Vol. 60, 1909 - University of North Carolina at Chapel Hill

REVIEW OF SOUTHERN MEDICAL LITERATURE.
eucaine. The adrenalin is damaged by the
boiling and as it is already sterile it is not
necessary to boil it. The solution should
be carefully made and if the operator does
not make it himself, lie should caution the
druggist not to boil it after the addition of
the adrenalin. The syringe and needles
should of covirse be properly sterilized but
as any alkali will spoil the solution they
should be boiled in water and not the usua
soda solution.
Tirginia Medical Scwi-Monthlp, Scfit. lOti
1909.
Local Anesthesia In Major Operative
Work.— Dr. K. M. Hasbrouck describes
the technique as follows:
It is a good idea to precede the operation
with quarter grain morphine given hypo
dermically. This quiets all nervousnes'and
apprehension, and while it is not
necessity, I have always found itsinfluenc>
for good. All of the preliminary work an
most of the subsequent work will be di ;
with the weaker solution, 1-1000, and \\\
first step is that of skin infiltration for \\.
initial incision. This is one of the nn
important steps in the method, and unle^thoroughly
done, pain is produced at
outset and we lose the confidence of our
patient, and this confidence once lost, let
me assure you, is :iever regained;—failure
in tiiis first stage may defeat the whole procedure.
I'or this purpose two or more hypodermic
syringes are kept busy, the empty ones be
ing kept filled, while the others are in use.
Remembering that our solution is non-toxic
we use it freely along ilii.' entire line of incision,
just barely beneath the skin, producing
a wheal ahead of us as we ad\ance, and
then deeply kneading the tissues so as to
disseminate the fluid. (Jn cutting down we
will find the tissues blanched and bloodless
and entir.'ly without sensation. On reaching
the deeijer structures knowledge of
nerve distinction becomes of prime importance,
for by availing ourselves of Crile's
method of nerve blocking, the sensory nerves
are picked up one by one, and injected with
a few minims of the one per cent, solution,
after which the entire field becomes insensible
t