Cases have been reported where there was a _scirrhus tumor_ or cancer connected with the neck of the uterus, even during labor; happily such cases are rare. The scirrhus would be felt hard and unyielding. A tumor of any kind connected with the os uteri, the vagina or the rectum may obstruct the descent of the child’s head more or less according to its size and mobility. Of course they can be detected. A VAGINAL CYSTOCELE ought always to be rectified. It sometimes happens that the bladder is caught by the head of the child in its descent into the cavity of the pelvis and pushed before it, and it can be seen as a soft red tumor between the vulva. The finger can be passed posterior to it, but not anterior, and the catheter cannot be passed in the usual direction. A few cases are on record where a _stone_ (calculus) in the bladder was pushed down before the fœtal head. A careful examination will show that the tumor is covered by the bladder; its hardness will indicate its nature. A COLLECTION OF HARDENED FECES IN THE RECTUM is detected without difficulty. It will be of an irregular form, hard and inelastic. SWELLING OF THE SOFT PARTS may cause obstruction. If the child’s head is detained for a long time pressing upon the brim of the pelvis, it may obstruct the circulation and diminish the capacity of the passage. In such cases there is unusual heat and dryness in the parts. When a nurse or midwife makes an examination by touching, she needs to continue it through several pains, and to repeat it again soon to know if there is any progress to the labor. If the progress is very slow this may be from various causes, some of which I will now simply name. It may be because the uterus is very much distended, and this renders the pains inefficient; there may be partial and irregular contractions of the uterus, weakness of constitution, fever or local inflammation, a want of irritability in the constitution, a deformity of the pelvis and spine, or doubts and fears on the part of the patient may diminish the action of the uterus. The labor may be slow because it is the first one, or because the membranes were ruptured too early, or because the woman is advanced in years at the time of having her first confinement. The uterus may be pitched over obliquely, there may be extreme rigidity of the os uteri, extreme rigidity of the soft parts of the mother, a contracted or small pelvis, the head of the child may be large and ossified so as to be unyielding. One or both arms may come down by the side of the head of the child; on the part of the mother there may be a distended bladder from inability to void the urine, there may be cicatrices (scars) or adhesions of the vagina, and in some cases it has happened that an enlarged ovary has dropped down into the pelvis, or a portion of intestine containing scybala or hardened feces obstructs the passage, or the os uteri is very minute, or imperforate, or totally absent.