciently discussed. 
It is said that great violence of the pains contra-indicate the 
forceps, on the ground that a reinforcement of the expulsive 
power would be dangerous. This doctrine is entirely erroneous. 
The use of the forceps in such cases, in addition to its ordinary 
advantages, saves the womb from some part of that perilous 
violence of muscular action that, beside minor evils, sometimes 
threatens even its own integrity. 
Neither is extreme resistance or rigidity of the soft parts a 
contra-indication. It is even an indication. If rigid perineal 
tissues be the obstacle, the danger of their laceration will be 
lessened by the forceps. The wedge-like form of the proximal 
end of the locked blades is an important aid in dilatation. It 
prepares the way. Meantime it diffuses the bearing of the 
uterine force along the longitude of the vagina, lessening its 
intensity at any point. On the other hand, so far as the resist- 
ance is due to the action of the perineal muscles, greater 
mechanical force in overcoming it is no way objectionable ; and 7 
it can certainly be more cheaply furnished by the arm of the 
obstetrician than by the uterus of the mother. 
Moreover, the experienced practitioner will remember that a 
majority of the cases of laceration of the perineum occur when, 
after long delay at that point, and many ineffectual pains, the 
uterus, as if vexed by the futility of its efforts, with one tre- 
mendous throe suddenly bursts through the obstacle. Reflex 
power, when repeatedly foiled, does thus accumulate. The 
forceps, by securing the steady progress of the head, in some 
degree, obviates the danger. 
Besides this, it is to be remembered that laceration of the 
perineum seldom or never occurs, save when there is a con- 
genital deficiency of the elastic tissues of the vulva. This 
imperfect development may be hardly appreciable, or it may 
approach atresia. If it exist in even a slight degree, laceration 
of the parts is perhaps inevitable. Whatever the degree of 
danger may be, it will not be increased by the forceps unless 
the final delivery be wantonly and violently precipitated. The 
additional bulk made by the blades is next to nothing, and is 
more than balanced by the slight elongation of the head that 
almost necessarily attends their use. Meantime their wedge- 
like shape, beginning earlier the dilatation of the external parts, 
necessarily makes it more gradual and therefore safer. 
Not a few authors declare that the use of the forceps should 
not be attempted when the head is above the superior strait. 
I can conceive of no good reason for this limitation. The 
operation under these circumstances is somewhat more dif- 
ficult to the inexpert, and is sometimes impossible, but it is 
entirely free from the objection of peril. When the waters 
have escaped, tonic uterine contraction generally holds the head 
firmly against the inlet of the pelvis, with a larger or smaller 
segment of it engaged therein. In this condition a toler- 
ably expert operator will have no great difficulty in grasping 
it with his instrument, and, if it be not detained by insuperable 
mechanical obstacles, delivery can be readily effected. On the 
other hand, when, from deficient tonicity of the uterine walls, 
or from the presence of a considerable quantity of amniotic 
fluid, or from both of these causes combined, the head is freely 
movable or floats above the pelvic brim, the attempt to apply 
the forceps will be of doubtful success. Turning is then the 
surer resource. This exigency may co-exist with hemorrhage, 
convulsions or other accidents calling for speedy delivery ; but 
it can hardly obtain in any of the forms of dystocia proper, 8 
save in that in which there is so considerable narrowing of the 
pelvic brim as to make impossible any other means of delivery 
than embryotomy. The principal source, in my opinion, of the 
objection that many authors entertain to the use of the forceps 
when the head is in high situations, is in their utterly erroneous 
mode of applying the instrument. It is this that makes very 
many respectable authors oppose its use even when the head is 
already engaged in the superior strait, and needs but the touch 
of skill to cause it to finish its course. 
III. What hind, of forceps should loe used ? 
To the possessor of the long, double-curved forceps, the 
short forceps is utterly useless. Every thing that can be done 
with the latter can be done with equal facility, safety and pain- 
lessness with the former. The obstetrician who sports both kinds, 
must be of a piece with the well-known gentleman who directed 
his carpenter to make in his garret door a big hole for the old 
cat and a little one for the kittens ! 
Equally unnecessary is it, in my opinion, to have several dif- 
ferent forms of the long forceps. The editor of Prof. Simpson's 
Obstetrical Works reports him as saying, that "the more fre- 
quently he applied the forceps the more firmly he became con- 
vinced that one pair, of proper form, would answer for all 
forceps cases." (Vol. 1. p. 442.) I entirely coincide in this 
opinion, and in the last fifteen years of tolerably extensive 
obstetrical experience have had occasion to touch but one pair. 
I am, accordingly, quite unable to appreciate the practice, in this 
particular, of Prof. Elliott, who, in his "Obstetrical Cases," re- 
ports himself as often trying several pairs in succession in the 
same labor. He seems to carry about with him as many tools 
as a carpenter or a burglar. This, of course, is not done for 
effect. He may safely trust more to his own skill and less to 
the skill of his instrument maker. 
