allowed to go
above that line in several instances she will have several
so-called "isles of memory," and will be able to draw a picture
of her labor in her mind and thus lose the benefit of the
treatment.

These methods of anesthesia are very important and have merit.
They should be used when properly indicated. No one should limit
himself to a routine method. Each case should be individualized
and the form of anesthesia best suited to the case in hand should
be employed. For instance, in dealing with a primipara--one who
is full of fear, who cannot stand pain, who is of an hysterical
nature--morphin-scopolamin anesthesia is best suited in that
particular case, because these drugs have a selective action when
it comes to allay fear and produce amnesia. On the other hand, in
a multipara who has had three or four children, whose soft parts
are relaxed and who has short labors, the anesthetic of choice
would be a few whiffs of chloroform as the head passes over the
perineum. It is ridiculous to try to give such women the
"twilight sleep." Furthermore, take the cases you see for the
first time at the end of the first stage of labor, or during the
second stage; these cases are best treated with the nitrous oxid
and oxygen method. You have to individualize your cases. The
prospective mother now consults the obstetrician early to find
out if her particular case is suitable for the "twilight sleep."
She has been informed that certain examinations--urine, blood
pressure, etc.--are necessary. She knows that these examinations
have to be made at regular intervals. In other words, we get the
patients early and we can give them good prenatal care.

This chapter has been devoted to "twilight sleep;" the following
chapter will consider "nitrous oxid" and other methods of anesthesia
in connection with labor, and should be read along with the foregoing
discussion in order to obtain an intelligent view of the whole subject
of "painless labor."

CHAPTER X

SUNRISE SLUMBER AND NITROUS OXID

Since the public has already been told so much about obstetric
anesthesia, we deem it best to go into the whole subject thoroughly,
so that the expectant mothers who read this book will be able to form
an intelligent opinion regarding the question, and thus be in a
position to give hearty cooperation to t