OBSTETRICAL‐GYNAECOLOGICAL EPONYMS: JAMES YOUNG SIMPSON AND HIS OBSTETRIC FORCEPS

THE obstetric forceps has been modified and redesigned in new form probably more times than any of the other countless number of instruments and devices that man’s mind has conjured up for the diagnosis and treatment of his ills. The Chamberlen family is often credited with invention of the first safe and effective forceps, in the late sixteenth or early seventeenth century ; but archaeological evidence (Fig. 1) shows the forceps to have been in use for the delivery of living infants much earlier, probably the second o r third century, in the days of the Roman Empire (Baglioni, 1937). During the latter part of the nineteenth century almost every obstetrician of renown seems to have felt the need to add his own modification to the forceps; and even now scarcely a year passes without the addition of at least one new instrument to our forceps arsenal. For fully a century now, however, year in and year out, the vast majority of forceps deliveries has been carried out by means of an instrument popularized by Sir James Young Simpson and usually known as the Simpson forceps, although models embodying minor changes continue to bear the names of their new inventors. Simpson demonstrated his forceps for the first time on 10th May, 1848 at a meeting of the Edinburgh Obstetrical Society (Simpson, 1848). “They differ from the short forceps in some points of construction,” he explained, “but more particularly in regard to their mode of application and working. They differ for example in their length; in the shanks being parallel for some distance beyond the lock, an indispensable point in order to prevent them injuring the outlet; in their blades being curved; and in the part intended to embrace the head being sufficiently long and large . . . The blades are the same as Dr. F. Ramsbotham’s, but scarcely so much curved. The lock is Smellie’s, but with knees or projections above it of such size as to prevent the blades readily unlocking in the intervals between the pains, these giving it the fixed character of the locks of Levret and Bunninghausen’s instruments, without their complexity. The joints are made so loose as to allow of their lateral motion and overlapping to a very considerable degree, thus facilitating their introduction and application. And, lastly, the handle is that used by Naegele and other German accoucheurs, viz., with transverse knees or rests below the lock for one or two of the first fingers of the right hand to drag by, the long forceps being only properly used as an instrument of traction, not of compression. In addition, the handles are grooved and marked 011 the anterior side, to distinguish that from the other side when the blades are within the pelvis . . .” The forceps were used in the management of uterine inertia, haemorrhage during labour, and other complications, “but the common reason for employment of the long forceps,” in Simpson’s words, “is morbid contraction of the brim of the pelvis in its most general form, and from its most general cause, viz., in the conjugate or antero-posterior diameter, from projecting forward of the promontory of the sacrum. How are the long forceps applied when used in this, the case in which they are most generally had recourse to in practice? It is first requisite to state, that under this complication the child’s head is found situated in the brim, with its long or fronto-occipital diameter lying in the transverse diameter of the brim, or with the forehead looking to one ilium, and the occiput looking to the other. In other words, the long diameter of the head is not placed, as usual, in the right