Consumers Union Report on Licit and Illicit Drugs The Consumers Union Report on Licit and Illicit Drugs by Edward M. Brecher and the Editors of Consumer Reports Magazine, 1972 Part VI Inhalants and Solvents and Glue-Sniffing The first two anesthetic gases, nitrous oxide (N 2 O, "laughing gas") and ether, were used recreationally prior to their adoption for surgical anesthesia. Nitrous oxide can produce a relatively shallow anesthesia, useful in dentistry and during childbirth, and, together with other anesthetics, in surgery. Ether has been widely used as a general anesthetic, but its flammability and other disadvantages have seen it largely replaced by newer anesthetics. Chloroform is still sometimes administered in obstetrics, but its use otherwise is greatly limited because of possible undesirable side effects from moderate doses and possible death or liver damage from overdose. Organic solvents, such as gasoline, benzene, and related chemical substances, are toxic when inhaled for lengthy periods in unventilated areas, such as some industrial settings. Brief inhalation of these and similar substances can also produce many of the effects of alcohol intoxication and, sometimes, a hallucinogen-like "trip." The best known example is glue-sniffing, which involves inhaling the organic solvents found in "hobby glue," mainly toluene. Chapter 43. The historical antecedents of glue-sniffing That drugs of many kinds reach the brain more rapidly and efficiently when they are sniffed rather than swallowed is a commonplace of physiology. The lung, after all, is designed to admit oxygen promptly and effortlessly into the bloodstream; and such drugs as heroin, nicotine, and cocaine readily follow the same short route when they are inhaled, reaching the brain in seconds. Nicotine and marijuana are customarily taken via the lung route. Inhalation is also commonly used to produce anesthesia with ether, chloroform, nitrous oxide (laughing gas), and a wide range of newer anesthetic agents. In this chapter we shall review the nonmedical use of these anesthetic inhalants, and of a number of other mind-affecting substances most of them organic solvents extracted from petroleum that are commonly inhaled. "The voluntary inhalation of vapors for the purpose of altering psychological states has a long history," Edward A. Preble and Gabriel V. Laury noted in the Fall 1967 issue of the International Journal of the Addictions. "At Delphi, in the ancient Greek world, the Pythia sat on a tripod above a cleft in the rocks and inhaled cold vapors emanating from inside the earth, which induced in her an ecstatic alteration of mind. In this altered state she uttered mystical observations in the presence of the Delphi Prophet, who translated them into oracular pronouncements. "In the ancient Judaic world, the vapors from burnt spices and aromatic gums were considered part of a pleasurable act of worship. In Proverbs (27:9), it is said that 'ointment and perfume rejoice the heart.' Perfumes were widely used in Egyptian worship. Stone altars have been unearthed in Babylon and Palestine which have been used for burning incense made of aromatic wood and spices." 1 While casual readers today may interpret such practices as mere satisfaction of the desire for pleasant odors, this is almost certainly an error; in many or most cases, a psychoactive drug was being inhaled. In the islands of the Mediterranean 2,500 years ago and in Africa hundreds of years ago, for example, leaves and flowers of a particular plant were often thrown upon bonfires and the smoke was inhaled; the plant was marijuana (see Chapter 53). The inhalation of LSD-like snuffs by North and South American Indians is similarly well-documented. Thus drug inhaling as it is known today has a long tradition. With the dawn of modern chemistry, new substances were discovered that had mood-altering effects effects usually resembling those of alcohol, but in some cases producing in addition the equivalent of a short, mild hallucinogenic "trip." The late Dr. David R. Nagle, assistant professor of pharmacology at the University of Kentucky, made a historical study of these newer substances; following his death, his findings were published in the Spring 1968 issue of the International Journal of the Addictions. Nitrous oxide (N 2 O). This gas was discovered in 1776 by Sir Joseph Priestley, and was first synthesized in the same year by an English chemist, Humphrey (later Sir Humphrey) Davy. Davy exposed nitrous peroxide (N 2 0 4 ) to iron and thus removed three of the four oxygen atoms. When inhaled, Davy learned, the gas N 2 0 produces initially a state of excitement often accompanied by loud laughter; hence nitrous oxide came to be called "laughing gas." Davy soon gathered around him for nitrous-oxide parties, Dr. Nagle reports, "a group of gay spirits who were perhaps more interested in seeking 'pleasurable effects' getting drunk than in scientific research ." 