GONORRHEA during pregnancy may cause great discomfort in the shape of irritation and itching of the vulva, or even excoriation of the mucous membrane, and sometimes abscesses of the vulvovaginal glands. Occasionally the infection reaches the decidua and causes an abortion. But the chief danger in gonorrhea is that, after delivery, if the disease has remained uncured, the organisms may travel up from the vagina to the uterine cavity and tubes, and there set up an inflammation, or possibly cause a general postpartum infection. The greatest danger to the child is that its eyes may become infected during the passage of the head through the birth canal. This is the reason for the very great care that is taken of the eyes of the newborn, which will be described in a later chapter. It is very important, therefore, for the sake of both mother and child, that gonorrhea be discovered early, for treatment started at this stage is often attended by very gratifying results, as the disease may be entirely cured before it is able to invade the uterus and tubes. This is because the closure of the internal os, by the membranes, converts the vagina and cervix into more or less of a cul-de-sac, to which the infection is restricted. Being thus localized, it may often be eradicated with relatively little trouble. The yellow vaginal discharge, characteristic of gonorrhea, may become profuse and purulent. It is removed by means of low, very gently given douches. Tampons and vaginal suppositories are sometimes used, while abscesses and abrasions are given appropriate surgical treatment. The nurse must observe the strictest technique while caring for these patients because of the danger of infecting herself and others with the discharges. She should wear a gown and rubber gloves when giving douches or dressing diseased vulva, and because of the possibility of contamination by splashing fluids, she should hold her head well to one side in addition to protecting her eyes with goggles. All utensils for each patient should be isolated and they should also be washed and boiled after each time that they are used. “Lying-in is neither a disease nor an accident, and any fatality attending it is not to be counted as so much per cent. of inevitable loss. On the contrary, a death in child-bed is almost a subject for an inquest. It is nothing short of a calamity which it is right that we should know all about, to avoid it in future.” FLORENCE NIGHTINGALE. PART IV THE BIRTH OF THE BABY CHAPTER X. PRESENTATION AND POSITION OF THE FETUS. Breech, Head, Face, and Vertex Presentations. Longitudinal and Transverse Presentations. Position of Fetus. Time of Engagement. Methods of Ascertaining Position and Presentation of Fetus. Abdominal Palpation. Vaginal Examination. Rectal Examination. Auscultation of the Fetal Heart.