moderate at first; approach the instrument slowly to the mouth, and if choking or other uneasy sensation or effect occur, remove the inhaler somewhat, and at length bring it where it is designed to be placed."

If the lungs be previously emptied by a full expiration, the sooner is etherization established. Let the breathing now be full and slow, and observe its effects. Ask the person to raise the eyelids, to speak, or to move a limb. Raise a limb, and if it fall suddenly and powerless, the desired effect is produced. Now remove the inhaler at once, and the person may afterwards indicate its application(apply it herself.) I speak of its use in midwifery practice alone, or we may re-apply it as circumstances indicate. It will be found almost without exception that the continuance of the etherization will be effected, with a moderate use of its agency, after it has been once established. This remark is of much practical value in midwifery practice, since many hours will elapse before a labor is terminated from the first inhalation. In some and in a majority, this state is induced easily, and continued with a small amount of ether, while in others there is a strong antagonism in the system to its establishment and preservation.

It is not necessary in midwifery practice to induce so full and perfect a state of etherization, viz.: of unconsciousness and insensibility as is demanded in surgical operations, especially in natural labor. In operative midwifery it would be necessary to produce and maintain a more perfect etherization. The object in simply severe labor, is to moderate or diminish the suffering. There is much of this suffering that the patient readily bears. So true is this in practise, that cases are constantly occurring in which etherization is induced, and the patient determines herself the extent to which it shall be carried by a partial, or perfect inhalation of the anæsthetic. In the intervals of uterine contraction, the instrument is removed by the patient, or by her direction given in some way, and which is at once understood. She knows when the pain is coming on, and demands the inhaler. She graduates the supply, so to speak, to the demand, and in this way is presented to the observation of the practitioner, one of the most important and interesting agencies in operation for relieving suffering, which he ever observes. In this way his office seems to be to see the patient the practioner, while he has but to witness its effects.

Patients of delicate nervous temperament often suffer severely from nervous agitation. Great nervous excitement marks the first stage of labour and sometimes continues through the whole period of parturition in females of such a temperament. A degree of nervous apprehension marks the commencement of each pain-they feel their pains most acutely; lose all control of the will, and express their suffering in the most heart-rending manner. To such conditions of system, chloroform seems to be so admirably adapted as often to act like a charm in dissipating the patient's suffering, and when the system is but partially brought under its influence, to fortify it by soothing the nervous system. It checks those irregular and spasmodic pains which retard the proper expulsive efforts, and by taking off the resistance which the will offers to the contractive efforts and bringing it in harmony with nature in her expulsive efforts, shortens materially the duration of labour. Chloroform unquestionably is the most reliable remedy for taking away the anguish and distress which often proceed to such an extremity of suffering as seems unendurable by the patient, and saves, too, the practitioner and friends from the pain of witnessing those struggles and that agony which often completely unnerves them.

The physiological effects of chloroform, are a loss of consciousness, sensibility and voluntary muscular motion. The vital actions are not ordinarily interfered with; indeed, are in no way affected, unless it be from the mental excitement attendant upon the inhalation, or rather in anticipation of it. The action of the heart is from the same cause, rather increased than otherwise. When fully etherized the pulse is rather fuller and slower than ordinary. Respiration is also at first rather accelerated, as though affected by the mental excitement. Digestion not at all impaired, unless it be that occasionally there has followed its exhibition some sickness of stomach and vomiting. Hence you will find in the directions touching its administration an injunction not to administer it on a full stomach; this precaution being taken, vomiting is seldom observed to follow the inhalation of chloroform. The action of the uterus being involuntary, its contractions are not at all influenced by etherization; and the relaxation of the muscular system secures a diminution of the resistance the perinei muscles offer to the force of the pains, and that very relaxation diminishes the danger of a laceration of the perineum under labour.

This suspension of muscular action, and muscular resistance, saves the patient from the exhaustion attendant upon ordinary labour, and enables her sooner to recover from the effects of labour upon the system; protects her from the shock the nervous system sustains, as well as the soreness so common from the strain of the muscles; and inasmuch as the patient is saved from the exhaustion, so is she from the diseases of the puerperal state dependant upon the exhaustion of nervous power. Hence we are warranted in saying, chloroform not only saves the patient from the pains of labour, but measurably from the perils of child-birth.

The contra indications for the use of chloroform are not now, as formerly, supposed to be made known by any special condition or function of system. It was long and very generally supposed that even functional diseases of the lungs or heart, and particular conditions of the nervous system contra indicated the use of anesthetics; whereas observations have proven that the sufferings of patients with diseases of the lungs have been very much alleviated by their use. In cases of distressing dyspnea and asthma, patients have found relief from chloroform when all other means tried have failed. Some forms of cough have also been very much palliated. In affections of the heart, etherization has been safely used as well as in affections of the brain, or of the head, so called. There are many cases where etherization has been resorted to with its usual good results. And it has not only been used in child-birth where such a condition of things has been found existing, it has even been used as a remedial measure in cases of chronic and paroxysmal headache, and with decidedly happy effects.

