ly. When the head once begins to descend, there is seldom much | 
subsequent difficulty in finishing the delivery, as the cause of the — 
difficulty usually exists at one particular part of the pelvis. Shou ithe 
head rest several hours in this situation, no inconvenience would — 
thence arise to the mother, and the longer it rested the greater ad- 
vantage we should probably gain when we renewed our attempts t) - 
extract it. 3: 
It may be presumed, when the head of the child has been wedged 
in for a long time in the position we are supposing, and great force 
has been used to extract it, that there is little reason to expect the 
ehild should be born alive ; yet such instances sometimes occur. 
When we can hook a finger on the lower jaw of the child, the de- 
rection of the head may be changed to one more favorable ; but we 
must not extract with so much force as to incur the hazard of break- 
ing or tearing away the jaw. Pressing the head of the child from 
the pubes to the sacred bone,jwith the fingers and thumbs carried up 
as high as we can reach, will often be of great use in these cases. 
If the difficulty of extracting the head arises from its enormous 
size, occasioned by some disease, as dropsy in the head, &c. these ~ 
methods steadily pursued will answer our intention; as by a prudent 
use of the force in our power, integuments will burst, or even the _ 
bones be broken. The necessity for the use of forceps very Le 
occurs in these cases. ane ae aoe me 
Under these circumstances, should it be absolutely necessary to 
lessen the head of the child, a perforation may be conveniently made 
behind either of the ears, or where we can most conveniently fix the 
point of the perforator. A portion of the contents of the head will ; 
~ then be evacuated, when the skull may be compressed to the requir- 
ed size. 
Should the body be separated from the head by the force we have 
used, there will be no occasion, for this reason alone, to act hastily 
or rashly, as the head may even then be expelled by the pains. But 
if this should be impossible, or if it should be absolutely necessary to 
extract the head speedily, on account of the situation of the motker ; 
then the general rules for lessening the head must be applied to this | 
case, and the head may be confined to. a proper situation by com- — 
pressing the abdomen with a napkin pana aniiedl it, or by the 
hands of an assistant. sie 
Familiar observations. —The physician should by all means in- 
gratiate himself into the confidence of the woman, by kindness, 
indulgence, attention, even in trifling. matters, and by appearing 
mterested in her welfare; for want of confidence deranges every 
thing. Rough, bearish, and overbearing conduct:is. certain to dis- _ 
gust the woman, and frustrate all her efforts. The physician should 
recollect that this operation is peculiarly the business of Nature, and _ 
that his province is only that of her hand-maid, when she one is 
unequal to the performance, but never to direct her. tee 
__4he woman, if she have regard to cleanliness, should prepare her- 
self for the occasion, by putting on clean linen, and. fastening 
jher waist, while a sheet or other cloth shoul 
fer, reaching dowa far enough to protect 
