A practical guide to the administration of anaesthetics / by R. J. Probyn-Williams.

  • Probyn-Williams, R. J.
Date:
1909
Catalogue details

Licence: In copyright

Credit: A practical guide to the administration of anaesthetics / by R. J. Probyn-Williams. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    may be performed without the patient experiencing any pain. There may be some general impression of the removal of the tooth, but it may be absolutely painless. Practically, however, this period of analgesia is of little use to the operator, as at best it is very short, and the points of time at which it begins and ends cannot be exactly determined. Second Stage From ihe loss of consciousness to the loss of the corneal reflex The line of demarcation between the first and second stage, namely the loss of consciousness, is not easily recognised. It is generally supposed that consciousness is lost as the breathing becomes freer and deeper, but there is no definite line to divide the first two stages as there is between the second and third—the loss of the corneal reflex. In this stage there is unconsciousness, that is, the patient will remember nothing that takes place during the period which elapses between his passing into this stage, and his gradual return to consciousness on recover- ing from the effect of the anaesthetic. Besides this loss of memory there is also loss of volition and intelligence, though there will still be some response to various stimuli. If questions are asked, a reply will often be given, but probably it will be quite unintelligible, or absurd. The patient may make the movements which are ordered, but they soon become inco-ordinate. This second stage is known as the strugghng stage, for in it some patients, especially those who are alcoholic, struggle more or less violently. With the struggling there is often associated singing or shouting, which, though quite coherent at first, gradually become more and more incoherent. This condition is generally more marked