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 on the Eye._ The operations for cataract are frequently
performed without chloroform, when the patient has sufficient resolution
to keep his eye steady. I have, however, administered chloroform
fifty-three times during the extraction of cataract; thirty of the cases
occurred in the private practice of Mr. Bowman. On November 25th, 1851,
I administered chloroform whilst Mr. White Cooper extracted a piece of
flint from the interior of the eye; and on February 7th, 1852, whilst
Mr. Bowman extracted the capsule of the lens. On February 17th of the
same year, I assisted Mr. White Cooper with chloroform whilst he
extracted a cataract from the eye of an elderly lady; and I assisted him
in eleven other cases during that and the following year. I assisted Mr.
George Pollock in two operations of the extraction of cataract in June
1852; and Mr. Lawrence in three operations in 1853. Eighteen of Mr.
Bowman’s operations were performed in the summer and autumn of 1854, and
were of the usual kind; but in six out of the twelve cases in which I
have since assisted him, the cataract was first drilled and then
removed, in a softened state, through a small opening in the cornea, by
means of a small scoop. I have assisted Mr. Alexander in two cases, and
Mr. Critchett also in two. Several of the patients were over eighty
years of age.
The operation for the extraction of cataract is said not to be a painful
one, but the patient requires to be as insensible during its performance
as if he were about to undergo lithotomy, or a great amputation; without
this, the eye and eyelids will not be steady. The insensibility must be
kept up completely until the cataract is extracted.
It is necessary that the stomach should be empty when the patient
inhales chloroform for this operation, in order that vomiting may, if
possible, be avoided. There was a little vomiting in a very few of the
cases in which I administered chloroform, but it was not attended with
straining, and I believe it did no harm in any case. Mr. Bowman informed
me of a case of his in which chloroform was administered in the
Ophthalmic Hospital for the extraction of cataract, and the woman
vomited violently afterwards, and the eye was destroyed. She, however,
was a person of bad constitution, and the vomiting might have occurred
without the chloroform. The patients were lying on a sofa in all the
operations, except, I think, one by Mr. Alexander.
Public-domain text, read in full here on John Shaqi.
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