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The Tucker-McLane forceps
THE
T~CK~~-~~~A~E
FORCEPS
Wistory STEWART (From
A. the
E&I,
M.D.,
Sloane Hospital
NEW
YORK, for
N.
Y.
Women)
S THE early days of American obstetrics all of the instruments in use were of European design. Then, as American medicine developed, the ingenuity of obstetrical practitioners increased and subsequently a number of excellent American obstetrical forceps were developed. One of these, the Tucker-MeLane forceps, was the product of the efforts of two prominent obstetrical practitioners of the late nineteenth century, James Woods McLane and Ervin Alden Tucker. This instrument is unique in that it is probably the only forceps in common use today which utilizes the solid blade. This feature combined with an overlapping shank and reasonably light construction makes a particularly useful instrument for rotation of the occiput and other obstetrical operations in which a thicker, larger blade would be lesssuitable. The characteristic solid blade was not original with Dr. Tucker or Dr. Mclane, for before the middle of the nineteenth century there were at least ten recorded European types of forceps with nonfenestrated b1ades.l In 1850 Dr. Anton F. Hohl* of IIalle, Germany, described in his text a long-shanked, solidSladed forceps with a depression on the inside of the cephalic curve of the blade to increase the holding effect. This same feature is found today in the Luikart modification of the Tucker-McLane forceps. In 1860 Dr. Samuel 7‘. Knight1 of Baltimore, Md., introduced a forceps of his own design with a narrow, nonfenestrated blade. Like many other forceps, this never became popular and soon sank into oblivion. During the latter part of the same decade, the instrument which was to become known as the Tucker-McLane forceps was conceived by Dr. McLa.ne. This original instrument, which bore Dr. &Lane’s name, consisted of thin, nonfenestrated blades with a moderate cephalic curve. The shanks were slightly separated and converged on a.n English-type lock. The ebony handles, which were larger than those of most popular instrun1ent.s of the day, had prominent shoulders and convenient finger grips. The date the original McLane forceps was made cannot be determined exactly. However, existing records of George Tiemann and Company3 of NORYork, the manufacturers of the original instrument, indicate the first model was made sometime during the year 1868. The first illustration of the forceps appears in Tiemann’s catalogue of 1880. Dr. Mcriane was not a prolific writer and he never published any description of his forceps. The earliest record o-f the use of the McLane forceps is in 1891 in the first report of the Sloane Maternity Hospital. This report b;- Dr. MeTJane’ describes the first thousand deliveries 1042
Volumel65 Number 5
TUCKER-MC
LANE
FORCEPS
1043
at Sloane Hospital. There were 83 I forceps deliveries recorded and forceps of “Dr. Melane’s pattern” were used in 81 instances for both “high and low operations. ’ ’ The first child born by forceps operation at the Sloane Hospital was delivered by Dr. McLane with his own forceps. This instrument is still preslerved in the forceps museum of the Sl.oane Hospital for Women in New York.
Fig.
l.-James
Woods
~&me,
1639-1912.
The date Dr. Tucker first modified the original McLane instrument 1)~ lengthening the shanks, causing the shanks to overlap somewhat, and changing the handle from ebony to h.ard rubber is not known. Again, no published or written record of this change was made. However, the date certainly lies between the years 1890 and 1895 while Dr. Tucker was a resident at Sloane Maternity Hospital. Dr. McLane describes the modification in his own words as follows : “Dr. Tucker, a resident physician, thought the shank too short for high operations and had it made slightly longer as seen in the ‘McLane-Tucker’ instrument.” In 1876, R. Olshausenl of Berlin described a forceps of his own design with solid blades, long, slightly divergent. shanks, and a smooth handle. This, instrument closely resembles the present-day Tucker-McLane forceps and it is quite possible that Dr. Tucker’s idea for elongating the shanks of the McLanfe forceps was conceived while he was studying at Olshausen’s clinic in 1890. The changes that Dr. Tucker introduced have been retained and represent the instrument as it is used today. Subsequent modifications of the Tucker-McLane forceps have been made but are not widely used. In 1910 Dr. George 7vTT.Kosmak5 of New York developed a forceps for outlet use only which used the Tucker-McLane blades inserted directly into the handles, completely omitting the shanks. The same
year Dr. Ellice McDonald” of New York modified the Tucker-&Lane forceps by cutting from 8 to 15 small transverse fenestra in the blades to prevent slipping with strong traction, since this is probably the greatest defect of th.e Tucker-McLane forceps. In 1937 Dr. Ralph Luikart’ of Omaha, Neb., inserted elliptical depressions in the cephalic curve of the blades, also representing an at.tempt to increase the holding power. This identical feature is found in Hohl’s solid blade forceps of 1850. Dr. Arthur Bille of Western Reserve University devised, in 1924, an axis traction apparatus (Bill’s handle) which. is used on the Tucker-MeTlane forceps when accurate axis traction is needed for midforceps operations. Brief biographies of Dr. Mellane and Dr. Tucker are in order here as both physicians were outstan.ding practitioners of their day.
