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
At the autopsy, performed by Mr. Paget, twenty-two hours after death,
“the thorax was first examined, and nothing whatever abnormal could be
detected in any of the viscera; the lungs were healthy and crepitant in
every part; their posterior lobes were not more congested than is seen
in almost every examination; the heart, collapsed, but not contracted,
and containing a small quantity of fluid blood in each cavity, was of
normal size and proportions, in every respect, and its muscular
structure, examined by the microscope, showed no degeneration.... The
brain, its sinuses, ventricles, etc., were all carefully examined, and
neither in texture nor quantity of blood was anything abnormal
detected.”[105]
Although the failure of the pulse was the first symptom of danger in
this case, it continued to be felt as a very feeble flutter for about
four minutes, so that the heart was not so completely paralysed as in
most of the fatal cases. It must, however, have been so far paralysed as
to be past recovery.
_Case 35._ Professor Dumreicher related a case of death from chloroform
at the meeting of the Vienna Society of Physicians, held on November 16,
1853. The patient was a young man, aged nineteen, in somewhat feeble
health, who inhaled chloroform in the recumbent position, in order to
have his anchylosed knee-joint forcibly extended. It was inhaled from a
vessel resembling a snuff-box, which was held to the nostrils. “The
inhalation was continued for fifty seconds, and the patient had spoken a
few seconds previously, when Professor D. observed that the pulse had
become frequent and undulating. He immediately suspended the
administration of the anæsthetic. Trismus occurred; the respirations
became irregular; the face turned livid, and he foamed at the mouth.”
The measures which were employed included the abstraction of eight
ounces of blood from the jugular vein, but they were of no avail. He
only once made a feeble attempt at inspiration.[106]
_Case 36_ occurred in the practice of Dr. Wüstefeldt of Neustedt. “A
young girl, thirteen years of age, had on the dorsal region a voluminous
lipoma, which extended from the last dorsal vertebra to the crest of the
ilium.... One drachm of chloroform was employed. As soon as
insensibility was manifested, the operation was commenced, but scarcely
had the surgeon divided the skin, when the girl, yielding to the laws of
gravity, fell suddenly forwards on her chest. Dr. Wüstefeldt, struck by
the phenomenon, which he had witnessed before under similar
circumstances, immediately desisted from operating, and strove to
restore the patient to life; but every effort was useless, and, in the
course of a few minutes, it became evident that she was dead.”[107]
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