128 . FISTULA AND POLL-EVIL 
how tractable the patient may seem. Opera- 
tions performed in the standing position under 
some form of narcosis always turn out to be 
very unsurgical exhibitions. The patient should 
be cast with ropes or else placed upon an op- 
erating table. The latter is much the best be- 
cause of the elevated position of the head. On 
the floor or ground the field is not so accessible 
and must be elevated by blocking the neck and 
head up in some way to bring it where the sur- 
geon can work. Chloroformed, the patient can 
be handled better than under narcosis. When 
rope restraint is used chloroform should really 
be administered because it is difficult to control 
the sweeping movements of the head of a par- 
tially anesthetized subject down on the ground. 
Our plan in field work is to clean up the poll 
well while the subject is standing, cast with 
ropes, administer chloroform and then block 
up the neck and poll with a tightly filled sac of 
straw. This sac may be bound to the neck and 
head with cords, one around the middle of the 
cervical region and one around the head just 
below the eyes. Thus tied the blocking will 
stay in place when the neck and head move. 
This form of blocking is particularly essential 
when the operation is done on the ground un- 
der narcosis. It is important that the sac be 
well filled, otherwise it will flatten down and do 
