contracted very str upon-the body of the child 
some degree. But the difficulties which may occur 3 
of turning the child, in these cases, will be fully 
the following distinctions. as es 
3. The third distinction exists, when the mouth of the womb has — 
been fully dilated, the membranes broken, and the waters long dis- 
charged ; the womb being at the same time strongly contracted, and 
the body of the child jammed at the upper aperture of the pelvis: 
The difficulty in the management of these eases depends upon 
the degree of contraction of the womb, and upon the distance or 
awkward position of the feet of the child, but chiefly upon the forme: 
circumstance. ‘The womb is in some cases contracted to a globular, — 
and in others to a longitudinal form: and it is always easier, with 
an equal degree of contraction, to turn the child when the womb is 
in the globular form. sae eae a gi SE 
When we are called to a case of this kind, we should not form 
an opinion hastily, or proceed to deliver the woman immediately, 
until we understand the case by thorough examination. We shall _ 
be able to judge in what part of the womb the feet of the child lie, if 
we consider whether it be the right or left hand which presents, 
which may be known by the direction of the thumb and palm of the- 
But the contraction of the womb is the principal difficulty: 
surmounted, and the danger in turning the child is in: propc : 
the difficulty. ‘This danger consists in rupturing the womb. The 
contraction of the womb is of two kinds; first, the permanent con-_ 
traction, in consequence of the waters having been long drained o 
which may occur when there has been little or no pain; 
the extraordinary contraction arising froin the action ‘o 
returning at intervals, and always’ attended with pain. 
The hand must be introduced with a degree of force 
gradually to overcome the permanent contraction of | 
the operation could never be performed: but we ought 
ceed in our attempt to turn the child while labor is pr 
womb is acting with violence, as the hand would be 
' “womb ruptured, ite 
___ The action of the womb is rendered more 
this stage, by the generally increased irritability 
this irritability. This will be effected by the free adminis 
the “ mother’s cordial 
time is very favorable. 
Without regarding the 
be introduced in the manner ec 
into the womb, if there be sufficient: But if the 
med at the upper aperture of the pelvis, the hand 
