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
It has already been shown in this work, from experiments on animals, and
from the physiological effects and physical properties of chloroform,
that accidents from this agent would arise by its suddenly paralyzing
the heart, if it were not sufficiently diluted with air; and a careful
review of all the recorded cases of fatal accident shows that nearly
every one of them has happened in this way, and not from any neglect in
watching the symptoms induced, or mistaking their import.
The first rule, therefore, in giving chloroform, is to take care that
the vapour is so far diluted that it cannot cause sudden death, without
timely warning of the approaching danger; and the next rule is to watch
the symptoms as they arise. A description of those symptoms, and what
they indicate, has already been given.
I have previously stated that the most exact way of giving chloroform to
a patient is to put so much of it into a bag or balloon as will make
four per cent. of vapour when it is filled up with the bellows; but I
have not often resorted to this plan, on account of its being somewhat
troublesome. I have previously described (p. 81) the inhaler which I
employ. By arranging the bibulous paper suitably, and by ascertaining,
with the inhaler in the scales, how much chloroform a given quantity of
air carries off at different temperatures, I am able to produce very
uniform results in the administration of chloroform. But, as I
previously stated, those who do not wish to have the trouble of studying
a suitable inhaler, may give chloroform on a handkerchief without
danger, and with results sufficiently certain, by diluting this agent
with an equal measure of spirits of wine. As the spirit (nearly all of
it) remains behind, it is desirable, in a protracted operation, to
change the handkerchief or sponge, now and then, for a dry one.
TREATMENT OF SUSPENDED ANIMATION FROM CHLOROFORM.
It is probable that artificial respiration, very promptly applied, will
restore all those patients who are capable of being restored from an
overdose of chloroform. All the patients who are related to have been
restored after this agent has occasioned a complete state of suspended
animation, have been resuscitated by this means. It is only by
artificial respiration that I have been able to recover animals from an
overdose of chloroform, when I felt satisfied that they would not
recover spontaneously. And under these circumstances I have not been
able to restore them, even by this means, except when a tube had been
introduced into the trachea, by an incision in the neck, before giving
them what would have been the fatal dose.
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