case becoming urgent, I saw her with Dr. Paterson. The head was low down in the pelvis; but it was placed in the right occipito-posterior position (the third of Naegele), and the forehead instead of the vertex was presenting, one orbit being easily felt behind the symphysis pubis. It had been lodged in nearly the same position for many hours. The foetal heart was still distinct, but weak. I applied the forceps, turned the head round with them a quarter of a circle, into an occipito-anterior position (the second of Naegele); and, after being so adjusted, it still required considerable force to extract it. Before applying the forceps, the patient was sent into a state of deep anesthesia by the inhalation of chloroform; and subsequently, when she awakened out of it, she was in no small degree surprised to find that she had really been delivered while she was sleeping and resting so soundly. The placenta separated, and the uterus contracted firmly. The child, which was large, lived for eight hours after delivery; but, despite of all the measures tried, full and perfect respiration was never established in it-apparently in consequence of some effusion or injury about the base of the brain. Unfortunately a post-mortem examination was not obtained. The mother has made an excellent recovery. I quote the following instance of craniotomy under chloroform from a letter (dated 29th November), which I have received from my friend Professor Murphy of London. I give the case in Dr. Murphy's own words: CASE XII.-"I have tried the chloroform with great success in a case of distorted pelvis. It was the ovate deformity, the conjugate measurement being only 2 inches; the head of the child could not enter the brim, and I was obliged to perforate. I got Dr. Snow to assist me in bringing her under the influence of chloroform. She made some resistance, and struggled a good deal at first, chiefly, I think, from apprehension that we were going to do something very dreadful; however, she soon began to inhale quietly, and gradually fell into a kind of dreamy sleep. I perforated the head, and labored with the crotchet, sometimes with the craniotomy forceps, for three quarters of an hour before I could get the head through the brim. She was at length delivered; the placenta was separated in about ten minutes, the bandage applied, soiled clothes removed, and she was made clean and comfortable,' as the midwives say. My patient was perfectly unconscious all this time, and did not awake for about a quarter of an hour after the operation; she did so then quite quietly, and was greatly surprised to find that all her miseries were over. There was no hemorrhage; but the uterus felt rather spongy and large. She is now recovering most favorably. I never had a case recover so far, so well." Other cases, both of natural and morbid labor, in which the patients were delivered in an anesthetic state from the inhalation of chloroform, have been reported to me by Dr. Protheroe Smith, Dr. Imlach, Dr. Robertson of Birkenhead, Dr. Malcolm, Dr. Buchanan, &c.; but as these and some other instances which I have myself seen, presented nothing new or different in their phenomena from the cases which I have already detailed, I have thought it unnecessary to give at present the details of them. CHAPTER III. ANSWER TO THE RELIGIOUS OBJECTIONS ADVANCED AGAINST THE EMPLOYMENT OF ANESTHETIC AGENTS IN MIDWIFERY AND SURGERY.' "For every creature of God is good, and nothing to be refused, if it be received with thanksgiving."-1st Timothy, iv. 4. "Therefore to him that knoweth to do good and doeth it not, to him it is sin."-James iv. 17. ALONG with many of my professional brethren in Scotland, and perhaps elsewhere, I have, during the last few months, often heard patients and others strongly object to the superinduction of anæsthesia in labor, by the inhalation of ether or chloroform, on the assumed ground that an immunity from pain during parturition was contrary to religion and the express commands of Scripture. Not a few medical men have, I know, joined in this same objection;2 and have refused to relieve their patients from the agonies of childbirth, on the allegation that they believed that their employment of suitable anæsthetic means for such a purpose would be unscriptural and irreligious. And I am informed, that in another medical school, my conduct in introducing and advocating the superinduction of anesthesia in labor has been publicly denounced ex cathedrá as an attempt to contravene the arrangements and decrees of Providence, hence reprehensible and heretical in its character, and anxiously to be avoided and eschewed by all properly principled students and practitioners. I have been favored with various earnest private communications to the same effect. Probably, therefore, I may be Published by Sutherland and Knox, Edinburgh, December, 1847. 