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carefully peruse this short work, and compare it with Pro-chaska yourself." This, Sir, and gentlemen, I have done. Ihave read it, and I will say, that if there be any work worthyof comparison with Euclid in medical writings, this is thework. It is the very opposite to the writings of its critic;terse for wordy, plain for misty, solid for frothy. I hold it in

my hand: its bulk need deter no one. I will beg you shortlyto examine its contents, its text, and its plates, with me. Iwill leave it on the table of our Society, for the use and ad-vantage of our members. It ought to be on the table of everymedical society in the kingdom.* And, Sir, as no one canbe master of its author’s views who has not pored overthis volume, I will again beg you to adjourn our debate oncemore, in order that we may come to the subject prepared. Ihave only myself just imbibed the full idea of the spinal sys-tem, its central organ, and its incident and reflex nerves, inits distinctness from all that is cerebral and ganglionic, withall its applications to physiology, pathology, &c., and to the

DIAGNOSIS of that great class of the diseases of the nervoussystem. I will say nothing of the part which I took in our lastevening’s discussion. I was mistaken-deceived-misinformed

by a malignant, but specious reviewer; a man who, in astyle of impudent mockery, speaks of its being "grievous towrite it down" !-to write down this book, I say, Sir. It isindeed grievous to see a man, holding a sort of position in ourprofession, " write himself down;" and not only that, but writehimself down an -, (I beg pardon for a little warmth,) for aslong as physiology shall last. This is my apology.The young M.D.—I beg, Sir, most cordially to second this

proposition; and if I might presume, I would propose a voteof thanks to Mr. —(our Stranger), for his noble candour andmost generous conduct.The Presiclent.-I will put both these motions at once; they

ought not to be separated. [Carried by acclamation.)

Operations Without Pain.ST. GEORGE’S HOSPITAL.

THERE were three operations here on Thursday, Feb. 4th,in which the vapour of ether was exhibited again by Dr. Snow,in the presence of Sir B. C. Brodie, Mr. Keate, and a numerousassembly of spectators.The first operation, by Mr Caesar Hawkins, was for the re-

moval of dead bone from the tibia. When the patient-ayoung woman-had inhaled the ether for three or fourminutes, the operation was commenced without causing theleast cry or struggle. After a minute or two, the inhalationwas left off; but resumed again for a short time. The pupilsdilated as she became insensible, and the eye was turned upas in sleep; but before the inhaling was discontinued, thepupils had contracted, and remained so for some time. Thepulse became frequent, about 140, and remained frequent forsome time. The ether was discontinued some little timebefore the completion of the operation. During this interval,she gradually regained her consciousness; and in answer toquestions as to how she felt, complained of a little pain in theforehead, but did not notice what was being done to her limb.As the wound was being bound up, she recognised the sisterby her, and began to cry, evidently from mental feeling, forshe said she had felt no pain.The next case was an operation, by Mr. Tatum, for fistula

in ano in a man. He groaned a little during the operation,and said afterwards that he felt it just a little, but nothing tosignify: he seemed, indeed, quite merry. The operation inthis case was apparently commenced a little too soon.Mr. Cutler performed the last operation, which was the

amputation of a scirrhous breast in a woman who had notreached the middle period of life. In this case, the etherwas most completely successful; there was not the least ap-pearance of suffering either pain or any kind of uneasiness;and when the patient quietly recovered, she said she had beendreaming she was in France, from whence she had latelycome.

In the two latter cases, the process of inhaling vapour didnot begin quite so soon as it appeared to do; for the patients

* This is also our most deliberate opinion.—ED. L.

began by inhaling merely atmospheric air, and when a littleinitiated to the process, etherized air from the apparatuswas gradually let on, by means of a tap, opening two ways,which had been added since the previous week, and whichDr. Snow said Mr. Ferguson, the instrument maker, had con-trived.

