The next notice of any attempt to prevent the pain of operations, that I am aware of, occurs in the work on Surgery of Theodoric, an author who lived in Italy in the latter half of the thirteenth century. He writes as follows:[15] “The making of a flavour for performing surgical operations according to Dominus Hugo. It is thus made:—take of opium, of the juice of the unripe mulberry, of hyoscyamus, of the juice of hemlock, of the juice of the leaves of mandragora, of the juice of the woody ivy, of the juice of the forest mulberry, of the seeds of lettuce, of the seeds of the dock, which has large round apples, and of the water hemlock [cicuta]—each an ounce; mix all these in a brazen vessel, and then place in it a new sponge; let the whole boil, as long as the sun lasts on the dog days, until the sponge consumes it all, and it is boiled away in it (the sponge). As oft as there shall be need of it, place this sponge in hot water for an hour, and let it be applied to the nostrils of him who is to be operated on, until he has fallen asleep; and so let the surgery be performed. This being finished, in order to awaken him, apply another sponge, dipped in vinegar, frequently to the nose, or throw the juice of the root of fenugrek into the nostrils; shortly he awakes.” I altogether disbelieve that a sponge, prepared as above, would, after being placed in hot water, give off any odour or vapour which would cause insensibility. The active ingredients, as they exist in the various plants, are not sufficiently volatile to be given off at a heat below that of boiling water. Hemlock, indeed, contains a volatile principle, which can be liberated by an alkali; but, even if it were set free by any chance during the preparation of the sponge, it would all be dissipated by the long boiling. If sleep were really caused in this way, it must have been by some of the moisture from the sponge reaching the mouth or throat, and being swallowed; and it may be remarked that the author speaks of the preparation of a taste or flavour (confectio saporis), rather than an odour, although the sponge is certainly directed to be applied to the nostrils. It must be remarked, also, that if the patient were made so insensible, as not to feel the surgeon’s knife, he would be little affected by vinegar, or the juice of fenugrek, in his nostrils. Immediately after the prescription quoted above, and in the same paragraph with it, Theodoric gives another recipe from Master Hugo, directing antimony, quicksilver, soap, quick lime, and a little arsenic, to be sublimed together. A portion of the resulting compound, the size of a nut, is directed to be placed over a hernia, or whatever else is to be operated on. Then follows a rather lengthy direction for subliming arsenic, also from Dominus Hugo. The arsenic so sublimed is described as rendering surgical operations extremely pleasant. The words are—“hæc acus fiat mitis et suavis: sicut sudor beatæ virginis quum peperit Christum.”