other complications; women such as
these, and other special cases, are the ones to benefit most from the
employment of "twilight sleep."

15. This method as has already been intimated, is most useful in the
case of the first baby, or in the case of women who have established a
record of tedious and painful labors. It has no place in normal and
short labors; although it may be used to great advantage in certain
cases during the first stage of labor--being carefully and lightly
administered--while chloroform or gas is utilized at the end of the
second stage just as has been our custom for a generation.

16. As noted under the special claims made for this method, it is (as
also is nitrous oxid) the ideal procedure in cases of heart,
respiratory, kidney, and other organic difficulties, the details of
which have already been noted, and their repetition here is not
necessary.

17. It must be remembered that scopolamin and morphin are more or less
uncertain in their action; scopolamin is variable in its results,
often producing such marked nervous excitement in the patient as
greatly to interfere with the carrying out of an aseptic technic;
while morphin has been shunned by obstetricians for a whole
generation, because of its well-known bad effects on the unborn child
as well as its interference with muscular activity on the part of the
mother.

In Germany, it is said, that a great many damage suits against
prominent physicians have resulted because of the alleged ill effects
which have followed the use of "twilight sleep."

18. In presenting these facts and opinions regarding "twilight sleep,"
the reader should bear in mind that we are not only endeavoring to
state our own views and experience, but also to give the reader just
as clear and fair an idea of what other and experienced physicians
think of the method, both favorably and unfavorably; and we will draw
these conclusions to a close by citing the opinion of one or two who
have had considerable experience with the method and who, in summing
up their observations, say:

The disadvantages of the method are entirely with the accoucheur
and not to the mother or child. _It requires his presence at the
bedside from the time the treatment is undertaken until the
completion of labor_, not so much because of any danger, but to
keep the patient evenly under anesthesia on a line midway between
consciousness and unconsciousness, for if she is