2 Among those who inhaled nitrous oxide with Davy were the poets Coleridge and Southey, the potter Josiah (later Sir Josiah) Wedgwood, and Roget of Roget's Thesaurus. The experience was pleasant and a little like getting drunk but it had several major advantages over alcohol drunkenness. The N 2 0 effect sets in within thirty seconds after inhaling the gas, and the peak effect lasts only two or three minutes. Unlike alcohol, moreover, there is no tendency to increase the dose at each inhalation. On the contrary, experienced N 2 0 inhalers report an increase in effects without increasing the dose, as is also the case with marijuana. Davy apparently thought of marketing the new gas, for he calculated that he could supply it in bags at a lower price than was then being charged for alcoholic beverages and alcohol at the end of the eighteenth century was notoriously cheap. Southey commented after one of Davy's N 2 O parties that the atmosphere of the highest of all possible heavens was no doubt composed of nitrous oxide. Noting that pains vanished under the influence of nitrous oxide, Davy proposed in 1799 that it be used in surgical operations; but no one bothered to test this possibility for another forty-five years. Dr. Nagle cites several references to nitrous-oxide intoxication in American medical publications of the early 1800s. There are also nineteenth-century American references to the use of nitrous oxide by students, indicating that N 2 0 sniffing for its "exhilarating" effects 3  was endemic among American students. One young American medical student, Gardner Quincy Colton, decided like Sir Humphrey Davy that nitrous oxide might be profitably marketed in competition with alcohol as a recreational drug; when his first public demonstration of the gas netted him $535, he quit medical school and went into the nitrous-oxide business. An advertisement for his nitrous-oxide demonstration in Hartford, Connecticut, in 1844 read as follows: A Grand Exhibition of the effects produced by inhaling Nitrous Oxide, Exhilarating or Laughing Gas! will be given at Union Hall this (Tuesday) Evening, Dec. 10th, 1844. Forty gallons of Gas will be prepared and administered to all in the audience who desire to inhale it. Twelve Young Men have volunteered to inhale the Gas, to commence the entertainment. Eight Strong Men are engaged to occupy the front seats to protect those under the influence of the Gas from injuring themselves or others. This course is adopted that no apprehension of danger may be entertained. Probably no one will attempt to fight. The effect of the Gas is to make those who inhale it either Laugh, Sing, Dance, Speak or Fight, and so forth, according to the leading trait of their character. They seem to retain consciousness enough not to say or do that which they would have occasion to regret. N.B. The Gas will be administered only to gentlemen of the first respectability. The object is to make the entertainment in every respect a genteel affair. * 4 * The twenty-five-cent admission charge included a dose of N 2 O. Among those who attended Colton's Hartford demonstration was a young dentist, Horace Wells, who was particularly impressed when one of the nitrous-oxide sniffers tripped and fell to the ground, gashing his leg in the process. To the victim's own astonishment, the wound was unaccompanied by pain. Wells questioned the young man closely about this and was so impressed by the absence of pain that the next day he had Colton pull one of his teeth under nitrous-oxide anesthesia. Feeling no pain, Wells exclaimed, "A new era in tooth-pulling!" Thereafter he used nitrous oxide on several patients in his Hartford dental practice and a few weeks later, on January 10, 1845, he demonstrated the use of nitrous oxide during surgery at the Massachusetts General Hospital in Boston. Unfortunately, the patient came out of the anesthesia too soon and screamed in pain; Wells was laughed out of the hospital. 5 Despite this unfortunate inaugural, the use of N 2 O as an anesthetic spread, and the gas is in common use today for the reduction of pain during tooth extractions and other dental procedures, during childbirth, and (in association with other more potent and longer-acting anesthetics) during surgery. 