ETHER.

Ethyl Oxide or Ethylic Ether (sometimes called Sulphuric Ether), C4H10

O

Preparation for use , Inhalation of vapor, dilute with alcohol.

Authorities.

1 , L. Simon, Jr. pathogenetic effects from pure experiment or observed in patients previous to surgical operations, Journ. de la Méd. Hom., 3, 31; 2 , E. V. Atlee, effects on a servant-girl, Boston Med. Intelligencer, April 6th, 1824; 3 , effects, Brit. and For. Med.-Chir. Review, April, 1847; 4 , Buchanan, effects, Med. Gazette, April 23d, 1847; 5 , general effects, Brit. and For. Med.-Chir. Review, April, 1847; 6 , effects, ibid.; 7 , Smith, effects, Lancet, May 27th, 1847; 8 , Third, effects on a gentleman when taken for extraction of tooth, Med. Gazette, Feb. 26th, 1847; 9 , Waller, effects on a man, ibid.; 10 , Richardson, a girl, aged 18 years, took it for extraction of tooth, Med. Gazette, April 2d, 1847; 11 , R. Spencer Wells, general effects, London Med. Gazette, 1847, pt. 2, p. 547; 12 , Copeman, effects on a medical gentleman who wished to have a tooth extracted, Amer. Journ. of Med. Sciences, Oct., 1847, from Provincial Med. and Surg. Journ.; 13 , Amussat, general effects, Amer. Journ. of Med. Sci., July, 1847 (from Comptes Rendus); 14 , James H. Pickford, general effects, Edinb. Med. and Surg. Journ., July, 1847; 15 , James Crawford, effects, London Med. Gazette, 1847, pt. 1, 1050 (from an East Indian paper); 16 , Braithwaite, general effects, Retrospect, Jan. to June, 1847; 17 , Flagg, Tucker, et al., general effects, Committee's Report in London Med. Gazette, 1847, pt. 1, p. 172; 18 , effects on a young lady, ibid.; 19 , effects on a young man, ibid.; 20 , Miss A. D. took it for extraction of tooth, ibid.; 21 , Miss J. R. took if for the same purpose, ibid.; 22 , Alex. Fairbrother; a girl, aged 15 years, took it for amputation of thigh, London Med. Gazette, 1847, pt. 1, p. 364; 23 , W. Philpot Brookes; a woman aged 21 years, took it for extraction of tooth, ibid.; 24 , effets on John Combes when taken for amputation of thigh, ibid.; 25 , effects on William Guy when taken for surgical operation, ibid.; 26 , Symptoms in the case of Mrs. Parkinson, London Med. Gazette, 1847, pt. 1, p. 610 (from London Times); 27 , Somerset Tibbs; E. J. took it for extraction of teeth, ibid.; 28 , J. Willot Eastment, effects on a boy, aged 11 years, who took it for amputation of thigh after an accident, and died in three hours, ibid., p. 631; 29 , effects on a man with a cancerous tumor, London Med. Gazette, 1848, pt. 1, p. 432 (from Gazette Médicale); 30 , J. Miller, E. A., aged 15 years, took it repeatedly, and died in twelve days, ibid. (from Phila. Med. Examiner); 31 , effects on a girl, aged 11 years, ibid.; 32 , Paul F. Eve, effects of 1 oz., Amer. Journ. of Med. Sci., July, 1849 (from Southern Med. and Surg. Journal); 33 , Ranking, effects, Abstract, 5, 380; 34 , F. D. Lente, effects on a boy, aged 8 years, when taken for an operation, N. Y. Journ. of Med., Nov., 1856; 35 , effects on a man, aged 25 years, when taken for extraction of teeth, ibid.; 36 , effects on a man, aged 30 years, when taken for the same purpose, Ranking's Abstract, 25, 148; 37 , Robbs, effects on a woman, aged 21 years, when taken several times before an operation for malignant tumor on thigh, Amer. Med. Times, Nov. 9th, 1861; 38 , Mendoza, effects on a woman, aged 60 years, when taken for amputation of leg, ibid.; 39 , Sir James Alderson, effects on Sir Frederick Pollock, aged 86 years, of its habitual use, New York Med. Journ., Feb., 1870 (from Practitioner); 40 , Hutton, effects on a young man when taken for removing a splinter of iron, Amer. Observer, 10, 309 (from Phila. Med. Reporter); 41 , C. A. Ewald, effects on a man, aged 32 years, of its habitual use, London Med. Record, April 7th, 1875 (from Med. Clinic of Med. Counsellor Frerichs).

