Æther

Ethyl Oxide or Ethylic Ether (sometimes called Sulphuric Ether), C,H,„0. . . ,

Preparation for use. Inhalation of vapor, dilute with alcohol.

Aidhorities. 1, L, Simon, Jr., pathogenetic effects from pure experiment or observed in patients previous to surgical operations, Journ. de la Med. Horn., 3, 31; 2, E. V. Atlee, effects on a servant-girl, Boston Med. Intelligencer, April 6th, 1824; 3, effects, Brit, and For. Med.-Chir. Review, April, 1847 ; 4, Buchanan, effects, Med. Gazette, April 23d, 1847; 5, general effects, Brit, and For. Med.-Chir. Review, April, 1847; 6, effects, ibid.; 7, Smith, effects. Lancet, May 27th, 1847; 8, Hird, effects on a gentleman when taken for extraction of tooth, Med. Gazette, Feb. 26th, 1847 ; 9, Waller, effects on a man, ibid.; 10, Richardson, a girl, aged 18 years, took it for extraction of tooth, Med. Gazette, April 2d, 1847 ; 11, R. Spencer AVells, general effects, London Med. Gazette, 1847, pt. 2, p. 547 ; 12, Copeman, effects on a medical gentleman who wished to have a tooth extracted, Amer. Journ. of Med. Sciences, Oct., 1847, from Provincial Med. and Surg. Journ. ; 13, Muscat, general effects, Amer. Journ. of Med. Sci., July, 1847 (from Comptes Rendus) ; 14, James H. Bickford, general effects, Edinb. Med. and Surg. Journ., July, 1847; 15, James Crawford, effects, London Med. Gazette, 1847, pt. 1, 1050 (from an East Indian paper) ; 16, Braithwaite, general effects. Retrospect, Jan. to June, 1847 ; 17, Flag, Tucker, et al., general effects. Committee’s Report in London Med. Gazette, 1847, pt. 1, p. 172 ; 18, effects on a young lady, ibid.; 19, effects on a young man, ibid.; 20, Miss A. D. took it for extraction of tooth, ibid.; 21, Miss J. R. took it for the same purpose, ibid.; 22, Alex. Fairbrother; a girl, aged 15 years, took it for amputation of thigh, London Med. Gazette, 1847, pt. 1, p. 364; 23, W. Philos Brookes; a woman aged 21 years, took it for extraction of tooth, ibid.; 24, effects on John Combes when taken for amputation of thigh, ibid.; 25, effects on William Guy when taken for surgical operation, ibid.; 23, Symptoms in the case of Mrs. Parkinson, London Med. Gazette, 1847, pt. 1, p. 610 (from London Times) ; 27, Somerset Tibbs; E. J. took it for extraction of teeth, ibid.; 28, J. Willow Basement, effects on a boy, aged 11 years, who took it for amputation of thigh after an accident, aud died in three hours, ibid., p. 631 ; 29, effects on a man with a cancerous tumor, London Med. Gazette, 1848, pt. 1, p. 432 (from Gazette Medical) ; 30, J. Miller, E. A., aged 15 years, took it repeatedly, aud died in twelve days, ibid, (from Phila. Med. Examiner) ; 31, effects on a girl, aged 11 years, ibid.; 32, Paul F. Eve, effects of 1 oz., Amer. Journ. of Med. Sci., July, 1849 (from Southern Med. and Surg. Journal) ; 33, Ranking, effects. Abstract, 5, 380 ; 34, F. D. Lente, effects on a boy, aged 8 years, when taken for an operation, N. Y. Journ. of Med., Nov., 1856; 35, effects on a man, aged 25 years, when taken for extraction of teeth, ibid.; 38, effects on a man, aged 30 years, when taken for the same purpose, Ranking’s Abstract, 25, 148; 37, Robbs, effects on a woman, aged 21 years, when taken several times before an operation for malignant tumor on thigh, Amer. Med. Times, Nov. 9th, 1861; 38, Mendoza, effects on a woman, aged 60 years, when taken for amputation of leg, ibid.; 39, Sir James Anderson, effects on Sir Frederick Pollock, aged 86 years, of its habitual use. New York Med. Journ., Feb., 1870 (from Practitioner) ; 40, Hutton, effects on a young man when taken for removing a splinter of iron, Amer. Observer, 10, 309 (from Phila. Med. Reporter); 41, C. A. Ewald, effects on a man, aged 32 years, of its habitual use, London Med. Record, April 7th, 1875 (from Med. Clinic of Med. Counsellor Frerichs).

