reely circulating, and more especially by that contained within the
trunk and head. That which is incarcerated behind the ligatures is as
effectually withdrawn from the realm of physiological action as though
it had been abstracted by the surgeon's knife. Elimination by the
knife and elimination by the ligature are, for present purposes, then,
one and the same thing. Hence, if we let _d'_ represent the amount of
blood incarcerated behind the ligatures, _x_ the magnitude of the
physiological effect which we are seeking, _b_ the amount of remedy
exhibited, and a the total amount of blood contained in the whole
organism, we shall have the formula,

b b
x = ------ = -----
a - d' a - d

Several years since, I had an excellent opportunity of proving the
truth of the foregoing, in connection with the administration of ether
in the case of a patient who resisted all attempts to anaesthetize him
in the ordinary way.

The case in question was a man under treatment at the Manhattan Eye
and Ear Hospital, upon whom it was deemed advisable to perform an
operation. As has been said, the ordinary means of inducing anaesthesia
had proved ineffectual, for the man was a confirmed drunkard; and it
was at this juncture that I was called in consultation and requested
by my friend, Dr. David Webster, one of the surgeons of the hospital,
to endeavor to devise some means of getting the man under the
influence of the anaesthetic.

The procedure which I suggested was this:[3] Around the upper part of
each thigh a flat rubber tourniquet was tightly drawn and secured in
place in the usual manner. By this means the sequestration of all the
blood contained in the lower limbs was accomplished; but, inasmuch as
both artery and vein were compressed, only the amount of blood usually
contained in each limb was shut off from the rest of the body--which
would not have been the case had we contented ourselves with merely
compressing the veins, as some have done.

[Footnote 3: On the "Effective and Rapid Induction of General
Anaesthesia," the New York _Medical Journal_, October 22 and December
24, 1887.]

In subsequently commenting on my published report of this case, that
most accomplished writer and physician, Henry M. Lyman--than whom
there is no greater authority on anaesthesia--observes that the plan
proposed and adopted by me on this occasion (that of compressing both
vein and artery) is far pref