Chapter 17 - Surgical Diseases
Modern Surgery
Inflammation
Suppuration and Abscess
Mortification
Pyaemia
Ulceration and Ulcers
Boils
Carbuncle
Malignant Pustule
Burns and Scalds
Frost Bite
Chilblains
Mechanical,Injuries
Septic Wounds
Incised Wounds
Rules for Examining and Dressing Wounds
Antiseptic Dressings
Way Wounds Unite
Punctured Wounds
Lacerated Wounds
Granulation and Scarification
Gunshot Wounds
Poisoned Wounds
Fractures
Way Broken Bones Unite
Dislocations
Different Diseases of Bones
Pereostitis
Necrosis
Coxalgia
White Swelling
Bunions
Whitlow
Stiff Joint
Tumors
Cancer
Polypus
Piles
Wens
Aneurisms
Bronchocele
Water in the Scrotum
Blood in the Scrotum
Phlebitis
Varicose Veins
Hernia
Varicocele
Deformities and Irritations of the Spine
Wry Neck
Foreign Bodies in the Eye
Stye
Inflammation of the Edge of the Eyelids
Disorder of the Lashes
Ptosis
Chronic Inflammation of the Lachrymal Sac
Opthalmia
Inflammation of the Cornea
Inflammation of the Iris
Weakness of Sight
Imperfect Vision
Short and Long Sight
Squinting
Affections of the Ear
Inflammation of the Meatus
Wax in the Ear
Earache
Inflammation of the Tympanum, Deafness
Bleeding from the Nose
Ingrowing Toe Nail
Chafing and Excoriation
Foreign Substances
Bleeding from Wounds
Proud Flesh
Ambrine
Compression of Arteries to Stop the Flow of Blood
Anesthetics
Care of the Teeth
Rotting of the Teeth
Tooth-Ache
Filling Teeth
The First Teeth
Cleaning the Teeth
Ulcer of the Stomach
Glanders
X-Ray
Radium
Trachoma
Arterio-Sclerosis
Flatfoot
Riggs' Disease
Bandages

17.76 Anesthetics

Anaesthetics.

In these days when so much wonderful surgery is done and when everybody desires to have the advantage of all modern methods being employed in the treatment of their case, a little knowledge of anesthesia will be of service to the reader. Before the discovery of ether an operation meant torture to the patient. If you should visit some of the old operating~ rooms you would find rings in the floor to which ropes used to be attached in order to hold down the patient. Ether is the most commonly employed anesthetic, and is safe to inhale, sure in its action and gives the least mortality. Something like one person in 50,000 dies from the inhalation of ether against one in 15,000 to 30,000 when inhaling other anesthetics. It is not over pleasant to inhale, as it is somewhat pungent and choky to breathe when first inhaled. This sensation soon passes off. A longer time is required to produce anesthesia with ether than with chloroform, but its greater safety overbalances this slight disadvantage. Vomiting more frequently occurs after ether than after chloroform.

Chloroform is the next most commonly employed anesthetic. It is agreeable, quick in its action, and very little is required. It is the common anesthetic in European practice, yet its greater mortality, the sudden change in heart and lung action, render its usefulness much more limited in this country than that of ether. It is employed especially in cases complicated by lung and kidney disease in the young and very old.

The A. C. E. mixture, so called, is still a third antithetic, and is composed of a mixture of alcohol, chloroform and ether, and is frequently given to start a case with, as its inhalation is pleasant and its anesthetic properties quick. Its mortality rate lies between that of ether and chloroform. Some people take these anaesthetizes with perfect comfort; others, being timid, require a larger amount and give in to its soporific effects very slowly.

Of late Cocaine has been introduced into medical practice as a means of rendering the flesh numb and painless when injected under the skin about the site of the part to be operated on. It has the great advantage of maintaining the senses other than that of sensation and pain perfectly intact. By its use large operations may be done, and, in the case of minor operations, time and money are saved and bad after effects are avoided. Sometimes a temporary faintness occurs from the use of a too strong solution, but this can always be avoided by weaker solutions and overcome at the time by a little stimulant.
For many local operations requiring incisions in the skin, temporary anesthesia can be obtained by spraying the skin with a nature of chloride ethyl. This acts by rapid evaporation in a way to freeze the skin, not enough to impair the tissue but sufficient to allow rapid operating for two or three minutes duration.
There is a popular feeling that ether and chloroform leave their traces in the system for a long time afterward; such is not the case, however, and fear need never be entertained that the system win be left the weaker for it.
In the use of anesthetics proper certain rules are to be observed. Nothing solid is to be eaten for a number of hours previous to the inhalation. All artificial teeth must be removed and all waist bands and tight clothing should be loosened if not removed.
A little strong coffee or a little brandy and hot water maybe given by mouth to prevent the subsequent vomiting and nausea.

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