THE DESCRIPTION and USE OF DR.
LEAKE
's FORCEPS VINDICATED.
[Price One Shilling.]
A VINDICATION OF THE FORCEPS DESCRIBED AND RECOMMENDED By DR.
LEAKE;
IN WHICH, The INJUDICIOUS and ILLIBERAL REMARKS on that Subject, signed
THOMAS DENMAN,
are examined and refuted.
By a late PUPIL of Dr.
Leake
's.
LONDON; Printed for J. Hinton, in Paternoster-Row.
M DCC LXXIV.
TO DR.
THOMAS DENMAN.
IT is now above three years since Dr.
Leake
published a description of his
New Forceps with three Blades,
together with an elegant Copper-plate Print of that Instrument. From this Publication, though attended with considerable expence, he derived no advantage, since it was chiefly intended as a compliment to his
Pupils,
and to such other Gentlemen of the Profession as were particularly engaged in the province of
Midwifery.
It is true, when his
Introductory Lecture
was lately published, his paper on the
Forceps
was annexed to it, but without being mentioned in the Advertisement, or making any addition to the price.
Of this I can speak with confidence, as I had at that time the pleasure of attending the Doctor's Lectures, and was therefore, well acquainted with the truth of the particulars which I now mention. I was likewise one of the many, who, from the principles on which it was recommended, thought this a valuable addition to the Apparatus of Midwifery; nor has my experience of its use in Practice hitherto failed to confirm this opinion. But the merit of Dr.
Leake
's
Forceps
rests on a much better foundation than any thing I can pretend to advance in its favour. Many of the best Accoucheurs, both at home and abroad, have been pleased to commend it as a considerable Improvement; many Commissions were soon received by the Instrument-Makers, for sending it to different quarters; and to my certain knowledge, it has been for some time past a familiar Instrument in the hands of several Practitioners of the first name in
France, Russia,
and
Holland,
as well as
Great Britain
and
Ireland.
With so many and such respectable Suffrages in its favour, I thought the credit and use of the
new Forceps
had been universally established, till I was lately convinced, by perusing your
Remarks on that Instrument,
that there was at least one dissenting voice. When, or in what manner, these Remarks were first ushered into light, I will not take upon me to say; but I am apt to think they had a
clandestine Birth,
as I do not remember to have seen them advertised in the usual way; a circumstance which would not have readily escaped me, as my fondness for Improvement, especially at so great a distance from Town, makes me always very attentive to the Article of new Publications. It was by mere accident therefore, and only very lately, that I had the happy opportunity of seeing this striking Specimen of your Candour and literary Talents; and as soon as I had glanced it over, I was determined to employ my first intervals of leisure, from the duties of my Profession in vindicating Dr.
Leake
from so illiberal and injurious an Attack. Together with this motive you may attribute as much as you please to the vanity of a young man, whom you may suspect, perhaps, of seeking for an occasion to try his strength in the lists of Controversy; and indeed, to be perfectly ingenuous with you on this head, I will frankly own, that so far as it may be natural to take courage from the weakness of an Adversary, I did think I could never hope for a better opportunity of making a first Essay with so little hazard to my Reputation.
In censuring Dr.
Leake
's
Forceps,
which you are pleased to declare an ineffectual as well as a dangerous Instrument, you alledge the public good as your sole inducement for undertaking the trouble of your
precious
Remarks upon it. This is certainly a good Plea, and worthy of a good Man; but it has been so often hackneyed and abused, that we are sometimes apt to suspect a counterfeit. It is a convenient pretence, however, when a man is either ashamed or afraid to avow his real motives, and in the present case, it would not perhaps be difficult to assign others. But as this may be a matter of conjecture only, I shall not insist upon it, as I would not wish to attack even an ungenerous Adversary, by the sly method of Insinuation.
Allowing you, therefore, the full merit of your pretended zeal for the public safety; let me ask you, why you did not sound the alarm sooner, when as you say and would have it believed, there was so much impending danger, and such
dreadful consequences
to be apprehended from the use of this Instrument? Let me still further ask you, why at length, these benevolent remarks of yours were not exhibited to the world in a public and open manner, instead, as I am informed, of being privately handed about, among such young and unexperienced Gentlemen of the Profession as were not competent Judges of the subject? Did you mean that the poison conveyed in this artful and insidious manner, should have time to operate and produce it effects before an antidote could be administered?
