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 twenty-six hours after death by Drs.
Mussey, Lawson, Baker and Mulford. The following are the chief
particulars of the appearances met with. A larger quantity of blood than
usual flowed from the sinuses of the dura mater. General aspect, colour,
and consistence of the brain, normal. Lungs considerably but not
intensely congested; crepitated freely at all points; no extravasation.
Lining membrane of bronchia slightly congested, apparently the result of
recent catarrh; deeply stained by the blood. Pleura at all points highly
injected; six drachms of bloody serum in the right, and two ounces in
the left chest. Pericardium contained six drachms of bloody serum. Heart
flaccid, and all its cavities entirely empty; inner surface of both
ventricles and auricles deeply stained. Abdomen—one ounce and a half of
bloody serum in the right hypochondrium. Stomach and intestines
distended with gas. Partially digested aliment, amounting to about three
gills in the stomach. Blood fluid as water in every part of the body;
not a coagulum was seen in any vessel. Lining membrane of all the
bloodvessels deeply stained. The colour in every part of the system was
that of dark venous blood.
It was estimated, in the inquiry which took place respecting this case,
that one-fourth part by measure of what the patient inhaled might be
vapour of chloroform; but this is evidently an over-calculation, for
there could not be this quantity unless the interior of the glass globe
were maintained at the temperature of 80° Fah. and the air were quite
saturated with vapour in passing through it; however, less than half the
amount of vapour here assumed would have the effect of causing sudden
death, in the way it happened. The period of the inhalation, a minute or
seventy-five seconds, during which the patient took twelve or fifteen
inspirations, did not admit of the blood in the body being regularly and
uniformly charged with the chloroform; and the increase of its effects,
owing, no doubt, to the absorption and circulation of the vapour
contained in the lungs at the moment when the inhalation was
discontinued, was well marked. The patient became pale during the
inhalation, but the alarming symptoms suddenly came on during the
extraction of the fourth stump, probably within half a minute after the
inhalation ceased. The patient seemed, in fact, to die with the slight
struggle that took place at this moment. In the case of Hannah Greener,
related above, the spasm at the moment of dying was even more marked.
This is a symptom I have often seen during the death of animals killed
suddenly with vapour of chloroform in a concentrated state, before they
were made thoroughly insensible. Although the heart was empty, the
stained condition of its cavities showed that they had contained blood
at the time of death and afterwards. Owing to its fluid state, it
probably escaped from the heart during the moving of the body;
Public-domain text, read in full here on John Shaqi.
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