be kept in the horizontal position, that they may not be ruptured; and you should remain in constant attendance upon the patient, and be prepared to interfere the instant the necessity arises." Speaking of the operation of turning in these cases he remarks as follows:-- "In some favorable cases of shoulder and arm presentation, the uterus is widely dilated before the membranes are ruptured and the liquor amnii discharged; and no difficulty is experienced in passing the hand into the uterus, laying hold of the feet, and extracting the child by the operation of turning. If the uterus is not contracting strongly and at short intervals, little resistance is offered to the introduction of the hand, and the delivery may be speedily accomplished with safety both to the mother and child. But if the membranes have burst, the liquor amnii escaped, and the uterus has been contracting firmly upon the child many hours before the operation of turning is attempted, the child is often destroyed by the pressure, and the coats of the uterus exposed to great danger from contusion and laceration in passing up the hand and bringing down the feet. The shoulder and thorax become so strongly impacted in the pelvis, that great force is required to introduce the hand to grasp the feet, and much exertion necessary before the position can be changed. "In other cases of shoulder and arm presentation, the membranes burst and the liquor amnii escapes at the commencement of labor, and the os uteri is rigid and undilated, so that the hand cannot be passed into the uterus after the labor has continued many hours. The difficulty and danger of these cases is greatly increased when the uterus is contracting with violence, and the pelvis is distorted, or a disproportion exists between the child and pelvis from any other cause. The greater number of women, if abandoned to the efforts of nature under these circumstances--the uterus having no power to alter the position of the fœtus--would ultimately die undelivered, from exhaustion or rupture of the uterus and vagina." Fortunately these cases are very rare, and when assistance is rendered _early_, the difficulty is readily overcome. This is a strong reason why all women especially should know what to do, because a little timely help may save much suffering, or even life. SECTION VII. ACCIDENTS DURING LABOR WHICH MAY COMPROMISE THE MOTHER'S LIFE. CHAPTER XXI. UTERINE HEMORRHAGE, OR FLOODING, DURING LABOR. This is always a troublesome, and frequently a fatal accident. It should be always watched for, and attended to as early as possible--_a few minutes_ frequently determining the recovery or death of the patient.