MIND

• Emotional.
• The effects may be described in the same terms as apply to the effects of alcoholic liquids, an exhilaration and excitement of the mind, which gradually passes into a state of narcotism, with stupefaction, 4.
• Violently excited, 29.
• 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, 32.
• 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, 21.
• Every indication of great cerebral excitement, 19.
• There was altogether so much excitement that his attendant was alarmed, 8.
• Became delirious about an hour after she got home; this lasted all night, 20.
• 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, 30.
• 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 of 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, 31. [10.]
• 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, 41.
• The sensations induced are almost universally described as pleasurable, and much resemble those resulting in the early stages of alcoholic intoxication, .

HEAD

• 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 passage, 3.
• Vertigo.
• Vertigo and conscious loss of muscular power preceding insensibility, 11.
• Dizziness, 35.
• Dizziness, just enough to amount to slight vertigo when the standing posture has been attempted, 39.
• Giddiness and debility made it difficult for her to walk (after three days), 30.
• Slight degree of giddiness at times during the day, 27.
• General Head. [50.]
• Head drops on one side, 33.
• Head was thrown back, as if to relieve slight stiffness of the muscles of the neck, 31.
• Determination of blood to the brain and eyes, 17.
• Symptoms of meningitis, etc., persisted in spite of all treatment, and he died (fifth morning), 32.
• Head hot, 10, 12.
• Pain about the head, 35.
• She complained of some pain in the head, 31.
• The inhalation was attended with very painful sensations in the head and partial blindness, which lasted three days, 30.
• She complained of great pain in her head, which was relieved by free cupping, 2.
• Intense pain in the head, 10. [60.]
• Aching of head and dizziness for a few minutes, when senses returned, 20.
• Headache more or less considerable for some hours, and even for a day or two, 3.
• Headache, more or less violent, 1.
• Forehead.
• Great pain in the forehead (second day), 32.
• Temples.
• Temporal arteries enlarged, 8.
• Action of the temporal artery very strong, .

EYE

• Eyes full and somewhat suffused, 31.
• Eyes injected (bloodshot), 18, 19.
• Lids.
• Eyes half open and turned upwards (after third day), 30.
• Eyelids closed, 12. [70.]
• Eyes sometimes open, sometimes shut (during operations), 1.
• Eyelids begin to tremble in a manner very characteristic, 33.
• Conjunctiva.
• Vessels of the conjunctiva injected, 10.
• Slight injection of the conjunctivæ, 41.
• Conjunctivæ much injected, 12.
• Conjunctiva of eye was sensible, 26.
• Ball.
• Rolling of the eyeballs during the spasms, 1.
• She complained of difficulty in turning her eyes downward, but rolled them about in an unnatural manner (after third day), 15.
• Pupil.
• Pupils dilated, 10, 14.
• Pupils dilated and fixed, the eyes turned upwards (after ten minutes), 29. [80.]
• Pupils dilated, fixed, and did not act during the whole time, 22.
• The pupils became widely dilated, this state being apparently not preceded by contraction (in seven minutes, when 150 cubic centimetres (about four ounces) of Ether had been used), 41.
• Pupil oscillates, with a tendency to turn upward and inwards, 33.
• Contracted pupil, 9.
• The iris seems to be generally expanded, sometimes contracted, 3.
• Vision.
• Impaired vision (after third day), 30.
• Dimness of sight, 1.
• She complained of obscure vision, describing it as a mist or thin cloud before her eyes, 31.

EAR

• Hearing was obtuse, 31.
• Sounds are indistinct and seem far off, yet they resound violently in the ears, 1. [90.]
• Deafness, 1.

FACE

• Countenance was wild and a little vacant at intervals, sometimes indicating slight surprise, 31.
• 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, 41.
• Face flushed, 8, 23.
• The expression is sometimes calm, but generally the face is flushed and animated, 1.
• Face injected, 29.
• The countenance is livid, 14.
• Face pallid, 26.
• The face often becomes either pale or morbidly flushed, 3.
• Distortion of the features, 17.
• Cheeks. [100.]
• Cheeks flushed; after half an hour they resembled two pieces of scarlet velvet, 10.
• Lips.
• The lips often swell and become blue, 1.
• Lips slightly congested, 26.
• Lip and tongue are blue, 14.
• His lips became purple, 8.

