Anaesthetic agents are used to quiet pain and spasm from disease, to render the dressing of injuries and surgical operations painless, and to produce muscular relaxation. Ether-inhalations give entire relief to the pain of neuralgia (tic-douloureux), cancer, and inflammation; to pain dependent on spasms—tetanus, chorea, hepatic and nephritic colic, etc. It is not necessary in these cases, as a rule, to induce full anaesthesia, for, as has already been pointed out, the sensibility to pain ceases before the condition of insensibility is reached —before, indeed, the perceptive centers of conscious impressions are otherwise impaired than as to the appreciation of pain. Paroxysms of maniacal delirium, and of puerperal mania, when violent and uncontrollable, are sometimes quickly quieted and refreshing sleep obtained, from which the patient eventually arouses in a calmer frame of mind. Ether is the proper agent for this purpose. It should not be forgotten that anaesthetics are dangerous in delirium tremens.

In puerperal convulsions due to reflex irritation, or to uraemia, the use of chloroform is invaluable. It is equally effective in the reflex convulsions of early life, in the uraemic convulsions of scarlet fever, and in the so-called hystero-epilepsy. When puerperal or other forms of convulsive seizures are due to cerebral haemorrhage, no good can be accomplished by anaesthetic inhalations. In any case, although convulsions may be arrested by anaesthetic inhalations, other appropriate measures must be resorted to for the permanent removal of the causes. A paroxysm of epilepsy impending may be aborted by the inhalation of ether, but the nitrite of amyl is a more effective remedy for this purpose.

In certain neuroses of the respiratory organs, great relief is obtained by anaesthetic inhalations. Laryngismus stridulus may be quickly cured by the vapor of chloroform. A few drops of chloroform on a handkerchief will suffice, and special care should be taken to dilute the vapor largely with air. A similar procedure will relieve severe paroxysms of whooping-cough, but a more energetic use of chloroform is required when convulsions occur during a fit of coughing. No single agent gives more relief in asthma, but, like all other remedies for this disease, the power of relief declines, and increasing doses of the anaesthetic become necessary, so that the habit of chloroform or ether narcosis is formed.

Anaesthetic inhalations should not be recommended in cases which will probably require their use for a long time, because the inclination for this kind of intoxication grows rapidly, and is as difficult to control as the opium-habit. The author has seen one case in which the patient consumed a pound of chloroform daily, but, as might be expected, this extraordinary consumption of the anaesthetic did not long continue, for the patient succumbed in a few months.

In obstetric practice the applications of anaesthetics are numerous and important. The indications and contraindications for chloroform in natural labor may be formularized as follows: When the labor is of short duration, and not excessively painful, anaesthetics should not be used; on the other hand, when the labor is protracted and the suffering great, they favor the progress of the case and prevent exhaustion and uterine inertia. In prim ipara caution is necessary. The inhalation of the anaesthetic should not begin until near the close of the first stage, unless those painful but ineffectual contractions occur which have been aptly characterized as "nagging pains," when the vapor, very much diluted, may be cautiously inhaled for their relief. The inhalation should be practiced only during the existence of the pain. The influence of the anaesthetic on the pulse, respiration, and uterine contractions, should be carefully observed, and, if the pulse fail, the respirations become shallow, or the pains lose in efficiency, the inhalation should be discontinued. If the anaesthetic cause great excitement, and the patient become loudly clamorous for more, while the uterine contractions are lessening in force, it is doing harm and should be withdrawn. It is never necessary, nor proper, to administer the anaesthetic to complete unconsciousness. Toward the close of the second stage, when the head begins to distend the external parts, the quantity of chloroform may be somewhat increased, but the inhalation should be discontinued when the occiput has passed under the pubic arch. If these rules are followed, the action of the anaesthetic is beneficent. Properly administered, the use of chloroform may be considered perfectly safe in the parturient female. It is generally conceded that no well-authenticated case of death from the use of chloroform in labor has occurred, when the administration was in the hands of a properly-qualified medical man.

The following evil results, the author believes, have followed the incautious use of anaesthetics in labor: the progress of the case arrested, so that forceps became necessary; slow and imperfect uterine contractions, and consequent post-partum haemorrhage; a toxic condition of the mother's blood, with after - excitement, wakefulness, and puerperal mania; asphyxia of the child, tedious convalescence, and subinvolution of the womb.

When instrumental delivery is required, the utility of anaesthetics is unquestionably great. It facilitates the necessary manipulations, and prevents shock. The inhalation should be carried far enough in these cases to produce sufficient quietude in the patient, and it may be to complete muscular resolution. When turning is to be performed, the state of chloroform narcosis must be deep enough to suspend uterine contractions.

If puerperal convulsions occur at any stage, the utility of chloroform is unquestionable. The limits of its utility in these cases have already been indicated.

When careful examination of the pelvic viscera is to be made to establish the diagnosis in difficult and obscure cases, as, for example, phantom tumor, ovarian and fibroid growths, pelvic abscess, etc., the importance of full anaesthesia can hardly be over-estimated.

The use of anaesthetics in operative surgery is now an indispensable practice. It may be compendiously stated that ether, or chloroform, is required in all surgical operations of magnitude, for the reduction of dislocations, for the taxis in strangulated hernia, for dressing painful wounds and adjusting fractures, for breaking up adhesions, and contractions of muscles and tendons in cases of deformity, for establishing the diagnosis in feigned diseases, etc.

The after nausea and vomiting, which are sometimes most depressing, and occasionally dangerous, produced by anaesthetics, may be prevented by the hypodermatic injection of morphine and atropine before beginning the administration of the anaesthetic. After the patient emerges from the anaesthetic sleep, the above-mentioned unpleasant after-effects may be relieved by a minute quantity of morphine (1/12 of a grain) and atropine (1/125 of a grain) injected subcutaneously.