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I KNOW a woman who says that if she wants to get her ...
The Direction Of The Body In Locomotion
LIFTING brings us to the use of the entire body, whic...
Action Balance Of
An excellent guide to the proper treatment of any case is to b...
Bronchoscopy should be done in all cases of chronic pulmonar...
The Blood-mesh Of The Skin
The Blood Vessels under the Skin. Not merely the nails and th...
Varieties Of Forms Of Scarlatina
The above is the description of scarlet-fever, as it most fre...
Biscuits And Water
The biscuits referred to are manufactured in Saltcoats.[A] The...
As the patient should have a constant supply of pure air for ...
For use in our treatment we recommend Coutts' Acetic Acid. It ...
Eruptive Cutaneous Diseases
Take A D current, pretty vigorous force in acute cases; mild ...
Anomalies Of The Tracheobronchial Tree
Tracheobronchial anomalies are relatively rare. Congenital e...
Instructions To The Patient
Before beginning endoscopy the patient should be told that h...
This fever may be either intermittent, remitting, or continue...
Mineral Acids Muriatic Acid Prescriptions
have also been used with good effect in some epidemics. _Muri...
Stokes Adams Disease Heart Block
Stokes-Adams disease, or the Stokes-Adams syndrome, is a name...
_Erythema_ may be considered an exceedingly mild form of erys...
Essentials Of A Successful, Safe Fast
1. Fast in a bright airy room, with exceptionally good ventil...
As in cholera morbus, keep the patient on his back, still as ...
See Abscess; Ankle; Armpit; Bone, Diseased. ...
The Development Of Allergies
There are three ways a body can become allergic. (1) It can h...
Anesthesia In Heart Disease
Source: Disturbances Of The Heart
While no physician likes to give an anesthetic to a patient who has
valvular disease of the heart, and no surgeon cares to operate on
such a patient unless operation is absolutely necessary, still in
valvular disease with good compensation the prognosis of either
ether or chloroform narcosis is good.
When there are evidences of chronic myocarditis or a history of
broken compensation and the borderline of compensation and
dilatation is very narrow, or when there is arteriosclerosis, the
danger from an anesthetic and an operation is much greater; it may
be serious, in fact, and the decision must be made whether or not
the operation is absolutely necessary. Under any circumstances it is
understood that the anesthetist must be an expert, as there can be
no carelessness and nothing but the best of judgment in causing
anesthesia when there is cardiac defect.
The anesthetic to select is a subject for careful decision, as one
cannot assert which anesthetic is the best.
While chloroform seems occasionally to cause a fatty degeneration of
the heart, or if given too rapidly at first may cause sudden death,
especially in cardiac weakness, ether has its disadvantages, owing
to the increased tension (especially if there is likely to be much
valvular or cerebral excitement), and the greater amount of ether
that must be given, with the attendant danger to the kidneys, which
may have been disturbed from the cardiac conditions. Generally,
however, the better method is perhaps to administer first chloroform
to the point of producing sleep and then to change to ether, the
first mild chloroform narcosis preventing the ether from causing
acute stimulation, and ether being better for the operation, as it
is more of a stimulant. Some anesthetists believe that it is better
to administer morphin, with perhaps atropin hypodermically before
the anesthesia, and then to use ether. Nitrous oxid gas would be
contraindicated as tending to increase arterial pressure, and
therefore endanger a damaged heart; it is a serious danger to
damaged blood vessels.
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