ANÆSTHETIST TO THE GLASGOW ROYAL INFIRMARY. CASE I.-The patient, a man aged 23 years, a labourer, was admitted to the Glasgow Royal Infirmary on March 8th, 1910, as a result of a severe injury to his left arm, occasioned by being caught between the rollers of a machine, and resulting in the complete destruction of the skin from the shoulder to the wrist. To allow of grafting this he was anaesthetised on three occasions, on the first and last by myself, and on the second by the house surgeon.

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... sical examination before anaesthesia revealed nothing abnormal. On the first occasion (March 24th) anassthesia was induced by gas and ether; after 10 minutes a change was made to chloroform, administered on Skinner's face-piece. There was no difficulty of any kind, the ajisesthesia lasting 25 minutes. On the second occasion (April 1st), of which I have no detailed note, the house surgeon gave chloroform on Skinner's facepiece. After induction, during which there was some struggling, the respirations became shallow and stopped. Artificial respiration was commenced and continued for about one minute, after which natural respiration returned and remained good during the operation, five grafts being applied. On the third occasion (April 23rd) chloroform was administered on Skinner's face-piece. During the first stage there was considerable excitement, with violent struggling, followed in six minutes by unconsciousness,-abolition of the corneal reflex, medium pupil, good breathing and pulse, with slight cyanosis. The patient was allowed four or five breaths of air, after which chloroform was again applied. At eight minutes the patient was turned on his right side to permit of grafts being taken from the outer side of his left thigh. His left arm hung over and slightly pressed on the chest. At this minute the breathing suddenly became interrupted and gasping, then ceased, with dilatation of the pupils, livid pallor, and almost imperceptible pulse. The patient was at once turned on his back, his head was lowered, his tongue pulled forward, and artificial respiration by Silvester's method commenced. By this time the pulse was quite imperceptible and the cardiac impulse could be neither felt nor heard. Hot-water cloths were applied to the proacordium, and 30 minims of brandy and 1/60th of a grain of strychnine were injected hypodermically, but with the exception of one or two gasping inspirations the patient gave no further indication of life. A post-mortem examination revealed the following conditions :-Heart : normal. Lungs : some engorgement at base ; no mdema. Brain : fresh hasmorrhage extending over both cerebral hemispheres downwards towards the base, more extensive on the left side. There was no hypertrophy of the lymphatic tissue. CASE 2.-The patient, a woman aged 61 years, was admitted to the Glasgow Royal Infirmary on May 12tb, 1910, with a diagnosis of carcinoma of the cascum. Although for some time before the admission she had been losing flesh she was still very stout. Physical examination before anaesthesia showed no abnormality, except rather feeble heart sounds, but no valvular lesion. On May 14th she was ansesthetised by Dr. A. Stewart, house surgeon, the anassthetio chosen being chloroform administered on Skinner's mask. The first stage was quiet, but before the patient had entered the second stage preparation of the skin for the operation was commenced, causing slight straining of the abdominal muscles and holding of breath. After five minutes' administration, when about two drachms of chloroform had been given, difficulty arose. Respiration ceased, with cyanosis and weaker pulse. The usual methods of resuscitation were adopted, as in Case 1, with the exception of the injection of brandy, and after artificial respiration had been continued for about seven minutes respiration was resumed and the pulse improved in volume. An I attempt was made to continue anaesthesia with ether by the open method, but this gave rise to the same alarming condition, though artificial respiration was not called for, and the patient was sent back to bed without operation. She kept well for three days, when it was noticed that there was slowness in answering questions, with delayed comprehension and slight mental dulness. Later in the day (May 17th) paralysis of the left arm develooed, with slight drawing of the mouth to the right side, and unconsciousness. On the 18th, there was a slight return of consciousness, the patient being then able to answer questions, otherwise her condition remained the same.