The operating room should never be cold enough to chill a patient so prepared. Hot-water bottles or a warm pack can be placed between or about the limbs to equalize the external circulation. This is especially necessary when chloroform is administered, as this lowers the temperature of the body. Have the bowels and bladder emptied. Choose the early part of the day for operations of some length, because the stomach is then empty and vomiting with resultant gastric disturbance will be lessened or entirely avoided. The anesthetizer should be experienced and attend to his duty implicitly. He must at all times watch the patient, take note of the pulse, pupils, and respiration. Close by he must have a mouth-gag, tongue forceps, long-handled sponge holders, containing dry absorbent cotton sponges, and a basin in case of emesis. He should quietly instruct the patient how to breathe and at first assure him, and as narcosis comes on command him to do what is necessary. No desultory or detracting conversation should be permitted. A small but efficient faradic apparatus must be within call of the administrator. Sterile vaselin should be smeared about the nose and mouth to prevent skin irritation. CHLOROFORM (_Guthrie_) The pure product must be used. It is a colorless, mobile liquid, having an ethereal odor and sweet to the taste. It should not affect litmus or turn brown with sulphuric acid or give a precipitate with nitrate of silver. If there is emphysema of the lungs, bronchitis, or renal disease, chloroform is to be preferred to ether, also in operations about the oral cavity. Children bear chloroform narcosis better than adults. [Illustration: FIG. 27.—SCHIMMELBUSCH DROPPING BOTTLE.] [Illustration: FIG. 28.—ESMARCH DROPPING BOTTLE.] Chloroform first affects the brain, then the sensory tract of the spinal cord, then the motor tract, followed by an involvement of the sensory path of the medulla, paralyzing the respiratory centers, while cardiac syncope may come on at any time during narcosis. Death may be either due to respiratory or cardiac failure, often from both. To overcome this the anesthetic should not be crowded, nor should the apparatus be held too close to the mouth of the patient. The best method of giving it is by means of the dropping bottle of Schimmelbusch (Fig. 27) or that of Esmarch (Fig. 28) and a simple mask or apparatus. [Illustration: FIG. 29.—SCHIMMELBUSCH IMPROVED FOLDING MASK.] [Illustration: FIG. 30.—ESMARCH INHALER.] The wire frame affair, to be covered with a fold of muslin, designed by Schimmelbusch, is perhaps the best (Fig. 29). Another splendid inhaler is that of the Leiter improvement of the Esmarch folding frame (Fig. 30). A folded towel, crumpled or pinned into a hollow oval form, may be substituted for the above.