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The case of lithotomy was in a boy of twelve years, one of the 

 most obstinate, self-willed patients of his age I have met with; it 

 was difficult to secure him upon the operating table. The stone, 

 weighing 282 grs., was extracted while he was in a quiet sleep; a 

 few minutes afterwards rousing up, he requested me, as he had done 

 before he went to sleep, not to begin to cut before he got to sleep. 

 He was saved all the pain of the operation; was comfortable from 

 that time onward ; has had not a single unpleasant symptom, and 

 now, seven days from the operation, is almost well. 



I must give the preference to chloroform compared with ether. 

 It is more sure to control the sensibility, exerts its sedative influ- 

 ence sooner, is less liable to agitate the voluntary muscles and craze 

 the patient, and its effects pass away sooner. In not a single in- 

 stance, among my twenty-two cases, have I witnessed an unpleasant 

 symptom indicative of injury to the patient. In administering the 

 chloroform, I introduce it slowly by allowing the patient to inhale 

 small quantities in succession, till the requisite insensibility arrives. 

 My opinion is that it can be safely administered in all ordinary 

 cases in which the viscera of the head and chest are sound. 



In the case of Mrs. Simmons, who died under influence of the 

 chloroform, it is evident that too large a dose was given, considering 

 the time occupied in the inhalation. She went to the breathing of 

 it with her characteristic resolution and energy — and a dozen or 

 fifteen deep inspirations did the work. She was probably dead in 

 five minutes from the time of the first inspiration. Her organs 

 were sound ; but the entire fluidity of the blood, as if from a stroke 

 of lightning, and the broken and fragmentary state of its corpuscles 

 as revealed by the microscope, would seem to show that a powerful 

 agent had been at work in it. 



Accompanying this, is a pamphlet, containing a full account of 

 the case, with the post-mortem appearances. 



Very respectfully yours, 



R. D. MUSSEY. 



Dr. Isaac Parrish. 



