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
Several cases have come within my knowledge, in which the sickness has
continued for two or three days after every thing that was taken into
the stomach. These cases have not been under my care, but under that of
the surgeon. I have been informed, however, that all the usual remedies
for sickness were applied for the time mentioned above without success.
The cases in which the sickness lasts so long form but a very small
portion of the whole number in which chloroform is administered, and
they chiefly occur in persons who are subject to attacks of vomiting
from slight causes, or, as they say, to bilious attacks.
The most usual time for the vomiting to commence is when the inhalation
has been discontinued, and the effects of the chloroform are passing of.
In many cases, it occurs before the patient has become quite conscious,
and he does not know that it has occurred unless he is told. In a few
cases, especially where there is a good deal of food in the stomach, the
vomiting comes on before the operation is finished, or even before it is
commenced. When vomiting comes on during an operation, it is apt to
interfere with the inhalation, and it is sometimes difficult to prevent
the patient from waking; but this can be accomplished by wiping the
patient’s mouth, and reapplying the chloroform, the moment the act of
vomiting ceases. In many cases, however, the sickness does not come on
till the patient is quite awake, and perhaps, even then, not until he
moves. I believe that the sickness which is due to chloroform always
commences within an hour or two, or at the farthest, just after the
first food which is taken. I have known vomiting attributed to the
chloroform which did not occur till the following day, but I ascertained
that a dose of opium had been taken at night, and it was to this that
the sickness was probably owing. In those cases where the chloroform
does cause sickness in the first instance, it is not always the cause of
all the vomiting which the patient may suffer. If the patient becomes
infected or is inoculated with the poison of erysipelas or hospital
gangrene at the time of the operation, he will probably be attacked with
vomiting a day or two afterwards; and if sickness has already been
caused by the chloroform, that which is due to disease may appear to be
a continuation of it.
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