a patient insensible during operation (which is by no means the case,) and supposing the dose could be exactly adapted to every case, and supposing the effects to be uniform, do we know of any evil consequences which have up to this time resulted from its use ?--and are they of so serious a character as to make a prudent man hesitate in recommending his patient to become subject to its influence?

Great excitement of the nervous system, sometimes approaching to apoplexy, an asthmatic condition of the respiratory organs,spitting of blood,-syncope,-are among the results which have been observed; but these are by no means the worst. In many instances —already we are aware of six or seven-death has followed quickly upon operations so performed. It may be that in some of these cases death would have resulted even had the ether not been inhaled ; but, as far as we have been informed, several of the deaths have occurred under circumstances which are not observed under ordinary operations. It is to be regretted that the same alacrity is not shewn in furnishing journals or newspapers with these fatal cases as with the "dexterous operations." We are sorry to say it, but we believe it to be the fact, that none of these cases, with the exception of that reported by Mr. Nunn, have been recorded in this country.

How different is the conduct of M. Jobert, the distinguished surgeon of St. Louis, at Paris. At the sitting of the Academy of Medicine, held February 16th, he stated that in two cases death after operation had occurred in his wards, and that the inhalation practised in both instances did not appear to him to have been altogether unconnected with the fatal issue.

Why there should be this want of common honesty we cannot conceive. There are few persons who do not concede the necessity of fairly trying the agent; and, if that be admitted, its failure cannot attach any reproach to the operator unless there have been a want of proper caution in the administration. So far as the effects have been at present observed, they do not justify us in condemning the agent, but they show us the necessity of grave circumspection in its employment.

There is another matter connected with this subject which presses more heavily upon us: and it is under a strong sense of duty that we raise our voice against it. We allude to the system by which this discovery has been introduced to the public. It is so inconsistent with that relf-respect which should actuate the conduct of every member of a liberal profession, that 'we could not be silent without a failure of the duty which we owe to those who pursue the higher path. To extend invitations to be present at operations to every layman of his acquaintance is surely not the way in which an enlightened surgeon would seek to advance the cause of science. Under this new agent, the phenomena, where females are concerned, are often so peculiar, that the opportunities of being present are sought for by some persons as means of gratifying a prurient curiosity: and what is not less to be deplored, is the fact that what is observed has the effect of influencing incorrectly the judgment of people whose infirmities may render

them the subjects of operation, but cannot tend to the advancement of

science.

The experiments have been in many instances so made, that the public are no longer spectators only, but judges of the propriety of the administration of the remedy;-and patients now direct that ether shall or shall not be employed, instead of allowing the practitioner freedom of action.

It is with much pain that we have observed the headlong pursuit of any opportunity for performing surgical operations,--sometimes even without urgent necessity,--because they are likely to come before the public. One day it is the section of tendons, another the administration of ether :-and we are confident that nothing tends more to shake public confidence in professional men, than the restlessness with which each new phantom is followed and abandoned.

But what is still less worthy is the system of puffing in the public papers to which the inhalation of ether has given rise. The presence of a newspaper reporter, however able in his own field, is not necessary in the operating theatre of an hospital, and he can scarcely be a competent judge of the merits of a surgical operation. A surgeon would scarcely say that an amputation was performed in a masterly manner, when the soft parts, left to cover the bone, were insufficient for the purpose, by an inch and a half, the bone being left protruding, and yet such an operation has so fascinated a reporter that he could scarcely set any bounds to his glowing description of its excellence. Is it ignorance, or something corrupt, which affords the readiest explanation of these things?

It will not do for us to wrap ourselves up in our mantles, and to inveigh against Holloway and others, if quasi respectable members of our own profession, and even Hospital Surgeons, await only a convenient opportunity to advertise themselves in terms as gross and as objectionable as those of Culverwell, Goss, and others.-Lond. Med. Gaz.

