General Surgery ii 



tion is: Production of profound narcosis unaccompanied by reflex 

 raovements which is preceded by a mild preliminary period of 

 excitement and succeeded by a rapid recovery from its effects. It 

 is dangerous only when administred in concentrated form. It is 

 then liable to produce rapid fall of blood-pressure through paraly- 

 sis of the vaso-motor center, which is quickly followed by paralysis 

 of the respiratory center. At the same time the heart's action 

 grows weak under the combined influence of vag^s inhibition, vaso- 

 motor paralysis and dilation of its cavities from the direct action 

 of the drug, though it may continue to beat two to five minutes after 

 respiration has ceased. In a small percentage of cases the heart's 

 action may be the first to fail. 



Ether is safer than Chloroform on account of its stimulating 

 properties. But there are well-deserved objections to its use, the 

 stage of excitement being very great and prolonged, even if the 

 administration be pushed without admixture of air; it is usually 

 productive of reflex movements and tetanic contractions of the ex- 

 tremities ; and complete narcosis is only possible under continuous 

 administration. These objectionable features can, however, be over- 

 come in large measure by previous administration of narcotics. 

 Only the best quality of ether fortior should be used. 



But ether is liable to produce undesirable after-effects in the 

 form of affections of the respiratory tract, whereas the danger 

 from chloroform ceases with its withdrawal. Under ether-anes- 

 thesia there is always great secretion of saliva and mucus, while 

 under chloroform the amount is infinitesimal. This matter was care- 

 fully studied by Hoelscher in a series of experiments on dogs. The 

 animals were subjected to anesthesia lasting one hour. They were 

 laid in various positions — in the horizontal, with head elevated, and 

 with the head depressed. The buccal secretions were also stained 

 by injections of gentian violet. In all the animals that lay in the 

 horizontal position, the colored secretions were found to have pene- 

 trated to the smallest bronchii, showing that the force of the in- 

 spired air current was sufficient to drive back the buccal contents 

 into the bronchii. Moreover, the secretion acted as an obstruction 

 to the passage of the air and the animal was forced to breathe 

 harder. When the animal lay on the left side it tended to reach 

 the left lung more, and only slightly the right. In animals whose 

 heads were greatly elevated, this was sufficient to cause death by oc- 



