On chloroform and other anæsthetics: their action and administrationSnow, John
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On chloroform and other anæsthetics: their action and administration
Snow, John
Anesthetics; Chloroform; Snow, John, 1813-1858
Struggling and rigidity are less likely to occur, when chloroform is
administered slowly, than under opposite circumstances; but it is
impossible to prevent these phenomena altogether in certain patients.
After they are once subdued, they but very rarely recur during the
operation; the patient, in most cases, seems to take on, when he is
subdued by the chloroform, the same relation to it that women, children,
and persons in a state of debility have from the first. M. Chassaignac
has called this condition one of tolerance of the chloroform. It is a
condition in which the patient bears both the chloroform and the
operation very comfortably; but tolerance of a medicine is generally
meant to imply that the patient can take it in larger quantity than
before. But this is the reverse of what occurs when the patient is in a
tranquil state from chloroform; he has already absorbed a considerable
quantity, which has most likely penetrated deeply into the tissues, and
he certainly does not require, and could not bear, so much as in the
earlier stage of inhalation, where he is restless and breathing more
quickly, and thus exhaling and getting rid of the chloroform at a
greater rate.
It might be a question whether the absence of muscular excitement, in a
number of cases, does not arise from the circumstance that anæsthesia,
or absence of common sensibility, is obtained, and the operation
performed, at a stage of narcotism anterior to that in which the
muscular rigidity and spasm occur. This is true in a few cases, but I am
satisfied by careful observation that, in the greater number of
instances in which muscular excitement is absent, it would not occur at
all, though the inhalation should be pushed to the most extreme degree.
Many animals also are killed by chloroform without the least excitement
of the muscular system occurring at any part of the process.
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