e to use instruments in such deformities, and
may wish the counsel of an older and more experienced doctor. And this
precaution will give him time to be ready for any emergency.

But more than ninety per cent of all cases are of a very simple nature.
The mother is warned by pains in back and womb, coming and repeating at
intervals of one-half hour to less time. When by the finger the doctor
can tell the mouth of the womb has opened to the size of a quarter or
half dollar, he then may know that labor will soon start in good
earnest, and at this time it is well to call for a twine, cut two
strings about a foot long, to tie around the navel cord.

CAUTION.

The first duty of the obstetrician is to carefully examine the bones of
the pelvis and spine of the mother, to ascertain if they are normal in
shape and position. If there is any doubt about the spine and pelvis
being in good condition for the passage of the head, through the bones,
and you find pelvic deformity enough to prohibit the passage of the
head, notify the parties of the danger in the case at once, and that you
do not wish to take the responsibility alone, as it may require
instruments to deliver the child, as there is danger of death to the
child and mother also, but less danger to the mother than to the child.
Now you have done that which is a safeguard against all trouble
following criminal ignorance.

I will give you a condensed rule of procedure in all normal cases of
obstetrics. With index finger, examine os uteri; if closed and only
backache, have patient turn on right side, and press hand on abdomen
above pelvis, and gently press or lift belly up just enough to allow
blood to pass down and up pelvis and limbs. Relax all nerves of the
pelvis at pubes.

SECOND EXAMINATION.

Caution: Wait a few hours; examine os again. If still closed and no
periodical pains are present, you are safe to leave case in the hands of
the nurse, instructed to send for you if regular pains return at
intervals. On your return, explore os again, if found to open as large
as a dime, you are by this notified that labor has begun its work of
delivery. You now place patient on her back, propped to an easy angle of
near thirty degrees, with rubber blanket in place. After you find os,
dilated to nearly the size of a dollar, then relax nerves at pubes. Soon
you will find in mouth of womb an egg-shaped pouch of water, which you
must not press with fingers till very late in lab