The two greatest Continental authorities of modern times, viz. Madame La Chapelle and Professor Naegelé, confirm this opinion: the former points out one of the sources of error which has induced practitioners to suppose that they had met with other species of faulty presentation besides those of the arm or shoulder. "In the greater number of shoulder presentations," says this experienced authoress, "I have very distinctly touched the chest, in some positions of the nates I have been able to reach the loins, the hips, or lower part of the abdomen; but it would require no slight bias from prejudice and theoretical systems to find presentations of the chest, the back, the abdomen, or the loins, the neck or the ear."[108] We would, therefore, limit the term malposition of the child merely to presentations of the arm or shoulder: other presentations, it is true, occur, but not of the full-grown living foetus; they are only where the child is premature, or has been dead in utero some time. Under such circumstances it will follow no rule whatever; for in the first case it is too small, and therefore the passages can have no effect in directing its course through them; and, in the second, a child which has been dead some time becomes so softened by gradual decomposition, that it may be squeezed by the pressure of the uterus into almost any shape: it is by this cause that we occasionally see in still-born children parts in close contact, which in a living child could not have been brought together. We do not deny that such presentations may be made by ignorant and awkward attempts to deliver, but it is to be hoped that such cases are daily becoming of rarer occurrence. Malposition of the child is fortunately not of very frequent occurrence: as a general average we would say that it occurs once in 230 cases, as the following results will show:--At the Westminster General Dispensary (1781) it occurred to Dr. Bland once in 210 cases: at the Dublin Lying-in Hospital, to Dr. Joseph Clarke, once in 212: in private practice, to Dr. Merriman, once in 155: "calculated from a great number of cases," to Professor Naegelé, once in 180: at the Dublin Lying-in Hospital, to Dr. Collins, once in 416: at the Maternité, of Paris, to Madame La Chapelle, once in 230. In arm and shoulder presentations the back of the child is turned towards the anterior part of the uterus more than twice as frequently as it is in the contrary direction, from which circumstance Professor Naegelé has called this the first position of the shoulder to distinguish it from the other, which, as being rarer, he calls the second.