=a^----
■3o-l



  ETHER  AND  CHLOROFORM;
DISCOVERY  AND  PHYSIOLOGICAL  EFFECTS.
FROM THE
BOSTON MEDICAL AND SURGICAL JOURNAL; AND THE ^TRANSACTIONS OF

        THE AMERICAN MEDICAL ASSOCIATION, VOL. L
               BY



     HENRY J. BIGELOW, M.D.

ONE OF THE SURGEONS OF THE MASSACHUSETTS GENERAL IIOXl'ITAL.
             BOSTON:

DAVID CLAPP, PRINTER....184 WASHINGTON STREET.

               1848. 
 
ETHER AND CHLOROFORM:
A COMPENDIUM
HISTORY, SURGICAL USE, DANGERS,
AND DISCOVERY.
BY HENRY J. BIGELOW, M. D.
  ONE OF THE SURGEONS OF THE MASS. GEN. HOSPITAL.
           Z6Z9/

          BOSTON:
DAVID CLAPP, PRINTER....184 WASHINGTON STREET.
            1848. 
 
 
   The author of these pages docs not propose to dig up the well-
worn hatchet of the ether controversy.  It may, therefore, be pro-
per to state that the first part of  this pamphlet was published  more
than six months ago, in a Medical Journal.   The  second part was
then also  written, at their request, for the Surgical Committee of
the National Medical  Convention ; and the  appearance of both in
this form has been deferred till now, by the necessary delay in the
publication of the transactions of that body.
  o  Chaunci/  Place, Nov. 1848. 
ETHER  AND  CHLOROFORM.
The  astronomer  Leverrier calculated  the  direction  and  rate of travel
of a star, and pointed to its place in  the heavens.  A star appeared;
yet astronomers tell  us  that this was not his star, that its rate of travel
was other than  had  been predicted by Leverrier.   No other appeared
exactly to fulfil  the  astronomer's  calculations.  Yet Leverrier is great,
and his name is familiar.
   Professor Schonbein  converted  cotton into a new vehicle of sudden
force.   The  belief that gun cotton might be cheaply used for  purposes
of offence or of defence, gave to the name of Schonbein a currency in all
parts of the civilized world, and to gun cotton the position  of one of  the
discoveries of the age.
   The French experimenter has  attached his name to the Daguerreo-
type, and  this, too, is great, although  a  mere luxury when tested by its
applicability to the necessities of man.
   Few will deny to these inventions and discoveries the  epithet great,
when compared with others of the day ; and yet their greatness is of very
different kind.   What,  then, shall be  considered  a test of greatness in
discovery ?
   A writer upon  patents has said  that an  invention is  entitled  to  pro-
tection from the  law, when it  materially modifies the result produced, or
the means by which it  is produced  ;  that a  patent  right is  due  to
novelty  in a  machine producing  an old fabric  in  a new way,  or to
the manufacture  of a new and  very different  fabric,  resulting from  a
slight  change in   the machine; in other words, to novelty in the com-
bined result of means and end.   This distinction, if not legal, is appa-
rently just; and  I should, in like manner, call an invention great, in pro-
portion to the combined amount of mind invested in its production,  and
of its  intrinsic ability to  minister  to the supposed or real comfort  and
well-being of the race.
   What, then, is the character of the  discovery of etherization ?  And
it is not idle nor superfluous to examine definitively the claims of this in-
vention.  I shall  presently show that  there are  regions where the use of 
6
Ether and  Chloroform.
multiplying experiment, while the value of the  discovery would be  in-
finitely enhanced.
  To'settle these important questions,  many instances of insensibility
were needed, which were not long in  offering themselves  to  the tenant
of a largely frequented dental establishment.  Each new trial  added evi-
dence in geometrical proportion,  while the absence of serious mishap en-
couraged hope.
  Here is a second point in the discovery, and I consider  a second pro-
position to have been now pretty well demonstrated.  This was, not that
ether might produce insensibility during the extraction of a tooth, and
that the state  of somnolence might be unattended with danger, but that
it could always  produce  insensibility, and  that the danger  was compa-
ratively slight.
  Brief inhalation may be considered as fairly tested, and the discovery
fairly demonstrated, in this  rapid and multiplied experience.
  Analogy, the degree of  insensibility, and its superficial  extent, render-
ed it quite  probable  that  such  insensibility would  prove complete and
universal.   An  experimentum crucis  could  alone determine such a  point,
nor was it long delayed.
  The  gentleman who  had  conducted  these  experiments determined
upon submitting the new phenomena to the test of a surgical operation ;
and there  was  a  certain  liberality of spirit which  was instrumental in
introducing the discovery into the Massachusetts General Hospital.   Many
such  pretended discoveries had failed.  To  be a party to such public
failure,  was to invite an imputation  of lack of judgment; and although
this novelty presented  peculiar and unequivocal evidence, and  possessed
an  intrinsic worth which need have  regarded  no opposition, yet  a  spirit
of liberality and of discernment is to be recognized in the attitude of Dr.
Warren, who assumed  the responsibility of failure, and of the danger that
might well seem possible lo one who had not witnessed the previous ex-
periments.   Ether has not always  met with equal consideration.
   The operation of that  day was incomplete in  its results, for reasons
to  be hereafter indicated.   A  young  man offered signs  of sensibility,
during  and after a dissection  which  was  not  particularly  painful.
Some powerful drug already known,  or  even the imagination, might well
have been suspected of agency in the phenomena.
   On the  ensuing  day, a woman offered herself with a tumor of con-
siderable magnitude in the right shoulder.  A few minutes of the most com-
 plete and passive  insensibility served for its extirpation.  No imagination
 was here to be accused.   The drooping  lid, the  head  fallen on  the 
Ether and  Chloroform.
7
shoulder, the stolid  relaxation of the mouth, suggested no overworking
of the intellect, no rapt unconsciousness, nor inspired ecstasy.  The phe-
nomena were real, familiar to daily experience ; they belonged  to the
pfofoundest  sleep.    This operation of  Dr.  Hayward,  first  showed
conclusively  the  power  of  the  new  agent  in  averting  the   terrors
of the surgical art.   The  casual spectator would  have remarked  no ex-
pression  of wonder  nor unusual excitement in the by-standers  at the
working  of this miracle.   Nothing to  awe or  startle, marred the tran-
quillity of  the operating-room.  Yet I think those present will  not soon
forget the  conviction of those few  moments, associated  at this  remote
day   with the breathless silence  of the  crowd,  and the unwonted fumes
of aromatics burned  to mask the emanations  from  the  yet  mysterious
agent.  Cognizant of these facts,  and having studied the  phenomena of
etherization in a number of successive experiments at the dental  estab-
lishment before alluded to, I  felt that there was no longer any hazard in
vouching for the efficacy of ether; and on the 3d of November, I read a me-
moir upon  the subject before the American Academy of Arts  and Scien-
ces.   The  case of Alice Mohan, whose limb was successfully amputat-
ed by Dr.  Hayward under  the new influence, occurring soon  after, I  in-
corporated  this confirmatory evidence into a second paper read before the
Medical Improvement Society of this city.  This paper, afterwards pub-
lished  in this Journal, was the  first  upon  the  subject, and was  that, I
believe, which carried the news to the South and across the Atlantic.
  It  has been well  said  that the first attitude of the world towards a
great  discovery is incredulity,  and  then  hostility ; and this was  well ex-
emplified in  the  reception of this  announcement at the  South.   Three
weeks elapsed before  any  notice of the subject appeared.   Then came
the doubts of those  sagacious and experienced philosophers  who were
not easily to be deceived.
  In  January, 1847,  a New York  Medical  Journal announced  that
"the  last special wonder has  already arrived at the natural  term of its
existence.   It has descended  to the bottom of that great abyss which has
already engulphed so many of its predecessor novelties, but which con-
tinues, alas, to gape  until  a  humbug yet  more prime shall  be  thrown
into it."
  The New Orleans Medical  Journal says, in  the same  month,  " That
the leading surgeons of Boston could be captivated  by  such an inven-
tion as this, excites our amazement."   " Why, mesmerism, which is repu-
diated by  the savans of Boston, has done  a thousand times  greater
wonders."
  A  leading medical periodical in Philadelphia,  says—" We  should 
8                     Ether and Chloroform.

