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 ununited Fracture._ I have notes of seven operations by
Mr. Fergusson and Mr. Bowman, for ununited fracture of the femur,
humerus, radius, and ulna. The usual course has been to scrape and
puncture the ends of the bones by subcutaneous incision, and where this
has not succeeded, to cut down on the bones and saw off the ends; or to
bore holes near the ends, and introduce ivory pegs.
_The Reduction of Dislocations._ I have notes of twenty-seven cases in
which I have administered chloroform during the reduction, or attempted
reduction, of dislocations. Only three of these were recent
dislocations. One had existed a few days; and the other twenty-three for
some weeks or months. Twelve of the operations were performed by Mr.
Fergusson, and the others by Mr. Cæsar Hawkins, Mr. Cutler, Mr. Bransby
Cooper, Mr. Partridge, Mr. Tatum, Mr. H. C. Johnson, Mr. Charles
Hawkins, Mr. Hewett, Mr. Henry Lee, and Mr. Price. Most of the
dislocations at the shoulder were quite successfully reduced; one of
them by the late Mr. Bransby Cooper, as long as ten weeks after the
accident. Dislocations of the hip were successfully reduced in three
weeks and five weeks after the accident. At longer periods, dislocations
of the femur were often benefited by the operation, but not completely
reduced. The dislocations at the elbow were not successfully reduced
except when recent, although the position and motion of the forearm were
improved in several cases by the operation. Pulleys were applied, often
for a length of time, in the old dislocations; and many even of the
successful operations could not have been performed except the patient
had been in a state of anæsthesia. A full dose of chloroform is required
in the attempts to reduce old standing dislocations, in order to
suspend, as nearly as may be, the resistance of the muscles.
_Forcible Movement of Stiff Joints._ I have given chloroform in
twenty-two operations of this kind, within the last three years, for the
restoration of motion in the knee, elbow, and hip, after the joints had
become fixed in one position, generally by adhesions resulting from
disease. The first operation of the kind in which I assisted was one
performed by Mr. Brodhurst, whom I have since assisted more frequently
in these kinds of operations than any other surgeon; but other
operations have been performed by Mr. Fergusson, Mr. Cæsar Hawkins, Mr.
Partridge, Mr. Bowman, Mr. Hewett, and Mr. Edwin Canton. These
operations would evidently not have been performed except for the
discovery of producing a state of anæsthesia by inhalation.
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