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Show ADDRESSES AT CHARLESTON, 8. 0. tmtment of goitre, with the followin reault: That goitre is more prevalent in the North than in the South, and among Females than amon males; th?t it is found in l d i t i e s where the water is hard, while an absence of tfe malady e noted rhere soft, pure water is to be had; that among the causes of goitre may he named unhy-genic surroundings poor food, and ex osure to cold; that intermankge exmk an mfluence, and drinhg mow water is ttou ht to rodnce the disease. An operation sometimes proves beneficia f but & ere are so many da the removal of goitre that it makes one hdsitate and exhaust the w h % " , " E 3 medieinea before resorting to this procedure. [Dr. G ~ B R~. WE~T PILLC, heyenne and Arapaho Agency. OkIs.1 I define anaesthesia to be a condition of the body, 1-1 or general, superinduced h disease or medicine, in which the subject is obliv~ousto all outward impremiona, w%ether of leasure or pain. Dr. Pearson, of Birmingham England, is believed ta hsve been tRe first physician to inhale the vapor of sulph-c ether for the produc-tion of ansesthesia in 1785. To America belongs the honor of having first demon-strated to the worid the successful use of sulphuric ether in operations. Dr. Morton etherized a patient for Dr. Warren todissect a tumor from his neck at the Maseachu-setts General Hospital. Previous to Morton's discovery surgery was ademier resort, and might almost be classed among the lost arts. When one contemplates an o ra tiou of former times (the subject lashed to the tableand numerous assistants h o g - him immovable under the surgeon's knife) and then contra& it with an operation? to-day (the patient sleeping peacefully throughout the ordeal, unconscious of sufier-ing), he can not withhold, according to Dr. Morton, the highest tributes thai were ever id to a benefactor of mankmd. I s g l l conaider ansesthesia under two heads, local and general. The 1-1 a m - theties are cold, produced by freezing mixtures, equal park of ice and aalt, and the ra. id evaporation of volatile substances such as ether and rigoline, and the hydro-chforate of cocaine. Since the introdu&ion of cocaine, freesing mixturea have been in a great measure discarded. Local ansethesia may be obta~ned in a remarkable degree by the judicious employment of the hydrochlorate of cocaine. The 1, 2, and 4 per cent solutions am the mlxtures most frequent1 used. A plied to the cornea, conjunctiva, or any mucous d a c e , cocaine is rapidyy absorbex the capillaries are contmcted and the teminationsof the s e m r y n e ~ e s p a ~ a l eUdp on the unbroken iutpgumenlt it produces no effect whatever. Injected into the tissuea it prod-ansesthesia. wherever it reaches, in hone, musele, or the subcutaneous structurea Thrown into the substance of a nerve or its immediate vicinity, it is rapidly absorbed and produces amsthesia in all parts in the range of distribution of the nerve trunk beyond the pint of injection. The quantity which can he safely used hss not yet been detemmed. Applied to the eye there is no danger of absorption of a quantity capable of doing harm. Upon the mucous surface of the buccal cavity and pharynx several drams of a 4 per cent solution may be brushed in the course of an operation lasting an hour, for here the excess is washed off and diluted with the saliva, which, of course, should not be swallowed. Injected into the deeper tissues below the face and neck, from 20 to 30 minims of a 4 per cent solution should be the limit within at least one hour before the dose is repeated. The largerquantity should beused only in well-selected cases. Partial respiratory paralysis has occurred in several instances after the injec-tion of 15 minims of a 4 per cent solution in the supraorbital region and other por-tionsof tbe face. Artificlalrespiration was found neceswy to rawitate thewient. All injections about the face should be given with great caution. It is said that ether or chloroform should never be administered while a patient isunder the iniluenoe of comne. Far the eye, drop 2 or 3 minims of a 4 per cent solution in this orgsn every four or five minutes until from twenty to thirty minutes have ela such as the removal of a foreign body ortouching the lids witg ebelude stone, ltihgeh smt aller quantity will su5ce. For cataract operations, indectomy, etc., the amstheah should be more profound. In the mouth, it will be sufficient to mint the part to be anseathetized with a 4 E.lrf v vnr aolnri(8n 1,). mcann of a camel's-Lair brush &very two or three minutr. fur a lhrur l,cforc and at intervals during the operation. In this way ulcers may be cautcrircd or limited iuciaiulw mndr with ncrfwt ic~renaihilitva. nd hv t h e mmnll,v- ~~~ - ~ ~ p - ~ - - ~ ~ , -- ., .- -.7.A ~ -., ment of this agent any irritable condition dr the mouth and throat may be reheved. |
