Appendix to Down Bros.' catalogue of surgical instruments and appliances : Octoberr 1910 / Down Bros., Ltd.
- Down Bros. (Firm)
- Date:
- 1910
Licence: In copyright
Credit: Appendix to Down Bros.' catalogue of surgical instruments and appliances : Octoberr 1910 / Down Bros., Ltd. Source: Wellcome Collection.
206/264 page 198
![No. 9150 NASAL ETHER APPARATUS. SUGGESTED_BY Dr. G. CrILE, OF CLEVELAND, OhIO, AND AS USED BY Mr. H. M. PaGE, F.R.C.S., ANESTHETIST TO Guy’s Nasal Ether Apparatus,— £ d. Crile’s ......... eaeli 0 13 (3 Extract from the “ Lancet,” August 7, 1909. A METHOD OF OIVINO ETHER BY MEANS OF NASAL TUBES. By H. M. Page, F.R.C.S.Eng., Anesthetist to Guy’s Hospital, etc. Dr. George Crile of Cleveland, Ohio, devised this method for adminis- tration of ether in cases of removal of the tongue aiul of operations for malignant disease of the mouth, and in extensive dissection.s for secondary disease in the neck. The axh antages claimed by Dr. Crile after a largo experience are that a laryngotomy is avoided ; that no blood or septic material is inhaled, and therefore the risk of bronchitis and pneumonia is eliminated ; that tlie anaesthetist is altogether out of the way of the opera- tor ; and that in the neck cases asepsis can be more certainly attained than by the other methods in use foi' ami'sthetizing these cases, ’riiovigh the number of cases in which I lun-e used this method has been small, I \-enture to publish an account of them, as 1 do not find the method described in the English textbooks on amesthetics, and 1 think it tleservos further trial and to be better known over hero. 1 have also for the same reasons fully described the technique of the method. The apparatus necessary is very sinqile and has been most satisfactorily made for me by Messrs. Down Bros, from a ]ihotograph which Dr. Crile was kind enough to send me. It is shown in the accompanying illustration. It consists of two india-rubber tubes sufficiently large to closely fit the naros ; these nasal tvd)es are coupled to a much larger india-rubber tidje by means of a V-shaped jiiece of glass tubing ; the larger india-rubber trdoe is connected with ai hu•g{^ glass funnel which is covered with a. single layer of thin (humel, and it is interrupted in its course l)y a glass trap to prevent aitiy exc(>ss of eth(>r running down the nasal tubes. An injection of mor])hinp and atro])ino is gi\-en a.n hour beft)re the opera- 1 ion. 1 have used | gr. a.nd gr. respectively. Ether anaxsthesia is iiulucetl by the op(>n dro]! method, the mouth is then opened, a.nd the jiharynx and pharyngeal aspect of the epiglottis and larynx are brushed o\-er with a 2 f:er cent, solution of cocaine, and the closely fitting india-rubber tubes are pushed down the mires till the lower ends are opposite the epiglottis, d’he pharynx is then ]iacked with a roll of sterilizecl gauze whilst the tongue is being pulled forwai'd. In packing, though it must be done thoroughly, care ’ must be taken not to compress the tubes, and the space betiveen the lateral jiartsof the jiha.rynx and the outer sides of the tulies must not b(' negh'eted. Ether ana-stliesia is now maintained by the ilrop metbod on the flannel eovi'r- ing the glass funnel. It is a hel|i to get some one to bi'gin dropping ether on the flannel as soon as the nasal tubi's are passinl a.nd so pi'e\'i'nt to some extent the lessening of ana'sthesia which must occur whilst the ])aeking, etc., of the throat is being done. A sterilized towel is thrown o\er the hea.d of the jiationt, complotoly covering it. 'Phe amesthetist stands about two feqt](https://iiif.wellcomecollection.org/image/b29012946_0206.jp2/full/800%2C/0/default.jpg)
