After the injection has been completed the patient is placed flat on his back and then lowered into the Trendelenburg position. Analgesia appears first in the scrotum and perineum, extends down the medial side of the leg to the foot, then appears on the front of the leg, and travels up to the groin and the lower part of the abdomen. The progress of the analgesia is tested from time to time by lightly pinching or pricking the skin, the patient’s eyes being screened. When the analgesia reaches the level of the nipples, the patient is raised into the horizontal position and the the operation may be commenced. Some surgeons object to the lowering of the head as rendering paralysis of the respiratory centre from upward diffusion of the drug more likely. If tropacocaine is used in the dosage indicated and the table elevated when the anæsthesia reaches the nipple line, there seems to be little risk of this complication. If analgesia is only desired in the lower extremity, the lowering of the table may be omitted; but if a good anæsthesia is desired above the level of the groin, it should always be carried out. Analgesia is complete in five or ten minutes as a rule. The duration varies from three-quarters of an hour to an hour and a half. If a preliminary hypodermic injection of morphine and scopolamine has been given, the patient lies quietly and patiently until the operation is completed. In some cases the patient actually drops off to sleep from the effects of the morphine. It is not uncommon to observe a temporary nausea and faintness about fifteen or twenty minutes after the injection has been made, and it is good practice to give the patient a little brandy and water at this stage. Complications and After-Effects. A great deal has been written in the past with regard to unpleasant results of spinal analgesia, but most of these would appear to have been the result of faulty technique or of the use of an impure or irritating drug. When tropacocaine is used in the manner described, the usual result is that, except for occasional nausea and faintness at the commencement, the patient has a comfortable, painless operation, and a recovery which is unmarred by the sickness and other distressing symptoms which are so common after general anæsthesia. _Deaths_ have been recorded, and these have been ascribed to the drug having travelled too high and brought about paralysis of the respiratory centre in the medulla oblongata. Too much importance has probably been ascribed to these fatal cases. They have been most common in patients greatly enfeebled by shock, old age, or debilitating illness, who are liable to die during the operation whatever anæsthetic is used. Thousands of cases have been recorded without a death, and in the hands of surgeons of skill and judgment fatal cases are almost unknown.