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Handbook of anæsthetics

INDEX.

Reading edition

A

Abdominal operations, ix, 7

local anæsthesia in, 187

Abdominal muscles, rigidity of, 19

Abnormalities of anæsthesia, minor, 38

major, 140

Acapnia, 10, 29, 39

Accidents of anæsthesia, 140

Acetonuria, 153

Acidosis, 153

Adenoids, 127, 166

in status lymphaticus, 148

Adrenalin, 175

danger of, with chloroform, 113, 166

Aedentulous patients, 23

After-effects of anæsthetics, see Sequelae

Ages, dosage of morphia at various, 45

selection of anæsthetic at various, 164

Airshaft, natural, 96

Airway, natural, 15, 31, 114, 145

artificial, 23

Alcoholics, anæsthesia in, 2, 87, 103, 137, 165

Alkaloids, 12, 43, 88, 103

Aneurysm, 56

Anoci-association, 11

Anoxæmia, 15

Arm, management of in anæsthesia, 157

regional anæsthesia of, 181

Arteries, spouting of, x, 37

Arterio-sclerosis, 56, 167

Artificial respiration, 146

Asphyxia, 15

Athetosis, 38

Atropine, 43, 45, 112, 147

Auer and Meltzer, 96

B

Barth 3-way tap, 50

Bicarbonate of soda in acidosis, 156

Bladder, reflexes from, 39, 168

local anæsthesia in operations upon, 190

Blistering, by chloroform, 109

Blood, changes in, during anæsthesia, 207

spouting of, from cut arteries, x, 37

Blood-pressure, in natural sleep, 1

in shock, 6

in asphyxia, 17

in nitrous oxide, 46

in ether, 75

in chloroform, 110

in ethyl chloride, 122

clinical observation of, 37

Blowing respiration, 34, 89

Boothby, on ether percentages, 99

Boyle, Mr Leonard, 70

Brachial plexus, nerve blocking in, 181

Brain, see Nervous System

local anæsthesia for operation upon, 191

Breath-holding, 34, 112, 114

Breathing, deep (see Acapnia)

Bronchitis, 150

C

Carbon-dioxide, 10, 18, 206

Cardiac cyanosis, 37

Cardiac disease, 107

Cardiac failure (see Syncope)

Castration, anæsthesia in, 169

C.E. mixture, 83, 134, 137

Cells, nerve, changes in, 5

Centripetal impulses, 6

Children, 45, 94, 125, 164

Chloretone, 93

Chloride of ethyl (see Ethyl Chloride)

Chloroform, administration of, 113

decomposition of, 109

delayed poisoning by, 153

physiology of, 109

Choice of anæsthetics, 162

Circulation, observation of, x, 37

in shock, 10

in asphyxia, 17

in valved breathing, 29

in nitrous oxide, 46

in ether, 75

in chloroform, 110

in ethyl chloride, 122

in C.E. mixture, 131

failure of (see Syncope)

Circumcision, anæsthesia in, 169

Clarke’s apparatus, 69

Clenching of Jaws, 15, 24

Clinical phenomena of asphyxia, 18

of normal anæsthesia, 33

Closed ether, 78

Closed method, features of, 29

Clover’s inhaler, 78, 138

Cocaine, 170

Collapse (see Syncope)

Conduction of nerve impulses, 3

Connell, Karl, 90, 205

Conjunctival reflex, 31, 35

Convulsions, 17

Corneal reflex, 32, 35

Crile, Prof., 5, 9

Crowing respiration, 16, 169

night crowing, 148

Cyanosis, 18, 37, 53

Cylinders for nitrous oxide, 43

for oxygen, 64

D

Dangers of chloroform, Prof. L. Hill upon, 120

Death, causes of, 17, 110, 140, 144, 148

Decomposition of chloroform, 109

of ether, 74

Deep breathing, 10

Degrees of anæsthesia, 31

Dental anæsthesia, 54, 57, 128, 131, 163

Depth of anæsthesia, 36

Dextrose in acidosis, 156

Difficulties of anæsthesia, major, 140

minor, 38

Dilatation of pupils, 5, 17, 35, 53, 66, 125, 136, 141, 143

Disease, relation of anæsthesia to, 166

acute infectious, 168

Dislocations, anæsthesia in reduction of, 164

Dorsal position, 157

Dosimetric method for chloroform, 114

for ether, 90

Dott, Mr N., direct laryngoscope, 104

Douche method, 20

Dread (see Fear)