The exact shape of the blades and the mode of locking have 
been the subject of a great deal of attention, and of many modi- 
fications and supposed improvements. One would imagine, 
from the amount of ingenuity that has been expended on the 
subject, that accoucheurs were in pursuit of a key to open some 
intricate lock, and not of a pair of slender artificial hands to 
glide along a passage of well-known shape to a position that 
our own hands cannot reach, and to clasp there simply an ovoid 
body. All of the modes of locking are good enough; and I am 
inclined to think that the slight differences in the shapes of the 9 
modern instruments are not very material. The instrument that 
I use (and of course think the best that was ever made) is called 
in Paris "Dubois" forceps, and was made by Charriere of that 
city. It is considerably longer, and somewhat more pronounced 
in its pelvic curve than Simpson's or Elliott's, and, in my opin- 
ion, is therefore better. I have not found it necessary to add to 
it the sliding guard of the latter inventor. 
IV. The position of the patient. 
The expert operator can apply the forceps equally well with 
the parturient on her side and on her back. The former position 
has this advantage, that, since women in this country are gener- 
ally confined on the side, the arrangements for the operation in 
that position are less disturbing than in the other, and therefore 
less menacing to the imagination of the patient. This position 
also gives better access to the field of operation. I shall how- 
ever recommend the other posture; for the reason that it better 
enables the practitioner to see, with the mind? s eye, the anatomy, 
the mechanism, and the physics of the matter in hand. It is 
the position in which bodies are dissected, and in which we are 
in other ways most familiar with the female pelvis. In addition, 
this posture is symmetrical with the posture of the operator 
while operating-a fact which greatly facilitates both his con- 
ceptions and his manipulations. 
The grand question in the use of the obstetrical forceps is, 
whether the law of their application should hare relation to 
the particular presentation of the head, or to the curve of the 
pelvic axis ; to the anatomy of the child, or to the anatomy of 
the mother. Shall we have regard to the theater, peculiar and 
nearly invariable in form, and definitely limited in extent, in 
which our operation is to be conducted, or to the posture in which 
the object to be seized may chance to lie ? It is the former of 
these alternatives that the American, English and French 
authors that happen to be within my reach, unanimously adopt. 
Most of them say that the blades of the forceps should be 
applied "to the sides of the child's head," "parallel with the 
parietal bones." Even those who admit a less exclusive rule, 
substantially coincide with Prof. Bedford, who delares : " It is 
the position of the head that should determine the position of 
the blades. (Principles and Practice of Ostetrics, p. 558). 
V. The pr inciple of the application. 10 
The same doctrine is taught by all the public lecturers on 
obstetrics that I have had the opportunity of hearing. In 
short, this is the principle that the American student finds 
everywhere laid down. It is not necessary to multiply 
quotations. 
Prof. Simpson, it is true, appears to be partly aware of the 
absurdity of this rule. He says (Obstetrical Works, vol. I., p. 
440), that "the application of the long forceps to the lateral or 
aural surfaces of the child's head at the upper strait, as described 
by Burns, Dewees, etc., and pictured by Churchill, is impos- 
sible in the very cases in which they are generally required ; ' ' 
for these reasons, among others, that "their pressure would 
greatly endanger the urethra and bladder in front," and "that 
they could not thus be placed in the axis of the brim, in conse- 
quence of the pressure of the perineum upon the instrument 
below." He makes like objections to the mode of application 
taught by Deleuyre, Davis and others, and illustrated in Rams- 
botham. But when Dr. Simpson comes to lay down a method 
of his own, he falls into the same fundamental error as those 
whom he condemns. He directs the blades to be applied upon a 
certain diameter of the head. In other words, he teaches us to 
be governed by the presentation, and not by the maternal 
anatomy. 
In my opinion this rule is entirely erroneous. I believe that 
the blades should simply follow the course of the utero-vaginal 
canal, and, when applied, should, in all cases, be in accord 
with the curve of the pelvic axis, regardless of the presentation. 
I believe that the presentation is not of the slightest consequence, 
and cannot be advantageously, or, in many cases, even inno- 
cently regarded. Wherever the sides of the head may be, the 
blades should be applied to the sides of the pelvis. I should 
perhaps hesitate in thus rejecting the traditional and uniform 
instructions of our authorities, did I not find it casually men- 
tioned in Cazeaux, p. 802, that the method that I recommend is 
the practice of at least a part of the profession in Germany. 
If the received doctrine on this subject be an error, it is a very 
grave error, and leads to very grave evils. The first of these is 
that it imposes upon the operator the necessity, as a preliminary 
step, of ascertaining the presentation. Even to the experienced 
practitioner this is not always easy; to the neophyte it is 
always difficult and uncertain. Knowing it is to be so, he is never 
sure that he is handling his blades rightly. This doubt is a 11 
constant source of embarrassment and hesitation, and often 
makes him withdraw and introduce a blade again and again. 
