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to spasm would aggravate the difficulty of reduction during its 

 access. 



Lastly, ether has proved of service in abating the spasm of stric- 

 ture, in lithotrity, and in the breaking up of adhesions resulting 

 from fracture near the joints. Yet in the latter cases pain has 

 always offered sure indication of the advisable extent of the respect- 

 ive operations, and in its absence, considerable discrimination is to 

 be exercised. I have myself seen an arm refractured by an attempt 

 to overcome the resistance of a mass of callus, after the adhesion 

 of the articulating surfaces had yielded. 



Age. — Experience shows that no especial ill effects result from 

 the administration of ether to patients of average physical force at 

 almost any age. Though I have operated on a child of three months, 

 who was so far inebriated that its cries were modified into a sort of 

 moan, yet I know of no case in which a young infant has been com- 

 pletely narcotized after its birth. Indeed, the facility of controlling 

 a child of this age, together with the fact that it has neither the 

 anticipation nor remembrance of suffering, however severe, seems to 

 render this stage of narcotism unnecessary. 



Antidotes. — It has been well said that fresh air, and in an extreme 

 case artificial respiration is the best antidote to ether inebriation. 



The symptoms of spasm, vomiting, &c, generally subside when 

 the patient is left to himself. When the pulse is small and slow, 

 this state of narcotism must not be identified with that of syncope. 

 Brandy and other diffusible stimulants, appropriate remedies for 

 syncope, belong to the class of agents which induce the anaesthetic 

 symptoms; and it is quite probable, though evidence is yet incom- 

 plete upon this point, that the difficulty would only be aggravated 

 by their use. Besides, the patient cannot always swallow. Cold 

 water, dashed upon the face, or injected into the ears, undoubtedly 

 aids in arousing the patient from the common ether narcotism. 

 Galvanism to the precordial region has been suggested as a remedy 

 in an extreme case ; and it may be a question whether rest in the 

 recumbent posture or active exercise, as adopted for the restoration 

 of subjects affected with narcotism from opium, be best adapted for 

 these cases. If any fluid is to be administered internally, analogy 

 would suggest strong tea or coffee. 



The nature of the anaesthetic state is a question of considerable 

 interest. Perhaps the most satisfactory evidence upon this point, 

 is that afforded by the analogy between the symptoms resulting 

 from ether vapour in the lungs, and those of alcohol in the stomach. 