Drop bottles; chloroform, 117

ether, 83

Drop method, 30, 83

Drugs for local and spinal anæsthesia, 170 to 174

E

Emphysema, 167

Empyæma, 167, 187

Enema, before operation, 42

Ether, 74, et seq.

closed, 78

intratracheal, 96

open, 83

physiology of, 75

rectal, 93

warmed vapour, 90

Ether, respiratory sequelæ of, 150

Ether tremor, 38

Ethyl chloride, 122, et seq.

combined with nitrous oxide, 128

freezing anæsthesia by, 200

Eucain, 174

Excitement (see Struggling)

Extraction of teeth (see Dental Anæsthesia)

Eye reflexes, definition of, 31

F

Face-down posture, 157

Face, adaptation of masks to, 21, 52, 83

Face-pieces for nitrous oxide, 51

False anæsthesia, 41

Faradism of motor nerves in anæsthesia, 3

Fat patients, 158, 165

Fatty changes after anæsthesia, 153

, effects of, 9

prevention of, 11, 43, 88

Feeble patients, 168

Ferguson, Dr., W. J., 87

Fingers, regional anæsthesia for, 184

Flame, open, dangers of, 74, 104

Forceps, tongue, 24

Food before anæsthesia, 42

Foreign bodies in the larynx, 16

Freezing analgesia, 201

Fright (see Fear)

G

Gags, 25

Gardner, Mr Bellamy, 23, 24, 83

Gas and air, 54

Gas and ether, 138

Gas and ethyl chloride, 128

Gas-oxygen, 60

Gasping, 40

Genito-urinary operations, 168

Glossotilt, 24

Glottis, spasm of, 16, 20, 26, 105

Goitre, anæsthesia for, 160, 185

Goitre, exopthalmic, 9, 167

Grey and Parsons on shock, 6

Guy, Dr Wm., 128

Guy-Ross, gas oxygen method, 131

Gwathmey, warmed ether vapour, 90

oil-ether, 93

H

Hæmorrhage, as a factor in shock production, 9

observation of, by anæsthetist, x, 37

Hæmorrhoids, local anæsthesia for, 191

Harcourt, Vernon, 114

Head and neck operations, position for, 158

Head and neck, raising, 152

lowering, 110, 145

extra pillow in deep chested patients, 157

Heart, failure in asphyxia, 17

observation of, 37

action of ether upon, 75

of chloroform upon, 110

of ethyl chloride upon, 122

failure of, in secondary syncope, 144

Heart disease, anæsthetics in, 167

Henderson, Yandell, 10, 29

Hernia, local anæsthesia in, 189

Heroin, 44

Hewitt, Sir Frederick, 22, 50, 62, 81, 137

Hill’s direct laryngoscope, 104

Hill, Prof. Leonard, 111, 120

Hornabrook, 87, 123

Hydrochloric acid, as an impurity in chloroform, 109

Hypnotics, 12, 42

Hypodermic medication, 12, 42

I

Impurities of anæsthetics, 74, 109, 122

Infiltration analgesia, 175

Inhalers, Clover, 78

Clarke, 68

Guy, 128

Guy-Ross, 130

Hewitt, 50, 62, 81

Junker’s, 115

Ormsby, 81

Paterson, 58

Rendle, 135

Inhibition, vagal, 111, 143

Intestinal obstruction, 141, 189

Intranasal surgery, 160, 166, 192

Intratracheal method, 96

Kelly’s instrument for, 100

Shipway’s, 101

Inversion, Leonard Hill’s experiments upon, 110, 111

J

Jactitations, 53

Jaundice, 154

Jaws, clenching of, 15, 26

falling back of, 16

operations upon, 166

management of, in anæsthesia, 23, 83

Joints, anæsthesia in dislocation of, 164

Junker’s inhaler, 115

K

Kidney, position for operations upon, 168

Kelly’s intratracheal instrument, 100

L

Labour, anæsthesia in, 44, 169

Lane, Sir Arbuthnott, 14

Laryngeal stridor, 16, 20, 26, 40, 169

Levy, Goodman, 112, 145

Light anæsthesia, dangers of, in chloroform, 9, 112

Levy’s views, 113

Light reflex, 32

Local anæsthesia, 170 et seq.