A far greater evil is that this doctrine necessarily makes the 
rules to be followed exceedingly complex : for the modes of in- 
troducing and applying the forceps must be as various as the 
presentations. Accordingly we find in all our authors a great 
variety of rules for the different presentations. Cazeaux gives 
special directions for each of eight vertex presentations when 
the head is at the inferior strait. Above that point, vertex pre- 
senting, he makes still other varieties of procedure. In face 
presentations he gives us similar changes in the modes of appli- 
cation. 
Dr. G. S. Bedford has four variations in the application of the 
forceps at the upper, and four at the lower, strait. After these 
conies a miscellany of some half a dozen other modifications. 
Dewees says, "the forceps should be applied to the sides of 
the head." He has four variations in this operation for the 
seven primary presentations that he counts, and still others for 
the more rare and difficult presentations. 
Meigs lays down the same rule, "that the blades are to be 
applied to the sides of the head," and makes as many variations 
in the operation, some ten or a dozen, as consistency seems to 
him to require. His whole chapter on this subject is worth 
reading as an example of "confusion worse confounded." 
Churchill says, that "at the brim of the pelvis the forceps 
may be applied in the transverse, the oblique, or the antero- 
posterior diamete •, etc., etc., according to the presentations. 
These references to popular authors, selected at random, are 
sufficient to show the extreme complexity of the rules for deliv- 
ery by the forceps-as they are presented to learners at the 
present day. 
It will be worth while for those who are curious on the subject 
to follow farther this comparison of obstetrical authorities. They 
will not fail to notice that, true to the native inconsistencies of 
error, the directions given in the different text books follow no 
common law or principle, but are various and conflicting in the 
utmost degree. The number of varieties in the mode of appli- 
cation is from three to more than a dozen. Some authors give 
different directions, according as the head is at the upper or the 
lower strait, or between these points; others make no distinc- 
tions. Some make a difference in their instructions, according 
as the long or the short forceps is to be used, others treat of both 
in the same words. So greatly unlike are their descriptions of 12 
the proper way of introducing and managing the blades, of the 
direction of the handles, etc., etc., in any particular presenta- 
tion, that a reader would not suppose they were treating of the 
same case, or even the same subject. 
What is the reason of these discrepencies and this confusion i 
Truth is always simple. The handling by learned and ex- 
perienced men of a subject so long familiar to the profession as 
this has been ought to exhibit the simplicity, uniformity and 
exactness of scientific truth. It exhibits in our leading authors 
none of their qualities. The cause is that the principle with 
which they start, and on which their reasonings and descrip- 
tions are based, is essentially and totally erroneous. It is not 
the presentation that should govern the mode of application. 
However the head may present, the law that should govern the 
position of the blades is one and the same. 
That law is that the pelvic curve of the forceps shall follow 
and coincide with the utero-vaginal curve. 
For what purpose, let me ask, is the pelvic curve given to the 
long forceps, unless it is to accommodate the shape of the 
instrument to the anatomy of the mother ? It is only a single 
line of direction that this curve can fit; that is the line of the 
pelvic axis, and it will bring the blades symmetrically against 
the sides of the pelvis, with the convexity of their pelvic 
curves following the bend of the sacrum. The curve of the 
sacrum and of the vagina and the resistance of the floor of the 
pelvis, elements so powerful that in every labor we see them 
change the direction of the head by more than a quadrant of 
a circle, must be fully regarded, not only in the form of our 
instrument, but also in the position in which it may be placed 
in the utero-vaginal canal. Obvious as this would seem to be, 
I look in vain among the authors within my reach for the due 
acknowledgment of its importance. 
I assert that till the head is actually at the outlet of the 
pelvis it is substantially impossible to apply the forceps in 
any other than the manner I have indicated. A slight devia- 
tion of the instrument toward an oblique diameter I admit 
to be possible, but its own shape and the laws of mechanics 
confine that deviation within narrow limits. How can you 
place the blades along the parietal bones when the plane of 
those bones make an angle with that part of the pelvic axis 
in which the head is situated ? Or how can you, without 
undue violence, lay them there when their pelvic curve must 
widely divert from and antagonize the curve of the maternal 13 
passage ? The curve of the vagina still exists even when that 
canal is dilated to permit the passage of the head: can it be 
disregarded in the mechanics of forceps delivery ? If we com- 
pare the distance, following the sacral curve, between the pos- 
terior commissure of the vulva and the posterior edge of the 
pelvic brim, with its anterior counterpart, it will be obvious that 
the blades, one following one line and the other the other line, 
cannot be brought squarely and symmetrically to embrace the 
head, without forcing their handles violently back to the very 
coccyx. Nor, when the head is at the superior strait, can it be 
done even thus. Nevertheless these are the virtual impossibili- 
ties that authors and lecturers, in the most matter-of-course way, 
call upon us to perform. They hardly ever suggest a difficulty 
or a doubt. Their language would make one think that the 
forceps can be played about in the female pelvis, with its pelvic 
curve bulging this way or that, as freely and easily as in an 
india rubber bag or in a barrel. 
