NITROGENIUM OXYGENATUM.
Nitrous oxide (gas). NO.
Laughing gas.
The gas is slightly soluble in water.
Authorities.
[Selected from numerous
observations. -T. F. A.] 1, Sir
Humphry Davy, experiments on self, Researches Chem. and Philosophical,
London, 1800; 2, same, subsequent
experiments with the gas mingled with the air; 3,
same, “when fatigued by a journey, I respired nine quarts of the
gas;” 4, same, “when
fatigued by a journey, I respired seven quarts;” 5, same, effects after having taken the gas,
often as many as four times a day, for a fortnight; 6, same, effects of inhaling the gas, in a
tight box, into which twenty quarts of gas were thrown; 7, same, effects on Mr. Toblin; 8, same, on Mr. Clayfield; 9, same, on Mr. Kinglake; 10, same, effects on Mr. Burnet; 11, same, on Mr. Edgeworth; 12, same, on Mr. Southey; 13, Pfaff, Nord. Archiv, 1804 (Frank’s Mag.,
3, 709), effects on Dr. Struve; 14,
same, on another individual; 15,
same, on another individual; 16,
Curtis, Bost. M. and S. Journ., 2, 425, effects in a lady, suffering
from asthma; 17, B. W. James, M.D.,
N. Am. J. of Hom., 1866, p. 517, effects in self; 18, Jeannel, Gaz. Hebd., 1869, experiments on
self; 19, same, effects in another
individual (taken for extraction of tooth); 20,
Braine, Brit. Med. Journ., 23 (1869), effects; 21,
Amory, N. Y. J. of Med., 1870, effects on self; 22,
Mitchell, experiments on friends, West Riding Lunatic Asylum Reports,
1871, p. 44, Mr. J.; 23, same, Dr.
N.; 24, same, Mr. D.; 25, same, Mr. H.; 26,
same, general effects; 27, same,
effects on self; 28, Maclaren, Edin.
Med. Journ., 1871, general effects; 29,
Mason, Lancet, 1873, p. 254, effects in a lady, who inhaled the gas to
have a tooth extracted; 30,
Farrington, Am. J. Hom. M. M., 4, 105, effects of inhalation in a
colored woman (with scrofulous glands); 31,
“S. W.,” Lond. Med. J., 1873, “personal experience;”
32, Br. Med. Journ., 1873,
“personal experience of a medical man;” 33, Thomson, Phil. Med. Times, 1873 (November
15th), general effects; 34,
Berridge, N. Am. J. of Hom., N. S., 5, p. 375, effects in self; 35, same, in another man; 36, same, in a girl; 37,
same, Am. Obs., 1875, p. 307, effects on self; 38,
Ostrom, Hahn. Month., 1875, p. 16, effects of a large amount, in a girl,
aged nineteen.
MIND.
►
Became so violent in dentist’s chair, could hardly hold her, [30]. ►
Unusual exaltation of mind, the most agreeable sensations and fancies;
had an involuntary desire to laugh (after one hour), [13]. ►
“The principal feeling was a total difficulty of restraining my
feelings, both corporeal and mental; or, in other words, not having any
command over myself,” [11]. ► Begged me to give her something to kill
her or else make her better, [30].
► Mental torture beyond endurance. It
was a nightmare of the mind, pure and simple, in which no earthly
objects took part. He was like Blake, or any other madman you might
name, trying in that exquisitely painful moment to solve the insoluble
and grasp the illimitable; he was now endeavoring to conceive what lay
beyond all space, and now trying to realize the condition of nothing.
Then came a spiral winding from an infinite distance into a point, when
he exclaimed to himself, “I can bear it no longer; I am going
mad,” and at that instant awoke, [31].
► “Inhaling the gas, I felt as
if every nerve was gently agitated with a lively enjoyment,” [10]. ►
Soon found his nervous system agitated by the highest sensations of
pleasure, but which were difficult of description. When the bags were
exhausted and taken from him, he suddenly started from his chair, and
vociferating with pleasure, made towards those that were present, as he
wished they should participate in his feelings. He struck gently at
Davy, and a stranger entering the room at the same moment, he made
towards him and gave him several blows; but, he adds, it was more in the
spirit of good humor than in that of anger. He then ran through
different rooms in the house, and at last returned to the laboratory
somewhat more composed, although his spirits continued more elevated for
some hours after the experiment; he felt, however, no subsequent effects
either in the evening or day following. Upon another occasion, he states
that his sensations were superior to anything he ever before
experienced; his step was firm, and all his muscular power increased.
