Page 260 - My FlipBook

258 DENTAL MEDICINE.
" Give chloroform on a thin towel, folded in conical form,
4.
with open apex, so that the vapor, before inhalation, will be freely
diluted with atmospheric air. In holding this cone over the face
of the patient, at some little distance from the nose, place the
fingers under the borders of the cone, for the double purpose of
allowing the air to enter freely, and also to prevent the chloro-
form liquid on the towel from coming in contact with the skin of
the patient's face, and thereby avoid its blistering effects.
"5. Should loud snoring occur, force up the chin. This
manipulation, by straightening the air passages from the nose to the
larynx, makes easy breathing. The forcible elevation of the chin
is far better in every respect than pulling out the tongue. It is easier
of application, more quickly done, requires no instrument, and is
much more efficient in removing the impediment to respiration.
" While operating, I have constantly in view both the color of
the face and the respiration of the patient, which I consider even
more important for the surgeon to 'observe than to feel the pulse."
( See " Chloroform " for further directions and precautions to be
observed during the administration of this agent.)
Dr. H. A. Hare states that if during anaesthesia, respiration
stops, he has found that in a large number of instances, both in
man and in the lower animals, the free use of ether poured upon
the belly causes so great a shock, by the cold produced by its
evaporation, as to cause a very deep inspiration, which is often
followed by the normal respiratory movements.
Dr. H. I. Neilson gives the following conclusions concern-
ing the pupil as a guide in the administration of chloroform :
1. The first effect of chloroform narcosis on the pupils con-
sists in a dilatation which varies in intensity and duration in dif-
ferent individuals. As the anaesthesia becomes more profound
the pupils begin to contract and finally become very small and
immovable. If now the chloroform is pushed still further, a
sudden dilatation occurs, which is the result of asphyxia, from
which the patient seldom recovers.
2. As long as the pupil is observed to dilate in response to
sensory stimuli, such as pinching the skin, the anaesthesia is not
yet sufficient to allow the commencement of the operation.