_Anchylosis of the joints of the foetus._ Lastly, we may mention a very rare cause of this species of dystocia, which has been observed by Professor Busch, where the obstruction to the passage of the child arose from anchylosis of its joints. "The head had been delivered by the forceps, but the body would not follow. As no cause of obstruction could be discovered, a gentle and then more powerful traction was used: this was followed by a cracking sound, and the upper part of the trunk passed through the os externum: here again it stopped, but still, as no cause of obstruction could be discovered, and as the child was dead, another traction was made, with a repetition of the cracking sound, and the child was delivered. On examination it was found that all the joints of the extremities were anchylosed in the usual position of the foetus in utero, so that the ossa humeri and then the ossa femoris had given way. The child had been dead some time." (_Neue Zeitschrift für Geburtskunde_, vol. xv. 1837; and _British and Foreign Med. Rev._ April 1838, p. 579.) No precise rules can be given for the treatment of these cases of malformation of the child; it must be modified according to the peculiarities of each individual case. Whenever a part has undergone considerable increase of size from accumulation of fluid, this can be in most cases removed without much difficulty by perforation, whether it be of the head or abdomen. With monstrous growths the accoucheur must depend upon his own resources, ingenuity and knowledge of the mechanism of parturition. The more careful and correct his diagnosis is, the more efficient will be the means he adopts for delivering the child. In such cases the examination can scarcely be made effectually by the finger alone, but the hand will be required for this purpose. CHAPTER III. THIRD SPECIES OF DYSTOCIA. _Difficult labour from faulty condition of the parts which belong to the child.--The membranes.--Premature rupture of the membranes.-- Liquor amnii.--Umbilical cord.--Knots upon the cord.--Placenta._ In describing this species of dystocia, according to the arrangement of Professor Naegelé, which we have adopted, it will be necessary to observe that serious obstructions to the passage of the child is seldom produced by it, although, at the same time, many slight derangements in the progress of labour are liable to result, which demand the care of the practitioner.