His nerves were more alive to every surrounding impression; he threw
himself into several theatrical attitudes, and traversed the laboratory
with a quick step, while his mind was elevated to a most sublime height;
he says that it is giving but a faint idea of his feelings to say that
they resembled those produced by a representation of a heroic scene on
the stage, or by reading a sublime passage in poetry, when circumstances
contribute to awaken the finest sympathies of the soul. The influence,
however, of this inspiring agent appears to have been as transitory as
its effects were vivid; for he afterwards observes, “I have seldom
lately experienced vivid sensations. The pleasure produced by the gas is
slight and tranquil, and I rarely feel sublime emotions or increased
muscular power,” [7]. ► First, there was noticed a pleasant
sensation of exhilaration or general stimulation, in which the thoughts
ran rapidly through the brain, and soon it appeared to me that I was
dreaming; then the head felt full, giddiness supervened, and a humming
or buzzing sensation, together with a feeling as though I was gradually
being elevated up into the air and passing away. A peculiar tingling
sensation in the finer nerves of the extremities was observed, somewhat
analogous to that which is felt when experiencing that feeling which is
commonly expressed by the term “hand or foot being asleep,”
caused by pressure on the main nerve-trunk of the part, and similar to
that I noticed over the whole body when I was suffering from an attack
of “spotted fever” or typhus petechialis. The last impressions
were that I was laughing, while at the same time I was flying through
the air, and my feet were trembling and going up and down as though
pressing upon a treadle that propelled the imaginary machinery that was
conveying me through the air, while everything around was fast becoming
dim; complete unconsciousness then ensued. The return from this state
was sudden, as if arousing from a sound sleep, and the first objects
that attracted my attention were the five or six gentlemen who were in
the room, violently convulsed with laughter, while I myself was seized
with a hearty convulsion of laughter, which I could not in any manner
control, [17]. ► It produced the usual pleasurable
effects, and slight muscular motion. I continued exhilarated for some
minutes afterwards; but in half an hour found myself neither more nor
less exhausted than before the experiment. I had a great propensity to
sleep. I repeated the experiment four or five times during the following
week with similar effects. My susceptibility was certainly not
diminished; I even thought that I was more affected than formerly by
equal doses, [4]. [10.] ►
For three minutes I experienced no alteration in my sensations, though
immediately after the introduction of the Nitrous oxide, the smell and
taste of it were very evident. In four minutes I began to feel a slight
glow in the cheeks, and a generally diffused warmth over the chest,
though the temperature of the box was not quite 50°. I had neglected to
feel my pulse before I went in; at this time it was 104 and hard; the
animal heat was 98°. In ten minutes the animal heat was near 99°; in a
quarter of an hour, 99.5°, when the pulse was 102, and fuller than
before. At this period twenty quarts more of Nitrous oxide were thrown
into the box, and well mingled with the mass of air by agitation. In
twenty-five minutes the animal heat was 100°, pulse 124. In thirty
minutes twenty quarts more of gas were introduced. My sensations were
now pleasant; I had a generally diffused warmth, without the slightest
moisture of the skin; a sense of exhilaration similar to that produced
by a small dose of wine, and a disposition to muscular motion and to
merriment. In three-quarters of an hour the pulse was 104, and animal
heat not 99.5°; the temperature of the chamber was 64°. The
pleasurable feelings continued to increase, the pulse became fuller and
slower, till in about an hour it was 88, when the animal heat was 99°.
Twenty quarts more of air were admitted. I had now a great disposition
to laugh, luminous points seemed frequently to pass before my eyes, my
hearing was certainly more acute, and I felt a pleasant lightness and
power of exertion in my muscles. In a short time the symptoms became
stationary; breathing was rather oppressed, and on account of the great
desire of action, rest was painful. I now came out of the box, having
been in precisely an hour and a quarter. The moment after, I began to
respire twenty quarts of unmingled Nitrous oxide. A thrilling, extending
from the chest to the extremities, was almost immediately produced. I
felt a sense of tangible extension, highly pleasurable, in every limb;
my visible impressions were dazzling and apparently magnified; I heard
distinctly every sound in the room, and was perfectly aware of my
situation. By degrees, as the pleasurable sensations increased, I lost
all connection with external things; trains of vivid visible images
rapidly passed through my mind, and were connected with words in such a
manner as to produce perceptions perfectly novel. I existed in a world
of newly connected and newly modified ideas. I theorized; I imagined
that I made discoveries. When I was awakened from this semi-delirious
trance by Dr. Kinglake, who took the bag from my mouth, indignation and
pride were the first feeling produced by the sight of the persons about
me. My emotions were enthusiastic and sublime, and for a minute I walked
round the room perfectly regardless of what was said to me. As I
recovered my former state of mind, I felt an inclination to communicate
the discoveries I had made during the experiment. I endeavored to recall
the ideas; they were feeble and indistinct; one collection of terms,
however, presented itself, and with the most intense belief and
prophetic manner, I exclaimed to Dr. Kinglake, “Nothing exists but thoughts! The universe is composed of
impressions, ideas, pleasures, and pains!” About three
minutes and a half only had elapsed during this experiment, though the
time, as measured by the relative vividness of the recollected ideas,
appeared to me much longer. Not more than half of the Nitrous oxide was
consumed. After a minute, before the thrilling of the extremities had
disappeared, I breathed the remainder. Similar sensations were again
produced; I was quickly thrown into the pleasurable trance, and
continued in it longer than before. For many minutes after the
experiment, I experienced the thrilling in the extremities; the
exhilaration continued nearly two hours. For a much longer time I
experienced the mild enjoyment before described connected with
indolence; no depression or feebleness followed. I ate my dinner with
great appetite, and found myself lively and disposed to action
immediately afterwards. I passed the evening in executing experiments.
