I press the fingers together in the form of a cone, the thumb between the fingers—slowly and carefully press them into the vagina in an interval between the pains, and constantly and slowly press the hand in, only when the contractions of the uterus remit; never using any force, gently pass the fingers into the os; gently open the fingers a little occasionally to dilate the os sufficiently, and when it is expanded pass the hand into the uterus, make out the presentation accurately, so as to keep my hand to the abdomen of the child; always keep the hand still during a pain; when there is an interval between the pains, carefully search for the feet; when one of the feet is found, clasp the leg at the knee with one finger; flex the leg at the knee so that the finger has a good hold of it, draw it down in the absence of a pain; as the knee approaches the os when it is drawn down over the abdomen of the child, the shoulders and head recede towards the fundus, and when the head has reached the fundus and the knee is brought through the os, the case is converted into a knee presentation, and I deliver slowly but without needless delay—making a little traction during each pain, the management being conducted as in feet presentations, and the whole process being assisted by pressure made on the uterus by my left hand, or by the hand of an assistant. Possibly these directions will be better understood if I use the language of another who directs: 1. That the patient be placed on her left side near the edge of the bed. 2. The os externum is then to be dilated with the fingers reduced into a conical form, acting with a semi rotary motion of the hand. 3. When the hand is passed through the os externum it must be slowly conducted to the os uteri. We may perforate the membranes with the finger if they are not broken. 4. The hand must then be passed along the thighs and legs of the child until we come to the feet. If both the feet lie together we must grasp them firmly with one hand, but if they are distant from each other we may deliver by one foot. 5. Before we begin to extract we must be sure that we do not mistake a hand for a foot. The feet must be brought down with a slow, waving motion into the pelvis, when we are to wait till the uterus contracts, still retaining them in the hand. 6. The feet are to be brought down with each return of the pain, and the labor may be finished partly by the efforts of the mother and partly by art. 7. If the toes are turned towards the pubis the back of the child is towards the back of the mother which is an unfavorable position. 8. If the toes are towards the sacrum, the back of the child is towards the abdomen of the mother, and this position is advantageous when the head comes to be extracted.