On chloroform and other anæsthetics: their action and administrationSnow, John
History
On chloroform and other anæsthetics: their action and administration
Snow, John
Anesthetics; Chloroform; Snow, John, 1813-1858
The rigidity and struggling previously mentioned (pages 39 and 50) as
occurring occasionally in the third degree of narcotism, more
particularly in robust persons, often form a very prominent feature in
the effects of chloroform; and have sometimes caused the medical man to
discontinue the exhibition of chloroform, under the belief that it did
not agree with the constitution of the patient, and that its further
exhibition would be unsafe. The proper course to pursue is to continue
the inhalation gently, till the struggling and rigidity are subdued. The
patient is often insensible before these symptoms are subdued, but it is
necessary to have him quiet, in order to enable the surgeon to operate
with convenience and safety. I have always succeeded in subduing the
involuntary struggling and rigidity, but have occasionally occupied five
or six minutes in doing so. It is desirable to proceed slowly and
cautiously, because, when these symptoms occur, the patient has already
absorbed nearly the usual quantity of chloroform, and he often holds his
breath, and then takes a sudden and deep inspiration, when he might
inhale an overdose of vapour, unless it were presented to him in a well
diluted state.
When the rigidity and struggling are subdued, the breathing, in some
cases, becomes stertorous, and relaxation of the muscles takes place,
the limbs appearing quite flaccid; but by proceeding gently, these
effects may generally be avoided, and the patient becomes quiet, whilst
the breathing is natural, and the muscles are in a moderate state of
tension. If the operator should be afraid to proceed with the exhibition
of chloroform, on account of the violence of the muscular spasm and
rigidity, it will be satisfactory to him to know that, if the inhalation
is resumed in a few minutes, these symptoms will be less violent than at
first.
Public-domain text, read in full here on John Shaqi.
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