To cap the climax of absurdity, our professors illustrate their 
instructions on that most useless and preposterous of all human 
contrivances, called by Dr. Meigs, with unconscious appropri- 
ateness, "the Phantom." I well remember, as a pupil, spend- 
ing hours over that effigy, learning, as I innocently supposed, 
to apply the forceps to the sides of the head when it presented 
in this, that and the other position. Nothing could be less like 
nature, and nothing, therefore, could be less instructive. It 
was like breakfasting on the morning fog. You might as well 
practice passing a catheter on the town pump. 
I admit that when the head is at the pelvic outlet, the forceps 
may be applied to it in any of the diameters of that outlet. 
But even here the blades are best applied to the sides of the 
pelvis ; for only thus will they be in symmetrical and easy rela- 
tion to the maternal parts. The application of them in an 
antero-posterior position, or in a position approaching that, 
involves straining back the perineum in a painful and injurious 
manner, and threatens harm to the soft parts that underlie the 
peb'is. For these evils this mode of application has no com- 
pensating advantages. 
I shall be asked to reconcile the position I take in this matter 
with what authors represent themselves as doing. I prefer not 
to undertake to do this. When a man describes the application 
of the blades of the forceps antero-posteriorly at the upper 
strait, he describes what is impossible. Let me add that many 
times operators deceive themselves with regard to the direction 14 
i n which the blades are passed; and many times authors, in 
their descriptions as well as in their maxims, blindly follow the 
beaten path. 
If I am deemed guilty of unwarrantable audacity in speaking 
thus of our obstetrical authorities, I shall shelter myself behind 
the quotation that I have already made from Professor Simpson. 
If Burns and Dewees and Churchill describe impossible pro- 
cesses, and even sketch them for the engraver, as he says they 
do, why may not the most modern book-makers err in the same 
way ? I am of the opinion that they do so err. I think, more- 
over, that it is entirely proper for any practitioner to repudiate 
authorities that are so utterly inharmonious as those that now 
bear sway in this matter of the application of the forceps. 
Professor Elliott, though he follows the rest in instructing us 
to obey the presentation and apply the blades along the sides 
of the head, betrays the idleness of the rule when he says, 
page 300: "In difficult applications they will generally be 
applied over one of the oblique diameters of the foetal head." 
Inspection of the head, after delivery, will show that they almost 
invariably lie upon the head in this manner, and almost never 
along the parietal bones. 
An inspection of the cuts for illustrating forceps delivery that 
are to be found in treatises on midwifery, will show that the 
representation of impossibilities with which Professor Simpson 
charges Churchill is sometimes avoided by making the picture 
entirely inconsistent with the text. An application in an oblique 
diameter of the pelvis is described in the text, while the illus- 
tration of the forceps in position represents the instrument 
laterally applied, the locked handles being unmistakably in 
the plane of the transverse diameter of the pelvis, and resting 
squarely against the perineum. The fact is, that a properly 
constructed blade of the long forceps, when once engaged 
between the head of the child and the wall of the vagina and 
pushed home along that canal, has, from its very shape, so 
strong a tendency to settle into the position to which alone its 
double curve is adapted, that only the perverse misdirection of 
ill taught and violent hands can make it go astray. This is the 
reason why the young accoucheur, after repeated but futile 
efforts, has often found his instrument strangely and unexpec- 
edly slip into its place just when he was despairing of success 
and had almost ceased to try. 
It is easy, too, for older operators, when the greater part of 
the blade is buried out of sight in the pelvis, to be deceived 15 
with regard to the direction it is taking, donble cnrved as it is, 
and to erroneously believe that its whole course is on the line 
in which it began. 
There are two ideas wTiose influence seems to have kept the 
minds of obstetric teachers fixed on always aiming to apply 
the blades of the forceps to the sides of the child's head. The 
one has relation to the safety of the child, the other to facil- 
itating delivery by getting hold of the head endwise. In regard 
to the first, it is true that the blades so applied will "fit" 
somewhat better than when applied in any other diameter, but 
the head is so near a globe in its form that the difference in the 
fit or in the security of the hold is not material. The immunity 
of the child, in bone or feature or viscus, is never endangered 
by the proper use of the forceps. The obstetrician whose 
instrument disfigures the new-comer is a bungler whose only 
excuse is that he was taught in a bad school. Forcing the 
end or the edge of the blade into the child's tender flesh is a 
barbarous result of that stupid idea in obedience to which we 
are told to compress the head in order to diminish its size or to 
prevent the instrument from slipping from its hold. 
I shall, of course, admit that the head will pass easiest end- 
wise ; but I deny that the forceps can always be applied 
parallel with the long diameter of the head and along the 
parietal bones, and thus insure that facility. Whatever can be 
done by this instrument toward bringing the head into the most 
favorable position for delivery or toward directing its progress, 
will be best done by applying the blades symmetrically along 
the sides of the pelvis, fixing the head between them as in a 
frame, and, having it thus under control, giving to it whatever 
change of position or direction may be advantageous and pos- 
sible. It will certainly be much easier to give your locked 
instrument a departure from mesial and symmetrical relation 
with the pelvis than to place the blades separately in that 
departure. It is safer, too ; for the locked blade can move only 
with its fellow and with the enclosed head. Even in the most 
untaught or incautious hands its end or its edge can now do 
little harm. The locked forceps, applied in symmetry with the 
pelvis, may be regarded as an absolutely innocent instrument. 