At night, I found myself unusually cheerful and active, and the hours
between 11 and 2 were spent in copying the foregoing detail from the
common place book, and in arranging the experiments. In bed, I enjoyed
profound repose. When I awoke in the morning, it was with consciousness
of pleasurable existence, and this consciousness, more or less,
continued through the day, [6]. ► A few seconds after the commencement of
the inhalation the pulse began to grow firmer and less compressible, and
to decrease in frequency, falling from 85 to 75 in the course of the
first minute. In less than a minute the breathing became quicker and
almost of a blowing character. He was somewhat exhilarated and stamped
with his feet to show the satisfaction he felt. The breathing then
assumed a labored, almost stertorous, character, and I attempted to
remove the face-piece, but he clutched it firmly and resisted my efforts
to do so not long, however, for he soon began to lose consciousness and
his hold relaxed. On recovering, which was almost instantaneous after
removal of the inhaler, he said he felt as if just aroused from a
delicious sleep, [22]. ► (The headache, which had troubled me
during the afternoon and before going to sleep, was entirely gone, and I
felt much invigorated by the effects of the gas), [17]. ► It
produced feelings analogous to those of intoxication. He was for some
time unconscious of existence, but at no period of the experiment were
his sensations agreeable; a momentary nausea followed, but unconnected
with languor or headache. In a subsequent trial it would appear that he
did experience certain thrillings that were highly pleasurable, [8]. ►
Sensations perfectly new and delightful, [12].
► The dilute gas has almost
invariably an exhilarating effect upon me; for the first few seconds the
symptoms resemble those caused by the pure gas, but come on more
gradually. The breathing is at first affected, and frequently at the end
of a minute is of a panting character. At this stage a slight sense of
suffocation may be felt, soon passing off, however, not to return again
as long as the supply of Nitrous oxide is abundant. The next symptom is
a feeling of fulness in the head, and a tendency to fixedness of the
eyes; then it soon becomes apparent that general sensibility is
affected, the perception of external objects being slower. Next is
noticed a sense of increased resistance in the feet, suggesting the idea
that they might act involuntarily in throwing the body forward. These
symptoms become more marked, and develop into unmistakable dizziness,
more noticeable, of course, if the inhalant is standing, and then an
effort is required to maintain the equilibrium. At this stage, too, are
perceived the thrilling and vibratory sensations; the accommodating
power of the eye is affected, and objects are seen as through a mist.
The senses of smell and hearing become more acute; distant and otherwise
faintly heard sounds are judged to be near, and are distinctly heard; if
they are of a rhythmical kind, as the sounds of a mason’s hammer, they
seem to recur more frequently, and the appreciation of the rhythm is
more acute. And now the more strictly mental symptoms come into
prominence. Having on one occasion inhaled the gas when I had a rather
severe headache, it was at this stage the sense of pain left me, after
which it seemed to me there was an interval between the perception that
the pain had given and that feeling of satisfaction which always follows
sudden relief from suffering, and my mind began to busy itself with
definitions of pleasure and pain; but this mood quickly changed to one
of extreme self-confidence-recklessness as to every other consideration
but that of having plenty of Nitrous oxide, and a general feeling of
contempt for all metaphysical questions whatever. Ideas rushed in a
disordered current through my mind, and delirium set in. It is at the
commencement of this stage that the mind loses the power of
discriminating between the appropriate and the ridiculous, and is
preternaturally susceptible of receiving and being influenced by
suggestions from without; and it is on the ideas and actions now
initiated that the delicious intoxication turns. The ideas seem, as it
were, to expand beyond the recognition of the mind, which at this point
in its disordered activity also seems to vault over that interval which,
in its normal condition, it recognizes to exist between the wish and its
realization. Automatic acts succeed each other, or are repeated with
great rapidity, and are performed in an exaggerated manner, the subject
of the experiment shouting and gesticulating with the greatest vehemence
should he wish to communicate any, even the most trivial thing, and
often repeating the last word of a sentence many times, and each time in
a louder key. I have endeavored to arrest the action of the gas in all
stages of its operation, with a view of analyzing, if possible, the
state of mind indicated by the confident belief that a great discovery
has been made. When it is considered with what avidity the gas is
inspired, and that it is necessary that the inhalation should be
discontinued at the very moment when the enjoyment it is affording is at
its height, and when all sense of prudence and responsibility seems to
be annihilated, it will be understood how great are the difficulties in
the way of success in such an attempt. On account of the delirium which
always accompanies this condition I could never be certain, on
recovering from the effects of the gas, that I had not passed through a
short stage of unconsciousness, nor that the idea my mind has grasped,
as being the last that had passed through it, was indeed the last. In
the milder forms of delirium it has seemed to me as though consciousness
kept ebbing and flowing. I feel sure, however, that in some instances I
have been able to secure the receding thought and to retain it until the
momentary confusion of mind had passed off. Two such instances I will
describe. On one occasion I wanted to find out how much gas was being
consumed in the experiment, and impressed on my mind the exceeding
desirableness of learning this. On emerging from the state of delirium I
found myself with uplifted hand in the act of striking my knee, to
impress upon my memory the fact that I had refilled the inhaling bag;
and I fancied that I either had shouted, or was upon the point of doing
so, in a triumphant voice, “I have filled it again.” The act
by which I sought to emphasize the important observation was a
