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
_Raising depressed Portions of Skull._ In Dec. 1848, I administered
chloroform to a gentleman in Norfolk, aged sixty-two, on whom the late
Mr. Aston Key operated. The patient had been thrown from his horse four
years previously, and probably kicked whilst on the ground. He believed
that he did not lose his consciousness. There was a considerable
depression of a portion of the right parietal bone, near its upper and
posterior angle; but there were no symptoms of cerebral pressure or
irritation for two years after the accident; but at that time he fell
from his seat in some kind of fit, after which he had partial paralysis
of the left arm, impaired vision, and a melancholy or apathetic state of
mind. He was also subject to attacks of real or apparent suspension of
breathing, and to occasional attacks of vomiting.
His ordinary medical attendant, Dr. Bell of Aylsham, objected to the
chloroform, on account of feeble and irregular action of the heart, in
addition to the above symptoms. The patient, however, became gradually
insensible, without any unfavourable symptoms. After making incisions in
the scalp, Mr. Key sawed out a good sized piece of the parietal bone
with Hey’s saw. The insensibility was kept up gently during the
operation, which lasted above half an hour. There was pus under the
bone, and the dura mater was diseased, and gave way during the
operation. Mr. Key immediately expressed a bad opinion of the case. The
patient recovered his consciousness in about a quarter of an hour, and
in a little time was in the perfect enjoyment of all his faculties,
being very cheerful, and in a totally different state from the one of
apathy and almost unconsciousness, in which he appeared when we first
saw him. He was attacked with inflammation of the brain on the third
day, and died on the fifth.
In May 1855, I administered chloroform in St. George’s Hospital to a
young man who had been kicked by a horse. The frontal bone above the
right eye was driven in to a good depth, and a little of the brain had
escaped. Mr. Cæsar Hawkins cut a piece from the frontal bone, just above
the depressed portion, with the bone forceps, to enable him to introduce
the elevator. The depressed portion being quite loose, was removed,
together with the roof of the orbit. The youth was partially comatose
before chloroform was given, but made a resistance to the operation. A
week after the operation, when I saw him, he was conscious, but
feverish, and he died a week or two later.
Mr. Bowman, on one occasion, made an incision over the frontal sinus in
a gentleman; and made an aperture in the outer table of the frontal
bone, which gave exit to a quantity of pus which had been formed in the
sinus.
In the summer of 1847 the late Mr. Liston performed a similar operation
on a lady, the patient of Dr. Locock, who was present. I exhibited
sulphuric ether on that occasion.
Public-domain text, read in full here on John Shaqi.
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