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
_Case 10_ was that of a labourer, named Samuel Bennett. It occurred on
February 20th, 1849, at a dispensary in Westminster. The patient inhaled
chloroform for amputation of one of the toes. Half an ounce of
chloroform was “sprinkled on a handkerchief, and held over the mouth and
nose.... This quantity of the agent failed, however, to produce
anæsthesia, having caused only the ordinary excitement and struggling.”
After a delay of two hours, more chloroform was procured, and half an
ounce was again applied on a handkerchief, “care being taken to allow
the entrance of air at short intervals.” Insensibility was induced, and
the toe was amputated; the chloroform being applied, as I was told,
during part of the time of the operation. At the close of the operation,
no blood escaped when the pressure was removed from the arteries; the
patient was in fact dying, and in a short time expired. “A few
inspiations were noticed after the pulse had ceased at the wrist.”[80]
The lungs were of a dark venous hue throughout, a large quantity of
blood escaping from them when cut into. Mucous membrane of trachea and
bronchi congested. Heart rather large but flabby; auricles empty; each
ventricle contained about an ounce of semi-fluid blood (the lungs had
been inflated). Head: sinuses and veins contained blood, but not to any
remarkable amount. But few bloody points occurred in cutting into the
cerebral mass. Kidneys congested.
The failure of the first attempt to cause insensibility in this case,
when so large a quantity of chloroform was used, illustrates very
forcibly the uncertainty and irregularity of the way in which it was
administered. On the first occasion only excitement and struggling were
produced, and on the next the patient died suddenly.
_Case 11_ occurred on August 23rd, 1849, at Langres, France. The subject
of it, Madame Labrune, was reported to be a healthy married woman. She
inhaled chloroform with the intention of having a tooth extracted.
“Complete insensibility was not produced at the first trial: more
chloroform was placed on the handkerchief, and she drew a full
inspiration. Her countenance immediately became pallid; her features
were visibly altered; there was dilatation of the pupils, with a
convulsive rolling of the eyes; and no pulse could be felt. Every
attempt was made to restore life, but without success. She died as if
struck by lightning.”[81] The instantaneous arrest of the circulation,
on a full inspiration being taken, immediately after more chloroform had
been placed on the handkerchief, is particularly worthy of notice. The
heart was paralysed, in this instance, as quickly as in experiment No.
25, above related.
No inspection of the body is reported in this case.
_Case 12_ is the first which occurred in any of the hospitals in this
metropolis. The following is the account of it.
Public-domain text, read in full here on John Shaqi.
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