ANESTHESIA 181 



pies passed round the cleats in figure-of-eight style. 

 The positions in which the patient is placed are 

 the abdominal and the ventral. In the former the 

 patient is stretched on the table on his belly; in 

 the latter, on his back. Occasionally the position 

 of lateral recumbency is required, when the patient 

 is placed on his side and the feet secured to. the 

 cleats opposite to each other. 



Anesthesia 



To obtain the best results, as well as for humani- 

 tarian reasons, all operations (with the exception, 

 perhaps, of evacuating an abscess, which as a rule 

 requires only one bold stroke of the knife) should 

 be performed under anesthesia. 



Anesthesia may be either local or general. As a 

 general rule local anesthesia is applicable only in 

 minor operations of short duration. It is applied 

 by a spray to the part to be operated on, or the 

 part is injected subcutaneously, by means of an 

 ordinary hypodermic syringe, with the anesthetic 

 selected. Ethyl chlorid is sprayed on the site ,of 

 operation until the tissues are nearly frozen. It is 

 of use, only in such operations as opening an abscess 

 or giving an intravenous injection, because the 

 anesthesia is only fleeting and cannot be pushed on 

 account of the danger of the tissues sloughing from 

 too prolonged freezing. The anesthetics admin- 

 istered hypodermically are solutions of cocain, 

 eucain, urea and quinin hydrochlorid, alypin, acoin, 

 novocain, and stovain. Of these cocain is probably 

 the most*^ used and is quite safe, provided that the 

 amount injected does not exceed three-fourths of 

 a grain. Although solutions of varied strength may 

 be used with the above limitation as to dose, a 

 four-per-cent solution is found to be the most suit- 

 able for general work. It must be remembered that 



