

45 



formed, but in a disordered manner; the movements are 

 instinctive, guided by volition, though not by knowledge or 

 reason ; there may be struggling, screaming, or laughing ; the 

 patient may be tractable or obstinate ; dreams occur in this 

 stage. An operation would cause pain, though the patient 

 might, perhaps, not remember it ; this stage is not proper for 

 operations. In the third degree there is no evidence of any 

 mental function being exercised, and consequently, no volun- 

 tary motions occur; but muscular contractions, in addition 

 to those concerned in respiration, may sometimes take place as 

 the effect of the ether, or of external impressions. The eyes are 

 stationary, the breathing is usually regular and deep, though it 

 sometimes stops for a time, and there may be muscular rigidity ; 

 in operations there may be some flinching and moaning, but 

 no articulate sound, and there is no recollection of what has 

 been done. In the fourth degree no movements are seen 

 except those of respiration, and patients are incapable of being 

 influenced by external impressions. The eyelids fall, the eyes 

 are fixed, the muscles are all relaxed, the face is placid and 

 expressionless, the breathing regular and automatic, and some- 

 times there is snoring, a state which would be alarming if we 

 did not know the cause of it. In this the patient remains 

 perfectly passive under every kind of operation. In the fifth 

 degree, not witnessed in the human being, the respiratory 

 movements are more or less paralyzed, and become difficult, 

 feeble, and irregular. If continued, this ends in death; yet, 

 according to Dr. Snow, the animals always recover if the 

 vapour is discontinued before the breathing has actually 

 ceased. 



"These various stages disappear in the inverse order in 

 which they make their appearance ; that is, the third succeeds 

 the fourtb, the second succeeds the third, and the first con- 

 cludes. It is to be observed that the degree of insensibility 

 is greater in a stage when retiring than when advancing; that 

 is, for instance, a patient might feel while in the second stage, 