As every man has an undoubted right to approve or disapprove of whatever is presented to public view, I by no means blame you for making Dr.
Leake
's
Forceps
a subject of enquiry, provided you had done it in the way of a candid examination, founded on the evidence of his own Description: a mode of trial to which no Author can reasonably object, and to which every one has an undeniable claim. But how far you have done justice to that Gentleman in your Quotations, or the conclusions you draw from them, will be left to the following Strictures, and the Reader's judgment without farther anticipation.
You will please to observe, Sir, that contrary to your method, I shall quote and examine those your remarks fairly, without perverting your meaning, where that is to be found, or omitting one part and inserting another, as best suits my purpose. I must likewise inform you, that in quoting an Author you have no right either to
alter
the Diction or transpose the Sentences, especially in points of Controversy, because from thence may arise an alteration in the sense, which may wholly misrepresent the original meaning; both which you have frequently done without ceremony, in your Remarks on Dr.
Leake
's paper on the
new Forceps.
With the skilful and candid, I believe, that paper might very safely have been left to vindicate itself; but least your Remarks, puerile and superficial as they are, should chance to mislead the unexperienced, who sometimes mistake sound for sense, I will proceed to examine and place them in their proper point of view.
I shall pass over in a general way, the self-conceit, and finical precision, as well as the childish vanity and formal parade with which you are pleased to bring forth your elaborate trifle; which examined in all its parts, will appear to every eye but your own, a
shapeless abortion,
deformed, unfinished, and sent before its time.
In the first article of your Remarks, you take the liberty to assert, that Dr.
Leake
's Description of the
Forceps
is not correct; but in what manner you make good that assertion, the Reader will best be able to judge, from an exact quotation of his Description, compared with your own.
Dr.
Leake
's Description of the
Forceps
is as follows:
"The
Forceps
used in Midwifery may be considered as an Instrument consisting of two Levers, which act in contrary Directions from one common Centre or Fulcrum, where their Blades unite and are sustained by each other, consequently, their power on the Body to be moved will be in Proportion to the length of their
Levers
or Handles."
The following in your Description.
The Forceps ought to be considered as an instrument consisting of two Levers, acting alternately from two centres, which are those parts of the Child's head undergoing the greatest friction.
To speak thus, is to assert that the Forceps, which is the active body, finds a Fulcrum or resting point upon the Child's head which is wholly passive, being the very part which is to be extracted. I should be glad to ask, how the Child's head can be the part from which the Blades act, since it is demonstratively the part acted upon? A very slender knowledge of Mechanics might have taught you that every Lever must necessarily act from its centre of motion; but on the contrary, if the Child's head afforded a centre of motion to the Blades of the Forceps, as you assert, then it would follow, that those Blades, considered as Levers, would not act
from,
but
towards
their centre of Motion; a thing so contrary to reason and common sense as to deserve no further attention. In a word, Sir, you have palpably confounded the idea of the part acted upon by the Lever, with that of the part from which it acts. But perhaps you are about to establish some new Principle in Mechanics, which may solve this Paradox, and prove that an active and a passive body is one and the same thing.
You say—
It is true, that with respect to themselves, viz. (the Blades) the Centre of Motion will be at that part where they unite; but when in the hands of the Operator, and containing a body within their Curve, the alternate motion necessary for the extraction of that body through a small space, changes the whole circumstance.
It is wholly inconsistent and improper, thus to talk of Motion, or a Centre of Motion in a body (the
Forceps
) which as above, you are describing totally at rest; that is unemployed and not in the hands of the Operator.
Again, you say,
That when the Blades are really in the hands of the Operator, then the whole circumstance is changed
—Without doubt the circumstance is changed, but not at all in the manner you apprehend; for if the blades contain a body within their Curve, the action for the extraction of that body, must still be derived from their Junction as a resting Point, otherwise they would want a Fulcrum, and therefore could not act at all.—If this is difficult to be understood, you may, if you please, suppose two Blades without such junction, to be passed up along the Child's head, and as these Blades could not possibly then be locked, they would not act on the Child's head, and consequently it could not be extracted.
Besides, the Blades of the Forceps, considered as two Levers, do not act alternately as you tell us; for as both of them closely and equally embrace the Child's head, the one cannot possibly be made to act without the other; their action therefore is not
alternate
but
simultaneous.
