_Febrile patients_ absorb anæsthetics very rapidly and therefore go under very quickly. Acute septic cases must not have chloroform or ethyl chloride (_see_ page 155): nitrous oxide and oxygen is ideal, ether the next best. Patients who have suffered from acute infectious disease, especially diphtheria and influenza, may present some weakness of heart muscle for many months after the attack. EXHAUSTED AND SHOCKED CASES. Give nitrous oxide and oxygen if possible--failing that, ether. Closed-ether sometimes does very well for the induction stage. DIABETES. Chloroform is wholly inadmissible. GENITO-URINARY SYSTEM. _Kidneys._--Avoid ether in acute or sub-acute nephritis: give it, however, for nephrectomy when the other kidney is sound. _Bladder._--Distending the bladder with lotion often causes reflex inhibition of respiration: if that happens, stop the anæsthetic, give artificial respiration, and ask the surgeon to get on with opening the bladder. _Morphia_ usually arrests temporarily the secretion of urine: it should therefore not be given if chromocystoscopy or catheterisation of the ureters is contemplated. _Prostatectomy cases_ are often rather broken subjects: give a fairly deep anæsthesia until the shelling out of the prostate is begun: then be careful--the patient is breathing deeply as a rule, and can readily get an overdose. He will inevitably suffer a fair amount of shock: be ready to lower the table at the head end if any serious collapse occurs. Don’t be shy of starting a little artificial respiration even though the natural function is not entirely abolished. _Circumcision_ usually causes a good deal of laryngeal spasm, especially in children. Don’t try to abolish this by deepening the anæsthesia. You won’t succeed unless you nearly kill the patient. Rub the lips, and if very severe ask the surgeon to stop a minute until the crowing becomes less. _Castration._--Always give ether, or gas-oxygen. Castration and reduction of dislocation are the two commonest causes of reflex syncope under chloroform. MENSTRUATION, PREGNANCY, AND LABOUR. It is usual to avoid anæsthetics during the menstrual period if possible, the nervous system being unlikely to be at its best at that time. Pregnant patients take no harm from an anæsthetic properly given, but undue cyanosis must be avoided or abortion may occur. The pains of labour may be alleviated by chloroform given to an early second stage only, or by “twilight sleep” (_see_ page 44). For the major operations of obstetrics, however, ether has its usual advantages, provided no bronchitis be present. The shock of such operations as a difficult version is considerable, and quite sufficient to call for ether rather than chloroform.