Aether

 Ethyl Oxide or Ethylic Ether (sometimes called Sulphuric Ether), с4H10O. Preparation for use, Inhalation of vapor, dilute with alcohol.

 Emotional. The effects may be described in the same terms as apply to the effects of alcoholic liquids, and exhilaration and excitement of the mind, which gradually passes into a state of narcotism, with stupefaction. Violently excited. He became furiously excited and it required several persons to control him; he was forced upon a bed, but on being awakened he again became very much excited; indeed, so much so that cold water was dashed over him. She became much excited and talked strangely; afterwards was seized with delirium and carried home in that state; she remained so, except at short intervals, for three days; friends afraid to leave her. Every indication of great cerebral excitement. There was altogether so much excitement that his attendant was alarmed. вecame delirious about an hour after she got home; this lasted all night. In attempting to walk upstairs in the evening of the third day, she stopped suddenly, screamed so as to alarm the family, and complained of faintness and the pain in her head; some aberration of mind was now manifest, and in the course of the night she became delirious, screaming and evincing alarm at imaginary dangers; more comfortable next morning under remedies prescribed, but during all the day she gave decided proofs of mental incoherence, which continued to increase; when any subject was introduced, she spoke rationally upon it for a moment, and then referred to some other, frequently to the experiment with Ether; her nights became sleepless, and were spent in screaming and loud talking upon all subjects, until she sank rapidly into a comatose condition. She conversed incoherently at intervals, introducing strange topics, and had sometimes been observed to laugh immoderately without any assignable cause, for several days before I saw her; when I visited her, she was capable to conversing upon any subject, introduced in so rational a manner that the hallucination might have been overlooked by an uninterested observer; I noticed, however, that she conversed with clearness only so long as the subject was kept before her mind with some care. He pretty soon fell into a state of intoxication, during which he talked extravagant nonsense, danced about the room, laughed, and appeared to be very much pleased; but his condition was far removed from narcosis in its ordinary sense. The sensations induced are almost universally described as pleasurable, and much resemble those resulting in the early stages of alcoholic intoxication. вy some, pleasant dreams, indescribable but delightful sensations, rapid flights through the air, gorgeous visions, and unearthly music. Most agreeable and even most sensual dreams; women sometimes pass into a state of ecstasy; some see God and angels; others fancy themselves again with the companions of their childhood. He immediately lost consciousness, and had a host of lively illusions, principally consisting, it seems of theologico-mystical conceptions, in which, however, as is the case in opium and hashish smoking, there was a complete disregard of matter, time, and space; he believed he had travelled through whole world and had lived for an infinity of time, and yet, when he awoke, his candle showed that he could scarcely have been narcotized a quarter of an hour; the Ether bottle was empty, although he did not remember taking it more than once in his hand. When he repeated the experiment, the dream-world into which he lulled himself was not so splendid, not so rich in colors and images, as that of the first narcosis; and however often he endeavored to conjure it back, by larger and larger doses, it would not reappear. The character of his hallucinations was, from the first, and has always remained, exclusively mystic, free from any erotic or other admixture, and has thus remained dependent on his prevailing disposition. The little child dreams of his playthings; the sportsman is following the hounds or catching imaginary salmon; the gamekeeper we have known to dream of a conflict with poachers; the laborer that he is getting drunk in a pot house of which he is an habitue; in females, especially of a warm temperament, emotions have been manifested which are ill adapted for general inspection; in some it was evident by their movements that they were under the influence of the highly developed sensations of the venereal organs. A Provencal talked about his native country. A horse- jockey dreamed that some one was trying to steal his horse. A woman in labor fancied herself in the conjugal abode, and called to her side a student, whom she took for her husband.
 Frightful dreams; a man fancied he heard the ringing of his own funeral knell. She said: I felt, when the tooth was coming out, as if I was having a horrid dream. She gave a scream during the operation. She had a dream, and thought she was at the bar of judgment pleading for mercy, and that God Almighty was punishing her for her sins. As with other narcotics, so even more with Ether, the disposition to hallucinative action appears to present individual differences; and a susceptibility of this kind, such as our patient has possessed, in a more or less distinct form, from the first day till now, may well be attributed in part to an alienated direction of his disposition or development-to a slight psychosis; this he has himself acknowledged. Loquacity. He muttered like a man intoxicated. Greater inclination towards silence than formerly. When the numbness seizes the subject, a great tendency to gayety is generally shown; there is spasmodic, jerking laughter, which is followed by copious tears. The greatest variety of the effects upon self-consciousness, and of the degree in which the recognition of surrounding objects is retained, are reported; with many, the hilarity induced quite equals that produced on the inspiration of Nitrous Oxide. Anxiety. Very low-spirited, and fearful of some disease; and was still nervous and desponding after two months. Fright and delirium. Intellectual. The intellect is both tranquillized and fortified. Judgment was retained unimpaired to such a degree that he lost none of the sensations he wished to analyze; moreover, when the anaesthesia was most complete, so that he could prick himself without feeling it, he willed to walk, and did not. The intellect is often disordered, but the subject does not always lose self-consciousness. In one case, the experimenter retained full possession of his faculties; while giving way to convulsive laughter, he himself compared it to the barking of a dog, and was quite aware that he was acting foolishly. For some time, much confused. Answered questions with a weak voice, though remembering nothing which had passed. Semi-consciousness; the patient raised himself to a sitting posture and looked about him with a vacant stare, the conjunctiva being very red and suffused. Although he seemed to be aware that people were talking to him, he had no consciousness of what was really passing around him. She lost consciousness in three or four minutes after inhaling; felt no pain. She became stupid, with a weak pulse and heavy stertorous breathing; her strength failed more and more, and she died fifteen hours after the operation. A state of almost profound stupor. In many, as total a temporary suspension of all the mental faculties and cerebral functions as in the most profound sleep, nothing being remembered, after the few first inhalations, until the period of returning consciousness. At the first trial, after breathing fifteen or twenty minutes, she became comatose for two hours; at the second trial, she became comatose in four minutes, recovering rapidly.

