DUE
LAST DATE
«*»»>——.—.
MAY 14 
 
ETHER  AND CHLOROFORM:
THEIR EMPLOYMENT
SURGERY,  DENTISTRY,  MIDWIFERY,
      THERAPEUTICS, ETC.
J.  F. B. FLAGG, M. D.,
.-»»
SURGEON DENTIST,
MEMBER OF THE RHODE ISLAND MEDICAL SOCIETY.

en
Oo.^
v.fi
       PHILADELPHIA:
LINDSAY AND BLAKISTON.
          1851. 
*
fsoA-e
    Entered, according to Act of Congress, in the year 1851,

             BY LINDSAY AND BLAKISTON,

In the Clerk's Office of the District Court for the Eastern District of
                     Pennsylvania.
0. SHERMAN, PRINTER. 
TO
          JOSIAH   F.  FLAGG,  M.D.,
                     SURGEON DENTIST,
              BOSTON, MASSACHUSETTS.
  As I know of no one who will peruse the following pages with
greater leniency, or with a more just appreciation of my motive
for  giving them publicity,—I would therefore respectfully in-
scribe them to you, with my sincere thanks  for the independent
course manifested by  yourself at the commencement of Ether
inhalation in your city.
  In the earnest wish for your long-continued health and use-
fulness, believe me,
            Truly your affectionate brother,
                                       J.  F.  B. FLAGG.
    190 Arch Street, Philadelphia.
        December, 1850. 
 
CONTENTS.
                                                   PAQK
Introduction,        -                                  7
Oxide of Ethyl, oe Ether,     -      -      -     -    18
Chlorofoem, its Chemical Constitution,   -     -       16
Ethee, Review of the History of its Inhalation,    -    19
General Directions for Administering Ether, etc.,       43
Physiological Effects of Sulphuric Ether,   -     -    48
Sulphuric Ether in Suegeey,      ...       51
Pathology, consideeed in  connection with Ether In-
      halation,   ------    64
Diagnosis, assisted by the  Ether Inhalation,     -       80
Neurology, New Theory suggested, etc.,      -          88
Psychology, in connection with Ether Inhalation,        95
Chloroform, as a Local Anesthesia,    -      -     -  119
Anesthesia in Midwifery,   -                        123
Correspondence in Relation to the Efficacy of Ether
      and Chloroform,  -----  142
Miscellaneous Cases,       -                        154
Sulphuric Ethee, Unfavourable Impressions  in regard
      to its use,  ------  177
Conclusion,  ------     181
                           1* 
 
INTRODUCTION.
  The  excitement,  consequent upon the  discovery
of the application of sulphuric ether in painful sur-
gical  operations, having passed sufficiently away to
enable us more calmly to view and understand its
real merits, I cannot but feel it a pleasurable  duty,
on my part, to lay before the community those facts
and circumstances in reference to the subject, which
my position has enabled me to collect.
  In  treating upon its  history as a discovery, I
would  here  observe, that I have no other interest
or feeling in the matter, than what I believe  to be
a desire to  elicit truth;  making statements,  or re-
peating such as may have reached me, with no fur-
ther  comment  than the case seems absolutely to
require; preferring that my  readers should  draw
their deductions, and form  conclusions  from simple
relation, rather than from party prejudice.
  It is much to be regretted, that several candidates
should have appeared simultaneously for the  exclu- 
1** SL 3u
viii             INTRODUCTION.

sive honour of having first induced  anaesthesia by
inhalation; when the  part allotted  to each in its
promulgation, would have been sufficiently  merito-
rious  to  rank him  among the philanthropic of the
age.   It is equally humiliating that secrecy, caveats,
and quackery, in various shapes,  should ever have
been  connected  with this  subject; as they have all
tended to bring into disrepute  a valuable discovery.
The consequent  excitement required the utmost can-
dour, the calm exercise of judgment, in short  every
ennobling trait, to meet the many  objections that
have  been suggested through fear, jealousy, or other
wrong motives.
   Sufficient  time has elapsed, and an amount of ex-
perience has been gathered throughout the civilized
world, to place ether upon that basis which its  most
sanguine friends claimed for it from the first, as a
safe  instrument in the  hands of  prudent  men, to
secure the abolition  of  suffering in  surgical opera-
tions.
   Having, from time to time, furnished various arti-
cles  upon the subject of ether, for  the  purpose of
giving information relative to many of its  peculi-
arities, as well as to remove  deep-rooted prejudice,
it has been my object to collect and embody in this
work, most of those writings, and  to arrange them,
with  cases cited, as may serve to illustrate  its use- 
INTRODUCTION.
ix
fulness in general; and if possible, to gain for it
that  attention which  the subject demands at  the
hands of the medical world.
   It would  seem officious (in the odious acceptation
of the word) in me, to  introduce a chapter in this
work in relation to the use of ether in  cases of par-
turition, were it  not that I have been  much impor-
tuned in  this matter.   The knowledge that it has
been very extensively and happily used in midwifery
all over Europe, is fast gaining ground in this coun-
try;  and I  see no good reason why the ladies of
America  should  be made  any longer  an excep-
tion  to its benefits; and, what is more to the pur-
pose, they  are  beginning to  see  the  same  thing.
My opinion, advice, and directions, are  daily sought
in this department; and duties and  responsibilities
have  been forced upon me, which at  least should
have been shared  with  me, if  not altogether taken
off my hands, by those engaged in its  practice.  This
brief statement of facts  must be my apology.
   The great variety of constitutional habits,  disease
in its various conditions, mental organization, &c,
wherein ether has  been  used simply for the purpose
of annulling pain  in the extraction of a  tooth, and
from  which  immediate and permanent benefits have
been the result, having  occupied much  of my atten-
tion,  as to  its importance  as  a remedial agent, I 
X
INTRODUCTION.
have confined my remarks in this department to those
mostly of a suggestive character; instancing such
cases as I have had  opportunities of seeing  carried
out, and giving them, with the hope that  the good
already derived may not end with their recital.
  In conclusion, I beg here to acknowledge my high
appreciation of  that  confidence  manifested  in  me,
and in the course I have pursued in  this matter, by
many of the professors in  our  medical  schools, and
other  gentlemen of scientific  attainments, who are
also more desirous of  adopting  the use of any agent
calculated to relieve human sufferings, than to allow
themselves to be actuated by any other than prudent
and philanthropic  motives.  Many,  who have been
deterred from  the use of ether  in  their practice
through timidity alone, are now yielding  to its in-
fluence slowly but surely.   The thanks of these gen-
tlemen for my continued advocacy in the cause, are
now more than compensating me for those injuries
inflicted by former ungenerous  and disrespectful re-
marks;  in  many instances, not stopping  short of
personal  abuse.   Others, again, are fast being led
into the ranks of its advocates from necessity; find-
ing the demand of their patients more urgent than
their willingness to  comply,  and a  correspondent
depreciation in their  practice  as a consequence;  a
motive, as little creditable  as  that which  led them 
INTRODUCTION.               XI
to oppose it.  This  applies very particularly to the
department of midwifery, and to a  certain extent in
dentistry;  instances of which, I shall have occasion
to advert to in another place.
   My  time has been  so much occupied in calming
the fears of nearly  all who present themselves for
etherization, and in  relating incidents  of former
similar cases to secure their confidence, that I hope
my motive for  appearing  before the public in  the
character of an author will be charitably estimated.
By my endeavour to afford both useful information
and amusement  in this form, I trust those unpleasant
duties will be materially lessened.
   The  communications  of  my medical friends will
assist materially in calming these fears, and, I doubt
not, will be read  with much pleasure.   To  these
gentlemen I tender  my warmest  thanks for  their
prompt assistance in this cause. 
 
ETHER  AND  CHLOROFORM.
        OXIDE OF ETHYL, OR ETHER.

COMMONLY CALLED SULPHURIC ETHER, FROM THE MODE
                 OF PREPARING IT.

  The following  description of this  article is taken
from "Graham's Elements of Chemistry."
  "Ether is the product of a remarkable decomposition
of alcohol by sulphuric, phosphoric, and arsenic acids,
and is also formed by the action upon alcohol of the
fluoride of boron,  the  chloride of zinc, the chloride
of tin, and some other chlorides.  All these agents have
a great affinity for  water, and might be  supposed to
convert alcohol into ether, by simply combining with
the water which the former is  supposed  to contain;
but the close examination which the process of etheri-
fication  has received from  chemists,  proves that  its
rationale is by no means so simple.
  " Ether is evolved when alcohol and oil of vitriol are
heated together, and may be  obtained by mixing and
distilling in a glass retort equal weights of these mate-
rials, due attention being  paid to the condensation of
the product, which is volatile, by keeping  the receiver
                        2 
14
ETHER.
very cold.   But as the poAver of the acid to  decompose
alcohol  is  not exhausted in  this process, it  is found
advantageous to make additions of alcohol to the remain-
ing acid, or to  introduce the latter in a continued stream.
The following  is a continuous process for ether, first pro-
posed by M. Mitscherlich, as it is given  by  M. Liebig.
Alcohol  is  employed of density 0*822,  or  of 90 per
cent., which may be obtained by digesting proof  spirits
upon an equal weight of well-dried carbonate of potash
(free from  caustic potash), when two liquids are formed,
the upper alcohol, of the strength mentioned, which may
be drawn off for  use, and the lower, a solution of car-
bonate  of  potash in water.   Five parts, by weight, of
this alcohol are mixed with nine parts of oil of vitriol,
in  a  copper  or  cast  iron vessel, surrounded  by  cold
water, and the mixture afterwards introduced  into a
tubulated glass retort, which  the mixture should fill one
half, or even a little more.  The distillation is best con-
ducted by the  heat of a sand-pot, in which the retort
should not  be  deeply sunk, and  commenced  at a gentle
heat; when the  temperature increases too briskly, the
fire should  be  withdrawn.   A glass  tube is  fixed by a
cork in  the tubulure of the  retort,  of which the ex-
tremity  within the retort is drawn  out into  a point,
having an opening about one line in diameter, and dips
one inch in the liquid.  Without the  retort, the same
tube is bent at a right angle, and may extend horizontal-
ly for two or three  feet; it communicates with a reser-
voir of  alcohol by means  of  a metallic  tube and stop-
cock, by which the flow of the alcohol is  regulated.  The
latter should be supplied so as to keep the liquid in the
retort at its original level, at which a mark should be 
ETHER.
15
placed for that purpose.   To condense the ether, which
distils  over, the beak  of  the  retort is  connected with
Liebig's tube condenser, charged with the coldest water.
A leaden  alembic is used when ether is prepared on a
large scale.  It is said that when the operation is well
directed, nothing is formed but ether  and water: the
same sulphuric acid may also be  used indefinitely for
the preparation of "ether without  sensibly diminishing,
the ether and water, into  which the alcohol is resolved,
coming off  entirely, and  leaving none  of its elements
with the acid.
   "To obtain the ether perfectly free from alcohol and
other impurities, the crude product may be mixed with
some milk of lime, and an  equal volume of water, the
lighter liquid drawn off, and allowed to digest for seve-
ral days upon chloride of calcium, or quick lime; and
finally be rectified from the same substances.   The last
product has a specific gravity between 0*720 and 0*725."
   It will thus be seen, that but a few years since, ether
was considered  perfectly  pure when  its  weight was
about  three quarters that of water.  But since its dis-
covery as an anaesthetic agent, it has been the custom
further to wash it of its impurities, by which means it is
reduced  to but  little more than  half  the weight  of
water; while its vapour is  between twice and  three
times  as heavy as atmospheric air.  According to Gay-
Lussac, its  density is 2*586. 
CHLOROFORM.
         ITS CHEMICAL CONSTITUTION.

  As this new agent, intended to take the place of sul-
phuric ether, will probably  continue  to  be used to a
considerable  extent, notwithstanding  several cases of
fatality have attended its use, I  am desirous of furnish-
ing my  readers  with some  account  of its  chemical
nature and properties.  Much research and labour are
saved to me by quoting from Prof. Simpson's admirable
work on this subject.   It gives me pleasure  that I shall
frequently  have  occasion hereafter to introduce that
gentleman, the  more perfectly to enforce conviction as
to the vast importance of this pain-annulling discovery.
  "Formyle is  the hypothetical  radical of formic acid.
In the red ant [Formica rufa), formic acid was first dis-
covered, and hence its name.  Gehlen pointed it out as
a peculiar acid; and it was  afterwards first artificially
prepared by Doebereiner.   Chemists  have now devised
a variety of processes by which formic acid  may be ob-
tained from starch, sugar, and, indeed, most  other vege-
table substances.
  "A series of chlorides of formyle are produced, when
chlorine  and the hypochlorites are brought to  act  on
the  chloride, oxide,  and  hydrated oxide of methyle 
CHLOROFORM.
17
 (pyroxylic or wood  spirit).  In the same way as formic
 acid may be artificially procured from substances which
 do  not contain formyle  ready formed, so also are the
 chlorides of this radical capable of being procured from
 substances which do not originally contain it.
   " Chloroform, chloroformyle,  or the perchloride of
 formyle, may be made and obtained artificially by vari-
 ous processes, as by making milk of lime, or an aqueous
 solution of caustic alkali, act upon chloral, by distilling
 alcohol,  pyroxylic spirit, or acetone, with chloride of
 lime, by leading a stream of chlorine gas into a solution
 of caustic potass  in spirit of wine, &c.  The prepara-
 tion which I have employed was made according to the
 following formula of Dumas.

    R.   Chloride of lime in powder,    ...    ftiy.
        Water,   -------    ftxii.
        Rectified spirit,     -----   f3xii.

   "Mix in a capacious retort or still, and distil as long
 as a dense liquid, which sinks in the water with which
 it  comes  over, is produced. {Girays Supplement  to the
 Pharmacopoeia, 1846, p.  633.)
  " The resulting  perchloride of  formyle consists of
 two atoms of carbon, one  of hydrogen, and three of
 chlorine.  Its specific gravity is much greater than that
 of water, being as high as 1*480.  It boils at 141°.  The
density of its vapour is 4*2.  It is not inflammable; nor
changed by distillation with potassium, potash, sulphuric
or other acids."
  We  are indebted  conjointly to Liebig, Guthrie, and
Soubeiran, for the discovery of chloroform, and, singular
                         2* 
18
CHLOROFORM.
as it may seem, without any concert of action between
these gentlemen.   It appears that Dr. Samuel Guthrie,
late of Sacketts Harbour, N. Y., published an account
of its therapeutical effects, and method of obtaining it,
in January, 1832; but to Prof. Simpson, belongs the
credit of first demonstrating its effects by inhalation. 
ETHER.
     REVIEW OF THE HISTORY OF ITS INHALATION.

  About the commencement of the present century, it
was  discovered that the inhalation  of  sulphuric ether
was attended by effects similar to those induced by the
nitrous oxide, commonly called the laughing gas.  It
was much resorted to at that time, and has frequently
been used  since for the purposes of amusement, and
"the development of character."  For nearly half  a
century  it was considered  sufficiently  harmless to  be
freely used as a substitute  for  the nitrous oxide, and,
so far as my knowledge extends, without any greater
evil  resulting from its use, than leading to a desire for
a too frequent or excessive indulgence therein, tending,
in a few instances, to induce diseases somewhat similar
to those which result  from inordinate alcoholic  drinks.
Momentary or temporary mischief, indeed, occasionally
occurred through excitement (not always unattended by
design), such as dealing  a  blow upon the person of an
unpopular  professor,  or upsetting some unlucky, med-
dlesonTe classmate.   Very seldom  did anything like
injury occur to  individuals under its influence, or vio-
lence  to their immediate friends.  A  partial etheriza-
tion, or its intoxicating stage, has emboldened many 
20
ETHER.
young men to vent their petty spleen upon the objects
of their dislike, when true courage could never have been
aroused by any other means.  This, I presume, is what
is meant by its developing character.
   It  had frequently  been observed, that while under
the influence of ether  for the above-mentioned purposes,
whatever bodily injury was sustained at the  time, was
as invariably unattended by consciousness of pain.  For
instance, if the inhalation was carried to  such  an extent
as to  disqualify the person from distinguishing between
an  individual and a  post  or  tree, a blow would quite
likely be levelled against one of these latter substitutes
of sufficient force to mutilate the hand; and the person
thus  suffering  has always  been the last, among those
assembled, to be conscious of the fact.  The only reason
why this peculiar feature in ether inhalation was not
made  available for surgical  operations  at an earlier
date,  was the  desire  of inducing  perfect quiet on the
part of the  patient, rather than excitement.   Its nar-
cotic  influence, through excess of excitement, or the
previous condition of mind, had never been considered;
and it was left to rude experiment, through the sugges-
tion of fear, rather than to philosophical reasoning, to
establish this greatest blessing to suffering humanity.
  Fifty years  ago, whilst  experimenting upon the ef-
fects  of various gases and vapours upon the  lungs, it
was suggested by Sir Humphry Davy, that it was
possible some agent might be discovered  for inhaktion
whereby all pain in surgical operations should be abro-
gated.  Even this thought, this remarkable hint, had
nothing to do with its  ultimate discovery.   To the ever- 
ETHER.
21
lasting disgrace of  science, with all its means for expe-
riment and observation, with all the hints and practical
demonstrations afforded it, this  discovery, as such, can
never take rank above a simple  Yankee guess.
  Dr. Simpson has furnished a very interesting paper,
in which he shows  that ethef was known in the 13th
and 14th centuries.   That its formation was described
in the 16th century  by Valerius Cordus; and that it
was first designated " Ether," by Frobenius, in  1730.
It also appears that the idea of painless  operations is
of very ancient date,-—a  remarkable receipt for which
being given as early as the  13th century, in the  sur-
gical  treatise  of  Theodoric, described as  " Spongia
Somnifera."
  It appears, from well-substantiated  documents, that
in the  year  1844, Mr.  Horace  Wells,  of Hartford,
Conn.,  a dentist   by  profession, becoming seriously
troubled with an aching  tooth, conceived the idea of
placing himself under the influence of nitrous oxide gas,
while submitting to  its  extraction.   The experiment
succeeded far beyond his expectations, he  feeling no
pain whatever in  the  operation.   Mr.  Wells  imme-
diately made known his discovery to  many friends in
that city, operating upon quite a number with equally
happy results.   He, by advice, soon visited New York,
where he was told that sulphuric ether would have pre-
cisely the same effect as the article he was using.  He
used the ether  in one or two  cases, and preferred it for
the reason that no labour was necessary in its prepara-
tion for immediate use.  But, upon returning to  Hart-
ford, he was persuaded to abandon the ether; his medi- 
22                     ETHER.
cal friends  entertaining some doubts  as  to its  perfect
safety.*
   In the fall or winter of that year, Mr. Wells visited
Boston for  the  purpose of calling the attention of medi-
cal men in  that city to the importance of his discovery.
He so far succeeded as to obtain a  hearing before  the
medical class then attending lectures; and, it appears,
induced  Dr. Warren  to  allow him to administer  the
nitrous oxide to a patient,  who was about  to undergo
some important surgical  operation.   In this case,  some
delay occurring, through excitement or oversight on  the
part  of Mr. W., it is  stated that Dr. Warren  became
impatient, and  proceeded in the operation without its
use.
   Previously to Mr.   Wells establishing  himself  in
Hartford, he had practised as a dentist in  Boston, and
while in  this latter city,  a young man by the name of
Morton entered his office as  his pupil.  In  a short time
their names appeared  together  as joint partners (Wells
&  Morton), but soon after this  Mr. Wells  retired, and
left the business in  the hands of Mr. Morton.   As  the
story goes,  Mr. M. hired his office  of Dr. C. T. Jack-

  * The  "Dispensatory," in speaking of the uses of this ether, says
its effects  (when  inhaled)  are similar  to the nitrous  oxide,  but
"dangerous if carried too far." It is said that the young men of
one of our Eastern colleges became very much in the habit of using
the ether, to the great annoyance of some of the faculty.  One day
as one of the professors was in the  city, the following ruse suggested
itself.  He called upon an eminent physician, and  obtained from
him a written statement, to the effect  that the inhaling of sulphu-
ric ether was "dangerous,  if carried too far."  This being read to
the students, had its desired effect.   The learned physician, unques-
tionably, would have said the same thing of a joke. 
ETHER.
23
son, and occasionally saw Dr. J. at his laboratory.  Mr.
Wells informs us, that upon  his visit to Boston, on the
occasion above alluded to, he saw both these gentlemen
(Dr.  Jackson and  Mr. Morton), and  that they discou-
raged his proceeding in this inhaling matter any fur-
ther, denominating it "a humbug !"  No one of suffi-
cient  influence could  be found in Boston to extend to
Mr. Wells  a helping  hand on this occasion,  in this his
most excited moment.   He returned to Hartford imme-
diately,—baffled,  dejected,  and  almost heart-broken.
The reaction threw him upon a  bed of sickness, which
lasted some months.   At   length  he  recovered, and
resumed  his business,  trusting to  his  success  in  his
private practice for the eventual reputation of ances-
thesia.
   During  the summer, or  early in the fall of 1846
(nearly two years  after Mr. W.'s visit to Boston), the
public are startled  by the announcement of the most won-
derful discovery of the age.  The surgeons of Massachu-
setts  General Hospital, together with a few initiated,
become  astonishingly fervent in their praises of  an
" invention," which  required the combined efforts of
scientific attainments  and mechanical skill to develope.
Classical erudition came to their aid, and, for. a season,
good, old  " sulphuric ether" was made to  succumb to
the name of "Letheon."
   A circular is broadly cast through the length  and
breadth of the country,  announcing that " a compound"
has been discovered, which, by breathing into the lungs,
induces so deep a slumber as to enable us to perform the
most painful surgical  operations with entire unconscious-
ness on the part  of  the patient.   In connection  with 
24
ETHER.
this announcement, are the names of Dr. Jackson and
Mr. Morton, as its combined [?] discoverers.
   A patent is sought, and under the protection of a ca-
veat,  agents are appointed to traverse the country, sell-
ing to all,  who will bug, the  right to  use the "com-
pound."   Thus qualifying  everybody and  anybody in
the use of  this powerful agent that  would pay the sum
of—
 " In cities over 150,000 inhabitants,  .    $200 for seven years.
   "  "   "   50,000 and less than
                150,000,   .     .     150
   And so on,  down to—

 " In cities under 5,000  .      .     .      $37 for seven years.

   Accompanying  this circular, is a quotation  from a
paper read  before the Boston Society of  Medical Im-
provement, Nov. 9th, 1846, by Dr.  II. J. Bigelow, one
of the surgeons of the Massachusetts General Hospital.
As this paper  is published in full in the number for the
18th November of " the Boston Medical and Surgical
Journal," I will extract only that portion which pertains
to ether  inhalation, and  inhalers in  general, for the
purpose  of  contrasting that scientific  dissertation with
the present known facts upon the subject. Surely other
things beside ether serve to " develope character."
   Dr.  Bigelow says (p.  309),  " I subsequently under-
took a number  of experiments, with  the view of ascer-
taining the  nature of this new agent,  and shall briefly
state them, and also give  some notice  of the previous
knowledge which existed of the use of  the substances I
employed. 
ETHER.
25
   " The first experiment was with sulphuric ether, the
odour of which was readily recognised in the preparation
employed by Dr.  Morton.  Ether inhaled in vapour is
well known to produce symptoms  similar  to  those  pro-
duced by the nitrous oxide.   In  my own former expe-
rience, the exhilaration has been quite as great, though
perhaps less pleasurable, than that of this gas, or of the
Egyptian hasehish.  It seemed  probable that the ether
might be so long inhaled as to produce excessive inebri-
ation and insensibility;  but in several experiments the
exhilaration was so considerable that the subject became
uncontrollable, and  refused  to  inspire through the
apparatus.   Experiments were  next made  with the oil
of wine  (ethereal oil).   This is well known to be an
ingredient in the preparation  known  as Hoffman's  ano-
dyne, which also contains alcohol, and this was  accord-
ingly employed.  Its effects upon the three or four  sub-
jects who tried it were singularly opposite to those of the
ether alone.  The patient was tranquillized, and gene-
rally lost all inclination to speak or  move.   Sensation
was partially paralysed,  though  it was remarkable  that
consciousness was always clear,  the patient desiring to
be pricked or pinched, with a view to ascertain how far
sensibility  was lost.  A much larger proportion of oil
of wine, and also chloric ether, with and without alcohol,
were tried with no better effect.
   " It may be interesting to know how far medical inha-
lation has been previously employed.  Medicated inha-
lation  has been  often  directed to the amelioration of
various pulmonary affections with indifferent  success.
Instruments  called inhalers were employed long ago by
Mudge, Gairdner, and Darwin, and the apparatus fitted 
26
ETHER.
 up by Dr. Beddoes and  Mr. James  Watt for respiring
 various gases, has given birth  to some octavo volumes.
 More  recently, Sir Charles  Scudamore has advocated
 the inhalation of iodine and conium in phthisis, and the
 vapour of tar has been often inhaled in the same disease.
 The effects of stramonium, thus administered, have been
 noticed by Sigmard.
   " The inhalation of the ethers has been recommended
 in  various maladies, among which may be  mentioned
 phthisis and  asthma.  ' On  sait  que la respiration de
 Tether sulfurique calme souvent les accidents nerveux
 de certains croups,' is from the Diet, des Sc. Me"d.; but
 I find that mention  of  the inhalation of this  agent  is
 usually coupled  with  a  caution  against  its abuse,
 grounded apparently upon two or three cases, quoted
 and requoted.  Of these the first is from Brand's Jour-
 nal of Science, where it is thus reported: ' By impru-
 dent respiration  of  sulphuric  ether, a gentleman  was
 thrown into  a very  lethargic state, which  continued
 from one to three hours, with occasional intermissions
 and great  depression of  spirits, the pulse  being, for
 many  days, so low  that  considerable  fears were  en-
 tertained for his  life.'  Christison quotes the following
 from the Midland Medical  and Surgical  Journal, to
 prove  that  nitric  ether  in vapour  is  a  dangerous
 poison  when  too  freely  and too long inhaled:—'A
 druggist's maid-servant was found one morning dead
in bed, and death had evidently arisen from the air of
her  apartment having  been accidentally loaded %ith
 vapour of nitric  ether, from the breaking  of  a three-
 gallon jar of the Spiritus iEth. Nitric.  She  was found
 lying on her  side, with her arms folded across  her 
ETHE R.
27
chest, the countenance and  posture composed, and the
whole appearance like a person in a deep sleep.   The
stomach was red internally, and the lungs were gorged."
The editor of the  Journal where this  case  is related,
says he is acquainted with a similar instance, where a
young  man was found completely insensible from breath-
ing air loaded with sulphuric ether, remained apoplectic
for some  hours, and would  undoubtedly have perished,
had he not been discovered and removed in time.  Ether
is now  very commonly administered internally as a dif-
fusible  stimulant and antispasmodic, in a dose of one or
two drachms.  But here also we have  the evidence of
a few experiments  that  ether is  capable of producing
grave results under certain circumstances.  Orfila killed
a dog by confining a small quantity in the stomach by
means  of a ligature  around  the oesophagus.   Jager
found that 3ss. acted as a fatal poison to  a  crane.  It
was for a  long  time  supposed to be injurious to the
animal economy.   The old Edinburgh Dispensatory,
republished here in 1816,  explicitly states that it is to
be inhaled by holding  in the mouth a piece of sugar
containing a  few drops, and also that  regular practi-
tioners give only a few drops for a dose ; 'though,' it
adds, 'empirics  have  sometimes  ventured upon much
larger  quantities, and with  incredible  benefit,' p. 566.
Nevertheless, it was known  to  have been  taken in cor-
respondingly large doses with impunity.  The chemist
Bucquet,  who died of scirrhus of the  colon, with in-
flammation of the  stomach  and intestines, took before
his death a pint of ether daily, to alleviate his excrucia-
ting pains (he also took 100 grs.  of opium daily);  and
Christison mentions an old gentleman  who consumed 
28                    ETHER.
for many years sxvi. every eight or ten days.   Such
facts probably led Merat and De Lens, in their Matiere
Mddicale, to question its grave effects when swallowed.
Mentioning the case of Bucquet, they say, even of its
inhalation, that it produces  only ' un sentiment de frai-
cheur que suit bientot une legere excitation.'
   "This  variety of evidence tends to  show  that the
knowledge of its effects, especially those of  its inhala-
tion, was of uncertain character.  Anthony Todd Thom-
son well sums up what I conceive to have been  the state
of knowledge at the time upon this subject, in  his Lon-
don  Dispensatory of 1818.   ' As an antispasmodic, it
relieves the paroxysm of spasmodic  asthma,  whether it
be taken into the stomach, or its vapour only be inhaled
into  the lungs.   Much  caution, however, is required in
inhaling the vapour of ether, as the  imprudent inspira-
tion  of  it has produced lethargic and apoplectic symp-
toms.'  In his Materia Medica  and Therapeutics, of
1832, however,  omitting  all mention of inhalation, he
uses the following  words: ' Like  other diffusible exci-
tants, its effects are rapidly propagated  over the system,
and  soon  dissipated.  From  its volatile nature its  ex-
citing influence is probably augmented; as it  produces
distension of the stomach and bowels, and is thus applied
to every portion of their  sensitive surface.  It is also
probable that it is  absorbed in its state of vapour, and
is therefore directly applied to the nervous centres.   It
is the diffusible nature of the stimulus of ether which
renders it so well adapted for causing sudden excite-
ment, and producing immediate  results.   Its effects,
however,  so soon disappear, that the dose requires to be
frequently repeated.' 
ETHER.
29
   "Nothing is here said of inhalation, and  we may
fairly infer that the process had so fallen into disrepute,
or was deemed to  be attended with such danger, as to
render a notice of it  superfluous in a work treating, in
1832, of therapeutics."
   The paper from which the  above is  quoted,  as  a
whole, is one of much interest, and would have reflected
infinitely  more  credit upon its  author  had sulphuric
ether not been the " new agent."
   Very soon after the caveat had been secured, a rup-
ture occurred between these  two professed discoverers,
which has led to a vast amount of controversy, much
bitter feeling, and some  truth.  They each deny that
any credit belongs to the other.   This is  true to a very
considerable  extent; but I hope  to show, in as  brief a
manner as possible, that the world is really under obli-
gations to them both, for the sudden and simultaneous
adoption of ether in surgical practice in all  civilized
countries.
   The known reputation of Dr. Jackson as a scientific
chemist, carried with it much force when  the assurance
came from  him that  pure washed sulphuric ether was
innocuous (in view of a healthy condition), when taken
into the lungs sufficiently to induce narcotism.
   The bold  experiments  of Mr.  Morton, even to the
shutting off or partial exclusion of atmospheric air, and
the holding  of a burning  candle within  a  few inches
of the mouth of a patient while  under its influence, are
certainly worthy of much consideration.  They serve at
least to imbue us with additional confidence in its safety,
when used in a prudent, careful, and proper manner.
   There is so much that is disagreeable to dwell upon
                         3* 
30
ETHER.
in the contest which was carried on between the parties,
professedly  friendly to the various claimants for dis-
covery in this matter, for more than a year, that  I feel
anxious  to  draw this part of ether history to a rapid
close, and only desire  to  state wThat seems  to  me  the
most rational conclusion as to its discovery:—
   1. To  Sir Humphry Davy unquestionably belongs the
credit of first suggesting the idea of inhaling into the
lungs some agent which would deaden sensibility during
painful surgical operations.
   2. To  Mr. Horace Wells of Hartford (now deceased),
as unquestionably belongs the  merit of having first de-
monstrated this happy idea, by using both nitrous oxide
and sulphuric ether  for this purpose.
   3. To  Dr.  Charles T. Jackson, of Boston, the thanks
of the world  are due for lending that influence which
his well-earned reputation so  admirably qualified him
to do, in establishing confidence in the public mind in
the use of sulphuric ether, as a substitute  for the nitrous
oxide; and
   4. To Dr.  W. T. G. Morton, dentist, of Boston, we
are under obligations, for his indefatigable  exertions in
securing the attention of leading medical men to this
subject;  and thus rapidly expediting the use of sulphuric
ether in  connection with the practice of surgery.
   Within ten days of the appearance  of  the  article
before referred to (Dr.  Bigelow's), it was  understood
that sulphuric ether was the  principal, if not the only
ingredient, used in  the cases reported by him.  Accord-
ingly, experiments were performed with that material in
my office on the evening of Nov. 28th, 1846, Drs. Bond,
Roper, and Dillingham being present. The effects upon 
ETHER.
31
most of those who inhaled it on that occasion, will be
seen under an appropriate head in another part of this
work.   On the following  day I used  it  in my practice,
and have continued to do  so ever since.
  The excitement occasioned by the  introduction of
ether inhalation for the period  of two  or three years,
was, perhaps, as  great as  that  attending  the  earlier
practice of vaccination, though, as yet,  I have heard of
no one  being actually stoned for resorting to its  use.
Whilst one portion of the medical and  scientific  world
were extolling its merits with  unbounded praise, others,
equally  learned, were most  actively engaged in  con-
demning it, for reasons which I will proceed to show.
  1. The prudent saw the  liability to abuse, in the
wholesale  manner  in which it  was likely to  be used by
a large  class  of men, totally unqualified to administer
it.  This  was  a  motive  for  its opposition,  not   only
creditable to  the foresight of such as  assumed this posi-
tion, but it has had a most salutary  effect in  confining
its use to its  legitimate limits.
  2.  The timid  have  been uncompromising in  their
opposition to ether, through  imaginary evils that  Avere
constantly about to occur; fears that have  never been
realized, not  even slightly, except by gross abuse, and
in no one instance attended by fatality!  The effect of
this  timidity  on  the  part  of those  who should  have
ranked  among the pioneers in this cause, has been to
influence a large  portion of  the community with the
same  sentiment.   The unpleasant effects of the ether
under these  circumstances,  will be  shown  in another
place.
  3.  Religious scruples  have had  their influence in 
 32                    ETHER.

