and peritonitis before the stage of effusion, simple and eruptive fevers, puerperal and surgical fevers, facial erysipelas, acute rheumatism, cardiac affections with overaction or hypertrophy and without valvular lesion, diarrhoea and dysentery from cold or exposure, menstrual suppression from chill, and neuralgia of the 5th (externally and internally), it having a very positive and selective influence on that nerve. It is also highly recommended in otitis, nervous palpitations, restlessness, and sick headache, as also in the acute stage of gonorrhoea.

Aconite is best administered in small doses frequently repeated; from half a drop to a drop of the tincture every fifteen minutes in a teaspoonful of water as a rule give better results than do proportionately larger doses at longer intervals.

Aconitine has been remarkably efficient in trigeminal neuralgia ;-so also has Napelline been in the same affection, and as an hypnotic it is well mentioned by several observers of authority.

ADEPS, Lard,—is the prepared internal fat of the abdomen of Sus scrofa (Pig), purified by washing, melting and straining. A soft, white, unctuous solid, of bland taste and neutral reaction, entirely soluble in ether, benzin, and bisulphide of carbon; composed of 38 per cent. of stearin and margarin, and 62 per cent. of olein. Lard forms 70 per cent. of Ceratum, and 80 per cent. of Unguentum, and enters into the composition of several of the official cerates.

Preparations.

Adeps Benzoinatus, Benzoinated Lard, has 2 per cent. of Benzoin in powder incorporated by stirring.

Oleum Adipis, Lard Oil,—is a fixed oil expressed from lard at a low temperature.

The actions of the Oils and Fats will be described under MORRHUÆ OLEUM (which see).

Lard is only used as an ingredient of ointments and cerates. Lard Oil is used in making the Unguentum Hydrargyri Nitratis, but has been proposed as an inferior substitute for Cod-liver oil in cases where the taste of the latter is particularly offensive.

ÆTHER, Ether, Ethyl Oxide (C,H),O,-in its absolute form is not official, the strongest preparation containing 6 per cent. of alcohol and some water. Considered as a generic term, an ether is analogous to a salt, as an alcohol is to a metallic hydrate. The particular ether officially so named is Ethyl Oxide, prepared from Ethyl Hydrate (Ethylic Alcohol) by a dehydrating agent with the aid of heat, and then purified by various processes. The agent used is Sulphuric Acid, hence this ether is improperly called "Sulphuric Ether," but the acid simply dehydrates

the alcohol and remains in the retort, becoming constantly more diluted by the abstraction of water from the alcohol. Consequently H2O is the difference between Alcohol and Ether. (C,H,O), — H2O = (C2H1),O. The official ethers are the three following, viz. —

ÆTHER, Ether, -is a liquid composed of about 74 per cent. of Ethyl Oxide, and about 26 per cent. of Alcohol containing a little water; an inflammable, thin, very diffuse, clear and colorless liquid, having a burning, sweetish taste, and a neutral reaction, of sp. gr. about 0.750 at 59° F. Its vapor is heavier than air and forms therewith a highly explosive mixture. Ether is freely soluble in alcohol, chloroform, benzol, oils, and in 8 volumes of water at 59° F. It boils at the temperature of the body (98.6°), and is a solvent of oils, fats, resins, caoutchouc, guttapercha, and many other substances. It has chiefly a pharmaceutical value.

ÆTHER FORTIOR, Stronger Ether,— is a liquid composed of about 94 per cent. of Ethyl Oxide, and about 6 per cent. of Alcohol containing a little water. Sp. gr. not above 0.725 at 59° F. It is the preparation employed for anæsthetic use, and is generally though improperly called "Sulphuric Ether," a term which belongs to Ethyl Sulphate (C1H1SO1). The dose of Æther Fortior for internal administration is m x-3j, in syrup. ETHER ACETICUS, Acetic Ether, Acetate of Ethyl, C2H,C,H ̧O,—is an inflammable liquid, transparent and colorless, of ethereal and acetous odor, soluble in alcohol, ether, chloroform, and 17 of water. Sp. gr. 0.889 to 0.897. Is a constituent of Sp. Odoratus and Tr. Ferri Acetatis. Dose, m x-3j.

HYDROBROMIC ETHER, Ethyl Bromide, C,H,Br (Unofficial),-is not inflammable. Dose, internally and hypodermically, mx-3j.

HYDRIODIC ETHER, Ethyl Iodide, C,H,I (Unofficial), -is a colorless. liquid, non-inflammable, and insoluble in water. Dose, inhaled, mxv.

[For the Chlorinated Ethers see under CHLOROFORM.]

Preparations.

Oleum Ethereum, Ethereal Oil,-is a volatile liquid, consisting of equal volumes of heavy Oil of Wine and Stronger Ether. Used to prepare the Spt. Ætheris Comp., and as it occurs in commerce is usually a worthless preparation.

