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
I have notes of 867 cases in which I have administered chloroform during
the extraction of teeth, chiefly by dentists living in this
neighbourhood: amongst whom are Mr. Saunders, Mr. Cartwright, Mr. Samuel
Cartwright, Mr. Arnold Rogers, Mr. Thomas A. Rogers, Mr. Tomes, Mr.
Bigg, Mr. Crampten, Mr. F. W. Rogers, Mr. Alfred Canton, Mr. Woodhouse,
Mr. Lintott, Mr. Rahn, Mr. Vasey, Mr. Sercombe, Mr. Fletcher, and
several others; and there is one dentist in the City, Mr. West of Broad
Street, whom I have frequently assisted. The number of teeth, or stumps
of teeth, extracted in these 867 operations, has been about 3021. In
some cases in which several teeth have been removed, I have not been
sure of the exact number, but have put down about the number.
The number of teeth extracted at an operation has varied from one to
nineteen. The latter number was extracted by Mr. Canton on one occasion,
and on two or three occasions, Mr. Arnold Rogers and Mr. Samuel
Cartwright extracted seventeen at one sitting; but these gentlemen and
others, as well as myself, have thought it better, as a general rule, to
make more than one operation, when the number of teeth to be drawn
exceeded ten, in order that the mouth might not contain too many wounds
at one time, and that the loss of blood might not be very great. A great
number of the operations have been for the extraction of the four first
permanent molars, in children about thirteen, as these teeth are very
apt to decay at an early period.
I have on 181 occasions, of which I have memoranda, given chloroform for
the extraction of a single tooth. I exhibited it lately to a lady, aged
eighty-six, whilst Mr. Bigg extracted an abortive wisdom tooth, which
had recently come through the gum, and was giving pain. She awoke in
about two minutes after the operation, and was quite cheerful and well.
The patients have been seated in an easy chair in all the operations on
the teeth, except in a very few cases where a female patient was too ill
to sit up. In many cases, and always if there was any feeling of
faintness, the patient has been placed on a sofa, after the operation,
for twenty minutes or half an hour. I am not aware of any inconvenience
from the chloroform, in any of the cases of tooth-drawing, excepting
sickness and vomiting, which in a very few of the cases have been
troublesome for some time.
It is necessary in tooth-drawing to make the patient unconscious, and to
continue the chloroform a little while after unconsciousness is induced,
till the sensibility of the edge of the eyelid is very much diminished,
or almost altogether suspended, otherwise the patient will probably make
a resistance that will interfere with the operation, or scream out and
alarm his or her friends. I nearly always take about four minutes in the
inhalation. It is not desirable to take longer than five or six minutes,
as the patient would be slower than is desirable in recovering
completely from the effects of the vapour.
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