THE THEORY OF ANESTHESIA. 34! 



face-tension in aqueous solutions, in blood plasma and lymph, 

 and in all probability also the surface-tension of all cells, but 

 especially of the nerve-cells. This would make them incapable 

 of receiving or transmitting a nerve-impulse." 1 



The general view that narcosis is essentially a phenomenon of 

 asphyxia or retarded oxidation is an old one, suggested by 

 Claude Bernard and others, and has been revived in somewhat 

 different form of recent years, chiefly through the influence of 

 Verworn 2 and his pupils. Decrease in oxidations is in fact 

 frequently observed during narcosis. Thus Alexander and 

 Cserna 3 showed by direct analysis of blood a marked decrease 

 in the oxygen-consumption of the brain during ether and mor- 

 phine narcosis; oxidation-processes in the liver are also decreased 

 under the influence of various narcotics. 4 But whether this 

 decrease is simply a consequence of a paralysis of metabolic as 

 well as of other functions, or whether it is the primary and 

 determinative condition, is a question which has been answered 

 differently by different investigators. Verworn has identified 

 narcosis with asphyxia chiefly because of certain similarities 

 between the physiological behavior of asphyxiated and narcotized 

 tissues and cells. A summation of the effects of narcosis and 

 of asphyxia is seen under certain conditions; thus Winterstein 

 found that frogs asphyxiated by perfusion with oxygen-free salt 

 solution until reflex activity was lost showed no recovery from 

 the asphyxia if supplied with oxygen while still in a state of 

 anaesthesia. 5 The condition of narcosis appears to render oxygen 

 unavailable to the cells. Frohlich 6 found the same rule to hold 

 for nerve-trunks; normally oxygen revives irritability which has 

 been lost in an oxygen-free medium (nitrogen atmosphere) ; 



1 A. B. Macallum, "Surface-tension and Vital Phenomena," Univ. of Toronto 

 Studies, 1912, No. 8, p. 70. 



2 Cf. Verworn, "Die Narkose," Jena, 1913; cf. also Harvey Lectures, 1911-12, 

 p. 52. Cl. Bernard ("Legons sur les anesthesiques et sur 1'asphyxie," pp. 92 seq.) 

 discusses the question whether anaesthesia is a form of asphyxia, but rejects this 

 view on the ground that anaesthetized animals show no signs of general asphyxia 



(p- 97)- 



3 Alexander and Cserna, Biochem. Zeitschr., 1913, Vol. 53, p. .100. 



4 Cf. Joannovics and Pick, PJliiger's Archiv, 1911, Vol. 140, p. 327; Baer and 

 Meyerstein, Arch. f. exper. Path. u. Pharm., 1910, Vol. 63, p. 441. 



6 Winterstein, Zeitschr. f. allg. PhysioL, 1902, Vol. i, p. 19. 

 6 Frohlich, Zeitschr. f. allg. PhysioL, 1904, Vol. 3, p. 75. 



