2. Although in cities and villages generally, a physician’s services can in most instances be immediately obtained, in the country it is not always practicable to obtain them within an hour or two of time. 3. Such knowledge as is necessary for the performance of this operation may be obtained from such description and instruction as can be given in books. 4. There are some women who possess the necessary traits of character, the complete exercise of their faculties, with the perfect coolness which is demanded of the operator in such a case. 5. I do not advocate trusting the operation to a nurse when the services of an accoucheur can possibly be obtained within the proper time. 6. The services of a physician, if obtained one or two hours after the arm is first thrust down in the vagina, may not be of any use because the time for turning is passed. 7. The operation of turning, performed by a properly instructed nurse, does not involve the least danger to the mother or child. 8. The only danger connected with this operation arises from the size of the hand of the operator, and the woman’s hand is small. 9. It is a historical fact that at one period practitioners overrated the performance of turning, and extended its use to unsuitable cases, and after the invention of the forceps, they fell into an opposite error. It is possible that we may be in error if we hold that the nurse cannot be instructed to perform the operation of turning. 10. I do not advise that the nurse should ever attempt to turn in those cases in which the membranes have been long ruptured—the shoulder and arm pressed down into the pelvis, and the uterus contracted around the body of the child. I once succeeded in a case that two experienced physicians had tried in vain for several hours to turn, and I never had very much difficulty in turning, but there have been many cases where excellent operators could not succeed in turning. In cases of PRESENTATION OF SHOULDER, ARM OR TRUNK, delivery by the natural powers is quite exceptional, though the natural powers have occasionally succeeded in expelling the child. The safety of the mother and child depend upon the early detection of the abnormal position of the fœtus, and upon their receiving proper treatment before labor has been long in progress. The position of the child is one intermediate between the long and transverse diameters. It may lie with its back towards the abdomen of the mother or with the back towards the spine of the mother, and the head of the child may be towards the right or the left of the mother.