. Regional anesthesia : its technic and clinical application . ist on his guard against injecting large doses of novocain-adrenalinsolution before examining the condition of the heart and blood-vessels,and to teach him the successful management of all kinds of patients. For the excision of benign tumors of the breast, such as fibroma,adenoma, cysts, it is customary to circummject the lesion with per cent, solution, according to the general principles of technic of OPEEATIONS ON THE THOR-AJf 343 regional anesthesia. The tumor is fixed by the left hand, the needlepassed through a certain
. Regional anesthesia : its technic and clinical application . ist on his guard against injecting large doses of novocain-adrenalinsolution before examining the condition of the heart and blood-vessels,and to teach him the successful management of all kinds of patients. For the excision of benign tumors of the breast, such as fibroma,adenoma, cysts, it is customary to circummject the lesion with per cent, solution, according to the general principles of technic of OPEEATIONS ON THE THOR-AJf 343 regional anesthesia. The tumor is fixed by the left hand, the needlepassed through a certain number of wheals raised around it (Fig. 261),and the solution distributed fanwise in the substance of the gland inthe immediate neighborhood of the tumor. Subcutaneous injectionsare then made along the lines joining the wheals together, thus avoid-ing the injection along the line of incision. From 40 to 50 of per cent, solution are sufficient to produce absolute anesthesia. Thegland is lightly massaged to help the diffusion of the injected Fig. 261.—Field-block for excision of a fibroma of the breast. (Partly after Braun.) For the esthetic removal of multiple adenomata or cysts, or for theexcision of part of the gland by way of the axillary incision, or thecrescentic sulcus incision, the procedure described for the simple ampu-tation of the breast is the one of choice (Fig. 259). The injection alongthe line of incision should be avoided, because it is occasionally fol-lowed by a defective healing of the wound which results in an ugly scar. RADICAL AMPUTATION OF THE BREAST Complete control of the psychic element of the patient must beobtained before the anesthetic procedure is begun. The usual dose 344 REGIONAL ANESTHESIA of morphin (i gr.) and scopolamin {-^ gr.), given one hour before, issupplemented by a second injection, especially in fat women, eitherat the beginning of the injections or as soon as they have been com-pleted, according to the nervous be
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