. Anaesthetics : their uses and administration. refullyapplied with the supply apertureopen. There must be most accuratecoadaptation, so that no air entersunder the inflated rim of the few breaths having been taken,3 , in the case of an adult, arethen sprayed into the bag at theend of a forcible expiration. Theinlet is then closed, and the patientencouraged to breathe freely. If heholds his breath, as may happenwith nervous patients, the chinshould be sharply jerked upwards,as this induces an fifteen or twenty seconds,when the breathing has becomefuller and more rap
. Anaesthetics : their uses and administration. refullyapplied with the supply apertureopen. There must be most accuratecoadaptation, so that no air entersunder the inflated rim of the few breaths having been taken,3 , in the case of an adult, arethen sprayed into the bag at theend of a forcible expiration. Theinlet is then closed, and the patientencouraged to breathe freely. If heholds his breath, as may happenwith nervous patients, the chinshould be sharply jerked upwards,as this induces an fifteen or twenty seconds,when the breathing has becomefuller and more rapid, the inlet isagain opened during an expira-tion, and 2 more of ethylchloride are sprayed in. If a pro-longed anaesthesia is desired, and the patient is vigorous andfull-blooded, 3 , or even 4 , may be given instead ofthe 2 The plan of dividing the dose, which I have adoptedand described, is based upon the following when they commence breathing ethyl chloride often* Made by Messrs. Duncan & Fig. 71.—The Simplexinhaler* (Luke). 3IO AN/ESTHETICS. breathe feebly, and do not inspire the full dose fromthe bag. As, however, they become partly narcotisedthe respirations grow more vigorous, and the seconddose, which is then sprayed into the bag, is inspiredfreely, and thus a good and prolonged anaesthesia is thirty to sixty seconds from the commencement ofinhalation the breathing will become loudly and musicallystertorous. The stertor deepens ; in most cases the eyeballs will befixed—being usually rotated downwards—and the pupilsdilated; the anaesthesia is then complete. The degree ofinsensibility is very profound, yet, if the anaesthetic is with-drawn as soon as well-marked stertor is present, it deepensfor a few seconds afterwards. This deepening of narcosisafter the mask is withdrawn is very considerable in childrenof any age under seven years. It will often happen that ifthe mask is withdrawn while the child is sti
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