James Woods McLanes~ I1 was born in New York City Bug. 29, 1839. Re received his early education from private tutors and at Phillips Academy, Andover, Mass. He graduated from Yale University in 1861 and immediately nndertook the study of medicine at the College of Physicians and Surgeons in New York. He graduated from this institution in 1864 with “more than the average reputation for diligence.” Dr. McLane at once entered practice in New York City, and after several promotions was made Professor of Obstetrics and the Diseases of Children at the College of Physicians and Surgeons in 1872, eight years after his graduation. He served in this capacity until 1898 when he became Emeritus. In addition to many professional affiliations, including being the first attending obstetrician of Sloane Maternity Hospital, he was appointed President of the College of Physicians and Surgeons in 1889. He held this position until 1891 when the school became affiliated with Columbia University, He continued aft,er the merger for 12 years as Dean of the Faculty of Medicine. Through his
Volume Number
65 j
TUCKER-MC
LANE
FORCEPS
1045
efforts funds were obtained from William K. Vanderbilt to establish the wellknown Vanderbilt Clinic of the Columbia-Presbyterian Medical Center of New York. In addition, hel2 obtained funds from Mr. and Mrs. W. D. Sloane to build the Sloane Maternity Hospital which opened on Jan. 1, 1888. This is now known as the Sloane Hospital for Women and is also affiliated with the ColumbiaPresb,yterian Medical Center. In 1898 Dr. McLane retired from active teaching and was succeeded by Dr. E. B. Cragin in the Chair of Obstetrics. Ervin Alden Tucke+‘p I3 was born on Feb. 2, 1862, in Attleboro, Mass. He received his early education in the public schools of Attleboro and in Providence, R. I. He graduated from Amherst College in 1885 with a B.S. degree. He then attended the College of Physicians and Surgeons in New York for 3 years and graduated in 1889 with honors. Following this Dr. Tucker served six months as assistant resident physician at Nursery and Child’s Hospital in New York. In December, 1889, he went to Germany to study obstetrics with Olshausen, Diihrssen, and others. The following December he returned to New York and becam.e an instructor in obstetrics at the College of Physicians and Surgeons and the sixth resident physician at Sloane Maternity Hospital.
Fig. 3..-The original forceps (below).
McLane From the
forceps forceps
(above) museum
and a very of the Sloane
early model of the Tucker-McLane Hospital for Women, New York.
From 1890 to 1895 Dr. Tucker had the satisfaction of seeing the Sloane Hospital service increase from 400 to 900 deliveries a year, making it the largest Besides his modification of the Mcobstetrical hospital in the united States. Lane forceps and the improvement of many of the existing obstetrical instruments of the day, he introduced the “cephalic” rather than the then existing He was planning publication of this “pelvic” method of forceps application. now commonly used method in 1902 when he met an untimely end at the age of 40 years.
Dr. Tucker resigned as resident of Sloane Ilospital in 1893 and became the first man in New York City to devote himself exclusively to the practice of obstetrics. He was extraordinarily successful becauseof his abilit,x and had a. ver?large practice.