repetition of a blow I had already given my knee, as there was still
some feeling of it left, and I thought that it was due to this that I
had so suddenly awaked to perfect consciousness. I found that I really
had turned the key to admit more of the gas into the bag. Had I not came
to myself at that moment, I have no doubt that in the next this trivial
occurrence would have been magnified beyond recognition, and have left
the feeling that I had discovered the secret of the universe. The second
time, returning clearness of intellect found me vociferating, in a most
triumphant tone of voice, and each time I fancied in a higher key,
“Off, off, off.” In this case the predominant idea, before the
commencement of the experiment, had been that I should notice how, and
in what time, I passed off into unconsciousness. Again, to show how
susceptible to suggestion the mind becomes under the influence of
Nitrous oxide, and how it takes up and exaggerates any activity, whether
bodily or mental, and how great the tendency is to dwell on and
intensify any process of thought or series of automatic acts, I may
describe how I was affected by the gas on other occasions. I respired it
standing, to notice whether this position would in any way incite to
bodily activity. As soon as I felt the influence of the gas stealing
over me I commenced gesticulating, and immediately noticed a strong
tendency to repeat the same movements, which, though at first wholly
voluntary, soon became automatic in character, and required an effort to
stop them. Commencing to shuffle about my feet as if dancing, I quickly
found myself going through the steps of a Scotch reel, the only dance I
ever properly learned, and which I believed I had forgotten. Each step
was made with more alacrity than the one before, until I found it
impossible to maintain any degree of accurate adaptation of the inhaler
to my face, and then the feelings of exhilaration died away. On almost
immediately resuming the inhalation in the sitting posture, however, I
passed into the delirious stage in a few seconds. I have found that, by
imitating the contortions of face attendant upon crying or laughing, I
can at will, at a certain stage in the operation of Nitrous oxide,
induce a most uncontrollable paroxysm of either. The general propensity
to laughter, I have thought, might be attributable, in some measure at
least, to the fact that when the inhalation has been continued a certain
length of time, convulsive contractions of the diaphragm always occur,
which would, of course, initiate one very important movement in the
automatic series accompanying laughter. The sense of hurry and
tumultuous rushing of ideas through the mind may be exaggerated by, if
it is not, in a great degree, due to, the furious panting which is
commonly observed before delirium sets in, [27]. ► He
found that he could breathe nine quarts of Nitrous oxide for three
minutes, and twelve quarts for rather more than four; but that he could
never breathe it, in any quantity, so long as five minutes. Whenever its
operation was carried to the highest extent, the pleasurable thrilling,
at its height about the middle of the experiment, gradually diminished,
the sense of pressure on the muscles was lost, impressions ceased to be
perceived, vivid ideas passed rapidly through the mind, and voluntary
power was altogether destroyed, so that the mouthpiece generally dropped
from his unclosed lips. When he breathed from six to seven quarts,
muscular motions were produced to a great extent; sometimes he
manifested his pleasure by stamping or laughing; at other times by
dancing round the room and vociferating, [5].
► I put myself into the hands of the
dentist one morning after my breakfast, and, after inhaling the gas for
the average time, soon became insensible; that is, to physical pain; but
my mental tortures, during that short period, were beyond endurance. It
was a nightmare of the mind, pure and simple, in which no earthly
objects took part. I was like Blake, or any other madman you might name,
trying in that exquisitely painful moment to solve the insoluble and
grasp the illimitable; I was now endeavoring to conceive what lay beyond
all space, and now trying to realize the condition of nothing. Then came
a spiral winding from an infinite distance into a point, when I
exclaimed to myself, “I can bear it no longer; I am going
mad,” and at that instant I awoke. I was perfectly collected, asked
if the tooth was out, and declared that I had felt no pain. I rose and
was about to leave when, being faint, I again sat down and was placed in
a horizontal position. Some brandy was given me, and in about half an
hour I revived. I again rose to leave; but on reaching the street-door,
I became faint once more, and was obliged to return. In another hour I
was assisted home, a few yards, feeling exceedingly ill, and was
compelled to lie down again when I reached my study. Presently I thought
I could see a patient who was waiting to consult me; but after
conversing with him a short time, the faintness again came over me and I
took once more to my couch. This state of things continued for four or
five hours, and was then succeeded by a severe headache, which lasted
for the rest of the day. Next morning I rose very “seedy,” as
if I had just come off a sea-voyage, and for a week afterwards was
exceedingly unwell, feeling low and depressed, as if my whole nervous
system had received a severe shock, which indeed it had, [32]. ► It is
curious to remark how often, as unconsciousness comes on, the ruling
idea is one of noise and motion combined. Some patients think they are
seated in or running after an omnibus; but many more imagine themselves
in a railway carriage, travelling faster and faster, till they suddenly
seem to enter a dark tunnel, and then all is a blank to them. Sensual
emotions are not unfrequently excited in both sexes. A man, who had been
married about three months, stated, on awaking, that he had been
dreaming of his wife; and an unmarried hysterical girl certainly gave
evidence, by her movements, that she was quite aware of one of the
duties of married life; and moreover, in this case, the idea was still
present when she was able to speak, for she addressed the administrator
in terms far fonder than the occasion warranted; while another girl, who
had behaved in a similar manner, said, “I hope I have not said
anything naughty,” [20]. ► In half a minute the respiration became
hurried, and the pulse accelerated. In one minute the pulse had risen
from 84 to 110, but was not more compressible than at the commencement.
