PRACTICAL POINTS IN ANESTHESIA BY FREDERICK-EMIL NEEF B. S., B. L., M. L., M. D. NEW YORK CITY [Illustration: colophon] NEW YORK, U. S. A. Surgery Publishing Company 92 WILLIAM STREET 1908 ------------------------------------------------------------------------ COPYRIGHT, OCTOBER, 1908 BY SURGERY PUBLISHING CO. NEW YORK ------------------------------------------------------------------------ PREFACE I have tried to present some of my impressions on the correct use of chloroform and ether and of a very useful combination of these—anaesthol. No doubt, my observations and conclusions will have to be modified in many details by the experiences of others. I have merely voiced a simple and coherent working theory, which has gradually forced itself upon me as my views on the practice of anesthesia have become a little broader and more comprehensive. FREDERICK-EMIL NEEF 941 Madison Avenue New York ------------------------------------------------------------------------ CONTENTS Preface, 5 The Induction of Anesthesia—The German Hospital System, 9 Cardiac Collapse, 12 Respiratory Collapse, 13 When Shall the Patient be Declared Ready for Operation, 15 Maintenance of the Surgical Plane of Anesthesia, 16 Some Important Reflexes, 22 Vomiting During Anesthesia, 23 Obstructed Breathing, 24 The Use of the Breathing Tube, 26 Indications for Stimulation during Anesthesia, 28 The Influence of Morphine on Narcosis, 30 General Course of the Anesthesia, 31 Awakening, 31 Recession of the Tongue after Narcosis, 33 Post-Operative Distress, 34 Morphine-Anaesthol-Ether Sequence, 36 Minor Anesthesia with Ethyl Chloride, 38 Intubation Anesthesia, 38 Cases Requiring Superficial Anesthesia, 43 Cases Requiring Anesthesia Of Moderate Depth, 44 Cases Requiring Profound Anesthesia, 44 Conclusion, 45 ------------------------------------------------------------------------ PRACTICAL POINTS IN ANESTHESIA THE INDUCTION OF ANESTHESIA. I can spare the reader the ordeal of many words by beginning in a concrete way with the outline of a system of anesthesia that is now largely followed at the German Hospital, New York City. [Sidenote: The Mask]