+------------------+-------------+------------------------------------+ | | Strength of | | | Age of Patient. | Ether in | Quantity of Mixture required. | | | Mixture. | | +------------------+-------------+------------------------------------+ | Under 6 years | 50% | One ounce to each 20 pounds body | | | | weight (no preliminary morphia) | | | | | | 6 to 12 years | 55% to 65% | Do. do. | | | | | | 12 to 15 years | Do. | One ounce to each 20 pounds body | | | | weight (but use ¹⁄₁₂ gr. morphia) | | | | | | 16 years and | 75% | One ounce to each 20 pounds body | | upwards | | weight with ⅙ gr. morphia as a | | | | preliminary | +------------------+-------------+------------------------------------+ In practice then, for the ordinary adult, one uses eight ounces of the mixture, six ounces of which are pure ether. The oil and ether require to be shaken together, but remain blended long enough for introduction. In five or ten minutes, the patient begins to feel a rather pleasing numbness and tingling in the lower, and later the upper extremities, and drops quietly to sleep in about twenty minutes. In a large proportion of cases, it is necessary to deepen the anæsthesia by the use of the open mask for a few minutes, but once a deep anæsthesia has been thus obtained, the absorption from the rectum will balance the loss in expiration and maintain a good anæsthesia for three quarters of an hour at least. On return to bed of the patient, the nurse passes two tubes placed side by side, as high into the rectum as she can; the end of a Higginson syringe is inserted into one of them, and a considerable quantity of soap and water is pumped gently into the bowel, escaping down the second tube. The washing must be continued until all smell of ether is removed. Finally the soapy water itself is washed away by a little saline. Unless there be some pre-existing local inflammatory disease of the rectum (in which case the method should not be used), there are no unpleasant sequelæ after oil ether. The chief objection to the method is the amount of labour thrown on the nursing staff, which is so considerable as to bar it from adoption as a routine. This should not, however, be allowed to prevent its use in the limited number of cases in which it is strongly indicated. These are:-- (1) Panic-struck cases who cannot face the ordeal of ordinary methods.