The Induction of Premature Labor.—In our systematic treatises on obstetrics electricity is hardly recognized as an agent deserving of serious consideration among the means to be resorted to for the purpose of in ducing labor. Lusk, for instance, classes it among the methods which are not entitled to anything more than mention as having been suggested; Schrader ranks it with the !tents which have only a historical value; Playfair says that it is a means too uncertain to be relied upon, and that it is irksome both to the patient and the practitioner; Barnes, after test• ing it in three cases, while he succeeded in inducing labor, found the method tedious and sometimes distressing to the patient. Notwithstand ing these views, a number of instances have of late years been reported, which seem to speak quite strongly in favor of this method of inducing labor. Bayer,' from his experience in eight cases, claims that electricity is the best, safest, and most certain means of inducing labor; and Baird records a number of instances where the agent was of unquestionable value, although he used it in connection with local dilating measures. The most recent writer on this subject is Briihl, who reports' in detail seven cases in which the value of electricity was carefully tested. He • used, as also Bayer, the constant current, and these cases may be taken as typical of what may be expected from resort to galvanism. his con clusions are, and the record justifies them, that, while the method does not carry with it special risk to the mother or the foetus, its effects are uncertain, and if the applications be persisted in, the uterus may be ren dered so irritable as not to respond readily to other means of inducing labor in case it becomes requisite to resort to them. In not one of the instances he reports was galvanism alone effective; in three it failed alto gether; in four contractions were evoked and the cervix partly dilated, but these contractions had to be re-enforced by other means. It isto be
noted, further, that galvanization was repeated from two to twenty-four times, and that from five to twenty-eight days was required, even in con nection with other means, to attain the desired end. The length of time and the number of applications requisite were about the same in the cases reported by Bayer. We may fairly, hence, conclude that galvanism is hardly entitled to consideration among the means for inducing labor, since not uncommonly, where interference of this nature is called for, the welfare of the patient is opposed to the waiting which this current neces sitates. In regard to faradism, when used alone, the same general con clusion is warrantable. Owing to its acknowledged greater power of in ducing muscular contractions, the time requisite for starting labor by means of it is likely to be considerably shorter than that demanded by galvanism. But the point to be emphasized is that although contractions of the uterus may be evoked, they are very likely to die away as soon as the stimulus is withdrawn, and to maintain them some adjuvant means must be utilized. This is precisely what Baird did in the instances he has recorded. He faradized the uterus, and at the same time dilated the cervix by his finger and Barnes's bags, and was thus enabled in seven cases to induce labor in lees than ten minutes. It is at once apparent that the combination of these two means has advantages over any recog nized method used alone, and herein would seem to lie the reason why electricity, in the faradic form, may be classed among the means suitable for inducing premature labor. It is assuredly entitled to further testa, for although the ultimate result may only be its estimation as an adju vant, as such there is ample scope for it in an emergency where, on speedy result, the welfare of the mother and of the fwtus not infrequently depends.