not consider  it entitled  to  the least notice, but that we perceive, by a
Boston Journal, that  prominent members of the profession  have been
caught in its  meshes."   It  was  " fully persuaded  that  the surgeons
of Philadelphia would not be seduced  from the  high professional path
of duty, into  the quagmire of quackery, by this Will o'  the wisp."  What
the surgeons of  Philadelphia have considered the  "high professional
path of duty," up to a very recent date, I shall soon show.
   It is fair to state, that at the West, in Chicago, Buffalo, and St. Louis,
the discovery received candid consideration.
   The great show of dissatisfaction, emanating from those who were  not
contented to receive  tranquilly this great discovery, and to recognize it
as such, was directed  against the patent right  connected with its early
history ; but, so soon as the discovery received  the confirmation of Euro-
pean  testimony, it was providentially discovered that  the patent was
probably invalid, and hesitation and opposition rapidly  subsided, although
for some weeks the enthusiasm of periodical  medical literature was tem-
pered by  the character of the reports which readied  us from the other
side of the Atlantic.
   The article before alluded to was, I believe, the first published in the
European Journals.   The  discovery, then, rested  in  Europe upon  the
identical evidence  which  introduced it to  the medical community  for  this
side of the water, and it  is  interesting to observe what was the attitude
there assumed towards it.
   Upon the arrival of the steamer  of December  1st,  private  notices
were at once forwarded  to many of the eminent  surgeons in London,
who zealously investigated the subject.  Mr. Liston, who amputated a leg,
was, on  the  whole, successful.  Yet there, as elsewhere, doubtful cases
occurred.  A signal  failure happened  at Guy's Hospital.  Other cases
of incomplete success contributed to  place the subject upon doubtful
ground.   Notwithstanding these failures, the mere chance of producing
insensibility to pain once demonstrated, aroused an  inconceivable enthu-
siasm in the surgical world.  The English Journal which announced the
discovery, remarked,  in an editorial article, " The discovery seems to have a
remarkable perfection about  it; even  in  its  first promulgation."   " We
suppose we shall hear no more of mesmerism and  its  absurdities as  pre-
parations for  surgical operations."  And  of the paper alluded to and of
Liston's case, it says, " it is almost impossible to discredit the statements
conained in the communication referred to."   A similar tone was  held by
other leading Journals, experiments were instituted in all the leading hos-
pitals,  and new evidence daily arrived from the provincial towns.
   Information  was  conveyed to Paris, by a private letter,  in  the month 
Ether and  Chloroform.
9
of November,  1846.  The  incredulity of surgeons  prevented its early
adoption.  Velpeau " politely declined " to experiment upon it.   When,
however, in January, the accumulation of evidence arrived from England
and  America, a  new  interest was at once excited.  Experiments, the
majority of which had  previously been  failures, were  now instituted
with a  Boston  inhaling apparatus, which  soon arrived, and  before the
first of  February, the  two great  surgeons, Velpeau  and Roux, averred,
in the presence of the  two Academies, that the  discovery  " was a glo-
rious  conquest  for humanity."   The news rapidly spread  through  the
European cities, and over the civilized world.
  Once, and only once, out of the country of its birth, did  a  govern-
ment discountenance the discovery.
  In  this country, where no legal form hinders any individual from pur-
chasing a bottle of prussic acid for his own private consumption, such in-
terference excites comment;  but, when we remember that a court ad-
viser is quite likely to be some single philosopher who has become too wise
for innovation, an error of judgment emanating from such  a source is less
remarkable.
  In thus detailing the early narrative of the discovery I have endeavor-
ed to present the contemporaneous and accumulaing  evidence  of  experi-
ment, in order to show how far, at each  stage of its advancement, new
experiments were justified,  and  also  to exhibit in this relation, the  va-
rious  attitudes  of those who were to  be  the instruments of its progress.
And this is important.   At  various points in its history those who stood
between this agent of  mercy and the world, those whose duty it was to
deal  out to mankind  this  inestimable  blessing, have seen fit to refuse it
to the unhappy victims  of surgical art, and  have condemned them to
severe suffering which  might easily have been avoided.
  It 'would  be  illiberal  to impugn  the  motives  of those who occupy
this  position ;  nor do I  conceive  it  would  be  attempted by those
who know the  variety and complication of the secret agencies of  human
action.   Yet a wide  influence  is diffused  by many such, and it is im-
possible to calculate how far the mass of human misery may  be augment-
ed by such opinions joined to authority.
  However easy it may  be for  an individual, or body of individuals, to
promulgate what they  conceive to be  their  convictions, yet if there is  a
chance  of error in these convictions, and  if  that error tends considerably
to increase the  aggregate of human suffering, it will be readily conceded
that the world has a right to question how far such convictions  may  be
reasonable.  Fortunately for this purpose, human reason is identical in all. 
10
Ether and Chloroform.
 To establish how far etherization ought to be adopted by  the  world, let
 us re-examine the evidence in relation to its more obvious conclusions.
   Ether was said, in one instance, to have produced  insensibility.  In
 another experiment,  it made an individual unconscious of the drawing of
 a tooth.   Twenty or more experiments were immediately instituted, with
 nearly the same effects and no accidents.
   These were  certainly  novel and striking  circumstances.  They were
 calculated to arrest attention.  They presented  credentials which  had  a
 right to  be examined.  Ether had a right to  be  tried,  candidly and
 fairly, unless it  could be shown that its previous bad character forfeited
 all claim to further consideration.  What, then,  was its previous charac-
 ter ?   What is  the a priori evidence respecting the danger of ether on the
 one  hand, or its  narcotic  power on  the  other?  And, first, the dan-
 ger rests mainly upon the evidence of a few cases; the gentleman in Brande's
 Journal,  the druggist's maid  servant, and the  young man of  the Midland
 Medical  and Surgical Journal ;  to which may be added  the  experiments
 of Orfila  upon dogs, and Brodie upon Guinea pigs.
   I  put  against these cases  the hundreds of young men who had been
 for years harmlessly  exhilarated by ether; I add  to  these  well-known
 facts, the half hundred cases which  occurred in a few weeks after the
 discovery ;  and re-affirm  that, as far as danger goes, ether, before the end
 of 1846, had a right to be tested anew.   Analogy fortifies this ground.
 It points  to a state of dead drunkenness effected  through the air tubes, as
 corresponding to a similar state effected through  the stomach.  Patients
 dead  drunk had lost  their legs without  pain ; others  had instantaneously
 revived when alcohol was pumped out of their stomachs.  Why should
 not the lungs  become the recipient of the  inebriating agent, and  respi-
 ration  be the resuscitating stomach  pump  ?  This analogy, which still
 holds good, was  distinctly  alluded  to in  the original article upon the
 subject of ether inhalation.
  Many  people had  died  when alcohol was not thus  pumped  out of
 their stomach ;  and might they not well die  when the  atmosphere of a
 room   was  surcharged with  ether,  and they  asleep  in  it ?   If the
 argument from  analogy proves  anything, it  proves  that it is  no  more
 dangerous to be narcotized by  inhaling  ether, than to  be dead  drunk
 with  alcohol.   I hold, then, that at the time alluded  to, the  middle of
 November, 1846, neither analogy nor fact forbade the use of ether.
  At this  date, too, certain  doubters shook  their heads and  talked of
mesmerism.  Now there  was  something  in the  previous knowledge of
ether  which widely  separated it  from such  pretended agencies, whose 
Ether and Chloroform.
11
phenomena are opposed to our experience of the order of nature.   Ether
is  very different from mesmerism ; and I  think it must have  occurred to
any one who fairly investigated  the subject, that  it was  quite possible ,
and  even probable, that  what was  now  affirmed of twenty cases, was,
unlike mesmerism, likely to be true  from all  previous evidence.   A gen-
tleman  well  known  in  the  professional  and  scientific world,  hearing,
on the day of the first experiments, that inhalation had produced  insensi-
bility to pain, exclaimed, as conviction flashed upon him,  " I believe  it J
It can be  done !   Ether will  do it!"   Such discrimination is not to be
generally  looked for ; but such a fact tends to show that previous evidence
led towards ether, and not from  it.
   Mesmerism, in spite  of the  bad odor of repeated failure and  de-
ception, has not unfrequently obtained  a  candid hearing; and this  cir-
cumstance singularly contrasts with the  philosophy that  refused to  give
ether an impartial  hearing, even after it was invested with the accumulated
evidence  of experience.
   A  hundred  promiscuous  cases rapidly occurred ; often in  the face of
hundreds of spectators, not one of whom attributed the results  to deception
or imagination.  Many of these cases  were detailed in papers published
by Drs. Warren,  Hayward,  Peirson,  Townsend, J.'M. Warren, Park-
man, and  many others,  of equal credibility.    The mass of evidence
swelled as  it  rolled  onward,  month  after month,  to  every   part  of
this country and  of the  civilized world; and yet in  November, 1847,
more than a year  after the discovery, we find it stated, that, in one of the
largest hospitals in North America, ether  " had not been tried at  all."
   For the sake of humanity, if not  of  science, it is to  be hoped that no
hospital gates are  barred against ether,  at this late day.
   How different  was  the attitude  of the London surgeons, who, only
eight weeks after the first discovery, and with  far less  evidence than lay
at the disposal of any one on this side of the water, hailed the American dis-
covery with generous enthusiasm.   The  gentleman  to whom the com-
munication above alluded to was sent, was kind enough to return to me
the replies received  from some  of  the leading medical men.  Thomas
Bell  writes, " I  fully intend to try it  the first opportunity.  The cases
are  very  satisfactory, and  the  whole affair most  important."   Liston
says, December  21, "I tried the ether  inhalation  to-day, with  perfect
and satisfactory results ;"  and at once  writes,  " It is  a very  great matter
to be able thus  to  destroy  sensibility to  such an extent without appa-
rently a bad result.   It is a fine thing  for operating surgeons, and 1 beg to
thank you most sincerely for the early information you were so kind as to 
12
Ether and  Chloroform.
give me of it."   Of Liston's  case  of amputation, which is usually sup-
posed to have carried with it extraordinary conviction, Sir James Clarke
says,  " The man  said that he felt something was  doing with his  leg,
but it was not pain."   Yet he does not hesitate to avow, that " it is really
a marvellous  thing."  December  17, Richard Bright, in  spite  of infor-
mation from Guy's Hospital that  " they had completely failed to produce
the desired state of intoxication, apologetically writes,  " However, there
must  have been some  want  of  skill  in  this first  attempt,  and I  can
scarcely doubt  that  future experience will  lead  to   better  success."
Lastly, Dr. Forbes adds  to the American  communications Liston's case,
and writes, " I have sent copies of  the  enclosed  to  all the newspapers,
so that I hope all the world will soon  have the great  news."
   Here was the effect of evidence upon  the  scientific mind  of Europe.
Now it is unquestionably  very respectable to  doubt.   The world may not
question the judgment  of those who  suspend  their  judgment.    Yet
there  are times when doubt is sophistry, and  indecision culpable.   Rich-
ard Bright did not delay  to forward  the news to  Guy's Hospital,  " that
no  time  might be lost in affording  so  great  a relief to any who might
be  in  the unfortunate condition  of being obliged to  undergo a serious
operation."
   Ought not the motive of relieving human pain to induce the appointed
officers of public  charities to ask what is  the nature  of this anodyne,
in  whose behalf united  nations  rise to  testify?   Is  it  supposed that
one of these gentlemen would lose his own  arm without invoking ether ?
Shall  none remonstrate, when those who are appointed to alleviate human
suffering in  administering the  accumulated charities of years,  virtually
avow, that, having  tried  no experiments,  and comparatively ignorant  of
the subject, they consider that  the decision of mankind is wrong ; and,
acting upon  this  avowal,  they condemn, not themselves, nor yet the
reasoning community who resist their influence, but their helpless hospital
patients, to the horrors of the knife !
   If these consequences  were limited to the sphere of  a few institutions,
the public would  have  a proportionally limited interest in the  subject;
but the wide-spread influence which such institutions  exercise upon  their
own section of the country, and upon the large community of which they
are the scientific centre, as well as  the indirect influence they may have ex-
ercised upon  governments, render it imperative at least to exhibit the ac-
tual value of  the influence they choose to  exert. 
Ether and Chloroform.
13
   Equally futile were the objections to the new and patent method upon
the ground  of quackery and professional etiquette.  Such considerations
should fall before a question of this magnitude; and as to  the fact, pro-
fessional custom does not sanction such  objections.
   A  few words upon  the patent  may not be here inappropriate.  Dis-
coverers  in art tax  the world for a pecuniary equivalent.   In the higher
atmosphere  of science, which  deals with abstract  truth, it  is not easy,
nor is it usual, thus to  extort a value for any  application growing out of
discovery.  It is well that a line  should  be drawn between  discoveries
in pure science, which enlarge the sphere of the intellect and the bounda-
ries of permanent knowledge, between such discovery, and the transitory
and  less disinterested labors directed to the amelioration of a narrower
circle and a briefer term.
   It does not harmonize with our  better impulses, that a great invention
in the art of relieving human suffering should be in any way conditional.
I  believe that  nations would   have emulated each other  in  meeting
any liability generously abandoned  to them as a debt of honor.   Yet it
should  be remembered  that the  question  of  patent is very insignificant
compared with the discovery itself, or  the  gratitude due to it.   Besides
which, secrets  are common, and  perhaps justly  so,  in  the  profession
with which  this discovery had  an intimate connection in its early history,
and a patent there is not a subject of comment.
   Some  of the Journals seem  to have been indignant at  the  announce-
ment of  this  patent by a regular  physician.   I  investigated  and pub-
lished some of the first experiments, by the  permission of those  concerned
in making them, and announced the patent with its extenuating circum-
stances, at their stipulation.  That the patent was an error of judgment
as well as a violation of custom, I had no doubt;  I vainly endeavored, as
far as my very humble influence might weigh, to prevent  the  final mea-
sures for  procuring it.  I  even urged an appeal to interest; the force of
which has been  fully verified in this case;  viz., that when  the burden of
sustaining his position  falls on  the patentee, and  not upon the violator
of the patent, nor upon the governmenfwho grants it, an invention may
be so valuable as to be worthless to  the patentee >in a pecuniary point of
view.   In other words, the encroachment of the multitude  may become
too formidable for the resistance of an individual.
   Finding such  expostulation  of no avail, and as an humble  instrun ent
in the announcement of a great discovery, I did, what I should be most
ready to do every week, if by  so doing, I were able to accelerate, even
by a few  days only, the ability of the world  to relieve human suffering.
Those who  were  most indignant  at  the  patent, seem  to have been
               2 
14
Ether and Chloroform.
 slowest to grant ether to  their patients.  A fear of "quackery" was in-
 strumental in  persuading Congress to withhold the agency of ether, when
 it might assuage the agony of the wounded  soldier.   Let us  hope that
 such  nice discriminators have no more  to lay  to their consciences,  than  a
 violation of professional etiquette, like that of announcing and using a pa-
 tent right, by which a man is lulled to slumber while his leg is amputated.
   A  want of  ability has  been  displayed in  confounding the questions of
 ether patent and  ether inhalation.   Those  who  have  declaimed against
 the  ether  patent,  upon   this side  of the  Atlantic, have found it  very
 difficult to give a candid hearing to the  separate  question of ether insen-
 sibility.   But it was not so abroad.   In England, scientific discrimination
 far outweighed any discreditable feeling of prejudice  or jealousy.   The
 very  unimportant  question of patent was soon at rest.  This error  of
 custom or of taste  was forgotten; and  the  united scientific world aban-
 doned themselves  to a determination of the  real value of the discovery.
 No opportunity for experiment was lost;  no evidence rejected.   The
 whole medical community gave themselves to the work, and in a short
 time  most honorably avowed that  the discovery  of etherization was not
 second to the  discovery of their own Jenner.   Let us believe that in the
 country of its birth, prejudice against ether inhalation  will now yield to
 a  recognition of its value.

