On chloroform and other anæsthetics: their action and administrationSnow, John
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On chloroform and other anæsthetics: their action and administration
Snow, John
Anesthetics; Chloroform; Snow, John, 1813-1858
With regard to the cases of labour in which chloroform may be employed,
it will be readily conceded that, in cases where the pain is not greater
than the patient is willing to bear cheerfully, there is no occasion to
use chloroform; but when the patient is anxious to be spared the pain, I
can see no valid objection to the use of this agent, even in the most
favourable cases. The benefits arising from chloroform in severe cases
of labour are experienced in a lesser degree in favourable cases; and
the patient may be fairly allowed to have a voice in this, as in other
matters of detail which do not involve the chief results of the case.
The determination of the kind of labours in which chloroform should be
used, or withheld, is really a matter of not much importance, because,
as we pass from cases that are severe and protracted to those which are
short and easy, the quantity of chloroform that is used, and the amount
of diminution of the common sensibility, and of interference with the
mental functions, become so trifling, that very little remains about
which to hold a discussion. Indeed, from what I have observed of the
continued use of this agent in medical cases, and its use by healthy
persons for experiment, I believe that the quantity which is inhaled in
a short and easy labour might be continued daily for an indefinite
period, without appreciable effect on the health.
The above remarks apply also, in some measure, to the question as to the
period of the labour when the exhibition of chloroform should commence;
for, in proportion as the pains are feeble, it must be more sparingly
administered. The most usual time when the accoucheur and I have
determined that the inhalation should be commenced, has been when the os
uteri was nearly dilated to its full extent, and the pains were taking
on an expulsive character. In many of the cases which I have attended,
it has, however, been commenced much earlier; for the suffering caused
by the dilating pains in the first stage of labour is often very great,
and the chloroform is consequently of the utmost service when employed
at this time.
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