302 REPORTS ON THE STATE OF SCIENCE. 
a young man of twenty-five years. In this instance there was vomiting 
seven times during the first fourteen hours after recovery of consciousness. 
Liquid nourishment was taken between the attacks of sickness, and there 
was no serious constitutional disturbance. In several cases there was 
yomiting once or more after recovery of consciousness. In one of these 
the vomit consisted of altered blood on the two occasions on which it 
occurred: this was a case of gastro-enterostomy. In practically all cases 
there was, twenty-four howrs after operation, complete freedom from 
sickness and from feeling of nausea. Our belief is that after-effects are 
less common with this method than with most others now in use. 
8. Conclusions. 
Our experience leads us to believe that this mixture used in the 
particular manner described is a trustworthy and comparatively safe 
anesthetic. By this we mean that if the simple principles are adhered 
to of starting gradually and limiting the moistened area of the mask 
overdosage is very unlikely to occur. It seems to us highly probable that 
the percentage of chloroform vapour thus offered to the patient is within 
the safe physiological limits. Moreover, the danger of post-anzsthetic 
lung complications which detracts from the otherwise safe nature of a 
similar ether anzesthesia is apparently no greater than is the case with 
chloroform. In our judgment the fact that even the most vigorous subject 
may be anesthetised by this mixture on an open mask marks a distinct 
step in the progress of practical anzesthetics. The Rendle Inhaler, and 
all similar semi-open inhalers for the ACE or the CE mixture, should, 
in our opinion, now be discarded. The method described seems to us to 
contain the advantages of open etherisation with those of percentage 
chloroformisation, although, of course, it does not pretend to any abso- 
lute scientific accuracy so far as vapour percentages are concerned. By 
this method chloroform is rendered far safer than when administered 
per se on a Skinner’s frame, and very much safer than when adminis- . 
tered on lint or towel. We go so far, indeed, as to express the view that 
the administration of undiluted chloroform by means of lint, hand- 
kerchief, or towel should henceforth be proscribed in practice. The 
anesthesia produced by this method is doubtless a chloroform anesthesia 
in its essential features, but the dilution with ether renders it possible to 
present continuously a weak and comparatively safe chloroform per- 
centage to the patient. Moreover, this mixture may, with the rarest 
possible exceptions, be used whenever chloroform itself is indicated. 
But it has advantages of another kind. It answers admirably and 
certainly far better than ether in so-called difficult cases, particularly 
in those liable to display symptoms of obstructed breathing during in- 
duction and in those in which the secretion of mucus would constitute 
a difficulty. As a substitute for the ‘ gas ’-ether-chloroform sequence 
this mixture and method have much to be said in their favour. We have 
come to the conclusion, indeed, that some of the slight difficulties ex- 
perienced by the anesthetist in securing the most favourable surgical 
conditions during abdominal operations are often dependent upon the 
presence of small quantities of mucus within the upper respiratory 
passages resulting from the use of ether during the induction stage. 
Though rapid induction may be depended upon by ‘ gas and ether’ or 
similar methods before proceeding to chloroform or CE mixture, a 
