RELATIONS AND VALUES OF THE ANAESTHETICS. 
255 
thp drug-, and discreditable in every way to both operator 
and anaesthetist, who place themselves in a dilemma between 
two horns —unpardonable ignorance and vicious cruelty . How 
different from the custom abroad, notably in the United 
Kingdom, where the management of anaesthesia is always 
intrusted to an expert, a professional anaesthetist! The result 
is, the patient is suddenly choked and strangled into submis¬ 
sion and into narcosis, by means of a highly irritating vapor ? 
without once being permitted a whiff of the much needed 
oxygen. All the sensations of asphyxia and impending dis¬ 
solution are present, and it is little wonder that fatalities from 
shock and other causes sometime supervene. Indeed, the mira¬ 
cle is they are not more frequent, and that bronchitis and 
other unpleasant and possible sequelae are not more common. 
A few years since a case of strangulated hernia was brought 
into the operating room of one of the large American hos¬ 
pitals, when the surgeon commanded his assistant, an under¬ 
graduate, to “ use plenty of ether and press the cone down 
firmly on the mouth and face to avoid a lengthened period of 
excitement. ” This was done, and the hernia reduced by 
taxis during the relaxation, when it was discovered the vital 
spark had fled ; life was extinct even before the operation 
began, the poor fellow having been smothered with ether va¬ 
por. In all probability the first sudden application produced 
strangulation and spasmodic closure of the glottis. 
It should never be forgotten that ether vapor when too 
much diluted with air is a simple stimulant incapable of induc¬ 
ing any condition except excitement and intoxication, no 
matter how much used or for how long a time ; and, further, 
that when too diluted and the mechanical act of respiration at 
the same time obstructed by pressing down upon the mouth 
and nose the cone or inhaler, the patient may be very easily 
partially or wholly suffocated. 
Neither is there economy of time or material in the “ cram¬ 
ming ” process, as is too frequently claimed, as it tends to 
render the patient resistant, and consequently more difficult 
to anaesthetize, and to keep anaesthetized. The short, shallow 
wand imperfect respiration induced thereby, and the irritation 