—EtnotiO)l(tl, The effects may be described in the same terms as apply to the effects of alcoholic liquids, an exhilaration and excitement of the mind, which gradually passes into a state of narcotism, with stupefaction,\—Violently excited,^®.—He became furiously excited, and it required several persons to control him; he was forced upon a bed, but on being awakened he again became very much excited; indeed, so much so that cold water was dashed over him,^^—She became much excited aud talked strangely; afterwards was seized with delirium and carried home in that state; she remained so, except at short intervals, for three days ; friends afraid to leave her,^h—Every indication of great cerebral excitement,^®.—There was altogether so much excitement that his attendant -was alarmed,®.—Became delirious about au hour after she got home; this lasted all night,^®.—In attempting to walk upstairs in the evening of the third day, she stopped suddenly, screamed so as to alarm the family, and complained of faintness and the pain in her head; some aberration of mind was now manifest, and in the course of the night she became delirious, screaming aud evincing alarm at imaginary dangers; more comfortable next morning under remedies prescribed, but during all the day she gave decided proofs of mental incoherence, which continued to increase ; when any subject was introduced, she spoke rationally upon it lor a moment, aud then referred to some other, frequently to the experiment with Ether; her nights became sleepless, and were spent in screaming and loud talking upon all subjects,^util she sank rapidly into a comatose condition,®®.—She conversed incoherently at intervals, introducing strange topics, and had sometimes been observed to laugh immoderately without any assignable cause, for several days before I saw' her; when I visited her, she was capable of conversing upon any subject, introduced in so rational a manner that the hallucination might have been overlooked by an uninterested observer; I noticed, however, that she conversed with clearness only so long as the subject was kept before her mind with some care,®h—[10.] He pretty soon fell into a state of intoxication, during which he talked extravagant nonsense, danced about the room, laughed, and appeared to be very much pleased; but his condition was far removed from narcosis in its ordinary sense,“.—The sensations induced are almost universally described as pleasurable, and much resemble those resulting in the early stages of alcoholic intoxication,®.—By some, pleasant dreams, indescribable but delightful sensations, rapid flights through the air, gorgeous visions, and unearthly music,^h—Most agreeable and even most sensual dreams; women sometimes pass into a state of ecstasy; some see God and angels ; others fancy themselves again with the companions of their childhood,®.—He immediately lost consciousness, and had a host of lively illusions, principally consisting, it seems, of theological-mystical conceptions, in which, however, as is the case in opium and hashish smoking, there was a complete disregard of matter, time, and space; he believed he had travelled through whole worlds and had lived for an infinity of time, and yet, when he awoke, his candle showed that he could scarcely have been narcotized a quarter of au hour; the Ether bottle was empty, although he did not remember taking it more than once in his hand. When he repeated the experiment, the dream-world into which he lulled himself was not so splendid, not so rich in colors aud images, as that of the first narcosis; and however often he endeavored to conjure it back, by larger and larger doses, it would not reappear,''®.—The character of his hallucinations was, from the first, and has always remained, exclusively mystic, free from any erotic or other admixture, and has thus remained dependent on his prevailing disposition,®®.