With the enclosed head it may glide, or turn, or roll in the 
pelvis to some small extent, but it cannot jam, or cut, or tear, or 
bruise the maternal parts. 
If it be true, as I have endeavored to show, that the obscure, 
complex, contradictory and multiform rules of the books are 16 
based on an erroneous principle, their abrogation is of the highest 
importance. Even if they were sound, their multiplicity and 
variety would make it impossible to remember them, while their 
obscurity would often make it difficult to understand them. 
When to this we add that their correct application presupposes 
that the practitioner can make himself sure of the presentation, 
which for most of us is often difficult, and for many of us some- 
times impossible, it needs no argument to show that under 
their guidance the young obstetrician is indeed in pitiful straits. 
Whose heart does not sink at the remembrance of his own 
first forceps case ? Let the scene come back. His mind already 
possessed by the bugbear of the danger and difficulty of the oper- 
ation, the novice first gropes and studies and sweats over the diag- 
nosis of the presentation. Only partly sure of this, he next 
endeavors to find in his memory the special rule of the case. Is 
it strange, that, with such a mixed sea of authorities on this 
point as the books present, the endeavor is often vain ? Never- 
theless, he must go on. This is no time for delay or hesitation. 
He enters a blade. Practical difficulties now meet him. The 
blade will not go to its place. He is balked. Fears possess 
him. He doubts the correctness of his diagnosis, he doubts 
his memory, he doubts his skill. Confiding youth! it never 
occurs to him to doubt the soundness of his teachers. He 
begins to fear that he shall harm his patient; lacerations, rup- 
tures - God knows what! - rise before his mind. He withdraws 
his instrument. He tries again, and perhaps by chance suc- 
ceeds ; or, failing a second and a third time, he sends for counsel, 
to find it perhaps as helpless as himself; or, no professional 
aid being within reach, he makes shielding excuses to the 
friends of "contracted pelvis," or "slipping instruments," or 
" abnormal bulk of head," and resorts at last, more to be pitied 
than blamed, to the deadly perforator. 
Is not this a true picture ? And must not that young man be 
sustained by an exceptionally courageous heart who ventures 
to take his forceps in hand, save on the pressure of dire 
necessity, or of that public opinion of the lying-in room which, 
direr still, calls upon him to show himself equal to every 
emergency, or to prepare to meet the sidelong glance of distrust, 
and even the pointing finger of contempt ? 
The principle of applying the forceps according to the pre- 
sentation being thus proved to be illusory and impractible, it 
VI. The manner of introduction. 17 
remains to substitute for it a rule to which the obstetrician may 
safely trust in this important operation. Such a rule, simple to 
understand and easy to follow, is, in my opinion, not difficult 
to find. It is, that, in conducting the blades along the pelvic 
passage, and in grasping with them the head of the foetus, we 
shall disregard entirely the presentation, and have regard only 
to the curve of the vagina and the contour of the pelvic cavity. 
The mind's eye must simply see a rounded body lying in the 
utero-vaginal canal, while the hand, obeying the anatomy of 
that canal, directs each blade of the forceps so as to pass 
around and embrace it. 
Let this be established as the rule, and the operation becomes 
free from complications. It is no longer necessary to remember 
the endless variety of rules with which authors are filled. One 
simple law is in all cases to be followed, but two anatomical 
elements are to be held in the mind, and a uniform manipula- 
tion is to be executed. 
It is, moreover, no longer necessary, as a preliminary, to 
ascertain the presentation. If there are those who assert that 
this is no bother, and who set me down as wanting the tactus 
eruditus, I shall simply ask them what they will do with the 
table given in Simpson's obstetrical works, ser. I., p. 414, 
according to which the ratio of occipito-posterior presentations 
to other presentations found by different experts, varies from 1 
in 1336 to 1 in 3 or 4? or with the table given by the same 
author on the next page ? I dare to assert, that if it be necessary 
to know the presentation before applying the forceps, the old 
rule of waiting till you can "feel the ears," is still a sound one. 
I am well satisfied that the operation is in fact usually per- 
formed, sometimes intentionally and sometimes unintentionally, 
on the principle that I have laid down above, and I confidently 
believe that my position will not need to be supported by 
authorities in the judgment of men of experience. But it is 
still necessary to introduce the doctrine into the books, and lay 
it before the generations of learners. It is for those that have 
the art of the forceps still to learn that I write. 
If it be true, as indicated by Cazeaux, that this simple and 
easy rule of practice is somewhat generally followed in Ger- 
many, the fact will explain what we find in the statistics col- 
lected by Churchill. (Midwifery p. 339, et seqd) It seems that 
the German practitioners there mentioned resort to the forceps 
nearly three times as often as do the English. It explains, too, 
why, as we are told by the same author, the Germans report a 18 
very small proportion of crotchet cases, and a very small 
fatality among children after the forceps. 
