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
An examination of the body was made the day after death by Sir John Fife
and Dr. Glover, who reported as follows:—“The body was that of a
well-grown female of about fifteen years of age.... On opening the
chest, the lungs were not collapsed. One or two very slight adhesions
were encountered on separating them from the walls of the chest. The
external appearance of both lungs, over the whole surface, but
especially in the inferior portions, was that of organs in a very high
state of congestion. They were mottled with patches of a deep purple,
blueish, or scarlet hue. They were everywhere crepitant. Along the outer
and interior border of both lungs, particularly of the upper lobe of the
left lung, were several emphysematous bubbles of small size.... The
pulmonary tissue was filled with bloody froth, which was also found in
the interior of the bronchi, mixed with mucus. There was no appearance
of hepatization. On examining the larynx and trachea, the epiglottis was
found reddened at the summit, of a vermilion hue. The mucous membrane of
the larynx was redder than natural—mottled with vascular patches. The
sinuses of the larynx contained a good deal of dark mucus. The œsophagus
was healthy. The stomach was distended with food. Some of the veins were
more distinct than usual. The heart contained dark fluid blood in both
its cavities: very little in the left. Its structure, and that of the
great vessels near it, quite healthy. The brain, externally and
internally, was more congested than usual; and the ventricles contained
rather more than the usual quantity of serum.”[66]
Sir John Fife and Dr. Glover expressed the opinion that chloroform
caused death by producing congestion of the lungs. After the further
experience which has been gained respecting chloroform, this opinion of
the mode in which it caused death, in the above case, would probably not
now be offered. Indeed, in similar cases which have since occurred, the
same opinion has not been advanced; and as the lungs were crepitant
throughout, in the above case, it is probable that the congestion was
not greater than is commonly met with in cases of sudden death without
hæmorrhage. Dr. Simpson published his opinion, immediately after this
case occurred, that it was not caused by the chloroform, but by the
brandy which was given when the alarming symptoms came on; but Dr.
Meggison replied that only a teaspoonful of brandy was given; that it
was swallowed, though with difficulty; that there were no symptoms of
choking from it; and that the girl was without pulse when it was
given.[67]
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