The "deceased having become insensible after inhaling the above quantity of "methylene, he (witness) removed the finger from his hand, the operation not "lasting more than one minute. It was then proved that the deceased's head "had fallen upon one side, his eyes were upturned, and breathing and pulsa'tion had ceased. Every means was at once adopted to restore animation, "but without effect. He had since made a post mortem examination and found "the brain and every other organ in a perfect state of health. There was "nothing whatever to account for death. There was not the slightest trace of "any action of the methylene on either the heart or brain, the organs mainly "affected by chloroform when administered. The only way he could account "for the man's death was, that being in a state of great nervous excitement at "having to undergo the operation, the methylene had acted upon the nervous "system, producing instant death. He had known death to have resulted "under an operation from the nervous excitement of the patient, without chloro"form having been inhaled. There was no doubt that the death of the "deceased had been produced by the methylene he had inhaled. The cases of "death while under the influence of methylene were extremely rare.

In all "probability the deceased would have survived the operation had it been per"formed without his inhaling the methylene, which was administered at his "own request. He never allowed methylene to be administered to a patient "about to undergo an operation unless with the patient's full consent after due "deliberation. The Jury returned the following verdict: - 'That the deceased "died from the effects of methylene properly administered during an opera"tion." - Standard, April 22nd, 1871.

Hundreds of similar cases could be adduced. This is the answer why, in 1840 to 1844, thirty years since, the anaesthetic investigation was not systematically proceeded with according to the ideas and experience of 1871. If these awfully sudden deaths did not occur we might forgive this forgetfulness or rather uncharitableness on the part of writers, who lose sight of past difficulties in the advocacy of a new discovery. This severe criticism, however, recoils on itself. Had one of the above cases of instantaneous death in the experiments of rendering the body insensible by alcoholic vapour in 1840 to 1844 occurred, would the writer of the article in the Lancet have the temerity to state that the experimenter would not have been tried for murder, found guilty, and executed? Let him imagine, certainly not asking too much, the discovery in 1900, or thirty years hence, of an anaesthetic which will not be liable to produce such baneful results as chloroform and bichloride of methylene. It would not be noble or generous and manifest much magnanimity on the part of a writer in a medical journal who then, in 1900, would denounce Dr. B. W. Richardson or Sir James Simpson because of these untoward results in 1871.

It is so easy to find fault or see defects in others.

Oh, wad some power the giftie gie us, To see oursels as others see us, It wad frae mony a blunder free us, And foolish notion.*'

It should not be forgotten that, though no one could claim priority in experiments performed in 1840, 1841, 1842, and 1843, with no experience to guide, still not a single fatal result ensued, though frequently the most alarming condition was induced.

Note. - Between bichloride of methylene and chloroform there is a distinction without much difference; practically it is chloroform diluted. But the advocates of methylene claim for it, that it is more gentle in its action, that there is less struggling, less vascular excitement, its narcotic effects are equally prolonged, in fine, that it is as effective as chloroform, without any of its disagreeables.

If these are facts, the reason of the superiority of the methylene must result because of its containing less chlorine than the chloroform. Does not this fact lead to the conclusion that all compounds containing chlorine are liable to paralyse the heart's action, more especially in those whose nervous system indicates great sensibility. The inhalation of ether is not liable to the same dangers as either chloroform or methylene, its composition being carbon 4 atoms, hydrogen 5, oxygen 1. The only foreign agent to the respiratory organs being the hydrogen.

The most unobjectionable anaesthetic is without doubt the nitrous oxide, or protoxide of nitrogen gas. It is indeed a frivolous excuse, that because of the greater portability or convenient facility of administration of chloroform, methylene, or ether, that they should be used in preference to the nitrous oxide which, from its close analogy to atmospheric air, must at once recommend its use as an anaesthetic. The nearer we approach to the natural respiratory medium, in the same ratio do we reduce the mischances which jeopardize life itself, from the inhalation of an agent so foreign to the system as chloroform or methylene.

It is not to be supposed that I would entirely deprecate their use, but the administration must be so managed as to prevent such pungent vapours from acting too suddenly, and thus paralysing the great nervous centres in constitutions of special idiosyncrasy or nervous peculiarity. When the first shock to the nervous system has been overcome, no subsequent danger need be apprehended.

I am at this moment engaged in the construction of an inhaling apparatus, which I have every reason to believe will meet all the conditions required, so that the nervous congestive, or insensible state may be prolonged by the inhalation of the nitrous oxide gas to ten minutes, which is of sufficient duration for the great majority of surgical operations to be performed painlessly, without endangering, in any case, the life of the patient.

Time will demonstrate that the only anaesthetics which can with safety be administered, are those which increase the vital condition by producing a true nervous congestion of the brain and nervous centres. All those which negative or depress, must necessarily endanger life.

Robert H. Collyer, M.D.

199, Brompton Road, S.W.

Near South Kensington Museum. June, 1871.