Opinions as to the field and indications for spinal anesthesia differ sharply. Published statistics are favorable, but much first-class surgical opinion is adverse to this method, for many individual results have been unfavorable. The prevailing confusion seems due to our failure to divide a large subject into its constituent problems and subject each of these to adequate investigation. The most serious problem at the moment concerns high spinal anesthesia. Is there danger that respiratory paralysis will supervene when the anesthesia extends up to the arms, neck and face, or is such a fear foolish and the pains taken to avoid it unnecessary? The present communication is an effort to throw light on this question.
Universal experience has accumulated a considerable mass of pertinent data. Procaine hydrochloride introduced into the subarachnoid space, or brought into contact with motor nerve fibers more distally, produces paralysis of ordinary striated muscle. Experience with spinal