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of carbolic acid, extract of pinus canadensis, etc. Used bromide of potassium for some time without much effect upon the noises, but with an improvement in the hearing of the defective ear to double the hearing distance by the 27th of March. The alkaline treatment was then changed to extract of belladonna, ergot, and hydrobromic acid, which was continued until May with less vertigo, but the noises continued. As her memory was more or less affected the treatment was then changed to a solution of phosphoric acid as a lemonade. The Eustachian tubes were touched at their orifices with a solution of nitrate of silver, of forty grains to the ounce of water, by means of the author's Eustachian forceps, and then medicated and washed out through the nose by a solution of chloride of sodium. The hearing further improved to three feet, and the whole condition of the young person was improved; she had, however, still these noises. During May the spray of chloroform, nitrite of amyl, sulphuric ether, and hydrobromic ether, were all at different times passed into the middle ear by means of the Eustachian catheter, and were blown up freely by means of an air-bag fitting to the orifice of the catheter. None of them even improved or relieved the noises except the hydrobromic ether. When fully under the influence of this agent the noises all disappeared, and after the effects had passed away she had not the distress in her head or heart which she had suffered under the influence of chloroform. Neither had she the disposition to faint which was produced by chloroform. Her recovery from the anaesthetic influence of the hydrobromic ether was prompt and complete, while it required fully one hour to recover from the chloroform, after which, for a whole day, she felt faint, and distressed.

CASE 2.-April, 1878, T. L., aged 57, of Philadelphia, a gentleman of means, who has suffered with pericarditis, with irregular action of his heart, also with flatulent dyspepsia, and distressing pains in the lower bowels and rectum. He has had to resort to large doses of anodynes, with carminatives, for relief, and has had to be placed at times under the influence of sulphuric ether and chloroform; but the former agent always, from the first, caused great distress, clammy skin and cough, owing to oppression following their use. With the latter, by distress in his head and heart, and intense throbbing of the vessels of the brain. I placed this patient three different times under the influence of hydrobromic ether with entire relief to his pain and less distress of his heart, and more rapid elimination of the drug from his system.

CASE 3.-September, 1877, James W. H., aged 21, a mechanic, while making some alterations in my house, had been suffering with acute periostitis of the jaw, and owing to exposure to cold the inflammation became so intense and distressing that he had to give up his work. On examination it was found to involve the antrum Highmorianum, and I feared pus had formed in it. I proposed at once to extract the tooth and cut down to the bone; he was very timid and nervous, heart irregular, and pulse fluttering, and desired to have an anæsthetic. Fearing the effects of chloroform, and the long period consumed in such cases by the administration of sulphuric ether, I proposed this new agent to him, and

he agreed to it. I placed upon an Allis inhaler f3iij of hydrobromic ether, and, although he breathed it with great irregularity, in the course of three minutes he was fully under its influence. I extracted the tooth, and cut through the bone into the antrum, which incision was followed by a free discharge of blood and pus without his evincing the least indication of pain. His recovery was in about the same time as was consumed in the administration, and it was 'so complete that he was able to resume his occupation after an hour's rest. He had no vomiting, not even nausea following it.

CASE 4.-M. P., aged 23 years, student of medicine, health perfect, pulse 68. Respiration normal, not at all nervous. On an empty stomach, inhaled by Allis inhaler f3iiss of hydrobromic ether, producing complete anæsthesia in two minutes and a half. Pulse not influenced in the least, temperature normal, respiration but slightly accelerated. So complete was the influence of the anesthetic that the cornea could be touched with the finger without causing motion of the eyelids. Snoring loudly. From the time of discontinuing the administration to complete consciousness just two minutes, so that he was able to walk and talk coherently. Had, after rising from the recumbent posture, slight vomiting of mucus.

CASE 5. With two drachms of hydrobromic ether completely anæsthetized a child of six years of age in about three minutes. While fully under its influence slit up both canaliculi, and introduced Bowman's probes, without evidence of pain. Consciousness returned immediately after. The ether was withdrawn during the operation; no vomiting or other bad symptoms.

CASE 6. After the administration of about four drachms of hydrobromic ether, Allis inhaler, secured sufficient anesthesia to lacerate a soft cataract in a child three years of age. No other anæsthetic during the operation. No bad symptoms, no vomiting, and rapid return to consciousness.

CASE 7.-Administered to a woman, by Allis inhaler, hydrobromic ether. This patient was feeble, but heart normal. Subject to bronchial asthma. Stomach was fortunately empty. Complete anæsthesia was induced in three minutes, and kept up for five minutes, during removal of cystic tumor from her head. After operation there was slight vomiting of mucus.