Such frivolous and far-fetched Objections shew that you have taken great pains to find them out, and that you have been at whip and spur in pursuit of Game; but like an unskilful Huntsman who mistakes the mettle of his Stead, as well as his own; you have unfortunately quite unhorsed yourself in attempting the five Bar-gate. Upon the whole, either your knowledge of Mechanics should have been greater, or your presumption less, in contradicting established and self-evident principles.
So much for your Accuracy and Skill; I shall next quote your second Article verbatim, as a curious specimen of your Candour, and the respect due to your Superiors:—Reader, please to attend to the following modest Assertion.
Professors have generally misled us in the persuit of practical knowledge, being too often of that order of men, who are the bane of real improvement.
Inquirunt, says Dr.
Harvey,
non quomodo res sunt, sed quid alii dicunt.
If such Professors are any where to be found, your preceding Remarks evidently shew that you have no small Title to be included in their number."
Nomine mutato, de te fabula narratur.
In a word, if such Reflections in one of real consequence, whose judgement was ripened by time and experience, would justly be thought uncommonly presuming, and so replete with arrogance as to have got the better of both prudence and decency;—What then shall be said of—Dr.
Thomas Denman.
Thus you proceed,
I believe there are reasons for suspecting that M. Crantz is but little qualified for laying down Rules for the use of Instruments in Midwifery, and M.
Levrette
is not unexceptionable authority.
You ought to have mentioned those Reasons at large, otherwise an affertion so rude and injurious, on your own authority only, is claiming more credit than the Reader may be willing to allow you; for you must know that M.
Crantz
was an eminent Professor of Midwifery at
Vienna,
and that he wrote judiciously on the Use of Instruments, in his
Dissert. de re instrumentaria in arte obstetricaria,
a book very necessary for your perusal.
M.
Levrette,
you say, is not unexceptionable authority—If none but yours is opposed to it, I believe it will remain unexceptionable. To tell any other of the profession but yourself who
Levrette
was, would be unnecessary; but as you have spelt his name wrong as often as you have had occasion to mention it, it appears you have no better acquaintance with him than with the former Gentleman, whom you have so uncivilly censured.
Levret
of
Paris
is sufficiently known throughout
Europe,
both by his Writings and public Lectures. In short, the Merit and Judgment of the two respectable Authors in question are so universally acknowledged, and their reputation so superior to your insignificant Cavils, that the present circumstance would be apt to put one in mind of a Village-cur barking at the Moon.
I shall now proceed to quote the substance of what Dr.
Leake
has advanced, and to examine the propriety and validity of your
Remarks
on the present subject.—In his description of the
Forceps
he speaks thus:
"
H. Crantz,
professor of Midwifery at
Vienna,
and
Levret
of
Paris,
both observe, that when the Child's head is wedged within the bones of the Pelvis,
(capite incuneato)
it can scarcely ever be extracted by the
common Forceps
recommended by
Smellie,
because of their shortness; and as their Blades are only curved in one Direction, whenever it happens that the Hind-head is forced over the Symphysis of the Pubes, it cannot be got hold of within the curve of the Blades, which being only applied along the Ears in a streight Direction, are therefore apt to slip downwards over the Face, and to foil the Operator in the Extraction of the Head: This will the rather happen, because they are made taper towards their Points, which will diminish their contact on the head and prevent them from taking a firm hold;—
so that they are the least serviceable in those very Cases where they are the most wanted,
—that is, where the Pelvis is narrow; for it must be allowed, of all Difficulties, that which happens from the above cause, is by far the most insurmountable obstacle to the birth, since it can only be overcome by very strong Pains, which compress the head and force it to conform to the bony Passage."
Your remarks on the preceding Paragraph are as follows:—
When the Head is
incuneatum, enclavée,
or wedged in the Pelvis, it is a case in which Forceps of any kind cannot be used with prudence. If we did try them, we should happily miscarry in the attempt, for if we succeeded, dreadful would be the consequence to the parts of the Mother, crushed between the Child's head and Forceps on one hand, and the bones of the Pelvis on the other.
The Reader is here presented with a dish of all sorts,—a perfect
Oleo,
but without a single grain of salt or seasoning, curiously garnished with fresh rhetorical flowers, but of the
exotic kind;
such as that of miscarrying happily; success being attended with dreadful consequences, &c.
