Amylenum nitrosum

Volume I — Main text

AMYL NITROSUM.

Nitrite of amyl. Product of action of nitric acid upon amylic alcohol (fiisci oil),

I. Proving^.' -i, a. At lO. 29 p.m., pulse 54 and slightly irregular, 10 min, were inhaled for 2 m. At 10.31 pulse 136^ regular; face much flushed, and strong throbbing in ears ; conjunctivae bloodshot ; muscular tremor of arms ; involuntary coughing. At 10.33 pulse 80* very irregular ; at 10.36, 72, more regular ; at 1 1,80, regular. Temp. 977^ throughout.

b* On another occasion, thermometer was placed under tongue and temp, found 977*^- Pulse was 60. At 11.84 5 "^^"- were inhaled for 4 m. Temp* now 979^ ; feeling of intense fulness in head, with violent throbbing in ears ^ face scarlet \ slight perspiration on forehead; slight dyspnoea with inclination to cough. At t rgj pulse was 65.* At 11. it nothing remaining save slight dizziness* rrom 11.13 ^^ 11.48 temp, was 981'^ : pulse at first 72 and irregular, then 64.

f. Pulse 120, having been accelerated by fast walking; 5 min, were inhaled. Flushing of face and throbbing of head came on in 30 sec, pulse reaching 160. Mr. Bader examined eyes ophthaK moscopically, and found veins of disc enlarged, varicose, and tortuous ; arteries were small, but not abnormally so.

d. Pulse 84, 3 min. inhaled. In 5 sec, pulse 108; in 10 sec, 120; in 15 sec, 144; throbbing in head now commencing, also flushing; left off inhaling. In 60 sec, pulse 124; still much throbbing. In 120 sec, pulse 84, very irregular ; heavy aching all through head*

r In the few cases in which sphygmographic tracings were made, k was found that in the very first stage of its action the upstroke produced by the contracting ventricle was almost imperceptible, giving unpleasant visions of impending syncope. This feature was apparently due to the excessive rapidity of the heart's action, and was succeeded in a very few beats by a sudden and jerking impulse which gave no positive indication of anything more than an exaggeration of normal conditions.

/: The respirations were not altered in frequency, but in all cases, coincidently with the flushing of face^ great inclination to cough wa9 experienced with an indescribable feeling of fulness about the chest.

• 1. Experimenter states that quickenlfig of pulse was invariably first Aymptom of action of dmg.^ — Eds.

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g. In full doses of 8 or lO drops^ sight became impaired slighd)r» and outline of objects hazy and indistinct.

A. After all experiments, a feeling of lassitude remained behind for 30 or 40 m.^ and dull aching in head for some time longer. (GrooD- HART, Practithmry vi^ 12,)

2* I have given it experimentally to some 50 friends and patients, and have found that Its inhalation invariably causes increased frequency of cardiac pulsation, accompanied with flushing of face, warmth of head, face and neck, and perspiration — warmth and perspiration often being general.^ The pulse is the first tell-tale of its effects > in from 8 to 12 sec, its frequency rapidly increases, A pulse of 20 in the J m, will often rise in 10 or 15 sec. to 40. The beating of the heart and of the carotids is in some persons very marked. The reddening of the face sets in later ; it usually takes from 30 to 40 sees, before there is much flushing. It sometimes causes a little breath less ness and coughing. Now and then it gives rise to giddiness ; and, in some, to a feeling of intoxication — girls who have inhaled it have often complained that it has given them a headache.f (Talfourd Jomes, Ibid,^ vii, 214.)

3- Pulse being 66, and resp. 20, I inhaled the drug strongly for 30 sees. After a second or two my ears began to throb and my head seemed to swim round. In 25 sees., pulse 130, resp, 20, deep facial flush with hammering at vertex ; then sensation seemed to travel hack, and I felt throbbing in occiput ; objects began to look yellow. Then came beating behind ears. After 2 m. all appreciable efiict of drug had disappeared, pulse was 70 and breathing 24. An h. after, I was still conscious I had a heart, and a bruised sensation in the brain had been left behind. (Dr. Edw. Blake, Mmthiy Horn. Rev.j xv, 168.)

4» J. N. B — inhaled freely for 30 sec. At end of m. there was precordial anxiety ; accelerated heart's action ; frontal humming ; hot, red face , desire to sigh convulsively ^ sensation of a piston working up and down in the ears ; primrose halo, even with eyes closed and shaded* During 3rd. m. there was bursting in forehead and vertigo.

