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 above case differs to a certain extent from those previously quoted,
inasmuch as the first symptoms of danger were those of profound coma,
and of threatened death by apnœa, as a consequence of the action of the
chloroform on the medulla oblongata and nerves of respiration. In
addition to this cause of danger, however, the chloroform present in the
lungs at the moment when the inhalation was discontinued must have acted
directly on the heart, or the prompt assistance of so able an authority
on asphyxia as Mr. Erichsen, the moment the breathing was suspended,
would surely have restored the patient. The mode of death, although not
exactly the same as that in Experiment 24 (page 110), differs from that
in the previous experiment, where the heart’s action was good and
distinct after the breathing ceased; it resembles the mode of dying in
many animals that I have killed with chloroform; being, in fact, a
combination of death by apnœa and cardiac syncope, which generally
occurs when the quantity of vapour in the respired air is intermediate
between that in Experiments 23 and 24, or somewhere between 5 and 10 per
cent.
A great peculiarity in the way in which chloroform was administered in
the case we are considering was that the head and face of the patient
were covered by a towel, under which the lint wetted with chloroform was
held. The countenance and state of respiration could not be observed in
this mode of giving the chloroform; the person administering it had to
depend almost entirely on the pulse; and, except for this cause, there
is every reason to conclude that the chloroform would have been
withdrawn in this instance in time to save the patient. It was not
apparently till a peculiar and very loud stertor attracted the attention
of the operating surgeon himself, that the inhalation was discontinued,
and the face was already suffused.
This plan of administering chloroform with the head and shoulders of the
patient covered with a towel, was introduced by Mr. Clover, who was for
several years a resident officer of the institution; and it is but right
to state that it led to no accident in his hands; in those of his
successors it was, however, less successful; three accidents having
occurred in a little more than a year and a half. I much regret to find
that Mr. Erichsen recommends this method of giving chloroform in the
edition of his work on surgery recently published.
Public-domain text, read in full here on John Shaqi.
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