   An impartial consideration of the question—" Who  was the discoverer
 of ether  insensibility lo  the pain  of surgical operations?"  will  be best
 attained by a  previous consideration of the abstract question of discovery ;
 reserving for its conclusion, a special application of the principles illustrated
 by it, to this special subject.
   Why was the discovery not made before ?   Why did no one discern the
 value of the exhilarating agent which had attracted the attention of so many ?
   Because the human mind is fettered by  long  custom.  It runs in the
 channels of routine.   First diverted from its course by some little obstacle
 its current swells and deepens, bearing  down solid opposition that it may
 roll tranquilly  in its distorted bed.   Watch  the tide of human footsteps,
 guided by the mind of successive generations.   The pathway turns here
 and there to avoid some  little inequality, and  the old man and  the child
follow the winding  track.   Mind follows  where  mind  has been.   Few
turn aside to analyze  the  difficulties which discouraged others.  That a
thing  has not been, is to most men, perhaps justly, a reason why it will not
be; and here is  the  office  of philosophic  incredulity which  doubts the
track  of custom.
   It  is quite  obvious that such incredulity may emanate  from  widely 
Ether and Chloroform.
15
differing sources.  It often grows out of depth and originality of intellect;
of capacity which takes a wide and  general  view, discovering imperfec-
tion in mode or in material.
   On the other hand, as he who is  ignorant of a path may make the
shortest route from  point  to  point, so one  who  is not  familiar with the
erroneous conclusions of previous knowledge, may first trace a true result.
In such  a  case, ignorance of error  is an   accidental  vantage  ground,
which places its  man  considerably  nearer truth, than that  occupied by
prejudice based upon error.
   I hold that such incredulity, whether of knowledge or of  ignorance,  is
likely to indicate a philosophic mind.   It proposes to think for itself.  Its
experience  of  the  world  has shown it  that the world may be wrong.
Its experience  of its own abilities  has taught it  to  respect itself.   For
example, Whitney was said to form  his decisions, not after the model of
common opinion, but by his own nicely-balanced judgment.   Perhaps in
some details, humble though they be, such  a miud has seen  the defect of
others' judgment, and has had cause to prefer its own results; and, thus
instructed,  turns to a new subject, determined to win its own experience,
to make its own investigation.
   Such  incredulity,  brought to bear  upon an  extended system, espe-
cially in  the inexact sciences, is justly viewed with suspicion ; and the re-
former in politics, in the social  system, or  in medical science, meets no
enthusiastic greeting. A little zeal, with a little error of premises or of rea-
soning,  may then make the reformer dangerous.   Here, the experimentum
cruris cannot easily be  tried, either from the number of elements in the
problem, from the length of time required, or from the magnitude of
interests at stake ; and  the world therefore very justly maintains a degree
of conservatism and immobility, in its moral, social and political relations.
   In the exact physical sciences, the tenets of a  reformer may be easily
tested.   Here  the logician easily supplies himself with facts.  The r e
suit of single  and  brief experiments  made  at will,  can admit  of little
doubt.   Even  in the  obscurer  parts of medicine, where  the  material
and immaterial influences are  numerous and sometimes  inappreciabl
every honest  and  logical mind  must,  upon   points  of  importance,
arrive at one and the same result.  No danger can result from incredulity
in  medical  science.  On  the contrary,  in  view  of the  errors of fact
which grow out of want of time or qualification on the part of observers,
or the intrinsic  difficulties of the science,  a healthy and vigilant skep-
ticism of recorded  facts, whether in  diagnosis or in  therapeutics, is
of the essential methods of its advancement, 
16
Ether and Chloroform.
   It is quite obvious that such incredulity—such distrust of recognized au-
 thority, occupies a merely  negative position.  It is a quality which adapts
 its possessor for the reception of new light, from which the act of inven-
 tion may emanate.  But that such  act  should in reality occur, certain
 active  faculties are requisite.   Positive inventive talent is required ; the
 nature of which  I shall attempt to show.  But let  it  be  remembered
 that there  is  a  partial substitute for talent.   It has  been  said that  the
 difference between men lies more in their power of application, than  in this
 quality.  Great application, resulting from strong stimulus, will be readily
 allowed to  bring  about results,  much like those of talent.  At any  rate,
 it is more nearly allied  to  the untiring  zeal  and stern energy which re-
 cognizes no obstruction to its march.  It is well known that this unyield-
 ing  perseverance  has  characterized a  large  proportion of inventors;  it
 has  animated them in failure, and nerved  them  through  adversity.  Of
 Whitney, whose cotton gin, even fifteen  years ago, was said to be demon-
 strably worth  100,000,000 dollars to the United States, it was said, " of
 all my  experience in the thorny profession of the  law, I  never saw a
 case of such  perseverance, under  such persecution.   Even now,  after
 thirty years, my head aches, to recollect his narratives of new  trials, fresh
 disappointment and accumulated wrongs."  Fulton's energy was marvel-
 lous.   His experimental boat was completed after inconceivable difficul-
 ties in  the spring of 1803, when a messenger announced that  the  " boat
 had broken in pieces and gone to the bottom."   After  a momentary des-
 pondency, which till  then  he had never felt,  and  without returning  to
 his lodging, without rest or  refreshment, he labored with his own hands to
 raise her, during twenty-four hours incessantly.   To this  imprudence he
 attributed much of his  subsequent bad health.   The boat  was almost en-
 tirely re-built, and  was  again completed in July.  I take Fulton, Whitney
 and Arkwright as types of the  mechanical inventor.   They possessed,
 in an eminent degree, the inventive talent,  but  this did not predominate i
 over determination and  perseverance, as  not unfrequently  happens when
 such talent  is  exaggerated.  Of Whitney's  power  of invention, it was
 said, "it never ran wild ; it accomplished, without exception, all that he
 ever asked of it,  and no more.   I emphasize this  last expression, from
having  in mind the case of a man, whose inventive power appeared  to
be more fertile even than  Whitney's,  but  he  had  it  under  no control.
 When  he had imagined and  half executed  one fine thing, he  darted off
to another; and  he perfected nothing.  Whitney  perfected  all he  at-
 tempted."
   Such energy, vital  to the existence  of most  discoveries,  may grow 
Ether and Chloroform.
17
out of either the inventor's sense of the necessity, or his conviction of the
possibility of reaching his object.  And  the last is another  agent,  mys-
terious to many, which is allied to the incredulity before alluded to, and
which eminently  characterizes  the  inventor's mind.  It may be defined
as a belief in the  possibility, or certainty, of producing a result  attained
by  the  more  active perception  and reflection of  the inventor's mind, by
a series of processes  which  he may  be, and often is, totally unable to
impart.   He is often, in consequence, considered  as unsound or unwise;
for  as far as the  subject  in  hand is concerned, the inventor is  actually
ahead of  the  world.   His faculties  may  not be recognized  as stronger,
his  character more forcible, his intellectual  range broader, nor his know-
ledge of experience greater,  than those of other men.   Yet  for  the nar-
row point at issue, he  is  more  competent than any other.   His percep-
tions  are stimulated and  brought to a focus ; and  his energy is hot.   He
may actually become a better  instrument for a special purpose, than an-
other whose intellectual mechanism  is far  more complicated.  Franklin,
in an essay before the American Philosophical Society, gave  a  drawing
of a water-wheel,  accompanied  by a demonstration,  conclusive as he sup-
posed, that  such wheels could  not  he used  to  advantage in  propelling
steamboats.  He  proposed a jet from the  stern.  Fulton  proved that
among all methods proposed, the jet was  the worst, and  the wheel the
best.   Fulton was right,  and not Franklin.
   The  power of remodelling old  forms, of abbreviating method, of de-
vising and  economizing  force  for  the passage of  trodden or untrodden
paths, appears  to  me essentially the same in most of the vocations of the
human  mind.   Superadded  to  it, may be a  taste  or a talent  for the  com-
binations of mechanical  or other force, or for the complicated  details of
number and of space, or for  any other of the fields of science.   But how
often  is a mind simultaneously given  to various inventive fields ;  exhibiting
its powers in various directions, and intuitively recognized and stigmatized
by  the world as having a genius which incapacitates it for the daily rou-
tine of life.  And  how many, like Newton or Franklin, who added the ele-
ment of perseverance to this  genius, have been distinguished  for a versa-
tility of talent, manifesting itself each year in a new field, and exhibiting
in each its peculiar trait.   Franklin was a reformer; Fulton  a warm ad-
vocate of the principles of free trade;  while  Whitney, in his college  com-
positions and  in  the  words  of  his biographer, " with a spirit somewhat
prophetical, anticipated the decline and overthrow  of all arbitrary govern-
ments, and the substitution in their  place of a purely representative sys-
tem like our own."
               2* 
18
Ether and Chloroform.
  The inventor invents or devises the means to attain his ends.  He is,
therefore, most  likely, other things being  equal, to be a  discoverer, be-
cause he will best devise the instruments, material or abstract, to cross-ex-
amine nature, and discover abstract truth.   Yet it often happens  that an
inventive talent confines itself to the  exposition  of mechanical truths of
limited application ; not demonstrating large and  suggestive laws in sci-
ence, but settling limited questions of expediency  in art; or making com-
binations, as Newton did his watch, for the intellectual pleasure of it.
  Such mechanical talent as that of Fulton  and Whitney, and  hosts
of others, whose names are or are not attached  to great  inventions and
discoveries, is not the less  because it remained  circumscribed by the field
of mechanical force, to which it first addressed itself.  The modifications of
mechanical force do in fact  afford an  ample field  to such intellect.   But
give opportunity to such men as Fulton, or to a thousand nameless artizans,
whose talent is  valued at  more  than gold by those who  convert such
knowledge into money ; find some way of delecting this humble genius
and  give to it the opportunity for education in science  and unmerchanta-
ble truth, which may take the place of natural  strong  taste for it, and the
combination of the  inventive talent with the scientific  knowledge, would
yield the true philosopher.  Newton  built a watch, and, having a rare
genius for arithmetic computation, discovered the law of gravitation.
  It is difficult  to over-estimate this talent for  expedients and  resources.
What is American ingenuity ?  It is this  great talent seeking  a field  in
mechanical combinations in  a country where  opportunities  for scientific
knowledge have been hitherto  comparatively rare.   The  elements  of
