July 22 at 6 A.M., I was called to see Mrs. F,, aged 26, multipara, in labor. History: general health good; family history not good. She was the mother of two children; one died in a few months, and the other is about two years old. Patient had a bad fright and fall about one week before present confinement, and suffered severe pain in right side four inches external to umbilicus, until the date of this confinement. She is of Irish birth, large and angular in form, with broad pelvis; height five feet six inches; weight 140 pounds.
When I arrived, she told me that labor had been in progress all night. Digital examination revealed a breech presentation, first position, the nates already engaged in the superior strait. The amniotic fluid escaped at the first examination, the membrane being then accidentally ruptured. The size and shape of the membranes is