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 Pasuelin

Anwsthe-

Action of Chloro- form,

140 PHYSICAL EXAMINATION OF PELVIC ORGANS.

CAUTERY.

‘The ordinary cantery may be employed in the treatment of the pedicle in ovariotomy. Details are postponed till that subject is considered.

In the well-known Puquelin’s cautery, the vapour of benzoline is pumped throngh a slender, hollow cone of platinmm, which hes been previously heated in % gas flame or spirit lamp, It speedily becomes red or white hot by thy combustion of the vapour, and can then be used.

Note as to its use: (1) To be earcful with the benzoline as it is exceedingly inflammable ; (2) To heat the platinum cone first (in outer most zone of the flame) before pumping im the benzoline. If the vapour is pumped in before the platinum is hot enough to ignite it, the cone is covled by its cold stream.

The cantery should be used at a dull heat. When white hot it causes bleeding, because it thoronghly burns the tissues and thus leaves no char to act ax a hemostatic.

When used to cauterize the cervix, care is necessary that the hot metal vod does not touch the vaginal walls. Various plans have been tried to prevent this accident. Thus the rod may he covered except at its terminal two inches with a wooden case which must not touch the metal. Fig. 111 shows some of the various rods of Paquelin’s cautery,

AN AISTHETICS.

LITERATURE, Bruatow, T. L.—Kemarks ou One of the Causes of Death during tle Uxtraction of Teeth under Chloroform: Br, Med. J., IL, 1873, p. 895. Ghémne— Chloroform: London Tractitioner, January 1877. Hurt, D. B.—On Death from Insufficient Administration of Chloroform: Ed. Med. J., 1879. Lister— Chloroform : Holmes’ System of Surgery, Vol. V. Report of Br. Med. Ass, Com- mittee: Dr. Med. J., Vol. 1, 1870. Murray, R. Milne—The Cessation of Respiration under Chloroform and its Restoration by a new method: Edin, Med. d., 1853. Sec also Index of Recent Gynecologteal Literature in the Appendix.

Tue chief anesthetics are chloroform and ether. Other agents or mix tures have been tried—yiz. ethidenc; imixtures of alcohol, ether, and chloroform ; nitrous oxide; bichloride of methylene ; the results have not been satisfactory with thesc. In the British Medical Report on the action of anmstheties, ethidene is strongly recommended. Chloroform and ether, however, still remain our most trustworthy agents,

Action of Chloroform.— Chloroform when administered toa patient has a perfectly definite effect on the nervous system. Sensation is first abolished, and theu reflex action. This is all the effect wished for im any case. Tf, however, the chloroform be pushed further, the respiratory centre becomes paralysed so that breathing ceases ; and finally the heart stops from paralysis of tts ganglia. In almost all cases this is the sequence in the susceptibility to chloroform of the parts of the nervous system regulating sensation, reflex action, respiration, and the circulation, Rarely have we the heart affected before the respiratory centre, When