Cleft-palate and hare-lip : the earlier operation on the palate / by Edmund Owen.

  • Edmund Blackett Owen
Date:
1904
Catalogue details

Licence: Public Domain Mark

Credit: Cleft-palate and hare-lip : the earlier operation on the palate / by Edmund Owen. 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.

    32/120 page 28
    tube instead of the ordinary vulcanite mask. The ad- ministrator may prefer, however, to continue giving the chloroform by the flannel mask, or on a piece of lint, or on the stiff corner of a towel, keeping it, as best he is able, out of the way of the surgeon. If the mask is being used, the anaesthetist should look well to it that by no chance does any of the chloroform drip through the saturated flannel into the child's mouth. I have seen this happen, and it is very dangerous. He should be careful, too, that chloroform does not come into actual contact with the mucous membrane of the lip or with the skin of the face, there to cause, perhaps, the formation of a blister. When once the operation is started but very little of the vapour is needed, for the narcosis should not be deeper than is necessary to keep the child quiet. Sometimes, when the operation is a long one, I ask the anaesthetist to allow the child partly to recover, in order that we may be sure that the narcosis is not needlessly deep. In my experience, there is no operation in which the need of a skilled anaesthetist is greater than in that of the closure of a wide palatine cleft in a delicate child, and especially so when the difficulty is increased by troublesome bleeding. No one should accept the responsibility of giving the anaesthetic for this operation unless he has had experience in administering chloroform to children, and especially to children in whom the mouth has been the field of operation. The surgeon ought to be able to feel that the child is only just 'under,' and that at any moment the anaesthetist could wake him up if need be. I do not mind the patient making a purposeless movement from time to time; indeed, I like it, for I then know that his reflexes are good, and that he is ' upon the safe side' of the border. The child
    digitised image 1
    digitised image 2
    digitised image 3