These are cases (severe heart disease) in which, in my opinion, it is the physician’s duty to concern himself with the subject of the use of preventive measures, and having regard for the preservation of a woman’s life, and uninfluenced by any false delicacy, but with simple earnestness to inform his patient with respect to the needful prophylactic measures. The artificial termination of pregnancy, which unquestionably is often justified in women suffering from heart disease, but which unfortunately is apt to have very unfavorable results, will rarely need to be discussed if by the proper employment of preventive measures care is taken that pregnancy does not recur too frequently. P. 255. _OBSTETRICS. A Text Book for the use of Students and Practitioners. Whitridge Williams, Professor of Obstetrics, Johns Hopkins University; Obstetrician in Chief to the Johns Hopkins Hospital; Gynecologist to the Union Protestant Infirmary, Baltimore, Md. D. Appleton & Co., 1912._ Some authorities recommend that women suffering from heart lesions should be dissuaded from marriage, or if married, from becoming pregnant. This, however, appears to be an extreme view, though of course when the lesion is serious and the compensation faulty the dangers of child-bearing should be carefully explained. P. 498. _THE PRACTICE OF OBSTETRICS. In Original Contributions by American authors. Edited by Reuben Peterson, A.B., M.D., Professor of Obstetrics and Gynecology in the University of Michigan, Ann Arbor, Mich.; Obstetrician and Gynecologist-in-Chief to the University of Michigan Hospital. Lea Bros. & Co., Phil. and New York. 1907. Chapter XIX._ “Leyden claims that about 40% of all women with serious heart lesions meet their death in connection with childbirth. Still greater than the demands upon the heart during pregnancy are those made by labor. The strain, mental excitement, and especially the sudden changes in the blood pressure, conditions which are well recognized as extremely harmful to every patient with a chronic heart lesion, and which cannot be avoided in the course of labor, make the situation extremely dangerous.” (Hugo Ehrenfest, M.D.) P. 357. “The prognosis for the fetus is unfavorable. Fellner, whose figures undoubtedly are low, places the frequency of premature, spontaneous interruption of pregnancy as 20%, other writers at from 40% to 60%.” P. 358.