Mr. Cfesar Hawkins, after the operation, said that hewished publicly to express the thanks of himself and col.leagues to Dr. Snow, who had invented the apparatus, andapplied it in these cases. He considered the instrument ofDr. Snow very much superior to those they had previouslyused; and it had the great advantage of enabling us to regu-late the proportion of vapour administered.

MIDDLESEX HOSPITAL.EMPLOYMENT OF ETHER DURING OPERATIONS FOR THE REMOVAL

OF VENEREAL WARTS, FOR STRANGULATED HERNIA, AND FOR

ENTROPIUM.

Reported by J. H. RoGERS, Esq., Acting House-Surgeon.ON February lst, Mr. Arnott excised a large crop of venerealwarts from the labia and perineeum of a young female, whoconsented to have them removed, on being told that thisusually most severe operation could be performed withoutgiving her any pain. She was placed in a recumbent positionon a table, and the mouth-piece of the ether apparatus ad-justed. At first she coughed and sputtered a good deal, butthis soon subsided, and, after breathing deeply for about twominutes, (the nostrils having been compressed by the fingersof an assistant,) the muscles of the face and limbs becamerelaxed, and the operation was commenced, and completedwithout occasioning the slightest struggle, or a single move-ment of the features. She uttered, however, one or two

tolerably loud cries, when the operation, which lasted sevenor eight minutes, was about half finished; but as these ex-clamations were unaccompanied by any corresponding actionof the muscles of expression, it is probable that they werenot indicative of actual pain. The mouth-piece was retainedduring the whole time, but she was allowed to breathe occa-sionally through the nose: when it was removed, on thecompletion of the operation, she remained for a short time ina state of profound stupor, the face pale, the eyes open, andthe pupils widely dilated. This state of insensibility graduallypassed off, she rose and stood up, staring vacantly about her,like a person suddenly roused from a deep sleep. The ex-

pression of her countenance, her action, and tone of voice,bore a striking resemblance to the acting of Malibran in thecharacter of Amina, in the scene where she awakes and findsherself in the bed-room of the Count. On questioning her asto her sensations, she declared that she felt no pain, and wasnot aware that anything had been done. The anodyne effectsof the ether appeared in this case to continue many hours, asafter being placed in bed, the patient soon fell asleep, andcontinued dozing during the remainder of the day, making nocomplaint of pain or soreness. She said, on the followingday, that she recollected crying out, for she was dreamingthat she was relating to her mother what Mr. Arnott pro-posed doing, and that she cried out when he insisted onoperating.On February 2nd, Mr. Tuson operated on an elderly female

for strangulated hernia. The ether was tried in this case,but failed, from its being found impossible to adapt the glassmouth-piece to the emaciated cheeks of the patient.On February the 5th, Mr. Arnott removed the breast of a

female, aged fifty, containing a carcinomatous tumour. Shecame to this hospital because she had been informed that itcould be cut out without giving her pain. About four minutesafter the inhalation of the ether, the limbs became relaxed,and the operation was commenced. The excision of thetumour, and of several suspiciously indurated masses im-bedded in the cellular tissue of the axilla, into which theincisions extended, with the ligature of several vessels, occu-pied about nine minutes. During all this time, the limbs andfeatures were perfectly tranquil, but she uttered, during thefirst part of the operation, several subdued groans, but thesesounds, as in the former case, were unaccompanied by anyaction of the external muscles. The wound was covered withsome wet lint, and the mouth-piece, which had been kept infor thirteen minutes, was then removed.The patient continued reclining on the table in the attitude

of a person in tranquil sleep. When spoken to, she answeredslowly, but distinctly, and said, in reply to a question, that shedid not know where she was. "Do you wish to have the