—The little child dreams of his playthings; the sportsman is following the hounds or catching imaginary salmon ; the gamekeeper we have known to dream of a conflict with poachers ; the laborer that he is getting drunk in a pothouse of which he is an habitue; in females, especially of a warm temperament, emotions have been manifested which are ill adapted for general inspection ; in some it was evident by their movements that they were under the influence of the highly developed sensations of the venereal organs/^—A Provenyal talked about his native country/.—A horse-jockey dreamed that some one was trying to steal his horse/.—A woman in labor fancied herself in the conjugal abode, and called to her side a student, wlrom she took for her husband,*. —[20.] Frightful dreams; a man fancied he heard the ringing of his mvn funeral knell/.—She said: I felt, when the tooth was coming out, as if I was having a horrid dream. [She gave a scream during the operation.],*®. —She had a dream, and thought she was at the bar of judgment j^leading for mercy, and that God Almighty was punishing her for her sins,^^—As with other narcotics, so even more with Ether, the disposition to hallucinative action appears to present individual differences; and a susceptibility of this kind, such as our patient has possessed, in a more or less distinct form, from the first day till now, may well be attributed in part to an alienated direction of his disposition or development—to a slight psychosis; this he has himself acknowledged,**.—Loquacity,*.—He muttered like a man intoxicated,^®.—Greater inclination towards silence than formerly,®*.—When the numbness seizes thesubject, a great tendency to gayety is generally shown; there is spasmodic, jerking laughter, which is followed by copious tears,*.— The greatest variety of the effects upon self-consciousness, and of the degree in which the recognition of surrounding objects is retained, are reported ; with many, the hilarity induced quite equals tha]; produced on the inspiration of Nitrous Oxide,®.—Anxiety/*.—[30.] Very low-spirited, and fearful of some disease ; and was still nervous and desponding after two months,®®. —Fright and delirium,**.—Intellectual. The intellect is both tranquillized and fortified,®®.—Judgment was retained unimpaired to such a degree that he lost none of the sensations he wished to analyze; moreover, when the anaesthesia was most complete, so that he could prick himself without feeling it, he willed to walk, and did walk,*.—The intellect is often disordered, but the subject does not always lose self-consciousness. In one case, the experimenter retained full possession of his faculties; while giving way to convulsive laughter, he himself compared it to the barking of a dog, and was quite aware that he was acting foolishly,*.—For some time, much confused,*®.—Answered questions with a weak voice, though remembering nothing which had passed,®®.—Semi-consciousness; the patient raised himself to a sitting posture and looked about him with a vacant stare, the conjunctiva being very red and suffused,*®.—Although he seemed to be aware that people were talking to him, he had no consciousness of what was really passing around him,*®.—She lost consciousness in three 6r four minutes after inhaling ; felt no pain,®®.—[40.] She became stupid, with a Weak pulse and heavy stertorous breathing; her strength failed more and more, and she died fifteen hours after the operation,®®.—A state of almost profound stupor,®.—In many, as total a temporary suspension of all the mental faculties and cerebral functions as in the most profound sleep, nothing being remembered, after the few first inhalations, until the period of returning consciousness,**. — At the first trial, after breathing fifteen or twenty minutes, she became comatose for two hours; at the second trial, she became comatose in four minutes, recovering rapidly,®*.