Let us now approach the bedside of the patient and pro- 
ceed to perform what has properly been called the "obstetric 
miracle. ' ' 
The first question that arises is: Which blade shall first be 
introduced ? In regard to this little matte]>singular obscurity 
and confusion will be found in authors. The individual blades 
are variously and loosely designated as the "upper and lower," 
'' right and left, " " male and female," " anterior and posterior, ' ' 
etc., and I nowhere find a uniform law of precedence clearly 
laid down. Such a law is nevertheless easily pointed out. 
That blade is to be entered first, which, when both are intro- 
duced and crossed, will be next the posterior commissure of the 
vulva. A moment's inspection of the lock will show which this 
is. It may most properly be called the posterior blade, and, as 
the forceps are commonly constructed, is that one that must 
find its place in the left half of the pelvis. 
Now, while the operator with one or two fingers of his right 
hand supine touches the scalp well back toward the sacrum, let 
Him take this blade near its center of gravity 'with the fingers of the 
left, and holding it nearly perpendicularly, but a little inclined to 
his own left, slide it into the vagina along the palmar surface 
of his hand till its extremity is engaged between the head and 
the maternal parts. From this point it is not the touch of the 
operator, but the imagination, the mind's eye, informed by 
anatomical knowledge, that must guide his motions. While he 
gently pushes along the blade, he must remember both the oval 
of the head and the bend of the vagina, and both the cranial 
and the pelvic curves of his instrument. He must remember, 
that while the point of his blade follows the utero-vaginal canal, 
it must so follow it as to bring its fiat concave, not behind, but 
along-side the head, and its concave edge under the os pubis. 
In order to accomplish this double indication, the handle, as 
the point of the blade advances, must describe an intermediary 
between two curves. While it conies backward toward the 
operator and downward, it must also go outward toward his 
left and downward, and must describe in each of the two curves 
near a quarter of a circle. In other words, while the blade 
in respect of its cranial curve obeys the contour of the head, in 
respect of its pelvic curve it seeks the bend of the pelvic pas- 
sage, and in order to adapt itself simultaneously to both, it 
must follow a spiral that contains them both. 19 
In order that the young obstetrician may study the movement 
of his blade in detail and guide it most intelligently, it may be 
well for him, holding it as above described, at first to follow 
with its extremity simply the curve of the child's head, bringing 
the handle backward and downward, but not outward. As the 
blade advances deep into the pelvis, its convex edge will come 
to press against the right side of that cavity, its pelvic curve 
antagonizing in part the utero-vaginal curve, and the strain will 
resist its further progress. Now let him add to this movement 
obedience to the pelvic curve, by carrying the handle also out- 
ward and downward, and this convex edge will be turned 
gradually toward the sacrum, with whose curve its own contour 
is in harmony, and the before reluctant blade will glide along 
as if by instinct. Thus enlightened by watching his own pro- 
gress and seeing the reason of it, the dullest disciple will hardly 
find difficulty in accomplishing the subsequent steps of the 
introduction. Whenever the onward progress of the blade is 
resisted, he will almost invariably find it due to an excess of one 
of the two above-described elements of the combined or spiral 
movement; and gentle trial of them separately will show him in 
which direction easy progress lies. 
The double or-spiral movement described is to be carried on 
till the handle is brought into the mesial plane of the body and 
firmly back against the perineum. The novice will be surprised 
at the length of the road he has to travel. Let there be no fear 
of passing the blade too far. There is no danger of doing this. 
After surmounting the convexity of the head, the end of the 
blade will necessarily approach the mesial line, and its impinge- 
ment upon the body of the child will arrest its progress at the 
proper stage. From the opposite error great evils arise. From 
not carrying in the blades far enough it comes that they refuse 
to lock, and that their ends may be made to cut the scalp or 
gouge out the eyes, or may slip from their hold. The second or 
anterior blade is to be passed to its place in precisely the same 
way, mutatis mutandis, as the posterior blade. 
The introduction of the hand into the vagina, as recommended 
by some authors (Bedford, for example), for the purpose of 
guiding the blade of the forceps, is an entirely superfluous piece 
of barbarity. The obstacle that often resists the onward motion 
of the blade is not a fold or cul-de-sac of the soft parts, whether 
of the mother or of the child. It is some false direction of the 
blade ; and it usually and naturally results from the attempt of 
the practitioner to follow the erroneous rules laid down in the 20 
books. In my opinion there is no danger of punching a hole 
through the utero-vaginal cul de sac. When the edge of the os 
is beyond the reach of the finger, it has so far disappeared into 
the adjacent walls, that the extremity of the blade is in little 
or no danger of catching outside of it; and whatever danger 
there may be, is easily obviated by hugging a little the head of 
the child. The fear of punching off the ears of the child or of 
peeling its head, which are expressed by some authors, are not 
deserving of attention. 
