Ether greatly lessens the force of mus cular contractions (including the uter ine) so soon as one-half minute after inhalation begins. The effect of ether disappears in five to twenty minutes. The contractions of the abdominal mus cles cease during anmsthesia under ether. The patient recovers her power of uterine contraction far sooner after the use of ether than after the employ ment of chloroform. Hensen (Archiv fiir Gyniik., B. 55, H. 1, '98).
Contra-indications.—The main toxic effects of ether involving the respirdtory centres, any disease of the respiratory tract is thought to reduce the safety of anaesthesia in proportion with the degree of involvement. It is probable that the respiratory centres are influenced in both ways: reflexly at the start through the nasal nerve-supply, or, later on, in subjects suffering from stenotic disorders of the respiratory tract, as a result of the toxTmia through undue exposure of the pulmonary area to the effects of ether. Hence, all conditions tending to reduce the diameter of the trachea or the bron chial tubes, goitre, asthma, bronchitis, etc., are to be looked upon as compro mising factors. The Trendelenburg posi tion, considerably used at present, is dan gerous, through the pressure exerted upon the diaphragm by the intestines.
Ether is not recommended for opera tions on the face, and is directly contra indicated in all diseases of the air passages, including compression of the trachea. P. Ziegler (Miinchener med. Woch„ No. 23, '95).
Ether is contra-indicated in operations within the mouth and upon or close to the air-passages; certain conditions of the lungs, particularly acute bronchitis, asthma, double empyema; advanced renal disease and diabetes; operations demanding the use of the actual or ther mocautery upon or close to the face. J. B. Blake (Boston Med. and Surg. Jour., June 0, '95).
Twenty-five thousand cases anfesthe tized by the author during twenty-seven years. In young subjects up to the age of 14 years ether is found too irritating, especially when any trace of broucbititi existed. In aged persons suffering from emphysema and pulmonary catarrh ether is contra-indicated. Ponect (Sled. Press and Circular, June 12, '95).
Organic heart disease is not looked upon now with as much dread as for merly, but when the cardiac disorder is sufficiently advanced to cause dyspncea or oedema, or when there is concomitant and marked asthenia, the circulatory system may quickly succumb as a sec ondary result of the respiratory paresis.
The presence of arteriosclerosis is not thought to increase the danger; but all such cases should be closely watched.
Arteriosclerosis does not constitute a contra-indication for the use of ether. The deaths by chloroform occur, in the majority of cases, in young, robust, and healthy persons before complete chloro form narcosis is obtained. Ether deaths are met with usually in persons over 50 years of age, and are generally ac counted for by lesions found at the autopsy. Robert Weir (\. Y. Med. Jour., Mar. 1, '90).
Post-mortem appearances in a series of deaths during ether anesthesia: Ex tensive disease of the heart found in 5 cases; in 3, death from cardiac syncope was reported, and the autopsy revealed extensive pulmonary disease, in 1 case coupled with morbus cordis. In 6 cases death took place before the operation, in 2 during, and in 2 immediately after ward. Of the deaths under ether, 2 oc curred in persons exhausted by constant vomiting, due to intestinal obstruction, 1 from apparent cardiac syncope, the pa tient being a confirmed drunkard and in delirium tremens at time of operation. The death under "gas and ether" was that of a very anaemic, weakly woman. R. Williams (Med. Chronicle, p. 150, '93).
In 15,000 etherizations but two deaths. In the one case a tubercular infant in a depraved state of health died from as phyxia. The necropsy showed advanced aortic disease and disseminated tubercu losis. In the second case an anaemic woman *as, after the operation, placed in the sitting posture while being car ried to her bed. Although apparently rallying under restorative measures, she died in the night from symptoms of progressive nervous exhaustion. Over vigorous attempts at artificial respira tion seem to have done this patient grievous harm. I'oncet (Annual,'95).
Case of limn in good health to whom ether was administered in order to break up adhesions. Operation was completed, and administration of ether stopped. The patient breathing stertorously and well, like one recovering from ether. Corneal reflex tried and found present. About half an hour after administration of any ether, breathing noticed to be in gasps, and patient blue in the face. Death followed immediately.