Pulse. Resp.

Normal . • • 64 . . • 16. After 90 sec. , 106 ... 20.

20,— (/^/V.)

5* Dr. MoRRissoN, in good health, on March toth, at 10,25 Pni.^ entered room in which amyl nitrite had been escaping from a jij phial Odour in room was pungent. Effects were : increasing sense of stupefaction, with flushing of face and scalp ; sudden smarting of con-

• " SotnetlmcSf while the rest of the surface glows^ the hands and feet may bet'ome very cold, and this condition of the extremities may last many hours" (Rikgeh, op, at,}.

f •• It may be proper to recall the fact obsen^ed by Hoffmann, that crude nitrite of amyl, as prcparea by action of nitrous acid an amylic alcohol, contains hydrocyanic acid ; thi» must of course he rcmovtd by caustic 4oda before experiments can he tried. The presence oi this impurity was probably the cause of its discoverer^ Balard^ atrrihuting to nitrite of amyl the power of producing violent headache* No svch effect was experienced by the 15 or lo students, of ages varying from 15 to 151 whom I have induced to try it.*' (Guthrie, yoam, oJChttn. Soc,^ '859» P' »4-^.)

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junctiva;, with injection, and dimness of vision as from a film ^ subacute smartings in various places, shifting position rapidly, most persistent in eyes, bases of lungs, and spine ; increasing dyspnoeaj with sneezings, coryza, and sighing respiration i pulse (sitting) 68, small, feeble. After enduring increasing discomforts for 20 m., respiration became a series of gaspings ; and he left room. On waking next m. pains returned in renewed intensity, with catarrhal symptoms, and severe fron to-orbital headache. They recurred during d,, at times accompanied by sighing respiration ; and were intensified by odour being again inhaled. Urine clear, acid j sp. gr. 1014, free from albumen or phosphates, light clouds of an oxalate, and distinct traces of sugar. Pulse (sitting) 78 — 84, feeble* On 12th, during m*, dull aching in cervical, removing to suboccipital region, then passing away. During e. smarting in eyeballs, with injection. Urine clear, acid ; sp. gr. 1020 ; trace of oxalates, and sugar in marked quantity. 13th. Symptoms the same, general lassitude. I4ih. Occipito- frontal headache, with achings in r, renal region ; smartings of conjunctiva ; urine same. 1 5th* Severe occipito-cervical achings, with increased frequency of renal ; pulse (sitting) 70, regular. 16th — 18th. Achings and conjunctival smarting remain, with weakness of eyes; sugar lessening. From this time the achings and smartings became occasional only. The sp. gr. of the urine fell ; but there were still traces of sugar in it up to April 1 8th, Dr. Morrisson adds that many of the subjective symptoms returned on inhaling the i, dil. ; and that the achings were increased by fatigue, and most marked during the c. (/iiV., xxi, 320.)

6, Dr. Aldridge caused seven persons to inhale nit, of amyl, and in every instance found (by ophthalmoscope) tint of retina deepened, and arteries perceptibly enlarged, (ff^est Riding Asylum Reports,

h 950

7, In a case described by Dr. Strahan, a chronic maniac, act. 53, had suffered for several d. from severe lumbago, A 10 min. dose of a 10 per cent, solution was injected hypodermically. " Immediately after the injection the pain disappeared. He got up from the bed, and was able to stoop and touch the floor with his fingers. In, as nearly as could be guessed, about i^ m., he suddenly became deadly pale and sank back upon the bed," Then his face, head (bald), and neck, became congested, and he was strongly convulsed for about \ m. The convulsions affected the face and arms strongly, the legs slightly. The teeth were ground, and the breathing was suspended. In a few m., after coming out of this fit, he was attacked by a second one, during which the heart's action become very faint.* He was made to inhale some chloroform and the fits did not return, [PractitUnir^ Dec,

1884,) : . ,

8, C. E. H — . Immediately after inhalation intense crushing pain on head, gathering into a feeling of confusion threatening unconscious-

• ** I have seen one case where a woman immediately after a drop dose turned deadly pale, fch giddy, and then became partially unconscious, remaining »o for 10 m. . , . One delicate woman, after gtt. ^, passed for a few m. after each dose into a trance-like stale, everything seeming to her unreal, and the breathing becoming rather panting*' (Ringer, op, cit,),

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ness. At same moment quicks somewhat sharp throbbing it head, and intense glowing of face, with general perspiration, especially in palms, where it was quite visible. Also frequently-repeated sensation as if scalp were jerked forward from occiput to verge of forehead. Pulse increased about 12 beats. Felt dull headache for about 3 h., and after 1 h. had slight epistaxis from 1. nostril, a thing quite unusual. (Dr C« Wess£Lho£Ft's provings, N. EngL Mid, Gaz,y xi, 3S8.)

