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
OCCASIONAL SEQUELÆ OF THE INHALATION OF CHLOROFORM.
_Sickness._ The chief drawback to the benefits conferred by chloroform
is the sickness which in many cases follows its use. It is most frequent
when the inhalation takes place soon after a meal, and some of the
precautions which are requisite in order to avoid this symptom, or
render it as rare as possible, have already been described (p. 74); but
it occurs in certain cases, notwithstanding the best measures which may
be used for its prevention. Moving the patient as the effects of the
chloroform are subsiding is very apt to excite vomiting when it might
not otherwise occur; it is therefore desirable, when convenient, to
allow the patient to lie for half an hour or so, without moving his head
from the pillow. By this means, even when a feeling of nausea is
present, it often subsides without the occurrence of vomiting. It is
advisable also not to give the patient anything to eat or drink till
about an hour after the inhalation, and, as a general rule, not even
then, unless there is some inclination for it; for if anything is taken
into the stomach before the effects of the chloroform have entirely
subsided, it is apt to excite vomiting. Even medicine, such as an
opiate, is better delayed for an hour or upwards, unless there is an
urgent necessity for giving it sooner. Severe faintness from loss of
blood during an operation of course forms an exception to this rule; in
such a case brandy and water should be given, and repeated if it should
be vomited.
These rules respecting food are, moreover, meant to apply only to the
use of chloroform in surgical operations, and not to its employment
during labour. Under the latter circumstances, one allows the patient
all the nourishment that is desirable, intermitting the inhalation now
and then for the purpose. And chloroform, given in the moderate way in
which it is employed in labour, hardly ever causes sickness, but often
alleviates it when present from physiological causes.
The sickness induced by chloroform usually subsides of itself in the
course of an hour, or even less; I, therefore, think it advisable not to
do anything for it during this space of time. When it has continued
beyond this period, I have found a little cold brandy and water to
remove it in most cases; and when the tendency to vomit still remained
after a few hours, I have seen it removed by a dose of opium.
Effervescing draughts have not appeared to be of service in the sickness
from chloroform, and sal volatile and draughts of warm water seem
injurious. It is desirable for the patient to make no effort, but only
to vomit if obliged to do so.
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