Indeed, the opposite view is now entertained by the profession; that is, that prompt delivery by forceps will prevent the parts from being injured, when the soft parts, and particularly the bladder, is under severe and prolonged pressure by the child’s head. There is no question that there is greater peril to the mother and child, in undecisive delay, provided the attendant has the requisite judgment and experience to act intelligently. The hypothesis upon which this is based is the restorative property that living tissue possesses, to regain its vitality, after it has been subjected to severe and inordinate pressure. This we may observe in our daily experience; when, for instance, we jamb or crush our finger, or a child has its fingers momentarily crushed between a closing door, the fingers are sometimes crushed flat, but upon being released, they rapidly regain their shape and vitality. If the pressure were continued for any length of time, the blood in the tissues would have become congealed, and the circulation permanently shut off, so that recuperation would have been impossible, and the tissues would have sloughed or mortified. If the bladder, under the direct pressure of the child’s head against the pubic bone, be subjected too long, the same results would naturally follow: the tissues could not regain their vitality, and they would either tear or subsequently slough or mortify, which causes the _fistula_. The vagina and bladder, like every other tissue of the body, except that of the brain or nerves, will suffer a great deal of contusion for a short time, but if protracted beyond a reasonable length of time, it will be permanently destroyed or injured. A urinary fistula is always a serious malady, since it exercises a deleterious influence upon the patient’s health. If the opening is only small, a spontaneous cure may take place, but if it reaches considerable dimensions, it requires to be accurately adapted and stitched together. The best time for the repair of the injury, is six to eight weeks after the receipt of the injury. Rupture of the female bladder is comparatively rare, for the reason that women are not exposed to the same serious accidents as men; but if women will persist in doing everything that men ought to do for them, the statistics may be reversed. When the bladder is distended and violence is brought to bear on the abdominal walls, corresponding to the region of the filled bladder, a rupture is likely to result. Surgical measures should at once be resorted to, so that the injury can be repaired before inflammation of the peritoneum sets in. CHAPTER XIII. ACUTE AND CHRONIC INFLAMMATION OF THE VAGINA.