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Arch Surg. 1930;21(4):582-596. doi:10.1001/archsurg.1930.01150160029002.
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Surgical studies and investigations are made more and more in large hospitals where resources are unlimited and assistants numerous. It is evident that there spinal anesthesia has a large place. But much of the world's surgical work is done, and more will be done, far from such centers, as simpler surgical procedures, such as herniotomies and interval appendectomies, are standardized and turned over to the general practitioner.

The surgeon who works with simple equipment and few assistants finds anesthesia his major technical problem. The Mayo Clinic can report the use of general anesthesia in 50,000 cases without a death, but inexpert anesthetists, at least in the Near East, have a very different record. Moreover, the disadvantages of general anesthesia are not limited to its occasional fatalities. Every surgeon in this part of the world has given artificial respiration dozens of times because his patient had received too much anesthetic, and


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