consequent upon the distention of the external parts; they convulse the whole frame; the bearing down becomes more frequent and continuous, and there is not infrequently vomiting. The patient quivers and trembles all over; her face is flushed, and, with the rest of her body, bathed in profuse perspiration. Her looks are staring and wild, and her features alter so much as to be scarcely recognizable. Her impatience rises to its maximum in loud crying and wailing and frequent express ons of agony, which, even with the strongest, most sensible women, border close upon insanity. Everything denotes the violent manner in which both body and mind are affected. Such is natural labor. Velpeau describes those piercing cries, that agitation so lively, those excessive efforts, those inexpressible agonies, and all but intolerable pains, which accompany the last stage of labor in the human mother.

This, gentlemen, is what we have all observed again and again. We have believed that we sympathized with the gentle, delicate creature who lay before us, enduring untold agony, and appealing to us for help, but in vain. The Letheon that would have changed all this suffering to endurable pain or to sweet oblivion, with safety, and indeed with added surety of perfect recovery, was withheld, and we have only had for answer: "Oh! it's nature's course, you are doing well; be patient.

If we have had a truthful description of natural labor, who shall describe labor complicated by any of the many conditions that add to its dangers and agonies: a contracted pelvis, a disproportionate head, a slowly dilating os uteri, an unyielding perineum, or some slightly or greatly wrong presentation with necessity for version, or even more serious operation? In the early history of mankind, when man's inhumanity to man led to the invention of all manner of appliances by which the human frame could be racked and tortured, and every nerve made the source of untold agony, did any fiend ever invent any means by which the body could be tortured as this frail and delicate body of woman is made to suffer when brought to this bed of horrors? Does any surgical operation ever devised for the saving of life or limb, or the relief of deformity, bear any considerable proportion to it in its power to produce agonizing suffering? And yet, who does propose an operation, even so slight as the evulsion of an ingrowing nail, without suggesting, as a matter of course, the use of an anesthetic?

The Son of Man has justly commanded and received the adoration and gratitude of mankind in all ages for his sufferings upon the cross, yet it is quite possible that in the stable at Bethlehem, on that night when there was no room in the inn, greater sufferings may have been endured by the patient mother who bore him.

The fact that in all ages the pains of child-birth have been borne by unnumbered millions, that their agony has been (unrelieved, and that they have generally lived to suffer again and again, does not in any manner absolve us from our great duty to relieve pain and suffering, as well as to save life.

And how may we most safely and surely relieve these pains? For the dragging, aggravating pains which accompany the first stage of labor, the stage of dilatation, and which partake more of the nature of neuralgia of the sacral plexus, it is better to use, when necessary, potassium bromide and chloral. As soon, however, as the second stage has clearly begun, with expulsive, bearing down pains, small quantities of an anesthetic should be administered during the pains, softening and assuaging them, and preserving the patience and strength of the mother, the administration to be suspended during the intervals between the pains. Should the os uteri be rigid and undilatable, no remedy will be so likely to relieve the diffiuclty as anasthesia pushed to unconsciousness for a short time, then intermitted. During the passage of the head through the pelvic arc, the administration of the anaesthetic should be proportioned to the severity of the pains, and when the resistant perineum holds back the approaching head, and the agony is constant and all but intolerable, the effect of the drug should be pushed to entire abolition of suffering and complete relaxation of the resisting tissues. Thus may the process of child-birth be shorn of its terrors, which appal and affright all womankind, and the great event of every woman's life be made an endurable one.

We have, perhaps, little appreciated the dread and terror with which this event is associated in the minds of our wives, sisters and daughters, and how much it has to do with the crying sin of our age, the crime of abortion. With the advance of civilization, the general education and enlightenment of mankind, the more sensitive organization, and greater capacity for suffering-the knowledge that, in some way, the function of child-bearing, with its attendant agonies, has brought into existence the terrible trade of the abortionists.