There was twitching of the eyelids, and he said he felt jolly, but lazy,
and in a longing mood. At the end of two and a half minutes he felt
numbness in the feet, and hot and flushed about the face and ears. At
three and a half minutes the pulse was 108, tolerably firm; respiration
40. He now cried, in a excited voice, “I have something to
explain-give me some air!” The inhalation was continued altogether
seven minutes, when lividity of the face began to set in. Except a
little compression of mind, accompanied by flushing of the face, which
continued about a quarter of an hour, he felt much as usual, [24]. [20.]
► I could not take one full
inspiration of this gas without producing giddiness, and I could not
count after the sixth inspiration. I took twenty inhalations before
losing sensation. I could use my hands and was perfectly conscious, for
I endeavored to push away from the outlet-valve Dr. N.’s finger, as he
was obstructing the passage of inspired air. I then held my nose, and,
after three expirations more, I felt as if all my members were what is
commonly called asleep, especially in the right arm, in which the
circulation was accidentally impeded. In two more, I could not see, but
could hear Dr. N. counting, and was conscious of my respiration being
hurried and blowing, but not troubling me. I then lost all sensation,
and experienced a most singular feeling of elevation (as if I was in
rapid motion in the air). I could not now control my pharyngeal muscles,
so that air passed through my nostrils. I recovered most instantly, but
had trouble in talking, my words coming thick and throaty. I have since
taken the gas several times, and experienced the same pleasurable
sensations, only occurring more rapidly. Two inspirations of the gas
(purified) are sufficient to thicken my voice and cause dizziness. After
the sixth or eighth, I know nothing. Three inspirations caused the
peculiar feelings in the periphery, which I supposed due to the arrest
of capillary circulation. When the tube dropped from my mouth, I sat as
in a trance for half a minute, making no respiratory effort, when all of
a sudden I was told that I began to smile and to expire the contents of
my lungs at the same instant. I was conscious of smiling, but did not
know whether I expired or inspired air after the tube dropped from my
hands, [21]. ►
Palpitation of heart; afterwards felt and heard in head; then giddiness;
then rapid rush of thoughts through the mind; loss of muscular power;
the unconsciousness, with dilated pupils and livid face; woke as from a
dream, but could not remember what the thoughts were about; felt rather
faint; slight headache and nausea; face covered with perspiration, [34]. ►
He found that he was more irritable and restless than usual; that he
slept less, and previous to sleep the mind was long occupied by visible
imagery. Appetite and pulse were not materially affected, though there
were uneasy feelings about the præcordia analogous to the sickness of
hope, [5]. ►
After the giddiness, rapid rush of thoughts through the mind; afterwards
unconsciousness; woke as from a dream, but could not remember what the
thoughts were about, [34]. ► From three to four quarts was the usual
dose. It sometimes produced slight vertigo, and a feeling of languor;
these, however, went off in a few minutes, and, in about a quarter of an
hour, the pulse was usually lowered from 8 to 12 beats in a minute; in
one instance from 120 to 108; in another from 104 to 96. The heat of the
body was at the same time raised; a thermometer placed between the
shoulders rose, in one instance, from 92° o 96°; in another from 94°
to 98°; but never beyond 98°. The hands and feet, which were generally
cold, glowed; and the face, which was usually of purple or leaden hue,
assumed the natural appearance, [16].
► On April 16th, Dr. Kinglake being
accidentally present, I breathed three quarts of Nitrous oxide, from and
into a silk bag, for more than half a minute, without previously closing
my nose or exhausting my lungs. The first inspiration occasioned a
slight degree of giddiness, which was succeeded by an uncommon sense of
fulness in the head, accompanied with loss of distinct sensation and
voluntary power-a feeling analogous to that produced in the first stage
of intoxication, but unattended by pleasurable sensation. Dr. Kinglake,
who felt my pulse, informed me that it was rendered quicker and fuller, [1]. ►
Attacks of fainting, which began with a feeling of oppression at the
chest, and rolling upwards and to the left of both eyes; the loss of
consciousness which followed was so complete as to be unaffected by the
usual restoratives; during the attack, respiration slow but regular;
heart’s action was at first normal, but gradually became slow and
irregular, until almost imperceptible; pulsation could not be detected
in the temporal arteries; face, which was at first of a natural color,
became livid, with blue lips, and dark rings around the eyes; pupils
dilated and insensible to light; attacks lasted from ten to twenty
minutes; the return to consciousness was accompanied with much mental
anxiety, and followed by despair and silent weeping; the interval
between the attacks was never longer than five minutes (second day), [38]. ►
When about to leave, became faint; after reviving, became faint again on
reaching the street-door; after being assisted home, feeling exceedingly
ill, was again compelled to lie down; then, on conversing a short time,
the faintness again came over him, and he took once more to his couch.
This state of things continued for four or five hours, [31]. ► The
turns of faintness were succeeded by a severe headache, which lasted the
rest of the day, [31]. ► The feelings were different from those I
had experienced in former experiments. After the first six or seven
inspirations, I gradually began to lose the perception of external
things, and a vivid and intense recollection of some former experiment
passed through my mind, so that I called out, “What an amazing concentration of ideas!”
