New methods of treatment frequently appear, and the quack is likely to be among the first by which the new is tried. The use and abuse of pituitrin is an example of such a method. About 1909, pituitary extract as a uterine stimulant was first described and it was immediately taken up by competent men and more frequently, perhaps, by the quack. The extract is from the posterior lobe of the pituitary gland, and when injected subcutaneously or into a muscle it is a very powerful oxytocic. In a few minutes the injection markedly increases the intensity and duration of the pains. The effect lasts for an hour or an hour and a half. Whitridge Williams[129] says a judicious administration of the drug will do away with the use of low forceps in from one-third to one-half of the cases, but its ignorant use places the life of the mother and child in jeopardy. Mundell[130] found twelve cases of rupture of the uterus, thirty-four cases of fetal death, and forty-one cases of fetal asphyxia pallida in which resuscitation was effected only after prolonged and vigorous efforts, sometimes for over an hour. [129] _Obstetrics_, 4th ed. New York, 1917. [130] _Jour. Amer. Med. Assoc._, June 2, 1917. If there is any serious obstacle at all to delivery in the parturient canal or in the fetal position, or the like, pituitrin is likely to cause rupture of the uterus and asphyxiation of the child. It should never be used when there is the slightest danger of rupture of the uterus; or when the child is suffering; or in a shoulder and most pelvic presentations; or in elderly primiparae with rigid muscles; or when the cervix is not fully dilated, lest the undilated cervix be torn off; or where there is inertia after prolonged effort to overcome an obstacle to delivery. It is never to be used in a normal delivery merely to hasten the birth. Obstetrical cases are tedious, and an impatient physician with an atonic conscience is likely to use pituitrin so that he can get back to his bed.