Anæmia

GENERAL. The production of lo of sensation by the use of narcotics was without doubt known to the ancients. Dioscorides and Pliny allude to the use of mandragora ( Atropa mandragora ) for the prevention of pain in surgical operations. Hoa-Tho, a Chinese physician of the third century, rendered his surgical patients insensible to pain by the use of hashish ( Cannabis sativa ). Shakespeare, in Romeo and Juliet, and in Hamlet, alludes to anæsthetic draughts. In 1800 Sir Humphrey Davy foreshadowed the probable inhalation of volatile anæsthetic agents when he said: "As nitrous oxide in its extensive operation seems capable of destroying physical pain, it may probably be used with advantage in surgical operations in which no great effusion of blood takes place." The inhalation of sulphuric ether for asthma was practiced by Richard Pearson in 1795. Its power to produce anæsthesia was demonstrated by Good win in 1822, Mitchel in 1832, and was referred to by Wood and Bache in 1834. The first utilization of this agent to prevent pain during surgical operation, however and probably the first inhalation of any agent for this purpose-was by a backwoods surgeon, Dr. W. C. Long, of Jefferson, Jackson Co., Ga., in March, 1842. In December, 1844, Horace Wells, a dentist of Hartford, Conn., had a tooth removed while under the influence of nitrous oxide, and during the next two years used this agent quite extensively in his practice. Dr. Morton, a dentist of Boston, on the 30th of September, 1846, administered sulphuric ether for the extraction of a tooth, and subsequently for surgical operations. He succeeded in making known this practice to the profe ion to such a degree that his name is commonly a ociated with the first administration of anæsthetics in surgery. The first employment of A. in midwifery was the use of ether to relieve the patient, by Sir James Y. Simpson, on the 19th of January, 1847; and in November of the same year, he drew the attention of the profe ion to the effect of chloroform.-A number of volatile substances have been used for the purpose of producing anæsthesia, but the most valuable are nitrous oxide, ether, chloroform (already named), and hydrobromic ether, or the bromide of ethyl. The latter agent was discovered by Serullas in 1827; its use advocated by Thomas Nunnelly, of Leeds, in 1849. It was introduced in America by Lawrence Turn bull in 1877, and was shortly afterward very largely used by Dr. Richard J. Levis.-Nitrous oxide is a very rapid anæsthetic, but its effects pa quickly. It is serviceable in dental work and for surgical operations requiring but little time. Its chief objection is that, being a gas, it requires for its administration a rather cumbersome apparatus which is inconvenient to transport. Bromide of ethyl also acts quickly, and its effects are very evanescent. It is an admirable anesthetic for short operations, and for the examination of patients, as its effects are quickly removed, and it is le likely than the stronger anesthetics to be followed by nausea. In general surgery, ether and chloroform are preferred. The power of chloroform is to that of ether in the pro(Continued in SECTION II. IMG:content-0217.jpg:[graphic]