You tell us that,
The Doctrine of applying Forceps before the bulk of the Head has passed the superior aperture of the Pelvis, carries great danger and insurmountable difficulties on the face of it. Those who have endeavoured to reduce it to practice (for it is an old and obsolete Doctrine) have in their accounts given us Histories of their attempting it, of the difficulties they met with, of the mischiefs they did, and a retraction of their Errors.
According to your account, this Doctrine wears a very
frightful and gorgon-like countenance.
—Alas poor prostituted
word Doctrine!
how miserably art thou profaned and misapplied; I fear thou wilt next be tack'd to the method of making pease-pottage, or manufacturing mutton-pies. But to be serious; was it not doing injustice to
John Bunyan
by the comparison; I should think I had been reading his description of the
Pilgrim's Progress
through the Vale of Tears.
When the greatest bulk of the Head has passed the superior Aperture of the Pelvis, the greatest difficulty is over, as appears by the following quotation from Dr.
Leake,
and therefore the Forceps are seldom ever then necessary, except floodings or other dangerous symptoms should suddenly exhaust the Patient's strength.
"The
short Forceps
may indeed be effectually applied when the Child's head is low in the Pelvis, but where that is the Case, artificial Assistance is seldom necessary, the principal Difficulty being then over; and should any still remain, it will now be removed by the Concurrence of two Causes, viz. the inferior Parts of the Pelvis will gradually dilate and give way to the Pressure of the Head, which, at the same time, will be squeezed into a longitudinal Form, and therefore its transverse Diameter, in respect to the Passage, will become considerably less and less; both which Circumstances have a manifest tendency to facilitate the Birth."
Those then, and such like your Remarks, are more than sufficiently answered by the following quotation from Dr.
Leake
's Paper, which shews the necessity and propriety of the practice he recommends, and also that he was not unaware of Cavil and Criticism.
"I know that the Application of the Forceps is objected to by some, till after the Head has got below the Brim of the Pelvis, on the Supposition that the Force applied to bring it down would prove injurious to the Mother;—but will not the
violent and long continued Compression of the soft Parts,
viz. the
Vagina
and
Neck of the Bladder,
&c. when squeezed between the Head and Bones of the Pelvis, as two solid Bodies, be much more liable to endanger the Patient?—Since Instances may be found where a
Mortification
has been the Consequence, and where the Child, which always suffers in Proportion, was also
born dead.
In cases, therefore, extremely laborious, when the
Head is large,
—the
Pelvis narrow,
or both;—where the Patient's Strength is exhausted by a
Flooding,
—where she is suddenly attacked with
Convulsions, Faintings,
or other alarming Symptoms, and consequently, where the
labour Pains are insufficient
to bring forth the Child; the
long double curved Forceps,
hereafter described, may be used with great safety and advantage, either with or without the
Lever
or
third blade,
as occasion may require.—Every one who has had much Experience knows, that it is often improper, as well as difficult and dangerous to turn the Child, and sometimes even
impracticable
without bursting the Uterus, or applying so much Violence as might be fatal to the Mother; and to open the head of a
living infant,
before the
long Forceps
and every other Expedient had been tried in vain, would surely be deemed rash and unnatural Practice."
It may be observed, that whatever Dr.
Leake
recommends he always gives his reasons for it; but what you advance is only mere matter of assertion, or if you attempt any thing further, such is your success, that what you endeavour to prove, still remains to be proved by some other person.
The question is—What should be done for the safety of the Mother when her strength is exhausted, and her pains insufficient to bring the Child; so that she is every moment in danger of dying undelivered.—Dr.
Leake
admits, there is danger in the Operation, but at the same time shews why there is much more, when it is neglected, and therefore, of two evils, the least is to be chosen; especially since there is no other alternative, than that one of killing the Child, by opening its head; for he has shewn that
Smellie
's
Forceps
are much too short to reach and extract it thus situated, and that it is by no means eligible to turn the child: so that all you have been able to advance against this practice, is mere invective; being nothing but a few formidable Epithets to excite horror, and to deter the weak and timorous from using the Forceps recommended by Dr.
Leake;
and lest his ingenious Invention of combining the action of the Forceps and Lever, should chance to pluck a feather out of your wing.
