years 220-230 of our era, gave to his patients, when he had to make a deep incision or moxa, a preparation of hemp (Ma-yo), and at the end of some moments he, the patient, became as insensible as if he had been drunk or deprived of life. Then the operation was performed without pain. From the rapidity with which the insensibility by this author is said to have been produced, Snow is of opinion, that the fumes of the hemp must have been inhaled while the substance was being burned; and in support of this view, he quotes that the ancient Scythians, according to Herodotus, were in the habit of inhaling the fumes of hemp until they produced drunkenness. This hypothesis is in accordance with other experience, the practice being an old one to administer the fumes or smoke of various burning substances by inhalation. The application of the ammoniacal fumes of the burning feather is a case directly in point, and another very ancient practice in the treatment of bees is equally significant. For many ages it has been common in this country, and in various parts of the Continent, to rob the beehive of its rich contents without destroying the industrious occupants of the hive, by subjecting the bees to the fumes of the fungus, called in common language 66 puff ball" and in technical language "Lycoperdon giganteum." Some years since, I think about 1851, I investigated this practice, and found that the fumes of the Lycoperdon supplied a volatile substance, which produced the most perfect insensibility. I performed many veterinary operations on various animals while they were under the influence of this sleep-producing agent, and I suggested its general application for painless operations on the lower animals. Afterwards Dr. Thornton Herapath, a young chemist whose career, most promising, was cut short by death, followed up my enquiries, and on making a more perfect analysis of the fumes, discovered that the narcotic agent was carbonic oxide. A third illustration of the hypothesis of Snow is afforded, again, in the plan of inhaling the fumes of burning opium, until the production of intoxication. In the intoxication after smoking of opium all sense of pain is annihilated; and as the practice is attended with very little immediate danger to life, it is most curious that in the East it was not adopted, generally, preparatory to the performances of the surgeon. Opium used in this way would answer well; for I remember, when I was experimenting with the fumes of the burning Lycoperdon, inhaling them, and comparing their effects with the effects produced by the smoke from a little opium in a pipe, there was very little difference of effect; and I found that, even in the early stage of stupor from opium, the skin was insensible to pain.

The hypothesis that a volatile narcotic was administered by inhalation by the Chinese, is yet more clearly supported by the

fact, that the inhalation of the smoke of haschisch has been a long-prevailing custom in the East. This is the same substance as the nepenthes of Homer, and the preparation of it as a luxury forms a distinct trade or calling. The distinguished Polli of Milan, who has recently investigated the action of haschisch, explains that the substance is sold in candle-shaped pieces, from three to four inches long; it smells like impure wax, is sharp to the taste, is easily soluble in water, and is taken either by the mouth in honey or coffee, or by the process of smoking. Occasionally, it is taken in the form of a spirituous liquid or wine. In all cases, the active principle of the substance is derived from the flowering extremities of the hemp, the substance said to have been used by Hoatho; the active principle resides in a resin peculiar to the hemp-flower of the East; this variety of hemp is called the Cannabis Indica, and the resin is called cannabina or haschischina.

When the haschisch is smoked or swallowed, or when the simple flower and seed are smoked or swallowed, there is induced a peculiar inebriation, which follows rapidly under the inhaling process, slowly after the eating, and lasts, in each case, a considerable time. Polli subjected himself and two friends to the action of the hemp, and describes the effects with singular clearness and power. The most noticeable coincidence is the similarity of the symptoms brought out with those which are produced by the inhalation of nitrous oxide gas mixed with air. In fact, Sir Humphrey Davy's description of his sensations under the influence of the gas, and Polli's description of his sensations under the influence of haschisch are so alike, it could be inferred that the same agent was at work. The haschisch not only modifies ideas and conceptions of surrounding objects, and excites new ideas respecting time and space, but it removes common sensibility, so that a blow may be administered to a person under it without exciting either pain or anger.

Snow notices yet another author who recommends a volatile anæsthetic. This author is the famous Theodoric of the thirteenth century, who gives a recipe after Dominus Hugo. Dominus directs that "there be taken, of opium, of the juice of the unripe mulberry, of henbane, of the juice of hemlock, of the juice of the leaves of mandragora, of the juice of the woody ivy, of the juice of the forest mulberry, of the seeds of lettuce, of the seeds of the dock which has large round apples, and of the water hemlock, of each an ounce. These are all to be mixed in a brazen vessel and then in the vessel is to be placed a sponge: the whole is to boil so long as the sun lasts in the dog days, until the sponge consumes all, and all is boiled away in the sponge. The sponge is now to be kept, and as oft as there is need of it, it is to be placed in hot water for an hour and afterwards applied

to the nostrils of him who is to be operated on until he has fallen asleep, and so let the surgery be performed." The success of this method of applying a sleep-producing sponge, as detailed above, is disputed by Snow, on grounds which seem sufficient, theoretically speaking. He did not, however, put the question practically to proof, and it is possible, I think, that a sponge prepared in the manner described might contain in its porous substance many bodies which could be volatilised by heat, and which would, if inhaled, produce sleep. If the instruction had been that the sponge, or portions of the sponge were to be burned, and the fumes of the burning substance inhaled, the effectiveness of the procedure would have been sufficiently clear.

Whatever had been, in their day, the value of any of these plans, they died out, and failed altogether to become systematised. One mode, the offshoot probably of the mandrake wine system, was occasionally followed, and that consisted in administering, by the mouth, a dose of opium previous to operation. It was probably a dose of this drug which was administered to Augustus, king of Poland and Elector of Saxony, as told in Meissner's Skizzen, quoted by Dr. Silvester, sic:

"Augustus, King of Poland and Elector of Saxony, suffered from a wound in his foot, which threatened to mortify. The court medical men were opposed to the operation of amputation; but during sleep, induced by a certain potion surreptitiously administered, his favourite surgeon, Weiss, a pupil of Petit, of Paris, cut off the decaying parts. The royal patient was disturbed by the proceeding, and inquired what was being done, but on receiving a soothing answer he again fell asleep, and did not discover till the following morning, after his usual examination, that the operation of amputation had really been performed."