6 That nitrous-oxide inhalation for recreational purposes has continued on a small scale, with few interruptions, to the present time, seems well established. Use among young people was reported from Maryland in 1971 7 and was observed in Vancouver, British Columbia, in the course of research for this Consumers Union Report. In 1970, Dr. Edward J. Lynn and his associates at Michigan State University, in cooperation with the staff of the East Lansing Drug Information Center, made a survey of the nonmedical use of N 2 0 in mid-Michigan. It was not uncommon [they reported] to hear from individuals who had been to parties where a professional (doctor, nurse, scientist, inhalation therapist, researcher) had provided nitrous oxide. There also were those who work in restaurants who used the N 2 0 stored in tanks for the preparation of whip cream. Reports were received from individuals who used the gas contained in aerosol cans both of food and non-food products. At a recent rock festival nitrous oxide was widely sold for 25 cents a balloon. Contact was made with a "mystical-religious" group that used the gas to accelerate arriving at their transcendental-meditative state of choice. Although a few, more sophisticated users employed nitrous oxide-oxygen mixes with elaborate equipment, most users employed balloons or plastic bags. They either held a breath of N 2 O or rebreathed the gas. There were no adverse effects reported in the more than one hundred individuals surveyed. 8 The Michigan group also supplied nitrous oxide to 34 volunteers who breathed it under laboratory conditions. "Subjective findings generally indicated pleasurable effects," which set in within fifteen to thirty seconds. Tests were administered shortly after inhaling; "cognitive defects were noted during the peak high but returned to normal within five minutes." Adverse effects in general were described as "minimal." The Lynn group reported their findings at the, May 1971 meeting of the American Psychiatric Association. Ether. Though ether is available as a liquid, it vaporizes very easi1y at room temperature; it can therefore be either swallowed or inhaled. The effects are quicker when it is inhaled but are otherwise much the same. This drug is manufactured by distilling alcohol and sulphuric acid together a discovery said to date from the thirteenth century. "A dose of a little more than [a teaspoonful]," Encyclopaedia Britannica reported back in 1911, "will produce a condition of inebriation lasting from one half to one hour, but the dose must soon be greatly increased. The aftereffects are, if anything, rather pleasant, and the habit of ether-drinking is certainly not so injurious as alcoholism." * 9 * This comparison is quoted here as a common opinion in England at the time rather than as an established medical fact. Ether was introduced into medicine under the trade name Anodyne by Friedrich Hoffmann (1660-1742). Hoffmann recommended his Anodyne for pains due to kidney stones, gallstones, intestinal cramps, earache, toothache, and painful menstruation. Ether labeled as Anodyne, Dr. Nagle notes, is "still available over the counter in some countries. Genteel ladies who would never think of touching sinful whiskey have been known to treat their ills with the drops." 10 A 1761 textbook on pharmacology recommended ether as "one of the most perfect tonics, friendly to the nerves, cordial, and anodyne," directing that three to twelve drops be taken on a lump of sugar, swallowed with water. 11 Ether was also used for recreational purposes at least as early as the 1790s, when James Graham (1745-1794), described by Dr. Nagle as "a famous London quack, proprietor of the Temple of Hymen and owner of the Celestial Bed," 12 was accustomed to inhale an ounce or two several times a day, in public, "with manifest placidity and enjoyment." 13 There are accounts of ether drinking and ether sniffing at universities in both England and the United States during the nineteenth century. But the major nineteenth-century outbreak occurred in Ireland, under circumstances that carry a lesson. Dr. Nagle reports: "About 1840 a Catholic priest, Father Matthew, led a great temperance crusade through England, Scotland, and Ireland. It was one of the most successful that ever occurred; thousands took the pledge." One of them was an alcoholic physician named Kelly who practiced in Draperstown, Northern Ireland. "Aghast at the pleasure he had given up, but not wishing to break his pledge, [Dr. Kelly] cast about for a substitute. He had prescribed ether by mouth on occasion and knew of its pleasant effects. After a few personal experiments he imparted the knowledge to his friends and patients who had also taken the pledge." 