You talk of dreadful consequences, and crushing of heads, as others would talk of cracking nuts; but if such reasoning as this could prevail; then the use of the short Forceps, of which you are so fond, should also be rejected, even when the Child's head is below the brim of the Pelvis; for fear of lacerating the Perinaeum; and for the very same reason if it could be found to have any weight, no Surgeon would ever venture to cut for the Stone, lest the patient should die by the consequence of the Operation.
You say,—
It is supposed that the hind-head is forced over the Symphysis of the Pubes. Whenever this is the Case it is not possible to apply Forceps of any kind, with advantage, or without the utmost danger; and I call upon every Gentleman conversant in practice to confirm the truth of the Assertion.
It is not possible, you say, to apply Forceps of any kind. Dr.
Leake
being apprized of the difficulty attending the application of all Forceps
in this particular case,
because of their lateral pressure, which increases the longitudinal diameter of the head, and forces the
Occiput
still more over the Pubes, has therefore, invented a
third Blade,
which combined with the Forceps acts as a Lever, applied immediately to the resisting point or
Occiput;
and that without the least danger of hurting the mother; a circumstance which has often happened by the use of the common Lever.
Those things premised and duly attended to, I think it will follow that you may call on Gentlemen conversant in practice a long time before they answer to the truth of your Assertion, without your appeal is made to those who are as much averse to improvement as you seem to be yourself, and who chuse to grope in the dark, when they might walk in open day.
The following Abstract from Dr.
Leake
's
description of his Forceps,
will still more fully illustrate and explain the true nature and use of the Lever or
third Blade,
and shew under what particular circumstances its application becomes necessary and advantageous.
"When the fore-head presents to the Os Sacrum, and the hind-head to the
Pubes,
the long axis of the head intersects the short axis of the Pelvis, and therefore, these Parts may be considered as two Ellipses crossing each other;—a Position of the head very unfavourable to the Birth of the Child.—Whenever this is the Case, a very capital Inconvenience, even in the long double-curved Forceps will occur, for when they are thus applied on the Sides of the Head, the more it is there compressed by the Action of the Blades, the more will the
Hind-head be forced over the Pubes,
and the
Fore-head against the Sacrum,
which will still add to the difficulty, and consequently it cannot be extracted in this manner, without great violence both to the Mother and the Child:—This Circumstance has happened to me in Practice several times, particularly in two laborious Cases, where the repeated Application of the Blades at the sides proved ineffectual; and dangerous Symptoms appearing, I was afraid of further delay, and therefore, (the patient being placed on her side) I introduced them at the Sacrum and Pubes, that is, on the
Face
and
Occiput,
and extracted the head with ease at the first effort.
As this Success was plainly owing to the Compression of the longest part of the Head, it first suggested to me the Hint of applying a pair of
Forceps with three Blades,
one of which may be occasionally used as a
Lever,
which will act on the same Principle as that of
Roonhuysen
's.
But notwithstanding the seeming Simplicity of
Roonhuysen
's Lever, it may be attended with the utmost Danger; for, as the Symphysis of the Pubes is the Centre from which it acts, and the Point upon which the whole Stress is laid, whenever much force is applied to bring down the head, (Action and Re-action being the same) the
Vagina, Neck of the Bladder,
and
nervous Parts
may be so violently bruised, as to occasion a
Mortification,
or even the very Symphysis of the Pubes may happen to give way.
To remedy this Inconvenience, which is the principal Objection to the
Lever,
I have, for some Years past, in my Course of Lectures on Midwifery, recommended an
Instrument consisting
of
three Blades,
being, in fact nothing more than a Pair of long Forceps with a double Curve, and the Addition of a Lever, which may be applied without the least danger of hurting the Mother; for here the
Fulcrum
of the
Lever
is
removed from the Pubes to the Junction of the two Blades,
which not only act as a Pair of Forceps, but at the same time afford a firm resting Point for the third Blade, by means of a small Pivot or central Pin, placed on the under Side of one of their Blades.
After the Introduction of the Blades of these Forceps at the Sides of the Child's-head, this Lever is to be passed up between the Occiput and Pubes, and as the Pelvis there forms a kind of Arch, and is also extremely shallow; by inclining the Handle low towards the Perinaeum, it may be introduced without the least Degree of Violence.