I had no pleasurable feeling whatever; I used no muscular motion, nor
did I feel any disposition to it; after a minute, when I made the note
of the experiment, all the uncommon sensations had vanished; they were
succeeded by a slight soreness in one of the arms and in the leg; in
three minutes these affections likewise disappeared, [3]. [30.] ► He remained perfectly quiet for nearly a
minute, and when asked how he felt, said he was drowsy, and just going
to sleep. He was told that he must keep awake. When he had respired the
gas for nearly two minutes, and seemed indisposed to activity of any
kind, he was told, in a loud voice, to get up, and asked if he was not
ready to dance; at the same time he was seized by the arm as if to lift
him from the chair. He immediately sprang to his feet, saying he was
ready for anything, and began capering and swinging his arms about as
though he had lost all control over his movements. He came to himself,
however, in a few seconds, looked bewildered, and said he remembered
nothing from the first few seconds after the commencement of the
inhalation, [25]. ► In the concentrated form it produces
anæsthesia in so rapid and agreeable a manner, that there is only time
to remark that the gas has a pleasant taste and odor; that it causes a
sense of dimness to pass before the eyes, and gives rise to a sound as
of rushing water in the ears, when all consciousness and power of
volition are annihilated. The outward signs of its action, as seen by a
spectator, do not make quite so agreeable an impression on the mind, for
with the commencement of anæsthesia lividity of the face sets in. The
muscles lose their tonicity; the jaws and lips fall asunder; the head
droops, and the face assumes a besotted aspect. Generally, loud snoring
accompanies inspiration, when the anæsthesia is very profound, though
this is not always the case. When an unusually large quantity of the gas
has been inhaled to produce anæsthesia, or when the gas has been in the
slightest degree diluted with common air, convulsions may occur
affecting the muscular system generally, though it is more common for
only the muscles of one limb to be affected. Mr. Fox has noticed that
violent twitchings often occur when young children are made to inhale
the gas. The intermediate signs are, that the breathing becomes quicker
in about twenty seconds after the commencement of inhalation; at the end
of a minute, however, it becomes smaller again and less frequent.
Complete anæsthesia is sometimes produced in less than a minute, but in
the majority of cases the inhalation must be continued a minute and a
half. When the administration is discontinued, recovery very rapidly
takes place, the first feelings being like those one has on being
suddenly awakened from an agreeable sleep; and on rising from the chair,
there is, for a moment or two, a feeling of unsteadiness, together with
slight confusion of ideas, and a tendency to stammering in speech. It is
very rarely that any disagreeable after-effects are complained of, [26]. ►
The first inspiration, and, I may say, the first contact of the gas with
the pulmonary membrane, produced a general sensation of numbness
somewhat like sleepiness. On the second inspiration the sensation of
numbness was decided; I seemed to see a gauze vibrating before the
vision, similar to that observed from the influence of chloroform. On
the third inspiration the numbness had made rapid progress, but
intelligence remained, with perfect freedom of movement. I pricked my
hand with a pin and found that sensibility was considerably diminished.
After the fourth inspiration, I began to be separated from the external
world; ideas were vague and exalted, yet I was quite able to prick my
hand with a pin, but did not experience any sensation therefrom; the
loss of sensibility, however, was not complete; I was conscious of
contact like that of a blunt instrument; the gauze before the eyes was
white and very brilliant, and the vibrations were very rapid, resembling
persistent phosphorescence; I continued to assist in the experiment of
which I was the subject. On the fifth inspiration I lost consciousness
and fell into a profound sleep without troubled dreams; during this the
inhaler was removed from my mouth without my being conscious of it, and
after remaining in this condition for half an hour, I came to myself;
the numbness disappeared very rapidly after inhaling pure air. After
four or five inspirations the forehead was covered with perspiration.
After the experiment I walked two kilometers without fatigue, and had a
very good appetite; I had lost none of my activity during the remainder
of the walk, only at night I felt more fatigued than usual, [18]. ►
After the third or fourth inspiration I experienced a heaviness of the
head and a little general muscular fatigue. My vision was affected, and
objects placed in front of me seemed to have a constant indistinct
motion. After one or two more inspirations I experienced a noise like
that of a railroad train passing through a tunnel; at this moment my
consciousness was perfect; I was still master of my will, although
feebly so; I noticed that I was not lying straight upon the couch, and
by a voluntary movement I rectified the position of my limbs.