Lowering of head and shoulders, 110, 145

Lumbar puncture, site for, 196

Lungs, ventilation of, by normal breathing, 96

by intratracheal method, 97

Lymphatism, 148

M

Malcolm, J. D., 9

Marshall, Dr Geoffrey, 70

Masks for chloroform, 110

for ether, 82

for perhalation method, 28

Massage of heart, 148

Mechanical asphyxia, 15

Meltzer and Auer, on intratracheal method, 96

Menstruation, 169

Micturition before nitrous oxide, 51

Mixtures, C. E., 83, 134, 137

of nitrous oxide and oxygen, 60

of nitrous oxide and ethyl chloride, 128

Morphine, 12, 43, 152

Mouth, breathing through, 22

Mouth, operations upon, 165

Mouth props, 22

Mucus in air passages, 40

Musculo-spiral paralysis, 157

Muscles in anæsthesia, ix, 3, 19, 34

Muscle tone, 3, 19, 53

N

Nasal breathing, 23, 166

Naso-pharyngeal catarrh, 151

Nasal methods of giving nitrous oxide, 57

Nasal tube for Junker’s bottle, 119

Neck, position of, 20

relaxation of muscles of, 21

posture for operation upon, 159

tumours and inflammatory swellings in, 7, 166

Nephritis, influence of, upon choice of anæsthetics, 77, 168

Nervous system, effects of anæsthetics upon, 2, 75

Nerves, peripheral, unaffected by anæsthetics, 3

Nerve blocking, 12, 179

Night-crowing, 148

Nitrous oxide, 46

with air, 54

with ether, 138

with ethyl chloride, 128

nasal, 57

physiology of, 46

contra-indications to, 56

Nitrous oxide and oxygen, 8, 12, 60

various systems for, 66, 70, 130

for use in major surgery, 72

with ethyl chloride, 131

O

Obesity, 158, 165

Obstruction, intestinal, 141

respiratory, 15, 141

Oil ether, Gwathmey’s method of, 93

Oligæmia in shock, 10

Omnopon, 44

Open method, definition of, 28

chloroform, 117

ether, 83

ethyl chloride, 123

O’Malley’s technique for intra-nasal surgery, 160

Ormsby’s inhaler, 81, 137

Over-dosage, 36, 110, 144

with nitrous oxide, 54

Oxygen, reduction in blood in anæsthesia, 206

as a relief in asphyxia, 27

to old patients, 165

with nitrous oxide (see Nitrous Oxide and Oxygen)

with nitrous oxide and ethyl chloride, 130

P

Paralysis, musculo-spiral, 157

Patella reflex in anæsthesia, 3

Percentages of chloroform and ether required in anæsthesia, 6

of chloroform, 111

of ether, 86, 99, 201, 204

Perhalation method, definition of, 28

ether (see open Ether)

