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

  • Probyn-Williams, R. J.
Date:
1901
Catalogue details

Licence: Public Domain Mark

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 Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    he has been giving the drug rather freely, the corneal reflex will be quite abolished, and other signs of overdose, as men- tioned on page t6, may be present. To remedy this more air must of course be given. If the dilated pupil is accompanied by a brisk corneal reflex, the cause of the increase in size is the reflex irritation due to the operation which follows too light an anaesthesia. The pupil will soon contract when more of the drug is given. This reflex dilatation occurs more readily in the case of children and weakly and anaemic women than it does in men. When vomiting actually takes place a pupil which may have been pin-point will often be seen to dilate to a large size. 5. Presence of the Corneal Reflex. When the patient has once reached the third stage described above, it will be found necessary for the performance of many operations that he should be kept in this condition by the administrator, in other words, the corneal reflex must be kept away. Of course the mere presence of the corneal reflex is in itself immaterial to the operator, but when once it has re- appeared, if more of the anaesthetic is not given, it may be followed by the other signs of the second stage, namely, swallowing, straining, vomiting, coughing, and muscular move- ments, and each or any of these may be sufficient to ruin an important operation. There are, however, many slight operations where any of these would not absolutely spoil the work of the surgeon, such as operations on the extremities, where a slight movement might be controlled by assistants, etc., and in these the corneal reflex may be allowed to be present, though the other signs of light anaesthesia should, if possible, be kept away. For the performance of serious operations, especially those on the abdomen, it is safer, as a rule, to keep the corneal reflex just away; but in some emergency operations on the abdomen in