 opposing this heaven-sent agent.   This objection  has
 mostly, however, been  confined to its  use  in  obstetric
 cases.  The idea  that  God  desires us to suffer bodily
 pain  under  certain circumstances, and that  it would
 contravene His will to resort to the use of sulphuric
 ether, any more than  by using other remedial agents,
 is probably the quickest met, by allowing those to suffer
 who prefer to suffer; whilst others may find new cause
 of thankfulness in freely  using this blessed gift.  This
 objection will be subsequently considered.
   4.  Jealousy has had a  large share in traducing  sul-
 phuric ether.  Physicians have opposed it for the very
 cogent  reason, that it was the discovery of a dentist!
 Some repudiate it, because  of its Yankee  origin !  and
 others condemn it, who feel their incompetency to ad-
 minister it.
   Such have been, and are yet to  a considerable extent,
 the leading objections made  and  held against  ether in-
 halation.   It has been made  responsible for its mal-
 administration.  Deaths, and less serious injuries, result-
 ing from  the use  of other agents, particularly chloro-
 form, have been freely attributed to sulphuric  ether.
 Falsehood has been busy with its thousand  tongues,
 and  rumour has  not  unfrequently  " amputated   the
 healthy limb, and  left the fractured one to recover."
   The following case  occurred in my  practice  in  the
 earlier part of ether history, which I report, as  a fair
illustration of the many  attempts to bring it into dis-
repute.—Dec. 29th, 1846.  Mr. K. brought to  me  his
son, about 12 years of age, to have a lower molar tooth
removed, which had been  very troublesome for some
time.   He took  the  ether, and  with pleasant results. 
ETHER.
33
 The third day after the operation a lady informed me,
 that she had heard the ether had made this lad quite
 sick.   Again that  day, some  one  informed  me  that
 such was the  case.  I replied, " I thought  not; as his
 father would most probably have sent for me, if such
 was the fact."   The next  day my friend, Mr. Dilling-
 ham, a dentist and near neighbour, called upon me, and
 stated that he had heard a similar report.   I immediate-
 ly called upon Mr. K., and  inquired after the health of
 his son.   He said he had been very sick,  but was then
 better.  Upon my asking him  if he thought the ether
 had anything to do with his  case, he immediately an-
 swered " Oh, no,—it was  not  the  one that took the
 ether,  but another son !"
   The excitement that prevailed throughout the summer
 of 1847, will not soon be forgotten.  Ether had been
 adopted  by most of the hospitals of Europe and approved.
 Soon,  statistics  went  to  prove  that  from  15  to  20
 per cent, of human  life was saved in capital operations
from  its use alone.   Most  of  the English  and French
 medical  periodicals contained  little else of interest.
 Experiments were performed with it in every variety of
 way, upon all kinds of animals.  In short, the  ordeal
 through  which ether passed, was rigid in the extreme.
   For a period, the  subject of ether inhalers occupied
 public  attention  largely.  Much  ingenuity  was spent
 upon  these articles;  but as a general thing, those that
 had a  valve here, and a stopcock there, were  considered
 by far the best.   It was not long, however,  before they
 ceased to  be used altogether,  and a simple  sponge, or
 napkin, saturated with ether, became their substitute.
   Stripped of its mysteries, and outliving a bad  name, 
34
ETHER.
at the close of 1847, ether was acquiring a rapid popu-
larity.   Many, it is true, still continued  to  oppose it, „
in order to maintain their consistency; but it was  evi-
dently hard for these  to  stem the popular current, as
was shown from the position they occupied on  the  in-
troduction of Chloroform.
   In the early part of January, 1848, this new anaes-
thetic agent made its appearance  in  Philadelphia.   Its
application as a substitute for sulphuric ether was  dis-
covered by Professor J. Y. Simpson of Edinburgh.  Ac-
companying a formula for its manufacture was a report
of several cases  out of  about forty in which Prof. S. had
administered it; all of which were attended with favour-
able symptoms.  The  first  that was used in this  city
was by myself.  After using  it in a few cases  (one of
which was for amputation of the breast), with agreeable
results, I published an  account approving it, for  reasons
similar to those  set forth by Dr. Simpson.  Immediately
the cry was loud in its  favour,—so  much so that no
apprehensions as to its safety were expressed in my
office by one in ten who took it at  my hand.
   The part taken by those who had been consistent op-
ponents of ether, was amusing at this period. The often-
quoted remarks, " Now we  have  an article that is per-
fectly safe."   "I always said that ether  would soon be
forgotten," &c,  &c, showed too plainly how chloroform
came to the relief of—the enemies of anaesthesia.
   What inspired this community with such sudden con-
fidence in the use of chloroform ?  Had Professor Simp-
son, of Edinburgh  (not a professed chemist), such ad-
vantages  of reputation   over Professor  Jackson  (a
chemist), of our own country ? Or were some forty or 
ETHER.
35
fifty successful experiments with  an article so new and
strange, and withal so much more powerful in its nature,
sufficient  to  establish its supremacy over  ether, which
had  been  used by  so many thousands  with  perfect
impunity ?  Strange as all this seems it is none the less
true,  that confidence  was placed in chloroform  as  a
plaything, which was denied to ether for useful purposes !
How stands the case at present ?
  Very soon after my adoption of the use of chloroform,
I discovered this  remarkable peculiarity as one of its
most frequent features.  What were premonitory symp-
toms in ether inhalation, became secondary when chloro-
form was  used.  I also had  occasion to observe that a
large  per cent, of my patients made complaints that
never pertained to the use of ether; and, consequently,
I felt it my duty to caution the public, at that time,
in regard  to  it, in an article through the columns of
the " City Item."   I  think  this  was the  first note
of alarm  that  was sounded  against  chloroform in this
country.   Soon after this,  a  case of death  was re-
ported as having  occurred  in Cincinnati  from its
mal-administration.  The public mind received a  shock
by this announcement which lasted for  some  weeks.
Chloroform was proved  to possess the power  to kill;
and ether, as  a  matter of  course, shared largely in
its disgrace.   Every unfavourable  case  that  reached
us from abroad, where  chloroform  was the agent  em-
ployed, was as frequently attributed to ether, and by
this means additional causes sprang up to increase the
alarm of the timid.
  Chloroform has  now almost ceased  to be used in this
section of the country, except to be mixed in very small 
36                    ETHER.
proportion with the ether, and, occasionally, by local
application.—(See chap, on Local  Application.)
   Anxiety upon the subject of ether was  not confined
to this country.   Idle tales  and false alarms circulated
as freely in London as  in  Philadelphia, as an  extract
from a transatlantic brother will  serve to show.   The
following is from  the  pen of J. Robinson,  Surgeon
Dentist, London :—" It is well known that deaths have
followed operations in which etherization was employed,
and out of the number that have taken place in England,
four at least have  been more or less publicly attributed
to the ether.  The four cases to which we  refer are—a
case of lithotomy  in one  of the  London  hospitals; a
case of amputation  in  private practice  by an eminent
London  surgeon; a case of lithotomy  at  Colchester;
and a case of the  removal of  a tumour at Grantham.
The subjects of the foregoing cases survived the respective
operations about the following periods:—the first, twelve
days ; the  second, three days and a half; the third,
more than two days; the fourth, more than one day.
   " The most  remarkable features of these cases, as
reported, appear to be,
   " 1st. In the Colchester case of  lithotomy, the patient
recovered from the effects of ether after a short time,
and continued in  a quiet, passive state, but  without
decided reaction, for twenty-four hours.  At this period
he had a chill, which lasted for nearly twenty minutes.
Not long after this chill, there supervened a state of
collapse, from which the patient  never  rallied, though
he lived after it upwards of twenty-four hours.  Nothing
particular was  found in the body on dissection, unless 
ETHER.
37
we  consider  'the fluid  state of the  blood,' and  the
' flaccid state of the heart,' as such.
  " 2d. In  the Grantham case  (removal of  a  large
malignant tumour from the back of the thigh), the ether
did not produce  the  usual full effect of insensibility.
The operation was a severe and long one, lasting fifty-
five minutes.  When put to bed she appeared conscious
—indeed, she seemed quite conscious during the whole
time from  the operation till her decease.  She never
rallied,  however,  after the operation,  but lived about
twenty-eight  hours after it.   In this case,  also,  the
blood was found fluid on dissection, and there was some
congestion of the brain.   There was no other unusual
appearance.
  " 3d. In  the case of  amputation in private practice,
the patient, a gentleman upwards  of seventy,  was
placed under  the influence of the ether by an expe-
rienced man, and took about the average quantity.   He
does not,, however, seem to  have been  completely af-
fected by the ether, as he gave signs of pain,  and after-
wards said he had felt some pain during the  operation.
He seemed  doing pretty well  for a time, though never
rallying satisfactorily.   He, however, lived nearly four
days, presenting various anomalous nervous symptoms;
among others slight  recurrent  delirium.  The stump
did not put on the healthy reparative process.
  "4th. In the  case of lithotomy in the boy, all  the
primary effects of the  ether  passed  off' as usual;  the
patient living many days, and dying from the effects of
local inflammation, the consequence  of the  operation.
In this case, there is no mention made of fluidity of the
blood, in the  account  of the  dissection  with which we
                          4 
88
ETHER.
have been favoured by the eminent surgeon of the Hos-
pital.
  " The question is  here  put to the candid  considera-
tion  of all experienced  surgeons, whether there is any-
thing in any one of these cases specially different, or in
any respect different, from what they have repeatedly
seen after severe operations, performed before the em-
ployment  of ether ?  In three of the cases we have the
ordinary phenomena of  'shock,' or 'sinking,' varied as
it has been ever seen to vary in different cases.  In the
Grantham case, a most  unusually long and severe ope-
ration (and in which, by the way, as well as in the case
of amputation, it may be fairly questioned if the system
was ever fairly under the  influence of ether  at all), we
have  scarcely any attempt  at rallying,  and  gradual
sinking to death within  thirty-six  hours.   In the case
of amputation, we  have  nothing like  immediate sinking,
but that anomalous,  nervous state,  described  by  Mr.
Travers as  'prostration  with excitement,'  eventually
ending in  death after five  days.  In the lithotomy case
in the boy, we have nothing but what is witnessed every
year in every hospital; feeble reaction  in a bad subject,
followed  by unhealthy  inflammation and  death many
days after the operation."
  Here follows a  report of twelve cases, where opera-
tions had been performed without the use of  ether, ter-
minating fatally; the symptoms of which were so per-
fectly in keeping with those previously mentioned, that,
without question,  had this agent been  employed, no
other cause  would  have  been thought  necessary to
account for the sad catastrophe.
  The same work shows that, out  of eighty-nine cases 
ETHER.
39
in which  ovariotomy  had been either  performed  or
attempted, thirty-four sunk, or nearly four in  every
ten cases died.
  In  201 amputations of the thigh, 126 died,  or 6 in
every 10.
  " In the Edinburgh Infirmary, during the four years
commencing July, 1839, there occurred 72 amputations
of the thigh, leg, shoulder-joint, arm, and forearm.   Of
these 72 patients 37  recovered  and 35 died, or nearly
5 in every 10.
  " In the many other cases  furnished by this valuable
report, the evidence, as collected,  principally  goes to
prove that in similar operations, from 4 to 6 in  10 have
proved fatal.
  " It would appear, on the one hand, we have three
cases, out of the many hundreds of etherized  patients
subjected to  capital operations, in  which the patients,
after the departure of all the peculiar effects or  primary
symptoms produced by etherization, such as sopor,  in-
sensibility, &c, succumbed with a set  of other, and
equally  peculiar  secondary symptoms, well  known  to
surgeons;—well known to terminate frequently in death,
and, in the cases in question, presenting  not one pecu-
liarity to distinguish them  from the old,  ordinary eases
of ' sinking from shock.'  On the other side,  we have
many thousands of instances in  which the same process
of etherization was had recourse to for slight operations,
such as extraction of teeth, or for mere experiment, and
in which all the  same primary phenomena of etheriza-
tion were as effectually induced as in the  others, and
yet, not  one  example of the occurrence of the peculiar
secondary symptoms referred to, much less any instance 
40
ETHER.
of death.   If, in the fatal  cases, the etherization was,
in any way, the source of these  peculiar symptoms, or
the cause of death, is it not most extraordinary that in
the other thousands  of instances it should  not  have
given  rise to some of  the symptoms  which  in  these
cases preceded death, or even death itself?  What was
the sole peculiarity that existed in the two sets of cases
that have relation to  the process of etherization ?  Only
the important one, that in  the set in which the deaths
supervened  there was  a severe operation, and  in the
other there was not.   Is not  the conclusion irresistible
that in these fatal cases it was the operation, not the
ether which killed the patients ?"
   Great caution has been  manifested, particularly in
this meridian, in adopting the use of ether, as a general
thing, in surgical operations.   I, of course, cannot com-
plain of this, knowing, as I  do, that a large share  of the
alarm was naturally produced  by  the fact  that  this
powerful agent was in  the hands of irresponsible men;
used by them  indiscriminately,  without any knowledge
of its medical properties, its physical  or psychological
effects; and without  those necessary  precautions so
requisite to a  correct diagnosis.  This  has been enough
of itself to create disgust; but, as the greatest fear has
been apprehended  from its primary  effects, such as
producing asphyxia,  apoplexy, rupture  of the   aorta,
prolonged insanity from congestion, &c, and no such
cases  have, as  yet,  been reported,  it  is really  to be
hoped that, in  future,  more  confidence will be  mani-
fested by the  faculty, in its innocence as well  as  in its
usefulness.
   In regard  to its secondary  effects upon the system, 
SULPHURIC  ETHER.
DIRECTIONS FOR ITS ADMINISTRATION, BY INHALATION,
  FOR SURGICAL AND DENTAL  OPERATIONS, WITH  SUG-
  GESTIONS TOUCHING ITS USE IN OBSTETRICS.

  I know of no condition wherein the use of this article
can be considered  as really dangerous, if governed by
a knowlege of its  effects  under all circumstances, and
handled with that prudence  which should ever be exer-
cised  in the use of all powerful agents.   Steam may be
used with safety in a poor boiler, in view of certain con-
siderations, none  of which,  however, embrace the idea
of ignorance or recklessness  on the  part  of  the en-
gineer.
  Ether, to be inhaled into the lungs, should be very
highly rectified, washed free from its acid and alcoholic
properties, rendering its specific gravity but little more
than half that of distilled water.
  No apparatus should  be used as an inhaler  which
does not amply provide for the admission of atmospheric
air, or that by  any means would  render the breathing
difficult.   A good  sponge, well and frequently saturated
with ether, is probably the best and simplest method of
administering it; but a tumbler or  cup for the purpose
of holding a sponge, has  been both convenient and eco- 
44
ETHER.
nomical, particularly when the frequent use of ether is
required.
  It is well to establish that understanding between
yourself and your patients which will secure their most
implicit confidence,  both in yourself and in the full
power  of  the  ether  to  accomplish the  end desired, re-
quiring them to answer  any question you may put to
them while  inhaling, as long as they perfectly compre-
hend you.  By the manner in which they answer, you
will find  one very  good guide when to  perform  the
simple operation of extracting one or two teeth. I have
found  that partial etherization has been preferable in
nearly all short operations, and particularly where the
co-operation of the patient has been at all desirable.
  The pulse should  always  be consulted.   Its general
tendency  is  upward or quickened.  When this takes
place very rapidly, it is proper to cease giving the ether
for  a  few inhalations, or until  reaction  takes  place,
when a repetition  of  the  ether will not unfrequently
promote its  downward tendency.   Under ordinary cir-
cumstances I consider  it safe to increase a pulse to 160
(one hundred and  sixty) beats in  the minute; or to
suffer  it to  decrease to 50 (fifty), but of  course there
must be  exceptions to this  rule  too obvious to need
particularizing.
  The expression of the countenance and temperature
of the head should be observed. When the face becomes
suddenly  turgid, cold  water  should be applied to  the
forehead and  temples, suffering the patient to breathe
ammonia,  or concentrated vinegar, allowing at the same
time plenty  of fresh  air, directing them to take full and
rapid inspirations.   The variation of the  temperature 
ETHER.
41
in view of an operation, we at present only know that
a  few cases  out  of many thousands  have. terminated
fatally;  and, as reported, "because  no reaction took
place!"   Now, this very want of reaction would  seem
to imply a want of  perfect  etherization, or that the
patients had  received  a moral  or physical "shock"
previous  to  the  operation;   for  one  of the greatest
merits ceded to the ether  is,  that it spares the  patient
that sudden  prostration so common in  the  use of the
knife: 1st, morally, because he is assured, and has con-
fidence that  there  is nothing to dread;  and 2d, physi-
cally, because, in fact, the operation is painless.
   The time has already arrived, that establishes  beyond
a question the use of sulphuric ether, in connection with
surgery  and parturient patients.   But  inquiry should
not end here.  It seems to me to be the duty of every
man who engages in its administration, to observe most
particularly all its effects; and, in an  especial manner,
where disease of  any kind is  known to exist. By pur-
suing  this course, the day is not far distant when  ether
will be admitted to the widest field of  therapeutics, and
thus made eminently  conducive to human happiness.
   Since writing  the  foregoing, several  articles  have
appeared in the " Transactions of the  American Medi-
cal Association," all of which are commendatory of
ether  and chloroform.   They  will do  much in  esta-
blishing a  confidence  among  medical  men.   But as
they are likely to be read by physicians only, they do
not  meet  the demand of  the general  inquirer.   The
public have  received a  fright or shock  at the hand of
medical  alarmists, that cannot be so readily allayed by
                          4* 
42
ETHER.
contradictory  statements  reported in  this  form,  and
intended for the professional eye alone.
   Two remarks which I quote from the above work are
too much in keeping with the views  I have held for a
long period, not to mention them here.  They will be
found on p. 246, vol. ii.    In speaking of advantages
unlooked for in its use, the article says:—" It will be
not a little curious  should observation prove  that  a
danger,  which anaesthetics  were  supposed  likely to
increase, is  diminished  by them."   Again, in relation
to obstetric cases.   "A  year ago, a  very  intelligent
committee of  the  Association  expressed the opinion
that they (anaesthetics) had then  been given to more
than two thousand parturient women.   That this num-
ber has been, during the past year, more than propor-
tionably increased, the committee have no doubt.   The
practice has,  as  they  believe, gained ground  every-
where, and has, in some places, become almost general.
The cases must certainly now be enumerated by thou-
sands.   In no one has a fatal  result followed.  No one
woman has yet lost her  life in consequence of the pains
of her labour having been  controlled by etherization." 
ETHER.
45
of the head is best detected by the habit of taking the
pulse from the temporal artery.
  The ether  should be  brought gradually to the mouth
of the patient,—by so doing all irritation of the larynx
and lungs is avoided.   Direct to take regular and natu-
ral  inspirations, to avoid  swallowing  the vapour;  and
should the breathing become stertorous, or  in any way
distressed, desist from its use until the  natural breathing
is restored.
  If it should be found  desirable to give  the ether to
that extent to induce  narcotism,  never suffer  yourself
to be thrown off your  guard by  any  demonstration on
the part of your  patient.  Firm,  cool conduct  on your
part is more  remarked  by the patient  than the casual
observer would suppose.   It  is not unfrequent that a
loud  outcry  may be induced, a  distressing groan, or
other  manifestations of inconvenience  or  pain, which
invariably pass off, and the strongest assurances  are
given  by the  patient,  if  aware  of this fact,  that he
knows of no  particular  reason for  such conduct.
   It  will be found, after  inhaling for a minute or two
and no effect is produced,  that by allowing the patient
to take one breath of atmospheric air considerable diz-
ziness is felt.  As a  general thing, a very few inhala-
tions -vcter this are sufficient; and if the patient should
resist, it is  best  not  to  meet  that resistance  by any
physical force, but by firm yet kind treatment.
   Should the operation  be  one  that  will  require  the
introduction  of the finger or thumb between the teeth
of the patient, it may be  well to  protect it with a ban-
dage, in view of his closing the mouth.
   If ether should  produce much prostration (which it is 
46                    ETHER.
most  apt  to  do when the atmosphere  is least charged
with oxygen), it is  well  to recommend self-exertion, as
walking about, &c.;  but if the  desire to sleep is  too
strong to  be  resisted, entertain no fear from that in-
dulgence,  as  the patient  will soon awake refreshed.
  After inhaling for a certain  period, should any spas-
modic action occur  to retard breathing, sprinkle a little
cold water suddenly into the  face, or a  pretty active
slap between the shoulders, will  be sufficient to relieve
any obstacle  in this respect.
  I have  occasionally given the  ether  for the removal
of a tooth, and, when the effect  passed off,  some little
complaint of headache was made, but a few inspirations
of  the same  by  the  nose will invariably remove this
difficulty.
  The foregoing directions were prepared by myself in
1847, and published in the " Dental  News-Letter," for
the purpose  more  particularly, of securing  a safe  ad-
ministration  of ether in dental operations. When used,
however, for  painful and  long-continued surgical cases,
it should  be given more intensely.   The knife should
not be  used until  the  patient is  brought  completely
under its  influence; and  fresh ether and fresh air should
be alternately inhaled in such proportions as the  case
may require  to keep the  patient perfectly passive.
  When used  in labour,  the  directions  are so very
simple as to  render  it  almost impossible that any one
can be injured by it, even if she should take  into her
own hands its supervision. The pains are of a character
that may  always be entirely relieved or much mitigated
by  the ether, at a point  far short of the loss of con-
sciousness ; and no  woman of  ordinary judgment could 
ETHER.
47
be using the ether for the space of five minutes, under
these circumstances, without really knowing more about
it than any one can tell her,  though a volume be filled
in so  doing.   It is only necessary that the cloth or
sponge should be frequently supplied  with fresh  ether.
I would be understood in this, of course,  to have refe-
rence  to a natural  labour and healthy condition of the
patient.
  In regard to its use in complicated cases, it will often
be necessary to administer it to its greatest extent, and
in view of this, those directions  which are given for its
use in  dentistry and surgery will be found applicable.
  I believe there can be no previous condition of health
which  can be made  to suffer by a judicious use of ether
in childbirth, so much  as by  withholding it, unless,
indeed, it be aneurism  of  the  aorta; and even to this
critical condition of the  system do I carry my doubts. 
SULPHURIC   ETHER.
             ITS PHYSIOLOGICAL EFFECTS.

   TnERE is, probably, no one article in the whole range
of  Materia Medica,  used as  a specific,  which, being
taken  into  the  system, presents so great a variety of
contradictory and  conflicting  phenomena as sulphuric
ether,  both as  relating to different individuals  and to
the same person under different circumstances.
   This is forcibly illustrated, in the first place,  as a
matter of taste.   To  most people the smell of the ether
is particularly  agreeable, if  not  approached  too  sud-
denly.   Others  entertain for it no  particular fondness
or disrelish, while another class are  much annoyed by
the least recognition of  its odour.   Tastes also  vary
under different conditions of health; and, perhaps, other
trifling circumstances may serve to influence our ideas
in this respect, as for instance, its being taken  upon a
full or an empty stomach.
  I have never known an  unpleasant dream to occur,
or  any unpleasant  effects  whatever  (everything  else
being equal), when the ether has been agreeable to the
palate.   Hence, I view it as  important so to administer
it, as to make it the most agreeable, or  least objection- 
ETHER.
49
 able to the patient.  Affectation of dislike to the ether,
 even, will have its pernicious influence upon the mind.
   Ether varies as an irritant to the mucous  membrane.
 Its vapour frequently induces considerable coughing,
 and its liquid  application, excoriation.  In others, it is
 similarly used  with the greatest impunity.   It most fre-
 quently becomes a counter-irritant if inhaled during a fit
 of spasmodic coughing.
   Ether is exceedingly pervious to  the  air-cells of the
 lungs, being more persistent in its effects, in proportion
 to the depth it may have reached, over and  above the
 former free ingress of atmospheric air.  It has  been
 known, in  a  few  instances, to be  retained  upon  the
 breath for an entire week.  It affects the breathing as
 variously as it  does the pulsations  of the heart, or the
 working of the mind.  Sometimes  the  breath is short
 and quick;  at  others, long-drawn and full.   It will not
 unfrequently be accompanied  with  a groan  or  snore,
 and as frequently induce the  quiet  breathings of the
 infant.   All these effects,  however, are  very much
 within  the  control of the operator,  and great pains
 should  be taken to establish that system of breathing,
 which it may be most  desirable -to keep up during the
 whole process of inhalation.
  The  effect of the ether upon the heart is most fre-
 quently to quicken somewhat  its  pulsations.  It  also
 induces a gradual  decrease and weakening of the pulse,
 and it is not unusual that no perceptible variation takes
place, from what  may be  considered as a perfectly  nor-
mal condition of that  organ.
  Deoxydation of the blood has been attributed to the
ether.   Although  no  alarm has ever been  expressed
                          5 
50
ETHER.
from this fact, I am disposed to believe, that whenever
the arterial blood has been found unusually dark, there
has been some mismanagement in the administration.
There has been a great variety of inhaling instruments
constructed, many of them  with the express object  of
shutting off  the  atmospheric air.   Now,  inhaling the
ether under such circumstances would be most likely  to
induce apoplexia suffocata, and the blood would be very
apt to present all  the appearances it  does when sub-
jected to congestion from any other cause.   A capital
surgical  operation where this state of things exists, has,
probably, saved the lives of many from the consequent
loss of blood.
   In  perfect etherization, its effect is  to  relax all the
voluntary muscles, without seriously affecting the action
of  those commonly called  involuntary, as  the heart,
lungs, uterus, &c.;  and, whenever  these  functions are
interfered  with, it  becomes modified by  the judicious
use of the ether alone.
   Copious  perspiration, accompanied  with  heat over
the whole  surface of  the  body, the head and trunk
heated, with the extremities cold,  a numbness in the
hands  and feet, and a noise in the ears,  are the most
usual  effects of the ether.   But these are productive  of
no other  inconvenience than as  they may  prove agree-
able or disagreeable at the moment of inhaling.
  The action of the  ether  upon the  nervous system
will be found in the paper  of  M. Longet, introduced
in another part  of this  work, also under the  head
"Neurology." 
      SULPHURIC  ETHER IN  SURGERY.


  I believe that  ether has been used in almost every
variety of surgical cases that are at the present  day
known and  practised.   If  there  are any exceptions to
this universal usage, they  have probably been mostly
those  of deep-seated diseases, or of  malformation about
the throat, rendering  it important  that  every  facility
should be enjoyed by the operator, even to the presence
of mind  on the part of the patient.  Still, very many
formidable  operations of this character have been per-
formed with the  aid  of the  ether.   Others have been
commenced  under its  influence, saving  to the  patient
the whole of the pain  and shock incident to  the first
and most extensive incisions, and then suffered to pass
off, if the nature of the case seemed to require it;  also,
in a few instances, it has been  resorted to in the latter
stage  of an operation, when the pain  would have been
intense without it, and circumstances could allow of this
half-way system of using it.
  So  generally and so  frequently has the ether  been
employed by surgeons during the past four years, sim-
ply for the purpose of abrogating pain  in the passage
of the knife, and so much has been written establishing
this fact, it would seem hardly  necessary for me to
multiply  words upon this part of my subject, merely to 
52
ETHER.
recapitulate cases that have  already been reported in a
way to meet the public eye.   Still a few suggestions in
this place may not be  amiss.
   It has heretofore been deemed  all-sufficient that  the
ether has* secured  a  painless operation;  and  without
leaving in its train  any serious or bad consequences.
This, to  be sure,  is  the  primary consideration, and
one, of  itself, of immense  magnitude.   All its inci-
dental effects,  both  upon the mind and the body, have
been too much overlooked;  they have, at  most, been
viewed  as ether peculiarities, and suffered to pass  too
easily from the minds  of those who have witnessed
them.  I would suggest greater care and closer observa-
tions in  these respects.   I believe  none  are better
qualified  to investigate this matter than  the surgeons
and physiologists of our own country, and I trust they
require no other incentive  to action than the assurance,
that it is a field, not only for useful, but exceedingly
delightful investigation.  I am satisfied that ether pecu-
liarities are intended to subserve some greater end than
to  add  merely to  our  momentary  amusement.   The
surgeon  who  is  in  the  constant use  of the ether will
have frequent  opportunities  of observing  these effects,
and an occasional report of them may serve greatly to
the advancement of mental philosophy.
   I would recommend the use of the  ether in all cases
of probing or sounding, as in wounds, fistulas, affections
of the urethra, bladder, &c.   I was present at a case in
company with my friend Dr. Griscom, where it was  im-
possible to administer  an enema in consequence of  the
great irritation of the  parts.  The ether  was inhaled,
and the difficulty entirely obviated. 
ETHER.
53
  As the advantages of ether in  surgery will be made
to appear in  every case reported  under other heads in
this little volume, I shall proceed at once to their con-
sideration.
5* 
PATHOLOGY,
 CONSIDERED IN CONNECTION WITH ETHER INHALATION.


