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
_Operations for Necrosis._ Anæsthesia is of the utmost service in these
operations, which are often tedious, and would be of the most painful
nature. The operations are of the most successful kind of any in
surgery; they usually relieve the patient from a very painful affection,
and leave no mutilation. I have administered chloroform in many cases of
necrosis in which an operation could not have been undertaken without
its assistance; and in a still larger number, in which the operation
could not otherwise have been satisfactorily completed. I have memoranda
of 197 cases of necrosis in which I have given chloroform. In 70 of
these, the tibia was the bone affected; in 15 cases, the femur; in 24
cases, the humerus; in 14 cases, the radius, or ulna, or both of these
bones; in 29 cases, the bones either of the carpus or tarsus, or
metacarpus or metatarsus. I have notes of six cases of necrosis of the
sternum; in five of these the operation was performed by Mr. Fergusson,
and in one case by Mr. Solly. Great care was required in some of the
cases to avoid going through into the chest with the bone nippers. There
have been nine operations for necrosis of the os calcis. In one of
these, Mr. Wm. Adams lately removed, along with the necrosed bone, a
small bullet which had been in the bone for six years.
The other cases of necrosis comprise the upper and lower jaw, the
parietal bone, the edge of the orbit, the scapula and clavicle, the
sacrum, the ileum, and the phalanges of the fingers and toes.
_Excision of the Head of the Femur._ I have notes of five cases of this
operation. They all occurred in children from eight to thirteen years of
age. Three of the operations were performed by Mr. Fergusson, one by Mr.
Bowman, and one by Mr. French; I also recollect assisting Mr. Henry
Smith in a similar operation in a child in 1848, at a time when I did
not keep any account of the operations in which I administered
chloroform. In one of Mr. Fergusson’s operations, he removed some
diseased portions of the acetabulum.
_Excision of the Elbow._ There is every reason to conclude that this
excellent operation has been performed more frequently in consequence of
the inhalation of narcotic vapours than it otherwise would have been. I
have memoranda of 19 cases of this operation in which I have exhibited
chloroform; 18 of them were performed by Mr. Fergusson, and the
remaining one was performed by Mr. Coulson, whilst Mr. Fergusson was
present.
_Excision of the Knee._ I have notes of 17 cases in which I have given
chloroform during the performance of this operation. Thirteen of the
operations were performed by Mr. Fergusson, two by Mr. Bowman, one by
Mr. Partridge, and one by Mr. Henry Smith.
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