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
“For three or four minutes nothing unusual presented itself; the pulse
and respiration proceeded normally. There was put on the lint, at first,
one fluid drachm of chloroform; and, at the end of three or four
minutes, forty minims more were added. This was the whole quantity of
chloroform employed. Within a minute after the second quantity of
chloroform was added, the patient struggled violently both with her arms
and legs. During these struggles I was holding her right hand, and was
unable to feel the pulse in consequence of her constant motions. The
struggling lasted about a minute, and on its ceasing, the patient
commenced to breathe with loud, rough stertor. I at once removed the
lint from before the face, and felt for the pulse, which I could not
find. Immediately cold water was dashed on her face. She breathed with
this stertor for two or three short inspirations, and then two or three
long ones, and then the breathing ceased. Immediately artificial
respiration was resorted to, and within a minute galvanism was applied
to the back of her neck and the diaphragm. Under the influence of these
agencies, the patient gasped about three times at intervals; after this,
no further signs of life were exhibited.
“At the time when the stertor commenced and the pulse failed, the pupils
were dilated, and the face of the patient was only slightly altered. The
tongue was not retracted, for one of the bystanders at once put his
fingers into her mouth to ascertain this.”
At the autopsy made by Dr. Garrod thirteen hours after death, the rigor
mortis was well marked; the blood was very fluid in all parts of the
body. There was about an ounce of colourless fluid in the pericardium.
The heart was quite collapsed and empty, but, as Dr. Garrod observes,
this may have been due to the fluidity of the blood. The weight of the
heart was seven ounces and three-quarters; valves healthy. Walls of the
right ventricle flabby and pale; mean thickness one eighth of an inch.
At some parts the muscular substance was in a very thin layer, being
much encroached on by fat. In several places there was scarcely any
muscular fibre visible. This was chiefly the case near the apex.
Examined by the microscope, much fatty degeneration of the muscular
fibres of the right ventricle generally was discovered. The walls of the
left ventricle were flabby, dry in appearance, pale, and very friable.
Both lungs were crepitant throughout, not much engorged. Brain not
congested. The intestines above the strangulation were much distended
with flatus, and inflamed.[103]
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