ONPANAESTHESLICS 165 
And I have seen other patients thrown into a condition of distinct peril from 
the same cause carried to a minor degree. Yet we have seen in the experiments 
above recorded that, even in animals which seem to have been peculiarly sensi- 
tive to the action of chloroform, atmospheres which produced anaesthesia in 
a very few minutes did not cause death till they had continued in action con- 
siderably more than an hour. Those atmospheres had the peculiarity of being 
on the one hand, extremely mild, and, on the other hand, constant in quality . 
and, assuming that effects more or less closely analogous would follow in the 
human subject, it is clear that we ought to make a systematic attempt to attain 
them. If for the fitful mode of administration by the folded towel, with atmos- 
pheres perpetually oscillating between the needlessly strong and the uselessly 
weak, we can substitute a method which shall give a uniform and at the same 
time a mild anaesthetic air, we may anticipate very beneficial results. The 
avoidance of the needlessly strong atmospheres can hardly fail to diminish the 
chances of mishap from inadvertence, and this in two ways: first, by making 
respiratory embarrassments less likely to occur; and, secondly, by rendering 
it far less dangerous to continue the administration of the anaesthetic when 
the patient is fully under its influence. An equable exhibition of the drug 
will also save time, and thus not only promote the convenience of the surgeon, 
but also the comfort of the patient, since the after-effects of the narcotic are 
more or less proportioned to the length of the period during which it has con- 
tinued in operation. 
Moreover, the facts which M. Paul Bert has elicited may well embolden 
us to continue a steady administration of the chloroform after the patient has 
been brought fully under its influence. For we know that, when complete 
anaesthesia has been brought about, a very much smaller proportion of the 
chloroform is needed for the maintenance of that state than was required for 
its production: all that is necessary being to supply enough to compensate 
for the elimination of the drug by the lungs and other emunctory organs. Hence, 
if an atmosphere of the mild but constant character referred to, while effective 
for the rapid production of anaesthesia, may in the lower animals be continued 
for an hour or more of full strength without causing death, it seems only reason- 
able to anticipate that, if the greatly reduced proportion that suffices for main- 
taining anaesthesia were substituted when the patient had been fully subdued, 
it might be steadily continued without danger for any length of time that might 
be desirable. And I need hardly remark on the convenience that would result 
from such an arrangement, as compared with the liability to partial recovery 
with its attendant struggling in the middle of an operation, when chloroform is 
given from the folded towel by any but very experienced administrators. 