   Early fears entertained  in the  use  of  ether, from
any diseased condition of the system, led to by far the
most serious objections urged against its indiscriminate
administration.  These objections, it will readily be seen,
were of a character to preclude a large portion of the
community  from participating in its advantages,  ren-
dering it of .the greatest importance that its use should
be limited as much as possible to the hands of careful
medical men.
   Empiricism, to  a certain extent,  must be employed,
in view of these circumstances, to feel our way along;
to use the  ether  as a  prudent navigator would throw
his lead in passing into an unexplored harbour, was the
duty its pioneers had to perform.   Among this class it
has  been my lot to be placed, even at the risk  of being
denominated "quack."   But the  following cases  are
submitted, and the truth they may elicit must be  my
justification.
   Case I.   Bronchitis.—Miss J., a patient of Mr. D.
Neill, dentist, was brought to me by that gentleman, in
the summer of 1847, for the purpose  of  taking  the
ether to have several teeth extracted.  She  had been a 
PATHOLOGY.
55
 sufferer from the above complaint for more than a year,
 and no previous treatment had afforded her relief.  I
 gave her ten  or twelve  inhalations of ether.   It  pro-
 duced considerable irritation, and  I  requested her to
 call again  that  afternoon to let  me know its effect.
 She  did  so, informing  me  that  she  felt no further
 inconvenience since the  morning's experiment.   I  pro-
 ceeded to give her more.  She inhaled  it more easily
 at  this second  exhibition, when I carried it  to such
 an extent as to produce a slight dizziness, and then
 stopped, desiring her to call the next day, when I  pro-
 mised, if she felt no serious inconvenience from  previous
 trials, I would give her enough to allow of the removal
.of  some of her  teeth.   The next day  she called,  and
 stated that, so far from  injury, she felt  that the ether
 had been beneficial.  I administered it  that morning,
 and several teeth were  removed.   Upon awaking, she
 felt no inconvenience, and desired me to  give her more.
 This  I declined  doing, for the reason  that the remain-
 ing portion of the operation would lead to the necessity
 of  taking  more  ether than I thought would be prudent
 at  that time, and an intermission of a  few days would
 enable  us  to form a better conclusion as to its effects
 upon the throat.  Three days after this the ether  was
 given again, and the operation completed;  Miss J. ex-
 pressing herself  as feeling perfectly free from her  for-
 mer complaint.   The fauces presented nearly a healthy
 appearance.*
  Among many similar cases wherein I  have used  the

  * The foregoing case I took occasion to call to the attention of
 Drs. C. Morris, J. D. Griscom, and other medical friends, at the
 time of its occurrence. 
56
ether.
ether, I have had  opportunities  of carrying  out  my
observations  in two others only.   One of these was a
gentleman about  thirty years  of  age, the  other, a girl
aged fourteen; in both of which the ether effected cures
without  the  aid of any other  agent.   In  none of the
others have I heard of injury resulting.*
   Case II.  Hysteria.—Perhaps  the most remarkable
and interesting case I can relate  under this head is the
following :—A young lady, aged 17 (habits not formed),
came to  have two very large and much decayed lower
molar teeth extracted, accompanied by her  father.   She
resisted the operation most strenuously.  He very man-
fully assisted me, feeling,  however painful, it was  a
duty that must be  performed, as his daughter's health
was suffering.  I think, in the whole course of my prac-
tice, I never  have witnessed a more distressing scene.
Her  screams were alarming,  and  her  sobbing  and
moaning, for  two or three minutes after the teeth were
out, were enough to harrow the feelings even  of a den-
tist; when, suddenly, she laid her head back upon the
chair; her features  perfectly calm, she exclaimed to our
astonishment, "Oh, what a heavenly dream I  have had !
I thought I was at a ball, dancing the  polka, and such
a band of music!"  All  this was told with constant

  * In a letter from Dr. Protheroe Smith, of London,  to Professor
Simpson, he says this: " I have kept patients under its (chloroform)
influence from half an  hour to twenty-eight and a half hours.  I
have used it in cases in which bronchitis was present;  and one
lately in which, at the time, there was complete aphonia."
  As this was a case of  parturition, and  the Doctor further says:
"She has never  had so good a time," in previous confinements, the
inference is, that she sustained  no injury from its use as relates  to
the throat. 
PATHOLOGY.
57
interruptions from her  sobbing, an accompaniment she
found it difficult to reconcile with  her  feelings.   She
assured us she had not been  hurt by the operation, nor
suffered the least inconvenience.
  A very similar case to the above, was one of a young
lady about the same age, who,  upon being questioned
why she cried so bitterly, exclaimed, " I cannot  tell,
unless it  is for joy that the teeth are out."   She  said
she suffered no pain in the operation, and did not know
the teeth were out, until  she saw she was spitting the
blood.
  I have noticed this peculiarity in hysterical patients :
if the fit is occasioned by  the idea of the operation, the
ether will almost invariably allay it.   If, on the  con-
trary, the patient is  calm and collected, the ether will
induce it.
  Case III. Haemoptysis.—A married lady, about thirty
years of age, desired the ether for the removal of one
tooth.   She  informed me, that  she  had coughed  from
the  lungs,  the  day  previously, a  small quantity of
blood.  She had, also, a similar attack the year before,
which left her much prostrated for a long time after-
wards.  I  proceeded to give the ether as described in
Case  I., Bronchitis;  and, on the third trial, removed
the tooth.   This was on the third day after the bleed-
ing.   When  this lady called, after having inhaled the
ether twice, she made  this remarkable observation.
" In walking to your office, Dr. Flagg, I could not feel
the stones to my feet.   Since  taking the  ether, my
moving  about is  more  like flying than walking.   The
air now passes into  my lungs, where it has not been for
more than a year!"   Nearly a week after this, the 
58
ETHER.
husband of this lady called to inform me, that his wife
was enjoying better health than she  had for  many
months, and—this is all I know of the matter.
   I am aware, .that a few cases have been reported of
hemorrhage  having  followed ether inhalation,  at  a
period varying from twenty-four hours to a week after
its use; but none under its immediate or primary in-
fluence.   What part the ether  had to do in bringing
about this bleeding,  any more than the last liquid that
was taken  into the stomach, has not  been explained.
Hence, it  becomes  a question  whether the  bleeding
might not  have occurred even  earlier  than it did, or,
being delayed for a few days,  might  not so large  a
portion  of vascular  organization have become  impli-
cated, as to have rendered the bleeding more profuse,
and, consequently,  more  dangerous?    A celebrated
Eastern judge used to say, " If things hadn't happened
just as they did happen, nobody could possibly tell how
they would have happened."
   I have given the ether to  a  large number who have,
at  some former period,  bled at the  lungs, and I know
of  none  among them  who have  suffered, in any  way,
from its use.
   Case IV.  Phthisis.—Dr. W., of Brooklyn, N. Y.,
visited me in the early  part of 1849.   He was on his
way to Washington to recruit himself, suffering  from
excessive  labour in his professional calling, and, appa-
rently, fast sinking from  this disease of  the lungs.  The
object of his call upon me, was to have me fill a couple
of teeth that required that operation.   His cough was
almost incessant, and he had become so weak, as to be
unable to  raise anything  from   his lungs, unless the 
PATHOLOGY.
59
secretions became very copious.   He was  greatly ema-
ciated.  Upon attempting to prepare his teeth for the
reception  of the gold, I found it impossible to proceed,
and suggested that  he inhale a small quantity of ether
to check his spasms.   He did  so, and I was thus ena-
bled to complete the operation to his entire comfort.   I
then directed him  to obtain a small vial  of ether, and
to resort to  it as often  as he felt his coughing oppres-
sive.    My  directions  were followed,  and the Doctor
now tells  his friends  that he cured himself  by the use
of sulphuric ether.
   A  gentleman, now  residing in  Washington,  informs
me that an  examination by  one  of the  most eminent
physicians of that city, leads him  to believe that he has
but  one lung  left!   He passed the winter  of '48 and
'49 in this city in great  distress,  suffering from  cough,
night  sweats, and  sleeplessness.   He  tried  the ether
but found it too exciting, and now resorts to the use of
chloroform as the only means by  which he  can obtain
rest.*   Many other  cases I  am acquainted with  in

  * Sunday, Sept.  22d, 1850.—The gentleman above alluded to,
Mr. Stansbury, departed  this life  at 6 o'clock, a. m., this day.
Yesterday morning he  sent his nurse for me to visit him, for the
purpose of putting  him under the influence of ether, as he was in
great  distress.  I saw  him  at  9 a. m. ;  he was attended  by  his
mother, and was evidently dying  at that time ; pulse 140, wiry.
Had  slept little  or none  through the night;  mind clear, and ex-
pressed himself as sensible of dying.  In requesting me to give him
the ether  he only feared that it might induce coughing.  He could
not bear that conversation should be carried on between his mother
and myself,  even in the lowest whisper.  We therefore retired to
an adjoining room, where I  stated to Mrs. S. the liability of her
son's breathing his last before we could get back to him, that I
feared to give the ether, as it might be too irritating, and that he 
60                       ETHER.
which the ether has  been much  used as a palliative in
this terrible disease, and particularly when accompanied
by symptomatic catarrh.
   Case V.  Dyspepsia.—A young lady, aged 20, became
my patient in the  summer of  1847.   Her  health was
much impaired  at that  time.  But little could be re-
tained on the stomach, and distress felt at  every  meal.

might die while inhaling the chloroform;  but if he was my own son
I would not withhold it from him under the circumstances.
   I wet a small sponge with about twenty drops of chloroform ;  he
held it to his nose, and breathed it for about a minute and  a half,
his pulse continued its frequency, but became very smooth, and he
dropped into  a quiet slumber,  which lasted half an hour.  When he
awoke he expressed himself as feeling refreshed.  I left the chloro-
form  and directions with his mother in case  he should desire its
repetition before I saw him again.
   At  1£ o'clock, p. m. I called, he was just recovering from one of
his frequent  violent spasms.   When this last attack  came on  he
requested the chloroform; his mother gave it to him, and he breathed
it but once  or twice, and gave it back to her.  No effect,  at this
inhalation, could have been  induced, either for good or harm, and
upon  my leaving, I requested his  mother to be governed entirely
by the amount of desire  on  the part of her son, as to giving the
chloroform again.
   Sunday at 11 o'clock, a. m.—I saw his  mother, and learned the
following particulars.   Her son died at 6 o'clock, this morning.
Just previous to his death, he begged  for the  chloroform again.  It
was handed to him, and he made the attempt to breathe it as before.
His sense of smell was gone;  he complained that it was weakened,
or that it was not chloroform, and fell back and died.  Having
smelt  only once or twice of  the sponge, with the weakness of a
dying man, I  am not disposed  to view it of any more consequence
than if it had been so much vinegar.  His mother thinks it eased
somewhat his last moments.  It is my belief that the refreshing
slumber he obtained from its  first administration enabled him to
hold out  some hours longer than he  would have done without its
use. 
PATHOLOGY.
61
She  had  been treated  for more  than a year for spinal
affection, by a man who  saw this disease  in every case
that  presented itself for treatment in his practice.
  It being  necessary to remove a decayed tooth for
this  lady, I gave  her the ether, not to entire uncon-
sciousness, but enough to induce the pleasurable tingling
sensation with no unpleasant symptom attending it.  A
few days after this my patient  called again with  her
mother, and informed me  that  she had felt  so  much
better since I last  saw her, she was  inclined to attribute
it to the ether, and requested me  to repeat the dose.
This I  readily  assented  to,  and  thus commenced  a
regular ether treatment, which was followed  by its use
every three or four days for nearly a month ; at the  end
of which time she expressed herself as feeling quite well.
The  health of this  patient has remained comparatively
good till the summer of the present year  (1850), when
some of her former symptoms appearing, she has at once
resorted to the ether with similar benefit.
  Case VI. Tetanus.—In the summer of 1847 I visited
a patient, in company with Dr. Pancoast, who was suffer-
ing with trismus and other spasms,  resulting from a cut
in the arm with a shoemaker's knife.   The patient, a man
of about  thirty-five years of age,  had inflicted this
injury upon himself in  the  country by the slipping of
his  knife, wounding the radial artery.   It was tied a
short distance  above  the wound by his  physician at
home ;  but, as the bleeding  continued, he  came to  the
city, and the operation was again performed by Dr. P.,
of tying it just below  its bifurcation from the ulnar.
The  bleeding  was thus stopped, and the patient was
doing well for several days  subsequently.   I think it 
62
ETnER.
was seven  or  eight  days after this that spasms com-
menced.  When I saw him his pulse was 140.  Deglu-
tition so much impaired  as not  to be able to swallow
liquids.   Jaws  closed, and dorsal muscles rigid ; com-
plaining of much pain in his arm  and back.
  At 11 o'clock, A. M., I gave him the ether, administer-
ing it only to such extent as to make him perfectly free
from pain.   He opened  his mouth sufficiently wide  to
enable me  to pass my thumb between his teeth.   Pulse
a little quickened;  could not  swallow.   At 5 o'clock,
p. M., saw him again; he had slept about one  hour after
we left  him  in the morning; pulse continued 140.
Muscles  of the jaws remained relaxed; back a little
relieved, but arm more painful; deglutition entirely in-
terrupted.   The ether was given till all his pains were
relieved.   He  seemed very happy, and  exclaimed with
much earnestness, "Oh, that I could die now !"
   The next morning, at 7 o'clock, I called upon patient,
and found him in great suffering  ; much agitated ; con-
stantly getting off the bed and lying down again; pulse
rapid, and so irregular as to be unable to count it.
   At 9 o'clock, a. m., Dr. Pancoast called upon  me by
appointment to  visit patient with  him.   I informed him
that I had seen him two hours previously, and from the
condition in which I found him, it  would be of no ad-
vantage, in my opinion, to continue ether treatment any
further.  About noon that day the poor fellow died.  A
post  mortem  examination showed that  a small, hard
tumour had formed in the wrist a short distance below
the wound, and a result  of that wound, which was bear-
ing hard directly upon the nerve;  thus exerting a mecha- 
. PATHOLOGY.
63
nical influence, rendering all medicinal treatment, as  a
matter of course, inefficacious.
  But few cases of this  disease are reported as having
been cured by ether or chloroform ; still they are both
agents that should be freely  used, as immunity  from
pain will, in many cases, afford ample time for those
medicines to act which will have the  effect to remove
exciting causes. Again,  it is not unusual to extract one
or more teeth  in cases of lock-jaw, for the purpose of
enabling the  patient  to  get food or medicine into the
mouth.   The ether would save  this necessity, and if its
good stops there, how invaluable must it be.
  I would recommend that ether be used in tetanus by
inhalation, and chloroform by external application; as
suggested in treatment  of Neuralgia  and Rheuma-
tism.
  Case VII. Hydrophobia.—I can only advert to a sin-
gle case of this disease in  which anaesthetics have received
the credit of effecting  a  cure.  A report of much inte-
rest is furnished for the  April number of " The Ameri-
can Journal of the Medical Sciences," [1849] by Prof.
Samuel Jackson, of this  city.  From this report it will
be sufficient for me to furnish the prominent facts only,
while I would like all who are  interested in the subject
to obtain  the Journal, and read the entire article as  it
there appears.
  In  the month  of July, 1848, Mrs. B.,  residing at
Camden,  N. J., in endeavouring  to  rescue her  child
from the attack of a dog, received a bite upon the inside
of her  wrist,  so  slight,  however, as not to lead her to
mention. the circumstance at the time, and no inconve- 
64
ether.
nience was felt  until the early part of October of that
year.
  It appears that the fangs of the dog had  made two
small punctures about  an inch  apart, one  of which
festered, and the  other  was  hard and  painful at this
time.  In a few days a small tumour formed on the arm
near the axilla.
  Near the end of October, Mrs. B. was  surprised to
find that the sight of water induced great dread and
shuddering, yet she  said  nothing to  her husband of
having been bitten in  July.   In attempting to swallow
some water, she was seized with violent spasms of the
throat.  Her physician, Dr. Fisher, was sent for, who im-
 mediately called Dr. Jackson to his  aid.   Dr. J. says:
 " While in the parlour  down stairs, I heard a peculiar
 sound that bore some resemblance to a dog's bark.  It was
 remarked that the patient was then in a spasm, as in
 them she made that noise."
   Here follows a description  of the  symptoms.   But
 Dr. Jackson expressed,  at this visit, his doubts as to its
 being hydrophobia, and was  inclined  to look on the
 affection as one of a nervous or hysterical character.
   Together with  other articles, it was  agreed upon  to
 give her chloroform 5ss, in  an emulsion every hour if
 required; and at the  next  visit, there were so .many
 favourable  symptoms in the case, that the doctor's first
 impressions were rather confirmed than weakened.  A
 similar  course of  treatment continued.
    Soon after this she was attacked with violent spasms.
 The air produced from a slight motion of the hand
 behind  her head, would  instantly induce shuddering,
 respiration arrested, &c.  Her sufferings  were so great 
PATHOLOGY.
65
as to cause her to toss about the bed, gnashing  her
teeth, and  to bite  and tear the bed-clothes.   The  fol-
lowing is the language of the report.
  " Chloroform was sent for.   It was obtained from an
apothecary in the  neighbourhood.   When  procured, as
no sponge  was at  hand, I  soaked a rag  with it,  and
seizing her by the  back of the neck, attempted to hold
it near her mouth.   The inhalation was imperfect; as
the spasms kept the patient in constant motion, and she
was  making plunging  efforts to seize the rag with  her
teeth, some caution was required to avoid being bitten.
  "A sponge was then procured, and  the  inhalation
was more effectually performed; as the effect took place,
and  the  spasms were  mitigated,  the  patient assisted
herself to  hold  the sponge to her mouth.   In a few
minutes the full effect was  produced, and she fell,  per-
fectly  insensible,  every muscle in perfect relaxation,
and the respiration easy and natural.   An enema  was
now  administered,  consisting of Pulv. ipecac, composit.,
9ij;  chloroform, 5ij? hi starch water."
  At this period a consultation was had, and the con-
clusion formed, to  cut  out  the cicatrix upon her arm;
and, at the suggestion  of the patient herself,  the wound
was cauterized.
  Again I quote.   " The excision of the  cicatrix  was
hardly completed,  when a spasm came on.  The chloro-
form was immediately  administered with the  sponge, its
full effects  were induced, and she again became insensi-
ble.   She was some time in this state;  as  she was re-
covering from it, she raised herself slowly on her knees,
and with her eyes intently gazing, and her arm stretched
upwards, she addressed the vision of  her lately  lost
                         6* 
66
ETHER.
child.  When  she had  entirely recovered she related
the vision she had seen."
  Monday, October ZOth.—Patient was found improving,
so much so, that a few inhalations would suffice to arrest
further development of spasms, timely notice now being
given of their approach.
   A singular  feature of this case is, that the hearing
and sight of Mrs. B. should  have become much quick-
ened in her sickness;  the same being-rather  dull in
health.  The report is continued up to the 25th Novem-
ber, and there reads:  " Rested well  last  night;  arm
less sensitive; wound  looks healthy; omit pills;  con-
tinue the liniment."
   " From this  period Mrs. B. continued to improve in
health.   Her milk returned.   The wound cicatrized in
the second week of December; the  pains ceased in the
 forearm, but the shoulder and axilla  continued sensitive,
 and  occasionally painful, into  the commencement of
 January.   To the present time she continues to enjoy
 the most perfect health."
   Dr. Jackson now gives it as his opinion that this was
 a true case of hydrophobia.
   Case  VIII. Cholera.—An article, some two years
 since, was making the circuit of our  various papers, pur-
 porting to be a letter from some European physician, in
 which he states that, being at a former period in a  town
. that was then suffering by the presence of cholera, he
 became  attacked himself in  the middle of the night
 with all its premonitory symptoms.  No one was  near
 to assist him, and it so happened that no other medicine
 was within his reach except a bottle of  sulphuric ether.
 He seized upon this, and inhaled a large quantity.  The 
PATHOLOGY.
67
result he states to have been entire freedom from pain,
profuse sweating, and  a  quiet slumber until morning.
When he awoke, the transaction appears to have passed
from his mind, and it was not till several years after-
wards (when ether had  acquired its new celebrity), that
the facts in his case made their impression upon him.
  I wish particularly to call attention to the use of this
agent  in  cholera,  for  what  it is really worth.   It is
always desirable to relieve pain and break up spasms of
all  kinds.   Ether  has  seldom been  known  to fail  in
doing this.  Another important desideratum is  to infuse
heat into the system, and to elevate the pulse.  In a
healthy condition, the ether  is known  most frequently
to do this ;  how it would do in this particular abnormal
state I am not prepared to say, but as I have seen very
little  upon  this  subject, and as  this  destroyer is now
stalking abroad in our land, it is to be hoped the  ether
may have a fair chance to show its merits.
   Case IX. Insania.—Seeing it suggested in the " Bos-
ton Medical and Surgical Journal" that the ether had been
used  with advantage in this disease, particularly that
of a wakeful type, I  am happy in being able to attest
its utility to a very remarkable  extent in a  case which
presented itself to my notice. Mrs. G., a lady of about
fifty years of age, being subject to occasional attacks of
partial derangement, in consequence of severe  exposure
to the sun's rays a few years since, was suffering in the
fall of  '48  with one of these turns, when her husband
se"nt for me as a friend of the family, in part, and  also
in part as medical adviser in the  case.   Upon entering
the chamber, I found  Mrs.  G. much excited; more so
in consequence of my  presence.   Recognising me,  she 
68                    ETHER.
called  me by name, and requested  me  to  give what-
ever medicine I saw fit to her husband, she required
none;  when  she  did she would send for  me,  &c.  I
observed to her that, hearing of her desire  to sleep,
and her extreme wakefulness, I  had called  as a friend,
and desired  her  to look upon my visit in that light
altogether.   She became reconciled in a measure, but
still insisted that  she should take no medicine.  I re-
                               v
quested  her  to  allow me  to  take  her  pulse; this she
refused.   At  this stage, one of the members  of the
family called  me one side, and observed they thought
it would be necessary to use some force, as the  patient
was always very determined in  having  her own way in
these paroxysms.   Mrs. G. observed the whisper, and
made some excellent remarks in relation to it,  saying,
" If anybody had  anything to say  in  her room, she
desired they would  say it aloud, and in an honest way."
I immediately acceded to  the justness  of  her remark,
and, turning to her, observed, we had a desire that she
would inhale the ether, as that would be very likely to
give her  a short but refreshing  slumber.   She insisted
that she  did not reqilire sleep, and begged of me not to
give her  the ether against her wishes.  I assured her I
should do no such thing; so far from it, I considered
it a privilege that all should appreciate when they could
obtain a  safe administration of it.  I then turned to one
of  the ladies, and  observed  carelessly, " By the way,
speaking of ether, there are  some strange peculiarities in
regard to it.  Among other things I have observed lately
a sort of mesmeric  influence it seems to possess, and I
think I can, to a certain extent, control the dreams of
my  patients." This caught the attention of the patient, 
PATHOLOGY.                 69
and she expressed some interest to hear about it.  I
paid no attention to her, but went on relating a case in
point at the lady in attendance.  When I had finished,
Mrs.  G. observed that she had a brother whom she had
not seen for many years, and if I would  promise her a
sight of him  she would take the ether.   I told her I
would make the attempt if it was her wish.
   In an experiment of this character, close observation
of all the little circumstances attending the inhalation
is necessary to secure success.  After the patient begins
to inhale properly, a few judicious remarks touching
the subject should be  made, in  order that the mind of
the patient may be fully occupied  by it, to  the  exclu-
sion of all others.  If any noise occur in the house, or
in the street, adroitly turn it to account as part of the
subject-matter.   The noises in the head, and other  sen-
sations  induced  by the  ether, can all be  turned to
account, as will be seen more  fully hereafter.
   I administered the ether, in this  case, about  five or
six minutes.    In less than half that time my patient
was asleep.   The pulse fell from 120 to 80, and  a  pro-
fuse  perspiration ensued.   The sleep continued  for
about fifteen minutes, when she awoke  much refreshed
and  calm.  She said she  had been  to Mexico,  and
there found her brother, but she could  not get a good
view  of him.   "It was  only a side  view."  I  then
requested her  to compose herself, and try to obtain a
natural sleep, which  she  did; and,  in  a few minutes,
she was enjoying that slumber she had been denied for
three days.  She slept" from 11 o'clock  that evening,
till 8  o'clock the  following morning, and, on that day,
was free from  excitement. 
70
ETHER.
  In  a few  subsequent attacks,  the  ether  has  been
resorted  to in a much earlier stage,  in the  hope of
arresting its progress; but, I am sorry to say, with no
such decided  benefit as in this first  instance.   This
leads me to the opinion, that the ether is specific only
in such cases of extreme tension as the one cited.
  Since  writing   the  above-^my young friend,  Dr.
Hooper,  of this  city, has  returned  from  Paris,  and
informs me that the ether  is resortecTlto in France for
various degrees and  characters of excitement with the
greatest  benefit.   Delirium tremens has been treated
successfully by the use of the ether, both in this country
and in Europe.
  Case X. Catarrhus.—The particular  case  I would
instance  under this  head,  was one that fell  into my
hands more  than three  years since.   I was walking
with  the  gentleman, when  he was suddenly  attacked
with  violent  sneezing; at the same time the  mucous
secretions  were so profuse, as  to  be exceedingly trou-
blesome.   As we were in the vicinity  of my house, I
requested him to step in, and take a pinch of pulverised
sugar for his complaint;  but, on entering my  office, he
exclaimed, "How strong you smell  of ether," and had
no  sooner  seated himself than his sneezing ceased.  I
observed jocosely, " My ether  has cured you  already."
My friend was  disposed   to  treat the matter  more
seriously,  and really felt  that the ether had  affected
him pleasantly.  This took my attention sufficiently to
allow him to  inhale it from a tumbler through  the nose,
for a  minute or two;  when he expressed himself as
having entirely recovered from the attack.
  The ether  was resorted to, in this case, for occasional 
PATHOLOGY.                 71
similar attacks for about a year, and invariably  with
instantaneous relief.  It is now two years that no in-
convenience has been experienced.
  Common colds in the  head, attended with a sense of
fullness, headache, obstruction in the nose, hoarseness,
&c, have been much mitigated, and many times relieved
altogether, by the ether used in this way.
  Case XL  Uterine Hemorrhage.—The properties of
the ether are  strangely contradictory, or apparently so
at least, when considered in connection with some of the
functions  of  the womb.  It has  seriously  been appre-
hended, that much danger to the mother would result
in the use of ether, in view of flooding.  But, strange
to say, in every case reported out of the many thou-
sands, it  is averred that its influence  is beneficial in
this  respect.   A lady, who had depended  upon my
directions  in taking the  ether,  in the event  of her
approaching  confinement, informed me soon afterwards,
that,  in every previous  labour,  her life had been de-
spaired of from excessive hemorrhage;  but that, in the
last, no such alarm was felt.   This has  been  invariably
the case,  as  far  as I can  learn, in all whom  I  have
influenced to take the ether.
  I observed  that the effects  of  the ether appeared to
be contradictory: my meaning  will be understood by
the recital of the next case, under the head of
  Case XII. Dysmenorrhoea.—A young lady, aged 18,
had always been regular in her courses  for three years,
but they were so much obstructed for the first twenty-four
hours, as  to cause her great suffering, and were always
attended  with indisposition, lasting from one to three
days.  Having experienced the  benefit of ether under 
72
ETHER.
other circumstances, she resorted  to it for these pains,
and was most agreeably surprised to find that, not only
were her pains relieved, but  all obstructions removed,
and the menses established.
   It is now more than a year since  there has been any
necessity for using the ether in this case, but I am in-
formed  by the mother of the  young  lady,  that her
daughter thinks so much of the ether,  as never to allow
herself to suffer bodily pains of any character, without
an immediate resort to it.
   I am indebted  to my  friend Dr. J.  D. Griscom,  of
this city for the following:—
   Case XIII.—"J. A.,  unmarried, tall, slight figure;
accustomed to passing much of her time standing; has
throughout her catamenial period been troubled with
irregularities  of that function.  Was  first seen  by me
in  1845, while suffering greatly.   Has  since  been re-
peatedly seized with intense pain, of the  character
usually observed in this  affection;  which in  each in-
stance that came under my care,  were relieved in some
hours  by free doses of the  usual  anodyne  remedies.
Her attacks,  however, appeared  to be  growing  more
intense; so that I was induced to look  for some more
effectual  means of relief, should  she  be again seized.
In the latter part of 1849, I was summoned to see her.
Her suffering now  was of the  most  intense character:
each paroxysm  resulting first in convulsions,  and then
insensibility.  I determined to exhibit  the ether, and
proceeded  with  it  at once.  After  a  few inhalations,
the patient declared that  her suffering had ceased, and
in about one minute, she sank into a quiet sleep,  which
lasted two hours; there  being then some return of her 
PATHOLOGY.
73
suffering,  I again exhibited the ether  with  the same
good results as at first.   After which she had no more
pain, and in a few days, was in her usual health.   This
was by far the most severe attack of this kind,  that I had
ever witnessed in this patient, or indeed, in any other.
I need not say that the relief was more prompt  than
under the former treatment, for it  was  immediate and
perfect.   She has not since had a similar attack."
  Case XIV. Diarrhoea.—But one case of this disease
has been made known  to me;  and, as that presents a
little novelty, I report  it  without  comment.   A lady,
somewhat subject to this complaint, as the extreme hot
weather came round, had frequently resorted  to the
various known remedies,  both  allopathic and  homoeo-
pathic, sometimes with results  that would lead  her  to
suppose that neither school knew much, for a  certainty
in cases of this kind; if they did, her own  particular
case was  an exception; and when  she recovered, as a
consequence, nature,  and  her  own good  constitution,
came in for the largest share of merit  in effecting a
cure.
  This lady happened to be in my office  in company
with a friend,  who was  undergoing some professional
operation; and, as the subject of ether was touched
upon, I incidentally made the remark, that " I  had  no
doubt  ether would  be  discovered  to  possess remedial
properties in diseases we little dreamed of  at present."
In making the observation, I certainly "little  dreamed"
what an impression I was making upon the mind of the
subject of this article.
  Upon returning home this patient  discarded all her
other medicines, and immediately commenced inhaling
                          7 
74
ETHER.
the ether.  She breathed it for more  than an hour, but
not to unconsciousness;  as  she approached that point,
she would stop for  a minute or two, and then take it
up again, till, finally, she took one heavy dose, and fell
asleep.   She continued to sleep well through the night,
and during the  next day felt no motion  of the  bowels.
On the third day costiveness was so great, as to require
a resort to a dose' of senna and manna.   The following
week I received a visit from my quondam patient, when
the foregoing particulars were related to me.
   Case XV. Neuralgia.—Ether  and chloroform have
both  been  resorted to for neuralgic  affections very
extensively,  and with various  results;  but in no re-
ported case as yet,  have I  seen what  I conceive to be a
proper and thorough  administration  of  these  agents.
In  some, the simple inhalation  of one or the other of
these articles, has been all that was deemed necessary;
other medicines  being relied on, which are used com-
monly in these complaints  to effect the cure; whilst in
others, local application  in the immediate region of the
pain has only been  tested.   Even under these  circum-
stances, ether and chloroform are being hailed with joy
as  palliatives.   I would have  them  take rank more
decidedly as curatives, and  to secure this end I confi-
dently recommend the following treatment.
   From  ten to twenty drops of chloroform to be applied
on lint to the part affected, and protected from evapo-
ration by oiled  silk; this  to be  renewed at least once
each hour,  and oftener if  the strength should be lost,
and the parts  suffer  no  excoriation.   Three or four
drops of chloroform, in  a  teaspoonful of water, taken
into the stomach once  in three or four hours ; and the 
PATHOLOGY.
75
sulphuric ether  taken by inhalation  twice  or three
times in twenty-four  hours, until a glow, or some other
primary symptom is induced.
   I would not recommend the ether to be inhaled upon
a full stomach, as nausea or headache  is  most likely to
result;  nor  would  I  advise its  inhalation immediately
after  taking the chloroform into  the  stomach,  for the
same  reason.
   A case of neuralgia will be found under the head of
" Chloroform, as a local anaesthetic,"  and the benefits
of ether in  various other  instances  have been  freely
reported  to  me.   In  conjunction  with the above,  I
would include rheumatic  affections, and  would  recom-
mend for them a similar course of treatment.
   Case  XVI.  Nephritic  Colic.—Dr.  Stills  reports  a
case,  which  I find copied in " The American Journal of
the Medical Sciences,"  p. 550.  "Within the last three
weeks, a lady, about twenty years of age, after retiring
to bed  some hours, was attacked with violent pain in
the region of the right kidney.  About an hour after-
wards (10 o'clock, p. m.),  Dr. S. was  sent  for.  The
mother  had  applied warm  fomentations  to the  loins,
and immersed the feet in  a mustard-bath.  There was
still intense  pain, with tenderness over  the  region of
the right kidney.  The patient was lying bent double,
her hands and  feet were  cold, her pulse feeble, and
about sixty in the minute.   The pain  extended in  the
direction of  the ureter; there, was pain  and a twitching
motion  of the right thigh, with frequent inclinations to
urinate.   From  a review of the  symptoms, Dr. S. con-
sidered  the  case to be one  of nephritic  colic.  " The  use
of ether  was suggested.   A  teaspoonful was poured 
76                    ETHER.
upon  a handkerchief, and  inhaled for five minutes,
when the patient fell asleep.   In about fifteen minutes,
she was aroused by a return  of the pain.   The ether
was again inhaled, and its impression was  kept up for
about an  hour, without carrying it so far as to abolish
consciousness :  the pain ceased, the extremities became
warm, and the  pulse  rose to seventy-five.   The  next
morning there was no pain  complained of, but conside-
rable soreness was experienced when pressure was made
over the region  of the kidney. The pain did not return
until two nights afterwards, when  a larger  dose of the
ether was used by the patient, without Dr.  Still's  pre-
sence  or  direction; but, from  some cause, it did not
produce the same alleviation of the pain as before.  At
four o'clock in the morning, Dr. S. saw her.  The pain
had,  by this  time,  somewhat abated; and, upon the
administration of an opiate enema, complete relief was
procured.   The pain has  not since  returned."
   In the month of September, 1850, I had occasion to
prescribe the ether to a young lady,  who  had, in the
evening, eaten  pretty freely of ice cream.   When  I
saw her, between 11  and 12 o'clock, p.m., she was in
great  pain with spasmodic  colic, accompanied  with
violent chills.   She  had  retired to her bed more than
an hour previously, but  had not  been able to sleep.
Two minutes' breathing the ether  dispelled  both chills
and  pain.   She slept quietly all  night, after a  few
minutes  of profuse  perspiration.    My patient  was
enjoying her usual good health in the morning.
   Case XVII.  Strangulated Hernia.—It gives me
pleasure  to introduce  the  following  case   upon  this
subject, as prepared by my friend, Dr.  John S.  Rohrer, 
PATHOLOGY.
77
of this city.  Two others of equal interest will be found
under the head of "Midwifery," in another place.
  "May 9th, 1850.—Was called, late in the evening, to
see  Mrs. H----,  aged  thirty-five years, of spare habit,
and short but delicate frame, the mother of four or five
children.   I found her labouring under  severe colica
pains of  the  abdomen, attended with  retching  and
vomiting.  Her eyes were much sunken, the skin moist
and  somewhat  corrugated, and the  expression  of her
countenance denoting much suffering.  Upon inquiry, I
found her bowels constipated, nothing having  passed
through  them  for  twenty-four  hours.   I  asked her
whether she had hernia, but finding  she did not under-
stand the  term, I said to her,  ' Have you a lump in
the groin ?' to which interrogatory  she replied that ' /
was quite mistaken ; there was nothing of the kind the
matter with her.   True,' she remarked,  'there  was a
small lump in her left groin, but a burgundy pitch
plaster would soon remove it, it having relieved her
before, and that the  pain was not in that place, but in
the bowels.'   On examination,  however,  I  found  she
had crural hernia already in a state of strangulation.
I immediately had recourse to the taxis, but the stricture
being firm, and the tumour tender to the touch and un-
yielding, I did not think it*prudent to use much pressure
in attempting to reduce it.  Indeed,  I would deprecate
the practice of using much force  in  manipulation in all
cases where there is  tenderness and  pain on slight
pressure.
  " An effort  was now made to open the bowels with
calomel and castor oil, assisted by injections, but with-
out effect.
                         7* 
78                    ether.
   "Different cathartics were administered and repeated
as often as they could  be done with safety, when they
were  abandoned, and opium instituted.  Recourse  was
also had to hot and cold applications to the tumour, but
with no better success than the foregoing treatment.
   "I left my patient after midnight, having first ordered
the opium in combination with calomel, to be continued
with the hope  of relaxing the part, and procuring an
operation  before morning.
   " 10th, 9 o'clock, a. m.—Found my patient much pros-
trated, retching and vomiting having continued all night;
hiccough and ejection of faecal matter having supervened;
cramp in  the legs; skin moist and cold; pulse small
and contracted; abdomen  turgent;  and  great  pain
over  the  hypogastric  region.   Injections were  again
tried, but  came  away  without any alvine  discharge.
Made another attempt at reduction by the taxis,  but
without effect.
   " 11 o'clock, A. m.—My friend, Dr. Pancoast, Profes-
sor of Jefferson College, was now called in consultation,
and the operation for strangulated hernia agreed upon,
the patient  consenting to  any mode for relief,  having
given up  all  hopes of recovery.  While arrangements
were being made for the operation, which was to have
taken place at 12  o'clock, -m., we  agreed, previous to
this last resort, to try the effects of ether and  chloro-
form in proportion of seven parts of the former to  one
of the latter.  The patient was suffered  to  inhale it
freely until perfectly under  the influence of the  anaes-
thetic, when the sponge was removed, and the introduc-
tion of the hernia effected in less than one minute. 
PATHOLOGY.
79
  " In conclusion, I am happy to state that from the
time of the inhalation of the chloretic ether she experi-
enced, neither pain nor sickness of the stomach, and in
a few  days was able to attend, as  usual,  to her do-
mestic duties, without any detriment.
                           "John S.  Rohrer,
                               "No. 557 Chestnut Street.
  "Philadelphia, December 6th, 1850." 
DIAGNOSIS,
         assisted by the ether inhalation.

