200 



had assigned to tliem, many of them are of comparatively trifling 

 import as a sequence of an anaesthetic agent; -while, on the other 

 hand, a few comparatively quiet indications stand at the limit of 

 vital endurance, and give notice of real danger. The order of ex- 

 perience, — a few type or model cases as they occur, will perhaps 

 afford the readiest method of exposing these phenomena. 



1. A patient courageously inhales the ether; — a term intended to 

 include the chloroform. Soon the respiration becomes more rapid; 

 the chest heaves; the lips are blown out with the expiration, and 

 while the patient is manifesting unequivocal signs of enjoyment, the 

 head suddenly falls to one side, and the individual during the next 

 two or five minutes is insensible to pain in any form. He awakes 

 suddenly, smiles, is surprised to find the operation, if one has been 

 performed, over; has had a pleasurable dream, and experiences no 

 ill effects. This is etherization in its most favourable form, less fre- 

 quent than the next. 



2. A second patient averts his head to cough; inhales again and 

 again coughs; declares his inability to take the ether; yet perseveres. 

 The trachea has now become less irritable; respiration is tranquil, 

 and insensibility of rapid access. Such cases are quite common in 

 the practice of the dentist. 



3. A third subject makes grimaces, and getting exhilarated rejects 

 the apparatus; but is still amenable to peremptory discipline; and 

 being directed to be quiet and to close his eyes, is soon narcotized. 



4. Yet not always at once. A large and muscular man, perhaps 

 habituated to stimulus, sometimes modifies grimace into a demon- 

 stration of resistance; closes his lips and jaw firmly, and refuses to 

 inhale; objects to verbal and other interference; at last becomes vio- 

 lent, and if athletic, requires the united force of several assistants 

 to confine him. 



Here is a sufficient reason for not attempting the etherization of 

 athletic subjects when such aid is not at hand. I believe that the 

 best practice in such a case is to confine the patient, and to apply 

 the ether steadily to the mouth and nose. For some seconds, per- 

 haps many, the patient may refuse to breathe; and bystanders un- 

 accustomed to the phenomena, exchange significant glances. But 

 if the pulse is good there is no real danger, and at last, exhausted 

 nature takes a deep and full inspiration, which, while it aerates the 

 blood, is laden with the intoxicating vapour; colour returns; and 

 the patient falls back narcotized. Violent resistance is *not common. 



5. It is, however, less unfrequent for the patient to vomit soon 