 Confusion. In a great majority of cases, the only effects afterwards are, slight muzziness of the head, sometimes amounting to headache, odor and taste of Ether in the mouth and nasal passages. Vertigo. Vertigo and conscious loss of muscular power preceding insensibility. Dizziness. Dizziness, just enough to amount to slight vertigo when the standing posture has been attempted. Giddiness and debility made it difficult for her to walk (after three days). Slight degree of giddiness at times during the day. General Head. Head drops on one side, Head was thrown back, as if to relieve slight stiffness of the muscles of the neck. Determination of blood to the brain and eyes. Symptoms of meningitis, etc., persisted in spite of all treatment, and he died (fifth morning). Heat hot. Pain about the head. She complained of some pain in the head. The inhalation was attended with very painful sensations in the head and partial blindness, which lasted three days. She complained of great pain in her head, which was relieved by free cupping. Intense pain in the head. Aching of head and dizziness for a few minutes, when senses returned. Headache more or less considerable for some hours, and even for a day or two. Headache, more or less violent. Forehead. Great pain in the forehead (second day). Temples. Temporal arteries enlarged. Action of the temporal artery very strong.
 Eye.
 Eyes full and some what suffused. Eyes injected (blood-shot). Lids. Eyes half open and turned upwards (after third day). Eyelids closed. Eyes sometimes open, sometimes shut (during operations). Eyelids begin to tremble in a manner very characteristic. сonjunctiva. Vessels of the conjunctiva injected. Slight injection of the conjunctivae. сonjunctivae much injected. сonjunctiva of eye was sensible. вall. Rolling of the eyeballs during the spasms. She complained of difficulty in turning her eyes downward, but rolled them about in an unnatural manner (after third day). Pupil. Pupils dilated. Pupils dilated and fixed, the eyes turned upwards (after ten minutes). Pupils dilated, fixed, and did not act during the whole time. The pupils became widely dilated, this state being apparently not preceded by contraction (in seven minutes, when 150 cubic centimeters (about four ounces) of Ether had been used). Pupil oscillates, with a tendency to turn upwards and inwards. сontracted pupil. The iris seems to be generally expanded, sometimes contracted. Vision. Impaired vision (after third day). Dimness of sight. She complained of obscure vision, describing it as a mist or thin cloud before her eyes.
 Ear.
 Hearing was obtuse. Sounds are indistinct and seem far off, yet them resound violently in the ears. Deafness.
 Face.
 Countenance was wild and a little vacant at intervals, sometimes indicating slight surprise. At first, an expression of extraordinary pleasure on his face, and he inhaled the Ether- vapor with real eagerness; he afterwards assured us that he had had a pleasant narcosis. Face flushed. The expression is sometimes calm, but generally the face is flushed and animated. Face injected. The countenance is livid. Face pallid. The face often becomes either pale or morbidly flushed. Distortion of the features. сheeks. сheeks flushed; after half an hour they resembled two pieces of scarlet velvet. Lips. The lips often swell and become blue. Lips slightly congested. Lip and tongue are blue. His lips became purple.

