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
the child was red in the face, and crying violently from pain, which was
relieved by a little more chloroform. It appeared to be a minute or a
minute and a half from the time when the sponge with chloroform was
removed, till the breathing became of a gasping character. There is no
doubt that in this case the heart was paralyzed, or nearly so, by the
chloroform, and that its action was restored by the spontaneous gasping
inspirations of the child. The accident could have been prevented by
having the chloroform, which was put on the sponge, diluted with spirit.
The other case occurred in the latter part of 1852. I have no notes of
it, as it took place at the beginning of an illness, which prevented me
from writing for some time; but I recollect the chief particulars of it
sufficiently well. The patient was a lady rather more than sixty years
of age, rather tall and thin. She required to have a polypus removed
from the nose. Mr. Fergusson, who was about to operate, was nearly an
hour after the appointed time, and during this interval she was pacing
up and down the room, apparently in a great fright. She was placed in an
easy chair for the operation, and the pulse was small and feeble when
she began to inhale. Nothing particular occurred during the inhalation,
but just at the time when the patient was becoming insensible, the
breathing ceased, and the pulse could not be felt. She appeared to have
fainted, and was immediately placed on a bed which was in the room. I
applied my ear to the chest, but could hear no sound whatever. Mr.
Fergusson applied his mouth to that of the patient, and with a very
strong expiration, inflated her lungs, so as to expand the chest very
freely. I immediately heard the heart’s action recommence with very
rapid and feeble strokes, as I had so often heard it recommence in
animals. The patient soon began to make distant gasping inspirations,
and the natural breathing and pulse were soon reestablished. Mr.
Fergusson made only one or two inflations of the lungs after the first
one, which of itself was the means of restoring the patient. It was
about twenty minutes, however, before she became conscious; and during
the greater part of this time there were spasmodic twitchings of the
features and limbs on one side. In about an hour, she was pretty well;
and on the following day the operation was performed without chloroform.
The most ready and effectual mode of performing artificial respiration
is undoubtedly the postural method, introduced by Dr. Marshall Hall a
little time before his death. It consists in placing the patient on the
face and making pressure on the back; removing the pressure, and turning
the patient on his side and a little beyond; then turning him back on
the face and making pressure on the back again; these measures being
repeated in about the time of natural respiration.
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