Head p. 222

Confusion. In a great majority of cases, the only effects afterwards are, slight muzziness of the head, sometimes amounting to headache, odor and taste of Ether in the mouth and nasal passages

Vevtigo. Vertigo and conscious loss of muscular power preceding insensibility

Dizziness

Dizziness, just enough to amount to slight vertigo when the standing posture has been attempted,^®

Giddiness and debilitymade it difficult for her to walk (after three days')

Slight degree of giddiness at times during the day

Head. Head drops on one side

Head was thrown back, as if to relieve slight stiffness of the muscles of the neck

Determination of blood to the brain and eyes

Symptoms of meningitis, etc., persisted in spite of all treatment, and he died (fifth morning)

Head hot

Pain about the head

She complained of some pain in the head,®’..

The inhalation was attended with very painful sensations in the head and partial blindness, which lasted three days

She complained of great pain in her head, which was relieved by free cupping

Intense pain in the head

Aching of head and dizziness for a few minutes, when senses returned

Headache more or less considerable for some hours, and even for a day or two

Headache, more or less violent

Forehead. Great pain in the forehead (second day)

Temporal arteries enlarged

Action of the temporal artery very strong

Fife p. 223

Eyes full and somewhat suffused

Eyes injected (bloodshot)

Lids. Eyes half open and turned upwards (after third day)

Eyelids closed

Eyes sometimes open, sometimes shut (during operations)

Eyelids begin to tremble in a manner very characteristic

Conjunctiva. Vessels of the conjunctiva injected

Slight injection of the cjonjunctivse

Conjunctivse much injected

Conjunctiva of eye was sensible

Ball. Rolling of the eyeballs during the spasms

She complained of difficulty in turning her eyes downward, but rolled them about in an unnatural manner (after third day)

Pupil. Pupils dHated

Pupils dilated and fixed, the eyes turned upwards (after ten minutes)

Pupils dilated, fixed, and did not act during the whole time

The pupils became widely dilated, this state being apparently not preceded by contraction (in seven minutes, when 150 cubic centimetres (about four ounces) of Ether had been used)

Pupil oscillates, with a tendency to turn upwards and inwards

Contracted pupil

The iris seems to be generally expanded, sometimes contracted

Vision. Impaired vision (after third day)

Dimness of sight

She complained of obscure vision, describing it as a mist or thin cloud before her eyes

Ears p. 223

Hearing was obtuse

Sounds are indistinct and seem far off, yet they resound violently in the ears

Deafness

Face p. 223

Countenance was wild and a little vacant at intervals, sometimes indicating slight surprise

At first, an expression of extraordinary pleasure on his face, and he inhaled the Ether-vapor with real eagerness; he afterwards assured us that he had had a pleasant narcosis

Face flushed

The expression is sometimes calm, but generally the face is flushed and animated

Face injected

The countenance is livid

Face pallid

The face often becomes either pale or morbidly flushed

Distortion of the features

CheeliS. Cheeks flushed ; after half an hour they resembled two pieces of scarlet velvet

Lips. The lips often swell and become blue

Lips slightly congested

Lip and tongue are blue

His lips became purple

Mouth p. 223

Mouth often opened

Mouth was slightly dry, and she was observed to drink oftener than usual

Some heat in the mouth

Saliva. Profuse salivation (after a few days)

Slight frothing at the mo u th

Taste. Bad taste in mouth

Disagreeable taste of Ether in her mouth in the evening

Speech. Evident difficulty in using the organs of speech ; the pronunciation was indistinct, and performed with some apparent effort; afterwards speechless

Throat p. 224

Pricking in the throat

Stomach p. 224

Appetite. Loss of appetite

The appetite for solids is visibly diminished when any considerable amount has been inhaled shortly before a meal

Loathing of ether,*. Niccol(f1i. Violent hiccough set in after twenty-five minutes, but ceased, as did also the dilatation of pupils, as soon as the inhalation was discontinued

Nausea and Vomitluff. Nausea

Nausea and sickness

Nausea and vomiting in the evening

Sickness

She complained of sickness and distress of the stomach

Vomiting

Vomiting, soon after return of consciousness, although no food had been allowed for seven hours; stimulants were immediately rejected by the stomach

Itespivatortj Organs. Slight bronchial irritation

Inhalation is accompanied by a sensation of stinging or heat in the bronchia, which excites coughing

Cough

Violent coughing

Violent cough and spitting

Spitting of blood

She raised blood from her lungs, it wassupposed about a pint; bleeding soon ceased (second morning)

Breathing rapid for a short time, when effect first produced, and then became natural

Respiration is quickened, and the face becomes red; then the inspirations slacken, but are extremely deep; finally, they become imperceptible ; the face then regains its quiet expression and natural color

Respiration Was hurried (after five minutes); deep and slow, but free from stertor (after ten minutes)

Full and frequent respirations

The respirations were deep, and increased from eighteen to twenty-five in a minute

Respirations short; the expirations prolonged and forcible

Respiration becomes slow and labored

Sonorous breathing

Stertorous breathing *®.

