AMONG the severe labors, which give much trouble, and exact much patience from all parties, from the patient, the midwife, and all the assistence, this case may challenge a place. It is that, in which the head of the child having presented itself foremost, and having ingaged itself half way, or thereabouts, in the streight of the bones of the pelvis, and of the orifice of the uterus, the labor-pains remit, languish, and the progress of the labor becomes suspended. Whether there be any mis-conformation of the bones of the pelvis, or whether (as our practitioners are pleased to express it,) the head of the fœtus be too large for the passage, or whether, in short, both these causes concur to the formation of this obstacle, or exist in complication with other circumstances; it is, in this case, we may say the head is hitched, stuck or ingaged in the passage. MR. De la Motte, book the 3d. chapter the 20th, describes this state of the fœtus. “WHEN (says he) the head has struck into the streight of the passage which, at first, affords a great deal less room than were to be wished, for its letting it pass, the head ingages itself as much forward as possible, from the continual and violent pains the woman suffers, which act upon the child, whose head lengthens and flattens, in such a manner, to adjust and mould itself to the passage, that the hairy scalp becomes quite tumefied, so as to make the head look almost like a double head, which however remains stuck fast between the bones, without being able to get out, and only ingages itself the more the more it advances ... but growing larger as it advances, and the aperture which it obliged to force diminishing more and more, makes it so that the head remains at length so jammed in, that it cannot be drawn out without diminishing its volume, which (as this author says) cannot be executed without instruments: as I was obliged to do, to accomplish the following delivery.” MR. De la Motte then proceeds to tell us, that he was called to lay the wife of a laborer, the head of whose child was hitched in the passage. After having well examined the state of the mother and child, and ascertained as much as it is possible to ascertain the death of the latter——“I determined, (says he) to finish the delivery, which I did by opening the head of the child with my incision-knife, and scooped out therewith part of the brain. After which, I made use of my hand, with which I got hold of the inside of the skull, and in an instant drew the child out, who appeared to have been dead a long time.” IT is not here that, in answer to M. De la Motte, I shall stop to propose a more gentle and more natural method of giving a good account of this case of a hitched head, than the cruel and dangerous expedients suggested by the instrumentarians: I reserve the submission to better judgment of my own ideas of practice, in this point, till after I shall have quoted the notions of more authors.