On Etherization. Since we last noticed this subject, although the inhalation of ether has been practised to a great extent, much of the enthusiasm which at first prevailed respecting it has been dissipated. The occasional unpleasant, and in a few instances even fatal effects which have resulted from its use, have caused a salutary check to the extravagant anticipations which were formed with regard to it. Further experience only can enable us to form correct notions of those circumstances which may render its application warrantable. In the meantime it is our intention to give a short summary of the novel facts which have been elicited in connexion with etherization during the past month.

Apparatus and mode of inhalation.-The forms of apparatus invented for inhaling ether are already endless. The desideratum at present is to render them cheap and portable, without destroying their efficiency. The apparatus employed by Professor Simpson com

pletely answers these purposes. (See our Report of the Med. Chir. Society, March 3d.) Experience has shown that the inhalation should be so conducted as to produce its full effect as soon as possible, in order to prevent or shorten the period of excitement. With this view a large volume of vapour should be inhaled from the first, the individual should not be disturbed, or the inhalation interrupted, and the ether should be pure.

It has been proved experimentally by Mr. Young, cutler, Edinburgh, on his own person, before the Society of Arts, that so far from there being any danger of explosion during the inhalation, that flame applied to the mouth, and breathed upon, is immediately extinguished.

Physiological effects.-Numerous experiments have been performed on the lower animals by MM. Flourens, Serres, Gruby, Longet, Magendie and others. The same phenomena have for the most part been observed in them as in man. Stupification by ether constitutes a convenient mode of depriving animals of sensation, for experiments on the excito-motory system. If pushed too far, however, even this is affected, and death is occasioned. Different degrees of insensibility may be produced, aud an action upon the brain proper alone, or combined with this upon the medulla oblongata, and spinal chord, be occasioned according to the extent to which inhalation is carried. According to M. Flourens, ether acts on the nervous centres in the following order :-First, on the cerebral hemisphere; second, on the cerebellum; third, one the spinal chord; lastly on the medulla oblongata, destroying successively intelligence, regular movements, sensibility, and life. Dr. Buchanan of Glasgow, having pointed out that the blood surcharged with ether is sent directly to the heart and brain, explains the evanescence of its action by comparatively pure blood from the lower regions of the body, succeeding it as soon as the inhalation is stopped. (Paper read to the Philosophical Society of Glasgow.) The peculiar sensations experienced by individuals vary considerably in different cases.

Applications. The removal of pain during surgical operations still constiutes the chief object of inhalation. Even this application of it, however, has caused perhaps less sensation than that of destroying the pains of child-birth, without interfering with the progress of labour. This fact, first ascertained by Professor Simpson, of Edinburgh, has been confirmed by Professor Paul Dubois of Paris, and subsequently by several others.

We are informed by Dr. Simpson that latterly he has ascertained two important points with regard to the use of ether in midwifery. First, its action may be kept up for hours. In one case he had a patient placed for four, and in another for five hours and a half, under its influence before the child was born. When the patients awoke, about thirty or forty minutes after delivery, they were quite unconscious of the birth of their infants, and could scarcely at first be persuaded of the happy result. Both labours had been previously exceedingly tedious. One of the patients had child's head arrested at

the brim, and after being above thirty-six hours in labour, was delivered by Dr. S. with the long forceps. Second; the fœtus in utero seems not to be deleteriously affected by even such prolonged etherization of the mother. In these two cases the action of the foetal heart was carefully watched by Dr. S. with the stethoscope, and did not vary above ten or fifteen beats during the whole time of the etherization. Both children were born alive and well.

Ethereal inhalation has also been tried in several cases of facial neuralgia, inducing insensibility to the painful paroxysms, and sleep which could not otherwise be procured.

Another application has been made by M. Baudens to determine true from feigned diseases in the army. In one case, where curvature of the back was simulated, the deformity disappeared during the insensibility caused by ether, and the individual was led to confess the imposture. In another case. a suspected ankylosis of the hip joint was in the same way proved to be a reality.

