GENERAL ANAESTHESIA. 55 



suggest, absolutely innocent, and has claimed a number of victims in 

 human surgery. Nevertheless Gurlt's statistics show the mortalit}' 

 from chloroform to be fifteen times greater than that from ether. 



Anaesthesia can be produced by the introduction of ether vapour into 

 the rectum. It was tried first on animals by Dupuy and Thiernesse, 

 adopted for man by Pirogoff (1847), and recently b}' Daniel Molliere 

 (1884), and has been recommended by Cagny for the purpose of 

 producing a certain degree of drowsiness in horses to facilitate casting 

 or to permit of trifling operations in the standing position. The 

 system is simple ; a flask or tube with a. narrow neck is partially filled 

 with ether ; one end of a rubber tube is slipped over the neck, and the 

 other end introduced into the rectum. The flask is placed in water 

 heated to 120° F. Ether vapour is at once given off, enters the 

 rectum, and is absorbed by the mucous membrane. One and a half to 

 two ounces of ether are sufficient. Experience does not show this 

 method to have any marked advantages. In place of partial anaesthesia 

 active excitation often follows. Such violent expulsive efforts are some- 

 times made as to produce rectal prolapse. In man cyanosis, collapse, and 

 even a kind of asphyxia have resulted. The uncertainty and serious 

 inconvenience of this method have prevented its being commonly 

 adopted. Mixed anaesthesia, produced by the injection into the rectum 

 of ether vapour and the subcutaneous administration of morphine and 

 chloral, is slow in its effects and of little practical utility. 



In English human surgery a favourite method is to obtain anaes- 

 thesia with nitrous oxide and maintain it with ether. The method has 

 many advantages, and has come largely into use. 



Chloral is usually injected intra-venously, alone or after hypodermic 

 injection of morphine. Intra-venous injection of 20 to ^^ per cent, 

 solutions produces very rapid and complete anaesthesia. Though declared 

 dangerous by human surgeons, this method has been recommended in 

 France and Denmark for the horse, on account of the ease with which 

 injections can be made into the jugular. The solution, which may be 

 of any strength between 10 and ^^ per cent., must be freshly prepared, 

 and should contain a little carbonate of soda to insure its being 

 alkaline. 



Intra-venous injection requires very special precautions. The point 

 of operation must be thoroughly disinfected, and all instruments should 

 be sterilised. Everything being ready, an assistant compresses the vein 

 low down in the jugular furrow ; the operator then draws the skin in 

 the direction of the head with one hand, while with the other he 

 thrusts a needle or fine trocar into the distended vessel, taking a 

 very oblique course from above downwards, i. e. almost parallel 



