It would appear therefore that in the vast majority of cases the disease (tuberculosis) is not transmitted directly from the mother to the fetus, and that the latter is born with a tendency to tuberculosis, rather than with the disease itself. Hence it follows that the children of tubercular mothers should be brought under the best hygienic surroundings, and should not be suckled by their mothers. In view of the fact that the tubercular process usually becomes exacerbated either during pregnancy or after child birth, most authorities recommend that abortion be induced as a matter of routine in all tubercular women, and many that they be rendered sterile by artificial means. This appears to be a somewhat too extreme point of view, but I consider that abortion should be induced in the first pregnancy occurring after the onset of the disease, and whenever it makes its appearance during the early months of pregnancy. Page 494. _THE PRACTICE OF OBSTETRICS. In original contributions by American Authors. Edited by Reuben Peterson, A.B., M.D., Professor of Obstetrics and Gynaecology in the University of Michigan, Ann Arbor, Mich. Obstetrician-in-Chief to the University of Michigan Hospital. Lea Bros. & Co. Philadelphia and New York. 1907. Chapter IX._ COMPLICATIONS ARISING FROM MATERNAL DISEASES AND ANOMALIES Exact observations on a large number of cases have demonstrated beyond doubt that with very rare exceptions a pregnancy exerts a harmful effect upon the course of the disease (tuberculosis). Page 344. So seriously is the tubercular process affected by a concomitant pregnancy that it seems the duty of the physician to warn every tubercular girl against marriage. Especially deleterious to the patient are pregnancies which follow each other at short intervals. In such instances the patient must be strongly advised against a new impregnation. It hardly can be denied that in some of these cases artificial sterilization may be justified. An additional argument in favor of this procedure is the comparative frequency with which, if not the infection itself, at least a marked disposition to it is transmitted to the fetus in utero. P. 344. _A TEXT BOOK OF OBSTETRICS. Barton Cooke Hirst, M.D., Professor of Obstetrics in the University of Pennsylvania; Gynaecologist to the Howard and Orthopaedic and the Philadelphia Hospitals, etc. W. B. Saunders Co. 1909._ The influence of pregnancy upon tuberculosis is most unfavorable and in women predisposed to tuberculosis, gestation may be the determining factor in lighting up an attack. It is the duty of a physician to advise strongly against marriage and maternity in the case of a woman already infected, or predisposed to tuberculosis. If the patient is pregnant an induction of labor should be considered. P. 427.