The additional Blade or Lever applied immediately to the resisting Point or Occiput, where it rests at the Pubes, will not only effectually shorten the Head, and detach it from the Place of its Obstruction, but will also prevent the Forceps from slipping; for if they tend down towards the Face, the
Lever,
which is fixed at the Hind-head, and sustained at the Junction of the Blades, must be drawn down with them, and consequently the head also will still be the more brought into the Centre of the Pelvis, and therefore more easily extracted; which may be better understood by referring to the
third Figure in the
Copper-plate.
In short,
these two mechanical Powers of the Forceps and Lever thus combined, will mutually assist each other;
—For, the Lever will not only
prevent the Forceps from slipping,
but will also
shorten the Head,
and bring it down below the Arch of the Pubes into the Centre of the Pelvis, by which means it may be the more easily extracted; on the other Hand, the Forceps will afford a resting Point to the Lever, from which it may effectually act
without any Sort of Danger to the Patient,
so that we have the Advantages of both Instruments, without the defects of either."
Dr.
Leake
does not here vainly magnify the merit of inventing this new Instrument, but plainly tells us, it was owing to a mere matter of accident which occurred to him in practice.
You tell us that—
The censure of Dr.
Smellie
's Forceps is unprofitable
—You cannot then say, that Dr.
Leake
is mercenary; but I must inform you that to censure and to disapprove are very different things: Those who are best acquainted with Dr.
Leake
well know that he is less disposed to censure than commend; and it is apparent he has not treated Dr.
Smellie
in the disrespectful manner with which you mention the Names of
M. Leveret
and
H. Crantz.
You next proceed as a panegyrist—
Dr. Smellie was a Man of great candour, industry, and ingenuity, and we are all indebted to him.
I have often heard Dr.
Leake
in the course of his Lectures mention his name with great respect, and chearfully subscribe to his merit.
You say—
We are all indebted to him.
Those who have attended his Lectures, I presume, will not deny it; for your part, Sir, had you been as grateful to the Gentleman from whom you received your Instructions in Midwifery, we should not have seen you engaged with him in a News-paper Billingsgate contest, A. D. 1769.
Again you say—
Dr.
Smellie
's Forceps are not taper at the point
—Not so taper as the point of a Sword;—but they are taper—verily they are
taper.
You add—
The largeness of the head, and narrowness of the Pelvis are relative terms,
&c.—This seems to be a new and very notable discovery, and what makes it the more valuable, it is not more difficult to be demonstrated, than that two and one make three.
You say—
The case supposed in this Paragraph, I believe, never can happen at the upper part of the Pelvis.
In what Paragraph? for you do not say, whether in Dr.
Leake
's, or your own. Pray Doctor
what Professor, except such as you have mentioned in the beginning of your Remarks,
ever talks of a Case happening at the upper part of the Pelvis; I suppose you mean a case where the Child's head could not happen to be so placed at the upper part of the Pelvis; if this is not your meaning, the case you allude to must be a headless case, a case without a head;—a very piteous case indeed, and such as probably never happened to any one except Dr.
Thomas Denman.
You proceed—
My reason for preferring the streight Forceps, is a conviction that this opinion is true, and that under these circumstances the curvilinear Forceps become inconvenient.
Your reason is a conviction that this Opinion is true:—A very curious reason indeed; but I shall say no more on this passage, lest I make a mistake; for I confess 'tis far too sublime for my comprehension.
Again, you say—
I know enough of the History of the Vectes, in as able hands as Roonhuysen
's,
to convince any reasonable man, that much mischief may, and has been done by them.
For this very reason Dr.
Leake
has contrived a Lever or Vectes, which occasionally combined with the Forceps, will produce all the effects of a Lever without the least danger of hurting the Mother.
Thus you proceed—Roonhuysen
's Vectes changes its centre of action, and though it may be fixed against the Symphysis of the Pubes, the Ramus of the Ischium, near the obtuse process, must become the
Fulcrum,
or you will not be able to extract the head.
Here it is presumed you meant to have said
ignoramus,
and that by some unaccountable blunder of the Printer's, the word
Ramus
unluckily slipt in.
You tell us that—
The resisting Point is not particularly where the hind head presses against the Pubes; but that the head is wedged and presses on many Points.