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operation performed ?" " Yes."—" Would you rather have it Idone to-day, or wait till to-morrow?" "To-day:’"It hasbeen done; it is all over." "Has it ! I felt no pain. I’m somuch obliged to you all." Her face during this conversationwas pale and tranquil. She appeared in a kind of dreamycondition of mind, unconscious of what was passing aroundher, except when she was roused by being spoken to. Shewas removed immediately to bed, wrapped up warm, and herface bathed with cold water, and in a short time she recoveredher ordinary manner. No stimulants were given, as it wasthought probable that the vomiting which ensued soon afterthe operation in the case of the old man, reported on a formeroccasion, was attributable to their injudicious administration.The wound was dressed five hours after the operation, thepatient making scarcely any complaint of pain during thisprocess, the anodyne effect appearing to continue in this ain the last case. She passed a very quiet night, and has sincegone on most favourably.On the same day. Mr. Arnott operated for entropium. The

patient was a short, stout, red-faced female, upwards of sixtyyears of age, who had been employed for many years aboutthe hospital as an occasional nurse. The apparatus beingadjusted, she breathed with great gravity and perseverance, inspite of the coughing, for full ten minutes. As her face, atthe end of this period, had assumed a redness of more thanordinary intensity, without any of the usual effects of the etherbeing observed, the mouth-piece was removed, as it was con-sidered unsafe to proceed longer with a person of such plethorichabit and advanced age. The operation was then performedon both eyes, the patient perhaps suffering less than theaverage amount of pain. The failure was certainly not attri-butable to the vapour being imperfectly inhaled. The appa-ratus used in this and all the other operations was one furnishedby Mr. Bell, of Oxford-street, and fitted with the valves con-trived by Mr. Gilbertson. By watching the movements ofthese valves, which are contained in a transparent glass tube,the operator can at once detect any defect in the adjustment ofthe mouth-piece. If this does not fit properly, or becomes dis-placed so as to allow the air to be drawn in at the sides, thevalves do not act.* The non-effect of the ether is probablyto be attributed to the circumstance of this woman havingbeen all her life in the habit of indulging pretty freely in thenurse’s favourite remedy-gin. There was, however, accordingto her own account, some effect produced, as she stated after-wards, that just before the mouth-piece was removed, shebegan to dream-a true nurse’s dream: she "dreamt thatMr. Arnott was talking to a patient in No. 9 bed." It is pro-bable, then, that if the inhalation had been continued, the fulleffects would have been produced, her previous indulgence inspirituous liquors rendering her less susceptible of this newmode of intoxication. No ill effects resulted from the in-halation.

KING’S COLLEGE HOSPITAL.EXCISION OF THE SCAPULA AND ONE HALF OF THE CLAVICLE.

SINCE our last report of operations at this hospital underthe influence of ether, many others have been performedunder similar circumstances. In some instances, the etheri-zation has been complete, while in others the patients havedeclined to persist in inhaling. With several, the vapour, thoughused for a considerable time, has seemingly had no effect,except slight noisy excitement.On Saturday last, (Feb. 6th, 184’7,) one of the most remark-

able operations ever yet tried under the influence of etherwas performed by Mr. Fergusson.W:H-, a discharged soldier, aged thirty-three, had his

arm amputated at the shoulder-joint, about three years ago, forscrofulous inflammation of the articulation. The articularsurface of the scapula being diseased was scooped away. Thepatient regained a fair share of health; but the wound neverentirely healed. The stump gradually enlarged, and indica-tions of extensive disease in the scapula became manifest.Through eight or ten sinuses the probe could be pushedagainst carious bone. The outer end of the clavicle seemedenlarged.

It was thought that any further partial operation on thescapula would not be advisable, and its total removal wasresolved upon.Hooper’s apparatus was first used to administer the ether,

but with no advantage. The patient breathed most indus-triously, but the only effect was slight excitement. Startin’s

* This apparatus is described by Mr. Jacob Bell, in the last number of therharmaceutical Journal, p. 355.

