(From a faetus, and to draw). A hook for the extraction of a child when labour is difficult. In the present practice of midwifery, as circumstances vary, the foetus is drawn from the uterus by the blunt hook, the straight forceps, the curved forceps, or the crotchet: the latter would be fatal to the child, if alive, so that it is unless it is known to be dead; but its delivery is only-expedited and facilitated by the other three.

The blunt hook is used when the child presents with its breech, and the pains are not sufficient for effecting its delivery. In this case the hook is carefully to be fixed in the groin of the child, and, as the pains return nature must be assisted by gently pulling with the hook; but if much strength is required, it is still better to leave the delivery to the usual assistance of the hands only with the labour pains, because the hook may dislocate or break the thigh of the child. When the hook is used, it should be taken away as soon as the finger can be fixed in the child's groin.

The crotchets are used in the same manner as the forceps, except that the crotchet, having a hook at its point, is forced into the part to which it is applied.

The straight forceps are used for bringing the head of the child forward, when, by reason of its size, or the want of pains, it cannot otherwise be protruded; but much care should be taken in using them. They are never to be employed while the head is above the brim of the pelvis, and indeed very rarely when it has descended lower. Dr. Hunter absolutely forbids their use, if they can possibly be avoided, consistently with the safety of the child; for, if time is allowed, the parts will dilate, and the head will be moulded so as to pass with the least possible violence.

The forceps, as improved by Smellie, are the best; he reduced their length, to prevent their being used before the head is sufficiently low. They should not be applied before the ears can be felt, and previous to their use the following rules should be observed:

1. The external parts should be sufficiently dilated.

2. The exact situation of the child's head should be known; and this is best, discovered by feeling one ear.

3. A finger should be in the os internum to guide the forceps, lest a part of the uterus itself should be included in them. When the finger cannot be thus introduced, great care is required in passing the forceps along the side of the child's head.

4. The blades of the forceps should be well greased before they are introduced.

5. If possible, apply the blades over the child's ears; for thus they are placed on the narrowest part of the head; when this cannot be done, fix one before one ear, and the other behind the opposite one.

6. The forceps should be passed up in the direction of a line that may be supposed to pass through betwixt the navel and the scrobiculus cordis; at the same time keeping the handles as far back as the perinaeum will easily admit. When the forceps are secure, pull them from blade to blade; for otherwise they are apt to slip off.

7. The handles should be tied tight before the operator begins to pull downwards with them; and when the two blades are locked, the lock should be about an inch from the child's head.

8. As the child's head advances, the operator should alternately rest and pull while the perinaeum is on the stretch, and until the vertex is brought from under the os pubis; then the handles of the forceps being gradually raised towards the mother's belly, and the pulling repeated with caution, whilst with one hand the perinaeum is supported, the forehead will be freed from it. The forceps are now to be taken away, and the delivery finished, as is usual, with the hands alone.

The different cases in which these forceps are required maybe seen under the article Praeesentatio.

The long curved forceps were invented by Smellie, with a view to save the life of the child, when, the body being delivered, the head could not be brought away in the usual manner. In this case the crotchet was formerly used. These forceps are longer than the straight ones, because they are applied when the head of the child is above the brim of the pelvis; but as it can very rarely happen that where the buttocks have passed (especially when doubled, as in breech presentations) the head will be detained, these instruments are scarcely ever necessary. Indeed, when the head is separated from the body, and left in the uterus, if the pelvis be much distorted, the long curved forceps may sometimes be preferable to the straight ones; but in this case, if the size of the head is lessened by emptying it of part of the brain, the delivery may generally be effected by one hand and one blade of a crotchet. Notwithstanding the advantages proposed by the use of the foregoing instruments, in some cases they are unavailing: it is then advised to open the head by the use of a large pair of scissors, with a stop put on the outward edge of each blade, about the middle; the inner edges of which are blunted downwards. These contrivances are, first, to stop the scissors before they are expanded in a proper situation, and to prevent cutting the vagina or uterus, in occasionally closing them. See Praesen-tatio, cases where the head presents, which will show the utility of these instruments more clearly. See the figures of these instruments represented in plate 5 of Midwifery, No. 3, 4, 5, 6, 7, 15..