Sixty-three eases of asphyxia due to various causes restored by rhythmic traction of the tongue. Laborde ("Les Tractions Rhythmks de In Langue," Paris, '94).
For the salivation, atropine has been found to be an excellent preventive. Three-quarters to one hour before the anxsthetization an hypodermic is given of the following solution:— Atropine sulphate, grain.
Morphine hydrochlorate, 3 grains. Distilled water, drachms.
The dose to be injected varies, with the condition and the age of the patient, from S to 16 minims, which represent about: atropine, Vino to VG, grain, and morphine, to grain. IV. Reinhard (Therap. Monats., May, 1901).
Usually, quickened breathing indi cates a too-shallow zone of anesthesia, requiring more ether. Respiration, color, and the pupil should always be watched. Any cyanosis renders it im perative to give the patient more air. Failure of the respiration is shown by lividity of the face and other evident signs. The pupils are dilated and the lips blue; cardiac failure may follow or manifest itself suddenly before the res piration ceases, but, ether being a diac stimulant, this very rarely occurs, and almost all the deaths that have taken place have been due to preliminary lung disease or to some organic disorder in volving the respiratory tract.
Treatment of Ether Collapse.—Arrest of respiration calls for the immediate in jection of grain of strychnine and of 10 minims of the fluid extract of digi talis, supplemented by rectal injections of warm coffee. Cardiac failure is best counteracted by means of atropine phate: grain given hypodermically.
The Sylvester should at once be tuted, and the indications given under CHLOROFORM (volume ii) resorted to if prompt results are not obtained. After-effects. — Vomiting is a very common after-effect of ether anesthesia. It is rarely persistent. A mixture of 4 to 5 drops of chloroform with 2 to 3 drops of vinegar of opium is mended by Buxton. Inhalations of strong vinegar-fumes (or acetic acid) sometimes act promptly.
Oxygen has a positive value in short ening the time of returning conscious ness and in diminishing the unpleasant after-effects of ether. It is a good car diac and respiratory stimulant and is indicated in threatened collapse. J. 13.
Blake (Boston Med. and Surg. Jour., Nov. 12, '96).
The most satisfactory method of con trolling nausea and vomiting after anes thesia is the administration of strong vinegar by inhalation. A towel or cloth, saturated with fresh, strong vinegar, is held a few inches above the patient's face, or hung from the bedstead, so that it will be near his head. It should be used directly after the has been discontinued, and kept up continu ously for hours. J. T. Rugh (Dungli son's College and Clin. Record, Apr., 'OS).
Post-anaesthesia vomiting is due to excretion of ether into the stomach, with resulting acute gastritis. Drugs are of no avail in its prdvention. The present technique of preparation of pa tients for etherization is faulty, in that fluids are usually entirely prohibited or limited, whereas they should be pushed to aid in excretion of ether. In antici pation of gastric irritation one to two glasses of water should be given just before beginning anaesthetization. R. J. Hess (Med. Record, Feb. 22, 1902).
Ether-pneumonia may be caused by di rect exposure to the surrounding air, while the powers of resistance of the sys tem are reduced as a result of the opera tion and of the physiological effects of the aneesthetic. The temperature is gen erally reduced from V., to 1 degree by the evaporation from the lungs, and ex posure, especially when any portion of the body is wet, that would under other circumstances produce no evil effect, now becomes dangerous. Important also is the quality of the ether employed. Remnants from partially-emptied bot tles should never be used.
[Attention drawn some years ago to dangers arising from rapid evaporation of ether from pulmonary mucous mem brane by Tait. Best plan is to give ether from a closed inhaler separated from the patient's face by a bag contain ing air. DUDLEY BUNTON, Assoc. Ed., Annual, '96.] With the exception of acute pulmo nary troubles, there are few, if any, contra-indications to ether when prop erly given. Ether is as efficacious as chloroform, and the death-rate is far less than under chloroform. Pallas (Revue de Chin, Apr., '93).