Sighing, groaning

Each expiration was accompanied by a loud hah !

The air expired by the patient, at the end of eight days after the last experiment, still had a strong smell of Ether

Laborious breathing *®.

Breathing laborious two or three times

The respiration, bearing a due relation to the frequency of the pulse, becomes labored and stertorous

Difficulty of breathing

Difficulty of breathing for several days (after two days)

Breathing became very difficult, so exceedingly labored, that it would have been almost impossible to perform any operation

Dyspnoea

Chest p. 224

Pulmonary and cerebral congestion

With some difficulty I led him to the outer door, when he exclaimed Cover my chest; cold, cold, cold

Tightness across the chest

Irritation and pain in the chest (after twenty-five inhalations in two days

Heart and Pulse p. 224

Prcecordiuni. Heart and lungs greatly oppressed

Hears Action. Excitement and invigoration of the action of the heart, which seems to continue throughout

Protracted failure of the heart’s action

Pulse. Rapid pulse

The pulse is at first accelerated, and afterward falls, but rarely to the natural standard; respiration seems to follow the same rule

The circulation at first became rapid, then slow and feeble

First effect upon the circulation is to accelerate it; the pulse subsequently falls, and in the third period loses power as well as frequency

Small, frequent pulse

Pulse full, hard, and bounding

The pulse, hitherto weak and low, became full and strong, and remained so as long as the narcosis continued, increasing in frequency at the same time from 72 to 80

Pulse commenced sinking rapidly

Pulse very feeble and weak in the evening

When felt, the pulse was found to be soft, full, and very slow; it suddenly ceased to beat, and the patient was dead

The pulse, as we ascertained by the sphygmograph, was not once changed, nor was there any alteration in the urine

Pulse rose to 150 while inhaling

Pulse 100, with much throbbing of the carotids (third day); 140 (tenth day)

Pulse natural in the morning, 76; rose to 84 previous to inhalation (probably from the appearance of the surgeons and expectation of operation); during inhalation, rapidly increased to 140, but before inhalation ceased, it became small and feeble

Being much excited, her pulse rose to 130 (before inhalation) ; 70 (after inhalation)

Pulse 120,'l

Pulse 98, small and tense

Pulse 90 (before the operation); 75 (in the ethereal state)

Pulse 84 (before the operation); varied from 60 to 70 (during the ethereal process)

Extremities in General p. 225

Frequent trembling of the limbs

Convulsive movements of the limbs

Spasmodic rigidity of the limbs

Superior Extremities p. 225

His arms were stretched; his fingers extended

Arms fall relaxed

Inferior Extremities p. 225

A slight imperfection in her gait terminated in paralysis of the lower extremities, after some time, and she became helpless

Severe cramps in the legs

Generalities p. 225

His whole aspect was so indicative of misery, that he would have been put down as one of the wretchedly poor, were it not for the unusual contrast between his aspect and his distinctly formed speech, and for the fact that (as was at first thought) there was a remarkably strong smell of alcohol in his breath ; the patient, however, explained that he did not smell of alcohol but of ether, and the peculiar sweetness and mildness of Ether vapor was then easily recognized, notwithstanding its strength

His appearance altogether was so distressing, as to excite great alarm in the minds of the bystanders

