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
On February 11th, 1854, Mr. Fergusson removed a large fibrous tumour,
situated over the right scapula of a stout gentleman about forty. It
weighed about three pounds. The tumour was very adherent to all the
surrounding tissues, and the removal of it occupied five or ten minutes,
and was attended with considerable hæmorrhage. At the time when the
tumour was completely detached, the patient became pale, and the pulse
could no longer be felt in either wrist or in the temporal arteries. He
did not faint, however, for the breathing continued to be well and
regularly performed. He partially recovered his feeling once or twice,
whilst the vessels were being tied, and more chloroform was given to
him. At the end of the operation he was quite conscious, and did not
complain of being faint, although no pulse could be felt. The pulse had
not returned when I left him half an hour after the operation, and I was
informed that it did not return for about three hours. Four hours after
the operation, when I called to see him, he had a frequent and very
distinct pulse. He had some hot brandy and water just after the
operation, and about ten minutes afterwards he insisted on going to the
water-closet in the next room, and could not be persuaded to lie still.
The moment he was raised on his feet, however, he fainted, but was
immediately laid down again, when he as quickly recovered his
consciousness, and was content to lie still. This was the only faintness
he had. It is my opinion that the effect of the chloroform kept up the
breathing and prevented syncope, whilst the smaller arteries of the
exterior of the body contracted so as to confine the remaining blood
very much to the vital organs. The patient seemed in some danger for two
or three days, but was walking out quite well in less than a fortnight.
In April 1856, Mr. Paget removed a fibro-cellular tumour, weighing
probably ten or twelve pounds, from a lady a few weeks out of her
confinement. The tumour was situated over the sacrum and nates. Sir
Benjamin Brodie was present at the operation. The patient recovered
favourably.
_Nævi._ I have memoranda of 116 operations on vascular tumours, the
greater part of them in infants. The operations have generally been
performed by subcutaneous ligature, and have been extremely successful.
The greater number of them have been performed by Mr. Fergusson and Mr.
Bowman, in private practice and in King’s College Hospital. Some of the
nævi on the faces of infants, which were operated on by Mr. Fergusson,
were very large, and required a succession of operations.
Public-domain text, read in full here on John Shaqi.
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