ADDRESSES 



37 



duction or elimination of so-called "shock," with the purpose 

 of returning the patient to his active vocation in the shortest 

 possible time and of causing the individual the smallest 

 amount of injury through the operation itself. 



With all of the benefits which come from properly con- 

 ducted surgical operations, intelligent surgeons have always 

 recognized that the ordinary administration of ether or chlor- 

 oform and the ordinary surgical procedure, are accompanied 

 by a certain amount of psychic and physical violence which 

 make their impress upon the mind and body of the patient 

 with certain definite prejudicial results. 



;This injury is caused in several ways. First, there is the 

 element of fear. Second, the powerful impression carried to 

 the brain through the violence done to the tissues involved in 

 the operation. Third, the depression caused by the deep in- 

 toxication of prolonged anaesthesia. 



To overcome this element of shock there has been devised 

 a method known as the Nitrous Oxide Oxygen Anosi Associa- 

 tion. The process is relatively new, but I am satisfied, from 

 a personal experience of several months, that it is a method 

 which will eventually be adopted by the conservative surgeons 

 of the world. 



Briefly, this Anosi theory, as taught by Crile, of Cleveland, 

 assumes that potential energy is stored in the brain, the liver 

 and in suprarenals, and that when this energy is destroyed in 

 sufficient amount, there results a condition known as exhaus- 

 tion or shock. This discharge of potential energy may be 

 brought about by any insult to the body such as trauma, hem- 

 orrhage, starvation, worry, excitement or insomnia, and is 

 produced to an enormous extent in ordinary surgical opera- 

 tions and this discharge is occasioned in surgical operation, 

 although the patient may be thoroughly anaesthetized and un- 

 conscious of actual pain. The unconsciousness does not pre- 

 vent the transference of sensation from the field of operation 

 to the brain, although the patient may be oblivious to the 

 pain which would thereby be occasioned were he awake. 



The Anosi Method of handling the patient for surgical 

 operation consists of the following logical steps: 



1. The element of fear is eliminated as far as possible, the 

 attitude of the surgeon and his assistants is essentially opti- 

 mistic and encouraging. The patient is given a preliminary 

 injection of morphine and scopolamine to quiet his anticipa- 

 tion and to reduce the amount of anaesthetic required. 



