will be necessary, for in such cases syncope is very frequent. Besides, such a patient resists the action of the drug for a long time, and it must be administered in far greater quantity than in the other case. The chloroform always retains its power, but the cerebral excitation to which some patients are subject enables them to resist its toxic action, as though the will could, so to speak, brace itself up to resist the action of the poison on the nerve-centres. The same occurs in the use of alcohol. One who will not be intoxicated may drink a large quantity without being drunk. At length, however, his will is conquered, and he falls to the ground, but he will not have experienced the exhilaration, the mad excitation, of the man who gives himself up to the influence of the liquor.
Thus, then, under the action of chloroform we find an antagonism existing between the various intellectual faculties—on the one hand the voluntary, and on the other the unconscious faculties. The latter are slowest to disappear; ideation, its guide and check, being deranged or destroyed, follows its habitual laws: association of ideas persists. External sensations are still borne in upon the mind, each one awaking a long series of ideas. As the sense of hearing is the last to disappear, the patient, though he can no longer either see or feel, hears every word that is spoken, and is set a-thinking at once. The same thing occurs in ordinary sleep, rarely in adults, but very frequently in young children. In fact, a certain degree of natural somnambulism is nearly always to be found in children. The child speaks out aloud without waking, he laughs and talks; more frequently he is frightened and cries. The course of his thoughts may be altered, diverted into another channel, by speaking to him gently, and this without arousing him from sleep. On awaking, all recollection of this has vanished. This method has been tried in mental alienation, to divert the thoughts of melancholies and hypochondriacs.
But soon these external phenomena which indicate the preservation of the intelligence, if not its integrity, disappear in their turn. The period of excitation is succeeded by the period of relaxation, and then the patient is in a deep sleep. However violent the external excitations, however painful the surgical operation, nothing can arouse the patient out of the comatose state into which he has fallen. His respiration is regular, his pulse slow and full, his pupils are motionless, and his features, paralyzed as it were, no longer wear that convulsive grimace which may be regarded as the last trace of sensibility. Intelligence is now destroyed. The coma of chloroform and that of alcohol appear to be essentially one. And, yet, what a difference! The former saves man from pain, the latter drags man down to the lowest depths of degradation; yet in both all signs of intellectual life have disappeared—there is a temporary death of the mind. It may be that, in the inmost nerve-tissues, brain-work still goes on, unconscious and silent, but whether this is so we know not.
