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 late Mr. Liston lost a patient from hæmorrhage during the removal of
a tumour of the upper jaw, before the prevention of pain by inhalation
was discovered; and it is evident that the chloroform did not contribute
either directly or indirectly to the death of Mr. Hewett’s patient. His
symptoms were simply those of exhaustion from loss of blood; he
recovered from the effects of the chloroform some time before he died;
and the small quantity of blood which spotted the lungs, and was
observed to enter as he was dying, would not have led to any immediate
urgent symptoms if it had entered during the operation.
_Tumours of the Lower Jaw._ I have notes of twelve cases in which I have
given chloroform during this operation. Eight of the operations were
performed by Mr. Fergusson, and the others by Mr. Stanley, Mr. Tatum,
Mr. Hancock, and Dr. Pettigrew. In some of the cases the jaw was divided
on each side above its angles, and in most of the others it was
disarticulated on one side, and divided near the symphysis. Three of the
patients died within three days, from the hæmorrhage which occurred at
the time of the operation, but the others all recovered.
The remarks which were made respecting the application of chloroform in
the removal of tumours of the upper jaw are applicable here. After the
operation has been commenced, one should endeavour to keep up the
insensibility by means of a mixture of chloroform and spirit on a hollow
sponge. In tumours, both of the upper and lower jaw, the operating table
is preferable to an easy chair for the patient under chloroform. The
head and shoulders must be raised by the movable flap of the table, or
by some other contrivance if the operation be performed in a private
house. I have, however, seen the operation performed on a sofa, and with
the patient in bed. The blood does not flow into the throat so much in
the removal of tumours of the lower jaw, as in those of the upper one.
Public-domain text, read in full here on John Shaqi.
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