In almost all the cases where death has resulted from its injudicious administration or from its injudicious continuance, where symptoms sprang up showing that it was not being borne kindly, there has been nothing, as I can learn, discovered by the post mortem examination, either of structural derangement prior existing, or resulting from its use that would account for the death of the patient; and yet I would caution you against administering it in congestions of the brain or lungs, and in structural discases of the heart. The symptoms that spring up under the inhalation, that may be regarded as untoward, that should teach us not to press its use, are paleness -lividity-observable in the lips, face and fingers, diminished temperature of body, disturbance in the circulation, pulse feeble and rapid, respiration, sighing, slow, deep, occasionally noiseless and still, so as not to be perceived, the patient lying perfectly still, no expression or change to the countenance. These symptoms may manifest themselves suddenly after the first inhalation; if they do so, they will probably resemble syncope, and the remedy should be discontinued. In the report of the fatal case in the Albany Hospital, one of the last fatal cases reported, it is said the patient fainted; the inhalation was discontinued for a few minutes and then was again resorted to, the patient fainted a second time and did not recover from it. If these symptoms come on later in the period of inhalation, it would suggest itself to your minds as being the result of the exclusion of the atmospheric air. The indications in both cases, are to cease the inhalation, give the patient a free admission of air possibly by a fan, if one be at hand, or opening a window, seeing in either case that the heat of the body is not too rapidly abstracted.

The objections of Prof. Meigs to chloroform in parturition, as embodied in a letter to Dr. Channing, of Boston, I have carefully considered, and if I rightly understand them, are altogether of a physiological nature, demanding for their support the succession of its action on the several parts of the brain, from the hemispheres to the medulla oblongata, while it is obvious no such law of succession can be ascertained. There is no known effect of anæsthetic agents upon the brain; either upon the hemispheres, or medulla oblongata, so uniformly following their administration, as to demonstrate to us their law of action. This is clearly proven from the great variety of results observed in the system on post mortem examinations. The heart and lungs have been found in opposite conditions; with one the heart has been found congested, with another empty. And equally various are the conditions in which the blood itself is found, in cases where death has followed immediately after etherization, proving most conclusively that no such law of succession is known. In the present state of physiological science, especially that part of it relating to the nervous system, the law of succession of the action of anæsthetic agents cannot be learned. And yet so fully has that gentleman yielded himself to the guidance of prejudice to frame an objection, based upon such a foundation, and in the enjoyment of which he seeks to justify himself as to give utterance to the following sentiment:-"If the voice of Prof. Simpson, of Edinburgh," he says, to

whom he was writing, "should reach me from across the Atlantic, with the triumphant reply that in one hundred thousand cases chloroform had been administered without accident, I would not be moved from my position." Now, gentlemen, with such a determined opposition to the introduction of any new agent in the treatment of disease, how are we to advance one step farther in the discovery of truth? And what, too, will become of the authority of statistics? which medical writers examine with so much interest, and on which they are wont to rely with such unshaken confidence, a science which in matters of fact has been of the greatest practical benefit. Submit yourselves to such teaching-admit the fact, that statistical testimony, however cumulative, must not weigh with you when conflicting with supposed physiological action, and you may cease to record your facts-for midnight darkness again encircles us. To such objectors it matters not whether ten-a thousand-ten thousand-or a million of cases, duly authenticated, have been successfully and happily treated under etherization. Now, gentlemen, you perceive this is a priori reasoning in its inception and carrying out.

It completely disregards any and every array of facts that the experience of the profession may present for our consideration. Just the mode of reasoning that was opposed to the facts, that the founder of our system, and his coadjutors, presented for the consideration of the profession, with the hope they would unite with us in demonstrating, the universal applicability of the great law of cure to every variety of suffering, and every form of disease. A mode of arguing that sets at defiance the accumulating facts that make the foundation of every inductive science. Those influenced by such reasoning never ask, what has homœopathy done in assuaging suffering or curing disease? Nor will they ask, what has etherization done in child-birth to the mother or for the mother and to the child? is it salutary or deadly in its influence? Their question, the rather, is, what should it do upon certain physiological principles? assuming always the correctness of their position from the confused grouping of physiological facts, on points upon which the mists that encircle that science have not yet been fully dissipated.

I would rather, gentlemen, you would carry with you, in your examinations of this subject, the principles that have guided you all along in the study of homeopathy. Examine the subject with the torch of a Baconian philosopher. Learn what you can from