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ETHER—ANESTHESIA. 257
with chloroform generally takes about four minutes; often more;
seldom less. With ether, the time required is longer and the
quantity of the agent greater.
It should also be remembered that, in summer, chloroform and
ether evaporate more readily than in the colder seasons.
The operator should devote his undivided attention to the
patient, during the inhalation of anaesthetics. One finger should
be kept on the pulse, and the respiration should be carefully
noted ; for the latter is of more importance than the former,
although the pulse is by no means to be neglected. When the
patient becomes excited, he should be watched very closely, and
if the respiration becomes proportionately quickened, so must
the vapor of the anaesthetic be proportionately weakened, by
withdrawing the lint or towel slightly from the face.
When the muscles become rigid, and the patient holds his
breath and becomes livid, the anaesthetic should be given very
weak indeed, as such a state of semi-asphyxiation, due to the
suspension of respiration, is often followed by extreme rapidity
and depth of respiration, and a dangerous condition is apt to
supervene, because anaesthesia is added to asphyxia. The cu-
mulative action of these general anaesthetics should also be re-
membered, for a state of narcosis frequently intensifies for half
a minute or more after the suspension of the administration,
which is due to the vapor of the anaesthetic which was in the
lungs entering the blood after the administration ceases.
Prof. Chisholm, of the University of Maryland, gives the
J. J.
following five simple rules for the administration of chloroform,
and which will apply to ether also :
" I. I always, without a single exception, give a strong drink
of whiskey, from one to two ounces, to every adult to whom I
intend to administer chloroform. This is done a few minutes
before the operation.
" 2. Always loose the neck and chest clothing, so as to have
no impediment to respiration.
" Only administer chloroform
3. in the recumbent posture,
with body perfectly horizontal and head on a low pillow, this
pillow to be removed as the anjesthesia progresses.
17
ETHER—ANESTHESIA. 257
with chloroform generally takes about four minutes; often more;
seldom less. With ether, the time required is longer and the
quantity of the agent greater.
It should also be remembered that, in summer, chloroform and
ether evaporate more readily than in the colder seasons.
The operator should devote his undivided attention to the
patient, during the inhalation of anaesthetics. One finger should
be kept on the pulse, and the respiration should be carefully
noted ; for the latter is of more importance than the former,
although the pulse is by no means to be neglected. When the
patient becomes excited, he should be watched very closely, and
if the respiration becomes proportionately quickened, so must
the vapor of the anaesthetic be proportionately weakened, by
withdrawing the lint or towel slightly from the face.
When the muscles become rigid, and the patient holds his
breath and becomes livid, the anaesthetic should be given very
weak indeed, as such a state of semi-asphyxiation, due to the
suspension of respiration, is often followed by extreme rapidity
and depth of respiration, and a dangerous condition is apt to
supervene, because anaesthesia is added to asphyxia. The cu-
mulative action of these general anaesthetics should also be re-
membered, for a state of narcosis frequently intensifies for half
a minute or more after the suspension of the administration,
which is due to the vapor of the anaesthetic which was in the
lungs entering the blood after the administration ceases.
Prof. Chisholm, of the University of Maryland, gives the
J. J.
following five simple rules for the administration of chloroform,
and which will apply to ether also :
" I. I always, without a single exception, give a strong drink
of whiskey, from one to two ounces, to every adult to whom I
intend to administer chloroform. This is done a few minutes
before the operation.
" 2. Always loose the neck and chest clothing, so as to have
no impediment to respiration.
" Only administer chloroform
3. in the recumbent posture,
with body perfectly horizontal and head on a low pillow, this
pillow to be removed as the anjesthesia progresses.
17