1. L. A. P — . Inhalation followed immediately by dizziness and nausea ; heat and redness of face ; heaviness and pressure outward in forehead and temples. Though not warm, perspiration started freely, cold chills at same time running down back. Great restlessness and uneasiness ; pain in head increased, accompanied by stupid, drowsy sensation, and burning in stomach up to throat. Fulness and pressure m stomach with belching of gas ; oppressed, difficult and rapid breathing i feeling as if of weight on sternum ; stitching pains in cardiac region and feeling of constriction (no palpitation) \ griping pain in umbiiic^il region ; drawing tensive pains in K wrist and finger-joints ; pulsations sensible in finger-tips ; pulse (from 60) 72jhard and fulL Heavy head and oppressed breathing continued about 3 h. [Ibid,)

2. W. R. B — inhaled i, dil. three times, with 5 m, between each inhalation. Head symptoms as usual \ trembling sensation all over^ and cannot sit still ^>t fear of something dreadful happening 9 pulse not accelerated but irregular ; sharp pain in region of heart; sense of constriction in throat ; numb feeling in nasal bones (several h.) {IbidJ)

U. E. B. H — proved 2nd cent. dil. Took £^tt.j. In 15 m. pulse 10 — 12 beats quicker. After 30 m. gtt. iij. In 13 m. more hands moist, head and body (especially abdomen) felt warm, in 30 m* warmth greater still. Took 3 drops more. Jn 13 m. slight blurring of letters when reading. Next d. 10 drops. In 5 m. heat in head and along oesophagus to stomach, lasting | h. After i h, took 20 drops. In 10 m. heat^ chiefly in stomach i moist skin ; in 16 m. chill crept over back and sides. Next d. 40 drops. In 12 m. pulse rose 20 beats, remained so for some m., then gradually fell to normal \ very slight pressure in head, increasing (with slight throbbing in temple) up to 36 m., when violent exercise during one m. produced dull headache; later, heat from gas caused dull pain to extend from temple to occiput, principally left sided. Dull occipital pressure remained 2 — 3 h. After exercise, more violent palpitation than usual (Ibid,)

1. H. E. R — proved same, 1.15 p.m. Soon after gtt. j, peculiar sensation in r. chest. 2.30, repeated dose. Tingling sensation in different parts of body i slight dull aching in r. chest. 3, same dose. In 1 0 m. slight frontal headache j chest pain more severe, but not constant. At 4, 2 drops. Pain in back of £yes on looking at near objects. At 4.30 took 3, and at 5 took 4 drops. Slight pain in r. temple ; general weakness felt about 10, with tendency to perspire easily on slight exertion* Next d. woke about 5, with extremely dry and parched sensation in mouth and throat ; and on rinsing mouth noticed marked stiffness and dryness of lips. {Ibid.)

2. Miss A. W. S — proved same. At 1.30 p.m. took i drop. In S m. pain in r occiput i sudden sharp pain under 1. eye j face flushed

and hot (last two transitory only). At 3 another drop-, at 5 2 drops, and at 9 repeated dose, without new symptoms* Two d. later toolc 5 drops. Great heaviness of head in front, head would fall from side to side ; overpowering drowsiness for more than t h* ; severe colicky pains in abdomen, increased on lying down. At 7.45 p,m, repeated dose* No marked symptoms at n. ; in m* severe dull heavy pains across forehead ; pain and weakness in loins. On another occasion, after 10 drops, pulse fell, in 25 m,, from 83 to 63, after 2 h. rising to 73, and not returning to first (its normal) rate for ad* more*