The crime of abortion is committed occasionally when a pitying eye would weep for the poor deceived maiden, more sinned against than sinning, who would hide her degradation at the risk of her life. But here is not the harvest of the wretch who lives that the unborn may die. It is the woman who would glory in maternity but for its terrors, who submits to the degradation that she may escape the rack of child-birth.

Somehow, this knowledge of the pain and suffering of confinement is almost intuitive. The maiden goes to the bridal bed, all love and confidence, but whispers: "How can we avoid the children?" Then follow months of doubt and fear and terror untold, and, when the ordeal is over, the resolution. not to again submit to its penalties, is well nigh universal. Who of us is not besieged with demand for the means to prevent conception or to destroy its product? We urge the danger to life and the almost certain permanent injury to health, but are met with the answer: "I know it is wrong-a crime, I know the danger to life, the possible ruin to health, the almost certain destruction of family happiness- I know it all, but, no matter, I'll give anything you ask, I'll do anything you demand, but I'll never again endure the agony of child-birth if I can avoid it." And so, all your advice unheeded, she hears your refusal to aid her, and turns away to go to the villain, the abortionist, and makes the sacrifice of sometimes her life, always a large fee, and the price, we have every reason to believe, usually includes her honor, which, in her desperation, is forfeited with all her pride and delicacy.

This is no fancy sketch, gentlemen. The fact that the best families of our land raise fewer than a single child each, that the rising generation consists largely of the descendants of our imported lower classes, together with our own observation, proves to us that there is too much truth here. We may pride ourselves that our skirts are clear, but is it true that we are wholly innocent, wholly irresponsible for the frightful prevalence of this awful crime? Is it not almost wholly due to the dread of the ordeal of child-birth? What mother grudges the care of, or would part with her living child-aye, would not die for it if necessary-or gives up with an unwillingness the pleasure of society for her child.

If we can say to every woman who approaches us with the proposition of child-murder: "Go home; take the best of care of your

self; be cheerful and hopeful, and I will make the time of your a. couchement only a blissful memory, or at most a day not at all to be dreaded. You shall sleep when nature exacts most of you, and shall be abundantly rewarded for the little pain you suffer" - can we not thus bless our race? Can we not be true to every instinct of gallantry and humanity, and so hold the honored place of family physician that no man may come between us and any woman in our clientage, with such entire confidence and perfect trust that honors us and is a blessing to those who put their faith in our judgment, knowledge, purity and honor?

ARTICLE VII.

CHRONIC METRITIS AND ENDOMETRITIS.

BY E. E. LOOMIS, M. D., OF JANESVILLE.

Member of the Committee on Obstetrics and Gynecology.

The two diseases which form the subject of this paper, become of great importance not only to the so-called gynecologist, but to every earnest. hard working physician, who has the welfare of this large class of sufferers at heart, and his success will be in proportion to to the readiness with which he can diagnose the prominent symptoms, and make application of the best treatment known to the profession.

That they are of often great perplexity, require our best skill, and unlimited patience, must be the experience of every physician who has given the diseases of women much of study and practice. My object is to call forth a discussion on our best methods of treatment. Inventive genius and skillful workmanship have made the armamentarium of the gynecologist so perfect, that the subject of diagnosis need not be discussed in this paper. Therefore, I shall make but brief mention of some of the most prominent symptoms, that justify the gynecologist in making examinations for uterine diseases, of which these two are the most frequent and possibly to some, the most stubborn we have to deal with, and are often overlooked.

Natural delicacy prompts the lady of refinement to shield herself behind an apparent dyspepsia, heart disease or rheumatic trouble, and thus often puts the physician, who is not alert, off his guard and he neglects his duty of first searching for the cause, and prescribes with his eyes blindfolded. The consequences are too well known to us all. The patient gets no better and soon tells her suf. ferings to another.

Therefore, in the study and treatment of these cases, while I make no claim as a specialist, I have made it a rule that when a