   It is hardly necessary for me to  say that it is im-
portant, to a correct and judicious treatment of disease,
that all the peculiarities of the case should be  well
understood by the medical attendant before he attempts
to effect a cure;  but if a new agent, however objection-
able it  may be from petty  causes, is found  to  be an
instrument  in  our hand to  aid in  the least  in  this
matter, it becomes not only  necessary but an agreeable
duty  in me to urge its  claims  with all  the power I
possess.
   As  I have observed  elsewhere, my attention  in the
course of my practice  is incidentally  caught by certain
demonstrations,  resulting  from  frequent use  of  the
ether  in  the department of  my profession,  limited
almost  entirely to the simple object of removing an
offending tooth.  In this early stage of ether treatment
in  surgical practice,  it  is  natural  that by far the
larger portion of  those who  would present  themselves
as  candidates for such operations would  possess,  as a
general thing, firm constitutional habits, and the average
of good health.   My opportunities for testing it in all
the branches of a regular medical practice,  therefore,
being limited, disqualify me from making this particu-
lar branch of my labour what I would  desire it to be, 
DIAGNOSIS.
81
in order to secure a full co-operation at once among my
medical brethren.  Still, if my conclusions are correct,
and sustained by the few cases which follow under this
head, enough will be shown, I think, to secure the use
of the ether in this important field.
   Case  I. Spinal Affection.—In Case No. V., Dys-
pepsia, p. 60, it will be seen that  the patient had been
treated for many months  without  any benefit, for  a
diseased spine.  Although this was a patient who fell
into the hands of what is commonly called an irregular
man, yet there were certain symptoms in  her case cal-
culated to mislead in  forming a conclusion as to the
precise character of her disease.  Generally inert;  diffi-
culty in sustaining the  erect  position ;  and a sensation
sometimes of  pain, and at others, of numbness  in the
right arm, were probably  the doctor's justification  in
this instance;  but his infallible powders alone ought to
have opened his  eyes to the possibility of error after a
trial of from twelve to eighteen months with no obvious
advantage.
   There was no  unnatural curvature of the spine, nor
tenderness along the column, indicative of diseased ver-
tebrae, so I presume the treatment  was strictly in view
of reaching  the medulla  spinalis.  1  am  led  to this
opinion  also, from the fact  that the  doctor  told this
patient the ether woxdd certainly kill her I
   The French physiologist, M. Longet,  says, " The func-
tions of the  encephalic centres  always are suspended
before those of the spinal  marrow."  If this is the case,
then would it be safe to carry etherization  to  a  limited
extent, even  should it  prove injurious under circum-
stances  where spinal disease is known to exist.  This 
82                    ether.
reason alone, at the time, led me to try the ether.  As
my patient expressed the opinion that her  health was
improved, I concluded (as  the  spine  was not intended
to be reached, and, according to  M. Longet,  it was not
reached), the disease was not pertaining to  the  spine,
but was merely symptomatic of indigestion.
   If, on the  other hand, the Frenchman is wrong, and
I  am  wrong in my  opinion as to  the nature of the
disease, and the ether really  reached and  served  to
cure  this "spinal  affection," then all  I ask  is to let it
take rank among the curatives of that formidable com-
plaint.
   Case II.  Carditis.—A lady, residing in  the city of
New York, came to Philadelphia in  the summer of '49
for the purpose of taking the ether  at my hands, and
having a troublesome tooth extracted.  She was accom-
panied by Dr. E. Wallace, of this city.  She observed
to me that she had been under treatment in New York
for several months past, for an  affection of  the  heart,
and that her physician was  very much opposed to her
taking the  ether.  Her husband was also much alarmed
at her determination to act in opposition to  the advice
of their medical friend.   The principal difficulty in her
case appeared to be a fluttering of the heart.   This was
the case, as she said, upon the  occasion of any undue
excitement,—running  up stairs, or sudden  agitation.
Upon my questioning her if  this fluttering was accom-
panied  by  much distress,  she  said " No;  and it soon
passes off."  "Well," I observed, "there  is no more
cause to fear this  palpitation from a  little  ether than
from  a little exercise."  I proceeded to give her the
ether, with my finger placed upon the temporal artery ; 
DIAGNOSIS.
83
and she had not taken more than  ten or twelve inspira-
tions when she suddenly complained that her heart was
fluttering.   I requested my friend, Dr. W., to take the
pulse at the  wrist,  and  see that  no  acceleration had
occurred.  I immediately pronounced it a nervous spas-
modic action in the region of, but entirely disconnected
with, the heart.  In  this opinion Dr. W. fully  con-
curred.
   I carried the etherization in this case sufficiently far
to remove the tooth  without pain, and the pulse did not
vary from a  regular beat of 80 in the minute all the
way through.
   The  following week this  lady  visited me again, re-
peating the  compliment  to me of riding one  hundred
miles to avail herself of my services.*
   Case III. Diseased Antrum.—The case I  am now
about to relate was also a lady from New  York, and a
patient of Dr. Herring's  of this city.
   In the month of June, 1849, Mrs. B. came to  this
city to  consult with Dr. H. in relation  to an unpleasant
discharge of matter from the  nose, which had troubled
her for some time, and which had  not yielded to medical
treatment, although much skill  had been  employed in
the case.
   This lady had received a blow upon the forehead from
a fall about a year previous to my seeing her, and it was
supposed that the discharge proceeded from the frontal
sinus.   Dr. H. suspected that it might  proceed from

   * Since writing out the  above case, Dr. Wallace has informed me
that the physicians of the  lady have  concluded that  her disease is
not one  of the heart, but pneumonia,  a difference of no great conse-
quence on one account, as the modus medendi is pretty much the
same. 
84
ETHER.
the antrum, and desired her to see me  upon the sub-
ject.
   There were but two facts in the case which would
lead to the belief that the matter  came  from the an-
trum, but they were so prominent that  I  recommended
the antrum  operation to  be performed, if for no other
reason, to  clear  all doubts in the  case.   In  the first
place, there  was a very decayed upper molar tooth,
from which  considerable uneasiness  had been  expe-
rienced ; and, secondly, the discharge at the nose was
more frequent and  profuse when the patient was recum-
bent than when the head was  in  an erect position.  It
was  desirable, also, that the tooth should be  removed
independent of all  previous  considerations.
   Before proceeding to extract this tooth, I explained
to my patient  that  it was possible one of its  fangs
might open directly into the cavity of the jaw;  and  if
such  was the case, and  matter existed there, it would
at once  discharge  itself.  But, on  the other  hand,  it
might be necessary to broach  through a thin plate of
bone after extracting, and this would give neither pain
nor  inconvenience.   The  lady  was willing that the
tooth should be removed; but, from a needless  dread of
having an opening forced into  the chamber of the jaw,
she exacted  a promise from me  that I would not per-
form  that operation.  The  result was, as no  opening
was made by the primary operation, of course we were
no nearer in ascertaining the  precise seat  of disease.
But my object in stating this case is only to show how
the ether could be  made subservient to this end, as the
patient could  not  be prevailed upon  to  have a  tooth
extracted even, without its use. 
DIAGNOSIS.
85
  Case IV.  Feigned Disease.—A lady, upon a visit
to this city about two  years since, for the purpose of
obtaining the advantage of Professor Jackson's medical
skill in her case, was treated by that gentleman for seve-
ral weeks, or until he saw fit to abandon it, finding that
her symptoms did not yield to any of the remedies used.
Her friends made known the case to me ; and, as a tooth
was to be extracted for  the young lady, the  propriety
of inhaling the ether was  discussed  and concluded upon.
  This young lady was about twenty years of age, of
sanguine,  nervous temperament, appetite and general
health good.  Her  mother, and  only parent, had been
extremely indulgent with her;  this, with a naturally
strong and wayward disposition,  had led her very often
to practise upon  the fears and credulity of  her  atten-
dants, members of  the family, and other friends.   She
would frequently, when by herself, scream in the most
frightful  manner, as if in great distress, causing much
uneasiness and fear on  the part of the family, that she
might, in some of these fits, do herself or others some
bodily harm.  At  times she  would indulge in  these
freaks, and  turn them  somewhat  to amusement,  by
laughing at  the  distress they  seemed  to  induce  in
others.  She  seldom was inconvenienced by them her-
self, unless, indeed, it  was when she failed to get  up
the usual degree of excitement among her attendants.
They  would  sometimes occur two or three times a day,
and again not more frequently than that in a week.
  I had visited her for a few times in order to acquire
some  knowledge of  her natural  character aad disposi-
tion, and that she might be led to feel sufficiently fami-
liar with myself, to  remove that restraint which  might
                         8 
86
ETII er.
exist in view of her taking the  ether from an entire'
stranger.   In these visits I found  her a pleasant, social,
and quite  intelligent Miss, conversing freely, and, as I
thought, understandingly,  on  the nature of her com-
plaint.  She was delighted at the idea  of taking  the
ether, and appointed the time when she  would visit me
at my house for this purpose.
   On the day set, this lady came  in company with her
aunt and  a sister, and I  proceeded to give  her  the
ether.   She had progressed  but a minute or two  in
inhaling, when she cried out,  " That's enough—take it
away—oh, that is just the way I feel in my fits !  Oh
horrible !  don't go away—stay by me," &c.  Her eyes
glared,  and she looked tragical.   She held very firmly
to my hand.   Her  friends were somewhat alarmed, but
I was satisfied  that  the effect of the ether was neither
painful nor hysterical, as  in  either case she would be
more likely to  repel than to hold on to the cause of her
trouble; I, therefore,  assured her I would not leave
her, if  she would stop screaming, and take up the sub-
ject of her case in a  more rational manner.  This she
acceded to, but insisted very strongly that if her hands
should be suffered to come together the  pain would be
intolerable, and the consequences might be serious!  I
asked  her if she was fully sensible  of that fact.   She
said she was.   " Then," said  I, "it would be an  act of
great folly for you to bring your  hands together;" and,
withdrawing mine,  I gave  her to understand she must
take the risk of her own hands meeting.
   Soon after  this, I observed to my patient I thought
she was mistaken about this  hand business, and that
she might venture to lay one hand upon  the other with- 
DIAGNOSIS.
87
out any uncomfortable feeling.  She expressed a doubt,
but was willing to make the effort.  In  doing so, there
was much hesitancy about the proceeding, not at all in
keeping with  the  previous  idea, that her hands would
rush together if left to themselves.  Observing this, I
remarked,  "It is a case of will entirely.  If you desire
to act, you can act; and when you create alarm  in your
family, a  high moral  sense of your obligations would
tell you to proceed in a very different manner.  All
you  have to do is to sit  perfectly still, and  hold your
tongue whenever you feel  this disposition to jump about
and make a noise;  and, in doing so, I cannot see wherein
you will  differ from other well-behaved young ladies."
She  had by this time placed one of her hands in the
other,  and, perceiving that  they  felt natural to each
other,  was  pleased  to compliment  me by  saying she
thought I understood her  case very well, and she would
endeavour to follow my directions.
   The health of this young  lady continues  good, and
she now seldom has these  violent turns;  still she is not
entirely free from them.   I suppose it to be a species of
epilepsy, that a rigid, moral  discipline would do  more
for than any other treatment.
   " M. Bouisson, of Montpellier,* proposed in 1847  to
apply ether inhalation as a test in  cases of feigned deaf-
ness,  dumbness, stammering, and contraction  of the
back or limbs.   He cites a  case of feigned contraction
and atrophy of the muscles  of the throat, the character
of which he readily detected by ether."
* Gazette M^dicale, Aofit, 1847. 
NEUROLOGY.
  NEW THEORY SUGGESTED FROM ETHER INHALATION.

  The following is an article communicated by myself t j
the "Medical Examiner,"No. XXXVII., January, 1848.
  " The theory of the  nervous system, or rather that
portion which embraces the passage of the nerves from
the brain to the outer surfaces of the body, has hereto-
fore  been held to consist merely in a  double arrange-
ment of organization, thus classified:—1st, the motor
nerves,  or  those  which incite to  action;  and 2d, the
sensor,  or that complicated system of machinery, which
is so constructed as to  convey to the mind various sen-
sations through one  medium.   One set of nerves has
been thought sufficient  to  allow us  to discriminate be-
tween that sensation which we denominate simply touch
or feeling, and that commonly called pain.
   "From a series of experiments with sulphuric ether, in
which  I have been engaged for some time past, I am  in
possession  of facts, which certainly go far to refute pre-
conceived opinions, touching this interesting question  in
physiology;  yet, with proper  diffidence would I lay be-
fore the scientific world, deductions I cannot resist,
arising from those facts.
   " That ether can induce that condition of perfect un-
consciousness of pain,  during the passage of the sur- 
NEUROLOGY.
89
geon's knife in any known  operation, is a  question  at
the present moment  entirely beyond cavil.   As to the
propriety or safety of so doing, it is a matter of no im-
portance in reference to this subject of communication,
except that it has led to as little use of the article  as
would justify us in securing the greatest  good.   For
example:—cases  have presented  themselves  to  me,
where I would not suffer more ether to  be taken than
would cause  the consent  of the patient to  the removal
of a tooth;  a consent that  could not be obtained under
usual circumstances.   The  pain probably was as great,
or nearly so, as it would have been without the ether;
but even under these circumstances, such individuals
have been very united in ceding to it great  merit.
   "It therefore became  a  desideratum (in the  dental
department particularly) to give, as  nearly as possible,
just  a suitable  quantity, and no  more; and in my en-
deavours  to  establish this  point, many peculiar mental
and physical effects have been produced, which I have
deemed worthy, from time to time, of presenting to the
public, through different periodicals of the day.
   " There is a particular point of etherization, which, if
improved at  the  moment, will  leave  the patient in full
possession of all his faculties, with the single exception
of the sense of pain ; and  particularly, the conscious-
ness of touch is as acute   as  under  ordinary circum-
stances, if not quickened even.  To account for this,  I as-
sign to the system, two sets of nerves ; one, to carry  to
the brain the idea of touch, the other of pain.
   " I submit the following  cases and certificate in  sup-
port of my theory:—
   "A lady,  operated upon for scirrhous breast,  I  so
                         8* 
90                    ether.
etherized as to keep her in conversation upon indifferent
subjects through the whole operation, which required
two incisions, together about sixteen inches in  extent,
the entire removal  of the gland, and the taking up of
five or six arteries.   Her replies to my questions were
in a drowsy tone of  voice, but  strictly correct and con-
sistent ; her sense of taste and smell was tested by one
of the medical gentlemen present, and found to be un-
affected.   She expressed much astonishment when told
that the operation was completed, and observed that she
only felt them marking it out.
   "So large a number have told me that they felt  dis-
tinctly every  part of an  operation,  unconnected  with
pain, that I deem it only necessary to report the follow-
ing, as illustrative of increased sense of touch:—
   "In extracting a tooth  for a gentleman, I used the
German key (an instrument which carries with it many
painful associations).  I requested him to note any little
thing that  might occur to him, and explain it to me
after the operation.  He said that he was entirely con-
scious of the sense of touch; so much so, that he could
detect by the feeling, that the  bandage  which  I  used
upon  the  fulcrum was composed of  silk; nothing like
pain was felt.
   " Several have remarked that a sensation of cold has
been imparted from the instrument,  without pain.
   "The following certificate,  I am  authorized  to sub-
mit:—
                      [Copy.]
                             Philadelphia, Dec. 15, 1847.
  My attention  having been  taken  by Dr. J. F.  B.
Flagg, to the subject of fixing  my mind upon the sensa- 
NEUROLOGY.
91
tion of touch, while under the influence of ether, for the
purpose  of  having a tooth  extracted, I hereby certify,
that at the moment my tooth was removed, I distinctly
felt the slightest touch upon my hand, my knee, and my
forehead; that I  felt the  whole process of extracting
my tooth, but not the least  pain.
                                         F. Stout.

   " In reference to the above case, I would mention that
after the gentleman had completed inhaling, and the in-
stant  previous to extracting his tooth, I made a cross
upon his knee with my finger, so delicately as scarcely to
be sensible  of the touch myself.  When the  effect of the
ether had passed off, I asked him what figure I described
upon his knee.  He replied that he  barely felt it, but
what he did feel was like a  figure 8.   Now it  will
readily be perceived, that in order  to make a cross, we
necessarily  make  the   motion  as  described  by  this
patient."
   An operation of amputating  the arm at the  shoulder
joint, performed by Dr. Mutter, at the Jefferson school,
in this city, last  winter, I mention in this  place as re-
markable,  from  the  fact that  the patient only com-
plained of the cold during the operation; but was made
comfortable by throwing his garment across his shoul-
ders.  This case will be found more fully reported under
the head of " Clairvoyance."
   The following  are  a few of the general propositions
in which the results of experiments are summed up, as
performed  by M. Longet, taken from the  British  and
Foreign  Medical Review.
   " 1st.  In etherized animals there is absolute momen- 
92                    ether.
tary suspension of sensibility, as well in all parts of the
cerebro-spinal axis, usually sensitive, as in the nervous
trunks themselves.
  " 6th. The action of ether  on  the nervous system ia
much  more directly  and completely stupifying than
alcohol,  which merely  renders  the  sensibility  more
obtuse, without suspending it entirely, at least  in the
nervous centres.
  " 7th. Ether abolishes momentarily, but completely,
the excito-motor, or reflex action of the spinal marrow
and medulla oblongata;  and, consequently,  acts in an
opposite manner  to strychnine and opium, which exalt
it.
  "9th. The functions of the encephalic centres always
are suspended before  those of the spinal marrow, and
return before them.
  " 10th. Ether  supplies a new  means of isolating, in
the living  animal,  the seat of general sensibility from
the seat of the intellect and will.
  " 11th. In animals, we can so graduate the action of
ether as to  produce, at will, two stages, which I name,
1, Etherization of the  cerebral lobes;  2, Etherization of
the  annular protuberance.
  " 13th. Ether  is only preventive of pain when it acts
on the annular protuberance.
  " 14th. In animals  which have  suffered etherization
of the annular protuberance, this organ always recovers
its functions as the perceptive centre of tactile impres-
sions, before it becomes itself a sensible organ.
  " 15th. The course of the phenomenon of etherization
is far from being  the same in  men as in animals.
  " 16th. The process of de-etherization of the annular 
NEUROLOGY.
93
protuberance may begin while etherization of the cere-
bral lobes still continues.  This explains the cries that
take place  towards the end  of some  operations, which
commence amid the most perfect quiet;  cries, however,
of  which the  patient  retains no recollection  on awa-
kening.
   " 17th. The true chirurgicalperiod corresponds to that
of etherization of the annular protuberance, or absolute
insensibility.
   " 18th.  For some time after the faculty of sensation
is restored in etherized animals, there is transient exal-
tation of the sensibility.
   " 20th.  At  a particular period of the  experiments,
the blood becomes almost black in the arteries.  Insen-
sibility always shows itself previous to this occurrence.
   " 21st. If, after the point of total insensibility, inha-
lation is continued, the animals (rabbits),  caeteris pari-
bus, die within the space of from six to  twelve minutes.
   " 22d. On  the contrary, on mixing  a  greater quan-
tity of air with the  vapour,  the  period  of insensibility
may be kept up a long time (three-quarters  of an hour
and more) without injury to  the animal's life.*
   "23d. Ether  introduced into the  stomach  does  not
produce insensibility in animals.
   " 24th.  In etherization, the functions of the gangli-
onic nervous system appear to be over-excited, and this

   * It would  appear, from the above 21st and 22d propositions,
that these experiments were carried on by means of an instrument
calculated to  exclude the  atmosphere as much  as possible.  It
was by such  a course that the valuable horse  in London, and the
mouse  alluded to in the "Lancet," were sacrificed to the cause of
science. 
94
ETHER.
system appears to become a sort of diverticulum for the
nervous power which has, for the time, abandoned the
cerebro-spinal system.
   " 25th. The death of etherized animals is, perhaps,
owing to a sort of asphyxia, originating particularly in
the respiratory nervous centre." 
PSYCHOLOGY,
 CONSIDERED IN CONNECTION WITH ETHER INHALATION.


