The tying of the cord is by some deemed unnecessary, and in most cases probably is so, but as children have been known to bleed to death, when it was not done, it should never be neglected. Some practitioners only tie it once, leaving that part open which is still attached to the placenta, and they suppose this is advantageous, inasmuch as it partly empties the placenta of its blood, and so helps to detach it. There is little or no fear, as some suppose, that this bleeding can be extensive enough to hurt the female, or second child if there be one, and even if it were likely to be so it could soon be stopped; it has the inconvenience however of soiling the bed more, and this is probably one great reason why the second ligature is applied, which certainly is not _necessary_. In my directions I have said that the cord may be tied about two inches from the abdomen, and this will be sufficient if the child breathes; but if not it should be left about four inches long, so as to give room to cut it again, which is occasionally needed, as will be seen further on. The knot should be drawn very tight, and great care must be taken never to tie it so near as to pinch the skin of the abdomen, which passes a little distance up it. A small portion of the intestine will enter the cord sometimes, and swell it out for an inch or more; this must be pressed back with the thumb and finger, and carefully avoided by the ligature. Some practitioners cut the cord first and tie it after, but I think the other plan is decidedly the safest and the best. After this is accomplished the accoucheur should place his hand again over the fundus of the uterus, to discover whether it contracts, and also to judge whether there be another fœtus. If the womb is felt drawn up into _a hard round ball_, in the middle of the abdomen, all is right, and no apprehension need be felt; but if it remains unaltered in size, and is soft, _flooding_ is to be feared, and the hand should be firmly pressed, or kneaded, over the fundus, to bring on contraction. If there be another fœtus, the womb will remain much the same as before labor, and the child may also be felt. It is better however to make an examination internally, and then, in most cases, the membranes and presenting part of the second fœtus will be found at the upper strait. If there be any doubt after this it is even better to carry the hand a little way into the womb, than to remain in ignorance on such an important point. The delivery of the second fœtus usually follows close upon the first, though sometimes there will be a delay of some hours, or even days. And in general there is little or no difficulty with the second, owing to the parts having been already prepared; but the longer it is delayed the less easy it becomes.