=Precipitate labor= is an over rapid advance of the child wherein the stages of labor are merged into one another and the child expelled in two or three pains. It may be due to unusual capacity of the pelvis, or to strong contractions which the patient is not aware of, or both. These cases predispose to post partum hæmorrhage and to serious lacerations of cervix and perineum. The child is usually delivered in an undesirable place, such as a toilet basin or a street car, and perishes from the fall, from cold, from umbilical hæmorrhage, or lack of facilities for revival. The nurse who is watching a case is responsible for the prevention of a precipitate. If the event impends, the woman must be placed upon her side with legs straight, and she should be instructed to cry out with every pain. Chloroform may be given and the head forcibly held back. =Uterine Inertia.=—A sluggish state of the uterus may characterize the labor and the contractions will be slow, shallow and inefficient. The intervals may be prolonged, although the patient complains bitterly of pain. The condition is seen most frequently in multiparas and is due to defective innervation of the uterus or to imperfect reflexes, and in primiparas also it may be due to the newness of the function that is suddenly called into play, or to contracted pelvis. Many times the trouble results from overfatigue and want of sleep. If this is the case, the remedy may be found in the administration of morphine sulphate ⅙ gr. and scopolamine 1/150 gr. The pains are diminished or abrogated while the contractions continue. The scopolamine may be repeated if necessary. Under proper indications and conditions this treatment is harmless, both to mother and child, but requires supervision on the part of the nurse or physician. If the patient is not overly fatigued, the introduction of a Vorhees bag, as described under the head of Induction of Labor (p. 208) will dynamically increase the strength and frequency of the contractions, mechanically aid the effacement of the cervix and the dilatation of the os, and shorten the first stage anywhere from six to twelve hours. As soon as the os is dilated, pituitrin may be given under due precautions, as hereafter indicated. Pituitrin has but little influence on the nonfunctionating organ, but acts well on a uterus which is definitely contracting. It should not be given during the first stage, since when the uterus contracts, there must be an adequate opening for the advance of the child. Five to seven minims is the usual dose, injected into the deltoid muscle. The injection may be repeated in an hour, if required, since the effects, which begin about five minutes after the injections, will pass off in fifty-five minutes. By the use of pituitin many operative procedures are altered or avoided. A high forceps case may be converted into a case for the low instruments, and the latter in many instances avoided altogether.