CASE 8.-A woman, aged 25, with a peculiar hyper-sensitiveness of the whole alimentary tract, with excessive torpidity of the bowels, retroversion of the uterus, and neuralgia of the splanchnic nerves, with dreadful suffering. With a little less than one ounce of hydrobromic ether there was produced complete anesthesia in four minutes, long enough for placing of a pessary to relieve the above symptoms. During the administration the pulse was but slightly accelerated. Return of consciousness, was accompanied by excessive gagging and vomiting of large quantities of mucus, great burning in stomach and throat, severe headache, cold perspiration, weak and rapid pulse, all of which continued for twenty-four hours, with more or less severity. Both sulphuric ether and chloroform had previously, on several occasions, produced similar symptoms, but not so severely. Many of the distressing symptoms in this case

were owing to the peculiar sluggishness of the intestines, due to the irritation caused by congestion and change of position of the uterus, and this extending to the ovaries, and passing up to the sensory nerves of that organ, thence to the nerve centres, whence it was reflected down to the splanchnics. At the time they are thus excited, and simultaneously with the rarest of the peristaltic action, the blood pressure rises in the aorta and its branches, from the blood being driven out of the intestinal vessels by their contraction. In this case large doses of opium would be the best remedy in pills of one grain, twice a day, with hot fomentations over the abdomen as a laxative.

CASE 9.-Child three years old, perfectly healthy. Had lacerated soft palate, by running into it a pointed piece of wood. Two slight sprinklings of hydrobromic ether on a napkin, sufficiently relaxed the patient, and produced such a temporary anesthesia as to permit touching of cornea and thorough examination and stitching of the wound, and full examination of fauces.

Conclusions. From the three cases first reported in my work before referred to, and the seven new cases, making ten in all, I would deduce the following conclusions:

Shortest time taken to place a patient under

the anæsthetic influence

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Minutes. Seconds.

30

4

14

2

Average time under influence

Smallest quantity of hydrobromic ether two inhalations from sprinkled handkerchief.

Largest quantity of hydrobromic ether employed half an ounce. Vomiting occurred in three cases after the administration. Excitement (hysterical) in two cases. Prostration in one case, but no alarm felt concerning the patient's life. No asphyxia or fainting.

It will be noticed that as yet I have not resorted to its use in a protracted operation.

The advantage of this agent is the rapidity of its elimination from the system by the respiratory passage.

Action on the Lower Animals.-Rabbits and dogs are with difficulty brought under the influence of chloroform. Hydrobromic ether produces absolute anesthesia with rabbits, dogs, and frogs much more rapidly than chloroform does. With chloroform the shortest time required to place a small dog under anaesthetic influence was two minutes and thirty seconds; while with hydrobromic ether the shortest time with the same animal was but two minutes, and in from two to five minutes the animal had recovered all its powers. With a tin inhaler and a sponge saturated with bromide

of ethyl, dogs can be completely anesthetized. With frogs a sponge saturated with the same is placed under a bell glass. Water can be so charged with this variety of ether that a frog can absorb it through its skin; this requires a much longer time.

Action on Man.-There is but very slight increase of the pulse or the arterial tension. There is a prickling feeling of the skin at the elbow and in the hands, with a rapid loss of power to move; the brain is comparatively free; pupils not affected; skin in some. few instances cold and moist, but in the majority of cases natural. It differs from ordinary ether in the stage of excitement being short, the sedation and subsequent elimination rapid.

REPORT OF COMMITTEE OF REVISION OF THE UNITED STATES PHARMACOPEIA, OF THE PHILADELPHIA COUNTY MEDICAL SOCIETY.

REFERRED BY THE SOCIETY TO THE STATE SOCIETY.

TO THE PRESIDENT AND MEMBERS OF THE

PHILADELPHIA COUNTY MEDICAL SOCIETY :—

The Committee of Revision of the United States Pharmacopœia respectfully present the following report of their proceedings:

Organization.

At a special meeting of the Philadelphia County Medical Society, held May 9th, 1877, it was resolved "that a committee of five be appointed by the President to suggest such alterations and additions to the United States Pharmacopoeia as may in their judgment seem desirable, and report to this Society before the meeting of the State Medical Society in 1878." By subsequent action of the Society, at its Conversational Meeting, held October 10th, the number of members of the Committee was increased to ten, of which number the President of the Society, Dr. H. H. Smith, was to be one. The following gentlemen were appointed on the Committee: Drs. Richard J. Dunglison (Chairman), Andrew Nebinger, Richard A. Cleemann, John B. Roberts, Frank Woodbury (Secretary), William B. Atkinson, Albert H. Smith, William M. Welch, J. Solis Cohen, Henry H. Smith.

At a Conversational Meeting of the Society, held February 27th, 1878, for reasons which will be hereafter stated the Committee was still further enlarged by the addition of ten members-the Committee as now constituted consisting therefore of twenty members the President appointing for this purpose Drs. George B. Dunmire, Louis K. Baldwin, Joseph G. Richardson, J. Cheston Morris, James Collins, Albert Fricke, Charles B. Nancrede, Samuel R. Skillern, Ferdinand H. Gross, and S. Dotie Risley.

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