1. L* A. P — proved same. At 7 p.m. took 3 drops. Dizziness with slight nausea, worse when eyes are closed ; dull, heavy pressure over eyes as if heavy weight were within* At 8 repeated dose. Painful pressure outward in temples, especially 1., with dull heavy aching in occiput extending to nucha (while walking) i burning in stomach and crampy pain ; later, throbbing in temples. At 10, same dose. Sleep restless, full of anxious dreams ; frequent waking, with severe pain in temples, and in stomach and bowels. Next d, vertigo, headache, and nausea, on rising j anorexia. At 9 a.m. 3 drops. Severe pain as before, in temples, occiput, and over eyes, with burning in stomach ; everything appears as if trembling and wavering ; aching in eyes when in sunlight, with profuse lachrymation, followed by sneezing j drowsiness ; crampy pains in umbilical region ; sense of oppression in chest, i specially in lower sternum ; drawing pains in L side between 7th and 9th ribs, short but fretjuent ; pulse quickened, full and hard ; skin moist, and free perspiration during moderate exercise* {Ibid.)

15* L. G. H* R — proved same. At 145 p.m. 2 drops; pulse ^3- l'5S» pulse 68 ; slight pain over both eyes* 2,5, dull pain in occiput^ pulse 65, not regular; slight heat in face. 2.15, pulse 68 ; burning in face j boring pain in occiput ; uneasy feeling \n extremities, 2.25, face flushed and still hotter ; occipital pain continues. At 3,17 repeated dose; pulse 63, 3.27, dull feeling in forehead; beating of arteries felt in fingers ; occipital pain returned. 3.37, pulse 70, and irregular ; burning in face ; pain in cardiac region, extending round to back. 3.47, pulse 65 ; face and head as before. 4.5, pain in occiput, aggravated by heat of room and by writing ; when forehead was painful occipital pain was less severe. 4.30, after writing, pulse 63, and quite full ; heat of face still sensibly felt, {Ibid,)

1. H* P. C — proved same. This student is described as "sensitive, inclined to neuralgia.** After doses of i drop, 3 drops, and 6 drops respectively, a number of slight and transitory pains occurred in various parts of bod? ; but a later dose of 6 drops on same day had no effect. Next d» 10 drops produced no decided symptoms, but he was restless after it. Four d. later took 15 drops, after which there was slight oppression at fronto-parietal suture, then proceeding to frontal bone ; dimness of sight ; pulse accelerated. After \ h. took 20 drops, with no further effect; and in | h. more 40 drops, which simply made him confused and drowsy, (Ibid,)

2. Miss A, E. S — proved same. After taking, at ^ h. intervals, 3 drop doses, in to m* face flushed, in 25 m. sharp pain in L calf ;

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slight griping in bowels ; feeling as though band were drawn tightly about head ; dull pain over eyes. At n. nausea; dizziness j also contraction of muscles in hypogastrium, which felt hard on pressure ; rumbling in bowels. {Ihid,)

1 8, Miss M. M — proved same. After i drop had, in succession during } h., slight discomfort in r. shoulder ; decided dizziness and heaviness of head ; drowsiness ; suggestion of pain in r* side of headi burning of r* cheek, extending up into eye and round to ear ; heat in I. ear i lameness of flexors of r. arm. After I h. all symptoms subsided. [Ihid,)

1. a. The subjective colour-sensations which occur under the influence of amyl nitrite arc not alike in all cases, as Schroder {Ztitich, f, Piychiatrie^ xxxii, 527) found in a number of patients, but are only now and then very distinct, and are not identical at every inhalation. In their typical form they consist, according to Pick {Centralblatt f^ d. mtdic* IVissemchafun^ 1^73» P* ^66), in the appearance of an intensely yellow halo around any fixed point upon a clear background. The yellow circle is surrounded by a bluish violet border. This phenomenon IS probably nothing more than the projection of the macula lutea, and. the bluish-violet border its complementary colour. The patients treate with nitrite of amyl by Sander stated, of their own accord, after i\ inhalation, that for some time everything had seemed yellow to them. It could not be clearly determined whether or not this phenomenon was due to the yellow colour of that portion of the field of vision which corresponds to the macula lutea. The ycUow vision disappears only after some m*, growing gradually paler.

b, Schroder also observed a diminution of the clearness of sight. Patients who had inhaled nitrite of amyl for a considerable time were unable, i^g*^ to see clearly the figures on a large clock, which seemed blurred to them. Normal vision returned immediately after they stopped using the drug.

