On chloroform and other anæsthetics: their action and administrationSnow, John
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On chloroform and other anæsthetics: their action and administration
Snow, John
Anesthetics; Chloroform; Snow, John, 1813-1858
Whether the artificial breathing is successful or not must depend
chiefly on the extent to which the heart has been paralyzed by the
chloroform, as was previously observed. The fact of the breathing
continuing after the action of the heart has ceased, in some of the
fatal cases, shows that the heart may be so paralyzed as not to be
readily restored by the breathing. It is probable that in all cases in
which artificial respiration can restore the patient, its action would
be very prompt; still it is desirable to persevere with this measure for
a good while.
As already stated, there is every reason to conclude that the right
cavities of the heart are distended with blood, in all cases of
suspended animation by chloroform, and therefore it would be desirable
to open one of the jugular veins if the artificial respiration does not
immediately restore the patient. In opening animals, just after death
from this agent, I have observed the contractions of the heart to
return, to a certain extent, when the distension of its right cavities
was diminished by the division of the vessels about the root of the
neck. Opening the jugular veins has been resorted to in a few of the
cases of accident from chloroform, but hitherto without success.
I have not succeeded in restoring an animal from an overdose of
chloroform, by means of electricity, in any case where I felt satisfied
that it would not recover spontaneously; and I have not heard of any
patient being restored by its means. For keeping up respiration,
mechanical means, such as the postural method, are better; as they cause
air to enter the lungs without exhausting the remaining sensibility. If
electricity be used, it should be directed towards restoring the action
of the heart. It is probable that the electric current would not reach
the heart without the help of the acupuncture needle; but it would be
justifiable to use this in a desperate case, when other measures had
failed. The needles should be coated with wax, or some other
non-conductor of electricity, except near the points.
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