American  ingenuity constitute the perception, the discrimination,  and the
resources of the American  people.
  The true power of originating, wherever  manifested, is the combined
result of  a  power  of analysis  and a  power   of  combination ; the
former enabling the inventor to  discover the  differences  between the
elements of existing combinations, to  detect the  influence  of each, and
to reject the useless, while the latter perceives  the relations of  new  ele-
ments to the  problem, and invokes their agency in the  new combinations.
The intellectual philosopher may justly  recognize in these faculties, the
agency both of  powerful judgment and of the imaginative quality ;  both
brought to bear upon a range of subjects with which their  possessor is
familiar.
  It has been conceded that this talent is peculiar ; often an uncultivated
gift,  brought  to  bear upon some narrow range of material, by those whose
general knowledge does not testify to their industry or opportunities, or 
Ether and Chloroform.
19
whose intellectual calibre and general range, does not at all comport with
this local development of talent in the direction to which  taste has guid-
ed  it.
   On the other hand, many discoveries, important to the world, owe little
to this peculiar talent.  They depend upon a fortunate or accidental suc-
cession of events, encircling a comparatively moderate ability ;  and then
the magnitude of the invention may be much out of  proportion to  the
degree of the inventive faculty.   The invention of printing, perhaps  the
greatest in the scale of social importance, was but a division of the Ro-
man printing block.  Gun-powder, which happens to abbreviate warfare,
was an unpremeditated  invention.   The discovery of Jenner has  been
attributed—1, to  his talents; 2,  to  his education under  Hunter; 3, to
his situation in the vale of Gloucestershire.
   I would not abate  a leaf of the laurel to which the  discoverer has an
undisputed right;  and 1 shall presently indicate another quality, different
from the  inventive talent, which ranks high in intellect, and often compen-
sates a discoverer  for  this talent.   I wish  here  to  show that a discovery
of great practical  importance may result in part from good fortune; from
the first occupation of a ground;  from perseverance in a particular direc-
tion, or from some other  adventitious circumstance;  that its magnitude
and importance may  be out of proportion to the character of the intel-
lectual processes invested in it; and that it has happened that a discovery
of immense practical  importance to the human race, with good fortune to
aid  it, has involved but an inconsiderable intellectual pang in its creation ;
and in  consequence, that  any a priori reasoning upon the mode of its
creation, has very little connection with what may well be a question of
pure fact.
  Having thus considered the intellectual qualities  concerned in  the  in-
vention, I pass to  the progress of  the invention itself, and to a considera-
tion of its successive  steps.  These consist, first, of the suggestion;  and,
second, of the generalization.
  Perhaps  the  most fertile source of error  in  the history of invention,
grows  out of a  misappreciation of these two stages of discovery.  Yet
they can  be  shown to differ widely, both in their character, and  in  the
credit they deserve.
  There  can be no doubt  that  unless invention be a result of pure acci-
dent, suggestion always  precedes  it.   It has been often  distinctly record-
ed, in connection with the greater inventions  and  discoveries.  Thus  the
vertical spindles of an overturned  spinning wheel, suggested the jenney
to Hargreaves.   Iron rolling suggested the drawing of cotton by rollers to 
20
Ether and  Chloroform.
 Arkwright, who thus re-invented the machine (ignorant of Wyatt's pre-
 vious invention) ; the valves of Fabricius, the circulation  of the blood ;
 and so on.
    In  such cases the inventor or discoverer abstracted from the individual
 instance, some inherent element, the applicability of which tootherinstanc.es,
 he alone saw.  Hargreaves saw the value of a vertical position to spindles ;
 Newton, of the force which  attracted  the  apple; Harvey,  of the  idea
 that venous blood could  run in only  one direction ;  and they generalized
 this element in  re-applying it.
    It does not modify the truth  of this proposition, that the  first sugges-
 tion  or experiment should yield  a new result;  that  instead of a  falling
 apple, it  should be the contraction of a frog's leg, or an unpremeditated
 pustule on the hand of a Gloucestershire  milkmaid.   Such facts were
 still suggestions and  not discoveries ;  and were  new only in  the aspect
 they  received from the mind whose key-note they  struck ; new  because
 attention  was  then  first drawn to them in a new relation, and not  new
 in their actual  occurrence.
   And the suggestion varies in its  suggestive power, both from its own
 character and from that  of the  mind  it works  upon.  The  apple fell,
 and Newton alone abstracted a principle in behalf of the moon.   Horace
 Wells says, and I believe first—" Reasoning from  analogy, I was led to
 believe that surgical operations might be performed without  pain, by the
 fact that an  individual, when much excited  from  ordinary causes, may
 receive severe wounds without manifesting the least  pain ; as, for instance,
 the man who is  engaged in combat may have a limb severed from his body,
 after which he  testifies that  it  was  attended with no pain  at  the time.
 And  so the man who  is intoxicated with spirituous liquor, may be treat-
 ed severely without his  manifesting  pain. *  * *  By these facts I w as
 led to inquire if the same result would not follow, by the  inhalation of
 some exhilarating gas."   And it is well known that he tried the experi-
 ment, with various results, upon himself and others, in November, 1844.
 And yet the philosopher Seneca  makes  the remarkable observation—
 " That which  presses hard upon you, and is very urgent, if  you begin
to withdraw yourself, will certainly pursue you and fall heavier.  If, on
the  contrary, you stand  your ground and seem resolved upon opposition
you will drive it from you.  How many strokes do  boxers receive on
 the  face and whole body !   Yet a thirst of glory makes them regardless
ol pain.                                                      °
  To Seneca it  suggested nothing; but to Wells, a principle.
  A suggestion derived from one or two instances, becomes an invention 
Ether and Chloroform.
21
 only when  its important element is abstracted and  actually re-applied;
 and it will  be soon seen  that  the  abstraction itself, the supposition, the
 theory, without this actual re-application, amounts to nothing; and that for
 every actual  and successful  re-application of a newly-appreciated  phe-
 nomenon,  there  have  been  innumerable  claims  from  those  who sus-
 pected  that such  re-application  might be  made,  but did not actually
 make it; who mistook a single truth for  a  universal  truth ; suspicion for
 certainty ; theory for fact.
   It will  be found, by  reference to the histories of discoveries, that the
 suggestion and generalization have occurred almost invariably in the ex-
 perience of one  and the  same individual.   Though  it is quite possible
 to conceive that while the suggestion occurred to one individual, he might
 transfer it for generalization  to another individual,  yet I am unable to
 find any instance  in  which this has occurred.   On the contrary, the sus-
 picion, the  groundwork of the hypothesis, has  generally stimulated and
 goaded the possessor, until he was able to  convert it into fact.  The sus-
 picion has been then established ; or, much more frequently, has not been
 established.   It has proved erroneous ; hope has not been realized, and the
 discovery has  turned out to  be no discovery.   Watt,  whose name is
 identified  with the history of steam, and the  soundness of whose practi-
 cal views no one will dispute, speaks of "  the  cast of a die.   For,"  says
 he,  " in that  light I look upon  every  project  that has not received the
 sanction of  repeated success."
   This transfer of a suggestion, a theory,  unconfirmed by fact, or relying
 upon one or two facts alone, is, as  I have said, quite possible.   It would
 then  have  the character of  a  ticket  in a lottery which should be thus
 transferred,  with which the recipient  may draw a prize, but which is far
 more likely  to turn up a blank.
   But especially in great discoveries, the theory has  not been thus made
over to a second party.   The perceptions  of the inventor, keen upon
this point, have enabled him to  discern its  value, and he has allowed him-
 self no rest, no interval, in the  steady prosecution of his task.
   I  have  alluded to  a  second  quality  which  contributes to discovery.
The inventive  talent lies  at one end  of the  intellectual vibrations.   At
the other  extreme is  a  high  quality which  elaborates another element;
while the invention itself is the  electric flash which results from  the con-
tact of the two.
   Here let me do ample  justice to  the  mind  of Jenner, which I do not
find  to have been especially characterized, in  his  biography, by the  in-
ventive genius.  It did  possess,  as an equivalent, the power of appreciat- 
22
Ether and  Chloroform.
 trig the importance of a discovery;  and  it was  in  this power and in
 the perseverance that resulted from it,  and  indicated it, that I recognize
 his  chief merit.  Jenner comprehended that vaccination would conside-
 rably prolong the average  of human  existence.   A breadth of view, a
 simultaneous consideration of many circumstances, with ability to reason
 justly upon them ;  in short, a very clear conception of the whole subject,
 could alone afford the notion of importance or necessity which was to become
 the stimulus  and proximate cause of the discovery.   Few minds are
 capable of becoming so  imbued with  the importance  of a merely pos-
 sible result, as to permit it to divert  the current of daily life.  Such men
 are  pointed at as having one idea; their wisdom is questioned ; they are
 the  butt of ridicule.  And  when  the  result demonstrates the accuracy
 of their convictions, we may fairly bow at once  to  their discernment and
 understanding, whether it  detected a  possibility, or comprehended a ne-
 cessity  which others overlooked.
   At this point let us pause to make a distinction of cardinal importance.
 We have hitherto considered the qualities  of the  inventor's mind, and the
 successive steps  of the  process by which  it accomplishes its  end.   An-
 other element  now complicates the problem.   The invention  is  to go
 forth to the world ;  and to establish certain  relations between the world
 and the discoverer.
   Up to  this point it is  quite obvious  that an  invention may be made,
 that it may grow from an original hint into a theory, which  again   may
 be confirmed beyond a doubt,  by  the  test »f repeated experiment, and
 yet that the whole process  may be  confined to the inventor's mind ; to
 his own cognizance.   So long as he thus retains  it for his own benefit or
 for that  of  a few friends, does the world stand in his debt ?  Clearly not.
 The demonstration  of the world  to an  inventor is a demonstration of
 gratitude and  honor—gratitude for the donation of a great invention,
 honor to intellectual  ability.   To the latter  it is conceded in  the case of
 certain astronomical discoveries, for example, not immediately concerned
 in the direct welfare of mankind ;  but the  product of vast and  recognized
 intellectual power.
  But when a  discovery becomes  great,  not from  the character of the
intellect invested in it, but from its immediate applicability to the ameliora-
 tion  of  the condition of humanity, then  the gratitude and honor con-
