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
the galvanic apparatus was in working condition, and it was applied on
each side of the diaphragm. It acted remarkably well; at each
application of the sponges, the muscle descended as if the patient was
in life; air passed through the tube in the trachea, and for some time I
was in great hopes that the man was to be saved; but the muscle
gradually lost its contractility, and although the galvanism was kept up
for an hour, it was evident that all our efforts were in vain—that life
was extinct. The post-mortem examination was made the following day at
one o’clock, rather more than twenty-four hours after the patient’s
death, and I give the report of it as drawn up by Dr. Gairdner, the
pathologist to the Infirmary:—
“John Mitchell, aged forty-three, died 28th September. A very robust
man; height five feet eight inches; diameter (lateral) of base of
thorax, ten and a half inches.
“External appearances.—Considerable lividity of face and neck, and more
than usual congestion of depending parts. Considerable amount of fat,
but more in omentum and around viscera of abdomen than in external
parietes.
“Chest.—Right pleura presents a few slight adhesions near the middle;
left pleura free. No fluid in either pleural cavity. Pericardium
contained about half an ounce of serum, and presented a few opaque
patches on its surface. Both sides of heart contained blood, the right
side rather more than the left. Blood more than usually fluid. External
fat of heart considerable, about three lines on some parts of right
ventricle. Muscular tissue of heart generally flabby, and rather pale,
but not distinctly disorganized to the naked eye. Valves perfectly
healthy. Aorta presented very faint traces of atheroma. A few traces of
atrophy of right lung towards its apex and anterior edge, but very
limited. In all other respects lungs free from disease, but somewhat
congested.
“Spleen soft, but not diffluent.
“Liver congested, but otherwise normal.
“Kidneys congested, but otherwise healthy.
“Brain.—The subarachnoid fluid presents considerable milky opacity, and
is of moderate quantity. Moderate congestion of the meninges generally.
About half an ounce of fluid in the ventricles. Substance of brain
healthy. Arteries at base perfectly free from atheroma. Air
passages.—Glottis perfectly patent. Mucous membrane of larynx and
trachea slightly congested.
“Microscopic examination shewed the fibres of the heart to be nearly
normal, though scarcely so distinctly striated as in some cases. The
minute vessels of the brain and pia mater presented at some points a few
clustering granules, but to no great extent.”[101]
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