Materia Medica anti Therapeutics. 557 these agents, but also after they have, been stopped for some little time (a source of serious danger), it is necessary for the person who has charge of the adminis¬ tration of the drug to be on the lookout for symptoms of this occurrence, both during the time the agent is being given, and for some time after the patient has recovered from its more evident effects. 3. The danger of death, from stoppage of the respiratory functions, must be borne in mind in

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... very ease in which amesthetics are given; but, of perhaps greater importance is the danger from interference with the proper action of the heart-particularly when it is remembered that, by artificial means, we can com¬ bat the former contingency. It. might even be advisable, in certain cases, to in¬ troduce a tracheal-tube by the mouth-so as to enable us to force air into the lungs by means similar to those adopted in experiments with animals; or, in cir¬ cumstances where such a procedure was impracticable, tracheotomy might be per¬ formed, with the same object in view. Artificial respiration should be continued, even though all evidence of cardiac action has ceased. 4. As regards comparative danger, the three amesthetics may be arranged in the following order: chloroform, ethidenc, ether; and the ease with which the vital functions can be restored may be conversely stated, thus : the circulation is more easily re-established when its cessation is due t.0 ether than toethidene; and when tlie result of ethidenc, than when chloroform has been used. The advan¬ tages which chloroform possesses over ether-in being more agreeable to the pa¬ tient and more rapid in its action, in the complete insensibility produced by it, and the absence of excitement or movements during the operation-are more than counterbalanced by its additional dangers. 5. The chief dangers are: (1) sudden stoppage of the heart; (2) reduction of the blood-pressure; (3) alteration of the pulse-respiration ratio; and (4) sudden cessation of the respiration. The danger with ether approaches from the pulmo¬ nary rather than from the cardiac side-so that, by establishing artificial respira¬ tion, we have a means of warding off death. Its disadvantages are, to a great extent, obviated by the use of ethidenc; whilst the dangers of chloroform are also reduced to a minimum.