8. Weakness of the constitution when the general health of the woman is below the natural proper standard may be a cause why the uterine contractions are not severe. But in such cases the parts are not rigid, and nothing more than a dose of four or five grains of quinine is needed to make the pains effectual. 9. A want of irritability in the constitution frequently observed in fat and inactive women, or in those who are exceedingly timid, will sometimes be a cause of slow and lingering labor. Fear often lessens the energy of all the powers of the constitution, and diminishes or wholly suppresses for a time the action of all the parts concerned in parturition. Attendants should endeavor to inspire such patients with activity and resolution, and remove all fear from their minds. These cases are not dangerous but I have often found it necessary in this kind of cases to apply forceps. The skilled nurse might perhaps give eight or ten grains of quinine, if no physician has charge of the case. 10. Every woman is expected to suffer greater pain and to have a more tedious labor with her first child, and if a woman be advanced in age at the time of having her first child the difficulty attending her labor may be somewhat greater. A longer time may be required for the completion of the labor than in ordinary cases, but I do not advise giving any medicine unless it is perhaps a dose of quinine. There may be a little more need of assistance by instruments, &c. 11. An oblique position of the os uteri, it being projected on one side or the other of the center of the superior strait, or so far backwards that it cannot be felt for several hours after labor has begun, is a cause of delay. The presenting part may be found pressing against the walls of the pelvis at one point, instead of keeping its course in the center of the pelvic cavity. You should endeavor to place the patient so as to remedy this condition. When the presenting part is found to one side, it will be found that the fundus of the womb is lying to the opposite side; this should be remedied by a proper support of the abdominal tumor or by holding it up by the hands. For example, if the os uteri be projected to the left side, she ought to rest on the right side and have a pillow placed under her body; some physicians would prefer that she lay on the left side, but without the pillow under her.