206 



Muscular relaxation ; the temporary loss of muscular contractility; 

 the passive flexibility of the arm ; is the most valuable sign of com- 

 plete narcotism. It is succeeded by snoring inspiration and slow 

 pulse. 



Signs of returning consciousness are, swallowing, coughing, moan- 

 ing, an effort to articulate, and muscular movement. 



Rapidity of access of the Ancesthetic State. — Somewhat modified 

 by the strength and temperament of the individual, the rapidity with 

 which the system yields, is generally in direct relation with the dose 

 administered. The maximum dose will be again discussed under the 

 head of dangers ; but it may be here stated that many of the unfa- 

 vourable symptoms owe their existence to the protracted inhalation 

 of an inadequate dose ; while after the first irritation of a large 

 volume of vapour at once introduced into the air tubes has subsided, 

 the patient yields tranquilly, and is much less liable to disagreeable 

 and annoying symptoms. 



Vomiting is especially connected with the long duration of the 

 inhalation, and also with its inadequacy. So, also, is general excite- 

 ment, and resistance; and probably spasm, whether of the vocal 

 chords or of the muscular system generally. 



The common imperfections of the inhaling process are, the use of 

 too large a sponge for ether, and of too small a sponge for chloroform. 

 The former distributes and evaporates the ether rapidly, while its 

 insterstices admit a good deal of air. The latter will not detain an 

 adequate amount of chloroform without endangering the patient's 

 skin. If the sponge be previously wrung out in water, its capillary 

 attraction is increased. 



ANAESTHETIC SYMPTOMS CONSIDERED SEPARATELY. 



Intellectual Phenomena.— -It is said that a patient may take cog- 

 nizance of the amputation of his own leg. This occurrence I have 

 never seen, though it is far from improbable. It implies a distinct 

 recognition of surrounding objects through special sense, at a mo- 

 ment of complete insensibility to pain in its severer forms. Such 

 complete insensibility is more frequently attended with entire disa- 

 bility of special sense ; yet sensation may be partially annulled, and 

 the patient continue quite cognizant of the external world. 



The manifestation of acute suffering, and even of well-directed 

 resistance, may occur without the patient's subsequent remembrance 

 of it. Here the faculty of memory is extinct. 



