When the head presents in the commencement of labor, if the fundus of the uterus is not too much inclined forwards, and there is no deformity of the pelvis, the os may easily be reached, and the hard round head of the child be felt without difficulty. Should a hard presenting part not be felt either through the dilated os or the walls of the uterus, it may be because there is a breech or body presentation, or there may be twins, or there may be an unusual amount of water in the uterus, or the child may have hydrocephalus—in either of these cases it might not be possible to decide immediately about the presentation and position. FACE PRESENTATIONS cannot be detected very early in the labor. Before the membranes are ruptured the head is high and difficult of access. When it is reached the forehead is first encountered, afterwards we may feel the nose and mouth. It is unfortunate for us that we cannot usually distinguish a face presentation in the early stage of labor. It is not so important that we make an early diagnosis of presentation of the breech, as there is no danger to the mother involved in the latter. PRESENTATION OF THE BODY should always be detected early, at least as soon as the membranes are ruptured. The abdomen of the mother is much longer in the transverse diameter than is usual, and the head of the child may sometimes be felt in the iliac fossa. The form of the mother’s abdomen is irregular as the fœtus lies curved on itself. When we are able to touch the fœtus, if the shoulder presents, we first feel a small bony projection, the acromion point of the shoulder; then other points, including the acute angle of the shoulder blade. We should ascertain as soon as possible on which side the head lies, and also the posterior plane of the child. Sometimes the hand comes down in the vagina or even appears at the vulva; if it does we may know by that (and by slipping the finger of our hand up into the axillary space) just how the child lies. If the back of the child’s hand is turned towards the mother’s right thigh the head is to the right, and if to the left thigh, to the left. The little finger being towards the coccyx indicates that the child’s back is towards the mother’s loins, and the same finger being towards the pubis is evidence that this is in front. It is quite important that these points should be noted. There are various causes of tedious, difficult and obstructed labor, and in each case we are obliged to depend principally upon the touch for diagnosis. In some instances the difficulty will be obvious as soon as we attempt to make an examination. A NARROW and UNDILATABLE VAGINA will be easily recognized, but this will rarely be found a serious obstacle to the passage of the child; as the labor proceeds the vagina seems naturally to dilate and to be more softened and relaxed.