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 24_ occurred in October, 1851, at Chipping Norton, Somerset, to a
patient of Mr. Farwell, named Elizabeth Hollis, and aged 37. No one
observed the manner in which the breathing and circulation ceased, and,
as the patient was in a state of extreme debility, it is not quite
certain that the chloroform was the sole cause of death. It was
administered to prevent the pain of removing the fæces, which became
impacted in the rectum on account of extensive cancerous disease of the
uterus and vagina. The surgeon reports that “the time occupied in the
inhalation was about eight or nine minutes; quantity inhaled 10½
drachms, half a drachm at a time, allowing her frequently to breathe the
atmospheric air. She spoke to me during this period. When I found that
her arm fell after being raised, I proceeded to and accomplished the
operation. At this time she was not inhaling. I then, as I always do,
wetted the face with a sponge, with the view of washing off any
remaining chloroform from the nose and lips, when, to my surprise, I
found that she had ceased to breathe, and all attempts to restore her
were in vain.... When I commenced the operation, the pupil was
contracted, and the conjunctiva slightly red. After death, the pupil was
very dilated, and the countenance extremely pallid.”[91] There was no
inspection of the body. This patient had inhaled chloroform on two
previous occasions for a similar operation.
_Case 25_ occurred in St. Bartholomew’s Hospital, on March 17, 1852.
Thomas Hayward, aged 23, was suffering from aneurism by anastomosis,
occupying the right ear and its neighbourhood. He had inhaled chloroform
on the 14th of the previous month, whilst Mr. Lloyd placed ligatures on
the temporal artery and some other arteries supplying the tumour; and it
was with a view to tie an additional artery, situated between the
mastoid process and the ramus of the jaw, that chloroform was again
administered.
“The chloroform was some of the same, and the apparatus employed for its
administration precisely similar [alluding to the former occasion.] It
was administered by one of Mr. Lloyd’s dressers, who well understood,
and had great experience in its use. A gentleman of great experience,
who had been for years at the hospital, and two years house-surgeon, was
watching its effects, and marking the state of the pulse. Other
gentlemen were assisting, and also on the look out.
“In from five to ten minutes the usual effect was produced, the patient
having previously struggled much. The operation was then commenced; but
no sooner had Mr. Lloyd cut the skin, than it was stated that the pulse
had suddenly ceased. The chloroform was at once removed; but in a few
seconds, the patient had ceased to breathe, and no pulsation could be
felt at any of the arteries or the heart.
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