thereby you put the patient in the best possible condition to withstand this serious illness. I believe Dr. Loomis was mistaken in his premises and deductions, and that instead of being the best thing, it was the worst thing that could be advised; at any rate Dr. Loomis was called upon to test in his own person the correctness of his own theories and treatment, and he like the majority treated with opiates failed to come back to life and health to tell us how nicely it relieved the pain, but how terribly it locked up the secretions, stopped the cough, checked the expectoration, increased the difficult breathing, intensified the sufferings and how it bound them hand and foot and delivered them over to the Grim Reaper.

I firmly believe that the use of opium in pneumonia and capillary bronchitis is one of the grossest abuses of one of the greatest of remedies, and to this fact I respectfully ask your attention. I believe it is the direct cause of more mortality in these two diseases than any other one In pleuritis these remarks do not apply.

cause.

In typhoid fever the drug has its uses in controlling the diarrhoea, when too profuse, in relieving the pain and quieting the restlessness of the patient, thereby inducing sleep; yet its use should be limited.

In meningitis its use is contra-indicated, owing to its tendency to cause increased congestion of the meninges and brain.

In acute mania and delirium tremens it should be used cautiously, preference being given to Bromides and chloral hydrate.

In tic-douloureux, sciatica, pelvic neuralgia, cardialgia and neuralgias generally, the use of the drug is to be condemned, except it be occasionally, as the danger of

addiction is great in this class of cases.

The seductive powers of morphia, when given hypodermically, are too great to be resisted by many patients unless the physician is discreet and shields them from its evil influence.

In diabetes mellitus, codeine exercises an almost incredible power, checking the inordinate appetite, allaying the distressing thirst, lessening the secretion of urine, reducing the amount of sugar and arresting the changes in the nervous system, seeming to exert a really curative action.

In obstetric practice it is often of the greatest value, being used with great advantage in the first stage of many cases of labor, and in abortion.

In puerperal eclampsia hypodermics of morphine act quickly in controlling the convulsions, and give time for other measures to be employed.

The abuses of opium consist largely in the indiscriminate prescribing of it for all sorts of aches and pains, in chronic pelvic and nervous ailments; in the prescribing of "cough syrups ;" in its administration in obstetric practice for the purpose of relieving "after-pains;" in the acute chest and nervous troubles of infancy and childhood; and in the too common use of it in so-called "soothingsyrups," paregoric and other vile mixtures which are made use of by lazy and ignorant mothers and nurses who care more for their own ease and comfort than for the good of their little ones.

We, as a profession, should not fail to enlighten the people among whom we go in our daily round of duties regarding the baneful effect of such mixtures upon the health of their little ones and by so doing we shall in some measure atone for the mistakes made by some of the more care

less of the profession in the too prolonged and injudicious administration of the drug.

Thanking you for your attention, I leave the subject for further discussion.

My First Twelve Years' Obstetric Practice.

By J. Sutcliffe Hill, M. D., Bellows Falls, Vt.

In presenting a paper on the above subject I do so from the fact that I believe we can accomplish the most good by bringing up for discussion the practical questions. of every-day life instead of the abstract questions and theories that lend interest only from their scientific value. All will admit I am sure, that the first few years of a practitioner's life are ones of great anxiety and solicitude, especially when called to his first case of obstetrics.

When we consider the many complications which are liable to occur, either ante-partal, partal, or post-partal, it behooves us to approach these cases with clean hands and a clear conception of the responsibility that is placed upon us.

In the whole range of medical practice there is nothing that so tends to bring out the qualities of the man in regard to the duties of the profession as the practice of obstetrics.

As physicians we are so often brought in contact with. pathological conditions where either medical or surgical inteference is a necessity and a duty, that in a physiological condition we are apt to look upon it in a pathological sense and many times by our misguided efforts change the physiological into a pathological condition. This is possible

by allowing sympathy to supercede judgment, a desire on the part of the attendant to finish the case by the use of the forceps on account of time, and a neglect of the necessary precaution in regard to cleanliness on his part and that of his assistants.

My desire is to give a resumé of my own experience. in this branch of our profession as it has occurred during my first 12 years, pointing out my shortcomings during this period, as it is only by a realization of these facts that we can expect to become better practicioners. Labor per-se is a physiological condition in which our duty is to watch, not with blindness born of ignorance, but with an intelligence attained through knowledge, that we may if possible be the means of bringing to a successful termination the delivery of the mother.

In being called to attend a case of labor the physician should be prepared as far as possible for all the vari ous contingencies which may arise. In looking over well known text books on this subject, in regard to the various articles the physician should carry, I find the omission of what I consider of as much importance, or more than all the rest mentioned, namely:-the articles for the preparation of the physician himself. I have no doubt that some of the later works on this subject have given it some attention but I know from actual experience in every-day practice that these instructions are not carried out, and until they are, no opportunity should be neglected to present them. It is only during the last few years that I have carried them out fully myself. My custom is to carry with: me one of my clean surgical frocks-of which I keep a number-which I wear until the completion of the labor. I wash my hands and arms with warm water and soap and