During the winter l)efore his death Dr. Tucker had been working extremely hard and on the “wretchedly stormy night” of Feb. 25, 1902, he was called to see a patient at two in the morning.l”, 15,IF His Tvife begged him to send someme in his place, but he refused. He was unable to procure a cab, for it was “the night of the gala opera performa.nce given in honor of Prince Henry” and he stood twenty minutes on the corner of 59th Street waiting in the storm for a crosstown car. He remained up with his patient t,hroughont the night and nest, morning he started his rounds after only an hour’s sleep. At t.he home of a paCent he had a severe chill, so he excused himself and went home to bed. It was obvious that he was quite ill and he received immediate medical attention from
Voi”nle Plumber
65 5
TUCKER-MC
LANE
FORCEPS
1047
the best Kew York physicians, including Dr. Francis Delafield and Dr. Edward C. Janeway. However, lobar pneumonia had become too. well established and he never recovered. On the sixth day of his illness, abont II:30 in the evening of March 3, he suddenly became delirious, developed pulmonary edema and died, thus cutting short a brilliant career in ?ts prime. Dr. McLane outlived Dr. Tucker by ten years and continued in active practice until several years before his death on Nov. 25, 1912. References 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16.
1929, The C. V. Moxby Company. Das, Kedarnath: Obstetric Forceps, St. Louis, Hohl, Anton F.: Lehrbuch der Geburtshiilfe, Leipzig, 1855. George Tiemann and Co., N. Y.: Personal communication. MeLane, James Wood: Am. J. Obst. 24: 396, 18Yl. Kosmak, George W. : Bull. Lying-In Hosp., N. Y. 6: 170, 1910. McDonald, Ellice : Am. J. Obst. 61: 215, 1910. AM. J. OBST. & GYNEC. 34: 6861937. Luikart, R.: Bill, A. M.: AM. J. OBST. & GYNEC. 9: 606, 1925. Shrady, John: History of the College of Physicians and Surgeons, New York, 1903, Lewis Co., vol. 1, p. 223. Sh.rady, John: History of the College of Physicians and Surgeons, New York, 1903, Lewis Co., vol. 2, p. 6. Editorial: Columbia Universitv Quarterlv. N. Y. 15: 152. 1913. Cragin, E. B.: Columbia University Quarterly, N. Y. 14: 273, 1912. Walsh, J.: History of Medicine in New York, 1919, New York National Americana Societv. vol. 4. Fielder, Fr%eis: Columbia University Quarterly, N. Y. 4: 2iS, 1902. Editorial: Medical News, N. Y. 80: 692, 1902. Broadhead, George L.: Am. J. Obst. 45: 692,1902.
T~CK~~-~~~A~E
FORCEPS
Wistory STEWART (From
A. the
E&I,
M.D.,
Sloane Hospital
NEW
YORK, for
N.
Y.
Women)
S THE early days of American obstetrics all of the instruments in use were of European design. Then, as American medicine developed, the ingenuity of obstetrical practitioners increased and subsequently a number of excellent American obstetrical forceps were developed. One of these, the Tucker-MeLane forceps, was the product of the efforts of two prominent obstetrical practitioners of the late nineteenth century, James Woods McLane and Ervin Alden Tucker. This instrument is unique in that it is probably the only forceps in common use today which utilizes the solid blade. This feature combined with an overlapping shank and reasonably light construction makes a particularly useful instrument for rotation of the occiput and other obstetrical operations in which a thicker, larger blade would be lesssuitable. The characteristic solid blade was not original with Dr. Tucker or Dr. Mclane, for before the middle of the nineteenth century there were at least ten recorded European types of forceps with nonfenestrated b1ades.l In 1850 Dr. Anton F. Hohl* of IIalle, Germany, described in his text a long-shanked, solidSladed forceps with a depression on the inside of the cephalic curve of the blade to increase the holding effect. This same feature is found today in the Luikart modification of the Tucker-McLane forceps. In 1860 Dr. Samuel 7‘. Knight1 of Baltimore, Md., introduced a forceps of his own design with a narrow, nonfenestrated blade. Like many other forceps, this never became popular and soon sank into oblivion. During the latter part of the same decade, the instrument which was to become known as the Tucker-McLane forceps was conceived by Dr. McLa.ne. This original instrument, which bore Dr. &Lane’s name, consisted of thin, nonfenestrated blades with a moderate cephalic curve. The shanks were slightly separated and converged on a.n English-type lock. The ebony handles, which were larger than those of most popular instrun1ent.s of the day, had prominent shoulders and convenient finger grips. The date the original McLane forceps was made cannot be determined exactly. However, existing records of George Tiemann and Company3 of NORYork, the manufacturers of the original instrument, indicate the first model was made sometime during the year 1868. The first illustration of the forceps appears in Tiemann’s catalogue of 1880. Dr. Mcriane was not a prolific writer and he never published any description of his forceps. The earliest record o-f the use of the McLane forceps is in 1891 in the first report of the Sloane Maternity Hospital. This report b;- Dr. MeTJane’ describes the first thousand deliveries 1042
Volumel65 Number 5
TUCKER-MC
LANE
FORCEPS
1043
at Sloane Hospital. There were 83 I forceps deliveries recorded and forceps of “Dr. Melane’s pattern” were used in 81 instances for both “high and low operations. ’ ’ The first child born by forceps operation at the Sloane Hospital was delivered by Dr. McLane with his own forceps. This instrument is still preslerved in the forceps museum of the Sl.oane Hospital for Women in New York.
