On the other hand, the use of scopolamin and morphin is a routine in certain excellent maternity hospitals, and by many obstetricians of the first rank, who maintain that with a nurse in attendance and the observance of ordinary precautionary measures, the advantages far outweigh the disadvantages of a modified “twilight sleep.” An anesthetic is usually administered during the second stage, after the use of the scopolamin-morphin treatment. COMPLETE ANESTHESIA. If an emergency should arise and the nurse be required to change from the light anesthesia _à la reine_, and to give complete anesthesia, her responsibilities increase, for she must watch carefully the patient’s pulse, respirations, color and pupils. The flat pillow which is ordinarily left under the patient’s head during normal labor, should be removed and the inhaler should be held closely over her face with the nurse’s fingers so placed as to hold it in position and also to hold the patient’s jaw forward and up. (Fig. 106.) The ether should be dropped in clean drops, not poured, upon the inhaler. The dripping should be steady, but slow at first, gradually increased as the patient becomes accustomed to the fumes. [Illustration: FIG. 106.—Method of holding inhaler and supporting patient’s jaw in giving ether for complete anesthesia. (From photograph taken at Johns Hopkins Hospital.) ] With the average, normal patient who is taking ether well the _respirations_ become somewhat stertorous and more rapid, increasing to possibly 36 or 40 per minute; the _pulse_ starts at a little above the normal rate and increases to 116 or 120 and then drops to normal, which is slightly below the rate at which it started; the _color_ is normal at first and then may become crimson, or it may change very little; the _pupils_ first dilate, and then contract almost to a pin point. Unfavorable signs are: _respirations_ that are rapid and shallow, then possibly slow, but still shallow; increasing _pulse_ rate, this being so serious that the ether is usually stopped if the pulse approaches 140, and stimulation is promptly given; _cyanosis_ which is slight at first and then extreme, and dilated _pupils_. It is obviously not wise nor possible to attempt, by means of a few paragraphs and illustrations to teach a nurse so technical and important a procedure as the administration of an anesthetic, but it is hoped that these general suggestions may be helpful, particularly to the nurse who is unexpectedly confronted by an emergency.