General appearance like one going into a state of epilepsy

To appearance, the energies of mind and body were nearly extinct

The individual, to the common eye, seems to be sinking into the sleep of death

Perfect quiet

Agitation of the system

An affection of the nervous system approaching apoplexy

Hysterical excitement in women for some hours, and even for a day or two

In the evening (after several hours) he complained of some difficulty about his chest, when, all at once, he fell from his chair, exhibited great restlessness, tossing about of the arms and legs, with great difficulty of breathing, but no loss of consciousness, declaring all the time he could not get his breath for the Ether, and that he should die; his hands and feet were said to be cold; various restoratives were applied in vain ; it was evident that it was a case of violent hysterics, unusually well marked in a male; he would laugh and joke, then express fears of impending suffocation, with jactitation, declaring that as vapor of Ether was heavier than air, he ought to be held up and allow it to run out of his lungs; several doses of Morphine had no effect; it was only after several hours that he could be quieted ; he had never previously exhibited any tendency to hysteria

She was in a state of unconsciousness, and became quite unmanageable; she required two persons to hold her; I lanced her gum, without any sign of pain, and she recovered her sensibility immediately ; she again inhaled, and, when under the influence of the Ether, some excitement returned, and on drawing the tooth with the claw, she cried “Oh !” but, on coming to herself, stated she had had no pain

He appeared to have much suffering, throwing his body almost out of the chair

Muscular tremors/

Trembling of the whole frame when consciousness returned/®.

Subsultus till twelve hours before death (after three days)/®.

General shocks, involving all the muscles of the trunk

Violent nervous attack

Convulsions

Convulsions supervened, attended with slight stertorous breathing, and other symptoms of an alarming character ; he gradually recovered, but suffered from the effects for some time afterwards

Limbs and trunk were strongly convulsed for five minutes; limbs relaxed (after ten minutes)

Incipient convulsions

After the operation, sie bent her body backwards and sank out of the chair; she began to cry, and consciousness returned, but in a short time she again lapsed into a state of unconsciousness, with convulsive movements of the muscles; she again got better and attempted to walk, but could not; the convulsions returned; there were convulsive movements of the muscles of the left side of the face; the angle of the mouth was drawn upward ; after half an hour the convulsions became stronger, spasmodic twitchings of the muscles of the face more frequent and more violent

Slight spasm (tenth day)

Opisthotonos

He was perfectly cataleptic; after applications of cold, and administering brandy and water, these cataleptic symptoms were succeeded by severe hysteria, with about the same degree of consciousness as is usual in that disease

Muscles universally relaxed

General muscular relaxation, affecting the limbs, also the eye, the ball moving about and evading the needle or the cataract knife; also the muscles of the perineum during labor

The voluntary muscles become relaxed ; the jaw falls down ; the arms hang down; the eyes roll upward under the upper lid

The muscles lose their power of retraction (during amputation) ; they are also pale and discolored

Temporary depression of the vital powers

Weakness

Weakness, and disposition to faint on the slightest attempt to walk, lasting several days (after two days)

General prostration

Felt nothing for several minutes, but on a sudden appeared to lose all muscular power,'l

Fie attempted to rise, but tottered like a drunken man, and suffered a degree of exhaustion and giddiness which lasted until he was taken to bed

Ohjective. Staggered about the room (soon)

Disposition to faint and fall down

They exhibit all the marks of intoxication ; they fall, without the power of raising themselves, become insensible to all operations performed on them, and either recover soon when the experiment ceases, or sink if it be prolonged

Syncope

The state of the brain during this period was peculiarly distressing; there were alternate manifestations of excitement and depression of the sensorial powers, at one time resembling syncope, and again like violent intoxication, until the boy died

M. Robert and other-s have attempted to indicate three stages in its effects: first, that of incoherence, agitation or delirium, as the case may be; second, acceleration of the pulse, with loss of sensibility and loss of voluntary power; third, exhaustion and coldness of the surface

The average duration of the state of sleep or insensibility may be stated to be about the same as the period required to induce it, or a little less, say from two to four minutes; the period, however, occasionally exceeds this, extending sometimes to half an hour or even an hour; the awakening is sudden and complete

Several persons who were to be operated on next (lay, were subjected to preparatory inhalations, by which they were completely narcotized; sensation, voluntary motion, and consciousness were abolished, yet, when repeated at the operating time, the experiment was a failure

Great uneasiness

Remarkable restlessness, in the period of reaction, ceasing in twenty-four or forty-eight hours/.

