. Text-book of operative surgery . recom-mends Krohne and Sesemanns apparatus.^ Brauns apparatus is amongst the best. Although an apparatus by which an admixture by volume of Chloroform and aircan be supplied possesses undoubtecl advantages, yet Esmarchs simple mask is still inmost common use. The mask depicted here, while pieserving the shape of Esmarchsand of Gerards, leaves a sufficiently wide gap all round to render it impossible to re-spire too concentrated Chloroform, and it has the advantage that narcosis may be in-duced with minimal doses at first, if the drop method be adopted. This m
. Text-book of operative surgery . recom-mends Krohne and Sesemanns apparatus.^ Brauns apparatus is amongst the best. Although an apparatus by which an admixture by volume of Chloroform and aircan be supplied possesses undoubtecl advantages, yet Esmarchs simple mask is still inmost common use. The mask depicted here, while pieserving the shape of Esmarchsand of Gerards, leaves a sufficiently wide gap all round to render it impossible to re-spire too concentrated Chloroform, and it has the advantage that narcosis may be in-duced with minimal doses at first, if the drop method be adopted. This method,which was recommended by us a year before the publication of Zuckerkandls paper inthe Correspondenzblatt für Schiueizerärzte, in ignorance of Leon Labbes publication,is now, by the employment of Kappelers apparatus, the method in general permits of such a dose being administered to any patient as will induce narcosiswithout risk. In the hands, however, of inexperienced or careless angesthetists a mask does not. Fig. 23. give assurance against the worst accident, viz. suclden death at the beginning of thenarcosis in comparatively healthy individuals. That these deaths may surely beavoidecl with proper foresight, every surgeon who has seen thousands of Chloroformcases without one such accident will affirm. Bardeleben, after 30,000 cases, had hisfirst experience of such a death. But, it must be admitted that this danger is moredifiicult to avoid with the use of Chloroform than it is with that of ether, becauseChloroform produces its toxic action in much smaller doses, and therefore Berts safeinterval ( zone maniable ) is a much narrower one. Even careful surgeons are still confronted with the great difficulty of maintainingthe right degree of narcosis during a prolonged Operation, because by it the blood-pressure becomes markedly reduced, and such complications as loss of blood addstill further to the danger. However, it is not possible to avoid the more intens
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