. Regional anesthesia : its technic and clinical application . each extremity of the interosseous spaces, are the pointsof entrance of the needle, the solution being distributed fanwise in bothspaces. If two consecutive toes with their respective metatarsal bones areto be resected, the three interosseous spaces involved in the operationmust be injected, always using the per cent, solution in such quanti-ties as would not produce too much pressure on the blood-vessels of theregion. In every case the infiltrated area is massaged and the operationbegun only when the tips of the toes have beco
. Regional anesthesia : its technic and clinical application . each extremity of the interosseous spaces, are the pointsof entrance of the needle, the solution being distributed fanwise in bothspaces. If two consecutive toes with their respective metatarsal bones areto be resected, the three interosseous spaces involved in the operationmust be injected, always using the per cent, solution in such quanti-ties as would not produce too much pressure on the blood-vessels of theregion. In every case the infiltrated area is massaged and the operationbegun only when the tips of the toes have become absolutely insensitive. OPERATIONS ON THE LO-\VER EXTREMITIES 435 The anesthesia of the entire foot induced in the manner described foroperations on the ankle and foot is a better procedure for more extensiveoperations on the toes and metatarsal bones. Correction of a Hammer-toe.—Anesthesia is induced in the samemanner as for the resection of the second toe with its metatarsal two adjacent interosseous spaces are infiltrated with about 20 Fig. 310.—Field-boick for excision of ingrown toe-nail. Ring of subcutaneous infiltra-tion around the base of the toe. of the per cent, solution and subcutaneous injections are made joiningthe wheals together. Excision of Ingrown Toe-nail.—Through two or three wheals placedon the dorsum of the great toe, a ring of anesthesia is infiltrated aroundthe root of the toe, using about 5 of the 1 per cent, solution. Theedematous ring is massaged and the operation begun only when thetip of the toe has become absolutely insensitive. CHAPTER XIIINTRASPINAL BLOCK (Spinal Anesthesia) Spinal anesthesia was first suggested by Corning in 1885; but it isto Bier that credit must be given for endowing surgery with the 1898 Bier started with cocain as an anesthetic agent, and obtainedcomplete anesthesia of the lower half of the body, although in one patientthe analgesia extended as high as the scalp; but the after-effect
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