herself on the right side of the bed, and as the patient lies on her left side, with the hips well drawn to the edge of the bed, the nurse should gently hold back the baby's head during a pain. This is to prevent a tear from occurring by the sudden expulsion of the head. She should favor the gradual stretching of the parts. She should avoid interfering in any way, as in making efforts to enlarge the opening by stretching it with the fingers, etc. All such attempts will inevitably result in harm. When the opening is sufficiently stretched, the head will slip out of itself. The passage of the child's head is rendered easier if the patient's knees are separated by a pillow. The nurse should simply continue to support the head with her hand, and as soon as the head is born her left hand should be placed over the mother's abdomen, resting upon the womb, which may be distinctly felt through the abdominal walls. The pressure of the hand acts as a stimulant to the womb and induces good contractions. A tendency to hemorrhage is thus averted. The right hand of the nurse should support the child's head. With one finger she should feel around the baby's neck to learn whether it is encircled by a loop of the navelstring or cord. If so, she should gently pull first on one side and then on the other, of the cord, to see which end gives. This loosens the pressure and prevents the stoppage of the circulation in both cord and child's neck.

When, after a pause, the pains start up again to expel the rest of the child's body, the nurse had better have some one instructed how to hold the womb properly, as

both her own hands will be needed to receive the body of the child as it is expelled. The mother herself may be shown how to make this pressure over the womb. If there is no one to make this compression of the womb, the nurse should try to manage the baby with one hand and keep up the pressure over the lower part of the abdomen with the other. The flannel wrap for the baby may be put close up to the mother's hips, and the nurse can manage with one hand to lay the baby down on this, cover it up, and draw it far enough away from the mother's hips to keep it out of the discharges. She should see that the baby's mouth is free from liquids. The little finger of her right hand acting as a hook, the end of the finger should be passed in at one corner of the baby's mouth and out at the other corner, thus scooping out any liquids that may have been drawn in during the birth. She should be careful to see that the cord is not dragged upon and that the baby breathes well. Babies usually cry lustily just after the birth. This should be a welcome sound to both nurse and mother, as it ensures expansion of the lungs. Occasionally, a child will be born with what is known as a "veil" or caul," a portion of the membranes, drawn tightly over the face. This may cause death from suffocation unless it is quickly seized by the fingers and torn off, so as to free the child's mouth and nose.

Resuscitation of Baby.-If the baby is apparently lifeless when born, besides the measures spoken of for clearing its mouth of liquids, it may be turned over on

its face, to empty out the discharges from the air-passages, and efforts should be made to start breathing. The head of the child should be lowered, to keep as much blood there as possible.

The back may be slapped-several short, quick slaps

given over the buttocks. A stream of cold water may be poured on the chest just for a moment, and this repeated several times.

If these fail, the nurse may breathe into the baby's mouth. To do this properly, the baby's nose should be held, the

nurse's lips placed closely over the baby's open mouth, as she breathes into it, then the nurse's mouth is removed and the grasp on the nose loosened, the sides of the child's chest being pressed upon to press out the air. The number of breaths given by the nurse in a minute should not at first exceed twelve.

FIG. 15.-Sylvester's Method of Resuscitation (Second Movement).

Sylvester Method.-Another valuable method of carrying on artificial respiration is known as Sylvester's method. The baby is placed on its back, with a roll made by a towel placed under its shoulders. The head is thrown back. The arms are then slowly lifted and

carried well up over the head. They are held in this position until five can be slowly counted. By this movement the ribs are elevated, the chest expanded, and a vacuum produced in the lungs into which the air rushes; or, in other words, the movement produces "inspiration." The arms are then carried slowly downward, placed by the side, and pressed inward against the chest. This forces out the air and produces "expiration." These movements should be slow, repeated about fifteen times during each minute, and should be carried on until the breathing becomes regular. Should there be no sign of life, the efforts at resuscitation should not be abandoned for at least two hours after the birth.

Schultze's Method.-A third method, which, however, requires the separation of the baby from the afterbirth, is most excellent. It is known as Schultze's method. It would be more apt to be practised by a physician, because it necessitates the early and quick tying of the cord and is only of advantage when practised at once after the delivery. The method is as follows: The child is seized by the shoulders and upper arms and swung head downward above the operator's head. The weight of the lower part of the body is thus thrown upon the chest, and any liquids which may have been drawn into the air-passages are thus forced out. Being held thus for a time, while the operator counts five, the body is then brought down in reversed position between the operator's knees. The weight of the lower extremities is thus made to drag upon the chest and