14 Ether sniffing became endemic in Draperstown. Fifteen years later, when the British government placed a stiff tax on alcoholic beverages and when the constabulary clamped down on home distilled Irish whiskey, Kelly's discovery was recalled and exploited to the hilt. Ether, which was not subject to the tax, was distilled in London and shipped to Draperstown and other places in Northern Ireland by the ton. Ether "was preferred in some ways, and especially among the poor, to the now-expensive whiskey. The drunk was quick and cheap, and could be achieved several times a day without hangover. If arrested for drunkenness, the offender would be sober by the time the police station was reached." 15 A surgeon visiting Draperstown in 1878 remarked that the main street smelled like his surgery, where ether was used as an anesthetic. Old ether topers, he added, could finish off a three-ounce wineglassful at a single swig, without even water for a chaser. "Everyone who discussed this particular phenomenon," Dr. Nagle notes, "admitted that there appeared to be less chronic damage than with alcohol." But hazards were also noted: chronic gastritis, deaths from overdosage, and fatal burns from smoking while drinking for ether is extremely flammable. "By 1890," Dr. Nagle continues, "the pressure of temperance societies, aided by an article by the editor of the British Medical Journal, 16 and loss of tax revenue, caused a Parliamentary committee to investigate. 17 Subsequently, regulations limiting the sale of this ether were imposed." As in the case of heroin prohibition, alcohol prohibition, marijuana prohibition, and other forms of prohibition, however, ether prohibition failed. In 1910, ether drinking was still prevalent in Draperstown. It died out in the 1920s, "replaced by [alcoholic] beverages that were cheaper and more easily available." Ether turned up again in the United States during the alcohol Prohibition era (1920-1933), when nonalcoholic "near beer" and other "soft" drinks were frequently "spiked" with ether as well as with alcohol; and ether was drunk in Germany during World War II, when alcoholic beverages were rationed, expensive, and of poor quality. 18 Ether inhalation has a similarly long and fascinating history. It was inhaled at Harvard by students during the nineteenth century, for example and by at least one professor, Dr. Oliver Wendell Holmes of the Harvard Medical School.* No doubt this college use was one of the factors that led William T. G. Morton, a dentist studying medicine at the Harvard Medical School, to ask permission to use ether as an anesthetic at the Massachusetts General Hospital on October 16, 1846 20 one of the several occasions sometimes cited as the birth of modern inhalational anesthesia. * Dr. Holmes inhaled ether at a time when it was popularly supposed to produce mystical or "mind-expanding" experiences, much as LSD is supposed to produce such experiences today. Here is his account of what happened: "I once inhaled a pretty full dose of ether, with the determination to put on record, at the earliest moment of regaining consciousness, the thought I should find uppermost in my mind. The mighty music of the triumphal march into nothingness reverberated through my brain, and filled me with a sense of infinite possibilities, which made me an archangel for a moment. The veil of eternity was lifted. The one great truth which underlies all human experience and is the key to all the mysteries that philosophy has sought in vain to solve, flashed upon me in a sudden revelation. Henceforth all was clear: a few words bad lifted my intelligence to the level of the knowledge of the cherubim. As my natural condition returned, I remembered my resolution; and, staggering to my desk, I wrote, in ill-shaped, straggling characters, the all-embracing truth still glimmering in my consciousness. The words were these (children may smile; the wise will ponder): A strong smell of turpentine prevails throughout.' " 19 Thereafter, Dr. Nagle adds, ether continued in recreational use in many countries, and was sniffed as well as drunk. "For example, ether inhalation as a substitute for ingestion of alcohol was felt to be widespread among the upper classes in England during the late 19th century. 21 Yvonne, mistress of Guy de Maupassant and a ballet dancer, said that she and her fellow dancers, and even the director of the corps de ballet, took ether for a pick-me-up when they were dancing." 22 France, Russia, Norway, and Michigan were also reputed to have ether users; and there were reports of the simultaneous sniffing and swallowing of ether. Is ether sniffed and drunk in the United States today? Though reports are few, it seems highly likely. Ether sniffing by a child was reported in Salt Lake City in 1962. 23 Dr. Nagle states that "there are anesthetists in this country who have become addicted to anesthetic agents. Anecdotal accounts are not uncommon in professional circles. All the major agents, including ether, nitrous oxide, cyclopropane, ethyl chloride, ethylene, thiopental and balotbane have been indicted." 