rged to strain
so as to help nature in the birth, that it may be brought forth. And to
do this more easily, and that the hold may be surer, wrap a linen cloth
round the child's thighs, taking care to bring it into the hand face
downwards.

In case of flux of blood, if the neck of the womb be open, it must be
considered whether the infant or the _secundine_, generally called the
afterbirth, comes first, and as the latter happens to do so
occasionally, it stops the mouth of the womb and hinders the birth, and
endangers both the woman's and the child's life. In this case the
afterbirth must be removed by a quick turn. They have deceived many
people, who, feeling their softness, have supposed that the womb was not
dilated, and by that means the woman and child, or at least the latter,
have been lost. When the afterbirth has been removed, the child must be
sought for and drawn out, as directed above; and if the woman or the
child die in such a case, the midwife or the surgeon are blameless
because they have used their best endeavours.

If it appears upon examination that the afterbirth comes first, let the
woman be delivered as quickly as possible, because a great flow of blood
will follow, for the veins are opened, and on this account two things
have to be considered.

_First_:--The manner in which the afterbirth advances, whether it be
much or little. If the former, and the head of the child appears first,
it may be guided and directed towards the neck of the womb, as in the
case of natural birth, but if there appears any difficulty in the
delivery, the best way is to look for the feet, and draw it out by them;
but if the latter, the afterbirth may be put back with a gentle hand,
and the child taken out first. But if the afterbirth has come so far
forward that it cannot be put back, and the child follows it closely,
then the afterbirth must be removed very carefully, and as quickly as
may be, and laid aside without cutting the entrail that is fastened to
it; for you may be guided to the infant by it, which must be drawn out
by the feet, whether it be alive or dead, as quickly as possible; though
this is not to be done except in cases of great necessity, for in other
cases the afterbirth ought to come last.

In drawing out a dead child, these directions should be carefully
followed by the surgeon, viz.--If the child be found to be dead, its
head appearing first, the delivery will be more difficult; for it is an
evident