minute) although I never found it necessary to use any of them except the former in one case in my private practice, when I entrusted the anesthetic for a few minutes to the friend of the patient. The use of the tongue forceps and mouth gag is usually an indication of inexperience or incompetency on the part of the anesthetizer, as they are seldom required when the anesthetic is administered properly. After the patient has reached a profound degree of anæsthesia, it does not, as a rule, require much chloroform to prolong the narcosis. Method of Giving Ether-In administering ether I prefer the use of Allis' inhaler to the ordinary towel cone, its chief advantage being that it allows the anæsthetic to be given gradually. This is important, especially to begin with, as a concentrated vapor frightens the patient and produces an excessive amount of mucus in the throat. If the ether can is full, it should be partially emptied, as the ether can then be poured on gradually without dripping over the patient's face. The patient's jaw should be held forward and a little to one side to allow the mucus to gravitate to that side from where it can be wiped out with a piece of gauze. To illustrate the danger that sometimes arises from the injudicious selection of ether as an anesthetic, I will cite two cases which came under my observation. The first, a lady about 45 years of age, gave a tubercular history and had some old tubercular adhesions of one of her lungs. She was given ether and was operated for hemorrhoids (in 1896) by a prominent Chicago surgeon. She developed pneumonia, which terminated fatally about one week afterwards, although oxygen gas and other recognized methods of treatment were used. The other case is also an instructive one. In May, 1899, Dr. H. D. Niles was called in consultation with me to see Mrs. B., a lady about 50 years of age. Examination showed her to be suffering from a ventral hernia, which caused some trouble in getting her bowels to move, but which could be replaced and retained by a truss. She was very stout, unwieldly and showed considerable obesity. I made an examination of her urine, which showed marked albuminuria. Conservative, non-operative, eliminative and supportive treatment was recommended, until her condition could be improved. She recovered from the attack. Some time afterward she had another attack. This time a homeopathic physician was called. He referred her to a surgeon who evidently was actuated by the "furor operativas." A laparatomy was performed, the ventral hernia repaired, but as might be expected by any rational surgeon who had made sufficient preliminary examinations, the patient promptly died. Method of Administering Schleich's Mixture-Schleich's No. III Solution. Is administered practically the same as chloroform, with the exception that it should be given more rapidly; in fact, it may be poured on gradually in most cases without producing any alarming symptoms. Patients, as a rule, are not nauseated, and the absence of mucus and of cyanosis, and the rapidty (five to ten minutes, frequently) with which the patients regain consciousness, make it a very desirable anæsthetic in selected cases. About two and one-half to three ounces is sufficient for the average surgical operation. I have given it to children as young as one month of age, for the performance of circumcision, with excellent results. In all cases, however, the patient requires to be carefully watched, not only on account of the liability of his quickly awakening, but because it sometimes produces depression of the heart. I do not regard it as safe an aæsthetic as ether, but I do believe it has a broad field of usefulness if carefully administered. After Treatment-After the administration of chloroform, as well as all other general anæsthetics, the patient should be put in a warm, well-ventilated room, and, if the anesthetic has been prolonged, hot water bags should be placed around the body and limbs. A nurse should remain with the patient until he has recovered consciousness. Strych. sulph. may be administered if required. Abundant fresh air is the most practical and efficient restorative. The use of alcoholics is irrational, as they belong to the same class of drugs as the anaesthetics themselves. The inhalation of the vapors of vinegar relieves to a slight extent the nausea produced by chloroform. It is said (by Lewin) that the acetic acid neutralizes the effect of the free chlorine. The inhalation of oxygen gas lessens the nausea and hastens the return to consciousness. It has, however, not been very generally adopted by the profession. To relieve the intense thirst before any water can be retained by the stomach, I frequently advise the use of rectal enemata of warm normal salt solution-about one-half pint every four hours. In conclusion, I wish to briefly summarize: The anesthetizer should be experienced, especially if chloroform or Schleich's Mixture is used, for as much depends on the qualities of the anesthetizer as on the kind of anæsthetic. Systematic examinations of all important surgical cases should be made before using any anæsthetic. Proper preparation of the patient should never be neglected except in emergency cases. All anæsthetics should be given gradually, especially in the beginning. Ether may occasionally be crowded to prevent vomiting, but chloroform should never be given too concentrated. The condition of the pupil is a valuable guide as to the degree of narcosis. MARCHAND'S EYE BALSAM (C. P. Vegetable Glycerine combined with Ozone.) 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Like the the proof of which is "in the eating," is Pepto-Mangan ("Gude") "the therapeutic value of which is proven "in the trying." That this pleasant tasting, neutral combination of organic Iron and Manganese is an efficient "Blood-Builder" in cases of Anæmia, Chloro-Anæmia, Chlorosis, Rhachitis, etc. is shown in two ways: Ist-By the obvious and rapid improvement in the patient's color and general appearance. 2d-By the increased number of red blood cells and the greater percentage of haemoglobin, as shown by instruments of precision (haemocyclometer, haemoglobinometer, etc.) Do you want to make these tests yourself? If so, we will send you a sufficient quantity for the purpose. To assure proper filling of prescriptions, order Pepto-Mangan "Gude" in original bottles (3 xi). IT'S NEVER SOLD IN BULK. M. J. BREITENBACH COMPANY, Sole Agents for U. S. and Canada, LABORATORY, DENVER MEDICAL TIMES THOMAS H. HAWKINS, M.D., LL.D., EDITOR AND PUBLISHER. COLLABORATORS: Henry O. Marcy, M.D., Boston. S. H. Pinkerton, M.D., Salt Lake City. Subscriptions, $2.00 per Year in Advance; Single Copies, 20 Cents. Address all Communications to Denver Medical Times, 1740 Welton Street, Denver Colo. We will at all times be glad to give space to well written articles or items of interest to the profession. [Entered at the Postoffice of Denver, Colorado, as mail matter of the Second Class.] EDITORIAL DEPARTMENT. IN MEMORIAM. THE POLITICAL ASPIRATIONS OF CHARLES S. THOMAS.-On the 24th day of April, 1899, the Governor of Colorado, Charles S. Thomas by name, affixed his signature to the veto of the Medical Practice Act that had been passed by the General Assembly, in response to the demands of the people of Colorado. So The Governor at that time probably did not fully appreciate the momentous nature of his action. true is it that the crucial points of our lives often are passed unconsciously. Mr. Thomas has had one great ambition during his whole adult life. The position of Governor was to him but a stepping stone to that of United States Senator. To the attainment of this object every political act of his has been directed; the chief executive of the state became a political organizer, directing a machine for the purpose of electing himself to the Senate; he sacrificed personal principles, political integrity and the welfare of the state in a mad endeavor to secure the support of those elements of the community whom |