. Contributions from the Department of Neurology and the Laboratory of Neuropathology (reprints). pth of the insure protection of the wound the skin is painted with\Vliiteheads varnish. An adequate protective dressing isapplied and secured in place with strips of adhesive plaster. There are a few other technical points that merit comment;the selection of an anesthetic is a matter of some importance,especially as in my case, when the patient had a severebronchitis, when spinal anesthesia was selected. Theoperation was conducted under stovaine anesthesia, andit may be of interest to not
. Contributions from the Department of Neurology and the Laboratory of Neuropathology (reprints). pth of the insure protection of the wound the skin is painted with\Vliiteheads varnish. An adequate protective dressing isapplied and secured in place with strips of adhesive plaster. There are a few other technical points that merit comment;the selection of an anesthetic is a matter of some importance,especially as in my case, when the patient had a severebronchitis, when spinal anesthesia was selected. Theoperation was conducted under stovaine anesthesia, andit may be of interest to note that shortly after its injection 17 the patients condition caused lis not a little a moderate dose was used and the injection madebetween the second antl third limibar vertebra, within afew minutes the area of anestliesia extended up to the dis-tribution of the trigeminal, the pulse became weak thoughnot rapid, and the breathing so seriously embarassed thatartificial respiration was resorted to. All the muscles ofrespiration except the diaphragm were paralyzed, and the. Fig. 10.—Illustration from photograph sliowing the muscle layeralready closed with interrupted sutures, a continuous suture beingintroduced into the aponeurosis. action of the latter hardly sufficient to prevent respiration, inhalations, and hypodermicinjections were continued for fifteen or twenty minuteswhen the patient had revived sufficiently to warrant thecontinuance of the operation. It may be interesting tonote in passing that the accessory respiratory muscles didnot resume their function altogether until at least six orseven days after the operation. 18 The position of the patient is not of minor have been instances where the patient died in collapseon the table, as did one of Tietzes cases, and this catastrophemust be due, in part at least, to the loss of so much cerebro-spinal fluid. As a precautionary measure, therefore, es
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