Inhaler was then tried, and the result was most striking. Ina few minutes a quiet slumber was induced, when the surgeonproceeded with the necessary incisions. A wound was madealong the upper surface of the clavicle, sufficient to permitthe division of that bone at its middle with the saw; the skinwas next cut along the surface of the acromion and spine ofthe scapula, to permit the division of the trapezius muscles,these two wounds were then continued in a single line downthe cicatrix of the stump as far as the axilla, near to the lowerangle of the scapula: the skin was now partially raised fromthe back part of the bone, a small flap was raised in front,the pectoralis minor was cut from the coracoid process, thescapula drawn backwards to permit the division of the musclesattached to it behind, and the whole bone, with the outerend of the clavicle attached to it, was speedily severed.The axillary artery was open to the end of the stump, butbleeding from it was arrested by pressure on the subclavian,over the first rib. Five or six vessels beside this one re-quired ligatures, but not more than three or four ounces

of blood was lost. The wound was stitched, cold clothswere applied, and a roller was carried lightly round thechest. The whole proceedings of the surgeon occupiedabout fifteen minutes, and during the most of this timethe patient was unconscious of suffering. As the etherseemed to lose effect, he breathed it again from time to time,and though in some degree aware of what was being done, asevinced by occasional remarks made to those around, and byslight moaning and moving, he seemed to feel nothing in com-parison with the severity of the operation and the magnitudeof the wound. Shortly after, as he regained his senses, he de-clared that he was hardly conscious of anything having beendone, and that he felt altogether very differently than onthe occasion when formerly under the surgeon’s hands.Feb. 10th.—Up to this date, the patient has been going on

favourably; no bad symptom has yet appeared.This operation is of much interest as regards the influence

of ether, and, in a surgical point, of great importance, as it isunderstood to be the first example of the kind that has everoccurred in this country.

CHELTENHAM GENERAL HOSPITAL.

By W. PHILPOT BROOKES, M.D., M.R.C.S.E., Surgeon to theGeneral Hospital and Dispensary.

SINCE reporting my former case, I have successfully, per-formed the following operations under its effect:Ann W , aged sixty-nine, living at No. 1, Burton-street,

had been suffering for the last twelve months with fistula inano, and had been during the whole of that time confined toher bed. She was of a very nervous, debilitated habit, andwould not give her consent to the performance of an operation;but upon hearing of my former painless case, she sent for me,and desired to have the operation performed. On examination,I found the whole verge of the anus in a state of ulceration,accompanied with great pain. The probe discovered a fistu-lous sore, extending full four inches into the rectum, the wallsof it of some thickness. Having put her in train for per-forming the operation, it was done in two days afterwards.The patient was laid on her back with the head elevated, soas to have no difficulty with the ether, the buttocks, raisedknees drawn up and held apart. I then passed up my fingerand inserted the director, when the inhalation of the ethercommenced (with merely a bladder and elastic tube), and shewas in a complete state of unconsciousness in two minutes.The bistoury was then introduced, and the fistula divided inits whole length, without her showing the least symptom ofpain or uneasiness. When it was over, I asked her if she hadquite made up her mind to have it performed. She said, " Yes,please go on with it as quickly as possible." When told it wasover, she uttered great surprise. At this operation the fol-lowing gentlemen were present:-Drs. Wright, Bagnall, Bell,Smith; Messrs. Eves and Orrell.The next case was that of Ruth Mr—, aged twenty-one,

who wished to have the last molar tooth extracted under theetherial influence; she is of a plethoric, full, and excitablehabit. In one minute and a half she was in a state of uncon-ciousness from the ether, and became quite unmanageable,her face flushed, and she required two persons to hold her. Ilanced the gum without any sign of pain, and she recovered hersensibilitv immediately. As she was very anxious to have thetooth extracted, she again inhaled it; and when under its in-fluence, some excitement returned, and on drawing the toothwith the claw, she cried " Oh!" but on coming to herself,stated she had had no pain; and having had out nine teethbefore, she could judge of its effects, and said, " I will never