2 " Pain during operations is, in the majority of cases, even desirable; its prevention or annihilation is, for the most part, hazardous to the patient. In the lying-in chamber, nothing is more true than this: pain is the mother's safety, its absence her destruction. Yet, there are those bold enough to administer the vapor of ether, even at this critical juncture, forgetting it has been ordered, that 'in sorrow shall she bring forth.'"-On the "Injurious (?) Effects of the Inhalation of Ether;" in Edinburgh Medical and Surgical Journal for July, 1847, p. 258. excused if I attempt, however imperfectly, to point out what I conscientiously conceive to be the errors and fallacies of those who thus believe that the practice in question ought in any degree to be opposed and rejected on religious grounds. It is almost unnecessary to begin with premising, that those who object to the superinduction of anesthesia in parturition upon religious grounds, found their objections principally on the words of the primeval curse which God pronounced after the temptation and fall of our first parents. Few or none, however, of those who have most zealously urged the existence of this curse as a reason against the employment of anesthetic means in obstetric practice, have, I believe, made themselves at all intimate with the words and tenor of the curse itself. I shall therefore, in the first place, quote the words of it in full from the third chapter of Genesis, interpolating in Italic letters the Hebrew originals of those two nouns which are the more immediate subjects of doubt and difference of opinion. GENESIS, chap. iii. v. 14.—" And the Lord God said unto the serpent, Because thou hast done this, thou art cursed above all cattle, and above every beast of the field; upon thy belly shalt thou go, and dust shalt thou eat all the days of thy life: 15. "And I will put enmity between thee and the woman, and between thy seed and her seed; it shall bruise thy head, and thou shalt bruise his heel. 16. "Unto the woman he said, I will greatly multiply thy sorrow (itztzabhon) and thy conception: in sorrow ('etzebh) thou shalt bring forth children; and thy desire shall be to thy husband, and he shall rule over thee. 17. "And unto Adam he said, Because thou hast hearkened unto the voice of thy wife, and hast eaten of the tree, of which I commanded thee, saying, Thou shalt not eat of it: cursed is the ground for thy sake; in sorrow ('itztzabhon) shalt thou eat of it all the days of thy life; 18. "Thorns also and thistles shall it bring forth to thee; and thou shalt eat the herb of the field. 19. "In the sweat of thy face shalt thou eat bread, till thou return unto the ground; for out of it wast thou taken: for dust thou art, and unto dust shalt thou return.” In the form of a few separate observations, I will now add the remarks and answers which I wish to make. And I would begin by observing, that, 1. The primeval curse is triple. It contains a judgment, First, upon the serpent (verses 14, 15); Secondly, upon the woman (v. 16); and, Thirdly, upon the ground for the sake of the man (v. 17-19.) With the first of these three curses-that on the serpent-and its apparent permanence (Isaiah lxv. 25), our present inquiry has nothing to do. It is enough for me to remark, that the second and third curses-on the woman and on the ground—are evidently, from different parts of the Holy Word, not immutable. God himself, on more than one occasion, promises the removal of them, and in general conjunctly, to the Israelites, provided they would keep their covenants and obey his laws. See, for example, Deuteronomy, vii. 13, "I will bless the fruit of thy womb, and the fruit of thy land," &c.; xxviii. 4, "Blessed shall be the fruit of thy body, and the fruit of thy ground," &c. See also chap. xxviii. 11, &c. In Isaiah (xxviii. 23-29), man's culture by the plough, &c., of the ground cursed by God, is said to come from the providence of God himself. "For his God doth instruct him to discretion, and doth teach him" (v. 26); and, "This also cometh forth from the Lord of hosts, which is wonderful in counsel and excellent in working" (v. 29). 