Most authors direct the first blade, when introduced, to be 
be given to an assistant to be held in place. This is generally 
unnecessary. When the blade is pushed to its proper place 
and its handle carried well back, it will stay there. 
Probably there is not one of my readers, that, in his first 
essays with the forceps, did not have great trouble in making 
the blades lock. Even with experienced accoucheurs this is 
one of the most common and embarrassing of the difficulties 
that are met with. What solution of it is furnished by authors ? 
None, or worse than none. The best they have to suggest is, to 
withdraw one blade or both, and try again. This is a sort of 
"scribe" rule, "cut and try" or "rule of thumb," that cer- 
tainly does no credit to a learned and scientific profession. 
Cazeaux recommends, in addition, that when one or both 
blades "turn outward," "the handles shall be grasped by the 
whole hand." What this means, unless it be an attempt to 
force them into place, it is not easy to see. If it means that, it is 
a vile rule. Dr. Bedford lucidly informs us, page 588, that 
when the blades have embraced the head the accoucheur will be 
able, "by judicious manipulation," to lock the forceps! This 
is highly instructive! What is "judicious manipulation?" 
The whole operation of the forceps is done by "judicious man- 
ipulation." Professor Meigs, page 558, speaks of "pushing" 
the blade this way and that in order to bring it into a position 
to lock. These are fair samples of the guidance that the prac- 
titioner will find in the books in this important emergency. 
It is in default of better instruction that in our early trials 
we introduce and withdraw the instrument again and again, 
and, it may be, utterly fail at last. I cannot think that men 
who can furnish no better rules than these fully understand 
the forceps. I believe that two simple precepts may be given 
that will almost invariably secure quick and easy success in 
VII. Locking. 21 
locking the blades. These are : to push the blades far enough 
along, and to carry the handles far enough back against the 
perineum. The first step places the blades fairly upon the 
head, the second carries them back into the axis of that part 
of the utero-vaginal curve in which the head is situated ; and, 
the blades being now symmetrical to each other, the handles 
must necessarily cross each other in the same plane, and will, 
therefore, lock,. All ordinary cases of failure to lock, provided 
that the blades are laid anywhere in the neighborhood of their 
proper place, are due to deficiency in one of these particulars. 
These two steps of final adjustment, it will be observed, are 
but the continuation and completion of the process of apply- 
ing the blades which I have already described ; but their exact- 
itude may properly be left till both blades are introduced and 
crossed, when, if they do not lock, the fault almost always 
will be found to be in the incompleteness of one or both of these 
steps. In disproportionately roomy pelves, the course and 
position of the instrument not being normally controlled by the 
shape of that cavity and of the head, one or both of the blades 
will sometimes need to be slided toward the pubis. A deformed 
pelvis may make another exception to the sufficiency of the 
rules above given. 
VIII. Are the forceps liable to slip ? 
This is an important practical question. The reader will 
observe that in a considerable number of the cases in Dr. 
Elliott's "Obstetrical Cliniques" the forceps "slipped." Pro- 
fessor Meigs is so much afraid of this accident that he directs 
us to keep the finger against the head of the child in order to 
detect its incipience. In short, nearly all of our standard 
authors warn us against this danger. My forceps never slip, 
and in the face of these authorities I unhesitatingly assert, that 
in all ordinary proportions of the head and pelvis, with decent 
instruments correctly applied, the danger of slipping is wholly 
imaginary. Properly embraced between the blades, the head 
no way tends to slip from between the edges, either forward or 
backward ; nor is there room for it to do so. Equally impos- 
sible is it for their ends to override the bulge of the cranium 
and let them come back to us empty. They must do this sim- 
ultaneously if at all, and this will involve such wider separation 
of their bellies as the limits of the pelvic cavity do not admit. 
They certainly cannot slip over the head and come away with 22 
out occupying more room in their void grasp than they would 
in bringing the head along with them. 
When the forceps slip it is because the blades are not passed 
far enough to truly embrace the head. Their ends rest against 
it, on or near its bulge, instead of reaching nearly or quite to 
the cervical region. This is the explanation of all the cases of 
slipping that I have ever seen, or can imagine. The instrument 
slips off because it has never been on. The question is impor- 
tant, not because the slipping of the blades can do any material 
harm, but because the apprehension of it is sure to lead to the 
wicked practice of violently 
IX. Compressing the Head. 
So far as the danger of slipping is concerned I think I have 
shown that this is entirely unnecessary. The degree of com- 
pressing force that is necessarily used in grasping the instru- 
ment is all that is required, in any permissible exercise of 
extractive power, to make sure the hold of the forceps when 
properly applied, even in a disproportionately roomy pelvis. 
But our authorities, moreover, with a good degree of unanim- 
ity, instruct us to compress the foetal head in order to promote 
its elongation, and thereby facilitate delivery. Indeed, accord- 
ing to Prof. G. S. Bedford (Principles and Practice of Obstetrics, 
p. 575), "accoucheurs are divided as to whether the forceps 
acts principally as a compressor or an extractor." I can but 
regard this doctrine as erroneous and singularly unreasonable. 