24 Chloroform. This is a liquid at room temperatures but it gives off vapors which are highly potent when inhaled. It was discovered independently and simultaneously in Germany, France, and the United States in 1831; and its recreational use in the United States began concurrently with its discovery. "During the last six months," Samuel Guthrie, the American discoverer, reported in his paper announcing the discovery, "a great number of persons have drunk of the solution . . . in my laboratory, not only very freely, but frequently to the point of intoxication, and so far as I have observed, it has appeared to be singularly grateful, both to the palate and stomach, producing a lively flow of animal spirits, and consequent loquacity; and leaving, after its operation, little of that depression consequent upon the use of ardent spirits [alcohol]." 25 In other words, no hangover. Sixteen years later chloroform was introduced into Scotland by Dr. James Y. Simpson for anesthesia during surgery and childbirth. Strong opposition to its obstetrical use immediately came from some clergymen who argued that obstetrical anesthesia violated God's word in Genesis 3:16: "In pain you shall bring forth children." Dr. Simpson responded by quoting Genesis 2:21 to show that God used anesthesia before extracting Adam's rib to fashion Eve: "So the Lord God caused a deep sleep to fall upon the man, and while he slept took one of his ribs. . . ." The controversy was calmed, and chloroform popularized, when Dr. Simpson gave Queen Victoria chloroform during the birth of her eighth child. * 26 * The Queen knighted Dr. Simpson for his pioneering work. Chloroform gradually fell into medical disrepute, however, due in part to the hazard of sudden death from overdose and in part to the rise in popularity of other anesthetics. Its occasional recreational use continued, sometimes with fatal outcomes. Dr. Nagle reports: "Although chloroform never achieved ether's spectacular success in replacing liquor for whole areas, individual case reports have been published in most countries. Indeed, the total number of such reports is greater than with ether, since a dead patient is more likely to be written up than a chronic drunk. . . . The use of chloroform for addiction is now considered rare, but it is not totally extinct" 27  and as evidence, Dr. Nagle cites cases published in the Bulletin of the Menninger Clinic (1945) and the Journal of the American Medical Association (1963). Other organic solvents. These include a broad range of chemicals, many of them secured through the distillation of petroleum. When their vapors are inhaled, these can produce intoxication resembling alcoholic drunkenness and in some cases effects resembling those of a short hallucinogenic trip. Many, such as gasoline, are highly flammable and even explosive. A wide variety of common household products contain these organic solvents, whose rapid evaporation speeds drying for example, paint thinners, lacquers, enamels, varnishes, varnish removers, glues and cements, cigarette lighter fluids, charcoal lighter fluids, fingernail polishes and polish removers, spot removers, and other dry-cleaning products. The effects of inhaling gasoline fumes, Dr. Ewart A. Swinyard of the University of Utah College of Medicine points out in Goodman and Gilman's textbook (1970), can be similar to those of drinking an alcoholic beverage. "The signs and symptoms include incoordination, restlessness, excitement, confusion, disorientation, ataxia, delirium, and, finally, coma that may last for a few hours to several days." Most gasoline sniffers stop long before the severer symptoms set in, of course, just as most alcohol drinkers stop before they pass out cold. Repeated inhalation of gasoline fumes, Dr. Swinyard adds, "induces dizziness, giddiness, a 'butterfly feeling,' and hallucinations. If the desired end point is exceeded, unconsciousness results." Dr. Swinyard adds that "prodromal symptoms such as headache, blurred vision, vertigo, ataxia, tinnitus, nausea, anorexia, and weakness are not uncommon" with low concentrations of gasoline fumes; and that chronic exposure to gasoline fumes may produce "muscular weakness, listlessness, fatigue, nausea, vomiting, abdominal pain, and weight loss" along with "neurological effects such as confusion, ataxia, tremor, paresthesias [itching], neuritis, and paralysis of peripheral and cranial nerves." 