“DEFINITION. The progress of the labor is impeded by some mechanical obstruction in the passages connected with the soft parts, which by causing delay in the second stage leads to the developement of symptoms of powerless labor.” The symptoms that arise and that cause anxiety are the same as in a case of powerless labor, except that while in the latter kind the pains are feeble, in the case of obstructed labor the pains may be vigorous and severe but ineffective in consequence of obstacles. I may say, however, that these obstacles have not been often met with in my practice. Since I commenced the practice of midwifery three thousand cases of pregnancy have been under my observation for treatment, and I have not yet met with any of the following causes of obstructed labor: Occlusion of the os uteri, cancer of the os uteri, undilatable vagina, tumors in the pelvis, or diseased ovary, stone in the bladder, imperforate hymen, hernial protrusion into the vagina, or blood effusions, or swelling of the soft parts. I have met with one case of excessive œdematous effusion of the vulva, which I relieved by puncturing the skin; one case of cystocele which I relieved by first drawing the water and then returning the bladder, before the head of the child descended into the pelvis; one case of ovarian tumor that was not at that time in the pelvis; one case of small fibrous tumor on the neck of the uterus, which did not much obstruct the labor; and numerous cases where hardened feces in the rectum was an obstacle until they were removed by the use of enemata. In cases of obstructed labor the skilled nurse will show her wisdom by detecting the obstructions and sending for an accoucheur. DEFORMED PELVIS. “DEFINITION. The progress of the labor impeded by abnormal deviations in the form of the pelvis, giving rise to delay in the second stage, or rendering the descent of the child impossible without assistance, or altogether impracticable. The symptoms are those of powerless labor.” The EQUALLY ENLARGED PELVIS, enlarged in all its parts, is not often met with, and is of no obstetric importance. If in any case this condition is diagnosed preceding or during labor, the patient should be watched by the nurse lest labor close so precipitately that the child falls to the ground. THE EQUALLY CONTRACTED PELVIS—equally contracted in all its diameters, generally renders the labor difficult and tedious but not impracticable, by the natural powers. Other distortions such as has often been caused by rickets, &c., offer great obstruction to the passage of the child. In some cases a modification of the position of the child allows it to descend, but in many cases it is necessary to interfere and terminate the labor artificially. The nurse should not wait for unfavorable symptoms to appear before she sends for a man that is able to use the forceps, &c. MALPOSITION AND MALPRESENTATION OF THE CHILD.