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 examination of the body, the right cavities of the heart were
found gorged with blood. The walls of the right ventricle were thinner
than natural, and affected to a certain extent with fatty
degeneration.[118]
A paragraph was inserted in some of the Edinburgh newspapers, and
forwarded by Dr. Roberts to the _Lancet_,[119] in which it was implied
that death in this case was not caused by the chloroform. It is,
however, like the preceding case, a well marked instance of the sudden
and fatal action of this agent.
_Case 47._ A sailor, aged thirty, died whilst inhaling chloroform in St.
Thomas’ Hospital, in October 1856, preparatory to having some necrosed
bone removed from one of his fingers. “He did not appear to be in robust
health; still there was no obvious reason against his having the
chloroform, which was accordingly administered as follows. One drachm
was poured on a sponge folded between two thicknesses of lint, and this
held at a little distance from his mouth, while he was sitting in a
chair. He appeared to be going off very comfortably, when the chloroform
was left off for from half a minute to a minute, and then resumed. He
now began to raise his hands and tremble, and kept spitting in the lint,
and appeared as if about to vomit. Suddenly he was violently convulsed
through his whole frame, as if in an epileptic fit. The chloroform was
at once discontinued, and he was laid in a semi-horizontal posture. The
convulsion only lasted for a few seconds, and when it had ceased he
began to breathe with effort and puffing of the lips, and almost
immediately to gasp irregularly. His pulse was almost imperceptible and
intermittent. Artificial respiration was at once performed by alternate
compression and relaxation of the walls of the chest, the tongue being
held out of the mouth by the forceps. Ammonia was applied to the
nostrils, and cold water dashed in the face, and in about a minute he
rallied so as to breathe without assistance, but in a few seconds he
relapsed, and could not be recovered.
“At the post-mortem examination there was found to be fatty degeneration
of the heart, liver, and spleen, and the membranes of the brain were
thickened. The lining of the ventricles presented a peculiar pitted
appearance, apparently from inflammatory deposit. The brain itself was
pale.”[120]
“It was ascertained after the man’s death that he had been of
intemperate habits, and had had an attack of delirium tremens three
weeks previously. In the report of this case in the _Association Medical
Journal_, the following is the account of the appearances met with after
death. In the autopsy in the present case, which we observed with
particular care, the brain was in a state of œdema and bloodlessness,
very like the brain in a patient who died from chloroform in the
Ophthalmic Hospital. The liver was fatty; but the heart seemed the very
model or type of the healthiest kind of heart. All the other organs were
also healthy.”[121]
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