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laryngeal aperture shuts off the supply of atmospheric air from the 

 pulmonary tubes. The same condition results from the voluntary 

 closure of the mouth and lips; but the last soon yields, -while the 

 spasm of the glottis gives rise, in rare cases, to a partial asphyxia, 

 indicated by the then livid colour of the cutaneous surface. Similar 

 lividity is often exhibited during a spasm of whooping-cough or in a 

 hysteric fit, and is of comparatively slight importance, from the fact 

 that when the system feels peremptorily the necessity for air, the 

 spasm resulting from the anaesthesia relaxes, the patient breathes 

 freely, and the blood is aerated. Two or three inspirations suffice 

 to restore to the cheek its natural colour. 



Muscular System. — The ordinary affections of the voluntary mus- 

 cles have been alluded to. Organized resistance resulting from 

 nervous excitement; tonic and clonic spasm; the cataleptic state being 

 not unfrequent; while in one case I observed a convulsive effort of the 

 whole system of voluntary muscles. 



Other muscles are partially affected. The sphincters very rarely 

 lose their contractility. It is well known that the uterus contracts 

 during partial and even complete unconsciousness; a diminution of 

 cessation of its contractile action being the rare exception and not 

 the rule. The respiratory muscles play tranquilly during narcotism, 

 while the heart, losing the force and frequency of its pulsations, 

 slowly ceases to beat, in its latest and profoundest stage. 



Pulse and Pupil. — Incidental excitement usually accelerates the 

 pulse, the relative frequency of which, during the earlier stage, 

 it is difficult from this circumstance to estimate. It does not lose 

 either in force or frequency until the whole system is profoundly 

 narcotized. It is then, as at other stages of the process, a most 

 valuable indication of the condition of the nervous system, and ulti- 

 mately of the limits of vital endurance. 



The pupil, though commonly at first contracted, and subsequently 

 dilated, is less to be relied on as an indication. 



Prolonged insensibility is quite exceptional and rare. In the case 

 of a young woman, of the details of which I am cognizant, such 

 insensibility ensued upon a brief recovery of the ordinary character, 

 and after the ordinary interval. The patient then again became 

 insensible, apparently without cause, and slept heavily, in spite of 

 efforts to arouse her, during an hour. The symptom which excited 

 apprehension, was the smallness of the pulse, which at times was 

 barely perceptible at the wrist. This patient ultimately recovered, 

 as I believe, have all others similarly affected. The phenomena sug- 