Fig.
l.-James
Woods
~&me,
1639-1912.
The date Dr. Tucker first modified the original McLane instrument 1)~ lengthening the shanks, causing the shanks to overlap somewhat, and changing the handle from ebony to h.ard rubber is not known. Again, no published or written record of this change was made. However, the date certainly lies between the years 1890 and 1895 while Dr. Tucker was a resident at Sloane Maternity Hospital. Dr. McLane describes the modification in his own words as follows : “Dr. Tucker, a resident physician, thought the shank too short for high operations and had it made slightly longer as seen in the ‘McLane-Tucker’ instrument.” In 1876, R. Olshausenl of Berlin described a forceps of his own design with solid blades, long, slightly divergent. shanks, and a smooth handle. This, instrument closely resembles the present-day Tucker-McLane forceps and it is quite possible that Dr. Tucker’s idea for elongating the shanks of the McLanfe forceps was conceived while he was studying at Olshausen’s clinic in 1890. The changes that Dr. Tucker introduced have been retained and represent the instrument as it is used today. Subsequent modifications of the Tucker-McLane forceps have been made but are not widely used. In 1910 Dr. George 7vTT.Kosmak5 of New York developed a forceps for outlet use only which used the Tucker-McLane blades inserted directly into the handles, completely omitting the shanks. The same
year Dr. Ellice McDonald” of New York modified the Tucker-&Lane forceps by cutting from 8 to 15 small transverse fenestra in the blades to prevent slipping with strong traction, since this is probably the greatest defect of th.e Tucker-McLane forceps. In 1937 Dr. Ralph Luikart’ of Omaha, Neb., inserted elliptical depressions in the cephalic curve of the blades, also representing an at.tempt to increase the holding power. This identical feature is found in Hohl’s solid blade forceps of 1850. Dr. Arthur Bille of Western Reserve University devised, in 1924, an axis traction apparatus (Bill’s handle) which. is used on the Tucker-MeTlane forceps when accurate axis traction is needed for midforceps operations. Brief biographies of Dr. Mellane and Dr. Tucker are in order here as both physicians were outstan.ding practitioners of their day.
James Woods McLanes~ I1 was born in New York City Bug. 29, 1839. Re received his early education from private tutors and at Phillips Academy, Andover, Mass. He graduated from Yale University in 1861 and immediately nndertook the study of medicine at the College of Physicians and Surgeons in New York. He graduated from this institution in 1864 with “more than the average reputation for diligence.” Dr. McLane at once entered practice in New York City, and after several promotions was made Professor of Obstetrics and the Diseases of Children at the College of Physicians and Surgeons in 1872, eight years after his graduation. He served in this capacity until 1898 when he became Emeritus. In addition to many professional affiliations, including being the first attending obstetrician of Sloane Maternity Hospital, he was appointed President of the College of Physicians and Surgeons in 1889. He held this position until 1891 when the school became affiliated with Columbia University, He continued aft,er the merger for 12 years as Dean of the Faculty of Medicine. Through his
Volume Number
65 j
TUCKER-MC
LANE
FORCEPS
1045
efforts funds were obtained from William K. Vanderbilt to establish the wellknown Vanderbilt Clinic of the Columbia-Presbyterian Medical Center of New York. In addition, hel2 obtained funds from Mr. and Mrs. W. D. Sloane to build the Sloane Maternity Hospital which opened on Jan. 1, 1888. This is now known as the Sloane Hospital for Women and is also affiliated with the ColumbiaPresb,yterian Medical Center. In 1898 Dr. McLane retired from active teaching and was succeeded by Dr. E. B. Cragin in the Chair of Obstetrics. Ervin Alden Tucke+‘p I3 was born on Feb. 2, 1862, in Attleboro, Mass. He received his early education in the public schools of Attleboro and in Providence, R. I. He graduated from Amherst College in 1885 with a B.S. degree. He then attended the College of Physicians and Surgeons in New York for 3 years and graduated in 1889 with honors. Following this Dr. Tucker served six months as assistant resident physician at Nursery and Child’s Hospital in New York. In December, 1889, he went to Germany to study obstetrics with Olshausen, Diihrssen, and others. The following December he returned to New York and becam.e an instructor in obstetrics at the College of Physicians and Surgeons and the sixth resident physician at Sloane Maternity Hospital.
