300 REPORTS ON THE STATE OF SCIBNCE, 
feebleness from acute illness of some duration. Other examples of 
unfavourable conditions present in the patient were Graves’ disease, 
acute bronchitis, and extreme anemia. We have already conducted about 
three hundred administrations and are continuing to employ the method. 
The preparation of patients has varied to some extent in the private 
cases. In hospital patients it was as follows :— 
On the afternoon of the day preceding the operation a dose of castor 
oil, usually about an ounce, was given. On the morning of the operation 
(which took place after 1 p.m.) an enema was given at 6 a.m. Tea and 
bread-and-butter were given at 7—two slices and one cup. A pint of 
beef tea was given at 10. The enema was repeated if necessary. 
4. The Time required for inducing Anesthesia and the Symptoms evoked 
during Induction. 
Time of induction is reckoned from the moment of commencement 
of inhalation to the moment when the patient is ready for the operation. 
That this point had been reached was judged by the presence of 
(1) faint or absent corneal reflex ; 
(2) complete muscular relaxation ; and 
(3) presence of inspiratory stertor. 
The average induction period in a series of hospital cases was 8} 
minutes ; the longest time spent in securing readiness for operation was 
17 minutes; the shortest time was 5 minutes. With children 5 minutes 
was the rule, and this was the time also in the case of a woman very 
anemic and ill with peritonitis. 'The longest induction period was in 
the case of a middle-aged carman, red-faced and accustomed to large 
amounts of beer, who had to be operated on for fistula in ano. 
At the beginning of inhalation the vapour was not, as a rule, objected 
to, particularly if constituents made from ethylic alcohol were used. 
There is never any difficulty in getting patients to breathe freely. Excited 
talking becoming incoherent, or quiet busy muttering occurred in ten of 
forty hospital cases. Some rigidity of limbs and of jaw muscles occurred 
in eighteen of these cases. Excited movements of limbs or trunk, so 
forcible as to require restraining lest the patient should fall off the couch, 
occurred in one case. Excitement of the above kinds, when it occurred 
at all, was always after consciousness had gone—at any rate, to such an 
extent that the hearing was already quite lost. Secretion of mucus and 
saliva is not a feature of the induction stage with this anesthetic. In 
difficult cases there is less temporary interference with respiration during 
the induction stage than when employing ether or ‘ gas and ether.’ 
5. Amount of Mixture required. 
Generally speaking, it is found that in the case of an adult male the 
mask has to be kept moist over its whole surface after the first four 
minutes until full anesthesia is induced. After this it is necessary to 
keep it moist to that extent only in the case of ‘ difficult ’ subjects. In 
the case of easier male subjects and in the case of women and of children 
only half of the mask is kept moist when anesthesia is once esta- 
blished. In the case of children and women who are particularly feeble 
never more than half the mask is moistened from first to last and most 
