that we should give her at that time the best that our knowledge affords, so that she can better perform the duties of motherhood.

There are many points that I have not mentioned in this connection as I am of the opinion that with perfect cleanliness and sound physiological judgment the vast majority of these cases will stay where they belong and not pass into a secondary classification.

Obstetrics.

By F. R. Stoddard, M. D., Shelburne.

This is a subject that is of more or less interest to all general practitioners, especially the country doctor, who must be physician, surgeon and obstetrician.

In this short paper, I will report some of the gleanings of fourteen years' obstetrical work in a small country town. In the fourteen years I have confined three hundred women, and there have been three hundred and four children born. Of the presentations, of the left occipito-anterior, two hundred and forty-five right occipito-anterior, forty-six; breech, eight; face, two; foot, three. Of these three hundred, one hundred were first confinements.

Sex. There were one hundred and forty-two boys and one hundred and sixty-two girls. The largest living boy weighed fifteen pounds, the smallest four pounds. The average weight of the boys was seven and one-half pounds. The largest girl weighed eleven and one-half pounds, the smallest living girl three and one-half pounds. The average weight of the girls was seven pounds. The only malformations were one spina-bifida and one hydrocephalus. The child with spina-bifida was a girl which weighed seven pounds and was a normal child in all respects, but on the back in the lumbar region, there was a tumor, soft and covered with a reddish skin and membrane. The tumor was

about the size of an English walnut when the child was born, but in a few days began to grow and attained the size of one's fist at the end of three weeks, when the child died. The child had no use of her legs and I think there was loss of two or more of the bones in the spinal-column in the lumbar region.

The parents were very ignorant and superstitious and there was no treatment attempted or post mortem made, and I am not able to learn that any treatment of the disease is of much avail. The hydrocephalus baby was born September 2, 1896, and well do I remember the day. The mother was a primipara French Canadian, short and exceedingly fat. She was taken in labor on Sunday but the pains were not very severe till I was called on Tuesday morning at 9 o'clock. The woman had pains about every fifteen minutes. On examination I could not reach the os per vagina but by examining the abdomen, I saw the woman had a very large flabby belly with a large child, and I thought the head was presenting but could not be certain on account of the excess of fat. I called at noon, the pains were about the same in frequency, but I was still unable to reach the os. The same condition was present at six P. M. in regard to pain and inability to reach the os. At ten P. M. I was called again and was just able to reach the os which was quite rigid and would just admit the end of my index finger. I gave her a hypodermic of 14 gr. morphia, and went home, with instructions to call me if needed before morning. At three A. M. Wednesday I was called and found the pains about the same as at ten P. M. The hypodermic had given the woman about two hours rest. The os was dilated a little more and I gave another hypodermic of 14 gr. morph. and returned home. At nine A. M.

I found the os dilated to about the size of a twenty-five cent piece, pains quite regular about ten minutes apart. At 12 M. there was a little more dilation, the os about the size of a fifty cent piece, pain every five minutes and very severe with bearing down.

Pains continued hard and regular all the afternoon. At 4 P. M. the woman began to show signs of exhaustion, having been in labor sixty-four hours, and as the os was somewhat larger than a silver dollar, I gave her chloroform and applied my forceps to the head while it was still in the uterus.

The forceps were applied without much difficulty or any injury to the woman, and traction was made during each pain. The forceps would not stay on the head at all but would slip off and I could not bring the head down at all. So I thoroughly chloroformed her, and introduced my hand into the vagina and tried to turn the child by bi-polar method, working during cessation of the pains. In a short time my right hand was numb and I changed and used the left with the right on the abdomen. After a time I succeeded in getting one leg and then both, and soon had the body delivered, and without much trouble delivered the head which was about thrice the size of an ordinary baby's head.

The baby was still-born and weighed thirteen pounds. The head was filled with a watery fluid and the bones were all loose. The woman made a good recovery.

Puerperal-eclampsia has occurred only twice; both were primipara women and each was thirty-six years old, one a slender woman, the other stout. The first occurred nineteen hours after confinement. The labor was not very hard and instruments were not required. The child, a male,

was still-born, showing signs of having been dead several days. This excited the mother and made her very nervous as she had looked forward to the birth of her first child with a great deal of anticipation. But there was nothing unusual about the case until nineteen hours after confinement when she had a terrific convulsion, followed by several others. I reached the house about an hour after the first convulsion and she had three after I got there. I began the use of ether and bromide soda, gr. ten, and chloral, gr. five, every fifteen minutes. There were only three more convulsions, but the woman was in an unconscious state for twenty-four hours. The urine was normal before and after confinement. She made an uninterrupted recovery and has since borne a healthy girl baby without any convulsions.

Case second occurred in October, 1895.

Mrs. C., American, age thirty-six, married, first pregnancy. Was very well up to two weeks before confinement, no headache or albumen in the urine as I examined it several times. October 27th, there was some oedema of the feet and limbs. The urine passed that day contained quite a quantity of albumen. I ordered her to take one tablespoonful of cream of tartar and Rochelle salts dissolved in a glass of water, to take a teaspoonful every hour until bowels were freely moved. October 29th, Mr. C. came to my office at 8 A. M., said his wife was not so well, some headache. I drove right down, it being five miles away, reached there about 9.

I found the woman unconscious and that she had had one severe convulsion about half past eight. At 9 o'clock there was another convulsion. I endeavored but could get only one or two drops of blood. her thirty gr. of bromide soda and fifteen grs. chloral and

to bleed her, I then gave