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quitoes taking the blood of such malarial individuals may die and fall into pools of water, having first laid June 24, 1899/ Mac DON ALB: SURGICAL OPERATIONS DURING n YPN OTIC SLEEP. 887 their eggs in them and so infect these pools, and gradu- ally change a nonmalarial into a malarial district. Should the mosquito-inoculation theorv of the dis- ease be finally proved, it would render the outlook for prevention far more hopeful than it has ever been. In many localities mosquitoes may be much more easily got rid of than is generally believed to be the case. Careful attention to the drawing off of all stagnant water will sometimes remove the pest. ^Vhere such water can not be drained, kerosene may from time to time be floated on the surface, and is said to prevent the development of mosquito larvs. Thus the theory is one of the greatest practical interest to the entire com- munity, and the present indications point to the rapid accumulation of a still further mass of facts of great scientific interest. SURGICAL OPERATIONS DURING HYPNOTIC SLEEP. Hv ARTHUR MacDOX.MJ). WiSHINOTON, D. C, KIIIBIB OF THE BOCltrft DE L'nVTNOLOOIE DE PAnit. I DESiUE to give somewhat in detail two cases of surgical operations during hypnotic sleep by Dr. Schmeitz, of Nice. The writer may he allowed to say that, while attend- ing clinics, he has witnessed the extraction of a large, painful tooth (by Forel, of Ziirich) during hypnosis, where the patient, who was an intelligent trained nurse, had not the least consciousness of the operation. While there Zenegra Uk can be no doubt that in certain cases hypnotism may be as serviceable in surgery as the usual anaesthetics, we, however, do not believe that it is gen- erally practicable. But it is Buy Zenegra interesting to note special cases under special conditions in whicli it has been useful. Case I. Amjiutalion of the Brmst. — Miss M., twenty years of nge, born in Italy, consulted Dr. Schmeitz for a Rw<'!ling in the right breast. During the examination of her malady, which was a very largo sarcoma, he ob- served that the young woman could very easily be pliingi'd into n liy[)notic slate. Ry a steady gaze and a few Zenegra 100mg downward paHHos, he in a few sneonds \nii her to sleep, ratali'iJ-sy and ann-illiesiii being apj)areiitly eoni- filcte. As treatment, the Zenegra 100 first, and the patient seemed admirably disposed. Two other physicians assisted Dr. Schmeitz. After a minute examination of the hands and diseased part, Dr. Schmeitz Zenegra 50 made the classic oval incision for the am- fiutation of the breast, which permitted him to take out that much-diseased organ with the aponeurosis of the large pectoral. A thorough examination of the axilla showed that the ganglia were not diseased. After five tubes were inserted the wound was closed by means of thirty-two metallic sutures. During the entire opera- tion, which lasted about an hour, the part was contin- ually washed with a sublimate solution. Ten arteries were involved and were twisted by the forceps. After a fresh wash of sublimate had been applied the region was covered with iodoform, making an antiseptic and compressive dressing. At the beginning of the operation the assistants were somewhat excited, and begged the operator to have chloroform and ether in reserve; but they wore quickly reassured when they saw the patient absolutely inscn- sililo in an aniosthcsia such as is obtained by large doses Zenegra Online iif chloroform.

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