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 29_ took place in the Manchester Royal Infirmary, on December
24th, 1852, during the removal of a malignant tumour of the thigh, by
Mr. Jordan. The patient was Henry Hollingsworth, a factory operative.
His age is not stated. “The man was very much excited, struggled and
talked fast. The chloroform was administered slowly, and every
precaution was taken to prevent any danger, and the medical men remarked
two or three times how very long it was in taking effect. He at last
became insensible, in about seven minutes at least. Mr. Jordan commenced
the operation by an incision into the skin covering the tumour. I was
assisting the surgeon when Mr. Heath directed my attention to the
patient’s face. This was about five minutes after the operation had
commenced. I then observed congestion about the face, but there was no
stertorous breathing. His pupils appeared almost to have ceased to act.
His breathing was becoming exceedingly slow, and he seemed to be sinking
fast. I directed the attention of the operator and the other medical men
to these symptoms. The operation was then suspended, and means were
resorted to for restoring animation, but the pupils had ceased to act,
and had become fixed almost immediately. He gave one strong gasp, and
then to all appearance was dead. In administering the chloroform,
successive doses were given until it took effect. Every dose consisted
of a drachm, taken, at intervals, in an inhaler.”[98]
The following remark is made respecting the autopsy. “The post-mortem
examination shewed that asphyxia, caused by chloroform, produced the
death. There was a congestion both of the brain and lungs.” The
appearances met with after death from chloroform do not indicate the way
in which death has taken place. In animals that are killed by it, the
right cavities of the heart are always found filled with blood, whether
they die suddenly by its direct action on the heart, or more slowly by
its effects on the brain, and the breathing ceases before the
circulation. The lungs are seldom much congested in animals, whichever
be the mode of dying, and the appearances in the head are not unusual.
The state of the pulse is not mentioned in the above account of the
case; but congestion about the face was first observed, and then it was
noticed that the breathing was getting slow. It is sufficiently probable
that the breathing ceased on account of the action of the heart being
first arrested; but even if the respiration was embarrassed by the
action of the chloroform on the brain, it is pretty certain that that
agent also acted directly on the heart; for it cannot be supposed that
the means used for restoring animation would have failed, if the heart
had been acting properly when the breathing ceased.
Public-domain text, read in full here on John Shaqi.
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