Improvements in Midwifery and other Obstetrical Forceps.
Year: 1893

page_text: Date of Application, 20th Feb., 1893
Complete Specification Left, 20th Nov., 1893-Accepted, 27th Jan., 1894
I, AUGUSTINE FRANCIS DOWNEY, of Clonmel in the County of Tipperary,
Ireland, Physician and Surgeon, do hereby declare the nature of this invention to be
as follows:-
A rigid forceps by means of which traction can be applied in the true axis of
the inlet of the pelvis.
I propose to construct the forceps with three curves, namely, cephalic, pelvic,
and compensating. This compensating curve begins where the pelvic curve ends
and is continued, with its concavity backwards, towards the coccyx until, when the
instrument is applied to the foetal head, it reaches the axial line of the pelvic inlet,
and then terminates in a handle or handles which may be either in direct continuity
with the before-mentioned axial line or at right angles to it.
Now the traction exerted on the handle or handles of such forceps, when applied,
being in the direct or true axis of the pelvic brim or inlet, causes the foetal head
to enter the pelvic cavity or canal in the same axis.
Dated this 20th day of February 1893.
AUGUSTINE FRANCIS DOWNEY.
COMPLETE SPECIFICATION.
Improvements in Midwifery and other Obstetrical Forceps.
AUGUSTINE FRANCIS DOWNEY 43 Lichfield Street, Hanley, N. Staffs
Physician and Surgeon do hereby declare the nature of this invention and in what
manner the same is to be performed, to be particularly described and ascertained in
and by the following statement :—
A rigid forceps by means of which traction can be applied in the true axis of the
inlet of the pelvis.
1 propose to construct the midwifery (and other obstetrical) forceps with three
curves, namely, cephalic, pelvic, and compensating. In this forceps the cephalic
and pelvic curves are similar to those of the ordinary -long forceps in general use;
the method of locking the blades is the same; but its chief feature of novelty is
the compensating or perineal curve ending below the coccyx in a handle or handles
which are in a line of continuity with the axis of the pelvic brim-that is, in a line
passing upwards and forwards through the tip of the coccyx to the umbilicus.
The appended drawings adequately explain the proposed improvements. Fig. I.
gives a side view of the blade commonly used. Fig. 1. gives a similar view of
the improved blade with the perineal curve (A), and the handle (B) in a line with
the axis of the fenestræ, i.e. with the axis of the pelvic brim. Fig. III. shows
wherein the difference exists between the ordinary blade and the modification.
It will be seen that both blades are similar as regards the cephalic (C) and pelvic
curves (D), but differ essentially in other respects. It is evident that the line of
traction in Fig. I.—that is, the line drawn from the centre of the fenestræ to the
handles will differ widely from that of Fig. II. This difference constitutes the
'angle of error," and is very manifest in the combined Fig. III. It is true that, by
forcing backwards the handles of the ordinary forceps, when applied to the head,
this "angle of error or angle of misapplication may be somewhat lessened-at the
cost of crushing and bruising the perineum-but cannot be eliminated.
66
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page_text: With regard to the principles of its application, some words of explanation are
required: The blades having been applied to the factal head and locked in the
usual way, traction is exerted downwards and backwards in the line or plane of the
true pelvic axis until the head reaches the coccyx and perineum; then, with his
right hand grasping the perineal curve, whilst the left holds the handles, the operator
makes continuous or alternate traction-downwards with the left hand and forwards
with the right. The result of these forces is that the foetal head moves, in their
diagonal, downwards and forwards as the perineum thins out and stretches under
the pressure; that is, the head moves in the axis of the pelvic outlet. It will be
seen that, with this forceps, traction can be made downwards, from first to last, in
a plane corresponding with the axis of the pelvic brim; and it will also be seen
that this force may be modified, at any stage, in a backward or forward direction
by the operator seizing the perineal curve with one hand and pushing the forceps
towards the sacrum backwards, or drawing it towards the pubis forwards, at the
same time as the other hand is employed in downward traction; or either hand
may exert its special force alternately with the other. The compensating curve
being simply a continuation backwards towards the coccyx of the pelvic curve, no
pressure on or crumpling of the perineum occurs when the instrument is applied to
the fatal head above or at the brim.
Having now particularly described and ascertained the nature of my said inven-
tion, and in what manner the same is to be performed, I declare that what I
claim is :-
:-
I. The addition of a third or compensating curve beginning where the pelvic
curve ends, continued with its concavity backwards towards the coccyx, and
terminating in a handle or handles which are in a direct line with the axis of the
pelvic inlet and by means of which traction can be made on the foetal head so that
it enters the pelvic cavity or canal in the true axis, no "angle of error" existing
between the actual line of force of traction and the axis of the pelvic brim.
II. The invention of a scientific forceps.
Dated this 18th day of November 1893.
AUGUSTINE FRANCIS DOWNEY.