Evident restlessness, mostly of the head and upper extremities

So much restlessness, that it was impossible to perform the intended operation

Subjective. In some refractory subjects, sensibility was heightened instead of being depressed

The next day she inhaled it ten minutes prior to the operation, which lasted half an hour, and during which she manifested great pain, declaring afterwards that she felt every cut made; she was conscious from this time until her decease forty hours afterwards, but spoke in a low, faint voice

Perception of external objects fails

Skin Avas not sensible on being sharply pinched

Complete and instantaneous abolition of tactile sensibility; this effect is not constant, but is pretty general; it is accompanied by a diminution of voluntary contractility; it affects the most deeply seated parts of the nervous system

The functions of the brain and nervous system are suspended, sensation is annihilated, and the patient, to all intents and purposes, for the time being, is a senseless corpse

Loss of sensibility ; but drunkenness, attended by vomiting and other symptoms not consequent on inhalation, supervened in both cases

The instant the knife touched her, she cried out, put her hands down to the part, and betrayed other marks of uneasiness; after half a minute to a minute, the operation Avas proceeded Avith, and signs of apparent suffering Averse not to be mistaken, so much so, that it induced some gentlemen present to imagine that the operation Avas felt, and the patient AA^as aware of it; after the operation Avas completed, and on awakening to a state of consciousness, and being asked if she suffered any pain, she expressed no knowledge of any

One person becomes as impassible as the subject on the dissecting-room table; another talks incoherently or mirthfully, replies to questions or obeys instructions; others utter exclamations of pain, Avhich they afterwards retain no reminiscence of having felt; and others, again, declare they have suffered pain, but felt themselves powerless for its expression ; finally, in not a feAAq ungovernable, violent convulsive actions, quite adverse to the performance of any delicate operation, take place; Avith some, an utter oblivion is induced; while others, whilst undergoing all the apparent tortures of a prolonged dissection, are rev^elling in the realms of memory and the fields of imagination

Ill, and much dejected (third evening)

General malaise

After repeated experiments, a general malaise replaces the agreeable feeling experienced at first

His sensations were so dreadful, that he would rather undergo any amount of pain than submit to the same again, Avhich he could compare only to a state of utter helplessness and impending dissolution

He felt irresistibly disposed to lie doAvn and get his head upon the ground

He seemed to take leaA'e of the external Avorld, but experienced a dreadful sensation of universal tremor, and yet a perfect fixedness of the limbs

Sensation of numbness, beginning at the toes, and affecting, in succession, the legs, arms, loins, and genitals; it extends to the head, and is then accompanied Avith a sense of heat, as from intoxication

By a flav, a sense of great oppression, resembling nightmare

The distressing symptoms continued for more than an hour

Skin p. 227

The skin of the face, as Avell as that of the chest, of a violet-red color (after ten minutes), afterwards livid

Sleep p. 227

After inhalation, all the usual phenomena of the deepest sleep supeiweue almost suddenly, gliding often into the profoundness of sopor, and verging occasionally upon, if not actually lapsing into, coma

Fever p. 227

Chilliness. Much distressed Avith a sensation of cold

Cold and chilly in the evening

Shivering; chattering of the teeth

Cold extremities/.

Skin hot (third day)/®.

Agreeable feeling of heat, accompanied by formication and a kind of tremor similar to that felt on touching a large bell in a state of vibration

Swecit, Perspiration, followed by chill