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either in force or frequency; relaxation has been promoted; pain 

 and suffering lessened or entirely annulled; the placenta readily 

 thrown off, and all the circumstances following the birth of the 

 most favourable character. 



It has been objected, and with some reason, that etherization 

 should not be resorted to in instrumental delivery, because, it is 

 urged, the sense of feeling on the part of the woman is an important 

 guide to the operator in the application and use of his instruments ; 

 that as he cannot, like the general surgeon, see how and where he 

 is operating, there would be great danger of his doing irreparable 

 mischief, unless guided and restrained by the cries of his patient, 

 when pain was unnecessarily inflicted. We are of opinion, that 

 where the forceps or other instruments are intended to be used, 

 etherization should be employed only to a partial extent, or with 

 the utmost caution, unless (which is the better way) the instruments 

 be adjusted before the ether be inhaled at all. This latter precau- 

 tion is generally practicable, and as it is the use, not the adjustment 

 of the forceps, which causes pain, it will generally accomplish all 

 we desire. Many cases, however, are on record where instruments 

 have been used during a profound sleep and yet without injury, and 

 it is probable that a skilful and cautious accoucheur could generally 

 effect his purpose with entire safety. In performing the operation 

 of turning, etherization is of doubtful benefit. Further observations 

 are necessary to enable us to decide whether the freedom from pain 

 be not more than counterbalanced by the increased tonic contrac- 

 tion of the uterus, supposing this (a point perhaps not definitely 

 settled) to be one of the ordinary effects of chloroform. 



Directions for its Use. — 1. The recumbent position is de- 

 cidedly the most favourable for the inhalation of chloroform, and in 

 obstetrical practice it should be administered in no other. 



2. No inhaling apparatus should be employed. A common pocket 

 handkerchief folded in the form of a compress, or a sponge, applied 

 so as to cover both the nostrils and mouth, is the best vehicle. With 

 these there is no danger of the exclusion of atmospheric air, an acci- 

 dent to which we may be exposed in a greater or less degree with 

 ordinary inhalers, and they are at the same time much less formida- 

 ble in appearance, and much more readily applied. 



3. Upon the handkerchief, or sponge, may be poured a drachm 

 of chloroform, if the full anaesthetic effect be desired, or one-half or 

 one-third of this quantity, if a less decided result only is sought for: 

 the effect, however, to be the guide rather than the quantity used, 

 as very different quantities are required in different cases. 



