Dr. Polak, professor of obstetrics at the Long Island College Hospital, reported[204] on 155 cases of the twilight sleep method, and he is in favor of it under several restrictions. He uses the drugs from ampules which contain one two-hundredth of a grain of scopolamine and half a grain of narcophin, which is a proprietary drug said to be composed of the meconate of morphine with the meconate of narcotin in molecular proportion. Morphine itself is a tribasic meconate, and narcotin, of course, another opium derivative. The American Council on Pharmacy and Chemistry was unable to accept the claims made for narcophin.[205] Polak says he finds no difference between morphine and narcophin. [204] _Long Island Medical Journal_, December, 1914, and _American Journal of Obstetrics_, May, 1915. [205] _Jour. Amer. Med. Assoc._, November 21, 1914. In the twilight sleep treatment the patient, especially if she is a primipara, should be definitely in labor before any injection is given. She should have pains occurring at regular intervals, preferably every four or five minutes, before the first injection of scopolamine and morphine is administered; that is, the first stage of labor should be well advanced. Gauss gives one-sixth of a grain of morphine at the first injection, and Polak nearly three-fourths of a grain of narcophin, with one two-hundredth of a grain of scopolamine. If the woman is a multipara, Polak begins the treatment at the very beginning of the pains. The patient is kept in bed, in a darkened room, removed from all noise and excitement. Some stop the ears and blindfold the patient, and, according to Baer of Chicago, the women are put into restraining sheets as a routine practice in certain clinics to keep them from infecting themselves. The ordinary practice is to give a half dose of scopolamine an hour after the first dose and about every two hours thereafter, according to the indications. The morphine may be discontinued, or used approximately every six hours in a long labor. Smaller doses are required if the first is given early in the labor, and larger if the pains have been well developed. In these latter cases the danger to the child is, of course, greater.