Immediately after this my vision disappeared, and I completely lost
consciousness, but for an instant only I was able to analyze my
sensations; I seemed more lucid and exalted, as if separated from the
world. This state seemed to last for some seconds. When under the
influence of a new inspiration of the gas, I lost all recollection, and
seemed to pass into a state of sleep. I was afterwards conscious of a
noise in my ears, and of a vague impression of something touching my
tooth, not at all resembling pain. On inspiring atmospheric air I
returned to myself, without excitement and the recollection of the whole
experiment was agreeable rather than painful, [19]. ► The
feelings experienced during each stage of the operation of the gas, up
till the power of communicating them failed him, were described as they
occurred, and written down at the time. He first felt a difficulty in
moving the extensors of the left arm, then the flexors became affected
in like manner. The feeling next spread to the right arm and hand, and
immediately afterwards to the lower extremities, and there was a sense
of tingling all over the body, accompanied by a sort of vibrating
agitation of the muscles generally. He then said, with great emphasis,
“Intoxication,” and ceased further communicating his feelings,
though he seemed to know and be able to appreciate what was taking place
about him. There seemed no disposition to laughter. He soon fell into a
partly anæsthetic condition; but on an attempt being made to touch the
conjunctiva, he seemed to be roused to perfect consciousness again, and
tried to remove the face-piece, saying he had something to tell us.
Inhalation was then discontinued; he had breathed the gas a little over
two minutes. He imagined that he had made a very important discovery,
showing the manner in which Nitrous oxide acted, but on endeavoring to
recall it no trace of it remained, beyond a confident feeling that such
a discovery had flashed across his mind, [23].
► Whole body throbs after the
paroxysms of semi-unconsciousness, [30].
► She seemed to herself to pass
through a dream, [36]. ► Spells of semi-consciousness, preceded by
a numb feeling in head, spreading thence over the body; she falls
backwards to the ground; if she can get to the open air the spells are
postponed, but are all the harder when they do come; when busy at her
work they will no appear, but as soon as she goes to bed, or sits down
unoccupied, she is at once attacked; partially conscious; knows she is
sick, but cannot help herself; like one in nightmare afterwards her
whole body throbs, [30]. ► Complete loss of consciousness, and a
kind of ecstasy, with violent involuntary muscular movements, [13]. ►
On April 17th, having previously closed my nostrils and exhausted my
lungs, I breathed four quarts of the gas from and into a silk bag. The
first feelings were similar to those produced in the last experiment;
but in less than half a minute, the respiration being continued, they
diminished gradually, and were succeeded by a sensation analogous to
gentle pressure in all the muscles, attended by a highly pleasurable
thrilling, particularly in the chest and in the extremities. The objects
around me became dazzling, and my hearing more acute. Towards the last
inspirations, the thrilling increased, the sense of muscular power
became greater, and, at last, an irresistible propensity to action was
indulged in; I recollect but indistinctly what followed; I know that my
motions were various and violent. These effects very soon ceased after
the respiration of the gas. In ten minutes I had recovered my natural
state of mind. The thrilling in the extremities continued longer than
the other sensations. This experiment was made in the morning; no
languor or exhaustion was consequent; my feelings throughout the day
were as usual, and I passed the night in undisturbed repose. The next
morning the recollection of the effects of the gas was very indistinct;
and had not remarks written immediately after the experiment recalled
them to my mind, I should even have questioned their reality, [1]. [40.]
► The first marked effect is a
quickening of respiratory movements, which effect continually increases
up to the period of insensibility. In some cases the breathing is very
rapid and laborious, two or three inspirations being made per second.
Another effect, that seems to be common to all cases, is that during the
period of unconsciousness, so called, there is left scarcely more than a
bare idea of existence; all over ideas seem to be obliterated. Another
common effect is, that before the period of unconsciousness there is a
confusion of ideas. The appearance of a person who has become
unconscious from the inhalation of Nitrous oxide is evidently that of
asphyxia or suffocation. The countenance assumes a leaden hue; the eyes
lose their lustre and have, instead, a vacant stare, [33]. ► The
phenomena usually observed in the human subject when the gas is inhaled
are as follows: when it has been inspired two or three times, there is
an increase in the force and frequency of the pulse. In about twenty
seconds, if the breathing has been steady and regular to begin with, it
is also noticed to increase in frequency. This, however, from the
commencement is often irregular, shallow, and rapid, from the nervous
condition of the patient. In about thirty seconds, the patient’s color
begins to turn livid. When the gas has been continued for about one
minute the pulse is almost invariably noticed to fall in force and
frequency, the breathing is often labored, sometimes stertorous, though
I have several times seen cases where it became feebler until the
expiring valve was hardly raised; it was then either the case that the
patient was completely anæsthetized, or, if not, the breathing
commenced to improve in character. In the majority of cases, in one
minute and thirty seconds the patient is over. This is known by
different signs,-the one which is least open to mistake is a sudden
change in the patient’s appearance, which is difficult to describe, but
readily recognized; another is a nervous twitching of the hands. It is
not by any means necessary to carry the administration the length of
this in every case, but when it is present for a few seconds the patient
is quite insensible. In one case to which I gave the gas, this muscular