Spiritus Etheris, Spirit of Ether, has of Stronger Ether 30 parts, Alcohol 70. Dose, mx-3j.

Spiritus Etheris Compositus, Hoffman's Anodyne,-contains Stronger Ether 30, Alcohol, 67, Ethereal Oil 3 parts. Dose, mv-3j.

Spiritus Atheris Nitrosi, Spirit of Nitrous Ether, Sweet Spirit of Nitre,-is an alcoholic solution of Ethyl Nitrate, C,H,NO2, containing 5 per cent. of the crude ether. It turns acid with age, and should not be kept long. It is a constituent of Mist.Glycyrrhizæ Co. (3 per cent.). Dose, 3 ss-3 ss. Its incompatibles are Potassic Iodide, Ferric Sulphate, Tr. Guaiaci, Tannic and Gallic Acids, and Antipyrine.

Anæsthetic Mixtures.

Nussbaum's has-Ether 3 parts, Chloroform 1, Alcohol I.

Vienna General Hospital uses-Ether 9, Chloroform 30, Alcohol 9.

The Vienna Mixture,"-Ether 3, Chloroform 1.

Medico-Chirurgical Society of London (1864) proposed-Ether 3, Chloroform 2 Alcohol I.

ETHER.

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PHYSIOLOGICAL ACTION OF ETHER.

ETHER is anodyne, antispasmodic, diaphoretic and anthelmintic; a cardiac and cerebral stimulant, an anesthetic, and a narcotic poison. Given internally, it is one of the most powerful stimulants of the secretions, acting especially on the secretions of the stomach, salivary glands and pancreas. On the cerebrum and the motor and sensory nerves its action is similar to that of alcohol, but more prompt and less protracted. It is eliminated rapidly, chiefly by the lungs. Externally it is a powerful refrigerant and local anesthetic; also rubefacient when rubbed into the skin.

Inhaled Ether produces at first faucial irritation, a sense of strangulation and cough; then a stage of excitement (cerebral intoxication), in which the face is flushed and the respiration and pulse are accelerated. A tetanic convulsive stage generally follows, the face being cyanosed, the muscles rigid, and the respiration stertorous. This soon subsides, and complete insensibility is established, the muscles being then relaxed, the reflexes abolished, and the cerebral functions suspended, the lower centres in the medulla carrying on the processes of respiration and circulation. If the inhalation be continued, these also become paralyzed, death usually resulting from slow paralysis of respiration, the heart pulsating long after breathing has ceased. If the inhalation be discontinued before the lower centres are affected, the patient gradually emerges from the condition of insensibility, and, as the narcosis subsides, vomiting is usually experienced.

Dr. Brunton found that in a hot climate Ether will decompose within a few hours, and hence, during his investigations for the Hyderabad Chloroform Committee, he found it impossible to obtain pure ether. This may account for the preference for Chloroform as an anesthetic which is so universal in the Southern States.

ETHER COMPARED WITH CHLOROFORM.

Ether is less irritant than Chloroform to the mucous membranes when swallowed, but its vapor is more irritant to the air-passages. It is more of a general stimulant, and less depressant to the heart and circulation. It does not clot the blood. Its vapor is very inflammable, less pleasant to inhale, slower in action, has a longer stage of excitement, and a less profound narcosis, and causes a greater degree of vomiting. It is much less dangerous than Chloroform, death from the inhalation of Ether occurring slowly and usually by paralysis of respiration-from Chloroform, it is always sudden. Ether has undoubtedly caused a number of deaths, besides several which occurred some hours after the anesthesia. The reported cases of fatal Chloroform narcosis number about 500, those from Ether about 20.

Modes of Dying from Anæsthetics.

(1.) From sudden paralysis of the cardiac ganglia, early in the inhalation, by reflex action proceeding from some peripheral injury before complete anesthesia is produced. Thus, in the extraction of teeth, a small quantity of Chloroform having been administered,

the heart is enfeebled, and the action of the cerebral hemispheres suspended, but not those of the basal or medullary ganglia. If at this stage the 5th nerve be irritated, by the intimate relation of its nucleus with that of the pneumogastric reflex inhibition may be transmitted over the latter, arresting the cardiac ganglia. The stage of incomplete anesthesia is always a dangerous one in which to perform any operation around the distribution of the 5th nerve.

(2.) In the stage of rigidity, from tetanic fixation of the respiratory muscles, the blood backing up on the venous side, and the arresting of the heart's action, respiration ceasing before the cardiac action is stopped.

(3.) In the stage of complete relaxation, by paralysis of respiration; or by paralysis of the tongue, causing obstructed respiration.

(4.) In the same stage, by paralysis of the motor ganglia of the heart.

(5.) From depression of the functions by chloroform narcosis, and from shock,—and may occur in the anaesthetic state, or afterwards.