MOUTH

• Mouth often opened, 31.
• Mouth was slightly dry, and she was observed to drink oftener than usual, 31.
• Some heat in the mouth, 11.
• Saliva.
• Profuse salivation (after a few days), 40.
• Slight frothing at the mouth, 18.
• Taste. [110.]
• Bad taste in mouth, 1.
• Disagreeable taste of Ether in her mouth in the evening, 22.
• Speech.
• Evident difficulty in using the organs of speech; the pronunciation was indistinct, and performed with some apparent effort; afterwards speechless, 31.

THROAT

• Pricking in the throat, 1.

STOMACH

• Appetite.
• Loss of appetite, 41.
• The appetite for solids is visibly diminished when any considerable amount has been inhaled shortly before a meal, 39.
• Loathing of ether, 1.
• Hiccough.
• Violent hiccough set in after twenty-five minutes, but ceased, as did also the dilatation of pupils, as soon as the inhalations was discontinued, 41.
• Nausea and Vomiting.
• Nausea, 7.
• Nausea and sickness, 3. [120.]
• Nausea and vomiting in the evening, 22.
• Sickness, 7.
• She complained of sickness and distress of the stomach, 21.
• Vomiting, 1.
• Vomiting soon after return of consciousness, although no food had been allowed for seven hours; stimulants were immediately rejected by the stomach, 34.

RESPIRATORY APPARATUS

• Slight bronchial irritation, 3.
• Inhalation is accompanied by a sensation of stinging or heat in the bronchia, which excites coughing, 33.
• Cough, 1, 38.
• Violent coughing, 17.
• Violent cough and spitting, 9. [130.]
• Spitting of blood, 18.
• She raised blood from her lungs, it was supposed about a pint; bleeding soon ceased (second morning), 20.
• Breathing rapid for a short time, when effect first produced, and then became natural, 26.
• Respiration is quickened, and the face becomes red; then the inspirations slacken, but are extremely deep; finally, they become imperceptible; the face then regains its quiet expression and natural color, 1.
• Respiration was hurried (after five minutes); deep and slow, but free from stertor (after ten minutes), 29.
• Full and frequent respirations, 31.
• The respirations were deep, and increased from eighteen to twenty-five in a minute, 41.
• Respirations short; the expirations prolonged and forcible, 33.
• Respiration becomes slow and labored, 3.
• Sonorous breathing, 32. [140.]
• Stertorous breathing, 7, 18.
• Sighing, groaning, 17.
• Each expiration was accompanied by a loud hah! 12.
• The air expired by the patient, at the end of eight days after the last experiment, still had a strong smell of Ether, 41.
• Laborious breathing, 17, 19.
• Breathing laborious two or three times, 22.
• The respiration, bearing a due relation to the frequency of the pulse, becomes labored and stertorous, 14.
• Difficulty of breathing, 11.
• Difficulty of breathing for several days (after two days), 36.
• Breathing became very difficult, so exceedingly labored, that it would have been almost impossible to perform any operation, 12. [150.]
• Dyspnœa, .

CHEST

• Pulmonary and cerebral congestion, 7.
• With some difficulty I led him to the outer door, when he exclaimed, "Cover my chest; cold, cold, cold," 12.
• Tightness across the chest, 12.
• Irritation and pain in the chest (after twenty-five inhalations in two days), 1.

HEART AND PULSE

• Præcordium.
• Heart and lungs greatly oppressed, 2.
• Heart's Action.
• Excitement and invigoration of the action of the heart, which seems to continue throughout, 4.
• Protracted failure of the heart's action, 7.
• Pulse.
• Rapid pulse, 9.
• The pulse is at first, accelerated, and afterward falls, but rarely to the natural standard; respiration seems to follow the same rule, 3. [160.]
• The circulation at first became rapid, then slow and feeble, 14.
• First effect upon the circulation is to accelerate it; the pulse subsequently falls, and in the third period loses power as well as frequency, 33.
• Small, frequent pulse, 41.
• Pulse full, hard, and bounding, 10.
• 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, 41.
• Pulse commenced sinking rapidly, 34.
• Pulse very feeble and weak in the evening, 22.
• When felt, the pulse was found to be soft, full, and very slow; it suddenly ceased to beat, and the patient was dead, 29.
• The pulse, as we ascertained by the sphygmograph, was not once changed, nor was there any alteration in the urine, 41.
• Pulse rose to 150 while inhaling, 19. [170.]
• Pulse 100, with much throbbing of the carotids (third day); 140 (tenth day), 30.
• 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, 26.
• Being much excited, her pulse rose to 130 (before inhalation); 70 (after inhalation), 18.
• Pulse 120, 12.
• Pulse 98, small and tense, 31.
• Pulse 90 (before the operation); 75 (in the ethereal state), 25.

