Smellie,1 in his book on midwifery, describes a difficult case to which he was called by a midwife. This was in 1744, 184 years ago. After careful examination, he decided that the case was one of occiput posterior, and that this malposition was the principal factor in the dystocia. He applied forceps, and his keen appreciation of the difficulties encountered and of the dangers of various expedients is well shown in the following quotation:
As I found I could not deliver the head by pulling either downward to bring out the forehead, or upwards because the head would not yield that way, on account of the chin's being pressed against the breast, neither did I choose to try the blunt hook, because of the bad consequences attending that method. I was also averse and loth to destroy the child by opening the head. While I paused a little, considering