  The peculiar  sensations and actions induced  upon
different  persons, and  also upon the same  individual,
under different circumstances,  have been noticed as a
striking feature  of ether  inhalation, more particularly
since its adoption into the practice of surgery, than when
used ostensibly  for  no other purpose than that  of a
momentary excitement.  This will  be  accounted  for in
two ways:—1st, The  ether  was never so  universally
used;  and when  used, seldom  if ever carried  to  a
perfect narcotic or unconscious  state.   2d, When  taken
for  the purpose  of  amusement,  it was  not generally
given by one  whose  attention  was likely to be  at all
engrossed with  the  subject; but, on  the contrary,  it
was most generally superintended by the  party as a
whole, in a manner  quite too  democratic to allow any
one sufficient opportunity to  analyze  or  to  arrange all
the causes which led to the effects witnessed.
  The effect of the ether  upon the mind will be better
understood, when  we take into consideration these ex-
ternal and incidental causes; and, in order  to do so, I
shall arrange this portion of my subject with a series of
illustrative cases, under the three following  heads. 
96
ETHER.
   I. Object in view of taking the ether.
   II. Previous condition of the mind.
   III. Incidental suggestive  circumstances.
   First.  The  object for which  we inhale the ether is,
of itself,  much of a dictator  as  to any outward demon-
stration of its mental effects,  even  when taken to  abso-
lute unconsciousness.
   Case I. Many years since I  was present at an exhi-
bition of amusement, in which the nitrous oxide gas was
used.  A young gentleman  took  it, who was passion-
ately devoted to the  study  of  languages.   So strong
was his desire to obtain a correct  pronunciation of  the
French, he would stop  in the street and appear  to have
his attention  taken with articles  exposed  in a shop-
window,  whenever  two Frenchmen  were stopping to
converse.  His diffidence and acute sense of propriety
as an eavesdropper, never allowed his attention to be
taken to  the subject-matter in discussion : all he wanted
was idiom, intonation,  and gesticulation.   These he  ob-
tained, and so perfectly, that when under the influence
of the gas,  he gave utterance  to  his feelings in  the
French language with such purity as to lead Frenchmen
present to hail him  as a fellow-countryman.
   This young gentleman said  to  me that  he  had no
idea of speaking when  he commenced inhaling, and he
trusted entirely to the  chances as to what he might  do.
Every one who knew him was ready to admit that  the
chances were—he would talk  French !
   When  the ether  is  taken  at convivial parties,  the
prevailing disposition is to dance  or sing.  If taken by a
graduating class at college, a  large  amount of eloquence
is suffered, as a matter  of course. 
PSYCHOLOGY.
97
  Case II.  In the winter of '46 and '47, a young man,
a student  of medicine, took the ether at my house in
the presence  of  several medical  gentlemen, some of
whom filled  the chairs at the  school at which he  was
attending.   His object in taking the ether was to expe-
rience  its effect  upon himself, as he  had chosen  this
subject  for  his thesis, in view  of graduating; and  he
was led to believe that he could prepare a better paper
from the advantage such experience would afford him.
  Under its influence he was  as  solemn  as though he
was really under what is commonly called  "a quiz;"
but what influence the  motive for  taking  it, or  the
presence of  his preceptors had, I shall leave for others
to infer.
  Case III.—One of the most beautiful experiments I
have ever witnessed, illustrative of the controllable effects
of ether by the motive for its  use, was at the residence
of a friend in Spruce Street, about two years since.
  The  ether was sent  for, to  be used by one  of  the
ladies who was suffering from  irritation of the throat,
and attended with cough.   In the course of the evening
it  was  desired by  one  of the  company that a certain
gentleman present should inhale it for the amusement
of all  assembled.  To  this proposition the gentleman
somewhat demurred, stating that he was  not afraid to
take it, but  as nothing was the matter with  him, there
could be no  object beyond idle  curiosity, which  he  felt
no inclination to indulge at that moment.  I explained
that a good  motive could be found for  his  taking it, if
he felt willing to assist in a little experiment.
  It had so  frequently happened  in my practice that
my patients had  expressed  to  me their utter impossi-
                         9 
98
ether.
bility of doing  any way different from what  I directed
them to do, as, for  example, if they attempted  to get
out of the chair, my saying " sit  still," to them  was a
law too potent for them to think of breaking ; or if they
inclined to laugh, my suggestion  of "perfect quiet and
calmness," was as instantly obeyed,—it occurred to me
to propose the following experiment.  One of the ladies
was to administer the ether to this gentleman, with the
express understanding that he was to obey  any direc-
tions she might give  him while under its influence, if,
by possibility, he could do  so.
   The ether was inhaled sufficiently to secure a painless
operation, had it been necessary to  extract a  tooth ;
and the lady immediately asked him " What o'clock is
it?"" His  hand was carried to  his vest pocket to re-
move his watch, he  hesitated a moment, and then car-
ried his other hand  to the same place.  He soon changed
his hands very rapidly in the vicinity of his watch, but
did not take it out.   Whilst doing so, the lady requested
him to sing.  The gentleman was  known to possess con-
siderable musical powers, but the  noise he made resem-
bled more the howling of a wolf, than anything  else I
could liken it to.  He then whistled  about as much of
a tune as he sang ;  but soon stopped, and getting up,
made castanets of his fingers, waltzed around his chair,
and resumed his seat.  The ether passed off.  The gen-
tleman put his  hand to his  head  and exclaimed, " Oh!
heavenly!"
   When entirely restored  to himself he  gave this ex-
planation.   He knew  everything that had transpired.
When  the  lady asked him the  "time," he  was  not
prepared for the question, and  felt somewhat confused, 
PSYCHOLOGY.
99
but recollected that he was to obey this lady.  In feel-
ing for his watch it occurred to him, as he could not see,
it would be folly for him to take it  out, and he moved
his hands about to indicate that folly.  When requested
to sing, he was  equally taken by surprise, if not more
so than at first; for he was not quite clear in his mind
that he had complied with the lady's first requirement,
or that she fully understood him.   Still he felt a bind-
ing  obligation  to  do  his  best.   What to sing, became
now a serious question with him, and the noise he made
was trying his voice.   He was aware that there was no
regularity or gradation of sounds,  but could  not  help
it.   In his  anxiety to obey, and finding  he could not
sing, he  attempted to whistle.   Here he was  as much
at a loss for a tune as at first, when a lucky expedient
presented  itself,—" If I  dance and  keep time," he
thought, " she must be satisfied that I have done all in
the way of music it is possible for me to do ;"  and this
gentleman attributes  a large share of his happiness to
being able to accomplish the dance.   He likewise asserts
that he knew of no one being present but the  lady who
administered the ether.  He saw nothing in the room,
and did not know where he was until the ether passed off.
   Case IV.—A gentleman from Kentucky called upon
me to have  a tooth extracted on each side of the lower
jaw.   When placed, as I thought, sufficiently under the
influence  of the ether, I removed one of the teeth.   He
groaned  as if in  much pain.   I gave him more ether,
and removed the  other tooth.   He groaned as before,
but jumped up  and exclaimed  " Glorious !"   He said
he had not  been hurt in the  operations; he had  no
recollection that  I repeated the dose of ether; remem- 
100
ETnER.
 bered the pulling  of both teeth, and knew he groaned.
 He said there was no other reason for the groans than
 the  knowledge of  the  fact, that his teeth were  being
 extracted.  His mind was so pre-occupied with this idea,
 and the horror of teeth extracting, that he  supposed his
 groaning to be a necessary accompaniment.
   Second.—Previous condition of the mind undoubtedly
 has  a large influence upon those who are placed,  either
 fully or partially,  under the power of  the ether.  To
 such an extent have I noticed  this feature,  I can almost
 invariably tell my patients what will be its mental effect,
 by a few minutes' conversation with them previous to
 administering it.   Even in the same subject, where its
 effects have been totally different under apparently simi-
 lar circumstances, at different times of inhaling, I could
 readily assign the reasons, without knowing any of the
facts in the case.  The few instances which I here re-
 port, I hope will not only serve to illustrate, but have
 the  effect to  secure pleasant dreams by establishing a
 confidence among the timid, and causing  the thoughtless
 to act a nobler part than that of alarmist.
   Case I.—A lady desiring several teeth to be removed,
 and fearing the ether about  as much as  the operation,
 visited  me for the  purpose of first obtaining my assu-
 rance  that the ether would not kill her, and  next, to
take it with but half her doubts removed.   This lady
had  been so situated as to hear  nothing but the  most
alarming stories upon the subject; and the most favour-
able  account she  seemed to  have received, was, that a
few had lived to bear testimony in its favour.  I believe
she looked upon  me  as another "Acres," and that I
killed my  man a week. She was accompanied by a gen- 
PSYCHOLOGY.
101
tleman who  knew  nothing about the ether, and was
much opposed to her taking it.   This gentleman was to
act the part  of protector,  and see that  I  did not give
her too  much.   I told this lady I  would remove  her
teeth without her feeling pain, but that she would have
an  unpleasant  dream.   I gave  the  ether, constantly-
endeavouring to allay her fears and keeping the  gentle-
man quiet.   I extracted four teeth, she screaming quite
loud,  and in less than a minute  afterwards she told me
she had not been hurt, but thought she was dying. The
gentleman nearly fainted, and partly fell over.
   In a  subsequent conversation with this lady,  she
laughed most heartily at some of the absurdities of the
scene, and is now  satisfied that the ether must  take
rank  among the greatest blessings of the age.  She also
assures me that she should take it again without fear.
   Case II.—Among a large number of similar cases,
it is only necessary for me  to relate one in  this place, in
order to  show the  happy influence of ether under the
most favourable circumstances.   To  secure  this,  the
most  implicit confidence must be  had in the ether,  and
in the person who  administers it.   The mind should be
as free from  excitement of all kinds as possible, and the
close attention to all the directions given for its inhala-
tion,  serves  much  to secure  a  perfect  quiet,  and to
remove,  to a great extent, the  idea  of a subsequent
operation.
   A young lady, about 20 years of age, the charge of
whose teeth I had had for  several years, found it neces-
sary to lose the first inferior molar tooth on each side of
the jaw, and called upon me to take the ether  for this
purpose.  I requested her  to  have but one removed at 
102
ETHER.
 that time, and wait a few days for the jaw to heal, thus
 enabling her to reserve one side for the purpose  of a
 better mastication.  She proceeded with the inhalation
 in perfect confidence ; a perfect quiet ensued until the
 tooth was  removed.  When she was aware that it was
 out, she arose from the  chair and said all her sensations
 were delightful.   Seeing that she was  then  becoming
 excited in  her  anxiety to  relate  her sensations, I re-
 quested her to sit down and keep quiet for a minute, as
 some reaction might be expected.   She closed her eyes
 for a minute or two, and then observed that it  had en-
 tirely passed off,  and her feelings were now natural.
   When this lady called the following week to have the
 operation completed, she was accompanied by  her aunt,
 who was desirous of witnessing the ether effects, as de-
 scribed by her niece.   We  proceeded as  before, but on
 attempting  to extract  the  tooth,  she exclaimed that I
 should  not, and got up from  the  chair, seeming much
 offended.   She took her seat in  another part of the
 room, and observed that she did not like me, calling me
 by  name, and that  she  should never allow me to ex-
 tract that tooth.   In a minute the ether was off, and
 she was much astonished at finding  herself so  remote
 from the position she occupied when she  fell asleep.   I
 requested her to postpone  taking  the ether for a few
 days, when  she would probably feel  in  better humour
 for  the operation.   She acceded, and left.
  In less than an hour after this patient left my office,
 she returned and stated that she would  then  be  ethe-
rized and have her tooth out.  She explained to me how
she was fully sensible that the presence of her aunt had 
PSYCHOLOGY.
103
 an unpleasant influence;  she felt as though she was on
 exhibition.
   Being  satisfied that this was  the  cause,  and only
 cause  of  the  recent failure, I  proceeded to administer
 the ether again, when its effect was precisely  similar to
 that of the few clays previous.
   Case III.—The present  case, like the  last, I had an
 opportunity of testing twice, and for the same  reason as
 there reported, to avoid having both  sides of the jaw
 lame at the same time. This was a Miss  about 17  or 18
 years of age,  who was learning the millinery business
 of Madam B., in Eighth Street.   It serves to show the
 contrast between a total ignorance of  all reports  upon
 the subject  of ether,  either for or  against its use, and
 the effect of prejudice upon the mind of one and the
 same person.
   When this  young lady presented herself at first, she
 knew nothing  of the ether;  but, as most  of my patients
 require it, I proceeded to  give it, without thinking it
 was at all strange to her.  She merely asked me  what
 it was, and what it would do.   I saw no excitement in
 her mind whatever;  and  I .only said to her,  "It is
 ether ;  by breathing it a minute or two it will not  hurt
 you to  have your tooth out."   She did so ;  and  stated,
 after a minute's  sleep, that it  seemed  to her as  though
 it was some  hours since  she began to inhale  it.  She
 had neither pain nor any dream.   Her whole conduct,
 after knowing that her  tooth was extracted, showed
that she supposed this method was  an old established
usage, but that she had not been so situated as to  hear
of it before.   No comments were made by either of us.
The quiet of the thing was a  novelty in the course of 
104
ETHER.
my ether  practice, which  I  felt no inclination to dis-
turb; and she left, with the understanding that she
would come to have the other extracted in a few days.
  About  a  week  afterwards Miss  ----  called, and
brought with her Madam B.    I  proceeded with the
ether as upon the former occasion,  and when she was
similarly  affected,  I attempted  to extract her  tooth.
She resisted; I gave her more ether.  She soon  strug-
gled to avoid taking  any more, and attempted to get
up from the chair, appearing alarmed.  I immediately
turned to Madam  B., and inquired of her, "Who has
told this girl that she did wrong in taking the ether?"
Madam B. replied, in much  astonishment, " Not any-
body."  At this point the ether passed off, and the girl
wished to know if  the  tooth was out.   She  put her
finger into her mouth, and, finding the tooth still there,
expressed much disappointment.   I then put the same
question to  her, with this addition, " Did any one say
to you that ether would  kill you if you breathed it ?"
She looked a moment earnestly at Madam B.
  Madam B.  " Did anybody ?"
  Miss----.   "I will tell you if no trouble shall  come
of it."
  Madam B.  " Oh no,  it must have been thoughtless-
ness, and  no harm intended."
  Miss----.   " On going home the other day, one of
the girls  (calling her by  name) smelt my breath, and
asked me  where  I  had been.   I told her, and she said
I was a fool, and that ether killed folks ; but I did not
let it trouble me, and I felt no inconvenience from hav-
ing taken  it.
  Now this young lady was by no means " a fool;"  on 
PSYCHOLOGY.
105
the contrary,  she possessed a  large share of common
sense.   She had experienced the benefit of the ether in
her own case,  and she at once concluded  that her expe-
rience was worth infinitely more than any idle  rumour
that mio-ht reach the ears of her alarmist.  In posses-
sion of her full faculties, she repudiated  the idea that
any respectable man would deliberately give her any-
thing to breathe, which would be attended with  imme-
diate risk to her life or health.  However qualified this
lady might have been to reason the case in her natural
condition,  it would  be extremely difficult to resist the
influence of an idea growing out of such a remark, while
under ether modification.
   Case IV.—A married lady, residing in the country,
about twenty-five miles from Philadelphia, visited me
in the summer of 1847 to avail herself of my services,
and to take the ether for the purpose of  having  two or
three teeth extracted.   She was  very doubtful  if the
ether could be made to affect her in any way whatever.
She entertained no fear about  inhaling it all day long
if I would administer  it; but, as she said to her  hus-
band before leaving home, her whole uneasiness seemed
to consist  in  the idea that she should  be the exception
to the general rule.   She had tried mesmerism " faith-
fully,"  and wasted  many hours in  fruitless attempts to
be brought under its influence.
   This lady brought with her a nursing infant.  Her
health  was delicate, but she possessed  no organic de-
rangement that would  interfere with her inhaling  very
largely of the ether.   I administered  it in the most
condensed manner, i.  e., from a  glass  receiver,  con-
stantly agitating it, and allowed her to breathe it for 
106                   ETHER.
about fifteen or twenty minutes.  I could not perceive
that it had the effect of changing her pulse, her breath-
ing, or her reasoning faculties in the least.  I requested
her to wait a little while, and rest upon it.  She became
much concerned, wept and  wrung her  hands in great
agony, that she should be so constituted as  not to be
susceptible, like others, to its influence.
  After about ten minutes' suspension of the use of the
ether, I proceeded again in a similar manner, and about
the same  length of time,  with  no better result.   Her
system was completely filled with ether;  so much so,
that I feared somewhat its effect upon her child.  I,
therefore, requested  her to abandon it for  the time; to
note what influence (if any) it  had upon her  infant,
and to call upon me the next day, when I would make
another effort, and I hoped with better results.   In the
mean time, I requested her to discard, as much as possi-
ble, the notion that it would be a failure in her case in
particular.  I  saw no reason  why  it should be,  and
encouraged her  to  hope  for  a happy effect  in  the
morning.   I requested her to  call  upon me the next
day at 9 o'clock, to eat a light breakfast, and to come
with confidence.
  At the  time appointed, June 4th, my patient came.
She said she felt quite well—had slept well—also  her
infant.  My greatest astonishment  was, that she  had
wakened in time to fulfil her engagement.  I observed
to her  that I was pleased to see  her so calm upon the
subject; that I  had no doubt  a good night's rest,  and
the difference in the  time of day, would enable us to
succeed far better than upon  the previous trial.   She
inhaled the ether less  than ten minutes.  Her head 
PSYCHOLOGY.
107
rolled over upon one side, and she was sound asleep.  I
then extracted two teeth, cut  off the crowns  of  two
others, and destroyed their nerves with a broach; when
she awoke, and was in  an ecstasy of joy at learning
what had been done.
   On the 7th of the same month, I etherized this lady
again, and extracted another tooth for her without the
least trouble.   If  half the blessings  she invoked upon
my head ever reach me,  I shall be a happy man.
   Third.—Incidental  circumstances  serve very much
to suggest thought and action on the  part of those  who
inhale the ether, whatever may be the motive for which
it is taken.   A word spoken, the slamming of a door,
the passing of a carriage in the street, or the noise in
the ears, induced frequently by the ether itself, will  lead
the mind of  the  etherized not unfrequently into  the
strangest vagaries.  These are often  turned to account
by the patients, according to their preconceived  notions
in regard to the ether,  as has been  shown in a previous
place;  hence  the  necessity for discrediting the  various
bugbear  stories so frequently told in relation to  the
ether, and the cruelty in circulating them.
   Case I.—Among the very first of my ether cases, in
1846, a young lady called, in company with her mother,
to have  a tooth extracted.  It was at a time so early in
the ether practice, that no prejudicial stories had been
circulated in regard to  it, and  the young  lady appre-
hended no evil from it.   Her mother was not prepared
for any other exhibition  of  its power than that of in-
ducing a perfectly quiet sleep.
   This  patient inhaled  the  ether very  well, and  was
soon brought  under its  influence.    In proceeding to 
108                  ether.
 extract the tooth, I found great difficulty in getting her
 mouth  open, and  was occupied in this attempt  long
 enough to have enabled me to extract, probably ten or
 a dozen teeth.  Just as I succeeded in placing  the for-
 ceps upon the tooth, she  cried out, " Stop pulling ! stop
 pulling!" I paid no regard to this, however, but pulled
 the tooth.   She rose from the chair in much excitement,
 and would have fallen to the floor, but I caught and
 sustained her for  a moment, when the  ether instantly
 passed  off.
   The mother of  this  young lady was,  as a matter  of
 course,  very much alarmed ; she walked  the room, and
 knew not what to  do.  When her daughter recovered
 consciousness, and saw the effect upon her mother, she
 exclaimed, "What is the matter, mother! what ails you?"
 "What ails me?"  said her mother, "hasn't  the doctor
 murdered you?"   To which the daughter replied, that
 she had not been hurt,  and was greatly surprised to find
 that her tooth was out.
   This  young lady dreamed that she had made a voyage
 to Europe;  was on her  return home, and was about
 being wrecked on  our  coast.   She saw the  rocks and
 breakers ahead,  pieces of broken spars floating, and
 men struggling in the water.   She  cried out to the man
 at the wheel with all her  strength, to "stop pulling!"
 (She mistook the  guiding for  the  propelling power  of
 the ship.)  Here she awoke.
  I account for this dream in the following manner:—It
is probable, while I was engaged in placing the instru-
ment upon her tooth, there was a moment of semi-con-
sciousness of the fact on  her  part.  In that case, her
first  cry would have  been not only  natural,  but ap- 
PSYCHOLOGY.
109
plicable to the case.   She instantly became oblivious to
everything  but  the  sound of her  own  voice.   The
words  uttered,  suggested the dream,  and the second
time of her saying " stop pulling" had reference to the
dream alone.
   Case II.—One of the most  frequent  and  uniform
effects of the ether, is a peculiar rattling noise in the ears,
very much resembling that produced by a train of rail-
road cars when in rapid motion.   So much so, indeed,
we can often suggest a pleasure excursion by this means
of travelling, and thus secure  a pleasurable dream.
   I have been led to observe that all who are subject to
this noise when etherized, are also  enabled  to  hear the
beatings of the pulse whenever they lay their  heads
upon the pillow, lying  upon the ear, and thus  shutting
off all external sounds from that ear.   This condition
pertains to about 50 per cent, of those of whom I have
inquired  among my patients, during my investigations
upon this subject, and I have never known it to vary.
All who do not hear these sounds, never hear their hearts
beat under the above circumstances.
   This hearing of the pulsation, is dependent upon the
anatomical construction  of the  internal ear.   In some,
the internal carotid artery is located so  near to the
tympanum, or  drum of the ear, as to be reached and
pressed upon by that membrane, whenever the air is con-
fined within the more external chamber;  in others, the
artery is  too remote to be affected by this means.   This
fact  led  me to suppose at first, that the  noise heard
 when etherized, was  the pulse  alone ; but  the rapidity
 of the beats, being so  much greater  than  any healthy
 pulse, seems to forbid this conclusion,  and connect with
10 
110                   ether.
it the  idea of external noises, possessing considerable
influence in this  phenomena.   Let the causes be what
they may, such are the facts.
   Mr. E----, a  dentist of good fame, now  established
in Paris, brought his wife to  me  on the eve of their
leaving their native country, for the purpose of having
me extract three  teeth for her.  The ether was inhaled
to entire unconsciousness.  I  observed that  I  should
send her to Europe in advance of  the real voyage, and
I wished her to tell us how she liked Paris.  She began
to hear this rattling noise ; I likened it to a  locomotive.
She slept till I removed the teeth, and when she awoke
she said she  had  travelled  by railroad, not only to
Paris, but over the whole world! she had seen nothing
but cities,  and  heard nothing  but the  noise of the
cars.
   Case III.—An Irish woman, who had never heard of
the ether previous to calling upon me for the purpose of
having  a large molar tooth extracted, took  it on being
told that she would suffer no pain, and would, probably,
have an interview with her friends in the old country.
Just as its influence commenced, I remarked  to her that
I should like her  to observe what occupation her friends
were engaged in, if she succeeded in finding them.  I
removed the tooth ; she moved not a muscle  of the face,
but remained as in a quiet sleep, for about one minute.
Upon opening her eyes, she exclaimed:  "I have  seen
all my  friends ;  they were engaged in  spinning;  and
don't I hear their wheels now, sure?"   She said it
appeared to  her  as though she had been absent many
months.  She recollected that she went home in a steam
vessel, heard the noise of steam and machinery, declared 
PSYCHOLOGY.
Ill
herself unhurt  by the operation, and wished me to see
if there  was not " another tooth what wanted  to be
drew."
  It appears in this  case  that  the  noise  in  the  ears
served a double purpose; 1st, as a means to get her to
Ireland, and 2d, to suggest to the mind the occupation
of her friends.    This  noise continued for a moment
after her return to consciousness, and so strong was the
impression,  she really thought  she  heard  the noise of
their spinning wheels across the Atlantic.
  Case IV.—Master  C----, a lad about 12 or 13 years
of age, came to  have a tooth  extracted ;  he  took the
ether very well, and did not know when the operation
took place.  When he began  to recover, I requested
him  to spit  out the blood into the basin, but he looked
up  at  the  wall, into the  corners  of  the room,  and
stretched his head far back, looking  over his shoulders
very earnestly. I asked him what he was looking after,
what he  expected to see ?  He  said he wanted to find
the  machinery.   I   showed him the instrument, and
observed to him, "this is  all the machinery  I  used."
He then smiled, and  observed that he thought he was
in a cotton  mill.
  A few days after  this I removed another tooth for
this  lad, when  the second effect of  the ether and his
ideas were identical with its first exhibition.
  Case V.__At a very critical moment of etherization,
my office door closed  with quite a loud noise.  The lady
started and said, "Who fired that  gun?"  While in
the act of removing the tooth I answered, " Boreas."
  This lady dreamed that  she  had been  absent  from
home many years ; was  now returning, and the friends 
112
ETHER.
of her youth were welcoming her with noisy demonstra-
tions of joy.  She distinctly heard music, was delighted
with everything, but much annoyed at the firing of the
gun.
  Case VI.—A little Miss,  whose father is engaged in
the coal business, called on  me and inhaled the ether.
I extracted a large permanent tooth for  her.  The roots
of this tooth were very much spread apart, and when it
left the socket of the jaw  it  made a report like drawing
a cork suddenly from a bottle.
  I attempted to give this little  girl a pleasurable rail-
road excursion, and accordingly directed her attention
to this subject when the  noise commenced in her ears.
The instant the tooth was drawn she sprang out of my
chair, and crouching upon the floor, looked up anxiously
at me, and inquired if anybody  was killed.   I  lifted
her up, and answered, "Oh no, my dear, there is nobody
hurt."  She expressed herself much delighted, said  she
thought she was at Pottsville, and desired to come home,
that no passenger cars were coming, nothing but a coal
train, and, consequently,  they  gave her in charge of
the engineer, who placed  her upon the  top of the loco-
motive.  As  soon  as they started  the  boiler blew  up,
and she was thrown high  up upon an embankment,  but
was not hurt.
  All this was told under considerable  excitement.  I
soothed her,  and requested her  to  shut her eyes and
keep quite still for  a few minutes, saying at the same
time, "You made a mistake; you  should have waited
for  the passenger train."  She slept again, in perfect
quiet, without inhaling any more ether,  for about three
or four minutes, and awoke perfectly calm and refreshed, 
PSYCHOLOGY.
113
saying she had enjoyed a delightful ride.  Supposed  it
all to have  been one dream.  Had no  recollection of
having wakened, and relating to me the first dream; and
did not know that she had been out of the chair.
  There appears to be  a  train of suggestive circum-
stances in this case, altogether too strong to  admit  of a
doubt as to their influence upon the mind of the child.
It was a very natural mistake that she should  make,
when we consider that her father was  interested only in
the coal trains.  The noise produced  by the extracting
of her tooth might well be likened to the bursting  of a
boiler, and her falling upon the floor to that of being
thrown upon the embankment.
   Case VII.—A gentleman came  to  take the ether for
the purpose of having some teeth extracted.  His wife
came with him,  "Merely from curiosity," as she  said,
" to  see how it would make him act."  When etherized,
he threw up one arm and one foot, upsetting my foot-
stool.  I  extracted a tooth, upon which he  exclaimed
"high !"   Seeing that his mouth continued  wide open,
I removed another, when he  said " diddle !"  Again, I
took out the  third, when, in saying " did," he came to
himself, and thus explained his feelings.  He thought
he was at home, singing his  boy to sleep,  and had  a
very vivid recollection of having turned over the cradle.
His wife said  " she never knew him to tend babies  any-
how,  and if he did, they had no boy."
   Case VIIL—A little girl was brought to me for the
purpose  of having  a few  temporary teeth removed.
She  was accompanied by  her parents  and  a younger
sister.  She was  a  timid  child,  and,  finding myself
placed  in the midst of a very nervous family, I endea-
r                      10* 
114
ETHER.
voured to prevail upon  the  little  Miss to allow me to
extract the teeth without the ether ; assuring  her that
it  could  be done with  comparative  ease  to herself, as
they were shedding teeth, possessing little or no roots.
This idea  she  repelled  with  much  indignation.  The
child's mind was bent  upon  the  ether;  and I  verily
believe  she would  have taken it at my hand,  had  I
assured  her  that she would  never  awaken from  her
sleep, rather than submit to  the  operation without it.
In this  condition of things,  anticipating considerable
excitement, not so  much from  the  ether as  from  the
amount  of sympathy present; I requested  the  family
to  keep perfectly  quiet, and assured them the child
would not be hurt, whatever demonstration of pain she
might make.  I proceeded  with the  ether;  its effects
were delightfully soothing,—but just  as  she was about
to pass into unconsciousness with a smile upon her face,
her mother exclaimed, " Don't give her too much, Doc-
tor !"  In an instant the child was alarmed; I had only
time to remove one tooth.  She gave a loud scream, and
struggled very  much.   The mother  and sister ran out
of  the room, crying, if anything, a  little louder than
the patient.   The  father insisted upon my stopping,
which, under the circumstances, I was very glad to do.
In less  than  one  minute the ether passed off.  The
little girl was astonished that  a  tooth had been drawn;
had a confused recollection  of having made an outcry,
and no knowledge of  struggling  or of suffering.  Her
account of the  matter was, that  she  was  having a  de-
lightful dream,  but  that some one vexed her.  The next
day I  gave her the  ether  again to  remove two other 
PSYCHOLOGY.
115
teeth;  she came  with her father only, and both were
much pleased with its effects.
  Case IX.—A gentleman from Chambersburg visited
me with his wife for  the purpose of employing my pro-
fessional services.  They had just previously been pass-
ing a few days at Cape May.
  When I gave this lady the ether, her husband suddenly
ihade the same remark as mentioned in the last case.  I
checked him, fearing  it would affect her confidence in
me.   She was giving every manifestation of pleasurable
sensations, but the imprudent observation  reached her
ear just as she was going  into  the surf!   Something
was the matter, she did not know  exactly what: her mind
had been occupied for the last  month with this teeth-
pulling business.   Her pleasures had been ministered
to by her  bathing.  It is not surprising that she should
associate the  two  together, when brought under the in-
fluence of ether.  She dreamed that while  in the water
she was attacked  by  a shark.  There was  a good  deal
of excitement, but she felt no pain, although the hold
of the monster was so firm, the  company present were
obliged to  extract his teeth before she could be  libe-
rated.
  Case X.—The following will show the importance of
strictly following  the directions, as far as  the effect
upon  the mind is in question.  A gentleman desired
me  to  send him upon an excursion while undergoing an
operation. When the noise commenced in his ears, I
desired him to get into the cars and depart. He became
serious, and I asked him if the effect was not pleasura-
ble ?   He said "No, not very."   I told him to endea-
vour  to fix his mind upon pleasurable things, but he 
116
ETHER.
made no reply, and continued to indulge in the gloomy
mood.  Upon  returning to consciousness,  he said  he
had been through Heaven and Hell!   He expressed no
horror at the jaunt he had taken; would  rather go it
over again than to have a tooth out without the ether.
Was satisfied that he had not followed my directions to
the letter, as there was no railroad established to either
of the places he visited.
   Case  XL—It is not unusual for the person who is
etherized for the purpose of undergoing a surgical ope-
ration, to suppose that this very operation is being per-
formed upon some  one else; that they are mere spec-
tators to the  scene; and, if they suffer at all, it  is only
from  sympathy.  The three following cases will illus-
trate  this clairvoyant condition,  together with the influ-
ence possessed by the person who properly  administers
the ether.
   Among the patients at the Jefferson Medical  School
of this city,  to whom I have given the  ether,  was a
man,  about 38 years of age, who required his arm to be
amputated at the shoulder-joint, for a tumour of great
extent upon the arm [fungus haematodes).   The opera-
tion was performed by Dr.  Thomas D. Mutter, before a
class of nearly six hundred students and medical men.
  Previous to  the  patient's  entering the operating-
room, I requested him to give me  his entire confidence
in taking the ether; to hear nothing that might be said
during the operation, unless spoken by myself.   But,
if he  comprehended any question  that  I might  put to
him, I wished him to answer me.
  During this  formidable operation, the patient  mani-
fested  a  slight symptom of pain.   He was well under 
PSYCHOLOGY.
117
the ether influence.  I said to him in a whisper, "How
do  you feel ?"   He answered, " Pretty comfortable,
only a little cold."   (The shirt had been taken off, and
the door being open, this was his only uneasiness.)
   At a farther stage of the operation, when the arm
was entirely removed from the body, with the exception
of a small portion which contained the brachial artery,
Dr.  M. addressed  the audience in a loud voice, and
explained to them that he was now about to separate
this only connecting link.   At this moment I inquired,
"Do you hear anything that is being said?"   He re-
plied,  " No,  I hear only a confused buzzing sound, but
cannot understand it."
   This man was happy, when the ether passed off, at
seeing  his arm upon the  table some six feet distant.
He made a rapid recovery, and is  now well.
   Case XII.—Another  operation (plastic)  was per-
formed by the same gentleman, in his private practice,
upon the brow of Mr. T., a dentist of this city.  My
services, as a friend of the parties, were required in the
ether  department.  During this operation, which con-
tinued just  one hour, there was considerable conversa-
tion carried  on, but no remarks addressed to the patient
 in particular.   When the ether was allowed to pass off,
 there  was some excitement  on the part  of the patient.
 He was very desirous of explaining  all his feelings  at
 the moment.  This I would not allow, but desired him
 to keep perfectly quiet, to lie  down  and  sleep awhile,
 and then we would hear all he might have to say.
    A few days after  the  operation, I called on Mr.  T.
 He had never heard of the clairvoyant properties of the
 ether, and naturally enough supposed he had discovered 
118                   ether.
something new in relation to it.   He said, although his
eyes were shut, he saw every cut of the knife.  He saw
the shape of the wound  upon the forehead; and, what
was better than all, this cutting appeared to him to be
done upon somebody else.
   Case XIII.—A Miss M., from Florida, 15 years of
age, attending  school  in this city, took the ether, and
had  a  tooth extracted.   Her  dream  was  a  singular
mixture  of fancy  and fact—the agreeable and  disa-
greeable—the idea of going home to visit her parents,
and going to  the dentist's  to get her teeth extracted!
   This young  lady had  got, in her dream, past the
"Hole in the Wall," and was becalmed on the " Bahama
Banks."  Suddenly, one of the passengers was attacked
with a violent toothache, and it was advised to  have it
out.   All hands gathered  around to witness the fun.
   Now it appeared, in  the imagination of my patient,
that it took quite a number of the passengers to  make
up this one passenger, who  was  to  undergo the opera-
tion.   One person constituted a single  feature; some of
them represented the teeth, while Miss M. was to offi-
ciate as the gums.   This  was a source of  much uneasi-
ness to her.  She wished to be the tooth that was to be
drawn, as that would  come out and be  at  liberty.
Besides  the gums  were  to be pressed  upon to  remove
the tooth, and she thought that must be painful.   Just
as the  tooth flew out, and she was left behind, she awoke
in great merriment.   The reaction of the ether induced
a few hysterical tears, but, as a whole, she enjoyed the
affair very much. 
CHLOROFORM,
         AS  A  LOCAL  ANAESTHESIA.