 ceded by the world is a mere equivalent for  value received.   The world
 will  not concede this gratitude until they have received  the value.   They
 will  only concede it to  the  source through which  they  receive it, and
 they will examine very closely the claims of those who  may claim to
 have acted as agents in the matter. 
Ether and Chloroform.
23
   To investigate this last position further—The world is to bestow a lan*e
reward in honor and in gratitude, but  requires indisputable evidence of
merit on the part of the recipient.   It is prejudiced against ex post facto
claims ;  because it naturally argues, first, that one  who  had made the
invention and appreciated  it, would in anticipation of this honor, o-rateful
to all men, have published his invention  when  he made it; and secondly,
that although  such expost facto claimant be a real inventor, yet he is so
only in relation  to himself or those with  whom he has communicated  ;
and as  he either could  not, or  did not,  make the world at large feel the
full value of it,  so they owe him nothing.  Such is ample reason for the
world's prejudice against such  claims.
   This suspicion of inventors who do not  appear  until after  the  world
has been made to recognize a discovery, is also  justified by the  remark-
able fact that hardly an invention of importance was ever  made known,
that it was not at once claimed; often  simultaneously  from a variety of
sources.   It  is perfectly natural that it should  be thus  claimed.  The
world, whether  in science or in  art, is  built up to a certain  point, by the
easy and wide transmission of knowledge, and upon this  elevation  stand
a  multitude of  philosophers, engaged, often, in identical  researches, and
who will be possessed of much  information upon the  subject to  which a
discoverer first gives  utterance.  The world  is  then liable for a  short
time to confound their claims, to confuse the perfect  with the imperfect
knowledge;  the incomplete result of few facts with the complete demon-
stration from  many;  the unproved with the  indisputable;  theory with
fact.   But the law of the land has left no doubt upon this point.   Before
ceding a patent, it first identifies a discoverer.   Here is an  opinion  from
the clear head of Judge Story.  " He is the first inventor in the sense of
the act, and entitled to a patent for his invention, who has first perfected
and adapted the same to use; and until it is so perfected and  adapted to
use, it is not patentable.  An imperfect and incomplete invention, resting
in mere theory or in intellectual notion, or in uncertain  experiments, and
not actually reduced to practice, is not and cannot be  patentable  under
our patent acts.   In a race of diligence between two independent inven-
tors, he who first reduces his invention  to a fixed, positive and practical
form, would seem to be entitled to  a priority of right to a patent therefor."
   And the actual history of discovery and invention  is conclusive  upon
these points.   The world, if it has doubted  awhile,  has  always  been
right  in  the  end.   The man who has first generalized  the proposition,
and first made  the world allow  that it was thus generalized, has been the
inventor.
   About 1750  one Sultzer published an  account of the peculiar taste, 
£4                    Ether and Chloroform.
arising from the contact of bits  of silver  and of lead with  the tongue.
Forty years after, Galvani  brought metals in contact with a frog s  leg.
In each case a hint  was  received ;  Sultzer  published it, but the  worlt, .
were not impressed with its importance.   Galvani pursued the  hint with
numerous experiments ; demonstrated that the phenomena resulted from a
new modification of abstract force;  compelled the world to recognize it,
and was  the discoverer.
  The young countrywoman at Sodbury said of smallpox, I cannot  take
that diseaseffor I have had cowpox!—The Duchess of Cleveland said
she had no fear about her beauty, for she had had a disorder which would
prevent her from ever catching the small-pox.   Were these discoverers ?
No.  They furnished the isolated hint, and made no farther experiments.
Jenner, with infinite  energy and perseverance, through many successive
years, in spite of ridicule, at last proved, not that cowpox might  protect
the system, but that it always would thus protect it, and that it was safe.
He generalized the single fact, and was a discoverer.
   Many experimenters raised their voice to say that they, too, had wiped
up acids with a towel which had  then  burned like powder.  Schonbein
was the first to make the world allow  that  cotton, treated  by  a  certain
process,  always would thus burn.
   The Abbe Nollet suspected the identity of the electric fluid  and of
lightning, and experiments were made in France.  Franklin, braving the
ridicule of failure, flew his kite, and by this and  subsequent experiments
with a lio-htning rod, he proved that the electric fluid was  thus  identical.
   Adams made a calculation with regard to the existence of a new plan-
et, and could not or did not compel  the world, through  the astronomer
royal, to listen  to him.   Leverrier  calculated a  result,  compelled the
world to recognize its intrinsic  greatness, and the  magnitude of his  own
mathematical power,  and was  the discoverer.
   Jonathan Hull, the Abbe Arnal, the Earl of Stanhope, Franklin, and
others, proposed to  propel boats by steam.  They tried it, and failed to
 persuade the world of the expediency or value  of  the  method.   Long
after, Fulton, impressed with  the  immense importance of the  subject,
 made a series of experiments and  calculations, discerned  the  cause
 of previous failures,  persevered through inconceivable difficulties, and in
 the face of ridicule he felt but did not yield to, demonstrated  a proposi-
 tion ; not that steam, a long recognized power, might be made  to move a
 boat, but that it could do so efficiently and profitably.  He first  compelled
 the world to  recognize  this  great  fact, and was the discoverer  of this
 abstract truth, and the inventor of a profitable steamboat.
    A hundred  other  instances might  be  cited  to show that the  man, to 
Ether and  Chloroform.
25
 whom the original hint occurs, is not the inventor;  nor yet he who forms
 a theory upon this hint; nor even he who publishes this theory, if he does
 not convince other people of its truth.  This last may readily occur. A man
 may  happen  upon a fortunate theory, and yet not appreciate its  value;
 so he gives  himself no trouble  to proclaim it; or perhaps his proofs  are
 not conclusive,  and  the  world  will  not believe.   Goethe  knew  this
 when he said, " many things may  be  discovered  and  made  known for a
 long  time without producing any effect on  the world, or  the  effect may
 be wrought without its being observed ;  wrought and yet not take hold of
 the multitude.   This is the reason why  the  history  of inventions is so
 surrounded with strange riddles."
   He is the inventor who generalizes the single instance, and who  makes
 the world concede that it  is  thus generalized.
   Now, if there is any one point which has identified the true inventor's
 mind, it has  been an invincible  determination to compel the world  to
 recognize the reality and value of its  invention.  The inventor  saw it
 himself when other men could not, and  he determined that  other men
 should  see it, and he accomplished  his determination.   " He," Sidney
 Smith says, in the Edinburgh Review, " is  not the inventor who first says
 the thing, but he who says it so long, loud and clearly, that he  compels
 mankind to hear him."
   Recognize this  point,  and the question  of invention is comparatively
 simple.   Yet it  is not  recognized.  There is no  abatement of claims to
 previous invention.  The writer of a  Life of Fulton well says—" Those
 who question Mr. Fulton's claim are precisely those who have been utterly
 unsuccessful  in  their own attempts;  and it would seem that  exactly in
 proportion as  their efforts were abortive, and  as  they  had thrown  away
 money in fruitless  experiments, their claims rose in their own estimation,
 and  that of their  partizans."  And  the witness, I  believe before  the
 House of Commons, probably did not overstate the matter when he gave
it as his opinion, that if  a man were to show that  he had found a road to
the moon, his  neighbors would testify, that, if they had  not been  there
themselves, they  knew  several individuals who were familiar with the
 road in  question.
  The above considerations  have been  presented with the intention and
desire of exposing the authority of precedent with impartiality.  I have
wished that the reader should not lean to one or the other side of the ether
controversy, until all these considerations were presented.  It remains  to
show  their bearing upon the  gist  of the evidence contained in the  state-
            3 
26
Ether and  Chloroform.
ments which have been made in behalf of Dr. Jackson and of Dr. Morton.
The considerations alluded to bear upon four principal points.
   1. The character of the mind and education required for discovery.
   2. The suggestion of the discovery.
   3. The generalization of this suggestion.
   4. Its presentation to the world.
   1.__This community is familiar  with  the  great  scientific talent  and
attainment of Dr. Jackson.   Dr. Morton has acuteness, ingenuity, zeal,
and perseverance.  The discovery is not of a character to have demanded
extensive scientific acquirement, and it is probable that either Dr. Jackson
or Dr. Morton might have made it.
   2.—The suggestion occurred  to Davy, Jackson, Wells, Morton,  and
many others.  Horace Wells  seems to have  conceived this hypothesis
more distinctly than any other individual.  So persuaded was  he of its
probability, that  he made several experiments ; and even made a journey
to the Medical Class at  Boston, before  whom,  however, he entirely failed
to verify his theory.   He then abandoned it, until it  was confirmed  by
Dr. Morton.   Dr. Jackson fails to prove  that Dr. Morton was ignorant
of the hypothesis, until he suggested it to him, because Dr. Morton shows
by the evidence, that he was considering  the properties of ether,  at the
intervals both of three months, and of three days, before  his  interview
with Dr. Jackson.
   3.—I have shown that he who verifies the  suggestion is the real  dis-
coverer.  Dr. Morton,  according to the  evidence, did generalize  this
discovery.   He verified the suggestion, from whatever source it emanated.
He made and modified the experiments at his own discretion.  He assumed
the responsibility of danger.  He first conclusively demonstrated of ether__
1, that  it would always produce  insensibility to pain—2, that  it was
safe.   These two points constitute  the discovery.  Dr. Morton demon-
strated these points, and no one else did.
   To show that Dr. Morton was only a " nurse "—an  instrument of pre-
established knowledge—such knowledge  must  be proved to be  pre-
established.   It  is impossible  for human reason to infer, upon the experi-
ments put in evidence by Dr. Jackson, either that  ether was__1 universal
in its effects, or—2, that it was safe.   It must, therefore, be argued  that
this knowledge was not pre-established—that Dr. Morton was not a mere
administrator, but that he was an originator.
   4. Lastly—Many may have been the real discoverers of ether insensi-
bility to pain, and at a remote period.   But if so, they have kept it to
themselves ; and they will be known as discoverers only to themselves 
Ether and  Chloroform.
27
The world has always honored that individual among such  discoverers,
who presented  his discovery  to  them.  Dr. Morton was, according to
the evidence in print, both the prime mover and  the  immediate agent in
the introduction of this discovery to the world. 
 
