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
“_Case 2._ In December 1851, a child, a few months old, was put under
the influence of chloroform for the purpose of having a nævus removed
from the right cheek. As soon as insensibility was produced, the
operation was commenced—the handkerchief containing the chloroform
remaining over the face, as some difficulty had been experienced in
keeping up the anæsthetic effect. Suddenly the breathing ceased; the
muscles became flaccid; the countenance pale and collapsed, and the lips
of a purple colour. Artificial respiration was employed, and in less
than a minute the breathing returned, and the child was restored.”
“_Case 3._ On the 6th of March, 1852, I had occasion to remove the
finger of a robust, healthy-looking young man, in the Royal Infirmary.
He was already under the influence of chloroform when I entered the
room, and as there had been some difficulty in producing complete
anæsthesia, and the last of the chloroform in the bottle was already on
the handkerchief, it was thought advisable by my friend in charge of its
administration to keep up the inhalation, in order to produce a coma
sufficiently profound to last until the completion of the operation. It
was therefore left over his face, and I commenced and removed the
finger, slowly disarticulating it from the metacarpal bone. I distinctly
recollect hearing the man breathing quickly and shortly; and I also
remember, that when just about to look for the vessels, my attention was
attracted to his condition, by not any longer hearing the respiration.
The handkerchief was still on his face. I took it off, and found, to my
consternation, that the breathing had ceased; the face was livid; the
eyes suffused; the pupils dilated; the mouth half open. He was to all
appearance dead; still the pulse could be distinguished as a small,
hardly perceptible thread, beating slowly. Immediately artificial
respiration was commenced. For a minute or two, his condition did not
alter in any respect—then the lividity of the countenance increased, the
pulse was no longer perceptible, and the sounds of the heart could not
be satisfactorily heard. During the whole of this time, artificial
respiration had been diligently employed, but still the air appeared to
enter the chest very imperfectly. I despaired. I felt certain that the
man was dead, and that no human aid could restore him; and if it had not
been that those standing near me urged me to persevere, I believe I
should then have deserted the case as hopeless. Just at this time it
occurred to me to put my finger in the mouth and draw forward the
tongue, in order to secure there being no impediment to the air entering
the lungs. Retaining it in this position, we again began the artificial
respiration, and found that then the chest was fully expanded by each
inflation. After keeping it up for a minute or two, the gentleman, who
had all along kept his hand on the pulse, exclaimed, to our delight,
that he could again feel it—‘It was just like a slight flutter that
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