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
The effects of chloroform on the brain should not be carried during
labour beyond what I denominate the second degree of narcotism, or that
condition in which the mental functions are diminished, but not
altogether suspended, except when the effect of the vapour is associated
with natural sleep. The patient under the influence of chloroform to
this extent, has no longer a correct consciousness of where she is, and
what is occurring around her, but is capable of being aroused to give
incoherent answers, if injudiciously questioned. In this state, the
patient will sometimes assist the labour by bearing down voluntarily, if
requested to do so, and be otherwise obedient to what is said; and by
withholding the chloroform for a few minutes, she at any time becomes
quite conscious. As a general rule, it is desirable not to hold any
conversation whilst the patient is taking chloroform, in order that her
mind may not be excited. The plan mentioned above, of giving the
chloroform very gently at first, also has a tendency to prevent its
causing mental excitement, the patient coming gradually under its
effects. In surgical operations, excitement of the mind can nearly
always be avoided by carrying the patient pretty rapidly into a state of
insensibility, in which the mental functions are necessarily suspended.
But in the practice of midwifery, it is not allowable to cause a state
of coma or insensibility, except in certain cases of operative delivery,
hereafter to be mentioned.
I nearly always employ, in obstetric cases, the inhaler that I use in
surgical operations. There is not the same necessity for an accurate
means of regulating the proportion of vapour in the air which the
patient is breathing during labour, where but a trifling amount of
narcotism requires to be induced, as in surgical operations, where a
deeper effect is necessary; still I find the inhaler much more
convenient of application than a handkerchief, and it contains a supply
of chloroform which lasts for some time, thereby saving the trouble of
constantly pouring out more. When I do administer chloroform on a
handkerchief during parturition, I follow the plan of putting only ten
or fifteen minims of chloroform on the handkerchief at one time.
Public-domain text, read in full here on John Shaqi.
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