 Mouth often opened. Mouth was slightly dry, and she was observed to drink oftener than usual. Some heat in the mouth. Saliva. Profuse salivation (after a few days). Slight frothing at the mouth. Taste. вad taste in mouth. Disagreeable taste of Ether in her mouth in the evening. Speech. Evident difficulty in using the organs of speech; the pronunciation was indistinct, and performed with some apparent effort; afterwards speechless.
 Throat.
 Pricking in the throat.

 Appetite. Loss of appetite. The appetite for solids is visibly diminished when any considerable amount has been inhaled shortly before a meal. Loathing of ether. Hiccough. Violent hiccough set in after twenty-five minutes, but ceased, as did also the dilatation of pupils, as soon as the inhalation was discontinued. Nausea and Vomiting. Nausea. Nausea and sickness. Nausea and vomiting in the evening. Sickness. She complained of sickness and distress of the stomach. Vomiting. Vomiting, soon after return of consciousness, although no food had been allowed for seven hours; stimulants were immediately rejected by the stomach.

 Slight bronchial irritation. Inhalation is accompanied by a sensation of stinging or heat in the bronchia, which excites coughing. сough. Violent coughing. Violent cough and spitting. Spitting of blood. She raised blood from her lungs, it was supposed about a pint; bleeding soon ceased (second morning). вreathing rapid for a short time, when effect first produced, and then became natural. Respiration is quickened, and the face becomes red; then the inspirations slacken, but are extremely deep; finally, they becomes imperceptible; the face then regains its quiet expression and natural color. Respiration was hurried (after five minutes); deep and slow, but free from stertor (after ten minutes). Full and frequent respirations. The respirations were deep, and increased from eighteen to twenty- five in a minute. Respirations short; the expirations prolonged and forcible. Respiration becomes slow and labored. Sonorous breathing. Stertorous breathing. Sighing, groaning. Each expiration was accompanied by a loud hah. The air expired by the patient, at the end of eight days after the last experiment, still had a strong smell of Ether. Laborious breathing. вreathing laborious two or three times. The respiration, bearing a due relation to the frequency of the pulse, becomes labored and stertorous. Difficulty of breathing. Difficulty of breathing for several days (after two days). вreathing became very difficult, so exceedingly labored, that it would have been almost impossible to perform any operation. Dyspnoea.
 Chest.
 Pulmonary and cerebral congestion. With some difficulty I led him to the outer door, when he exclaimed, Cover my chest; cold, . Tightness across the chest. Irritation and pain in the chest (after twenty-five inhalations in two days).

 Precordium. Heart and lungs greatly oppressed. Heart’s Action. Excitement and invigoration of the action of the heart, which seems to continue throughout. Protracted failure of the heart’s action. Pulse. Rapid pulse. The pulse is at first accelerated, and afterward falls, but rarely to the natural standard; respiration seems to follow the same rule. The circulation at first became rapid, then slow and feeble. First effect upon the circulation is to accelerate it; the pulse subsequently falls, and in the third period loses power as well as frequency. Small, frequent pulse. Pulse full, hard, and bounding. The pulse, hitherto weak and low, became full and strong, and remained so as long as the narcosis continued, increasing in frequency at the same time from 72 to 80. Pulse commenced sinking rapidly. Pulse very feeble and weak in the evening. When felt, the pulse was found to be soft, full, and very slow; it suddenly ceased to heat, and the patient was dead. The pulse, as we ascertained by the sphygmograph, was not once changed, nor was there any alteration in the urine. Pulse rose to 150 while inhaling.
 Pulse 100, with much throbbing of the carotids (third day); 140 (tenth day). Pulse natural in the morning, 76; rose to 84 previous to inhalation (probably from the appearance of the surgeons and expectation of operation); during inhalation, rapidly increased to 140, but before inhalation ceased, it became small and feeble. вeing much excited, her pulse rose to 130 (before inhalation); 70 (after inhalation). Pulse 120. Pulse 98, small and tense. Pulse 90 (before the operation); 75 (in the ethereal state). Pulse 84 (before the operation); varied from 60 to 70 (during the ethereal process).