          ANESTHETIC  AGENTS,

THEIR MODE  OF EXHIBITION AND PHYSIOLOGICAL EFFECTS.

        BY  HENRY  J.  BIGELOW,  M. D.

       [Extracted from the Transactions of the Am. Med. Ass., Vol. I.]
  There is no difference of importance in the general character of
the insensibility or other symptoms resulting from the inhalation of
ether and chloroform.   The latter, whose discovery in this relation
the world owes  to  Professor  Simpson, is much more potent than
ether, more palatable, and less irritating to the lungs.
  Chloric ether  was extensively employed by Mr.  Lawrence, and
has been since used by other experimenters.   Its effects  are appa-
rently identical with those of common ether, than which it is if any-
thing less powerful, while  its vapour may be a little less  irritating.
Its  odour is certainly more agreeable.
  Nitrous oxide was employed by Horace Wells in his experiments.
It was then found to produce exhilaration out of proportion to its
inebriating properties.   In order to  place this gas in circumstances
favourable for its complete effect, it should be furnished to the lungs
as freely and as pure,  as ether vapour from the evaporating surface
of liquid ether.  It should be  supplied from a large  gas-holder, and
not from a small gas bag; and that portion of the gas  which has
been deprived by the lungs of its inebriating  principle, should be
exhaled as waste.   Thirty quarts thus inhaled by myself produced
complete but brief insensibility; and on the 26th of April,  I removed
a breast by the aid  of  about twice that quantity, consumed during
six  minutes, and producing a  most tranquil  and complete insensi-
bility.   Though bulky, nitrous oxide is quite likely to prove a cer-
tain, as well as safe, and agreeable anaesthetic agent, administered
in the above manner, which I have not seen alluded to.  In the case
mentioned, the pulse, which Dr. Townsend was good  enough to note
       1 
2
for me, rose from 90 to 120, and continued at that point during the
operation.
   Aldehyde, used by Monsieur Poggiale, although  it is said to be
stronger than  chloroform, is also conceded to be  more suffocating
than  ether, the odour  of which  it  has.   It is probable, therefore,
that ether is the less objectionable of the two agents.   It produces,
says Professor  Simpson, much bronchial constriction and coughing.
   Nitrate of ethyle, upon the same authority, is also rapid and pow-
erful in its effects; yet  produces excessive noise and fullness in the
head, with subsequent headache and dizziness.
   The bisulphuret of carbon, a rapid and  powerful anaesthetic, has
"a peculiarly offensive smell of putrid cabbage."
   Benzoin. The vapour of this liquid, of rather a pleasant aromatic
odour, is said to be less powerful than that of chloroform.   In the
hands  of Mr. Snow it  produced in  the patient certain convulsive
tremors.  The four last agents are "not comparable," says Professor
Simpson, "with chloroform  or  sulphuric ether, either in their man-
ageableness or in their effects."
   By a rough estimate of the quantity consumed in operations, chlo-
roform  is eight times as strong as  ether;  and a drachm of the one
or an ounce of the other, is a fair allowance for  inhalation at the
commencement of the  process.   As it evaporates, the fluid may be
replaced if necessary.
   The absolute necessity of interposing something between  the lips
and the inebriating agent, when the latter, like chloroform, irritates
the skin, was quite over-estimated in the case of common ether; and
the public attached as false a value to the inhaling apparatus, as to
the stethoscope in a kindjed  science.  In administering ether, an
inhaling apparatus  is occasionally  convenient.  The more compli-
cated form, in all its modifications, contains as its chief element the
double valve originally suggested by Dr. Gould; and a tube furnished
with it may be dilated or constricted so as to represent almost all the
principal inhalers in use.
   For brief and repeated inhalation, and to avoid the odour of sul-
phuric ether, as well as to retard its evaporation, an inhaler is con-
venient; but for  common purposes, a bell-shaped sponge  is  quite
efficient, and is to be turned from time to time during an expiration,
to bring the gravitating ether to the top.
   With the introduction of chloroform the invention  of apparatus
received new impetus.  Its stimulant, and even vesicating proper-
ties contraindicate the direct application  of this fluid  to  the skin. 
3
 The simplest contrivance is the best, and Simpson's folded hand-
. kerchief rolled into a  cone answers well  for  a  brief inhalation.
 Channing's pasteboard cone, so cheap that each  patient may have a
 Hew one, lasts through an average midwifery case; a lamp-chimney,
 stethoscope, or other tube containing a  sponge answers equally the
 purpose, while for the rapid and complete insensibility required for
 surgical purposes, and for hospital use, some  more durable form of
 apparatus is requisite.   It  should comprise  a  mouth-piece, a recep-
 tacle for the sponge, and a diaphragm  to prevent the flow of the
 fluid towards the mouth.
   It is optional whether the vapour enter the system simultaneously
 through the  mouth and nasal orifices,  or by the mouth alone, the
 nostrils being closed.   It has been said, that the effect is more im-
 mediate when the nasal cavities are  filled with vapour; but the dif-
 ference in the time of inhalation, if any, is  inconsiderable.
   It is a striking fact,  that in many  of the first experiments both in
 this country and abroad, vapour was inhaled from  a shut cavity or
 sac in which the contained oxygen must have been rapidly exhausted.
 If there is one condition vital to the safety of inhalation, it is that
 an  adequate supply of oxygen should be insured to the patient.
   Inhalation should be of atmospheric air impregnated with vapour,
 and not of vapour alone.  Air should be  conducted through the
 medium containing the inebriating  agent,  and  not merely to and
 from a closed cavity.
   The production of the brief insensibility which suffices for the ex-
 traction of a tooth, is rarely accompanied with  danger or with em-
 barrassing circumstances; but the administration  of ether for a length
 of time in a surgical operation, demands much attention.  Now it is
 difficult for the surgeon to attend  at once  to a dissection, perhaps
 remote from the head, and at the same time to satisfy himself of the
 adequacy and safety of the anaesthetic state; and it is therefore not
 improbable that  the  part of etherizing, especially for a length of
 time and to a considerable extent, will be soon recognized as involv-
 ing an entirely distinct responsibility, from that  of the surgeon who
 performs the operation.
   Let  a patient be now subjected to any of the ordinary modes of
 inhalation, with  the view of inducing for examination, some of the
 ordinary phenomena of etherization.   It is unnecessary either to
 extenuate or to dissemble the symptoms which occasionally occur
 during the approach or continuance of the anaesthetic state.  Though
 alarming in  connection with the causes which previous  experience 
4
had assigned to them, many of them are of comparatively trifling
import as a sequence of an anaesthetic agent;  while, on the other
hand, a few comparatively quiet indications stand at the limit of
vital endurance, and give notice of real danger.   The order of ex-
perience,—a  few type or model cases as they occur, will perhaps
afford the readiest method of exposing these phenomena.
  1. A patient courageously inhales the ether;—a term intended to
include the chloroform.  Soon the respiration becomes more rapid;
the chest  heaves;  the lips are blown out with the expiration, and
while the patient is manifesting unequivocal signs of enjoyment, the
head suddenly falls to one side, and the individual during the next
two or five minutes is insensible to pain  in any form.  He awakes
suddenly,  smiles, is surprised to find the operation, if one has been ^
performed, over; has had  a pleasurable dream, and experiences  no
ill effects.   This is etherization in its most favourable  form, less fre-
quent than the  next.
  2. A second  patient averts his head to cough;  inhales again and
again coughs; declares his inability to take the ether; yet perseveres.
The trachea has now become less irritable;  respiration is tranquil,
and insensibility of rapid access.   Such cases are quite common in
the practice of  the dentist.
  3. A third subject makes grimaces, and getting exhilarated rejects
the apparatus;  but is still amenable to  peremptory discipline; and
being directed to be quiet and to close his eyes, is soon narcotized.
  4. Yet not always at once.   A large and muscular man, perhaps
habituated to stimulus, sometimes  modifies grimace into a demon-
stration of resistance; closes his lips  and jaw firmly,  and refuses to
inhale; objects  to verbal and other interference; at last becomes vio-
lent, and if  athletic, requires the  united force of several assistants
to confine him.
  Here is a sufficient reason for not  attempting the  etherization of
athletic subjects when such aid is not at hand.   I believe that the
best practice in such a case is  to confine  the  patient, and to apply
the ether steadily to the mouth and nose.  For  some seconds, per-
haps many, the patient may refuse to breathe;  and bystanders un-
accustomed  to  the phenomena, exchange significant  glances.   But
if the pulse is  good there is no real danger, and at last, exhausted
nature takes a  deep and full inspiration, which, while it aerates the
blood, is laden  with  the intoxicating vapour;  colour returns;  and
the patient falls back narcotized.  Violent resistance is not common.
  5. It is, however, less unfrequent for the patient  to vomit soon 
5
after the appearance of the signs of etherization ; and partly from
the exertion, and partly from the inspiration of fresh air, he may
then recover sensibility.
  6. Lastly, the signs of insensibility having been manifested, the
operation is begun.   In a few moments the patient partially regains
his  consciousness,  and exhibits the unequivocal  appearance of suf-
fering,  which may  or may  not be subsequently  remembered;  or
without being violent, is wild and uncontrollable.
  It will be observed, that in all these cases, ether was administered
for a comparatively short time.   The result of such brief inhalation
is brief narcotism, either complete or incomplete.   If inhalation be
arrested at this  time, the period of subsequent insensibility to pain *
varies from one  to three minutes.  This short or partial insensibility
is adapted to the operation of the dentist, which is usually rapid; the
instrument is applied, and whatever be the demonstrations of the pa-
tient, it accomplishes its purpose.   Here are no important nerves to
be severed, nor vessels to be wounded.  But in a dissection, such as
occurs  in many surgical operations, especially in one of a formidable
character, it is important that the  subject of the operation should
not hazard his safety by being liable to sudden and convulsive move-
ments while the knife is dealing with the tissues.  If the patient thus
partially revives, assistance is not unfrequently required  to confine
him, and it is necessary to re-administer the  ether; the whole in-
terfering materially with the tranquillity of the operation, and the
comfort of those concerned; perhaps endangering the welfare of the
patient.
  Although many operations were performed abroad, both in Eng-
land and upon the continent, and at no remote  date, upon patients
yet capable of movement and resistance,  yet  there is  an obvious
want of safety in operating under these  circumstances.   Decided
preference should be bestowed  upon  a condition  of complete  and
passive narcotism, provided it can be produced with equal certainty,
and is  equally free from serious results.
  Such a condition  is quite  possible,  and a short time  suffices to
induce  a train  of symptoms  indicative of it.   Let  the  inhalation
be  continued beyond the period, during which  the patient exhibits
the earlier signs of narcotism.  The muscles will be found gradually
and completely to relax under its influence; and at a later period
the inspiration becomes a snore.  The patient exhibits  no sign of
consciousness, and is, in short, profoundly narcotized.
  In the symptoms  hitherto detailed, two stages of  the anaesthetic 
6
 state will readily be recognized; the first embracing the phenomena
 of partial consciousness, while the second presents the indication
 of total insensibility.
   These two stages of anaesthesia demand separate consideration.

   First Stage.—The first stage is  characterized, either  by the
 incomplete  or  partial character of the narcotism or  by its brief
 duration.  These  phenomena suggest  the notion that  the blood  is
 insufficiently impregnated with ether, or that the vapour has affected
 a portion only of the circulating fluid, the influence of which upon
 the brain is  soon  counteracted by the arrival in the  cerebral ves-
 sels of fresh and unadulterated blood.   Such theory illustrates the
 degree and  the duration of the phenomena attending such inebria-
 tion.
   The first stage requires for its induction a comparatively small
 proportion of the ether vapour.  Insensibility, if complete is brief,
 and the patient revives in a  period varying from  one to three mi-
 nutes, commonly without  nausea, headache, vertigo, or other sensa-
 tions  of discomfort.  But  in  certain  cases, and especially when
 either from pulmonary irritability, or want of determination on the
 part of the patient, the dose has been insufficient, and its inhalation
 by consequence protracted through a period of six or  eight minutes,
 a different range of symptoms is presented.   The patient may be
 bewildered, like a  man waking from a  deep sleep, or  uncontrollable
 except by moderate coercion.   At this  time  the pulse is natural,
 or yet more frequently  accelerated, either from exertion, or per-
 haps it has not regained its normal standard after  the  unavoidable
 excitement of  anticipation.   Though in the  first  stage of  anae-
 sthesia we might expect the  pulse  to be accelerated, yet it often
 deviates  but little from its natural standard.  Nor is the pupil espe-
 cially affected in this stage.  The muscular fibre is yet animated by
 the nervous influence, and is generally somewhat rigid; the arm re-
 sisting flexion or extension.  Occasionally it exhibits the phenomena
 of catalepsy, retaining any position given to the limb.  In rare
 cases  I have noticed the access of clonic spasm, local or general in
 its invasion.  When the spasm affects the glottis, it gives rise  to a
 peculiar symptom, to be alluded to hereafter.
  To  the first stage of anaesthesia belong those remarkable and  un-
 anticipated physiological phenomena, which seem  to unlink the inti-
mate connection between sensation and an intellectual recognition
 of it; between cognizance and  memory;  between will  and action. 
7
 A patient,  thus  partially etherized, is said quietly to criticise the
 amputation of his own leg, or resists the dentist's instruments, and
 to appearance suffers, and yet remembers nothing of it;  or remem-
 bers, but has not felt;  or, which is unpleasant and fortunately rare,
 has  felt but could not move. Such occurrences, familiar to the early
 history of etherization, have been somewhat less frequent, since the
 subject has  been better comprehended.  Yet at a comparatively
 recent date, partial consciousness of the  patient during an amputa-
 tion, for example, has  been regarded as  a circumstance  of unfore-
 seen occurrence, and not always amenable to ready influences.
   The inconveniences of partial consciousness have been alluded to ;
 and I am now especially desirous of exposing  the advantages of a
 state of  inebriation, during  which  the  patient lies  passive and
 motionless, exhibiting only the phenomena of deep sleep.

