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 patient usually becomes conscious within five minutes after the
inhalation has been discontinued. After a short inhalation, for a very
brief operation, consciousness sometimes returns immediately, and after
a prolonged inhalation the recovery of consciousness is sometimes
retarded till ten minutes have elapsed. Old people are often longer than
others in awaking from the effects of chloroform, owing, no doubt, to
their slower breathing and circulation. Children, on the other hand,
usually recover very quickly from its direct effects; but they often
lapse into a natural sleep which lasts a considerable time—even for
hours if they are not disturbed, and if the operation has left no
painful wound or other cause of uneasiness.
It is desirable not to talk to the patient as he is recovering from the
effects of chloroform, but to leave him to collect his ideas, and not
speak to him till he is quite conscious, or makes some remark or inquiry
himself. If not prevented by the medical attendant, the friends of the
patient often address him the moment he opens his eyes; and the words
they generally use are of a very equivocal meaning to one who cannot
understand their application. They usually say “It’s all over”, which
very often has the effect of raising an indefinite feeling of alarm in
the patient; for, until he has had time to recover his memory, the
operation he was to undergo is generally the farthest thing from his
mind. When left to himself the patient usually recovers from the
insensibility in a very tranquil manner. If he has not been moved whilst
insensible, and awakes in the position in which he fell asleep, he
supposes, very commonly, that he has not been asleep at all; and in a
great number of instances will contend this point very stoutly, even
after a protracted operation, and assert that the chloroform has not
taken effect. It is as well to let him remain in this conceit for a
while, or even till he finds out the mistake himself; for, if reminded
of the pain they have been spared, just on waking after an operation,
persons are liable to be excited by emotions of pleasure and gratitude;
but a few minutes later, when the effects of the chloroform have more
completely subsided, they are better able to control their emotions. A
few persons wake with a full recollection of the preceding
circumstances, and inquire if the operation is done; whilst others, on
first awaking, are still entirely occupied with the subject of their
dreams.
The greater number of patients who inhale chloroform have to remain in
bed on account of the operation which has been performed, but after
minor operations, the patient is sometimes able to walk away within five
minutes; although more frequently there is a little languor or feeling
of fatigue for half an hour or so; and it is desirable in all cases for
the patient to sit or lie quietly for this space of time, if not longer,
before he makes any mental or bodily exertion, even if he feels quite
well.
Public-domain text, read in full here on John Shaqi.
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