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 March 10th, 1852, I administered chloroform in St. Mary’s Hospital to
a woman, apparently about thirty-five, who had suffered from an ovarian
cyst about eighteen years. Mr. Isaac Baker Brown made an incision, about
six inches in length, into the peritoneal cavity, drew out a portion of
the cyst, tapped it, and removed several pints of clear serum. He then
cut away a piece of the anterior wall of the cyst, about as large as the
hand, and allowed the rest of the cyst to remain loose in the abdomen.
The wound in the parietes of the abdomen was stitched up. If I remember
rightly, the patient died, but I have no note of the result.
_Operations for Cancer of the Vagina._ I have notes of eighteen cases in
which I have given chloroform for operations of this kind by the knife,
which would have been extremely painful without the use of an
anæsthetic.
I exhibited this agent, in 1848, to a lady, whilst the late Mr. Aston
Key applied the actual cautery to malignant excrescence of the os uteri;
and I have administered it in several cases in which potassa and other
caustics have been applied to the os uteri. In operations on the vagina
or perineum, the woman should inhale chloroform whilst lying on her
back; and when insensible, should be drawn to the edge of the bed, or
the foot of the operating table, and have the knees held back and
separated.
_Operations for Rupture of the Perineum._ I have notes of fourteen
operations for this accident. Six of them were performed by Mr. I. B.
Brown, five by Mr. Fergusson, and the others by Mr. Paget, Dr. Protheroe
Smith, and Mr. Henry Lee. Mr. Fergusson has, in five cases, performed an
operation for prolapsus uteri, by paring the edges of the outlet of the
vagina, and stitching them together so as to diminish the orifice.
I have given chloroform in several operations for vesicovaginal fistula,
some of which were performed by Mr. Spencer Wells; and also for the
removal of warts and other growths from the labia pudendi, either by the
knife or caustics.
_Removal of the Testicle; Amputation of the Penis, etc._ I have
memoranda of twenty-seven cases in which I have administered chloroform
during the removal of a testicle, generally for malignant disease; and
six cases in which I have administered it for amputation of the penis,
always for malignant disease. There were six operations, also, in which
a part of the penis was removed for malignant disease; and eleven cases
in which warts were removed from the glans penis, generally with the
knife. In two cases in August 1854, Mr. Acton destroyed a number of
venereal warts on the glans penis and prepuce by a caustic composed of
potassa and lime. In all the operations on the testicle and penis, under
chloroform, the patients have been lying on the back.
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