  When I was administering the chloroform by inha-
lation, in the beginning of 1848, it was my habit to wet
a piece of sponge with  it about the size of a chestnut,
and hold it between my thumb and fingers, to the mouth
of the patient, until the  desired effect was  produced.
I was soon led to notice that when I was much engaged
with this article, I had a very disagreeable sensation of
numbness at the ends  of  my fingers.  This led me to
try the experiment of cutting my finger while it was
thus affected, and to my surprise, I was enabled to  do
so till the  blood flowed pretty freely with the slightest
possible degree of pain.  I then made  trial of it  upon
my gums with like success, and felt that I had  a pretty
good substitute for the ether, in such  cases as might
present objections to  its inhalation.   It was not long
before a case offered, in the  person  of  a lady who was
too  timid  to have  a  tooth  extracted,  either  with or
without ether, and I pursued this course  :—After pencil-
ling the gum around the tooth with chloroform for about
a minute, I began to lance, and cut sufficiently to make
it bleed.   She said she scarcely felt it.   I then applied
more chloroform to the wound, waited another minute,
and cut deeper, with similar results.  Another applica- 
120
CHLOROFORM,
tion of the liquid allowed me to force the forceps almost
to the end  of the roots, and  the  tooth was removed.
The tooth was firmly set, but the lady observed that the
operation was painless.
  In many other cases which  followed, the success va-
ried  too much to make  it altogether gratifying.  In
some it failed entirely;  and frequently it would be ne-
cessary to apply it so long, that the  patient would be
more or less  affected by it, through the medium of the
lungs.   It occurred to me that the  absorbent vessels
might, in many cases be too sluggish in  their action,
and that they might be stimulated  by an application of
kreosote.  I used this article  in  connection with the
chloroform, and am inclined to view it as  an improve-
ment over chloroform alone.
   Pain arises from various conditions  of the teeth, and
there can be, as a consequence, no one universal tooth-
ache remedy.  I have applied the  chloroform upon the
exposed nerve of a  tooth, and  it has increased rather
than  mitigated the pain.  It is probably used to the
best advantage in suppurative cases, and often in inflam-
mations leading to that condition.
   A letter from my son contains an account of a case,
of sufficient interest to justify the  following extract:—
"While in Valparaiso, I got a small, but long and hard
thorn  in my finger,  at the root of the nail.  I partially
extracted it, thinking I had  it all; my finger festered,
swelling much.   I bathed it in lye-water, poulticing it,
and was fearful of a felon;  but seeing a black speck, I
attempted laying the finger  open ;  the pain was excru-
ciating on account  of  inflammation,  but  as  soon as  I
brought blood, I applied  a drop or two of chloroform. 
AS A LOCAL  ANESTHESIA.        121
I then laid it open nearly to the bone, and about one
inch in length, taking  out even more of a thorn than
at first, and not feeling as much pain as I should had I
operated upon some other person !  I then bandaged it,
and allowed it to heal in the  blood.  At  the end of the
week I removed the bandage; the finger was well, and
I saved the nail.   What was the value  of that chloro-
form to me?"
   Dr. Isaac Hays reports a case of neuralgia of the foot,
before the College of Physicians, Philadelphia.   It  is
found in the " American Journal of the Medical Sci-
ences," p. 550.  Dr. Hays stated, " that he had employed
the chloroform to produce local anaesthesia, with appa-
rently the most  happy effects, in a case  of neuralgia,
occurring in a gentleman 50 years of age, who had been
for a long time a sufferer from neuralgia of the foot, in
which all the remedies that had been previously employed,
 failed to produce relief.  Dr.  H. was called to this pa-
 tient about eight days since, and found  him in intense
 pain, which  had deprived him of sleep the whole of the
 preceding night.  Dr.  H. directed the affected parts to
 be enveloped with a pledget  of lint, or a few folds of
 muslin wet with chloroform,  and the whole to be covered
 with a portion of oiled silk,  to prevent evaporation;  on
 the next morning he found him  entirely free from pam,
 which has not  since returned.  Whether the relief ex-
 perienced in this  case is to  be ascribed to the  local
 anaesthesia produced by the chloroform, or is to be con-
 sidered as a mere coincidence, Dr. H. does not pretend
 to decide."
    " Since this communication was made to the College,
  the further history of this case, has shown that an arrest
                          11 
122               CHLOROFORM.
of the paroxysm is  always accomplished by the appli-
cation of the chloroform ; and by the use of the article,
several other similar cases have been attended with like
results."
  The following case illustrates the value of chloroform
thus  used:—A lady for whom  I had filled  a  large
number of  teeth, was  much troubled by  an  abscess
forming at  the  root of one  of the incisors.  It would
occasionally become very painful; swell and discharge;
when relief  would ensue for several weeks.  I  had fre-
quently treated this  case with much care, till finding all
accustomed  remedies failing,  and  the annoyance becom-
ing insufferable,  the patient concluded to have it ex-
tracted.   I  stated to her that the local application of
chloroform might give her  one more chance of retaining
her tooth, if used at  a proper moment.   I chose for that
time, the  earliest symptom of disquiet  in the region of
disease.   The result has been immunity from pain, and
the tooth  is  restored to its former usefulness.   It has
now been necessary to  pursue this  treatment  but four
or  five times, at periods varying  from  one  to two
months, and the  gums  present  a healthy appearance
intermediately. 
ANESTHESIA IN MIDWIFERY.
  Ether and Chloroform have both been used in par-
turition to such  an extent since their  discovery, as to
render it unnecessary for me to do more than advert to
the subject.
  I have, upon a previous page, said all I have to offer
by way of apology for thus (apparently) interfering with
a department foreign to  my immediate  profession, and
would recommend  to. all who  are desirous of obtaining
information that must add much to their happiness, to
read the works furnished by Professors Simpson of Edin-
burgh, and Channing of Boston, expressly on this subject.
These  two gentlemen, than whom none stand  higher as
accoucheurs (in Europe or America), each report a list
of more  than five  hundred cases wherein these articles
have been most successfully used, and in no one instance
have they been productive of injury.
   Religious objections  have been urged against the use
of ether in no department so strongly as this; and that,
too, by  those  who  have  not  sufficiently  heeded the
primeval  curse  to let  nature take her own course.
Opiates, instruments,  laxatives, and  stimulants  have
been resorted to ever since civilization  commenced, and
no one's conscience  has  been  disturbed in the matter.
Who shall decide as to  the precise  amount of pain ne-
cessary to satisfy the  demands of  a  "violated  law?" 
124
ETHER.
Surely you may be allowed to spare yourselves all the
pain you can, particularly such  pains  as are attended
with risk to your  lives and the lives of those whom you
arc  about  to bring  into existence.    Embrace every
agent God  has been pleased to give  you for this pur-
pose, and seek consolation in doing good to others.
   The two  following paragraphs, taken from " Simpson's
Anaesthesia," pp. 125 and 6, abound  in argument, and
will, no doubt, remove all objections  from the minds of
those who are so  constituted as to be  influenced by any
course of reasoning.  In a letter to Dr. Protheroe Smith,
of London, he says:—
   " Some  of your London  medical  divines, however,
argue, I hear, that 'etzebh  must  mean  pain, and that,
meaning such, the  curse must be taken literally; and
hence that woman must  be  allowed to go on suffering.
In the pamphlet  referred to I have attempted to answer
this by showing that  then we, of the sex of Adam, must
adhere literally also to the words of the curse, as far as
they apply to us, and hence must earn our bread  by
the  ' sweat of our face,' and by  that  only.  Nay, the
very physicians who  thus insist on reading and acting
upon this and other texts literally—and literally only,
forget, I fear, (that according to their own doctrines) in
practising  physic they are really and truly practising a
profession  of sin and iniquity, in so far as man in the
primeval curse was doomed  to  die, and yet they daily
and hourly  persist in  attempting to  make him live.
An  esteemed clerical friend, in writing to me on the
matter, stated that he was afraid  his cloth was perhaps
even more sinful than  ours,  if  this  outrageous view
were true, for the introduction  of sin  was the conse-
quence of  the  fall,  and the  church, in  labouring  to 
ANESTHESIA  IN MIDWIFERY.       125
  banish and abrogate that effect, in trying to turn man-
  kind  from sin,  were  actually  trying  to  cancel  the
  greatest and  most undoubted effects of the first curse
  upon the human  race.
    "But the accoucheurs and surgeons among  you who
  object to the use of chloroform, on  the  ground  that it
  goes, in their opinion,  against  the  object  and end of
  the primeval curse upon woman, strangely  forget  that
  the whole  science and whole  art and  practice of mid-
  wifery is, in its essence and object, one continuous effort
  to mitigate and remove the effects  of that curse.   By
  warm baths, aperients, regulated diet, &c, they attempt
  to destroy  the intensity of the approaching pains  and
  penalties of childbirth ;  during labour they use  counter-
  pressure on the back to relieve the intense pains there;
 they use unguents, perineal support, venesection, &c,
 &c,  to  ease  the pains,  and insure the safety of the
 mother.   By these means  they succeeded partially, in
 times past, in mitigating the sufferings  and effects of
 parturition, and  thought they committed  no sin.  But
 a means is discovered by which the sufferings of the
 mother may be relieved far more effectually, and then
 they immediately denounce this higher amount  of relief
 as a high sin.   Gaining  your end, according  to their
 religious views, imperfectly, was no  sin; gaining your
 end more fully and perfectly is, they argue, an undiluted
 and unmitigated piece of iniquity.   To relieve our pa-
 tients, however, by our interference, a little, and a little
 only, is assuredly, in a moral and religious point  of view,
just as sinful as if we succeeded in affording them com-
plete relief from suffering.  The principle of interference
is not altered by the degree of relief afforded being more
                         11* 
126
ETHER.
or less, greater or smaller.   ' For whosoever shall keep
the whole law, and yet offend in one point, he is guilty
of all.'  If, on religious grounds, your obstetric friends
object to relieving entirely a woman of her  worst pains
(now that they have the means  of doing so), they must,
on the very same grounds, refuse to relieve her imper-
fectly and partially of  these or any other  pains  and
sorrows  connected with parturition; they must, or at
least ought to abstain, in fact, from all obstetric prac-
tices whatsoever; they  should,  in  short, give up their
present profession  as  a profession  of sin, and ' in  the
sweat of their face eat bread.'   I can see  no other pos-
sible alternative  for them, provided, that is to say, they
choose to reduce actually their theory into practice.   If,
on the other hand, they think it not sinful to relieve their
female patients,  to a small amount, from the alleged
sufferings  entailed upon them  by the first curse, then
surely it is not sinful in them to relieve  their patients
from their sufferings to a far greater  amount, now that
they have the power of doing so,—nay, is it  not  sinful
in them obstinately to withhold  that  relief ?  For, ' to
him  that knoweth to do good, and doeth  it not, to him
it is  sin.' "
  Many of my  female  patients, who have depended
upon my verbal and written directions, in view of their
approaching  confinement, have  reported  to me their
great satisfaction and their sense of  obligation for the
relief ether has afforded  them ;  and  in addition  to this,
they have uniformly concurred in these two important
facts, viz. :
  First.  The time  of  their labour has been  shortened
from  eight, ten, and twenty-four hours to one and two 
ANESTHESIA  IN MIDWIFERY.      127
 hours;  and  not  unfrequently  to  thirty  and forty
 MINUTES!
    Second.  Haemorrhage has never occurred to produce
 the slightest cause for alarm; even in those cases where
   reat apprehensions have  heretofore been felt on this
   ccount.
    Quite a number have informed me that in every pre-
 vious confinement,  it was  necessary that  instruments
^ should  be  resorted to.   The ether entirely super-
 seded THEIR USE.
    Case I.—A lady who had taken  the ether for the
 purpose of having one or two teeth extracted by myself
 (against the advice of her family physician), desired me
 to direct her as to its use in he* confinement, which was
 soon to take place.  This  lady was the mother of some
 two or three children, at the time of whose births her
 life was despaired of for many days.   Her labour was
 protracted and terrible  in the  extreme; the  exertions
 thus induced, caused such  a tendency of blood to the
 brain as seriously to  affect the  mind, and  this became
 an additional source of uneasiness to her friends, even
 should she recover her usual tone of bodily health.
    In an interview with this lady, she informed me that
 her physician was opposed to the use of the ether, and
 would  allow of  her  taking it  upon  no  consideration
 whatever.   I observed to her that it was of more conse-
 quence to her to take  the ether  than to retain her
 doctor.  "If Doctor ------- declines  giving  you the
 ether, Madam, Doctor-------  and Doctor------- are
 equally eminent, and they  will recommend  it."
    This lady again  sent for her physician, and  desired
 him to say definitely, if he would agree to her taking 
128
ETHER.
the ether.   His answer was, "No, Madam."   "Then,"
said she, "I shall have no occasion for your services."
" Oh—ah—ahem—yes—that is, yes, Madam, you shall
take the ether, if you insist upon it, that is, if it don't
cause too much flow of blood to the brain !"  Here was a
doctor  too  suddenly converted,  decidedly.   Half  the
rush of blood to the  brain, from the use of ether, would
be viewed as more dangerous  than twice  the quantity
from agonizing pain!
   A few days previous to this lady's  confinement,  her
mother called upon me, and informed me as to the state
of affairs.   I then urged  upon  her the necessity of  her
daughter's adhering  to her determination.  I urged  her
to be present to insist that her daughter  should have
the ether, "as much as she wanted;  rush of blood, or
no rush of blood!" and I further said : "If her doctor
is  disposed  to act the alarmist, you had better put him
in the next room with the rest of  the children, and
allow of no  one to be present who cannot be useful."
   The ether was used in this case; consciousness was
at no time interrupted.   In less than one  hour, and at
the last stage of delivery, the patient  was in  no pain.
The doctor was alarmed at this fact!   He  said " Take
away the sponge."   The nurse obeyed, but the patient,
understanding it  all, squeezed  out the  ether from  the
sponge into  the bed-clothes about her, and  went  on
breathing  it.   The sponge was given up with a smile
of victory at having outwitted the doctor.
  This lady says she has been well from the hour of her
confinement.
  Case II.—The following case I relate as one bearing
the general character of  a great  many that are  almost 
anesthesia in  midwifery.     129
daily reported to me.   I hear of none that essentially
vary from it, when my informants are qualified to speak
comparatively on the  subject.
  A lady who used the ether in her confinement, during
the past summer,  observed to me that her health had
been uninterruptedly good.   Her time of labour was
thirty-five minutes.   She had no  pains that could be
called   such,  and  no  haemorrhage  of  consequence.
The time between the  birth of her first and this last
child,  was  six  years,  and   she  had had no  child
intermediately.
   The sufferings  of this lady with her first child were
of a character to make an impression upon her mind,
that she says  is as vivid now  as ever, and  it never can
be  obliterated during her lifetime.   In  an ecstasy  of
gratitude at the  application of ether in such  circum-
stances, she said  she would  not object to bearing a
child a week, if she  could properly provide for  such a
family.
   Case III.—Among the first cases  reported by Pro-
fessor  Simpson, in which chloroform was  used, is the
following:—
   "I exhibited it  (chloroform) with Mr. Carmichael,  to
a patient who had, at her  preceding  confinement, been
in severe labour for twenty hours, followed by flooding.
She began  the inhalation when  the  dilatation of the
os  uteri was  half completed.   The child was  born  in
fifty minutes afterwards.   She was kept under its influ-
ence for a quarter of an hour longer, till  the placenta
was removed, and the binder, body, and  bed-clothes,
all adjusted.   On awaking she declared she had been
sleeping refreshingly, and was  quite unconscious that 
130
ether.
the child was born, till she suddenly heard it squalling
at  its  first toilet,  in  the  next  room.   No flooding.
An hour  afterwards  she  declared  she felt  perfectly
unfatigued,  and  not  as  if  she  had borne a  child
at all."
   The following letter I take  occasion to introduce in
this place, for the purpose of showing how the  subject
of anaesthesia is  generally viewed by eminent  men in
Europe;  and hope it will contribute largely to esta-
blish   a  corresponding  confidence  among   ourselves.
It  is from  Mr.  Lansdowne,  of Bristol,  England, to
Professor Simpson.
   "I have now used ether or chloroform in seventy-one
midwifery cases ;  I have two modes of administering it;
the one with a bladder, in  which is placed a brass pipe
with a stop-cock,  and into  this is screwed, after I have
poured the chloroform into the bladder, a piece of elastic
tubing with a mouth-piece, the whole being pierced with
a bore f  of an  inch, through which the vapour can be
readily inhaled.   If I  find I am likely to be giving the
chloroform for a  long time, I use this  apparatus, both
for the sake of  convenience, and also of economy, as
5j, will last me nearly or quite  an hour with this; and
should I use  it many  hours, it not only effects a great
saving of material, but does not so frequently require
replenishing,  and is always ready at the approach of
each separate uterine action, and it may be (as has been
the case with me), used by any friends, or by the nurse,
should the practitioner require to be  absent for a short
time.   The other apparatus  is an  inhaler, such as is
commonly sold;  it  is  made of a  thin  pliable  lead,
adapted over the nose and  mouth,  having  a piece of 
anesthesia  in midwifery.       131
perforated zinc  in  its front, and containing  a  piece of
sponge, over which the chloroform is thrown; the depth
of this inhaler  is  such  as  to  prevent  the nose being
touched by the chloroform.  It is home manufactured,
not  expensive, and very easy of construction.  This
latter I make use of if I am likely to be wanting it for
a short time  only;  it requires to be  supplied afresh
every five or ten minutes, and accordingly, I use 3j or
3ss,  which latter is my  quantity when  about to extract
a tooth.   If  the action of the uterus causes great pain,
as is frequently the case  in an early period of the labour
with the first child, I commence giving it as soon as the
os uteri is sufficiently dilated for  the  head to  pass;  I
have given it when the opening  has  not exceeded the
size  of half-a-crown.  I believe it may be given with
impunity as  early in the labour as we please,  and the
only obstacles to its being  so used that I can see, are
the inconvenience  to the medical attendant, in being
thus occupied with one patient for such a length of time,
and also the very great expense which such a length-
ened use of it must entail.   On the patient's account, I
can see no possible reason  why it may not be  used for
a whole day, or even more ; indeed, I cannot see why a
limit should be set to the length of time in which it may
be used.  I have no doubt but that  it will soon be the
anodyne generally  used  at  the latter stages of painful
cancerous  diseases.   The  greatest length of  time in
which  I have used it, has been 16 J hours, a fresh inhala-
tion being made at every renewal of the action of the uterus;
in other cases I have given  it 11£ and 12 hours, and the
only reason of the  inhalation being limited to this time,
has  been  the  cessation of the necessity for  its  use, 
132                  ETHER.

namely, that the child has been born, otherwise it would
have been continued until such event had taken place.
   " I have found that nearly all my patients  have re-
covered very rapidly; most of those who have  had
children previously, have been astonished at the unusual
rapidity of their recovery.
   "I find no difference as to the expulsion of the  pla-
centa and the subsequent discharge, when administering
chloroform, to what  takes place in  the  usual natural
labour.  I have, upon two occasions, used it for severe
after-pains, pains so severe  that their  cries could be
heard  at a considerable distance ; indeed they appeared
worse than the pains of actual labour ; in both  cases the
pain was  completely subdued by its use.  Both these
persons had determined not  to avail themselves of the
benefit of  the chloroform during  labour;  neither did
they, but they were delighted afterwards with its sooth-
ing effects.   The former of these, I had  long  resolved
to give it to for this  express  purpose;  it was her thir-
teenth child;  her labours have always been very rapid,
scarcely any pain accompanying them, but no sooner
has the child been born, than her agony has been almost
past bearing, the pain recurring at intervals for a fort-
night.   Upon this occasion I gave it to her three times
within the first ten hours, and  she  had nothing to com-
plain of afterwards.
   "As regards sickness, I have not found that symptom,
except where  fluid has been previously taken; on the
contrary, if the patient has  been sick, the chloroform
has almost invariably checked it.  The cramp I  have
not heard  them suffer from whilst under  its influence. 
ANESTHESIA  IN MIDWIFERY.       133
I have never yet met with anything which  has caused
me to regret having used it."

   The two following cases are kindly  furnished me by
Dr. J. S. Rohrer, of this city:—

   Case IV.—" May 12th, 1850.  Late in the evening
was called to see Mrs. M----, aged eighteen years,  a
healthy-looking  woman  of delicate and  symmetrical
proportions, in labour with her  first child.  Her pains
had come on early in the day, and increased in  fre-
quency towards  evening, when she was advised by her
nurse to send for me.   I immediately hastened to see
her, and found her, as described, in labour  pains.  On
examination per vaginam, the os uteri was rigid, and
high up in the pelvis, inclining towards the sacrum, and
dilated to the size of a quarter of a dollar.  I desired
her to bear her  pains with patience,  and assured her
that she would  not require my assistance before morn-
ing, apprising her, at the same time, of the likelihood
of her pains disturbing her all night.
   " 13th. Early in the morning Avas summoned to her
bedside; the  pains had  increased in frequency  and
force; and, as anticipated, she  had received no rest
during the night.   Her face was now flushed, and skin
moist, the pains  grinding, and principally in the  lower
part of the  abdomen, extending to the hips and back,
the os uteri  dilated to  the size of half a dollar.   Her
bowels being constipated, I ordered an enema, and left
her, promising to return in two or three hours.
   "11 o'clock,  A.M. Visited  my patient again—had
scarcely entered the door when met  by the nurse, who,
                         12 
134
ETHER.
greatly alarmed by her outcries, hurried me to  her
presence, exclaiming the " child  was near the world."
On examination, however, I found  no such favourable
news;  the os uteri very little more  dilated than on my
previous visit.  But the pains were  now very severe,
recurring at intervals of two and three minutes, and of
about twenty or thirty seconds' duration.   As  the pains
had  continued all  night and  morning,  without  much
change in the condition of the os uteri, I anticipated a
tedious time, and informed  her that I would leave  her
a few hours more in the care of her nurse.  I need not
add that she consented to this  proposition with great
reluctance.
   " 1  o'clock, P. M. The patient  is pretty much in the
same condition as when I left her; pains as before,  and
the muscles of the abdomen hard and contracted over
the uterine  tumour, as in the last stage of labour;  the
os uteri dilated to the extent of an  inch and a half, but
very rigid.
   " 3  o'clock,  P. M. The  pains  increasing in violence,
and  recurring every minute or  two,  accompanied  by
nausea and vomiting.   Vertex  pressing on the  os tincae;
about half a gill of water distending the membranes.
   " 6 o'clock, p. M. Have been absent one hour ; found
the patient on her knees on the  floor,  two  or three
attendants holding her up, and  supporting her  back.
This move was at  the suggestion  of the nurse,  who
insisted upon helping her out of bed, and placing her
on the floor on her knees; the same position, she re-
marked, in which she had all her own children.
   "Having  ordered  my patient  to  bed again,  and
placed on  her left  side, I made an  examination  per 
ANESTHESIA  IN MIDWIFERY.      135
vaginam,  which showed the os uteri  still rigid, sharp
round  the edge, and  painful to the touch.  The pulse
being full and quick, I resolved to bleed her by the
arm, which I did to the extent of fifteen ounces.
  "8 o'clock, p.m. The patient much exhausted  by the
bleeding,  respiration  somewhat hurried, and the pains
not the least modified in violence  or  frequency.  On
making an examination, I was surprised to find  the  os
uteri still rigid and  unyielding, although dilated to the
extent of  about two inches.   The  membranes  entire,
and the vertex to the left acetabulum.  Patient screams,
and  bears on her pains with  great force, but without
forwarding the labour.  Her outcries alarmed her neigh-
bours,  and arrested the attention of  persons passing by,
giving  rise to speculation  as  to what was  going  on
within.
   " Taking now into consideration  the  exhausted con-
dition  of the patient, the labour having been protracted
already over thirty hours, the os uteri still  hard and
rigid, the  pains evidently dilating pains,  though seeming
to force down on the child, I  was driven to one  or the
other of the following alternatives,  to wit, Dr. Dewees'
method of bleeding, ad  deliquium animi, etherization,
or waiting for time.   In the  latter  alternative, without
regarding the risk of  inflammation from farther pro-
traction, but judging alone  from the state of the  uterus,
the  lack  of expulsive power, delivery  could  not have
been accomplished in less than six or eight hours.   As
to bloodletting,  the  patient  had  already lost  fifteen
ounces without any evident relaxation of the  os uteri,
or mitigation of  suffering, and to push it any further, 
136
ETHER.
with a view of benefiting the  patient, was an expedient
of doubtful utility.
  " Having read with much interest a treatise on Etheri-
zation in Childbirth, by Professor Channing, I was for-
cibly struck with his explanation of the manner in which
etherization acts in obviating  the perils of labour; and
also  having lately observed the relaxing  effects of it in
a case of strangulated hernia, I resolved  in this case to
give it a trial, as a means of relief,  and  if possible, of
expediting labour.   According to  the  writer  above-
mentioned it gives the demanded relief, by ' increasing
dilatability, diminishing or suspending sensibility, and
taking away  the disturbing action  of the will;'  results
most devoutly to be wished for  in the peculiar crisis at
which the patient had arrived.
  "As the case  was one of  extreme suffering,  and in
every way favourable for the exhibition of the ' torture-
saving agent,' I  at once informed her of my intention,
and  explained to her the  effects which it was intended
to produce.  She acceded  to my proposition  with alac-
rity, although having never heard of  the agent in ques-
tion before.
  "  Half past 8 o'clock, p. M.—Eight parts of ether to
one of chloroform was now applied to the mouth of the
patient by means of a sponge, of which she commenced
inhaling freely.   The pains  continued as before; she
complained immediately of the ether burning her throat,
and  pushed away the sponge ;  but as the pains returned,
asked for  it  again, and  in  less than five minutes was
under the influence of the anaesthetic.  The sponge was
removed from  the mouth for a moment, at intervals,
and  the patient  suffered to inspire atmospheric air until 
ANESTHESIA IN MIDWIFERY.      137
the effects of inhalation had partially passed off, when
it was resumed, but without producing, as  I supposed,
the full anaesthetic effect.   The pulse soon fell from 90
to 70  in a minute;  the pains  continued  regular  as
before,  but  more  efficient;  she  seemed  conscious  of
what  was going on,  and showed some indications  of
suffering, but bore the pains without any outcries;  and,
although she still complained of the vapour hurting her
throat, grasped the sponge firmly, and inhaled  without
interruption until requested to lay it  aside.   In fifteen
minutes after inhalation the os uteri  was  fully dilated,
the pains recurring at intervals of one and two minutes,
and of thirty and forty seconds' duration.   Labour was
now progressing  rapidly, and in twenty minutes more
the vertex passed into the hollow  of the sacrum.
   "9 o'clock, fifteen minutes.—The head escaped  from
the os externum, and a fine boy, much over the  medium
size, was delivered.   The placenta came away in a few
minutes  after the birth of the child,  and  the uterus
contracted firmly without  any hemorrhage.
   "14th, 9  o'clock,  a. M.—After the excitement  of
suddenly finding herself the mother  of a healthy boy
had passed  away, she  fell  asleep, and did not wake
before morning, when she  felt refreshed  and free  of
pain or fever.   On inquiry as to  her  sensations during
the time of etherization, she declared that she did not
remember anything connected with her  labour from the
time she first inhaled  the  contents of the sponge ; was
perfectly unconscious  of what  had  passed until she
h«ard the cries of her infant.   I  may add that she got
well without a single unpleasant  symptom,  and in less
than a week was able  to take charge  of  her babe.
                         12* 
138
ETHER.
   " Remarks.—It  was not  my  intention at the time
these notes were taken, to  give them publicity, nor do
I at this time take a stand  in favour of etherization in
midwifery.   Although I believe  in the doctrine that
' meddlesome  midwifery is bad,'  and that it is seldom
necessary or proper to interfere in the natural progress
of labour, yet I am also inclined to believe,  from what
I have witnessed, that the agent in question, when cau-
tiously administered,  is not  only safe  and efficient in
relieving pain  and mitigating suffering, but has  the
power of increasing dilatability of the os  uteri, while,
at the same time, it does not  suspend or interfere with
uterine contractions.  I should therefore be  induced in
all cases of painful labour,  when the uterus is rigid and
the  dilating pains very severe, to  give it a  trial.  It
possesses important  advantages over opium  in producing
its effects almost instantaneously; and I have no doubt
in  this case  it  increased powerfully the dilatability of
the os uteri, and thereby greatly hastened  the progress
of  labour.   It  will  be recollected that the patient had
suffered  the  most violent  pains  for more than thirty
hours before the application of the  anaesthetic, and the
condition of  the os uteri at the time of its administra-
tion was still  rigid,  and but  partially  dilated.  It will
also be seen that the  indications  at  the time favoured
the opinion, that without its  employment  the suffering
of the patient must have been prolonged  six or seven
hours more;—partial anaesthesia  accomplished it in
forty-five minutes !"
   " Case V.  Dec. 8th, 5 o'clock, a. m.—Was called to
see Mrs. S----, aged about 23 years, in labour with her
first child.  She was in her seventh month of pregnancy, 
ANESTHESIA  IN MIDWIFERY.      139
and  had lifted a heavy trunk the  day previous, which
caused her  a slight pain in the back; but did not con-
sider it of any consequence, and went to  bed  at the
usual hour.   At midnight she was suddenly awakened
by a gush of water which passed from her, and at the
same time experienced  a severe pain  in the back and
lower part of her abdomen;  supposing her ' water had
broke,' she sent for me, and  at the  time of my arrival
the pains recurred  every  five minutes  with considerable
severity.   Upon examination the head of the child was
low  down in the pelvis, but the os uteri was not dilated
over the size of a quarter of a dollar.  I left her, pro-
mising to return at noon.
   " 12 o'clock, M.—The patient  had  grinding  pains,
 recurring every three minutes, and  the os  uteri dilated
 to  the extent of half a dollar, and  rigid.  I left her
 again, and  desired her  not  to send for me  until  the
 pains were  stronger, and of  longer duration.
   " 11  o'clock at  night, was sent for in  great haste;
 pains as before; the os uteri dilated  to the size of a
 dollar, and was felt at the lower and posterior part of
 the globe presenting.  The  pelvis being capacious, and
 the vertex  to the  left acetabulum, I expected the re-
 sistance of the os tincce  would soon be overcome, and a
 speedy delivery effected.  In this I was mistaken ; the
 uterus was stretched tightly over the vertex, and when
 the pains were on, the os uteri was hard and unyielding,
 and although considerable effort was made to stretch it
 with my finger, to  overcome its resistance, it remained
 as  before,  and prevented the head  of the  child from
 descending.   This  state of things  continued, with in-
 creased uterine action, until after midnight. 
140
ETHER.
  " 1 o'clock, A. M.—Proposed etherization, and agreed
to by the patient.   Half past 1 o'clock the patient com-
menced to inhale,  and in five or six minutes was under
its influence; the pains continued at intervals, as before ;
pulse fell from one hundred  and ten to ninety in ten
minutes. On examination the os uteri was dilated suffi-
ciently to push it back over the vertex, and it soon dis-
appeared beneath  the arch of the pubes.  The pains were
now  not so frequent but  more effective.  In one hour and
twelve minutes after the administration of the ether the
child was safely delivered. The head remained about half
an hour on the perineum, on account of longer intervals
between the pains and the expulsive force having some-
what diminished.   The  patient  was  only suffered to
inhale during the continuance of each pain, and in this
way  the anaesthetic  state was  kept up until labour was
accomplished.  From the sudden change in the uterus, I
was led to the same conclusion as heretofore expressed,
to wit, that etherization  increases dilatability of the os
uteri, or in other words, overcomes the resisting power by
relaxing the soft parts.  As a general rule, I would not
think it necessary to keep up the full anaesthetic state any
longer than is necessary to moderate uterine action, and
mitigate the suffering of the patient.   For this purpose
partial anaesthesia can be kept  up for many hours, and
increased, if necessary, to its full effect  at the close of
labour, particularly at the  time the  vertex passes the
os externum.
  " The patient in question was of nervous temperament,
and  subject to attacks  of  hysteria; and although the
child died in  ten  hours after  birth,  she is doing well;
and  it is probable, under these  circumstances, without 
          ANESTHESIA IN MIDWIFERY.      141

etherization taking away  the ' disturbing action of the
will,' she would not  have escaped  an attack of her
malady.   The child, I omitted to state, had  an imper-
forate anus, which hastened its death.  Autopsy revealed
that the rectum terminated in a  cul-de-sac in the lower
and anterior part of the vagina.
                      "John S. Rohrer, M.D.,
                              "No. 557 Chestnut Street.
   "Philadelphia, December 12th, 1850." 
     TESTIMONIAL  CORRESPONDENCE.


  The desire to lay before my readers the evidence of
some of our most eminent practitioners  in  the medical
department, in  support  of etherization,  induced me to
address the following  circular  to  a number  of  my
friends.  Their answers, with a report of cases, will be
found under the respective heads upon which they may
treat.  I would here  beg leave to tender my thanks to
all who have so kindly given me their attention.

                         Philadelphia, December 6, 1850.
My dear Sir:—
  Having in readiness for the press a small work upon
the subject of ether and chloroform, I am  desirous of
adding to  it the  testimony of such of my  medical
friends in this vicinity,  as may have  used either one or
both of these articles in  their practice.
  My own experience has been  mostly  confined to the
use of these agents  in  surgery and  dentistry, for the
purpose merely of inducing  anaesthesia; with only  an
occasional  opportunity  of witnessing their effects  in
cases of impaired health.  I feel, therefore, particularly
desirous of availing myself of such information as you
may be pleased  to communicate to me on the subject.
  If you have used them in the midwifery department
of your practice, and  will  favour me  with the report of 
CORRESPONDENCE.
143
a case, you will not only confer an obligation upon me,
but it will do  much toward  confirming that confidence
in the public mind, which has been, heretofore, so much
abused, and which I have  laboured to correct for  the
four years past, as an important condition to secure the
happiest results in etherization.
   Should you have  discovered any  injurious conse-
quences  referable  to  the  use  of these  medicines,  I
would thank  you to  mention them, as  facts quite as
desirable to be known as the advantages  pertaining to
their use.
              With much respect,
                     I am truly yours,
                                   J. F. B. Flagg.
  The following is from Dr. Rohrer, of this city:—

" Dear Sir :—
  " In a communication with which you honoured me, on
the subject of ether and chloroform, you desired me to
give you the result of my experience, either in favour or
against its employment, and favour you  with the report
of a few cases in the midwifery department of my prac-
tice.  It affords me great pleasure to comply with your
request; and, in doing so, if my humble tribute  only
tends to confirm what  has already been written on the
subject, with a view of  directing  a more general atten-
tion to this department of medical  inquiry, an impor- 
144
CORRESPONDENCE.
tant result in etherization will have been attained.  It
also gives me great pleasure to state, that having chiefly
employed the agent in question  in protracted and com-
plicated cases of labour, I have witnessed no bad effects
from its use.
   " The following cases,* with some remarks, I  have
given  you in detail,  which are among the most striking
which have  occurred in  my practice  under the use of
the anaesthetic.
               " Very respectfully yours,
                          "John S. Rohrer,
                                " No. 557 Chestnut Street.
   " Philadelphia, December 12th, 1850."
             (From Dr. Griscom, of this city).f

             "216 Arch Street, Philadelphia, 12 mo. 14, 1850.
" Respected Friend :—
   " Thy note of the 2d inst., in reference to the use of
ether for inducing  anaesthesia,  is  before me;  and, in
reply to thy queries, I can say that I have repeatedly
used  ether  with this  object  in my obstetric practice,
during the past two years, with very gratifying results.
In  a  few cases, little or no benefit seemed to  follow.
The result  of my experience is an increased confidence
in its safety when judiciously administered, and a belief

  * These cases are of much interest, and will be found both in the
Pathological and Midwifery arrangement of this  work.—Ed.
  f See also Dysmenorrhoea,  Case XIII., p. 72. 
correspondence.
145
that much useless suffering, mental and physical, may
be alleviated or removed by its use.
                  " Sincerely thy friend,
                             "John D. Griscom."
(From Dr. Mutter, Professor of Institutes and Practice of Surgery,
         in Jefferson Medical College, Philadelphia.)

