Operative surgery . er tube, or permittingthe patient to be sufficiently conscious to dislodge it. Still another methodis to confine the patient in a rocking chair, tipped forward or backward ascircumstances require. In this instance morphin-chloroform narcosis in-duced by a hypodermic injection of morphine followed by the inhalationof chloroform until excitement is manifested when the chloroform is de-creased, can be employed. The patient suffers but little pain, is consciousand spits out or swallows the blood, as directed. However, the danger of cere-bral anaemia while in the upright positio
Operative surgery . er tube, or permittingthe patient to be sufficiently conscious to dislodge it. Still another methodis to confine the patient in a rocking chair, tipped forward or backward ascircumstances require. In this instance morphin-chloroform narcosis in-duced by a hypodermic injection of morphine followed by the inhalationof chloroform until excitement is manifested when the chloroform is de-creased, can be employed. The patient suffers but little pain, is consciousand spits out or swallows the blood, as directed. However, the danger of cere-bral anaemia while in the upright position must be kept in view and itsslightest manifestation heeded and the patient placed on the back with thehead lowered during the remainder of the operation. The surest of all isto perform a preliminary tracheotomy and then tampon the floor of thepharynx. Preliminary tracheotomy is not, as a rule, necessary unless theoperation be complicated with a very vascular morbid growth requiring re- 366 OPERATIVE SURGERY. pSr-w. Fig. 378.—Instruments employed in excision of bones of the curved bone-euttin£? forceps, b. Rongeur, c. Fergussons lion-jaw Toofeh-pulling forceps, e. Small crown trephine. /. Sponge holder, g. Keyholesaw. h. Sequestrum forceps, i. Volsellum forceps, h. Mouth gag. I. Trache-otomy tube. TO. Bone drills, n. Rugine. p. Curved and straight scissors, q. Peri-osteotome. Scalpels, mallet and chisels (Pig. 374), harelip pins, silkworm gut, andaseptic cotton yarn for the pins, are required. OPERATIONS ON BONES. 36Y moval. However, there seems to be little doubt of the fact that the post-operative dangers are lessened sufficiently by preliminary tracheotomy towarrant its frequent employment. Whether the operation of tracheotomyshall be merged with the profounder one or be practiced a few days in ad-vance of the latter, can not be wisely determined except by careful consid-eration of the demands in this respect of individual cases. If the importantas
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