 Frequent trembling of the limbs. сonvulsive movements of the limbs. Spasmodic rigidity of the limbs.
 Superior Extremities.
 His arms were stretched; his fingers extended. Arms fall relaxed.
 Inferior Extremities.
 A slight imperfection in her gait terminated in paralysis of the lower extremities, after some time, and she became helpless. Severe cramps in the legs.

 His whole aspect was so indicative of misery, that he would have been put down as one of the wretchedly poor, were it not for the unusual contrast between his aspect and his distinctly formed speech, and for the fact that (as was at first thought) there was remarkably strong smell of alcohol in his breath; the patient, however, explained that he did not smell of alcohol but of ether, and the peculiar sweetness and mildness of Ether vapor was then easily recognized, notwithstanding its strength. His appearance altogether was so distressing, as to excite great alarm in the minds of the bystanders. General appearance like one going into a state of epilepsy. To appearance, the energies of mind and body were nearly extinct. The individual, to the common eye, seems to be sinking into the sleep of death. Perfect quiet. Agitation of the system. An affection of the nervous system approaching apoplexy. Hysterical excitement in women for some hours, and even for a day or two. In the evening (after several hours) he complained of some difficulty about his chest, when, all at once, he fell from his chair, exhibited great restlessness, tossing about of the arms and legs, with great difficulty of breathing, but no loss of consciousness, declaring all the time he could not get his breath for the Ether, and that he should die; his hands and feet were said to be cold; various restoratives were applied in vain; it was evident that it was a case of violent hysterics, unusually well marked in a male; he would laugh and joke, then express fears of impending suffocation, with jactitation, declaring that as vapor of Ether was heavier than air, he ought to be held up and allow it to run out of his lungs; several doses of Morphine had no effect; it was only after several hours that he could be quieted; he had never previously exhibited any tendency to hysteria. She was in a state of unconsciousness, and became quite unmanageable; she required two persons to hold her; I lanced her gum, without any sign of pain, and she recovered her sensibility immediately; she again inhaled, and, when under the influence of the Ether, some excitement returned, and on drawing the tooth with the claw, she cried Oh! but, on coming to herself, stated she had had no pain. He appeared to have much suffering, throwing his body almost out of the chair. Muscular tremors. Trembling of the whole frame when consciousness returned. Subsultus till twelve hours before death (after three days). General shocks, involving all the muscles of the trunk. Violent nervous attack. сonvulsions. сonvulsions supervened, attended with slight stertorous breathing, and other symptoms of an alarming character; he gradually recovered, but suffered from the effects for some time afterwards. Limbs and trunk were strongly convulsed for five minutes; limbs relaxed (after ten minutes). Incipient convulsions. After the operation, she bent her body backwards and sank out of the chair; she began to cry, and consciousness returned, but in a short time she again lapsed into a state of unconsciousness, with convulsive movements of the muscles; she again got better and attempted to walk, but could not; the convulsions returned; there were convulsive movements of the muscles of the left side of the face; the angle of the mouth was drawn upward; after half an hour the convulsions became stronger, spasmodic twitchings of the muscles of the face more frequent and more violent. Slight spasm (tenth day). Opisthotonos. He was perfectly cataleptic; after applications of cold, and administering brandy and water, these cataleptic symptoms were succeeded by severe hysteria, with about the same degree of consciousness as is usual in that disease. Muscles universally relaxed. General muscular relaxation, affecting the limbs, also the eye, the ball moving about the evading the needle or the cataract knife; also the muscles of the perinaeum during labor. The voluntary muscles become relaxed; the jaw falls down; the arms hang down; the eyes roll upward under the upper lid. The muscles lose their power of retraction (during amputation); they are also pale and discolored. Temporary depression of the vital powers. Weakness. Weakness, and disposition to faint on the slightest attempt to walk, lasting several days (after two days). General prostration. Felt nothing for several minutes, but on a sudden appeared to lose all muscular power. He attempted to rise, but tottered like a drunken man, and suffered a degree of exhaustion and giddiness