CONTRAINDICATIONS FOR ANÆSTHESIA are-fatty degeneration or dilatation of the heart, renal and pulmonary disease, enlarged tonsils, cerebral tumor, and chronic alcoholism-particularly the first and last named.

DANGEROUS SYMPTOMS should be met by withdrawing the vapor and inverting the patient head downwards, drawing the tongue forwards, and applying a cold douche to the face and chest. Atropine hypodermically is an agent of great value in combating the cardiac failure,-artificial respiration and faradization of the respiratory muscles if breathing ceases. Amyl Nitrite by inhalation, or Ammonia hypodermically. Heat to the body and limbs.

Notes on Other Anæsthetics.

A comparison of these agents in respect to their safety has been lately made by Dr. Richardson, who considers Methylic Ether to be the safest of all, and the others as follows: Safe are-Ethyl Bromide, Ethyl Chloride, Ether, Ethene (olefiant gas), Ethene Chloride, Methyl Bromide, Methyl Chloride, Methyl Ether, Methene Chloride, Methane (marsh gas), Nitrous Oxide.

Of doubtful value are-Amylene, Amyl Chloride, Butyl Chloride, Benzene (benzol), Carbon Disulphide, Carbon Dioxide, Carbon Tetrachloride, Methyl Alcohol, Methylal, Spirits of Turpentine.

Dangerous are-Amyl Hydride, Butyl Hydride, Carbon Monoxide, Ethyl Hydride. Chloroform and Ethene Dichloride are considered useful, but requiring care.

PHYSIOLOGICAL ACTION OF OTHER ETHERS.

HYDRIODIC ETHER is an antispasmodic and a general stimulant; also an anesthetic if inhaled for a sufficiently long time. Its use as a medicinal agent is chiefly to bring the system rapidly under the influence of iodine. It increases appetite, stimulates the action of the heart, gives vivacity to the general feelings and activity to the intellect.

HYDROBROMIC ETHER has a not unpleasant odor, produces but little irritation of the air-passages, has very brief stages of excitement and rigidity, and but a short stage of insensibility, with prompt awakening and but little of the mental confusion and excitement consequent on the use of the other anæsthetics. It is not inflammable, acts quickly, and is a good local anesthetic. Its actions in other respects correspond with those of Ether.

NITROUS ETHER is a mild diaphoretic, a diffusible stimulant, a carminative, and an efficient diuretic. On the blood it acts similarly to Amyl Nitrite, diminishing oxygenation, relaxing the peripheral vessels, accelerating the heart's action, and thus lowering arterial tension. Relaxing the renal and cutaneous vessels, it is diuretic and diaphoretic.

ACETIC ETHER has a pleasant odor and taste, forming agreeable combinations with other carminatives as a stimulant and antispasmodic.

THERAPEUTICS.

When diluted with alcohol Ether mixes readily with water, and may be administered internally with advantage in indigestion of fats, and to aid the digestion of Cod-liver Oil. It is also given in hysteria to relieve the paroxysm and flatulence, and in hepatic colic from calculi, Ether with Turpentine (Durande's solvent remedy), which acts only as an anodyne and antispasmodic, is considered by some as of great value.

Subcutaneously Ether is used in the algid stage of cholera, sudden cardiac depression, neuralgia, and in the adynamia of hemorrhage, pneumonia and the eruptive fevers.

Local anesthesia by the Ether-spray affords great relief in neuralgia of superficial nerves, lumbago, chorea, and spinal irritation. In minor surgical operations it is a valuable method.

AS AN ANESTHETIC the vapor of Ether is less prompt than that of Chloroform, but is equally efficient and much safer. It should be inhaled in as concentrated a form as possible, and will then produce insensibility in from 5 to 10 minutes. If a light be in the room it should be high above the patient. A grate-fire or gas-stove in the vicinity is very dangerous. [Compare Chloroform.] Besides its surgical uses ether-anesthesia is employed in neuralgia, cancer, tetanus, chorea, colic, delirium, puerperal mania and convulsions, infantile convulsions, hystero-epilepsy, epileptic seizures, laryngismus stridulus, whooping-cough, and asthma. The unpleasant after-effects may be greatly modified if not entirely prevented by the previous administration of Morphine (gr.) and Atropine (gr.) subcutaneously.

Its

HYDROBROMIC ETHER had a short period of popularity as an anæsthetic, but fell into disrepute after a few cases of death under its influence, which were probably not due to the agent used (Levis' and Sims' cases). Its action is less prolonged than that of Ether, but it has many advantages, requiring only 3j to zij rapidly given, and being uninflammable. inhalation has been of especial value in hysteria, epilepsy, chorea and other spasmodic disorders; and it has been employed subcutaneously in place of Ether in the treatment of such spasmodic affections as whoopingcough, chorea, etc.