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
reached the uppermost of his four fingers,’ all of them being placed
over the course of the artery. It gradually became more distinct and
firmer, and at the same time, the lividity of the face decidedly
lessened. In another minute, the man made a slight inspiratory effort. I
ceased directly the artificial respiration, and merely assisted the
expiration by pressure upon the ribs. Another and another inspiration
followed, and in a short time he breathed freely without assistance. The
countenance became natural, and he appeared as if in a sound sleep. In
half an hour, he spoke when roused; then he vomited, and complained of
giddiness. In an hour afterwards, he had recovered sufficiently to walk
home.
“Moments of intense anxiety appear much longer than they really are; but
even allowing this, I am quite sure that, at the very least, five
minutes elapsed from the time when the man ceased breathing before the
first inspiratory effort took place, and that for not less than one
minute the pulse was imperceptible, and the heart’s action almost, if
not altogether, inaudible.”
“_Case 4._ A few weeks after the occurrence just described, I was
assisting Mr. Syme in removing the breast of a lady. A gentleman, my
superior in the hospital, was conducting the inhalation of chloroform.
Anæsthesia was complete, and the breathing good, when the operation
commenced. The chloroform was allowed to remain over the face during the
whole time of its performance. Before it was over, I noticed the
respiration become very quick and incomplete, and suggested, in
consequence, the propriety of removing the handkerchief. My remark was
neglected for eight or ten seconds, and then, just as it was taken away,
the breathing ceased suddenly. The face became deadly pale; the eyes
vacant; the lips livid. Instant dissolution appeared inevitable (the
pulse was not felt). Artificial respiration was immediately commenced,
but the air not entering the lungs freely, the tongue was pulled
forwards, and retained so by the artery forceps. The chest then expanded
freely with each inflation, the air escaping with a cooing sound. In
rather less than a minute, the respiratory movements recommenced, but at
first so slowly and imperfectly that it was necessary to assist
expiration. When recovery was a little more established, the operation
was completed. Before the putting in of the sutures, sensation had
partially returned, and in a short time the lady had perfectly
recovered.”
Mr. Bickersteth very properly adds: “There can be no doubt, that in the
foregoing cases, a grievous error was committed by continuing the
inhalation after anæsthesia was produced, and that it was in consequence
of this, the accidents, so nearly fatal, occurred.”
Public-domain text, read in full here on John Shaqi.
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