Page 261 - My FlipBook

ETHER—ANy*:STHESIA. 259

As soon as the pupil becomes strongly contracted and im-
3.
movable, the administration of the anaesthetic must be suspended,
until a commencing dilatation is observed, and the patient must
be held at just this point as long as the operation continues.
4. Vomiting causes a dilatation similar to that occurring as the
patient emerges from the narcotic condition, but it is usually
more sudden in the former case. The contraction of the pupils
does not appear to begin until the blood-pressure is somewhat re-
duced, and the dilatation proceeds pari passu with the increase in
the blood-pressure. He therefore regards the appearance of the
pupil as a very reliable guide for the administration of chloro-
form, as he is enabled to judge accurately concerning the condi-
tion of the patient.
When ether or chloroform is administered for the extraction
of teeth, the operation should be performed in a dental chair so
constructed as to admit of the patient being placed in as hori-
zontal a position as is possible to operate successfully, and every
instrument it is necessary to use should be within reach of the
hand of the operator. As soon as the operation is completed the
head of the patient should be gently inclined to the side, so as to
permit the blood to run from the mouth and not pass down the
throat. Any considerable change in the position of the patient
should be avoided until recovery has taken place. Fresh air
should be admitted by lowering the window, and the patient freely
supplied with it by means of a fan.
The vapor from a mixture composed of equal parts of chloro-
form and alcohol has been combined with the nitrous oxide gas.
This vapor from two or three drops of the chloroform and alco-
hol mixture is used with each gallon of gas, the anaesthetic effect
of which, it is claimed, is more lasting, and at the same timeless
dangerous, than from either of the two agents alone. An appa-
ratus for combining these two agents is in use, which is attached to
the gas cylinder, in place of the ordinary connection. ( See the
combinations of oxygen and air with nitrous oxide, under Ni-
trous Oxide.
)
The administration of anaesthetics through the nose has been
suggested by Dr. B. C. A. Windle, of England, a peculiar in-