e compelled to state that it
is not the panacea the lay press has led many of our patients to
believe. (That we believe a much better and safer method has been
devised, the next chapter will fully disclose.)

2. We do not expect this method ever to become general in its use; we
do not look for a chain of special "twilight hospitals" to stretch
across the continent and then to overrun the country. We expect much
of the recent forced enthusiasm to die down, while scopolamin-morphin
anesthesia takes it proper place among other scientific methods of
alleviating the pangs of labor.

3. We know that standard and fresh solutions--as already noted--are
absolutely essential for the success of this method.

4. We are certain that no routine method or technic can be developed.
Each patient must be individualized. The method does not consist in
injecting scopolamin every so often. The patient's mental and physical
condition--as also that of the unborn child--must control the
administration of "twilight sleep."

5. The patient must be in a quiet and partially darkened room. She
must not be disturbed; while the physician, or a competent trained
nurse, must be in constant attendance.

6. While this method of treatment is best carried out in the
well-appointed hospital, there is no real reason why it cannot be
fairly well carried out in a well-regulated private home, provided the
necessary preparations have been made, a trained nurse is present, and
provided, further, that the physician is willing to remain in the home
with the patient the length of time required properly to supervise the
treatment.

7. Even when the treatment is not instituted early in labor, it can,
in certain selected and appropriate cases, be utilized even in the
second stage of labor--thus saving these special cases much
unnecessary pain; in fact, some authorities regard it as a valuable
adjunct in the management of "borderland contractions" as it allows
the patient a full test of labor.

8. In our opinion, this method has little effect on the first stage of
labor if properly administered; but it does undoubtedly prolong and
tend to complicate the second stage; in fact, we are coming to look
upon "twilight sleep" as being more distinctly a first stage
procedure; that it bears the same relation to the first stage of labor
that chloroform bears to the second stage--relieving the pain but not
stopping the progress of labor.

9. That when safe amounts of th