28 If Dr. Swinyard is correct and there is no reason to doubt his long lists of signs and symptoms why does anyone sniff gasoline vapors? The answer becomes clear when we move from the confines of the pharmacological textbooks to the world of real children and young people. There it appears that gasoline sniffing, like numerous other common activities, makes you feel good (or better). One of the best descriptions of gasoline sniffing as it actually occurs was published in 1955 by the late A.E. ("Tajar") Hamilton of the Hamilton School in Sheffield, Mass., in his classic account of children at work and play, Psychology and the Great God Fun. One day when the other children had gone on an expedition, Tajar Hamilton reports, he found a boy nicknamed Bullet with a can of gasoline and a gasoline-soaked rag. After a few preliminary questions, Tajar (with Bullet's consent) turned on a recorder and preserved the dialogue for posterity. Talar: Bullet, you said you would come up to the attic and tell me about the gasoline and the bicycles. Will you talk your story into the mike, just as you remember it? Bullet: Well, I was awful mad when they said I couldn't go on the trip. Sure I picked up the axe when Martha told me not to, but I put it back again. Then she said I couldn't go, and Donnie was going, and when they all went I didn't have anything to do to have fun and I began to get madder and madder all the time. It made me feel kind of sick to be so mad, so I went where they keep the gasoline can and I started to smell it. Taiar: What made you want to smell gas, Bullet? Bullet: Well, when you feel bad, you smell it and it makes you feel kind of hot and kind of drowsy, like you was floating through the air. It makes you feel sort of hot inside and different from the way you were before. Taiar: And after you smelled the gas and felt better, what did you do? Bullet: Then I began to feel mad again and had to do something, so I found a nail. It was an old rusty one, and I got a piece of board to push it with so it wouldn't hurt my hand, and I made holes in all the tires except Donnie's. Taiar: Why not in Donnie's? Bullet: Because they're solid and you can't.... Taiar: And after you had punched all those holes what did you do? Bullet: Mary hollered to come to dinner, so I went and we had hot dogs at the Council ring and then we had some games and then I didn't feel so good, so I went and smelled the gas again. Taiar: How long have you liked to smell gas, Bullet? Bullet: Well, here at camp, ever since about two weeks after I came to the farm. I showed Donnie how to smell it. It makes you feel like you was in fairyland or somewhere else than where you are.... Tajar: Bullet, how come so much gas was spilled on the cellar floor? Bullet: Oh, I just wanted to get more on my rag. If you have a lot it makes you sort of dream. It gets all dark and you see shooting stars in it, and this time I saw big flies flying in it. They were big and green and had white wings. Taiar: And you feel better about yourself and about people after you have one of those dreams? Bullet: Yep, until I begin to feel bad again, or get mad. Tajar: Okay, Bullet, that's all for now. Thank you for being truthful with me. 29 The solvents found in the other common household products listed above have effects on the whole quite similar to those Bullet described for gasoline. Whether these substances are addicting, or, indeed, what permanent effects if any result from recreational use, remains undetermined. In two bulletins of the National Clearinghouse for Poison Control Centers (a unit of the United States Public Health Service), one dated February-March 1962 and the other July-August 1964, Mr. Henry L. Verhulst and Dr. John J. Crotty reviewed both the older toxicological literature on organic solvents and recent laboratory studies on glue-sniffing in particular. The older literature was based on exposure among industrial workers who breathed solvent fumes eight hours a day, five days a week for months or years. The workers suffered adverse effects like those listed by Dr. Swinyard, as well as serious damage to the brain, liver, and kidneys. Solvent sniffing for recreational purposes, however, involves only a transient rather than a prolonged exposure. Hence, Verhulst and Crotty concluded, the older toxicological data on industrial exposure could not be extrapolated to cover occasional recreational sniffing. 30 Solvent sniffing in general was not particularly widespread in the 1950s, and there is no reason to believe that it is any more widespread today. But there is one startling exception. Glue-sniffing, almost unknown before 1959, became a source of nationwide concern and a major form of drug use shortly thereafter. The factors that led to the almost overnight popularization of glue-sniffing deserve close scrutiny; they are therefore reviewed in detail in the following chapter. Foototes