"Dear Sir:—
  " In reply to your note of the 6th inst., I have to say,
that  for several months past, and in a large  number of
cases  demanding  surgical  operations,  I have  used
' ether,' as an  anaesthetic agent, with great advantage,
and without the development of a single bad symptom.
  "'•Chloroform,'  in my  hands at least, has  not  suc-
ceeded so well; and, from the hazards to which several
of my  patients have been subjected in  consequence of
its administration,  I have abandoned its use.
                      "Yours, &c,
                            " Thomas D. Mutter.
  "Philadelphia/December 12th,  1850."
  Dr. Samuel Jackson writes thus:—

" Dear Sir :—
  " In reply to your  favour of the  6th, I have only to
                         13 
146
CORRESPONDENCE.
say that I have never used ether or chloroform by inha-
lation, in any case.
  " Since I  became reconciled to the use of ether, I
have met with no case that required it.
         "Very respectfully,
                     " Your friend and servant,
                               " S. Jackson,
                                   "30N. Ninth Street.
  "Philadelphia, December 12th, 1850."
(From Dr. Pancoast, Professor of General, Descriptive, and Surgical
         Anatomy, in Jefferson Med. College, Phila.)

" Dear Sir :—
   " In reply to your  inquiries of the 6th inst., in refe-
rence to my employment of ether and chloroform  as
anaesthetic agents, I may state that my experience with
the former has  been  the most extensive.   I have used
it very commonly since its  first  introduction to  notice
as an agent  of this description, without its having, to
my knowledge, produced any permanent inconvenience
in a single case.   Its employment, on the other hand,
in cases that could  be fully  brought under its influence,
has seemed to me  to have  been of incalculable advan-
tage to my patients, enabling them, under the anticipa-
tion of its use,  not  only to submit with more confidence
to surgical operations, but  to bear them, even  of the
severest kinds, when  performed, with little and some-
times no consciousness of suffering; thus escaping, in a 
correspondence.
147
great measure, a severe shock upon the nervous system,
and thereby rendering their recovery more prompt and
certain.
   " My experience of the use of ether in midwifery is
very limited;  but  I am  very confident I have seen it
mitigate suffering, without prejudice to  the  mother or
child, and facilitate the relaxation of the partes molles,
in protracted cases, that would  otherwise have  called
for venesection.
   " Chloroform I have also many times  employed,  as a
preliminary to surgical operations; and though I am
not confident that  I  have  seen it  produce injurious
effects,  I now generally employ ether in  its stead, as
this,  in prudent  hands,  and  properly administered, I
believe  is attended with little or  no risk  to life.
                   " Very respectfully yours,
                               " Joseph Pancoast.
  "Philadelphia, December 14th, 1850."
   Dr. J. M. Wallace replies as follows:—

 " Dear Sir :—
   "You ask me to let you know what I have seen of
-the use of ether as an  anaesthetic agent in medicine and
 surgery.  I have  repeatedly used it, and seen it used
 by others, in surgical  operations of all degrees of seve-
 rity, and never, in any instance, with any but the hap-
 piest effects.
   " In medical cases  I have  used the  ether for three 
148
correspondence.
weeks  at  a time, every evening, to procure sleep in a
very aggravated case of neuralgia, and the patient, who
was unable to  bear any ordinary anodyne, found the
greatest advantage from it in relieving her sufferings,
which were excessive until  this agent was resorted to.
  " In two severe  cases of  dysentery, I administered
the ether for twelve hours at intervals, when the pain
came  on severely, and with the most agreeable results.
In obstetrical practice, I have  had recourse  to  it but
twice, and I thought in each case, it  relaxed  the parts
very favourably, as well as giving relief from the pains,
which were very severe;  and I shall continue to employ
it in all cases to which it seems  adapted.
                         " Yours, truly,
                                "J. M. Wallace.
  " Philadelphia,  Dec.  26, 1850."
                  (From Dr. E. Wallace.)

                            "Philadelphia, Dec. 27, 1850.
" My dear Sir :—
   " In reply to  your note, I would  inform you that I
have  used sulphuric ether as an anaesthetic agent, in
but  one  case of  midwifery.   Its  use  was continued
during  the uterine  contractions, for more than four
hours.  It did not appear  to have any influence on the
duration of the labour, but  prevented all  appreciation of
pain by the patient, although it was not  carried to per-
fect narcotism.   Her after condition presented nothing 
                correspondence.             149

unusual, and the recovery was a good one. The amount
of ether inhaled was 3xiv.
                "Yours, respectfully,
                          "Ellerslie Wallace."
  The following is from Dr. H. Bond, of this city:—

"Dr. Flagg:—
  " Dear Sir—I received, in due time, your note request-
ing me to furnish you the results of my observation in
the use of ether and chloroform, as anaesthetics.   For
sufficient reasons, part of which are known to you, and
the others, it would here be out of place to state, I have
hitherto been precluded from replying to it.
  " My experience in  the  use  of  those articles, as
anaesthetics, is limited  to  a few cases.   I have never
used either of them in parturition.   One reason for this
is, that for some time  I have been compelled to relin-
quish  almost  entirely,  this  department  of practice.
Should I, however,  meet with such cases of labour, as I
have sometimes  had heretofore, I should  resort to the
use of one of them; but the frequent  every-day use of
anaesthetics in midwifery, I deem to be unnecessary and
unwarrantable.  As I had also relinquished my limited
amount of operative surgery, some time before the intro-
duction of the anaesthetic practice, I have had no occasion
to use these agents  in this department of practice.
  "My limited experience would leadme in  most cases to
prefer  chloroform to ether.  The former is much the most
                        13* 
150
correspondence.
powerful, and when it is considered how extensively it has
been used, and by how many rash experimenters; when it
is also considered how often we meet with idiosyncrasies,
that will not tolerate a remedy, or an  article of  diet,
which is neither offensive nor injurious to other persons,
it is not strange that it has  sometimes produced injuri-
ous and even fatal results.  To those incautious, dashing,
experimenters, who are prone to be unmerciful riders of
new hobbies, it might perhaps be prudent to recommend
the use of ether.
   " I will briefly  state  one case, which  seems to me
to possess some interest in reference  to  your inqui-
ries.   I  had  under  my  care, for  several  years, a
most distressing case  of neuralgia,  affecting  more  or
less every part of  the nervous  system.   It was beyond
question, the  most distressing case that  ever  came
under  my observation,  and all the  resources of the
medical art, so far as it  is known to many of the  most
eminent practitioners  of Philadelphia,  were  exhausted
upon it, without effecting more than a mitigation. Homoe-
opathy  was tried,  and its nothings produced no effect.
Mesmerism was tried, and she was very susceptible of
its influence.   At  first it produced  such  a mitigation,
that she had much better rest  at night; but the effect
became less  marked  every time it was  tried, and  very
soon it  was found entirely useless.
   "In  January, 1847 (when she  had been under my
care about 7 years, being then about 23 years old), her
sufferings became excessively aggravated;  she had  slept
none for several nights, and she could neither have her
dress changed, nor even  be turned in bed by a  most
careful  nurse, without being  thrown into a violent con- 
correspondence.
151
vulsion.  I  invited my friend, Dr. Jackson  (of North-
umberland), to go with me and witness a trial of chloro-
form. I administered it by dropping about 30 or 35 drops
upon a handkerchief,  which soon  produced its usual
effect; but as  this was about to  pass  off sooner than I
desired, I added more, and  she  continued in the anaes-
thetic state nearly an hour.   We carefully watched its
effects.   Her countenance lost its distressful expression.
It was neither suffused nor pale, and it appeared as calm
and  composed as  if in the sweetest sleep.   There was
no acceleration  or other disturbance of the pulse or
respiration.   When the effect of the chloroform passed
off, she was much refreshed, and passed the following
night  more comfortably than she had  done for a long
time before; but the attempts to turn her in bed and
to arrange her dress, brought on convulsions  as before,
and as the distressing symptoms  were increasing, chloro-
form was again  administered with a  like  favourable
result.   She continued  in  this condition more  than
a year,  and chloroform was administered  every day,
once,  twice,  or  three times.   It  was  only when
under  its influence that she  could be moved without
producing   horrid  agony  and  convulsions.   During
this  period,  no dangerous or alarming symptoms occur-
red,  which could be  attributed to the remedy.   I  con-
tinued to visit her at more or less remote intervals, but
the chloroform was always, after  the first day or two, ad-
ministered by her mother.  For an hour or two after
the  anaesthesy had passed off,  she had some dulness
and  uncomfortable feeling in the head, and this was the
only inconvenience resulting from the practice.
   " After the lapse of more than a  year, the symptoms 
152
correspondence.
became so much  aggravated, that  she  was  in  excru-
ciating  agony or convulsions the whole time, when not
under the influence of chloroform ; and her friends kept
her under its influence as much  as half the time for ten
days.  This inordinate, enormous  use of it produced
some disturbance  of the mind, and a good deal of dis-
tress in the head.   There were no other  unpleasant
symptoms attributable to it.   As the violent symptoms
were now subsiding, the  use of the remedy was lessened,
and very soon almost  entirely discontinued.
   " I have stated so much of this case (for a full report
of  it would fill a volume), in  order  to  show to what
extent this remedy may be used,  in  a  system of the
extremest nervous susceptibility, without inducing any
dangerous or alarming symptoms, or, at least, not until
the patient was kept fully under its influence half the
time for several days.
   " For several months  past I have had under my care
a patient long affected with, and now in a very advanced
stage of chronic bronchitis, and whose lungs have both
become implicated.    His respiration  was a good deal
oppressed, and he was much affected with nervous irri-
tability and neuralgia  about the fauces  and air-passages.
His  stomach has  been in such a condition for many
months past, that it would not tolerate those remedies
which are usually found most serviceable in such cases.
In order to mitigate his  symptoms, I recommended the
inhalation of ether, but not to the extent  to produce
anaesthesia.   It seemed for  a time to afford  conside-
rable alleviation, but after a trial of a few weeks it was
discontinued, as affording no essential  relief.
   " About  the same time that he began the inhalation 
CORRESPONDENCE.
153
of ether, I recommended  the  use  of chloroform  exter-
nally, as an anodyne and  counter-irritant to the throat
and chest.   I moistened a piece of muslin more or less
with it, according to the effect desired;  and, upon its
application to  a part,  immediately covered it with a
piece of oiled silk, or some other article that  would
prevent  evaporation.    These  applications  produced
very decided relief—so decided that he has continued
the use  of  them until now,  more  than  four  months,
using them  repeatedly every day.   His skin does  not,
of late, seem to be so susceptible of the action of chlo-
roform  as  at first, and he uses it  much more freely,
using at present not less than an  ounce daily,  and in
such a manner that  he inhales  much of the vapour, so
much as manifestly to affect him, but not so as to pro-
duce  complete anaesthesia.    Sometimes,  indeed, it  ap-
proaches very nearly to  it.  The use of it seems to
have become almost indispensable to him ; and  although
now reduced to extreme  debility, almost  to the lowest
stage of vitality, neither he nor myself have discovered
any ill  effects produced  by it.   Some time since I re-
commended another trial of ether, but it  was neither so
pleasant nor so beneficial  as chloroform, and  it  was
forthwith discontinued.
               " With my best wishes,
                     " Respectfully yours,
                                   " Henry Bond.
   "January 8, 1851." 
        MISCELLANEOUS  CASES.


  It has been my object thus far  to report only one
ether case, as illustrative of each of the positions I have
assumed in the arrangement  of this work.  To have
multiplied them, would only have served to establish the
same facts in different degrees.  Having selected such
as appeared to me to bear most strongly upon the several
subjects, I  trust my readers may find  amusement at
least, in the perusal of what follows.
  Case I.—A  gentleman desiring to have a tooth ex-
tracted commenced breathing the ether,  but immedi-
ately stopped to say:—"I have taken this, years since,
and if I go on breathing it, it  will make me crazy, and
take twenty men to hold me." (He supposed from its
nick-name, "Letheon," that it was something new.)
I thanked him for mentioning  this fact, and  explained
to him the difference in  its  effect, growing out of the
motive for which it was taken. After exacting a promise
from him that he would  be governed by me when ethe-
rized, as far as he could understand me,  I proceeded to
put him under its influence.   He  had  inhaled but a
minute or two, when he began  to swing his  arms about,
showing some little belligerent disposition.  I said to
him:  "Keep your arms still."  He dropped them at
once into his lap, but immediately commenced stamping
his  feet.  I commanded him  to keep these  still also. 
            miscellaneous cases.         155

He obeyed as  readily, but began to make a loud noise,
somewhat between a quarrelsome and a merry drunken
mood.   At this, I exclaimed  with a  little severity:
" Sit perfectly still and keep quiet."  He seemed to be
instantly transfixed. He held his breath for half a minute.
I removed the tooth without the least resistance on his
part, and with no change from a comically fixed  counte-
nance  and position.   The  whole was  ludicrous in the
extreme, and while his friend and myself were enjoying
the scene,  he suddenly  cried out: "By ----  I  must
halloo."   "Well," I said, "halloo  now as much as you
please."   The  ether was now off.   He  had no  disposi-
tion to make  further  disturbance, and  did not know
when he lost his tooth.   He said he thought there was
a great excitement about something or other; he could
not tell  what.   That  everybody around him was very
happy, cheering  and making  a great noise.   He de-
sired to join in the fun, but could not; he was perfectly
spellbound, and believed he  should have  died had he
not given vent to his feelings as stated above.
   Case II.—Two young ladies from West Chester made
me a visit, each requiring a tooth to be extracted, and
upon  etherizing the first one and removing her tooth,
 she remained perfectly calm for about one minute after
 it was out.  She then began to cry quite loud, and con-
 tinued to  do so for  a minute  or  two, when  the  ether
 passed off, and she said  she had a  perfect  consciousness
 of all that had occurred except she thought her friend
 had undergone the operation instead of herself, and her
 tears  were those of sympathy.
   Case III.—Two sisters, aged eight and ten years,
 came to my office together, for the  purpose  of taking the 
156         miscellaneous  cases.
 ether and losing a tooth apiece.  The eldest commenced,
 in order to set the example  to  the younger ;  and while
 giving her the ether, the other came forward and took
 her  seat  in a chair directly  in front,  to witness the
 operation.  The sympathies  of this  little  girl  were
 much  awakened, and  she  shed tears  freely on  the
 occasion.  When the ether was off sufficiently for the
 patient to begin to  comprehend  matters, seeing  her
 sister  in  tears,  she said: "Did it  hurt?"  The other
•answered, "How should I know?"   Elder sister.—
 "Didn't  the  Doctor  pull your tooth?"  Here she be-
 came fully conscious,  and much merriment followed the
 singular mistake.
   Case IV.—Whilst  engaged  in giving the  ether to  a
 young  gentleman of  this  city,  he suddenly  stopped
 breathing it,  and very  handsomely apologizing for the
 interruption, observed to me, that the last time he took
 the  ether, he fought with  the dentist.  He hoped  I
 would excuse  him if his conduct should be similar in my
 office.   I merely said  to him that I  should consider him
 as on his good behaviour, and  there was no trouble in
 his case whatever.
   Case V.—In an early period of my ether practice,  a
 gentleman from New York desired to try its effect upon
 himself and have his tooth extracted.  It was my custom
 at that time  to give the ether by means of an inhaler,
 a glass globe with  a flexible  tube  and  mouth-piece at-
 tached.   The whole was constructed with the  necessary
 number of valves to produce the desired  effect.
   This gentleman held the cup or mouth-piece to his
 lips, and began breathing very comfortably.   There
 was  no irritation of the  throat,  and  of course, no jjispo- 
miscellaneous  cases.         157
sition to cough.  His  pulse quickened  somewhat, and
after breathing about a minute, the perspiration stood
upon his forehead.  I asked him how he liked it ?  He
said, "Very well."  In about a minute afterwards I
asked him how he felt?   He replied, " Very  well."
Another minute  passed.  He looked for  a moment a
little wild,—rolled  his  eyes—countenance flushed.  I
again said,  "Do you  hear any noise  in your  ears?"
He seemed to listen for a moment, but made no answer.
At this  point, he closed his eyes and  rolled his head
over upon one side.   I took away the mouth-piece ;  his
mouth  remained  open.  I  remarked, " That will do !"
He answered in the same way  as before, " Very well."
   This monotonous way of speaking in etherized patients
is generally one very good  guide (short of perfect  nar-
cotism)  when to extract a tooth.   It often  occurs  that
patients will say (after answering the first question
affirmatively), "yes,"—"yes,"—"yes," to every suc-
ceeding question  that may be  put to them,  without  the
least regard to  the nature of the question itself.
* I  extracted  the  second  lower molar tooth for this
gentleman,  and  used  the  old-fashioned " wrench," or
"German key," to perform the operation.  This I did,
in order to illustrate to him how crud  a tool might be
used with impunity, when under the influence of ether!
   My patient made pretty much all the usual  demon-
strations of pain  that are  manifested when the  opera-
tion is really a painful one, "  and no mistake,"  such as
distorted features, raising his  foot, a groan, approach-
ing an outcry.  Immediately after the tooth was  out, he
carried his  hand to his jaw, and swayed his body as if
in much agony.  I asked him  if it hurt him much ?  He
                          14 
158          miscellaneous cases.

said, " It did,  very much !"  I, at the moment, was
under the impression that his answer was dictated from
the manner of my putting the question, and I waited a
few minutes to give time for the ether to pass off.  I
then said, "What were your  feelings?"   He replied,
" I did not perceive  any difference in my feelings from
what they ordinarily are."   " Did you have no dizzi-
ness, no noise in the head, no tingling  sensation in the
hands or feet?"   "No, not any!"   "Then why did
you allow  me  to extract  your tooth?"   "Because,"
said  he,  " you said, ' that  would do,'  and I supposed
you knew all  about  it."   He said it was of no  conse-
quence, as the tooth was out; but he looked as  though
an imposition had been practiced upon  him.
  In the course of  a little  farther  conversation with
this gentleman  (not perceiving the smell of the ether in
his breath), I ventured the opinion that he had  not in-
haled any.   I  then examined the mouth-piece  of my
inhaler, and  discovered that the inner valve had stuck
in such a manner as to preclude the possibility of the
passage of its vapour!  He  had drawn through his nose
the atmospheric air, and expelled the  same by mouth
through the tube.
  After  relieving  my apparatus of this obstruction, I
requested him to inhale it, to see if he had obtained any
of it upon his previous trial.  He took a strong inspi-
ration, and jumping out of the chair, exclaimed, as soon
as he was able  to speak, " No, sir, I am thankful I got
none of that  stuff before !"
  I could  not  prevail upon this patient to place him-
self under the influence of the ether ; he expressed him-
self as perfectly satisfied to take my word for it. 
MISCELLANEOUS CASES.         159
  Case VI.—It sometimes occurs in ether practice that
much difficulty is experienced in getting the patient to
breathe it  beyond  the exciting influence.   He will,
occasionally, resist it beyond  this point to  such  an
extent as to render it quite  as well  to attempt  the
forcible removal of  a tooth, as to compel him to inhale
the ether so as to induce absolute slumber.   This fact
frequently  makes the operation one of a nature more
unpleasant to witness than to experience.
  The following I relate as the most  remarkable and
unpleasant case that has occurred in my practice:
  A poor woman came into the city from a neighbouring
town to obtain  something  from an  apothecary to  put
into her aching teeth.   She had several bad teeth; three
of them were then giving her pain, and had been doing
so for some months past.
  The  druggist to whom  she  applied, looked at  her
teeth, and told her she must have them extracted.  She
said "I will die first!"  He then said to her, "If you
dread the operation so much, you had better go to  Dr.
Flagg's ; he will give you something to put you to sleep,
and will take them out without  your knowing it."  She
was much delighted at hearing  that such a thing  could
be done, and immediately called upon  me in  company
with  quite  an elderly woman, who was  her near neigh-
bour, and who represented to me, that my patient had
already suffered from  this attack to such an extent, as
not only to obtain no rest herself for several nights
past,  but her  friends  had  also been broken  of theirs
very much  on  her account, and, if it was possible,  she
hoped I could  relieve her.   The old lady really spoke
feelingly upon the subject. 
160
MISCELLANEOUS CASES.
   This patient entertained no fear as to the ether; her
whole mind was filled  with  the thought of her teeth.
She was much prostrated with her long sufferings, and,
in short, she was  the personification of the horror  of
tooth-pulling.
   I had proceeded but a minute or two in giving her
the  ether, when she began  to  resist and to  cry out
"Stop, stop, stop."  She  became violently  rude, pulling
off my spectacles, and displacing my watch by  catching
hold of  the  guard.   She kept  her teeth  very  firmly
closed.   I requested the old lady to hold her hands;
at the same time assuring her that the young woman
was not conscious of her resistance.   This, the attendant
did  not fully credit, and her assistance  consequently
amounted to nothing.   Soon the ether passed off, when
the  patient exclaimed "Are they out?"   Upon being
told that her resistance frustrated my attempt  at ex-
tracting, she desired me to give  her the ether again.  I
did so, and had  the full co-operation of the old woman
this time, but with no better success than at first.  On
recovering from its effects, her conduct was the same
as before,  desiring me to give it again, &c.   I  said it
would be of no  use, unless she allowed me to call  in
assistance  enough to hold her;  and requested  her  to
put  it off for a few days, when I hoped  it might be
taken with happier effects.  She would not hear  to this
last proposition, but begged me to give her more, desir-
ing  me  to  call to my aid all  the assistance  I  might
require.
  At this third  etherization, my force consisted of two
strong Irish girls, in addition to  my former help.  Find-
ing them insufficient to hold her, I allowed the  ether  to 
MISCELLANEOUS CASES.         161
 pass entirely  off, before I began to explain the nature
 of the difficulties in  the  case.  Much  ether had  been
 consumed in these fruitless  attempts.   There was con-
 siderable  prostration on the part of my patient  from
 previous suffering, and I felt some apprehension that
 reaction, after so much excitement, might  be injurious
 to her.  After a period of fifteen  or  twenty minutes,
 and discovering no unpleasant results from the ether, I
 was induced, by the most earnest importunities  on her
 part, to tie her firmly into the chair, and make one more
 effort in this singular case.
   After using  up an  entire  clothes-line in binding her,
 hand and foot, to the chair,  I again required the aid of
 my three female assistants.  When etherized, as at the
 previous trials, her struggles were tremendous.   She
 uttered no  cry,  but  worked herself  down into  the
 chair, in  defiance of  rope, women, and what  aid I
 could render to keep  her in position.   By the time I
 succeeded  in  extracting  one  tooth, I  discovered  the
 rope, that was  previously  around  her waist, to be
 drawing tightly  across her  throat.   It became  neces-
 sary  to relieve  her  from this situation immediately,
 and by the  time I had  got her disengaged, she  was
 sufficiently recovered  to be  sensible  that a tooth  had
 been extracted.  She soon began to walk up and down
 the room,  exclaiming: "Is  it  possible! I have had a
 tooth out!"  " How  was it  done ? and I didn't know
 it!"  "God bless  you, sir, God bless  you!"   After
 sitting down a  few minutes she very deliberately said:
 " Give me some more, and take the others out."   "No,
 Madam," said I, "however amusing all  this may be to
you, we are  tired out."  And  nothing but  my plea of
                         14* 
162
MISCELLANEOUS CASES.
 inability, from utter fatigue, quieted her earnest solici-
 tations for more ether.
   I had removed the most objectionable tooth.   The
 others could have been easily extracted,  and would not
 have been painful, even without ether. This I explained
 to her, and offered then to take them out if she would
 allow me ; but I declined giving her more ether.  As a
 substitute, I offered  to extract them gratuitously, and
 more, if she would have them out, I would refund to her
 the fee I had taken for extracting the first.  She was a
 poor woman.  She hesitated a moment, and then fell
 back upon her original text, "I'll die first."
   Case VII.—A gentleman and  his lady visited me,
 lately from Tiverton, Rhode Island.  They each desired
 to take the ether and have some offensive teeth extracted.
 They were much  gratified with it, but there was not any-
 thing remarkable in that.
   The  gentleman was sorely afflicted with a boil upon
 his hip.   It was his intention to remain  in the  city for
 a week, but he abandoned the idea of  being  able  to
 visit the objects of attraction in our beautiful city.  His
 pain was intense in almost any position he could assume.
 Walking  gave him great  uneasiness, and sitting was
 quite impracticable, from  the  extreme tension of the
 parts embraced in the swelling.
   On  examination, I found it  quite remote from the
 suppurating point.  It was much inflamed and indurated.
 I recommended him to  take the ether and to allow me
to open it freely.   This  he consented to, and suffered
no inconvenience in the operation, except when in the
last stage of manipulation he said it hurt a little.   The
discharge of blood was pretty copious, but very little 
MISCELLANEOUS CASES.         163
matter was discoverable.  I bound up the wound with a
small, simple bread poultice, into which I put 10 or 12
drops of chloroform.
  The day following this  operation, my patient said he
was  comfortable, and walked  about the  city with com-
parative ease.  This boil  was  cured in much less time
than it would  have taken  to  ripen, and at least*'one
week's  suffering  was saved, to say nothing of the  in-
conveniences to which he would have been subjected.
  Cases VIII. and IX.—Ether baby vs. Ether  baby.
As many have been  occupied in spreading false alarms
in relation to ether, it is not strange that an occasional
trick should reach our  ears, when  these  rumours have
failed to intimidate in the first instance.
  The  physiological  effects of ether have  been well
investigated, both at home  and abroad, particularly as
relate  to lying-in  women.    The  received unanimous
opinion of all who  have given it thus far, is decidedly
favourable to its use.  No bad effects have been reported,
either to mother or child !
  It is  said,  as  a general thing, that  ether  children
enjoy as good health, are  as bright, and in all respects,
are equal to those who  are  born without  this agent, if
not superior to them.   Now with the amount of experi-
ence already had upon  this subject, what shall be said
of the man, who from motives  of prejudice, would attri-
bute to  it the death of a still-born infant, a malforma-
tion, or, a thing not unusual, an irritable temperament ?
Whether said in earnest or in jest, the effect is intended
to be the same.   It is to alarm confiding, and in many
instances, too credulous women.  No woman would take
the ether, if she  thought it attended with  risk to her 
164          MISCELLANEOUS CASES.
child.   No woman  has  taken it  that  does not daily
thank God for the gift.
  I.—A lady lately  confined with her fourth child, took
the ether.   She was much gratified with  it, and  in  all
respects did well.  Her infant is a good deal troubled
with "wind  colic."   The  child is  more  "worrysome"
than either of her previous children, and her physician
attributes it to the ether.
  II.—A  lady  lately confined with  her fourth  child,
took the ether.   She was much gratified with it, and in
all  respects did well.  Her infant is a remarkably quiet
child ; more so than either of her previous children.  In
all  other respects, these children are, of course, the best
children that ever were born.
  Case X.—A Rash Vow.—In the spring of 1850, a
lady drove in her carriage  to my office,  accompanied by
a favourite domestic, who had been suffering for several
days with toothache, arising from  a  small and very
loose, but inflamed root.   The poor woman had exacted
a promise from her mistress the day previous, to accom-
pany her, to the exclusion  of all other calls which the
lady was desirous of making;  equally promising, on her
part, to take the  ether and rid herself of her trouble-
some tooth.
  On entering my room,  this patient  manifested the
greatest timidity.  She would not allow me to approach
within five or six feet of her  person, but kept at least
that distance every time she desired to  show to me her
tooth.  It required a long  time to  induce  her to take a
seat in the chair, and then as long  again to prevail upon
her  to  open  her  mouth.  This I could not have done
with anything that  looked like an  instrument  in my 
MISCELLANEOUS CASES.         165
hand.   She acted very much like  a child, expecting to
be  suddenly cheated out of a tooth.   I am  not clear
that she did not desire  her tooth to be removed upon
this principle.   Her mistress,  I think, must have taken
a similar view of the case, for in  an instant she threw
her arms around her, and exclaimed, with a good deal.
of excitement,  " Take it out  now, Doctor, I  can hold
her;  take  it out!  I  will be responsible!"   "No,
Madam," I said, "I shall do  no  such  thing;  I would
not  extract a tooth in this way for a child, and I am
sure I shall not for a full-grown  woman."   Another
half hour was spent in endeavouring to  persuade  the
woman  either to take the ether, or to  have her tooth
extracted without it, and we seemed no  nearer a con-
summation of the object of her call.  Suddenly the lady
uttered  the following remarkable words;  " I solemnly
vow, I will not  leave this room till that tooth  is out!"
This was a rash vow; but I  believe the lady to have
been altogether too much  excited at the moment to be
held strictly responsible for her words.   Her mind was
wholly bent upon the comfort of her servant.  She saw
the lack  of moral courage and wished  to present  the
highest  motive  to stimulate her to the deed, namely,
this solemn committal of herself.
  This lady has long sustained a  high reputation  for
her literary acquirements and firmness of  character, as
well as her goodness of heart and great integrity, in all
her walks  in life.  It was a  great error, however, to
have made two such mistakes as were embraced in  her
vow.  In the first  place, the object to be attained was
altogether  of too  trifling a character  to  require  the
solemnity  of an oath, and  secondly,  the  object  for 
166          MISCELLANEOUS CASES.
whom the pledge  was made,  could  not appreciate its
importance in the slightest manner  possible.   When
this was made manifest to the lady,  her alarm became
very  great.   The readiest  method  which presented
itself to  her mind to  absolve herself, was  to send out
and  obtain sufficient force to compel  her  to the  opera-
tion.   This  I  repudiated, and finally  succeeded in
arresting  their attention by the recital of two or three
ether cases of some  interest, which presented  them-
selves to my mind at the moment.
   At the end of three hours and a half, she consented
to take a little ether.  It was not so  bad to take  as she
had  thought  it.   She took a little more.  She was sur-
prised to find it was  rather  pleasant  than otherwise.
A little  more, and  for an instant she was gone.   In
that instant  I pushed her tooth out  of its socket, and
lodged it upon her tongue.
   Case XI.—It has often been observed  in relation to
ether inhalation, that it  would only be  justifiable to
resort to it, in view of undergoing some very severe and
long-continued surgical operation. Extracting teeth has
been looked upon  as altogether of too trifling a matter,
to warrant us in the risk of so powerful an agent, &c.
   Strong, courageous  men, and pain-enduring women,
shrink more  from  the  extracting of a tooth, than from
the  most formidable operations  practised in surgery;
and  if additional risk is at all dependent on the  length
of time necessary to keep up the effects  of the  ether,
most certainly its advantages,  in this respect,  are in
favour of dental operations.   Besides, the necessity for
the use of ether is, in  a great measure, dependent upon 
MISCELLANEOUS CASES.         167
the amount of dread  occupying the patient's  mind in
reference to his case.
  A lady, of this city, on finding it necessary to have
a few defective  teeth extracted, said to her husband, it
would kill her to have them out, and she might as well be
killed by the ether as by the operation.   This  lady had
twice submitted to the cruel operation of having her toe-
nail split, and dragged out by the roots; and this without
giving the ether a thought.  Her husband was opposed
to ether " tooth and nail," but he reluctantly  gave his
consent in this instance, and  accompanied his wife to
witness its effects.
   The ether was inhaled, and  the lady became at once
most earnest  in her commendation  of it.   The ground
was broken to  eradicate her husband's prejudices, and
a few subsequent cases served to confirm him  as an
advocate for its use.
   Case XII.—A  gentleman  commenced taking the
ether in  the evening, for  the purpose of  having his
tooth extracted.  It was necessary that a light should
be  held to enable me to perform the operation ;  and,
for this purpose, I called to my aid one of my domes-
tics.  The gentleman soon began to manifest marked
symptoms of excitement.   He sang and beat time with
his feet, and was very happy;  but,  finding that he was
becoming too noisy, and that his movements were likely
to interfere with my operating with safety, I requested
him to be quiet.  He obeyed me very well, but laughed
immoderately, until I had succeeded in removing the
tooth.   My servant became imbued with the  spirit  of
fun, and thoughtlessly remarked, " Sich cuttings up I
never saw."   In an instant, my patient jumped out of 
168          MISCELLANEOUS  CASES.
the chair, and cried out, " Cut who up ?   No you don't,
Doctor !" and he accompanied the saying with the usual
sign, as though he knew a thing or two.
  This  gentleman then begged of  me  to say nothing
about his conduct.  He said, "  I ought  to have known
better—it was  only a dream;" and he seemed quite
mortified.   After a few minutes' conversation, I said
to him I thought  it was too good to  be  lost, and asked
why he  objected  to  my mentioning the  facts ?   He
did not remember anything  that had occurred from the
time he commenced singing, and had no objections to
my making such use of the case as I might see proper.
  But few instances have  been witnessed by myself
wherein the  patient has remained under the influence of
the ether (mentally), to exceed four or five minutes
after ceasing to exhibit it, and it certainly is a peculiar
feature, whenever this does happen, that their conversa-
sion is as rational as  it could possibly be with full pos-
session  of all their faculties, so much  so, indeed, as
nearly always to  mislead me, till they  may suddenly
exclaim, "Now it's off!" or  a  similar thing  occurs to
that cited in the above case.
  Case  XIII.—I recently  extracted two  teeth  for a
young lady who had previously  taken the  ether  for a
similar purpose, and she said to me, that notwithstand-
ing she  suffered no pain, she  always  dreamed that  she
was getting a tooth extracted.  I requested her to visit
London, and see  how they  were progressing with the
fair for  the " World's Convention."   She followed my
advice, and said they had got their machinery in motion.
She had a  delightful time; but she insisted upon it
that I followed her, and pulled her teeth out. 
MISCELLANEOUS CASES.
169
   Case XIV.—On the same day with the last case, a
young man visited me with the same object.  I related
to him the success of my sending the young lady across
the ocean, and desired him to take the same trip.   He
was readily brought under the influence of the ether,
and  was  somewhat excited.   He  manifested great de-
light, both by the motions of his  body and by the ex-
pression of his  countenance.   His  breathing was rather
hurried, and  approached very nearly  to a laugh.   At
each attempt to force my  forceps  high up  into the jaw
to remove the decayed roots, he  became  very  quiet,
stopped breathing, and looked serious; then he would
immediately resume his former happy mood.  This was
repeated  some five or six times before  the  operation
was concluded.   When it was over, he said he had en<
joyed the greatest sleigh-ride, "And," he added, "how
I did go it!   It  was  rare sport;  but  I didn't like the
stopping-places.''
   Case XV. Leading Questions.—A young gentleman
from Virginia, requiring my professional services, called
with  a friend, and as I extracted his tooth, he made
the usual  demonstrations of pain.  I immediately asked
him  if it  hurt.  He  said "It did."   Said I, "Very
badly?"  "Yes,"  he replied,  "very badly."    I of
course expressed  my regret that  I  had operated before
he was sufficiently etherized.   He said  it was of no  con-
sequence,  and immediately left my office.   In less  than
ten minutes he returned, and observed that he walked
about the  distance of  a  square before  the ether passed
off, and then  he  was first made aware that his tooth
had been  extracted.   He returned to  apologize  to me
for giving me the impression that I had hurt him.
                         15 
170
MISCELLANEOUS CASES.
   During the early part of November last I was happy
in responding to a request on the part of  a few citizens
of Easton, Pennsylvania, that  I should visit that place
for the purpose of addressing them upon  the subject of
ether,  and to demonstrate to them its usefulness, under
every  variety of  circumstances,  as  an anaesthetic in
painful operations.
   The views  and feelings of most of those  who pre-
sented themselves to me for  professional  services were
influenced more or  less by those surrounding circum-
stances which always, to some extent, pertain  to new
discoveries.   This condition, intermediate between hope
of success and fear of serious consequences, based upon
reports prejudicial  to  ether  inhalation,  is one  of the
most difficult to control.  It  is, however,  much  depen-
dent on the  mind of the patient himself whether  perfect
control or not shall be had in his particular case.  The
confidence manifested in me by my Easton  friends on
this occasion was  not only a gratifying compliment to
myself, but must, of itself, have had  its  wholesome  in-
fluence on the mind of the etherized.
  I take the liberty of reporting a few of  the cases, in
the desire that they may be made subservient in the
calming of that excitement which so unnecessarily pre-
vails upon this subject.
  A lady, desirous of having several objectionable teeth
extracted, inhaled the ether for this purpose on two
successive days, each day having quite a number taken
out.  Although this lady had previously visited the city
for a similar purpose, and  had there  made use  of the
ether under  more unfavourable  circumstances (suffering
with impaired health at the time), and knowing from this 
MISCELLANEOUS CASES.          171
experience that no pain need be felt, still there was a doubt
in her mind as to the propriety of her resorting to this
agent, based, I think, entirely upon religious scruples.
She was persuaded into the use of the ether without
having had  a fair opportunity of disabusing her  mind
of this conception ; and although her confidence in the
ether and in my ability to administer it was all but un-
limited, still it  became impossible to carry  it beyond its
exciting influence.   In  the  course  of a minute  after
beginning to breathe the ether she  would become quite
agitated, and much difficulty was experienced in endea-
vouring to obtain that uniform  breathing  so requisite
to  secure quiet  and pleasant sensations.   She mani-
fested under these circumstances  much more distress
than  she really  felt; and  it  was  difficult  for her  to
assign any good reason why she  could not continue  to
inhale in strict accordance with my directions.  Enough,
however, was accomplished, with all these adverse con-
ditions,  to  secure the  removal  of the teeth with but
trifling pain;  and so much to  her satisfaction  as  to
cause her to say  she would not hesitate to  take it again
if it  should ever be necessary for her to lose another
tooth.
   A  somewhat similar case to the above  occurred  in
my parlour  at the " American  House."  A lady visited
me who had been much alarmed  in relation to the ether
by her physician, and by the many prejudices which
prevailed in her neighbourhood against its use.   She
resided about twelve or fourteen  miles from Easton, and
made two visits  to  that town during my stay there,
before she could  allow herself to take the ether.   Upon
being etherized she resisted me somewhat in  the re- 
172
MISCELLANEOUS CASES.
 moval of  a couple  of  teeth, and made a slight outcry,
 but in a minute afterwards  she  said she had no know-
 ledge of her teeth having been drawn, and that she had
 suffered no pain: she felt uneasy about her children at
 home;  thought they were  being molested by  snakes.
 This lady also expressed much satisfaction with the ether.
   A lady for whom I extracted eight teeth inhaled  the
 ether.  This lady had no fears to interrupt the happiest
 arrangement in placing her fully under its influence.
 Her mind was calm, in view of a painless  operation, to
 be secured by means of an agent, well  tried and  highly
 approved  by many of the best men in  the world.  She
 possessed also  the  great advantage of the confident
 assurance of her father, who is a  physician of much
 eminence  in our state, and who was  present on  this
 occasion.
   The influence of the ether upon the mind of this lady
 was natural, and such  as can  often be secured  under
 the circumstances.  She thought she had been in heaven,
 and was there accompanied  by her  father.   The ether
 passed off in a minute or two, leaving no  other impres-
 sion than  that  of having slept soundly, and the  enjoy-
 ment  of a pleasant dream.
  A young lady, for whom I extracted four teeth, in-
 haled the  ether with great confidence, and followed well
 all my directions in  relation to it.  She became totally
unconscious of the  operation,  which was one of much
severity, and did not even occupy the time while etherized
with  a  single  thought upon any subject.   It was an
absolute blank  of about  three minutes' duration ;  and
when  she recovered  her consciousness, it was very much
like waking from a deep sleep. 
MISCELLANEOUS CASES.         173
   This patient had been troubled  for some time with
 considerable stricture upon the lungs, accompanied with
 a  dry, short, and unsatisfactory cough.   She informed
 me a few days after this  operation,  that her breathing
 had become easier, her cough was  loose, and she was
 readily relieved of superabundant  secretions  in  the
 lungs.  In short, her health was improved, and she felt
justly disposed to attribute it to the ether.  This case
 was witnessed by the Rev. Dr.  Grey, to whom I desire
 to  express  my  acknowledgments, not merely  for the
 many acts of kindness and hospitality shown to  me on
 this occasion, but for the interest manifested by him in
 the promulgation of that knowledge upon the subject of
 ether inhalation, which, I trust, will soon lead  to the
 abrogation of a vast amount of physical suffering.
   A  gentleman visited my room, in company with Dr.
 Swift, and wished me to extract the root of an eye-tooth,
 which had been broken even with the gum on the pre-
 vious evening, under the  following  unpleasant circum-
stances :  this gentleman had  previously arranged with
his dentist in Easton, for the purpose of supplying the
loss of a few teeth by means of artificial work upon  a
gold plate.  On the evening before his call upon me,
he  had visited his dentist, and complaining of much
pain in one of his teeth, asked  advice as to the course
he should pursue with it.  The dentist told him it must
be extracted.   The gentleman thanked him for  letting
him know the worst at once, and thus opportunely, as  I
was then in  town, and he desired to avail himself of the
ether. Whereupon the dentist requested him  to  let
him look  at it again.   The young man stated that he
                         15* 
174          MISCELLANEOUS CASES.

