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
Dr. Patrick Black has made an objection to the fact of the patients
having died of paralysis, or over-narcotism of the heart, in the
accidents from chloroform.[132] He says that paralysis of the heart
would be death by syncope, but that the symptoms before death, and the
conditions of the organs met with afterwards, are not in accordance with
such a view of the case. In order to show that both the symptoms and the
after death appearances, in the fatal cases of inhalation of chloroform,
are consistent with paralysis of the heart, it is necessary to point out
the difference between ordinary syncope and cardiac syncope. One of the
best examples of ordinary, or what may be called anæmic syncope, is that
which occurs in a common blood-letting, whilst the patient is in the
sitting posture. When the bloodvessels, especially the veins, which at
all times contain the greater part of the blood in the body, do not
accommodate themselves fast enough to the diminished quantity of blood,
the right cavities of the heart are supplied with less and less of the
circulating fluid; and in a little time are not supplied at all, when
the heart ceases to beat, in accordance with the observation of Haller,
that it does not pulsate when it is not supplied with blood. The moment
the heart ceases to supply blood to the brain there are loss of
consciousness and stoppage of respiration; but on the patient being
placed in the horizontal position the blood flows readily into the right
cavities of the heart from the great veins of the abdomen and lower
extremities; the heart immediately recommences its contractions; the
brain is again supplied with blood, and respiration and consciousness
return.[133]
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