Bell, in his System of Surgery, published in Edinburgh last century, speaks of the practice of administering a large dose of opium prior to surgical operations; but Bell was not favourably impressed with the practice, because it produced vomiting; and his opinion would appear to have been pretty generally

shared.

The history of the systems of removing pain by causing general insensibility of body and unconsciousness, is, I think, fairly exhausted in the above recitals, that is, up to our own time. But it must not be omitted, that various local methods for removing pain were also devised of old: some of these are deserving of remark. I notice again, after Snow, a receipt of Theodoric from Master Hugo for this purpose. Antimony, quicksilver, soap, quick-lime, and a little arsenic are to be sublimed together, says the Dominus Hugo, and a portion of

the resulting compound, the size of a nut, is to be applied over the part that is to be operated on. The arsenic so sublimed is described, adds Snow, "as rendering surgical operations extremely pleasant;" but with his keen scepticism he analyses, distrusts, and practically does away with the whole story.

The benumbing influence of extreme cold may be accepted as a natural discovery, coeval with the existence of mankind in the temperate and frigid zones, and physicians, at an early date, seemed to have used cold for the relief of pain. Its systematic use probably came in later; after the revival of letters, so called. It is related of Harvey, the discoverer of the circulation of the blood, that he was accustomed to seek relief from the pain of gout by going on the leads of his house, and there immersing his painful foot in ice-cold water. But we have to name another man, living in the same age, to see the same remedy employed in a direct manner in order to remove sensation in a part of the living body before subjecting the part to operation. This man was Thomas Bartholinus, one of the most learned and industrious masters in physic. Bartholinus wrote a treatise of 232 pages on the medical uses of snow ("De Nivis Usu Medico "). The book, from beginning to end, is wonderfully suggestive, and in the twenty-second chapter he conveys the practice of applying extreme cold to produce insensibility before the performance of surgical operations. The plan, he says, was taught to him by Marcus Aurelius Severinus of Naples. In our day the same application of cold has been, independently, brought into use by a man of singular originality and genius, Dr. James Arnott.

One more method calls for a word, and that is the method of removing sensibility to pain by means of pressure. This plan is fully described by Bell, in a chapter entitled, " Preventing or Diminishing Pain during Chirurgical Operations." He says it has long been known that the sensibility of any part may not only be lessened, but even altogether suspended, by compressing the nerves which supply the part. To effect this systematically, Mr. James Moore, of London, invented, in 1784, an instrument which produced pressure on the large nerves, an instrument which was tested by no less a surgeon than John Hunter, in St. George's Hospital. It partially succeeded, but the pressure had to be maintained an hour before the operation, and the proceeding fell into disuse.

We are brought now to the early part of the present century, and to the researches of Sir Humphrey Davy. Sir Humphrey discovered that nitrous oxide gas, when inhaled, produces insensibility to pain, a kind of intoxication, and sleep. In the course of his enquiries he tells us that he had a very good opportunity of ascertaining the power of the immediate operation of the gas in removing intense physical pain. In cutting one of

the unlucky teeth called dentes sapientiæ, he experienced an extensive inflammation of the gum, accompanied with great pain, which equally destroyed the power of repose and of consistent action. On the day when the inflammation was the most troublesome, he breathed three large doses of nitrous oxide. The pain always diminished after the first four or five inspirations, the thrilling came on as usual, and uneasiness was for a few minutes swallowed up in pleasure. As the former state of mind, however, returned, the state of organ returned with it; and he once imagined that the pain was more severe after the experiment than before. The results of Sir Humphrey Davy's experiments led him to suggest that -" as nitrous oxide in its extensive operation appears capable of destroying physical pain, it may probably be used with advantage during surgical operations, in which no great effusion of blood takes place."

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In these observations of Sir Humphrey, a new era was opened. Nearly forty years truly elapsed before the idea above suggested received practical form and accomplishment, but inhalation of nitrous oxide gas was never lost sight of; year by year it was used, in play, in the chemical schools, and many a student, laughing under the inebriation it produced, was pinched and thumped unconsciously by his fellows-operated upon in fun.

Meanwhile, comparisons were being made between the action of nitrous oxide and some other agents, the most important fact elicited in this direction being, that the vapour of sulphuric ether possesses an analogy of action. We touch in these words. the history of the modern development of the science of anæsthesia. Two men claim here to have been first pioneers; these are Dr. Collyer and Dr. Horace Wells, both Americans. Collyer, whose name has hardly been heard of in the matter, adduces evidence that he performed a capital operation under anæsthetic sleep, as early as the year 1839. His evidence is, in my opinion, strong, but I have not seen the original document, which, I am told, renders it conclusive. Wells's claim dates from December 11th, 1844, when he inhaled nitrous oxide at his own request, from a Mr. Colston, while Dr. Riggs, a dentist, extracted for him a tooth. Two years later Dr. Morton, also an American, began to perform operations under sulphuric ether.

At this point our history shall stop: it is too closely contemporaneous to be written at length, without the possibility of injuring unintentionally some fame, or touching some susceptibility, or exciting some mental pain. Suffice it to say, that the work which has since been done by all, has been unequalled in its time in science, unequalled, I mean, in industry, earnestness of purpose, and usefulness to the whole human race.