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
In administering chloroform it is desirable to continue it steadily and
gradually till the pain is relieved; and if the patient is rendered
unconscious before the pain is removed, to continue it till all signs of
suffering disappear. After the first inhalation of the vapour, the pain
will generally return in a few minutes, but when again subdued, it will
not return so quickly; and after it has been suspended a few times by
the repetition of the chloroform during the space of an hour or so, the
pain is usually removed either permanently or for two or three hours. In
some cases I have had to repeat the chloroform occasionally throughout
the day, and, on one or two occasions, for two or three days in
succession. The chloroform can, in general, only be considered a
temporary remedy, and therefore such other medicines should be applied
as may be thought advisable.
When I have prescribed chloroform in a liniment, to be applied to the
face, the patient has often found out that he obtained more relief by
smelling at the liniment than by applying it. Chloroform generally gives
great relief, however, when applied locally in neuralgia, either alone
or mixed with camphorated spirit; it is advisable to apply it on a piece
of lint or blotting paper, which should be covered over with tinfoil, or
some other impermeable substance, to prevent the evaporation. It causes
about as much heat and uneasiness as a mustard poultice, before it
relieves the pain.
_Spasmodic Asthma._ On November 12th, 1850, I administered chloroform in
the Hospital for Consumption, at Brompton, to a married woman, aged
thirty-five, a patient of Dr. Cursham. She was in a fit of spasmodic
asthma, but was the subject also of chronic bronchitis. Twenty minims of
chloroform were inhaled from an inhaler. It gave immediate relief,
producing a momentary state of unconsciousness, or a state bordering on
it. In a few minutes the difficulty of breathing gradually returned, but
not to the same extent, and the inhalation was repeated with a like
effect. The difficulty of breathing returned less quickly and severely;
and after a third inhalation of twenty minims she was completely
relieved, and could lie down. The patient had a good night, and was
better next day. On the 14th, she had another fit of spasmodic asthma,
which was relieved completely by the chloroform in the same manner as
the previous one. This patient inhaled extract of stramonium every
evening, by a method which will be described further on.
Other cases of spasmodic asthma have been relieved as readily and
completely; but in one or two cases, in which the difficulty of
breathing seemed to depend on disease of the heart, the relief was not
so great; the patient went to sleep, but the breathing remained
embarrassed.
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