Where the child has descended gradually, and the arms have advanced with the breast into the pelvis, if the cord be considerably upon the stretch, a portion should be pulled gently down in order to relax it, and we should endeavour as far as possible to guide that part of it which is within reach towards one of the sacro-iliac synchondroses, being less liable there to suffer from pressure. One or two fingers should be introduced to bring down the arms, which are now coming into the lower part of the hollow of the sacrum: they should be hooked down by the bend of the arm, in order to prevent the humeri from sticking across the passage. When this has been effected, the shoulders follow as the head descends through the pelvis. The body of the child should now be wrapped in warm flannel, and two fingers passed up towards the face: the lower jaw must not be trusted to in bringing the head through the pelvic outlet and os externum, for it may easily be broken: the fingers should be applied one on each side the nose, and the chin depressed as much upon the breast as possible, by which means the head will come in a much more favourable direction, and pass readily. In no case is so much mischief done by impatient interference as in presentations of the lower end of the child. This is still more so in footling cases, for here the soft parts are not so well dilated as in nates presentations, where the child comes double: hence the fact, that presentations of the feet are easier to the mother but more dangerous to the child. In either case, the passage of the head through the pelvis must ever be attended with considerable hazard, for if it be delayed beyond a short time, the child's death is certain. "The more gradually the nates and body of the child are expelled, the quicker will its head pass through the pelvis, and the better will be its chance of being born alive." (_Obstet. Memorand._ 2d ed.) Hence, therefore, if the pains are slow at this moment, it will be desirable to rouse them with a dose of ergot; and if the child gives a convulsive twitch, the forceps ought instantly to be applied. The result of Professor Busch's practice in the lying-in hospital at Berlin shows, that by the timely use of the forceps a large majority of children may be saved. For the same purpose, the nurse should be instructed to have a warm bath in readiness, with some spirit, &c. for resuscitating the child the moment it is born. The numbers which we subjoin are taken from the cases in the Dublin Lying-in-Hospital, under the late Dr. Joseph Clark and Dr. Collins, from the private practice quoted in Dr. Merriman's _Synopsis_, and from the General Lying-in-Hospital. Of 71,578 labours, the nates presented once in every 78 cases, and the feet once in every 108-1/2. Of the nates cases the child was born dead in the proportion of 1 to 3·8, and in the footling births 1 to 2·8. PART IV. MIDWIFERY OPERATIONS. CHAPTER I. THE FORCEPS.