Phenomena of anæsthesia

normal, 33

abnormal, 38

of nitrous oxide, 52

of ethyl chloride, 125

Pericarditis as a cause of death in anæsthesia, 168

Phillip’s artificial airway, 23, 160

Physics of natural respiration, 96

Physiology of anæsthetic drugs, 1

of asphyxia, 17

of chloroform, 109

of ether, 75

of ethyl chloride, 122

of nitrous oxide, 46

Phthisis, 167

Pneumonia, post anæsthetic, 157

Position in anæsthesia, 157

Positive pressure in nitrous oxide, 52

in nitrous oxide and oxygen, 66

Post-chloroform poisoning, 153

Post anæsthetic complications, 150

Pregnancy, anæsthesia in, 169

Preliminary hypodermic medication, 11, 43, 152

Preparation of patient, 42

Primary syncope, 110, 143

Protection from shock by general anæsthetics, 8

Pulse, rate in shock, 6

clinical observation of, 37

Pupil, light reflex of, 32

size of, 35

in asphyxia, 17

Purging before anæsthetics, 40

Q

Quinine and urea hydrochloride, 174

R

Rebreathing method, 18

in nitrous oxide, 68

Rectal administration of ether, 93

Rectal saline, 42

Reflexes as a cause of shock, 4, 6

order of disappearance of, 3

Reflex, conjunctival, 31, 35

corneal, 32, 35

light, 32, 35

patella, 3

skin, 37

Reflex syncope, 8, 112, 145

Regional anæsthesia, 179

Renal disease, 163

Rendle’s cone, 135

Repeated administrations, 60, 156

Respiration, arrest of, 142

artificial, 146

blowing, 34, 89

crowing, 16

depressed, 39, 43

effect of morphia and chloroform upon, 43, 86

normal, 34

obstructed, 15, 141, 166

Respiration, physics of natural, 96

reflex arrest of, 39

Respiratory abnormalities, minor, 39

major, 141

Respiratory system, effects of ether upon, 76

after-effects of anæsthetics upon, 150

Rigidity of muscles in asphyxia, 19, 38, 39

in second stage, 33

S

Saline injections, per rectus, 42

subcutaneous, 14

Schimmelbusch’s mask, 28, 116

Scopolamine, 44, 103

Secondary syncope, 17, 138, 143

Secretion of mucus, 40, 76

of urine, 168

Sedatives, 12, 42

Selection of anæsthetic, 162

Semi-open method, 28

Septic cases, 9, 60, 156, 168

Sequelæ of anæsthesia, 100

Sex, relation to anæsthesia, 165

Shipway, Dr, 91, 101

Shock, 5

difference between syncope and, 142

Short, Mr Rendle, 154

Sickness (see Vomiting)

Sighing, 40

Sight-feed machines for gas-oxygen, 70

Signs of anæsthesia, 36, 53, 65

Silk, Dr J. W., 23, 87

Single dose anæsthetics, 30, 163

Sitting posture, 21, 158

Slow respiration, 39

Spasm, muscular, 19

of jaw muscles, 15

of larynx, 16, 26, 169

Specific gravity of chloroform, 109

of ether, 74

Spinal anæsthesia, 193

Stages of anæsthesia, 31

Starvation, a cause of shock, 9

of acidosis, 155

Status lymphaticus, 148

Stertor, 40, 53

Stimuli from field of operations, 6

Stomach tube, before operation, 141

Stovaine, 173

Stridor, 16, 26, 40

Struggling, 34

Strychnine, 147

Subcutaneous saline, 14

Swallowing, movements of, 33

Sylvester’s method of artificial respiration, 146

Syncope, 142

Syringe for local anæsthesia, 176

for spinal anæsthesia, 176

T

Teeth, danger of dropping of into larynx, 16

extraction of, 54, 57, 128, 131, 163

Teter, Dr., on nitrous oxide and oxygen, 68

Thomson, Prof. Alexis, 12, 158

Thomson, Torrance, on intratracheal anæsthesia, 96

Thoracic operations, local anæsthesia in, 186

Three-way tap for nitrous oxide, 50, 128

Thyroid gland, see Goitre

Time for operations, 42

Time afforded by single dose anæsthetics, 163

Tongue falling back of, 16

forceps for, 24

operations upon, 97, 118, 166

local anæsthesia for, 191

Tonsils and adenoids, 127, 166

Trachea, mucus in, 40

pressure upon, 17

Trachetomy, 142, 185

Tremor, ether, 38

Trendelenberg posture, 158

Tropacocaine, 173

Turner, Dr Logan, 125

U

Urine, secretion of prevented by morphia, 168

V

Vagus nerve, 110, 145

Valved method, features of, 29

Vapour method, ether, 90

ethyl chloride, 125

Vaso-motor system, in shock, 9

in asphyxia, 17

in nitrous oxide, 46 (and see Physiology)

Veins, large, emptying into heart, 10

engorgement of, 20, 151

Venesection in syncope, 147

Veronal, 12

Vicious circle of asphyxia, 20

Vital medullary centres, 3

Vomiting, 140, 152

impending, 39, 141

W

War, anti-shock, measures in, 11

lessons of, 61, 151

Warming anæsthetic vapours, 62, 90, 101

Wedge for opening clenched jaws, 25

Withdrawal of anæsthetic, for stridor, 26

for breath holding and struggling, 34

for syncope, 145

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