which lasted until he was taken to bed. Objective. Staggered about the room (soon). Disposition to faint and fall down. They exhibit all the marks of intoxication; they fall, without the power of raising themselves, become insensible to all operations performed on them, and either recover soon when the experiment ceases, or sink if it be prolonged. Syncope. The state of the brain during this period was peculiarly distressing; there were alternate manifestations of excitement and depression of the sensorial powers, at boy died. M. Jobert and others have attempted to indicate three stages in its effects: first, that of incoherence, agitation of delirium, as the case may be; second, acceleration of the pulse, with loss of sensibility and loss of voluntary power; third, exhaustion and coldness of the surface. The average duration of the state of sleep or insensibility may be stated to be about the same as the period required to induce it, or a little less, say from two to four minutes; the period, however, occasionally exceeds this, extending sometimes to half an hour or even an hour; the awakening is sudden and complete. Several persons who were to be operated on next day, were subjected to preparatory inhalations, by which they were completely narcotized; sensation, voluntary motion, and consciousness were abolished, yet, when repeated at the operating time, the experiment was a failure. Great uneasiness. Remarkable restlessness, in the period of reaction, ceasing in twenty-four or forty-eight hours. Evident restlessness, mostly of the head and upper extremities. So much restlessness, that it was impossible to perform the indented operation. Subjective. In some refractory subjects, sensibility was heightened instead of being depressed. The next day she inhaled it ten minutes prior to the operation, which lasted half an hour, and during which she manifested great pain, declaring afterwards that she felt every cut made; she was conscious from this time until her decease forty hours afterwards, but spoke in a low, faint voice. Perception of external objects fails. Skin was not sensible on being sharply pinched. сomplete and instantaneous abolition of tactile sensibility; this effect is not constant, but is pretty general; it is accompanied by a diminution of voluntary contractility; it affects the most deeply seated parts of the nervous system. The functions of the brain and nervous system are suspended, sensation is annihilated, and the patient, to all intents and purposes, for the time being, is a senseless corpse. Loss of sensibility; but drunkenness, attended by vomiting and other symptoms not consequent on inhalation, supervened in both cases. The instant the knife touched her, she cried out, put her hands down to the part, and betrayed other marks of uneasiness; after half a minute to a minute, the operation was proceeded with, and signs of apparent suffering were not to be mistaken, so much so, that it induced some gentlemen present to imagine that the operation was felt, and the patient was aware of it; after the operation was completed, and on awakening to a state of consciousness, and being asked if she suffered any pain, she expressed no knowledge of any. One person becomes as impassible as the subject on the dissecting-room table; another talks incoherently or mirthfully, replies to questions or obeys instructions; others utter exclamations of pain, which they afterwards retain no retain no reminiscence of having felt; and others, again, declare they have suffered pain, but felt themselves powerless for its expression; finally, in not a few, ungovernable, violent convulsive actions, quite adverse to the performance of any delicate operation, take place; with some, an utter oblivion is induced; while others, whilst undergoing all the apparent tortures of a prolonged dissection, are revelling in the realms of memory and the fields of imagination. Ill, and much dejected (third evening). General malaise. After repeated experiments, a general malaise replaces the agreeable feeling experienced at first. His sensations were so dreadful, that he would rather undergo any amount of pain than submit to the same again, which he could compare only to a state of utter helplessness and impending dissolution. He felt irresistibly disposed to lie down and get his head upon the ground. He seemed to take leave of the external world, but experienced a dreadful sensation of universal tremor, and yet a perfect fixedness of the limbs. Sensation of numbness, beginning at the toes, and affecting, in succession, the legs, arms, loins, and genitals; it extends to the head, and is then accompanied with a sense of heat, as from intoxication. вy a few, a sense of great oppression, resembling nightmare. The distressing symptoms continued for more than an hour.

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