A text-book of practical therapeutics . is given sogently that a sort of wheal or edematous spot is produced where theincision is to be made. As soon as this spot is developed the needle isinserted into its margin and carried under the skin a little farther, andthen the injection is repeated. In this way the line of an extensiveincision can be anesthetized progressively. If deep incisions arenecessary, the injections are made into the deeper tissues as injections must always be made into healthy skin, as if it isdiseased a slough may result. Schleich asserts that similar injectionsund
A text-book of practical therapeutics . is given sogently that a sort of wheal or edematous spot is produced where theincision is to be made. As soon as this spot is developed the needle isinserted into its margin and carried under the skin a little farther, andthen the injection is repeated. In this way the line of an extensiveincision can be anesthetized progressively. If deep incisions arenecessary, the injections are made into the deeper tissues as injections must always be made into healthy skin, as if it isdiseased a slough may result. Schleich asserts that similar injectionsunder the periosteum permit of operations on the bones. The anes- 236 DRUGS thesia lasts twenty-six minutes. The solution is of three strengthsas follows: Solution. I. II. III. Cocaine hydrochloride . gr. iv () gr. ij () gr. | () Morphine hydrochloride . gr. | () gr. § () gr. TV () Sodium chloride . gr. iv () gr. iv () gr. iv () Sterilized distilled water . fSiv () f Siv () f Siv (). To each of these solutions 3 minims of a 5 per cent, solution ofphenol are added. The second solution is the one commonly first is employed where acute inflammation is present, and thethird where repeated injections are necessary. (See Fig. 37.) The effect of these injections is considerablyemphasized if adrenalin chloride in theproportion ofjjl : 20,000 is added to themixture. For minor localized operations it isvery satisfactory; but for long and deepincisions it is of little value, as its effectsare inadequate unless doses so large asto be poisonous are employed, and be-cause it in no way diminishes the fearand mental suffering of the patient, inwhom the dread of the operation isworse than the actual pain. Undercertain circumstances, however, it maybe used in major surgery, such as tra-cheotomy, the removal of small super-ficial tumors, and in those patients whoare so profoundly ill that it is dangerousto use a general anesthetic, as, f
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Keywords: ., bookcentury1900, bookdecade1920, booksubjecttherape, bookyear1922
