would be mistaken for excitement or spasm caused by chloroform. In a case, No. 34, which occurred at St. Bartholomew’s Hospital whilst Dr. Black was present, and long before his pamphlet was written, the patient inhaled for five minutes, and sank off into a state of complete insensibility without alarming symptoms. The inhalation was discontinued, the patient moved into a proper position, and the operation just about to be commenced, when Dr. Black found the pulse to become extremely feeble and fluttering. Surely this patient breathed the chloroform, and died without any spasm of the glottis. In Case 48, so minutely related by Mr. Paget, the boy made one long inspiration, and became suddenly insensible. In a few seconds, the pulse suddenly failed, and then ceased to be perceptible, but the breathing continued for at least a minute afterwards. There was certainly no closure of the glottis in this instance. _Alleged Exhaustion from Struggling._ In cases where the patients have struggled violently whilst getting under the influence of chloroform, the accidents have been attributed to a supposed exhaustion caused by the struggling.[136] This opinion is, however, contrary to experience; for the patients who struggle violently are precisely those who bear chloroform the best, provided they do not breathe it in an insufficient state of dilution. They are generally cheerful and exhilarated by it, and are less liable to be depressed by its prolonged use, than those who come quietly under its influence. Although the patients who struggle bear the chloroform well, when it is carefully and judiciously administered, it is not improbable that the struggling has been now and then an indirect cause of accident. The muscular spasm and rigidity do not occur till about three-quarters as much chloroform has been absorbed as can be present in the system with safety; and, as the patients often hold their breath whilst struggling, and take deep inspirations suddenly and at long intervals, the greatest care is required that the vapour be administered in a very diluted state. In Cases 9, 44, and 47, the fatal symptoms came on whilst the patients were struggling; and in some other cases, the sudden failure of pulse occurred just after the struggling had ceased, rendering it probable that the patient inhaled too much of the vapour whilst struggling, or just as the spasmodic condition of the muscles was subsiding.