EXTREMITIES IN GENERAL

• Frequent trembling of the limbs, 41.
• Convulsive movements of the limbs, 10.
• Spasmodic rigidity of the limbs, 1.

SUPERIOR EXTREMITIES. [180.]

• His arms were stretched; his fingers extended, 12.
• Arms fall relaxed, 33.

INFERIOR EXTREMITIES

• A slight imperfection in her gait terminated in paralysis of the lower extremities, after some time, and she became helpless, 31.
• Severe cramps in the legs, 12.

GENERAL SYMPTOMS

• 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 a 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, 41.
• His appearance altogether was so distressing, as to excite great alarm in the minds of the bystanders, 12.
• General appearance like one going into a state of epilepsy, 18.
• To appearance, the energies of mind and body were nearly extinct, 2.
• The individual, to the common eye, seems to be sinking into the sleep of death, 3.
• Perfect quick, 33. [190.]
• Agitation of the system, 17.
• An affection of the nervous system approaching apoplexy, 16.
• Hysterical excitement in women for some hours, and even for a day or two, 3.
• 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, 36.
• 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, 23.
• He appeared to have much suffering, throwing his body almost out of the chair, 19.
• Muscular tremors, 41.

SKIN

• The skin of the face, as well as that of the chest, of a violet-red color (after ten minutes), afterwards livid, 29.

SLEEP. [250.]

• After inhalation, all the usual phenomena of the deepest sleep supervene almost suddenly, gliding often into the profoundness of sopor, and verging occasionally upon, if not actually lapsing into, coma, 3.

FEVER

• Chilliness.
• Much distressed with a sensation of cold, 12.
• Cold and chilly in the evening, 22.
• Shivering; chattering of the teeth, 1.
• Cold extremities, 1.
• Heat.
• Skin hot (third day), 30.
• Agreeable feeling of heat, accompanied by formication and a kind of tremor similar to that felt on touching a large bell in a state of vibration, 1.
• Sweat.
• Perspiration, followed by chill, 1.

SUPPLEMENT: ETHER. Authorities.

42 , W. H. Hewitt, Lancet, 1847 (1), p. 239, Jemima S., æt. nineteen years, inhaled it for six or seven minutes for the purpose of having a tooth extracted; 43 , Anne C. æt. fourteen years, inhaled it two minutes for the same purpose; 44 , R. Stewart, ibid., p. 397, death of a woman after the third inhalation; 45 , M. Cardan, ibid, p. 441, effects on a woman in the sixth or seventh month of pregnancy; 46 , Berridge, Organon, vol. ii, 1879, p. 260, a man, æt. twenty years, inhaled pure Ether.

MIND

• Hysterical (after first inhalation), 44.
• Hysteria preceded the insensibility, and occurred at intervals during the day, 42. [260.]
• Disorderly hilarity, 45.
• On recovering, she exclaimed, "Oh, why did you take me from that beautiful place? Let me go back. Oh! how beautiful! It is heaven!" and a variety of other rapturous expressions, evidently showing that she had had a dream, and was unconscious of any operation having been performed upon her, 42.
• When recovering, on asking her why she had kept the mouth so tightly shut, she said she had had a dream, and thought she was drowning, and that somebody was forcibly trying to open her mouth, 43.
• Insensibility, 42, 43.

HEAD

• headache for many hours (after second inhalation), 44.

EYE

Power of vision lost (after second inhalation), 44.

GENERALITIES

• After ten or twelve respirations, the infant made some struggles and convulsive movements, very painful to the mother; these movements became more violent, and succeeded each other with greater rapidity, in proportion as the Ether became absorbed; but as the mother grew insensible at the same time, she evinced only a vague kind of consciousness. When the mother recovered herself from the effects of the Ether, she complained of pain in the uterine region, such as might arise from blows and bruises, 45.
• The heart of the fœtus beat with extreme rapidity, so that the individual pulsations could scarcely be distinguished; it might be said, indeed, to be in constant tremor. The rapidity of the pulsations appeared to be in pretty direct relation to the motions or struggles of the child. The placental bruit lost its simple character, and took place in fits, which varied according as the struggles of the fœtus were more or less rapid, 45.
• Faintness and apprehension at once, 46.