In order to obtain the first stages of the action of anaesthetics, as in cases of intestinal, biliary, or renal colic, intense neuralgia, or in parturition, the best means of administration is one for the account of which I am indebted to Mr. W. J. Image, of Bury St. Edmunds. It consists of a tumbler, at the bottom of which is placed a piece of blotting-paper or linen thoroughly wetted with chloroform or ether. The patient holds the tumbler to the nose with his, or her, own hand. On account of the form of the tumbler, sufficient air always gets in at the sides, and the patient cannot inhale the vapour in too concentrated a condition. As soon as the anaesthetic begins to take effect, the hand drops, and the inhalation ceases. As the effect again passes off, the patient resumes the inhalation. In employing anaesthetics in this way, however, great care must be taken that the bottle containing the chloroform is never entrusted to the patient, but is always kept on a table at some little distance from the bed, and that the blotting-paper or lint in the tumbler is supplied with fresh chloroform by an attendant. If the bottle itself be entrusted to the patient, as the anaesthetic takes effect and produces stupidity, the stopper may fall out, the whole contents of the bottle may be sucked up by the pillow, bolster, bed, or bedclothes, and the vapour being inhaled, fatal suffocation may ensue.

Another method of administering chloroform, which is very convenient when complete anaesthesia is required for a length of time, and when the supply of chloroform is limited, was devised by Sir James Simpson: it consists of either a cup-shaped inhaler, formed of a wire framework covered with flannel, or else simply of a single fold of a pocket-handkerchief thrown over the face : the chloroform is dropped upon the flannel or handkerchief just under the nostrils in single drops at a time. Another plan is to pour some chloroform on to a folded towel or pocket-handkerchief, and then place it over the patient's face, taking care that it does not come so close over the nose as to interfere with a free admixture of air with the chloroform vapour. There is this difference between ether and chloroform, that whereas it is highly inadvisable to give chloroform vapour in a concentrated condition, it is requisite to give the ether vapour very strong, in order to produce an anaesthetic effect. A combined administration of nitrous oxide and ether is now used to a considerable extent: the nitrous oxide producing rapid anaesthesia, which is kept up by the ether.