Chapter 43

1. Edward Preble and Gabriel V. Laury, "Plastic Cement: The Ten Cent Hallucinogen," International Journal of the Addictions, 2 (Fall 1967): 271-272.



2. David R. Nagle, "Anesthetic Addiction and Drunkenness," International Journal of the Addictions, 3 (Spring 1968): 33.



3. Thomas Mitchell, Elements of Chemical Philosophy (Cincinnati: Corey and Fairbank, 1832), cited by Nagle, "Anesthetic Addiction and Drunkenness," p. 27.



4. Peter J. Cohen and Robert D. Dripps in Goodman and Gilman, 4th ed. (1970), p. 43.



5. Ibid.



6. Henry L. Price and Robert D. Dripps in Goodman and Gilman, 4th ed. (1970), p, 72.



7. Psychiatric News, December 15, 1971.



8. Edward J. Lynn et al., "Nitrous Oxide: It's a Gas!" presented at the 124th Annual Meeting of the American Psychiatric Association, May 1971.



9. Encyclopaedia Britannica, 11th ed., s.v, "Ether."



10. David R. Nagle, "Anesthetic Addiction and Drunkenness," p. 26.



11. W. Lewis, Materia Medica (London, 1761), cited by Nagle, "Anesthetic Addiction and Drunkenness," p. 26.



12. Nagle, p. 26.



13. T. Lee, "The Sedative Effects of Vaporous Ether Recognized Some Forty Years Since," Lancet, 1 (1847): 164, cited by Nagle, p. 26.



14. Nagle, p. 28.



15. Ibid.



16. E. Hart, "Ether Drinking," British Medical Journal, 2 (1890): 885, cited in Nagle, p. 29.



17. Select Committee on British and Foreign Spirits, 1890-1891, cited in Nagle, p. 27.



18. Nagle, p. 27.



19. Oliver Wendell Holmes, Mechanism in Thought and Morals, Phi Beta Kappa address, Harvard University, June 29, 1870 (Boston: J. R. Osgood and Company, 1871).



20. Peter J. Cohen and Robert D. Dripps in Goodman and Gilman, p. 44.



21. N. Kerr, "Ether Inebriety," JAMA, 17 (1891): 791, cited by Nagle, p. 30,



22. Axel Munthe, The Story of San Michele (New York: Dutton, 1929), cited by Nagle, p. 27.



23. Bulletin, National Clearinghouse for Poison Control Centers, U.S. Department of Health, Education, and Welfare, Public Health Service (February-March 1962), p. 2.



24. Nagle, p. 36.



25. Samuel Guthrie, "New Mode of Preparing a Spiritous Solution of Chloric Ether," American Journal of Science and Arts (Silliman's), 24 (1831): 64.



26. Henry L. Price and Robert D. Dripps in Goodman and Gilman, p. 83.



27. Nagle, pp. 31-32.



28. Ewart A. Swinyard, "Noxious Gases and Vapors," in Goodman and Gilman, 4th ed. (1970), pp. 937-938.



29. A. E. Hamilton, Psychology and the Great God Fun (New York: Julian Press, 1955), pp. 106-109.



30. Henry L. Verhulst and John J. Crotty in Bulletin, National Clearinghouse for Poison Control Centers, U.S. Department of Health, Education, and Welfare, Public Health Service (FebruaryMarch 1962).

