There is generally a considerable amount of anæsthesia connected with this degree of narcotism, and I believe that it is scarcely ever necessary to proceed beyond it in obstetric practice, not even in artificial delivery, unless for the purpose of arresting powerful uterine action, in order to facilitate turning the fœtus. The loss of sensation is indeed sometimes so complete in this degree, especially in children, that the surgeon’s knife may be used without pain; I have indeed seen a child unconsciously handling its toys all the time that the operation of lithotomy was performed on it. Commonly, however, the use of the knife, when the narcotism has not proceeded further than this degree, occasions expressions indicative of pain, which are either not remembered, or are recollected as having occurred in a dream. The patient is generally in this degree during the greater part of the time occupied in protracted operations; for although, in most cases, it is necessary to induce a further amount of narcotism before the operation is commenced, it is not usually necessary to maintain it at a point beyond this. In the third degree of narcotism, there are no longer any voluntary motions. The eyes, for instance, are not directed towards any object; and although the limbs may move, they are not directed to any purpose. The pupils are generally inclined upwards in this degree, and are at the same time usually somewhat contracted. The bloodvessels of the conjunctiva are generally somewhat enlarged in this degree in all persons who are well nourished and not deficient in blood. It is in this degree of narcotism that rigidity and spasms of the muscles occur in certain cases. These phenomena occur most frequently in cases where the muscles have been much exercised, and are consequently well nourished. They are never met with in infancy, and rarely before puberty. They are much more common in the male than the female sex. The rigidity and spasm are greatest and most constant in labourers and persons accustomed to athletic exercises, and they are usually absent in patients who have been long confined to the room, or are much reduced in strength from any cause. They are less marked in old age than in the middle period of life, and they are not by any means so frequent or strong in fat, as in thin, muscular persons. I have seen the spasms take an epileptiform character in a few cases; but by gently continuing the chloroform, they have always been subdued. In a great number of cases, the patient mutters in an almost inarticulate and a perfectly unintelligible manner, just as the muscular rigidity and spasm are subdued. Under these circumstances, I have never heard a single word pronounced so that it could be understood. If articulate language is uttered just after the muscular rigidity, it is evidence that the effects of the chloroform are being allowed to diminish, and that the patient is going back into the second degree of narcotism.