RECTAL BASAL NARCOSIS WITH THE SHORT-ACTING BARBITURATES BY

IN 1936 when evipan sodium had become generally recog-nised as a satisfactory intravenous anaesthetic its rectal administration was proposed by Gwathmey. During the next two years fairly widespread use of the drug was made in America as is shown by the series Jones and others. Little unanimity, however, seems to have been attained as to the effect of this substance on the human subject. For example, Grant and Abijan claim that adequate anaesthesia can thus be obtained for cystoscopy, and even for major urological proceedings, wjiile with almost identical techniques Harrison and Weinstein produced a state varying from amnesia to natural sleep. In spite of these differences all agree that the method is safe and effective. More recently this conclusion has been endorsed by Boston and James of the Nuffield Department of Anaesthetics at Oxford. In none of these articles, however, is there any detailed analysis of results. The advantages of rectal premedication are too well known to require more than passing mention. In brief they are uni-formity of action, ready administration to adults and children and a pleasant subjective response. The limitations of the method, apart from peculiarities of the drugs concerned, are that no bowel will accept more than 10 ounces of fluid as a retention enema and that very much smaller quantities are liable to be promptly returned by apprehensive adults while children may eject very much smaller quantities. Up to the present avertin has been the standard rectal basal narcotic. The difficulties of its administration are all too familiar; i