   Second Stage.—Such is the second stage  of  anaesthesia,  essen-
 tially characterized and identified by muscular relaxation.  Let the
 subjects of the last  mentioned experiments continue inhalation. The
 arm, from time to time, when  raised  from the side, resists.   Soon,
 however, it becomes flexible, and at last, falls passive and motionless.
 The voluntary muscles are now relaxed;  and it is impossible at this
 moment to rouse the patient.   This stage requires for its induction a
 considerable quantity of ether vapour, which may be presented to the
 pulmonary surfaces either rapidly in the course of two or four mi-
 nutes, or  a more diluted vapour may be administered during a pro-
 tracted  inhalation of many minutes.  In the former case, anaesthesia
 is of rapid access, and in its most favourable form.  But in the latter,
 the  dilute and protracted inhalation is often accompanied with the
 annoyances of partial anaesthesia, and it will be  stated in another
 part of this paper that  other symptoms, especially that of vomiting,
 are quite  apt to interfere with inhalation before the inebriation has
 reached its second stage.   The commencement of this state of nar-
 cotism,  characterized by passive flexibility of  the arm, suffices for
 any  brief surgical operation, which is not likely  to be impeded by
 the movements of returning sensibility.  Yet this  insensibility at its
 inception, though complete, is brief, and the revival of the patient
 often sudden.
  A few additional  inhalations so impregnate the system with the
 vapour,  that revival is deferred for some  minutes  after the inhala-
tion  of pure air.  Ether is this way cumulative in its effects.   Be-
sides this, recovery  is then generally not instantaneous, but gradual 
8
and preceded by the  signs of returning consciousness, which indi-
cate the readministration of the anaesthetic agent, and enable  the
surgeon thus to anticipate interruption.  Protract the inhalation yet a
little longer, and the inspiration becomes a snore; the pulse, which
may or may not  have been previously accelerated, beats  slowly;
while the pupil is frequently, though not invariably dilated.
   Some  little  familiarity with  these phenomena  is required to
enable the  surgeon so to graduate inhalation as  to continue  the
patient in this state of tranquil and deep sleep with safety.
   There is no doubt that it can be done if  necessary.  I  have  fre-
quently  myself maintained  insensibility nearly or  quite complete
for thirty minutes, and even for a longer period.   While  the snore
is heard, the patient does  not revive; yet the snore is an unnecessary
symptom, and is an indication for the  temporary suspension of in-
halation, when a few inspirations of unadulterated air soon re-esta-
blish quiet respiration; and  the patient is liable, at any moment, to
swallow or give  other indication of approaching consciousness.  The
cumulative effect of ether, before alluded  to, is at this time to be
borne in mind.  Young  subjects, too,  require  less than  adults; so
that after  eight or ten  minutes of insensibility in  the adult, or  a
considerably shorter period  in the  young  subject, the system  has
been  impregnated  with ether, and inhalation may be discontinued
even before the  snore is heard, without apprehension  that the  sub-
ject will  rapidly recover.   The signs of returning consciousness are
the limit on one side of that degree  of anaesthesia, which it is  im-
portant to maintain during most surgical  operations, and are indi-
cations for  the  reapplication of the inebriating  agent, when  it is
desired to protract insensibility.
   At the other limit of the second stage of anaesthesia, is a far more
important indication of over-narcotized vitality; and here is the pro-
tection against danger.  Without this  safeguard, I conceive that it
might well  be  hazardous  to overshadow  animal existence by  this
mysterious and powerful agency.  The sign is the diminution of the
force and frequency of the pulse.
   In a case of the early administration of ether, at which I  was
present,  and which has been reported, the danger  from  over nar-
cotism was quite as imminent as in any case, not fatal, I have  seen
since alluded to.  As a bystander, on that occasion, I casually felt
the pulse, and found it barely distinguishable; and though it subse-
quently still decreased, the means at once adopted for the restoration
of the patient, proved ultimately successful.  This occurrence pointed 
9
to the pulse as an indication of the stage of narcotism; a few subse-
quent experiments confirmed the opinion; and I have not since hesi-
tated to push etherization to complete insensibility, and to continue
it, if necessary, during a length of time, provided the pulse remained
full and strong.   If it be retarded, it is curious to observe with what
certainty  it recovers force and frequency, after a few inspirations of
pure  air.   It will betinferred from these remarks that the pulse is
to be carefully examined during  the whole  anaesthetic process, and
that inhalation is to be temporarily discontinued at its indication.
   Briefly to recapitulate, the first insensibility, partial though it be,
suffices for the dentist.   It exhibits the intellect  and sensibility in
novel and singular relations;  while muscular force may or may not
be impaired.   Nothing is here infallible in pulse or pupil.
   The second stage is of great value, and often essential to the sur-
geon.  It lies between the signs of returning consciousness on  the
one hand, and the decreasing pulse on the other.   It is  ultimately
accompanied by  snoring inspiration, and the partially dilated pupil;
which, together with the period of time necessary for the cumulative
effect of ether, may be considered, each, as an additional indication
for the temporary suspension of inhalation.
   Signs of Narcotism.—The eyes are usually closed during inhala-
tion.   Let the patient be directed to open  them.   If etherized, he
takes no notice of the voice.   Perhaps the head droops; or the hand
supporting the inhaling  apparatus falls.  These, alone, are signs of
narcotism, which may be  incomplete; or, if complete, temporary in
its duration.   If, in  such a case, the  arm of the  patient  be raised
from his side, it  is quite  likely to resist the effort;  or when raised,
remains extended; phenomena indicative of partial narcotism.  If
inhalation  be now suspended,  the patient soon regains  his con-
sciousness ; either manifesting unequivocal signs of pain, or resisting
interference, during  the  half conscious  state which often precedes
recovery.
   It should be added, that if the patient has inspired a good dose,
 and  for a length of time,  the dentist  may consider  any  unusual
 manifestation, as an indication of but partial sensibility to sudden
 pain ; protracted inhalation may be even taken as its priori evidence.
   One of the early and  occasional consequences  of inhalation  is a
 passive cessation of the respiration, while the pulse continues good.
 At this moment a tooth may be  painlessly extracted; but as the
 vapour has now temporarily ceased to gain access to the lungs, the
 patient may revive before the next inspiration. 
10
   Muscular relaxation; the temporary loss of muscular contractility;
the passive flexibility of the arm; is the most valuable sign of com-
plete narcotism.   It is succeeded by snoring  inspiration  and slow
pulse.
   Signs of returning consciousness are, swallowing, coughing, moan-
ing, an effort to articulate, and muscular movement.
   Rapidity of access of the Ancesthetic Stated—Somewhat  modified
by the strength and  temperament of the individual, the rapidity with
which  the system yields, is generally in direct relation with the dose
administered.   The  maximum dose will be again discussed under the
head of dangers;  but it may be here  stated that many of the unfa-
vourable symptoms  owe their existence to the protracted inhalation
of an  inadequate  dose; while after the  first  irritation  of a large
volume of vapour at  once introduced into the air tubes has subsided,
the patient yields  tranquilly, and is much less  liable to disagreeable
and  annoying symptoms.
   Vomiting is especially connected  with the long duration of the
inhalation, and also with its inadequacy.   So, also, is general excite-
ment,  and resistance; and probably spasm, whether of the vocal
chords or of the muscular system generally.
   The common imperfections of the inhaling process are, the use of
too large a sponge for ether, and of too small a sponge for chloroform.
The former distributes and evaporates the  ether  rapidly, while  its
insterstices admit a good deal of air.  The latter will not detain an
adequate amount of chloroform without  endangering  the patient's
skin.  If the sponge be previously wrung out in water, its capillary
attraction is increased.

        ANAESTHETIC SYMPTOMS CONSIDERED SEPARATELY.