f. After inhalation of d

fiig>

and to a certain extent as aji after-

effect, Sander observed profound collapse, which appeared suddenly, and was characterised by fainting, falling to the floor, pallor of face, smallness of pulse, and cold clammy perspiration. Samuelsohn describes a similar case, in which a patient, while fully under its influence, made a few deep spasmodic inspirations, and presented coldness of skin, which was bathed in sweat, and a small, thready, and extremely slow pulse, while consciousness, though weakened, was not entirely lost. Urbantschitsch has drawn attention to similar occurrences {fVttner Mid, Presses iSjj)*

d. BouRNEViLLE States that tremor of lips and difficult mastication often follow inhalation (Gf/z. Alcd, de Parity 1 876, No, 13). Urbantschitsch noticed dryness of mouth lasting from 12 to 24 h. after its use* Lalcndorf {BitL klin, JVochemchrtft^ 1874, p. 539) noticed occurrence of a violent dry spasmodic cough in a patient, on two occasions, during a four weeks* course of nitrite of amyl. A number of

» ** In one or two instances I have (H. C. Wood, ap. at.).

known alarming prostration to supervene '

authors have reported distressing nausea and vomiting as following repeated inhalations. (LewiNj ap, cit.)

1. The paralysing effect on the arterial system is well shown by the sphygmographic tracings, the flushing of the face, and the increase in the size of visible arteries like the temporal^ which often becomes notably large — sometimes, indeed, doubled in sixe, and branchts pre-

r viously invisible become plainly apparent ; also by the interesting fact observed by Talfourd Jones^ who, while cupping a patient over the loins, and finding that blood would not flow, administered nitrite of amyl by inhalation, when the cuts immediately began to bleed freely, (Ringer, op, di,)

1. Administering drug by inhalation to a patient in status epi- Pticusy Dr. Crichton Browne found it excite profound and repeated

'yawning, and this effect was confirmed by observations on other subjects in a similar state of coma. Given to a dog in this condition (from convulsions), animal beat ground with fore-paws and opened and closed mouth with rhythmic regularity, "In all the observations there were movements of the mouth. These were exceedingly various, the most common being a short munching movement of the lower jaw, which was depressed and elevated as in the act of chewing. The next most common movement was a smacking of the lips, as if in the act of tasting." [Practithner^ 1^83.)

III. Experimenti on aninwis, — i, a. In the lower animals the first stage of the action is like that described in man* After this the ibreathing becomes violently hurried and panting, progressive muscular 'weakness and diminution of reflex activity ensue, and finally death from failure of respiration, sensation and consciousness being preserved almost to the last. Convulsions are sometimes present, but in my experience more often the animal is exceedingly quiet throughout the poisoning.

b. Elaborate experimental studies of the action of the nitrite of amyl upon the circulation in animals have been made by Dr. Lauder Brunton {Journ, of Ana t, and Phys.^ v), by myself (yftw^r. jsurn, of Med. Sciences^ July, 1 871), and by Dr. AmezDroz (Arch, de Phys.y Sept,, 1873), The results are so uniform and in such accord that they must be accepted as proven facts Although the pulse is very much increased in frequency sometimes from the very beginning, the arterial pressure Is diminished, and finally reduced almost to zero ; and the fall of pressure occurs equally after section of vagi as at other times. As the number of heart- beats in the uninjured animal is increased rather than diminished, whilst the strength of the individual beat is not perceptibly lessened, it is evident that, at least in the early stages of the poisoning, the diminution of tension is not cardiac in origin, but must be due to dilatation of the arterioles. This conclusion is confirmed by an experiment of Brunton \ who found that if the descending aorta was tied high up no perceptible fall of pressure was produced by inhalation until very late in the poisoning, when the heart itself was acted upon by the drug. . . , Is the dilatation centric, due to an action on the vasomotor nerve-centres, or peripheric, due to a direct action on the muscular coat of the arterioles ? It must be peripheric, it cannot be centric, since, according to the experiments of Brunton and myself, it occurs

when, by division of the cord, the arterioles are separated from the raso-motor centres.* It must be due to a direct paralysing action of be drug upon the coats of the arterioles, a conclusion confirmed by our knowledge of the local action of the nitrite upon muscular tissue. In the latter stages of the poisoning another factor enters into the causes of lessened blood -pressure, the heart's force itself becoming largely extinguished by a direct action of the poison on the muscle.