Fig. 3..-The original forceps (below).
McLane From the
forceps forceps
(above) museum
and a very of the Sloane
early model of the Tucker-McLane Hospital for Women, New York.
From 1890 to 1895 Dr. Tucker had the satisfaction of seeing the Sloane Hospital service increase from 400 to 900 deliveries a year, making it the largest Besides his modification of the Mcobstetrical hospital in the united States. Lane forceps and the improvement of many of the existing obstetrical instruments of the day, he introduced the “cephalic” rather than the then existing He was planning publication of this “pelvic” method of forceps application. now commonly used method in 1902 when he met an untimely end at the age of 40 years.
Dr. Tucker resigned as resident of Sloane Ilospital in 1893 and became the first man in New York City to devote himself exclusively to the practice of obstetrics. He was extraordinarily successful becauseof his abilit,x and had a. ver?large practice.
During the winter l)efore his death Dr. Tucker had been working extremely hard and on the “wretchedly stormy night” of Feb. 25, 1902, he was called to see a patient at two in the morning.l”, 15,IF His Tvife begged him to send someme in his place, but he refused. He was unable to procure a cab, for it was “the night of the gala opera performa.nce given in honor of Prince Henry” and he stood twenty minutes on the corner of 59th Street waiting in the storm for a crosstown car. He remained up with his patient t,hroughont the night and nest, morning he started his rounds after only an hour’s sleep. At t.he home of a paCent he had a severe chill, so he excused himself and went home to bed. It was obvious that he was quite ill and he received immediate medical attention from
Voi”nle Plumber
65 5
TUCKER-MC
LANE
FORCEPS
1047
the best Kew York physicians, including Dr. Francis Delafield and Dr. Edward C. Janeway. However, lobar pneumonia had become too. well established and he never recovered. On the sixth day of his illness, abont II:30 in the evening of March 3, he suddenly became delirious, developed pulmonary edema and died, thus cutting short a brilliant career in ?ts prime. Dr. McLane outlived Dr. Tucker by ten years and continued in active practice until several years before his death on Nov. 25, 1912. References 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16.
1929, The C. V. Moxby Company. Das, Kedarnath: Obstetric Forceps, St. Louis, Hohl, Anton F.: Lehrbuch der Geburtshiilfe, Leipzig, 1855. George Tiemann and Co., N. Y.: Personal communication. MeLane, James Wood: Am. J. Obst. 24: 396, 18Yl. Kosmak, George W. : Bull. Lying-In Hosp., N. Y. 6: 170, 1910. McDonald, Ellice : Am. J. Obst. 61: 215, 1910. AM. J. OBST. & GYNEC. 34: 6861937. Luikart, R.: Bill, A. M.: AM. J. OBST. & GYNEC. 9: 606, 1925. Shrady, John: History of the College of Physicians and Surgeons, New York, 1903, Lewis Co., vol. 1, p. 223. Sh.rady, John: History of the College of Physicians and Surgeons, New York, 1903, Lewis Co., vol. 2, p. 6. Editorial: Columbia Universitv Quarterlv. N. Y. 15: 152. 1913. Cragin, E. B.: Columbia University Quarterly, N. Y. 14: 273, 1912. Walsh, J.: History of Medicine in New York, 1919, New York National Americana Societv. vol. 4. Fielder, Fr%eis: Columbia University Quarterly, N. Y. 4: 2iS, 1902. Editorial: Medical News, N. Y. 80: 692, 1902. Broadhead, George L.: Am. J. Obst. 45: 692,1902.