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
In Case 22 the change of countenance and sudden character of the death
are evidences of cardiac syncope. In Case 23 there was sudden cessation
of the bleeding and of the pulse; in Case 25 the pulse suddenly ceased.
In Case 28 the patient died suddenly, but the pulse was apparently not
examined at the time. Some remarks have already been made on Case 29,
which happened in the Manchester Infirmary. In Cases 31, 36, and 38 the
suddenness of the death showed that it took place by syncope. In the
last of these cases the pulse was being examined at the time it ceased.
In Case 36 there was no examination of the dead body; but in 31 and 38
the presence of blood in the right cavities of the heart indicates that
the kind of syncope was cardiac syncope. Respecting Case 42, some
remarks have already been made. The death commenced by deep coma, which
embarrassed, and then suspended, the respiration, and cardiac syncope
quickly followed. The chloroform was administered by a method which
precluded the medical attendant from observing properly the most
important symptoms.
The accompanying table of the fatal cases of the inhalation of
chloroform contains such short particulars respecting them as seemed
capable of being tabulated, and it may assist the reader in retaining a
more connected recollection of the facts previously related more in
detail.
MODE OF DEATH IN THE ACCIDENTS FROM CHLOROFORM.
In all the cases in which the symptoms which occurred at the time of
death are reported, there is every reason to conclude, as shown above,
that death took place by cardiac syncope, or arrest of the action of the
heart. In forty of these cases the symptoms of danger appeared to arise
entirely from cardiac syncope, and were not complicated by the
over-action of the chloroform on the brain. It was only in four cases
that the breathing appeared to be embarrassed and arrested by the effect
of the chloroform on the brain and medulla oblongata, at the time when
the action of the heart was arrested by it; and only in one of these
cases (No. 42) that the breathing was distinctly arrested by the effect
of the chloroform, a few seconds before that agent also arrested the
action of the heart.
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