Carcinoma of Bronchus-Beicher and Anderson MEDICAL URANeither the operative mortality nor the survival rate had changed significantly during the 15 years. The survival rate was not affected by the proportion of lobectomies among the resections, although this had risen considerably during the 15 years.There was some correlation between the five-year survival rate and the resection rate. REFERENCES Barrett, R. J., Day, J. C., O'Rourke, P. V., Chapman, P. T., Sadeghi Adams, 1944) that the intravascular injection of a local anaesthetic agent was associated with analgesia in the area supplied by that vessel, this knowledge was not put to practical use until Bier (1908) published his account of venous anaesthesia for limb surgery. His method achieved considerable popularity in the next few years, and its use was widely reported.Bier's technique, though effective, was cumbersome, and although an improvement in the form of a single-tourniquet method was described by Morrison (1931) few were then employing venous anaesthesia in this country. The subject was well reviewed by Adams (1944), but the credit for the reintroduction of the "technique" undoubtedly goes to Holmes. His series consisted chiefly of relatively short operative procedures of a type suitable for the casualty department. Our aims in the present trial were twofold: (1) to assess the suitability of the method for more extensive limb surgery, and (2) to investigate the incidence and nature of lignocaine toxicity phenomena occurring after release of the tourniquet. Materials and MethodThe technique described by Holmes was used. An indwelling needle was inserted in a vein before application of an Esmarch bandage and tourniquet. After exsanguination of the limb lignocaine was injected.Patients due for peripheral limb surgery were interviewed, and, after explanation of the method, were asked whether they would agree to have their operation performed under analgesia of this type. Premedication, usually with an appropriate dose of papaveretum and hyoscine, was given in over three-quarters of the cases. Plate electrodes were attached to each limb in the anaesthetic room and connected to a direct-writing E.C.G. machine. A von Recklinghausen oscillotonometer cuff was put on the arm not scheduled for surgery and the systolic bloodpressure recorded. Difficulty was occasionally experienced through Gordh needles becoming dislodged from veins during application of the Esmarch bandage; polyvinyl chloride catheters inserted through a Macgregor (1960) introducing needle or fine-gauge Intracaths were occasionally used. After injection of the lignocaine and positioning the patient standard lead E.C.G. tracings were obtained. During surgery the bloodpressure was recorded by the oscillotonometer on at least four occasions.After completion of surgery the tourniquet was deflated and an E.C.G. tracing begun: this ran for two and a half minutes. or longer if any irregularity was noticed. The blood-pressure was recorded at half-minute intervals during this period, and the appearanc...