Inconvenient effects have frequently resulted from the inhalation. Many of these will be found related by Professor Syme and Dr. Roberts, in our report of the meetings of the Medico-Chirurgical Society of Edinburgh. Great excitement, cough with expectoration of pus, hemoptysis, and convulsions, during the inhalation, have been witnessed by ourselves. In some cases, erotic feelings, and even nymphomania, have been occasioned in females, in others hysterical symptoms, or those of depression or intense headache, which have continued several days. In our last number we noticed the occasional occurrence of alarming sinking, which required vigorous measures to restore the individual. In some cases, the individuals have been thrown into such a state of agitation as to render the performance of the operation impossible.

Fatal effects have become multiplied. In our last number, one fatal case was noticed, occurring in the Edinburgh Royal Infirmary. We are informed that there are just now two other cases in which the ether was given, dying of secondary purulent deposits in the same institution. Is this result the effect of ether? An answer in the affirmative cannot be decidedly given, but, as we previously stated, all such cases require to be put on record. M. Jobert has brought forward two cases in which he considered death to be partly dependent on the ether. M. Roux has given another of tetanus, in which the patient never rallied from the stupefaction, and where death was decidedly accelerated by it. Mr. Nunn, of Colchester, has recorded a case of lithotomy, which sunk without the patient having rallied from the operation; and Dr. Maclagan has mentioned another, occurring in London after amputation of the thigh.

We observe in the Times, an account of an inquest at Grantham, in the County of Lincoln, in a case where an osteo-sarcomatous tumour was removed by Mr. Robbs, surgeon, under the influence of ether. The patient never rallied from the operation, which was in no way severe or prolonged, and the jury found "That the deceased, Ann Parkinson, died from the effects of the vapour of ether, inhaled

by her for the purpose of alleviating pain during the removal of a tumour from her left thigh, and not from the effect of the operation, or any other cause." In the correctness of this verdict the surgeon himself, Mr. Robbs, concurred.

Morbid Appearances.-The morbid appearances which have been found after death, caused by ether in animals, are similar to those observed in asphyxia, namely, fluidity of the blood, its collection in the right side of the heart and large veins, and engorgement of the internal viscera. In the fatal case of the Royal Infirmary there was found double pneumonia, bronchitis, and secondary purulent deposits in the joints. In the case of Mr. Nunn, cerebral congestion, lungs engorged posteriorly, and uniform fluidity of the blood. In the case at Grantham there was no great congestion, but the blood was fluid. throughout. The observations of Amussat and Lassaign have shown that in every case the blood loses its power of coagulation, although with the exception of the presence of a minute dose of ether, its chemical principles are unchanged.

Claims to the discovery. The merit of discovering the application of etherization to removing pain in surgical operations, has been lately claimed by Dr. Wells, of America. He states that he was led to the discovery by observing that individuals, when in a state of great excitement, as during battle, or intoxication, never felt the pain of local injuries. He consequently caused the patient to inhale ether, and nitrous oxide gas in several cases, and found that they were thus insensible to the pain of surgical operations. He was led to prefer the nitrous oxide gas for this purpose, from its causing less injurious effects than ether. He communicated his discovery to Drs. Morton and Jackson, who then received it with incredulity. He shortly after left America for Europe, and was much surprised on arriving at Paris to find that those gentlemen had propagated his ideas without any allusion to him.

Since writing the above we have been informed that Professor Syme has abandoned the use of ether in his surgical clinic.-Monthly Journal of Medical Science.

Fatal Effects of Ether Vapour in a case of Lithotomy. By ROGER NUNN, Esq., Surgeon to the Colchester and Essex Hospital.At a time when the attention of both the medical profession and the public is being called to the influence of the ethereal vapour as an agent in deadening pain during surgical operations, you may probably consider the accompanying case of sufficient interest to be admitted into your columns.

On Friday, the 12th inst., I operated upon Thomas Herbert, ætat. 52, the subject of stone in the bladder, in the presence of most of the medical gentlemen of the town and neighbourhood. The ether was exhibited by my colleague, Dr. Williams, who considered the patient to be sufficiently under its influence after having inhaled it seven or eight minutes, at the end of which time I commenced the operation. There was neither dificulty nor loss of time in cutting into the blad