2. Those who, from the terms of the first curse, argue against the superinduction of anesthesia in labor, aver that we are bound to take and act upon the words of the curse literally, "I will greatly multiply thy sorrow and thy conception;" or, as Gesenius and other Hebrew authorities state, that, being a case of Hendiadys, it may be more correctly rendered, "I will greatly multiply the sorrow of thy conception; in sorrow thou shalt bring forth children." If, however, we are bound to take this part of the curse literally, and act accordingly, then we are bound to take and act also upon all other parts of the curse literally. If it is sinful to try to counteract the effects of this part of it, referring to childbearing women, it is sinful to try to counteract the other parts of it, regarding the state of the ground, and the judgment upon man. The agriculturist, in pulling up "the thorns and thistles," which the earth was doomed to bear, so far tries to counteract that part of the primary doom; and yet is never looked upon as erring and sinning in doing so. Or grant, as I have heard argued, that he may be entitled to pull up "the thorns and thistles," because the curse further implies that he was doomed to till the ground,-still he was doomed to till it by "the sweat of his face." Now if, I repeat, the whole curse is, as is averred, to be understood and acted on literally, then man must be equally erring and sinning, when, as now, instead of his own sweat and personal exertions, he employs the horse and the ox-water and steam power-sowing, reaping, thrashing, grinding machines, &c., to do this work for him, and elaborate the "bread" which he eats. The ever active intellect which God has bestowed upon man, has urged him on to the discovery of these and similar inventions. But if the first curse must be read and acted on literally, it has so far urged him on to these improper acts by which he thus saves himself from the effects of that curse. Nay, more; if some physicians hold that they feel conscientiously constrained not to relieve the agonies of a woman in childbirth, because it was ordained that she should bring forth in sorrow, then they ought to feel conscien 1 "Augebo tibi Graviditatis molestias.”—Dathe's Pentateuchus, p. 38. tiously constrained, on the very same grounds, not to use their professional skill and art to prevent man from dying; for at the same time it was decreed, by the same anthority, with the same force, that man should be subject to death,-" dust thou art, and unto dust shalt thou return." If, on the other hand, it be allowed that it is justifiable in the physician to try to counteract the effects of one part of the curse, and justifiable in the agriculturist to try to counteract the effects of another part, it is surely equally justifiable in the accoucheur to try to counteract the effects of a third part of it. But if, on the contrary, it is unjustifiable for him to follow out this object of his profession, it is equally unjustifiable for the physician and agriculturist to follow out the corresponding objects of their professions. Are those who maintain the uncanonical character of using human means to contravene the pains of childbirth ready, then, to maintain that we should not use human means to contravene the tendency to death, or to increase the fertility and produce of the ground except by personal labor, and the actual "sweat" of the brow? To be consistent, they must of necessity maintain this strange and irrational view of man, and of the duties and destinies which God has appointed for man. Or, otherwise, they must own that if it is right and meet in us to exert the human intellect so as to ameliorate the condition of man from the results of the fall, it is equally right and meet in us to employ the same means to ameliorate the condition of woman from the results of the same cause. 3. But does the word sorrow ("in sorrow thou shalt bring forth children") really mean physical and bodily pain, as is taken for granted by those who maintain the improper and irreligious character of any means used to assuage and annul the sufferings of childbirth? Now the word "sorrow" occurs three several times in two consecutive verses of the curse; (verses 16 and 17.) The corresponding word, or rather words, in the original Hebrew, as I have already shown when citing the terms of the curse, are 'etzebh, and 'itztzabhon. These nouns are both synonymous in meaning and origin, although longer and shorter in form (like labor, laboriousness— pain, painfulness-in our own language). All philologists agree that they are derived from the same root, viz., the verb 'atzabh. The true and primitive meaning of a derivative word in the Hebrew, as in other languages, is generally the best attained by considering the signification of the root from which it is derived. The meaning of the verb 'atzabh (the root of these nouns) is given as follows, by Professor Gesenius, the highest authority, I believe, I could quote on such a point. In his Lexicon he enters "'atzabh, 1. To labor, to form, to fashion. The original idea (says he) is perhaps that of cutting, whether wood or stones. 2. To toil with pain, |