Part 6

In the aged, we know that it is not so much the operation itself as the broncho-pneumonia that often follows the anesthesia which deserves grave consideration. Chloroform, or a chloroform-ether combination, such as anaesthol, is undoubtedly, in such cases, preferable to pure ether, because it causes less bronchial irritation. In the morphine-anaesthol-ether sequence which I have tried to outline, chloroform and ether are blended in a way most adequate for anesthesia, and the system is so flexible that it readily adapts itself to an anomalous case.

The difficulties in respiration so frequently encountered, even by the experienced anesthetist, find a natural solution; if he has been studying the case he will be able to judge whether the trouble is due to crowding or to a mechanical cause.

I have no hopeful word for the anesthetist who is inattentive. Whether the case is an apparently simple or a critical one, it should be remembered that the good anesthetist, like the good surgeon, is he who, besides being competent, has a conscience, and feels his responsibility, who appreciates that there are some who are anxiously awaiting the outcome, and have a deep interest in the life that is in his hands.

INDEX

Anaesthol, 36

Anesthesia, Complete, 11 Depth Required by Various Cases, 43 General Course of, 31 Induction of, 10 Intubation, 39 Minor, with Ethyl-Chloride, 38 Primary, 11

Anesthetic, Concentrated, 24

Ano-respiratory Reflex, 22

Asphyxia, Post-operative, 33

Awakening, Signs of, 16, 31 Stimuli, 16

Breath, Holding the, 22

Breathing, Influence of Morphine on, 37 Mechanical Obstruction to, 25 Obstructed, 24

Breathing-tube, 26

Camphor-Ether Stimulation, 29

Cardiac Collapse, 12

Cases Requiring Superficial Anesthesia, 43 Deep Anesthesia, 44

Clogging of the Anesthesia Tubes, 42

Cocainization of the Pharynx, 40

Collapse, Cardiac, 12 Respiratory, 14

Color, 17 In Intubation Anesthesia, 42

Complete Anesthesia, 11

Cornea, 19

Coughing During Narcosis, 22

Crowding, 13, 24

Degree, Surgical, 11 In Intubation Anesthesia, 41

Distress, Post Operative, 34

Ethyl-Chloride, Minor Anesthesia with, 38

Eyelid Test, 20