The use of pituitin may be briefly summarized as follows: =Pituitrin= (Use no alcohol to cleanse syringe or skin before injection.) _Indications._— 1. Inertia uteri or weak, shallow pains in second stage. 2. Multiparity. 3. Post partum hæmorrhage. 4. To avoid use of forceps or to reduce a high forceps case to a low one. 5. Cæsarean section. If the patient is a multipara, sterile linen should be on and attendants ready for the delivery before an injection is given. _Conditions._— 1. Cervix effaced. 2. Os admits three fingers. (Better if membranes have ruptured.) 3. Head should be engaged. 4. No mechanical obstacle to delivery such as tumors or markedly contracted pelvis, etc. _Dangers of Long Labors._— Compression of cord. {Vesicovaginal fistulæ. Necrosis of maternal tissues. { {Rectovaginal fistulæ. Infection—peritonitis. Necrosis of skin over skull. Necrosis of cranium. Fracture of skull. Death of child. Maternal exhaustion and prolonged convalescence. =Premature rupture of the membranes= not infrequently occurs from over-distention, when twins or hydramnios is present, or at any stage of the pregnancy when the membranes are weak. The liquor amnii flows off, not all at once, but after the first gush by intermittent discharges, depending on the painless uterine contractions and the accuracy with which the head fits the pelvis. Labor usually comes on in from twelve to forty-eight hours, but it _may_ be postponed for a month. The labor is sometimes more painful and prolonged on account of the absence of the fluid wedge and the generous lubrication of the channel which is supplied by the liquor amnii. The danger of infection of the amniotic cavity with consequent death of the child is always to be apprehended after the escape of the liquor amnii. Also the fœtal parts may prolapse and complicate the labor; or if the cord comes down, the child may be imperiled by its compression. If near term, the rupture of the membranes is not of great importance though the case must be watched attentively. Daily observation must be made of the fœtal heart tones, the amount of liquor amnii flowing away, and the presence or absence of infection. If labor does not determine in a few days or if the heart tones rise above 160 or go below 120, labor must be inaugurated. (See Induction of Labor, p. 208.)