  Intellectual Phenomena.—It is  said that a patient may take cog-
nizance of the amputation of his own leg.  This occurrence I  have
never seen, though it is far from  improbable.   It  implies a distinct
recognition of surrounding objects through special  sense, at a mo-
ment of complete  insensibility to pain in its severer forms.  Such
complete insensibility is more  frequently attended with entire disa-
bility of special sense; yet  sensation may be partially annulled, and
the patient continue  quite cognizant of the external world.
  The  manifestation of acute  suffering, and  even of well-directed
resistance, may occur without the patient's subsequent remembrance
of it.  Here the faculty of memory is extinct. 
11
   Or memory may recall the manifestations of an operation of which
it has forgotten the sensations.   And it is said  that cognizance and
memory may be distinct, while the machinery of muscular action is
deranged.
  Mental excitement, hilarious  or hostile, is not uncommon in an
early stage  of narcotism,  and  is  materially influenced  by its
rapidity.             »
  Pulmonary irritability varies with the individual.
  Chloroform is less  irritating to the lungs than ether, and so, per-
haps, is chloric ether.
  Violent  cough  is  occasionally excited by a small quantity  of
vapour, while a much larger quantity may occasion none; but by a
little careful graduation of the first few inspirations, the patient may
be saved much unnecessary irritation.   Soon pulmonary sensibility
is  narcotized, and the patient  breathes quietly.   Even  habitual
dyspnoea, or the paroxysm of asthma, is temporarily solaced by this
agent.  As the process is continued, the trachea becomes insensible
to the  presence of fluid, whether blood from  operations near the
mouth,  or the increased natural secretions of the pulmonary surface.
   Nausea and vomiting are  not uncommon  sequences  or concomi-
tants either  of partial or complete  anaesthesia; nor, beyond their
interference with  the progress of the inhalation, and with the mere
comfort of the patient and  of the operator, are they objectionable.
They are allied to the nausea induced  by other narcotic and inebri-
ating agents, and have especial  relation with  the duration of the
anaesthetic process.
   The  snoring inspiration indicates profound sleep.  Varying a
little in the facility of its production in different individuals, it is a
constant phenomenon of a certain stage of narcotism.  While it is
often desirable to  induce this symptom, its exhibition renders further
inebriation unnecessary for the moment.  It is always accompanied
with muscular relaxation, and soon succeeds it.  It results from the
relaxation of the muscles of the palate;  and in this connection it is
desirable to distinguish it from  another symptom, of somewhat dif-
ferent signification, viz:
   Stertorous respiration, due to spasmodic action of the vocal chords,
and allied to the spasmodic action of other muscles.  It is somewhat
rare in its occurrence; once heard, it will be readily recognized, and
indicates a brief suspension of the inebriating  process.   Though of
itself it is quite unimportant, yet as the immediate cause of another
symptom,  it  deserves  further  consideration.  The  closure  of the 
12
laryngeal aperture  shuts off the supply of atmospheric air from the
pulmonary tubes.   The same condition results from  the voluntary
closure of the mouth and lips; but the last soon  yields, while the
spasm of the glottis gives rise, in rare cases, to a partial asphyxia,
indicated by the then livid colour of the cutaneous surface.   Similar
lividity is often exhibited  during a spasm of whooping-cough or in a
hysteric  fit, and is of comparatively slight importance, from the fact
that when the  system feels peremptorily the  necessity for air, the
spasm resulting from the anaesthesia relaxes, the patient breathes
freely, and the blood is aerated.   Two or three inspirations suffice
to restore to the cheek its natural colour.
   Muscular System.—The ordinary affections of the voluntary mus-
cles have been alluded  to.  Organized resistance  resulting  from
nervous excitement; tonic and clonic spasm; the cataleptic state being
not unfrequent; while in one case I observed a convulsive effort of the
whole system of voluntary muscles.
   Other  muscles are partially affected.   The sphincters very rarely
lose their contractility.  It is well known that the uterus contracts
during partial and  even complete unconsciousness; a diminution of
cessation of its contractile  action being the rare  exception  and not
the rule.   The respiratory muscles play tranquilly during narcotism,
while  the heart, losing the force and  frequency of its pulsations,
slowly ceases to beat, in its latest and profoundest stage.
   Pulse and Pupil.—Incidental excitement usually accelerates the
pulse, the  relative  frequency of which, during  the earlier  stage,
it  is difficult from this circumstance to estimate.   It does not lose
either in force  or frequency until the whole  system is profoundly
narcotized.  It is  then,  as at other  stages of the process, a  most
valuable indication of the condition of the nervous system,  and ulti-
mately of the limits of vital endurance.
    The pupil, though commonly at first contracted, and subsequently
dilated,  is less to be relied on as an indication.
    Prolonged insensibility is quite exceptional and rare.   In the case
of a*  young woman, of the details of  which I am  cognizant, such
insensibility ensued upon a brief recovery of the ordinary character,
 and  after the ordinary interval.  The patient then again became
insensible, apparently without cause,  and slept heavily, in spite of
 efforts to arouse her, during an hour.   The symptom which excited
 apprehension, was the smallness of the  pulse, which at times was
barely perceptible at the wrist.   This patient ultimately recovered,
 as I believe, have all others similarly affected.  The phenomena sug- 
13
gested those occasionally presented after an amputation, when the
patient awakes  in  acute suffering, and again spontaneously sleeps
while stitches are inserted.
  A few phenomena only remain to be noticed.
  Convulsions have been reported, occurring at the interval of many
hours after inebriation.
  A gentleman  of  Providence informs me  that he has suffered for
many months from  vertigo, headache and  disability for labour, which
ensued upon a dose of ether vapour.
  Such cases, with others which have been  detailed, must be con-
sidered as exceptional, due to peculiar  and  individual  susceptibility,
and they are also of exceeding rare occurrence.
  It may be convenient to arrange  etherization under several dis-
tinct  heads,  adapting its degree  to  the character of the surgical
operation for which ether is to be administered.
  1.  In amputations and other brief surgical operations,  and in the
extraction of teeth.—In this  latter case, inhalation may be discon-
tinued a few moments after insensibility.  In the former,  it is better
to continue  it two or three minutes longer,  and till muscular relaxa-
tion.   For  the  extraction of teeth, the  patient may himself retain
the sponge.   When the hand wavers, or falls, the mouth is carefully,
but if need be, forcibly, opened, without loss of time, and the forceps
are at once  applied.  In this way one or more teeth may be removed
while the patient  is  in  an unconscious or half conscious state, but
free from pain.
  2.  Protracted dissections may be commenced a short  time after
insensibility; the sponge being continued to the mouth, with an occa-
sional interval to insure the patient ample supply of oxygen.  When
there is snoring respiration, the sponge  should be removed  during
the short time required to  re-establish  quiet inhalation.  The pulse
is kept in hand, and any diminution of its  frequency or force, espe-
cially the former, is an indication for the admission of unadulterated
atmospheric air.  Forty-five minutes is a somewhat unusual duration
of insensibility, and is not to be attempted  by those not conversant
with the process.   It is important to the operator, in these cases, that
the patient  should  be fairly narcotized, and with a little  experience
with  a rigid attention to the above precautions, accident need not be
apprehended.
   It  may be added that much of the pain of a  dissection is not of an
acute character likely to arouse the patient; so that after some time
has elapsed, a state of semi-consciousness often suffices; the  vapour 
14
being then  applied, either during  the intervals of the operation, or
as manifestations of pain or resistance may present themselves.
   3. Hare-lip.—With  this operation may be included  others upon
the nose and mouth, fauces and trachea.  It has been presented as
the type of such operations, because it embraces  several particulars
of interest.   An operation in this region is often a dissection, and of
the parts concerned in inhalation.  It is, therefore, impossible to
continue this process during manipulation.   If, then, in such a case,
the patient  is to remain insensible, the surgeon has two  alternatives;
one of profoundly narcotizing the patient in the first instance;  the
other of re-administering the  ether;  often at an inconvenient  mo-
ment, and when the operation is materially interfered  with.  Of
these alternatives, the former  seems to me the  least objectionable.
Another important feature in these operations, is the liability of the
blood to accumulate in the trachea,  which is no longer irritable or
conscious of its presence.   When a tracheal  rale gives indication of
the collection of a  considerable quantity of blood or other fluid in
this region,  the patient should be made to lean forward, to facilitate
the natural expulsive efforts of the expiration or of the cough, as
consciousness returns.  In general during operations upon the face
and jaw, under the influence of ether, the patient should be sustained
in a position inclining somewhat forwards,  and care  should be taken
to prevent, as far as possible, by sponges or otherwise, the recession
of blood into the  buccal cavity.   Protracted operations upon  the
fauces  are difficult, if not  impractible, with the use of ether.   On
the other hand, the admission of instruments  to  the  trachea, espe-
cially from the outside,  is, without  doubt, thus facilitated.
  4. In dislocation, it is obvious that ether inhaled, can be of no
avail unless continued to the relaxation of the muscles.
  It is well known with what facility dislocation is reduced upon
the dead subject; and it is quite probable that all recent and favour-
able cases in the living  subject may  be  reduced with almost equal
facility, when muscular relaxation is completely effected.  This is
confirmed by one or  two cases of dislocated  shoulder, which have
fallen under my notice.  I have met with  no  case  of recent dislo-
cated hip since the  introduction of the anaesthetic agents.   It would
be desirable, in such a case, that an attempt  should  be made com-
pletely to annul muscular resistance, before efforts  are  directed to
the replacement of  the  bone.
  It is equally evident  that the reduction  of hernia can  be facili-
tated only by muscular relaxation, and  that anything approaching 
15
to spasm  would aggravate  the  difficulty of reduction  during its
access.
  Lastly, ether has proved of service in abating the spasm of stric-
ture, in lithotrity, and in the breaking  up of adhesions resulting
from fracture near the joints.   Yet in  the  latter cases pain has
always offered sure indication of the advisable extent of the respect-
ive  operations, and in its absence, considerable discrimination is to
be exercised.   I have myself seen an arm refractured by an attempt
to overcome the resistance of a mass of callus, after the adhesion
of the articulating surfaces had yielded.
  Age.—Experience  shows that  no especial ill effects result from
the administration of ether to patients of average physical force at
almost any age.  Though I have operated on a child of three months,
who was so far inebriated that  its cries were modified  into a sort of
moan, yet I know of no case in which a  young infant has been com-
pletely narcotized after its birth.  Indeed, the facility of controlling
a child of this age, together with the fact  that it has neither the
anticipation nor remembrance of suffering, however severe, seems to
render this stage of narcotism unnecessary.
  Antidotes.—It has been well said that fresh air, and in an extreme
case artificial respiration is the best antidote to ether inebriation.
  The symptoms of spasm, vomiting, &c, generally  subside when
the patient is left to  himself.  When the pulse is small and  slow,
this state of narcotism must not be identified with that of syncope.
Brandy  and  other  diffusible  stimulants, appropriate  remedies for
syncope, belong to the class of agents which induce the anaesthetic
symptoms; and it is quite probable, though  evidence  is yet incom-
plete upon thie point, that the difficulty would only be aggravated
by  their use.  Besides,  the  patient  cannot  always swallow.  Cold
water, dashed upon the  face, or injected into the ears, undoubtedly
aids in arousing the  patient  from  the common  ether  narcotism.
Galvanism to the precordial region has  been suggested as a remedy
in  an extreme case; and it may be a question whether rest in the
recumbent posture or  active exercise, as  adopted for the restoration
of  subjects affected with narcotism from opium, be best adapted for
these  cases.  If any fluid  is to  be administered internally, analogy
would suggest strong tea or coffee.
   The nature of the anaesthetic state is a question of considerable
interest.   Perhaps the  most satisfactory evidence upon this point,
is that afforded by the  analogy between the  symptoms resulting
from ether vapour in the lungs, and those of alcohol in the stomach. 
16
Both, in  small  quantities, produce  exhilaration.  Both, in a large
dose, produce the phenomena of dead drunkenness, and both, insen-
sibility to  pain.  With alcohol, the state persists, while the fluid
remains in  the stomach; and patients have been at once aroused by
the use of the stomach  pump.   In like  manner anaesthesia con-
tinues, while ether vapour fills the lungs; respiration pumps the
ether vapour from that receptacle, and gradually aerating the blood,
terminates  the anaesthetic state.   Alcohol is found in the blood  by
chemical analysis; ether is  equally detected in  it  by its peculiar
odour.
   Convulsions have been noticed in rare connection,  both with ether
and  with alcohol.  Finally, there  is in ordinary cases,  no great
solicitude for the  safety of a patient who is dead drunk, and expe-
rience has shown  that ether narcotism is very rarely accompanied
with danger.
   Time does not serve for  an analysis of  the  evidence relating to
the effect of ether upon the different portions of the nervous system;
nor is this evidence of a conclusive  character.   There may be some
connection  between  the spasm, occasionally produced  by  alcohol
and ether,  and that induced by opium, alluded to by Todd and Bow-
man, resulting from polarity of the spinal cord,  in cold-blooded, and
even in warm-blooded animals.
   Upon the same authority spasm of the glottis is among the results
of irritation of the medulla oblongata.  On the other hand, the me-
dulla oblongata has  been considered by Flourens, who  claims this
point as  his discovery, to be  the last stronghold from which life is
driven by the anaesthetic agent.  The animal then dies.  Yet spasm
of the glottis is not a formidable symptom.
   The details  of experiments in this obscure branch of physiology
may be found  in  the  papers of Flourens and  of Longet, and may
be compared with the intellectual phenomena elsewhere alluded to
in this paper.
   Dangers.—It remains only to speak  of the dangers  of the anae-
sthetic state.  From this category,  the symptom of asphyxia may
be rejected; this  being an evil easily anticipated, when due to  an
imperfection in the process; to the  non-admission to the  lungs of
oxygen.  Gradual and overwhelming narcotism may also be antici-
pated and arrested.   The danger arising from the specific effects of
an inebriating vapour in the pulmonary tubes may be considered, 1,
as a question of experience and fact;  and 2,  of analogy and pro-
bability.   As  to the fact, I have been unable to find any fatal case 
17
 clearly resulting from the inhalation of ether, until the very recent
 one at Auxerre, apparently resulting in part from convulsions im-
 properly treated, and in part from a neglect of the indications which
 the  pulse affords.  Of  this case the details are imperfect.   Deaths,
 like those reported by Nunn and  Robb, occurring at an interval of
 twenty-four hours or more after the operation, may or may not have
 been accelerated by ether;  which  does not prevent, nor is to be con-
 sidered  responsible for, the ordinary  collapse resulting  in certain
 states of the system, after  certain injuries and  certain operations.
 The strong argument in behalf of ether is, that so few opportunities
 have occurred  in which it could be  even suspected of agency in
 fatal results.
   With chloroform the evidence  is a  little different.  Two some-
 what remarkable cases of death, occurring during the brief admin-
 istration of this agent for surgical purposes at  once present them-
 selves.  The Cincinnati case and that of Mr. Meggison at Winlaton.
In these  cases death occurred in about five minutes from the begin-
 ning of the inhalation.  In the Cincinnati case the quantity inhaled
 must have been  considerable, from a saturated sponge in a four inch
 glass globe; yet in Meggison's case a drachm only was applied upon
 a handkerchief.  It is quite  possible that death resulted in the latter
 case, as Mr. Simpson avers, from  asphyxia produced by the admin-
istration  of brandy and other liquids before the patient was able to
swallow.   Such  error would be easily avoided. Yet these instances
suggest a specific cause of danger.  This is the sudden impression
upon the system of a powerful  inebriating agent.  Abundant alco-
holic stimulus has often produced immediate death; and analogy would
suggest that inebriating vapour  in the lungs may be the equivalent
of similar fluid in the stomach; and that in one or both  the  cases
alluded to, chloroform may have produced a sudden and overwhelm-
ing shock upon the system.
  Apart from the somewhat obscure case, before alluded to, there
 is no authentic evidence  that sulphuric ether has been a  cause  of
 sudden death; and  there is little doubt that this immunity from
 danger in its use is due in part  to the comparatively moderate de-
 gree of its inebriating property, and in part to its volatility.  Chlo-
 roform is much stronger than ether, while it is less volatile; so that
although the vapour of a few drops may only give rise to moderate
 symptoms, and then escape  by exhalation, that of  a large quantity
whose  volume the lungs might easily contain, might powerfully im-
press the system, while the delay of its evaporation would materially
       2 
18
 enhance its cumulative effects.  Such theory suggests  a considera-
 tion  of practical  importance.  That  in  the  use of  chloroform a
 moderate dose should be inhaled gradually and not at once.
   It  is obvious, too, that the agency of  heat to promote  its eva-
 poration, must increase the  chance of danger.  I  think it may be
 laid down as a rule that a drachm of chloroform, at ordinary tempe-
 ratures,  suffices for a  gradual  inhalation of three  minutes in the
 average adult.  In recognizing a possible danger from  an instanta-
 neous and powerful dose on the one hand, it  must not be forgotten
 that many of the  unpleasant symptoms of the anaesthetic state are
 undoubtedly induced, and aggravated by protracted and futile  at-
 tempts to produce insensibility, with an insufficient  dose.  Expe-
 rience shows that  after the first few  minutes, and with due regard
 to the condition of the pulse, it is  safe to increase the quantity of
 ether or of chloroform, until the inspired air is fully saturated, and
 the patient fairly narcotized.
   If  there is any one  consideration calculated to arrest attention
 in the history of  etherization, it  is, that although  the anaesthetic
 agents have been open to liberal use in every part  of  the civilized
 world, whether experimentally, ignorantly, or carelessly; although
 thousands have  experienced  their  good effects; and although the
 physiologist,  the ether opponent, and the coroner, have been equally
 ready to  seize upon and to  exaggerate any case of accident  that
 might seem to fall within their range; yet it is  probable that the
number of cases, thus  publicly suspected, have been less than ten,
while  the only conclusive instance of direct relation between an anae-
sthetic agent and death are two in  number.  Can antimony or opium
show  as clean a bill of health for the same period ?