The compression of an elastic body, while it diminishes one 
diameter of it, necessarily tends to increase all the diameters 
that are at right angles to the compressing force. Now it is 
obvious that there will seldom or never be need of reducing that 
diameter of the head which the blades of the forceps subtend, 
and which alone they can directly act upon. The contained 
must be less than the container, and the very fact that the blades 
have been passed around the head at the point where it has been 
stopped, is almost conclusive proof that in that diameter there 
is room enough. The obstacle, then, must be in another dia- 
meter of the head, and compression tending to increase that 
diameter, must tend to increase the obstacle. For example, it 
is seldom that a narrowing of any other than the antero-posterior 
pelvic diameter requires the application of the forceps at the 
superior strait. (Vide Simpson, op. cit.) But this diameter, as I 
have already shown, cannot be subtended by the forceps ; they 
can only be applied in a diameter nearly or quite at a right angle 23 
with it; and whatever compression they are made to exercise 
upon the corresponding dimension of the head necessarily tends 
to increase that dimension that lies in the narrowed pelvic dia- 
meter, and thereby to increase the difficulty of the case. What- 
ever elongation of the head may be effected by compression is 
no compensation for this evil; it is obtained at the expense of 
an increase potentially of the very cause that demands the for- 
ceps. The resistance of the maternal parts to distention is the 
influence on which we must alone rely to promote elongation of 
the foetal head. 
Whoever is taught to use compression, either to promote 
security of hold or elongation of the head, will be pretty sure 
to overdo the matter, and will be in great danger of inflicting 
serious injury on the child. The iron levers give great power, 
and in the excitement of the moment that power is sure to be 
used. Such warnings as Churchill gives, ' ' to limit the force used 
to what the head can bear without injury," are entirely useless. 
The benumbed and wearied muscular sense would deceive 
the best judgment. The injuries that the forceps are capable of 
inflicting, not simply on the child's scalp, but by compression 
upon the bones and even the viscera of its head, are well illus- 
trated in Elliott's Obstetrical Cases, pp. 245-246, 255-271. On 
p. 246, Dr. E. "changes his forceps in order to use compression 
with more effect." So far as the child was concerned, the 
"effect" evidently might have been spared. 
X. Extraction. 
It would hardly seem to admit of dispute that the extractive 
power of the forceps ought to be used in imitation of nature, 
and, accordingly, in the direction of the expulsive action of the 
uterine and abdominal muscles as modified by the lines of the 
pelvic passage. Nevertheless, for some incomprehensible reason, 
we are told by Prof. Bedford, that the force exerted by the 
obstetrician should be "one-third extractive and two-thirds 
lateral." This is also substantially the advice given by Prof. 
Meigs and other popular authors on midwifery. Such man- 
agement of the forceps is not in imitation of nature. Nature 
does not see-saw or wriggle her burden along. Were the walls 
of the passage as dry, friable and inelastic as those of a post- 
hole, or were the foetal head so rough and angular as to readily 
secure a bearing on those walls, this prying it out would not 
be unreasonable; but in reality its oval and gliding surface 
cannot be hastened along its lubricated and elastic road by 24 
working it from side to side. True it is, that, if our first efforts 
at moving the head along fail of success, we may very properly 
direct our subsequent tractions, tentatively, a little this way and 
that, distrusting the correctness of our judgment as to the exact 
law of the case, and thus learn to aid aright the vis-a-tergo. 
With this exception, based on the imperfection of human judg- 
ment, traction is the only function of the forceps. 
It has seemed to me that the common conception of the 
movement of the foetal head 'through the pelvis is somewhat 
erroneous in a very important particular. That traject is far 
more curvilinear than is comthonly supposed. If we compare 
the distance traveled by the part that emerges from under the 
pubic arch with the distance that must be traversed by the part 
that follows the curve of the sacrum, we shall easily see that 
the head is rotated on the symphysis pubis almost as on a pivot. 
This must be borne in mind in our extractive efforts ; and, at 
a point to be determined by our judgment, but earlier than is 
commonly supposed, they should be directed rather to roll out 
than to draw out the head. 
The rules that I have thus laid down, especially those for the 
introduction and locking of the forceps, are sanctioned not 
alone by my own experience and judgment. More than one of 
my younger professional brethren have thanked me for my sug- 
gestions to them in this matter, and assured me that they had 
made easy to them an operation that had always before been 
embarrassing and difficult. I now submit these opinions more 
publicly to the profession. If my expression of them savors 
somewhat of disrespect for authority, I trust it will be par- 
doned. In practical matters of this sort we are far too much 
governed by authority. I believe I shall have the consent of 
the great body of our profession when I say that in many other 
particulars our literature needs a thorough overhauling. It 
needs it in order to the substitution of simplicity and clearness 
for complexity and obscurity, to the settlement of questions 
disputed but not disputable, and to the getting rid of rubbish 
that has the rottenness as well as the respectability of antiquity. 
Oswego, N. Y., January, 1870.