You seem here to have forgot what every Practitioner in Midwifery ought particularly to remember, viz. that the Brim of the Pelvis is an Ellipsis from side to side, and measured in that direction, is one inch wider than from Sacrum to Pubes; and consequently the Head thus wedged in the bony passage, must of course meet with most resistance where the Pelvis is narrowest; particularly, as the long axis of the Head is now turned to the narrow axis of the Pelvis, or as Dr.
Leake
expresses it, where two Ellipses are crossing each other; and therefore, contrary to your assertion, the resisting point must necessarily be where the hind-head presses against the Pubes.
You say—
You object to the use of all curvilinear Forceps
—I suppose then you mean to make use of none at all; for all Forceps are
curvilinear,
or they could not be Forceps; but all Forceps have not a two-fold curve, which I presume is the thing you mean.
Thus, Sir, you continue to speak, and lest the elegance of your expressions should suffer by the least alteration, I shall set them down
verbatim.—The curve of M.
Levrett
's Forceps seems the most convenient, and Mr.
Osborn
has contrived a very elegant pair, by diminishing the size of
Levrett
's and very little alteration besides.
Just now you objected to the use of all such Forceps, but now all of a sudden
Levret
's are the most convenient; how does this accord?
Besides, as you say that Mr.
Osborn
's Forceps differs very little from
Levret
's, except in size, it is not easy to conceive how a diminution of the size alone, can properly be considered as a new invention. But here let me ask you whether this Contrivance of Mr.
Osborn
's, whatever it may be, was prior or subsequent to that described by Dr.
Leake.
A direct answer to this simple question might probably unfold the mystery, and determine what merit is due to Mr.
Osborn
from this
very elegant pair of Forceps.
Again you say—
Allowing Dr.
Leake
the full force of his own reasoning, I cannot conceive the advantage arising from this complicated Instrument.
Here, like the Satyr in the Fable, you blow hot and cold with the same breath; for hitherto you have endeavoured to controvert his reasoning in the best manner you were able; but now comes a kind of aukward and indirect assent.
You say—
You cannot conceive the advantage arising from this complicated Instrument.
The Forceps recommended by Dr.
Leake
is by no means complicated, for whenever the Lever is unnecessary, they may always be applied alone with the same ease and safety, and generally with a better effect than any other, for the reasons which he has specified.
Thus you proceed—
If we act with the Forceps from handle to handle, the third Blade can do no service.
The Lever or
third Blade
will effectually prevent the Forceps from slipping down over the Child's Face, which is a very capital advantage, especially as it cannot in the least injure the Mother more than the other two, although we act with them from handle to handle.
Again you say—
If we act with the Lever, the Forceps are useless or prejudicial.
You have before allowed that
Roonhuysen
's Lever is a dangerous Instrument; but as Dr.
Leake
has proved to a demonstration, that the Lever combined with the Forceps, may always be safely and advantageously applied, both your assertions become evidently groundless. Indeed, throughout the whole of your performance, from a doating affection for every thing you have said on the subject, you have never been fortunate enough to distinguish the very great difference between simple assertions and solid proofs; the first are always ready at every man's call—upon the last depends the fair and equitable decision of all points of controversy whatever.
I have now examined most of your Remarks, yet I confess that some of them are absolutely unanswerable;—those, Sir, alone are they which are utterly unintelligible; and to conclude, if I am not mistaken, as you were, when in speaking of the Forceps, you mistook the Child's Head for their Centre of Motion, all your Views centre in yourself; though even that part of your design you have executed but very indifferently, for your Style is clumsy, assuming, and pedantic; your Objections are frivolous and unfairly urged, and your Assertions, though positive, and highly expressive of self-importance, are generally unsupported by reasoning and matter of fact.—To conclude, considering the air of exultation with which you set out, it may be said with great justice and truth, that the whole of your performance
is most pompously poor indeed.
You tell us, that you pay great regard to Dr.
Leake
's Abilities; I wish I could with a safe conscience say as much for you; for if I was disposed to compliment you on your abilities, your candour must suffer; and if I had an opinion of your candour, it must necessarily be at the expence of your Abilities.
Thus, Sir, you have shot your lilliputian Arrows and wounded nothing but Air; when you can spare a little more of your precious time to advance any thing further on this subject for the
public good,
I shall not be wanting in giving it due Attention.
FINIS.