did not wish him to extract it, as he was just recovering
from  a severe  fit  of sickness, and did not feel able to
undergo the pain.   The tooth was suddenly seized, and
in the attempt to remove it, it was broken, as before stated.
   The effect of this treatment was singularly illustrated
the next  day, while  under the influence of  the  ether.
When satisfied that he had inhaled sufficiently to justify
my extracting his  tooth, I did so with but little resis-
tance on his part; but as soon as  the tooth was out, he
said : " You were too quick,  I was not ready for you!"
and this he repeated two or three times.   He then said,
" I was perfectly conscious when  you told the girl to
shut the door!"  The door had not  been opened, and
our party of three  had in  nowise  been  interrupted.
Here the ether left him, and he expressed much astonish-
ment at finding himself in my apartment.  He thought
himself back in the hands  of his former dentist, and
that  he was in reality undergoing a  repetition of abu-
sive  treatment.   All this, it  is  true, seemed to him
as a  dream, and the pain he felt was such as  we recog-
nise in dreams under ordinary circumstances.
   A  lady, desirous of having ten teeth extracted, was
much pleased with the effect of the ether as far as  the
operation  was concerned; but she was impressed, while
under its  influence, with  the singular notion that  her
husband did not recognise her  little  daughter (both of
whom were in the room at the time), and, for a minute,
she introduced them to  each other  with considerable
formality.
   A  few other cases which presented themselves  to me
while at Easton, developed no farther peculiarity in the 
             MISCELLANEOUS CASES.          175

action of the ether, than  is ordinarily observed in its
use.   All who inhaled it, and, I think, all who witnessed
its inhalation, are fully convinced of its usefulness, and
will constantly be found on the side of its advocates.
  Case.—Jan'y 9th,  1851. A peculiar effect of etheri-
zation having  occurred this day  in  my  practice,  and
this book  being too far advanced in  the  hands of my
publishers to allow  of its introduction under the proper
head, I here insert it, to induce  attention  to similar
cases that may arise in the use of this article.
  Miss----, about. 18 years of age, visited me, by the
advice of my friend,  Dr.  Samuel  M'Clellan,  to  have
two  much-decayed  molar  teeth extracted.   She  had
been  suffering for  some  time with intense neuralgic
pains about the head  and  neck, and these teeth  were
sufficiently impaired to suspect them of being implicated,
if not solely the cause of her trouble.
  This  young lady was well brought under the ether
influence, and lost her teeth without knowing it.  Upon
her return to consciousness, and after its usual effects had
passed off, she complained  that a small portion of the
lower lip retained the  peculiar numbing sensation that
had so recently pertained to the whole system.   It also
felt much enlarged.   Nothing had touched her lip, either
in the process of etherizing or extracting, beyond what
usually  occurs;  I was therefore  led  to  examine  more
closely into its condition.   There was discoverable, just
below the edge of the lip, and about half-way between
the centre and the angle  of the  mouth, a cicatrix  of
about three-quarters of an inch in extent, the  result of
a wound in early childhood.  As a consequence of this 
176
MISCELLANEOUS cases.
wound, there was the slightest possible enlargement of
the lip  directly over it.   To  this small region was the
persistent effect of  the ether limited.  Whether  from
deranged  anastomosis, or from  violence to a nerve at
the time this wound  was  inflicted, that  this peculiarity
should pertain, I am not prepared to say. 
SULPHURIC  ETHER.
  UNFAVOURABLE IMPRESSIONS IN REGARD TO ITS USE.


   Although there  is no well-authenticated  statement
in which ether  has been  proved to have done fatal, or
even serious mischief, it certainly is somewhat  surpris-
ing that such should  be the case, for reasons sufficiently
given on several pages of this book already.
   I have taken much pains  to  learn particulars in all
unfavourable ether cases that have reached me; and, in
nearly all, it has  been mismanagement or gross igno-
rance that has caused the trouble.
   Soon after the discovery of the application of ether
to surgical  purposes, a number of medical gentlemen
associated themselves together, in Boston, the better to
investigate or test all the merits and demerits which
presented themselves in connection with the whole  sub-
ject at  that time.  Among other things, they sought
out and reported  three or four adverse cases ; some of
which were of a distressing character it is true, though
none proved fatal.   It was enough that these patients
had taken the ether,  and that these bad symptoms  pre-
sented themselves.   Hoiv the ether had  been adminis-
tered was not adverted to;  and yet  we  have the  evi-
dence of Dr. Keep, one of the most respectable  citizens 
178
SULPHURIC ETHER.
of Boston, that it was the aim of some who gave the
ether at that time, to shut off the atmospheric  air  as
much as possible.  Although this was an error in judg-
ment, it is not to be wondered at in the very commence-
ment of this practice, and more particularly when we
take into  consideration the fact, that it is really  desira-
ble to induce sleep  in the shortest  possible time.   A
few  similar cases  have  been  reported to  me in this
vicinity, and I have traced them to a similar cause.
   With all my desire to impress my readers favourably
in regard to ether inhalation, I have, in no instance,
withheld  from them its unpleasant effects ; neither will
the  candid accuse  me  of having selected the most
favourable cases, unless, indeed, it has been to establish
some collateral point, in which, at the time, the patient
was not interested.
   A report of one or two cases in which the ether
failed, in my hands,  to  accomplish its object, may not
prove useless, if not particularly interesting.
   Case I.—The first instance in which I witnessed a
failure in the  ether  to  anaesthetize, occurred after an
experience  of some  five  or six months in its use.   It
was the first case in which I had the pleasure of assist-
ing  Professor  Mutter in his private practice  in  this
department; and, although the failure was total, I  am
happy to state that the desire on the part of this gen-
tleman to secure  to  his patients immunity from pain,
suffered no prejudice in this, his first experience.
   Miss -----, aged  12  years, required the toe-nail to
be split and extirpated.  I administered the ether  for
the space of five or six  minutes.    Her pulse ran up to
 about  140 beats in  a minute, and then became weak, 
               SULPHURIC  ETHER.            179

so as scarcely to be felt.  Her countenance  became
much flushed, perspiration profuse, and the breathing
somewhat difficult.   There was no dizziness, no noise
in the ears, no numbness  in the limbs ;  in short, there
was no one favourable etherized symptom in the case,
but several physiologically adverse.  I  was unwilling
to continue  its use, and  requested that the operation
should proceed.  The pain was quite as severe in this
case, as though no ether had been used.
   Case II.—Schirrous Breast.  It was also in the early
part of ether practice, that  my services were required
by Professor  Horner, in  a  case of amputation of the
breast.   The  patient,  a lady about 50  years of age,
was, in  every respect, a good subject for  etherization.
I had assumed the responsibility in regard to the ether,
under the impression  that  but one  breast  was to  be
removed; but, upon assembling at the hour appointed
for the operation, it was concluded to amputate both.
   The ether had never, to my knowledge, been so long
administered  at  any one time  as it would require  for
this compound operation, and prudential  motives sug-
gested to me the idea of trusting to its  partial  effects,
rather  than  to induce entire narcotism.    After the
first one or two incisions, the patient became so much
aroused as to suffer, perhaps, quite  as  much  as she
would have done in her natural condition.
   Case III.—As a result of great timidity on the part
of the patient, I  may instance the following as a failure
in etherization.   A lady called upon me, who had been
much alarmed on the subject of ether, from her dentist's
version of the matter, and commenced  inhaling it  for
the  purpose  of  having a tooth extracted.   She was 
180
SULPHURIC ETHER.
accompanied by several  friends, who were  desirous of
witnessing its effects, and who seemed anxious that she
should proceed to inhale it, as they  felt every confi-
dence in its safety.  After about six or eight very inef-
fectual inspirations, the lady exclaimed, " Oh, horrible!"
I observed to her that she had better abandon it, than
to  proceed  with  such  ideas.    She very prudently
adopted my suggestion, and there the matter ended.
  In  concluding this chapter, I would observe, that in
conversation with some of my medical friends who are
now using the ether, they have  expressed the opinion,
that in a few instances  they entertained doubts as to
any positive relief the  ether  might have afforded  their
patients, during the time of their confinement.  At the
same  time, they have  freely admitted that they might
not have carried its effects far enough.   This, undoubt-
edly,  was the case; and  I trust that,  hereafter, when it
shall  appear that certain idiosyncrasies will not admit
of successful partial etherization, they will not fail to
induce perfect narcotism. 
CONCLUSION.
  In taking leave of those who have favoured me with
a hearing through the foregoing pages, I feel that I can
render them no more  acceptable service, than by intro-
ducing still  another extract  from the writings  of the
Edinburgh philanthropist.
  It is very well known  that Professor Meigs,  of  this
city, addressed a letter to Professor  Simpson, of Edin-
burgh, containing a series of objections to the use of
anaesthetics, particularly in cases of midwifery.   They
were objections, well drawn up, and  manfully and fear-
lessly expressed.  I say this  is well known.  It is much
better known than the fact that Professor Simpson  has,
in the most able and satisfactory manner, answered and
met these objections.   Not that Professor  Meigs would
by any means desire  any undue  advantage  in  contro-
versy,  but such has been the  case as  a matter of course,
and entirely beyond the Doctor's  control.  Prejudiced
men have used  and circulated freely the  objections of
Prof. M., while  the answers of Prof.  S. have been in
many  instances  suppressed.   On the other hand, the
reply of Professor  Simpson  is so written, that every
reader is at once  put  in possession,  not only of the
nature of the objections,  but  the very forcible language
in which those objections have  been  made, is in all
respects submitted for the  candid consideration of his
readers.
                         16 
182
CONCLUSION.
  The first objection urged  by Professor Meigs is in
reference to the use of forceps, requiring the answer of
his patient to assist him in his diagnosis.  This is shown
by Professor Simpson to  be  in  reality no objection at
all,  and he  very ingeniously quotes  from Professor
Meigs himself  to  sustain  his position  throughout  his
entire reply. But allowing this objection to be perfectly
valid, it appears to me that  a vast'amount of suffering
might be saved if  etherization should  be suspended for
this  express purpose,  and  renewed to  complete the
delivery.
  It has elsewhere been  stated that no life has been
lost  as  the result of ether inhalation by  parturient
women;  and that  statistics go to  show a great  percen-
tage  of  human life  saved by  this agent under  these
circumstances.   Is it not our duty to act according to
light furnished in  this matter ?   If an additional chance
is proved to exist, in the use of ether,  to the well-doing
of lying-in women, should we not avail ourselves of that
chance ?   Dr. M.  says :  " Should  I exhibit the remedy
for  pain to a  thousand patients  in labour, merely to
prevent the physiological pain, and for no other motive,
and  if I should, in consequence,  destroy only one of
them, I should  feel disposed  to  clothe  me in sackcloth
and  cast ashes on my head for the  remainder  of my
days."
  Now, in  connection with  this  subject, I  feel  con-
strained  to inquire,—Have even our  most eminent ob-
stetricians been so singularly successful in their practice
as never  to have lost  patients, whom  some  other mode
of treatment than that, in their wisdom, adopted at the
time, might have  saved ?  Have any of the opponents 
CONCLUSION.
183
of anaesthesia, within the last four  years, not lost pa-
tients whom  ether might have saved ?  If such is the
fact, and had prejudice been the motive which debarred
its use,  what should be their substitutes for " sackcloth
and ashes" in the case ?
  I will proceed to complete the paragraph of Professor
Meigs, together with its reply: — " What  sufficient
motive have I to risk the life or the death of one in a
thousand in a questionable attempt to abrogate one of
the general conditions of man?"—"Let me add," says
Simpson,  " that I have  seen this  argument of yours
already repeated from your letter, and  strongly insisted
upon by the opponents of anaesthesia in this country."
  " And, indeed,  in  a  new  practice  such as that of
anaesthesia, and with which the mind is yet not at all
familiarized, the above forms one of  that kind of appa-
rently  strong statements, which  it  is  impossible  to
answer directly, or, indeed, by any other  way than by
taking, as I have already said, a corresponding illustra-
tion and simile from some other matter with which the
mind is already familiarized.   Let us, for a moment
longer, then, adhere to the familiar comparison which I
have already taken  up, under the last head, between
the physiological function of human  parturition, and
the physiological function of human progression.  Sup-
pose, then, that you and  I were standing at the Phila-
delphia station  on the first day of the opening  of the
railway  to Baltimore  or  New  York.  I wish the pas-
sengers  to Baltimore or New  York, or the shorter and
intermediate  stations, to  proceed  thither  by railway;
but you argue with them, like President Jefferson, that
'progression  is  the  culminating  point of the  human 
184
conclusion.
 somatic forces,' and that 'walking is  a desirable, salu-
 tary, and conservative manifestation  of life-force,' and
 that progression  being a ' physiological  function,' and
 fatigue a physiological pain, they ought to proceed on
 foot.  I say ' No.  Place yourself in a railway carriage,
 and thus eschew and obviate all the  great fatigue and
 useless over-exertion of foot travelling.'   Then comes
 that  answer and argument of yours which I  have
 quoted,  and which runs as  follows:  'But,  should I
 exhibit, sir,  the remedy for fatigue (a  railway carriage)
 to a thousand travellers, merely to prevent the physio-
 logical exertion  and fatigue of walking, and for no
 other motive, and if I  should, in  consequence, destroy
 only one of  them, I should feel disposed  to  clothe me
 in sackcloth and cast  ashes on my  head for the re-
 mainder of my days.   What sufficient  motive have I to
 risk the death of  one in  a thousand  in a questionable
 attempt to abrogate one  of the general  conditions of
 man, viz., his power of  progression by walking V
   " I shall not stop to inquire whether among  our  sup-
 posed lady passengers or patients (uninured, as most of
 them  are, either  to long pain or long walking), more
 than one in a thousand  would not  be worn out and de-
 stroyed by taking the journey on foot.  A less propor-
 tion, I believe, would be found to be ultimately destroyed
 by the perils and dangers  of the journey by railway
 than by the exertion and fatigue of the journey on foot,
 and the walk would shake and damage, both temporarily
 and permanently, many  more constitutions than  the
 railway carriage.   I have a firm conviction that, on the
great scale, there would be  found a more  absolute sav-
ing, both of human life and of human health, by adopt- 
CONCLUSION.
185
ing the means invented by art than the means provided
by nature; and I most firmly believe  that yet a similar
difference will be  found to hold good between the two
corresponding  practices  of  allowing women  to  pass
through labour afflicted with all their usual physiologi-
cal ' pangs  and agonies,' and carrying them through
that process without their being subjected to the endu-
rance of these pangs and  agonies.
   " But I proceed to remark, that if your supposed
theory with regard to the functions of parturition were
carried  out,  in  regard to the other functions of the
human body, it would  produce a vast and mighty revo-
lution in  the practices of civilized life.  Follow it out,
for instance, with  regard to  any one  of them, as, for
example, with regard to the one we have already spoken
of, viz., progression, and  see what would be the results.
Ever and anon our newspapers contain paragraphs, tell-
ing us of one or more human lives being lost by collisions
 on railways, explosions  of steamboats,  upsettings  of
 stage-coaches, &c.   Consequently, according to your
 doctrine, the featherless  biped pedestrian, man, should
 no longer,  when travelling, fly in railway cars, ply in
 steamboats, ride in coaches, &c, for these are evidently
 all so many questionable  attempts to abrogate what you
 call ' one of the general conditions of man, viz., his ori-
 ginal pedestrianism.'
    "In the great government and police of  nature, dis-
 ease and death are among the  most  certain 'general
 conditions of man.'  If your theory were true, the prac-
 tice  of medicine  itself should, I fear, be at once and
 summarily abandoned, for  perhaps, in your own lan-
 guage, it », at best, a questionable attempt to  abrogate
16* 
186
CONCLUSION.
one of the general  conditions of man, and I am sure
you  will  agree with me,  that  in  this 'questionable
attempt,' human lives are often lost from the mistakes,
or the passiveness, or the want of knowledge and skill
on the part of the physician.  In  England and Wales,
in 1840, there were, according  to the returns of the
Registrar-General, above 100 persons publicly and offi-
cially reported as having died from the effects of one
drug alone, opium.   But would  this be any reason, or
any  ground of reason, for abandoning in medicine the
use of opium, perhaps, in itself, the most valuable of all
the remedies  in  our pharmacopoeia?   Would  this be
any adequate  argument  for refusing to relieve,  by  a
dose of opium, the next appropriate case  of pain that
you are called to ?   Or because  chloroform or ether, in
a very rare case,  now and again produces deleterious or
even fatal consequences, should we refuse, in a thousand
other persons, to mitigate  and  annul  their agonies by
its use ?
   " In your esteemed letter to me,  you quote some re-
marks from the celebrated old work, ' Raynald's Birth
of Mankinde,' the first book on Midwifery printed in
English.  Look at the  prologue to this  work.   It  is
excellent  in  reference  to the very matter we  are dis-
cussing, viz., whether the rare accidents, from abuse or
otherwise, to which any good gift may  occasionally sub-
ject those who use it, should be a reason for repudiating
the general use of that gift.   ' There is not anything,'
says Raynald, 'so  absolute and perfecte,  but by the
occasion of the abuse thereof at  one time or other, may
and doth ensue greate damage and danger to mankinde.'
He instances fire and water, ' two righte necessary ele- 
CONCLUSION.
187
ments to the use  of man, without the which he could
not live,' yet sometimes 'by fire hath bin consumed and
devoured whole  cities and  countries; by  water swal-
lowed and drowned infinite men, shippes, yea, and whole
regions.  Againe,' he continues, 'meate and  drinke, to
the moderate users thereof, doth minister and maintain
life; and contrary to the unmeasurable and unsatiate
gourmands and gluttons, it hath full many times brought
surfeet, sicknesse,  and at the last, death. .  .  . But,' he
argues,  ' should men, for the avoyding of the aforesaid
inconveniences,  and for the reasons above  said, con-
demne and banish fire and water, or forsake their meate
and drinke ?  No, it were but madnesse once  to think of
it:
   "Before  passing  from  these,  your supposed dangers
of  anaesthetics, let me  add  two  remarks:  1st, I do be-
lieve  that if improperly and incautiously given, and in
some rare idiosyncrasies, ether and chloroform  may
prove injurious  or even fatal, just as  opium, calomel,
antimony, and every other strong remedy and powerful
drug will occasionally do.   Drinking cold water itself
will sometimes produce death.   'It is well known,' says
Dr. Taylor, in his excellent work on  Medical Jurispru-
dence, 'it is well known that there  are  many cases  on
record, in which cold water, swallowed in large quantity,
and in  an  excited  state of the system, has led to  the
destruction of life.'  (p. 8.)  Should we, therefore, never
allay our thirst  with cold water  ?   What would  the dis-
ciples of Father  Mathew say to this ?   But 2dly, you
and others  have very unnecessary and aggravated fears
about the dangers of ether  and chloroform, and in  the
course  of  experience  you will find these fears to be, in 
188                CONCLUSION.
 a great  measure, perfectly ideal and imaginary.  But
 the same fears have, in the first instance, been conjured
 up against almost all other innovations in medicine, and
 in the common luxuries of life. Revert again to our old
 simile regarding travelling.   Cavendish, the secretary
 to Cardinal Wolsey, tells us, in his Life of that prelate,
 that when  the Cardinal was  banished from London to
 York, by  his master, that regal Robespierre,  Henry
 VIII., many of  the Cardinal's servants  refused to  go
 such an enormous journey, for they were (says Caven-
 dish) 'loath to  abandon their native country, their
 parents,  wives, and children.'   The journey, which can
 now be accomplished in six hours, was considered then
 a perfect banishment.  We travel now between London
 and Edinburgh (some four hundred miles), in twelve  or
 fourteen  hours.  A century ago, the stage-coach  took
 twelve or fourteen days. And in his Life of Lord Lough-
 borough, Lord John Campbell tells us that when  he
 (the  biographer) first travelled from Edinburgh to Lon-
 don, in the mail coach, the time was reduced to three
 nights and two days;  ' but,' he adds, 'this new and swift
 travelling from the Scotch to the English capital was
 wonderful,  and I was gravely  advised, adds Lord John,
 ' to stop a day at York, as several passengers, who had
 gone  through without stopping, had died of apoplexy
 from  the rapidity of the motion.'—(Lives of the Lord
 Chancellors.)
   "Be assured that many of the cases of apoplexy, &c,
 &c,  alleged to arise  from ether and chloroform, have
as veritable an  etiology as this  apoplexy from rapid
locomotion, and that, a few years hence, they will stand
in the same light in which we  now look back upon the 
CONCLUSION.
189
apoplexy from travelling ten miles an hour.  And as to
the supposed great moral and physical evils and injuries
arising from the use of  ether and chloroform,  they will
by and by sound, I believe, much in the same way as
the supposed great moral and physical evils and injuries
arising from using hackney coaches at all, were seriously
described by Taylor, the water poet, two or three centu-
ries ago, when these coaches were first introduced.   In
his diatribe against hackney coaches, Taylor warned his
fellow-creatures to avoid  them, otherwise, to  quote his
own words,  ' they  would  find  their  bodies tossed,
tumbled, rumbled, and jumbled without mercy.'  ' The
coach,' says he, 'is a close hypocrite, for it hath a cover
for knavery; they (the  passengers) are  carried back to
back in it like  people surprised by pirates; and more-
over, it maketh men imitate sea-crabs in being drawn
sideways, and altogether, it is a dangerous carriage for
the commonwealth.'   Then he proceeds to call them
'hell-carts,' &c, and vents upon them a  great deal of
other abuse, very much of the same kind  and  character
as that lavished against anaesthetics in our own day."
THE END. 
 
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 PROF, SIMPSON ON  ETHER AND CHLOROFORM,



                        OR

THE EMPLOYMENT OF  CHLOROFORM AND  ETHER,
             IN SURGERY, MIDWIFERY, ETC.

      BY  J. Y.  SIMPSON. M.D., F.R.S.,
       Professor of Midwifery in the University of Edinburgh, &o.

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