power both of the uterus and of the accessory muscles, so that labor
is unnecessarily prolonged, and, possibly, the life of the fetus
endangered. Physicians have, therefore, been accustomed to employ
these drugs very sparingly, restricting their use to the very end of
the second stage, during the painful passage of the head through the
vulva. The results of the administration at this time are also
uncertain. If delivery be rapid the woman may not be able to inhale
sufficient to abolish her consciousness of pain. If it be slow she may
take too much and weaken the muscular powers, thereby prolonging labor
and, often, necessitating forceps delivery. It is not surprising,
therefore, that the medical profession has long been hoping that a
more satisfactory method of relieving the pain of labor would be
found.

CONCLUSIONS

In summing up our conclusions regarding analgesia and anesthesia in
labor cases, the authors would state their present position as
follows:

1. That anesthetics or analgesics are a necessary accompaniment of
confinement in this day and age; that the average labor case demands
some sort of pain-relieving agent at some time during its progress;
but that intelligent efforts should be put forth to limit and
otherwise control their use. While we recognize the necessity for
avoiding needless suffering, at the same time we must also avoid
turning our women into spineless weaklings and timid babies.

2. That we should seek to develop, strengthen, and train our girls for
a normal and natural maternity; that we should study to attain
something of the naturalness and the painlessness of the labors of
Indian tribes; and, even if we partially fail in this effort, we shall
at least leave our women with ennobled characters and strengthened
wills.

3. That the scopolamin-morphin method of inducing "twilight sleep" has
its place--in the hands of experts--and in the hospital; and that in
many cases it probably represents the best method of obstetric
anesthesia which can be employed.

4. That as a general rule and in general practice, the safest and best
method of inducing the "twilight" state of freedom from severe pain,
is by the use of nitrous oxid or "laughing gas"--the "sunrise slumber"
method. It has been our practice to start all general ether
anesthetics with "gas" for a number of years, while we have been doing
an increasing number of both minor and major operations with "gas"
alone.

5. That we still