c. I have found that the diminution of reflex activity and of voluntary motion which undoubtedly occurs in toxaemia from this agent is chiefly spinal in its origin, since after death the nerves and muscles preserve, though in an impaired condition, their functional power. Over the sensory centres it has but little influence.

d, A very interesting phenomenon of nitrite of amyl poisonings discovered by Dr, F, A, Hofl^mann, is the appearance of sugar in the urine* He found {ReUhert's Anhivy 1872, p. 747) that in the rabbit a hypodermic injection of 0*1 1 1 to c r 13 gramme of the drug is enough to cause glycosuria. If twice the amount be used the sugar becomes very abundant, and continues to be present from 12 — 30 h. Therewith is a great increase in the amount of the urine.t

If. Nitrite of amyl, in whatever way exhibited, most remarkably reduces animal temperature. This occurs even after death in those cases in which post-mortem rise or continuance of high temperature normally takes place. I have also experimentally determined that it is associated with diminished excretion of carbonic acid, it must therefore be due to a direct arrest or check of tissue changes, or of oxidation within or without the blood. The vapours of the nitrite have a very marked influence over oxidation outside the body, as is shown by many facts, among others the extinguishment of glowing phosphorus by a few drops of the amyl salt diffused through the jar. It cannot be doubted that within the economy the same thing occurs.

y*. When an animal inhales the nitrite of amyl, the arterial and venous blood soon becomes of a nearly uniform hue, a chocolate tint. Dr. Arthur Gamgee (PhiL Trans,^ 1868, p. 589) has found that the nitrite makes with the oxyhemoglobin a compound which has no power of absorbing oxygen. (H. C. Wood, Theraptutici^ sub voce.)

2, Lauder Brunton finds that when vapour of nitrite of amyl is passed directly into trachea of rabbit, blood pressure immediately sinks very much, but pulse-rate, which is naturally quick, remains unchanged. In dogs, where pulse is slow, inhalation produces comparatively little

• ** Recent experiments of Nussbaum, if correct, »how that in the frog, and there, fore probably in other animals, the vaso-motar centre 1% not situated solely in the medulla, but extends the whole length ot the spinal cord j for after iti section below the medulla, time bein^ allowed for the animal to recover from the shock of the operation, irritation ot a sensor)' nen'e will cause contraction of the arteries. If Nubsbaum's observations arc confirmed they would seem to show that nitrite of amyl may act through an infiuencc on the vasomotor centre " (Ringer, Therap., sub voce).

f " It has been experimentally ^hown that diabetes is produced by dividing the sympathetic ner'e of the liver, and thereby causing dilatation of the hepatic vcjseU^ so increasing the quantity of blood passing through the liver. Prob:ibly nitrite of amyl acts by its influence over the vaso.motor ncrvesi increasing the quantity of blood passing rh rough the liver '* {Bui,),

effect on blood pressure j but pulse becomes remarkably quick. If vagi

be first divided, so as to quicken pulse, pressure falls as in rabbit. {Journ. of Anatn and Phys,^ v, 92.)

Volume IV — Appendix

(See vol. i, p. 155.)

II. 22. Dr. G. F. Senter reports In the Indiana Mt^ital the case of a young lady who took by mistake a dessert-spoo nitrite of amyl. A druggist gave an emetic, which acted pr The doctor saw her in 25 ra. She was ejecting great quani fluid from her stomach, which saturated the whole room with ai like odour. Her face was greyish-white, her pupils widely dila eyes glassy and vacantly rolling in their sockets. Mouth w open J breathing spasmodic and irregular, a few breaths vcry^ slow and long-drawn, finally, they ceased all rapidity, afl barely perceptible. Pulse was irregular and jerking wh examined ; soon, however, it became so slow and feeble that could not be detected at the wrist. The patient presented *' t limp, limber, relaxed body imaginable." Skin was cold and < suffused with a moist adhesive perspiration, supersaturated wit General excitation, with coffee and opium, restored her. |H Joum.^ 1880, ii, 859.) ^1

III. 3. Drs. McBride and Kcmpster, on two occasions, ha an opening in the skull of an etherised rabbit, and — when e etherisation and operation have subsided — have administered i amyl. In both animals they saw the vessels of the pia matt and the brain, becoming intensely congested, protrude tl cranial opening. The ears were equally hyperaemic. of Nervous and Mental Diseasn^ 1^790