The interior of the nasal cavities are packed with gauze soaked in adrenalin and novocain a quarter of an hour before operation, and the patient receives a very small dose of morphia and atropine immediately before anæsthesis is induced; given in this way it does not complicate the induction with chloroform to the same extent as if given earlier. The patient lies with the top of the head level with the top of the table, and the head and shoulders (including the upper two-thirds of the shoulder blades) supported on the usual depth of pillow. Induction is by chloroform or mixture; a very light third stage only is aimed at. When it is attained the mouth is opened by a gag, and Phillip’s Oral Airway inserted (_see_ Fig. 8). Strict oral respiration is essential to success. If air is passing in and out of the nose, blood is spluttered all over the surgeon, seriously interfering with the harmony of the proceedings. Junker’s chloroform bottle is ready, and the end of the supply pipe is passed into one of the side holes in the air way. The head of the table is now elevated to an angle of 45°, and a small sand pillow slipped behind the occiput. The gauze is removed from the nose, and the operation can be performed with great comfort. The circulation of the patient needs careful watching for the first minute or two after the table head has been elevated, but thereafter there is usually no special cause for anxiety. The area of operation is locally anæsthetised by the action of the novocain and a light chloroform sleep only is required. CHAPTER XIX. CHOICE OF ANÆSTHETIC. In considering this matter, some repetition of points to which reference has already been made, is inevitable. Indeed, this chapter may be regarded as a revision of the whole subject. Before deciding upon drug and method suitable for the individual case, we must consider the age and sex, the physical type and temperament, the possible presence of some definite pathological condition, and the nature and duration of the operation. In relation to this last point, we must remember that an anæsthesia must be adequate to the purpose of the surgeon, but that it is improper to incur more risk to life than is necessary. For instance, an abdominal section case must be fully relaxed, and if in an individual case, chloroform is the only drug which will give that effect, there need be no hesitation in using it. On the other hand, many other methods with a far smaller mortality rate are available if all that is required is the extraction of a tooth or the incision of an abscess, and in that group of cases, unfamiliarity with such anæsthetics as nitrous oxide or “ethyl chloride and ether” will not be held as a sufficient defence if chloroform has been given with a fatal effect. Normal Subjects.