twitching affected the whole body, resembling almost an epileptic
convulsion; the patient was quite unconscious. It occasionally happens
about the period of the removal of the face-piece that the pulse
intermits a beat or two, and I have repeatedly seen the breathing stop,
during a period equal to four or five respirations, at the time when the
operation was commenced. It is very curious, and a fact which I have not
seen noticed by others, that the hearing remains acute frequently after
the other senses are in abeyance; thus patients are able to repeat
remarks made in their presence after they are apparently unconscious,
and one young lady was able to repeat a hasty remark, made by the
operator, Mr. Warwick Hele, when a tooth broke under the forceps,
although she did not feel its subsequent removal, and the observation
was made in so low a voice that I did not catch what it was, though I
was standing beside him. There often exists considerable muscular
rigidity during the latter stages of the administration. In thirty-seven
cases, the time taken to produce insensibility was as follows:
Up to 1 minute, inclusive,
Up to 1 minute 20 seconds, inclusive,
Up to 1 minute 40 seconds, inclusive,
Up to 2 minute inclusive,
Up to 2 minute 20 seconds, inclusive,9
17
5
5
1The shortest time was forty-five seconds, the longest
two minutes thirteen seconds. Recovery is usually rapid and complete,
the patient waking up as from a sleep. But it does sometimes happen,
usually in young ladies between the ages of fourteen and twenty, that
there is an intermediate stage between that of complete unconsciousness
and recovery, when some excitement is exhibited, such as tossing about
restlessly in the chair and weeping, they, on recovery, being generally
very much surprised to find themselves so doing. Out of the
above-mentioned cases, we have noted seven to have been affected in this
manner in a greater or less degree; three complained of slight giddiness
or faintness, and one was a little sick. One patient, a boy, urinated,
his father having declined to indulge his expressed wish to do it before
the operation. In several cases the removal of teeth was felt, but
unattended with pain. The longest period during which we have noticed a
patient to be insensible is one minute. In regard to the sensations
experienced by patients, the majority are able only to say that they
have been unconscious, save that they have been asleep and dreaming, the
dreams being often pleasant, sometimes more like nightmare; and lastly,
some complain that they have had considerable annoyance from rushing or
singing noises in the head. One little girl was immensely pleased with
it; she said that “she felt as if she was being tickled all
over.” Unconscious reflex screaming is not uncommon with children
during the operation, but it does not seem to be connected with any
particular form of dreaming, [28].
► Soon became insensible to physical pain, [31].
► A peculiar sensation of expansion, [14]. ►
For a week afterwards exceedingly unwell, feeling low and depressed, as
if the whole nervous system had received a severe shock, [31]. ► Rose
in the morning very “seedy,” as if he had just come off a
sea-voyage, [31].
HEAD.
►
On going into open air, vertigo, with staggering to the left, [36]. ►
Decided dulness and almost dizziness of the head, [15]. ►
Giddiness after the palpitation, [34].
► A kind of waving of the head, [14]. [50.]
► Numb feeling in head, spreading
thence over the body, before the paroxysms, [30]. ►
Headache and aching along spine, as if they were asleep, [30]. ►
Headache after the return of consciousness, [34].
EYE, EAR, AND FACE.
►
Dilated pupils with the unconsciousness, [34].
► Eyeballs protruding, [29]. ► On
waking from the unconsciousness, voices of others seemed to proceed from
a great distance, [35]. ► On waking, voices seemed to come from a
distance, or to be in a whisper, [36].
► He had to an excessive degree the
livid countenance and blue lips so frequently noticed in administering
this gas, [17a]. ► Livid face with the unconsciousness, [34]. ►
Livid face, [36]. [60.] ►
Features puffy and swollen, [29]. ► Blueness of the lips, ear, and face;
afterwards, face dusky, [29]. ► It needed great force to separate the
jaws, [29].
MOUTH, THROAT, STOMACH, AND RECTUM.
► Mouth and head feel numb, as though
asleep, [30]. ► The point of the tongue thrust between
the teeth, [29]. ► Weakness, and feeling of constriction in
the throat, which interfered with deglutition (second day), [38]. ►
Pressure in the epigastrium, [30].
► Nausea, after the return of
consciousness, [34]. ► Vomiting, subsequent to the operation,
from saliva running down the throat upon the epiglottis; he was of a
bilious temperament, and the next day suffered some from bilious
vomiting, [17a]. ► (The hæmorrhoidal pains, from which the
prover suffered, entirely disappeared), [13].
RESPIRATION, HEART, NECK AND BACK.
[70.] ►
Quick respiration, [36]. ► Breathing thick and stertorous, [29]. ►
Suffocating feeling, [36]. ► Palpitation of heart, afterwards felt and
heard in head, [34]. ► Tension in sides of neck, in region of
carotids, [37]. ► Drawing in neck, as though skin were
contracted or cords shortened, [30].
► Sensation of drawing in the
muscles, especially in the lumbar muscles, [13].
GENERALITIES AND FEVER.
► Increased muscular rigor, [13]. ► Loss
of muscular power, [34]. ► The account given by Dr. Kinglake agrees
pretty much with those already cited. He adds, however, that the
inspiration of the gas had the farther effect of reviving rheumatic
irritations in the shoulder and knee-joints, which had not been
previously felt for many months. Though much relieved of the pains,
noticed when the effects were passing off, a momentary recurrence of
rheumatic pains, not felt for some time before, and that a yellow area,
caused by a leechbite, became, during inhalation, red and swollen, and
the itching and tingling was so great as to cause a fear of suppuration,
[9]. [80.]
► General weakness and prostration, [39]. ►
Rather faint after the return of consciousness, [34]. ► Fever
every afternoon from 3 to 6, [30].
► Face covered with perspiration
after the return of consciousness, [34].
► Coldness of feet and legs to the
knees between the paroxysms of unconsciousness, [30].® 2000
Article