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
_Hysterical Paralysis and Contractions._ In December 1851, I
administered chloroform in Charing Cross Hospital to a young woman about
twenty-five, a patient of Dr. Chowne. She kept her left knee in a
semiflexed position, and would not allow it to be moved. She had been in
bed in the hospital for two months. She inhaled the chloroform
reluctantly, and, after becoming unconscious, she breathed and sobbed in
a hysterical manner. When insensible, the limb went down flat on the
bed, the knee being quite movable. A straight splint was applied, and
the limb was secured to it with bandages. I was informed that in a few
days she contrived to get her leg bent again. She was the domestic
servant of a nobleman. It was evident that there was nothing the matter
with her limb, and that it was only influenced by her volition, which
was perverted by the hysteria under which she was labouring.
In November, in the same year, I administered chloroform in the same
hospital to another patient of Dr. Chowne, whose case was more obscure
and complicated. The patient was a woman, aged thirty-three, who
represented that for several months she had been unable to open her
mouth, or to speak, and that she had, for the same length of time, been
paralyzed in the left arm and leg. The affection, it was said, came on
suddenly, in a kind of fit, which was followed by unconsciousness for
three or four weeks. It was also said, that she had one or two fits the
previous year, after which she was unconscious for a long time. The
patient was quite conscious before inhaling the chloroform, and replied
to questions by nodding or shaking the head, or by writing on a slate.
She was unmarried, and had not menstruated for some months past. The
chloroform was administered with a view to ascertain whether or not she
was feigning. On first becoming unconscious, the patient breathed in a
sobbing and hysterical manner. The chloroform was given very gradually;
and as she became more affected, there were some struggling and
rigidity, when the right arm and leg were moved about a good deal. The
left arm and leg were also distinctly moved, but not above a tenth part
as much as the extremities of the opposite side. When the patient was
quite insensible, the limbs being relaxed, the pupils turned upwards,
and the conjunctiva insensible, attention was turned to the jaws, which
were still firmly closed, but they were opened by using a moderate
degree of force with the fingers. The effect of the chloroform having
been allowed in a great measure to subside, it was again administered,
when the movements of the limbs recurred, and there was the same
difference between the motion of the right side and that of the left, as
before. When I left the patient, more than half an hour after the
chloroform was discontinued, she had not opened her eyes or answered
questions; and she did not do either for six days. I saw her five days
after the chloroform. The pulse was very rapid on my first going to the
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